Test 4
47. A nurse is preparing an order for grain of morphine IM. It is supplied as 10 mg per mL. How many mL should the nurse administer? Round to the nearest 10th mL. ____________________ mL
1.5 mL
____ 41. A patient is prescribed acetaminophen to help with pain control. How many grams of acetaminophen can the nurse safely administer to the patient each day? a. 4 grams b. 5 grams c. 6 grams d. 7 grams
a. 4 grams
____ 15. The nurse is collecting data for a patient with osteoporosis. Which serum calcium result indicates the typical changes that occur in serum calcium levels with osteoporosis? a. 6.5 mgdL b. 8.9 mgdL c. 9.7 mgdL d. 11.2 mgdL
a. 6.5 mgdL
____ 4. The nurse is gathering functional data on a patient with rheumatoid arthritis. Which of these areas should be included? a. Ability to dress b. Muscular build c. Nutritional status d. Height and weight
a. Ability to dress
____ 36. A patient 48 hours after surgery for a fractured femoral shaft is experiencing mental confusion, tachycardia, tachypnea, and dyspnea. The patients blood pressure is elevated and petechiae are present on the chest. After reporting the findings to the RN what should the nurse do while awaiting the physicians specific orders? (Select all that apply.) a. Administer oxygen. b. Prepare patient for arterial blood gas tests. c. Prepare patient for chest x-ray or lung scan. d. Maintain bedrest and keep movement to a minimum. e. Ask patient to move affected limb to see if pain is worse. f. Place patient in high Fowlers position or raise the head of the bed.
a. Administer oxygen. b. Prepare patient for arterial blood gas tests. c. Prepare patient for chest x-ray or lung scan. d. Maintain bedrest and keep movement to a minimum. f. Place patient in high Fowlers position or raise the head of the bed.
____ 39. The nurse is caring for a patient in traction. Which actions are appropriate when caring for this patient? (Select all that apply.) a. Allow weights to hang freely in place. b. Use assistance to reposition the patient in bed. c. Hold weights up if the patient is shifting position in bed. d. Remove weights if the patient is being moved up in bed. e. Lighten weights for short periods if the patient reports pain.
a. Allow weights to hang freely in place. b. Use assistance to reposition the patient in bed.
____ 22. The nurse is contributing to the plan of care for a patient who is scheduled for a below-the-knee amputation. What nursing diagnosis should be recommended for the preoperative plan of care? a. Anxiety b. Self-Care Deficit c. Fluid Volume Deficit d. Ineffective Airway Clearance
a. Anxiety
____ 42. The nurse is caring for a patient with a minor rotator cuff shoulder injury. What should the nurse emphasize when reviewing care with this patient? (Select all that apply.) a. Apply ice b. Rest the shoulder c. Take NSAIDs as prescribed d. Begin out-patient physical therapy e. Use 2 lb hand weights for exercising
a. Apply ice b. Rest the shoulder c. Take NSAIDs as prescribed d. Begin out-patient physical therapy
____ 25. A patient comes into the emergency department after vomiting blood. The nurse should be most concerned if the patient reports taking which medication? a. Aspirin b. Codeine c. Meperidine (Demerol) d. Acetaminophen (Tylenol)
a. Aspirin
____ 18. The nurse is reinforcing teaching for a patient who has had a total hip replacement on correct sitting positions. Which position should the nurse teach the patient to avoid? a. Crossing legs b. Elevating legs c. Flexing ankles d. Extending knees
a. Crossing legs
____ 7. A patient with a casted, fractured left leg asks why the leg has to be elevated. What should the nurse respond to this patient? a. Decreases swelling. b. Prevents cast cracking. c. Increases your comfort. d. Allows the cast to dry evenly.
a. Decreases swelling
____ 9. The nurse is preparing to provide an opioid medication for a patients postoperative pain. Which action should the nurse take first? a. Determine the respiratory rate. b. Observe the patients skin color. c. Take the patients oral temperature. d. Ask the patient when he last ate something.
a. Determine the respiratory rate.
____ 32. The nurse is collecting data for a patients health history as part of the musculoskeletal system assessment. What should the nurse include when collecting this data? (Select all that apply.) a. Diet history b. Occupation and activities c. Cardiovascular and respiratory problems d. Risk factors for musculoskeletal problems e. Family history of musculoskeletal problems
a. Diet history b. Occupation and activities d. Risk factors for musculoskeletal problems e. Family history of musculoskeletal problems
____ 10. The nurse is reinforcing teaching provided to a patient with rheumatoid arthritis (RA). Which patient statement indicates understanding of the symptoms of RA? a. Fatigue b. Paralysis c. Crepitation d. Shortness of breath
a. Fatigue
____ 40. The nurse is contributing to the plan of care for a patient recovering from total hip replacement. Which exercises should the nurse recommend to help prevent deep vein thrombosis (DVT) formation? (Select all that apply.) a. Foot circles b. Toe touches c. Heel pumping d. Deep knee bends e. Quadriceps setting f. Straight leg raises (SLRs)
a. Foot circles c. Heel pumping e. Quadriceps setting f. Straight leg raises (SLRs)
____ 28. A patient is completing instructions about complications that can occur from osteoporosis. Which complication should the patient state as evidence that teaching has been effective? a. Hip fracture. b. Overgrowth of bone. c. Bone spur formation. d. Increased bone density.
a. Hip fracture.
