PUCH64 PARTII

Which drug should be available to counteract the effect of edrophonium chloride? A. Prednisone B. Atropine C. Azathioprine D. Pyridostigmine bromide

B

The IOM Report Health Professions Education: A Bridge to Quality issued a number of challenges to the educational programs that teach nurses and members of other health professions. According to this report, what activity should educational institutions prioritize? A. More clearly delineate each profession's scope of practice during education B. Move toward developing a single health curriculum that can be adapted for any health profession C. Include interdisciplinary core competencies into curricula D. Elicit input from clients and families into health care curricula

C

A longterm care facility's newest client refuses to attend group activities or social events offered by the facility. Which level of Maslow's hierarchy do social events address? A. third: love and belonging needs B. second: safety and security needs C. fifth: self-actualization needs D. fourth: esteem and self-esteem needs

A

A nurse is performing an admission assessment on a client entering a long-term care facility. She notices a broken area of skin that extends into the dermis on the client's coccyx. How should the nurse document this wound? A. Stage I pressure ulcer B. Stage II pressure ulcer C. Stage III pressure ulcer D. Stage IV pressure ulcer

B

The nurse assesses initial skin redness in a patient who is at risk for skin breakdown. How should the nurse document this finding? A. Anoxia B. Eschar C. Hyperemia D. Ischemia

C

The nurse prepares to administer medication to the patient. The patient states, "I would prefer not to take that medication until I speak with my physician." The nurse honors the patient's desire to make decisions, following which common ethical principle? A. Autonomy B. Beneficence C. Fidelity D. Paternalism

A

While performing an initial nursing assessment on a client admitted with suspected tic douloureux (trigeminal neuralgia), for which of the following would the nurse expect to observe? A. Facial pain in the areas of the fifth cranial nerve B. Hyporeflexia and weakness of the lower extremities C. Ptosis and diplopia D. Fatigue and depression

A

Medical management of arthropod-borne virus (arboviral) encephalitis is aimed at A. preventing renal insufficiency. B. controlling seizures and increased intracranial pressure. C. maintaining hemodynamic stability and adequate cardiac output. D. preventing muscular atrophy.

B

The nurse is assisting a patient in assuming a side-lying position. What intervention would be best for the nurse to provide? A. Align the lower extremities in a neutral position. B. Extend the legs with a firm support under the popliteal area. C. Place the uppermost hip slightly forward in a position of slight abduction. D. Position the trunk so that hip flexion is minimized.

C

A nurse in a primary care provider's office is caring for a 73-year-old female client who is interested in learning things she can do to maintain movement and flexibility while coping with osteoporosis. In what situation would this client still be considered healthy even though she has been diagnosed with a chronic disease? A. Clients with a chronic illness can still achieve a high quality of life within the limits of the illness if they are physiologically stable and mentally healthy. B. Clients with a chronic illness can never be considered healthy. C. Clients with a chronic illness can be considered healthy only if they carefully follow their health care provider's advice regarding medications, activity, and diet. D. Clients with a chronic illness are considered healthy only until the point at which primary body systems begin to lose function.

A

The nurse has just taken report for the shift and is performing the initial assessments of clients. One of the clients asks if an error has been made in her medication. The nurse knows that an incident report was filed yesterday after a nurse inadvertently missed a scheduled dose of the client's antibiotic. Which of the following principles would apply when the nurse gives an accurate response? A. Veracity B. Confidentiality C. Respect D. Justice

A

A 45-year-old client is admitted to the facility with excruciating paroxysmal facial pain. He reports that the episodes occur most often after feeling cold drafts and drinking cold beverages. Based on these findings, the nurse determines that the client is most likely suffering from which neurologic disorder? A. Bell's palsy B. Trigeminal neuralgia C. Migraine headache D. Angina pectoris

B

A client is preparing for discharge from the emergency department after sustaining an ankle sprain. The client is instructed to avoid weight bearing on the affected leg and is given crutches. After instruction, the client demonstrates proper crutch use in the hallway. What additional information is most important to know before discharging the client? A. Whether the client needs to navigate stairs routinely at home B. Whether pets are present in the home C. Whether the client parks his car on the street D. Whether the client drives a car with a stick shift

B

A client is undergoing testing to confirm a diagnosis of myasthenia gravis. The nurse explains that a diagnosis is made if muscle function improves after the client receives an IV injection of a medication. What is the medication the nurse tells the client he'll receive during this test? A. Cyclosporine (Sandimmune) B. Edrophonium (Tensilon) C. Immunoglobulin G (Iveegam EN) D. Azathioprine (Imuran)

