Practice questions for exam 1

5) A client recovering from total hip replacement surgery is experiencing pain exacerbated with movement and tells the nurse, "I have no idea how I can return home, as I live alone." The client's BMI is 35. Which nursing diagnosis would be a priority for this client? A) Imbalanced Nutrition: More than Body Requirements B) Acute Pain C) Impaired Physical Mobility D) Ineffective Coping

A) "I have signed a contract with Lifeline." C) "I've borrowed a toilet seat riser from the equipment closet."

1) The nurse is presenting a program on surviving a fall at a senior center. Which statement indicates that the participant needs clarification of the content on emergency hip fracture actions after a fall? A) "I should crawl to a phone on the affected side to keep it stable against a hard surface." B) "I need to subscribe to an emergency call service like Lifeline." C) "To call for help, I can scoot on my bottom to a low wall-mounted phone." D) "If possible, I can crawl to a stairway and use the stairs to lift up to a standing position."

A) "I should crawl to a phone on the affected side to keep it stable against a hard surface."

4) A nurse is teaching a mother warning signs and symptoms to watch for in her child, who will be discharged with a full leg cast. Which statement by the mother indicates that further teaching is required? Select all that apply. A) "If her foot turns white and cold, I should call the call the physical therapist." B) "I can expect she will have some pain that the medicine will help." C) "We can use a blow drier on low to help with the itching." D) "We can cut a hole in the cast if her foot swells until we get her to a doctor." E) "It is ok that the plaster cast gets damp as long as I blow dry it."

A) "If her foot turns white and cold, I should call the call the physical therapist." D) "We can cut a hole in the cast if her foot swells until we get her to a doctor."

5) A client is admitted to the Emergency Department in a sickle cell crisis. The nurse assesses the client and documents the following clinical findings: temperature 102°F, O2 saturation of 89%, and complaints of severe abdominal pain. Based on the assessment findings, which intervention is the greatest priority? A) Apply oxygen per nasal cannula at 3 L/minute. B) Assess and document peripheral pulses. C) Administer morphine sulfate 10 mg IM. D) Administer Tylenol 650 mg by mouth.

A) Apply oxygen per nasal cannula at 3 L/minute.

5) A nursing student is preparing an educational program on hemolytic anemia for the residents of an assisted-living center. Which extrinsic causes of hemolytic anemia should the student include in the program? Select all that apply. A) Bacterial infection B) Thalassemia C) Ibuprofen use D) Prosthetic heart valves E) Acetaminophen use

A) Bacterial infection C) Ibuprofen use D) Prosthetic heart valves

11) The nurse gives discharge instructions to a 57-year-old bicycle enthusiast who sustained a fall and underwent open reduction and internal fixation of a fractured hip. Which of the following client behaviors support that discharge teaching goals were met? Select all that apply. A) Gives a return demonstration of an abduction pillow with the wide end at the bottom of the bed. B) Backs with a walker until posterior thighs touch the seat of a low chair prior to sitting. C) The client plans to drive to physical therapy appointment in 1 week. D) Verbalizes pain of 3/10 on discharge from the hospital. E) The client's daughter is present for all teaching.

A) Gives a return demonstration of an abduction pillow with the wide end at the bottom of the bed. D) Verbalizes pain of 3/10 on discharge from the hospital. E) The client's daughter is present for all teaching.

9) A pediatric nurse is educating the client with sickle cell disease and the client's family regarding the genetic implications of the disease. The nurse will include all information except: A) If both parents have the trait, then with each pregnancy, the risk of having a child with the disease is 50%. B) The disorder is transmitted as an autosomal recessive genetic defect. C) The sickle cell gene may have originated to protect against lethal forms of malaria. D) In African-Americans, sickle cell disease occurs in 1 out of every 500 births.

A) If both parents have the trait, then with each pregnancy, the risk of having a child with the disease is 50%.

3) A client with a history of anemia has started a vegan diet. Which addition to meals should the nurse recommend to help ensure that this client has adequate amounts of iron in the diet? Select all that apply. A) Legumes B) Orange juice C) Brewer's yeast D) Okra E) Peas

A) Legumes B) Orange juice E) Peas

4) An older client with renal failure is diagnosed with anemia. What does the nurse realize was the cause of this client's anemia? A) Loss of the kidney hormone erythropoietin B) A loss of appetite related to elevated blood urea nitrogen (BUN) and creatinine levels C) The renal dialysis used to treat the chronic renal failure D) Loss of blood through the urine because the failing kidney does not function properly

A) Loss of the kidney hormone erythropoietin

13) A nurse is providing discharge instructions to a client with iron deficiency who is experiencing glossitis. The nurse includes which statements to provide information to the client? Select all that apply. A) Monitor the condition of the lips and tongue daily. B) Use an alcohol-based mouthwash every 2-4 hours. C) Provide frequent oral hygiene. D) Apply a non-petroleum-based lubricating jelly or ointment to the lips after oral care. E) Use a soft toothbrush or sponge to provide oral care.

