Junior Year

To prepare a client for surgery, which explanation by a nurse would be accurate related to pneumatic compression devices? 1 They help the venous blood return to the heart. 2 They will not cause discomfort, but gently massage the legs. 3 They are used instead of anticoagulant therapy. 4 They must be worn until the first time the client gets out of bed.

1

which medications are used over the long-term to treat generalized anxiety disorder (GAD)? 1. duloxetine 2. venlafaxine 3. clonazepam 4. escitalopram 5. clomipramine

1,2, 4

Which food should be avoided by clients who are prescribed monoamine oxidase inhibitors? 1. Bologna 2. Potatoes 3. Citrus fruit 4. Grapefruit juice

1. Bologna has a high tyramine content; tyramine sould not be consumed by clients taling monoaminie oxidase inhibitors (MAOIs) because the drug interation may cause a negative drug interaction may cause severe hypertention.

Which organism causes smallpox? 1. Variola virus 2. Yersinia pestis 3. Bacillus anthracis 4. Clostridium botulinum

1. Variola virus

A 30 weeks' gestation patient is concerned about weight gain adn wants to lose weight. The nurse provides nutritional couseling. At the next visit, the client weighs 10 lbs less and didnt follow the recommended nutritional guidlines for preganacy. Which complication should the client be monitored for? 1. ketonemia 2.hyperglycemia 3. anorexia nervosa 4. hyperemesis gravidarum

1. When protein and carbohydrate intake is inadequate, the body catabolizes fat stores for energy, leading to the production of excess fatty acids. Excess fatty acids produce excess ketones in the blood (ketonemia)

Which is a primary glomerular disease? 1. Diabetic glomerulopathy 2. Chronic Glomerulonephritis 3. Hemolytic-uremic syndrome 4. Systemic lupus erthematosus

2. Chronic glomerulonephritis

The nurse is evaluating the actions of a client with pneumonia performing incentive spirometry. Which action by the client indicates a need for correction? 1 Recording the volume of the air inspired 2 Performing 10 breaths per session every hour 3 Inhaling air fully before inserting the mouthpiece 4 Taking a long, slow, deep breath keeping the mouthpiece in place

3

Which assessment finding is considered the earliest sign of decreased tissue oxygenation? 1 Cyanosis 2 Cool, clammy skin 3 Unexplained restlessness 4 Retraction of interspaces on inspiration

3

Which hormone influences kidney function? 1. Renin 2. Bradykinin 3. Aldosterone 4. Erythropoietin

3. Aldosterone is released by the adrenal cortex and influences kidney function

which cytokine is used to treat anemia related to chronic kidney disease? 1. a-Interferon 2. Interleukin-2 3. Interleukin - 11 4. Erythropoietin

4. Erythropoietin is used to Tx anemia related to chronic kidney disease

Which radiologic study is used to obtain a 3D image?

Computed tomography (CT)

Which drug may lead to bruxism? Vilazodone Isocarboxazid Clomipramine Levomilnacipran

Levomilnacipran Serotonin reuptake inhibitors and serotonin/epiniephrine reuptake inhibiors may lead to bruxism. Bruxism is a condition in which you grind, gnash or clench your teeth

What organism causes malaria? 1. Vibrio 2. Sporozoa 3. Ringworm 4. Spirochetes

b.

A nurse is providing dietary teaching for a client with celiac disease. Which foods should the nurse teach the client to avoid when following a gluten-free diet? Select all that apply. Rye Oats Rice Corn Wheat

rye , oat, wheat

Which nursing interventions would be beneficial for providing safe oxygen therapy? Select all that apply. 1 Check tubing for kinks 2 Run wires under carpeting 3 Post "no smoking" signs in the clients' rooms 4 Place oxygen tanks flat in the carts when not in use 5 Make sure that the client is familiar with the phrase "Stop, drop, and roll"

1,3

What gross motor skill is observed in children between 8 and 10 months old? 1 The child can creep on his or her hands and knees. 2 The child has predominant inborn reflexes. 3 The child can sit alone without any kind of support. 4 The child can bear his or her weight on forearms when prone.

