practice questions

Which of the following implanted hearing devices transmits sound through the skull to the inner ear?

Bone conduction devices

The intraoperative nurse advocates for each client who receives care in the surgical setting. How can the nurse best exemplify the principles of client advocacy?

By maintaining the privacy of each client

Hearing aids help with which of the following problems?

Makes sounds louder

Which group of medications causes pupillary constriction?

Miotics

An OR nurse will be participating in the intraoperative phase of a client's kidney transplant. What action will the nurse prioritize in this aspect of nursing care?

Monitoring the client's physiologic status

The postanesthesia care unit nurse is caring for a client who had a hernia repair. The client's blood pressure is now 164/92 mm Hg; the client has no history of hypertension prior to surgery and preoperative blood pressure was 112/68 mm Hg. The nurse should assess for which potential causes of hypertension following surgery?

Pain, hypoxia, and bladder distention

The parent of a young client with severe hearing loss is quite concerned about the child's future independence because of impaired hearing. Which type of hearing loss is usually irreversible? sensorineural conductive tinnitus noise exposure

sensorineural

What aspect should the nurse closely monitor for in clients who have been administered salicylates, loop diuretics, quinidine, quinine, or aminoglycosides? Signs of hypotension Reduced urinary output Tinnitus and sensorineural hearing loss Impaired facial movement

Tinnitus and sensorineural hearing loss

A medical nurse is providing palliative care to a client with a diagnosis of end-stage chronic obstructive pulmonary disease (COPD). What is the primary goal of this nurse's care? To improve the client's and family's quality of life To support aggressive and innovative treatments for cure To provide physical support for the client To help the client develop a separate plan with each discipline of the health care team

To improve the client's and family's quality of life

The nurse is providing preoperative teaching to a client scheduled for surgery. The nurse is instructing the client on the use of deep breathing, coughing, and the use of incentive spirometry when the client states, "I don't know why you're focusing on my breathing. My surgery is on my hip, not my chest." What rationale for these instructions should the nurse provide?

To promote optimal lung expansion

A client is in the recovery room following a nephrectomy performed for the treatment of renal cell carcinoma. The client's vital signs and level of consciousness have stabilized, but the client then reports severe nausea and begins to vomit. What should the nurse do next?

Turn the client to one side.

A client has just died following urosepsis that progressed to septic shock. The client's spouse says, "I knew this was coming, but I feel so numb and hollow inside." The nurse should know that these statements are characteristic of what phase? Complicated grief and mourning Uncomplicated grief and mourning Depression stage of dying Acceptance stage of dying

Uncomplicated grief and mourning

Diagnostic tests show that a client's bone density has decreased over the past several years. The client asks the nurse which factors contribute to bone density decreasing. Which response by the nurse would be best? "For many people, a lack of proper nutrition can cause a loss of bone density." "Progressive loss of bone density is mostly related to your genes." "Stress is known to have many unhealthy effects, including reduced bone density." "Bone density decreases with age, but scientists are not exactly sure why this is the case."

"For many people, a lack of proper nutrition can cause a loss of bone density."

When describing the term "grief" to a group of students, which of the following would the instructor include? A part of the life cycle in the form of change, growth, and transition The response experienced by anyone who has suffered a loss A feeling of connectedness with one's self and others Feelings of apprehension or worry in response to a situation

The response experienced by anyone who has suffered a loss

A nurse is providing a class on osteoporosis at the local center for older adults. Which statement related to osteoporosis is most accurate? High levels of vitamin D can cause osteoporosis. A nonmodifiable risk factor for osteoporosis is a person's level of activity. Secondary osteoporosis occurs in women after menopause. The use of corticosteroids increases the risk of osteoporosis.

The use of corticosteroids increases the risk of osteoporosis.

An older adult client is scheduled for cataract surgery and asks the nurse, "Will I need to wear thick lenses after surgery?" Which is the most appropriate response from the nurse?

"An implanted lens has replaced the need for corrective glasses."

A client is exploring treatment options after being diagnosed with age-related cataracts that affect her vision. What treatment is most likely to be used in this client's care?