A) Monitor the condition of the lips and tongue daily. C) Provide frequent oral hygiene. E) Use a soft toothbrush or sponge to provide oral care.

3) The nurse is assigned to care for a child with sickle cell disease who is being admitted with splenic sequestration crisis. Which room would be the most appropriate for this child? A) Private room B) Semi-private room C) Contact-isolation room D) Airborne-isolation room

A) Private room

6) The nurse is planning care for a young child who is admitted with sickle cell crisis. The parents are with the child, and neither has much information about the disease. When planning care for this family, the nurse will set which goal with this family? A) The child will drink adequate amounts of fluid each day. B) The child will play outside in the sun. C) The family will not have the child vaccinated. D) The family will plan vacations in high-altitude areas.

A) The child will drink adequate amounts of fluid each day.

2) The nurse is evaluating an older client in a long-term care facility after a fall. Which assessment finding requires priority action? A) The injured leg is shortened and externally rotated. B) Redness and severe swelling are found at the hip joint. C) Pain is relieved by moving the affected extremity. D) The patient is repeatedly flexing the injured leg at the hip.

A) The injured leg is shortened and externally rotated.

6) The x-ray of a client 14 weeks post-ulnar fracture exhibits no callus formation. Which collaborative action does the nurse anticipate? A) The physical therapist will set up Buck traction. B) The surgeon will order electromagnetic stimulation. C) The pharmacist will educate the client on antibiotics. D) The nurse will counsel the client on starting range-of-motion exercise.

B) The surgeon will order electromagnetic stimulation

7) A nurse is providing discharge teaching for a client with iron deficiency anemia. The client has been prescribed ferrous sulfate and has been told to increase the intake of foods that are naturally high in iron. Which client statements indicate a need for further education? Select all that apply. A) "I will take my ferrous sulfate tablet with my morning oatmeal." B) "I will decrease my intake of green leafy vegetables while taking my ferrous sulfate tablet." C) "I will increase my fluid intake while I am taking my ferrous sulfate." D) "I will take my ferrous sulfate tablet on an empty stomach." E) "I will decrease milk intake while taking my ferrous sulfate tablet."

B) "I will decrease my intake of green leafy vegetables while taking my ferrous sulfate tablet." D) "I will take my ferrous sulfate tablet on an empty stomach." E) "I will decrease milk intake while taking my ferrous sulfate tablet."

6) The home healthcare nurse is preparing a care plan for a client with severe anemia. The client currently lives alone and states, "I can't even walk to the kitchen without getting winded." What would be the priority nursing diagnosis for this client? A) Hopelessness B) Activity Intolerance C) Altered Nutrition, Less than Body Requirements D) Anxiety

B) Activity Intolerance

2) A nurse educator is teaching a group of parents how to prevent a sickle cell crisis in the child with sickle cell disease. What should the nurse instruct about the precipitating factors that could contribute to a sickle cell crisis? Select all that apply. A) Increased fluid intake B) Altitude C) Fever D) Vomiting E) Regular exercise

B) Altitude C) Fever D) Vomiting

8) The nurse is providing care to a client who has received multiple transfusions of packed red blood cells for treatment of sickle cell disease. Recent lab values for this client indicate high levels of iron. Which medication should the nurse expect to administer to the client experiencing an overload of iron? A) Acetaminophen B) Deferoxamine C) Morphine sulfate D) Tamoxifen

B) Deferoxamine

3) A postmenopausal client asks the nurse what she can do to prevent fracturing her hips, as her mother and grandmother both experienced this health problem. What should the nurse instruct this client? A) Avoid exercise. B) Do not smoke. C) Limit sun exposure. D) Use throw rugs throughout the home.

B) Do not smoke.

10) The nurse is caring for an older client with hemolytic anemia. What should the nurse recall about this diagnosis? Select all that apply. A) It causes the red blood cells to be microcytic. B) It is associated with an increase in the reticulocyte count. C) It is the result of blood loss. D) It is a result of the premature destruction of red blood cells. E) It always requires treatment with folic acid.

B) It is associated with an increase in the reticulocyte count. D) It is a result of the premature destruction of red blood cells. E) It always requires treatment with folic acid.

9) A client hospitalized with an open reduction and internal fixation of a fractured femur reports right calf pain. You note the right calf is 3.5 cm larger than the left calf with generalized posterior erythema. The right calf is tender to touch. Dorsalis pedis pulse is 3/4+ bilaterally. What is the nurse's next action? A) Use a Doppler stethoscope to confirm pedal pulses. B) Notify the healthcare provider of the findings. C) Prepare to apply a cast to the right leg. D) Prepare to administer intravenous heparin.