____ 27. A nursing home resident complains of joint pain. Which medication should the nurse choose first to relieve the patients pain? a. Ibuprofen (Motrin) b. Acetaminophen (Tylenol) c. Acetaminophen oxycodone (Vicodin) d. Acetaminophen codeine (Tylenol no. 3)
a. Ibuprofen (Motrin)
____ 28. A patient is experiencing a tendon that is torn from a moveable bone. What should the nurse observe when collecting data on the patients musculoskeletal system? a. Inability to move the joint b. Hyperflexion of the joint c. Hyperextension of the joint d. Crepitus and palpable nodules
a. Inability to move the joint
____ 6. The nurse is reinforcing teaching provided to a patient recovering from right total hip replacement. Which patient statement indicates a correct understanding of the teaching? a. Keep legs apart. b. Lie prone in bed. c. Move right leg closer to the left leg. d. Do not bear any weight on the left leg.
a. Keep legs apart.
____ 30. The nurse is admitting an 88-year-old woman to an extended care facility. Which findings should the nurse consider as normal age-related changes of the patients musculoskeletal system? (Select all that apply.) a. Limb weakness b. S-shaped curve to back. c. Loss of 2 inches in height d. Walks with small, shuffling steps. e. Mild pain experiencing in the hands during the morning hours
a. Limb weakness c. Loss of 2 inches in height e. Mild pain experiencing in the hands during the morning hours
____ 37. A patient asks the difference between osteoarthritis and rheumatoid arthritis. What manifestations should the nurse explain are characteristic of rheumatoid arthritis? (Select all that apply.) a. Low-grade fever b. Heberdens nodes c. Autoimmune disease d. Activity increases pain e. Early morning stiffness f. Involvement of other major organs
a. Low-grade fever c. Autoimmune disease e. Early morning stiffness f. Involvement of other major organs
____ 16. A patient scheduled for a magnetic resonance imaging (MRI) scan of the abdomen and pelvis asks how the machine takes a picture. What should the nurse respond to the patient? a. Magnetic fields create an image. b. Sound waves bounce off your organs to create the picture. c. Heat energy from the molecules of your body is detected to create a picture. d. X-rays from multiple angles are passed simultaneously to get a three-dimensional image.
a. Magnetic fields create an image.
____ 26. A patient with diabetes mellitus is scheduled for an arthroscopy of the right knee at 0800. What should be included in nursing preoperative care for this patient? (Select all that apply.) a. Maintaining NPO (nothing by mouth) status b. Obtaining blood glucose c. Providing a liquid breakfast d. Explaining the anesthetic agents e. Reviewing the surgical procedure f. Witnessing signature on surgical consent
a. Maintaining NPO (nothing by mouth) status b. Obtaining blood glucose f. Witnessing signature on surgical consent
____ 11. A patient receiving large doses of opioids is lethargic and difficult to arouse, with a respiratory rate of 6 per minute and constricted pupils. Which medication should the nurse anticipate being prescribed? a. Naloxone (Narcan) b. Furosemide (Lasix) c. Diazepam (Valium) d. Flumazenil (Romazicon)
a. Naloxone (Narcan)
____ 21. A patient who has a displaced mid-shaft fracture of the left femur and is in balanced suspension skeletal traction with 35 pounds of weights is experiencing calf pain with right foot dorsiflexion. Which action should the nurse take? a. Notify the RN. b. Check the traction setup. c. Reduce 5 pounds of weight. d. Encourage dorsiflexion more frequently.
a. Notify the RN.
____ 31. The nurse checks a patients casted right leg resting upon a pillow and finds that the cast appears too tight. What should the nurse do? a. Notify the RN. b. Administer pain medication. c. Apply an extra blanket to the leg. d. Remove the pillow under the cast.
a. Notify the RN.
____ 7. A patient with chronic pain is on a sustained-release opioid that is ordered every 12 hours. After 6 hours, the patient complains of increasing pain. Which intervention by the nurse is appropriate? a. Obtain an order for an immediate-release opioid for breakthrough pain. b. Teach the patient a relaxation technique to use until the next dose is due. c. Assess the patients vital signs, and administer the next dose of opioid early. d. Explain to the patient that the medication being administered lasts for 12 hours.
a. Obtain an order for an immediate-release opioid for breakthrough pain.
____ 12. A nurse provides an opioid antidote to a patient experiencing opioid toxicity. Which outcome should the nurse expect after providing this medication? a. Pain b. Sedation c. Confusion d. Tachypnea
a. Pain
____ 1. The nurse is preparing to assess a patients pain level. Which definition of pain should the nurse use to guide practice? a. Pain is whatever the experiencing person says it is. b. Pain is an unpleasant sensation caused by physical injury. c. Pain is a sensation that causes the patient to avoid its source. d. Pain is discomfort manifested by elevated vital signs and grimacing.
a. Pain is whatever the experiencing person says it is.
____ 38. The nurse is collecting data from a patient suspected of developing a fat embolus from a fracture of the right femur. Which manifestations should the nurse expect? (Select all that apply.) a. Petechiae b. A migraine c. Tachycardia d. Mental confusion e. Numbness in the right leg f. Muscle spasms in the right thigh
a. Petechiae c. Tachycardia d. Mental confusion
____ 27. A patient was an unrestrained passenger in a motor vehicle accident and hit the windshield. The patients leg was also fractured. Which areas should be included in a patients neurovascular checks? (Select all that apply.) a. Pulses b. Sensation c. Movement d. Orientation e. Pupil reaction f. Level of consciousness
a. Pulses b. Sensation c. Movement
____ 41. A patient in the ambulatory clinic is diagnosed with a muscle strain. What actions should the nurse instruct the patient to do to treat this injury? (Select all that apply.) a. Rest the limb. b. Elevate the limb. c. Apply heat for 1 hour. d. Apply ice to the area. e. Wrap with an elastic bandage.
a. Rest the limb. b. Elevate the limb. d. Apply ice to the area. e. Wrap with an elastic bandage.
