Exam 4

b

A client is admitted with Laennec's cirrhosis. What data in the client's past history should one inquire about in taking a current history from this client? History of: A. gallstones B. alcohol abuse C. viral hepatitis D. heart disease

d

A major finding in polycythemia vera is: A. thrombocytopenia. B. leukopenia. C. anemia. D. erythrocytosis.

d

An elderly client is who lives alone is tearful and does not know how she will get to the clinic once a week for her dose of 1M Iron Dextran. Your best response would be: A. "Make some calls, I am sure someone will give you a ride." B. "You live close by, walking might help you feel more energetic.' C. "You can keep the medication at home and self administer it weekly." D. "I will call the social worker, they can help arrange transportation to the clinic."

a, b, c

Choose all of the following that can contribute to the depressed clotting ability in the client with hepatic failure? A. Congestion of the spleen. B. Decreased production of clotting factors. C. Decreased vitamin K storage. D. Loss of vascular osmotic pressure.

d

Correct administration of liquid iron would include: A. administering the iron with a cup and then rinsing the mouth. B. administering the iron with milk to avoid GI distress. C. administer the iron between meals for better absorption. D. administering the iron with a straw and rinsing the mouth.

c

Hepatic encephalopathy is manifested by: A. ascites. B. splenomegaly. C. cerebral dysfunction. D. oliguria.

a

Indicate the true statement about DIC. A. The normal clotting process is accelerated. B. The release of thromboplastin is decreased. C. Heparin therapy is contraindicated. D. Only the extrinsic pathway is affected.

d

Management of multiple myeloma includes: A. Bed rest to prevent pathological fractures. B. A high protein diet to promote tissue healing. C. Calcium supplements to rebuild bone tissue. D. Hydration with IV fluids to prevent complications.

a

Studies indicate that acetycholine is drastically reduced in individual with Alzheimer's Disease. Which cognitive deficit is primarily associated with this reduction? a) Loss of memory. b) Loss of purposeful movement. c) Loss of sensory ability to recognize objects. d) Loss of language ability.

c

The nurse recognizes that the trigger for erythropoiesis is: A. decreased iron. B. increased hematocrit C. decreased tissue oxygenation D. decreasaed hemoglobin

a, b, d

What are the symptoms of multiple myeloma? Select all that apply. A. Anemia B. Bone pain C. Plethoric skin appearance D. Pathological fractures

a, b, d

When planning care for a woman who has been abused, which factors should the nurse recognize? (Select all that apply.) A) It often takes several attempts before a woman leaves an abusive situation. B) Substance abuse is a common factor in abusive relationships. C) Until children reach school age, they are usually not affected by abuse between their parents. D) Women in abusive relationships usually feel isolated and without support. E) Economic factors rarely play a role in the decision to stay.

b

When relaxed, which sphincter allows bile to flow into the duodenum? A. Pyloric sphincter B. Sphincter of Oddi C. Ampulla of Vater D. Ileocecal valve

e

Which most often causes biliary cirrhosis? A. malnutrition B. alcoholism C. hepatitis A or C D. autoimmunity E. gallstone duct obstruction

d

Which term would the nurse utilize to describe a syndrome that occurs after stopping the use of a drug to which one is addicted? A) Codependence B) Tolerance C) Guilt D) Withdrawal

b

Which type of jaundice is due to increased destruction of erythrocytes? A. Obstructive B. Hemolytic C. Hepatocellular D. Both b and c are correct

a

12. A teacher notices that a third grader has had an open lesion on her left arm for 1 week. It has never been covered with a bandage, and now is infected. The child is often absent from school, and seems apathetic and tired when she attends. Which does the school nurse recognize? A) Physical neglect B) Emotional injury C) Physical abuse D) Sexual abuse

c

A client experiencing a bacterial transfusion reaction needs to be treated for which of the following? A. Allergic reaction B. Anaphylaxis C. Septic shock D. Infection only