B) Notify the healthcare provider of the findings.

1) A client who sustained multiple fractures in a motor vehicle accident is at high risk of osteomyelitis due to which fracture? A) Avulsion B) Open C) Comminuted D) Depression

B) Open

3) The nurse is discharging a client after a fracture. You know this client has unsealed epiphyseal plates, experienced a spiral fracture, and is active for the client's age. Which are the most appropriate components of this discharge plan? Select all that apply. A) Teach on home safety related to fall prevention. B) Refer to social worker for assessment related to family dynamics. C) Refer to physical therapy for brace fitting. D) Teach on medication to treat osteoporosis. E) Teach on safety equipment for sports and play.

B) Refer to social worker for assessment related to family dynamics. E) Teach on safety equipment for sports and play.

10) An Emergency Department nurse is caring for a child in a sickle cell crisis. The nurse suspects the etiology of the crisis as being thrombotic in nature due to which clinical manifestations? Select all that apply. A) The client has profound pallor and fatigue. B) The client is in extreme pain. C) The client has profound hypotension and shock. D) The client has a fever. E) The client's chest CT reveals a pulmonary infarct.

B) The client is in extreme pain. D) The client has a fever.

2) The nurse is answering questions from participants after a presentation on preventing fractures at an assisted-living facility. Which resident is at highest risk for the development of fractures? A) The resident who participates in resistance training exercises 3 times a week and takes a calcium supplement B) The resident who hikes in the woods once a week and smokes 14 cigarettes per day C) The resident who line dances twice a week and has a glass of wine with dinner D) The resident who teaches yoga four times per week and is lactose-intolerant

B) The resident who hikes in the woods once a week and smokes 14 cigarettes per day

7) Which evaluation data indicates that a positive outcome was met in a client who is being seen for a 6-week follow-up status post a fracture associated with osteoporosis? A) Greenstick fracture exhibits complete union on x-ray. B) Twenty-pound weight loss has been accomplished since surgery. C) Prophylactic corticosteroid treatment course completed D) Physical therapy treatment course completed

B) Twenty-pound weight loss has been accomplished since surgery.

9) A client recovering from surgery to repair a fractured hip has a history of osteomyelitis. What can the nurse do to reduce the client's risk for a postoperative infection? Select all that apply. A) Assess for pain every 1-2 hours. B) Use sterile technique for dressing changes. C) Assess wound for size, color, and drainage. D) Administer antibiotics as prescribed. E) Monitor for edema and swelling.

B) Use sterile technique for dressing changes. C) Assess wound for size, color, and drainage. D) Administer antibiotics as prescribed.

1) A client complaining of mouth soreness had gastric bypass surgery 1 year ago. During the assessment, the nurse notes the client's tongue is beefy, red, and smooth and the client's skin appears yellowish. Which additional information is most likely needed before diagnosing this client? A) Vitamin B6 levels B) Vitamin B12 levels C) Potassium levels D) Iron levels

B) Vitamin B12 levels

1) Parents of a newborn infant are concerned that their baby may have sickle cell disease. The nurse reviews the medical record and finds that both parents have the sickle cell trait. Which is the best response for the nurse to give the parents? A) "Since neither of you actually has sickle cell disease, your baby is not at risk." B) "Your baby has the disease, as you both carry the trait." C) "As you both have the sickle cell trait, your baby will be tested for the disease." D) "Have you talked to a genetic counselor about your concerns?"

C) "As you both have the sickle cell trait, your baby will be tested for the disease."

8) The nurse is evaluating a client's understanding of dietary needs to treat dietary deficiency anemia. Which client statement indicates a need for additional teaching? A) "I will eat more fruits and vegetables, especially green leafy ones, to get more iron in my diet." B) "I will need to include more protein foods in my diet such as meats, dried beans, and whole-grain breads." C) "I will decrease foods high in vitamin C, as they decrease my absorption of iron." D) "I will take vitamins with extra iron in addition to eating a balanced diet with meat to correct my anemia."

C) "I will decrease foods high in vitamin C, as they decrease my absorption of iron."

8) The nurse in an orthopedic outpatient clinic expects to see several clients with fractures for follow-up. After reviewing the clients' charts, which client is at the highest risk of delayed union? A) 20-year-old college student with type I diabetes mellitus who sustained a fractured tibia in a bicycle accident. Nutrition recall tool completed during the last visit was consistent with American Diabetic Association (ADA) guidelines. B) 62-year-old bartender with a history of peptic ulcer who sustained a fractured clavicle breaking up a fight at work. He was upset about abstaining from upper body resistance training. C) 49-year-old teacher with osteoporosis who sustained an open ulnar fracture in a motor vehicle accident. Reports that she has cut down smoking to 10 cigarettes per day. D) 55-year-old accountant who sustained fractures to the 4th and 5th right metatarsals. He has a history of hypertension under good control with medication.

