Chapter 14: Care of the Patient with a Neurologic Disorder, Chapter 51: Care of the Patient with a Reproductive Disorder, Chapter 13: Care of the Patient with a Sensory Disorder, Chapter 43: Care of the Patient with a Musculoskeletal Disorder
11. What should the nurse include in the plan of care for a patient following a myelogram? a. Position in a semi-Fowler position for 8 hours to reduce potential of headache b. Place patient flat on back to compress puncture site c. Ambulate for brief periods to lessen postmyelogram headache d. Limit fluids to increase absorption of the dye
A
12. The nurse provides discharge teaching for a patient regarding her activity level as she recovers from her modified radical mastectomy. Which statement by her indicates to the nurse that the teaching has been successful? a. "I should sleep on the side opposite my mastectomy." b. "I should keep my right arm supported in a sling when I am up and around until my incision is healed." c. "I can do whatever exercises and activities I want as long as I don't elevate my right hand above my head." d. "I should take aspirin before moving or exercising my arm to prevent pain during the exercises."
A
16. Which foods should the home health nurse suggest for the patient with osteoporosis to help slow the disease? a. Leafy green vegetables b. Foods high in sodium c. Tea and coffee d. Vitamin A
A
19. When the patient with rheumatoid arthritis complains about the daily exercise, the nurse encouragingly reminds the patient that exercises: a. keeps the joints from "freezing." b. will ensure better sleep. c. should be vigorous for joint stimulation. d. need not be done daily.
A
20. Why is a mammogram the most useful method of diagnosing breast cancer? a. It is the most reliable method of detecting breast cancer before it becomes palpable. b. It is inexpensive and covered by most medical insurance plans. c. It involves no radiation and takes only a few minutes. d. It involves no pain or discomfort and is readily available.
A
21. The patient, age 52, is recovering from a modified radical mastectomy. Why is postoperative elevation of the patient's arm important after this procedure? a. To prevent vascular and lymph stasis, thus lymphedema b. To prevent drainage accumulation at the incisional site c. To prevent wound infection and dehiscence d. To prevent pleural effusion and respiratory distress
A
23. A 16-year-old male patient presents in the emergency room with a pathologic fracture of the left femur and complains of pain on weight bearing. These are cardinal indicators of: a. osteogenic sarcoma. b. osteoporosis. c. rheumatoid arthritis. d. osteochondroma.
A
23. When should postmenopausal women be instructed to perform breast self-examination (BSE)? a. On the same date of their choice each month b. Every 3 months c. Every day, because they are at high risk for breast cancer d. Whenever they begin to take estrogen supplements
A
24. The 14-year-old boy who is scheduled for left leg amputation says to the nurse, "What in the world am I going to do with only one leg?" What is the nurse's most therapeutic response? a. "What are you thinking about right now?" b. "With a prosthesis, you will be as good as new." c. "It is way too early to be concerned about that now." d. "When my brother had his leg removed, he did great!"
A
8. A patient had an open reduction with internal fixation (ORIF) for a compound fracture of the left tibia and has been placed in a long leg cast. The assessments by the nurse are: left foot warm/pink, pedal pulse weaker than right, capillary refill 3 seconds, and small 1 cm area of blood on cast. What should the nurse do? a. Notify charge nurse of impending compartment syndrome b. Document that all assessments are within normal limits c. Inform charge nurse about probable hemorrhage d. Place warm compresses on left foot
B
26. The nurse explains to a patient who has had a knee replacement that warfarin (Coumadin) is ordered to: a. increase the red blood cells. b. reduce the threat of hemorrhage. c. prevent formation of emboli. d. help stabilize the prosthesis.
C
3. What should the nurse instruct the patient before a magnetic resonance imaging (MRI) procedure? a. Void to completely empty the bladder b. Omit all citrus food for 12 hours before the procedure c. Remove all metal, such as jewelry, glasses, and hair clips d. Wear only cotton garments for the procedure
C
33. Why do false-negative results in mammography occur in specific age groups? a. Older women have greater density of breast tissue. b. Older women have less density of breast tissue. c. Younger women have greater density of breast tissue. d. Younger women have less density of breast tissue.
C
42. are produced in the seminiferous tubules and stored in the epididymis.
Sperm
Why would the nurse encourage a group of teenagers to protect their eyes with dark sunglasses while using a UV lamp? a. The lamp can cause cataracts. b. The lamp can cause presbycusis. c. The lamp can cause keratitis. d. The lamp can cause ectropion.
A
_________________ is/are responsible for the transmission of impulses between synapses. a. Neurotransmitters b. Dopamine c. Neurons d. Brain
A
The nurse is caring for a home health patient who had a spinal cord injury at C5 three years ago. The nurse bases the plan of care on the knowledge that the patient will be able to: a. feed self with setup and adaptive equipment. b. transfer self to wheelchair. c. stand erect with full leg braces. d. sit with good balance.
A
The total removal of an eye is a(n) ___________. a. Enucleation b. Calcification c. Ophthalmic d. Polypectomy
A
What are surgical navigational systems? a. Computerized devices that guide the surgeon b. A set of detailed anatomic maps pinpointing specific areas of the brain c. A written set of progressive processes for the resection of small brain tumors d. The use of radioactive materials to pinpoint small tumors of the brain
A
What does a tympanoplasty correct? a. Conductive hearing loss b. Sensorineural hearing loss c. Congenital hearing loss d. Functional hearing loss
A
What does diabetes retinopathy result from? a. Capillaries in retina hemorrhage b. Long-term overdosing of insulin c. Retinal detachment d. Aging
A
What is a common mistake that hinders communication when communicating with the hearing impaired? a. Overaccentuating words b. Facing the patient when speaking c. Speaking in conversational tones d. Speaking into the ear with the hearing aid
A
What is the first sign of Bell's palsy? a. Inability to wrinkle forehead and pucker lips on affected side b. Sudden pain in nostril on affected side c. Excessive salivation on the affected side d. Excessive mucus running from nostril on affected side
A
What is the process when the lens of the eye changes its curvature to focus on the retina? a. Accommodation b. Constriction c. Convergence d. Refraction
A
What is the visual disorder characterized by slow, progressive loss of central and near vision? A. Age-related macular degeneration B. Diabetic retinopathy C. Retinal detachment D. Glaucoma
A
What should the nurse include in the plan of care following a tympanoplasty? a. Elevating head of bed with operative side facing upward b. Enforcing bed rest for 72 hours c. Frequent turning, coughing, and deep breathing d. Continuous irrigation of the ear canal with antibiotic solutions
A
What should the nurse remind the hearing aid wearer to do when the nurse hears a whistling hearing aid? a. Reinsert the ear mold b. Change the battery c. Recharge the hearing aid d. Wash the ear mold with warm water
A
What type of hearing loss involves normal sound conduction through the external and middle ear, but distortion in the inner ear, making discrimination difficult? A. Sensorineural hearing loss B. Conductive hearing loss C. Mixed hearing loss D. Functional hearing loss
A
When the patient in the emergency room complains of seeing flashing lights and a curtain down over his right eye, the nurse recognizes this as a symptom of which condition? a. Detached retina b. Macular degeneration c. Early sign of cataract d. Diabetic retinopathy
A
Which is a sign of acute angle closure glaucoma (AACG)? a. Large fixed pupil b. Nystagmus c. Bluish color in sclera d. Drooping eyelid
A
Why is otitis media found more frequently in children 6 to 36 months? a. Eustachian tubes in children are shorter and straighter. b. Infection descends via the eustachian tube to the throat. c. Children's eustachian tubes are more vertical and longer. d. Otitis media is seen equally in both children and adults.
