2020 final

Question 1

A patient diagnosed with peptic ulcer disease reports asudden onset of sharp abdominal pain and presents with a tense, rigid abdomen.

Answer 1

manifestations of a perforated ulcer? (Hint: What would the priority nursing action be?)

Question 2

Patient teaching for a patient who is complaining of pain in the should blade status post laparoscopic cholecystectomy

Answer 2

drink a carbonated beverage and ambulate in the hall at least twice per day

Question 3

Nursing interventions to reduce discomfort for a patient with acute pancreatitis.

Answer 3

administer IVfluids(maintainhydration)and remainNPO (bowelrest)

Question 4

This is a similarity in the disease process of ulcerative colitis and Crohn’s disease.

Answer 4

an inflammatory process of the gastrointestinal tract?

Question 5

Patient teaching for a patient with an infected knee replacement who states he does not need antibiotics for the pain

Answer 5

teach the patient that treating the infection(aka the antibiotic)will reduce the swelling and will subsequently relieve the pain

Question 6

A patient who is being treated for sepsis could progress to multiple system(organ) failure. The nurse knows that this is how the patient’s vital signs will be affected.

Answer 6

low blood pressure (compensation) tachycardia, tachypnea, and low urinary output

Question 7

This is a priority action when determining a treatment plan for a patient who might have sepsis.

Answer 7

obtain cultures

Question 8

The nurse knows that this has occurred when a child with an earache and severe pain no longer has any pain.

Answer 8

rupture of the tympanic membrane

Question 9

Patient teaching for a patient who has been newly diagnosed with hepatitis B should include this.

Answer 9

limit activity (provide rest periods)until symptoms of hepatitis have subsided, avoid medications(acetaminophen)that are metabolized by the liver, and consume a diet with moderate amounts of protein(metabolized in the liver)

Question 10

Priority actions by the nurse who is admitting a patient suspected of having TB

Answer 10

place the patient in a negative pressure room and obtain an N95respirator

Question 11

Reasons why a patient with a spinal cord injury would benefit from physical rehabilitation

Answer 11

preventing further disability, maintaining current functional ability, restoring function, and learning a new technique

Question 12

A paraplegic patient who has reddened areas.

Answer 12

at risk for skin breakdown [Hint: what would the priority
nursing action(s) be?]

Question 13

The cornerstone of treatment for Parkinson’s disease

Answer 13

levodopa/carbidopa

Question 14

Manifestations of Parkinson’s

disease.

Answer 14

oily skin orthostatic hypotension, bradykinesia(difficulty moving), and uncontrolled drooling

Question 15

Manifestations of early osteoarthritis

Answer 15

pain with activity and pain relief with rest

Question 16

Primary prevention related to visual impairments

Answer 16

education on preventing visual impairments such as a class on healthy lifestyles

Question 17

How a patient may describe peripheral neuropathy

Answer 17

pain, numbness tingling, burning, or a loss of feeling in the extremities

Question 18

A priority action when providing teaching to a patient with a hearing deficit.

Answer 18

assess if the patient uses an assistive device(hearing aides

Question 19

Priority actions when assessing the home of a patient with decreased vision

Answer 19

remove rugs/cords in walkways, assess for the need to install safety devices, and do not rearrange the furniture

Question 20

Teaching the nurse should provide to a patient who is taking an antibiotic and complains of an altered sense of taste.

Answer 20

explain that many medications cause a change in the sense of taste but that it is temporary and will resolve when no longer taking the antibiotic? (Note: Finish taking the antibiotic!

Question 21

This occurs when a patient with dementia makes up stories when they can not remember the actual events

Answer 21

confabulates/confabulation

Question 22

Teaching the nurse should provide to the family/caregiver of an older adult who has a new diagnosis of dementia.

Answer 22

characterized by gradual onset, progressive disorder, and not curable

Question 23

Differences inmanifestations of delirium versus dementia.

