Exam V
A nurse is interviewing a client with a recent suicide attempt. What would be an appropriate question for the nurse to ask? A) "Do you currently have a plan for killing yourself?" B) "Why would you think about hurting yourself?" C) "Have you thought about hurting yourself?" D) "Do you ever think about hurting yourself?"
A) "Do you currently have a plan for killing yourself?"
A nurse is caring for a client with congestive heart failure who currently smokes cigarettes and has a 50 pack-year smoking history. When providing smoking cessation education to the client, the nurse will include which statement(s) regarding the pathophysiology of nicotine use? Select all that apply. A) "In low doses, nicotine stimulates nicotinic receptors in the brain to release dopamine." B) "In high doses, nicotine stimulates the parasympathetic system to release epinephrine, causing vasoconstriction." C) "Initially, nicotine increases mental alertness and cognitive ability." D) "Nicotine is a nonpsychoactive substance found in tobacco." E) "Gradual reduction of nicotine appears to be the best method of cessation."
A) "In low doses, nicotine stimulates nicotinic receptors in the brain to release dopamine." C) "Initially, nicotine increases mental alertness and cognitive ability."
At a local seminar discussing healthcare resources, the keynote speaker discusses the phenomenon that healthcare resources are declining while costs for health care are increasing. An older adult in attendance asks the speaker why it has become so difficult to obtain needed care and services. What is the best response by the nurse? A) "There is increased cost due to the increased incidence of malpractice lawsuits." B) "There is a decrease in the number of adults needing care." C) "There are not enough medications produced for those who need them." D) "There are plenty of nurses but not enough doctors."
A) "There is increased cost due to the increased incidence of malpractice lawsuits."
The nurse is teaching an in-service about metabolic disorders. Which person is at the greatest risk for malnutrition as a result of hypermetabolism? A) A client with chronic obstructive pulmonary disease B) A client with osteoporosis C) A client who is a vegetarian D) A client who has dysphagia
A) A client with chronic obstructive pulmonary disease
The nurse is participating on a local council as an advisor regarding community needs during an emergency. The nurse advises the council that during the emergency response phase, the community needs which of the following? A) A coordinated response to emergencies B) A comprehensive disaster plan C) Programs to restore the community D) The identification of potential hazards to the community
A) A coordinated response to emergencies
A nurse working on a medical-surgical unit has opted to return to school to earn a Bachelor of Science in Nursing (BSN) degree. After considering projected changes in health care and the population cared for in the community, the student might consider selecting which elective course? A) A course on medical Spanish B) A psychology course on young adults C) A personal finance class D) A class on the effect of illness on a young child
A) A course on medical Spanish
The nurse is caring for a client who was raped. What does the nurse understand as the underlying issue of most rapists? Select all that apply. A) A desire to overpower and control B) A desire to play out fantasies C) An uncontrollably strong sex drive D) The inability to control intense anxiety E) Acting out aggression
A) A desire to overpower and control E) Acting out aggression
The nurse is planning care for a client to prevent future suicidal behavior. Which interaction(s) would be appropriate for this client? Select all that apply. A) Add the names of community resources to a crisis card. B) Assist in creating a crisis card listing family members. C) Focus on reasons for living. D) Limit exposure to friends. E) Identify self-directed harmful behaviors.
A) Add the names of community resources to a crisis card. B) Assist in creating a crisis card listing family members.
The nurse understands that some factors affect health care delivery by creating new opportunities for the healthcare sector. Which of the following would affect healthcare delivery? A) Advances in technology requiring specialized personnel B) Healthcare literacy programs C) Changing demographics that increase the need for new jobs D) Managed care frameworks that coordinate clients and insurance plans
A) Advances in technology requiring specialized personnel
A nurse recently attended a seminar that discussed the many threats to homeland security. The nurse is responsible for planning for emergencies from bioterrorism. The nurse would be most concerned about which of the following agents? Select all that apply. A) Anthrax B) Tuberculosis C) Cancer D) Flu E) Smallpox
A) Anthrax E) Smallpox
A hospital in the community has been notified of a multi-car crash on the interstate that will result in the transfer of many injured clients to the hospital. As part of the emergency response, the charge nurses in the Emergency Department and intensive care unit (ICU) are responsible for which task(s)? Select all that apply. A) Assigning care for the clients as they are admitted to the unit B) Assuring that there are enough pain medications available C) Assessing the acuity of the current clients on the unit D) Delegating staff nurses to gather needed supplies for the arriving clients E) Notifying the operating room of the potential influx of clients needing surgery
A) Assigning care for the clients as they are admitted to the unit C) Assessing the acuity of the current clients on the unit D) Delegating staff nurses to gather needed supplies for the arriving clients
The nurse is taking care of a client being discharged but will need home nursing care, physical therapy, and speech therapy. Which framework helps the client who has multiple care needs? A) Case management B) Client-focused care C) Managed care D) Multidisciplinary nursing teams
A) Case management
The nurse knows that communication among healthcare team members is essential during mass casualty events. Which factors are the most important for nurses in order to foster better communication? A) Concise, accurate, timely information B) Preparing for ethical challenges C) Documenting to prevent legal issues D) Coordinating care between management and clinicians
A) Concise, accurate, timely information
The nurse providing rapid triage and emergency treatment for clients in an effort to stabilize them knows that what is the primary purpose of the warm zone? A) Decontamination B) Rapid triage C) Reverse triage D) Emergency medical treatment
A) Decontamination
Which of the following are appropriate ongoing, long-term treatment goals for a victim who experienced sexual abuse 8 months ago? Select all that apply. A) Demonstrate effective coping strategies. B) Involve significant others in the treatment plan. C) Become aware of legal rights. D) Establish rapport and build a trusting nurse-client relationship. E) Move from victim to survivor status.
