Nursing Comprehensive Exam 5

50 Questions  I  By Allfornursing on July 14, 2012

  

Question Excerpt

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1.  A client with newly diagnosed polycystic kidney disease has just finished speaking with the physician about the disorder.  The client asks the nurse to explain again what the most serious complication of the disorder might be.  In formulating a response, the nurse incorporates the understanding that the most serious complication is:
A.
B.
C.
D.
2.  A nurse is assigned to care for a client who has returned to the nursing unit following left nephrectomy.  The nurse places the highest priority on obtaining which of the following assessments?
A.
B.
C.
D.
3.  A client with a history or respiratory disease is ambulating with the nurse to the doorway of the hospital room. The client becomes pale and dyspneic. The nurse made the client sit down and takes the client’s vital signs. The respiratory rate is 32 breaths/min, oxygen saturation is 90%, and the heart rate has increased from 76 to 98 beats/min.  The nurse interprets that this client is experiencing:
A.
B.
C.
D.
4.  A client with gastric tumor is scheduled for subtotal gastrectomy (Billroth II procedure).  The nurse explains the procedure to the client and tells the client that the:
A.
B.
C.
D.
5.  A nurse prepares a postoperative plan of care for a client scheduled for hypophysectomy.  The nurse avoids including which of the following in the plan?
A.
B.
C.
D.
6.  A client undergoes a thyroidectomy.  The nurse monitors the client for signs of damage to the parathyroid glands postoperatively.  Which of the following findings would indicate damage to the parathyroid glands?
A.
B.
C.
D.
7.  A nurse is caring for a client who is comatose.  The nurse notes in the chart that the client is exhibiting decerebrate posturing.  Based on this documented finding, the nurse expects to note which of the following?
A.
B.
C.
D.
8.  A nurse is caring for a client who had a total knee replacement.  Postoperatively, which of the following nursing assessments is the highest priority?
A.
B.
C.
D.
9.  A nurse is assessing a client’s smoking habit. The client admits smoking ¾ pack per day for the last 10 years. The nurse calculates that the client has a smoking history of how many pack-years?
A.
B.
C.
D.
10.  A nurse is conducting a health history of a client with hyperparathyroidsm. Which of the following questions made to the client would elicit information about this condition?
A.
B.
C.
D.
11.  An 18 year-old client seeks medical attention for intermittent episodes in which the fingers of both hands become cold, pale, and numb, followed by redness and swelling and throbbing, achy pain. Raynaud’s disease is suspected. The nurse further assesses the client to see if these episodes occur with:
A.
B.
C.
D.
12.  A client is admitted to the hospital with a diagnosis of pericarditis. A nurse assesses the client for which manifestation that differentiates pericarditis from other cardiopulmonary problems?
A.
B.
C.
D.
13.  An ambulatory care nurse is assessing client with chronic sinusitis. The nurse interprets that which of the following client manifestations is unrelated to this problem?
A.
B.
C.
D.
14.  A client has Impaired Verbal Communication as a result of a temporary tracheostomy following a laryngectomy.   In planning for communication with this client, a nurse would avoid which of the following methods because it would be the least helpful for this particular client?
A.
B.
C.
D.
15.  A client seeks treatment in an ambulatory clinic for a complaint of hoarseness that has lasted for 6 weeks.   Based on the symptom, the nurse interprets that the client is at risk of having:
A.
B.
C.
D.
16.  A nurse in an ambulatory clinic administers a Mantoux skin test to a client on a Monday. The nurse plans to have the client return to the clinic to have results read on:
A.
B.
C.
D.
17.  A nurse is caring for a client who has just experienced a pulmonary embolism. The client is restless and very anxious. The nurse uses which approach in communicating with this client?
A.
B.
C.
D.
18.  A nurse is caring for an anxious client who has an open pneumothorax and a sucking chest wound. An occlusive dressing has been applied to the site. Which intervention by the nurse would be the best to relieve the client’s anxiety?
A.
B.
C.
D.
19.  A nurse is conducting a health screening clinic.  The nurse interprets that which of the following clients participating in the screening has the greatest need for instruction to lower the risk of developing respiratory disease?
A.
B.
C.
D.
20.  A nurse is interviewing a client with chronic obstructive pulmonary disease (COPD), who has a respiratory rate of 35 breaths/min and is experiencing extreme dyspnea. Which if the following nursing diagnoses would be most appropriate for this client?      
A.
B.
C.
D.
21.  A nurse has received a client assignment for the day and is organizing the required tasks. Which of the following will not be a component of the plan for time management?      
A.
B.
C.
D.
22.  A registered nurse (RN) is a preceptor for a new nursing graduate and is describing critical paths and variance analysis to the new graduate. The RN instructs the new nursing graduate that a variance analysis is performed on all clients:        
A.
B.
C.
D.
23.  A nurse manager employs a leadership style in which decisions regarding the management of the nursing unit are made without input from the staff. The type of leadership style that is implemented by the nurse manager is:
A.
B.
C.
D.
24.  A registered nurse (RN) in charge is preparing the assignments for the day. The RN assigns a nursing assistant to make beds and bathe one of the clients on the unit and assigns another nursing assistant to fill the water pitchers and to serve juice to all the clients. Another RN is assigned to administer all medications. Based on the assignments designed by the RN in charge, which type of nursing care is implemented?          
A.
B.
C.
D.
25.  A nurse is receiving a client in transfer from the postanesthesia care unit following a left above-the-knee amputation. The nurse should take which of the following most important actions when positioning the client at this time?  
A.
B.
C.
D.