a, c, e

A client has been admitted to a detoxification unit for treatment of alcohol withdrawal. He is estranged from his wife, who has taken their two young children to her parents' house. Because of his alcohol use, he has also recently lost his job, which was the sole source of income for the family. His wife refuses to return home until he commits to sobriety. The nurse concludes that which independent nursing action(s) would be appropriate for this client? (Select all that apply.) A) Assist the client to perform activities of daily living (ADLs). B) Educate the wife about signs and symptoms of alcohol dependence and withdrawal. C) Encourage the client to discuss triggers for relapse. D) Educate the client about signs and symptoms of detoxification. E) Encourage the wife to discuss triggers for relapse.

c

A client in the psychiatric unit states, "I attempted suicide because that is the only way I can get away from him." She is in a severely abusive relationship and fears for her life. Her husband sends flowers to the unit and a card asking her to come back, but taking no responsibility for his behavior. What does the nurse recognize about the husband's behavior? A) Phase I: The Tension-Building Phase B) Phase II: The Acute Battering Incident C) Phase III: The Honeymoon Phase D) Phase IV: The Forgiveness Phase

a

A client is admitted with a possible diagnosis of pancreatitis. The client rarely drinks alcohol because of her religious convictions. She becomes upset when the physician persists in asking her about alcohol intake. The nurse should explain that the reason for these questions is that A. there is a strong link between alcohol use and acute pancreatitis. B. alcohol intake can interfere with the tests used to diagnose pancreatitis. C. alcoholism is a major health problem, and everyone is questioned about alcohol intake. D. the physician must obtain the pertinent facts and religious beliefs cannot be considered.

d

A client is brought to the emergency department because of aggressive behavior; slurred speech; and impaired motor coordination; his blood alcohol level is 347 mg/dL. Although he denies that he is an alcoholic, the nurse encourages him to seek rehabilitative treatment. Which step does the nurse anticipate that the client must accomplish first to be successful in treatment? A) Identify someone to whom he can go for support. B) Give up all his old drinking buddies. C) Understand the effects of alcohol on the body. D) Correlate the problems in his life to his use of alcohol.

a

A client is brought to the emergency department by the police because of aggressive behavior; slurred speech; and impaired motor coordination; his blood alcohol level is 347 mg/dL. He has been drinking 1 pint of bourbon per day. His wife reports, "He starts drinking in the early afternoon and drinks continuously into the night." It is now 12 AM. When would the nurse expect withdrawal symptoms to begin? A) Between 4 AM and noon B) Around midnight C) In 2 to 3 days D) Around 4 to 6 PM.

a

A client is diagnosed with Non-Hodgkins lymphoma. An MRI has revealed a mass near the common iliac artery . The nurse will monitor the client's: A. pedal pulses. B. breath sounds. C. bowel habits. D. urinary output.

a

A client who has just been raped arrives at the ED, crying, pacing, and cursing her attacker. Which is the priority therapeutic statement for the nurse make when she arrives at the ED? A) "You are safe now." B) "I'll call your husband." C) "The police will want to interview you." D) "We'll have to take photographs of those wounds."

a

A client with advanced cirrhosis has begun treatment with Lactulose. The client reports experiencing several soft stools per day. What is the best response? A. "This is the normal expected response to this medication." B. "You may take Kaopectate liquid 3 times per day for loose stools." C. "Do not take any more of the medication until I check with your physician. 't D. "We will need to send a stool specimen to the lab for culture and sensitivity."

a

A college student experienced a sexual assault when out on a date. After several weeks of crisis intervention therapy, which client statement would indicate to the nurse that the student is making progress? A) "I know that it was not my fault." B) "My boyfriend is too passionate for me." C) "I'll just go on double dates from now on." D) "Next time I won't wear such a sexy dress."

