More Final Practice Questions
A nurse who provides care in a community clinic assesses a wide range of individuals. The nurse should identify which of the following clients as having the highest risk for chronic pancreatitis? a. A 45-year-old obese woman with a high-fat diet b. An 18-year-old man who is a weekend binge drinker c. A 39-year-old man with chronic alcoholism d. A 51-year-old woman who smokes one-and-a-half packs of cigarettes per day
c. A 39-year-old man with chronic alcoholism
Which type of graft utilizes the client's own skin for wound coverage? a. Heterograft b. Allograft c. Autograft d. Slit graft
c. Autograft
Which complication is common for victims of electrical burns? a. Inhalation injury b. Infection c. Cardiac dysrhythmia d. Hypovolemic shock
c. Cardiac dysrhythmia
The palm represents which percentage of a person's TBSA? a. 1% b. 5% c. 10% d. 15%
a. 1%
A nurse has reported for a shift at a busy burns and plastics unit in a large university hospital. Which client is most likely to have life-threatening complications? a. A 4-year-old scald victim burned over 24% of the body b. A 27-year-old male burned over 36% of his body in a car accident c. A 39-year-old female client burned over 18% of her body d. A 60-year-old male burned over 16% of his body in a brush fire
a. A 4-year-old scald victim burned over 24% of the body
In an industrial accident, a client who weighs 155 lb (70 kg) sustained full-thickness burns over 40% of his body. He's in the burn unit receiving fluid resuscitation. Which finding shows that the fluid resuscitation is benefiting the client? a. A urine output consistently above 40 ml/hour b. A weight gain of 4 lb (2 kg) in 24 hours c. Body temperature readings all within normal limits d. An electrocardiogram (ECG) showing no arrhythmias
a. A urine output consistently above 40 ml/hour
An emergency department nurse has just received a client with burn injuries brought in by ambulance. The paramedics have started a large-bore IV and covered the burn in cool towels. The burn is estimated as covering 24% of the client's body. How should the nurse best address the pathophysiologic changes resulting from major burns during the initial burn-shock period? a. Administer IV fluids b. Administer broad-spectrum antibiotics c. Administer IV potassium chloride d. Administer packed red blood cells
a. Administer IV fluids
A client's physician has ordered a "liver panel" in response to the client's development of jaundice. When reviewing the results of this laboratory testing, the nurse should expect to review what blood tests? Select all that apply. a. Alanine aminotransferase (ALT) b. C-reactive protein (CRP) c. Gamma-glutamyl transferase (GGT) d. Aspartate aminotransferase (AST) e. B-type natriuretic peptide (BNP)
a. Alanine aminotransferase (ALT) c. Gamma-glutamyl transferase (GGT) d. Aspartate aminotransferase (AST)
A nurse is caring for a client with hepatic encephalopathy. While making the initial shift assessment, the nurse notes that the client has a flapping tremor of the hands. The nurse should document the presence of what sign of liver disease? a. Asterixis b. Constructional apraxia c. Fetor hepaticus d. Palmar erythema
a. Asterixis
The spouse of a client who was struck by lightning asks the nurse why the areas involved seems so small but the damage is extensive. Which is the best explanation from the nurse? a. Electrical burns usually follow an internal path. b. Lightning is higher in voltage than electricity. c. The skin is a good conductor of electricity. d. Moisture intensifies the damage inflicted.
a. Electrical burns usually follow an internal path.
The nurse in the emergency department receives a patient who sustained a severe burn injury. What is the priority action by the nurse in this situation? a. Establish a patent airway. b. Insert an indwelling catheter. c. Replace fluids. d. Administer pain medication.
a. Establish a patent airway.