A) Demonstrate effective coping strategies. E) Move from victim to survivor status.
The nurse manager knows that insurance companies use which methods to ration healthcare resources? A) Denying coverage for services not supported by research B) Covering clients for preexisting conditions only C) Providing self-care allowances for covered individuals D) Increasing healthcare costs through organ donation
A) Denying coverage for services not supported by research
A nurse is conducting an admission assessment on a client admitted for thoughts of suicide. The nurse is determining the client's risk for suicide. Which would indicate to the nurse that the client is at a low level risk of suicide? Select all that apply. A) Displays mild depression. B) Shows curiosity about death. C) Discusses taking his or her life. D) Admits planning to end his or her life. E) Discusses a plan to end his or her life in detail.
A) Displays mild depression. B) Shows curiosity about death.
A client witnessed a violent bank robbery. What would indicate to the nurse that the client is experiencing posttraumatic stress disorder? Select all that apply. A) Fear of returning to sleep B) Excessive sleeping C) Terrifying nightmares D) Aggressive behavior E) Hair pulling
A) Fear of returning to sleep C) Terrifying nightmares D) Aggressive behavior
A client is experiencing health problems related to alterations in adrenal medulla function. On which areas should the nurse focus when assessing this client? Select all that apply. A) Heart rate B) Weight C) Respiratory rate D) Skin integrity E) Blood pressure
A) Heart rate B) Weight C) Respiratory rate E) Blood pressure
What can the nurse do to assist a client who was raped identify and prioritize concerns? A) Help the client use problem-solving skills. B) Provide anti-anxiety medication. C) Tell the client that the event is over and it is now time to move on. D) Instruct in guided imagery.
A) Help the client use problem-solving skills.
A client who has attempted to commit suicide in the past tells the nurse about feeling better since being prescribed an antidepressant medication. The nurse realizes the medication has done what for the client? A) Improved mood B) Improved sleep C) Improved feelings of guilt D) Improved appetite
A) Improved mood
A client in the clinic asks the nurse about a medication she saw on television. When the nurse suggests a generic, cheaper version of the medication, the client is resistant to changing her original thoughts. The nurse realizes that which of the following is correct about the healthcare treatment choices of consumers? A) Inappropriate healthcare treatment choices by consumers have contributed to increases in healthcare costs. B) The continued lack of accurate diagnoses by the primary medical team has contributed to increases in healthcare costs. C) Better treatments leading to an increase in medical expenses for more research have contributed to increases in healthcare costs. D) Decreased longevity due to an increase in chronic diseases has contributed to increases in healthcare costs.
A) Inappropriate healthcare treatment choices by consumers have contributed to increases in healthcare costs.
The client with diabetes mellitus reports having difficulty cutting his toenails because they are thick and ingrown. What should the nurse recommend to this client? A) Make an appointment with a podiatrist. B) Offer to file the tops of the nails to reduce thickness after cutting. C) Cut the nails straight across with a clipper after the bath. D) Make an appointment with a nail shop for a pedicure.
A) Make an appointment with a podiatrist.
A medication error occurred and the nurse is preparing to complete an incident report. Which information is required to thoroughly complete this report? Select all that apply. A) Name of client involved in the incident B) Location where completion of an incident report is located in the medical record C) Date and time of the incident D) Medication involved in the incident E) Number of hours the nurse was at work before the incident occurred
A) Name of client involved in the incident C) Date and time of the incident D) Medication involved in the incident
The nurse suspects a client is experiencing posttraumatic stress disorder when what is assessed? Select all that apply. A) Observed family member be raped and murdered B) Restores antique automobiles as a hobby C) Lives with spouse and has a garden D) Has a history of anxiety disorder E) Recently terminated from employment
A) Observed family member be raped and murdered D) Has a history of anxiety disorder E) Recently terminated from employment
A rape victim is being seen in the clinic. Upon assessment it is discovered the client has contracted syphilis. The clinic nurse would anticipate which pharmacological treatment will be prescribed? A) Penicillin B) Ceftriaxone and azithromycin C) Tinidazole D) Doxycycline
A) Penicillin
The nurse determines that a client is at risk for being raped when which characteristic or characteristics are assessed? Select all that apply. A) Previous history of being raped B) Current substance abuse C) Lives with parents D) Attends community college E) Unemployed
A) Previous history of being raped B) Current substance abuse E) Unemployed
When working with an emergency response team following a flood, the nurse working with the Clinical Outreach Communication Activity (COCA) team of the Centers for Disease Control and Prevention (CDC) knows that the role of the COCA includes which action? A) Provide two-way communication between clinicians and the CDC. B) Provide communication between doctors in the field during a disaster and their healthcare team. C) Provide resources to the community during times of disaster. D) Provide expert advice to nurses during natural disasters.
