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NUR 334 all prep u questions
Terms in this set (100)
A client with multiple sclerosis is being discharged. The nurse understands that living with chronic conditions imposes many challenges, including the need to accomplish the following. Choose all that apply.
1. Alleviate and manage symptoms
2. Validate family functioning
3. Validate individual self-worth
While talking with a client who has been diagnosed with a terminal illness, the client asks, " Am I dying?" Which response from the nurse would be appropriate? Select all that apply.
1. "This must be very difficult for you."
2. "Tell me more about what's on your mind."
A client and family are dealing with the client's recent terminal diagnosis. A nurse identifies a nursing diagnosis of hopelessness. Which of the following would be most helpful in supporting hope for this family? Select all that apply.
1. Arranging for appropriate psychosocial counseling
2. Encouraging the client to participate in care to foster control
3. Helping to obtain support from the community
A patient near the end of life is experiencing anorexia-cachexia syndrome. What characteristics of the syndrome does the nurse recognize? (Select all that apply.)
1. Alterations in carbohydrate, fat, and protein metabolism
2. Endocrine dysfunction
Anorexia and cachexia are common problems at the end of life. The nurse plays an important role in managing symptoms and preventing complications. Which of the following are appropriate nursing interventions for these problems? Select all that apply.
1. Encourage the patient to eat in an upright position.
2. Recommend that the patient eat when hungry, regardless of usual meal times.
3. Teach the patient how to increase the nutritional value of meals (i.e., add dry milk powder to milk).
A nursing instructor is lecturing to the junior students about common misconceptions of chronic illness. The instructor asks the students to write down and share some misconceptions with one another. Which of the following are common misconceptions? Choose all that apply.
1. Chronic diseases cannot be prevented.
2. Chronic diseases mainly affect people who are rich.
3. Everyone has to die of something and so chronic illness should not be treated.
A nurse who provides care on a palliative unit of a busy urban hospital performs numerous task and roles in the provision of holistic care to patients and their families. Which of the following tasks is essential for nurses to manage patients at the end of life? Select all that apply.
1. Educate patients and families about end-of-life decision making.
2. Contribute to a coordinated, interdisciplinary plan of care.
3. Manage pain and symptoms.
When evaluating a patient's response to acute pain, the nurse assesses for the presence of physiologic responses associated with the pain experience. Select all that apply:
1. Decreased urinary output
3. Increased cardiac output
4. Increased metabolic rate
Endorphins are chemicals that are released in response to painful stimuli. Select all the statements that represent the actions of endorphins. They:
1. Are found in heavy concentrations in the central nervous system.
2. Inhibit the transmission of painful impulses.
3. Produce analgesia and euphoria.
4. Are endogenous neurotransmitters structurally similar to opioids.
What does the nurse understand is the advantage of using intraspinal infusion to deliver analgesics? (Select all that apply.)
1. Effects on pulse, respirations, and blood pressure are reduced.
2. Side effects of systemic analgesia are reduced.
3. The need for injections decreases in frequency.
The client has suffered an injury to his right leg and is reporting pain at the level of "5" on a scale of 0 to 10. The client has a history of peripheral arterial disease. The client requests nonpharmacologic interventions. The nurse does all of the following
1. massages the client's back and shoulders
2. teaches the client to perform slow, rhythmic breathing
3. turns on the television to a show the client asks to watch
The nurse administered an analgesic to a client who was reporting pain. The medication is ordered as needed every 3 hours. Forty minutes later the client states he has had little relief. The nurse does all of the following:
1. consults with the healthcare provider about the client's report
2. evaluates the pain level using the established pain scale
3. assesses respirations, pulse, and blood pressure
The family practice physician group, where you practice nursing, treats a high number of older adult clients. Many of these older adults use nonopiod pain medications on a regular basis. Which of the following client education principles should you teach to these clients? Choose all correct options.
Avoid OTC analgesics consistently without consulting a physician
Inform the primary healthcare provider about the use of salicylates before any procedure
The client reports chest pain. The nurse uses which of the following questions to assess the pain further. Select all answers that apply.
1. "Rate the pain on a scale of 0 to 10, with 10 being the worst possible pain."
2. "What aggravates your chest pain?"
3. "How long have you experienced this pain?"
4. "Please point to where you are experiencing pain."