A
35. Select the interventions that should be performed with caution, in the affected arm, on patients who have undergone a modified radical mastectomy. (Select all that apply.) a. Vaccinations b. Taking of blood pressure or samples c. Insertion of IV line d. Physical therapy on uninvolved arm e. Wear watch and jewelry on involved arm f. Carry purse on involved arm or shoulder
A B C
39. Which of the following are the main purposes of traction? (Select all that apply.) a. Align and stabilize a fracture b. Prevent deformities c. Relieve muscle spasms d. Promote bed rest e. Increase circulation to the rest of the body
A B C
What factors must the nurse consider when assessing readiness to learn when teaching health promotion practices for the visually and hearing impaired? (Select all that apply.) a. Cultural beliefs b. Values c. Habits d. Income e. Occupation
A B C
Which may contribute to otitis media? (Select all that apply.) a. Exposure to cigarette smoke b. Allergies c. Upper respiratory infections d. Swimming e. Trauma f. Prolonged exposure to loud noise
A B C
36. What are some advantages of a vaginal hysterectomy over the abdominal hysterectomy? (Select all that apply.) a. Less postoperative discomfort b. Reduced hospital stay c. Less expensive d. Better visualization of the intrapelvic area e. Faster recovery
A B C E
32. Although menopause is a normal part of aging, why do many women enter menopause at an earlier age? a. Having become sexually active at an early age b. Living at high altitudes c. Excessive use of alcohol d. Morbid obesity
B
32. Which patient is most likely to develop osteoporosis? a. 43-year-old African American woman b. 57-year-old white woman c. 48-year-old African American man d. 62-year-old Latino woman
B
38. What does prolonged bed rest put the older adult at risk for? a. Ankylosing spondylitis b. Pathologic fractures c. Osteomyelitis d. Gout
B
6. Why would the nurse encourage the patient who is recovering from a modified radical mastectomy to exercise the affected arm? a. To reduce pain b. To stimulate appetite c. To reduce lymphedema d. To increase muscle tension
C
Following a myelogram the nurse should include in the postprocedure care assessment for: a. elevation of blood pressure. b. urine retention. c. sensation in lower extremities. d. slurred speech.
C
Why is the patient with suspected Guillain-Barre Syndrome (GBS) hospitalized immediately? a. The infection needs to be treated with IV antibiotics to prevent paralysis b. The brain may swell quickly causing seizures c. The disease can rapidly progress into respiratory failure d. IV hydration is needed to prevent possible fatal hypotension
C
1. Which condition would prevent the use of a vaginal hysterectomy? a. A woman with more than four pregnancies b. Large uterine fibroids c. Menorrhagia for over 6 months d. Women over the age of 50
B
10. Which patient statement indicates the need for additional teaching for a patient with rheumatoid arthritis who is taking meloxicam (Mobic)? a. "I am keeping a daily record of my blood pressure." b. "I take aspirin before I go to bed." c. "I know I can take meloxicam with or without regard to meals." d. "I weigh every day so I will be aware of any weight gain."
B
16. What instruction should a nurse give a patient with congenital herpes who does not have lesions at the present? a. "Continued use of acyclovir (Zovirax) will prevent reinfection by the virus." b. "Condoms should be used during all sexual activity to prevent transmission of the virus, even when lesions are not present." c. "Acyclovir ointment should be applied to the lesions to increase comfort and speed healing." d. "Recurrent genital herpes is promoted by any sexual stimulation."
B
17. What should the nurse include in the teaching plan for a patient who is taking alendronate (Fosamax)? a. Take drug with any meal b. Take drug first thing in the morning c. Drink at least 5 oz of milk before taking drug d. Take drug with an antacid to avoid heartburn
B
The nurse explains that the two divisions of the autonomic nervous system work to maintain homeostasis. Place in order the autonomic events. (Separate letters by a comma and space as follows: A, B, C, D) a. Parasympathetic nervous system dominates b. Extremely stressful or frightening event c. Blood pressure, heart rate, and adrenaline output decrease d. Sympathetic nervous system dominates e. Heart rate and blood pressure rise, secretion of adrenaline
B D E A C
What are the effects of normal aging on the nervous system? (Select all that apply.) a. Small vessel occlusion b. Loss of neurons c. Calcification of cerebrum d. Reduction of cerebral blood flow e. Lipofuscin f. Decrease in oxygen use
B D E F
13. Forty-eight hours after a patient sustained a fractured femur in a car accident, the nurse assessed a pulse of 110, respirations at 25, and labored crackles in both lung fields. The nurse immediately reports to the charge nurse the probability of a(n): a. impending pneumonia. b. atelectasis. c. fat embolism. d. anxiety attack.
C
14. What is the recommended age range for a baseline mammogram? a. 25 and 30 years b. 31 and 34 years c. 35 and 39 years d. 40 and 45 years
C
15. What does the diagnosis of secondary infertility refer to? a. Has never conceived b. Is infertile because of repeated infection c. Has conceived but is now unable to do so d. Is over the age of 38
C
17. The 10-year-old clinic patient reports that she is free of gonorrhea and can now engage in sexual activity. Which response is most appropriate? a. "If you have been free of symptoms for 2 weeks you are cured." b. "You should get a rapid plasma reagin (RPR) just to make sure." c. "No case is considered cured until you have had three consecutive negative cervical smears." d. "To confirm your cure, you should get a Venereal Disease Research Lab (VDRL)."
