M/S Exam 1
A nurse is caring for a client who receives a local anesthetic of lidocaine during the repair of the skin laceration. Which of the following adverse reactions should the nurse monitor for the client? A. Seizures B. Tachycardia C. hypertension D. fever
A
A nurse is planning care for a client has brain cancer and is experiencing headaches. Which of the following adjuvant medications are indicated for this client? A. Dexamethasone B. Methylphenidate C. Hydroxyzine D. Amitriptyline
A
A nurse is preparing to administer an opioid agonist to a client who has acute pain. Which of the following manifestations should the nurse monitor as an adverse effect of this medication? A. Urinary retention B. Tachypnea C. hypertension D. irritating cough
A
A nurse is teaching a client who obsessive compulsive disorder and has a new prescription for paroxetine. Which of the following instructions should the nurse include? A. It can take several weeks before you feel like the medication is helping B. Take the medication just before bedtime to promote sleep C. you should take the medication when needed for obsessive urges D. Monitor for weight gain while taking this medication
A
An overweight patient with sleep apnea would like to avoid using a nasal CPAP device if possible. To help him reach this goal, the nurse suggests that the patient A. Lose excess weight B. Take a nap during the day C. Eat a high-protein snack at bedtime D. Use mild sedatives or alcohol at bedtime
A
The nurse is planning care for a client who is to receive tetracaine prior to a bronchoscopy. Which of the following actions should the nurse include in the plan care? A. Keep the client NPO until pharyngeal response returns B. monitor the insertion site for hematoma C. palpate the bladder to detect urinary retention D. maintain the client on bed rest for 12 hours following the procedure
A
Insufficient sleep is associated with (select all that apply) A. Increased body mass index B. Increased insulin resistance C. Impaired cognitive functioning D. Increased immune responsiveness E. Increased daytime body temperature
A B C
A nurse is admitting a toddler to the hospital following acetaminophen toxicity. Which of the following medications should the nurse anticipate administering to this client? A. Acetylcysteine B. Pegfilgrastim C. Misoprostol D. Naltrexone
A.
A nurse is providing instructions to a female client who has a new prescription for zolpidem, what instructions should the nurse include? A. Notify the provider if you plan to become pregnant B. Take the medication one hour before you plan to go to sleep C. Allow at least six hours for sleep when taking zolpidem D. To increase the effectiveness of zolpidem take it with a bedtime snack
A.
A nurse is teaching a client about a new prescription for celecoxib. Which of the following information should she include in the teaching? A. Increases the risk for a myocardial infarction B. Decreases the risk of stroke C. Inhibits COX-1 D. Increases platelet aggregation
A.
A Nurse is caring for a client who was just too she has breast cancer and the nurse evaluates the client's response. Which of the following statements by the client reflects a lack of understanding of an illness perspective? A."I have no family history of breast cancer." B. "I need a second opinion; there is no lump." C. "I am glad we live in the city near several large hospitals." D. "I will schedule surgery next week, over the holidays."
B
A nurse is preparing to administer pamidronate to a client who has bone pain related to cancer. Which of the following precautions should the nurse take when administering pamidronate? A. Inspect the skin for redness and irritation when changing the intradermal patch B. assess the IV site for thrombophlebitis frequently during administration C. instruct the client to sit upright or stand for 30 minutes following oral administration D. watch for manifestations of anaphylaxis for 20 minutes after IM administration
B
A nurse is reviewing the medication administration record for a client who is receiving transdermal Fentanyl for severe pain. Which of the following medications should the nurse expect to cause an adverse effect when administered concurrently with fentanyl A. Ampicillin B. diazepam C. Furosemide D. prednisone
B
A nurse is teaching a client who has a new prescription for ramelteon. The nurse should instruct the client to avoid which of the following foods at the time of medication administration? A. Baked potato B. Fried chicken C. Whole grain bread D. Citrus fruits
B
A nurse working in an emergency dept. Is caring for a client who has benzodiazepine toxicity due to an overdose. Which actions is the nurses priority? A- administer flumazenil B- identify the clients level of orientation C- infuse iv fluids D- prepare the client for gastric lavage
B
Pain is BEST described as A) a creation of a person's imagination B) an unpleasant, subjective experience C) a maladaptive response to a stimulus D) a neurologic event resulting from activation of nociceptors
B
