Qualifying Exam 3rd Year Pointers (Final)
Factors underlying the increasing trend of population aging. Select all that apply (SATA) A. Increased longevity B. The aging of "baby boom" generations C. Social age D. Declining fertility
A, B, D
8. After teaching a client how to correctly self-administer his daily maintenance dose of 3 units of regular insulin and 4 units of NPH insulin, which client statement demonstrates that the teaching has been successful? A. "After taking my insulin out of the refrigerator, I'll draw up the clear insulin first to the line of 3 units and then cloudy insulin until there's a total of 7 units in the syringe." B. " I'll check my blood sugar after breakfast and give myself shots in my stomach." C. "I should inject the insulin into a different site each time and then put it back in the pantry for safe keeping." D. "First, I'll check my blood sugar; then I'll get the insulin from the ref and withdraw 7 units."
A. "After taking my insulin out of the refrigerator, I'll draw up the clear insulin first to the line of 3 units and then cloudy insulin until there's a total of 7 units in the syringe."
12. The nurse knows that an intermediate-acting insulin should reach its "peak" in: A. 4 to 14 hours B. 12 to 24 hours C. 2 to 4 hours D. 1 to 2 hours
A. 4 to 14 hours
4. A nurse is preparing a patient for ECG. She holds on the first ECG lead wire labeled as V1. This lead wire should be placed on: C. 5th ICS MCL A. 4th ICS RSB D. 5th ICS MAL B. 4th ICS LSB
A. 4th ICS RSB
80. The following are warning signs of Dengue Hemorrhagic Fever, EXCEPT; 1/1 A. Anorexia B. Abdominal pain C. Hepatomegaly-abnormal enlargement of liver \-> jaundice D. Increase in Hematocrit
A. Anorexia Rationale: High Fever Bleeding in naso-oral region Abdominal Pain Rashes on Skin (petechial) Blood in stool and urine Increased BP & breathing Swollen nodes, glands and dizziness Pain in joints.
90. The following are safety precautions that a nurse should practice when taking care of patients receiving brachytherapy EXCEPT: 1/1 D. Posting appropriate notices about radiation safety precautions A. Assigning only one nurse to take care of the patient per shift C. Limit time in giving direct patient care for 30 minutes in a day per nurse B. Nurses who enter the room of the patient should wear a dosimeter badge
A. Assigning only one nurse to take care of the patient per shift
99. The following are ways to assist a cancer patient in coping with hair loss EXCEPT: B. Wear hat, scarf, or turban A. Begin to wear a wig when the majority of the hair has fallen off. C. Contact the American Cancer Society for donated wig D. Explain that hair growth usually begins again once therapy is completed
A. Begin to wear a wig when the majority of the hair has fallen off Rationale: wear a wig before hair loss not majority of hair has fallen off
10. A patient with Heart Failure met his primary care provider and began treatment with an ACE inhibitor. When the patient begins treatment, the nurse should prioritize what assessment? D. Oxygen Saturation B. Level of Consciousness A. Blood Pressure C. Assessment for Nausea
A. Blood Pressure-ACE relaxes veins & arteries to lower BP
86. If the tumor of your client is graded by the physician as grade 1, what does it tell you about the tumor? 1/1 A. Cells of the tumor closely resembles that of the normal tissues D. Tumor cells are less differentiated and forms glands B. The tumor cells are undifferentiated C. Aggressive tumor with poor prognosis
A. Cells of the tumor closely resembles that of the normal tissues- Grade 1 tumors, (well differentiated tumors) closely resemble the tissue of origin in structure & function
As nursing students, you may have preconceived ideas about caring for older adults. Perhaps you already have a positive attitude toward caring for older adults. As a result, you can build on that value and consider devoting our time and efforts to the practice of gerontological nursing and that includes familiarization with the following terminologies. The study of all aspects of the aging process, including the clinical, physiologic, economic, and sociologic problems of older adults and the consequences of these problems for older adults and society. A. Geriatrics B. Gerontology C. Geropsychology D. Elderly Care
A. Geriatrics
8. The nurse is performing an initial assessment of a client diagnosed with Heart Failure (HF). The nurse also assesses the patient's sensorium and LOC. Why is the assessment of the patient's sensorium and LOC important in patients with HF? D. The most significant adverse effect of medications used for Heart Failure treatment is altered Level of Consciousness. A. HF ultimately affects oxygen transportation to the brain. B. Patients with HF are susceptible to overstimulation of the sympathetic nervous system. C. Patients with HF are susceptible to overstimulation of the sympathetic nervous system.
A. HF ultimately affects oxygen transportation to the brain.
1. Identify the regularity of the ECG rhythm shown above. 1/1 B. Regular C. The ECG strip misses out important information. D. None of the above A. Irregular
A. Irregular
6. A nurse is assessing an electrocardiogram rhythm strip. The P waves and QRS complexes are regular. The PR interval is 0.16 second, and QRS complexes measure 0.06 second. The overall heart rate is 64 beats per minute. The nurse assesses the cardiac rhythm as: 1/1 B. Sinus Bradycardia A. Normal Sinus Rhythm C. Sinus Tachycardia D. None of the above
A. Normal Sinus Rhythm- Rationale: Normal sinus rhythm is generally defined as between 60 beats and 99 beats per minute.
33. A nurse assessed that a client suffering from rheumatoid arthritis has deformities in his hand. She noticed that the proximal joint is too extended while the distal joint is too flexed. The nurse recalls that this is a/an: A. Swan neck deformity-Swan neck: hyperflexion of the joints of the fingers, B. Boutonniere deformity-Boutonneirre: hyperextension of joints of the fingers C. Ulnar deviation D. Baker's cyst
A. Swan neck deformity-Swan neck: hyperflexion of the joints of the fingers,
98. The nurse is preparing Cyclophosphamide (Cytoxan). Safe handling of drugs should be implemented to protect the nurse from injury. Which of the following actions by the nurse should be corrected? 1/1 B. Air bubbles should be expelled on wet cotton A. The nurse should only wear mask and gloves D. Vent vials after mixing to relieve pressure in the vial. C. Label the hanging IV bottle with "ANTINEOPLASTIC CHEMOTHERAPY" sign.
