Advanced Medical-Surgical Nursing Exam Review
Course Introduction
Advanced Medical-Surgical Nursing is designed to deepen students' understanding of complex health conditions and the multifaceted care required for adults with acute and chronic physical illnesses. This course emphasizes critical thinking, evidence-based practice, and clinical decision-making in the management of patients with multisystem disorders, including cardiovascular, respiratory, renal, neurological, and gastrointestinal conditions. Students will explore advanced assessment techniques, pharmacological interventions, and collaborative care strategies, while integrating cultural, ethical, and legal considerations. Through case studies, simulations, and clinical experiences, learners will develop the expertise necessary to provide comprehensive, patient-centered care in fast-paced and high-acuity healthcare environments.
Recommended Textbook
Medical Surgical Nursing in Canada 3rd Canadian Edition by Lewis
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72 Chapters
1742 Verified Questions
1742 Flashcards
Source URL: https://quizplus.com/study-set/3946
Page 2
Chapter 1: Introduction to Medical-Surgical Nursing
Practice in Canada
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14 Verified Questions
14 Flashcards
Source URL: https://quizplus.com/quiz/78758
Sample Questions
Q1) An emaciated older adult patient is admitted to the critical care unit.The nurse plans a schedule of turning the patient every two hours to prevent skin breakdown.This is considered to be what type of nursing action?
A) Dependent
B) Cooperative
C) Independent
D) Collaborative
Answer: D
Q2) A woman who is a lone parent is about to undergo gallbladder surgery.She tells the nurse on admission that she is uneasy about being in the hospital and leaving her two preschool children with a neighbour.During the assessment phase,what is an appropriate nursing action?
A) Reassure the patient that her children are fine.
B) Call the neighbour to determine whether she is an adequate care provider.
C) Have the patient call the children to reassure herself that they are doing well.
D) Gather more data about the patient's feelings about the child care arrangements.
Answer: D
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3
Chapter 2: Cultural Competence and Health Equity in Nursing Care
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10 Verified Questions
10 Flashcards
Source URL: https://quizplus.com/quiz/78747
Sample Questions
Q1) Which statement accurately reflects a health inequity experienced in Canada today?
A) Aboriginal adults are less likely to smoke tobacco than other adults in Canada.
B) Overall suicide rate among First Nation communities is about twice the rate of the general population.
C) Individuals from lower income neighborhoods undergo preventative health screening more than their higher income counterparts.
D) Recent immigrants are more likely to have a primary care physician than Canadian-born respondents.
Answer: B
Q2) Having a commitment to the goal of inclusivity and equity is classified as which domain in the ABCs of cultural competence?
A) Skills
B) Affective
C) Knowledge
D) Behavioural
Answer: B
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Chapter 3: Health History and Physical Examination
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14 Verified Questions
14 Flashcards
Source URL: https://quizplus.com/quiz/78736
Sample Questions
Q1) While the nurse is taking a health history,the patient indicates that his father and grandfather both had heart attacks and were unable to be very active afterward.Which functional health pattern is reflected in this statement?
A) Health perception-health management
B) Coping-stress tolerance
C) Cognitive-perceptual
D) Activity-exercise
Answer: A
Q2) Which assessment technique would the nurse have used to document a finding of crepitus?
A) Inspection
B) Palpation
C) Auscultation
D) Percussion
Answer: B
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5
Chapter 4: Patient and Caregiver Teaching
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15 Verified Questions
15 Flashcards
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Sample Questions
Q1) A patient admitted to the hospital with hyperglycemia and diagnosed with diabetes mellitus is scheduled for discharge the second day after admission.In view of the patient's limited hospitalization,what should the nurse's teaching plan emphasize first for the patient's education about diabetes?
A) Prioritize realistic goals that are essential to the patient's immediate learning needs.
B) Reflect a complete plan that can be implemented by home health care nurses.
C) Use all available time to teach the patient as much as possible about the condition.
D) Involve teaching the family instead of the patient about management of diabetes.
Q2) When completing the educational component of a general nursing assessment to prepare a teaching plan,which question is the best one to ask,initially?
A) What is the patient's level of motivation?
B) What does the patient think is most important to learn first?
C) Is the patient ready to learn?
D) What does the patient already know?
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6
Chapter 5: Chronic Illness
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15 Verified Questions
15 Flashcards
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Sample Questions
Q1) For which type of cancer does evidence exist to support a genetic predisposition to occurrence?
A) Lung
B) Breast
C) Cervical
D) Testicular
Q2) Which of the following reflects a characteristic of health-related hardiness known as "challenge"?