1. A child between 8 and 10 months old can creep on his or her hands and knees. A child between birth and 1 month old has predominant inborn reflexes. A child between 6 and 8 months old can sit alone without support. A child between 2 and 4 months old can bear his or her weight on his or her forearms when in the prone position.

which drug is derived from a natural source and may be prescribed for treatment of osteoporosis? 1. Calcicitonin 2. Raloxifene 3. Clomiphene 4. Bisphosphonates

1. Calcitonin - derived from fish,

A nurse assesses that several clients have low oxygen saturation levels. Which client will benefit the most from receiving oxygen via a nasal cannula? 1 Has an upper respiratory infection 2 Has many visitors while sitting in a chair 3 Has a nasogastric tube for gastric decompression 4 Has dry oral mucous membranes from mouth breathing

2

Which hormone is from a positive feedback mechanism? 1. Insulin 2. Estradiol 3. Parathormone 4. Catecholamines

2. Estradiol

Intravenous monnitol is which classification of dieurtics? 1. Loop 2. Osmotic 3. Potassioum sparing 4. Carbonic anhydrase inhibitor

2. Osmotic diuretic , increases the ostomitic pressure of the glomerular filtrate and thus decreases the sborptoon of sodium; they are used to treat cerebral edema and increase intraocular pressure

A nurse is providing preoperative teaching for a client regarding use of an incentive spirometer and should include what instructions? 1 "Inhale completely and exhale in short, rapid breaths." 2 "Inhale deeply through the spirometer, hold it as long as possible, and slowly exhale." 3 "Exhale completely; take a slow, deep breath; hold it as long as possible, and slowly exhale." 4 "Exhale halfway, then inhale a rapid, small breath; repeat several times.

3

Which criteria should the primary healthcare provider use for the prescription of long-term continuous oxygen therapy? 1 PaO 2-72, SpO 2- 96 2 PaO 2-60, SpO 2- 90 3 PaO 2-55, SpO 2- 88 4 PaO 2-40, SpO 2- 75

3

A client is admitted with head injury. The nurse id's that the clients urinary catherter is draining in large amounts of clear, coulorless urine. What does the nurse identify as the most likely cause? 1. Increased serum glucose 2. Deficient renal perfusion 3. Inaddequet antidiuretic hormone (ADH) secretion 4. Excess amounts of IV fluid

3. Deficient ADH from posterioir pituitary results in diabetes insipidus. This can be caused by head trauma; water is not conserved by the body, and excess amounts of urine are produced.

A client had a craniotomy for excision of a brain tumor. After surgery, the nurse monitors the client for increased intracranial pressure. Which clinical finding supports an increase in intracranial pressure? 1-Thready, weak pulse 2-Narrowing pulse pressure 3-Regular, shallow breathing 4-Lowered level of consciousness

4. Altered consciousness is the first sign of increased intracranial pressure. An increase in intracranial pressure causes impaired cerebral blood flow affecting the cells of the cerebral cortex, which results in a decreased level of consciousness. As the intracranial pressure increases, it places pressure on the thalamus, hypothalamus, pons, and medulla, resulting in a slow pulse. A widening pulse pressure occurs because of an increase in the systolic pressure. As the intracranial pressure increases, it places pressure on the thalamus, hypothalamus, pons, and medulla, resulting in irregular respirations that progress to deep, rapid breathing alternating with periods of apnea (Cheyne-Stokes respirations).

Which part of the brain interprets sensory information? a. Frontal b. Parietal c. Occipital d. Temporal

The parietal lobes, right behind the frontal lobes, are primarily responsible for recognizing and interpreting sensory information from the outside world, such as taste, temperature, smell, and touch

A client who had thoracic surgery complains of pain at the incision site when coughing and deep breathing. What action should the nurse take? 1 Instruct the client to splint the wound with a pillow when coughing. 2 Place the client in the supine position and inspect the site of the incision. 3 Assess the intensity of the pain and administer the prescribed analgesic. 4 Call the healthcare provider immediately and then check for wound dehiscence.

1

The nursing leader is teaching the newly hired nurse about the use of an electronic medication administration record. Which statement of the newly hired nurse indicates effective learning? 1 "It will identify medication errors." 2 "It will be accessible to a single user." 3 "It will decrease the accuracy of charge capture." 4 "It will decrease the accuracy of pharmacokinetic monitoring."

1

Which of these statements about language development in children ages 12 to 36 months are true? Select all that apply. 1. 24-month-old children use pronouns. 2. 18-month-old children use approximately 25 words.Incorrect 3. 24-month-old children speak in four-word sentences. 4. 24-month-old children have a vocabulary of up to 500 words.t 5. 36-month-old children learn to use five or six new words each day.

