NCSBSN Study Questions PART 6

A client admits to benzodiazepine dependence for several years. She is now in an outpatient detoxification program. The nurse must understand that a priority during withdrawal is A) avoiding alcohol use during this time B) observing the client for hypotension C) abrupt discontinuation of the drug D) assessing for mild physical symptoms

A

A client has been admitted with complaints of lower abdominal pain, difficulty swallowing, nausea, dizziness, headache and fatigue. The client is agitated, fearful, tachycardic and complains of being "too sick to return to work." The client is diagnosed as having somatoform disorder. In formulating a plan of care, the nurse must consider that the client's behavior A) is controlled by their subconscious mind B) is manipulative to avoid work responsibilities C) would respond to psychoeducational strategies D) could be modified through reality therapy

A

A client is admitted with low T3 and T4 levels and an elevated thyroid stimulating hormone (TSH) level. On initial assessment, the nurse would anticipate which of the following findings? A) Lethargy B) Heat intolerance C) Diarrhea D) Skin eruptions

A

A mother telephones the clinic and says "I am worried because my breast-fed 1 month-old infant has soft, yellow stools after each feeding." The nurse's best response would be which of these? A) "This type of stool is normal for breast fed infants. Keep doing as you have." B) "The stool should have turned to light brown by now. We need to test the stool." C) "Formula supplements might need to be added to increase the bulk of the stools." D) "Water should be offered several times each day in addition to the breast feeding."

A

A nurse aide is taking care of a 2 year-old child with Wilm's tumor. The nurse aide asks the nurse why there is a sign above the bed that says DO NOT PALPATE THE ABDOMEN? The best response by the nurse would be which of these statements? A) "Touching the abdomen could cause cancer cells to spread." B) "Examining the area would cause difficulty to the child." C) "Pushing on the stomach might lead to the spread of infection." D) "Placing any pressure on the abdomen may cause an abnormal experience."

A

A nurse arranges for a interpreter to facilitate communication between the health care team and a non-English speaking client. To promote therapeutic communication, the appropriate action for the nurse to remember when working with an interpreter is to A) promote verbal and nonverbal communication with both the client and the interpreter B) speak only a few sentences at a time and then pause for a few moments C) plan that the encounter will take more time than if the client spoke English D) ask the client to speak slowly and to look at the person spoken to

A

A nurse has asked a second staff nurse to sign for a wasted narcotic, which was not witnessed by another person. This seems to be a recent pattern of behavior. What is the appropriate initial action? A) Report this immediately to the nurse manager B) Confront the nurse about the suspected drug use C) Sign the narcotic sheet and document the event in an incident report D) Counsel the colleague about the risky behaviors

A

After successful alcohol detoxification, a client remarked to a friend, "I've tried to stop drinking but I just can't. I can't even work without having a drink." The client's belief that he needs alcohol indicates his dependence is primarily A) psychological B) physical C) biological D) social-cultural

A

Alcohol and drug abuse impairs judgment and increases risk taking behavior. What nursing diagnosis best applies? A) Risk for injury B) Risk for knowledge deficit C) Altered thought process D) Disturbance in self-esteem

A

During the initial physical assessment on a client who is a Vietnamese immigrant, the nurse notices small, circular, ecchymotic areas on the client's knees. The best action for the nurse to take is to A) Ask the client for more information about the nature of the bruises B) Ask the client and then the family about the findings C) Report the bruising to social services to follow-up D) Document the findings on the admission sheet

A

Following surgery for placement of a ventriculoperitoneal (VP) shunt as treatment for hydrocephalus, the parents question why the infant has a small abdominal incision. The best response by the nurse would be to explain that the incision was made in order to A) pass the catheter into the abdominal cavity B) place the tubing into the urinary bladder C) visualize abdominal organs for catheter placement D) insert the catheter into the stomach

A

In preparing medications for a client with a gastrostomy tube, the nurse should contact the health care provider before administering which of the following drugs through the tube? A) Cardizem SR tablet (diltiazem) B) Lanoxin liquid C) Os-cal tablet (calcium carbonate) D) Tylenol liquid (acetaminophen)

A

Parents of a 6 month-old breast fed baby ask the nurse about increasing the baby's diet. Which of the following should be added first? A) Cereal B) Eggs C) Meat D) Juice

A

The nurse is assessing a client in the emergency room. Which statement suggests that the problem is acute angina? A) "My pain is deep in my chest behind my breast bone." B) "When I sit up the pain gets worse." C) "As I take a deep breath the pain gets worse." D) "The pain is right here in my stomach area."

