Nsg 323 Final Practice Test
- 1.
After change of shift, you are assigned to care for the following patients. Which patient should you assess first?
- A.
A 60-year old patient on a ventilator for whom a sterile sputum specimen must be sent to the lab
- B.
A 55-year old with COPD and a pulse oximetry reading from the previous shift of 90% saturation
- C.
. A 70-year old with pneumonia who needs to be started on intravenous (IV) antibiotics
- D.
A 50-year old with asthma who complains of shortness of breath after using a bronchodilator
Correct Answer
D. A 50-year old with asthma who complains of shortness of breath after using a bronchodilatorExplanation
The patient with asthma did not achieve relief from shortness of breath after using the bronchodilator and is at risk for respiratory complications. This patient’s needs are urgent. The other patients need to be assessed as soon as possible, but none of their situations are urgent. in COPD patients pulse oximetry oxygen saturations of more than 90% are acceptable.Rate this question:
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- 2.
An experienced LPN, under the supervision of the team leader RN, is providing nursing care for a patient with a respiratory problem. Which actions are appropriate to the scope of practice of an experienced LPN? Select all that apply.
- A.
Auscultate breath sounds
- B.
Administer medications via metered-dose inhaler (MDI)
- C.
Complete in-depth admission assessment
- D.
Initiate the nursing care plan
- E.
Evaluate the patient’s technique for using MDI’s
Correct Answer(s)
A. Auscultate breath sounds
B. Administer medications via metered-dose inhaler (MDI)Explanation
The experienced LPN is capable of gathering data and making observations, including noting breath sounds and performing pulse oximetry. Administering medications, such as those delivered via MDIs, is within the scope of practice of the LPN. Independently completing the admission assessment, initiating the nursing care plan, and evaluating a patient’s abilities require additional education and skills. These actions are within the scope of practice of the professional RN.Rate this question:
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- 3.
pH 7.6 PaCO2 53 HCO3- 38
- A.
Metabolic Acidosis
- B.
Metabolic Alkalosis
- C.
Respiratory Acidosis
- D.
Respiratory Alkalosis
Correct Answer
B. Metabolic AlkalosisExplanation
The given pH value of 7.6 indicates alkalosis, which means the blood is more basic than normal. The elevated HCO3- level of 38 suggests a primary metabolic alkalosis. The PaCO2 level of 53 is not consistent with respiratory acidosis, as it would be expected to be elevated in that case. Therefore, the most appropriate explanation for the given values is metabolic alkalosis.Rate this question:
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- 4.
PH 7.17 PaCO2 48 HCO3- 36
- A.
Respiratory Alkalosis
- B.
Metabolic Acidosis
- C.
Respiratory Acidosis
- D.
Metabolic Alkalosis
Correct Answer
C. Respiratory AcidosisExplanation
The given values indicate a pH level below the normal range (7.35-7.45), which suggests acidosis. The elevated PaCO2 (partial pressure of carbon dioxide) of 48 indicates respiratory acidosis, as an increase in PaCO2 leads to an increase in carbonic acid and a decrease in pH. The HCO3- (bicarbonate) level of 36 is within the normal range (22-28), ruling out metabolic acidosis. Therefore, the correct answer is respiratory acidosis.Rate this question:
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- 5.
Nurse Channing is caring for four clients and is preparing to do his initial rounds. Which client should the nurse assess first?
- A.
A client with diabetes being discharged today.
- B.
A 35-year-old male with tracheostomy and copious secretions.
- C.
A teenager scheduled for physical therapy this morning.
- D.
A 78-year-old female client with pressure ulcer that needs dressing change.
Correct Answer
B. A 35-year-old male with tracheostomy and copious secretions.Explanation
The patient with problem of the airway should be given highest priority. Remember Airway, Breathing, and Circulation (ABC) is a priority.Rate this question:
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- 6.
You are providing care for a patient with recently diagnosed asthma. Which key points would you be sure to include in your teaching plan for this patient? (Select all that apply)
- A.
Avoid potential environmental asthma triggers such as smoke
- B.
Use the inhaler 30 minutes before exercising to prevent bronchospasm
- C.
Wash all bedding in cold water to reduce and destroy dust mites.
- D.
Be sure to get at least 8 hours of rest and sleep every night.
- E.
Avoid foods prepared with monosodium glutamate (MSG)
Correct Answer(s)
A. Avoid potential environmental asthma triggers such as smoke
B. Use the inhaler 30 minutes before exercising to prevent bronchospasm
D. Be sure to get at least 8 hours of rest and sleep every night.
E. Avoid foods prepared with monosodium glutamate (MSG)Explanation
Bedding should be washed in hot water to destroy dust mites. All of the other points are accurate and appropriate to a teaching plan for a patient with a new diagnosis of asthma.Rate this question:
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- 7.
