State Exam Practice #1 Flashcards
The initial diagnosis of pancreatitis would be confirmed if bills blood test showed a significant elevation in serum
a) Amylase
b) Glucose
c) Potassium
d) Trypsin
a) Amylase
You monitor bills vital sings frequently, observing for the signs of shock. Shock is extremely difficult to manage in pancreatitis primarily because of the
a) Frequency and severity of gastrointestinal haemorrhage
b) Vasodilating effects of kinin peptides
c) Tendency towards congestive heart failure
d) Frequent incidence of acute tubular necrosis
a) Frequency and severity of gastrointestinal haemorrhage
While helping bill change position in bed, you note bill has muscle twitching in his bands and forearms. These symptoms are significant because clients who suffer from pancreatitis are at risk of
a) Hypermagnisemia
b) Hypoglycaemia
c) Hypocalcaemia
d) Hyponatremia
c) Hypocalcaemia
Lydia asks the nurse, ‘how could this have happened?” the nurse responds to the question based on the most frequent mode of HIV transmission, which is
a) Hugging an HIV positive sexual partner without using barrier precautions
b) Inhaling cocaine or other recreational drugs
c) Sharing a drink bottle with an HIV positive person
d) Sexual intercourse with an HIV positive person without using a condom
d) Sexual intercourse with an HIV positive person without using a condom
Lydia acquires herpes genitalis and is counselled by the nurse concerning follow up care. Women who have this disease are at risk of developing
a) Sterility
b) Cervical cancer
c) Uterine fibroid rumours
d) Irregular menses
b) Cervical cancer
Which of the following nursing diagnosis categories would most likely be a priority for a client with herpes genitalis
a) Alteration in sleep; sleep pattern disturbance
b) Nutritional deficit
c) Alteration in comfort pain
d) Alteration in breathing patterns
c) Alteration in comfort pain
The primary reason that a herpes simplex infection is a serious concern to a client with HIV infection is that herpes simplex
a) Is an acquired immunodeficiency virus (AIDS) defining illness
b) Is curable only after 1 year of antiviral therapy
c) Can lead to cervical cancer
d) Causes severe electrolyte imbalances
c) Can lead to cervical cancer
In providing education to Lydia, the nurse should take into account the fact that the most effective method known to control the spread to HIV infection is
a) Premarital serologic screening
b) Prophylactic treatment of exposed people
c) Laboratory screening of pregnant women
d) Ongoing sex education about preventive behaviours
d) Ongoing sex education about preventive behaviours
Lydia becomes depressed about her diagnosis and tells the nurse “I have nothing worth living for now.” Which of the following statements would be the best response by the nurse
a) There is much to live for; you may not develop AIDS for years
b) You should not be too depressed; we are searching to find a cure for AIDS
c) You are right; it is very depressing to have HIV
d) Tell me more about how you are feeling at being HIV positive
d) Tell me more about how you are feeling at being HIV positive
James, a 34 year old man attending a sexual health clinic, is diagnosed with syphilis. The organism responsible for causing syphilis is classified as a
a) Virus
b) Fungus
c) Rickettsia
d) Spirochete
d) Spirochete
The typical chancre of syphilis appears as
a) A grouping of small, tender pimples
b) An elevated wart
c) A painless moist ulcer
d) An itching, crusted area
c) A painless moist ulcer
Probenecid is prescribed in conjunction with penicillin as treatment for syphilis because probenecid helps
a) Delay detoxification of penicillin
b) Inhibit excretion of penicillin
c) Maintain sensitivity of organisms to penicillin
d) Decrease the likelihood of an allergic reaction to penicillin
b) Inhibit excretion of penicillin
A priority nursing diagnosis for a james would likely be
a) High risk for infection transmission related to lack of knowledge about mode of spread
b) Pain related to cutaneous skin lesions on palms and soles
c) Altered skin tissue perfusion related to a bleeding chancre
d) Image disturbance related to alopecia
a) High risk for infection transmission related to lack of knowledge about mode of spread
An 18 year old female college student is seen at the university health centre. She undergoes a pelvic examination and is diagnosed with gonorrhoea.