A) Confidence to appraise a health stressor
B) Ability to modify responses to health stressors
C) Viewing a health stressor as an opportunity for growth
D) Optimal psychosocial adaptation to a health stressor
Q3) Which patient history indicates multimorbidity?
A) Chronic obstructive pulmonary disease and a urinary tract infection
B) Chronic kidney disease requiring an appendectomy
C) Lung cancer and pneumonia
D) Diabetes with exacerbation of rheumatoid arthritis
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Chapter 6: Community-Based Nursing and Home Care
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10 Verified Questions
10 Flashcards
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Sample Questions
Q1) Which of the following is a key principle of primary health care?
A) Universal access to health care on an economic basis
B) Focus on acute illness and cure
C) Partnership with other professions and sectors for health
D) Individuals as passive recipients of health care
Q2) A 78-year-old woman hospitalized for surgical repair of a fractured hip has recovered from the surgery but continues to have a nursing diagnosis of impaired physical mobility related to decreased muscle strength.In planning continued care for the patient,in which setting would the nurse consider that the patient's needs would best be met?
A) A public health unit
B) A community health centre
C) The patient's home
D) An occupational health facility
Q3) On average,what is the approximate national percentage of provincial/territorial budgets in Canada that are expended on health care costs?
A) 19%
B) 29%
C) 39%
D) 49%
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Chapter 7: Older Adults
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19 Verified Questions
19 Flashcards
Source URL: https://quizplus.com/quiz/78692
Sample Questions
Q1) What data collection method does the nurse recognize as eliciting the most complete information during a geriatric assessment?
A) Having the patient recount his or her health history
B) Having the caregiver provide the information on the patient
C) Using a reliable geriatric assessment instrument to evaluate the patient
D) Having the patient provide a diary of medical conditions and treatments
Q2) Which of the following is a normal physiological age-related change of the cardiovascular system?
A) Elastin and smooth muscle increases.
B) Vessel rigidity decreases.
C) Heart muscle decreases.
D) Mitral valve constriction increases.
Q3) Which of the following is an appropriate approach that the nurse should use to facilitate learning in older adults?
A) Using peer educators
B) Avoiding issues of a personal nature
C) Presenting material quickly to avoid fatigue
D) Acknowledging the older adult's dependence
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9
Chapter 8: Stress and Stress Management
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10 Verified Questions
10 Flashcards
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Sample Questions
Q1) When developing a pathophysiological map for a cognitive appraisal process,what must occur first?
A) A stimulus
B) A patient-identified need
C) Evidence of alteration in cognitive functioning
D) A primary appraisal of the patient and the situation
Q2) A woman is brought to the emergency department after she was assaulted in a shopping centre parking lot.Her purse was stolen,and she was thrown to the pavement,suffering minor abrasions and contusions.What finding related to the general adaptation syndrome would the nurse expect to find on assessment of the patient?
A) Uncontrolled sobbing
B) Repeatedly describing the attack
C) Hypoglycemia with tremors and hunger
D) Increased blood pressure,pulse,and respirations
Q3) Which initial area is stimulated when an individual experiences stress?
A) Anterior pituitary gland
B) Hypothalamus
C) Adrenal cortex
D) Posterior pituitary gland
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Page 10
Chapter 9: Sleep and Sleep Disorders
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10 Verified Questions
10 Flashcards
Source URL: https://quizplus.com/quiz/78687
Sample Questions
Q1) What should the nurse do,initially,to assist in determining whether a patient seen in the ambulatory care setting has chronic insomnia?
A) Schedule a polysomnography (PSG)study.
B) Arrange for the patient to have a sleep study.
C) Ask the patient to keep a two-week sleep diary.
D) Teach the patient about the use of an actigraph.
Q2) After the nurse has taught a patient about the use of extended-release Zopiclone (Imovane)for insomnia,which patient statement indicates a need for further teaching?
A) "I will take the medication an hour before bedtime."
B) "I should take the medication on an empty stomach."
C) "I should not take this medication unless I can sleep for at least six hours."
D) "I will schedule activities that require mental alertness for later in the day."
Q3) Which of the following is an arousal parasomnia that occurs during NREM sleep?
A) Enuresis
B) Hallucinations
C) Sleepwalking
D) Nightmares
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Chapter 10: Pain
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19 Verified Questions
19 Flashcards
Source URL: https://quizplus.com/quiz/78757
Sample Questions
Q1) A 45-year-old woman has breast cancer that has spread to her liver and spine.She has been taking oxycodone (Percodan)and amitriptyline (Elavil)for pain control at home,but she now has constant severe pain and is hospitalized for pain control and development of a pain management program.During assessment of the patient,what information related to her pain is most important for the nurse to obtain initially?