1 & 5 Children 24-months-old use pronouns and want independence and control. By 36 months, the child can use simple sentences and follow some grammatical rules and is learning to use five or six new words each day. Children 18-months-old use approximately 10 words. Children 24-months-old speak in two-word sentences drawn from a vocabulary of up to 300 words.

A client who takes four 325-mg tablets of buffered aspirin four times a day for severe arthritis complains of dizziness and ringing in the ears. Which complication does the nurse conclude that the client probably is experiencing? 1-Salicylate toxicity 2-Anaphylactic reaction 3-Withdrawal symptoms 4-Acetaminophen overdose

1. Excessive aspirin ingestion can influence the vestibulocochlear nerve (cranial nerve VIII), causing tinnitus and dizziness. The client is experiencing symptoms of toxicity, not an anaphylactic response.

A client with paralysis of the legs is found to have somatoform disorder, conversion type. What must the nurse consider when formulating a plan of care for this client? 1.The illness is very real to the client and requires appropriate nursing care. 2.Although the client believes that there is an illness, there is no cause for concern. 3. There is no physiological basis for the illness; therefore only emotional care is needed. 4. Nursing intervention is needed even though the nurse understands that the client is not ill.

1. Individuals who have somatoform disorders are really ill; they need care in a nonthreatening environment. The client requires physiological and emotional care for treatment of motor or sensory functional deficits.

Which period of Piaget's theory describes the idea of object permanence? 1 Sensorimotor period 2 Preoperational period 3 Formal operations period 4 Concrete operations period

1. There are four periods of Piaget's theory of cognitive development. The first period is the sensorimotor period; this period describes object permanence. During the ages of birth to 2 years old, the child understands that objects continue to exist even when they are not visible. The second period is the preoperational period, which is observed in children between the ages of 2 and 7 years. During this time, children learn to think about the use of symbols and have mental images. The third period is the concrete operations period, which is observed between the ages of 7 and 11 years. During this period, the child thinks about an action before performing it. The formal operations period is the fourth period, which is observed in children from the ages of 11 years old throughout adulthood. During this period, there is a prevalence of egocentric thought.

Which behavior indicates to the nurse the new mother is in the taking-hold phase? 1. calling the baby by name 2. talking abut the labor and birth 3. touching the baby with her finger tips 4. being invloved with the infants need to eat and sleep

1. the mother has moved into the taking-hold phase when she takes control anf becomes actively involved with her infant and calls the infant by name. She has completed the taking-in phase when her own needs nolonger predominate. Talking about the labor and birth occur in the taking-in phase when she has the need ti integrate the experience. Toucjing the baby with her fingertips is the initial early action of the taking-in phase.

A nurse manager wants to change the protocol of preoperative teaching to include aspects of deep breathing and infection control measures. Which strategies should the nurse implement to support this change? Select all that apply. 1 Mobilizing positive support from the clients for the change 2 Developing new skills and competency required for implementing the change 3 Excluding the non-nursing staff from the change initiative to reduce their influence 4 Making modifications in preoperative teachings to support the change initiative 5 Reducing the negative influences of late adopters from the group implementing the change

2,4,5

A primipara gives birth to an infant weighting 9lb 15 oz. During labor a midline episiotomy was preformed and the client sustains a third-degree laceration, The client tells the nurse that her perineal area is very painful. What is the physiological finding that is the cause of this pain? 1. Perineal muscles have been cut 2. The anal sphincter muscle has been traumatized 3. The anterior wall of the rectum has been traumatized 4. Structures suerficial to muscles have been damaged

2. A third degree laceration extends through the parineal muscles and continues through the anal sphincter muscle.

Which part of the brain primarily regulates muscle functioning and coordinates movement? 1. Cerebrum 2. Cerebellum 3. Epithalamus 4. Hypothalamus

2. Cerebellum Regulates motor movement resulting in smooth and balanced muscular activity

The nurse is caring for a client with Vascular dementia. What does the nurse identify as the cause of this problem? 1. A long hx of inadequate nutrition 2. Disruptions in cerebral blood flow, resulting in thrombi or emboli 3. A delayed responce to severe emotional truama in early adulthood 4. Anatomical changes in the breain that produce acute, transient symptoms

2. Vascular dementia results from the sudden closure of the lumen of arterioles, causing infarction of the brain tissue in the affected area. Inadequate nutrition may be one of the factors that bring about a general decline of health; however, there is no direct evidence that avitaminosis can cause primary degenerative dementia. Severe emotional trauma may contribute to primary degenerative dementia but does not necessarily cause it. Neural degeneration leads to permanent, not transient, changes.