C
Place the nursing intervention in appropriate order for the immediate care of a patient with a penetrating wound of the eye. (Separate letters by a comma and space as follows: A, B, C, D) a. Assess eye, do not remove object b. Cover both eyes with an eye shield or cup c. Lay the patient down flat d. Check for the irregularity of the pupil e. Obtain medical attention immediately
C A D B E
What are the three signs of Cushing response? (Select all that apply.) a. Increased pulse rate b. Increased blood pressure c. Widened pulse pressure d. Bradycardia e. Increased systolic blood pressure f. Uncontrolled thermoregulation
C D E
What should the nurse do when assisting a blind person to walk in an unfamiliar hospital environment? (Select all that apply.) a. Discourage the use of the cane b. Advise the patient to walk quickly c. Describe the surroundings d. Encourage the patient to ask for verbal cues e. Place patient hand on nurse's shoulder or elbow
C D E
46. The nurse gives discharge instructions to a person who has had a modified radical mastectomy of the right side to perform the "elbow pull-in." Place the steps of the exercise in appropriate order. (Separate letters by a comma and space as follows: A, B, C, D) a. Pull elbows forward until they touch b. Lower and straighten the arms c. Extend arms sideways to shoulder level d. Bring elbows back and extend arms e. Clasp hands behind neck
C, E, A, D, B
A patient with a spinal cord injury at T1 complains of stuffiness of the nose and a headache. The nurse notes a flushing of the neck and "goose flesh." What should be the primary nursing intervention based on these assessments? a. Place patient in flat position and check temperature b. Administer oxygen and check oxygen saturation c. Place on side and check for leg swelling d. Sit upright and check blood pressure
D
How should the nurse advise a patient who has severe vertigo from labyrinthitis? a. Lean against a wall and not head forward until vertigo lessens. b. Bend at the waist and take several deep breaths. c. Drink an iced drink slowly. d. Lie immobile and hold the head in one position until the vertigo lessens.
D
41. are the most benign tumors of the uterus and arise from the uterine muscle tissue.
Fibroids
Arrange the parts of the eye from the exterior to the most interior. (Separate letters by a comma and space as follows: A, B, C, D) a. Choroid b. Cornea c. Aqueous humor d. Retina e. Lens f. Iris
B C F E D A
14. What is the first priority nursing intervention for an impending fat embolism? a. Administer oxygen in a respiratory emergency b. Increase intravenous fluids c. Position in flat position to ease decreased blood pressure d. Cover with warm blanket
A
24. Which statement indicates that the patient who has had an abdominal hysterectomy needs further home teaching? a. "I understand I can lift as much as 20 lb." b. "I'm leaving today to stay with my daughter, who lives 20 miles away. My husband plans to drive the family car." c. "The doctor said I can't have sexual intercourse for 4 to 6 weeks." d. "I'm going to miss wearing my girdle or knee-high hose."
A
27. What should the nurse stress to a post-hip replacement patient in quadriceps setting exercises? a. Push knee down to mattress and raise heel off the bed b. Flex knee and extend foot c. Adduct leg and flex foot d. Lift leg and heel off the bed
A
46. The nurse administering the drug colchicine for gout will give 0.5 mg hourly for hours.
12
1. What is the movement of an extremity away from the midline of the body called? a. Abduction b. Adduction c. Flexion d. Extension
A
10. Which patient is most at risk for the infection of epididymitis? a. 17-year-old athlete who trains for several hours a day b. 22-year-old who has been exposed to mumps c. 45-year-old who was circumcised at the age of 10 d. 50-year-old who has smoked for 30 years
A
12. Which finding would delay a computed tomography (CT) scan? a. Patient's allergy to shellfish b. Patient in first trimester of a pregnancy c. Patient's allergy to milk products d. Patient's gluten intolerance
A
29. A 25-year-old woman comes to the clinic with a yellowish-green malodorous vaginal discharge. She says it makes her itch and makes it hard to urinate. After a microscopic examination that confirms trichomoniasis, the patient is placed on metronidazole (Flagyl) for 7 days. How should the nurse advise the patient? a. Avoid alcohol while on Flagyl b. Be aware that her urine may turn blue and will stain clothing c. Wear snug underwear during treatment d. Be aware that she need not notify her sexual partners as trichomoniasis is not contagious
A
31. How is rheumatoid arthritis distinguished from osteoarthritis? a. Rheumatoid arthritis is an autoimmune, systemic disease; osteoarthritis is a degenerative disease of the joints. b. Rheumatoid arthritis is an autoimmune, degenerative disease; osteoarthritis is a systemic inflammatory disease. c. People with osteoarthritis are considered to be genetically predisposed; there is no known genetic component to rheumatoid arthritis. d. Osteoarthritis is often caused by a virus; viruses play no part in the pathogenesis of rheumatoid arthritis.
A
31. What factor influences older women's reluctance to seek medical care for problems of the reproductive system? a. Embarrassment and cultural factors b. Denial c. Religious convictions d. Lack of free time
A
33. The patient, age 58, is diagnosed with osteoporosis after densitometry testing. She has been menopausal for 5 years and has been concerned about her risk for osteoporosis because her mother has osteoporosis. In teaching her about her osteoporosis, which information does the nurse include? a. Even with a family history of osteoporosis, the calcium loss from bones can be slowed by increased calcium intake and exercise. b. Estrogen replacement therapy must be started to prevent rapid progression of her osteoporosis. c. With a family history of osteoporosis, there is no way to prevent or slow bone reabsorption. d. Continuous, low-dose corticosteroid treatment is effective in stopping the course of osteoporosis.
A
34. Certain foods may increase the pain associated with gout. Which foods have the highest concentration of purines? a. Brain, liver, kidney b. Lettuce, corn, potatoes c. Beef, pork, chicken d. Fruits and fruit juices
A
4. The nurse instructs the patient who is to have a unicompartmental knee replacement that a major advantage of this partial knee replacement is that: a. the patient will be up and walking 2 to 3 hours after the operation. b. the kneecap is completely removed. c. the procedure is especially helpful in the treatment of rheumatoid arthritis. d. a small titanium disk replaces the worn cartilage.
