Evidence Based Practice-PrepU

The nurse works on a unit with elderly clients. Which of the following clients would the nurse visit first? The client who reports

"It feels like I have food stuck in my throat

A nurse is assessing the injection site of a client who has received a purified protein derivative test. Which finding indicates a need for further evaluation?

15-mm induration

Which of the following pressures show an increase in intraocular pressure (IOP)?

23 mm Hg

People are at increased risk for problems related to poor nutritional status if they have a BMI lower than

24

A nurse assesses the patient's level of consciousness using the Glasgow Coma Scale. What score indicates severe impairment of neurologic function?

3

A nurse is performing an admission assessment for an 81-year-old patient who generally enjoys good health. When considering normal, age-related changes to hepatic function, the nurse should anticipate what finding?

A slightly decreased size of the liver

A nurse caring for a patient admitted with a deep vein thrombosis is individualizing a prepared plan of care that identifies nursing diagnoses, outcomes, and related nursing interventions common to this condition. What type of tool is the nurse using?

A standardized care plan

The nurse is completing a neurologic assessment and uses the whisper test to assess which of the following cranial nerves?

Acoustic

Which of the following terms refers to the inability to recognize objects through a particular sensory system?

Agnosia Agnosia may be visual, auditory, or tactile. Dementia refers to organic loss of intellectual function. Ataxia refers to the inability to coordinate muscle movements. Aphasia refers to loss of the ability to express oneself or to understand language.

The nurse is conducting a screening for familial predisposition of cancer. Which of the following should the nurse note as a possible indication of hereditary cancer syndrome?

An aunt and uncle diagnosed with cancer

Which of the following positions are employed to help reduce intracranial pressure (ICP)?

Avoiding flexion of the neck with use of a cervical collar

A patient in the emergency room has bruising over the mastoid bone and rhinorrhea. These are indicative of which type of skull fracture?

Basilar

The treatment for symptomatic junctional rhythm is the same as for which of the following other heart rhythms?

Bradycardia

Which of the following is a key diagnostic indicator of heart failure (HF)?

Brain natriuretic peptide (BNP)

In women, which of the following types of cancer exceeds colorectal cancer?

Breast

At which level of cord injury does a patient have full head and neck control?

C5

Pentoxifylline (Trental) is a medication used for which of the following conditions?

Claudication

A nursing student is describing abstract ideas with a group of peers. The student says that these ideas can be a group of objects with relationships. The nursing instructor knows that the student is describing which of the following?

Concepts

The nurse on an evidence-based practice council is making recommendations to ensure patency of nontunneled central venous lines. The nurse recommends that daily saline and diluted heparin flushes be used in which of the following situations?

Daily when not in use

Which of the following types of posturing is exhibited by abnormal flexion of the upper extremities and extension of the lower extremities?

Decorticate

A recent immigrant is diagnosed with pulmonary tuberculosis (TB). Which intervention is the most important for the nurse to implement with this client?

Developing a list of people with whom the client has had contact

Which diagnostic study is usually performed to confirm the diagnosis of heart failure?

Echocardiogram

Which of the following terms refer to a method of recording, in graphic form, the electrical activity of the muscle?

Electromyogram

The nurse understands that research has demonstrated that a common source of hospital-acquired infections in clients with IV infusions is the hub on the IV tubing. Which Quality and Safety Education for Nurses (QSEN) competency is displayed when health care institutions recommend that health care providers always wash hands and wear gloves when accessing the hubs of IV tubing?

Evidence-based practice

In nursing class the instructor asks the students about the nursing research process. The student identifies the first nurse to collect data on clients as which of the following?

Florence Nightingale

A nurse is assessing a patient's level of independent functioning. Which tool would the nurse most frequently use?

Functional Independence Measure (FIMTM)

A nurse-manager in a pediatric intensive care unit notices an increase in nosocomial infections. What should the nurse do next?