You have obtained the following assessment information about a 3-year old who has just returned to the pediatric unit after having a tonsillectomy. Which finding requires the most immediate follow-up?
- A.
Frequent swallowing
- B.
Hypotonic bowel sounds
- C.
Complaints of a sore throat
- D.
Heart rate of 112 beats/min
Correct Answer
A. Frequent swallowingExplanation
Frequent swallowing after a tonsillectomy may indicate bleeding. You should inspect the back of the throat for evidence of bleeding. The other assessment results are not unusual in a 3-year old after surgeryRate this question:
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- 8.
Which of the following treatment goals is best for the client with status asthmatics?
- A.
Avoiding intubation
- B.
Determining the cause of the attack
- C.
Improving exercise tolerance
- D.
Reducing secretions
Correct Answer
A. Avoiding intubationExplanation
Inhaled beta-adrenergic agents, I.V. corticosteroids, and supplemental oxygen are used to reduce bronchospasm, improve oxygenation, and avoid intubation. Determining the trigger for the client’s attack and improving exercise tolerance are later goals. Typically, secretions aren’t a problem in status asthmaticus.Rate this question:
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- 9.
The healthcare provider is admitting a patient with a diagnosis of iron-deficiency anemia. The patient's skin and conjunctiva are pale, the tongue is smooth and red, and there are sores on the corners of the mouth. Which additional assessment finding will the healthcare provider identify as related to the iron-deficiency anemia?
- A.
Spoon-shaped nails
- B.
Paresthesias
- C.
Bradycardia
- D.
Jaundice
Correct Answer
A. Spoon-shaped nailsExplanation
Spoon-shaped nails, also known as koilonychia, are a classic sign of iron-deficiency anemia. In this condition, the nails become thin and concave, resembling a spoon. This occurs due to a decrease in the production of hemoglobin, which is responsible for carrying oxygen to the nails. Therefore, the presence of spoon-shaped nails suggests that the patient's iron-deficiency anemia is causing this abnormal nail shape.Rate this question:
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- 10.
Which of the following blood tests is most indicative of cardiac damage?
- A.
C-reactive protien
- B.
Complete blood count
- C.
Troponin I
- D.
Creatine kinase
Correct Answer
C. Troponin IExplanation
Option C: Troponin I levels rise rapidly and are detectable within 1 hour of myocardial injury. Troponin I levels aren’t detectable in people without cardiac injury.Rate this question:
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- 11.
What is the primary reason for administering morphine to a client with myocardial infarction?
- A.
To sedate the client
- B.
To decrease the client’s pain
- C.
 To decrease the client’s anxiety
- D.
To decrease oxygen demand on the client’s heart
Correct Answer
D. To decrease oxygen demand on the client’s heartExplanation
Answer: D. To decrease oxygen demand on the client’s heart
Option D: Morphine is administered because it decreases myocardial oxygen demand.
Options A, B, and C: Morphine will also decrease pain and anxiety while causing sedation, but isn’t primarily given for those reasons.Rate this question:
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- 12.
The client is diagnosed w Type 1 diabetes has an A1C of 8.1%. Which interpretation should the nurse make based on this result
- A.
This result is below normal levels
- B.
This result is within acceptable levels
- C.
This result is above recommended levels
- D.
This result is dangerously high
Correct Answer
C. This result is above recommended levelsExplanation
The nurse should interpret that the A1C result of 8.1% is above the recommended levels. A1C is a test that measures the average blood sugar levels over the past 2-3 months. For individuals with type 1 diabetes, the target A1C level is usually below 7%. Therefore, a result of 8.1% indicates that the client's blood sugar levels have been consistently higher than the recommended range. This may indicate poor glycemic control and the need for adjustments in the client's diabetes management plan.Rate this question:
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- 13.
The client received 10 units of Humulin R, a fast acting insulin, at 0700. At the 1030 the unlicensed assistive personnel (UAP) tells the nurse the client has a headache and is really acting “funny.” Which intervention should the nurse implement first?
- A.
Instruct the UAP to obtain blood glucose
- B.
Have patient drink a glass of orange juice
- C.
Go to clients room and asses the client for hypoglycemia
- D.
