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Exam Three Quiz Questions Flashcards

1
Q
  1. A nurse provides teaching for a patient with a newly diagnosed partial complex seizure disorder who is about to begin therapy with antiepileptic drugs (AEDs). Which statement by the patient indicates understanding of the teaching?
    A. “Even with an accurate diagnosis of my seizures, it may be difficult to find an effective drug.”
    B. “I will soon know that the drugs are effective by being seizure free for several months.”
    C. “Serious side effects may occur, and if they do, I should stop taking the medication.”
    D. “When drug levels are maintained at therapeutic levels, I can expect to be seizure free.”
A

A. “Even with an accurate diagnosis of my seizures, it may be difficult to find an effective drug.”

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2
Q
  1. A nurse is caring for a patient with a history of epilepsy who suddenly begins to experience a tonic-clonic seizure and loses consciousness. Which is the nurse’s priority action?
    A. Restraining the patient’s extremities
    B. Turning the patient’s head to the side
    C. Taking the patient’s blood pressure
    D. Placing an airway into the patient’s mouth
A

Turning the pts head to the side

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3
Q
  1. Which medication will the nurse prepare to administer to the patient who is experiencing status epilepticus?
    A. Atropine by intravenous push
    B. Lorazepam (Ativan) by intravenous push
    C. Propranolol (Inderal) orally
    D. Phenytoin (Dilantin) orally
A

B. Lorazepam (Ativan) by intravenous push

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4
Q
  1. When a patient is experiencing seizure activity, the most appropriate time to clear the airway is:
    A. Any time during the seizure.
    B. Throughout the ictal period.
    C. During the most intense period of the seizure.
    D. After the tonic-clonic movements stop.
A

After the tonic-clonic movements stop

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5
Q
  1. The patient with Parkinson disease is being discharged home with his wife. To promote compliance to the management plan, which discharge action is most effective?
    A. Involving the patient and his wife in developing a plan of care
    B. Setting up visitations by a home health nurse
    C. Telling his wife what the patient needs
    D. Writing up a detailed plan of care according to standards
A

A. Involving the patient and his wife in developing a plan of care

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6
Q
  1. The patient newly diagnosed with Parkinson disease is being discharged. Which instruction for the patient’s spouse is best for the nurse to provide?
    A. Administer medications promptly on schedule to maintain therapeutic drug levels.
    B. Complete activities of daily living for the patient.
    C. Speak loudly for better understanding.
    D. Provide large, high-calorie meals to maintain the patient’s weight.
A

A. Administer medications promptly on schedule to maintain therapeutic drug levels.

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7
Q
  1. The nurse visits a patient who is being treated with phenytoin (Dilantin) for seizures. Which instruction is most important to prevent precipitation of seizures in this patient?
    A. Notify the health care provider about unusual hair growth.
    B. Practice good dental hygiene to control gingival hyperplasia.
    C. Do not stop the drug abruptly without consulting the health care provider.
    D. Maintain a healthy lifestyle with regular exercise and nutritious diet.
A

C. Do not stop the drug abruptly without consulting the health care provider.

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8
Q
  1. Which intervention is most appropriate when communicating with a patient suffering from receptive and expressive aphasia following a stroke?
    A. Present several thoughts at once so that the patient can connect the ideas.
    B. Ask open-ended questions to provide the patient the opportunity to speak.
    C. Finish the patient’s sentences to minimize frustration associated with slow speech.
    D. Use simple, short sentences accompanied by visual cues to enhance comprehension
A

D. Use simple, short sentences accompanied by visual cues to enhance comprehension

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9
Q
  1. A patient presents to the emergency department reporting a sudden onset of headache described as “the worse headache ever.” The patient also reports nausea and visual disturbances. What collaborative intervention is a priority for the nurse?
    A. Prepare patient for transport to computed tomography (CT) scan.
    B. Obtain consent for lumbar puncture.
    C. Administer morphine sulfate 4 mg intravenous push (IVP).
    D. Administer Ondanestron (Zofran) 4 mg intravenous push (IVP) for nausea.
A

A. Prepare patient for transport to computed tomography (CT) scan.

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10
Q
  1. A patient aged 20, who developed seizures after a head injury, tells the nurse he or she feels like he or she has lost control over his or her life since the seizures. Initially, what is the most appropriate response by the nurse?
    A. “With medications and your health care provider’s assistance, I am sure you will be able to achieve your life goals.”
    B. “Tell me about what you would like to do and how the seizures affect you.”
    C. “New treatments come out every year, so don’t give up.”
    D. “You are young and can still heal from the injury. It has only been a few months.”
A

B. “Tell me about what you would like to do and how the seizures affect you.”

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11
Q

Which of the following is primary prevention for hearing loss? Select all that apply.