During a health education session, a participant has asked about the hepatitis E virus. What prevention measure should the nurse recommend for preventing infection with this virus? a. Following proper hand-washing techniques b. Avoiding chemicals that are toxic to the liver c. Wearing a condom during sexual contact d. Limiting alcohol intake
a. Following proper hand-washing techniques
Which factor may contribute to compartment syndrome? a. Hemorrhage b. Macular lesion c. Venous thromboembolus d. Disuse syndrome
a. Hemorrhage
Development of malignant melanoma is associated with which risk factor? a. History of severe sunburn b. African American heritage c. Skin that tans easily d. Residence in the Northeast
a. History of severe sunburn
A nurse educator is teaching a group of recent nursing graduates about their occupational risks for contracting hepatitis B. What preventative measures should the educator promote? Select all that apply. a. Immunization b. Use of standard precautions c. Consumption of a vitamin-rich diet d. Annual vitamin K injections e. Annual vitamin B12 injections
a. Immunization b. Use of standard precautions
A client's abdominal ultrasound indicates cholelithiasis. When the nurse is reviewing the client's laboratory studies, what finding is most closely associated with this diagnosis? a. Increased bilirubin b. Decreased serum cholesterol c. Increased blood urea nitrogen (BUN) d. Decreased serum alkaline phosphatase level
a. Increased bilirubin
Which of the following is the preferred IV fluid for burn resuscitation? a. Lactated Ringer's (LR) b. Normal saline (NS) c. D5W d. Total parenteral nutrition (TPN)
a. Lactated Ringer's (LR)
A nurse is planning the care of an older adult client who will soon be discharged home after treatment for a fractured hip. In an effort to prevent future fractures, the nurse should encourage what actions? Select all that apply. a. Regular bone density testing b. A high-calcium diet c. Use of falls prevention precautions d. Use of corticosteroids as prescribed e. Weight-bearing exercise
a. Regular bone density testing b. A high-calcium diet c. Use of falls prevention precautions e. Weight-bearing exercise
A 37-year-old male client presents at the emergency department (ED) reporting nausea and vomiting and severe abdominal pain. The client's abdomen is rigid, and there is bruising to the client's flank. The client's wife states that he was on a drinking binge for the past 2 days. The ED nurse should assist in assessing the client for what health problem? a. Severe pancreatitis with possible peritonitis b. Acute cholecystitis c. Chronic pancreatitis d. Acute appendicitis with possible perforation
a. Severe pancreatitis with possible peritonitis
The school nurse is instructing a parent in the care and elimination of lice from their child's hair. The parent brings all of the products for care in a bag. Which contents are not appropriate for use? a. Shampoo and conditioner b. Permethrin (Nix) c. Plastic wide-toothed comb d. New hair clips
a. Shampoo and conditioner
The nurse is triaging a client over the phone who states having a contact dermatitis rash. Which treatment option of over-the-counter preparations does the nurse suggest for the client? Select all that apply. a. Topical antihistamines b. Cosmetic lotions c. Hydrocortisone cream d. Moisturizing cream e. Lanolin based ointment
a. Topical antihistamines c. Hydrocortisone cream
A 15-year-old child is brought to the emergency department with symptoms of hyperglycemia. Based on the fact that the child's pancreatic beta cells are being destroyed, the client would be diagnosed with what type of diabetes? a. Type 1 diabetes b. Type 2 diabetes c. Non-insulin-dependent diabetes d. Prediabetes
a. Type 1 diabetes
The nurse is administering an insulin drip to a patient in ketoacidosis. What insulin does the nurse know can be used intravenously? a. short-acting or regular insulin b. peakless 24 hour acting c. intermediate-acting d. long-acting e. rapid acting
a. short-acting or regular insulin
The classic lesions of impetigo manifest as a. comedones in the facial area. b. honey-yellow crusted lesions on an erythematous base. c. abscessed skin and subcutaneous tissue. d. patches of grouped vesicles on red and swollen skin.
b. honey-yellow crusted lesions on an erythematous base.
A young client has head lice. What are appropriate steps in eradication? Select all that apply. a.Repeat combings daily until there is no more evidence of lice or nits. b. Apply a pediculicide to the hair (detailed directions also accompany this medication). c. Comb the hair free of tangles while the hair is damp. d. Use a special lice comb that has narrow stainless steel teeth. e. Comb through each area of the hair to remove lice.
a.Repeat combings daily until there is no more evidence of lice or nits. b. Apply a pediculicide to the hair (detailed directions also accompany this medication). c. Comb the hair free of tangles while the hair is damp. d. Use a special lice comb that has narrow stainless steel teeth. e. Comb through each area of the hair to remove lice.
A nurse who is taking care of a client with burns is asked by a family member why the client is losing so much weight. The client is currently in the intermediate phase of recovery. What would be the nurse's most appropriate response to the family member? a. "He's on a calorie-restricted diet in order to divert energy to wound healing." b. "His body has consumed his fat deposits for fuel because his calorie intake is lower than normal." c. "He actually hasn't lost weight. Instead, there's been a change in the distribution of his body fat." d. "He lost many fluids while he was being treated in the emergency phase of burn care."
b. "His body has consumed his fat deposits for fuel because his calorie intake is lower than normal."