Prepare to administer 1 ampule of 50% dextrose intravenously
Correct Answer
C. Go to clients room and asses the client for hypoglycemiaExplanation
The correct answer is to go to the client's room and assess the client for hypoglycemia. This is the first intervention the nurse should implement because the client's symptoms of a headache and acting "funny" could be signs of hypoglycemia, which is a potential complication of receiving fast-acting insulin. Assessing the client's condition will help determine if their symptoms are due to low blood glucose levels and if immediate treatment is needed. Obtaining blood glucose, having the patient drink orange juice, and preparing to administer dextrose may be necessary interventions, but assessing the client's condition is the priority.Rate this question:
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- 14.
A 36 year old male is newly diagnosed with Type 2 diabetes. Which of the following treatments do you expect the patient to be started on initially?
- A.
Diet and exercise regime
- B.
Metformin BID by mouth
- C.
Regular insulin subcutaneous
- D.
None, monitoring at this time is sufficient enough
Correct Answer
A. Diet and exercise regimeExplanation
The initial treatment for a newly diagnosed patient with Type 2 diabetes is usually a diet and exercise regime. This is because lifestyle modifications, such as healthy eating and regular physical activity, can help improve blood sugar control and reduce the need for medication. It is important to promote weight loss and a healthy lifestyle as the first step in managing Type 2 diabetes. Medications like Metformin or insulin may be added later if lifestyle changes alone are not sufficient to control blood sugar levels.Rate this question:
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- 15.
A family member asks the nurse to explain the purpose of hospice care. Which of the following is the best response? Hospice care:
- A.
Is appropriate when the patient desires to intentionally end his life
- B.
Focuses on minimizing the disease process as rapidly as possible
- C.
Focuses on symptom management for patients not responding to treatment
- D.
Is holistic care for patients dying or debilitated and not expected to improve
Correct Answer
D. Is holistic care for patients dying or debilitated and not expected to improveExplanation
Hospice care focuses on holistic care of patients actively dying or not expected to improve. It helps patients face death with dignity and comfort. Euthanasia refers to the deliberate ending of a life. Palliative care is aggressively planned care that manages symptoms of patients whose disease process no longer responds to treatment. Aggressive medical treatment is aimed at stopping the disease process.Rate this question:
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- 16.
When taking a health history, the nurse screens for manifestations suggestive of Diabetes Type I. Which of the following manifestations are considered the primary manifestations of Diabetes Type I and would be most suggestive and require follow-up investigation?
- A.
Excessive intake of calories, rapid weight gain, and difficulty losing weight
- B.
An increase in three areas: thirst, intake of fluids, and hunger
- C.
Poor circulation, wound healing, and leg ulcers,
- D.
Lack of energy, weight gain, and depression
Correct Answer
B. An increase in three areas: thirst, intake of fluids, and hungerExplanation
An increase in three areas: thirst, intake of fluids, and hunger are considered the primary manifestations of Diabetes Type I. These symptoms are indicative of excessive glucose levels in the blood, which leads to increased thirst and fluid intake to try and dilute the glucose. The increased hunger is a result of the body's inability to properly use glucose for energy. These symptoms would require follow-up investigation to confirm a diagnosis of Diabetes Type I.Rate this question:
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- 17.
A patient with nasogastric suctioning is experiencing diarrhea. The patient is ordered a morning dose of Lasix 20mg IV. Patient’s potassium level is 3.0. What is your next nursing intervention?
- A.
Hold the dose of Lasix and notify the doctor for further orders
- B.
Administered the Lasix and notify the doctor for further orders
- C.
Turn off the nasogastric suctioning and administered a laxative
- D.
No intervention is need the potassium level is within normal range
Correct Answer
A. Hold the dose of Lasix and notify the doctor for further ordersExplanation
The correct answer is to hold the dose of Lasix and notify the doctor for further orders. Diarrhea can lead to fluid and electrolyte imbalances, including low potassium levels. Lasix is a diuretic that can further decrease potassium levels. Therefore, it is important to hold the dose and notify the doctor to assess the patient's condition and determine if any adjustments need to be made to the medication regimen.Rate this question:
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- 18.
A patient has a potassium level of 2.0. What would you expect to be ordered for this patient?
- A.
Potassium 30 meq IV push
- B.
Infusion of Potassium intravenously
- C.
An oral supplement of potassium
- D.
Intramuscular injection of Potassium
Correct Answer
B. Infusion of Potassium intravenouslyExplanation
A potassium level of 2.0 is considered critically low (normal range is 3.5-5.0 mEq/L). To correct this deficiency, the most appropriate and effective method would be to administer potassium intravenously through an infusion. This allows for a controlled and gradual increase in potassium levels, ensuring patient safety and preventing complications associated with rapid administration. Oral supplements may not be effective in cases of severe deficiency, and intramuscular injections may not provide the immediate correction needed.Rate this question:
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- 19.