While caring for a patient with a history of narcolepsy with cataplexy, the nurse can delegate which activity to the unlicensed assistive personnel (UAP)? A. Teaching about the timing of medications B. Walking the patient to and from the bathroom C. Developing a plan of care with a family member D. Planning an appropriate diet that avoids caffeine-containing foods
B
Which statement(s) is/are true regarding rapid eye movement (REM) sleep (select all that apply)? A. The EEG pattern is quiescent B. Muscle tone is greatly reduced C. It occurs only once in the night D. It is separated by distinct physiologic stages E. The most vivid dreaming occurs during this phase
B E
A cancer patient who reports ongoing, constant moderate pain with short periods of severe pain during dressing changes is A) probably exaggerating his pain B) best treated by referral for surgical treatment of his pain C) best treated by receiving a long-acting and a short acting opioid D) best treated by regularly scheduled short-acting opioids plus acetaminophen
C
A nurse is caring for a client who has and stage cancer and is receiving morphine. The clients daughter asks why the provider prescribed methylnaltrexone. Which of the following responses to the nurse make ? A. The medication will increase your mothers respirations B. Medication will prevent dependence on the morphine C. The medication will relieve your mothers constipation D. Medication works with the morphine to increased pain relief
C
A nurse is planning to administer morphine IV to a client who is postoperative. Which actions should the nurse take? A. Monitor for seizures and confusion with repeated doses B. protect the client skin from the severe diarrhea that occurs with morphine C. withhold this medication is respiratory rate is less than 12 per minute D. give morphine intermittent via IV bolus over 30 seconds or less
C
A nurse is taking a history for a client who reports that he is taking aspirin about four times daily for a sprained wrist. Which of the following prescribe medications taken for the client is contraindicated with aspirin? A. Digoxin B. metformim C. warfarin D. nitroglycerin
C
A nurse is teaching a client who has a new prescription for escitalopram for treatment of generalized anxiety disorder. Which of the following statements by the client indicates understanding of the teaching? A- i should take the medication on an empty stomach B- i will follow a low-sodium diet while taking this med C- i need to discontinue this med slowly D- i should not crush this med before swallowing
C
A patient is receiving a PCA infusion after surgery to repair a hip fracture. She is sleeping soundly but awakens when the nurse speaks to her in a normal tone of voice. Her respirations are 8 breaths/minute. The MOST appropriate nursing action in this situation is to A) stop the PCA infusion B) obtain oxygen saturation level C) continue to closely monitor the patient D) administer naloxone and contact the physician
C
An IMPORTANT nursing responsibility related to pain is to A) leave the patient alone to rest B) help the patient appear to not be in pain C) believe what the patient says about the pain D) assume responsibility for eliminating the patient's pain
C
Providing opioids to a dying patient who is experiencing moderate to severe pain A) may cause addiction B) will probably be ineffective C) is an appropriate nursing action D) will likely hasten a person's death
C
Strategies to reduce sleepiness during nighttime working include A. Exercising before work B. Taking melatonin before working the night shift C. Sleeping for at least 2 hours immediately before work time D. Walking for 10 minutes every 4 hours during the night shift
C
A nurse believes that patients with the same type of tissue injury should have the same amount of pain. This statement reflects A) a belief that will contribute to appropriate pain management B) an accurate statement about pain mechanism and an expected goal of pain therapy C) a belief that will have no effect on the type of care provided to people in pain D) a lack of knowledge about pain mechanisms, which is likely to contribute to poor pain management
D
A nurse in an emergency department is performing an admission assessment for a client who has severe aspirin toxicity. Which of the following findings should she expect? A. Body temperature 35°C 95 Fahrenheit B. lung crackles C. cool dry skin D. respiratory depression
D
A nurse is administering amitriptyline to a client who is experiencing cancer pain. Which of the following adverse effects should the nurse monitor? A. Decreased appetite B. explosive diarrhea C. decreased pulse rate D. Orthostatic hypotension
D
A nurse is caring for a client who is admitted to undergo a surgical procedure. Which of the following pre-existing conditions can be a contraindication for the use of ketamine as an intravenous anesthetic? A. Peptic ulcer disease B. Breast cancer C. Diabetes mellitus D. Schizophrenia
D