C) 49-year-old teacher with osteoporosis who sustained an open ulnar fracture in a motor vehicle accident. Reports that she has cut down smoking to 10 cigarettes per day.

10) A client is undergoing surgery for a fractured hip. The surgeon has expressed that careful attention will be paid to preserving the epiphyseal plate. Which client will require this precaution during surgery? A) A post-menopausal paraplegic B) A 32-year-old competitive body builder C) A prepubescent girl who is a vegetarian D) An 85-year-old woman with osteoporosis

C) A prepubescent girl who is a vegetarian

4) The first day after surgery to repair a fractured hip sustained from a fall, an older client refuses to ambulate but says he will consider it tomorrow. Which is action is priority for the nurse? A) Coordinate personnel to assist with ambulation. B) Document the client's refusal. C) Assess why the client is refusing to ambulate. D) Notify the surgeon.

C) Assess why the client is refusing to ambulate.

12) A nurse is educating a client with anemia about the pathophysiological mechanisms of anemia. The nurse's teaching should include all except: A) Altered hemoglobin synthesis. B) Altered DNA synthesis. C) Decreased hemolysis. D) Bone marrow failure.

C) Decreased hemolysis.

9) The nurse suspects that a client with severe shortness of breath in the absence of cyanosis is experiencing anemia. Which laboratory tests should the nurse review to confirm anemia? Select all that apply. A) Serum electrolytes B) Cardiac enzymes C) Hemoglobin D) Blood sugar E) Hematocrit

C) Hemoglobin E) Hematocrit

11) A nurse is planning care for a client with sickle cell disease and chooses "Acute Pain" as the nursing diagnosis. The nurse plans all interventions to support this diagnosis except: A) Administer ordered analgesic medications around the clock. B) Place patient in position of comfort. C) Use heat or cold packs as tolerated. D) Support the client's joints and extremities with pillows.

C) Use heat or cold packs as tolerated.

4) A client in sickle cell crisis reports taking a recent skiing trip that caused a respiratory infection from the cold weather. The client reports a pain level of 8 on a pain scale from 0 to 10. Which nursing diagnosis is a priority for this client? A) Fluid Volume Excess B) Risk for Self-Mutilation C) Knowledge Deficit D) Acute Pain

D) Acute Pain

2) A client experiencing fatigue, pallor, and dyspnea on exertion has a complete blood count drawn. Which red blood cell disorder should the nurse anticipate the client is experiencing? A) Polycythemia B) Erythropoiesis C) Herpes simplex D) Anemia

D) Anemia

7) The nurse is caring for a client who was admitted to a medical-surgical unit in a sickle cell crisis. Which medication should the nurse expect to administer to this client? A) Acetaminophen (Tylenol) B) Ibuprofen (Advil) C) Meperidine (Demerol) D) Hydroxyurea

D) Hydroxyurea

8) An older client, diagnosed with a fractured hip, participates in golf and does home maintenance activities. The nurse realizes that this client is a candidate for which surgical repair procedure? A) Total hip replacement B) Open reduction and external fixation C) Austin-Moore prosthesis D) Open reduction and internal fixation

D) Open reduction and internal fixation

7) The nurse is evaluating care provided to a client recovering from hip replacement surgery. What would indicate that the client has achieved the expected outcome for pain management? A) Medicating for pain with intramuscular injection every 4 hours B) Client crying and requesting pain medication prior to morning care C) Client using PCA pump around the clock for pain management D) Providing pain medication prior to physical therapy

D) Providing pain medication prior to physical therapy

11) The nurse is instructing a client with iron deficiency anemia about appropriate menu choices. Which diet choice indicates that teaching has been effective? A) Tofu with mixed vegetables in curry, milk, whole-wheat bun B) Broiled fish, lettuce salad, grapefruit half, carrot sticks C) Pork chop, mashed potatoes and gravy, cauliflower, tea D) Roast beef, steamed spinach, tomato soup, orange juice

D) Roast beef, steamed spinach, tomato soup, orange juice

10) A client who is hospitalized after a left hip fracture is scheduled for surgery late this afternoon. After receiving report, the nurse evaluates the Buck traction applied by a new physical therapist. Which finding indicates that the traction is correctly applied? A) Foam boot covers the right lower leg from the knee down. B) 20-pound weights are connected to the bottom of a foam boot. C) Weights are supported by a stool at the end of the bed. D) The left knee and hip are in alignment above the foam boot.

D) The left knee and hip are in alignment above the foam boot.