MS II Final Exam

What are effective interventions to decrease absorption or increase elimination of an ingested poison (select all that apply)? a. Hemodialysis b. Eye irrigation c. Hyperbaric O2 d. Gastric lavage e. Activated charcoal

a. Hemodialysis d. Gastric lavage e. Activated charcoal

Nursing management of the patient with acute pancreatitis includes (select all that apply) a. administering pain medication. b. checking for signs of hypocalcemia. c. providing a diet low in carbohydrates. d. giving insulin based on a sliding scale. e. monitoring for infection, particularly respiratory tract infection.

a. administering pain medication. b. checking for signs of hypocalcemia. e. monitoring for infection, particularly respiratory tract infection.

The nurse is obtaining a subjective data assessment from a woman reported as a sexual contact of a man with chlamydial infection. The nurse understands that symptoms of chlamydial infection in women a. are frequently absent b. are similar to those of genital herpes c. include a macular palmar rash in the later stages d. may involve chancers inside the vagina that are not visible

a. are frequently absent

An older man arrives in triage disoriented and dyspneic. His skin is hot and dry. His wife states that he was fine earlier today. The nurse's next priority would be to a. assess his vital signs. b. obtain a brief medical history from his wife. c. start supplemental O2 and have the ED physician see him. d. determine the kind of insurance he has before treating him.

a. assess his vital signs.

When discussing risk factors for breast cancer with a group of women, you emphasize that the greatest known risk factor for breast cancer is a. being a woman over age 60 b. experiencing menstruation for 30 years or more c. using hormone therapy for 5 years for menopausal symptoms d. having a paternal grandmother with postmenopausal breast cancer

a. being a woman over age 60

In planning care for a patient with metastatic liver cancer, the nurse should include interventions that a. focus primarily on symptomatic and comfort measures. b. reassure the patient that chemotherapy offers a good prognosis. c. promote the patient's confidence that surgical excision of the tumor will be successful. d. provide information necessary for the patient to make decisions regarding liver transplantation.

a. focus primarily on symptomatic and comfort measures.

To prevent capsular formation after breast reconstruction with implants, teach the patient to a. gently massage the area around the implant b. bind the breasts tightly with elastic bandages c. exercise the arm on the affected side to promote drainage d. avoid strenuous exercise until the implant has healed

a. gently massage the area around the implant

Postoperative goals in caring for the patient who has undergone an abdominal hysterectomy include (select all that apply) a. monitoring urine output b. changing position frequently c. restricting all food for 24 hours d. observing perineal pad for bleeding e. encouraging leg exercises to promote circulation

a. monitoring urine output b. changing position frequently e. encouraging leg exercises to promote circulation

Which factors would place a patient at higher risk for prostate cancer? (select all that apply) a. older than 65 years b. Asian or Native American c. long-term use of indwelling urethral catheter d. father diagnosed and treated for early-stage prostate cancer e. previous history of the undescended testicle and testicular cancer.

a. older than 65 years d. father diagnosed and treated for early-stage prostate cancer

A patient with hepatitis A is in the acute phase. The nurse plans care for the patient based on the knowledge that a. pruritis is a common problem with jaundice in this phase. b. the patient is most likely to transmit the disease during this phase. c. gastrointestinal symptoms are not as severe in hepatitis A as they are in hepatitis B. d. extrahepatic manifestations of glomerulonephritis and polyarteritis are common in this phase.

a. pruritis is a common problem with jaundice in this phase.

Luteinizing hormone (LH) secretion by the anterior pituitary (select all that apply) a. results in ovulation b. causes follicles to complete maturation c. affects development of ruptured follicles d. directly inhibits both GnRH and FSH secretion e. stimulates testosterone production by interstitial cells of testes

a. results in ovulation b. causes follicles to complete maturation c. affects development of ruptured follicles e. stimulates testosterone production by interstitial cells of testes

In assessing patients for STIs, the nurse needs to know that many STIs can be asymptomatic. Which STIs can be asymptomatic? (select all that apply) a. syphilis b. gonorrhea c. genital warts d. genital herpes e. chlamydial infection

a. syphilis b. gonorrhea c. genital warts d. genital herpes e. chlamydial infection

Significant information about a person's health history related to the reproductive system should include (select all that apply) a. tobacco use. b. intellectual status. c. number of sexual partners. d. previous history of shingles. e. previous sexually transmitted infections.

a. tobacco use. c. number of sexual partners. e. previous sexually transmitted infections.