A
5. On the fourth postoperative day after a modified radical mastectomy, the nurse finds the patient with her back to the nurse. She is crying and tells the nurse she feels ugly and is worried that her husband will not be in love with her anymore. The nurse bases subsequent nursing interventions on what diagnosis? a. Disturbed body image related to removal of her breast b. Deficient knowledge related to inadequate education c. Impaired social interaction related to depression d. Fear related to the cancer diagnosis and surgical intervention
A
A patient, age 45, is to have a myelogram to confirm the presence of a herniated intervertebral disk. Which nursing action should be planned with respect to this diagnostic test? a. Obtain an allergy history before the test. b. Ambulate the patient when returned to the room after the test. c. Use heated blanket to keep patient warm after procedure. d. Keep NPO for 6 to 8 hours after the test.
A
Involuntary rhythmic movement of the eyes, with oscillations that may be horizontal, vertical, or mixed movements, is called ___________________ a. Nystagmus b. Priapism c. Glaucoma d. Cataracts
A
Progressive deafness caused by the ankylosis of the stapes is the condition of__________. a. otosclerosis b. calcification c. otitis media d. tinnitus
A
The 62-year-old home health patient who is recovering from eye surgery complains of a feeling of "grittiness" in the eye and is having blurred vision. The eyes are reddened and have stringy mucus. What do these complaints indicate? a. Sjögren syndrome b. Early cataracts c. Macular degeneration d. Retinal detachment
A
The newly admitted patient to the emergency room 30 minutes ago after a fall off a ladder has gradually decreased in consciousness and has slowly reacting pupils, a widening pulse pressure, and verbal responses that are slow and unintelligible. What is the most appropriate position for the patient? a. Neck placed in a neutral position b. Head raised slightly with hips flexed c. Supine in gravity neutral position d. Turn on right side with head elevated
A
The nurse assures an anxious family member of a 92-year-old patient who is demonstrating signs of dementia that many causes of dementia are reversible and preventable. What is one example? a. Hypotension b. Alzheimer disease c. Diabetes d. Parkinson disease
A
The nurse explains that the triad of signs of Parkinson disease is: _______, _______ and _______ a. tremors, rigidity, and bradykinesia b. hypertension, fever, bradycardia c. diaphoresis, tremors, fever d. tremors, ataxia, dysphagia
A
The nurse is aware that the drug t-PA (Activase), a tissue plasminogen activator, must be given in____hours of the onset of symptoms to have maximum benefit. a. 3 hours b. 4 hours c. 6 hours d. 8 hours
A
38. Which of the following are true of the Gardasil vaccine? (Select all that apply.) a. It requires two more immunizations at 6 months after the first dose b. It reduces incidence of cervical cancer c. It reduces the incidence of human papilloma virus (HPV) d. It can be given only to females e. It should be given before a person becomes sexually active f. It is safe for people as young as 8 years of age
A B C E
42. Which instructions should the nurse include in a teaching plan for a person with gouty arthritis? (Select all that apply.) a. Avoid excessive alcohol. b. Maintain rest and immobility while disease is symptomatic. c. Check urine and urine output for possible kidney stones. d. Include food high in purine in the diet. e. Use bed cradle to support linens.
A B C E
Select all the conditions that may cause conductive hearing loss. (Select all that apply.) a. Buildup of cerumen b. Foreign bodies c. Otosclerosis of external auditory canal d. Trauma e. Exposure to ototoxic drugs f. Otitis media with effusion
A B C F
What factors have been associated with the formation of cataracts? (Select all that apply.) A. Aging B. Ultraviolet light C. History of eye surgery D. Exposure to maternal rubella E. Smoking F. Loud music G. Diabetes mellitus
A B D E G
What is the reticular activating system (RAS) essential to? (Select all that apply.) a. Concentration b. Wakefulness c. Speech d. Attention e. Memory f. Introspection
A B D F
Which foods should the person who suffers from migraine headaches avoid? (Select all that apply.) a. Yogurt b. Caffeine c. Beef d. Pears e. Marinated foods f. Milk
A B E
34. Vaginal fistulas are caused by an ulcerating process resulting from (select all that apply): a. Cancer b. Radiation c. Poor hygiene d. Multiple sexual partners e. Weakening of tissue from pregnancies f. Surgical interventions
A B E F
40. The characteristics of osteoarthritis that should be included in a teaching plan would include that osteoarthritis (select all that apply): a. will cause the formation of Heberden nodes. b. can involve other organs. c. results from wear and tear. d. may affect only one side of the body. e. may cause constitutional symptoms of fatigue and fever. f. will cause marked erythema and edema of hands.
A C D
37. The nurse instructs a group of women who attend the health clinic that persons who are particularly at risk for cervical cancer are persons who (select all that apply): a. Smoke b. Wear tampons c. Have been sexually active since their teens d. Have multiple sexual partners e. Had chickenpox as a child f. Have a history of sexually transmitted diseases (STD)
A C D F
Which of the following are causes of cataracts? (Select all that apply.) a. Long-term use of corticosteroids b. Hypotension c. Congenital from exposure to maternal rubella d. Diabetes mellitus e. Exposure to sand and dust f. Smoking
A C D F
What would a nurse do when the patient arrives in the PACU after a left stapedectomy? (Select all that apply.) a. Turn the patient to his right side b. Change dressing as it becomes soiled c. Turn patient every 2 hours d. Leave the bed flat e. Medicate immediately on the complaint of nausea
A D E
30. The office nurse has noted the presence of an increase in lumbar curvature in a 20-year-old female patient. What is this condition known as? a. Scoliosis b. Lordosis c. Kyphosis d. Spondylitis
B
18. The patient has been diagnosed as having gouty arthritis. The patient asks the nurse to explain the cause of the inflammation of the great toe. What is the most appropriate nursing response? a. "You have calcium oxalate deposits that are seen in gouty arthritis." b. "The inflammation is from small accumulations of uric acid crystals, which are called tophi." c. "The small nodules are not related to the arthritis condition." d. "You have fat deposits that are common with gouty arthritis."