B

The nurse in collaboration with the rehabilitation team is working with a patient on performing therapeutic exercises. Which of the following would the nurse expect to encourage to increase the patient's muscle power? A. Passive exercises B. Resistive exercises C. Isometric exercises D. Active exercises

B

The care team has deemed the occasional use of restraints necessary in the care of a client with Alzheimer disease. What ethical violation is most often posed when using restraints in a long-term care setting? A. It limits the client's personal safety. B. It exacerbates the client's disease process. C. It threatens the client's autonomy. D. It is not normally legal.

C

The nurse is evaluating whether a client's walker is the right height for the client. While the client's hands are on the hand grip, the nurse assesses the client's elbows. The nurse determines that the walker is at the right height when the client's elbows are in which position? A. 0-degree flexion B. 15-degree flexion C. 25-degree flexion D. 45-degree flexion

C

A nurse working in the intensive care unit refers to the Institute for Healthcare Improvement (IHI) Ventilator Bundle before planning patient care. The nurse realizes nursing interventions outlined in the bundle will improve clients' outcomes. Which statement best describes how nursing interventions established by the IHI should be included in each bundle? A. Best practices derived from valid and reliable research studies guided nursing interventions being added to the IHI bundles B. Hospitals, physicians, and nurses worked collaboratively to design patient care activities included in IHI bundles C. Nurse case managers serving as patient advocates recommended nursing interventions to be included in the IHI bundles based on patient preference D. Nursing interventions found within the IHI bundles were selected based on the ability to provide optimal time management for the nurse

A

The nurse is assisting with the development of a program to administer flu shots to a group of senior citizens. What type of prevention does this program reflect? A. Primary prevention B. Secondary prevention C. Tertiary prevention D. Prevalence

A

The nurse is performing an initial assessment on a client admitted with a possible brain abscess. Which of the following would the nurse most likely find? A. Headache that is worse in the morning B. Ptosis that is more pronounced at the end of the day C. Diplopia that is constant D. Nuchal rigidity

A

The nurse is caring for a client with Guillain-Barré syndrome (GBS). The client also has an ascending paralysis. Knowing the potential complications of the disorder, what should the nurse keep always ready at the bedside? A. Nebulizer and thermometer B. Intubation tray and suction apparatus C. Blood pressure apparatus D. Incentive spirometer

B

A client has been admitted to the hospital with a large sacral pressure ulcer. The physician prescribes the wound care protocol to be performed twice a day. What would be a statement on the plan of care that would address the implementation phase of the nursing process for this client? A. A 6 cm x 4 cm wound with malodorous, yellow exudate B. The client's wound will heal by 1 cm by the end of 5 days. C. The client's wound has healed by 0.5 cm on day 3 of wound care. D. Turn the client every 2 hours.

D

A client is hospitalized with Guillain-Barré syndrome. Which nursing assessment finding is most significant? A. Warm, dry skin B. Urine output of 40 ml/hour C. Soft, nondistended abdomen D. Uneven, labored respirations

D

A client, 50 years old, is admitted for treatment of a gastric tumor. The client asks the nurse, "Do you think I have cancer?" Which response by the nurse would be most therapeutic? A. "Your physician can tell you more about it." B. "Most women your age have some kind of cancer." C. "We don't know for sure until you undergo more tests." D. "You sound concerned about what the physicians will tell you."

D

A nurse is teaching a client with a long leg cast how to use crutches properly while descending a staircase. The nurse should tell the client to transfer body weight to the unaffected leg, and then: A. advance both legs. B. advance the unaffected leg. C. advance the affected leg. D. advance both crutches.

D

A rehabilitation nurse is preparing a presentation for clients and caregivers about issues that clients with disabilities may face. Which of the following would be most appropriate for the nurse to include in the presentation? A. A loss of sexual functioning correlates with a loss of sexual feeling. B. Fatigue primarily results from physical demands. C. Most care tasks required after discharge focus on the physical care. D. Priority setting is helpful in dealing with the impact of the disability.

D

When applying Maslow's hierarchy of needs to patient care, the nurse determines that the patient has reached the ultimate goal indicating integrated human functioning and health when which level is met? A. Safety and security B. Belongingness and affection C. Esteem and self-respect D. Self-actualization

D