The ABCD method offers one way to assess skin lesions for possible skin cancer. What does the A stand for? a. Actinic b. Asymmetry c. Arcus d. Assessment
b. Asymmetry
An elderly client with diabetes comes to the clinic with her daughter. The nurse reviews foot care with the client and her daughter. Why would the nurse feel that foot care is so important to this client? a. An elderly client with foot ulcers experiences severe foot pain due to the diabetic polyneuropathy. b. Avoiding foot ulcers may mean the difference between institutionalization and continued independent living. c. Hypoglycemia is linked with a risk for falls; this risk is elevated in older adults with diabetes. d. Oral antihyperglycemics have the possible adverse effect of decreased circulation to the lower extremities.
b. Avoiding foot ulcers may mean the difference between institutionalization and continued independent living.
A patient has developed a boil on the face and the nurse observes the patient squeezing the boil. What does the nurse understand is a potential severe complication of this manipulation? a. Scarring b. Brain abscess c. Erythema d. Cellulitis
b. Brain abscess
A patient is admitted to the hospital with a possible common bile duct obstruction. What clinical manifestations does the nurse understand are indicators of this problem? (Select all that apply.) a. Amber-colored urine b. Clay-colored feces c. Pruritus d. Jaundice e. Pain in the left upper abdominal quadrant
b. Clay-colored feces c. Pruritus d. Jaundice
A nurse knows to assess a patient with a burn injury for gastrointestinal complications. Which of the following is a sign that indicates the presence of a paralytic ileus? a. Hyperactive bowel sounds b. Decreased peristalsis c. Fecal occult blood d. Hematemesis
b. Decreased peristalsis
A client with diabetes mellitus has impaired skin integrity due to an injury. Which skin disorder is the client likely to develop? a. Psoriasis b. Furuncle c. Dermatitis d. Dermatophytosis
b. Furuncle
A client's burns have required a homograft. During the nurse's most recent assessment, the nurse observes that the graft is newly covered with purulent exudate. What is the nurse's most appropriate response? a. Perform mechanical débridement to remove the exudate and prevent further infection. b. Inform the primary care provider promptly because the graft may need to be removed. c. Perform range-of-motion exercises to increase perfusion to the graft site and facilitate healing. d. Document this finding as an expected phase of graft healing.
b. Inform the primary care provider promptly because the graft may need to be removed.
A client has a squamous cell carcinoma removed from the right lower leg. After the surgery, the nurse reviews instructions for care of the pressure dressing and provides health information about the cancer. Which statements are correct regarding squamous cell carcinoma? Select all that apply. a. It is the third most common of all three types of skin cancer. b. It is an invasive carcinoma. c. It can develop from a keratosis. d. It is responsible for approximately 4,000 deaths per year. e. It requires follow-up examinations every 3 months for 1 year
b. It is an invasive carcinoma. c. It can develop from a keratosis. d. It is responsible for approximately 4,000 deaths per year. e. It requires follow-up examinations every 3 months for 1 year
A client undergoes open reduction with internal fixation to treat an intertrochanteric fracture of the right hip. The nurse should include which intervention in the postoperative care plan? a. Performing passive range-of-motion (ROM) exercises on the client's legs once each shift b. Keeping a pillow between the client's legs at all times c. Turning the client from side to side every 2 hours d. Maintaining the client in semi-Fowler's position
b. Keeping a pillow between the client's legs at all times
A nurse is caring for a client with type 1 diabetes who is being discharged home tomorrow. What is the best way to assess the client's ability to prepare and self-administer insulin? a. Ask the client to describe the process in detail. b. Observe the client drawing up and administering the insulin. c. Provide a health education session reviewing the main points of insulin delivery. d. Review the client's first hemoglobin A1C result after discharge.
b. Observe the client drawing up and administering the insulin.
A nurse is assessing a client and finds a malignant lesion on the client's face. The nurse suspects this is what type of skin cancer? a. Basal cell carcinoma b. Squamous cell carcinoma c. Malignant melanoma d. Dermatofibroma
b. Squamous cell carcinoma
A client with type 2 diabetes normally achieves adequate glycemic control through diet and exercise. Upon being admitted to the hospital for a cholecystectomy, however, the client has required insulin injections on two occasions. The nurse would identify what likely cause for this short-term change in treatment? a. Alterations in bile metabolism and release have likely caused hyperglycemia. b. Stress has likely caused an increase in the client's blood sugar levels. c. The client has likely overestimated her ability to control her diabetes using non-pharmacologic measures. d. The client's volatile fluid balance surrounding surgery has likely caused unstable blood sugars.
b. Stress has likely caused an increase in the client's blood sugar levels.
