Final Practice Questions 4 qtr.
Sally Struthers, age 22, has been diagnosed with an eating disorder. In reviewing her history as a teenage, which of the following is most indicative of a risk for acquiring an eating disorder? a. frequent dieting b. daily jogging and swimming c. use of alcohol and drugs d. low grades in school
A
When a client with a personality disorder uses manipulation as a way of getting needs met, the staff agrees to consistently setting limits on her manipulative behaviors. The rationale for such limit setting as an intervention is: a. external controls are necessary while internal controls are being developed b.the client's anxiety will decrease when staff assumes responsibility for her behaviors c. limit setting provides an effective punishment for unacceptable behavior d. By setting limits, clients have a focus for projecting their feelings of anxiety
A
When establishing rapport with a client who has Narcissistic PD, the nurse should: a. attentively listen to the client's stories and exaggerated accomplishments b. end the interaction when the client begins expressing a grandiose self-concept c. convey acceptance of the client by acknowledging his/her superiority d. directly challenge any unrealistic statements the client makes
A
A client has emphysema but no other underlying medical conditions. What dietary modifications are recommended for the client? [Select all that apply] a. Mechanical soft diet b. Low calorie diet c. Restricted potassium d. High protein e. Increase calcium f. Increased sodium
A & D
According to the DSM-V, which statement made by an adult client supports the criteria for generalized anxiety disorder? Select all that apply. A. I've been really anxious for at least 2 years now. B. My anxiety has to be genetic; my mom was a terrible worrier too. C. My marriage is in trouble because I'm always so irritable. D. I've had a good physical and my health care provider says I'm in good health. E. Its hard falling asleep and even harder staying asleep; I'm restless all night.
A C D E
Your client with hypertension has been taking chlorothiazide (diuril). her potassium level today is 2.9mEq/L. what assessments are you likely to find based on this medication and her potassium level? [select all that apply] a. muscle weakness b. tendon hyporeflexia c. Chvostek's sign d. polyuria e. cardiac dysrhythmias f. seizures g. lethargy and confusion h. decreased urine specific gravity I. pain j. decreased blood pressure
A, B, D, E, G, H, J
Which of the following have an increased risk of developing pneumonia [select all that apply] a. Client who has dysphagia b. Client who had AIDS c. client who was vaccinated for pneumonia and influenza 6 months ago d. client who is post op and has received local Anastasia e. client who has a closed head injury and is receiving ventilation f. client who has myasthenia gravis
A, B, E, F
Clients with ventricular fibrillation (V-fib) benefit from lidocaine because it... [select all that apply] a. helps regulate cardiac electrical activity b. acts like a local anesthetic on cardiac nerves c. reduces irritability of cardiac cells d. increases ventricular automaticity e. helps treat dysrhythmias originating in the ventricles f. slows the rate of atrial contractions
A, C, E
A client taking chlolorthiazide for chronic heart failure complains of leg cramps at night. the nurse should: a. check the client for peripheral edema and weight gain b. Question the client about intake of bananas and orange juice c. recommend the client frequently elevate her legs d. instruct the client to increase ambulation and calf muscle stretching exercises
B
The nurse notes a client with asthma had increased wheezing and complaints of chest tightness. The nurses priority action is to... a. inform the physician so an antibiotic medication can be ordered b. plan to intubate the client c. prepare to administer a nebulized bets-2 adrenergic agonist d. have the client lie on his/her right side and take deep breaths
C
True or false: a TB skin test result of >3mm induration is indicative of TB exposure
False (>10mm)
The charge nurse is delegating shift assignments. which client should be delegated to the most experienced RN. a. Client A diagnosed with biventricular heart failure who is being discharged today b. Client B who has clubbing of the fingers peripheral edema and weight loss c. Client C with a heart rate of 116 respirations of 30 and BP of 94/62 d. Client D who complains of chest pain with inspiration and a non-productive cough.
