Exam I

Write the equivalent indicated. 1kg =___lb a. 2.1 b. 2.0 c. 0.22 d. 2.2

2.2

Convert the following temperature as indicated. 18C = ___F a. 32.0F b. 103.0F c. 64.4F d. 65.4F

64.4F

The emergency department nurse is caring for an adult client who was in a motor vehicle accident. Radiography reveals an ulnar fracture. What type of pain is the nurse addressing with this client? a. osteopenic b. intermittent c. chronic d. acute

acute

The future of transcultural nursing care lies in finding ways to promote cultural competence in nursing students. How can this goal be best accomplished? a. by requiring students to care primarily for clients from other ethnic groups b. by offering multicultural health studies in nursing curricula c. by enhancing the content of community nursing classes d. by screening applicants according to their cultural competence

by offering multicultural health studies in nursing curricula

The nurse has just received report on a client who is coming to the unit from the emergency department with a torn meniscus. The nurse reviews the PRN medications and sees than an NSAID (ibuprofen) is prescribed every 6 hours. How should the nurse best implement preventive pain measures? a. provide medication as per client request and offer relaxation techniques to promote comfort b. check for allergies, use a pain scale to assess the client's pain, and offer the ibuprofen every 6 hours until the client is discharged c. do a complete assessment, and give pain medication based on the client's report of pain d. use a pain scale to assess the client's pain, and let the client know ibuprofen is available every 6 hours if she needs it

check for allergies, use a pain scale to assess the client's pain, and offer the ibuprofen every 6 hours until the client is discharged

The nurse caring for an older adult client with osteoarthritis is reviewing the client's chart. This client is on a variety of medications prescribed by different care providers in the community. In light of the QSEN competency of safety, what is the nurse most concerned about with this patient? a. depression b. inadequate pain control c. drug interactions d. chronic illness

drug interactions

The school nurse is working with a female high school junior whose BMI is 31. When planning this girl's care, the nurse should identify what goal? a. continuation of current diet and activity level b. increase in exercise and reduction in calorie intake c. increase in daily calorie intake d. possible referral to an eating disorder clinic

increase in exercise and reduction in calorie intake

A client was diagnosed with rheumatoid arthritis one year ago, but has achieved adequate symptom control with ibuprofen-NSAID. The nurse should recognize that this drug, like other NSAIDs, influences what aspect of the pathophysiology of nociceptive pain? a. distorting the action potential along the A-delta and C fibers b. inhibiting transduction by blocking the formation of prostaglandins in the periphery c. diverting noxious information from passing through the dorsal root ganglia and synapses in the dorsal horn of the spinal cord d. blocking modulation by limiting the reuptake of serotonin and norepinephrine

inhibiting transduction by blocking the formation of prostaglandins in the periphery

A hospice nurse is caring for a client who is dying of lymphoma. According to Maslow hierarchy of needs, what dimension of care should the nurse consider primary in importance when caring for a dying client? a. spiritual b. social c. emotional d. physiologic

physiologic

A community health nurse has scheduled a hypertension clinic in a local shopping mall in which shoppers have the opportunity to have their blood pressure measured and learn about hypertension. This nursing activity would be an example of which type of prevention activity? a. disease prevention b. secondary prevention c. primary prevention d. tertiary prevention

secondary prevention

The home health nurse is developing a plan of care for a client who will be managing his chronic pain at home. Using the nursing process, on which concepts should the nurse focus the client teaching? a. health promotion and exercise b. autonomy and need c. dependence and health d. self-care and safety

self-care and safety

The nurse is coordinating the care of victims who arrive at the ED after a radiation leak at a nearby nuclear plant. What would be the first intervention initiated when victims arrive at the hospital? a. survey the victims using a radiation survey meter b. perform soap and water decontamination c. administer prophylactic antibiotics d. irrigate victims' open wounds

survey the victims using a radiation survey meter

A home health nurse has been assigned to the care of an 82-year-old woman who has been discharged home following hip replacement surgery. At what level of care is this nurse most likely practicing? a. secondary prevention b. tertiary prevention c. preventative care d. primary prevention