Audiometric screenings

Keeping the TV volume at 50% or less of the maximum volume

Wearing ear protection while firing a gun

Teach patients on ototoxic medications to report tinnitus

A

Keeping the TV volume at 50% or less of the maximum volume

Wearing ear protection while firing a gun

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12
Q

Which strategies should be used when communicating with someone who is hard of hearing? Select all that apply.

Overenunciate all words

Play soft music in the background

Maintain eye contact

Provide adequate lighting

A

Maintain eye contact

Provide adequate lighting

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13
Q

People with Parkinson’s Disease lack which neurotransmitter?

Dopamine

Acetylcholine

Lewy bodies

Epinephrine

A

Dopamine

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14
Q

The most important modifiable RF for stroke is:

A

HTN

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15
Q

Glare and abnormal color perception

A

Cataract

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16
Q

Peripheral vision loss

A

Primary open-angle glaucoma

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17
Q

Central vision loss

A

Age-related macular degeneration

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18
Q

Sudden, severe eye pain with N/V

A

Acute angle-closure glaucoma

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19
Q

When ICP increases, cerebral blood flow

A

decreases

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20
Q

Change or loss of consciousness; the individual may appear awake but cannot interact with others.

A

Complex focal (partial)

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21
Q

Remains conscious and experiences an unusual feeling or sensation.

A

Simple focal

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22
Q

Loss of consciousness, stiffening of the body, then jerking of the extremities.

A

Tonic-clonic

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23
Q

Staring spell with eye blinking or jerking lip movement

A

Atypical absence

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24
Q

True or False: The terms “seizure” and “epilepsy” have the same meaning and can be used interchangeably.

A

False

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25
Q

Airway inflammation associated with asthma leads to which of the following? Select all that apply.

Airway hyperresponsiveness

Bradypnea (respiratory rate less than 12 breaths/minute)

Edema of the airways

Bronchoconstriction

A

Airway hyperresponsiveness

Edema of the airways

Bronchoconstriction

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26
Q

The patient diagnosed with pulmonary tuberculosis transmits this disease through:

skin contact.

fecal-oral contact.

airborne droplets.

blood transfusions.

A

airborne droplets

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27
Q

Potential triggers for asthma include which of the following? Select all that apply.

Exercise

Aspirin

Cigarette smoke

Upper respiratory infections

Allergies

A

Exercise

Aspirin

Cigarette smoke

Upper respiratory infections

Allergies

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28
Q

A person that experiences aspiration of their oral secretions has an increased risk of developing:

emphysema

pneumothorax

pneumonia

bronchiectasis

A

pneumonia

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29
Q

Pneumonia can be caused by which of the following?

A

Fungi
Parasites
Bacteria
Viruses

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30
Q

The major risk factor for developing chronic obstructive pulmonary disease (COPD) is

diabetes mellitus

influenza

air pollution

smoking

A

smoking

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31
Q

True or False: The airflow limitation associated with asthma is reversible.

A

True

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32
Q

TB is caused by a

A

bacterium

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33
Q

True or False: Smoking cessation helps to improve symptoms associated with chronic obstructive pulmonary disease (COPD).

A

True

34
Q

The alveoli often fill with fluid and debris when an individual has bacterial pneumonia. This is known as:

consolidation.

airway obstruction.

pleural effusion.

pleurisy.

A

consolidation

35
Q

Which action decreases the risk for skin breakdown in a patient with a new tracheostomy?

Providing preoxygenation with a bag-valve-mask device connected to oxygen prior to tracheal suctioning

Cleaning the skin around the stoma with normal saline and pat dry

Cleaning the stoma with hydrogen peroxide and drying thoroughly

Assessing temperature and reporting skin breakdown immediately

A

Cleaning the skin around the stoma with normal saline and pat dry

36
Q

The nurse has just auscultated rhonchi bilaterally on a patient with a tracheostomy tube. The patient is unable to cough up any secretions. What is the best action for the nurse to take?