What quick assessment technique should the nurse use to assess the percentage of burn injury? a. Observe the color of the client's wound b. Check the client's vital signs c. Compare the client's palm with the size of the burn wound d. Observe the client's level of consciousness
c. Compare the client's palm with the size of the burn wound
A nurse is teaching a client with a partial-thickness wound how to wear his elastic pressure garment. How should the nurse instruct the client to wear this garment? a. 4 to 6 hours a day for 6 months b. During waking hours for 2 to 3 months after the injury c. Continuously d. At night while sleeping for a year after the injury
c. Continuously
Which is the primary preventable cause of skin cancer? a. Fair skin b. Excess melanin c. Exposure to UV radiation d. Skin disease
c. Exposure to UV radiation
A nurse is performing a shift assessment on an elderly client who is recovering after surgery for a hip fracture. The client reports chest pain, has an increased heart rate, and increased respiratory rate. The nurse further notes that the client is febrile and hypoxic, coughing, and producing large amounts of thick, white sputum. The nurse recognizes that this is a medical emergency and calls for assistance, recognizing that this client is likely demonstrating symptoms of what complication? a. Avascular necrosis of bone b. Compartment syndrome c. Fat embolism syndrome d. Complex regional pain syndrome
c. Fat embolism syndrome
Skin grafts are necessary for which of the following burns? a. Superficial b. Superficial partial thickness c. Full-thickness d. First degree
c. Full-thickness
A triage nurse in the emergency department (ED) receives a phone call from a frantic father who saw his 4-year-old child tip a pot of boiling water onto her chest. The father has called an ambulance. What should the nurse in the ED receiving the call instruct the father to do? a. Cover the burn with ice and secure with a towel. b. Apply butter to the area that is burned. c. Immerse the child in a cool bath. d. Avoid touching the burned area under any circumstances.
c. Immerse the child in a cool bath.
A client has partial-thickness burns on both lower extremities and portions of the trunk. Which IV fluid does the nurse plan to administer first? a. Albumin b. Dextrose 5% in water (D5W) c. Lactated Ringer's solution d. Normal saline solution with 20 mEq of potassium per 1,000 ml
c. Lactated Ringer's solution
Which of the following is the cause of shingles? a. Parasitic fungi b. Itch mite c. Reactivated virus d. Hormonal change
c. Reactivated virus
Which of the following is a true statement regarding the purposes of skin grafts? a. Increases evaporative fluid loss. b. Increases potential for infection. c. Reduces scarring and contractures. d. Prolongs recovery
c. Reduces scarring and contractures.
A pregnant woman has been diagnosed with gestational diabetes. The client is shocked by the diagnosis, stating that she is conscientious about her health, and asks the nurse what causes gestational diabetes. The nurse should explain that gestational diabetes is a result of what etiologic factor? a. Increased caloric intake during the first trimester b. Changes in osmolality and fluid balance c. The effects of hormonal changes during pregnancy d. Overconsumption of carbohydrates during the first two trimesters
c. The effects of hormonal changes during pregnancy
A nurse is developing a care plan for a client with a partial-thickness burn, and determines that an appropriate goal is to maintain position of joints in alignment. What is the best rationale for this intervention? a. To prevent neuropathies b. To prevent wound breakdown c. To prevent contractures d. To prevent heterotopic ossification
c. To prevent contractures
A nurse is developing a care plan for a client recovering from a serious thermal burn. After maintaining respirations, the nurse knows that the most important immediate goal of therapy is: a. planning for the client's rehabilitation and discharge. b. providing emotional support to the client and family. c. maintaining the client's fluid, electrolyte, and acid-base balance. d. preserving full range of motion in all affected joints.
c. maintaining the client's fluid, electrolyte, and acid-base balance.