tertiary prevention

An elderly client is admitted with a diagnosis of community-acquired pneumonia. During admission the client states, "I have a living will." What implication of this should the nurse recognize? a. this document is binding for the duration of the client's life b. this document specifies the client's wishes before hospitalization c. this document is always honored, regardless of circumstances d. this document has been drawn up by the client's family to determine DNR status

this document specifies the client's wishes before hospitalization

A client has a newly diagnosed heart murmur. During the nurse's subsequent health education, he asks if he can listen to it. What would be the nurse's best response? a. "Listening to the body is called auscultation. It is done with the diaphragm, and it requires a trained ear to hear a murmur" b. "Heart murmurs are pathologic and may require surgery. If you would like to listen to your murmur, I can provide you with instruction" c. "Listening is called palpation, and I would be glad to help you to palpate your murmur" d. "If you would like to listen to your murmur, I'd be glad to help you and show you how to use a stethoscope"

"If you would like to listen to your murmur, I'd be glad to help you and show you how to use a stethoscope"

A nurse is conducting a health assessment of an adult client when the client asks, "Why do you need all this health information and who is going to see it?" What is the nurse's best response? a. "Health information becomes the property of the hospital and we will make sure that no one sees it. Then, in 2 years, we destroy all records and the process starts over" b. "Your health information is placed on secure websites to provide easy access to anyone wishes to see your medical records. This ensures continuity of care" c. "Please do not worry. It is safe and will be used only to help us with your care. It's accessible to a wide variety of people who are interested in your health" d. "It is good you asked and you have a right to know; your information helps us to provide you with your best possible care, and your records are in a secure place"

"It is good you asked and you have a right to know; your information helps us to provide you with the best possible care, and your records are in a secure place"

A family whose religion limits the use of some forms of technology is admitting their grandfather to your unit. They express skepticism about the fact that you are recording the admission data on a laptop computer. What would be your best response to their concerns? a. "We have found that it is easier to keep track of our clients' information this way rather than with pen and paper" b. "It's been found that using computers improves our clients' care and improves communication" c. "You'll find that all hospitals are doing this now, and that writing information with a pen is rare" d. "The government is telling us we have to do this, even though most people, like yourselves, are opposed to it"

"It's been found that using computers improves our clients' care and improves communication"

The nurse is performing a dietary assessment with a client who has been admitted to the medical unit with community-acquired pneumonia. The client wants to know why the hospital needs all this information about the way he eats, asking you, "Are you asking me all these questions because I am Middle Eastern?" What is the nurse's best response to this client? a. "We know that some cultural and religious practices include dietary guidelines, and we do not want to violate these" b. "We always try to abide by foreign-born clients' dietary preferences in order to make them comfortable" c. "We know that clients who grew up in other countries often have unusual diets, and we want to accommodate this" d. "We wouldn't want to feed you anything you only eat on certain holidays"

"We know that some cultural and religious practices include dietary guidelines, and we do not want to violate these"

An emergency department nurse is preparing to inspect and palpate the head and scalp of an older adult who experienced a fall. A member of which group would most likely consider this examination a violation of norms? a. African b. Islamic c. Asian d. Jewish

Asian

The "eight rights" of medication administration are: a. RIGHT: medication, order, signature, time, route, documentation, response b. medication, client, dose, time, unit, documentation, reason, assessment c. RIGHT: medication, solution, doctor, shift, time, documentation, patient, response d. RIGHT: client, medication, dosage, route, time, documentation, reason, response

RIGHT: client, medication, dosage, route, time, documentation, reason, response

The nurse who is a member of the palliative care team is assessing a client. The client indicates that he has been saving his PRN analgesics until the pain is intense because his pain control has been inadequate. What teaching should the nurse do with this client? a. the client will likely benefit more from distraction than pharmacologic interventions b. medication should be taken when pain levels are low so the pain is easier to reduce c. pain medication can be increased when the pain becomes intense d. it is difficult to control chronic pain, so this is an inevitable part of the disease process

medication should be taken when pain levels are low so the pain is easier to reduce

