NUR 356 Exam 1 Flashcards
In passing the physician for your patient in the hospital hall, he smiles and mentions he will be ordering an x-ray. You enter the patient’s room to find her crying. She states “Dr. X was so abrupt and rude. I have never been treated so badly. I want to talk to a supervisor”. As the nurse, your best initial response it?
- A. “What level of supervisor do you want to talk to?”
- B. “Dr. X is always rude to everyone. Don’t take it personally.”
- C. “What do you want to talk to the supervisor about? Perhaps I can help.”
- D. “You seem upset.”
D. “You seem upset”.
As a nurse, which of the following is your first priority of providing care?
A. Patient needs a dressing change.
B. Patient needs suctioning.
C. Patient is in pain
D. Patient is incontinent
B. Patient needs suctioning
This is Airway Maintenance. Use the ABCs first then move to safety and physical needs, emotional usually comes last.
A patient is scheduled for surgery. When getting ready to obtain the informed consent, the patient tells the nurse,” I have no idea what is going to happen. I couldn’t ask any questions”. The nurse does not allow the patient to sign the permit and notifies the health care provider of the situation. Which role is the nurse displaying?
A. Manager
B. Patient educator
C. Patient advocate
D. Clinical nurse specialist
C. Patient advocate
Which findings will alert the nurse that stress is present when making a clinical decision? (select all that apply.)
A. Tense muscles B. Reactive responses C. Trouble concentrating D. Very tired feelings E. Managed emotions
A. Tense muscles
B. Reactive responses
C. Trouble concentrating
D. Very tired feelings
An example of nursing activity that best reflects the American Nurses Association’s definition of nursing is
A. Treating dysrhythmias that occur in a patient in the coronary care unit.
B. Diagnosing a patient with a feeding tube as being at risk for aspiration.
C. Setting up protocols for treating patients in the emergency department.
D. Offering anti-anxiety drugs to a patient with a disturbed sleep pattern.
B. Diagnosing a patient with a feeding tub as being at risk for aspiration.
A nurse working on the medical-surgical unit at an urban hospital would like to become certified in medical-surgical nursing. The nurse knows that this process would most likely require
A. a bachelor’s degree in nursing
B. formal education in advanced nursing practice
C. experience for a specific period in medical-surgical nursing
D. membership in a medical-surgical nursing specialty organization
C. experience for a specific period in medical-surgical nursing
The nurse is assigned to care for a newly admitted patient. Number in order the steps for using the nursing process to prioritize care. (Number 1 is first step, and number 5 is the last step).
\_\_Evaluate whether the plan was effective. \_\_\_ Identify any health problems. \_\_\_ Collect patient information. \_\_\_ Carry out the plan. \_\_\_ Decide a plan of action.
1) Collect patient information
2) Identify any health problems
3) Decide a plan of action
4) Carry out the plan
5) Evaluate whether the plan was effective
Using the SBAR format, number in the order the steps for how the nurse would communicate information with the provider. (Number 1 is the first step, and number 4 is the last step.)
____ “I would like you to order an IV medication and come evaluate the patient as soon as possible.”
____ “This is Nurse M.H. I am calling from the unit because your patient, D.R., has a new onset of atrial fibrillation.”
____ “The atrial fibrillation started about 10 minutes ago. The heart rate is 124; BP 90/60. The patient is experiencing dizziness.”
____ “D.R., who is 2 days postoperative for a bowel resection for diverticulitis, has a history of mitral valve disease.”
1) “This is Nurse M.H. I am calling from the unit because your patient, D.R., has a new onset of atrial fibrillation.”
2) “D.R., who is 2 days postoperative for a bowel resection for diverticulitis, has a history of mitral valve disease.”
3) “The atrial fibrillation started about 10 minutes ago. The heart rate is 124; BP 90/60. The patient is experiencing dizziness.”
4) “I would like you to order an IV medication and come evaluate the patient as soon as possible.”
The nurse is caring for a diabetic patient in the ambulatory surgical unit who has undergone wound debridement. Which task is appropriate for the nurse to delegate to unlicensed assistive personnel (UAP)?
a. Check the patient’s vital signs.
b. Assess the patient’s pain level.
c. Palpate the patient’s pedal pulses.
d. Monitor the patient’s IV catheter site.
a. Check the patient’s vital signs.
The nurse’s role in addressing the National Patient Safety Goals established by The Joint Commission includes (select all that apply)
a. answering all patient monitoring alarms promptly.
b. memorizing all the rules published by The Joint Commission.
c. obtaining a correct list of the patient’s medications on admission.
d. encouraging patients to be actively involved in their own health care.
e. using side rails and alarm systems as necessary to prevent patient falls.
a. answering all patient monitoring alarms promptly.
c. obtaining a correct list of the patient’s medications on admission.
e. using side rails and alarm systems as necessary to prevent patient falls.