The nurse is planning the care for a patient at risk of developing pulmonary embolism. What nursing interventions should be included in the care plan? (Select all that apply.)
1. Assisting the patient to do leg elevations above the level of the heart
2. Using elastic stockings, especially when decreased mobility would promote venous stasis
3. Applying a sequential compression device
4. Encouraging a liberal fluid intake
Which of the following actions is most appropriate for the nurse to take when the patient demonstrates subcutaneous emphysema along the suture line or chest dressing 2 hours after chest surgery?
Record the observation
The nurse assesses a patient with pneumonia and notes bronchial breath sounds over consolidated lung areas. Which of the following breath sounds are diagnostic for pneumonia? Select all that apply.
3. Whispered pectoriloquy
4. Percussion dullness
Lillian Dalton, a 79-year-old female, is a client in the long-term care facility where you practice nursing. She has been battling typical pneumonia for about a month now, currently using her second course of antibiotics. What are complications that can result from pneumonia? Choose all correct options.
A patient is being seen in the health clinic for possible pneumonia. Which of the following is a sign and symptom that identifies viral pneumonia?
Blood cultures are sterile.
The nurse is caring for a patient with suspected ARDS with a pO2 of 53. The patient is placed on oxygen via face mask and the PO2 remains the same. What does the nurse recognize as a key characteristic of ARDS?
Unresponsive arterial hypoxemia
The nurse is aware that the clinical manifestations of atelectasis are correlated to the severity of the affected collapse. Which of the following indications are consistent with a smaller, affected area? Select all that apply.
1. Decreased tactile fremitus
3. Decreased breath sounds
Which of the following terms refers to lung tissue that has become more solid in nature due to a collapse of alveoli or an infectious process?
A 70-year-old woman was admitted to the medical unit with a diagnosis of pyelonephritis but failed to respond appreciably to antibiotic therapy. Upon demonstrating warning signs and symptoms of septic shock, the patient has transferred to the intensive care unit for treatment. Recent assessments suggest that the patient's infection is now beginning to resolve. What types of monitoring and assessment are likely to be required in this patient's immediate care? Select all that apply.
1. Peripheral intravenous access
2. Cardiac monitoring
A patient suffered a brain stem injury in an assault and is currently receiving controlled mandatory ventilation (CMV) in the intensive care unit. When conducting the scheduled assessments of this patient, the nurse should be aware of which of the following characteristics of CMV?
The rate and tidal volume are set, and the patient does not breathe spontaneously.
After responding favorably to treatment in the intensive care unit, a patient with a diagnosis of pneumonia is in the process of being weaned from ventilation. The patient is now able to breathe spontaneously but the ventilator is currently supplementing the patient's respiration throughout the cycle. What type of ventilation best matches this patient's oxygenation needs?
Pressure support ventilation (PSV)
An older adult patient has experienced a severe exacerbation of chronic obstructive pulmonary disease and requires mechanical ventilation. Which of the following settings will be specified by the primary care provider? Select all that apply.
1. Positive end expiratory pressure
2. Respiratory rate
3. Fraction of inspired oxygen
4. Tidal volume
A critical care nurse is aware of the high incidence and prevalence of ventilator-associated pneumonia (VAP) in high-acuity settings. In order to reduce patients' risks of developing VAP, what intervention should the nurse prioritize?
Provide frequent, thorough mouth care.
A patient is recovering from a motor vehicle accident, which has necessitated mechanical ventilation in the intensive care unit (ICU). The ICU nurse is aware that multiple nursing diagnoses are associated with mechanical ventilation. Which of the following nursing diagnoses is a consequence of mechanical ventilation?
Impaired Verbal Communication
Cortisol is secreted by the adrenal glands. Which of the following are factors that cause levels of this hormone to be elevated? Select all that apply.
1. Prolonged stress
3. Impaired cognition
Which type of prophylaxis is advised for all mechanically ventilated patients? Select all that apply.
1. Antiembolic stocking
2. ROM activity
3. Administration of antiplatelet medications
The nurse working in the medical intensive care unit has a patient admitted with mitral stenosis. The nurse knows that the pathophysiology of mitral stenosis is consistent with some of the following. Choose all that apply.
Left atrial hypertrophy
The patient with which of the following characteristics is considered high risk for the development of infective endocarditis?
Cyanotic congenital malformations
The nurse is on the infection control committee of a hospital and is looking into three cases of hospital-acquired infective endocarditis. What classification of patient is at highest risk for hospital-acquired endocarditis?
