Evidence Based Practice

A 52-year-old female patient is going through menopause and asks the nurse about estrogen replacement for its cardioprotective benefits. What is the best response by the nurse?

"Current evidence indicates that estrogen replacement is not effective at preventing cardiovascular disease and carries some risks."

Which statement by the nurse shows an understanding of the focus of the quality assurance programs developed in the 1980s?

"The quality assurance programs focus on processes used to provide care and improving those processes."

The nurse is teaching a client about rheumatic disease. What statement best helps to explain autoimmunity?

"Your symptoms are a result of your body attacking itself."

The nurse knows that what PR interval presents a first-degree heart block?

0.24 seconds

A client is to receive hypotonic IV solution in order to provide free water replacement. Which solution does the nurse anticipate administering?

0.45% NaCl

A nurse knows to assess a patient with type 1 diabetes for postprandial hyperglycemia. The nurse knows that glycosuria is present when the serum glucose level exceeds:

180 mg/dL

A patient is suspected of having glaucoma. What reading of IOP would demonstrate an increase resulting from optic nerve damage?

21 mm Hg or higher

Antiretroviral medications should be offered to clients with T-cell counts less than

350 cells/mm3.

In a client with a bypass graft, the distal outflow vessel must have at least what percentage patency for the graft to remain patent?

50

A nurse is providing discharge instruction to a victim who has been exposed to anthrax but does not have any symptoms. The nurse's teaching includes that prophylactic antibiotics must be taken for:

60 days.

This example of cholesterol gallstones (left side of picture) is the result of decreased bile acid synthesis and increased cholesterol synthesis in the liver, which in turn, form stones. Cholesterol stones account for what percentage of cases of gallbladder disease in the United States?

75%

What is the primary focus of the nurse advocacy role in managing a clinical pathway?

A patient's progress toward desired outcomes

Which signs are considered cardinal signs of brain death? Select all that apply.

Absence of brainstem reflexes Apnea Coma

Which of the following classification of medications is the most common cause of ototoxicity?

Aminoglycosides

Which of the following refers to fixation of a joint?

Ankylosis

Which of the following procedures involves a surgical fusion of the joint?

Arthrodesis

Lesions in the temporal lobe may result in which type of agnosia?

Auditory

Assessment of a client reveals evidence of a cystocele. The nurse interprets this as which of the following?

Bulging of the bladder into the vagina

Which is usually the most important consideration in the decision to initiate antiretroviral therapy?

CD4+ counts

A long-term care facility is the site of an outbreak of infectious diarrhea. The nurse educator has emphasized the importance of hand hygiene to staff members. The use of alcohol-based cleansers may be ineffective if the causative microorganism is identified as what?

Clostridium difficile

Which statement provides accurate information regarding cancer of the colon and rectum?

Colorectal cancer is the third most common site of cancer in the United States.

An initial, convenient assessment of an older adult client's complaint of hearing loss would be inspection, using an otoscope, for the presence of impacted cerumen. Which of the following is a primary cause of an external ear disorder in the elderly?

Conduction problem

Loud, persistent noise has been found to have which of the following effects on the body? Select all that apply.

Constriction of peripheral blood vessels Increased blood pressure Increased heart rate

The drug interleukin-2 is an example of which type of biologic response modifier?

Cytokine

What clinical manifestation would the nurse expect to find in a client who has had osteoporosis for several years?

Decreased height

During physical examination of a client with a suspected endocrine disorder, the nurse assesses the body structures. The nurse gathers this data based on the understanding that it is an important aid in which of the following?

Detecting evidence of hormone hypersecretion.

The nurse knows which diagnostic test is used to document the anatomic site of reflux and provides a quantitative measure of the severity of valvular reflux?

Duplex ultrasound scan

Which diagnostic study is usually performed to confirm the diagnosis of heart failure?

Echocardiogram

A client is scheduled for an abdominal ultrasound as a follow up to her pelvic examination. Which action by the nurse would be most appropriate?

