301 Exam #1 Clicker Questions
A patient is brought to an emergency department in an unconscious condition. The hemoglobin level of the patient is 20g/dl. How should the nurse interpret the lab result? A: The patient is dehydrated B: The patient has anemia C: The patient has internal hemorrhage D: The patient has fluid volume excess
A
A patient in end-stage kidney disease is prescribed epoetin (Epogen). Before administering the first dose, the nurse should: A: Check to see if the patient has any difficulty swallowing B: Assess the hemoglobin level C: Hold the medication if the BUN is elevated D: Administer diphenhydramine (Benadryl)
B
A patient is admitted to the hospital with idiopathic aplastic anemia. Which of these collaborative problems will the nurse include when developing the care plan? A: Potential complication: seizures B: Potential complication: infection C: Potential complication: hypokalemia D: Potential complication: pulmonary edema
B
A 68-year-old scheduled for a herniorrhaphy at an ambulatory surgical center expresses concern that he will not have enough care at home and asks if he can stay in the hospital after the surgery. The best response by the nurse is: A: "Who is available to help you after the surgery?" B: "I'm sure you will be able to manage at home after surgery. It is a simple procedure" C: "We will teach you everything you need to know to be able to care for yourself after surgery" D: "Your health insurance will pay for inpatient care only if complications develop during surgery"
A
A female patient's complicated history of signs and symptoms have finally led to the diagnosis of Lupus. Which statement demonstrates the patient's need for further teaching about the disease? A: "I'm hoping that surgery will be an option for me in the future" B: "I'll try my best to stay out of the sun this morning" C: "I know that I probably have a high chance of getting arthritis" D: "I understand that I'm going to be vulnerable to getting infections"
A
A patient has been taking opioid analgesics for more than 2 weeks to control his post-surgical pain. While the surgeon is pleased with his healing progress, he wants to change the analgesic to a non-opioid drug. The prescribes a gradually lower opioid dose and increasingly larger non-opioid drug does/ Why is the surgeon changing medications in this manner? A: To avoid withdrawal symptoms B: To avoid addiction C: To avoid tolerance D: To avoid respiratory depression
A
A patient is having major abdominal surgery tomorrow. During prep teaching, the nurse teaches the patient how to do deep breathing exercises after surgery by telling the patient to: A: "Hold your abdomen firmly with a pillow, and take several deep breaths" B: "Tighten your stomach muscles as you inhale, and breathe normally in and out of your mouth" C: "Raise your shoulders to expand your chest and rib cage" D: "Sit in an upright position and perform 'huff' breathing"
A
A patient is prescribed 325 mg/day of oral ferrous sulfate. The nurse includes in patient teaching, "Take your iron pill... A: 1 hour before breakfast" B: with dairy products" C: and decrease fruits and juices in your diet" D: along with a low residue diet"
A
A patient who has been newly diagnosed with SLE has been admitted to the med-surf unit. The nurse anticipates which diagnostic finding related to this disease? A: Thrombocytopenia B: Elevated hemoglobin level C: Negative antinuclear antibodies (ANA) level D: Glucosuria
A
A patient with a positive Mantoux test result is taking isoniazid (INH) for treatment on TB. In assessing for side effects of this medication, the nurse should specifically include which of the following during the clinic visit? A: Scleral assessment B: Assess for peripheral edema C: Assess for dyspnea D: Note return rate and capillary refill
A
After receiving change-of-shift report about these postoperative patients, which patient should the nurse assess first? A: Obese patient who had abdominal surgery 3 days ago and whose wound edges are separating B: Patient who has 30ml of sanguineous drainage in the wound drain 10 hours after hip replacement surgery C: Patient who has bibasilar crackles and a temperature of 100 degrees on the first postoperative day after chest surgery D: Patient who continues to have incisional pain 20minutes after hydrocodone and acetaminophen (Vicoden) was given.