A. The nurse should only wear mask and gloves
FOR QUESTION 13-15Mika, a 46-year-old farmer, is brought to the emergency department by ambulance with a suspected diagnosis of myocardial infarction. He appears ashen, is diaphoretic and tachycardic, and has severe chest pain. The nursing diagnosis is decreased cardiac output, related to decreased myocardial tissue perfusion. Question 13. The nurse knows that the most critical time period for his diagnosis is: C. within the first 48 hours after the attack. A. the first hour after symptoms begin. B. within 24 hours after the onset of symptoms. D. between the third and fifth day after the attack.
A. the first hour after symptoms begin.
HYPOVOLEMIA FLUID VOLUME DEFICIT
Occurs when water and electrolytes are lost in the same proportion Losing water + electrolytes= hypovolemia
respiratory alkalosis
PH ^ CO2 v
metabolic alkalosis
PH ^ HCO3 ^
Fully compensated:
PH is in range (7.35-7.45)
metabolic acidosis
PH v HCO3 v
8.A client is suffering from fluid volume excess. His nurse expects the following signs to be seen in him; SELECT ALL THAT APPLY: 1. Increased BP 2.Increased CVP-central venous pressure 3. Increased serum sodium 4. Tachycardia; bounding pulse 5. Altered mental status r/t cerebral edema
All of them 1. Increased BP 2.Increased CVP-central venous pressure 3. Increased serum sodium 4. Tachycardia; bounding pulse 5. Altered mental status r/t cerebral edema
45. A nurse is interviewing a client who is diagnosed with Urinary Tract Infection (UTI). She expects to see which signs and symptoms in his history of present illness. SELECT ALL THAT APPLY 1. Pyuria 2. Dysuria 3. Fever, chills 4. Loss of appetite 5. Pain, flank, one or both sides
All of them 1. Pyuria 2. Dysuria 3. Fever, chills 4. Loss of appetite 5. Pain, flank, one or both sides
75. A nurse is preparing a poster for a community health education and is listing the risk factors of having an infectious disease. SELECT ALL risk factors that the nurse would place on the list. Rationale: People with a compromised immune system (an immune system that doesn't work at full strength) have greater risk for certain types of infections. Those at higher risk include: People with suppressed immune systems, such as those going through cancer treatment or who have recently had an organ transplant 2. A neonate. 1. A person with a successful organ transplant. 3. An adult with chronic illness. 5. An elderly with dementia. 4. A woman with cancer.
All of them 2. A neonate. 1. A person with a successful organ transplant. 3. An adult with chronic illness. 5. An elderly with dementia. 4. A woman with cancer.
CPT- 6. A nurse is about to carry out a care provider's order to initiate chest physiotherapy to a client with Cystic Fibrosis. The nurse recalls considering the following nursing considerations, SELECT ALL THAT APPLY: 3. Do CPT of upper lobes before the lower lobes. 4. Provide oral hygiene. 1. Change position gradually to prevent postural hypotension. 2. Consider positioning through initial auscultation.
All of them 3. Do CPT of upper lobes before the lower lobes. 4. Provide oral hygiene. 1. Change position gradually to prevent postural hypotension. 2. Consider positioning through initial auscultation.
Which of the following measures should be done initially in the event that retinal detachment is suspected? Apply bilateral patch Apply ice on affected eye Place on prone position Flush eyes with NSS
Apply bilateral patch
26. When evaluating an ABG from a client with traumatic brain injury, the nurses notes the PaCO2 is 30 mm Hg. Which of the following responses best describes this result? A. Normal B. Appropriate; lowering the carbon dioxide (CO2) reduced intracranial pressure (ICP). C. Emergent; the client is poorly oxygenated. D. Significant; the client has alveolar hypoventilation
B. Appropriate; lowering the carbon dioxide (CO2) reduced intracranial pressure (ICP). Normal values: 35-45 but lowered to 30mmHg CO2 to reduce ICP
Curling's ulcer/mgt 67.Which of the following ulcers is associated with extensive burn injury? A. Peptic ulcer B. Curling's ulcer C. Duodenal ulcer D. Cushing's ulcer
B. Curling's ulcer
11. An example of commonly administered intermediate-acting insulin is: A. Lantus B. NPH C. Humulin U D. Humalog
B. NPH
13. Which among the set of signs and symptoms are found in patients with diabetes insipidus? A. Polydipsia & high urine osmolality B. Polydipsia & low urine osmolality C. Polyphagia & polyuria D. Low serum osmolality & high urine osmolality
B. Polydipsia & low urine osmolality
66.What type of pain is consistent with cholelithiasis? A. Severe epigastric pain radiating to the back and umbilicus. B. Severe right upper quadrant pain radiating to the back. C. Burning pain located in the epigastric area radiating to the groin. D. Burning and aching, located in the left lower quadrant radiating to the hip.
