NUR 227 Practice Exam Questions

Following instruction for a patient with newly diagnosed systemic lupus erythematosus (SLE), the nurse determines that teaching about the disease has been effective when the patient says,

"I need to restrict my exposure to sunlight to prevent as acute onset of sensitivity"

A client come into the health clinic 3 years after undergoing a resection of the terminal ileum and partial gastrectomy complaining of weakness, shortness of breath, and sore tongue. Which client statement indicates a need for intervention and teaching?

"I take a Vitamin B tablet everyday"

A male client with type 1 DM has a highly elevated glycosylated hemoglobin (a1c) test result. In discussing the result with the client, the RN would be most accurate in stating:

"It tells us about your sugar control for the past 3 months"

You assess you patient's skin and see hard, lumpy area in the abdominal sub-q tissue. What do you tell the patient?

"Rotate injection sites a bit more frequently"

Your. patient who has been living with HIV for 3 years bring their new partner in to talk about transmission risk. The patient's viral load has been undetectable for 1.5 years, and this is confirmed in the most recent lab values. What advice do you have for the patient and their partner?

"When someone is undetectable, that cannot sexually pass the virus to another person"

Which statement by the nurse regarding a1c of 13% testing requires follow up?

"With such a high a1c, we'll test the a1c every month to monitor progress of treatment"

The RN is caring for a female with type 1 DM who exhibits confusion, light-headedness, and aberrant behavior. The client is still conscious. The nurse should first administer:

15-20g of fast acting carbohydrate like orange juice

You patient has hyperglycemia every morning. You suspect somogyi effect. What best supports this suspicion?

3am blood sugar of 45

An RN received the change-of-shirt report about these clients. Which client does the nurse assess first?

75-year-old with demential who is receiving NG feeding and has a respiratory rate fo 38 breaths/minute

The pernicious anemia that may accompany gastritis is due to

A lack of intrinsic factor normally produced by acid secreting cells of the gastric mucosa

Which patient would benefit from a nasogastric tube?

A stroke victim who failed the swallow test

The nurse working at the Central Kentucky Blood Center is educating high school student about ABO typing. If the patient has A+ blood type, which blood types can he receive during a transfusion?

A- A+ O- O+

Which fo the following compatibility situations is most likely? A patient who is:

AB+ and receives B- will do fine

After undergoing a transurethral resection of the prostate to treat BPH, a patient is returned to the room with continuous bladder irrigation in place. One day later, the patient reports bladder pain. What should the nurse do first?

Assess the irrigation catheter for latency and drainage

A 58-year-old female is experiencing a flare-up with RA. While assisting the patient with her morning routine, the patient verbalizes a pain rating of 7/10 in the right and left wrist along with severe stiffness. You not the joints to be red, warm, and swollen. What non-pharmalogical nursing intervention can you provide to this patient to help alleviate pain and stiffness? SATA

Assist the patient with a warm shower and bath Assist the patient with applying wrist splints

Arya arrives for her urgent care appointment and appreciates when the assistant at the front desk asks for the name she goes by and her pronouns (Arya and she/her/hers). She is disappointed later, however, when the nurse asks if she "has a boyfriend" while taking a sexual health history. What did the provider do incorrectly?

Assuming Arya is in a monogamous relationship with a male partner

A patient needs 2 units of PRBC. The patient is types and cross-matched. The patient has B+ blood. As the nurse you know the patient can receive what blood? SATA

B- B+ O- O+

A 23-year-old female client was in an automobile accident and is now a paraplegic. She is on an intermittent urinary catheter program and diet as tolerated. The nurse's priority assessment should be to observe for:

Bladder distension

When a client is diagnosed with aplastic anemia, the nurse monitors for changes in which of the following physiological functions?