A nurse is preparing to administer Butorphanol to a client who has a history of substance use disorder. The nurse should identify which of the following information is true regarding Butorphanol? A. It has a greater risk for abuse than morphine B. It causes a higher incidence of respiratory depression than morphine C. It cannot be reversed with an opiate antagonist D. It can cause abstinence syndrome in opioid dependent clients
D
A nurse is providing teaching to a client who has a new prescription for buspirone to treat anxiety. Which info should the nurse include? A- take this med on an empty stomach B- expect optimal therapeutic effects within 24hr C- take this med when needed for anxiety D- this med has a low risk for dependency
D
A nurse is reviewing the health history of a client who has migraine headache and is to begin prophylaxis therapy with Propranolol. Which of the following findings in the client history should the nurse report to the provider? A. The client had a prior myocardial infarction B. the client takes warfarin for arterial fibrillation C. the client takes an SSRI for depression D. an ECG indicates a 1st degree heart block
D
Sleep is best described as a A. Loosely organized state similar to coma B. State in which pain sensitivity decreases C. Quiet state in which there is little brain activity D. State in which an individual lacks conscious awareness of the environment
D
When teaching the patient with primary insomnia about sleep hygiene, the nurse should emphasize A. The importance of daytime naps B. The need to exercise about 1 hour before bedtime C. The need for long-term use of hypnotics D. Avoiding caffeine-containing beverages 6-9 hours before bedtime
D
A nurse caring for a patient in the intensive care unit (ICU) implements strategies to create an environment conducive to sleep. Which strategy would be most effective? a. Turning off the lights in the room during the night b. Having the television on at all times for background noise c. Silencing the alarms on the bedside monitor and infusion pumps d. Administering ordered analgesics around the clock, even if the patient denies pain.
a
A patient comes to the clinic with a complaint of a dull pain in the anterior and posterior neck. On examination, the nurse notes that the patient has full range of motion (ROM) of the neck and no throat redness or enlarged head or neck lymph nodes. What will be the nurse's next appropriate assessment indicated by these findings? a. Palpation of the liver b. Auscultation of bowel sounds c. Inspection of the patient's ears d. Palpation for the presence of hip pain
a
A patient who has been taking ibuprofen and imipramine (Tofranil) for control of cancer pain is having increased pain. What would nurse recommend to the HCP as an appropriate change in the medication plan? a. Add PO oxycodone to the other medications. b. Substitute PO ketorolac, an NSAID, for imipramine c. Add transdermal fentanyl (Duragesic) to the use of the other medications d. Substitute PO hydrocodone with acetaminophen for the other medications.
a
A patient with advanced colorectal cancer has continuous, poorly localized abdominal pain at an intensity of 5 on a scale of 0 to 10. How does the nurse teach the patient to use pain medications? a. On an around-the-clock schedule b. As often as necessary to keep the pain controlled c. By alternating two different types of drugs to prevent tolerance d. When the pain cannot be controlled with distraction or relaxation
a
A patient with trigeminal neuralgia has moderate to severe burning and shooting pain. In helping the patient to manage the pain, the nurse recognizes what about this type of pain? a. Includes treatment with adjuvant analgesics b. Will be chronic and require long-term treatment c. Responds to small to moderate around-the-clock doses of oral opioids. d. Can be well controlled with salicylates or nonsteroidal antiinflammatory drugs (NSAIDS)
a
After receiving the assigned patients for the day, the nurse determines that stress-relieving interventions are a priority for which patient? a. The man with peptic ulcer disease b. The newly admitted woman with cholecystitis c. The man with a bacterial exacerbation of chronic bronchitis d. The woman who is 1 day postoperative for knee replacement
a
The nurse recognizes that a patient with newly diagnosed breast cancer is using an emotion-focused coping process where she: a. joins a support group for women with breast cancer b. considers the pros and cons of the various treatment options c. delays treatment until her family can take a weekend trip together d. tells the nurse that she has a good prognosis because the tumor is small
a
Which medication is a nonamphetamine wake-promotion drug that may be used for narcolepsy? a. Modafinil (Provigil) b. Fluoxetine (Prozac) c. Amitriptyline (Elavil) d. Suvorexant (Belsomra)
a
Which statement most accurately describes cultural factors that may affect health? a. Diabetes and cancer rates differ by cultural/ethnic groups. b. Most patients find that religious rituals help them during times of illness. c. There are limited ethnic variations in physiologic responses to medications. d. Silence during a nurse-patient interaction usually means that the patient understands the instructions.