e

A female client who has been treated for Addison's disease for several months and expresses concern that she is beginning to look more masculine. The nurse should tell the client: A. that the changes are a minor inconvenience to dying. B. that the changes are not that noticeable except for her 5 0'clock shadow. C. to only take her medicine every other day. D. that the changes are only temporary. E. that the changes are related to her medication therapy and that she/he will notify the doctor about her concerns.

d

A female client, devastated by a divorce from an abusive man, is very depressed and has sought counseling. Which client statement would indicate resolution of grief over the loss of her marriage? A) "I know things would be different if we could only try again." B) "He will be back. I know he will." C) "I'm sure I did lots of things to provoke his anger." D) "Yes, it was a difficult relationship, and he abused the children and me."

b

A heroin addict of 8 years lost custody of her first two children due to abuse and neglect secondary to her addiction. She is currently 4 months pregnant with her third child and has been admitted to the inpatient substance-abuse program for 3 days. Which statement best indicates that the client is working on her substance abuse issues? A) "I'm not going to use heroin ever again. I know I've got the will power to do it this time." B) "I cannot control my use of heroin. It's stronger than I am. I'm here to find out how to get started on the road to recovery." C) "I'm going to get all my children back. They need their mother." D) "My father abused me as a child, and my mother walked out on us. If anyone's got a right to use heroin, it's me."

a

A kindergarten student is frequently violent toward other children. The school nurse notices that frequent bruises or burns to the face and arms. If he does poorly on an assignment, he is often heard telling himself, "You're so stupid." Which condition does the nurse recognize? A) Physical and emotional abuse B) Attention-deficit/hyperactivity disorder (ADHD) C) Separation anxiety disorder D) Mental retardation

a

A lobule of the liver contains a centrally located: A. vein with radiating hepatocytes and sinusoids. B. arteriole with radiating capillaries and Kupffer cells. C. hepatic sinus with radiating sinusoids. D. hepatic duct with radiating Kupffer cells and cords of hepatic cells.

a

A mental health nurse has referred a client with an alcohol addiction to a 12-step Alcoholics Anonymous program. Which of the following is a basic concept of a 12-step program? a) Admit life is unmanageable. b) Detoxify from the addictive substance. c) Identify stimuli that promote drinking. d) Include family in counseling sessions.

d

A mother brings her preschool daughter to the emergency department with multiple bruises and a fractured arm. Which statement by the mother would cause the nurse to suspect child abuse? A) "She is uncoordinated." B) "She has a very high IQ." C) "She runs around all the time." D) "She isn't like my other children."

b

A new admission with Alzheimer's Disease states, "Last night I went on a wonderful dinner cruise." Which type of communication is this client expressing, and what is the underlying reason for its use? a) The client is using confabulation to achieve secondary gains. b) The client is using confabulation to protect the ego. c) The client is using perseveration to divert attention. d) The client is using perseveration to maintain self-esteem.

c

A nurse caring for a patient with a Sengstaken-Blakemore tube in place should have which of the following items in close proximity in case of an emergency? A. IV Magnesium Sulfate B. The obturator C. Scissors D. A 60 cc syringe

a

A nurse in a clinic is caring for a client who has a history of alcohol abuse and reports bruising and frequent nosebleeds. For which of the following is the client at risk? a) Cirrhosis b) Diabetes c) Hepatitis A d) Malnutrition

c

A nurse is discussing alcohol tolerance with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates understanding? a) "A client who has alcohol tolerance develops physical changes when they haven't recently ingested alcohol." b) "Alcohol tolerance causes the client to have an increased effect when taking opiates." c) "A client who has alcohol tolerance has a decreased physical response to alcohol." d) "Alcohol tolerance is a medical emergency and can develop as a result of withdrawal."

a

A nurse is discussing cultural concepts in mental health nursing with nursing staff. When discussing Native American clients, the nurse should identify which of the following as an increased risk for this cultural group? a) Substance abuse b) Schizophrenia c) Personality disorders d) Eating disorders

a

A nurse is performing a psychosocial assessment of a client who has a history of alcohol abuse. Which of the following questions asked by the nurse indicates that the client may have a Substance Use Disorder? a) "Has alcohol use affected your performance at work?" b) "Have you received prior mental health treatment?" c) "Do you receive treatment for any mental health disorders?" d) "At what age did you begin drinking alcohol?"