Answer 23

sudden onset, caused by an outside etiology (e.g.medication, infection), and can be corrected if the cause is identified (reversible)

Question 24

A hallmark sign of dementia.

Answer 24

short-term memory loss

Question 25

Interventions appropriate for a patient in the mild stages of dementia.

Answer 25

providing emotional support, providing gentle reminders, and ensuring safety (injury prevention)

Question 26

A patient states they are afraid to leave the house. The nurse uses this interpersonal therapeutic communication technique

Answer 26

clarification? The nurse may clarify the patient's statement by asking about specific fears or examples of what scares the patient.

Question 27

Interviewing a patient in a psychiatric unit is a patient-centered activity. This an appropriate way for the nurse to begin the interview

Answer 27

ask the patient what they would like to talk about today

Question 28

The nurse is using the SBARcommunicationtool. The nurse-correctly identifies the S step as this.

Answer 28

What is the situation? (Note: You should be able to identify each step of SBARand be able to select examples of each

Question 29

A nurse is caring for a patient who admits to being noncompliant with the prescribed medication regimen. This is an example of therapeutic communication by the nurse

Answer 29

using reflective comments to describe the patient's feelings and repeats what the patient has said? (For example, "You seem worried about your medication regimen.")

Question 30

The nurse is using this technique when she focuses on the problems and gathers more information from the patient.

Answer 30

focusing

Question 31

A patient who is overwhelmed with discharge instructions is rude when the nurse comes into the room. This is the best response by the nurse.

Answer 31

assess for more information

Question 32

A patient with a degenerative condition talks to the nurse about wanting to live independently. The best action by the nurse is this.

Answer 32

discuss resources, provide appropriate referrals, and work with the interdisciplinary team to help the patient achieve her goals safely

Question 33

These people should be involved when creating a treatment plan.

Answer 33

the patient, the provider, the nurse, the discharge planner/social worker, etc.

Question 34

Benefits of coordinating care.

Answer 34

continuum of care (services/agencies working together), cost-effectiveness, and better patient outcome

Question 35

These may occur when care coordination is not provided.

Answer 35

disconnected/fragmented care, wasted funds, and poor patient outcomes

Question 36

This occurs when a nurse provides the patient with the information necessary for making healthcare decisions.

Answer 36

being an advocate

Question 37

According to the Institute of Medicine, professional nurses do these things

Answer 37

teach, advocate, assess, and nurture

Question 38

Effective nursing leadership skills for a director of nursing.

Answer 38

have a plan, explain the plan, and get support from the staff nurses

Question 39

An essential quality for a nurse leader.

Answer 39

flexibility

Question 40

Nurses improve public health through this.

Answer 40

their scope of practice, specialized knowledge, and code of ethics? (Hint:GiddensConcept 39)

Question 41

A type of research where one group receives treatment and the other group does not.

Answer 41

What is experimental?(Hint:GiddensConcept 49)

Question 42

This is why nurses implement evidence-based practice.

Answer 42

What is to improve patient outcomes/quality of care?

Question 43

This type of research describes a phenomenon, experience, or perception.

Answer 43

qualitative research

Question 44

This type of research collects information (data) using numbers.

Answer 44

quantitative

Question 45

Nursing theory and the theorist who described how students learn from the beginning of nursing school to practicing as a nurse.

Answer 45

Novice to expert theory by Patricia Benner

Question 46

An unexpected occurrence involving death or serious physical or psychologic injury and that signals the need for immediate investigation and response.

Answer 46

sentinel event

Question 47

A medication error is this type of error.

Answer 47

What is a treatment error?

Question 48

A term coined by the Institute for SafeMedicationPractices to describe this practice which helps-differentiate look-alike-medication names (e.g.BenaDRYLandBenaZEPRIL

Answer 48

Tallman lettering

Question 49

These are aspects of nursing that contribute to a culture of safety.

Answer 49

leadership, teamwork, evidence-based, communication, learning, a just culture, and patient-centered care?