A nurse assesses a patient who is being evaluated for myocarditis. Which of the following clinical manifestations are consistent with this diagnosis? Select all that apply.
1. Jugular venous distention
4. An S3 gallop
A patient with acute mitral regurgitation should be assessed for the most common initial symptoms. Select all that apply.
A patient admitted to the hospital is suspected to have rheumatic endocarditis. What diagnostic test does the nurse anticipate will be ordered?
Which of the following changes occur to the heart as a result of heart transplant?
Heart beats faster than the natural heart
An asymptomatic patient questions the nurse about mitral regurgitation and inquires about continuing exercises. Which of the following is the most appropriate nursing response?
Continue exercise until mild symptoms develop.
The nurse explains to the patient with PACs that there are many causes, some of which are modifiable. Select all the possible causes.
2. Atrial ischemia
A patient has been scheduled for cardioversion for treating a tachyarrhythmia that has not responded appreciably to pharmacologic treatment. In anticipation of this procedure, what patient education should the nurse provide?
"Your health care provider will likely ask you to alter your normal medication routine before the procedure, so be sure to follow those instructions closely."
A 79-year-old woman with a complex medical history has recently moved to a long-term care facility. The nurse reads in the woman's documentation that she has a history of atrial fibrillation and hypertension. The nurse should presume that this patient will likely be taking which of the following medications?
The nurse has entered the room of a patient and found the patient diaphoretic, panicked, and clutching his chest. What action should the nurse first perform?
Perform a rapid assessment of the patient.
A 77-year-old woman who lives with her husband has undergone cardioversion twice in the past several months for the treatment of atrial fibrillation. When performing health education with the patient's husband, what subject matter should the nurse emphasize?
The correct technique for performing cardiopulmonary resuscitation
Before using a defibrillator to terminate ventricular fibrillation, a nurse should check the synchronizer switch. Why is this check so important?
The defibrillator won't deliver a shock if the synchronizer switch is turned on.
While teaching a CPR class, a student in the class asks what the difference is between cardioversion and defibrillation. What would be the nurse's best response?
"The difference is the timing of the delivery of the electric current."
A client has had a pacemaker inserted and is ready for discharge. The nurse is providing education about pacemaker safety. Which of the following are items that the nurse will be sure to address? Choose all that apply.
1. Carry a card identifying yourself as a pacemaker recipient.
2. Avoid large magnetic fields.
A 58-year-old construction worker fell from a 25-foot scaffolding and incurred a closed head injury as a result. As his intracranial pressure continues to increase, the potential of herniation also increases. If the brain herniates, which of the following are potential consequences? Choose all correct options.
2. Permanent neurologic dysfunction
3. Impaired cellular activity
A female client with meningitis has a history of seizures. Which of the following should the nurse do while the client is in a seizure? Choose all correct options.
1. Turn the client to the side during a seizure and do not restrain movements
2. Insert a padded tongue blade in the mouth
A college student goes to the infirmary with a fever, headache, and a stiff neck. The nurse suspects the student may have meningitis and has the student transferred to the hospital. If the diagnosis is confirmed, what should the nurse institute for those who have been in contact with this student? (Select all that apply.)
1. Administration of rifampin (Rifadin)
2. Administration of ciprofloxacin hydrochloride (Cipro)
3. Administration of ceftriaxone sodium (Rocephin)
A patient has been diagnosed with myasthenia gravis. The nurse documents the initial and most common manifestation of:
A nurse is teaching a client who was recently diagnosed with myasthenia gravis. Which statement should the nurse include in her teaching?
"This disease doesn't cause sensory impairment."
A patient has a severe neurologic impairment from a head trauma. What does the nurse recognize is the type of posturing that occurs with the most severe neurologic impairment?
Cerebrospinal fluid (CSF) studies would indicate which of the following in a patient suspected of having meningitis? Select all that apply.
1. Decreased glucose
2. Increased protein
3. Increased white blood cells
A 34-year-old patient is diagnosed with relapsing-remitting MS. The nurse explains to the patient's family that they should expect:
Acute attacks with full recovery or residual deficit upon recovery.
In a spinal cord injury, neurogenic shock develops due to loss of the autonomic nervous system functioning below the level of the lesion. Which of the following indicators of neurogenic shock would the nurse expect to find? Select all that apply.