____ 23. A patient is diagnosed with fractured thoracic vertebrae from a motor vehicle crash. Which other structure should the nurse suspect may have been damaged during this accident? a. Ribs b. Liver c. Heart d. Lungs
a. Ribs
____ 43. The nurse is reviewing medications prescribed for a patient experiencing pain. Which medications should the nurse realize are being used as adjuvant agents for this patients pain? (Select all that apply.) a. Steroids b. Antibiotics c. Cox 2 inhibitors d. Anticonvulsants e. Benzodiazepines f. Tricyclic antidepressants
a. Steroids d. Anticonvulsants e. Benzodiazepines f. Tricyclic antidepressants
____ 23. A patient has been requesting hydrocodone acetaminophen (Vicodin) for pain every 4 hours for several days. Now the patient calls the nurse after only 3 hours and says, I need more Vicodin. The pain is worse. On which initial assumption should the nurse base a decision about what to do next? a. The patient is in pain. b. The patient is becoming addicted to Vicodin. c. The patient is exhibiting drug-seeking behavior. d. The patient is physically dependent on Vicodin.
a. The patient is in pain.
____ 4. The nurse finds a 2-day postoperative patient who had a right total hip replacement lying supine with crossed legs. What data should the nurse collect on this patient? a. The right leg for shortening b. The right knee for crepitation c. The left leg for internal rotation d. The left leg for loss of function
a. The right leg for shortening
____ 13. The nurse is reinforcing teaching for a patient who has severe arthritis and is having an x-ray. Which patient statement indicates teaching has been effective? a. The table is hard and cold. b. I may move during the x-ray. c. A soft mattress covers the table. d. I may lie in a position of comfort.
a. The table is hard and cold
____ 42. A patient is prescribed a nonopioid medication for pain. Which characteristics of nonopioid drugs should the nurse keep in mind when caring for this patient? (Select all that apply.) a. They work peripherally. b. They produce tolerance. c. They have a ceiling effect. d. They are used for acute and chronic pain. e. They work in the central nervous system. f. They can be safely increased to treat increasing pain.
a. They work peripherally. d. They are used for acute and chronic pain.
____ 27. The nurse is reinforcing teaching provided to a patient who is postmenopausal, has lost 2 inches of height, and has osteoporosis. Which patient statement indicates correct understanding of the purpose of calcium supplements? a. To decrease bone loss b. To increase energy levels c. To decrease serum calcium d. To increase excretion of calcium
a. To decrease bone loss
____ 26. The nurse is caring for a patient with gout. Which laboratory value should the nurse review which indicates that the treatment plan is effective? a. Uric acid: 7.9 mg dL b. Creatinine: 0.8 mg dL c. Blood urea nitrogen: 15 mg dL d. Low-density lipoprotein (LDL): 115 mg dL
a. Uric acid: 7.9 mg dL
____ 20. The nurse is having difficulty assessing the pain of a mentally impaired patient who has an approximate functional level of a 4-year-old child. Which method should the nurse use to determine the patients pain level? a. Use the Faces scale. b. Ask are you hurting? c. Observe the patients facial expression. d. Explain to the patient how to use a 0-to-10 pain scale, with 0 being no pain, and 10 being the worst possible pain.
a. Use the Faces scale.
____ 46. The nurse is providing care for a patient being discharged on opioid therapy. What should the nurse include when teaching the patient about this medication? (Select all that apply.) a. You may feel sleepy when you take this medication. b. If you experience nausea, stop taking the medication. c. Avoid driving or operating machinery for a few days. d. It is important to drink 8 to 10 glasses of fluid each day. e. Fiber or bulk laxatives may be needed to prevent constipation. f. You should wait as long as possible to take your pain medication to prevent addiction.
a. You may feel sleepy when you take this medication. c. Avoid driving or operating machinery for a few days. d. It is important to drink 8 to 10 glasses of fluid each day. e. Fiber or bulk laxatives may be needed to prevent constipation.
____ 44. The nurse is determining equivalent doses of pain medication for a patient. Which dose is equivalent to a 10-mg dose of subcutaneous morphine? (Select all that apply.) a. 5 mg IV morphine b. 10 mg IV morphine c. 25 mg IM morphine d. 15 mg IM morphine e. 30 mg oral morphine f. 10 mg oral morphine
b. 10 mg IV morphine e. 30 mg oral morphine
____ 30. The nurse is questioning if a patient is experiencing pain. Which myth should the nurse recall when determining this patients pain level? a. A patient can sleep and still experience severe pain. b. A patient who is laughing and talking is not in pain. c. Respiratory depression can occur in patients receiving opioids. d. Oral pain medication can be as effective as injected medication.
b. A patient who is laughing and talking is not in pain.
____ 8. The nurse is caring for a patient who has had a right hip replacement. For which position is the nurse attempting to achieve when a pillow is placed between the legs during turning? a. Flexion of the knees b. Abduction of the thighs c. Adduction of the hip joint d. Hyperextension of the knees
b. Abduction of the thighs
____ 38. The mother of an adolescent recovering from surgery for a fractured leg asks if all pain medication can be non-narcotic, because she does not want her child to become addicted. What should the nurse respond to the mother? a. All pain medication is addicting. b. Addiction to opioids is uncommon when taken for pain. c. I will give the medication that you request to your child. d. Teenagers are more likely to become addicted to pain medication than other patients.
b. Addiction to opioids is uncommon when taken for pain.