B
2. On the second postoperative day, a patient who has had an abdominal hysterectomy complains of gas and abdominal distention. Which intervention would be most appropriate to stimulate a bowel movement? a. Offering carbonated beverages b. Encouraging ambulation at least four times per day c. Administering a 1000-mL soapsuds enema d. Applying an abdominal binder
B
22. A patient, age 46, is recovering from an abdominal hysterectomy. Postoperative nursing assessment findings include a urinary output of 100 mL in 4 hours. What should the nurse do? a. Force fluids b. Report urinary retention to the charge nurse c. "Milk" the urinary catheter d. Turn the patient onto her right side
B
22. What should the nurse do when a patient with osteomyelitis is admitted with an open wound that is draining? a. Enforce a low calorie diet b. Initiate drainage and secretion precautions c. Frequently do passive ROM on the elbow d. Ambulate several times daily
B
25. The patient with a swollen scrotum is amazed that diagnosis of the condition of hydrocele is such a simple thing as: a. placing the scrotum on a warm pad. b. shining a flashlight through the scrotum. c. squatting and letting the scrotum hang dependently. d. packing the scrotum in ice.
B
27. The 69-year-old patient laughs at the nurse when the nurse suggests that she should have a Pap smear and says, "I had my uterus removed except for the cervix 30 years ago and I am almost 70. Why in the world would I want to get a Pap smear at my age?" What is the nurse's most informative reply? a. "All persons who have a cervix remaining should be screened up to the age of 75." b. "Well, you have one more year to go to get a Pap smear." c. "My goodness, you look so young I thought you were still in the age bracket for regular Pap screens." d. "You are right. If you had no trouble so far, there is no need to do the smear."
B
28. What should the home health nurse include assessment for in the plan of care for an 82-year-old female with severe kyphosis from ankylosis? a. Urinary output b. Respiratory effort c. Sleep cycle d. Nutritional status
B
9. When a patient recovering from a fractured tibia asks what callus formation is, the nurse tells her it is: a. when blood vessels of the bone are compressed. b. a part of the bone healing process after a fracture when new bone is being formed over the fracture site. c. the formation of a clot over the fracture site. d. when the hematoma becomes organized and a fibrin meshwork is formed.
B
A ___________ is a diagnostic procedure used to identify lesions by observing the flow of radiopaque dye through the subarachnoid space. a. Diagram b. Myelogram c. X-Ray d. Fluoroscopy
B
A frantic family member is distressed about the flaccid paralysis of her son following a spinal cord injury several hours ago. What does the nurse know about this condition? a. It is an ominous indicator of permanent paralysis. b. It is possibly a temporary condition and will clear. c. It degenerates into a spastic paralysis. d. It will progress up the cord to cause seizures.
B
A patient has recently suffered a stroke with left-sided weakness and has problems with choking, especially when drinking thin liquids. What nursing interventions would be most helpful in assisting this patient to swallow safely? a. Use a straw b. Tuck chin when swallowing c. Take a sip of liquid with each bite d. Turn head to the left
B
A patient is in which stage of Alzheimer disease when she demonstrates "sundowning"? a. Early stage b. Second stage c. Third stage d. Final stage
B
A patient who had an enucleation of the right eye has been admitted PACU. What should the nurse include in the plan of care? a. Turn, cough, and deep breathe every 3 hours b. Apply a pressure dressing over the right eye socket c. Document dressing assessment every 2 hours d. Turn on the affected side
B
An 83-year-old patient has had a stroke. He is right-handed and has a history of hypertension and "little" strokes. He presents with right hemiplegia. To afford him the best visual field, the nurse should approach him: a. from the right side. b. from the left side. c. from the center. d. from either side.
B
As the result of a stroke, a patient has difficulty discerning the position of his body without looking at it. In the nurse's documentation, which would best describe the patient's inability to assess spatial position of his body? a. Agnosia b. Proprioception c. Apraxia d. Sensation
B
How would a nurse record the behavior when a patient with Alzheimer disease attempts to eat using a napkin rather than a fork? a. Apraxia b. Agnosia c. Aphasia d. Dysphagia
B
The home health patient complains of tearing and a feeling of dryness in the right eye. The nurse assesses that the eyelid is turned inward and the sclera is red. The nurse documents the presence of a(n)_________________. a. Aminoacid b. Entropion c. Vertigo d. Calcification
B
The nurse explains that a pneumatic retinopexy is a repair of a retinal detachment using a bubble of_________ to put pressure on the damaged retina. a. water b. gas c. nitrogen d. saline
B
The nurse is aware that the characteristic gait of the person with Parkinson disease is a propulsive gait, which causes the patient to: a. stagger and need support of a walker. b. shuffle with arms flexed. c. fall over to one wide when walking. d. take small steps balanced on the toes.
B
The nurse will assess for _____________ when the older adult home health patient complains that the entire right side of his head hurts and he cannot chew without pain. a. mumps b. external otitis c. otitis media d. labyrinthitis
B
What is the ability of the eye to focus on objects at various distances? A. Refraction B. Accommodation C. Constriction D. Convergence
B
What is the first indication of macular degeneration? a. The loss of peripheral vision b. The loss of central vision c. The loss of color discrimination d. Eye fatigue
B
What must a patient do following a left vitrectomy? a. Remain flat in bed for 48 hours b. Position self in a face-down position for 4 to 5 days c. Assume a side-lying position with the left side down for 3 days d. Keep head upright and cushioned with pillows for 24 hours
B
What should the nurse do when the child arrives on the floor with the diagnosis of bacterial meningitis? a. Arrange for humidified oxygen per mask b. Place the child in respiratory isolation c. Inquire about drug allergy d. Hold NPO until orders arrive
B
When taking care of a patient with newly diagnosed type 1 diabetes mellitus, the nurse notes the patient is expressing some fears about long-term complications of the disease. She states, "I know I'll go blind within 10 years. Why should I bother controlling my blood sugar?" On what knowledge can the nurse's best response be based? A. After 10 years with diabetes mellitus, most type 1 patients have advanced diabetic reti-nopathy. B. Diabetic retinopathy occurs more frequently in patients with long-standing, poorly con-trolled diabetes mellitus. C. The initial stage of diabetic retinopathy only lasts for a couple of months. D. The initial stage consists of vision loss and the presence of "floaters" in the visual field.