c

A nurse is teaching a client, who currently abuses alcohol, about Alcoholics Anonymous (AA). Which of the following client statements indicates an understanding of the program's basic concepts? a) "I am responsible for my alcoholism." b) "I need to identify things that cause me to be an alcoholic." c) "I am powerless about my addiction to alcohol." d) "I need to see a counselor who will be responsible for my recovery."

a

A nurse is teaching a community education course about the physical complications related to substance abuse. Which of the following should the nurse identify as a primary cause of cirrhosis? a) Alcohol b) Caffeine c) Cocaine d) Inhalants

a

A nurse manager is preparing to confront a staff nurse who is abusing alcohol. Which of the following responses should the nurse manager expect? a) Denial b) Repression c) Rationalization d) Projection

c

A nurse manager is preparing to report disciplinary action of a staff nurse for substance abuse. Which of the following has the authority to revoke a professional nurse's license? a) Civil judicial process b) Chief nursing officer of a hospital c) State board of nursing d) American Nurses Association

b

A nurse working with substance-abuse clients evaluates which statement as a knowledge deficit? A) "Although it's legal, alcohol is one of the most widely abused drugs in our society." B) "Tolerance to heroin develops quickly, leaving the addict searching to achieve that first-time high." C) "The effects of LSD, including flashbacks and hallucinations, may recur spontaneously weeks or months afterward." D) "Marijuana is like smoking cigarettes. Everyone does it. It's essentially harmless."

d

A recently divorced 43-year-old career woman suffering emotional upheaval began drinking daily. After losing her job due to her drinking problem, she received treatment for the acute stage of her illness and is being discharged from the hospital. Which outpatient therapy should the nurse plan to discuss in the discharge teaching? A) Aversion therapy B) Controlled drinking C) Detoxification D) Alcoholics Anonymous

c

A woman comes to the emergency department with a broken nose and multiple bruises after being beaten by her husband. She states, "The beatings have been getting worse and worse and I'm afraid to go home because next time he may kill me." Which is the appropriate nursing response? A) "I wouldn't want to go home either.'' B) "There are things you can do to prevent him from losing control." C) "Let's talk about your options so that you don't have to go home." D) "I'll call the police so that they can confront your husband about his behavior."

c, d, e

After dementia has been ruled out, a client is diagnosed with pseudodementia (depression). Which of the following symptoms would support this diagnosis? Select all that apply. a) Slow progression of symptoms b) Impaired attention and concentration. c) Diminished appetite. d) Symptoms diminish as the day progresses. e) Oriented to time and place with no wandering.

d

An early finding of acute pancreatitis is: A. elevated serum calcium value. B. decreased white blood cell count. C. decreased blood glucose level. D. elevated serum amylase value.

c

An elderly client is experiencing confusion in the emergency department. He is diagnosed with delirium and the family is told his condition is reversible. Which is the likely cause of this disorder? a) Multiple sclerosis b) Multiple small brain infarcts c) Electrolyte imbalance d) Alzheimer's Disease

c

An obstruction of the common bile duct would cause blockage of bile coming from: A. the gallbladder. B. the liver but not from the gallbladder. C. both the liver and the gallbladder. D. the pancreatic duct but not from the gallbladder.