B. Severe right upper quadrant pain radiating to the back.
68. A diagnosis of SLE can be made if at any time during the course of the disease a client will manifest how many signs and symptoms from the list of criteria? 1/1 C. 5 B. 4 A. 3 D. 6
B. 4
2. What is the heart rate of the patient? (refer to the figure above) 1/1 C. 90 B. 80 D. 10 A. 70
B. 80
3. Appearance of the P waves. (refer to figure above) 1/1 B. Abnormal A. Normal
B. Abnormal
CTT- 38. The nurse is assuring patency of a client's chest thoracostomy tube drain. Upon assessment she would expect fluctuation of water at which part of the system? Refer to Exhibit 1 1/1 A. Bottle 1 B. Bottle 2 C. Bottle 3 D. Air vent
B. Bottle 2
77. Which of the following laboratory findings suggest that the disease progressed from HIV to AIDS? 1/1 A. 10% body weight loss B. CD4 count of <200 mg/dl D. WBC count of 20,000 mg/dl C. Presence of oral candidiasis
B. CD4 count of <200 mg/dl Rationale: Most significant lab test for AIDS: CD4+ T lymphocyte count <200/mm3 or CD4+T lymphocyte total % <14
63. A patient undergoing blood transfusion suddenly complained of difficulty of breathing, chest tightness and pruritus. The nurse immediately stops the transfusion and open the normal saline IV fluid because she's aware that the patient is having a/an: 1/1 D. Cell-mediated hypersensitivity C. Immune complex hypersensitivity B. Cytotoxic hypersensitivity A. Anaphylactic hypersensitivity
B. Cytotoxic hypersensitivity Rationale: Type II- can be caused by drug, transfusion, erythroblastosis fetalis, autoimmune hemolytic anemia & thrombocytopenia
14. Because the area of infarction develops over minutes to hours, the nurse knows to interpret the following ECG results as indicative of initial myocardial injury: A. Presence of P waves B. Enlarged T wave C. Absent T wave D. ST segment depression
B. Enlarged T wave
28. Which assessment finding if present is consistent with a diagnosis of rheumatoid arthritis (RA)? A. Swelling and pain on one knee. B. Prolonged early morning stiffness. C. Swelling involving the knee or hips. D. Joint pain which worsens at the end of the day.
B. Prolonged early morning stiffness. Late Manifestations, Morning stiffness (gel phenomenon)
PTB/mgt-37. The doctor prescribed Isoniazid as one of the medications for the client's chemotherapy for Pulmonary Tuberculosis. The nurse would anticipate that the care provider will also order which of the following to prevent its side-effect: A. Thiamine B. Pyridoxine D. Ipratropium bromide C. Cyanocobalamin
B. Pyridoxine
65. A nurse caring for a client having an anaphylactic type of hypersensitivity would attribute the signs and symptoms from: 1/1 A. Decrease number of circulating antibodies C. Release of toxins by invading microorganisms B. Release of chemical mediators of mast cells D. Destruction of normal cells by the immune system
B. Release of chemical mediators of mast cells Rationale: type 1- mast cells are cells filled with basophil granules, found in connective tissue & releasing histamine other substances during inflammatory & allergic reactions. The reaction is extended or varied by reason of Platelets, Neutrophils and Eosinophils, since a study of the reaction site shows especially Mast cells and Eosinophils.
Mode of Transmission-2 72. As microorganism leaves its source, it requires a means of transmission to reach another person through a receptive portal of entry. Identify an example of indirect transmission. A. Having sexual intercourse with an infected person.- DIRECT D. Touching another person.-DIRECT C. Sneezing during a conversation.-DIRECT DROPLET TRANSMISSION B. Sharing of eating and cooking utensils.-INDIRECT TRANSMISSION
B. Sharing of eating and cooking utensils.-INDIRECT TRANSMISSION
3) A resident in a nursing home requests a new room because he or she does not like the view from the current room. While the resident is away from the home on a provider visit, the staff moves the resident's belongings to another room with a better view. The resident and the resident's family later file a formal complaint regarding the move. Which statement gives the best justification for the resident's complaint? A. The change was made without a provider's order. B. The resident was not included in the decision making. C. The resident's belongings were moved without his or her assistance. D. The resident's family was not included in the decision making.
B. The resident was not included in the decision making.
2) An 80-year-old patient, who lives at home with a spouse, is instructed to follow a 2 g sodium diet. The patient states, "I've always eaten the same way all my life, and I'm not going to change now." To promote optimal dietary adherence, the gerontological nurse's initial approach is to: A. inform the patient about the need to follow the diet. B. inquire about the patient's current food preferences and eating habits. C. list the variety of foods that are allowed on the diet. D. provide dietary instruction to the patient's spouse, who prepares the meals.