A
The instructor is reviewing "pneumonia" with the nursing student. Which statement could be included in the conversation? A: Streptococcus pneumonia is the most common causative organism B: Community acquired pneumonia (CAP) has a higher mortality than hospital acquired pneumonia (HAP) C: All pneumonias can be treated with antibiotics D: Vomiting is a prerequisite for aspiration pneumonia
A
The patient diagnosed with OA tells the nurse, "My friend takes steroid pills for her RA. Are steroids used for OA too?" What should the nurse explain to the patient? A: Intra-articular corticosteroids injections can be used to treat OA B: Oral corticosteroids are used in OA C: A systemic effect is needed in OA D: RA and OA are in fact treated with the same medication
A
The patient has a history of severe epistaxis. Which lab value is of most concern? A: INR=4.5 B: HgB=13.4 C: Hct=41% D: O2 sat=94%
A
The patient is in distress. Stat ABG's are drawn. Results are pH 7.32, pCO2 38, HCO3 19. Which findings in the patient's chart would be consistent with this problem? A: Uncontrolled diabetes mellitus B: Uncontrolled Vomiting C: Excessive opioids D: Uncontrolled anxiety
A
The patient with sleep apnea asks why he has to wear an oral appliance every night. The nurse's response is based on the fact that an oral appliance's primary purpose is to: A: Maintain patency of the oropharyngeal area B: Keep the upper and lower teeth from touching C: Provide positive pressure to the alveoli D: Reduce tension in the mandibular muscles
A
When developing a plan of care to manage a patient's pain from cancer, what should the nurse plan to do? A: Individualize the pain medication regimen for the patient B: Select medications that are likely to lead to addiction C: Administer pain medication as soon as the patient requests it D: Change pain medications periodically to avoid drug tolerance
A
A patient who is to receive external radiation for cancer says to the nurse "My family and friends say that I will get a radiation burn." Which response by the nurse is the best? A: "Daily application of an emollient will prevent the burn" B: "A localized skin reaction does usually occur" C: "It will be no worse than a sunburn" D: "They may be informed"
B
Which HCP order should the nurse implement first? A: Explain to the patient NPO status B: Insert the nasogastric tube and hook to suction C: Take the vital signs D: Insert the IV and start IVF's
C
A patient with laryngeal cancer has undergone a laryngectomy and is now receiving radiation therapy to the head and neck. The nurse would monitor the patient for which adverse effects of external radiation? Select all that apply A: Xerastomia B: Stomatitis C: Thrombocytopenia D: Cystitis E: Mucositis F: Leukopenia
A,B,E
Which findings would the nurse anticipate in a patient with a new diagnosis of osteoarthritis? Select all that apply. A: Negative rheumatoid factor (RF) B: Increased erythrocyte sedimentation rate (ESR) C: NO inflammation in joint fluid D: Increased serum creatinine E: Increased c-reactive protein (CRP)
A,C
A patient who has apnea during sleep would require which of the following interventions? Select all that apply A: Refer to primary healthcare provider B: Restrict family members from sleeping in the same room C: Assess sleep routine/hours D: Have the patient keep a sleep diary E: Teach pursed-lip breathing
A,C,D
A 92-year-old woman has bilateral OA of the knees. The nurse teaches the patient that the most beneficial measure to protect the joints it to: A: Use a wheelchair to avoid as much as possible B: Exercise regularly and maintain well-balanced diet C: Use a cane for ambulation to relieve the pressure on the hips D: Avoid sitting at a 90-degree angle or full flexion of the knees
B
A nurse is caring for a patient in PACU who has received general anesthesia. During the immediate postoperative period, which nursing action take the highest priority? A: Checking the dressing for bleeding B: Maintaining a patent airway C: Monitoring the vital signs D: Promoting urine output
B
Five minutes after receiving the ordered preoperative midazolam by IV injection, the patient asks to get up to go to the bathroom to urinate. Which action by the nurse is most appropriate. A: Carefully assist the patient to the bathroom B: Offer the patient a urinal or bedpan C: Ask the patient to wait until the drug has past it's peak action D: Tell the patient that a bladder catheter will be placed in the operating room
B