A patient with a potassium level of 2.1 has been taking Lasix daily. What medication will the patient most likely be switched to?
- A.
Spironolactone
- B.
None the patient will likely stay on the Lasix
- C.
Hydrochlorothiazide
- D.
Bumetanide
Correct Answer
A. SpironolactoneExplanation
A potassium level of 2.1 indicates severe hypokalemia (low potassium levels). Lasix (furosemide) is a loop diuretic that can cause potassium loss. Therefore, the patient will most likely be switched to Spironolactone, which is a potassium-sparing diuretic. Spironolactone helps to retain potassium in the body and can help correct the low potassium levels caused by Lasix. Hydrochlorothiazide and bumetanide are also diuretics but are not potassium-sparing like Spironolactone.Rate this question:
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- 20.
A patient is being discharged home on Hydrochlorothiazide (HCTZ) for treatment of hypertension. Which of the following statements by the patient indicates they understood your discharge teaching about this medication?
- A.
I understand a dry cough is a common side effect with this medication.
- B.
I will monitor my glucose levels closely because this medication may mask symptoms of hypoglycemia.
- C.
I will make sure I consume foods high in potassium.
- D.
I will only take this medication if my blood pressure is high.
Correct Answer
C. I will make sure I consume foods high in potassium.Explanation
Hydrochlorothiazide is a diuretic thus excess potassium can be excreted through the urine.Rate this question:
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- 21.
Which of the following patients is not a candidate for a beta blocker medication?
- A.
A 25 year old female with migraines.
- B.
A 45 year old male with angina.
- C.
A 39 year old female with asthma.
- D.
A 55 year old male with a history of two heart attacks.
Correct Answer
C. A 39 year old female with asthma.Explanation
A 39 year old female with asthma is not a candidate for a beta blocker medication because beta blockers can cause bronchoconstriction and worsen symptoms in patients with asthma.Rate this question:
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- 22.
Which patient(s) are most at risk for developing coronary artery disease? Select-all-that-apply:
- A.
A 25 year old patient who exercises 3 times per week for 30 minutes a day and has a history of cervical cancer.
- B.
A 35 year old male with a BMI of 30 and reports smoking 2 packs of cigarettes a day.
- C.
A 45 year old female that reports her father died at the age of 42 from a myocardial infarction.
- D.
A 29 year old that has type I diabetes.
Correct Answer(s)
B. A 35 year old male with a BMI of 30 and reports smoking 2 packs of cigarettes a day.
C. A 45 year old female that reports her father died at the age of 42 from a myocardial infarction.
D. A 29 year old that has type I diabetes.Explanation
Remember risk factors for developing CAD include: smoking, family history, diabetes, being overweight or obese, and high cholesterol.Rate this question:
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- 23.
A patient reports during a routine check-up that he is experiencing chest pain and shortness of breath while performing activities. He states the pain goes away when he rests. This is known as:
- A.
Unstable angina
- B.
Variant angina
- C.
Stable angina
- D.
Prinzmetal angina
Correct Answer
C. Stable anginaExplanation
Stable angina occurs during activities but goes away when the patient rests. Variant and Prinzmetal angina are the same and occur at rest during cycles. Unstable angina is chest pain felt during rest and is more severe.Rate this question:
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- 24.
You're providing education to a patient who will be undergoing a heart catheterization. Which statement by the patient requires you to re-educate the patient about this procedure?
- A.
“The brachial artery is most commonly used for this procedure.”
- B.
“A dye is injected into the coronary arteries to assess for blockages."
- C.
“Not all patients who have a heart catheterization will need a stent placement.” I
- D.
“I will not be completely asleep and will be able to breathe on my own during the procedure.”
Correct Answer
A. “The brachial artery is most commonly used for this procedure.”Explanation
The femoral or radial artery is used during a heart cath...not the brachial.Rate this question:
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- 25.
A patient calls the cardiac clinic you are working at and reports that they have taken 3 sublingual doses of Nitroglycerin as prescribed for chest pain, but the chest pain is not relieved. What do you educate the patient to do next?
- A.
Take another dose of Nitroglycerin in 5 minutes.
- B.
Call 911 immediately
- C.
Lie down and rest to see if that helps with relieving the pain
- D.
Take two doses of Nitroglycerin in 5 minutes
Correct Answer
B. Call 911 immediatelyExplanation
If a patient's chest pain is not relieved with 3 doses of Nitroglycerin, taken 5 minutes apart, they should call 911 immediately. The patient should never exceed more than 3 doses of Nitroglycerin or take 2 doses at one time.Rate this question:
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- 26.