A) The pattern,area,intensity,and nature of her pain
B) Identification of trigger points of pain by palpation of painful areas
C) The schedule and total dosages of the drugs she is currently taking and when breakthrough pain occurs
D) The presence of a sympathetic response,such as tachycardia,diaphoresis,and a rise in blood pressure
Q2) Which of the following is a possible musculoskeletal consequence of unrelieved pain?
A) Decreased peristalsis
B) Hypermobility
C) Muscle spasm
D) Muscle protein catabolism
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Page 12
Chapter 11: Substance Use
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19 Verified Questions
19 Flashcards
Source URL: https://quizplus.com/quiz/78756
Sample Questions
Q1) When working with individuals with any substance dependency,during cessation and recovery,why does the nurse advise them to avoid activities and places associated with the substance use?
A) To decrease cue-induced craving
B) To increase their motivation to continue abstinence
C) To prevent substance-abusing friends from influencing their behaviour
D) To avoid reminders of the negative behaviours they previously demonstrated
Q2) A patient hospitalized for elective surgery stopped smoking two days before admission as advised by the nurse.When caring for the patient postoperatively,what does the nurse recognize that nicotine withdrawal may cause?
A) Insomnia,craving,and hyperirritability
B) Headache,nervousness,and depression
C) Fatigue,somnolence,and shortness of breath
D) Loss of appetite,increased heart rate,and increased blood pressure
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13
Chapter 12: Complementary and Alternative Therapies
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14 Verified Questions
14 Flashcards
Source URL: https://quizplus.com/quiz/78755
Sample Questions
Q1) A patient comes to an outpatient clinic and requests an acupuncturist for treatment of her asthma.In responding to the patient's request,what does the nurse recognize about the effect of acupuncture on asthma?
A) Asthma is a disorder that should not be treated with acupuncture because of the risk for respiratory complications.
B) Acupuncture needles stimulate or block specific superficial nerves that cause alterations in physiological function.
C) Research has indicated that asthma patients may benefit from the effects of acupuncture.
D) The patient must have a strong belief in the concepts of health and disease held by traditional Chinese medicine for treatment to be effective.
Q2) Which of the following is true regarding healing touch?
A) It has strong ties to religious beliefs.
B) It is a physician-based program.
C) It assists the patient to self-heal.
D) The nurse determines its effectiveness.
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Chapter 13: Palliative Care at the End of Life
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13 Verified Questions
13 Flashcards
Source URL: https://quizplus.com/quiz/78754
Sample Questions
Q1) Which of the following refers to care that is provided in the last days or weeks of the patient's life?
A) Hospice care
B) Palliative care
C) Respite care
D) End-of-life care
Q2) When caring for a patient close to death,when does the nurse recognize that death legally occurs?
A) When the cerebral cortex function ceases
B) When respirations cease
C) When coma,absence of brainstem reflexes,and apnea occur
D) When cardiopulmonary resuscitative efforts are not effective
Q3) The nurse consults with the physician to arrange a referral for hospice care for a patient with end-stage kidney disease,based on what knowledge regarding when hospice care is indicated?
A) Family members can no longer care for dying patients at home.
B) Patients and families are having difficulty coping with grief reactions.
C) Preparation for death with palliative care and comfort are the goals of care.
D) Patients have unmanageable pain and suffering as a result of their condition.
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Page 15
Chapter 14: Inflammation and Wound Healing
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18 Verified Questions
18 Flashcards
Source URL: https://quizplus.com/quiz/78753
Sample Questions
Q1) An older adult patient has a large,open,infected surgical wound on the abdomen that contains a creamy exudate and small areas of red granulation tissue.How should the nurse classify this wound?
A) Black wound
B) Yellow wound
C) Superficial red wound
D) Full-thickness red wound
Q2) A patient with a systemic bacterial infection has "goose pimples," feels cold,and has a shaking chill.At this stage of the febrile response,what would the nurse expect to find?
A) Flushing of the skin
B) Rising body temperature
C) Decreasing blood pressure
D) Relief of muscle aching and fatigue
Q3) Which of the following activities occurs during the granulation phase of primary intention healing?