B
When the newly blind male home health patient asks the nurse how he might get assistance, who might the nurse suggest he contact? a. American Red Cross b. American Foundation for the Blind for a list of agencies c. Local hospital social worker d. The public health department
B
Which complaint made by a 64-year-old patient during a health interview would alert the nurse to the possibility of cataracts? a. Pain in the eyes b. Difficulty driving at night c. Loss of peripheral vision d. Dry eyes
B
41. What are the three vital functions muscles perform when they contract? (Select all that apply.) a. Absorb uric acid b. Maintenance of posture c. Motion d. Store minerals e. Production of heat f. To assist in return of venous blood to the left side of the heart
B C E
18. A Gram stain smear of the patient's discharge reveals the presence of N. gonorrhoeae. He tells the nurse that he had sexual contact with a new girlfriend but does not think he was exposed to gonorrhea because she did not appear to have any disease. Which information should the nurse include in response to his comment? a. "Women do not develop gonorrhea infections but can serve as carriers to spread the disease to males." b. "When gonorrhea infections occur in women, the disease affects only the ovaries and not the other genital organs." c. "Many women are not aware that they have gonorrhea because they often do not have symptoms of infection." d. "Women develop subclinical cases of gonorrhea that do not cause tissue damage or symptoms."
C
20. The nurse clarifies to a patient who is being evaluated for possible rheumatoid arthritis that the elevated erythrocyte sedimentation rate indicates the presence of: a. immunoglobulin M. b. abnormal serum protein. c. increased inflammatory reaction in the body. d. C-reactive protein.
C
21. What should the nurse instruct the patient before the initiation of the antimalarial drug hydroxychloroquine (Plaquenil)? a. Get a complete blood count to assess anemia. b. Get a chest x-ray. c. Get an eye examination. d. Take prophylaxis for malaria.
C
25. A patient has undergone a bipolar hip repair (hemiarthroplasty). Which is the most appropriate instruction? a. Sit in whatever position is most comfortable b. Sit in a firm, straight-backed chair at a 90-degree angle c. Avoid crossing the legs d. Begin full weight bearing as soon as tolerated
C
35. In order for a patient to flex the lower leg, which muscle must be contracted? a. Quadriceps b. Gastrocnemius c. Biceps femoris d. Rectus femoris
C
36. Calcium is a mineral found in many foods that can slow bone loss during the aging process. Which food is high in calcium? a. Oranges b. Bananas c. Spinach d. Eggs
C
37. A 56-year-old female patient is being seen for osteoarthritis of the knee in the clinic. What should the nurse recommend when discussing strengthening exercises? a. Jogging b. Walking rapidly on a treadmill c. Bicycling d. Aerobic exercises
C
4. A patient, age 41, has had a total abdominal hysterectomy and bilateral salpingo-oophorectomy for endometriosis. She asks the nurse if she will have "hot flashes." What knowledge will guide the nurse's response? a. Only the uterus was removed, and the ovaries are still producing estrogen and she will not have hot flashes. b. The patient is too young to have hot flashes associated with menopause. c. The uterus, ovaries, and fallopian tubes were removed, and she will have surgically induced menopause and may have hot flashes. d. The uterus and fallopian tubes were removed, and she will not experience "hot flashes."
C
5. A patient who has had a right below the knee amputation continues to complain of unpleasant sensation in the right foot. What can the nurse explain about this "phantom pain"? a. It only exists in the mind. b. It is a complication following an amputation and can be clarified by the surgeon. c. It is related to the severed nerves that are still sending messages to the brain. d. It occurs when the person becomes focused on the loss of the limb.
C
6. The patient that has a bipolar hip replacement following an intracapsular fracture has an order to be turned every 2 hours. The nurse understands that the correct nursing intervention is to keep the legs: a. together so they do not separate while turning. b. flexed to stabilize the prosthesis. c. abducted so the prosthesis does not become dislocated. d. adducted to prevent additional pain for the patient with turning.
C
7. A patient has been casted to stabilize a fracture of the right radius and ulna. The nurse assesses a capillary refill of 5 seconds and cold fingers of the right hand. Which initial intervention should the nurse deploy? a. Notify the charge nurse of a probable compartment syndrome b. Apply a warm compress to the fingers to relieve swelling c. Elevate the right hand to heart level to maintain arterial pressure d. Cut the cast off to release constriction
C
8. At what age should a male be taught testicular self-examination (TSE)? a. 10 b. 13 c. 15 d. 20
C
9. Which statement made by a patient who has been taught the technique of testicular self-examination indicates the need for further teaching? a. "The testes feel smooth and egg-shaped." b. "The best time to perform TSE is after a shower." c. "I will examine my scrotum after every ejaculation." d. "The epididymis feels like a soft tube."
C
Four hours after a stapedectomy the patient complains that hearing has not improved at all. What knowledge would the nurse use to shape a response? a. A large percentage of stapedectomies are not successful b. It will take at least 10 days for the graft to heal c. Hearing will not return until edema subsides d. Hearing will improve after irrigation of the ear
C
How would the nurse instruct a patient with Parkinson disease to improve activity level? a. To use a soft mattress to relax the spine b. To walk with a shuffling gait to avoid tripping c. To walk with hands clasped behind back to help balance d. To sit in hard chair with arms for posture control
C
The newly admitted patient to the emergency room after a motorcycle accident has serosanguineous drainage coming from the nose. What is the most appropriate nursing response to this assessment? a. Cleanse nose with a soft cotton-tipped swab b. Gently suction the nasal cavity c. Gently wipe nose with absorbent gauze d. Ask patient to blow his nose
C
The nurse clarifies that the difference between a photorefractive keratectomy (PRK) and a laser in-situ keratomileusis (LASIK) is that a LASIK: a. reshapes the central cornea. b. makes partial-thickness radial incisions in the cornea. c. removes some internal layers of the cornea. d. implants intracorneal rings.
C
The nurse counsels the 16-year-old boy that playing his music at high volume can result in impairment in hearing related to: a. damaged tympanic membrane. b. protective buildup of cerumen. c. damage of the fine hair cells in the organ of Corti. d. rupture of the oval window.
C
The nurse is aware that when assessing a patient by the FOUR score coma scale, the patient is assessed in four categories: eye response, brainstem reflexes, motor response, and respiration. How are these results reported? a. As a sum of the scores of the four categories b. As part of the Glasgow coma scale c. As individual scores in each category d. As progressive scores during a 24-hour period
C
The nurse takes into consideration that the Weber test indicated a conductive hearing loss in a patient because the patient reported hearing the tone: a. equally in both ears. b. as a shrill noise. c. louder in his affected ear. d. very faintly.