B. inquire about the patient's current food preferences and eating habits.
FOR QUESTIONS 11-12 Carlo, a 64-year-old retired secretary, is admitted to the medical-surgical area for management of chest pain caused by angina pectoris. Question 11. The nurse knows that the basic cause of angina pectoris is believed to be: 1/1 D. Spasms of vessel walls owing to excessive secretion of epinephrine. B. insufficient coronary blood flow. A. dysrhythmias triggered by stress. C. Minute emboli discharged through the narrowed lumens of the coronary vessels
B. insufficient coronary blood flow.
16.Which of the following independent nursing management is appropriate to patients with diabetes insipidus? A. Removal of the pituitary gland B. Administration of diuretics C. Fluid restriction
C. Fluid restriction
09. What do you call a serious complication of patient with type 2 DM characterized by blood glucose of 800 to 1000 mg/dL accompanied by hypotension and profound dehydration? A. Diabetic Ketoacidosis B. Somogyi's Effect C. Hyperglycemia hyperosmolar non-ketotic syndrome D. Dawn's Phenomenon
C. Hyperglycemia hyperosmolar non-ketotic syndrome
4. Which of the following nursing intervention is BEST for a patient with hyperthyroidism in the prevention of complications? A. Administer aspirin to prevent thrombus formation. B. Encouraged to eat iodine-rich food (i.e seaweed, dairy products). C. Instructed to not discontinue the drug abruptly. D. Advised to take medications whenever it is needed.
C. Instructed to not discontinue the drug abruptly.
14. Which of the following nursing consideration is correct during water deprivation test? A. Withhold any fluids for 12 to 24 hours. B. The patient is weighed at the beginning of the test. C. Test is terminated if tachycardia, weight loss and hypotension occur. D. Plasma and urine osmolality is taken at the end of the test.
C. Test is terminated if tachycardia, weight loss and hypotension occur.
2. A client with hyperthyroidism who experiences trauma, emergency surgery, or severe infection is at risk for developing which condition? A. Addisonian crisis B. Hypercalcemic crisis C. Thyroid storm D. Myxedema coma
C. Thyroid storm
57. The Physician ordered Total Parenteral Nutrition to a client with ACUTE PANCREATITIS. When client asks for an explanation, the nurse MOST accurate response would be: A. "Trust your physician, he is doing what's best for you" B. "It will meet your nutritional needs without stimulating the secretion of pancreatic enzymes" C. "It is the safest method for meeting your daily nutritional requirements" D. "It is easiest method to administer your needed nutrition"
C. "It will meet your nutritional needs without stimulating the secretion of pancreatic enzymes"
Suctioning- To carry out bronchial hygiene, chest physiotherapy should be followed with either coughing exercise or suctioning. The proper sequence of suctioning is: 1/1 1. Initial auscultation of the chest 2. Insert suction tip with gloved hand following aseptic technique 3. Apply intermittent suctioning during withdrawal while rotating the catheter. 4.Administer supplemental oxygen 5. Re-evaluate the client & reapply oxygen supply B. 2, 1, 4, 3, and 5 C. 1, 4, 2, 3 and 5 A. 1, 3, 2, 4, and 5 D. 4, 2, 3, 1 and 5
C. 1, 4, 2, 3 and 5 Correct order: 1. Initial auscultation of the chest 2. Administer supplemental oxygen 3. Insert suction tip with gloved hand following aseptic technique 4. Apply intermittent suctioning during withdrawal while rotating the catheter. 5. Re-evaluate the client & reapply oxygen supply
2) Gerontological nurses work with elderly person in different settings performing different roles. Identify the role performed by the nurse in the following activities: Acts in behalf of older adults to promote their best interests and strengthen their autonomy and decision making. A.Teacher B. Provider of Care C. Advocate D. Manager
C. Advocate
16. For a patient with the clinical finding of leukocytosis, the nurse should: Leukocytosis-increase of WBCs, signs of infection D. Schedule periods of rest and activity. C. Anticipate a possible physician order for antibiotic coverage. B. Inspect for signs of active bleeding. A. Initiate transmission-based isolation precautions.
C. Anticipate a possible physician order for antibiotic coverage.
7. Diagnostic imaging reveals that the quantity of fluid in a client's pericardial sac is dangerously increased. The nurse should collaborate with the other members of the care team to prevent the development of what complication? 1/1 D. Pericarditis C. Cardiac Tamponade A. Pulmonary Edema B. Pericardiocentesis
C. Cardiac Tamponade- Rationale: compression of the heart due to fluid buildup in the sac surrounding the heart
56. A client was given the order to have hemodialysis through a peripheral access on the right arm. A nurse considers the following care prior to his hemodialysis; EXCEPT: 1/1 D. Assess vital signs before and every 30 minutes during procedure A. Have client to void C. Comparing BP of both arms B. Auscultate for bruit
C. Comparing BP of both arms
10. The following are appropriate measures to prevent injury on the foot EXCEPT: A. Notify health care provider immediately if any foot problems occur B. Use lotion to prevent dryness and cracking C. Encourage use of heating pads to improve circulation D. Always wear socks and well-fitting shoes
C. Encourage use of heating pads to improve circulation
Breast Cancer Diagnostics 97. Nurse Shine is teaching a client who suspects that she has a lump in her breast. The nurse instructs the client that a diagnosis of breast cancer is confirmed by: B. Mammography C. Fine needle aspiration A. Breast self-examination D. Chest X-ray
C. Fine Needle aspiration
Oxygen therapy- 28. The nurse started a low concentration oxygen therapy at 2 L/min on a client with COPD for the reason that: 1/1 B. The client may become dependent on supplemental oxygen. D. Higher concentrations of oxygen may dry the oro-nasal mucosa, providing entry for organisms. A. Higher concentration of oxygen causes oxygen toxicity. C. Higher concentration of oxygen may eliminate the hypoxic stimulus for respiration.