A nurse who has practiced in the hospital setting for several years will now transition to a new role in the community. How does a physical assessment in the community vary in technique from physical assessment in the hospital? a. a physical assessment made in the community requires that the client be made more comfortable than would be necessary in the hospital setting b. a physical assessment made in the community does not require the privacy that a physical assessment made in the hospital setting requires c. a physical assessment in the community consists of largely the same techniques as are used in the hospital d. a physical assessment made in the community varies in technique from that conducted in the hospital setting by being less structured

a physical assessment in the community consists of largely the same techniques as are used in the hospital

Personal space and distance are culturally dependent and can impact nurse-client interactions significantly. What is the best way for the nurse to interact with a client who has a different cultural perspective on space and distance? a. position yourself 10 to 12 feet from the client to accommodate the most common cultural preferences b. allow the client to adopt a position that is comfortable for him or her c. realize that sitting close to the client is an indication of warmth and caring d. remember not to intrude into the personal space of the elderly

allow the client to adopt a position that is comfortable for him or her

A client is receiving postoperative morphine through a patient-controlled analgesic (PCA) pump and the client's prescriptions specify an initial bolus dose. What is the nurse's priority assessment? a. assessment for fluid overload b. assessment for decreased level of consciousness (LOC) c. assessment for paradoxical increase in pain d. assessment for respiratory depression

assessment for respiratory depression

A client has been diagnosed with small cell lung cancer. The client has met with the oncologist and is now weighing the relative risks and benefits of chemotherapy and radiotherapy. This client is demonstrating which ethical principle in making his decision? a. confidentiality b. beneficence c. autonomy d. justice

autonomy

The physician has recommended an amniocentesis for an 18-year-old primiparous woman. The client is 34 weeks gestation and does not want this procedure but the physician arranges for the amniocentesis to be performed. The nurse should recognize that the physician is in violation of what ethical principle? a. veracity b. autonomy c. beneficence d. nonmaleficence

autonomy

The nurse is admitting a client who is a recent immigrant from China and who has a diagnosis of adenocarcinoma. During the client's admission assessment, the client speaks of her beliefs related to health care and indirectly references the yin/yang theory. Based on her cancer diagnosis and her yin/yang beliefs, which meal will the client most likely order for lunch? a. turkey sandwich, small tossed salad, and iced tea b. chef's salad, bread, and water c. chicken noodle soup with crackers, fruit crisp, and hot tea d. fruit smoothie and granola bar

chicken noodle soup with cracker, fruit crisp, and hot tea

Two clients have recently returned to the postsurgical unit after knee arthroplasty. One client is reporting pain of 8 to 9 on a 0-to-10 pain scale, whereas the other client is reporting a pain level of 3 to 4 on the same pain scale. What is the nurse's most plausible rationale for understanding the clients' different perceptions of pain? a. one of the clients is exaggerating their sense of pain b. one of the clients may be experiencing opioid tolerance c. endorphin levels may vary between clients, affecting the perception of pain d. the clients are likely experiencing a variance in vasoconstriction

endorphin levels may vary between clients, affecting the perception of pain

An adult client has requested a "do not resuscitate" (DNR) order in light of his recent diagnosis with late-stage pancreatic cancer. The client's son and daughter-in-law are strongly opposed to the client's request. What is the primary responsibility of the nurse in this situation? a. temporarily withhold nursing care until the physician talks to the family b. contact a social worker or mediator to intervene c. honor the request of the client d. perform a "slow code" until a decision is made

honor the request of the client

Critical thinking and decision-making skills are essential parts of nursing in all venues. What are examples of the use of critical thinking in the venue of genetics-related nursing? Select all that apply. a. notifying individuals and family members of the results of genetic testing b. identifying individuals and families in need of referral for genetic testing c. providing a written report on genetic testing to an insurance company d. assessing and analyzing family history data for genetic risk factors e. ensuring privacy and confidentiality of genetic information

identifying individuals and families in need of referral for genetic testing, assessing and analyzing family history data for genetic risk factors, ensuring privacy and confidentiality of genetic information