A) Provide two-way communication between clinicians and the CDC.
During a mass casualty event, the demand for nursing skills increases and calls for which implementation? A) Reverse triage B) Assessment skills C) Collaboration with primary caregivers D) Triage skills
A) Reverse triage
A nurse educator is planning a class for a group of nursing students regarding risk management. Which information should the educator include in this presentation? Select all that apply. A) Risk management seeks to prevent harm. B) Risk management empowers clients. C) Risk management controls the cost of supplies. D) Risk management examines past mistakes and identifies potential hazards. E) Risk management assures that nurses are truthful.
A) Risk management seeks to prevent harm. D) Risk management examines past mistakes and identifies potential hazards.
The nurse working in the Emergency Department is aware that rape victims initially exhibit which emotions? Select all that apply. A) Shock B) Disbelief C) Anger D) Self-blame E) Denial
A) Shock B) Disbelief E) Denial
The nursing instructor is evaluating the success of training provided to staff nurses on ways to reduce the incidence of pediatric medication errors. Which observations indicate that training has been effective? Select all that apply. A) Staff nurses are double checking medication calculations. B) Staff nurses are refusing to administer medications. C) Staff nurses are using liquid preparations. D) Staff nurses are asking the pharmacy to prepare the exact doses. E) Staff nurses are asking each other to validate placement of decimal points.
A) Staff nurses are double checking medication calculations. C) Staff nurses are using liquid preparations. E) Staff nurses are asking each other to validate placement of decimal points.
Which assessment finding or findings increase a client's risk for suicidal ideation or behavior? Select all that apply. A) Substance abuse B) Age 59 C) Plays golf twice a week D) Widowed for 6 months E) Recently started a new job
A) Substance abuse D) Widowed for 6 months
The nurse knows that during the preparedness phase of an emergency management plan, which resource(s) will help nurses understand their roles and responsibilities? Select all that apply. A) The American Nurses Association (ANA) B) The Federal Emergency Management Agency (FEMA) C) The AMA D) The Red Cross
A) The American Nurses Association (ANA)
A nurse is planning a community health fair in a local community center. What goals are important for the client to understand about health promotion? Select all that apply. A) The ability to change and modify goals as health needs change B) The ability for clients to be able to assess and evaluate their health needs C) The ability for the client to promote health in other individuals D) The ability to promote cost-saving techniques to healthcare providers E) The ability to prevent disease by imitating nursing techniques
A) The ability to change and modify goals as health needs change B) The ability for clients to be able to assess and evaluate their health needs
The local clinic staff has noticed an increase in the flu this season and called the Centers for Disease Control and Prevention (CDC) for more vaccine. The nurse knows that the CDC will control the vaccine distribution by considering which factor(s)? Select all that apply. A) The amount of vaccine being requested by local health departments B) The speed at which the vaccine becomes available C) Who gets the available vaccine D) Ensuring that only medical personnel can receive the vaccine E) Ensuring that only babies and military personnel receive the vaccine
A) The amount of vaccine being requested by local health departments B) The speed at which the vaccine becomes available C) Who gets the available vaccine
As a working professional, the nurse knows that one reason to join the American Nurses Association is for which opportunity? A) To participate in national discussions about resources B) To gain local and national notoriety C) To determine how to fight for resources locally D) To advocate for resources through different business sources
A) To participate in national discussions about resources
The nurse is assessing the vital signs of a client experiencing hypoparathyroidism. While monitoring the blood pressure, the nurse notes the client's hand begins to spasm. How should the nurse document this assessment finding? A) Trousseau sign B) Chvostek sign C) Turner's sign D) Cullen's sign
A) Trousseau sign
Which of the following patients are most likely to experience secondary hyperparathyroidism? A. A 58 year-old male with chronic renal failure. B. A 69 year-old female with an adenoma on the parathyroid gland. C. A 56 year-old male with a magnesium level of 0.5 mg/dL. D. A 7 year-old with diabetes type 1.