C. Higher concentration of oxygen may eliminate the hypoxic stimulus for respiration.
12. The medical record lists a probable diagnosis of chronic stable angina. The nurse knows that Carlo's pain: C. Is relieved by rest and is predictable A. Has increased progressively in frequency and duration D. Usually occurs at night and may be relieved by sitting upright B. Is incapacitating
C. Is relieved by rest and is predictable
79. During the excitement stage of rabies, the nurse must do the following EXCEPT: 1/1 B. Provide a room away from the utility room D. Place in a quiet isolation room A. Provide a quiet environment, free from stimuli C. Offer fluid to relieve laryngospasm
C. Offer fluid to relieve laryngospasm-patient may choke Rationale: Laryngospasm is a rare but frightening experience. When it happens, the vocal cords suddenly seize up or close when taking in a breath, blocking the flow of air into the lungs.
60.The nurse is assessing a patient suspected to have appendicitis, upon palpation of the abdomen the nurse will palpate which quadrant last: A.LLQ B.RUQ C. RLQ D. LUQ
C. RLQ
5. The nurse now holds the limb leads with a label "N". This lead wire will be placed on the: 1/1 B. Left Wrist D. Left Foot A. Right Wrist C. Right Foot
C. Right Foot
29. A client with chronic bronchitis had his blood taken for ABG analysis, which of the following BEST illustrates the possible result: B. pH: 7.50, PaCO2: 38mmHg, HCO3: 38mEq/LD. pH: 7.30, PaCO2: 40mmHg, HCO3: 18mEq/L C. pH: 7.30, PaCO2: 52mmHg, HCO3: 30mEq/L A. pH: 7.52, PaCO2: 18mmHg, HCO3: 22mEq/L
C. pH: 7.30, PaCO2: 52mmHg, HCO3: 30mEq/L-ACID, RESPIRATORY, METABOLIC-Respiratory Acidosis Chronic Bronchitis- Respiratory Acidosis Issue
Partially compensated
Co2, Hco2 Both are out of range, PH is out of range
Uncompensated:
Co2, Hco2 in range, PH out of range
AGN clinical findings
Culture of GABHS History of sore throat, tonsillitis, skin infection-impetigo, pharyngitis Hematuria Edema Increase BP Azotemia-presence of metabolic waste product in the blod Proteinuria Urine may have WBCs Fatigue Anorexia N & V Headache Within 10-14 days Children may have full recovery, compared to prognosis of adults
Respiratory acidosis
Ph v CO2 ^
Expanded Senior Citizens Act of 2003 Expanded Senior Citizens Act of 2003 RA 9994 RA 7432 RA 10645 RA 9928
RA 7432
List five of 9 signs that indicate that an extravasation of an infusion of a cancer chemotherapeutic agent has occurred:
Redness, pain, swelling, phlebitis, tissue necrosis
Which of the following is the right way of eliciting the best motor response through central stimulation? a. rubs b. Trapezius pinch c. Applying pressure on the nail bed d. Applying pressure on suprasternal notch
Trapezius pinch
Situation 5: A nurse is assigned to the medical ward and received a number of adult patients. Question 18. A patient is placed on arterial blood gas (ABG) analysis, the trained nurse performs which clearance assessment before extraction: a. Allen's test b. O2 Saturation c. BP and pulse rate d. Clotting time and bleeding time e. Partial thromboplastin time and prothrombin time
a. Allen's test-used to find out if the blood flow to your hand is normal
A Nurse would like to know the challenges and difficulties of working students studying in the College of Nursing. The study will be conducted using an interview as well as a semi-structured questionnaire. Thematic analysis will be conducted using Colaizzis Method and will be reported as a theme. The sample size of this type of study is determined by: Select one: a. Data Saturation Point b. Web Application c. Sample Size Calculator d. Effect Size Calculator
a. Data Saturation Point
An endoscopic procedure can be used to remove an entire piece of suspicious tissue growth. The diagnostic biopsy method used for this procedure is known as: Select one: a. Excisional Biopsy-Most frequently used for easily accessible tumors of skin, breast and upper or lower GI & URT. Surgeon can remove entire tumor as well as the surrounding marginal tissues. b. Needle Biopsy-Performed to sample suspicious masses that are easily accessible, such s growths in the breasts, thyroid, lung, liver & kidney. May need local anesthesia, Aspirating tumor through the tumor. c. Aspirate Biopsy- Needle Biopsy d. Incisional Biopsy-Performed if the tumor mass is too large to be removed for analysis. Pathologist gets tumor wedge for accurate diagnosis.
a. Excisional Biopsy-Most frequently used for easily accessible tumors of skin, breast and upper or lower GI & URT. Surgeon can remove entire tumor as well as the surrounding marginal tissues.