Gather data on possible reasons for this increase

One of the primary focuses of nursing research is to

Generate knowledge to guide practice

Which type of benign tumor of the eyelids is characterized by superficial, vascular capillary lesions that are strawberry-red in color?

Hemangioma

The nurse is caring for a client with Guillain-Barré syndrome. Which assessment finding would indicate the need for oral suctioning?

Increased pulse rate, adventitious breath sounds

When planning care for a client with burns on the upper torso, which nursing diagnosis should take the highest priority?

Ineffective airway clearance related to edema of the respiratory passages

A nurse notices that a large number of clients who receive oxytocin to induce labor vomit as the infusion is started. The nurse assesses the situation further and discovers that these clients received no instruction before arriving on the unit and haven't fasted for 8 hours before induction. How should the nurse intervene?

Initiate a unit policy involving staff nurses, certified nurse-midwives, and physicians in teaching clients before labor induction.

NPH is an example of which type of insulin?

Intermediate-acting

A patient is being seen in the ER following a motor vehicle accident (MVA). He is having severe back pain. The preferred route of administration of medication in the most acute care situations is which of the following routes?

Intravenous

Two nurses have disagreed about the role in intuition in nursing practice, with one nurse characterizing it as "hocus-pocus" and the other nurse advocating it as a superior problem-solving strategy. Which of the following statements best conveys the role of intuition in nurses' problem solving?

Intuition can be a clinically useful adjunct to logical problem solving.

Which of the following medications causes constipation?

Iron supplements

In a client who has been burned, which medication should the nurse expect to use to prevent infection?

Mafenide

Which of the following vasodilator medications is used in the treatment of shock?

Nitroglycerin (Tridil)

Which level of health care provider may make the decision to apply physical restraints to a client?

Nurse practitioner

The patient tells the doctor that he and his family have accepted the terminal diagnosis of pancreatic cancer. The patient further explains that he is interested in being comfortable and that he no longer wishes to fight the cancer. This approach to end-of-life care is known as which of the following?

Palliative care

Which glands regulate calcium and phosphorous metabolism?

Parathyroid

A group of nurses are planning to investigate the effectiveness of turning immobilized stroke patients more frequently in order to prevent skin breakdown. The team has begun by formulating a PICO question. Which of the following will the "O" in the team's PICO question refer to?

Preventing skin breakdown

Because clients with pancreatitis cannot tolerate high-glucose concentrations, total parental nutrition (TPN) should be used cautiously with them. Which of the following interventions has shown great promise in the prognosis of clients with severe acute pancreatitis?

Providing intensive insulin therapy

Stress ulcers occur frequently in acutely ill patient. Which of the following medications would be used to prevent ulcer formation? Select all that apply.

Ranitidine (Zantac) • Famotidine (Pepcid) • Lansoprazole (Prevacid)

Morphine sulfate has which of the following effects on the body?

Reduces preload

Which of the following is the priority action the nurse should take when finding medications at a client's bedside?

Remove the medications from the room and discard them into an appropriate disposal bin.

A client with HIV will be started on a medication regimen of three medications. Which medication will be given that will interfere with the virus's ability to make a genetic blueprint. What drug will the nurse instruct the client about?

Reverse transcriptase inhibitors

A nurse is discussing dietary issues with a Latino client in the clinic. The client states, "I read a research article about the importance of beans in the Latino diet. The findings from the study suggested that inclusion of meat and beans in the diet would help in the development of muscles and bones." The information that the client is expressing is known as what?

Scientific knowledge

A patient has been diagnosed with systolic heart failure. The nurse would expect the patient's ejection fraction to be at which level?

Severely reduced

A client with diabetes mellitus is receiving an oral antidiabetic agent. Which of the following aspects should the nurse observe when caring for this client?

Signs of hypoglycemia

Which of the following terms refers to muscular hypertonicity with increased resistance to stretch?

Spasticity

The second step in implementation of evidence-based practice includes systematic review. In order to complete a systematic review of the literature the nurse must do which of the following?

Summarize findings from multiple studies that are related to a particular nursing practice.