____ 4. A patient has been on opioids for 3 months to control pain caused by injuries from a motor vehicle crash. The patient asks about the risk of withdrawal symptoms when the drugs are no longer needed. How should the nurse respond to the patient? a. Ask your doctor for a sedative to get you through the worst of the withdrawal symptoms. b. As long as you taper the drug dose down slowly, you should not experience withdrawal symptoms. c. You would have to be on these drugs much longer than 3 months to have problems with withdrawal. d. You were using the drugs for legitimate pain, so you will not have to go through withdrawal when you stop them.
b. As long as you taper the drug dose down slowly, you should not experience withdrawal symptoms.
____ 7. An older adult visiting a wellness clinic reports joint stiffness in the morning. What should the nurse respond to this patient? a. The stiffness is due to decreased moisture in joint bones. b. As we age, the cartilage in joints gets rough, causing stiffness. c. The fluid in your joints gets thinner as you age, so your joints get stiff. d. The body makes extra synovial fluid as we age, and that makes joints stiff.
b. As we age, the cartilage in joints gets rough, causing stiffness.
____ 17. The nurse enters the room of a patient who is moaning loudly and thrashing around in bed. What action should the nurse take first? a. Ask the patient to quiet down. b. Ask the patient what is wrong. c. Go and get a dose of the patients prn pain medication. d. Administer a sedative, and then assess the patients pain after it has taken effect.
b. Ask the patient what is wrong.
____ 13. A patient with gout has been instructed on the prescribed medication allopurinol (Zyloprim). Which patient statement indicates understanding of the action of this medication? a. Excretes proteins. b. Blocks formation of uric acid. c. Increases formation of purines. d. Increases metabolism of purines.
b. Blocks formation of uric acid.
____ 14. The nurse is collecting data on a patient with a crushing injury to the lower extremities. Which serum creatine kinase (CK) result should the nurse review and report to the physician? a. CK-MB b. CK-MM c. CK-BB d. CK1
b. CK-MM
____ 3. The nurse, who is inspecting the knee of a patient who fell and reports stiffness, hears a grating sound with knee movement. How should the nurse document this finding? a. Arthritis b. Crepitus c. Synovitis d. Inflammation
b. Crepitus
____ 44. The nurse is assisting in the development of an educational seminar on prevention of osteoporosis for a group of community members. Which actions should the nurse suggest be included in this presentation? (Select all that apply.) a. Drink one cup of caffeinated coffee each day b. Ensure an adequate intake of calcium each day c. Participate in weight-bearing exercise every day d. Wear well-supporting nonskid shoes at all times e. Consider participating in resistance exercise training
b. Ensure an adequate intake of calcium each day c. Participate in weight-bearing exercise every day d. Wear well-supporting nonskid shoes at all times e. Consider participating in resistance exercise training
____ 29. A patient in a motor vehicle crash has injuries to bones of the appendicular skeleton. Which bones should the nurse expect to support when caring for this patient? (Select all that apply.) a. Skull b. Femur c. Hyoid d. Rib cage e. Humerus
b. Femur e. Humerus
____ 25. A patient recovering from a biopsy of the right femur had pain medication 1 hour ago. Which symptom should the nurse report and closely monitor in this patient? (Select all that apply.) a. Temperature 98.4F b. Hematoma formation c. Capillary refill of 3 seconds d. Pain reported as 7 on a 0-to-10 scale e. Range of motion of the ankle and knee present
b. Hematoma formation d. Pain reported as 7 on a 0-to-10 scale
____ 8. The nurse is collecting data for a patient who is reporting pain in the hand joints. What question should the nurse ask to determine the quality of the pain? a. Does the pain move? b. How does the pain feel? c. Did an event cause the pain? d. How would you rate the pain?
b. How does the pain feel?
____ 30. The nurse reinforces medication teaching provided to a patient with rheumatoid arthritis. Which medication should the patient identify as helpful to control the symptoms of the health problem? a. Digoxin. b. Ibuprofen. c. Morphine. d. Penicillin.
b. Ibuprofen.
____ 45. The nurse is admitting a patient with pancreatitis. What should the nurse include in the patients pain history? (Select all that apply.) a. How much alcohol does the patient drink each day? b. Is the patient having difficulty sleeping, eating, or working? c. How does the patient describe the pain in his or her own words? d. Are there any aggravating or alleviating factors that alter the pain? e. How has the pain affected the patients ability to perform activities of daily living? f. Is the patient experiencing any nausea, vomiting, or anorexia associated with the pain?
b. Is the patient having difficulty sleeping, eating, or working? c. How does the patient describe the pain in his or her own words? d. Are there any aggravating or alleviating factors that alter the pain? e. How has the pain affected the patients ability to perform activities of daily living? f. Is the patient experiencing any nausea, vomiting, or anorexia associated with the pain?
____ 1. The nurse is contributing to the plan of care for a patient who has a right fractured femur. What intervention should the nurse include in the plan of care to prevent fat emboli? a. Decrease dietary consumption of fats. b. Maintain immobilization of the right leg. c. Encourage coughing and deep breathing hourly. d. Perform passive range of motion on the right leg.
b. Maintain immobilization of the right leg.
____ 1. The nurse is caring for a patient who had a bone biopsy on the right leg. Which activity should the nurse implement? a. Ambulate twice daily. b. Monitor site of biopsy for bleeding. c. Perform hourly passive range of motion. d. Perform active range of motion every 2 hours.
b. Monitor site of biopsy for bleeding.
____ 5. A patient has abdominal pain after gallbladder surgery. For which type of pain should the nurse provide care? a. Chronic b. Nociceptive c. Neuropathic d. Non-physiological
b. Nociceptive
____ 2. A patient has an open reduction of a radial fracture and is casted. Several hours after the operation, the patient reports a throbbing pain in the arm. What nursing action is essential for the nurse to take? a. Reposition arm. b. Perform neurovascular checks. c. Administer analgesics as ordered. d. Notify the physician immediately.
b. Perform neurovascular checks.