A) Migration of epithelial cells and clot formation
B) Remodelling of collagen and initiation of capillary growth
C) Migration of fibroblasts and secretion of collagen
D) Approximation of incision edges and increased capillary buds
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Page 16
Chapter 15: Genetics
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7 Verified Questions
7 Flashcards
Source URL: https://quizplus.com/quiz/78752
Sample Questions
Q1) When completing a pedigree,the nurse knows to use the symbol g (blue square)to denote which of the following?
A) Unknown sex,normal
B) Normal male
C) Female heterozygote
D) Affected male
Q2) When counselling parents about hemophilia A,an X-linked recessive trait,which of the following would be the basis for the nurse's response related to offspring?
A) Daughters will not be affected with the trait or be carriers.
B) Sons will not be affected with the trait or be carriers.
C) Fifty percent of sons will be normal,and 50% will be affected with the trait.
D) Fifty percent of daughters will be normal,and 50% will be affected with the trait.
Q3) On average,what percentage of children in a family will be affected with the mutated gene in an autosomal recessive trait?
A) 0%
B) 25%
C) 50%
D) 100%
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Chapter 16: Altered Immune Response and Transplantation
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19 Verified Questions
19 Flashcards
Source URL: https://quizplus.com/quiz/78751
Sample Questions
Q1) The nurse discusses the prevention and management of allergic reactions with a beekeeper who has developed a hypersensitivity to bee bites.The nurse identifies a need for additional teaching when the patient makes which of the following statements?
A) "I need to think about a change in my occupation."
B) "I should wear a MedicAlert bracelet indicating my allergy to insect stings."
C) "I will learn to administer epinephrine so that I will be prepared if I am stung again."
D) "I will need to take doses of corticosteroids to prevent reactions to further stings."
Q2) A patient develops a severe angioedema involving her face,hands,and feet,with burning and stinging of the lesions.What significant risk factor for allergies should the nurse ask the patient about?
A) A family history of allergies
B) The use of over-the-counter medications
C) Recurrent respiratory infections
D) A history of a recent fungal infection
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18
Chapter 17: Infection and Human Immunodeficiency Virus
Infection
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22 Verified Questions
22 Flashcards
Source URL: https://quizplus.com/quiz/78750
Sample Questions
Q1) What early manifestations of HIV infection should the nurse assess for in both the nursing history and the physical examination?
A) Ataxia and confusion
B) Rectal lesions and bleeding
C) Lesions of the mouth and tongue
D) Weight loss and wasting syndrome
Q2) Four years after seroconversion,an HIV-infected patient has a CD4<sup>+</sup> T-cell count of 800 per microlitre and a low viral load.What does the nurse recognize at this time?
A) The patient is at risk for development of opportunistic infections because of CD4<sup>+</sup> T-cell destruction.
B) The patient is in a clinical and biological latent period during which very few viruses are being replicated.
C) The body currently is able to produce an adequate number of CD4<sup>+</sup> T cells to replace those destroyed by viral activity.
D) Anti-HIV antibodies produced by B cells enter CD4<sup>+</sup> T cells infected with HIV to stop replication of viruses in the cells.
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Page 19
Chapter 18: Cancer
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30 Verified Questions
30 Flashcards
Source URL: https://quizplus.com/quiz/78749
Sample Questions
Q1) A patient hospitalized with ovarian cancer tells the nurse that she thinks her husband does not care for her anymore since she has become ill because he rarely visits her.On one occasion when the husband was present,he told the nurse he just could not stand to see his wife so ill and never knew what to say to her.What is an appropriate nursing diagnosis in this situation?
A) Impaired home maintenance related to perceived role changes
B) Risk for caregiver role strain related to burdens of caregiving responsibilities
C) Interrupted family processes related to effect of illness on family members
D) Compromised family coping related to disruption in lifestyle and necessary role changes
Q2) Which stage would a patient with Hodgkin's disease be experiencing when there is extensive local and regional spread of the cancer cells?
A) Stage I
B) Stage II
C) Stage III
D) Stage IV
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Chapter 19: Fluid, electrolyte, and Acidbase Imbalances
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22 Verified Questions
22 Flashcards
Source URL: https://quizplus.com/quiz/78748
Sample Questions
Q1) A patient with renal insufficiency develops lethargy and somnolence with a blood pressure of 100/60 mm Hg,a pulse of 62 beats/min,and respirations of 10 breaths/min.The nurse notes that the patient has been taking an aluminum hydroxide-magnesium hydroxide suspension (Maalox)for indigestion.Which of the following drugs would the nurse expect to be used by IV administration in the management of this patient?