Select-all-that-apply: Which of the following are NOT typical signs and symptoms of pericarditis?
- A.
Fever
- B.
Increased pain when leaning forward
- C.
Pericardial friction rub
- D.
Radiating substernal pain felt in the left shoulder
- E.
Breathing in relieves the pain
Correct Answer(s)
B. Increased pain when leaning forward
E. Breathing in relieves the painExplanation
These are findings NOT found in pericarditis. B is wrong because leaning forward actually helps relieve pain felt in pericarditis (supine position makes it worst). E is wrong because inspiration (breathing in) increases the pain felt with pericarditis.Rate this question:
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- 27.
Which of the following patients are MOST at risk for developing endocarditis? Select-all-that-apply:
- A.
A 25 year old male who reports using intravenous drugs on a daily basis.
- B.
A 55 year old male who is post-opt from aortic valve replacement.
- C.
A 63 year old female who is newly diagnosed with hyperparathyroidism and is taking Aspirin.
- D.
A 66 year old female who recently had an invasive dental procedure performed 1 month ago and is having a fever.
Correct Answer(s)
A. A 25 year old male who reports using intravenous drugs on a daily basis.
B. A 55 year old male who is post-opt from aortic valve replacement.
D. A 66 year old female who recently had an invasive dental procedure performed 1 month ago and is having a fever.Explanation
Options A, B, and D are all risks for developing endocarditis. Remember that any thing that allows entry of bacteria into the system can potentially cause endocarditis. Option C is not relevant.Rate this question:
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- 28.
Which patients are NOT a candidate for tissue plasminogen activator (tPA) for the treatment of stroke?* A. A patient with a CT scan that is negative.
- A.
A patient with a CT scan that is negative.
- B.
A patient whose blood pressure is 200/110.
- C.
A patient who is showing signs and symptoms of ischemic stroke.
- D.
A patient who received Heparin 24 hours ago.
Correct Answer(s)
B. A patient whose blood pressure is 200/110.
D. A patient who received Heparin 24 hours ago.Explanation
Patients who are experiencing signs and symptoms of a hemorrhagic stroke, who have a BP >185/110, and has received heparin or any other anticoagulants etc. are NOT a candidate for tPA. tPA is only for an ischemic stroke.Rate this question:
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- 29.
Which of the following are NOT typical signs and symptoms of right-sided heart failure? Select-all-that-apply:
- A.
Jugular venous distention
- B.
Persistent cough
- C.
Weight gain
- D.
Crackles
- E.
Nocturia
- F.
Orthopnea
Correct Answer(s)
B. Persistent cough
D. Crackles
F. OrthopneaExplanation
Persistent cough, crackles (also called rales), and orthopnea are signs and symptoms of LEFT-sided heart failure...not right-sided heart failure.
Left= Lungs Right = BodyRate this question:
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- 30.
A nurse is educating a patient about their new pacemaker, what should the nurse teach the patient to monitor.
- A.
Respirations
- B.
Blood pressure
- C.
Heart Rate
- D.
Oxygen Saturation
Correct Answer
C. Heart RateExplanation
The nurse should teach the patient to monitor their heart rate. This is important because the pacemaker is responsible for regulating the patient's heart rate. By monitoring their heart rate, the patient can ensure that the pacemaker is functioning properly and that their heart is beating at a normal rate. This can help in identifying any potential issues or abnormalities with the pacemaker or the patient's heart rhythm.Rate this question:
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- 31.
What assessment is used when monitoring cellulitis?
- A.
Monitor drainage amount on dressing.
- B.
Monitor color of drainage on dressing.
- C.
Mark the initial border and monitor change.
- D.
Assess the level of pain.
Correct Answer
C. Mark the initial border and monitor change.Explanation
When monitoring cellulitis, marking the initial border and monitoring change is the appropriate assessment to use. Cellulitis is a bacterial skin infection that can spread rapidly, so it is important to track the progression of the infection. By marking the initial border and monitoring any changes, such as increased redness, swelling, or spreading of the infection, healthcare providers can assess the effectiveness of treatment and determine if further intervention is necessary. Monitoring drainage amount or color on dressing and assessing pain may provide additional information, but they are not specific to monitoring cellulitis.Rate this question:
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- 32.
Which of the following instructions would Nurse Courtney include in a teaching plan that focuses on initial prevention for Sheri who is diagnosed with rheumatic fever?
- A.
Treating streptococcal throat infections with an antibiotic
- B.