A nurse is leading a community health clinic. What should the nurse emphasize in order to promote disease prevention? a. it is best achieved through attending self-help groups b. it is best achieved by exhibiting behaviors that promote health c. it is best achieved by reducing physiological stress d. it is best achieved by being an active participant in the community

it is best achieved by exhibiting behaviors that promote health

A medical nurse has obtained a new client's health history and completed the admission assessment. The nurse has followed this by documenting the results and creating a care plan for the client. Which of the following is the most important rationale for documenting the client's care? a. it keeps the client fully informed b. it creates a teaching log for the family c. it provides continuity of care d. it verifies appropriate staffing levels

it provides continuity of care

A client's intractable neuropathic pain is being treated using a multimodal approach to analgesia. After administering a recently increased dose of IV morphine to the client, the nurse has returned to assess the client and finds the client unresponsive to verbal and physical stimulation with a respiratory rate of 5 breaths per minute. The nurse has called a code blue and should anticipate the administration of what drug? a. acetylcysteine b. naloxone c. celecoxib d. acetylsalicylic acid

naloxone

The nurse is beginning a shift on a medical unit and is performing assessments appropriate to each client's diagnosis and history. When assessing a client who has an acute staphylococcal infection, what is the most effective technique for assessing the lymph nodes of the client's neck? a. auscultation b. percussion c. palpation d. inspection

palpation

The home health nurse is caring for a homebound client who is terminally ill. You are delivering a patient-controlled analgesia (PCA) pump to the client at your visit today. The family members will be taking care of the client. What would your priority nursing interventions be for this visit? a. provide client and family teaching regarding the operation of the pump, monitoring the IV site, and knowing the side effects of the medication b. teach the family the theory of pain management and the use of alternative therapies c. provide family teaching regarding use of morphine, recognizing morphine overdose, and offering spiritual guidance d. provide psychosocial family support during this emotional experience

provide client and family teaching regarding the operation of the pump, monitoring the IV site, and knowing the side effects of the medication

A group of disaster survivors is working with the critical incident stress management (CISM) team. Members of this team should be guided by what goal? a. educating survivors on potential coping strategies for future disasters b. determining whether the incident was managed effectively c. determining if individuals responded appropriately during the incident d. providing individuals with education about recognizing stress reactions

providing individuals with education about recognizing stress reactions

A nurse who provides care in a campus medical clinic is performing an assessment of a 21-year-old student who has presented for care. After assessment, the nurse determines that the client has a BMI of 45. What does this indicate? a. the client is mildly obese b. the client is of normal weight c. the client is overweight d. the client is extremely obese

the client is extremely obese

During discussion with the client and the client's husband, the nurse discovers that the client has a living will. How does the presence of a living will influence the client's care? a. power of attorney may change while the client is hospitalized b. the physician can override the client's desires for treatment if desires are not evidence based c. the client is legally unable to refuse basic life support d. the client may nullify the living will during her hospitalization if she chooses to do so

the client may nullify the living will during her hospitalization if she chooses to do so

The nurse is caring for a victim of a motor vehicle accident with a fractured pelvis and a ruptured bladder. The nurse's aide (NA) tells the nurse that she is concerned because the client's resting heart rate is 110 beats per minute, her respirations are 24 breaths per minute, temperature is 37.3C (99.1F) axillary, and the blood pressure is 125/85. What other information is most important as the nurse assesses this client's physiologic status? a. the client's serum glucose level b. the client's rating of her pain c. the client's white blood cell count d. the client's understanding of pain physiology

the client's rating of her pain

The nurse is receiving an older adult client from the PACU. Part of the report has been passed on from the preoperative assessment where it was noted that the client has been agitated in the past following opioid administration. What principle should guide the nurse's management of the client's pain? a. the elderly may have altered absorption and metabolism, which prohibits the use of opioids b. the elderly may require a higher initial dose of pain medication followed by a tapered dose c. the elderly may be confused following surgery, which is an age-related phenomenon unrelated to the medication d. the elderly may require lower doses of medication and are easily confused with new medications

the elderly may require lower doses of medication and are easily confused with new medications