C
A nurse is caring for a 76 year old female client brought into the ED by her husband. the husband states that she woke up this morning and did not recognize him or know where she was. the client reports chills and chest pain that worsens with inspiration. which of the following is the highest priority nursing action? a. obtain baseline vitals and O2 sat b. obtain sputum culture c. obtain a complete history from the client d. provide a pneumococcal vaccination
A
A patient arrives at an urgent care center after experiencing unrelenting severe substernal and epigastric pain and pressure for the past four hours. The laboratory result that best supports a diagnosis of myocardial infarction is an elevated level of: a. Troponin b. homocysteine c. Creatine kinase - MB d. C-reactive protein e. Myoglobin
A
For a bedridden client who excretes excessive amounts of calcium during the first few days after open heart surgery, which measure should the nurse implement to help prevent complications associated with excessive calcium excretion? a. ensure a liberal fluid intake b. provide and alkaline- ash diet c. administer medication to prevent constipation d. enrich the clients diet with dairy products
A
"I drank so much tequila that I no longer want to drink it" is a form of a. aversion therapy b. systematic desensitization c. modeling d. suppression
A
A 29-year-old patient has been admitted following a suicide attempt. Which nursing statement illustrates the concept of patient advocacy? A. "Dr. Raye, I notice you ordered fluoxetine for this patient. During the admission interview, the client stated they will refuse the medication because of adverse effects they experienced previously." B. "Dr. Raye, during the admissions interview the patient stated that there is a family history of three other suicide attempts in the past." C. "I'd like you tell me more about your depression and your suicide attempt?" D. "I will take you on a tour of the unit and orient you to the rules so you can get adjusted here."
A
A client is admitted to the cardiac ICU diagnosed with acute exacerbation of chronic heart failure. what signs would the nurse likely find upon assessment a. Apical pulse of 110 and 4+ pitting edema of the feet. b. thick white sputum and crackles that clear with coughing c. client sleeping in a supine position with eupnea d. radial pulse of 90 and capillary refill of <3 seconds
A
A client who was given CPR arrives in the ED... Which assessment finding best indicates that CPR has been successful? a. the client's pupils are equal and reactive to light b. the client has a regular pulse c. the client has pink mucous membranes d. the client's systolic BP is 80mm/Hg
A
A client with severe asthma has silent chest and is in resp failure. the clients ABG values would indicate: a. PH 7.27, C02 53, P02 50, HC03 24 b. PH 7.18, C02 44, P02 92, HC03 16 c. PH 7.53, C02 29, P02 100, HC03 23 d. PH 7.60, C02 37, P02 92, HCO3 35
A
A client with COPD is in the third post op day following a bullectomy. the nurse assesses that the client has required 8 L oxygen by mask to keep her O2 saturation greater than 88%. In response to this assessment, the nurse should... a. increase the oxygen flow rate to achieve O2 sat level of 90% b. determine the clients respiratory rate and notify the physician c. document this normal assessment finding in the clients chart. d. decrease the clients oxygen to 3L by mask
B
A nurse reading the medication order for a client diagnosed with HTN notes that the atenolol has been prescribed. which action should the nurse implement? a. notify the physician if the potassium level is 3.8mEq/L b. Question administering the medication if the blood pressure is less than 90/60 c. do not administer the medication if the heart rate is more than 90 d. prior to administering the medication, take an orthostatic set of blood pressures.
B
A nurse, active in local consumer mental health groups and in local and state mental health associations, keeps aware of state and national legislation affecting mental illness treatment. How can this nurse positively affect the climate for effective, mental health treatment? A. "By becoming active in politics leading to a potential political career." B. "By educating the public on the effects that stigmatizing has on mental health clients." C. "Advocating for laws that would make the involuntary long-term commitment process easier and faster for caregivers of mentally ill persons." D. "Advocating for reduced mental health insurance benefits to discourage abuse of the system by inappropriate psychiatric admissions."
B
Resilience is characteristic of mental health that allows people to adapt to tragedies, trauma, and loss. Which client behavior demonstrates this characteristic? A. "My mother made decisions about my husband's funeral when I just couldn't do that." B. "Losing my job was hard but my skills will help me get another one." C. "In spite of all the treatment, I know I'll never be really healthy." D. "My kids, happiness is worth any sacrifice I have to make."
B
The nurse is caring for a client with bulimia nervosa. The nurse understands that purging behavior is usually triggered by: a. feelings of nausea b. guilt, humiliation, and self-condemnation c. fear of being discovered as a binge eater d. sensation of fullness and bloating
B
The nurse observes a CNA removing the nasal canula from a client with COPD while ambulating the client to the bathroom. what action should the nurse take? a. Praise the CNA because the tubing may have cause the client to trip b. Place the oxygen cannula back on the client while he is sitting in the bathroom c. Inform the CNA that removing the clients oxygen is unsafe d. Discuss the CNAs actions with the CNA after the client has returned to bed.