Giving penicillin to patients with rheumatic fever
- C.
Using corticosteroid to reduce inflammation
- D.
Providing an antibiotic before dental work
Correct Answer
A. Treating streptococcal throat infections with an antibioticExplanation
Rheumatoid fever results from improperly treated group beta-hemolytic streptococcal infections, usually pharyngitis. Therefore, prompt treatment of streptococcal throat infections with an antibiotic is a key preventive measure.Rate this question:
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- 33.
A home care nurse provides instructions to the mother of an infant with cleft palate regarding feeding. Which statement if made by the mother indicates a need for further instructions?
- A.
“I will use a nipple with a small hole to prevent choking.”
- B.
“I will stimulate sucking by rubbing the nipple on the lower lip.”
- C.
“I will allow the infant time to swallow.”
- D.
”I will allow the infant to rest frequently to provide time for swallowing what has been placed in the mouth.”
Correct Answer
B. “I will stimulate sucking by rubbing the nipple on the lower lip.”Explanation
An infant with cleft palate would have difficulty in feeding despite stimulation for sucking.Rate this question:
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- 34.
The nurse is teaching the mother on how to take meticulous care of her child who is experiencing failure to thrive. The mother would not be correct in saying:
- A.
“I will feed the child slowly and carefully in a quiet environment.”
- B.
“I will burp the child frequently during and at the end of each feeding.”
- C.
“I will talk to the child in a loud and booming way so that he could be stimulated and respond accordingly.”
- D.
“I will carefully document food intake with caloric intake and strict intake and output records.”
Correct Answer
C. “I will talk to the child in a loud and booming way so that he could be stimulated and respond accordingly.”Explanation
Talk to the child in a warm, soothing tone to provide sensory stimulation.
A, B, D: All these options are correct interventions for a child who has failure to thrive.Rate this question:
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- 35.
The public health nurse is giving a lecture on potential outbreaks of infectious meningitis. Which population is most at risk for an outbreak?
- A.
Clients recently discharged from the hospital.
- B.
Residents of a college dormitory.
- C.
Individuals who visit a third world country.
- D.
Employees in a high rise office building.
Correct Answer
B. Residents of a college dormitory.Explanation
Outbreaks of infectious meningitis are most likely to occur in dense community groups such as college campuses, jails, and military installations.Rate this question:
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- 36.
A patient who had a mitral valve replacement with a prosthetic mechanical valve and is ready for discharge home. Which information should the healthcare provider include in the discharge teaching for this patient? Select all that apply.
- A.
"Your valve will need to be replaced after 10 years."
- B.
"If you plan to become pregnant be sure to consult your healthcare provider."
- C.
"You may need to take an antibiotic before certain medical dental procedures."
- D.
"You will need to come in regularly for coagulation studies."
- E.
"Call our office immediately if you experience an infection of any kind."
Correct Answer(s)
B. "If you plan to become pregnant be sure to consult your healthcare provider."
C. "You may need to take an antibiotic before certain medical dental procedures."
D. "You will need to come in regularly for coagulation studies."
E. "Call our office immediately if you experience an infection of any kind."Explanation
The correct answer choices provide important information regarding the patient's specific needs after a mitral valve replacement with a prosthetic mechanical valve. Planning to become pregnant requires consultation with a healthcare provider due to potential risks and adjustments that may need to be made. Taking antibiotics before certain medical dental procedures is necessary to prevent infective endocarditis. Regular coagulation studies are necessary to monitor the patient's blood clotting ability. Immediate reporting of any infection is crucial to prevent complications.Rate this question:
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- 37.
When a patient has long-term atrial fibrillation, the nurse would expect to include which drug in the plan of care to minimize the greatest risk that is commonly associated with atrial fibrillation?
- A.
Beta Blockers
- B.
Digitalis
- C.
Anticoagulants
- D.
Antiarrhythmics
Correct Answer
C. AnticoagulantsExplanation
c.) is correct because it reflects the greatest risk or complication of thrombi or emboli that occurs with long-term atrial fibrillation. Coumadin is often given prophylactically to prevent stroke, clots, or emboli from developing when hospitalizing a patient with long-term atrial fibrillation.Rate this question:
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- 38.
A 6 year-old is admitted with sickle cell crisis. The patient has a FACE scale rating of 10 and the following vital signs: HR 115, BP 120/82, RR 18, oxygen saturation 91%, temperature 101.4'F. Select all the appropriate nursing interventions for this patient at this time?
- A.
Administer IV Morphine per MD order
- B.
Administer oxygen per MD order
- C.
Keep NPO
- D.
Apply cold compresses.
- E.