Bleeding tendencies

Your patient has a history of hypertension and Type 2 DM for 10 years. He presents with altered LOC, hemiplegia, and aphasia. The team suspects stroke. Which assessment finding's helps support the medical team in ruling out DKA and HHDT? SATA

Blood sugar result of 170 No evidence of fruity breath smell No glucose present in urine

A client with macrocytic anemia has a burn on her foot and states that she had been eating TV while lying on a heating pad. What is the nurse's first response?

Check for diminished senses

Within the free clinic where you practice nursing, you hold weekly sexual education classes open to the public. Within the classroom, you communicate the CDC's numbers for the incidence of STIs and their impact upon public health. Which is the fastest-spreading bacterial STI in the United States?

Chlamydia

Recent blood sugar assessments have validated that the patient with Type 1 DM consistently experiences Somogyi Effect. What related nursing action can the nurse anticipate implementing?

Decrease the insulin dose regimen

A 26-year-old woman has been diagnosed with early SLE involving her joint. In teaching the patient about the disease, the nurse includes the information that SLE is

Disorder of immune function, but it is extremely variable in its course and there is no way to predict its progression

A client is admitted to the hospital with BPH, the nurse most relevant assessment would be

Distention of the bladder

The RN is discharging a patient after interventions were done to stop a bleeding episode from a duodenal ulcer. They were prescribed PO iron and a follow up in 1 month. Which fingers should they teacher the patient to report to the provider immediately after discharged?

Dizziness Decreased urine output Tarry stool

A nurse is caring for a client requiring surgery and is ordered to have a standby blood secured in case a blood transfusion is needed during our after the procedure. The nurse suggests to the client to do which of the following to lessen the risk of possible transfusion reaction?

Do an autologous blood donation

The nurse if preparing a discharge teaching plan for the male client who had umbilical hernia repair. What should the nurse include in the plan?

Drain/wound management

A nurse is caring for a client diagnosed with chlamydia infection. The nurse teaches the client about disease transmission and advises the client to inform his sexual partners of the infection. The client refuses, stating "This is my business and I'm not telling anyone. Besides, chlamydia doesn't cause any harm like other STDs" How should the nurse proceed?

Educate the client about why it's important to inform sexual contacts so they can receive treatment

You're developing a nursing care plan for a patient with count present in the right foot. What specific nursing interventions will you include in this patient's plan of care? SATA

Encourage fluid intake of 2-3 L per day Place patient's right foot in a foot board while the patient is in bed Apply alternating cold and warm compresses to right foot as tolerated by the patient daily

Your patient is 2 hours post-op from a cast placement on the right leg. The patient has family in the room. Which action by the SO requires you to reeducate the patient and family about cast care?

Gently using the fingertips of the hand to move the cast every 2 hours to help with drying

A client in the PACU with a left BTK amputation complains of pain in her left big toe. Which of the following would the nurse do first?

Give the client the prescribed narcotic analgesic

You are providing car to a patient with severe RA. While performing a head-to-toe assessment, you note the patient's overall skin color to be pale and the patient looks exhausted. You ask the patient how she is feeling, and she says "I'm so tired. I can't even get out of bed without getting short of breath." Which finding on the patient's morning lab work may confirm a complication that can be experienced with RA?

Hemoglobin 7 g/dL

You're explaining a group of outpatients about the signs and symptoms that may present with osteoarthritis. SATA

Herberden's Nodes Morning stiffness for less than 30 minutes Hard and bony joints Crepitus Bouchard's nodes

When providing discharge teaching for a client with uric acid calculi, the nurse should provide an instruction to avoid which type of diet?

High-purine

Kevin has a history of peptic ulcer disease and vomits coffee-ground emesis. What does this indicate?

His gastric bleeding occurred at least 2 hours prior

Which statement by the patient requires follow up by the nurse?

I'll make sure to check my blood sugar at the peak of my Lantus dose to avoid hypoglycemia

An 85 year old patient has an accidental fall while going to the bathroom without assistance. It appears the patient has sustained a bone fracture to the left leg. The patient's shape is deformed and the patient is unable to move it. The patient is alert and oriented but in pain. What will you do FIRST after confirming the patient is safe and stable?