13. What would the nurse suggests as the best action for the above condition? a. Retest b. Administer Kayexalate c. Increased oral fluid intake d. Start oral supplementation of K+
a. Retest
4) All of the following must be present for malpractice to exist. Select all that apply (SATA) a. A professional duty owed to the patient b. Breach of such duty c. Resulting damages d. Injury caused by the breach
b. Breach of such duty c. Resulting damages d. Injury caused by the breach
1)The process of enabling people to increase control over & improve their health by developing their resources to maintain or enhance well being a. Health prevention b. Health promotion c. Rehabilitation d. Disease prevention
b. Health promotion
Situation 4: A client who just had surgery of the thyroid gland suddenly experienced tingling and spasms of the extremities. His blood test revealed a total calcium level of 7 mg/dL and a potassium level of 3.5 mEq/L.The nurse may suspect. a. Hypercalcemia b. Hypocalcemia c. Hyperkalemia d. Hypokalemia
b. Hypocalcemia- 7 mg/dl is too low, normal values 9-11 mg/dL
14. Another client under the nurse's care has a potassium level of 6.2 mEq/L. The nurse anticipates that the doctor will order what possible treatment? a. Osmotic diuretics b. Insulin and glucose c. Sodium bicarbonate d. Potassium supplement
b. Insulin and glucose
A patient with a GCS score of 10 means that the brain injury is: a. mild b. Moderate c. Severe d. Braindead
b. Moderate
Which of the following is the correct documentation of the client's best motor response? a. Localized pain M5 b. Normal flexion M4 c. Abnormal flexion M3 d. Abnormal extension M2
b. Normal flexion M4
A health education specialist wants to know if growing a vegetable garden will have a positive impact on the diet of the gardeners and their immediate family. A study is designed that compares the diet of a group of vegetable gardeners and their families with the diet of a group of families that do not have a vegetable garden. What is the most appropriate research design to be utilized? Select one: a. Descriptive-Evaluative Research Design b. Descriptive Research Design c. Descriptive-Comparative Research Design d. Descriptive-Correlational Research Design
c. Descriptive-Comparative Research Design
26.The client's condition (from question 25) is possibly caused by: ketones, high glucose levels for years a. Vomiting b. Gastric suction c. Diabetes Mellitus d. Antacid overdose
c. Diabetes Mellitus
The nurse will also assess for the postoperative complication of septic shock, which is associated with all of the following EXCEPT: fluid volume deficit, everything is going out or down, BP is wack. a. Oliguria b. Tachycardia c. Hypertension d. Hypothermia
c. Hypertension
11. The nurse may anticipate that eventually the client may develop which sodium imbalance a. Both b. Hypernatremia c. Hyponatremia
c. Hyponatremia
7.A client's blood chemistry revealed Na level of 150 mEq/dL to prevent cellular dehydration what kind of solution will you anticipate the care provider to order: a. Expanders b. Isotonic solution c. Hypotonic solution d. Hypertonic solution
c. Hypotonic solution- Rationale: Pt. is experiencing hypernatremia >145 mEq/L
Situation 3: A body builder, was immediately admitted because of a back injury right after his workout and underwent routine tests including CBC, blood chemistry and urinalysis. There was a delay in the workup of the specimens but eventually were carried out. His blood chemistry result revealed an slight increase in serum potassium level of 6 mEq/L but he doesn't manifest any of its signs and symptoms. What could have caused this condition? a. Quick hemolysis of aged transfused blood b. Client have sweated too much from the workout c. Possible hemolysis from the delay of the blood studies d. Blood was taken from the arm with IV infusion with K+
c. Possible hemolysis from the delay of the blood studies
It is a type of research designed to answer questions about the complex nature of the phenomena with the purpose of describing, explaining, and understanding the phenomena being studied. Select one: a. Applied Research b. Mixed Method Research c. Qualitative Research d. Quantitative Research
c. Qualitative Research
22. The nurse receives the ABG values of a 35-year-old patient who has a chief complaint of shortness of breath and orthopnea. The result showed the following: pH of 7.30, PaCO2 of 50 mmHg, HCO3 of 26 mEq/dL and PaO2 of 97 mmHg. The nurse knows that this is: a. Partially compensated mix alkalosis b. Uncompensated metabolic alkalosis c. Uncompensated respiratory acidosis d. Fully compensated metabolic acidosis e. Fully compensated respiratory acidosis
c. Uncompensated respiratory acidosis-PH not in range, PACO2 not in range, HCO3 in range
19.The nurse is reviewing a 40-year-old client's arterial blood gas (ABG) result and it revealed the following values: pH of 7.36, PaCO2 of 32 mmHg, HCO3 of 17 mEq/dL and PaO2 of 94 mmHg. The nurse interpreted this as: a. Partially compensated mix alkalosis b. Uncompensated metabolic alkalosis c. Uncompensated respiratory alkalosis d. Fully compensated metabolic acidosis e. Fully compensated respiratory acidosis
d. Fully compensated metabolic acidosis- PH in range, PaCO2 not in range, HCO3, not in range
2.The most abundant cations; Intracellular: ________ while Extracellular: ________ a. Na and Cl b. Cl and PO4 c. PO4 and Mg d. K and Na
d. K and Na
Which of the following is the correct documentation of the client's best verbal response? a. Words V3 b. Sound V2 c. No response d. Not testable
d. Not testable
A Nurse would like to know the challenges and difficulties of working students studying in the College of Nursing. The study will be conducted using an interview as well as a semi-structured questionnaire. Analysis will be conducted using Colaizzis Method and will be reported as a theme. Which of the following is a Research Design for this study? Select one: a. Descriptive Correlational Research Design b. Case Study Design c. Descriptive Comparative Research Design d. Phenomenological Research Design
d. Phenomenological Research Design
23. What could be the possible cause of the patient's ABG result (client from question 22): Shortness of breath & orthopnea a. Anxiety b. Diarrhea c. Gastric fistula d. Pulmonary edema
d. Pulmonary edema
It is a type of experimental research designed to establish a true cause-and-effect relationship without the use of random assignment. Select one: a. True Experimental Research b. Participatory Action Research c. Descriptive Research d. Quasi-Experimental Research
d. Quasi-Experimental Research
25.A pH of 7.30 mmHg and partial pressure CO2 of 40 mmHg and HCO3 of 17 mEq/dL are the results of a young adult's ABG analysis. He also has increased ketones during care and is known to have uncontrolled high glucose level for years. The nurse interpreted this as: a. Compensated Respiratory acidosis b. Uncompensated Respiratory acidosis c. Compensated Metabolic acidosis d. Uncompensated Metabolic acidosis
d. Uncompensated Metabolic acidosis-PH abnormal, PACO2 normal, HCO3 abnormal
3. Poor health is inevitable in older age True False
false
ACUTE GLOMERULONEPHRITIS
is a bilateral inflammation of the glomeruli of the kidney which follows an infection caused by strains of Group A Beta Hemolytic Streptococci.