Question 50

In promoting a culture of safety, the nurse manager may do this.

Answer 50

fluctuate workloads or staff for census/acuity

Question 51

This is a comprehensive approach to clinical judgment that includes noticing, interpreting, responding, and reflecting.

Answer 51

model of clinical judgment

Question 52

A patient tells his nurse that he is not taking the medication the doctor prescribed because he could not afford it. These are the steps the nurse should follow to help the patient get optimal treatment.

Answer 52

notify the prescriber, explain why the patient isn't following the orders, and offer a less expensive alternative medication?

Question 53

A patient is admitted fora surgical procedure and complicated recovery. The nurse will start teaching and discharge planning at this time.

Answer 53

admission

Question 54

The nurse manager overhears a new nurse asking an experienced nurse to call a doctor for her because she doesn't think she can answer the doctor's questions. The nurse manager gives each nurse some advice

Answer 54

advising the experienced nurse to mentor the new nurse and advising the new nurse to reflect/learn/grow from the experience

Question 55

Describe processes used in care planning.

Answer 55

the nursing process, clinical judgment, and collaboration

Question 56

The nurse notices a NativeAmerican patient guarding their surgical site. This is the nurse's best action.

Answer 56

assess (e.g.ask the patient about pain, check vital signs)

Question 57

The nurse is providing teaching to aPhillipinopatient with a new diagnosis. The patient keeps smiling when asked if she has any questions. This is the nurse's best action

Answer 57

open-ended questions

Question 58

The nurse is counseling a middle-aged patient about preventative treatments and testing. The patient states he does not see a reason to test anything if he feels fine. This is the nurse's best action related to planning care.

Answer 58

develop short-term goals

Question 59

This is an important reason that there is an emphasis on cultural competence in healthcare.

Answer 59

increasing global diversity, global economy, or worldwide travel?

Question 60

These are components of cultural competence.

Answer 60

cultural desire, self-awareness, knowledge, and skill?(Giddens p.32-33)

Question 61

These are examples of HCO3, PaCO2, and pH for a patient with metabolic acidosis.

Answer 61

will vary. HCO3 normal, PaCO2 increased, and pH decreased.

Question 62

These are symptoms for a patient with metabolic alkalosis

Answer 62

bicarbonate excess, circumoral paresthesia, prolonged vomiting

Question 63

The assessment of a patient who has a history ofCHFincludescrackles, difficulty breathing, and edema in both ankles. The nurse anticipates an order for this.

Answer 63

furosemide

Question 64

A patient with this fluid and electrolyte imbalance may exhibit hypoactive bowel sounds, cardiac dysrhythmias, and muscle weakness.

Answer 64

low potassium or hypokalemia

Question 65

A patient with fluid volume deficit may exhibit these symptoms.

Answer 65

orthostatic hypotension, confusion, and low urine output

Question 66

A patient is being seen for flu-like symptoms including excessive vomiting. The patient may be at risk for this acid-base imbalance.

Answer 66

metabolic alkalosis?

Question 67

A patient's lab results show | PH low, PaCO2 high, HCO3-high. The patient's diagnosis could be this.

Answer 67

pneumonia, hypoventilation, or COPD

Question 68

Tingling in extremities, circumoral numbness, muscle cramps, and confusion are indicative of this acid-base imbalance

Answer 68

respiratory alkalosis

Question 69

ABG values are as follows pH7.36, PaO298 mm Hg,PaCO2 33mm Hg, andHCO3- 18mEq/L (18mmol/L). This is indicative of this acid-base imbalance.

Answer 69

metabolic acidosis

Question 70

A patient's ABG values areas follows pH 7.32, PaO2 94mm Hg,PaCO2 34mm Hg,and HCO3-18 mEq/L(18mmol/L). The nurse would assess for these symptoms.

Answer 70

reduced deep tendon reflexes, drowsiness, and increased respiratory rate? (metabolic acidosis)

Question 71

The nurse may teach a post-operative patient this technique to expand their lungs.