Which populations have a higher risk for acquiring sexually transmitted infections (STIs)? (select all that apply) a. transgender persons b. young adults (age <25) c. men who have sex with men d. men in long-term care facilities e. women in correctional facilities

a. transgender persons b. young adults (age <25) c. men who have sex with men e. women in correctional facilities

The first nursing intervention for the patient who has been sexually assaulted is to a. treat urgent medical problems b. contact support person for the patient c. provide supplies for the patient to cleanse self d. document bruises and lacerations of the perineum and the cervix

a. treat urgent medical problems

Cultures used in the diagnosis of STIs can be obtained from (select all that apply) a. urine b. vagina c. urethra d. rectum e. endocervix

a. urine b. vagina c. urethra d. rectum e. endocervix

An age-related finding during the assessment of the older woman's reproductive system is a. vaginal atrophy. b. increased libido. c. nipple enlargement. d. increased vulvar skin turgor.

a. vaginal atrophy.

A patient with breast cancer has a lumpectomy with sentinel lymph node dissection that is positive for cancer. You explain that, of the other tests done to determine the risk for cancer recurrence or spread, the results that support the more favorable prognosis are (select all that apply) a. well-differentiated tumor b. estrogen receptor-positive tumor c. overexertion of HER-2 cell marker d. involvement of two to four axillary nodes e. aneuploidy status from cell proliferation studies

a. well-differentiated tumor b. estrogen receptor-positive tumor

You are a community health nurse planning a program on breast cancer screening guidelines for women in the neighborhood. Which recommendations would you include? (select all that apply) a. women over age 55 may have biennial screening. b. screening should end when the woman reaches age 65. c. women aged 45-54 years should be screened annually. d. regular screening mammography should start at age 45 years. e. clinical breast examinations can be used if the woman is of average age risk.

a. women over age 55 may have biennial screening. c. women aged 45-54 years should be screened annually. d. regular screening mammography should start at age 45 years

The nurse should explain to the patient who has erectile dysfunction that (select all that apply) a. the most common cause is benign prostatic hypertrophy b. ED may be due to medications or conditions such as diabetes c. only men who are over 65 years or older benefit from PDE5 inhibitors d. there are medications and devices that can be used to help with erections e. this condition is primarily due to anxiety and best treated with psychotherapy

b. ED may be due to medications or conditions such as diabetes d. there are medications and devices that can be used to help with erections

In telling a patient with infertility what she and her partner can expect, the nurse explains that a. ovulatory studies can help determine tube patency b. a hysterosalpingogram is a common diagnostic study c. for most couples, the cause of infertility is usually not found d. semen analysis is performed only if testosterone levels are low

b. a hysterosalpingogram is a common diagnostic study

A chemical explosion occurs at a nearby industrial site. The first responders report that victims are being decontaminated at the scene and approximately 125 workers will need medical evaluation and care. The nurse receiving this report should know that this will first require activation of a. issue a code blue alert b. activate the hospital's emergency response plan c. notify the Federal Emergency Management Agency (FEMA) d. arrange for the American Red Cross to provide aid to victims

b. activate the hospital's emergency response plan

A patient has a core temperature of 90° F (32.2° C). The most appropriate rewarming technique would be a. passive rewarming with warm blankets. b. active internal rewarming using warmed IV fluids. c. passive rewarming using air-filled warming blankets. d. active external rewarming by submersing in a warm bath.

b. active internal rewarming using warmed IV fluids.

The nurse caring for a patient with suspected acute cholecystitis would anticipate (select all that apply) a. ordering a low-sodium diet. b. administration of IV fluids. c. monitoring of liver function tests. d. administration of antiemetics for patients with nausea. e. insertion of an indwelling catheter to monitor urinary output.

b. administration of IV fluids. c. monitoring of liver function tests. d. administration of antiemetics for patients with nausea.

A patient scheduled for a prostatectomy for prostate cancer expresses fear that he will have erectile dysfunction. In responding to this patient, the nurse should keep in mind that a. PD5 inhibitors are not recommended in prostatectomy patients b. erectile dysfunction can occur even with a nerve-sparing procedure c. the most common complication of this surgery is postoperative bowel incontinence d. the provider will place a penile implant during surgery to that any dysfunction

b. erectile dysfunction can occur even with a nerve-sparing procedure

The nurse explains to the patient with chronic bacterial prostatitis who is undergoing antibiotic therapy that (select all that apply) a. all patients require hospitalization b. pain will lessen once treatment has ended c. course of treatment is generally 2-4 weeks d. long-term therapy may be indicated in immunocompromised patients e. if the condition is unresolved and untreated he is at risk for prostate cancer.

b. pain will lessen once treatment has ended d. long-term therapy may be indicated in immunocompromised patients

In assessing a patient for testicular cancer, the nurse understands that the manifestations of this disease often include a. urinary frequency b. painless mass in the scrotal area c. erectile dysfunction with retrograde ejaculation d. rapid onset of dysuria with scrotal swelling and fever

b. painless mass in the scrotal area

The patient with advanced cirrhosis asks why his abdomen is so swollen. The nurse's response is based on the knowledge that a. a lack of clotting factors promotes the collection of blood in the abdominal cavity. b. portal hypertension and hypoalbuminemia cause a fluid shift into the peritoneal space. c. decrease perstalsis in the GI tract contributes to gas formation and distention of the bowel. d. bile salts in the blood irritate the peritoneal membranes, causing edema and pocketing of fluid.

b. portal hypertension and hypoalbuminemia cause a fluid shift into the peritoneal space.