B
What is the priority goal for a client with asthma who is being discharged from the hospital? a. Is able to obtain pulse oximeter readings b. Demonstrates use of a metered dose inhaler c. Knows the health care provider's office hours d. Describes how asthma affects the airways
B
Which nursing diagnosis would be a priority for a violent Antisocial PD client at the time of admission to the psychiatric unit? a. disturbed sensory perception r/t auditory hallucinations b. impaired social interactions r/t disregard of rights of others c. ineffective denial r/t need for immediate gratification d. social isolation r/t low self-esteem
B
Your client's ECG reveals a 1st degree heart block, the nurse correctly determines that... a. the sinoatrial node is not sending electrical impulses to the ventricles b. electrical conductivity through the heart is slower than normal c. a coronary artery occlusion is blocking electrical impulses through the heart d. contractility of the heart muscles is blocked due to insufficient electrical amplitude
B
forcing meds on a patient who doesn't want them is considered... a. assault b. battery c. I am the nurse d. elopement
B (but also c ;))
A client with Narcissistic PD informs the nurse, "I will not attend the group meeting with all those crazy mental patients." The nurse should appropriately respond: a. "They are not mental patients. They have problems just like you do, so you must attend the meeting." b. "Group meetings are meant to hep and support all patients, including you." c. "If you feel that way about the other patients, you should not attend the meeting." d. "Can you explain why you feel that way?"
B (you want to present reality)
A client has gone into PULSELESS Ventricular Tachycardia, the nurse should prepare to: a. administer digoxin b. administer lidocaine c. perform CPR d. prepare for transcutaneous pacemaker insertion
C
A client with asthma is being taught to use a peak flow meter to monitor his asthma control. What instructions should the nurse give? a. Exhale completely, then take a deep breath from the flow meter mouth piece b. Stand upright, then exhale while bending over c. Inhale completely then blow out as hard and as fast as possible through the mouthpiece d. Keep the mouthpiece two inches from the lips
C
A new nurse has accepted a position as a staff nurse on a psychiatric unit. Which statement made by the new nurse requires additional instructions regarding the therapies provided on the unit? A. "You will participate in unit activities and groups daily." B. "You will be given a schedule daily of the groups we would like you to attend." C. "You will attend a psychotherapy group that I lead that will help you care for yourself." D. "You will see your provider daily in a one-to-one session."
C
A nurse observes a client with an antisocial PD verbally abusing another client, flattering his primary nurse, acting withdrawn during a patient government meeting, and lying to a psychiatrist. Which behavior clearly warrants limit setting? a. flattering his nurse b. acting withdrawn c. verbally abusing another client d. lying to a psychiatrist
C
A patient is receiving a drug that decreases afterload. To evaluate the effect of the drug, the nurse monitors the patients: a. Heart rate b. lung sounds c. blood pressure d jugular vein distention
C
A realistic goal expected outcome for a patient hospitalized with anorexia nervosa would be: a. the client will achieve a weight gain of 5 pounds per week b .the client will not engage in physical exercise c. the client will eat 100% of meals ordered by the nutritionist d. the client will identify underlying emotional causes of anorexia nervosa
C
The parents of a newly diagnosed 15 year old with anorexia nervosa are meeting with the nurse. Which of the following remarks by the parents would the nurse interpret as typical for a client with anorexia nervosa? a. "We've given her everything, and look how she repays us!" b. "Shes has had behavior problems for the past year, both home and at school." c. "She's been a model child. We have never had any problems with her." d. "We have 5 children, all normal kids with some problems at times"
C
Which of the following symptoms are not seen in a client with bulimia? a. hoarse voice b. dental caries (cavities) c. amenorrhea d. Russell's sign
C
You evaluate that the client has accurate knowledge regarding her diltiazem regimen when the client states: a. "I will not take this medication together with chlorothiazide" b. I will not take this medication if my blood pressure is above 160/100 c. I will avoid drinking grapefruit juice while on this medication d. While on this medication, I will monitor my heart rate for tachycardia
C