a

Choose the correct sequence leading to cortisol release. A. CRH is secreted by the hypothalmus, CRH stimulates the pituitary gland which releases ACTH, ACTH stimulates the adrenal glands and cortisol is released into the blood stream B. ACTH is released by the hypothalmus, ACTH stimulates the pituitary to release CRH, CRH stimulates the adrenal glands to release cortisol into the blood stream C. Aldosterone stimulates the pituitary gland to release CRH, CRH stimulates the adrenal glands to release cortisol into the blood stream D. CRH is secreted by the pituitary gland, CRH stimulates the hypothalmus to release ACTH, ACTH stimulates the adrenal glands to release cortisol into the blood stream

c, d

During shift report, several nurses receive information about a new client in the psychiatric inpatient unit who is in a severely abusive relationship and fears for her life. One nurse cynically asks, "Why doesn't she just leave him?" Which is the appropriate nursing response from another nurse? Select all that apply A) "They don't know life any other way." B) "These women have limited cognitive skills and few vocational abilities to be able to make it on their own." C) "These women often have a lack of financial independence to support themselves and their children, and most have religious beliefs prohibiting divorce and separation." D) "A combination of physical threats made to her and her children and a sense of powerlessness and low self-esteem paralyzes her into inaction."

c

How is a pancreatic pseudocyst defined? A. A collection of pus enclosed by inflammatory walls. B. An area of necrotic infection enclosed by fibrous walls. C. An effusion of pancreatic juice enclosed by fibrous walls. D. A collection of bile and pus enclosed by inflammatory walls.

a

How is bone marrow transplant done? A. Intravenous infusion via a central line. B. Infusion into the bone marrow. C. Surgical implantation into the bone marrow. D. Direct patient to patient transfusion.

d

In acute pancreatitis, the first priority is to A. infuse IV nitroglycerin. B. titrate dietary protein intake. C. administer IV antibiotics. D. restore the fluid volume.

c

In addition to diaphoresis and tremors, which symptoms would the nurse expect to see as a client undergoes alcohol withdrawal? A) Bradycardia and hypertension B) Bradycardia and hypotension C) Tachycardia and hypertension D) Tachycardia and hypotension

c

In addition to the iliac crest, bone marrow aspiration can be taken from the. A. skull. B. scapulae. C. sternum. D. femur.

a

In pancreatitis: A. the tissue damage likely results from release of pancreatic enzymes. B. high cholesterol intake is causative. C. diabetes is uncommon in chronic pancreatitis. D. bacterial infection is the etiological cause.

a

In planning care for an abused child, which framework does the nurse recognize that conceptualizes victimization as a process whereby one realizes that regardless of attempts, the outcome of events is largely unpredictable and undesirable? A) Learned helplessness · B) Cycle of battering C) Psychodynamic theory D) Biological theory

b

In reviewing the laboratory data of a client admitted with cirrhosis of the liver, which serum levels would one expect to be elevated? A. Serum amylase and lipase B. Serum ammonia C. Serum CEA D. Serum calcium

d

Returning to work after three sick days, a married woman's facial bruises cannot be concealed by makeup. Her coworker recommends that she seek assistance from her employee assistance program. Which teaching should the nurse in the employee assistance program provide? A) Buy a gun. B) File for divorce. C) Press charges of assault and battery. D) Carry the number of a safe house for battered women.

a

Thalassemia is most common in individuals from which of the following geographical regions? A. Mediterranean B. Asian C. African D. European

b

The RBC indices for a patient with iron deficiency anemia would indicate A. macrocytic, hyperchromic cells B. microcytic, hypochromic cells C. normocytic, normochromic cells D. microcytic, normochromic cells

c

The chief role played by the pancreas in digestion is to: A. secrete insulin and glucagon B. churn the food and bring it into contact with digestive enzymes C. secrete enzymes, which digest food in the small intestine D. assist in absorbing the digested foods

b

The client with adrenal hyperfunction screams at her husband, bursts into tears and throws her water pitcher against the wall. She tells the nurse, "I feel like I am going crazy." What is the nurse's best response? A. "I will tell your doctor to order a psychiatric consult for you.' B. "You feel this way because of your high hormone levels. The doctor can order an antianxiety drug for you. C. "You feel this way because you are frightened about having a chronic disease. Would you like me to give you information about a support group?" D. "You must learn to control your behavior. Because you are disturbing others, I am going to keep the door to your room closed and restrict your visitors."