Advantages of using informatics in health care delivery are (select all that apply)
a. reduced need for nurses in acute care.
b. increased patient anonymity and confidentiality.
c. the ability to achieve and maintain high standards of care.
d. access to standard plans of care for many health problems.
e. improved communication of the patient’s health status to the health care team.
c. the ability to achieve and maintain high standards of care.
d. access to standard plans of care for many health problems.
e. improved communication of the patient’s health status to the health care team.
When using evidence-based practice, the nurse
a. must use clinical practice guidelines developed by national health agencies.
b. should use findings from randomized controlled trials to plan care for all patient problems.
c. uses clinical decision making and judgment to decide what evidence is appropriate for a specific clinical situation.
d. analyzes the relationship of nursing interventions to patient outcomes to discover evidence for patient interventions.
c. uses clinical decision making and judgment to decide what evidence is appropriate for a specific clinical situation.
Determination of whether an event is a stressor is based on a person’s
a. tolerance.
b. perception.
c. adaptation.
d. stubbornness.
b. perception
The nurse would expect which finding in a patient because of the physiologic effect of stress on the reticular formation?
a. An episode of diarrhea while awaiting painful dressing changes
b. Refusal to communicate with nurses while awaiting a cardiac catheterization
c. Inability to sleep the night before beginning to self-administer insulin injections
d. Increased blood pressure, decreased urine output, and hyperglycemia after a car accident
c. Inability to sleep the right before beginning to self-administer insulin injections.
Reticular formation - trouble sleeping
The nurse uses knowledge of the effects of stress on the immune system by encouraging patients to
a. sleep for 10 to 12 hours per day.
b. avoid exposure to upper respiratory tract infections.
c. receive regular immunizations when they are stressed.
d. use emotion-focused rather than problem-focused coping strategies.
b. avoid exposure to upper respiratory tract infections
The nurse recognizes that a person who has chronic stress could be at higher risk for (select all that apply)
a. osteoporosis.
b. fibromyalgia.
c. colds and flu.
d. high blood pressure.
e. high serum cholesterol.
b. fibromyalgia
c. colds and flu
d. high blood pressure
The nurse recognizes that a patient with newly diagnosed breast cancer is using an emotion-focused coping process when she
a. joins a support group for women with breast cancer.
b. considers the pros and cons of the various treatment options.
c. delays treatment until her family can take a weekend trip together.
d. tells the nurse that she has a good prognosis because the tumor is small.
a. joins a support group for women with breast cancer.
During a stressful circumstance that is unchangeable, which type of coping strategy is the most effective?
a. Avoidance
b. Coping flexibility
c. Emotion-focused coping
d. Problem-focused coping
c. Emotion-focused coping
A nurse is caring for a young adult at a college health clinic. Which of the following actions should the nurse take first?
A. Give the client information about immunization against meningitis
B. Tell the client to have a TB skin test every 2 years
C. Determine the client’s health risks
D. Teach the client about exercise recommendations
C. Determine the client’s health risks
A nurse in a clinic is planning health promotion and disease prevention strategies for a client who has multiple risk factors for cardiovascular disease. Which of the following interventions should the nurse include? (Select all that apply).
A. Help the client see the benefits of their actions
B. Identify the client’s support systems
C. Suggest and recommend community resources
D. Devise and set goals for the client
E. Teach stress management strategies
A. Help the client see the benefits of their actions
B. Identify the client’s support systems
C. Suggest and recommend community resources
E. Teach stress management strategies
A nurse in a health clinic is caring for a 21 year old client who tells the nurse that their last physical exam was in high school. Which of the following health screenings should the nurse expect the provider to perform for this client?
A. Testicular examination
B. Blood glucose
C. Fecal occult blood
D. Prostate specific antigen
A. Testicular examination
A nurse at a health department is planning strategies related to heart disease. Which of the following activities should the nurse include as part of primary prevention?
A. Providing cholesterol screening
B. Teaching about a healthy diet
C. Providing information about antihypertensive medications
D. Developing a list of cardiac rehabilitation programs.
B. Teaching about a healthy diet
A nurse at a provider’s office is talking about routine screenings with a 45 year old female client who has no specific family history of cancer or diabetes mellitus. Which of the following client statements indicates that the client understands how to proceed?
A. “So I don’t need the colon cancer procedure for another 2 to 3 years.”
B. “For now, I should continue to have a mammogram each year.”
C. “Because the doctor just did a Pap smear, I’ll come back next year for another one.”
D. “I had my blood glucose test last year, so I won’t need it again for 4 years.”
B. “For now, I should continue to have a mammogram each year.”
A nurse is caring for a client awaiting transport to the surgical suite for a coronary artery bypass graft. Just as the transport team arrives, the nurse takes the client’s vital signs and notes an elevation in blood pressure and heart rate. The nurse should recognize this response as part of the general adaptation syndrome (GAS).
A. Exhaustion stage
B. Resistance stage
C. Alarm stage
D. Recovery stage
C. Alarm stage
A nurse is caring for a client who has left sided hemiplegia resulting from a cerebrovascular accident. The client works as a carpenter and is not experiencing a situational role change based on physical limitations. The client is the primary wage earner in the family. Which of the following describes the client’s role problem?