A patient has been told that she has elevated liver enzymes caused by non-alcoholic fatty liver disease (NAFLD). The nursing teaching plan should include a. having genetic testing done. b. recommending a heart-health diet. c. the necessity to reduce weight rapidly. d. avoiding alcohol until liver enzymes return to normal.

b. recommending a heart-health diet.

Teaching in relation to home management after a laparoscopic cholecystectomy should include a. keeping the bandages on the puncture sites for 48 hours. b. reporting any bile-colored drainage or pus from any incision. c. using over-the-counter antiemetics if nausea and vomiting occur. d. emptying and measuring the contents of the bile bag from the T tube every day.

b. reporting any bile-colored drainage or pus from any incision.

Provide emotional support to a patient with an STI by a. offering information on how safer sexual practices can prevent STIs b. showing concern when listening to the patient who expresses negative feelings c. reassuring the patient that the disease is highly curable with appropriate treatment d. helping the patient who received an STI from his or her sexual partner in forgiving the partner

b. showing concern when listening to the patient who expresses negative feelings

A primary HSV infection differs from recurrent HSV episodes in that (select all that apply) a. only primary infections are sexually transmitted b. symptoms are less severe during recurrent episodes c. transmission of the virus to a fetus is less likely during primary infection d. systemic manifestations such as fever and myalgia are more common in primary infection e. lesions from recurrent HSV are more likely to transmit the virus than lesions from primary HSV

b. symptoms are less severe during recurrent episodes d. systemic manifestations such as fever and myalgia are more common in primary infection

A patient with acute hepatitis B is being discharged in 2 days. The discharge teaching plan should include instructions to a. avoid alcohol for the first 3 weeks. b. use a condom during sexual intercourse. c. have family members get an injections of immunoglobulin. d. follow a low-protein, moderate carbohydrate, moderate-fat diet.

b. use a condom during sexual intercourse.

An older woman arrives in the ED complaining of severe pain in her right shoulder. The nurse notes that her clothes are soiled with urine and feces. She tells the nurse that she lives with her son and that she "fell." She is tearful and asks you if she can be admitted. What possibility should the nurse consider? a. Dementia b. Possible cancer c. Family violence d. Orthostatic hypotension

c. Family violence

Postoperatively, a patient who has had a laser prostatectomy has continuous bladder irrigation with a three-way urinary catheter with a 30ml balloon. When he complains of bladder spasms with the catheter in place the nurse should a. deflate the catheter balloon to 10ml to decrease bulk in bladder b.deflate the catheter balloon and then reinflate to ensure that it is patent c. explain that this feeling is normal and that he should not try to urinate around the catheter d. stop the irrigation, assess the patient's vitals, and notify the HCP of possible obstruction

c. explain that this feeling is normal and that he should not try to urinate around the catheter

The nurse should advise the woman recovering from surgical treatment of an ectopic pregnancy that a. she has an increased risk for salpingitis b. bed rest must be maintained for 12 hours to assist in healing c. having one ectopic pregnancy increases her risk for another d. intrauterine devices and infertility treatments should be avoided

c. having one ectopic pregnancy increases her risk for another

In caring for a patient with endometriosis, the nurse teaches the patient that interventions used to treat or cure this condition may include (select all that apply) a. radiation b. antibiotic therapy c. oral contraceptive pills d. surgical removal of tissue e. total abdominal hysterectomy and salpingo-oophorectomy

c. oral contraceptive pills d. surgical removal of tissue e. total abdominal hysterectomy and salpingo-oophorectomy

To prevent or decrease age-related changes that occur after menopause in a patient who chooses not to take hormone therapy, the most important self-care measure to teach is a. maintaining usual sexual activity b. increasing the intake of dairy products c. performing regular, aerobic, weight-bearing exercise d. taking vitamin E and B-complex vitamin supplements

c. performing regular, aerobic, weight-bearing exercise

Preoperatively, to meet the psychologic needs of a woman scheduled for a modified radical mastectomy, you would a. discuss the limitations of breast reconstruction b. include her significant other in all conversations c. promote an environment for expression of feelings d. explain the importance of regular follow-up screening

c. promote an environment for expression of feelings

Female orgasm is characterized by a. resolution. b. increased breast size. c. relaxation of cervical os. d. vasoconstriction and dystonia.

c. relaxation of cervical os.

