Clinical Nursing Trivia Quiz

1. The nurse is inserting a nasogastric tube in an adult client. During the procedure, the client begins to cough and has difficulty breathing. What is the most appropriate action?

Insert the tube quickly.

Notify the health care provider immediately.

Remove the tube and reinsert it when the respiratory distress subsides.

Pull back on the tube and wait until the respiratory distress subsides.

During the insertion of a nasogastric tube, if the client experiences difficulty breathing or any respiratory distress, withdraw the tube slightly, stop the tube advancement, and wait until the distress subsides. It is not necessary to notify the health care provider immediately or remove the tube completely. Quickly inserting the tube is not an appropriate action because, in this situation, it is likely that the tube has entered the bronchus.

Explanation

During the insertion of a nasogastric tube, if the client experiences difficulty breathing or any respiratory distress, withdraw the tube slightly, stop the tube advancement, and wait until the distress subsides. It is not necessary to notify the health care provider immediately or remove the tube completely. Quickly inserting the tube is not an appropriate action because, in this situation, it is likely that the tube has entered the bronchus.

2. The clinic nurse is preparing to explain the concepts of Kohlberg's theory of moral development with a parent. The nurse should tell the parent that which factor motivates good and bad actions for the child at the preconventional level?

Peer pressure.

Social pressure

Parents’behavior.

Punishment and reward.

In the preconventional stage, morals are thought to be motivated by punishment and reward. If the child is obedi- ent and is not punished, then the child is being moral. The child sees actions as good or bad. If the child’s actions are good, the child is praised. If the child’s actions are bad, the child is punished. Options 1, 2, and 3 are not associated factors for this stage of moral development.

Explanation

In the preconventional stage, morals are thought to be motivated by punishment and reward. If the child is obedi- ent and is not punished, then the child is being moral. The child sees actions as good or bad. If the child’s actions are good, the child is praised. If the child’s actions are bad, the child is punished. Options 1, 2, and 3 are not associated factors for this stage of moral development.

3. The nurse is describing Piaget's cognitive develop- mental theory to pediatric nursing staff. The nurse should tell that staff that which child behavior is characteristic of the formal operations stage?

The child has the ability to think abstractly.

The child begins to understand the environment.

The child is able to classify, order, and sort facts.

The child learns to think in terms of past, present, and future.

In the formal operations stage, the child has the ability to think abstractly and logically. Option 2 identifies the sensorimotor stage. Option 3 identifies the concrete operational stage. Option 4 identifies the preoperational stage.

Explanation

In the formal operations stage, the child has the ability to think abstractly and logically. Option 2 identifies the sensorimotor stage. Option 3 identifies the concrete operational stage. Option 4 identifies the preoperational stage.

4. The nurse is monitoring a client who was diag- nosed with type 1 diabetes mellitus and is being treated with NPH and regular insulin. Which manifestations would alert the nurse to the presence of a possible *hypoglycemic* reaction? Select all that apply. ( 3 correct answer)

Tremors.

Anorexia.

Irritability.

Nervousness.

Hot, dry skin

Muscle cramps.

Decreased blood glucose levels produce autonomic nervous system symptoms, which are manifested classically as nervousness, irritability, and tremors. Option 5 is more likely to occur with hyperglycemia. Options 2 and 6 are unrelated to the manifestations of hypoglycemia. In hypoglycemia, usually the client feels hunger.

Explanation

Decreased blood glucose levels produce autonomic nervous system symptoms, which are manifested classically as nervousness, irritability, and tremors. Option 5 is more likely to occur with hyperglycemia. Options 2 and 6 are unrelated to the manifestations of hypoglycemia. In hypoglycemia, usually the client feels hunger.

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5. A client with a diagnosis of addisonian crisis is being admitted to the intensive care unit. Which findings will the interprofessional health care team focus on? Select all that apply. ( 2 correct answer)

Hypotension.

Leukocytosis.

Hyperkalemia.

Hypercalcemia

Hypernatremia

In Addison’s disease, also known as adrenal insufficiency, destruction of the adrenal gland leads to decreased production of adrenocortical hormones, including the gluco- corticoid cortisol and the mineralocorticoid aldosterone. Addi- sonian crisis, also known as acute adrenal insufficiency, occurs when there is extreme physical or emotional stress and lack of sufficient adrenocortical hormones to manage the stressor. Addisonian crisis is a life-threatening emergency. One of the roles of endogenous cortisol is to enhance vascular tone and vascular response to the catecholamines epinephrine and norepinephrine. Hypotension occurs when vascular tone is decreased and blood vessels cannot respond to epinephrine and norepinephrine. The role of aldosterone in the body is to support the blood pressure by holding salt and water and excreting potassium. When there is insufficient aldosterone, salt and water are lost and potassium builds up; this leads to hypotension from decreased vascular volume, hyponatremia, and hyperkalemia. The remaining options are not associated with addisonian crisis.

Explanation

In Addison’s disease, also known as adrenal insufficiency, destruction of the adrenal gland leads to decreased production of adrenocortical hormones, including the gluco- corticoid cortisol and the mineralocorticoid aldosterone. Addi- sonian crisis, also known as acute adrenal insufficiency, occurs when there is extreme physical or emotional stress and lack of sufficient adrenocortical hormones to manage the stressor. Addisonian crisis is a life-threatening emergency. One of the roles of endogenous cortisol is to enhance vascular tone and vascular response to the catecholamines epinephrine and norepinephrine. Hypotension occurs when vascular tone is decreased and blood vessels cannot respond to epinephrine and norepinephrine. The role of aldosterone in the body is to support the blood pressure by holding salt and water and excreting potassium. When there is insufficient aldosterone, salt and water are lost and potassium builds up; this leads to hypotension from decreased vascular volume, hyponatremia, and hyperkalemia. The remaining options are not associated with addisonian crisis.

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