A. Role Conflict
B. Role overload
C. Role ambiguity
D. Role strain
A. Role Conflict
A nurse is caring for a client who has a new diagnosis of type 2 diabetes mellitus. Which of the following nursing interventions for stress, coping, and adherence to the treatment plan should the nurse initiate at this time (select all that apply).
A. Suggest coping skills for the client to use in this situation.
B. Allow the client to provide input in the treatment plan.
C. Assist the client with time management, and address the client’s priorities.
D. Provide extensive instructions on the client’s treatment regimen.
E. Encourage the client in the expression of feeling and concerns.
B. Allow the client to provide input in the treatment plan.
C. Assist the client with time management, and address the client’s priorities.
E. Encourage the client in the expression of feelings and concerns.
A nurse is caring for a family who is experiencing a crisis. Which of the following approaches should the nurse use when working with a family using an open structure for coping with crisis?
A. Prescribing tasks unilaterally
B. Delegating care to one member
C. Speaking to the primary client privately
D. Convening a family meeting
D. Convening a family meeting
A nurse is assessing a parent who lost a 12-year old child in a car crash 2 years ago. Which of the following findings indicates the client is exhibiting manifestations of prolonged grieving?
A. Leaves the child’s room exactly as it was before the loss
B. Volunteers at a local children’s hospital
C. Talks about the child in the past tense
D. Visits the child’s grave every week after worship service.
A. Leaves the child’s room exactly as it was before the loss
A nurse is caring for a 48-year-old client who is grieving following the death of her husband seven months ago. The client reports that she has lost 30 lb, and is having difficulty sleeping. Which of the following factors indicate the client is experiencing maladaptive grieving?
A. The client is 48 years old
B. The client’s husband died seven months ago
C. The client has lost 30 lb.
D. The client is having difficulty sleeping
B. The client’s husband died seven months ago
The nurse is caring for a group of clients on a mental health unit. Which of the following should the nurse recognize as a maladaptive defense mechanism?
A. A client slams a drawer after misplacing her wallet.
B. A man buys his partner a gift after flirting with his secretary.
C. A client forgets to schedule needed appointments when fearing chemotherapy.
D. A client ignores the thought of pain when scheduled for oral surgery
C. A client forgets to schedule needed appointments when fearing chemotherapy.
A nurse is caring for a 4-year old child who has a new diagnosis of diabetes mellitus and is distressed after an insulin injection. Which of the following play activities should the nurse recognize is therapeutic in helping the child deal with the injection?
A. A needless syringe and a doll
B. A video game
C. A story about a child who has diabetes.
D. A period of play in the playroom
A. A needless syringe and a doll
A nurse at a college campus mental health counseling center is caring for a student who just failed an examination. The student spends the session berating the teacher and the course. The nurse should recognize this behavior as which of the following defense mechanism?
A. Conversion
B. Projection
C. Undoing
D. Regression
B. Projection
A nurse is caring for a client who was involved in heavy combat and observed war casualties. The nurse should suspect that the client is suffering from PTSD if the client makes which of the following statement?
A. “I check any room I enter because the enemy is still after me and could be hiding anywhere”
B. “My child was born with a birth defect due to an exposure I had overseas”
C. “I killed four enemy soldiers with my bare hands and save my entire battalion”
D. “In my dreams, all I can see are the wounded reaching out and trying to grab me”
D. “In my dreams, all I can see are the wounded reaching out and trying to grab me”
A nurse is assessing a client who is experiencing chronic stress. Which of the following findings should the nurse expect?
A. Hypotension
B. Viral infection
C. Increased energy
D. Increased cognitive awareness
B. Viral infection
A nurse is admitting a client who has experienced a weight loss of 11kg (25b) in the past 3 months. The client weighs 40kg (88lb) and believes she is fat. Which of the following aspects of care should the nurse consider the first priority for this client?
A. Identify the client’s nutritional status
B. Request a mental health consult
C. Plan therapeutic diet for the client
D. Provide a structured environment for the client
A. Identify the client’s nutritional status
A nurse in a mental health clinic is discussing guided imagery with a newly licensed nurse. Which of the following clients should the nurse suggest offering the therapy to?
A. Post-traumatic stress disorder
B. Schizophrenia
C. Pedophilia
D. Paranoid personality disorder
A. Post-traumatic stress disorder
The patient health history and physical examination provide the nurse with information primarily to
a. diagnose a medical problem.
b. investigate a patient’s signs and symptoms.
c. classify subjective and objective patient data.
d. identify nursing diagnoses and collaborative problems.
d. identify nursing diagnoses and collaborative problems.
The nurse would place information about the patient’s concern that his illness is threatening his job security in which functional health pattern?
a. Role-relationship
b. Cognitive-perceptual
c. Coping–stress tolerance
d. Health perception–health management
a. Role-relationship