a
A nurse is caring for a client who has cancer and is taking morphine and Carbamazepine for pain. Which of the following effects should the nurse monitor when giving the medications together (select all apply ) A. Need for reduced dosage of the opioid B. reduced adverse affects of the opioid C. increased analgesic effects D. enhanced CNS stimulation E. increased opioid tolerance
a b c
What strategies could decrease the distress of rotating shifts for nurses (select all that apply)? a. Take a brief onsite nap b. Use sleep hygiene practices c. Sleep just before going to work d. Maintain consistent sleep/wake schedules even on days off (if possible) e. Negotiate to control work schedule rather than having someone else impose the schedule
a b c d e
What are the leading determinants of a patient's health (select all that apply)? a. Genetics b. Health behaviors c. Family history of disease d. Social and physical environment e. Type and quality of medical care received
a b d
A nurse is caring for an older adult client who has a new diagnosis of type 2 diabetes mellitus and reports difficulty following the diet and remembering to take the prescribed medication. Which of the following is the appropriate action by the nurse? (select all that apply) A. Ask the dietitian to assist with meal planning B. Contact the client's support system C. Assess for age-related cognitive awareness D. Encourage the use of daily medication dispenser E. Provide educational materials for home use
a b d e
A nurse is evaluating clients at a health fair for modifiable variables affecting health and wellness. The nurse identifies which of the following as a modifiable variable? (select all that apply) A. Smoking on social occasions B. BMI of 28 C. alopecia D. Trisomy 21 E. History of reflux
a b e
A polysomnography (PSG) may be performed on a patient with signs and symptoms of a sleep disorder. What measures and observations does this study include (select all that apply)? a. Heart rate monitoring b. Noninvasive oxygen saturation (SpO2) c. Surface body temperature fluctuations d. Blood pressure monitoring (noninvasive) e. Airflow measured at the nose and mouth f. Muscle tone measured by electromyogram (EMG) g. Respiratory effort around the chest and abdomen h. Eye movements recorded by electrooculogram (EOG) i. Brain activity recorded by electroencephalogram (EEG) j. Actigraph watch worn on the wrist to monitor motor activity k. Gross body movements monitored via cameras and microphones
a b e f g h i k
A nurse is caring for a client who takes peroxidation to treat post dramatic stress disorder he reports that he grinds his teeth during the night the nurse should identify which of the following interventions to manage bruxism (select all that apply) A. Concurrent administration of buspirone B. administration of a different SSRI C. use of a mouth guard D. changing to a different class of anti-depressant medication E. increasing the dose of paroxetine
a c d
A 32-yr-old man is admitted to the hospital with an acute exacerbation of Crohn's disease. Coping strategies that may be suggested by the nurse during his hospitalization include (select all that apply) a. Humor b. Exercise c. Journaling d. A cleansing diet e. Relaxation therapy
a c e
The nurse's role in addressing the national patient safety goals established by The Joint Commission includes (Select all that apply): A. Answering all patient monitoring alarms promptly B. Memorizing and implementing all the rules published by The Joint Commission. C. Obtaining a complete list of the patient's medications and monitoring their use throughout the continuum of care. D. Encourage patients to be actively involved in and question their own health care. E. Using side rails and alarm systems as necessary to prevent patient falls.
a c e
A nurse is providing instructions to a client has been experiencing insomnia and has a new prescription for temazepam. The nurse should inform the client that which of the following manifestations are adverse affects (select all apply ) A. Incoordination B. Hypertension C. Pruritis D. Sleep driving E. Amnesia
a d e
A patient has recently had a myocardial infarction. What emotion-focused coping strategies should the nurse encourage him to use to adapt to the physical and emotional stress of his illness (select all that apply): a. Use meditation b. Plan dietary changes c. Start an exercise program d. Do favorite escape activities (e.g., playing cards) e. Share feelings with spouse or other family members
a d e
Nurse is assessing a client who has salicylism. Which of the following findings should the nurse expect (select all apply ) A. Dizziness B. diarrhea C. jaundice D. Tinnitus E. headache
a d e
An example of distraction to provide pain relief is A) TENS B) music C) exercise D) biofeedback
b
As part of the nursing process, cultural assessment is best accomplished by a. judging the patient's cultural values based on observations. b. using a cultural assessment guide as part of the nursing process. c. seeking guidance from a nurse from the patient's cultural background. d. relying on the nurse's previous experience with patients from that cultural group.