Surgical intervention

A terminally ill patient in pain asks the nurse to administer enough pain medication to end the suffering forever. What is the best response by the nurse? "I can't do that, I will go to jail." "I am surprised that you would ask me to do something like that." "I will see if the physician will order enough for that to occur." "I will notify the physician that the current dose of medication is not relieving your pain."

"I will notify the physician that the current dose of medication is not relieving your pain."

A client with cancer has just been told that the disease is now terminal. The client tearfully states, "I can't believe I am going to die. Why me?" What is the nurse's best response to elicit more information from the client? "I know how you are feeling." "You have lived a long life." "Tell me more about how you feel about this news." "Life can be so unfair."

"Tell me more about how you feel about this news."

A nurse is assessing a client who is experiencing peripheral neurovascular dysfunction. Which assessment findings are most consistent with this diagnosis? Hot skin and a capillary refill of 1 to 2 seconds Absence of feeling, capillary refill of 4 to 5 seconds, and cool skin Pain, diaphoresis, and erythema Jaundiced skin, weakness, and capillary refill of 3 seconds

Absence of feeling, capillary refill of 4 to 5 seconds, and cool skin

Which type of glaucoma presents an ocular emergency?

Acute angle-closure glaucoma

A client is in a hospice receiving palliative care for lung cancer which has metastasized to the client's liver and bones. For the past several hours, the client has been experiencing dyspnea. What nursing action is most appropriate? Administer a bolus of normal saline, as prescribed. Initiate high-flow oxygen therapy. Administer high doses of opioids. Administer bronchodilators and corticosteroids, as prescribed.

Administer bronchodilators and corticosteroids, as prescribed.

Based on the most common concern of a dying patient, the hospice nurse should: Administer pain medication on a schedule that prevents pain from intensifying. Position the patient to prevent difficulties with breathing. Offer supplemental fluids to prevent dehydration. Turn the patient every 2 hours to prevent decubitus ulcers.

Administer pain medication on a schedule that prevents pain from intensifying.

A nurse is part of a team involved with informing a client and his wife about the spread of his cancer. When communicating with the client and wife, which of the following would be most appropriate? Arranging to meet with the client and wife in the waiting room of the facility Providing them with extensive details of the findings and proposed treatment Allowing time for the client and wife to absorb and respond to the information Using technical terminology when describing the condition

Allowing time for the client and wife to absorb and respond to the information

Which of the following classification of medications is the most common cause of ototoxicity? Aminoglycosides Cephalosporins Sulfonamides Penicillins

Aminoglycosides

A client has been experiencing progressive increases in knee pain and diagnostic imaging reveals a worsening effusion in the synovial capsule. The nurse should anticipate what diagnostic procedure? Arthrography Knee biopsy Arthrocentesis Electromyography

Arthrocentesis

The nurse is planning teaching for a client who is scheduled for an open hemicolectomy. The nurse intends to address the topics of incision splinting and leg exercises during this teaching session. When is the best time for the nurse to provide teaching?

As soon as possible, and before the surgical procedure

A nurse is reviewing the pathophysiology that may underlie a client's decreased bone density. What hormone should the nurse identify as inhibiting bone resorption and promoting bone formation? Estrogen Parathyroid hormone (PTH) Calcitonin Progesterone

Calcitonin

An 87-year-old client has been hospitalized with pneumonia. Which nursing action would be a priority in this client's plan of care?

Cautious hydration

A client is reporting pain in her casted leg. The nurse has administered analgesics and elevated the limb. Thirty minutes after administering the analgesics, the client states the pain is unrelieved. The nurse should identify the warning signs of what complication? Subcutaneous emphysema Skin breakdown Compartment syndrome Disuse syndrome

Compartment syndrome

A nurse is performing a musculoskeletal assessment of a client with arthritis. During passive range-of-motion exercises, the nurse hears an audible grating sound. The nurse should document the presence of what assessment finding? Fasciculations Clonus Effusion Crepitus

Crepitus

A client who has been demonstrating signs of impending death is awake, alert, and wants to see grandchildren after they attend school. Which action will the nurse take to support this client's request? Suggest the family bring one grandchild per day to visit the client. Contact the family to ask for grandchildren to come to visit the client. Tell the family that the client will most likely not last until the end of the day. Remind the client that they need rest and the grandchildren can visit another time.