26.  A nurse manager is planning to implement a change in the method of documentation system in the nursing unit. Many problems have occurred as a result of the present documentation system and the nurse manager determines that a change is required. The initial step in the process of change for the nurse manager is which of the following?     
A.
B.
C.
D.
27.  A client who had a spinal fusion with insertion of hardware is extremely concerned with the perceived lengthy rehabilitation period. The client expresses concerns about finances and the ability to return to prior employment. The nurse understands that the client’s needs could best be addressed by referral to the
A.
B.
C.
D.
28.  A 39-year-old man learned today that his 36-year-old wife has an incurable cancer and is expected to live not more than a few weeks.  A nurse explores the client’s feelings and identifies which of these responses by the husband as indicative of effective individual coping?
A.
B.
C.
D.
29.  A camp nurse provides instructions regarding skin protection from the sun to the parents who are preparing their children for a camping adventure.  The nurse avoid telling the parents:
A.
B.
C.
D.
30.  A client displays signs of anxiety when the nurse explains that the intravenous (IV) line will need to be discontinued due to an infiltration. The nurse makes which appropriate statement to the client?    
A.
B.
C.
D.
31.  A client goes into respiratory distress, and an arterial blood gas (ABG) specimen is drawn from the radial artery. The nurse performs the Allen's test prior to the ABG to determine the adequacy of the:           
A.
B.
C.
D.
32.  A client has died, and a nurse asks a family member about the funeral arrangements. The family member refuses to discuss the issue.  The nurse’s most appropriate action is to:
A.
B.
C.
D.
33.  A client is being discharged with a peripheral intravenous (IV) site for continued home IV therapy. In planning for the discharge, the nurse teaches the client which of the following to help prevent phlebitis and infiltration?
A.
B.
C.
D.
34.  A client is diagnosed with hyperphosphatemia.  The nurse encourages the client to limit intake of which of the following items that exacerbates the condition?
A.
B.
C.
D.
35.  A client is diagnosed with thrombophlebitis of the left leg.  A nurse documents in the nursing care plan that the client should be placed on bed test with:
A.
B.
C.
D.
36.  A client is ready to be discharged to home health care for continued intravenous (IV) therapy at home.  Home care instructions regarding care of the IV have been given to the client.  The best way to evaluate the client ability to care for the IV site is to:    
A.
B.
C.
D.
37.  A client is scheduled for an arteriogram using a radiopaque dye.  A nurse assesses which most critical item before the procedure?            
A.
B.
C.
D.
38.  A client receives intralipids intravenously at home. The client’s spouse manages the infusion.  The community health nurse discusses potential adverse reactions and side effects of the therapy with the client and the spouse.  Following the discussion, the nurse expects the spouse to verbalize, that in case of a suspected adverse reaction, the priority action is to:
A.
B.
C.
D.
39.  A client scheduled for the insertion of an implanted port for intermittent chemotherapy treatment says, “I’m not sure if I can handle having a tube coming out of me all the time. What will my friends think?” Based on the client’s statements, the nurse plans to do which of the following first
A.
B.
C.
D.
40.  A client who has a history of gout is also diagnosed with urolithiasis.  The stones are determined to be of the uric acid type.  The nurse gives the client instructions in foods to limit, which include
A.
B.
C.
D.
41.  A client who has been receiving long-term diuretic therapy is admitted to the hospital with a diagnosis of dehydration.  A nurse would assess for which sign or symptom that correlates with this fluid imbalance?         
A.
B.
C.
D.
42.  A client who had drainage of a pleural effusion is in pain. The nurse avoids which of the following interventions in providing support to this client?
A.
B.
C.
D.
43.  A client with a history of self-managed peptic ulcer disease has frequently used excessive amount of oral antacids.  A nurse interprets that this client is at most risk for which acid-base disturbance?    
A.
B.
C.
D.
44.  A client with a peripheral intravenous (IV) site calls a nurse to the room and tells the nurse that the IV site is swollen. The nurse inspects the IV site and notes that it is also cool and pale and that the IV has stopped running.  The nurse documents in the client’s record that which of the following has probably occurred?
A.
B.
C.
D.
45.  A client with Chlamydia infection has received instructions on self-care and prevention of further infection.  The nurse evaluates that the client needs further reinforcement if the client states to:   
A.
B.
C.
D.
46.  A client with diabetes mellitus is told that amputation of the leg is necessary to sustain life. The client is very upset and says to a nurse. “This is all the doctor’s fault!  I have done everything that the doctor has asked me to do!” The nurse interprets the client’s statement as:         
A.
B.
C.
D.
47.  A clinic nurse provides information to a married couple regarding measures to prevent infertility.  Which statement made by the husband indicates a need for providing further information?
A.
B.
C.
D.
48.  A community health nurse is working with food services in a rural school setting.  A goal for the school dietary program is to avoid nutritional deficiencies and enhance children’s nutritional status through healthy dietary practices.  In implementing interventions by levels of prevention, which of the following would be a primary prevention intervention that the nurse could use?         
A.
B.
C.
D.
49.  A community health nurse visits a client who is receiving total parental nutrition (TPN) in the home. The client states, “I really miss eating with my family at dinner.” Which is the best response by the nurse? 
A.
B.
C.
D.
50.  A European-American client maintains eye contact with a nurse during conversation regarding a preoperative teaching plan.  The nurse interprets this nonverbal communication as: 
A.
B.
C.
D.
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