final questions

Question 1

The client newly diagnosed with Parkinson disease is being discharged. Which instruction is best for the
nurse to provide to the client’s spouse?

Answer 1

Administer medications promptly on schedule to maintain therapeutic drug levels.

Question 2

The client has Parkinson disease (PD). Which nursing intervention best protects the client from injury?

Answer 2

Monitoring the client’s sleep patterns

Question 3

The client with dementia and Alzheimer’s disease is discharged to home. The client’s daughter says, “He wanders so much, I am afraid he’ll slip away from me.” What resource does the nurse suggest?

Answer 3

Safe Return Program

Question 4

The client with a migraine is lying in a darkened room with a wet cloth on the head after receiving analgesic drugs. What will the nurse do next?

Answer 4

Allow the client to remain undisturbed.

Question 5

Which is the most effective way for the college student to minimize the risk for bacterial meningitis?

Answer 5

Getting the meningitis polysaccharide vaccine

Question 6

The home health nurse is checking in on the client with dementia and the client’s spouse. The spouse confides to the nurse, “I am so tired and worn out.” What is the nurse’s best response?

Answer 6

“Make sure you take some time off and take care of yourself too.”

Question 7

The nurse is administering the intake assessment for a newly admitted client with a history of seizures. The client suddenly begins to seize. What does the nurse do next?

Answer 7

Positions the client on the side

Question 8

The client is admitted with bacterial meningitis. Which nursing intervention is the highest priority for this client?

Answer 8

Assessing neurologic status at least every 2 to 4 hours

Question 9

The spouse of the client with Alzheimer’s disease (AD) is listening to the hospice nurse explaining the client’s drug regimen. Which statement by the spouse indicates an understanding of the nurse’s instruction?

Answer 9

“Donepezil (Aricept) will treat the symptoms of Alzheimer’s disease.”

Question 10

The nursing instructor asks the student nurse caring for a client with Alzheimer’s disease who has been prescribed donepezil (Aricept) how the drug works. Which response by the nursing student best explains the action of donepezil?

Answer 10

“It delays the destruction of acetylcholine by acetylcholinesterase.”

Question 11

The nurse has received report on a group of clients. Which client requires the nurse’s attention first?

Answer 11

Young adult who has experienced four tonic-clonic seizures within the past 30 minutes Correct Correct:

Question 12

Which change in the cerebrospinal fluid (CSF) indicates to the nurse that the client may have bacterial meningitis?

Answer 12

Cloudy, turbid CSF

Question 13

The nurse is teaching the client newly diagnosed with migraine about trigger control. Which statement made by the client demonstrates good understanding of the teaching plan?

Answer 13

“I must not miss meals.”

Question 14

The client with Parkinson disease is being discharged home with his wife. To ensure compliance with the management plan, which discharge action is most effective?

Answer 14

Involving the client and his wife in developing a plan of care

Question 15

The nurse is caring for the client with advanced Alzheimer’s disease. Which communication technique is best to use with this client?

Answer 15

Assuming that the client is not totally confused

Question 16

The client with myasthenia gravis (MG) is receiving cholinesterase inhibitor drugs to improve muscle strength. The nurse is educating the family about this therapy. Which statement by a family member indicates correct understanding of the nurse’s instruction?

Answer 16

“I should call 911 if a sudden increase in weakness occurs.”

Question 17

The nurse encourages the ventilated client with advanced Guillain-Barré syndrome (GBS) to communicate by which simple technique?

Answer 17

Blinking for “yes” or “no”

Question 18

The client arrives to the emergency department with new-onset ptosis, diplopia, and dysphagia. The nurse anticipates that the client will be tested for which neurologic disease?

Answer 18

Myasthenia gravis (MG)

Question 19

Which statement by the nursing student illustrates the commonality between Guillain-Barré syndrome (GBS) and myasthenia gravis (MG)?

Answer 19

The client’s respiratory status and muscle function are affected by both diseases. Correct

Question 20

The client with advanced Guillain-Barré syndrome (GBS) is no longer able to perform ADLs independently. Which priority problem best identifies measures to prevent pressure ulcers?

Answer 20

Impaired Physical Mobility related to weakness, paralysis, and ataxia

Question 21

A client with myasthenia gravis is admitted with generalized fatigue, a weak voice, and dysphagia. Which client problem has the highest priority?

Answer 21

Potential for aspiration related to difficulty with swallowing

Question 22

The nurse admits a client with suspected myasthenia gravis (MG). The nurse anticipates that the physician will request which medication to aid in the diagnosis of MG?

Answer 22

Edrophonium chloride (Tensilon)

Question 23

Which statement by the client with cirrhosis indicates that further instruction is needed about the disease?

Answer 23

“My liver is scarred, but the cells can regenerate themselves and repair the damage.”

Question 24

Which problem for the client with cirrhosis takes priority?

Answer 24

Potential for injury related to hemorrhage

Question 25

The nurse administers lactulose (Cephulac) to the client with cirrhosis for which purpose?

Answer 25

Promotes gastrointestinal excretion of ammonia

Question 26

How does the home care nurse best modify the home environment to manage side effects of lactulose?

Answer 26

Requests a bedside commode for the client

Question 27

Which activity by the nurse will best relieve symptoms associated with ascites?

Answer 27

Elevating the head of the bed

Question 28

It is essential that the nurse should monitor the client returning from hepatic artery embolization for hepatic cancer for which of these?

Answer 28

Bleeding

Question 29

What teaching does the home care nurse give the client and family to prevent spread of hepatitis C?

Answer 29

Prohibit members of the household from sharing toothbrushes.

Question 30

The health care worker believes that he may have been exposed to hepatitis A. Which intervention is the highest priority to prevent him from developing the disease?

Answer 30

Requesting injection of immunoglobulin

Question 31

The nurse receives report on a client with hydronephrosis. Which laboratory study should the nurse monitor?

Answer 31

Blood urea nitrogen and creatinine

Question 32

The client with chronic kidney disease presents with bradycardia, prolonged PR interval, and diminished bowel sounds. For which of these should the nurse monitor?

Answer 32

Hyperkalemia

Question 33

When caring for the client with acute kidney injury and a temporary subclavian hemodialysis catheter, which of these should the nurse report to the provider?

Answer 33

Temperature 100.8

Question 34

The nurse recognizes that the client with end-stage kidney disease has difficulty adhering to the fluid restriction when which of these is found?

Answer 34

Dyspnea and anxiety at rest

Question 35

When caring for a client who receives peritoneal dialysis (PD), which of these findings must the nurse report to the provider immediately?

Answer 35

Temperature of 101.2

Question 36

When caring for the client hoping to receive a kidney transplant, the nurse recognizes that which of these problems will exclude the client from transplantation?

Answer 36

Client with tuberculosis

Question 37

Discharge teaching has been provided for the client recovering from kidney transplantation. Which information indicates that the client understands the instructions?

Answer 37

The anti-rejection medications will be taken for life.”

Question 38

Which finding in the first 24 hours after kidney transplantation requires immediate intervention?

Answer 38

Abrupt decrease in urine output

Question 39

The client with a recently created vascular access for hemodialysis is being discharged. In planning discharge instructions, which information does the nurse include?

Answer 39

Avoiding venipuncture and blood pressure measurements in the affected arm