A. A 58 year-old male with chronic renal failure.
A patient is admitted to the ER. The patient is unconscious on arrival. However, the patient's family is with the patient and reports that before the patient became unconscious she was complaining of severe pain in the abdomen, legs, and back, and has been experiencing worsening confusion. In addition, they also report the patient has not been taking any medications. The patient was recently discharged from the hospital for treatment of low cortisol and aldosterone levels. On assessment, you note the patient's blood pressure is 70/45. What disorder is this patient most likely experiencing?* A. Addisonian Crisis B. Cushing Syndrome C. Thyroid crisis D. Hashimoto thyroiditis
A. Addisonian Crisis
Which of the following is a nursing PRIORITY when caring for a patient in Addisonian Crisis?* A. Administering IV Solu-Cortef B. Checking blood glucose C. Monitoring low urine specific gravity D. Elevating the head of the bed
A. Administering IV Solu-Cortef
A patient is recovering from a thyroidectomy. The patient starts to complain of tingling and numbness in the face, toes, and fingers. Which of the following findings below warrants attention?* A. Ca+ level: 6 mg/dL B. Na+ level: 145 mg/dL C. K+ level: 3.5 mg/dL D. Phosphate level: 4.3 mg/dL
A. Ca+ level: 6 mg/dL
A patient is diagnosed with hyperparathyroidism. Which of the following signs and symptoms would you NOT find in this patient? Select all that apply:* A. Calcium level 6 mg/dL B. Bone fracture C. Positive Trousseau's Sign D. Tingling and numbness of lips and fingers E. Calcium level of 15 mg/dL F. Phosphate level 1.2 G. Renal calculi
A. Calcium level 6 mg/dL C. Positive Trousseau's Sign D. Tingling and numbness of lips and fingers
A patient with Cushing's syndrome will be undergoing an adrenalectomy. Which of the following will be included in the patient's discharge teaching after the procedure?* A. Glucocorticoid replacement therapy B. Avoiding avocadoes and pears C. Declomycin therapy D. Signs and symptoms of Grave's Disease
A. Glucocorticoid replacement therapy
Which of the following is not a typical sign and symptom of Cushing's Syndrome?* A. Hyperpigmentation of the skin B. Hirsutism C. Purplish striae D. Moon Face
A. Hyperpigmentation of the skin
A patient was recently discharged home after being treated for Addison's Disease. The patient states they were unable to get their prescription for Prednisone filled after they were discharged from the hospital. The patient complains of pain in their abdomen, legs, and lowers back and is very weak. On assessment, you note the patient's blood pressure is 70/32, blood glucose 63, sodium 118, and potassium level 6.0. Which medication do you anticipate will be ordered by the doctor for this patient?* A. IV Solu-Cortef B. PO Hydrocortisone C. IV Morphine D. PO Prednisone
A. IV Solu-Cortef
In the scenario above (flashcard #4), what medication do you expect the patient to be started on?* A. IV Solu-Cortef B. PO Prednisone C. PO Declomycin D. IV Insulin
A. IV Solu-Cortef
In Cushing's Disease and Syndrome there are:* A. Increased cortisol production B. Low potassium and glucose levels C. Increased production of aldosterone and cortisol D. Decreased production of cortisol and aldosterone
A. Increased cortisol production
A physician orders Calcium Gluconate IV as treatment for a patient with hypoparathyroidism. The patient's calcium level is 5 mg/dL. Which of the following finding causes you to question this order?* A. The patient is taking Digoxin. B. The patient complains of muscle cramping and numbness in the face. C. The patient is taking Aluminum Carbonate. D. The patient's phosphate level is 7 mg/dL.
A. The patient is taking Digoxin.
The 70-year-old client with heart disease tells the nurse, "I am sick because I sinned by smoking cigarettes." What is the nurse's best response to this dying client? A) "Smoking cigarettes isn't a sin. There are many worse habits you could have." B) "Cigarette smoking was desirable when you began smoking. We didn't know about the problems it could cause." C) "Why don't we call the hospital chaplain and you can pray about your sins?" D) "You are correct, but it is too late to do anything about it now."
B) "Cigarette smoking was desirable when you began smoking. We didn't know about the problems it could cause."
The charge nurse has assessed clients during a mass casualty incident (MCI) and transferred some to other units and some to be discharged to home. In planning for the admission of critically ill clients from the Emergency Department, the charge nurse assigns the new clients to nurses who have which of the following? A) Risk-reduction knowledge B) Advanced assessment skills C) Impeccable ethics D) Exceptional self-care methods
B) Advanced assessment skills
The nurse is reviewing the laboratory test results for a client with an endocrine disorder. For which tests should the nurse expect to have current values on the medical record? Select all that apply. A) Prothrombin time B) Albumin C) Ammonia level D) Liver functions studies E) Hemoglobin and hematocrit
B) Albumin D) Liver functions studies
The nurse is caring for a client who has been prescribed calcitonin-human (Cibacalcin) nasal spray. What should the nurse include in the plan of care for this client? A) Take 1 hour before meals or 2 hours after meals. B) Alternate nostrils used daily. C) Take on an empty stomach in the morning with water. D) Remain in an upright position for 30 minutes after taking.
B) Alternate nostrils used daily.
A young mother brings her children to the health department for routine immunizations. The mother is crying because she lost her job and fears that her asthmatic daughter may be denied appropriate health care because she is unable to pay for it. The nurse realizes that many patients are experiencing these fears and that nurses should: A) Remind the client that everything will be fine. B) Become involved in the American Nurses Association (ANA). C) Move to an area that needs healthcare workers. D) Give the client medications and supplies from the clinic at no charge.
B) Become involved in the American Nurses Association (ANA).
The nurse is planning an inservice for the multidisciplinary team on smoking cessation care. Which statements should be included in the class? Select all that apply. A) There is no adverse risk if the client chooses to smoke while wearing a nicotine patch. B) Bupropion (Zyban) is used to suppress the craving for tobacco. C) A piece of nicotine gum should be chewed for 5 minutes of every waking hour then held in the cheek. D) Most persons quit smoking several times before they are successful. E) Alternative therapies should be considered to help reduce the stress that accompanies smoking cessation.