C
The surgical incision into the eardrum with either a knife or a heated wire loop to relieve pressure in the middle ear is a(n) ___________. a. polypectomy b. salpingectomy c. myringotomy d. ileectomy
C
What is the basic problem that prompts most of the early signs of Alzheimer disease? a. Changes in mood b. Misplacing things c. Memory loss that disrupts daily life d. Problems with words in speaking
C
What is the nurse aware of when assessing a person with a craniocerebral injury? a. Most injuries of this type are irreversible b. Open injuries are always more serious than closed injuries c. Signs and symptoms may not occur until several days after the trauma d. Trauma to the frontal lobe is more significant than to any other area
C
What is the purpose of a "drug holiday" in the treatment of Parkinson disease? a. Change all drugs b. Allow the natural dopamine levels to rise c. Restart drugs at a lower dosage with favorable results d. Reduce the extrapyramidal symptoms
C
What is the thick, white, opaque connective tissue that is part of the outermost layer of the eye-ball? A. Conjunctiva B. Cornea C. Sclera D. Retina
C
What should a patient who has had a cataract repair avoid? a. The use of eye patches b. The use of sunglasses c. The lifting of heavy objects d. Reading for long periods of time
C
What should the nurse advise the 20-year-old to do who has been put on cefaclor (Ceclor) for a resistant otitis media? a. Store suspension at room temperature b. Discontinue drug when symptoms abate c. Avoid alcoholic beverages d. Take with meals only
C
When caring for a patient who has just undergone a corneal transplant (keratoplasty), what is the most important nursing intervention? A. Preparing written postoperative instructions for the patient to read over B. Positioning the patient on the operative side C. Reporting any severe or progressive pain to the surgeon immediately D. Teaching the patient to avoid bending, lifting, or straining for 1 week
C
When the patient stares at the black dot on an Amsler grid, what should the nurse ask him to report? a. Any color visible on the grid b. Fading of the edges of the grid c. Any distortion of the grid d. Movement of the black dot
C
Which question is likely to elicit the most valid response from the patient who is being interviewed about a neurologic problem? a. "Do you have any sensations of pins and needles in your feet?" b. "Does the pain radiate from your back into your legs?" c. "Can you describe the sensations you are having?" d. "Do you ever have any nausea or dizziness?"
C
Which of the following techniques are necessary for safely feeding a hemiplegic patient? (Select all that apply.) a. Mixing liquids and solid foods together b. Taking the patient's dentures out to prevent choking c. Checking the affected side of mouth for food accumulation d. Offering small bites of food e. Elevating the patient to no more than 30 degrees f. Adding a thickening agent to liquids
C D F
11. A patient, age 26, has had a tubal insufflation (Rubin test) to ascertain whether her fallopian tubes are patent. She complains of pain in her right shoulder. Which response is most appropriate? a. "Don't worry, that is a normal reaction." b. "I'll report the findings immediately to the head nurse." c. "That is a symptom that resulted from your position on the operating table." d. "That is from the carbon dioxide passing from the fallopian tubes into your abdomen."
D
13. A female patient, age 48, is undergoing a routine physical examination for the first time in 5 years. Which procedure would be included in this examination? a. Culdoscopy b. Colposcopy c. Cervical biopsy d. Papanicolaou smear
D
15. A patient, age 68, has suffered an intertrochanteric fracture of the right hip. Before surgery, to provide support and comfort, an immobilizing device of a is applied. a. Thomas splint b. Bryant traction c. Russell traction d. Buck traction
D
19. The patient who had a colporrhaphy for the repair of a cystocele and rectocele asks that the catheter be removed as it is bothersome to her. How should the nurse explain the reason for the catheter? a. It replaces uncomfortable gauze packing b. It will prevent adhesions and will be in place for about 2 weeks c. It allows for quick urine sample collection d. It keeps the bladder empty, and prevents stress on the sutures
D
2. What is the large, fan-shaped muscle that covers the anterior chest from the sternum to the proximal end of the humerus and acts on the joint of the shoulder to flex, adduct, and rotate? a. Serratus anterior b. Intercostal c. Transversus abdominis d. Pectoralis major
D
26. A patient, age 36, is scheduled for a unilateral orchiectomy for treatment of testicular cancer. He is withdrawn and does not initiate interaction with the nurse. What is the most appropriate nursing action at this time? a. Carefully explain the postoperative activity restrictions. b. Show him a diagram of what the orchiectomy will accomplish. c. Assure him that he will have adequate future sexual functioning. d. Assess his concerns related to his diagnosis and treatment.
D
28. A male patient, age 23, seeks care at the health clinic because he has developed a profuse, purulent urethral discharge, and urination is painful. During assessment of the patient, it is most important that the nurse gather information related to his history of: a. recent urinary infections. b. episodes of prostatitis. c. contagious diseases like mumps. d. present and past sexual partners, and notify them to get treatment.
D
29. What should the nurse stress to a patient who has had a hip replacement and is beginning strengthening exercises for the unaffected leg? a. Flex the knee and flex the foot b. Lift the leg from the mattress and rotate the foot c. Pull knee to chest and extend the foot d. Push foot down against the footboard for a count of five
D
3. The young husband of a patient who has been scheduled for a hysterectomy because of the discovery of ovarian cancer in both ovaries says to the nurse, "Please go talk to my wife. She is real upset and says she won't be a 'woman' anymore." What is the nurse's most therapeutic response? a. "Don't be concerned. All young women get upset before this kind of surgery." b. "Certainly, I will be glad to tell her about hormone replacement." c. "She will get over this feeling soon." d. "No matter what I may say to her, it is you that needs to listen to her concerns and assure her."
D
30. The young woman comes to the free clinic for the complaint of stomach cramps. During the examination, the nurse recommends that she be tested for chlamydia. The woman says "I don't need any test...I don't have any symptoms for a sexual infection...I just came for my stomach." Which response is most informative? a. "Well, if you get more symptoms come back for testing." b. "The doctor may have to order medicine for syphilis and chlamydia. You probably have that too. You need to be tested today!" c. "Testing is not mandatory...I probably wouldn't bother either since you have no symptoms." d. "That stomachache may be part of a chlamydia infection. Many women do not have a discharge, but are carriers."