A

The nurse is assessing a healthy child at the 2 year check up. Which of the following should the nurse report immediately to the health care provider? A) Height and weight percentiles vary widely B) Growth pattern appears to have slowed C) Recumbent and standing height are different D) Short term weight changes are uneven

A

The nurse is caring for a pre-adolescent client in skeletal Dunlop traction. Which nursing intervention is appropriate for this child? A) Make certain the child is maintained in correct body alignment. B) Be sure the traction weights touch the end of the bed. C) Adjust the head and foot of the bed for the child's comfort D) Release the traction for 15-20 minutes every 6 hours PRN.

A

The nurse is caring for several hospitalized children with the following diagnoses. Which disorder is likely to result in metabolic acidosis? A) Severe diarrhea for 24 hours B) Nausea with anorexia C) Alternating constipation and diarrhea D) Vomiting for over 48 hours

A

The nurse is planning care for a 2 year-old hospitalized child. Which of the following will produces the most stress at this age? A) Separation anxiety B) Fear of pain C) Loss of control D) Bodily injury

A

The nurse is teaching diet restrictions for a client with Addison's disease. The client would indicate an understanding of the diet by stating A) "I will increase sodium and fluids and restrict potassium." B) "I will increase potassium and sodium and restrict fluids." C) "I will increase sodium, potassium and fluids." D) "I will increase fluids and restrict sodium and potassium."

A

What is the major developmental task that the mother must accomplish during the first trimester of pregnancy? A) Acceptance of the pregnancy B) Acceptance of the termination of the pregnancy C) Acceptance of the fetus as a separate and unique being D) Satisfactory resolution of fears related to giving birth

A

When counseling a 6 year-old who is experiencing enuresis, what must the nurse understand about the pathophysiological basis of this disorder? A) It has no clear etiology B) Enuresis may be associated with sleep phobia C) It has a definite genetic link D) Enuresis is a sign of willful misbehavior

A

When providing nursing measures to relieve a 102-degree Fahrenheit fever in a toddler with an infection, what is the most effective intervention? A) Use medications to lower the temperature set point B) Apply extra layers of clothing to prevent shivering C) Immerse the child in a tub containing cool water D) Give a tepid sponge bath prior to giving an antipyretic

A

Which statement describes the advantage of using a decision grid for decision making? A) It is both a visual and a quantitative method of decision making B) It is the fastest way for group decision making C) It allows the data to be graphed for easy interpretation D) It is the only truly objective way to make a decision in a group

A

Which type of traction can the nurse expect to be used on a 7 year-old with a fractured femur and extensive skin damage? A) Ninety-ninety B) Buck's C) Bryant D) Russell

A

While caring for a toddler with croup, which initial sign of croup requires the nurse's immediate attention? A) Respiratory rate of 42 B) Lethargy for the past hour C) Apical pulse of 54 D) Coughing up copious secretions

A

A child is sent to the school nurse by a teacher who has a written note that fifth disease is suspected. Which characteristic would the nurse expect to find? A) Macule that rapidly progresses to papule and then vesicles B) Erythema on the face, primarily on cheeks giving a "slapped face" appearance C) Discrete rose pink macules will appear first on the trunk and fade when pressure is applied D) Koplik spots appear first followed by a rash that appears first on the face and spreads downward

B

A client calls the nurse with a complaint of sudden deep throbbing leg pain. What is the appropriate first action by the nurse? A) Suggest isometric exercises B) Maintain the client on bed rest C) Ambulate for several minutes D) Apply ice to the extremity

B

A client refuses to take the medication prescribed because the client prefers to take self-prescribed herbal preparations. What is the initial action the nurse should take? A) Report the behavior to the charge nurse B) Talk with the client to find out about the preferred herbal preparation C) Contact the client's primary care provider D) Explain the importance of the medication to the client

B

A new nurse manager is seeking a mentor in the administrative realm. Which of these characteristics is a priority for the outcome of a positive experience with a mentor? A) Information is clarified as needed B) A teacher-coach role is taken by the mentor C) The mentee accepts feedback objectively D) The mentor is randomly assigned by administration

B

A nurse has just received a medication order which is not legible. Which statement best reflects assertive communication? A) "I cannot give this medication as it is written. I have no idea of what you mean." B) "Would you please clarify what you have written so I am sure I am reading it correctly?" C) "I am having difficulty reading your handwriting. It would save me time if you would be more careful." D) "Please print in the future so I do not have to spend extra time attempting to read your writing."