B) Bupropion (Zyban) is used to suppress the craving for tobacco. D) Most persons quit smoking several times before they are successful. E) Alternative therapies should be considered to help reduce the stress that accompanies smoking cessation.
The manager of a small clinic has cross-trained the nurses to perform electrocardiogram (ECG) testing, phlebotomy, and some respiratory therapy interventions. This clinic is providing client-focused care. Which of the following are the benefits of this delivery model? Select all that apply. A) Collaboration among many disciplines in providing client care B) Decreased steps to provide client care C) Decreased personnel required to provide client care D) Ease in tracking client progress E) Cost-effective care resulting in improved outcomes
B) Decreased steps to provide client care C) Decreased personnel required to provide client care
A client recovering from a rape tells the nurse that flashbacks do occur but can be managed. Which technique(s) could the client be using to manage flashbacks about the event? Select all that apply. A) Restoring personal choice B) Deep breathing C) Muscle relaxation D) Problem solving E) Guided imagery
B) Deep breathing C) Muscle relaxation E) Guided imagery
The parents of a client who committed suicide are observed arguing in the Emergency Department waiting area. What does the nurse realize the parents are at risk for developing? A) Risk for violence B) Ineffective family coping C) Anxiety D) Situational low self-esteem
B) Ineffective family coping
What should the nurse plan for a client diagnosed with posttraumatic stress disorder who has experienced symptoms for 4 months? A) Guidelines on conducting activities of daily living B) Information on the treatments available C) Referral to local employment agency D) Information on the need for adequate exercise
B) Information on the treatments available
A client diagnosed with posttraumatic stress disorder is experiencing insomnia. Which intervention(s) would be beneficial for this client? Select all that apply. A) Discuss the importance of exercise before sleep. B) Instruct in relaxation techniques. C) Encourage the use of sedatives. D) Suggest daytime naps. E) Coach in the use of guided imagery.
B) Instruct in relaxation techniques. E) Coach in the use of guided imagery.
The nurse is assessing a client in the free clinic. The nurse notes that the client's cholesterol level is higher than the target and has increased since the client's last visit. The nurse assesses the client for possible causes for this increase. After determining that the client has not changed dietary and exercise habits, the nurse concludes that the client: A) Has increased egg consumption. B) May not be taking medications as prescribed. C) Needs more aerobic activity. D) May be experiencing high triglyceride levels.
B) May not be taking medications as prescribed.
A group of nurses attended an in-service regarding emergency preparedness for the hospital. One of the nurses has three small children and lives in a two-story house in the suburbs. After the class, the nurse plans to initiate several actions to enhance family safety. Which of the actions is the most important for family safety? A) Installing deadbolt locks on the doors B) Obtaining a fire escape ladder for the second floor of the home C) Installing a generator for the house D) Installing a water purification system in the home
B) Obtaining a fire escape ladder for the second floor of the home
While performing an endocrine assessment on a client suspected of having Cushing disease, the nurse asks the female client if she has experienced recent weight changes. Which endocrine systems is the nurse assessing? Select all that apply. A) Gonads B) Pituitary gland C) Thyroid gland D) Adrenal gland E) Parathyroid gland
B) Pituitary gland C) Thyroid gland D) Adrenal gland
A client is being admitted with a diagnosis of post-traumatic stress disorder (PTSD). During a review of the client's history, the nurse is made aware that the client suffers from depression and suicidal thoughts. While interviewing the client, the client tells the nurse he is feeling extremely irritable and that the main reason he is there is because he has been having frequent nightmares. Based on the assessment findings, the nurse anticipates the physician will order which medication? A) Propanolol (Inderal) B) Prazosin (Minipress) C) Risperidone (Risperdal) D) Fluvoxamine (Luvox)
B) Prazosin (Minipress)
Which interventions would be appropriate for a client demonstrating acute anxiety related to posttraumatic stress disorder? Select all that apply. A) Encourage the client to discuss what caused the syndrome to develop. B) Provide a calm, quiet environment. C) Give the client paperwork to complete while waiting to be assessed. D) Ask the client what is causing the anxiety. E) Reassure the client that the environment is safe.
B) Provide a calm, quiet environment. E) Reassure the client that the environment is safe.
The nurse is concerned about the risk involved when implementing physicians' orders. Which strategy or strategies should the nurse consider to reduce this risk? Select all that apply. A) Question any order written for a postoperative client. B) Question any order a client questions. C) Question any order if the client's condition changes. D) Question any verbal order. E) Question any order that is incomplete.
B) Question any order a client questions. C) Question any order if the client's condition changes. E) Question any order that is incomplete.
The nurse is giving a health promotion class to adolescents. Which point is most important to convey to this audience? A) Teens are not strongly influenced by tobacco advertising. B) Smoking causes lung cancer. C) Cost is no deterrent to smoking. D) Alcohol use is strongly associated with smoking.
B) Smoking causes lung cancer.
The nurse is caring for a victim of rape. What are the priorities of care for this client? Select all that apply. A) Notifying an attorney for the client B) Supporting the victim during the examination C) Identifying the individual who committed the rape D) Treating acute injuries E) Providing referrals for follow-up care
B) Supporting the victim during the examination D) Treating acute injuries E) Providing referrals for follow-up care
The nurse is reviewing the effectiveness of care provided to a client diagnosed with posttraumatic stress disorder. Which would indicate that interventions have been beneficial for this client? Select all that apply. A) The client takes a sedative at least 4 times a day. B) The client has been sleeping throughout the night. C) The client keeps all of the lights on at home. D) The client verbalizes future plans with family and friends. E) The client will not enter a car with fewer than three people.