The nursing student is reviewing facts about the shiley trach to the patient and his wife, as he is undergoing a tracheostomy in the morning. Which statement could be included in the discussion? A: "Shiley tracks are metal" B: "Shiley trachs have a string with an inflatable balloon attached" C: "Shiley trachs have a reusable inner cannula" D: "Shiley trachs do not need an obturator to be inserted"
B
The patient with chronic bronchitis is admitted to the med-surf unit. The best help the patient maintain a patent airway and achieve maximal gas exchange, the nurse should: A: Administer scheduled anxiolytics daily to control related anxiety B: Instruct the patient to drink 2L of fluid daily C: Administer pain medication as ordered D: Maintain the patient on bed rest
B
When caring for a patient with SLE, the nurse recognizes which is the most serious complication of the disorder? A: Polycythemia B: Renal Failure C: Hepatitis D: Hypothyroidism
B
Which symptom indicates the patient with TB is contagious? A: + Mantoux test B: Sputum + for AFB C: Weight loss and night sweats D: Calcification noted on CXR
B
The nurse is assessing a patient in the PACU, who is recovering postoperatively from general anesthesia. The patient can give his name but is not sure where he is or the time of day. What should the nurse do next? A: Notify the surgeon B: Rub the patient's sternum to arouse the patient C: Tell the patient where he is and the time of day D: Take the patient's blood pressure
C
A nurse is caring for a patient who has developed dysphagia and is unable to swallow. The patient is receiving around-the-clock opioid pain medications for cancer pain, and hospice has recently begun caring for the patient. What is the best nursing intervention in preparing for patients discharge? A: Contact the patient's HCP to ask to substitute a liquid form of medications for the pill form B: Teach the patient and family members to crush pills and administer them in applesauce C: Contact the patient's HCP to discuss use of transdermal medications for pain control D: Teach the patient and family members about addiction that may occur as a result of opioid use
C
A patient has a bone marrow aspiration performed. After the procedure, what is the FIRST nursing action? A: Position the patient on the affected side B: Cleanse the site with an antiseptic solution C: Briefly apply pressure over the aspiration site D: Begin frequent monitoring of the patients vital signs
C
A patient is 5 hours s/p abdominal surgery. The oncoming nurse notes in report that there has been no drainage noted from the Hemovac, since surgery. Which finding may explain the absence of drainage? A: The patient has been lying on his side for 2 hours with the drain positioned upward B: The patient has a nasogastric tube in place that drained 400 ml C: The Hemovac drain isn't compressed; instead it's fully expanded D: There is a moderate amount of dry drainage on the outside of the dressing
C
A patient with SLE is getting ready for discharge. The nurse knows the patient has undergone the patient teaching when the patient states she needs to what? A: Get as much exposure to sunlight as possible to help control skin rashes B: Be as active as possible between flare-ups C: Monitor body temperature regularly D: Stop her corticosteroids when symptoms are relieved
C
A patient with gout should be assessed by the nurse for which complication? A: Cirrhosis B: Gastric ulcer C: Renal calculi D: Pulmonary emboli
C
A patient with many home-related responsibilities is diagnosed with OA. She tells the nurse she is concerned that the disease will prevent her for doing her chores. Which suggestion should the nurse offer? A: "Do all your chores in the morning, when pain and stiffness are least pronounced" B: "Do all your chores right after performing morning exercises to loosen up" C: "Pace yourself and rest frequently, especially after activities" D: "Do all your chores in the evening, when pain and stiffness are least pronounced"
C
After 3 months of supplemental iron therapy, there is no significant increase in the patient's hemoglobin level. Iron dextran is prescribed. What is the best way for the nurse to administer this medication? A: With a transdermal needle B: By massaging the injection site C: With use of Z-track method D: By administering at a 45 degree angle
C
On admission of a patient to the postanesthesia care unit (PACU), the blood pressure (BP) is 122/72. Thirty minutes after admission, the BP falls to 114/62, with a pulse of 74 and warm, dry skin. Which action by the nurse is most appropriate? a. Increase the IV fluid rate. b. Continue to take vital signs every 15 minutes. c. Administer oxygen therapy at 100% per mask. d. Notify the anesthesia care provider (ACP) immediately.