B

A nurse manager considers changing staff assignments from 8 hour shifts to 12 hour shifts. A staff-selected planning committee has approved the change, yet the staff are not receptive to the plan. As a change agent, the nurse manager should first A) support the planning committee and post the new schedule B) explore how the planning committee evaluated barriers to the plan C) design a different approach to deliver care with fewer staff D) retain the previous staffing pattern for another 6 months

B

An ambulatory client reports edema during the day in his feet and ankles that disappears while sleeping at night. What is the most appropriate follow-up question for the nurse to ask? A) "Have you had a recent heart attack?" B) "Do you become short of breath during your normal daily activities?" C) "How many pillows do you use at night to sleep comfortably?" D) "Do you smoke?"

B

Dual diagnosis indicates that there is a substance abuse problem as well as a A) cross addiction B) mental disorder C) disorder of any type D) medical problem

B

Hospital staff requests that the parents with a Greek heritage of a hospitalized infant remove the amulet from around the child's neck. The parents refuse. The nurse understands that the parents may be concerned about A) mental development delays B) evil eye or envy of others C) fright from spiritual beings D) balance in body systems

B

The emergency room nurse admits a child who experienced a seizure at school. The parent comments that this is the first occurrence and denies any family history of epilepsy. What is the best response by the nurse? A) "Do not worry. Epilepsy can be treated with medications." B) "The seizure may or may not mean your child has epilepsy." C) "Since this was the first convulsion, it may not happen again." D) "Long term treatment will prevent future seizures."

B

The nurse auscultates bibasilar inspiratory crackles in a newly admitted 68 year-old client with a diagnosis of congestive heart disease. Which other finding is most likely to occur? A) Chest pain B) Peripheral edema C) Nail clubbing D) Lethargy

B

The nurse is assigned to care for a client newly diagnosed with angina. As part of discharge teaching, it is important to remind the client to remove the nitroglycerine patch after 12 hours in order to prevent what condition? A) Skin irritation B) Drug tolerance C) Severe headaches D) Postural hypotension

B

The nurse is caring for a depressed client with a new prescription for a selective serotonin reuptake inhibitor (SSRI) antidepressant. In reviewing the admission history and physical, which of the following should prompt questions about the safety of this medication? A) History of obesity B) Prescribed use of a monoamine oxidase (MAO) inhibitor C) Diagnosis of vascular disease D) Takes antacids frequently

B

The nurse is caring for several 70 to 80 year-old clients on bed rest. What is the most important measure to prevent skin breakdown? A) Massage legs frequently B) Frequent turning C) Moisten skin with lotions D) Apply moist heat to reddened areas

B

The nurse sees a substance abusing client occasionally in the outpatient clinic. In evaluating the client's progress, the nurse recognizes that the most revealing resistant behavior is A) recurring crises B) continuing drug use C) rationalizing comments D) missing appointments

B

The nurse will administer liquid medicine to a 9 month-old child. Which of the following methods is appropriate? A) Allow the infant to drink the liquid from a medicine cup B) Administer the medication with a syringe next to the tongue C) Mix the medication with the infant's formula in the bottle D) Hold the child upright and administer the medicine by spoon

B

Which statement by a parent would alert the nurse to assess for iron deficiency anemia in a 14 month-old child? A) "I know there is a problem since my baby is always constipated." B) "My child doesn't like many fruits and vegetables, but she really loves her milk." C) "I can't understand why my child is not eating as much as she did 4 months ago." D) "My child doesn't drink a whole glass of juice or water at 1 time."

B

Which statement describes factors that help build personal power in an organization? A) Longevity in an organization, social ties to people in power, and a history as someone who does not back down in conflict ends with success B) Goals are met with the use of networking, mentoring, and coalition building C) High visibility and formal power are maintained with a confrontational style D) Credibility to one's position is enhanced when professional dress and demeanor are employed

B

While working with an obese adolescent, it is important for the nurse to recognize that obesity in adolescence is most often associated with what other finding? A) Sexual promiscuity B) Poor body image C) Dropping out of school D) Drug experimentation

B

A 35 year-old client with sickle cell crisis is talking on the telephone but stops as the nurse enters the room to request something for pain. The nurse should A) administer a placebo B) encourage increased fluid intake C) administer the prescribed analgesia D) recommend relaxation exercises for pain control

C

A 6 year-old child diagnosed with acute glomerulonephritis (AGN) is experiencing anorexia, moderate edema and elevated blood urea nitrogen (BUN) levels. The child requests a peanut butter sandwich for lunch. What would the nurse's best response to this request? A) "That's a good choice, and I know it is your favorite. You can have it today." B) "I'm sorry, that is not a good choice, but you could have pasta." C) "I know that is your favorite, but let me help you pick another lunch." D) "You cannot have the peanut butter until you are feeling better."