Start intravenous fluids per MD order
- F.
Administer iron supplement per MD order
- G.
Keep patient on bed rest
- H.
Remove restrictive clothing or objects from the patient
Correct Answer(s)
A. Administer IV Morphine per MD order
B. Administer oxygen per MD order
E. Start intravenous fluids per MD order
G. Keep patient on bed rest
H. Remove restrictive clothing or objects from the patientExplanation
To help alleviate the RBCs from clumping together and sickling, oxygen and hydration are priority. In addition, pain needs to be addressed. Opioid medication is the best on a scheduled basis rather than PRN (as needed). Avoid keeping patient NPO unless needed (remember patient needs hydration). Avoid cold compresses (can lead to more sickling) but instead use warm compresses. The patient will need FOLIC ACID supplements to help with RBC creation rather than iron (iron can actually build up in the body and collect in the organs in patients with sickle cell disease). Patients definitely need to be on bedrest, and restrictive clothing or objects (blood pressure cuff etc.) should be removed to help blood flow.Rate this question:
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- 39.
A nurse cares for a patient who recently completed genetic testing that revealed that she has a BRCA1 gene mutation. Which actions should the nurse take next?
- A.
Discuss potential risks for other members of her family.
- B.
Assist the client to make a plan for prevention and risk reduction.
- C.
Disclose the information to the medical insurance company.
- D.
Recommend the client complete weekly breast self-examinations.
- E.
Assess the client's response to the test results.
- F.
Encourage support nu sharing the results with the family members.
Correct Answer(s)
A. Discuss potential risks for other members of her family.
B. Assist the client to make a plan for prevention and risk reduction.
E. Assess the client's response to the test results.Explanation
The RN can asses the client's response to the test results, discuss potential risks for other family members, encourage genetic counseling, and assist the client to make a plan for prevention, risk reduction, and early detection.
Perform self-examinations monthly a week after the end of your period.
A person who test positive with BRCA1 should have at least yearly mammograms and ovarian ultrasounds.Rate this question:
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- 40.
A nurse has taught a client about dietary changes that can reduce the chances of developing cancer. What statement by the client indicates the nurse needs to provide additional teaching?
- A.
"Foods high in vitamin A & Vitamin C are important."
- B.
"Ill have to cut down on the amount of bacon I eat."
- C.
"I'm so glad I don't have to give up my juicy steaks."
- D.
"Vegetables, fruits, and high fiber grains are important."
Correct Answer
C. "I'm so glad I don't have to give up my juicy steaks."Explanation
To decrease the risk of developing cancer, one should cut down on the consumption of red meats and animal fat. The other statements are correct.Rate this question:
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- 41.
A client receiving IV chemotherapy asks the nurse the reason for wearing a mask, gloves, and gown while administering drugs to the client. What is the nurse's best response?
- A.
"These coverings protect you from getting an infection from me."
- B.
"I am preventing the spread of infection from you to me or any other client here."
- C.
"The policy is for any nurse giving these drugs to wear a gown, gloves, and mask.
- D.
"The clothing protects me from accidentally absorbing these drugs."
Correct Answer
D. "The clothing protects me from accidentally absorbing these drugs."Explanation
Most chemotherapy drugs are absorbed through the skin and mucous membranes. As a result health care workers who prepare or give these drugs are at risk for absorbing the,.Rate this question:
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- 42.
A client is on chemotherapy and has a platelet count of 25,000. Which intervention is most important to teach the client?
- A.
Eat a low-bacteria diet
- B.
Take your temperature daily.
- C.
Use a soft-bristled toothbrush
- D.
Never leave the hospital.
Correct Answer
C. Use a soft-bristled toothbrushExplanation
This client has thrombocytopenia which is a common s/e of chemotherapy. This increases the clients risk for prolonged bleeding in response to even minor injury.Rate this question:
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- 43.
The nurse is administering a combination of three different antineoplatic drugs to a patient who has metastatic breast cancer. Which statement best describes the rationale for combination therapy?
- A.
There will be less nausea and vomiting.
- B.
Increased cancer-cell killing will occur.
- C.
The drugs will prevent metastasis.
- D.
Combination therapy reduces the need for radiation therapy.
Correct Answer
B. Increased cancer-cell killing will occur.Explanation
Exposure to multiple mechanisms and sites of action will destroy more sub-populations of cells.Rate this question:
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- 44.
Which client problem does the nurse set as the priority for the client experiencing chemotherapy-induced peripheral neuropathy?
- A.
A potential for lack of understanding related to side effects of chemotherapy.
- B.
Risk for injury related to sensory and motor deficits.