C
The nurse in suctioning the patients tracheostomy. For what reason during the procedure does the nurse complete the below action? A: To lubricate the outside of the suction catheter B: To prime the tubing with air C: To clear secretions from the tubing D: To regulate the suction pressure
C
The nurse is caring for a patient receiving a chemotherpay drug in a peripheral line that is a potential vesicant. The patient is currently not a candidate for a central line. The patient c/o pain at insertion site; redness noted. Which nursing action would be included in the follow-up care? A: Slow the infusion rate while notifying the HCP B: Restart the infusion distal the dc'd IV site C: Assess the patient for skin sloughing D: Hold the site below the level of the heart
C
The nurse is making patient rounds following shift report. Which patient should the nurse assess first? A: A 38-year-old woman receiving internal radiation therapy for cervical cancer B: A 77-year-old man with lung cancer hospitalized for induction of high-dose chemotherapy C: A 75-year-old man with metastatic prostate cancer with a pathologic fracture of the femur who is in pain D: A 33-year-old woman with cancer undergoing surgery for placement if a central venous catheter
C
The patient with a history of severe emphysema and is a known CO2 retainer is admitted to the hospital to have an elective surgery performed tomorrow. Routine baseline ABG's are performed preoperatively. The patient is in no acute distress. Which ABG results are consistent with the scenario? pH____, pCO2____, HCO3___ A: 7.30, 60, 27 B: 7.50, 22, 27 C: 7.35, 65, 35 D: 7.45, 22, 35
C
Which of the following findings would be expected in a patient with chest trauma, rib fractures, and respiratory acidosis? A: Kussmaul respirations due to inability to take deep breaths B: A massive diffusion disturbance due to the rib fractures C: Hypoventilation due to inability to take deep breaths because of pain D: Hyperventilation due to inability to take deep breaths, so short fast breaths are more comfortable
C
A patient with pernicious anemia is receiving parenteral vitamin B12 therapy. Which patient statement indicated effective teaching about this therapy? A: "I will receive parenteral vitamin B12 therapy until my signs and symptoms disappear." B: "I will receive parenteral vitamin B12 therapy until my vitamin B12 level returns to normal" C: "I will receive parenteral vitamin B 12 therapy monthly for 6 months to a year" D: "I will receive parenteral vitamin B12 therapy for the rest of my life"
D
After knee arthroplasty, the client has a sequential compression device (SCD). What is the related nursing action with these devices? A: Elevate the sequential compression device (SCD) on three pillows. B: Change the settings on the SCD to make the client more comfortable. C: Stop the SCD to remove dressings and bathe the leg. D: Discontinue the SCD when the client is ambulatory.
D
An obese, malnourished client has undergone abdominal surgery. While ambulating on the 4th postoperative day, she complains to the nurse that her dressing is saturated with drainage. Before this activity, the dressing was dry and intact. Which of the following is the best initial action for the nurse to take? A: Splint the abdomen with a pillow and call the surgeon B: Administer oxygen per nasal cannula C: Reinforce the existing dressing with another dressing D: Lift the dressing to assess the wound
D
The nurse is caring for a patient with RA who is receiving NSAIDs. Which intervention included in the care plan will help the nurse provide safe and effective care? A: Provide potassium-rich diet B: Administer vitamin c supplements C: Teach deep breathing and kegel exercises D: Monitor for symptoms of GI distress
D
The nurse receives evening report on a patient who underwent posterior nasal packing for epistaxis earlier in the day. The first assessment of the patient the nurse should make is the: A: Patients temperature B: The level of the patients pain C: The drainage on the nasal dressing D: The oxygen saturation by pulse oximetry
D
The teaching plan for the patient with RA includes rest promotion. What position of the involved joints should the nurse tell the patient to avoid? A: Keeping the joints aligned B: Elevating the affected joints C: Lying in a prone position D: Maintaining the joints in a flexed position
D
Which statement by a patient undergoing external radiation therapy indicates the need for further teaching? A: "I'll wash my skin with mild soap and water only" B: "I'll not use my heating pad during treatment" C: "I'll wear protective clothing when outside" D: "I'm worried I'll expose my family members to radiation"
D
The nurse cares for a patient who has SLE. TO prevent an exacerbation of the condition, what should the nurse instruct the patient o avoid? A: Becoming fatigued B: Animal dander C: Dairy products D: Nonsteroid drugs
S