____ 22. The nurse is determining a pain management plan for a patient with chronic pain. What should the nurse identify as the best analgesic schedule for this patient? a. Prn b. Qid c. Around the clock d. Only when pain is severe, to prevent tolerance
b. Qid
____ 29. A patient is determined to be physically dependent on prescribed pain medication. How should the nurse interpret this patients dependency? a. The patient is addicted to pain medication. b. Stopping the drug causes symptoms of withdrawal. c. The patient requests pain medication more often than it is ordered. d. It takes more medication than previously to relieve the patients pain.
b. Stopping the drug causes symptoms of withdrawal.
____ 2. The nurse is caring for a patient 1 hour after a diagnostic arthroscopy of the right knee. Which activity should the nurse implement? a. Strict bedrest b. Straight-leg raises c. No weight-bearing on right leg for 3 days d. Partial weight-bearing on left leg for 1 week
b. Straight-leg raises
____ 21. A large family of a patient with terminal cancer pain is constantly calling to report that the patient is in pain or needs to be moved or needs a drink. The nurse is having difficulty caring for other patients because this family is so demanding. What is the best way to deal with this situation? a. Ask the family to leave. b. Teach the family how to help provide for the patients basic needs. c. Show the family the hospital policy stating that only two visitors are allowed in the room at a time. d. Negotiate with the family that if they avoid using the call light, the nurse will check on the patient every 30 minutes.
b. Teach the family how to help provide for the patients basic needs.
____ 14. A patient with chronic back pain has a new order for a fentanyl (Duragesic) patch. As the nurse applies the patch, the patient states, Im really glad to get that patch on. I am really hurting bad. Which response by the nurse is correct? a. You should feel some relief of your pain within about half an hour. b. The patch may take a while to work. Would you like a pain shot in the meantime? c. Other analgesics cant be given while the patch is on, so try to bear it until it takes effect. d. Because it is absorbed right through the skin, you will feel relief within minutes after I apply this patch.
b. The patch may take a while to work. Would you like a pain shot in the meantime?
____ 6. A patient with terminal cancer describes a pain rating of 7 on a 0-to-10 scale. The nurse notes that the patients vital signs are unchanged and recalls that vital signs may be elevated with pain. What is the best explanation for this? a. The patient is not really in pain. b. The patient has adapted to chronic pain. c. Acute pain is not associated with elevated vital signs. d. The patients vital signs are not responding because of the cancer.
b. The patient has adapted to chronic pain.
____ 26. A patient admitted with liver disease complains of pain in his right shoulder. What should the nurse use as explanation for this patients site of pain? a. The patient hurt his shoulder. b. The patient is experiencing referred pain. c. The patient is tense because of concern about the possible diagnosis. d. The patient is pretending to have more pain to obtain more analgesics.
b. The patient is experiencing referred pain.
____ 11. The nurse is collecting data for a patient who is reporting pain in the left wrist. What question should the nurse use to address the region of the pain? a. Is the pain mild? b. Where is the pain? c. Does the pain move? d. How does the pain feel?
b. Where is the pain?
____ 31. The nurse notes that a patient experiencing a pain level of 9 on a scale from 0 to 10 has a change in vital signs. What type of pain should the nurse realize this patient is experiencing? a. Cancer pain b. Neuropathic pain c. Acute pain from trauma d. Chronic nonmalignant pain
c. Acute pain from trauma
____ 31. The mother of a 6-year-old child is concerned that the child is not going to be tall like other family members. What should the nurse explain as influencing the growth of bone? (Select all that apply.) a. Reduced levels of insulin b. Limited amounts of thyroxine c. Adequate intake of vitamin D d. Production of growth hormone e. Adequate intake of vitamins A and C
c. Adequate intake of vitamin D d. Production of growth hormone e. Adequate intake of vitamins A and C
____ 10. A patient with peripheral neuropathy states, I dont know why the doctor put me on an antidepressant. I am not depressed! Which response by the nurse is best? a. Depression is often a factor in pain. Treating the depression helps treat the pain. b. Maybe you are more depressed than you realize. Would you like to talk about it? c. Antidepressants are sometimes used to treat nerve pain such as you are experiencing. d. Why dont you try it for a while, and if you dont feel better, you can ask your doctor if you can stop it?
c. Antidepressants are sometimes used to treat nerve pain such as you are experiencing.
____ 34. An 87-year-old female with a history of osteoarthritis reports an average generalized pain score of 4 on a 0-to-10 scale while using acetaminophen prn. Which response about this pain level should the nurse make to the patient? a. Do you take a daily calcium supplement? b. Im glad the acetaminophen is working for you. c. Are you satisfied with this level of pain control? d. Research shows that acetaminophen is not really effective for osteoarthritis pain.
c. Are you satisfied with this level of pain control?
____ 43. During a health history the nurse becomes concerned that a patient is at risk for developing osteoporosis. Which modifiable risk factors did the nurse use to come to this conclusion? (Select all that apply.) a. Small boned b. Postmenopausal c. Cigarette smoking d. Sedentary lifestyle e. Low calcium intake
c. Cigarette smoking d. Sedentary lifestyle e. Low calcium intake
____ 32. A patient recovering from surgery for a ruptured appendix yesterday has an order for morphine 4 mg q 6 hours prn. Every 5 hours and 55 minutes, the patient puts on the call light and asks for the morphine. A staff member comments that the patient is drug-seeking. Which action by the nurse is most appropriate first? a. Administer the morphine every 4 hours instead of every 6 hours. b. Explain to the staff member that labeling the patient as drug seeking is inappropriate. c. Consult with the RN or physician about ordering a higher or more frequent dose of morphine. d. Explain to the patient that weaning off the morphine as soon as possible is essential to reduce the risk of addiction.
c. Consult with the RN or physician about ordering a higher or more frequent dose of morphine.