b
Determination of whether an event is a stressor is based on a person's a. tolerance b. perception c. adaptation d. stubbornness
b
In identifying patients at the greatest risk for health disparities, the nurse would note that a. patients who live in urban areas have readily available access to health care services. b. cultural differences exist in patients' ability to communicate with their health care provider. c. a patient receiving care from a health care provider of a different culture would have decreased quality of care. d. men are more likely than women to have their cardiovascular disease symptoms ignored by their health care provider.
b
The nurse knows that a patient taught sleep hygiene practices needs further instruction when he says a. "Once I go to bed, I should get up if I am not asleep after 20 minutes." b. "It's okay to have my usual two glasses of wine in the evening before bed." c. "A couple of crackers with cheese and a glass of milk may help to relax before bed." d. "I should go to the gym earlier in the day so that I'm done at least 6 hours before bedtime."
b
The nurse uses knowledge of the effects of stress on the immune system by encouraging patients to a. sleep for 10 to 12 hours per day. b. avoid exposure to upper respiratory tract infections. c. receive regular immunizations when they are stressed. d. use emotion-focused rather than problem-focused coping strategies.
b
The student nurse is depressed. He is trying to study for an important exam but cannot focus. Yesterday he received news that his mother was diagnosed with metastatic breast cancer. What effect could the stress on the student's mind and spirit most likely have on the student's body? a. The student's stress will cause failure of the exam b. The student's stress will contribute to physical illness c. The student's worry will affect his driving to see his mother d. The student's emotional stress will cause bad feelings about the exam.
b
What is the best therapy to try first for insomnia? a. Complementary therapies such as melatonin b. Congnitive-behavioral therapies such as relaxation therapy c. Benzodiazepine-receptor agents (e.g., zolpidem [Ambien]) d. Over-the-counter medications such as diphenhydramine
b
What is the first step in developing cultural competence? a. Create opportunities to interact with a variety of cultural groups. b. Examine the nurse's own cultural background, values, and beliefs about health and health care. c. Learn about a multitude of folk medicines and herbal substances that different cultures use for self-care. d. Learn assessment skills for different cultural groups, including cultural beliefs and practices and physical assessments.
b
When a patient at the clinic is informed that testing indicates the presence of gonorrhea, the patient sighs and says "That, I can handle." What does the nurse understand about the patient in this situation? a. The patient is in denial about the possible complications of gonorrhea. b. The patient does not perceive the gonorrhea infection as a threatening stressor. c. The patient does not have other current stressors that require adaptation or coping mechanisms. d. The patient knows how to cope with gonorrhea from dealing with previous gonorrhea infections.
b
When communicating with a patient who speaks a language that the nurse does not understand, it is important to first attempt to a. have a family member interpret. b. use a trained medical interpreter. c. use specific medical terminology so there will be no mistakes. d. focus on the translation rather than nonverbal communication.
b
While caring for a female patient with Alzheimer's disease and her caregiver husband, the nurse finds that the patient's husband is experiencing increased asthma problems. What is a possible explanation for this finding? a. Progressive worsening of asthma occurs in people as they age. b. Chronic and intense stress can cause exacerbation of immune-based diseases c. The husband is probably smoking more to help him cope with needing to care continually for his wife d. The husband inadequately copes with his wife's condition by unconsciously forgetting to take his medications
b
While caring for an unconscious patient, the nurse discovers a stage 2 pressure ulcer on the patient's heel. During care of the ulcer, what is the nurse's understanding of the patient's perception of pain? a. The patient will have a behavioral response if pain is perceived b. The area should be treated as a painful lesion, using gentle cleansing and dressing. c. The area can be thoroughly scrubbed because the patient is not able to perceive pain d. All nociceptive stimuli that are transmitted to the brain result in the perception of pain.