Immobilize the fracture with a splint

A nurse is caring for an anemia patient receiving fresh frozen plasma, which outcomes best support the use of FFP in a patient? SATA

Improved clotting factors Effective cardiac output

The patient is admitted with facial trauma, including a broken nose, and has a history of gastric reflux. Which tube will the nurse anticipate being placed in the patient for feeding?

Jejunostomy tube

The provider notified the RN that the patient has anemia labs that designate the anemia as microcytic and hypo chromic. What does this mean? SATA

Low hemoglobin Low MCV Low MHCH

What is the monofilament test used for?

Maps sensation deficits in foot

A client has been vomiting and has had numerous episodes of diarrhea. Lab results indicate his serum K+ is 3.3mEq/L and serum sodium is 127 mEq/L. Which order can the nurse anticipate from the HCP? SATA

Monitor level of consciousness frequently Monitor for cardiac arrhythmia Monitor of electrolyte labs

While caring for a client with peptic ulcer disease, the client reports that he has been nauseated most of the day and is now feeling lightheaded and dizzy. Based upon these finding, which nursing actions would be most appropriate for the nurse to take? SATA

Monitoring the VS Notifying the provider of the client's symptoms

A patient is in balanced-suspension using a Thomas splint with a Pearson attachment that suspend the lower extremity and applies direct skeletal traction for a hip fracture. Which of the following assessments done by the nursing student should the nurse instructor question?

Neurovascular checks proximal to the splint

Your patient is anemia and complaining of shortness of air and dizziness. You have an order to transfuse 2u PRBC stat. Which of the following are appropriate in preparation got this procedure? SATA

Obtain consent from the client Teach patient to report S/S of transfusions reactions immediately Transfuse the blood within a 4 hour timeframe to minimize bacterial overgrowth

A patient with a peptic ulcer who has an NG tube to wall suction develops sudden, severe abdominal pain, diaphoresis, and a raid and board-like abdomen. Which action should the nurse take next?

Obtain vital signs

The hospitalized patient with GERD is complaining of chest discomfort that feels like heartburn following a meal. After administering an ordered antacid, the nurse encouraged the client to lie in which of the following positions?

On the left side with the head of the bed elevated 30 degrees

While caring for a client which a newly applied plaster of Paris cast, the nurse makes note of all the following conditions. Which assessment finding require immediate notification of the physician?

Onset of paralysis in the toes of the casted foot

A nurse is changing a central line dressing on a client receiving TPN and notes that there are redness and drainage at the insertion site. The nurse next assesses which of the following?

Patient's temp

A 55-year-old female arrives in the ER with a right leg fracture. An x-ray is performed and shows a closed tibia fracture. A closed reduction is performed and a cast is put in place. The patient is ordered Morphine 4mg IV every 4-6 hours as needed for pain. The patient calls on the call light to tell you the pain medication is not working at all and that it even hurts to slightly stretch the leg. What is your response to this statement by the patient. SATA

Perform neuromuscular checks Elevate the leg above heart level Loosen and remove restrictive items Notify the physician

Your patient with peritonitis is NPA and complaining of thirst. What is your priority?

Provide frequent mouth care

The major rationale for the use of acetylsalicylic acid (aspirin) in the treatment of rheumatoid arthritis is to:

Reduce the inflammation fo the joints

The nurse is caring for a client who had an ATK amputation 2 days ago. The residual limp was wrapped with elastic compression bandage which has come off. The nurse immediately

Rewrap the stump with an elastic compression bandage

A patient getting a blood transfusion reports the following symptoms after 10 minutes: back pain, facial flushing, fever, dyspnea. Which interventions are most appropriate? SATA

Send unit, filter, and tubing to lab Obtain first voided urine Monitor strict I/O Monitor VS and patient for symptoms of shock

You are concerned about preventing the gastrointestinal distress associated with enteral feedings. Which choices are most appropriate? SATA