Answer 71

cough and deep breath or turn, cough, and deep breath

Question 72

A patient reports symptoms of malaise, upset stomach, and a runny nose. This would be the nurse's best action.

Answer 72

further assessment

Question 73

The nurse is assessing a patient with a 50-year history of smoking 2 packs per day. The patient is complaining of hoarseness that won't go away. The nurse suspects the patient might have this.

Answer 73

laryngeal cancer

Question 74

Describe the characteristics of squamous cell carcinoma, basal cell carcinoma,and malignant melanoma.

Answer 74

A squamous cell tumor appears as a rough, thickened ulcerated tumor that can bleed. - A basal cell tumor usually begins as a small, waxy nodule with rolled, translucent, pearl borders. - Malignant melanoma is often varied in color, ranging from shades of red to white to blue. It

Question 75

These are ominous changes after a head injury.

Answer 75

widening pulse pressure, bradycardia, and respiratory changes (Cushing'striad)

Question 76

These are the components of GCS

Answer 76

eye-opening, motor responsiveness, and verbal responsiveness

Question 77

The first action by the nurse who sees a patient having a seizure this.

Answer 77

maintain the patient's safety

Question 78

Patient teaching for the spouse of a patient with a TBI should include these.

Answer 78

signs and symptoms to report (fever, difficulty breathing) , potential changes in personality, and memory loss

Question 79

Describe a patient who scores a 3 in each section of the GCS.

Answer 79

Eye open to speech. Inappropriate words, Decorticate (abnormal flexion score ) score 9

Question 80

The nurse should include this information in preop teaching related to fundoplication

Answer 80

the patient will have dietary changes after the procedure (e.g small, frequent meals)

Question 81

The patient with cholelithiasis should avoid these foods.

Answer 81

foods high in fat and cholesterol (e.g dairy, fried foods

Question 82

This should be the nurse's first response when a patient with a tube feeding begins vomiting

Answer 82

stop/hold the tube feeding

Question 83

The nurse should assess these in the patient who is on TPN.

Answer 83

electrolytes and glucose

Question 84

Habits to promote good nutrition in the elderly include these

Answer 84

allow uninterrupted time for eating, assess for mouth/tooth pain, assess for sores in the mouth make sure dentures fit appropriately, make sure the patient can see and reach the food, and serve high-calorie/high-protein foods? (You should know3-4.)

Question 85

This is an indicator of a positive outcome for a patient with a DVT.

Answer 85

clear lung sounds or SpO2 >90%?

Question 86

The priority of care for a patient with internal bleeding is this.

Answer 86

stop the bleeding or perfusion

Question 87

Risk factors for impaired cognition include these

Answer 87

advancing age, hypoxia,medication-related, dementia, Alzheimer's Parkinson's

Question 88

The nurse would provide this in the teaching to a patient with a new implantable cardioverter-defibrillator.

Answer 88

What are carry an I.D. (e.g.airports), avoid tight clothing, avoid strenuous activities, and avoid strong electromagnetic fields (e.g.MRI)?

Question 89

The proper treatment for a patient's inv-tach is this.

Answer 89

What is elective cardioversion when the patient is awake and responsive

Question 90

The goal for medications to treat autoimmune responses is this.

Answer 90

What is control the symptoms

Question 91

Symptoms of acute rejection of a renal transplant include these.

Answer 91

What are signs of kidney failure (e.g.decreasedurinary output, weight gain, increased blood pressure, and other signs of fluid overload)

Question 92

Chronic steroid use in a patient with an autoimmune disorder may lead to this.

Answer 92

osteonecrosis

Question 93

These are initial symptoms that may be experienced with HIV infection.

Answer 93

flu-like symptoms and night sweats

Question 94

The nurse is assessing a patient for an anaphylactic reaction. What should the nurse assess first?

Answer 94

breathing/airway