b
While teaching relaxation therapy to a patient with fibromyalgia, what does the nurse recognize as being most important to incorporate? a. Exercise b. Relaxation breathing c. Soft background music d. Progressive muscle relaxation
b
A nurse is planning care for a client who has cancer and is taking a glucocorticoid as a adjuvant medication for pain control. Which of the following interventions the nurse include in the plan of care? (select all apply) A. Monitor for urinary retention B. monitor blood glucose C. monitor blood potassium level D. monitor for gastric bleeding E. monitor for respiratory depression
b c d
A nurse is providing teaching to a client who is experiencing migraine headaches. Which of the following instructions to the nurse provide? (select all apply ) A. Take ergotamine as a prophylaxis to prevent a migraine headache B. identify and avoid trigger factors C. lie down in a dark quiet room at the onset of a migraine D. avoid foods that contain tyramine E. avoid exercise that can increase heart rate
b c d
The nurse recognizes that a person who experiences chronic stress could be at higher risk for (select all that apply) a. osteoporosis b. fibromyalgia c. colds and flu d. high blood pressure e. high serum cholesterol
b c d
Which words are MOST likely to be used to describe neuropathic pain (select all that apply)? A) Dull B) Itching C) Burning D) Shooting E) Shock-like
b c d e
What are clinical manifestations of insomnia (select all that apply)? a. Narcolepsy b. Fragmented sleep c. Long sleep latency d. Morning headaches e. Daytime sleepiness f. Difficulty concentrating
b c e f
Appropriate nonopioid analgesics for mild pain include (select all that apply) A) oxycodone B) ibuprofen (advil) C) lorazepam (Ativan) D) acetaminophen (Tylenol) E) codeine with acetaminophen (Tylenol #3)
b d
Which measures or drugs may be effective in controlling pain in the physiologic pain process stage of transduction (select all that apply)? a. Distraction b. Corticosteroids c. Epidural opioids d. Local anesthetics e. Antiseizure medications f. Nonsteroidal antiinflammatory drugs (NSAIDs)
b d e f
A patient with chronic cancer-related pain has started using MS Contin for pain control and has developed common side effects of the drug. The nurse reassures the patient that tolerance will develop to most of these side effects but that continued treatment will most likely be required for what? a. Pruritus b. Dizziness c. Constipation d. Nausea and vomiting
c
Amitriptyline is prescribed for a patient with chronic pain from fibromyalgia. When the nurse explains that this drug is an antidepressant, the patient states that she is in pain, not depressed. What is the nurse's best response to the patient? a. Antidepressants will improve the patient's attitude and prevent a negative emotional response to pain. b. Chronic pain almost always leads to depression, and the use of this drug will prevent depression from occurring. c. Some antidepressant drugs relieve pain by releasing neurotransmitters that prevent pain impulses from reaching the brain. d. Certain antidepressant drugs are metabolized in the liver to substances that nub the ends of nerve fibers, preventing the onset of pain
c
During a stressful circumstance that is unchangeable, which type of coping strategy is the most effective? a. avoidance b. coping flexibility c. emotion focusing coping d. problem focused coping
c
I nurse is caring for a client who is receiving moderate sedation with diazepam IV. the client is oversedated. which of the following medications should the nurse anticipate administering to this client A. Ketamine B. Naltrexone C. Flumazenil D. Fluvoxamine
c
On the first postoperative day following a bowel resection, the patient complains of abdominal and incisional pain rated 9 on a scale of 0 to 10. Postoperative orders include morphine (4 mg IV q4hrs) for pain and may repeat morphine (4 mg IV) for breakthrough pain. The nurse determines that it has been only 1 3/4 hours since the last dose of morphine and wants to wait a little longer. What effect does the nurse's action have on the patient? a. Protects the patient from addiction and toxic effects of the drug b. Prevents hastening or causing a patient's death from respiratory dysfunction c. Contributes to unnecessary suffering and physical and psychosocial dysfunction d. Indicates that the nurse understands the adage of "start low and go slow" in administering analgesics
c
Once generated, what may block the transmission of an action potential along a peripheral nerve fiber to the dorsal root of the spinal cord? a. Nothing can stop the action potential along an intact nerve until it reaches the spinal cord b. The action potential must cross several synapses, points at which the impulse may be blocked by drugs. c. The transmission may be interrupted by drugs (e.g., local anesthetics) that act on peripheral sodium channels d. The nerve fiber produces neurotransmitters that may activate nearby nerve fibers to transmit pain impulses
c