Encourage the patient to use the incentive spirometer every hour while awake.

Provide preoxygenation, then suction the tracheostomy using sterile technique.

Attach the Passy-Muir speaking valve to the tracheostomy tube.

Encourage the patient to increase oral fluid intake.

A

Provide preoxygenation, then suction the tracheostomy using sterile technique.

37
Q

The nurse is caring for a patient with a cuffed tracheostomy tube. The cuff inflation pressure should be checked every shift to decrease the risk of:

pneumonia.

accidental tracheostomy tube dislodgement.

hypoxemia.

tracheal necrosis.

A

tracheal necrosis

38
Q

When suctioning a tracheostomy tube, suction should be applied for a maximum of:

A

10 to 15 seconds

39
Q

What is the best way for the nurse to prevent infection when providing care to a hospitalized patient with a tracheostomy?

Instruct the nursing assistant to report any changes in the color or odor of the tracheal drainage

Assess for signs of local or systemic infection every shift

Utilize sterile technique when appropriate

Auscultate breath sounds every 4 hours and as needed

A

Utilize sterile technique when appropriate

40
Q

The main indication(s) for a cuffed tracheostomy tube include:

risk of aspiration

mechanical ventilation

BOTH

A

BOTH

41
Q

In a patient with a long-term tracheostomy, how often should the entire tracheostomy tube be changed?

Every two weeks

Weekly

Monthly

Every other month

A

Monthly

42
Q

Which item(s) should be at the bedside of a patient with a tracheostomy in the event that the tube is accidentally dislodged? Select all that apply

Bag-valve-mask device (ambu-bag)

Spare tracheostomy tube

Hydrogen peroxide

Obturator

A

Bag-valve-mask device (ambu-bag)

Spare tracheostomy tube

Obturator

43
Q

A pt with COPD has a nursing dx of imbalanced nutrition: less than body requirements. Which intervention would be most appropriate for the nurse to include in the plan of care?

A

Offer high-calorie protein snacks between meals and at bedtime

44
Q

Which info will the nurse include in the asthma teaching plan for a pt being discharged?

A

Tremors are an expected side effect of rapidly acting bronchodilators

45
Q

The home health nurse is visiting a pt with COPD. Which nursing action is appropriate to implement for a nursing dx of impaired breathing pattern RT anxiety?

A

Teach the pt how to use pursed-lip breathing

46
Q

The nurse receives a change-of-shift report on the following pts with COPD. Which pt should the nurse assess first?

A

The pt with a respiratory of 38 breaths/min

47
Q

Which finding by the nurse for a pt with a nursing dx of impaired as exchange will be most useful in evaluating the effectiveness of tx?

A

Pulse ox of 92%

48
Q
  1. A patient recently diagnosed with asthma receives prescriptions for an inhaled corticosteroid and a short-acting inhaled beta2-adrenergic agonist. Which statement by the patient indicates understanding of this medication regimen?
    A. “I should use the glucocorticoid as needed when symptoms flare.”
    B. “I will need to use the beta2-adrenergic agonist drug daily.”
    C. “The beta2-adrenergic agonist suppresses the synthesis of inflammatory mediators.”
    D. “The glucocorticoid is used as prophylaxis to prevent exacerbations.”
A

D. “The glucocorticoid is used as prophylaxis to prevent exacerbations.”

49
Q
  1. The nurse teaches a patient how to administer fluticasone (Flovent HFA) by metered dose inhaler (MDI). Which statement by the patient to the nurse indicates understanding about the instructions?
    A. “My breathing will improve slowly over the next 2 to 3 days.”
    B. “A spacer is used with this inhaler to prevent mouth dryness.”
    C. “I should use this inhaler immediately if I have trouble breathing.”
    D. “It is important to remember to rinse my mouth after using this inhaler.”
A

D. “It is important to remember to rinse my mouth after using this inhaler.”

50
Q
  1. The nurse notes that a patient with chronic obstructive pulmonary disease develops dyspnea with a change in respiratory rate from 26 breaths/minute to 44 breaths/minute. Which action by the nurse would be the most appropriate?