Which of the following positions should be utilized after supratentorial intracranial surgery?

Supine position with head slightly elevated

A client with rib fractures and a pneumothorax has a chest tube inserted that is connected to a water-seal chest tube drainage system. The nurse notes that the fluid in the water-seal column is fluctuating with each breath that the client takes. What is the significance of this fluctuation?

The chest tube system is functioning properly.

The Monro-Kellie hypothesis refers to which of the following statements?

The dynamic equilibrium of cranial contents.

Of the following, which best explains the importance of theoretic frameworks?

Theoretic frameworks advance nursing knowledge and practice

Which of the following is the most common site for a dissecting aneurysm?

Thoracic area

Which action should the nurse perform first after an exposure to a client's body fluids?

Wash the exposed area with soap and water

Which of the following is the gold standard for assessing placement of a nasogastric (NG) tube for the patient receiving feedings?

X-ray

The digestion of carbohydrates is aided by

amylase.

Diagnosis of Kaposi's sarcoma (KS) is made by which of the following?

biopsy

Which physical sensation will the client who has had an abdominal hysterectomy most likely experience if she hyperventilates while performing deep-breathing exercises?

dizziness

Which is an expected outcome for a client recovering from an upper respiratory tract infection? The client will:

experience less nasal obstruction and discharge.

Lower motor neuron lesions cause

flaccid muscle paralysis. Lower motor neuron lesions cause flaccid muscle paralysis, muscle atrophy, decreased muscle tone, and loss of voluntary control. Upper motor neuron lesions cause increased muscle tone. Upper motor neuron lesions cause no muscle atrophy. Upper motor neuron lesions cause hyperactive and abnormal reflexes

The nurse should monitor for which of the following manifestations in a patient who has undergone LASIK?

halos and glare

A positive tuberculin skin test indicates that a client:

has produced an immune response.

A 74-year-old gentleman is a client on the hospital unit where you practice nursing. He is scheduled to undergo rhinoplasty in the morning, and you are completing his admission assessment and paperwork. He reports medications he uses on a daily basis, which you record on his chart. Which of his daily medications have the potential to result in constipation?

laxatives

Which of the following enzymes aids in the digestion of fats?

lipase

Which of the following types of diuretic is the first-line treatment for those diagnosed with heart failure (HF)?

loop

Which action should the nurse anticipate in a client who has been diagnosed with acute respiratory distress syndrome (ARDS)?

mechanical ventilation Explanation: Endotracheal intubation and mechanical ventilation are required in ARDS to maintain adequate respiratory support. Endotracheal intubation, not a tracheostomy, is usually the initial method of maintaining an airway. The client requires mechanical ventilation; nasal oxygen will not provide adequate oxygenation. Chest tubes are used to remove air or fluid from intrapleural spaces.

According to the TNM classification system, T0 means there is

no evidence of primary tumor.

Which of the following is one of the levels of hospice care covered under Medicare and Medicaid hospice benefits that includes a 5-day inpatient stay and is provided on an occasional basis to relive the family caregivers?

respite care

A client with bacterial pneumonia is to be started on IV antibiotics. Which diagnostic tests must be completed before antibiotic therapy begins?

sputum culture

Which finding is an expected outcome for an elderly client following treatment for bacterial pneumonia?

the ability to perform activities of daily living without dyspnea

Which is an expected outcome of pursed-lip breathing for clients with emphysema?

to promote carbon dioxide elimination

Although all of the following are nursing responsibilities, which one would be expected of a nurse with a baccalaureate degree?

using research findings to improve practice

A nurse is caring for a client who has a tracheostomy tube and who is undergoing mechanical ventilation. The nurse can help prevent tracheal dilation, a complication of tracheostomy tube placement, by:

using the minimal-leak technique with cuff pressure less than 25 cm H2O.

Which of the following would be inconsistent as a common side effect of chemotherapy?

weight gain

The nurse is conducting a health history with a client with active tuberculosis. The nurse should ask the client about:

weight loss