- C.
Potential for ineffective coping strategies related to loss of motor control.
- D.
Altered sexual function related to erectile dysfunction.
Correct Answer
B. Risk for injury related to sensory and motor deficits.Explanation
Safety is always priority.Rate this question:
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- 45.
In staging and grading neoplasm TNM system is used. TNM stands for:
- A.
Time, neoplasm, mode of growth.
- B.
Tumor, Node, Metastasis.
- C.
Tumor, neoplasm, mode of growth.
- D.
Time, Node, Metastasis.
Correct Answer
B. Tumor, Node, Metastasis.Explanation
The correct answer is "Tumor, Node, Metastasis." The TNM system is used for staging and grading neoplasms, which refers to the extent and spread of cancer in the body. "Tumor" refers to the size and invasiveness of the primary tumor, "Node" refers to the involvement of nearby lymph nodes, and "Metastasis" refers to the presence of cancer cells in distant organs or tissues. This system helps in determining the prognosis and guiding treatment decisions for cancer patients.Rate this question:
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- 46.
The nurse providing care for a patient with suspected cancer recalls that the only diagnostic procedure that is definitive for a diagnosis of cancer is:
- A.
MRI
- B.
Biopsy
- C.
CT Scan
- D.
Tumor Marker
Correct Answer
B. BiopsyExplanation
Only a biopsy is a definitive means of diagnosing cancer because it actually identifies the pathological cells.Rate this question:
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- 47.
Which precaution is most important for the nurse to teach a client reciving radiation therapy for head and neck cancer?
- A.
Avoid eating red meant during treatment.
- B.
Pace your leisure activities to prevent fatigue.
- C.
See your dentist twice yearly for the rest of your life.
- D.
Avoid using headphones or headsets until your hair grows back.
Correct Answer
C. See your dentist twice yearly for the rest of your life.Explanation
Radiation therapy that is directed in or around the oral cavity has a variety of actions that increase the risk for dental cavities and tooth decay. The salivary glands are affected, which changes the composition of the person's saliva and often causes "dry mouth."Rate this question:
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- 48.
The nurse reviews the chart of the client admitted with a diagnosis of glioblastoma with a T1NXM0 classification. Which explanation does the nurse offer when the client asks what the terminology means?
- A.
"Two lymph nodes are involved in this tumor of glial cells, and another tumor is present."
- B.
"The brain tumor measures about 1 to 2 cm and shows no regional lymph nodes and no distant metastsis.
- C.
"This type of brain tumor is present somewhere else in your body."
- D.
"Glioma means this tumor is benign, so I will have to ask your health care provider the reason for the chemo therapy & radiation.
Correct Answer
B. "The brain tumor measures about 1 to 2 cm and shows no regional lymph nodes and no distant metastsis.Explanation
T1 means that the tumor is increasing in size to about 2 cm, and that no regional lymph nodes are present in the brain. M0 means no distant metastasis has occurred.Rate this question:
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- 49.
A nurse is going to visit a client who needs assistance with personal hygiene and feeding. Which of the following suggestions should be made to the family?
- A.
I'll teach you how to care for your family member to keep him comfortable or, if you can afford it, you can employ an aide."
- B.
"It's important that he try to take care of himself and, if he can't or won't, he ll have to deal with the consequences."
- C.
"Reimbursement is available for a nurse to come to the house each day if you would like this assistance."
- D.
"You can always have your family member readmitted to the hospital for care."
Correct Answer
A. I'll teach you how to care for your family member to keep him comfortable or, if you can afford it, you can employ an aide."Explanation
The only thing the RN can do id the care needed is maintenance and assistance with ADLs is suggest a HHA if the family can afford it, or teach the family how to help the client.Rate this question:
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- 50.
The client tells the nurse, "Every time I come in the hospital you hand me one of these advanced directives (AD) why should I fill one of these out?" Which statement by the nurse is most appropriate?
- A.
"You must fill out this form because Medicare laws require it."
- B.
An AD lets you participate in decisions about your health care."
- C.
"This paper will ensure no one can override your decisions."
- D.
"It is part of the hospital admission packet and I have to give it to you."
Correct Answer
B. An AD lets you participate in decisions about your health care."Explanation
An AD lets you participate in decisions about your health care. This statement is the most appropriate response because it accurately explains the purpose of an advanced directive. It emphasizes the client's autonomy and their ability to have a say in their own healthcare decisions. It also highlights the importance of the client's involvement in their own care planning process.Rate this question:
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Mar 20, 2023Quiz Edited by
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Nov 29, 2018Quiz Created by
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