A nurse is caring for a client with severe dyspnea who is receiving oxygen via a Venturi mask. What should the nurse do when caring for this client? 1 Assess frequently for nasal drying. 2 Keep the mask tight against the face. 3 Monitor oxygen saturation levels when eating. 4 Set the oxygen flow at the highest setting possible

3

While supervising the LPN's technique with medication administration, the nurse manager sees the LPN beginning to dispense an incorrect dose. How should the nurse manager respond initially? 1 By telling the LPN that an error has been made 2 By informing the nursing supervisor that the LPN is unsafe 3 By questioning the dosage in the hope that the LPN will identify the error 4 By pointing out the error just before the LPN begins to administer the medication

3

A nurse is caring for a client with a Venturi mask who is receiving 40% oxygen. What nursing actions are indicated? Select all that apply. 1 Keep the oxygen source higher than the client's airway. 2 Adjust the liter flow according to the oxygen saturation. 3 Prevent the client's blanket from covering the adaptor's orifices. 4 Ensure that the bag does not deflate completely during inspiration. 5 Check that the appropriate adaptor to deliver the prescribed FiO 2 is attached to the mask

3,5

A 14-month-old toddler is able to recognize the shapes of objects and fit smaller boxes into larger boxes. Which type of cognitive development does this action indicate? 1. Domestic imicry 2. Casual relationship 3. spatial relationship 4. object permanace

3. The toddler's ability to recognize the shapes of objects and fit smaller boxes in larger boxes indicates awareness of spatial relationships. If the toddler is acutely aware of others' actions and attempts to copy them in gestures and words, it indicates domestic mimicry. When the toddler explores an object each time it appears in a new place, it indicates an awareness of causal relationships. If the toddler understands that objects continue to exist even when they cannot be observed in the same place, it indicates an awareness of object permanence.

Dementia with Lewy bodies should avoid discussing events that require memory of what part of a clients life? 1. Married life 2. Work years 3. Recent days 4. Young adulthood

3. Dementioa with Lewy bodies (DLB) is characterized with short term memory, unpredictable cognistive shifts and sleep disturbances. Memory or remote events usually remains fairly intact.

A nurse instructs a client to breathe deeply to open collapsed alveoli. What should the nurse include in the explanation of the relationship between alveoli and improved oxygenation? 1 "The alveoli need oxygen to live." 2 "The alveoli have no direct effect on oxygenation." 3 "Collapsed alveoli increase oxygen demands." 4 "Oxygen is exchanged for carbon dioxide in the alveolar membrane.

4

What are the reasons for performing a lumbar puncture on a client? Select all that apply. 1.Confirming spinal cord injuries 2. Assessing sensory nerve problems 3. Measuring blood flow in many areas 4. Reading cerebrospinal fluid pressure 5. Injecting contrast medium for diagnostic study

4. & 5 A lumbar puncture is the insertion of a spinal needle into the subarachnoid space between the third and fourth lumbar vertebrae; it can be used to obtain cerebrospinal fluid readings with a manometer. Using a lumbar puncture, contrast medium or air is injected for diagnostic study. Evoked potentials measure the electrical signals to the brain generated by sound, light, or touch, and are used to confirm neurologic conditions like spinal cord injuries and multiple sclerosis. Evoked potentials are also used to assess sensory nerve problems. Cerebral blood flow evaluation is used to measure blood flow in many areas using radioactive substances.

The priority nursing intervention when the mebranes rupture spontaneously is an assessment of what? 1. Cervical dilation and effacement 2. The amount, color, and odor of the fluid 3. Frequency and duration of contractions 4.Variablw decelerations or fetal bradycardia

4. Detect the possibilty of cord compression or prolapse, which would be evidenced by variable declerations or fetal bradycardia

A 4-year-old child develops thrombocytopenia after vaccination. Which vaccination may be responsible? 1. Rotavirus vaccine 2. Varicella Virus vaccine 3. Human Papillomavirus Vaccine 4. Measles, mumps, and rubella virus vacine

4. Measles, mumps, and rubella virus vaccine (MMR) may cause transient thrombocytopenia. It is generally benign and occurs only rarely. Rotavirus vaccine carries a small risk for intussusception. Varicella virus vaccine and human papillomavirus vaccine may cause mild effects such as fever and fainting.