C

A client with bipolar disorder is reluctant to take lithium (Lithane) as prescribed. The most therapeutic response by the nurse to his refusal is A) "You need to take your medicine, this is how you get well." B) "If you refuse your medicine, we'll just have to give you a shot." C) "What is it about the medicine that you don't like?" D) "I can see that you are uncomfortable right now, I'll wait until tomorrow."

C

A client with considerable pain asks, "What is your opinion regarding acupuncture as a drug-free method for alleviating pain?" The nurse responds, "I'd forget about it as those weird non-Western treatments can be scary." The nurse's response is an example of A) prejudice B) discrimination C) ethnocentrism D) cultural insensitivity

C

A mother calls the clinic, concerned that her 5 week-old infant is "sleeping more than her brother did." What is the best initial response? A) "Do you remember his sleep patterns?" B) "How old is your other child?" C) "Why do you think this a concern?" D) "Does the baby sleep after feeding?"

C

A nurse and client are talking about the client's progress toward understanding his behavior under stress. This is typical of which phase in the therapeutic relationship? A) Pre-interaction B) Orientation C) Working D) Termination

C

A nurse is eating in the hospital cafeteria when a toddler at a nearby table chokes on a piece of food and appears slightly blue. The appropriate initial action should be to A) begin mouth to mouth resuscitation B) give the child water to help in swallowing C) perform 5 abdominal thrusts D) call for the emergency response team

C

A victim of domestic violence states, "If I were better, I would not have been beat." Which feeling best describes what the victim may be experiencing? A) Fear B) Helplessness C) Self-blame D) Rejection

C

Delirium tremens could best be described as A) disorganized thinking, feelings of terror and non-purposeful behavior B) a generalized shaking of the body accompanied by repetitive thoughts C) an excited state accompanied by disorientation, hallucination and tachycardia D) single or multiple jerks caused by rapid contracting muscles

C

In planning care for a 6 month-old infant, what must the nurse provide to assist in the development of trust? A) Food B) Warmth C) Security D) Comfort

C

The nurse is assessing the mental status of a client admitted with possible organic brain disorder. Which of these questions will best assess the functioning of the client's recent memory? A) "Name the year." "What season is this?" (pause for answer after each question) B) "Subtract 7 from 100 and then subtract 7 from that." (pause for answer) "Now continue to subtract 7 from the new number." C) "I am going to say the names of three things and I want you to repeat them after me: blue, ball, pen." D) "What is this on my wrist?" (point to your watch) Then ask, "What is the purpose of it?"

C

The nurse is caring for a client with COPD who becomes dyspneic. The nurse should A) instruct the client to breathe into a paper bag B) place the client in a high Fowler's position C) assist the client with pursed lip breathing D) administer oxygen at 6L/minute via nasal cannula

C

The nurse is caring for a client with a deep vein thrombosis. Which finding would require the nurse's immediate attention? A) Temperature of 102 degrees Fahrenheit B) Pulse rate of 98 beats per minute C) Respiratory rate of 32 D) Blood pressure of 90/50

C

The nurse is caring for several hospitalized children with the following diagnoses. Which disorder is likely to result in metabolic acidosis? A) Severe diarrhea for 24 hours B) Nausea with anorexia C) Alternating constipation and diarrhea D) Vomiting for over 48 hours

C

The nurse is discussing negativity with the parents of a 30 month-old child. How should the nurse tell the parents to best respond to this behavior? A) Reprimand the child and give a 15 minute "time out" B) Maintain a permissive attitude for this behavior C) Use patience and a sense of humor to deal with this behavior D) Assert authority over the child through limit setting

C

The nurse is planning care for a client during the acute phase of a sickle cell vaso-occlusive crisis. Which of the following actions would be most appropriate? A) Fluid restriction 1000cc per day B) Ambulate in hallway 4 times a day C) Administer analgesic therapy as ordered D) Encourage increased caloric intake

C

The nurse is talking by telephone with a parent of a 4 year-old child who has chickenpox. Which of the following demonstrates appropriate teaching by the nurse? A) Chewable aspirin is the preferred analgesic B) Topical cortisone ointment relieves itching C) Papules, vesicles, and crusts will be present at one time D) The illness is only contagious prior to lesion eruption