A) Calcium gluconate
B) Magnesium sulphate
C) Potassium chloride
D) 50% dextrose and regular insulin
Q2) Following bowel surgery,a patient has been receiving normal saline intravenous (IV)fluids at 100 mL per hour;has a nasogastric tube attached to low,intermittent suction;and is on nothing by mouth (NPO)status.Which of the following assessment findings would alert the nurse to a major fluid and electrolyte problem?
A) Weight gain
B) Flushed,moist skin
C) A decreasing level of consciousness (LOC)
D) A serum sodium level of 138 mmol/L
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21
Chapter 20: Nursing Management: Preoperative Care
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17 Verified Questions
17 Flashcards
Source URL: https://quizplus.com/quiz/78746
Sample Questions
Q1) What does appropriate preoperative teaching for a patient scheduled for abdominal surgery include?
A) How to care for the wound
B) How to breathe deeply and cough
C) What medications will be used during surgery
D) What drains and tubes will be present after surgery
Q2) Sarah,46 years old,is in the preoperative assessment area awaiting surgery.She is wringing her hands and perspiring,and she has a worried affect.The nurse's communication with Sarah is based on the knowledge that the most prevalent fear of patients awaiting surgery is which of the following?
A) Pain
B) Altered body image
C) Potential for death
D) Results of the procedure
Q3) Which of the following is the meaning of the suffix -ostomy?
A) Excision or removal
B) Creation of opening into
C) Incision or cutting into
D) Repair and reconstruction
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Page 22
Chapter 21: Nursing Management: Intraoperative Care
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16 Verified Questions
16 Flashcards
Source URL: https://quizplus.com/quiz/78745
Sample Questions
Q1) The nurse from the general surgical unit brings the patient's hearing aid to the surgical suite because the patient left the unit without it and it is needed to communicate with the patient.At the surgical suite,what areas can the general surgical unit nurse enter?
A) Clean core
B) Scrub sink areas
C) Information or nursing station
D) Corridors of the ORs
Q2) Which assessment finding would the nurse expect to observe in a patient with malignant hyperthermia?
A) Decreased heart rate
B) Low,irregular respirations
C) Decreased temperature
D) Ventricular dysrhythmias
Q3) What are the physical environment and traffic control measures of the OR primarily designed to do?
A) Protect the patient's privacy.
B) Prevent transmission of infection.
C) Ensure the proper function of electrical equipment.
D) Promote the development of teamwork among the OR staff.
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Chapter 22: Nursing Management: Postoperative Care
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20 Verified Questions
20 Flashcards
Source URL: https://quizplus.com/quiz/78744
Sample Questions
Q1) While assessing patients for complications during recovery from anaesthesia,the nurse recognizes that which of the following patients is at the greatest risk for developing postoperative hypothermia?
A) A 78-year-old female patient undergoing a vaginal hysterectomy under general anaesthesia
B) A 58-year-old male patient undergoing repair of a knee cartilage under general anaesthesia
C) A 68-year-old female patient with diabetes undergoing a great toe amputation under local anaesthesia
D) A 72-year-old male patient undergoing bowel resection for colon cancer under general anaesthesia
Q2) The nurse is documenting the daily amount that was collected in a patient's T-tube.Which one of the following daily totals would be considered normal?
A) 100 mL
B) 250 mL
C) 500 mL
D) 1000 mL
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24
Chapter 23: Nursing Assessment: Visual and Auditory Systems
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20 Verified Questions
20 Flashcards
Source URL: https://quizplus.com/quiz/78743
Sample Questions
Q1) When examining a patient's eyes,the nurse suspects a weakness or imbalance of the extraocular nerves on finding which of the following data?
A) A limited field of vision
B) A sluggish papillary reflex
C) An irregular corneal light reflex
D) Conjugate movement of the eyes through the cardinal fields of gaze
Q2) Which of the following is a possible cause of diplopia?
A) Superficial corneal erosion
B) Anterior uveitis
C) Abnormalities of extraocular muscle action
D) Liquefaction of the vitreous humor
Q3) In the visual pathway,fibres from the nasal portion of each retina cross over to the opposite side of which structure?
A) Optic nerve
B) Lateral geniculate body
C) Optic chiasma
D) Fovea centralis
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Page 25
Chapter 24: Nursing Management: Visual and Auditory
Problems
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35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/78742
Sample Questions
Q1) A 78-year-old woman has age-related macular degeneration and has undergone laser photocoagulation without significant improvement in her vision.The ophthalmologist has told her that further treatment is not warranted.What is an appropriate outcome for the nurse to plan with the patient?