Ensuring that the client has a full bladder

A nursing instructor is describing to a class the various roles that nurses assume. The instructor determines that teaching has been effective when the students identify which of the following as the focus of the nursing researcher role?

Establishment of a scientific basis for action

Stress ulcers occur frequently in acutely ill patient. Which of the following medications would be used to prevent ulcer formation? Select all that apply.

Famotidine (Pepcid) Lansoprazole Nizatidine

Which cerebral lobes is the largest and controls abstract thought?

Frontal

The nurse should monitor for which manifestation in a client who has undergone LASIK?

Halos and glare

Which action should be incorporated into the client teaching plan to prevent deep vein thrombosis?

Hourly leg exercises

An elderly client takes 40 mg of furosemide twice a day. Which electrolyte imbalance is the most serious adverse effect of diuretic use?

Hypokalemia

Which of the following areas of the brain are responsible for temperature regulation?

Hypothalamus

Which of the following are methods of removing foreign bodies from the ear? Select all that apply.

Instrumentation Irrigation Suction

A client has a tumor of the head of the pancreas. What clinical manifestations will the nurse assess? Select all that apply.

Jaundice Clay-colored stools Dark urine

The nurse is preparing a presentation for a local community group comparing photorefractive keratectomy and LASIK refractive surgeries. Which of the following would the nurse include?

LASIK involves working with the cornea on a deeper level.

A client with diabetes mellitus is prescribed to switch from animal to synthesized human insulin. Which factor should the nurse monitor when caring for the client?

Low blood glucose concentration

According to the 2013 OASIS data study, which client would be at greatest risk for re-hospitalization?

Male client who requires assistance to ambulate

A client in the emergency department is diagnosed with a communicable disease. When complications of the disease are discovered, the client is admitted to the hospital and placed in respiratory isolation. Which infection warrants airborne isolation?

Measles

Which of the following describes vertigo? Select all that apply.

Misperception of motion Spinning sensation Objects are moving around him or her

Which is the most common cause of spinal cord injury (SCI)?

Motor vehicle crashes

The nurse determines which statement reflects current research regarding the utilization of nonpharmacological measures in the management of burn pain?

Music therapy may provide reality orientation, distraction, and sensory stimulation.

To avoid the side effects of corticosteroids, which medication classification is used as an alternative to treat inflammatory conditions of the eyes?

NSAIDs

In the treatment of shock, which of the following vasoactive drugs result in reduced preload and afterload, reducing oxygen demand of the heart?

Nitroprusside

A patient is brought to the emergency department with a possible stroke. What initial diagnostic test for a stroke, usually performed in the emergency department, would the nurse prepare the patient for?

Noncontrast computed tomogram

Which period of acute renal failure is accompanied by an increase in the serum concentration of substances usually excreted by the kidneys?

Oliguria

The nurse recognizes the following as marker(s) of medication effectiveness in glaucoma control except:

Opacity of the lens

Which glands regulate calcium and phosphorous metabolism?

Parathyroid

A nurse is reviewing the medical records of several patients who have had their intraocular pressure (IOP) measured: Patient A: IOP 12 mm Hg Patient B: IOP 15 mm Hg Patient C: IOP 21 mm Hg Patient D: IOP 24 mm Hg Which patient would the nurse identify as having increased IOP suggesting glaucoma?

Patient D

A patient is suspected to have prostate cancer related to observed clinical symptoms. What definitive test can the nurse assist with to confirm a diagnosis of prostate cancer?

Prostate biopsy

When caring for a client with a head injury, a nurse must stay alert for signs and symptoms of increased intracranial pressure (ICP). Which cardiovascular findings are late indicators of increased ICP?

Rising blood pressure and bradycardia

A 10-year-old child is brought to the office with complaints of severe itching in both hands that's especially annoying at night. On inspection, the nurse notes gray-brown burrows with epidermal curved ridges and follicular papules. The physician performs a lesion scraping to assess this condition. Based on the signs and symptoms, what diagnosis should the nurse expect?