2. Venous pooling
A patient who suffered a T6 lesion during a spinal cord injury (SCI) 10 days ago is progressing with treatment and rehabilitation following the immediate treatment of his injury. When preparing to help the physical therapist mobilize the patient for the first time since the injury, the nurse should prioritize which of the following assessments?
Assessing the patient's blood pressure
Which of the following is an action of the osmotic diuretic mannitol? Select all that apply.
1. Dehydrates brain tissue
2. Reduces cerebral edema
3.Reduces blood viscosity
4. Enhances cerebral blood flow
Which of the following symptoms are indicative of a rapidly expanding acute subdural hematoma? Select all that apply.
2. Decreased reactivity of the pupils
Which of the following are criteria for brain death according to the Quality Standards Subcommittee of the American Academy? Select all that apply.
1. Condition is irreversible with known cause
2. No brainstem reflexes
3. Core body temperature greater than 90° Fahrenheit
4. Catastrophic central nervous system (CNS) disease
Damage to the brain from traumatic injury can be divided into primary and secondary injuries. Which of the following is cause of a secondary injury associated with brain injury? Select all that apply.
1. Cerebral edema
Which of the following are the immediate complications of spinal cord injury?
1. Respiratory arrest
2. Spinal shock
A patient who has sustained a basal skull fracture is admitted to the neurological unit. The nurse should know that the patient should be observed for:
Bleeding from the ears
A nurse encourages a client with an immunologic disorder to eat a nutritionally balanced diet to promote optimal immunologic function. Which snacks have the greatest probability of stimulating autoimmunity?
Potato chips and chocolate milk shakes
Which type of immunity becomes active as a result of the infection of a specific microorganism?
Naturally acquired active immunity
A nurse is monitoring a client who developed facial edema after receiving a medication. Which white blood cells stimulated the edema?
Proteins formed when cells are exposed to viral or foreign agents that are capable of activating other components of the immune system are referred to as
Which stage of the immune response occurs when the differentiated lymphocytes function in either a humoral or a cellular capacity?
Which type of cells is capable of directly killing invading organisms and producing cytokines?
Natural killer cells
The nurse is teaching a client who has been diagnosed with Hashimoto's thyroiditis. Which of the following statements correctly describes the process of autoimmunity?
The normal protective immune response attacks the body, damaging tissues.
A client reports an allergy to morphine sulfate, which represents an example of a hypersensitivity reaction. Which of the following statements correctly describes the process of hypersensitivity?
The body produces inappropriate or exaggerated responses to specific antigens.
The root cause of cancer is damage to cellular deoxyribonucleic acid (DNA). Such damage results from multiple factors. Which of the following is a carcinogen?
1. Dietary substances
2. Environmental factors
4. Chemical agents
5. Defective genes
6. Medically prescribed interventions
When a patient takes vincristine, an antineoplastic agent that inhibits DNA and protein synthesis, the patient needs to be informed that he should report which of the following symptoms that would be an expected side-effect of motor neuropathy? Select all that apply.
1. Muscle weakness
2. Cramps and spasms in the legs
3. Loss of balance and coordination
Which of the following are true statements about effective radiation therapy? Select all that apply.
1. Tumors that are small in size and dividing rapidly are more sensitive.
2. Tumors that are well oxygenated are more sensitive to radiation.
3. Slower-growing tissues at rest (muscle) are more radioresistant.
The human body is an amazing mechanism with multiple compensatory mechanisms and built-in protection against invasion. One of these systems is the immune system which is a major factor in the prevention or development of cancer. Which of the following is a weapon is the immune system "arsenal"?
The nurse is to administer a vesicant chemotherapeutic drug to a client who had a right mastectomy and inserts the intravenous line
With a soft, plastic catheter
You are giving a report in your pathophysiology class. The subject of your report is cancer cells. In differentiating between benign and malignant cells, what characteristics would you cite? Select all that apply.
1. Rate of growth
2. Ability to cause death
3. Ability to spread
A nurse is teaching a client who is receiving radiation treatment for left lower lobe lung cancer. Which client statement indicates a need for further teaching?
"I'll use hats to protect my head from the sun when my hair falls out."
The results of a 22-year-old college student's most recent Papanicolaou (Pap) test are suggestive of cervical cancer. Since learning of this news, the patient has asked numerous questions of all members of the health care team, including the nurses at the campus medical clinic. What patient teaching should the nurse at the clinic prioritize in this patient's care?