B) The client has been sleeping throughout the night. D) The client verbalizes future plans with family and friends.
During the assessment, the nurse observes a client who was a victim of a home invasion abruptly stand up and begin to run out of the room in response to hearing a loud bang. What should be the nurse's initial response? A) The client thought there was an earthquake. B) The client was reacting to the loud noise as a form of a flashback. C) The client wanted to check the cause for the loud noise. D) The client thought the assessment was concluded.
B) The client was reacting to the loud noise as a form of a flashback.
A client who has smoked 2 packs of cigarettes per day for 34 years has a history of intermittent claudication, chronic bronchitis, and emphysema. After 6 weeks of cessation the client reports yelling at his spouse and "flying off the handle." Which effect or effects of cigarette smoking are associated with this scenario? Select all that apply. A) Nicotine causes destruction of the alveoli. B) The release of epinephrine causes vasoconstriction. C) Dopaminergic processes are implicated in withdrawal symptoms. D) Tar causes the mucus production seen in chronic bronchitis. E) Tobacco use causes atherosclerosis.
B) The release of epinephrine causes vasoconstriction. C) Dopaminergic processes are implicated in withdrawal symptoms. D) Tar causes the mucus production seen in chronic bronchitis. E) Tobacco use causes atherosclerosis.
A patient is being discharged after recovering from Addisonian Crisis. Which of the following statements by the patient causes you to re-educate the patient about this condition?* A. "I will monitor my stress levels closely." B. "I can stop taking my medication once I feel better." C. "I am going to wear a Medic-Alert bracelet." D. "I will make sure I perform hand hygiene regularly and avoid sick people."
B. "I can stop taking my medication once I feel better."
A patient with Addison's Disease is being discharged home on Prednisone. Which of the following statements by the patient warrants you to re-educate the patient?* A. "I will notify the doctor if I become sick or experience extra stress." B. "I will take this medication as needed when symptoms present." C. "I will take this medication at the same time every day." D. "My daughter has bought me a Medic-Alert bracelet."
B. "I will take this medication as needed when symptoms present."
Which of the following patients are MOST at risk for hypoparathyroidism?* A. A 75 year-old female who is diabetic and takes Os-Cal daily. B. A 59 year-old male with a Mg+ level of 0.9 mg/dL. C. A 85 year-old female complaining of flank pain and constipation. D. A 19 year-old male with a Ca+ level of 8.9 mg/dL.
B. A 59 year-old male with a Mg+ level of 0.9 mg/dL.
Which of the following patients are at risk for developing Cushing's Syndrome?* A. A patient with a tumor on the pituitary gland, which is causing too much ACTH to be secreted. B. A patient taking glucocorticoids for several weeks. C. A patient with a tuberculosis infection. D. A patient who is post-opt from an adrenalectomy.
B. A patient taking glucocorticoids for several weeks.
Which of the following patients is MOST at risk for developing Addisonian Crisis?* A. A patient who is post-opt day 2 from thyroid surgery. B. A patient who is post-opt day 2 from an adrenalectomy. C. A patient with Addison's Disease who reports taking Prednisone regularly. D. A patient who is having gastrointestinal surgery.
B. A patient who is post-opt day 2 from an adrenalectomy.
A patient hospitalized with hypoparathyroidism is about to order lunch. Which food selection is best for this patient based on their dietary needs at this time?* A. Baked chicken, green beans, and boiled potatoes B. Broccoli salad, cottage cheese, and peaches C. Roast beef, carrots, and pinto beans D. Hamburger, fries, and sorbet
B. Broccoli salad, cottage cheese, and peaches
A patient is 6 hours post-opt from thyroid surgery. The patient's calcium level is 5 and phosphate level is 4.2. What physical signs and symptoms would NOT present with these findings? (Select-all-that-apply)* A. Bronchospasm B. Constipation C. Numbness and tingling in the face D. Positive Chvostek's Sign E. Absent Trousseau's Sign F. Hypertension
B. Constipation E. Absent Trousseau's Sign F. Hypertension
In Cushing's disease, the _______ is secreting too much ACTH (Adrenocorticotropic hormone) which is causing an increase in cortisol production.* A. Adrenal cortex B. Pituitary gland C. Thyroid gland D. Hypothalamus
B. Pituitary gland
Which of the following abnormal electrolyte imbalances is EXPECTED with Addisonian Crisis?* A. Potassium level of 3.2 B. Sodium level of 112 C. Blood glucose level of 120 D. Phosphate level of 1.2
B. Sodium level of 112
A client has been admitted with chronic obstructive pulmonary disease (COPD) and has asked the nurse for help and information regarding nicotine addiction and ways to quit smoking. The nurse will evaluate the treatment and determine that a goal has been met when the client states: A) "I will keep a pack of cigarettes in my closet in case I need it." B) "I will taper off smoking gradually." C) "I will chew sugar-free gum when I want a cigarette." D) "I will eat a snack when I am feeling nervous."