A patient with pancreatic cancer is admitted to the hospital for evaluation of possible treatment options. The patient asks the nurse to explain the Whipple procedure that the surgeon has described. The explanation includes the information that the Whipple procedure involves a. creating a bypass around the obstruction caused by the the tumor by joining the gallbladder to the jejunum. b. resection of the entire pancreas and the distal portion of the stomach, with anastomosis of the common bile duct and the stomach into the duodenum. c. removal of part of the pancreas, part of the stomach, the duodenum, and the gallbladder, with joining of the pancreatic duct, the common bile duct, and the stomach into the jejunum. d. radical removal of the pancreas, the duodenum, and the spleen, and attachment of the stomach to the jejunum, which requires oral supplementation of pancreatic digestive enzymes and insulin replacement therapy.

c. removal of part of the pancreas, part of the stomach, the duodenum, and the gallbladder, with joining of the pancreatic duct, the common bile duct, and the stomach into the jejunum.

An abnormal finding noted during physical assessment of the male reproductive system is a. descended testes b. symmetric scrotum c. slight clear urethral discharge d. the glans covered with prepuce

c. slight clear urethral discharge

A normal male reproductive function that may be altered in a patient who undergoes an orchiectomy (removal of testes) is a. PSA b. GnRH c. testosterone d. seminal fluid

c. testosterone

Postoperative nursing care for the woman with a gynecologic fistula includes (select all that apply) a. bed rest b. bladder training c. warm sitz bath d. perineal hygiene e. use of daily enemas

c. warm sitz bath d. perineal hygiene

An appropriate question to ask the patient with painful menstruation to differentiate primary from secondary dysmenorrhea is a. "does your pain become worse with activity or overexertion?" b. "have you had a recent personal crisis or change in your lifestyle?" c. "is your pain relieved by non steroidal anti-inflammatory medications?" d. "when in your menstrual history did the pain with your period begin?"

d. "when in your menstrual history did the pain with your period begin?"

You are caring for a patient with breast cancer following a simple mastectomy. Postoperatively, to restore arm function on the affected side, you would a. apply heating pads or blankets to increase circulation b. place daily ice packs to minimize the risk for lymphedema c. teach passive exercises with the affected arm in a dependent position d. emphasize regular exercises for the affected shoulder to increase range of motion

d. emphasize regular exercises for the affected shoulder to increase range of motion

Nursing care for the patient with endometrial cancer who had a total abdominal hysterectomy and salpingectomy and oophorectomy includes a. maintaining absolute bed rest b. keeping the patient in high fowler's position c. need for supplemental estrogen after removal of ovaries d. encouraging movement and walking as much as tolerated

d. encouraging movement and walking as much as tolerated

You are caring for a young woman who has painful fibrocystic breast changes. Management of this patient would include a. scheduling a biopsy to rule out malignant changes b. teaching that symptoms will probably subside if she stops using oral contraceptives c. preparing her for surgical removal of the lumps, since they will become larger and more painful d. explaining that restrictions of coffee and chocolate and supplements of vitamin E may relieve some discomfort

d. explaining that restrictions of coffee and chocolate and supplements of vitamin E may relieve some discomfort

To decrease the patients discomfort over care related to his reproductive organs, the nurse should a. relate his sexual concerns to his sexual partner b. arrange to have male nurses care for the patient c. give him written material and ask if he has questions d. maintain a nonjudgmental attitude toward his sexual practices

d. maintain a nonjudgmental attitude toward his sexual practices

To prevent the infection and transmission of STIs, the nurse's teaching plan would include an explanation of a. the appropriate use of oral contraceptives b. sexual positions that can be used to avoid infections c. the necessity of annual Pap tests for patients with HPV d. sexual practices that are considered high-risk behaviors

d. sexual practices that are considered high-risk behaviors

Explain to the patient with gonorrhea that treatment will include both ceftriaxone and azithromycin because a. azithromycin helps prevent recurrent infections b. some patients do not respond to oral drugs alone c. coverage with more than one antibiotic will prevent reinfection d. the increasing rates of drug resistance requires using at least 2 drugs

d. the increasing rates of drug resistance requires using at least 2 drugs

The nurse is caring for a patient scheduled for hysteroscopy. The nurse explains to the woman that a. the procedure treats cervical dysplasia. b. bleeding and discharge are rare after the procedure. c. the procedure involves curettage of the endometrial lining. d. the procedure allows visualization of the lining of the uterus.

d. the procedure allows visualization of the lining of the uterus.