Contact the family to ask for grandchildren to come to visit the client.

Immediately on cessation of vital functions, the body begins to change. The nurse would expect which physical change to occur following death? Dusky appearance Increased body temperature Flushed appearance Absence of incontinence

Dusky appearance

A nurse is assessing a client who comes to the clinic for care. Which findings in this client suggest bacterial pneumonia?

Dyspnea and wheezing

A nurse is taking a health history on a client with musculoskeletal dysfunction. What should the nurse prioritize during this phase of the assessment? Evaluating the effects of the musculoskeletal disorder on the client's function Evaluating the client's adherence to the existing treatment regimen Evaluating the presence of genetic risk factors for further musculoskeletal disorders Evaluating the client's active and passive range of motion

Evaluating the effects of the musculoskeletal disorder on the client's function

The nurse is providing care to a client who has been admitted to the hospital for treatment of an infection. The client is visually impaired. Which of the following would be most appropriate for the nurse to do when interacting with the client?

Face the client when speaking directly to him.

The nurse is admitting a 55-year-old client diagnosed with a left eye retinal detachment. While assessing this client, what characteristic symptom would the nurse expect to find?

Flashing lights in the visual field

The nurse is caring for a client who has had spinal anesthesia. The client is under a health care provider's order to lie flat postoperatively. When the client asks to go to the bathroom, the nurse encourages the client to adhere to the health care provider's order. Prevention of which outcome should the nurse include in the rationale for complying with this order?

Headache

A nursing instructor is preparing a class discussion about hope and end-of-life care. Which of the following would the instructor include as an example of a hope-fostering activity? Pain Abandonment Isolation Humor

Humor

A critical-care nurse is caring for a client diagnosed with pneumonia as a surgical complication. The nurse's assessment reveals that the client has an increased work of breathing due to copious tracheobronchial secretions. What should the nurse encourage the client to do?

Increase oral fluids unless contraindicated.

The nurse is creating the care plan for a 70-year-old obese client who has been admitted to the postsurgical unit following a colon resection. This client's age and body mass index increase the risk for what complication in the postoperative period?

Infection

A nurse is providing preoperative teaching to a client who will soon undergo a cardiac bypass. The nurse's teaching plan includes exercises of the extremities. What is the purpose of teaching a client leg exercises prior to surgery?

Leg exercises improve circulation and prevent venous thrombosis.

The nurse is caring for a client on the medical-surgical unit postoperative day 5. During each client assessment, the nurse evaluates the client for infection. Which of the following would be most indicative of infection?

Red, warm, tender incision

A client's fracture is healing and compact bone is replacing spongy bone around the periphery of the fracture. This process characterizes what phase of the bone healing process? Hematoma formation Fibrocartilaginous callus formation Remodeling Bony callus formation

Remodeling

A nurse is providing discharge education to a client who is going home with a cast on his leg. What topic should the nurse emphasize in the teaching session? Using crutches efficiently Exercising joints above and below the cast, as prescribed Removing the cast correctly at the end of the treatment period Reporting signs of impaired circulation

Reporting signs of impaired circulation

The client has been diagnosed with terminal COPD. The client and the client's family have not yet agreed on the final arrangements and are discussing options. How can the nurse best intervene in these final decisions? Respect the client's autonomy and right to determine how to spend the rest of his or her life. Persuade the client to follow their family's preferences for end-of-life care. Remind the family that the client needs to focus energy on recovery. Ask the family members about coordinating spiritual care for the client.

Respect the client's autonomy and right to determine how to spend the rest of his or her life.