a

The client with hyperaldosteronism is being treated with spironolactone therapy. What precautions should the nurse teach this client? A. "Avoid salt substitutes.' B. "Avoid adding salt to food." C. "Avoid excessive exposure to sunlight." D. "Avoid acetaminophen and acetaminophen containing products."

c

The client's platelet count is 30,000/mm3. What is the nurse's first best action? A. Document the report as the only action. B. Administer oxygen by nasal cannula. C. Institute bleeding precautions. D. Notify the physician.

a, c, d, e

The emergency room nurse is caring for a rape victim. Which should the nurse communicate to the client? (Select all that apply.) A) "I am very sorry this happened to you." B) ''You will feel better if you help the police catch your attacker." C) "You are safe here." D) "You are not to blame. It was not your fault." E) "I am glad you are alive."

c

The exocrine portion of the pancreas contains: A. alpha cells. B. beta cells. C. ducts. D. islets of Langerhans

b

The human adult liver DOES NOT: A. store glycogen. B. produce erythrocytes. C. convert ammonia to urea. D. produce blood coagulation proteins.

d

The most common manifestation of portal hypertension is: A. rectal bleeding. B. cirrhosis. C. intestinal bleeding. D. esophageal bleeding.

d

The most common type of anemia worldwide is: A. aplastic anemia. B. B12 deficiency anemia. C. folic acid deficiency anemia. D. iron deficiency anemia.

c

The nurse documents that a client diagnosed with Alzheimer's Disease presents with aphasia. Which behavior supports this finding? a) The client is sad and has no ability to experience pleasure. b) The client is extremely emaciated and appears to be wasting away. c) The client is having difficulty forming words. d) The client is no longer able to speak.

a

The nurse has administered Lactulose to a client with cirrhosis. The following day, the client reports having severe loose stools in the past 12 hours. What alteration in laboratory data would you expect to be present in this client as a result? A. Hypokalemia B. Hyponatremia C. Hypercalcemia D. Hyperglycemia

b

The nurse is caring for a client with a diagnosis of Polycythemia Vera. The client asks, "Why do I have an increased risk of having a stroke or heart attack?" The nurse's best response is, "This increased risk is due to: A. elevated blood pressure." B. increased blood viscosity." C. elevated platelet count." D. immaturity of red blood cells."

b

The nurse is obtaining an admission history from a patient who has been abusing drugs and alcohol for years, lost his job several months ago. His wife recently left him and is now living with their two children at her parents' house. He tells the nurse, "I wouldn't use drugs and booze if my wife hadn't been nagging me all the time to get a job. She never did think that I was good enough for her." How would the nurse interpret this statement? A) This is a dysfunctional family. B) The client is in denial about the problem. C) The client is under a lot of stress. D) The prognosis for recovery is slim.

c

The nurse noting Cullen's sign in a patient with acute pancreatitis would observe: A. blue ecchymosis on bilateral flank areas B. deep purple dilated veins in the abdomen C. light blue discoloration around the umbilicus D. split and brittle finger and toe nails

a

The nurse suspects a client is experiencing delirium. Which specific assessment information would support this suspicion? a) A decreased level of consciousness with intermittent hypervigilance b) Oriented to time and place with no wandering. c) Onset is insidious and relentless. d) The symptoms lasts for 1 month or longer.

c

The nurse would expect which of the following lab values for a client with aplastic anemia: A. high white cells, low red cells and low platelets. B. low white cells, high red cells and low platelets. C. low white cells, low red cells and low platelets. D. high white cells, low red cells and high platelets.