Sit the patient up at least 45 degrees Ambulate the patient frequently Assess bowel sounds at least every 4 hours

Your patient reports sudden onset of dyspnea, coach, and a bounding headache during a blood transfusion. Which interventions are most appropriate? SATA

Slow or stop transfusion Administer diuretic Expect order for chest X-ray Notify provider

Which diagnostic finding suggest the patient has experienced microvasular complications resulting from chronic DM? SATA

Snellen chart result change from 20/20 to 20/40 Creatinine: 2.1 Abnormal monofilament test

The nurse is teaching a client with secondary polycythemia about potential complications of this disease. Which manifestations would the nurse teach the patient to report immediately and go to the emergent department? SATA

Sore, reddened calf Chest pressure Facial droop

Aldedronate (Fosamax) is given to a client with osteoporosis. The nurse advises the client to:

Take the medication with a glass of water after rising in the morning

You are making room assignment for a newly admitted client who laboratory testing indicated pancytopenia as a result of Aplastic Anemia. All of these clients are already on the nursing unit. Which one will be the best roommate for the new client?

The client with fluid volume overload

A new RN is prepared to administer PRBCs to a client whose anemia was caused by blood loss after surgery. Which action by the new RN requires you, as a charge nurse, to intervene immediately?

The new Rn primes the transfusion set up using 5% dextrose in lactated Ringer's solution

The patient suffered a fractured femur. Which of the following would you tell the nursing assistant to report immediately?

The patient appears confused

Which assessment finding found while assessing a patient with a fracture who has traction requires immediate intervention?

The weights are freely resting on the floor

A patient has an acute upper GI hemorrhage. Your interventions include:

Treating hypovolemia

Select all that apply: Risk factors for development of diabetes type 2?

Waist > 40 inches Family history Hypertension Had gestational diabetes in 1st pregnancy

What are good/accurate teaching points for diabetic foot care? SATA

Wear clean, absorbent socks Report infections ASAP Use lanolin for cracked heels

The nurse is monitoring a female client with a diagnosis of peptic ulcer. Which assessment finding would most likely indicate perforation of the ulcer?

a rigid, board-like abdomen

Which of the following would lead the nurse to suspect that a client with a fracture of the right femur may be developing a fat embolus?

acute respiratory distress syndrome

When taking a health history, the nurse screens for manifestations suggestive of Diabetes Type 1. Which of the following manifestations are considered the primary manifestations of Diabetes Type 1 and would be most suggestive and require follow-up investigation?

an increase in three areas: thirst, intake of water, hunger

The RN is preparing to administer medication through a nasogastric tube that is connected to suction. To administer the medication, the nurse would:

change the suction setting to low intermittent suction for 30 minutes after medication administration

Mr. Wesley is newly diagnosed with Type I DM and is being seen by the home health nurse. The doctors orders include: 1200 calorie ADA diet, 15 units NPH insulin before breakfast, and check blood sugar qid. When the nurse visits the patient at 5 pm, the nurse observes the man performing blood sugar analysis. The result is 50 mg/dL. The nurse would expect the patient to be

confused with cold, clammy skin and a pulse of 110

A patient received 6 units of regular insulin 3 hours ago. The nurse would be MOST concerned if which of the following was observed?

diaphoresis and trembling

On a visit to the clinic, a client reports the onset of early symptoms of RA. Which of the following would be the nurse most likely to assess?

early morning stiffness

Which of the following is caused by a B-12 deficiency?

glossitis

Your patient has an a1c of 6.0% and has a waist of 40 inches. What is your priority teaching?

lifestyle modifications

Clients with Type 1 DM may require which of the following changes to their daily routine during periods of infection?

more insulin

The Rn is teaching the patient and family that peptic ulcers are:

promoted by a combination of factors that may result in erosion of the gastric mucosa, including certain drug and alcohol

A client is suspected of having SLE. The nurse monitors the client, knowing that which of the following is one of the initial characteristic signs of SLE?

rash on the face across the bridge of the nose