A nurse is interviewing a middle-aged client at the clinic. During the interview, the client states, "I've noticed that I keep having to move the newspaper farther away to read it. Soon my arms will be too short!" The nurse interprets this finding as indicative of which age-related change?

loss of accommodation

A nurse is preparing a presentation for a local community about hearing loss and prevention. Which of the following would the nurse integrate into the presentation as the most effective preventive measure? Maintaining daily hygiene for the ears Having yearly audiometric testing Obtaining prompt treatment for ear infections Wearing ear protection when exposed to noise

Wearing ear protection when exposed to noise

A nurse needs to change a dressing on an abdominal wound for a patient who is hearing-impaired and whose speech is difficult to understand. Which of the following is the best approach for the nurse? Write down the steps of the procedure for the patient to read before beginning the treatment. Change the dressing while the patient is reading the steps of the treatment because distraction decreases anxiety. Use nonverbal signals of agreement (head nodding), even if unsure, to instill confidence and trust. Minimize misunderstandings by completing the patient's sentences (e.g., fill-in-the-blanks) to decrease the patient's embarrassment.

Write down the steps of the procedure for the patient to read before beginning the treatment.

A nurse is caring for a 78-year-old client with a history of osteoarthritis (OA). When planning the client's care, what goal should the nurse prioritize? The client will express satisfaction with the ability to perform ADLs. The client will recover from OA within 6 months. The client will adhere to the prescribed plan of care. The client will deny signs or symptoms of OA.

The client will express satisfaction with the ability to perform ADLs.

The nurse is caring for a 90-year-old client who has never completed an advance directive. The client has a child but has not seen the child in several years. A neighbor has assisted the client with meals and housecleaning for many years. The neighbor states that the client expressed only wanting to have comfort measures. The estranged offspring wants the client to be treated aggressively. Which would be the nurse's initial step? Follow the child's directive. Follow the neighbor's directive. Assess the client's ability to state wishes. Notify the physician of the discrepancy.

Assess the client's ability to state wishes.

An older, female client with osteoporosis has been hospitalized. Prior to discharge, when teaching the client, the nurse should include information about which major complication of osteoporosis? Bone fracture Loss of estrogen Negative calcium balance Dowager hump

Bone fracture

The public health nurse is addressing eye health and vision protection during an educational event. What statement by a participant best demonstrates an understanding of threats to vision?

"I'm certainly going to keep a close eye on my blood pressure from now on."

A client has been diagnosed with glaucoma and the nurse is preparing health education regarding the client's medication regimen. The client states that eagerness to "beat this disease" and looks forward to the time that the client will no longer require medication. How should the nurse best respond?

"In fact, glaucoma usually requires lifelong treatment with medications."

A presurgical client asks, "Why will I go to the postanesthesia care unit (PACU) instead of just going straight up to the postsurgical unit?" Which response by the nurse would be best?

"It allows us to observe you until you're oriented and have stable vital signs and no complications."

A nurse is caring for a client who is in skeletal traction. To prevent the complication of skin breakdown in a client with skeletal traction, what action should be included in the plan of care? Apply occlusive dressings to the pin sites. Encourage the client to push up with the elbows when repositioning. Encourage the client to perform isometric exercises once a shift. Assess the pin insertion site every 8 hours.

Assess the pin insertion site every 8 hours.

A nurse is taking a health history on a new client who has been experiencing unexplained paresthesia. What question should guide the nurse's assessment of the client's altered sensations? How does the strength in the affected extremity compare to the strength in the unaffected extremity? Does the color in the affected extremity match the color in the unaffected extremity? How does the feeling in the affected extremity compare with the feeling in the unaffected extremity? Does the client have a family history of paresthesia or other forms of altered sensation?

How does the feeling in the affected extremity compare with the feeling in the unaffected extremity?

The nurse admits a client to the postanesthesia care unit with a blood pressure of 132/90 mm Hg and a pulse of 68 beats per minute. After 30 minutes, the client's blood pressure is 94/47 mm Hg, and the pulse is 110. The nurse documents that the client's skin is cold, moist, and pale. This client is showing signs of what potential issue?

Hypovolemic shock

The nursing care plan for a client in traction specifies regular assessments for venous thromboembolism (VTE). When assessing a client's lower limbs, what sign or symptom is suggestive of deep vein thrombosis (DVT)? Increased warmth of the calf Decreased circumference of the calf Loss of sensation to the calf Pale-appearing calf

Increased warmth of the calf

Verification that all required documentation is completed is an important function of the intraoperative nurse. The intraoperative nurse should confirm that the client's accompanying documentation includes which of the following?