C) "I will chew sugar-free gum when I want a cigarette."
A nurse is caring for a client who smokes cigarettes and asks the nurse about nicotine replacement therapy (NRT). Which statement made by the nurse is appropriate? A) "Over-the-counter (OTC) NRTs include transdermal patches, gums, nicotine inhalers, and nasal sprays." B) "NRT helps to relieve the psychological and physiological effects of nicotine withdrawal." C) "NRT does not address addictive behavior." D) "Combining the use of NRT and a smoking cessation program is no more effective than NRT use alone."
C) "NRT does not address addictive behavior."
A client who was raped tells the nurse that she must not get pregnant. What would be an appropriate response by the nurse? A) "The baby could always be given up for adoption." B) "You will not know for sure for at least a few more days." C) "There is a medication called Plan B, which is emergency contraception." D) "Are you sure the rapist did not use a condom?"
C) "There is a medication called Plan B, which is emergency contraception."
An adolescent client hospitalized with asphyxiation from a failed suicide attempt tells the nurse, "I know other kids have the same problems I do, but I just wanted to make it stop." What should the nurse do to help this client? A) Discuss the client's attendance at school and what activities are enjoyed. B) Suggest the client listen to music and read a light novel to reduce stress. C) Ask if the client would like to talk about stressors and problems. D) Ask what is so devastating that the client needed to commit suicide.
C) Ask if the client would like to talk about stressors and problems.
A nurse educator is teaching a group of students about managed care. The educator knows that the students have understood the concept when they state that managed care has an emphasis which of the following? Select all that apply. A) Bringing services to the client B) Integration of health care services C) Cost-effective care D) Preventive services E) Health promotion
C) Cost-effective care D) Preventive services E) Health promotion
A rape victim is being seen in the clinic. Upon assessment it is discovered the client has contracted trichomoniasis. The clinic nurse would anticipate which pharmacological treatment will be prescribed? A) Penicillin B) Ceftriaxone and azithromycin C) Metronidazole D) Doxycycline
C) Metronidazole
An older client is diagnosed with disorders of fat metabolism, reduced absorption of fat-soluble vitamins, and slightly elevated blood glucose level. When caring for this client, on which endocrine organ should the nurse focus interventions? A) Pituitary B) Thyroid C) Pancreas D) Adrenal medulla
C) Pancreas
A client tells the nurse about continually reliving a situation of being robbed and shot by a gunman. The nurse identifies the most appropriate diagnosis for this client as being which of the following? A) Fear B) Anxiety C) Post-Trauma Syndrome D) Ineffective Coping
C) Post-Trauma Syndrome
A graduate nurse recently attended a lecture regarding risk management. Which action should the nurse implement to reduce risks in practice? A) Not discussing errors made B) Questioning every order that the physician writes C) Purchasing liability insurance D) Storing unused equipment in the halls of the unit
C) Purchasing liability insurance
A client who was raped refuses to see any male physicians, tells the nurse that she had an "incident" that she does not want to talk about, and wants a bed by the door. The nurse identifies which diagnosis as being appropriate for the client at this time? A) Relocation Stress Syndrome B) Readiness for Enhanced Power C) Rape-Trauma Syndrome D) Acute Confusion
C) Rape-Trauma Syndrome
A nurse working at a clinic in a community serving a high population of smokers is planning an educational session on "Tips to Quit." Which topic will be appropriate for the session? A) Tell this group that smoking is unacceptable. B) Make sure the group is aware of the increased risk of liver disease and cancer of the esophagus. C) Review the available pharmacologic adjuncts to cessation. D) Recommend hypnosis at a local dinner theater.
C) Review the available pharmacologic adjuncts to cessation.
The nurse is planning care for a number of clients who have been victims of a hurricane. Which nursing diagnosis would the nurse consider a priority to include in the plan of care for the victims? A) Chronic Confusion B) Decreased Cardiac Output C) Risk for Post-Trauma Syndrome D) Fatigue
C) Risk for Post-Trauma Syndrome
You are providing discharge teaching to a patient who is prescribed calcium supplements with vitamin D for treatment of hypoparathyroidism. Which of the following statements by the patient warrants you to re-educate the patient on how they should take this medication?* A. "I will also make sure I eat foods rich in calcium, such as dairy and green leafy vegetables while I'm taking this medication." B. "A side effect of this medication is constipation. Therefore, I should drink plenty of fluids." C. "I will take my calcium supplements in the morning when I take my Synthroid." D. All the statements above are correctly stated by the patient.