Pain has been defined as "whatever the person experiencing the pain says it is, existing whenever the patient says it does." This definition is problematic for the nurse when caring for which type of patient? a. A patient placed on a ventilator b. A patient with a history of opioid addiction c. A patient with decreased cognitive function d. A patient with pain resulting from severe trauma
c
The nurse would expect which finding in a patient as a result of the physiologic effect of stress on the reticular formation? a. an episode of diarrhea while awaiting painful dressing changes b. refusal to communicate with nurses while awaiting a cardiac catheterization c. inability to sleep the night before beginning to self administer insulin injections d. increased blood pressure, decreased urine output, and hyperglycemia after a car accident
c
Unrelieved pain is A) not expected after major surgery B) expected in a person with cancer C) dangerous and can lead to many physical and psychological complications D) an annoying sensation, but it is not as important as other physical care needs
c
What controls the cyclic changes between waking and sleep? a. Fluctuating levels of melatonin b. The environment light-dark cycles c. Suprachiasmatic nucleus in the hypothalamus d. A variety of neurotransmitters released from the nervous system
c
Which statement about sleep is accurate? a. Lack of sleep causes medical and psychiatric disorders b. Adults generally require at least 5 hours of sleep every 24 hours c. During sleep an individual is not consciously aware of his or her environment d. Less than 10% of adults report at least one sleep problem, such as difficulty falling asleep
c
A nurse is providing teaching to a client who has migraine headaches and a new prescription for ergotamine. For which of the following adverse reaction should the nurse instruct the client to stop taking the medication and notify the provider? (select all apply) A. Nausea B. visual disturbances C. positive home pregnancy test D. numbness in tingling in fingers E. muscle pain
c d e
The health care provider has ordered continuous positive airway pressure (CPAP) for a patient with serious obstructive sleep apnea. How will CPAP help the patient? a. Prevent airway occlusion by bringing the tongue forward b. Be easily tolerated by both the patient and the patient's bed partner c. Provide enough positive pressure in the airway to prevent airway collapse d. Deliver a high inspiratory pressure and a low expiratory pressure to prevent airway collapse.
c.
A nurse in a health care clinical is evaluating the level of wellness for clients using the health/wellness/illness continuum tool. Which of the following clients is measured at the center of the continuum? A. A college student who has influenza B. An older adult who is newly diagnosed type 2 diabetes mellitus C. A new mother who has a urinary tract infection D. A young male who has a long history of well-controlled rheumatoid arthritis
d
A postoperative 68-yr-old opioid-naive patient is receiving morphine by patient-controlled analgesia (PCA) for postoperative pain. What is the rationale for not initiating the PCA analgesic with a basal dose of analgesic as well. a. Opioid overdose b. Nausea and itching c. Lack of pain control d. Adverse respiratory outcomes
d
An appropriate nursing intervention for a hospitalized patient who states she cannot cope with her illness is: a. controlling the environment to prevent sensory overload and promote sleep b. encouraging the patient's family to offer emotional support by frequent visiting c. arranging for the patient to phone family and friends to maintain emotional bonds d. asking the patient to describe previous stressful situations and how she managed to resolve them
d
An older patient asks the nurse why she has so much trouble sleeping. What is the most appropriate response by the nurse? a. "Disturbed sleep is a normal result of aging." b. "Have you tried an over-the-counter medications to help you sleep?" c. "Don't worry. You don't need as much sleep as you did when you were young." d. "Tell me more about the trouble you are having. There may be some things that we can do to help."
d
Forcing one's own cultural beliefs and practices on another person is an example of a. stereotyping. b. ethnocentrism. c. cultural relativity. d. cultural imposition.
d
Nurses play a key role in promoting health equity. An important mechanism to do this is to a. discourage use of evidence-based practice guidelines. b. insist that patients adhere to the Healthy People 2020 guidelines. c. teach patients to use the Internet to find resources related to their health. d. engage in active listening and establish relationships with patients and families.
d
The patient is complaining of insomnia and daytime fatigue. Which beverage would be the best option for this patient with an afternoon snack? a. Diet Coke b. Dr. Pepper c. Decaffeinated coffee d. A&W root beer float
d
What is a typical parasomnia? a. Cataplexy b. Hypopnea c. Sleep apnea d. Sleep terrors
d
While caring for a patient following an uvulopalatopharyngoplasty (UPPP), the nurse monitors the patient for which complications in the immediate postoperative period? a. Snoring and foul-smelling breath b. Infection and electrolyte imbalance c. Loss of voice and severe sore throat d. Airway obstruction and hemorrhage
d