____ 10. The nurse is collecting data for a patient who is reporting pain in the left knee. What question should the nurse ask to address radiation of the pain? a. Is the pain intense? b. Is the pain burning? c. Does the pain move? d. How would you describe the pain?
c. Does the pain move?
____ 12. The nurse is caring for a patient who has a newly casted, fractured wrist. Data collection reveals slightly puffy fingers with good capillary refill. What should the nurse do now to prevent complications? a. Notify the RN. b. Apply heat to the cast. c. Elevate the cast on pillows. d. Remove the pillow under the cast.
c. Elevate the cast on pillows.
____ 20. The nurse observes a petechial rash and respiratory distress in a patient recovering from a fractured femur. What should these findings suggest to the nurse? a. Infection b. Pneumonia c. Fat embolism d. Pleural effusion
c. Fat embolism
____ 11. A patient with a 36-hour-old fractured femur is in traction and is prescribed morphine 10 mg every 3 hours as needed. The patient received a dose 3 hours ago and is now reporting a pain level of 8. The patient is stable. Which action should the nurse take? a. Hold medication. b. Notify the registered nurse (RN). c. Give pain medication as ordered. d. Give pain medication in 30 minutes.
c. Give pain medication as ordered.
____ 40. A patient receiving opioid medication for cancer pain is experiencing increasing pain when being repositioned and changing bed linen. What should the nurse consider is occurring with this patient? a. Tolerance b. Addiction c. Hyperalgesia d. Breakthrough pain
c. Hyperalgesia
____ 22. A patient with a neurological illness has lost the function of opposing muscle antagonists. What should the nurse expect to assess in this patient? a. Steady cursive handwriting b. Perfect diction when talking c. Inability to maintain balance d. Intact gag and corneal reflexes
c. Inability to maintain balance
____ 29. The nurse is reviewing data collected during the health history for a patient with osteoporosis. What should the nurse identify as a risk factor for osteoporosis development? a. Daily use of antacid b. Walking 1 mile daily c. Increased caffeine intake d. Increased dairy food intake
c. Increased caffeine intake
____ 37. A patient requesting pain medication asks that the medication be provided in the form of an injection because it works better. The patient is prescribed oral pain medication. What should the nurse respond to this patient? a. Injected medications last longer than oral medications. b. Injected medications work better than oral medications. c. Injected medications are painful and dont absorb consistently from the muscle. d. Ill contact your physician to get an order for the medication to be given as an injection.
c. Injected medications are painful and dont absorb consistently from the muscle.
____ 15. The nurse enters a room just as a patients daughter pushes the button of his intravenous (IV) patient-controlled analgesia (PCA) pump. Which response by the nurse is appropriate? a. Thanks for helping out your dad. Is he too weak to push the button? b. If you need to push the button for your dad, first be sure his respiratory rate is higher than 10. c. It is dangerous for anyone but your dad to push the button. Remind him to push it himself if he needs it. d. It is against hospital policy for anyone but the patient to push the button. If I see you pushing it again, I will have to call the supervisor.
c. It is dangerous for anyone but your dad to push the button. Remind him to push it himself if he needs it.
____ 15. The nurse is reinforcing teaching provided to a patient with gout. Which food should the patient state will be avoided that indicates teaching has been effective? a. Rice b. Beets c. Liver d. Bananas
c. Liver
____ 34. A patient receiving morphine sulfate 5 mg IV every 4 hours around the clock and acetaminophen PO every 4 hours reports intense itching. Assuming all are ordered, which prn medication should the nurse administer? a. Ibuprofen (Motrin) b. Fentanyl (Duragesic) c. Nalbuphine (Nubain) d. Methadone (Dolophine)
c. Nalbuphine (Nubain)
____ 5. A patient recovering from a bone biopsy of the left leg has pain unrelieved by morphine 5 mg intramuscularly given 1.5 hours ago. The morphine is prescribed for every 3 hours. What should the nurse do? a. Elevate the extremity. b. Repeat morphine now. c. Notify the charge nurse. d. Administer morphine in 30 minutes.
c. Notify the charge nurse.
____ 8. A 91-year-old nursing home resident has been receiving meperidine (Demerol) injections for right shoulder pain. During the morning assessment, the nurse finds the resident irritable and jumpy. Which nursing actions and rationales is appropriate? a. Administer a dose of Demerol because the patient is exhibiting signs of withdrawal. b. Administer a dose of Demerol because these are symptoms of pain in an older adult patient. c. Notify the registered nurse (RN) or physician that the resident may be experiencing toxic effects of Demerol. d. Assess the patients pain level before determining the appropriate dose of Demerol to administer.
c. Notify the registered nurse (RN) or physician that the resident may be experiencing toxic effects of Demerol.
____ 36. A patient of Asian American descent recovering from abdominal surgery refuses all pain medication. What can the nurse do to ensure for this patients comfort? a. Provide a cup of tea. b. Offer to pray with the patient. c. Offer pain medication to promote healing. d. Document that pain medication is refused.
c. Offer pain medication to promote healing.
____ 18. A patient who has just returned from abdominal surgery states, I learned relaxation exercises, so I wont need any drugs. Which statement about relaxation therapy should the nurse use to guide care for this patient? a. Relaxation therapy works much the same as a placebo. b. Relaxation therapy is not useful for postoperative patients or for severe pain. c. Relaxation therapy is an excellent adjunct treatment for pain when used with analgesics. d. Effective use of relaxation therapy can eliminate the need for analgesics postoperatively.
c. Relaxation therapy is an excellent adjunct treatment for pain when used with analgesics.