A. Have the patient perform huff coughing

B. Teach the patient to use pursed lip breathing

C. Instruct the patient in using the acapella device

D. Perform chest physiotherapy for 5 minutes

A

B. Teach the patient to use pursed lip breathing

51
Q
  1. A patient with asthma is admitted to an emergency department with a respiratory rate of 22 breaths per minute, a prolonged expiratory phase, tight wheezes, and an oxygen saturation of 90% on room air. The patient reports using fluticasone (Flovent HFA) 110 mcg twice daily and has used 2 puffs of albuterol (Proventil HFA), 90 mcg/puff, every 4 hours for 2 days. The nurse will expect to administer which drugs?
    A. Four puffs of albuterol, oxygen, and intravenous theophylline
    B. Intramuscular corticosteroids and salmeterol (serevent) by metered-dose inhaler
    C. Intravenous corticosteroids, nebulized albuterol and ipratropium (atrovent), and oxygen
    D. Intravenous theophylline, oxygen, and fluticasone (Flovent HFA) 220 mcg
A

C. Intravenous corticosteroids, nebulized albuterol and ipratropium (atrovent), and oxygen

52
Q
  1. Which patient is at highest risk of aspiration?
    A. A 26-year-old patient with continuous enteral tube feedings through a nasogastric tube
    B. A 67-year-old patient who had a cerebrovascular accident with expressive dysphasia
    C. A 58-year-old patient with absent bowel sounds immediately after abdominal surgery
    D. A 92-year-old patient with viral pneumonia and coarse crackles throughout lung fields
A

A. A 26-year-old patient with continuous enteral tube feedings through a nasogastric tube

53
Q

Which type of urinary tract infection would be most likely to cause fever, chills, and flank pain?

Cystitis

Lower urinary tract infection

Pyelonephritis

Urethritis

A

Pyelonephritis

54
Q

Diverticula most commonly develop in which part of the gastrointestinal tract?

Cecum and ascending colon

Transverse colon

Ileum

Sigmoid and descending colon

A

Sigmoid and descending colon

55
Q

What is the most common pathogen causing a urinary tract infection?

Proteus mirabilis

Enterococcus faecalis

Escherichia coli

Klebsiella pneumoniae

A

E. coli

56
Q

Urinary incontinence

Spinal cord lesion above S2

A

Reflux

57
Q

Urinary incontinence

Bladder or urethral outlet obstruction

A

Overflow

58
Q

Urinary incontinence

Cog impairment/balance and mobility problems in older adults

A

Functional

59
Q

Urinary incontinence

Weakened pelvic floor muscles

A

Stress

60
Q

Urinary incontinence

An overactive detrusor (bladder) muscle

A

Urge

61
Q

What is the main risk factor that is thought to contribute to the development of diverticulosis?

Physical inactivity

Obesity

Cigarette smoking

Low-fiber diet

A

Low-fiber diet

62
Q

Causes of constipation include which of the following? Select all that apply

Low fiber intake

Immobility

Chronic opioid use

Avoiding the urge to defecate

A

Low fiber intake

Immobility

Chronic opioid use

Avoiding the urge to defecate

63
Q

Which is true of gout?

It results in chronic inflammation of lower extremity joints

It involves urate crystal formation within the articular tissues

It produces inflammation of muscle fibers, resulting in tissue necrosis

It is associated with bursal sac inflammation and calcium deposits

A

It involves urate crystal formation within the articular tissues

64
Q

Which statement regarding a pathologic fracture is true?

It is the result of a bending or crushing force applied to a bone.

It occurs in normal bone that is subject to repeated stress, such as jogging.

It often results when bone is weakened by disease, such as osteoporosis.

It occurs when a bone is broken and pierces the skin.

A

It often results when bone is weakened by disease, such as osteoporosis

65
Q

True or False: Most amputations in older adults are related to traumatic injuries.

A

False

66
Q

An unorganized network of bone composed of cartilage, osteoblasts, calcium, and phosphorus.

A

Callus Formation

67
Q

The space between bone fragments decreases and closes.

A

Consolidation

68
Q

Bleeding surrounds the ends of bone fragments

A

Fracture hematoma

69
Q

The basis of new bone substance (osteoid)

A

Granulation tissue

70
Q

Prevents movement at fracture site with gentle stress but fracture remains evident on x-ray.