Which of the following responses by the nurse would be best when the client says that she is nervous about the upcoming pelvic examination
a) can you tell me more about how you’re feeling
b) you’re not alone. Most women feel uncomfortable about this examination
c) do not worry about Dr smith. He’s a specialist in female problems
d) we’ll do everything we can to avoid embarrassing you
b) you’re not alone. Most women feel uncomfortable about this examination
The client informs the nurse that she has had sexual intercourse with her boyfriend and asks the nurse ‘would he have any symptoms?’ the nurse responds that in males, symptoms of gonorrhoea include
a) impotence
b) scrotal swelling
c) urine retention
d) dysuria
d) dysuria
A 24 year old female client, who is on her honeymoon, comes to an ambulatory care clinic in moderate distress with a probable diagnosis of acute cystitis
Which of the following symptoms would the nurse expect the client to report during the assessment
a) fever and chills
b) frequency and burning on urination
c) suprapubic pain and nausea
d) dark, concentrated urine
b) frequency and burning on urination
The client asks the nurse, ‘how did i get this infection?’ the nurse should explain that in most instances, cystitis is caused by
a) congenital strictures in the urethra
b) an infection elsewhere in the body
c) urine stasis in the urinary bladder
d) an ascending infection from the urethra
d) an ascending infection from the urethra
Winston, a 22 year old man, is brought to the emergency room with an apparent head injury after being involved in a motor vehicle accident. He is unconscious on arrival and exhibits signs of increasing intracranial pressure. His fiancée and his older sister accompany him
On winstons arrival in the emergency room, which of the following considerations should receive the highest priority
a) establishing an airway
b) replacing blood losses
c) stopping bleeding from open wounds
d) determining whether he has a neck fracture
a) establishing an airway
As winstons condition worsens, his rising intracranial pressure would be indicated by
a) rising blood pressure and falling pulse rate
b) rising pulse rate and falling blood pressure
c) rising blood pressure and rising pulse rate
d) falling pulse rate and falling blood pressure
a) rising blood pressure and falling pulse rate
The nurse assesses the client frequently for signs of intracranial pressure, including
a) unequal pupil size
b) decreasing systolic blood pressure
c) tachycardia
d) decreasing body temperature
a) unequal pupil size
Which of the following respiratory signs would indicate increasing intracranial pressure in the brain stem
a) slow, irregular respirations
b) rapid, shallow respirations
c) asymmetric chest expansion
d) nasal flaring
b) rapid, shallow respirations
During the past few months, Elizabeth, a 56 year old woman has felt brief twinges of chest pain while working, in her garden and has had frequent episodes of indigestion. She comes to the hospital after experiencing severe anterior chest pain while raking leaves. Her evaluation confirms a diagnosis of stable angina pectoris
Elizabeth states, ‘i really thought i was having a heart attack. How can you tell the difference?’ which response by the nurse would provide the client with the most accurate information about the difference between the pain of angina and that of myocardial infarction
a) The pain associated with a heart attack is much more severe
b) The pain associated with a heart attack radiates into the jaw and down the left arm
c) It is impossible to differentiate angina pain from that of a heart attack without an ECG
d) The pain of angina is usually relieved by resting or lying down
d) The pain of angina is usually relieved by resting or lying down
As an initial step in treating elizabeths angina, the physician prescribes nitroglycerin tablets, 0.3 mg given sublingual. This drugs principal effects are produced by
a) Antispasmodic effects on the pericardium
b) Stimulation of a- and 13- receptor sites
c) Vasodilation of peripheral vasculature
d) Improved conductivity in the myocardium
c) Vasodilation of peripheral vasculature
Which of the following symptoms should the nurse teach Elizabeth to report immediately to her physician
a) A change in the pattern of her pain
b) Pain during sexual activity
c) Pain during an argument with her husband
d) During or after an activity such as lawn moving
a) A change in the pattern of her pain
After stabilisation and treatment, Elizabeth is discharged from the hospital. At her follow up appointment, she is discouraged because she is experiencing pain with increasing frequency. She states that she visits an invalid friend twice a week and now cannot walk up the second flight of steps to the friends apartment without pain. Which action can the nurse could suggest that would most likely help the client deal with this problem
a) Visit her friend early in the day
b) Rest for at least an hour before climbing the stairs
c) Take a nitroglycerin tablet before climbing the stairs
d) Lie down once she reaches the friends apartment
c) Take a nitroglycerin tablet before climbing the stairs
The nurse teaches Elizabeth that common expected side effects of nitroglycerin include
a) Headache, hypotension, and dizziness
b) Hypertension, flushing and forgetfulness
c) Hypotension, diplopia and shortness of breath
d) Stomach cramps, constipation and urinary frequency
a) Headache, hypotension, and dizziness
Sublingual nitroglycerin tablets begin to work within 1 to 2 minutes. How should the nurse instruct the client to use the drug when chest pain occurs
a) Take one tablet every 2 to 5 minutes until the pain stops
b) Take one tablet; and rest for 10 minutes. Call the physician if pain persists after 10 minutes
c) Take one tablet, then an additional tablet every 5 minutes for a total of three tablets. Call the physician if pain persists after 3 tablets
d) Take one tablet; if pain persists after 5 minutes, take two tablets. If pain still persists 5 minutes later, call the physician
c) Take one tablet, then an additional tablet every 5 minutes for a total of three tablets. Call the physician if pain persists after 3 tablets
Which of the following points should the nurse include when instructing the client with angina about sublingual nitroglycerin
a) The drug will cause your urine to turn bright orange
b) Store the tablets in a tight, light resistant container
c) Use the tablets only when the pain is severe
d) The shelf life of nitroglycerin is up to 2 years
b) Store the tablets in a tight, light resistant container
Blood and urine analysis confirm a diagnosis of salicylate overdose. Josie is treated with activated charcoal, which would be administered by
a) Intravenous infusion
b) Nasogastric tube
c) Rectal infusion
d) Oral tablets
b) Nasogastric tube
What specific potential adverse effect of charcoal administration to josie must the nurse be aware and guard against
a) Anaphylaxis
b) Renal failure
c) Aspiration
d) Cardiac arrest
c) Aspiration
The nursing goal for performing passive range of motion exercises for an unconscious client such as josie would be to
a) Preserve muscle mass
b) Prevent bone demineralisation
c) Increase muscle tone
d) Maintain joint mobility
d) Maintain joint mobility
When assessing josies respiratory status, which of the following symptoms may be an early indicator of hypoxia
a) Cyanosis
b) Decreased respirations
c) Restlessness
d) Hypotension
a) Cyanosis