____ 17. The nurse is contributing to the plan of care for a patient who has a fractured hip and is placed in Bucks (boot) traction while awaiting surgery. What is the desired outcome for placing the patient in Bucks traction? a. Restrain patient. b. Realign fracture. c. Relieve patient pain. d. Maintain fracture reduction.
c. Relieve patient pain.
____ 19. A patient is experiencing sacroiliac joint pain after falling. Which structure within the vertebral column should the nurse suspect is injured in this patient? a. Axis b. Atlas c. Sacrum d. Coccyx
c. Sacrum
____ 23. The nurse is reinforcing teaching on positioning for a patient after a right total knee replacement. Which patient statement indicates a correct understanding of the teaching? a. Prone. b. Side lying. c. Supine with pillow under right knee. d. Supine with three pillows between legs.
c. Supine with pillow under right knee.
____ 16. The nurse is determining the effective of pain medication provided to a patient. What is the best way for the nurse to measure effectiveness of pain medication? a. The patient goes to sleep. b. The patient stops groaning. c. The patient states the pain is relieved. d. The patients vital signs return to normal.
c. The patient states the pain is relieved.
____ 19. The nurse is contributing to the plan of care for a patient who has an upper extremity amputation. Why should the nurse keep in mind that this type of amputation can be more debilitating than a lower extremity amputation when planning care? a. The upper extremity is more visible. b. Prosthetic fitting is easier for the leg. c. The upper extremity is more specialized. d. There is greater blood supply to the upper extremity.
c. The upper extremity is more specialized.
____ 12. The nurse is caring for a patient scheduled for an arthrography. What should the nurse explain to the patient about pain expectations during the procedure? a. There is no pain during the procedure. b. There is pain while the x-ray is taken. c. There is temporary pain during dye injection. d. The procedure will be uncomfortable until it is completed.
c. There is temporary pain during dye injection.
____ 28. A patient is experiencing neuropathic pain. What class of medications should the nurse expect to be prescribed for this patient? a. Opioids b. Beta blockers c. Tricyclic antidepressants d. NSAIDs
c. Tricyclic antidepressants
____ 24. The nurse is reinforcing teaching provided to a patient for carpal tunnel syndrome treatment. Which patient statement indicates a correct understanding of the teaching? a. Bedrest. b. Arm sling. c. Wrist splint. d. Hand exercises.
c. Wrist splint.
____ 21. The nurse is assessing capillary refill time for a patient with a fractured tibia and fibula. Which refill time should the nurse report to the physician? a. 2 seconds b. 3 seconds c. 5 seconds d. 7 seconds
d. 7 seconds
____ 17. The nurse is reinforcing teaching provided to a patient scheduled for an arthrocentesis. Which patient statement indicates understanding of the planned procedure? a. They will use a small camera to look inside the joint. b. They will inject dye that shows up on a special camera. c. Ill be in a closed tube while they take pictures of my arm. d. A needle will be used to draw off some fluid from my elbow.
d. A needle will be used to draw off some fluid from my elbow.
____ 3. A nursing assistant, observing the licensed practical nurse (LPN) prepare medication for a patient asks why so much morphine is being provided since patients have quit breathing after receiving such a high dose. The patient has been receiving the same dose of medication for several days without respiratory compromise. Which response by the LPN is best? a. I am a licensed professional and am able to decide what a safe dose is for my patient. b. You are correct; several days of this high a dose could be cumulative and cause problems. c. As long as I monitor the patient closely after giving the dose, breathing will not be affected. d. As long as the dose is increased gradually, patients develop tolerance to the side effects of morphine.
d. As long as the dose is increased gradually, patients develop tolerance to the side effects of morphine.
____ 25. A patient with a fractured pelvis and a left acetabular fracture is prescribed bedrest. When the patient asks to toilet, which measure would be appropriate? a. Help patient up on a commode very carefully. b. Turn patient onto right side, place the bedpan behind, and turn back. c. Have patient sit up as high as possible and lift self up with hands pushing on the bed, then slide the bedpan underneath. d. Ask patient to lift straight up using a trapeze mounted above the bed and slide a bedpan underneath from the right side.
d. Ask patient to lift straight up using a trapeze mounted above the bed and slide a bedpan underneath from the right side.
____ 39. A patient with a gastrostomy tube is prescribed a sustained-released opioid medication. What should the nurse do when preparing to provide this medication to the patient? a. Provide the medication orally for the patient to swallow b. Crush the medication and administer it through the tube c. Dissolve the medication in water and administer it through the tube d. Ask the physician to prescribe the medication as an elixir for tube administration
d. Ask the physician to prescribe the medication as an elixir for tube administration
____ 33. A patient is experiencing phantom limb pain. For which type of pain should the nurse plan care for this patient? a. Acute pain b. Cancer pain c. Intermittent pain d. Chronic nonmalignant pain
d. Chronic nonmalignant pain
____ 32. The nurse is contributing to the plan of care for a patient who has a bone fracture that is splintered and has shattered into numerous fragments. Which term should the nurse use to document this type of fracture? a. Impacted b. Avulsion c. Greenstick d. Comminuted
d. Comminuted
____ 35. A patient taking hydromorphone for cancer pain is experiencing constipation. What should the nurse teach to help this patient? a. Take a mild laxative. b. How to self-administer a Fleet enema. c. Slowly decrease the dose of hydromorphone. d. Eat a high-fiber diet and increase fluid intake.
d. Eat a high-fiber diet and increase fluid intake.