Informed consent

Which is a sign of approaching death? Increase in urinary output Clear sensorium Insomnia Irregular breathing patterns

Irregular breathing patterns

A client with a fractured femur is in balanced suspension traction. The client needs to be repositioned toward the head of the bed. During repositioning, what should the nurse do? Place slight additional tension on the traction cords. Release the weights and replace them immediately after positioning. Reposition the bed instead of repositioning the client. Maintain consistent traction tension while repositioning.

Maintain consistent traction tension while repositioning.

A hospice nurse should be aware that the most effective pain medication used at the end of life that also relieves dyspnea and anxiety is which of the following? Morphine Demerol Percodan Codeine

Morphine

The nurse is caring for a client who has terminal lung cancer and is unconscious. Which assessment finding would most clearly indicate to the nurse that the client's death is imminent? Mottling of the lower limbs Slow, steady pulse Bowel incontinence Increased swallowing

Mottling of the lower limbs

The circulating nurse will be participating in a 78-year-old client's total hip replacement. Which consideration should the nurse prioritize during the preparation of the client in the operating room?

Pressure points should be assessed and well padded.

The nurse is caring for a client who underwent a total hip replacement yesterday. What should the nurse do to prevent dislocation of the new prosthesis? Keep the affected leg in a position of adduction. Have the client reposition himself independently. Protect the affected leg from internal rotation. Keep the hip flexed by placing pillows under the client's knee.

Protect the affected leg from internal rotation.

A client with a brain tumor recently stopped radiation and chemotherapy for treatment of the cancer. The client recently reported dry mouth. Which intervention by the hospice nurse demonstrates that the nurse understands treatment measures for dry mouth? Begin 9% normal saline IV at 125 mL/hr. Place two drops of atropine ophthalmic 1% solution sublingually. Provide gentle oral care after each meal. Gently suction the client's mouth and buccal cavity.

Provide gentle oral care after each meal.

While performing an assessment, the nurse notes that a client has soft subcutaneous nodules along the extensor tendons of the fingers. Which disorder does this client most likely have? Osteoarthritis Rheumatoid arthritis Gout Paget disease

Rheumatoid arthritis

A nurse is planning the care of a client who will require a prolonged course of skeletal traction. When planning this client's care, the nurse should prioritize interventions related to what risk nursing diagnosis? Risk for Impaired Skin Integrity Risk for Falls Risk for Imbalanced Fluid Volume Risk for Aspiration

Risk for Impaired Skin Integrity

The nurse is admitting a 52-year-old father of four into hospice care. The client has a diagnosis of Parkinson disease, which is progressing rapidly. The client has made clear his preference to receive care at home. What intervention should the nurse prioritize in the plan of care? Aggressively continuing to fight the disease process Moving the client to a long-term care facility when it becomes necessary Including the children in planning their father's care Supporting the client's and family's values and choices

Supporting the client's and family's values and choices

A client has been hospitalized for treatment of acute bacterial pneumonia. Which outcome indicates an improvement in the client's condition?

The client has a partial pressure of arterial oxygen (PaO2) value of 90 mm Hg or higher.

The nurse is assessing a new adult client. What characteristic of this client's status should the nurse identify as increasing the client's risk for glaucoma?

The client has diabetes.

The nurse is taking the client into the operating room (OR) when the client informs the nurse that the client's grandparent spiked a very high temperature in the OR and nearly died 15 years ago. What relevance does this information have regarding the client?

The client may be at risk for malignant hyperthermia.

The circulating nurse in an outpatient surgery center is assessing a client who is scheduled to receive moderate sedation. Which principle should guide the care of a client receiving this form of anesthesia?

The client must never be left unattended by the nurse.

You are admitting a 30-year-old who has a hearing impairment. The client is accompanied by family members. What information would be important to ask the family members to help you care for your client? How the client lost their hearing What allergies the client has The client's preferred method of communication How much the client weighs

The client's preferred method of communication