A) The patient plans for institutional care when blindness becomes total.
B) The patient uses optical and nonoptical methods for vision enhancement.
C) The patient comes to accept the visual impairment and eventual blindness.
D) The patient verbalizes the need to seek a second opinion regarding her condition.
Q2) The nurse answers the call light of a newly admitted patient.The patient tells the nurse she is blind and asks the nurse to assist her to the bathroom.To assist the patient,how should the nurse proceed?
A) Take the patient by the arm,and lead her slowly to the bathroom.
B) Walk slightly ahead of the patient,and allow the patient to hold your elbow.
C) Lead the patient to the bathroom by the hand,describing the location and providing verbal cues.
D) Give the patient exact descriptive directions to the bathroom so that she can walk there independently.
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26
Chapter 25: Nursing Assessment: Integumentary System
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13 Verified Questions
13 Flashcards
Source URL: https://quizplus.com/quiz/78741
Sample Questions
Q1) Where would you find apocrine sweat glands?
A) Scalp
B) Eyelids
C) Back
D) Upper chest
Q2) When obtaining a self-care integument history,the nurse will ask the patient about which of the following?
A) Pain associated with skin conditions
B) The brands of moisturizers and cosmetics used
C) Lifestyle changes associated with skin conditions
D) Changes in the condition of the skin,hair,and nails
Q3) How would the nurse document a papule?
A) Firm,edematous,irregularly shaped area
B) Elevated,solid lesion smaller than 1 cm in diameter
C) Circumscribed,flat area with a change in skin colour,less than 1 cm in diameter
D) Circumscribed,elevated solid lesion,larger than 1 cm in diameter
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Chapter 26: Nursing Management: Integumentary
Problems
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22 Verified Questions
22 Flashcards
Source URL: https://quizplus.com/quiz/78740
Sample Questions
Q1) After spending an afternoon picking strawberries,a woman developed a severe contact dermatitis of her hands,arms,and lower legs.She states that the itching is severe,and she cannot keep from scratching.To help the patient manage the pruritus,what should the nurse advise her to do?
A) Use cool,wet dressings and baths to promote vasoconstriction.
B) Trim the fingernails short to prevent skin damage from scratching.
C) Expose the areas to the sun to promote drying and healing of the lesions.
D) Wear cotton gloves and cover all other affected areas with clothing to prevent additional irritation.
Q2) A patient is undergoing psoralen plus UVA light (PUVA)therapy for treatment of psoriasis.To prevent complications from this procedure,what should the nurse plan to do?
A) Shield unaffected areas with lead-lined drapes.
B) Monitor for accumulation of laser light in adjacent tissue.
C) Apply petroleum jelly to unaffected areas surrounding the lesions.
D) Have the patient use protective eyewear that blocks 100% of UV light.
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Chapter 27: Nursing Management: Burns
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23 Verified Questions
23 Flashcards
Source URL: https://quizplus.com/quiz/78739
Sample Questions
Q1) An employee spilled industrial acids on his arms and legs at work.What is the appropriate action by the occupational nurse at the facility?
A) Apply cool compresses to the area of exposure.
B) Apply an alkaline solution to the affected area.
C) Cover the affected area with dry,sterile dressings.
D) Flush the substance with large amounts of tap water.
Q2) Ranitidine (Zantac)is prescribed for a patient with major burns.In teaching the patient about the drug's purpose,the nurse should explain that it is used to prevent which of the following?
A) Diarrhea
B) Constipation
C) Adynamic ileus
D) Curling's ulcer
Q3) When does the nurse recognize that the patient with a burn injury moves from the emergent phase to the acute phase?
A) When inflammatory symptoms subside
B) When the burn area is completely covered
C) When granulation tissue forms in the wounds
D) When diuresis occurs with low urine specific gravity
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Page 29
Chapter 28: Nursing Assessment: Respiratory System
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24 Verified Questions
24 Flashcards
Source URL: https://quizplus.com/quiz/78738
Sample Questions
Q1) While assessing a patient with respiratory problems,what should the nurse specifically ask about?
A) Smoking habits
B) Alterations in sexual activity
C) The course of the patient's illness
D) Occupational exposure to heavy lifting
Q2) Which of the following is an age-related change in the respiratory system?
A) Increased elastic recoil of the lungs
B) Increase in chest wall compliance
C) Increase in anteroposterior diameter
D) Increase in functional alveoli
Q3) The physician performs a thoracentesis on a patient with a right pleural effusion.In preparing the patient for the procedure,how should the nurse position the patient?