2.The older population is growing at a faster rate in the less developed regions. True False
true
4. More developed regions have relatively high proportions of older persons True False
true
5. The proportion of older persons is projected to more than double worldwide over the next half century True False
true
66. A nurse caring for a client having an anaphylactic type of hypersensitivity would EXPECT an elevation of the client's: 1/1 B. Immunoglobulin E A. Eosinophils D. A & B only E. All of the above C. Neutrophils
D. A & B only
3. Which of the following situation will MOST likely lead to a thyroid storm? A woman with thyrotoxicosis who develops severe infection. B. A patient who had an appendectomy. C. A patient with Grave's disease who takes his/her medication on time. D. A patient who is 6-month pregnant.
D. A patient who is 6-month pregnant.
35. Sjogren's syndrome affects which part of the body? A. Joints B. Lacrimal gland C. Salivary gland D. Both B & C E. All of the Above
D. Both B & C
5. After undergoing a thyroidectomy, a client develops hypocalcemia and tetany. Which medication should the nurse anticipate administering? A. Sodium bicarbonate B. Potassium chloride C. Sodium phosphorus D. Calcium gluconate
D. Calcium gluconate
64. A student nurse who changed cosmetic make-up 3 days ago developed rashes on her face this morning. She recalls from her immunity lecture that she is having a/an: 1/1 C. Immune complex hypersensitivity A. Anaphylactic hypersensitivity B. Cytotoxic hypersensitivity D. Cell-mediated hypersensitivity
D. Cell-mediated hypersensitivity-type 4
58. The nurse started Newt's first hemodialysis treatment. Newt develops headache, confusion and nausea. These findings indicate which of the following potential complications? 1/1 C. Hyperkalemia-excess of potassium A. Peritonitis-inflammation in the peritoneum B. Air embolism-air bubbles in vein or artery D. Disequilibrium syndrome
D. Disequilibrium syndrome Rationale: occurs at the first few tx of hemodialysis N & V, headache, restlessness, agitation, muscle cramps, confusion and possible seizures ALL due to rapid correction of metabolic abnormalities and rapid fluid shifting
Case Scenario: A client with traumatic brain injury is intubated and is admitted in the ICU should be monitored if the brain injury is getting better or getting worse. Hence, GCS monitoring was ordered by the physician. Upon assessment the client has closed eyes and responded after eliciting pain on the nail bed. The nurse elicited a central stimulation in order to get the best motor response in which the client's arm slowly flexed inward with a clenched fist. How would you document the patient's best eye-opening response? a. Pain E3 b. Eye opening 2 c. To Pain E2 d. E2
D. E2
91. The following are the correct management of extravasation, EXCEPT: 1/1 D. Fast drip the main line to flush residual drug in the tubing A. Stop the anti-neoplastic infusion C. Inject antidote of the infiltrated drug B. Aspirate infiltrated medication from the tissue
D. Fast drip the main line to flush residual drug in the tubing
87. The following are side effects of radiation therapy on the skin EXCEPT: 1/1 B. Desquamation C. Alopecia A. Erythema D. Hirsutism
D. Hirsutism-abnormal growth of hair on a person's face and body, especially on a woman.
77. In assessing the abdomen which of the following steps is done last? A. Auscultation B. Inspection C. Percussion D. Palpation
D. Palpation
27. To teach a client with COPD about proper breathing exercise, the nurse instructs the client to: 1/1 A. Inhale deeply on a tripod position and breathe out through pursed lips. D. Place both hands on the abdomen while concentrating on inhaling, breathing against the hands-on abdomen through the nose and out through the mouth. B. Purse lips while inhaling as deeply as possible and then exhaling through the nose making sure of a longer expiration. C. Place one hand on the chest and the other on the abdomen while concentrating during inhalation to make the hand on the chest to move up and outward.
D. Place both hands on the abdomen while concentrating on inhaling, breathing against the hands-on abdomen through the nose and out through the mouth.