c

The nurse would identify which of the following signs when assessing the client with hemolytic anemia? A. Red facial complexion B. Red swollen tongue C. Jaundice D. Angular stomatitis

c

The pancreas: A. lies mostly on the left side of the abdominal cavity, anteriorly to the stomach and the spleen. B. secretes all of its products directly into the blood stream. C. is a gland with its duct ultimately opening into the duodenum. D. contains cells with endocrine function for the determination of secondary sex characteristics. E. is classified as a digestive exocrine gland, not having endocrine functions.

c

The wife of a man with alcoholism says to the nurse: "His problems at work are my fault. I should have called to say he was sick instead of insisting that he go to work, but I was tired of always covering for him." Which is the appropriate nursing response? A) "Why didn't you call in this time?'' B) "Let's deal with the present rather than the past." C) "Your husband needs to deal with the results of his drinking." D) "Do you know you're an enabler when you protect your husband like that?"

c

What condition causes circulating platelets to decrease but production of platelets remains normal? A. Thrombotic Thrombocytopenic Purpura (TTP) B. Disseminated Intravascular Coagulation (DIC) C. Autoimmune Thrombocytopenic Purpura (ATP) D. Non-Hodgkin's Lymphoma

c

What function of carbohydrate metabolism does the liver carry out in response to increased energy requirements? A. Storage of fatty acids and triglycerides B. Activation of Kupffer cells C. Release of glycogen D. Removal of ammonia

d

Which assessment maneuver should the nurse avoid performing with a client suspected of having a pheochromocytoma? A. Having the client attempt to touch the chin to the chest. B. Inflating the blood pressure cuff above 200 mm Hg C. Attempting to dorsiflex the feet D. Palpating the abdomen

d

Which client statement demonstrates positive progress towards recovery from substance abuse? A) "I'm ready for discharge and feel better now." B) "I don't need to be here with these crazy people." C) ''I only used the pills to be able to sleep." D) "Taking those pills got out of control. It cost me my job, my marriage, and my children."

a

Which hematologic problem would the nurse expect the client with liver failure to have? A. Prolonged bleeding after IM injections B. Elevated blood pressure from hypercellularity C. Increased formation of thromboses in deep veins D. Spontaneous bleeding from the gums and mucous membranes

a

Which is the priority nursing diagnosis for an individual experiencing alcohol withdrawal? A) Risk for injury B) Impaired thought C) Ineffective coping D) Ineffective denial

d

Which medication is administered to replace pancreatic enzymes? A. cholestyramine (Questram) B. probenecid (Benemid) C. tolazamid (Tolinase) D. pancrelipase (Viokase)

a, b, c

Which nursing diagnosis is appropriate for the adult survivor of incest? (Select all that apply.) A) Low self-esteem B) Powerlessness C) Ineffective coping D) Knowledge deficit E) Noncompliance

c

Which nursing intervention is most appropriate on the first day of alcohol detoxification? A) Strongly encourage the client to attend two AA meetings. B) Educate the client about the biopsychosocial consequences of alcohol abuse. C) Administer Librium for withdrawal symptoms. D) Ensure that the client consumes 95% of his or her meals.

c

Which of the following clients is most at risk for developing a vitamin B12 deficiency anemia? A. 26-year-old female in the second trimester of pregnancy. B. 3-year-old female who is a fussy eater. C. 47-year-old male who has had a gastrectomy. D. 64-year-old female with a history of GI bleeding.

d

Which of the following implementations will assist the nurse to decrease the knowledge deficit relating to reduction of pancreatic activity? A. Instruct the client to include flat sodas with meals. B. Reinforce the ingestion of fat-soluble vitamins. C. Emphasize alcohol consumption in moderation is important. D. Educate the patient to follow a low-fat diet.

a

Which of the following is false about cortisol? A. It is a mineralcorticoid B. There is an increase in its' release during times of stress C. It supresses protein synthesis D. It enhances protein catabolism

b

Which of the following relates to polycythemia vera? A. Has the symptom of hypocellularity. B. Causes plethoric appearance of the face. C. Causes hypotension and thrombosis. D. Can be cured with anticoagulants.