While assessing the skin of a 45 y/o, fair-skinned female client, the nurse notes a lesion on the medial aspect of her lower leg. It has irregular borders w/ various shades of black & brown. The client states that the lesion itches occasionally and bled slightly a few weeks ago. She also reveals a hx of sunburns. Based on these S/S, the nurse suspects: a. SCC b. acitinerosis c. melanoma d. BCC
c. melanoma
The nurse teaches the client who demonstrates herpes zoster (shingles) that a. once a client has had shingles, they will not have it a second time. b. a person who has had chickenpox can contract it again upon exposure to a person with shingles. c. the infection results from reactivation of the chickenpox virus. d. no known medications affect the course of shingles.
c. the infection results from reactivation of the chickenpox virus.
A nurse is caring for a client who has sustained a deep partial-thickness burn injury. In prioritizing the nursing diagnoses for the plan of care, the nurse will give the highest priority to what nursing diagnosis? a. Activity Intolerance b. Anxiety c. Ineffective Coping d. Acute Pain
d. Acute Pain
A client is brought to the ED by paramedics, who report that the client has partial-thickness burns on the chest and legs. The client has also suffered smoke inhalation. What is the priority in the care of a client who has been burned and suffered smoke inhalation? a. Pain b. Fluid balance c. Anxiety and fear d. Airway management
d. Airway management
A nurse is providing an educational class to a group of older adults at a community senior center. In an effort to prevent osteoporosis, the nurse should encourage participants to ensure that they consume the recommended intake of what nutrients? Select all that apply. a. Vitamin B12 b. Potassium c. Calcitonin d. Calcium e. Vitamin D
d. Calcium e. Vitamin D
Which information should be included in the teaching plan for a client receiving glargine, which is "peakless" basal insulin? a. Administer the total daily dosage in 2 doses. b. Draw up the drug first, then add regular insulin. c. Glargine is rapidly absorbed and has a fast onset of action. d. Do not mix with other insulins.
d. Do not mix with other insulins.
An older adult client with type 2 diabetes is brought to the emergency department by his daughter. The client is found to have a blood glucose level of 600 mg/dL (33.3 mmol/L). The client's daughter reports that the client recently had a gastrointestinal virus and has been confused for the last 3 hours. The diagnosis of hyperglycemic hyperosmolar syndrome (HHS) is made. What nursing action would be a priority? a. Administration of antihypertensive medications b. Administering sodium bicarbonate intravenously c. Reversing acidosis by administering insulin d. Fluid and electrolyte replacement
d. Fluid and electrolyte replacement
A client is brought to the emergency department from the site of a chemical fire, where he suffered a burn that involves the epidermis, dermis, and the muscle and bone of the right arm. On inspection, the skin appears charred. Based on these assessment findings, what is the depth of the burn on the client's arm? a. Superficial partial thickness b. Deep partial thickness c. Full partial thickness d. Full thickness
d. Full thickness
Which of the following types of shock will a nurse observe in a client with extensive burns? a. Anaphylactic shock b. Neurogenic shock c. Septic shock d. Hypovolemic shock
d. Hypovolemic shock
A client's burns are estimated at 36% of total body surface area; fluid resuscitation has been ordered in the emergency department. After establishing intravenous access, the nurse should anticipate the administration of what fluid? a. 0.45% NaCl with 20 mEq/L KCl b. 0.45% NaCl with 40 mEq/L KCl c. Normal saline d. Lactated Ringer's
d. Lactated Ringer's
A nurse is assessing a client who has been diagnosed with cholecystitis, and is experiencing localized abdominal pain. When assessing the characteristics of the client's pain, the nurse should anticipate that it may radiate to what region? a. Left upper chest b. Inguinal region c. Neck or jaw d. Right shoulder
d. Right shoulder
An emergency department nurse has just admitted a client with a burn. What characteristic of the burn will primarily determine whether the client experiences a systemic response to this injury? a. The length of time since the burn b. The location of burned skin surfaces c. The source of the burn d. The total body surface area (TBSA) affected by the burn
d. The total body surface area (TBSA) affected by the burn
An occupational health nurse is called to the floor of a factory where a worker has sustained a flash burn to the right arm. The nurse arrives and the flames have been extinguished. The next step is to "cool the burn." How should the nurse cool the burn? a. Apply ice to the site of the burn for 5 to 10 minutes. b. Wrap the client's affected extremity in ice until help arrives. c. Apply an oil-based substance to the burned area until help arrives. d. Wrap cool towels around the affected extremity intermittently.
d. Wrap cool towels around the affected extremity intermittently.
Which skin condition is caused by staphylococci, streptococci, or multiple bacteria? a. Scabies b. Pediculosis capitis c. Poison ivy e. Impetigo
e. Impetigo
