NURS 327- Exam 1

A patient has a serum osmolality of 250 mOsm/kg. The nurse knows to assess further for:

Hyponatremia.

A client who has developed a painless penile ulcer is diagnosed with syphilis. What treatment would physician prescribe?

IV penicillin G; single dose

The nurse is caring for a female client who has been diagnosed with Neisseria gonorrhoeae. The nurse is aware that if this client had not received treatment, what other serious issues could have resulted from this disease? Select all that apply.

Increased risk of HIV infection Infection and scarring of the Fallopian tubes Eye infection in an infant born to a woman with this disease

When preparing a presentation for a group of senior citizens, which vaccine would the nurse recommend that this age group receive annually?

Influenza

Which intervention is most appropriate for a client with an arterial blood gas (ABG) of pH 7.5, a partial pressure of arterial carbon dioxide (PaCO2) of 26 mm Hg, oxygen (O2) saturation of 96%, bicarbonate (HCO3-) of 24 mEq/L, and a PaO2 of 94 mm Hg?

Instruct the client to breathe into a paper bag.

A patient presents with vulvar itching and diffuse green vaginal discharge. Upon evaluation, she is prescribed metronidazole (Flagyl). What is the paramount nursing intervention in discharge planning?

Instruct the patient not to drink alcohol with this treatment.

When caring for a client who has risk factors for fluid and electrolyte imbalances, which assessment finding is the highest priority for the nurse to follow up?

Irregular heart rate

The nurse is seeing a client who has a pelvic infection. The client is upset and states, "I have been in a monogamous sexual relationship for 5 years, how is this possible?" Which questions should the nurse ask to be able to rule out sexual transmission of this infection? Select all that apply.

"Do you have an intrauterine device inserted?" "Have you and your partner ever discussed your sexual health histories?" "Do you have Pap smears on a regular basis?" "Did you have the human papillomavirus vaccination before you were 26 years old?"

The nurse is discussing information regarding the human papilloma viral (HPV) infection. Which statement, made by the client, requires clarification?

"HPV is spread during sexual intercourse."

The nurse is instructing the family on home care of a client with shingles. The family member asks whether their teenage children should stay in a different room. What is the best response by the nurse?

"Have they had chickenpox or the varicella vaccine?"

The parent of a child diagnosed with chickenpox asks when the child can go to play group again. What is the best response by the nurse?

"When the vesicles and pustules have crusted."

Malignant hyperthermia usually manifests about how many minutes after the induction of anesthesia?

10 to 20 minutes

The usual incubation period (from infection to first symptom) for hepatitis B is

45 to 160 days.

The nurse is instructing a client with herpes simplex virus type 2 (HSV-2) about self-care and precautions. Which instruction would not be included in this client education session?

A condom does not need to be used during sexual activity if the disease is dormant.

Which of the following measurable urine outputs indicates the client is maintaining adequate fluid intake and balance?

A patient with a minimal urine output of 30 mL/hour

The nurse is assessing a client who states having had "unusual aches" in the muscles and joints. On physical examination, the nurse notes the client has rough, reddish-brown spots on the palms and the soles of the feet. The client reports being infected with a "cold sore" from her partner 1 month ago. What should the nurse anticipate will be the next step in this client's care?

A prescription for a nontreponemal test (NTT)

A family will be staying in a cabin by a lake and, upon arriving, observes rodent droppings on the floor in the kitchen. What is the best way for the family to clean up in order to avoid contracting hantavirus from the feces?

Apply a bleach solution prior to sweeping or vacuuming the floor.

The nurse educator is teaching a group of young adult women about sexually transmitted infections. The nurse explains that which infection is most likely to be "silent" with no overt symptoms in women?

Chlamydia

Which electrolyte is a major anion in body fluid?

Chloride

The nurse is assisting the anesthesiologist with the insertion of an epidural catheter and the administration of an epidural opioid for pain control. What adverse effect of epidural opioids should the nurse monitor for?

Bradypnea

A nurse is caring for a client in the clinic. Which sign or symptom may indicate that the client has gonorrhea?

Burning on urination

The nurse is caring for a client being treated with isotonic IV fluid for hypernatremia. What complication of hypernatremia should the nurse continuously monitor for?

Cerebral edema

When preparing a teaching presentation regarding reproductive health in women, which points should the nurse include when discussing the prevention of bacterial vaginosis? Select all that apply.

Choose clothing options that are loose around the genital area If you smoke, try to quit Keep the frequency of your sexual activity balanced Prevent unprotected sexual encounters

A client presents with severe diarrhea and a history of chronic renal failure to the emergency department. Arterial blood gas results are as follows:pH 7.30 PaO2 97 PaCO2 37 HCO3 18 The nurse would expect which of the following sets of assessment findings?

Clammy skin, blood pressure 86/46, headache

Which term is used to describe microorganisms present in a host without host interference or interaction?

Colonization

Upon shift report, the nurse states the following laboratory values: pH, 7.44; PCO2, 30mmHg; and HCO3,21 mEq/L for a client with noted acid-base disturbances. Which acid-base imbalance do both nurses agree is the client's current state?

Compensated respiratory alkalosis

The following outcome appears on the plan of care for a client with genital herpes: "Client demonstrates knowledge about measures to reduce the risk of transmission and recurrences." Which of the following, if reported by the client, would support achievement of this outcome?

Consistently uses condoms with sexual activity

The nurse recognizes what groups of people are at an increased risk for infection? Select all that apply.

Debilitated clients Older adults Clients with impaired skin

The nurse is caring for a patient with a meningococcus infection. What type of precautions should be used for this patient?

Droplet

Before seeing a newly assigned client with respiratory alkalosis, a nurse quickly reviews the client's medical history. Which condition is a predisposing factor for respiratory alkalosis?