The relationship between viruses and cervical cancer
Nursing action for extravasation of a chemotherapeutic agent would include which of the following nursing actions? Select all that apply.
1. Stop the medication infusion at the first sign of extravasation.
2. Aspirate any residual drug from the IV line.
3. Administer an antidote, if indicated.
A patient with uterine cancer is being treated with intracavitary radiation. The patient will emit radiation while the implant is in place. The nurse is aware of the precautions necessary for the provider of care and visitors. Which of the following are appropriate guidelines to follow? Select all that apply.
1. Family members should stand about 6 feet from the patient.
2. Lead aprons should be worn to buffer the exposure.
3. Visitors may stay for 30 minutes or less.
During a client's examination and consultation, the physician keeps saying "Mrs. Isaacs, you have an abdominal neoplasm." Which of the following statements accurately paraphrases the physician's statement? Choose all correct options.
1. Mrs. Isaacs, you have a new growth of abnormal tissue in your abdomen."
2. "Mrs. Isaacs, you have an abdominal tumor."
What is the best way for the nurse to assess the nutritional status of a patient with cancer?
Weigh the patient daily.
The nurse should teach the patient who is being radiated about protecting his skin and oral mucosa. An important teaching point would be to tell the patient to:
Cleanse the skin with a mild soap, using his fingertips, not a rough wash cloth.
You are the clinic nurse caring for a patient whose grandmother, mother, and sister all had breast cancer. She has requested a screening test to determine her risk of developing breast cancer and it has come back positive. The patient asks you what she can do to help prevent breast cancer from occurring. What would be your best response?
"Research has shown that taking tamoxifen can reduce your chance of breast cancer."
The nurse is responsible for teaching the patient who is receiving head and neck radiation how to protect his mouth. Which of the following teaching points should be included? Select all that apply.
Use a bland mouth rinse before and after meals and at bedtime.
Avoid carbonated and caffeinated beverages.
Use fluoride preparations daily.
Which grade of tumor is also known as a well-differentiated tumor?
What are considered carcinogens?
Which of the following would be consistent with a benign neoplasm?
Usually progressive and slow
A patient, age 67 years, is admitted for diagnostic studies to rule out cancer. The patient is Caucasian, married, has been employed as a landscaper for 40 years, and has a 36-year history of smoking a pack of cigarettes daily. What significant risk factors does the nurse recognize this patient has? (Select all that apply.)
A patient will be receiving radiation for 6 weeks for the treatment of breast cancer and asks the nurse why it takes so long. What is the best response by the nurse?
"It will allow time for the repair of healthy tissue."
The immune abnormalities that characterize systemic lupus erythematosus (SLE) include which of the following? Select all that apply.
2. Abnormal innate and adaptive immune responses
3. Autoantibodies immune complexes
Which of the following clinical manifestations would the nurse expect to find in a client who has had rheumatoid arthritis for several years?
Small joint involvement
A patient is seen in the office for complaints of joint pain, swelling, and a low-grade fever. What blood studies does the nurse know are consistent with a positive diagnosis of RA? (Select all that apply.)
1. Positive C-reactive protein (CRP)
2. Positive antinuclear antibody (ANA)
3. Red blood cell (RBC) count of <4.0 million/mcL
Which diagnostic study is decreased in patient diagnosed with rheumatoid arthritis?
Red blood cell count
Which of the following maybe the first and only physical sign of symptomatic osteoarthritis (OA)?
Limited passive movement
A client who has been diagnosed with osteoarthritis asks if he'll eventually begin to notice deformities in his hands and fingers as the condition progresses. Which concept should the nurse include in her response?
Hand and finger deformities are associated with the development of rheumatoid arthritis.
Which of the following connective tissue disorders is characterized by insoluble collagen being formed and accumulating excessively in the tissues?
Which of the following refers to fixation of a joint?
The nurse is assessing a patient with a diagnosis of scleroderma. What clinical manifestations of scleroderma does the nurse assess? (Select all that apply.)
1. Dyspnea owing to fibrotic cardiac tissue
2. Dysphagia owing to hardening of the esophagus
3. Decreased ventilation owing to lung scarring
Which of the following would be consistent with the diagnosis of rheumatoid arthritis?
Cloudy synovial fluid
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