____ 6. The nurse is caring for a patient with a suspected bone tumor. Which serum laboratory result indicates to the nurse that this health problem is present? a. Decreased calcium b. Increased magnesium c. Increased creatine kinase d. Elevated alkaline phosphatase
d. Elevated alkaline phosphatase
____ 24. The daughter of an older female patient with osteoporosis asks what she can do to prevent the development of the disorder as she ages. What should the nurse suggest to the daughter? a. Keep body weight low. b. Increase oral intake of calcium. c. Engage in water aerobic activities. d. Engage in weight-bearing exercises.
d. Engage in weight-bearing exercises.
____ 3. The nurse is monitoring a patient with a casted left tibial fracture and a contusion of the thigh. The patient reports increasing pain in the left foot that has not been relieved by morphine injections. What should the nurse do? a. Reposition the casted leg. b. Repeat the morphine injection now. c. Give a higher ordered dose of morphine. d. Ensure physician is immediately notified.
d. Ensure physician is immediately notified.
____ 9. The nurse sees a neighbor fall and fracture a leg. What should the nurse do first for the neighbor? a. Assess pain. b. Transport to an emergency department. c. Cover site of open fracture with clean dressing. d. Immobilize the affected limb using minimal movement.
d. Immobilize the affected limb using minimal movement.
____ 24. A patient is given a prescription for oxycodone acetaminophen (Vicodin), two tablets to be taken every 4 to 6 hours as needed for pain. What should the nurse include when teaching about this medication? a. You shouldnt take this more than every 4 hours, because oxycodone will cause respiratory depression. b. Be careful not to take this more than every 4 hours, because Vicodin always relieves pain for at least 4 hours. c. Oxycodone and acetaminophen interact to form a dangerous metabolite if they are taken less than 4 hours apart. d. It is important to not to take this more often than prescribed, because acetaminophen can cause dangerous side effects if taken more frequently.
d. It is important to not to take this more often than prescribed, because acetaminophen can cause dangerous side effects if taken more frequently.
____ 35. A patient is diagnosed with osteomyelitis of the right lower leg. What should the nurse expect to be prescribed for this patients care? a. Anticoagulant therapy b. Casting of the extremity c. Fasciotomy of the wound d. Long-term antibiotic therapy
d. Long-term antibiotic therapy
____ 16. The nurse is contributing to the plan of care for a patient with Pagets disease. Which outcome should the nurse identify as being appropriate for this patient? a. Gain 5 lb weekly. b. Intake equals output. c. Identify coping skills. d. Pain is relieved at a satisfactory level.
d. Pain is relieved at a satisfactory level.
____ 19. A patient describes abdominal pain as my belly feels as if a watermelon is stuck in it. What is the best way for the nurse to document this information? a. Patient feels bloated. b. Patients abdomen is distended. c. Patient has acute pain related to distended abdomen. d. Patient states his belly feels as if a watermelon is stuck in it.
d. Patient states his belly feels as if a watermelon is stuck in it.
____ 5. The nurse is caring for a patient who had a closed reduction of the ulna with a cast applied. Later the patient reports left arm pain. What should the nurse do first? a. Pad the edges of the cast. b. Notify the physician immediately. c. Administer an analgesic as ordered. d. Perform neurovascular check on fingers.
d. Perform neurovascular check on fingers.
____ 14. The nurse is evaluating teaching provided to a patient with gout. Which patient menu selection indicates that additional teaching is required? a. Pike b. Bass c. Perch d. Sardines
d. Sardines
____ 20. A patient is suspected as having a fractured skull. When explaining this pathology to the patient, how should the nurse describe the joints between the cranial bones? a. Pivot b. Saddle c. Gliding d. Sutures
d. Sutures
____ 13. A physician writes an order to give a saline injection to a patient who has been requesting frequent meperidine (Demerol) shots. Which initial response by the LPN is best? a. Tell the patient that the physician has ordered a placebo. b. Administer the saline and carefully document the patients response. c. Tell the patient that a pain shot is being administered, without revealing exactly what it is. d. Tell the physician of feeling uncomfortable administering saline if the patient thinks it is Demerol.
d. Tell the physician of feeling uncomfortable administering saline if the patient thinks it is Demerol.
____ 18. The nurse is caring for a patient who is to have a needle biopsy of a tumor in the right calf. Which patient statement indicates correct understanding of the teaching? a. I will need a few stitches. b. I will need a spinal anesthetic. c. The biopsy is usually taken with fluoroscopy. d. The biopsy will be used to determine if this is a cancerous tumor.
d. The biopsy will be used to determine if this is a cancerous tumor.
____ 33. The nurse reinforces teaching on prevention of osteomyelitis with a patient who has an open fracture of the right leg. Which patient statement indicates that teaching has been effective? a. Apply ice to right leg. b. Keep leg immobilized. c. Increase calcium intake in diet. d. Wash hands prior to touching fracture area.
d. Wash hands prior to touching fracture area.
____ 9. The nurse is collecting data for a patient who is reporting pain in the right hip. Which question should the nurse ask to determine the severity of the pain? a. Is the pain burning? b. Is the pain throbbing? c. Does the pain radiate or move around? d. What number rating would you give your pain on a scale from 0 to 10?
d. What number rating would you give your pain on a scale from 0 to 10?
____ 2. The nurse answers a patients call for pain medication, only to find the patient laughing and joking with visitors. Which response by the nurse is appropriate? a. You dont need this pain medication after all, do you? b. Ill bring your medication back later after your visitors are gone. c. I can see your pain is better. Call again when you need your medication. d. Would you like your visitors to step out while I give you your pain medication?
d. Would you like your visitors to step out while I give you your pain medication?