Extreme anxiety

The nurse educator is discussing pathogens responsible for various sexually transmitted infections. When teaching about bacterial vaginosis (BV), the nurse educator is correct when stating the overgrowth of which bacteria is responsible for this infection?

Gardnerella vaginalis

A patient is admitted with severe dehydration related to diarrhea. The patient was hiking in the mountains during a camping trip and drank water from a mountain stream without purifying. What does the nurse know is the most likely cause of this diarrhea?

Giardia lamblia

In which of the following medical conditions would administering IV normal saline solution be inappropriate? Select all that apply.

Heart failure Pulmonary edema Renal impairment

The clinical manifestations of primary syphilis can be diagnostic. Select all the symptoms consistent with this diagnosis.

It occurs 2 to 3 weeks after initial inoculation with the organism a painless lesion forms at the site of infection the lesion resolves in 2 months.

Which term describes the time interval after primary infection when a microorganism lives within the host without producing clinical evidence?

Latency

The nurse is caring for a client with multiple organ failure and in metabolic acidosis. Which pair of organs is responsible for regulatory processes and compensation?

Lungs and Kidneys

Which is the most common cause of anaphylaxis?

Medications

What is an example of an intravenous anesthetic that is a hypnotic and produces excellent amnesia?

Midazolam and is often used as an adjunct to induction.

A nurse practitioner was preparing a health education program for freshmen college students. During orientation week, the nurse mentioned that C. trachomatis and N. gonorrhoeae are the two most common infections in sexually active young women under the age of 25. The nurse told the students that the most common finding for these infections is:

Mucopurulent cervicitis.

The nurse educator identifies the student understands the function of normal flora in the human body when the student makes which statement?

Normal flora compete with potential pathogens and work symbiotically with the host.

Which conduction block anesthetizes the nerves supplying the chest, abdominal wall, and extremities?

Paravertebral anesthesia

The nurse is reviewing the medical records of several patients who have been diagnosed with the following infections: Patient A: Mumps Patient B: Respiratory syncytial virus Patient C: Tuberculosis Patient D: Impetigo Patient E: Scabies

Patient B Patient D Patient E

What is the priority action when the circulating nurse is completing a second verification of the surgical procedure and surgical site?

Obtain the attention of all members of the surgical team.

Which can be used for rehydration therapy for diarrheal disorders?

Oral rehydration salts (ORS)

A list of commonly used medications for a particular surgical procedure is provided to the nurse. The anesthesiologist announces the administration of a nondepolarizing muscle relaxant. Which medication should the nurse document as having been administered?

Pancuronium

The anesthesiologist is administering a stable and safe nondepolarizing muscle relaxant. What medication does the nurse anticipate will be administered?

Pavulon (pancuronium bromide)

After discussing the vaccine available for human papillomavirus with the mother of a 12-year-old female client, the mother agrees to have her daughter immunized. It is July when the nurse administers the first dose. The nurse would instruct the mother to bring the girl in for her second dose at which time?

September The vaccine for human papillomavirus is given in three intramuscular doses, with the initial dose followed by a second dose in 2 months, and a third dose in 6 months after the first dose.

The physician is concerned about aspiration during a surgical procedure and orders a medication to increase gastric pH. Which medication would the nurse document as being administered?

Sodium citrate

Which statements reflects the nursing management of the client with West Nile virus infection?

There is no treatment for West Nile virus infection.

A patient begins to vomit during surgery. What would you do to help your patient?

Turn the patient to the side. Lower the head of the surgical table. Provide a basin for collection. Suction to remove saliva.

The nurse is scheduled to administer tetanus, diphtheria, and pertussis (Tdap) vaccine to a client at the clinic. The client states, "I had a reaction the last time I got an immunization." What action should the nurse take first?

Withhold the immunization.

The anticonvulsant __________ is a first-line analgesic agent for neuropathic pain.

gabapentin

A nurse is caring for a client in acute renal failure. The nurse should expect hypertonic glucose, insulin infusions, and sodium bicarbonate to be used to treat:

hyperkalemia.

A nurse practitioner is treating a client with early latent syphilis of less than 1 year's duration. The nurse told the client about the need to receive penicillin G benzathine injections according to the following protocol:

one injection.

Oncotic pressure refers to the

osmotic pressure exerted by proteins.

The nurse is analyzing the arterial blood gas (ABG) results of a client diagnosed with severe pneumonia. Which of the following ABG results indicates respiratory acidosis?

pH: 7.20, PaCO2: 65 mm Hg, HCO3-: 26 mEq/L

A nurse is monitoring a client being evaluated who has a potassium level of 7 mEq/L (mmol/L). Which electrocardiogram changes will the client display?

peaked T waves

A client admitted with acute anxiety has the following arterial blood gas (ABG) values: pH, 7.55; partial pressure of arterial oxygen (PaO2), 90 mm Hg; partial pressure of arterial carbon dioxide (PaCO2), 27 mm Hg; and bicarbonate (HCO3-), 24 mEq/L. Based on these values, the nurse suspects:

respiratory alkalosis.

A client is diagnosed with shigellosis. The nurse teaches the client and family how the disease is transmitted and treated and discusses the need for enteric precautions. The nurse should explain that enteric precautions must be maintained:

until three fecal cultures are negative for Shigella.

A nurse is assessing a client with vaginal discharge. The nurse suspects bacterial vaginosis when the client states which of the following?

"I noticed a strange fishy odor during my period."

The nurse is seeing a client who came into the sexual health clinic after discovering condylomata along her labia. The client states, "This makes no sense, I don't even know who I got this from and I have been so careful!" What is the nurse's best response?

"It sounds like you are feeling angry. Let's talk more about human papillomavirus (HPV) and strategies to stay healthy while you are being treated."