D
7. A 20-year-old patient presents in the emergency room with a temperature of 103° F, blood pressure of 92/58, headache, and desquamation of both palms. What should the nurse make sure to ask about during the interview? a. Any recent traveling outside the country b. Immunization against influenza c. Method of birth control d. Use of tampons
D
A family member of a patient who has just suffered a tonic-clonic seizure is concerned about the patient's deep sleep. What is this behavior called? a. Convalescent period b. Neural recovery period c. Sombulant period d. Postictal period
D
How would the nurse explain the purpose of photocoagulation to a diabetic patient with diabetic retinopathy? a. The procedure will destroy the retina, which is not getting enough blood supply. b. The procedure will reduce edema in the macula of the eye. c. The procedure will vaporize fatty deposits that appear in the retina. d. The procedure will destroy new blood vessels, seal leaking vessels, and help prevent retinal edema.
D
One of the housekeepers splashes a chemical in the eyes. What should be the first priority? a. Transport to a physician immediately b. Cover the eyes with a sterile gauze c. Irrigate with H2O for 5 minutes d. Irrigate with normal saline solution for 20 minutes
D
The nurse is aware that the patient has 20/40 vision. This means that the patient can see at 20 feet what the normal eye can see at _______ feet. a. 10 b. 20 c. 30 d. 40
D
The nurse is caring for a 75-year-old patient who has experienced some sensory deficits. What change might be explained by age-related changes of the sensory system? A. Decreased sensitivity to glare B. Inability to hear low-frequency sounds C. Difficulty with red/orange color discrimination D. Increased difficulty focusing on close objects
D
The nurse is caring for a patient who has had functional blindness for 10 years. Which statement is true? A. Pain is not associated with blindness, since the pain receptors have been destroyed. B. Since this patient has been blind for a number of years, the patient is in the acceptance phase of the illness. C. Since the patient's blindness is functional, not total, the patient is not considered to be legally blind. D. A comprehensive approach to patient care is essential with blind patients.
D
The patient tells the nurse that he is legally blind. How would this information impact the nurse's plan of care for this patient? a. The patient would be considered totally blind. b. This patient probably has some light perception, but no usable vision. c. This patient has some usable vision, which enables function at an acceptable level. d. The nurse would need to determine how this patient's visual impairment affects normal functioning.
D
The waxy substance that covers the neuron fibers and increases the rate of transmission of impulses is the ________. a. sheet b. synaptic c. arachnoid d. myelin
D
What Glasgow Coma Scale rating would a patient receive who opens the eyes spontaneously, but has incomprehensible speech and obeys commands for movement? a. 8 b. 10 c. 11 d. 12
D
What are the most appropriate nursing care and patient teaching for the patient with external otitis? A. Applying cold compresses to the affected ear B. Continuing antibiotic therapy until symptoms of the infection are relieved C. Advising patient to rinse ears out each morning in the shower D. Washing hands before and after changing cotton plugs
D
What are the two divisions of the nervous system? a. Somatic and the autonomic b. Cerebellum and the brainstem c. Medulla oblongata and the diencephalon d. Central and the peripheral
D
What do miotic eyedrops do for a patient with glaucoma? a. Dilate the pupil and sharpen vision b. Lubricate and moisten the dry eye c. Irrigate the surface of the eye d. Constrict the pupil and open the canal of Schlemm
D
What does the cataract treatment of phacoemulsification involve? a. "Drying" the cataract with hypertonic saline b. Removing the lens through the anterior capsule c. The insertion of a new lens d. Breaking the cataract with ultrasound
D
What does the nurse know about the stroke patient who has expressive aphasia? a. Has difficulty comprehending spoken and written communication b. Cannot make any vocal sounds c. Has total loss and comprehension of language d. Can understand the spoken word, but cannot speak
D
What is the cardinal sign of increased intracranial pressure in a brain injured patient? a. Pupil changes b. Ipsilateral paralysis c. Vomiting d. Decrease in the level of consciousness
D
What is the cranial nerve that supplies most of the organs in the thoracic and abdominal cavities and also carries motor fibers to glands that produce digestive juices and other secretions? a. Somatic motor nerve b. Visceral sensory nerve c. Abducens nerve d. Vagus nerve
D
What is the nurse assessing when asking the patient, "Who is the president of the United States?" during a level of consciousness assessment? a. Orientation b. Memory c. Calculation d. Fund of knowledge
D
Which symptom is specific to migraine headaches? a. Tachycardia b. They become worse in the evening c. They involve the entire head d. They are preceded by an aura
D
Why are the drugs neostigmine (Prostigmin) and pyridostigmine (Mestinon) helpful to the person with myasthenia gravis? a. Improves speech b. Improves visual disturbances c. Reduces pain d. Promotes nerve impulse transmission
D
45. Arrange the process of the menstrual cycle in order of their function to produce menses. (Separate letters by a comma and space as follows: A, B, C, D) a. Egg matures in the graafian follicle b. Corpus luteum is formed from old follicle c. Estrogen from the maturing follicle causes vascularization of the uterine lining d. Anterior pituitary releases luteinizing hormone (LH), releasing the ovum e. Anterior pituitary releases follicle-stimulating hormone (FSH) f. Corpus luteum releases estrogen and progesterone g. Corpus luteum disintegrates causing a decrease in progesterone h. Lining of uterus is shed as menses
E, A, C, D, B, F, G, H
48. The nurse takes into consideration that a healing fracture progresses through several healing stages. Place the stages in order of healing. (Separate letters by a comma and space as follows: A, B, C, D) a. Development of fibrin meshwork b. Collagen fibers collect calcium c. Osteoblasts home fracture site form d. Callus e. Formation of hematoma f. Clot formation g. Vascularization
F, E, A, C, G, B, D
43. The division of the skeletal system that comprises the skull, hyoid, vertebral column, and thorax is the division.
axial
39. A is performed to evaluate living tissue to establish or confirm a diagnosis or to follow the course of a disease.
biopsy
40. The nurse is assisting the physician in removing a small sample of tissue from the patient's cervix to have it evaluated. This procedure is called a cervical .
conization
47. The nurse explains that the use of the brace allows a person with a cervical fracture to be mobile.
halo
44. A patient's patellar-femoral cartilage has deteriorated due to arthritis. The medial and lateral cartilage is undamaged. This patient is likely to undergo knee replacement surgery.
partial, unicompartmental
45. The emergency department nurse assesses the two cardinal signs of a hip fracture in a newly admitted patient, which are the of the injured leg and the rotation of that same leg.
shortening, external
44. When the veins in the scrotum become dilated, and the scrotum becomes enlarged and dilated, the condition is called a .
varicocele
43. An alternative remedy, _ , is used by men for the treatment of impotence.
yohimbine, Pausinystalia yohimbe yohimbine Pausinystalia yohimbe