Scabies

Which of the following surgical procedures involves taking a piece of silicone plastic or sponge and sewing it onto the sclera at the site of a retinal tear?

Scleral buckle

A client is admitted to the health care facility for evaluation for Addison's disease. Which laboratory test result best supports a diagnosis of Addison's disease?

Serum potassium level of 5.8 mEq/L

What is used to decrease potassium level seen in acute renal failure?

Sodium polystyrene sulfonate

Which term refers to muscular hypertonicity in a weak muscle, with increased resistance to stretch?

Spasticity

Gynecomastia is a common side effect of which of the following diuretics?

Spironolactone

A client has undergone diagnostic testing and has been diagnosed with otosclerosis. What ear structure is primarily affected by this diagnosis?

Stapes

A client is admitted with nausea, vomiting, and diarrhea. His blood pressure on admission is 74/30 mm Hg. The client is oliguric and his blood urea nitrogen (BUN) and creatinine levels are elevated. The physician will most likely write an order for which treatment?

Start IV fluids with a normal saline solution bolus followed by a maintenance dose.

Which is a true statement regarding regional enteritis (Crohn's disease)?

The clusters of ulcers take on a cobblestone appearance.

The nurse auscultates a bruit over the thyroid glands. What does the nurse understand is the significance of this finding?

The patient may have hyperthyroidism.

The nurse at the eye clinic is caring for a patient with suspected glaucoma. What complaint would be significant for a diagnosis of glaucoma?

The presence of halos around lights

Results from the 2013 OASIS data study revealed that data from the study can be used to identify individuals at greatest risk for readmission to the hospital. Using this data, what can the nurse determine will decrease the readmission rate of hospitalizations?

The shift of resources to the community

Nursing students are reviewing information about attitudes related to death and dying. The students demonstrate understanding of the information when they identify which of the following as most accurate?

There remains a conspiracy of silence about dying despite progress in the area.

Early this morning, a client had a subtotal thyroidectomy. During evening rounds, the nurse assesses the client (who now has nausea) and records a temperature of 105°F (40.5°C), tachycardia, and extreme restlessness. What is the most likely cause of these signs?

Thyroid crisis

During an internal vaginal examination, the nurse practitioner notes a frothy and malodorous discharge. What bacteria does the practitioner suspect is causing this disorder?

Trichomonas

The spinal cord is composed of 31 pairs of spinal nerves. How many pairs of thoracic nerves are contained within the spinal column?

Twelve

A client with a traumatic brain injury has developed increased intracranial pressure resulting in diabetes insipidus. The expected treatment would consist of which of the following?

Vasopressin therapy

A change that occurs during chronic glomerulonephritis is termed

anemia

Kaposi sarcoma (KS) is diagnosed through

biopsy.

The nurse is reviewing the medication administration record of the client. Which medication would lead the nurse to suspect that the client is suffering from an acute attack of gout?

colchicine

Which diagnostic test is done to determine suspected pituitary tumor?

computed tomography scan

A nurse is monitoring a client for increasing intracranial pressure (ICP). Early signs of increased ICP include:

diminished responsiveness.

A client has been having cardiac symptoms for several months and is seeing a cardiologist for diagnostics to determine the cause. How will the client's ejection fraction be measured?

echocardiogram

A client reports light-headedness, chest pain, and shortness of breath. They physician orders tests to ascertain what is causing the client's problems. Which test is used to identify cardiac rhythms?

electrocardiogram

A client with diabetes mellitus is receiving an oral antidiabetic agent. When caring for this client, the nurse should observe for signs of:

hypoglycemia

Vasoactive drugs, which cause the arteries and veins to dilate, thereby shunting much of the intravascular volume to the periphery and causing a reduction in preload and afterload, include agents such as

sodium nitroprusside.