A client with Borderline PF has ongoing special requests, and frequently asks several different nurses on the unit to grant her requests. In order to promote consistency and minimize opportunities for splitting, the nurses should plan to: a. ask the client why she feels she is entitled to special requests b. ignore any inappropriate requests the client makes c. encourage the client to use coping and problem-solving skills d. inform the client she must contact her assigned nurse with all requests
D
A client with asthma asks the nurse "why is inhalation of corticosteroids the preferred route of administration in people with asthma?" the appropriate response by the nurse is: a. "inhaled medications are easiest to take" b. "It eliminates the need to use other drugs" c. "oral care is not needed after inhaling the drug" d. "the systemic adverse side effects are reduced
D
A client with heart failure is receiving digoxin, metoprolol, and furosemide while hospitalized. one morning he complains of abdominal pain with nausea and reports seeing bright yellow spots and halos around objects. before notifying the physician, the nurse should check which recently obtained lab value. a. potassium b. serum sodium c. furosemide level d. digoxin level
D
A nurse assessing a client correctly suspects left sided heart failure when the client exhibits... a. tachypnea, loss of appetite, ST elevation on the ECG b. increased heart rate, increased blood pressure, and diaphoresis c. asities, peripheral edema, jugular vein distention d. orthopnea, bilateral crackles, tachycardia, and S-3 sounds.
D
A nurse correctly suspects a person in a hypertensive emergency has target organ damage when which of the following findings is evident: a. BUN of 12mg/dL b. rapid elevation of body temp c. creatinine level of 0.9 mg/mL d. impaired peripheral vision
D
An 18 year old patient is admitted to the psychiatric ward for anorexia nervosa. As part of the psychiatric milieu, the patient can anticipate all of the following interventions EXCEPT: a. having trips to the bathroom monitored by an RN b. being weight daily c. being searched after having visitors d. being allowed to eat meals at desired times
D
The client is diagnosed with active TB and started triple antibiotic therapy. What signs would the client show if the therapy is inadequate: a. decreased SOB b. improved chest X ray c. a non productive cough d. positive bacilli in a sputum sample after 2 months of TX
D
The two most common causes of death in clients with anorexia nervosa are: a. kidney failure and cerebrovascular accident b. dehydration and low weight c. gastric rupture and esophageal tears d. cardiac failure and suicide
D
You enter your client's room and note that his ECG shows asystole. Your first action should be to... a. initiate CPR and call a code b. check that the ECG machine is functioning properly c. refer to your Nurs 201 lecture notes d. assess the client e. call a Priest, Minister, Imam, Rabbi, Medicine Man, Curandero, Shaman, or Grief Counselor
D
the only time the patient can refuse meds is... a. never b. 48 hours before court c. any time d. 24 hours before court
D
True or false: to reduce side effects of nausea and GI upset, clients should take an antacid with their TB meds
F (an antiemetic)
True or false: A person with latent TB does not require drug therapy
F (isoniazid)
True or false: Family members living with an individual who has TB should receive a 3-month course of treatment with rifampin and isoniazid
F (they should be tested)
True or false: Clients taking isoniazid should take vitamin C supplements
F (vitamin B6)
True or false: Symptoms of latent TB include chest pain, increased coughing, weight loss, chills and fever
False
True or false: after a person has been successfully treated for active TB, he/she has lifelong TB immunity
False
True or false: After a sequence of three negative TB sputum smears, an individual TB is considered to be non contagious
T
True or false: Individuals with TB must be reported to the state public health dept.
True
True or false: Most individuals with TB are treated on an outpatient basis
True
True or false: TB is transmitted by airborne droplets
True
True or false: the BCG vaccine can result in a false positive TB skin test result
True
True or false: the course of pharmacological tx for TB is 6-9 months
True
The client is hospitalized with active TB. [select all the care interventions that apply] a. Daily TB skin tests are obtained b. no visitors permitted until client is non- infectious c. room should have negative pressure airflow d. nurses in the clients room should wear a high efficiency particulate mask (HEPA) e. urine collected from the clients catheter bag should be labeled "hazardous" f. When the client leaves his/her room, the client should wear a mask
c, d, f
True or false: A person with latent TB has a positive reaction to the TB (PPD) skin test.
true