A mother brings her 6-year-old to the pediatrics clinic. stating that the child had not been feeling well, is weak and lethargic, and has poor appetite, headaches, and smokey-colored urine. What additional information should the nurse obtain that will aid diagnosis? 1. Rash on palms or feet 2. Shoulder and knee pain 3. Recent weight loss of 2 lbs 4. Strep throat in the past 2 weeks

4. Smokey urine and the stated symptoms should lead the nurse to suspect glomerulonephritis , which usually occurs after a recent streptococcal infection

which part of the brain contains the client's "central switchboard" of the central nervous system? 1Cerebrum 2Brain stem 3Cerebellum 4Diencephalon

4. The thalamus is considered to be the major relay station or "central switchboard" for the central nervous system (CNS). The thalamus, along with the hypothalamus and epithalamus, are located in the diencephalon of the brain.

at which stage of Kohlberg's theory is the child afraid of punishment? A. Stage 1 B. Stage 2 C. Stage 3 D. Stage 4

A

The nurse assesses a patient and determines that she has achieved thelarche. What clinical finding prompted the nurse's report?

Appearance of breast buds

Which symptoms present in a child indicate Turner syndrome? Select all that apply. a: Webbed neck b: Impaired language c: Tall stature with long legs d: Low position of posterior hairline e:Shield-shaped chest with wide space between the nipples

Turner syndrome is a chromosomal abnormality seen in females in which an X chromosome is partly or completely absent. The clinical manifestations of Turner syndrome include a webbed neck, low posterior hairline, and shield-shaped chest with wide space between the nipples. Impaired language skills are seen in clients with triple X or superfemale syndrome. The client with Turner syndrome has short stature. Tall stature with long legs is a finding in Klinefelter syndrome.

What cranial nerve damage maylead to a decrease in a clients's olfactory acuity? a. I b. X c. V d.VII

a. Cranial nerve I - olfactor nerve, originats at the olfactory bulb and assists with the perception of smell. Dmagae to this nerve can cause a decreased in olfactory acuity

Which lobe of the cerebrum includes the client's Broca speech center? a. Frontal b. Parietal lobe c. Occipital lobe d. Temporal lobe

a. Frontal - responsible for formation of words into speech

A client is admitted to the hospital for observation after an accident. The client is oriented ti person, place, and time and vital signs are within normal ranges. When performing an assessment the nurse observes a clear, watery drainage oozing from the clients ear. What should be the nurses first response ? 1. Test the fluid for glucose and aply a sterile dressing. 2. Position the client so that the uneffected ear is dependant 3. Cover the area with sterile guaze while applying slight pressure. 4. Clean the clients outer ear with normal saline and insert a clean cotton ball

a. The presence of glucose indicates that the drainage is cerebrospinal fluid (CSF)

What theraputic effect does the nurse expect to identify when monnitol is administered parenterally to a client with cerebral edema? a. Improved renal blood flow b. Decreased intracranial pressure c. Maintenanace of circulatory volume d.Prevention of development of thrombi

b.

Which drug would be effective for the treatment of pituitary Cushing's syndrome? 1. Mitotane 2. Cabergoline 3. Cypoheptadine 4. Bromocriptine mesylate

c. Cyproheptadine

A client with a head injury is admitted to the hospital. Which assessment finding alerts the nurse to increasing intracranial pressure? a. hypervigilance b. constricted pupils c. increased heart rate d. widening pulse pressure

d. Pressure on the vital centers in the brain causes increase in systolic blood pressure, widening difference between the systolic and diastolic pressures. The client will be lethargic and have a lowered level of consciousness.

Which cerebral lobe includes the speech area that allows the client to process words into coherent thoughts/ a. Limbic lobe b. Frontal lobe c. Occipital lobe d. Temporal lobe

d. Wernick's area (language area), which allows processing of words into coheremnt thought and understanding of written or spoken words, is located in the temporal lobe.

Increasing intercranial pressure compresses vital brain tissue and manifest by :

slugish pupillary response and and increase in systolic blood pressure