The mother of a client with cancer comes to the nurse concerned with her daughter's safety. She states that the dose of morphine that her daughter requires to control her pain is getting "higher and higher." As a result, the mother is afraid that her daughter will overdose. The nurse should educate the mother about what aspect of her pain management? a. there is no absolute maximum opioid dose and her daughter is becoming more tolerant to the drug b. the dose range is higher with cancer clients, and the medical team will be very careful to prevent addiction c. the increased risk of overdose is an inevitable risk of maintaining adequate pain control during cancer treatment d. frequently, female clients and younger clients need higher doses of opioids to be comfortable

there is no absolute maximum opioid dose and her daughter is becoming more tolerant to the drug

A nurse is creating a nursing care plan for a client with a primary diagnosis of cellulitis and a secondary diagnosis of chronic pain. What common traits of client who live with chronic pain should be integrated into care planning? a. they often have an increased tolerance of pain b. they often have a lower pain threshold than clients without chronic pain c. they are typically more comfortable with underlying pain that clients without chronic pain d. they can experience acute pain in addition to chronic pain

they can experience acute pain in addition to chronic pain

During a comprehensive health assessment, which of the following structures can the nurse best assess by palpation? a. pancreas b. thyroid gland c. gall bladder d. intestines

thyroid gland

A client is asking for a breakthrough dose of analgesia. The pain-medication prescriptions are written as a combination of an opioid analgesic and a nonsteroidal anti-inflammatory drug (NSAID) given together. What is the primary rationale for administering pain medication in this manner? a. to achieve better pain control than with one medication alone b. to eliminate the need for additional medication during the night c. to prevent respiratory depression from the opioid d. to eliminate the potentially adverse effects of the opioid

to achieve better pain control than with one medication alone

During a health assessment of an older adult with multiple chronic health problems, the nurse is utilizing multiple assessment techniques, including percussion. What is the essential principle of percussion? a. to create vibration in a body wall b. to assess the sound created by the body c. to create sound over dead spaces in the body d. to strike the abdominal wall with a soft object

to create vibration in a body wall

The nurse is caring for a postsurgical client who speaks very little English. How should the nurse most accurately assess this client's pain? a. ask the client to write down a number according to the 0-to-10 point pain scale b. use a chart with English on one side of the page and the client's native language on the other so he can rate his pain c. use the visual analog scale (VAS) d. use the services of a translator each time you assess the client so you can document the client's pain rating

use a chart with English on one side of the page and the client's native language on the other so he can rate his pain

The nurse is preparing a discharge teaching session with an Asian client to evaluate the client's ability to change a dressing. The client speaks and understands minimal English. What would be the best way to promote understanding during the teaching session? a. write the procedure out for the client in simple language b. use an interpreter during the teaching session c. have the client demonstrate the dressing change d. ask the client to repeat the instructions carefully

use an interpreter during the teaching session

A client with migraines does not know whether she is receiving for pain management or the new drug that is undergoing clinical trials. After discussing the client's distress, it becomes evident to the nurse that the client did not fully understand the informed consent document that she signed. Which ethical principle is most likely involved in this situation? a. sanctity of life b. fidelity c. veracity d. confidentiality

veracity

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. justice b. confidentiality c. veracity d. respect

veracity

The nurse is conducting an assessment of a client in her home setting. Your client is a 91-year-old woman who lives alone and has no family members living close by. What should the nurse be aware of to aid in providing care to this client? a. what the client's financial status is b. where the closest relative lives c. how many children this client has d. what resources are available to the client

what resources are available to the client