89. Which type of tumors are more sensitive to radiation therapy? 1/1 B. Big tumors sizes A. Poorly oxygenated tumor C. Slow proliferation rate D. Poorly differentiated
D. Poorly differentiated
67. A client is suspected of having Systemic Lupus Erythematosus (SLE). The nurse monitors the client, knowing that which of the following is a characteristic sign of this disease? 1/1 A. Fatigue D. Rash on the face across the bridge of the nose and on the cheeks C. Elevated RBC B. Fever
D. Rash on the face across the bridge of the nose and on the cheeks
9. An older adult patient with Heart Failure is being discharged home on an ACE (angiotensin-converting enzyme) inhibitor and a loop diuretic. The patient's most recent vital signs prior to discharge include oxygen saturation of 93% on room air, heart rate of 81 beats per minute, and blood pressure of 94/59 mm Hg. When planning this patient's subsequent care, what nursing diagnosis should be identified? D. Risk for falls related to hypotension C. Risk for ineffective breathing pattern related to hypoxia A. Risk for increased tissue perfusion related to dysrhythmia B. Risk for fluid volume excess related to medication regimen
D. Risk for falls related to hypotension
78. Which of the following actions would be the least effective STD risk reduction strategy? 1/1 B. Using a male condom after vasectomy D. Taking oral contraceptives for family planning C. Lifelong monogamy of both partners A. Abstinence
D. Taking oral contraceptives for family planning
73. Which of the following situations is an example of microorganism transmission via droplet nuclei? 1/1 D. Talking to a person who suddenly coughs. A. A virus is transmitted through sexual intercourse C. A contaminated stethoscope touches the skin of a client B. Rode an airconditioned bus with a covid-19 positive person.
D. Talking to a person who suddenly coughs.
69. The nurse is assigned to care for a client admitted to the hospital with the diagnosis of SLE. The nurse reviews the physician's orders, expecting to note which of the following medications is prescribed. 1/1 A. antibiotic D. anti-malarial B. narcotic analgesic C. antidiarrheal
D. anti-malarial (Chloroquine) Rationale: SLE MANAGEMENT-corticosteroids, NSAIDS, ASA, Anti-malarials, Sunscreen, topical or intralesional corticosteroids, B-Cells therapies, cytotoxic drugs
76. Which among the following patient isolation precautions must be employed to a client with food-waterborne diseases? 1/1 B. droplet precaution D. contact precaution A. reverse isolation C. quarantine isolation
D. contact precaution
1) A 90-year-old patient comes to the clinic with a family member. During the health history, the patient is unable to respond to questions in a logical manner. The gerontological nurse's action is to: A. ask the family member to answer the questions. B. Ask the same questions in a louder and lower voice. C. determine if the patient knows the name of the current president. D. rephrase the questions slightly, and slowly repeat them in a lower voice
D. rephrase the questions slightly, and slowly repeat them in a lower voice
FLUID VOLUME DEFICIT NURSING/MEDICAL MANAGEMENT
Encourage clients to increase Fluid Intake/Give oral fluids Carbohydrate/Electrolyte Solutions: Sports drink, gingerale, rehydrating soln. Observe patients for untoward symptoms. SPECIAL CONSIDERATIONS Oral discomfort/ Reluctant to drink- small, freq preferences N & V- antiemetics Cannot eat or drink- IV, NGT, or OGT
AGN-NURSING OUTCOME AND INTERVENTIONS
Fix the cause (Strep) Diet modifications -fluid restriction due to retaining sodium & edema -sodium restriction -low protein- due to azotemia -Provide lots of Carbs (provides energy & stop the breakdown of protein) Monitor -daily I & O -daily wt. Bed rest Monitor BP -antihypertensives -diuretics
Which of the following is one of the signs of retinal detachment? Loss of peripheral vision Myopic shift Seeing "halos" around lights Floaters on visual field
Floaters on visual field
Ca Imbalance & mgt.
Hypocalcemia < 9-11mg/dL > Hypercalcemia
K Imbalance & mgt
Hypokalemia <3.5-5 mEq/L > Hyperkalemia Can cause CARDIAC DYSRHYTHMIAS-LIFE THREATENING!
Na Imbalance & mgt.
Hyponatremia < 135-145 mEq/L > Hypernatremia
69To lower the down ammonia level in the blood and prevent development of hepatic encephalopathy the following management should be carried out: SELECT ALL THAT APPLY 1. Give Lactulose 2. Administer enema 3. Administer neomycin 4. Provide high protein diet
1,2,3
COPD management (diet)
1. High calorie, high protein, low carbs -especially for emphysema 2. Small frequent meals 3. Stay hydrated (thins mucous secretions)
Nephrotic syndrome/mgt A client diagnosed with Nephrotic Syndrome, was assigned to a nurse. Before doing her rounds, she reviewed that the most common manifestation of this disorder are; SELECT ALL THAT APPLY 1. Massive edema 3. Massive Proteinuria 2. Hyperlipidemia 4. Severe Hypertension
1. Massive edema 3. Massive Proteinuria 2. Hyperlipidemia
FLUID VOLUME DEFICIT: CLINICAL MANIFESTATIONS
1. acute weight loss 2. decreased skin turgor Assess: -elderly: sternum, dorsal hand, cheeks -children: abdomen, medial aspect of thigh 3. oliguria 4. postural hypotension 5. weak, rapid HR 6. flattened neck veins 7. increased/decreased temp; pale 8. thirst 9. delayed cap refill 10. muscle weakness/cramps 11. decreased LOC
HCO3 (bicarbonate in the blood, kidneys) value
22-26
PACO2 (CO2 in the blood, lungs) value
35-45
PH (how acidic or alkalotic blood is, lungs/kidneys) value
7.35-7.45
PAO2 (o2 in the blood, regulated by lungs) value
80-100
All are signs and symptoms of Parkinson's disease, EXECPT: Intention tremors Bradykinesia Cogwheel rigidity Forward-flexed posture
Intention tremors