A) Supine with the head of the bed elevated 45 degrees
B) On his left side with his right arm extended above his head
C) Sitting upright with his arms supported on an overbed table
D) On his left side in the Trendelenburg's position with both arms extended
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Chapter 29: Nursing Management: Upper Respiratory
Problems
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23 Verified Questions
23 Flashcards
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Sample Questions
Q1) On entering the room of the patient who has just returned from surgery for a total laryngectomy and radical neck dissection,the nurse recognizes a need for intervention upon making which one of the following observations?
A) The gastrostomy tube is clamped.
B) The patient is coughing blood-tinged secretions from the tracheostomy.
C) The patient is positioned in a lateral position with the head of the bed flat.
D) There are 200 mL of serosanguineous drainage in the patient's portable drainage device.
Q2) A patient with a tracheostomy is to use a fenestrated tracheostomy tube to provide for speech.What is it important that the nurse do?
A) Place the decannulation cap in the tube before cuff deflation.
B) Assess the patient's ability to swallow without risk of aspiration.
C) Remove the inner cannula of the tracheostomy tube after deflating the cuff.
D) Connect oxygen at 4 to 6 L/min to the second pigtail tubing of the tracheostomy tube.
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Chapter 30: Nursing Management: Lower Respiratory
Problems
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47 Verified Questions
47 Flashcards
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Sample Questions
Q1) A 68-year-old man has a long history of chronic obstructive pulmonary disease and is admitted to the hospital with cor pulmonale.Which clinical manifestation noted by the nurse is would indicate that the patient with a diagnosis of cor pulmonale also has heart failure?
A) Audible crackles at both lung bases
B) Peripheral edema
C) Loud murmur at the mitral area
D) High systemic blood pressure
Q2) The physician inserts two chest tubes connected with a Y-connecter in a patient with a hemopneumothorax.When monitoring the patient after the chest tube placement,the nurse will be concerned about which of the following?
A) A large air leak in the water-seal chamber
B) 400 mL of blood in the collection chamber
C) Severe pain with each deep patient inspiration
D) Subcutaneous emphysema at the insertion site
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Chapter 31: Nursing Management: Obstructive Pulmonary Diseases
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42 Verified Questions
42 Flashcards
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Sample Questions
Q1) A 32-year-old patient is seen in the clinic for dyspnea associated with the diagnosis of emphysema.The patient denies any history of smoking.The nurse will anticipate teaching the patient about which of the following?
A) (?<sub>1</sub>)-Antitrypsin testing
B) Use of the nicotine patch
C) Continuous pulse oximetry
D) Effects of leukotriene modifiers
Q2) The nurse identifies the nursing diagnosis of imbalanced nutrition: less than body requirements for a patient with COPD.What is an appropriate intervention for this problem?
A) Order fruits and fruit juices to be offered between meals.
B) Order a high-calorie,high-protein diet with six small meals a day.
C) Teach the patient to use frozen meals that can be microwaved at home.
D) Provide a high-calorie,high-carbohydrate,nonirritating,frequent-feeding diet.
Q3) Clinically significant airway obstruction develops in what percentage of smokers?
A) 5% to 10%
B) 15% to 20%
C) 25% to 30%
D) 40% to 50%
Page 33
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Chapter 32: Nursing Assessment: Hematological System
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14 Verified Questions
14 Flashcards
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Sample Questions
Q1) When evaluating the red blood cell (RBC)indices of a patient,what does the nurse know is indicated by a low mean corpuscular volume (MCV)?
A) RBCs of small size
B) A decrease in RBCs
C) Decreased saturation of RBCs with hemoglobin
D) Decreased weight of the amount of hemoglobin or RBCs
Q2) Which of the following is a normal age-related change in hematological studies?
A) MCV slightly decreased
B) Hemoglobin slightly increased in men
C) Ferritin level increased
D) Erythrocyte sedimentation rate (ESR)decreased
Q3) While obtaining a health history from a patient with numerous petechiae on the skin,the nurse asks the patient specifically about the patient's use of which of the following drugs?
A) Antiseizure medications
B) Oral contraceptives
C) Aspirin compounds
D) Antihypertensive agents
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34
Chapter 33: Nursing Management: Hematological Problems
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38 Verified Questions
38 Flashcards
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Sample Questions
Q1) A patient with sickle cell anemia is admitted to the hospital in crisis with severe abdominal pain.While caring for the patient,what is it most important for the nurse to do?
A) Limit the patient's intake of oral fluids.
B) Evaluate the effectiveness of narcotic analgesics.