A

Ossification

71
Q

Excess bone is resorbed and union is complete

A

Remodeling

72
Q
  1. The second day after admission with a fractured pelvis, a patient suddenly develops confusion. Which action should the nurse take first?

a. Take the blood pressure.
b. Assess patient orientation.
c. Check the oxygen saturation.
d. Observe for facial asymmetry.

A

Check O2 sat

73
Q
  1. A patient is admitted to the emergency department with a left femur fracture. Which information obtained by the nurse is most important to report to the health care provider?

a. Ecchymosis of the left thigh
b. Complaints of severe thigh pain
c. Prolonged capillary refill of the left foot
d. Outward pointing toes on the left foot

A

Prolonged cap refill of the left foot

74
Q
  1. Which action will the nurse take in order to evaluate the effectiveness of Buck’s traction for a patient who has an intracapsular fracture of the right femur?

a. Assess for hip pain.
b. Assess for contractures.
c. Check peripheral pulses.
d. Monitor for hip dislocation.

A

Assess for hip pain

75
Q
  1. Which statement by a patient who has had an above-the-knee amputation indicates the nurse’s discharge teaching has been effective?

a. “I should elevate my residual limb on a pillow 2 or 3 times a day.”
b. “I should lie flat on my abdomen for 30 minutes 3 or 4 times a day.”
c. “I should rinse the residual limb with hot water once a day .”
d. “I should use lotion on the residual limb to prevent skin drying and cracking.”

A

b. “I should lie flat on my abdomen for 30 minutes 3 or 4 times a day.”

76
Q
  1. A pedestrian who was hit by a car is admitted to the emergency department with possible right lower leg fractures. The initial action by the nurse should be to

a. elevate the right leg.
b. splint the lower leg.
c. assess the pedal pulses.
d. verify tetanus immunization.

A

Assess pedal pulses

77
Q
  1. The day after a 60-yr-old patient has open reduction and internal fixation (ORIF) for an open, displaced tibial fracture, the nurse identifies the priority nursing diagnosis as

a. activity intolerance related to deconditioning.
b. risk for constipation related to prolonged bed rest.
c. risk for impaired skin integrity related to immobility.
d. risk for infection related to disruption of skin integrity.

A

Risk for infection RT disruption of skin integrity

78
Q
  1. A patient who had arthroscopic surgery of the right knee 7 days ago is admitted with a red, swollen, hot knee. Which assessment finding by the nurse should be reported to the health care provider immediately?

a. The blood pressure is 86/50 mm Hg.
b. The patient says the knee pain is severe.
c. The white blood cell count is 11,500/μL.
d. The patient is taking ibuprofen (Motrin).

A

BP is 86/50

79
Q
  1. The nurse assesses a 78-yr-old who uses naproxen (Aleve) daily for hand and knee osteoarthritis management. Which information requires a discussion with the health care provider about an urgent change in the treatment plan?

a. Knee crepitation is noted with normal knee range of motion.
b. Patient reports embarrassment about having Heberden’s nodes.
c. Patient’s knee pain while golfing has increased over the last year.
d. Laboratory results indicate that the serum creatinine is elevated.

A

Laboratory results indicate that the serum creatinine is elevated.

80
Q
  1. When the nurse brings medications to a patient with rheumatoid arthritis, the patient refuses the prescribed methotrexate. The patient tells the nurse, “My arthritis isn’t that bad yet. The side effects of methotrexate are worse than the arthritis.” The most appropriate response by the nurse is

a. “You have the right to refuse to take the methotrexate.”
b. “Methotrexate is less expensive than some of the newer drugs.”
c. “It is important to start methotrexate early to decrease the extent of joint damage.”
d. “Methotrexate is effective and has fewer side effects than some of the other drugs.”

A

“It is important to start methotrexate early to decrease the extent of joint damage.”

81
Q
  1. The nurse suggests that a patient recently diagnosed with rheumatoid arthritis (RA) plan to start each day with

a. a brief routine of isometric exercises.
b. a warm shower followed by a short rest.
c. active range-of-motion (ROM) exercises.
d. stretching exercises to relieve joint stiffness.

A

A warm shower followed by a short rest

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