C

The nurse is teaching a client with metastatic bone disease about measures to prevent hypercalcemia. It would be important for the nurse to emphasize A) the need for at least 5 servings of dairy products daily B) restriction of fluid intake to less than 1 liter per day C) the importance of walking as much as possible D) early recognition of findings associated with tetany

C

The nurse should initiate discharge planning for a client A) when the client or family demonstrate readiness to learn self care modalities B) when informed that a date for discharge has been determined C) upon admission to a hospital unit or the emergency room D) when the client's condition is stabilized on the assigned unit

C

The parents of a 2 year-old child report that he has been holding his breath whenever he has temper tantrums. What is the best action by the nurse? A) Teach the parents how to perform cardiopulmonary resuscitation B) Recommend that the parents give in when he holds his breath to prevent anoxia C) Advise the parents to ignore breath holding because breathing will begin as a reflex D) Instruct the parents on how to reason with the child about possible harmful effects

C

A 24 year-old male is admitted with a diagnosis of testicular cancer. The nurse would expect the client to have A) scrotal discoloration B) sustained painful erection C) inability to achieve erection D) heaviness in the affected testicle

D

A client with a history of heart disease takes prophylactic aspirin daily. The nurse should monitor which of the following to prevent aspirin toxicity? A) Serum potassium B) Protein intake C) Lactose tolerance D) Serum albumin

D

A diabetic client asks the nurse why the provider ordered a glycosylated hemoglobin (HbA) measurement, since a blood glucose reading was just performed. You will explain to the client that the HbA test: A) Provides a more precise blood glucose value than self-monitoring B) Is performed to detect complications of diabetes C) Measures circulating levels of insulin D) Reflects an average blood sugar for several months

D

A nurse admits a 3 week-old infant to the special care nursery with a diagnosis of bronchopulmonary dysplasia. As the nurse reviews the birth history, which data would be most consistent with this diagnosis? A) Gestational age assessment suggested growth retardation B) Meconium was cleared from the airway at delivery C) Phototherapy was used to treat Rh incompatibility D) The infant received mechanical ventilation for 2 weeks

D

A nurse is caring for a client with peripheral arterial insufficiency of the lower extremities. Which intervention should be included in the plan of care to reduce leg pain? A) elevate the legs above the heart B) increase ingestion of caffeine products C) apply cold compresses D) lower the legs to a dependent position

D

During the two-month well-baby visit, the mother complains that formula seems to stick to her baby's mouth and tongue. Which of the following would provide the most valuable data for nursing assessment? A) Inspect the baby's mouth and throat B) Obtain cultures of the mucous membranes C) Flush both sides of the mouth with normal saline D) Use a soft cloth to attempt to remove the patches

D

The most common reason for an Apgar score of 8 and 9 in a newborn is an abnormality of what parameter? A) Heart rate B) Muscle tone C) Cry D) Color

D

The nurse is caring for a client with a pressure ulcer on the heel that is covered with black hard tissue. Which would be an appropriate goal in planning care for this client? A) Protection for the granulation tissue B) Heal infection C) Debride eschar D) Keep the tissue intact

D

The nurse is providing instructions for a client with pneumonia. What is the most important information to convey to the client? A) "Take at least 2 weeks off from work." B) "You will need another chest x-ray in 6 weeks." C) "Take your temperature every day." D) "Complete all of the antibiotic even if your findings decrease."

D

The nurse is speaking to a group of parents and elementary school teachers about care for children with rheumatic fever. It is a priority to emphasize that A) home schooling is preferred to classroom instruction B) children may remain strep carriers for years C) most play activities will be restricted indefinitely D) clumsiness and behavior changes should be reported

D

The nursing care plan for a toddler diagnosed with Kawasaki disease (mucocutaneous lymph node syndrome) should be based on the high risk for development of which problem? A) Chronic vessel plaque formation B) Pulmonary embolism C) Occlusions at the vessel bifurcations D) Coronary artery aneurysms

D

To obtain data for the nursing assessment, the nurse should: A) observe carefully the client's nonverbal behaviors B) adhere to pre-planned interview goals and structure C) allow clients to talk about whatever they want D) elicit clients' description of their experiences, thoughts and behaviors

D

What is the most important consideration when teaching parents how to reduce risks in the home? A) Age and knowledge level of the parents B) Proximity to emergency services C) Number of children in the home D) Age of children in the home

D

Which of the following should the nurse obtain from a client prior to having electroconvulsive therapy (ECT)? A) Permission to videotape B) Salivary pH C) Mini-mental status exam D) Pre-anesthesia work-up

D