a

Which of the following would be an appropriate task to delegate to a nursing assistant working on a medical-surgical unit? A. Obtaining vital signs on a client receiving a blood transfusion. B. Providing nutrition teaching to a client with iron deficiency anemia. C. Interpreting the vital signs for a patient with hemorrhagic anemia. D. Assessing skin integrity on an anemic client after a fall.

a

Which of the following would indicate the presence of B symptoms? A. Presence of fever and night sweats. B. Right sided upper abdominal pain during palpation. C. Unexpected weight gain during the past month. D. Enlarged supraclavicular lymph nodes.

d

Which of the following would most likely be a major nursing diagnosis for a client with acute pancreatitis? A. Impaired tissue perfusion: peripheral B. Fluid Volume Excess C. Impaired Swallowing D. Altered Nutrition: Less than Body Requirements

a

Which patient is at highest risk for acute pancreatitis? A. A 42-year-old man with a history of alcoholism. B. A 37-year-old woman with Crohn's disease. C A 56-year-old man with brittle diabetes. D. An 18-year-old woman with positive HIV.

b

Which precaution has the highest priority for instruction of the client going home with thrombocytopenia? A. "Drink at least 3 liters of fluid each day." B. "Avoid flossing your teeth until platelets return to normal." C. "Avoid drinking alcoholic beverages until your CBC is normal." D. "Avoid the use of salt substitutes that contain potassium chloride."

b

Which process must be completed by the nurse before caring for clients with substance abuse disorders? A) Recognize that their personal potential for addiction is very low. B) Process his/her own attitudes and perceptions regarding substance abusers. C) Avoid being confrontational with clients. D) Encourage clients to identify the role that others play in creating and perpetuating substance abuse.

b

Which rationale explains why a client requiring intervention for pain management should be assessed for a history of substance abuse? A) Narcotic pain medication is not permitted for clients with active substance-abuse problems. B) Clients with certain substance addictions develop a higher tolerance to pain medications, thus may require increased doses to achieve effective pain control. C) Clients with an active substance-abuse disorder have a higher tolerance for pain, so they should be given less medication to achieve effective pain control. D) Clients who use substances should be encouraged to use non-pharmacologic alternative for pain management because they are not permitted to take narcotics.

a

Which serum electrolyte values alert the nurse to the possibility of hyperaldosteronism? A. Serum sodium 150 mmol/L; Serum potassium 2.5 mmol/L B. Serum sodium 140 mmol/L; Serum potassium 5.0 mmol/L C. Serum sodium 130 mmol/L; Serum potassium 2.5 mmol/L D. Serum sodium 130 mmol/L' Serum potassium 7.5 mmol/L

a

Which statement made by an emergency department nurse indicates a firm knowledge base related to domestic violence? A) "Power and control are central to the dynamic of domestic violence." B) "These women must have dependent personality disorders because they can't live without those abusive men." C) "Abused women will always be attracted to abusive men." D) "Abuse starts very early in the relationship. I'm not sure why they stay so long."

b

Which technique would be most accurate for the nurse to use to measure the liver span of a client admitted with cirrhosis? A. Auscultation B. Percussion C. Inspection D. Palpation

b

While caring for a client who has under gone portal systemic shunting, an increased abdominal girth is noted. What is the best action? A. Document the finding as the only action. B. Notify the physician. C. Irrigate the shunt. D. Clamp the shunt.

b

You are caring for a client with suspected pheochromocytoma.What is the most likely complication you would be assessing for in this client? A. ARDS B. hypertensive crisis C. pancreatitis D. acute renal failure

d

Your friend's mother has been diagnosed with indolent lymphoma. She is very distressed and asks if her mother will die soon. What is the prognosis for this disease? A. Prognosis is grim; patients may live only weeks untreated. B. Prognosis is fair; patients may live several months untreated. C. Prognosis is fair; patients may livemany months untreated. D. Prognosis is good; patients may live years untreated.