C. "I will take my calcium supplements in the morning when I take my Synthroid."
A patient with Addison's Disease should consume which of the following diets?* A. High fat and fiber B. Low potassium and high protein C. High protein, carbs, and adequate sodium D. Low carbs, high protein, and increased sodium
C. High protein, carbs, and adequate sodium
Which of the following below is NOT a sign or symptom of Addisonian Crisis?* A. Low blood pressure B. Severe pain in the stomach, legs, and lower back C. Hypokalemia D. Hyponatremia
C. Hypokalemia
The ______ ______secretes ACTH which causes the ______ ______ to produce cortisol.* A. Hypothalamus, adrenal medulla B. Thalamus, pituitary gland C. Pituitary gland, adrenal cortex D. Adrenal cortex, pituitary gland
C. Pituitary gland, adrenal cortex
A patient is prescribed Fosamax (Alendronate). The patient is about to be discharged and you observe the patient taking the medication. Which of the following findings requires you to re-educate the patient on how to take this medication?* A. The patient takes the medication on an empty stomach. B. The patient takes the medication with water. C. The patient sits up for 10 minutes after taking the medication. D. The patient waits 30 minutes after taking Fosamax before taking the prescribed vitamins and antacids.
C. The patient sits up for 10 minutes after taking the medication.
A patient is recovery from a parathyroidectomy. Which of the following findings causes concern and requires nursing intervention?* A. The patient is in Semi-Fowler's position. B. The patient's calcium level is 8.9 mg/dL. C. The patient's voice is hoarse. D. The patient is drowsy but arouses to name.
C. The patient's voice is hoarse.
The nurse caring for a client recovering from a suicide attempt determines that care has been beneficial to eliminate future suicide attempts when the client states: A) "I am not looking forward to going home with my parents." B) "I now know that threatening suicide will help me get what I want from my parents." C) "Even though I failed this time, I lived to think about it again." D) "I am looking forward to going to school and seeing my friends."
D) "I am looking forward to going to school and seeing my friends."
A nursing instructor is evaluating a nursing student's knowledge regarding a client with suicidal thoughts. Which statement made by the student demonstrates an understanding regarding assessing a client with suicidal thoughts? A) "I should attempt to make light of the circumstances." B) "I should be indirect and respectful." C) "I should not talk about suicide directly." D) "I should directly acknowledge the situation."
D) "I should directly acknowledge the situation."
A nurse working in an outpatient primary care clinic is caring for a client with asthma who has an 80 pack-year smoking history. What statement made by the nurse is most appropriate when assessing the client's nicotine use? A) "Have you tried a nicotine patch for quitting smoking?" B) "Do you smoke cigarettes with filters or without?" C) "Do you smoke upon waking?" D) "Tell me about any attempts you've made to quit using nicotine."
D) "Tell me about any attempts you've made to quit using nicotine."
The nurse has completed gathering data on a client with esophageal cancer due to years of nicotine abuse. Which nursing diagnosis is a priority for this client? A) Decisional Conflict B) Situational Social Isolation C) Disturbed Body Image D) Ineffective Airway Clearance
D) Ineffective Airway Clearance
The nurse is working with a client to create a crisis care card in the event the client wants to attempt suicide in the future. What should be included on this card? A) Name of client's physician B) Name of client C) Address of client D) Name and address of friends to call in case of a crisis
D) Name and address of friends to call in case of a crisis
The nurse is caring for a client who sustained multiple injuries in an automobile accident. As a part of secondary prevention for this client, the nurse plans to do which of the following? A) Promote wellness. B) Detect early disease. C) Restore the client to previous functioning. D) Prevent the progression of more symptoms.
D) Prevent the progression of more symptoms.
A nurse is developing a plan of care for a client diagnosed with post-traumatic stress disorder (PTSD). The client was recently admitted to the hospital for suicide ideation and a sleep disturbance due to frequent nightmares. Which nursing diagnosis will the nurse identify as the priority nursing diagnosis for this client? A) Disturbed Sleep Pattern B) Post-Trauma Syndrome C) Risk for Other-Directed Violence D) Risk for Self-Directed Violence
D) Risk for Self-Directed Violence
A client often asks what life would be like if he had never been born or if he were to die. What does the nurse suspect this client is at risk for? A) A suicide attempt B) Suicide planning C) A suicide threat D) Suicidal ideation
D) Suicidal ideation
A nurse is developing a plan of care for a client diagnosed with post-traumatic stress disorder (PTSD). The client was recently admitted to the hospital for suicide ideation and a sleep disturbance due to frequent nightmares. Which goal will the nurse identify as the priority goal for this client? A) The client will report a reduction in or cessation of nightmares. B) The client will report a decreased perception of anxiety. C) The client will discuss emotions related to traumatic experiences. D) The client will remain free from injury or harm.
D) The client will remain free from injury or harm.
Addison's Disease is:* A. Increased secretion of cortisol B. Increased secretion of aldosterone and cortisol C. Decreased secretion of cortisol D. Decreased secretion of aldosterone and cortisol
D. Decreased secretion of aldosterone and cortisol
The role of cortisol in the body includes:* A. Decreasing the blood sugar and inhibiting fat and carb production B. Synthesizing proteins and increasing carb excretion C. Elevating the blood pressure and maintaining ADH (anti-diuretic hormone) D. Increasing blood glucose levels, and breaking down fats, proteins, and carbs
D. Increasing blood glucose levels, and breaking down fats, proteins, and carbs
This medication is used to treat hyperparathyroidism in patients with chronic renal failure. It works by mimicking the role of calcium in the blood and tricks the parathyroid gland into stop secreting PTH (parathyroid hormone). Which of the following medications does this describe below?* A. Calcitonin B. Fosamax C. Lasix D. Sensipar
D. Sensipar