C) Encourage the patient to ambulate as much as tolerated.
D) Teach the patient about high-protein,high-calorie foods.
Q2) Fifteen minutes after a transfusion of packed RBCs is started,a patient develops tachycardia and tachypnea,and complains of back pain and feeling warm.What is the nurse's priority action?
A) Discontinue transfusion,and infuse normal saline.
B) Administer oxygen therapy at a high flow rate.
C) Slow the transfusion rate,and reassess the patient in 15 minutes.
D) Stop the blood,and discard the used bag and tubing in a biohazard container.
Q3) During care of the patient with multiple myeloma,what is an important nursing intervention?
A) Limiting activity to prevent pathological fractures
B) Maintaining a fluid intake of 3 to 4 L/day to dilute calcium load
C) Assessing for changes in size and characteristics of lymph nodes
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D) Administering narcotic analgesics continuously to control bone pain
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Chapter 34: Nursing Assessment: Cardiovascular System
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21 Verified Questions
21 Flashcards
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Sample Questions
Q1) To auscultate for extra heart sounds in the mitral area,with what part of the stethoscope will the nurse listen?
A) The bell of the stethoscope with the patient in the left lateral position
B) The diaphragm of the stethoscope with the patient in a reclining position
C) The diaphragm of the stethoscope with the patient lying flat on the left side
D) The bell of the stethoscope with the patient sitting and leaning to the right side
Q2) A transesophageal echocardiogram (TEE)is ordered for a patient with possible endocarditis.Which of these actions included in the standard TEE orders will the nurse need to accomplish first?
A) Make the patient nothing by mouth (NPO)status.
B) Start a large-gauge IV line.
C) Administer O<sub>2</sub> per mask.
D) Give lorazepam (Ativan)1 mg IV.
Q3) Which of the following is a normal cardiac index (CI)assessment finding?
A) 2 L/min
B) 3 L/min/m<sup>2</sup>
C) 6 L/min
D) 8 L/min/m<sup>2</sup>
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Chapter 35: Nursing Management: Hypertension
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22 Flashcards
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Sample Questions
Q1) A patient with hypertension has just developed an abrupt elevation in BP.Which of the following would indicate that the patient is in a hypertensive crisis?
A) Widening pulse pressure
B) Systolic above 110 mm Hg
C) Diastolic above 120 mm Hg
D) Mean arterial pressure of 82 mm Hg
Q2) Which of the following amounts of exercise recommended by the Canadian Hypertension Education Program (CHEP)to reduce the possibility of a person becoming hypertensive?
A) 30 minutes of light exercise daily
B) 60 minutes of moderate exercise,twice a day,three times per week
C) 30 to 60 minutes of moderate exercise,four to seven times per week
D) 30 to 45 minutes of heavy exercise,three times per week
Q3) Which of the following is a correct mechanism action of aldosterone?
A) Increased sodium reabsorption
B) Decreased water reabsorption
C) Decreased blood volume
D) Increased potassium excretion
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Chapter 36: Nursing Management: Coronary Artery Disease
and Acute Coronary Syndrome
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39 Verified Questions
39 Flashcards
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Sample Questions
Q1) Three weeks after his hospitalization for an AMI,a patient returns to the cardiac centre for follow-up.When the nurse asks about his sleep patterns,the patient tells the nurse that he sleeps fine but that his wife moved into the spare bedroom to sleep when he returned home.He states,"I guess we will never have sex again after this." What is the best response to the patient?
A) "Sexual intercourse will be too strenuous on your heart,but closeness and intimacy can be maintained with holding and cuddling."
B) "You should discuss your questions about your sexual activity with your doctor because the activity it requires is a medical concern."
C) "Sexual activity can be resumed whenever you and your wife feel like it.Most sexual response is emotional rather than physical."
D) "Sexual activity can be gradually resumed like other forms of activity.A good comparison of energy expenditure is climbing two flights of stairs."
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Chapter 37: Nursing Management: Heart Failure
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22 Flashcards
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Sample Questions
Q1) When teaching the patient with congestive heart failure about a 2-g sodium diet,the nurse explains that which of the following foods must be restricted?
A) Eggs
B) Canned fruit
C) Frozen vegetables
D) Milk and milk products
Q2) When working in the heart failure clinic,the nurse knows that teaching for a 74-year-old patient with newly diagnosed heart failure has been effective when the patient does which of the following?
A) Says that the nitroglycerin patch will be used for any chest pain that develops
B) Calls when the weight increases from 56 to 59 kg in 2 days
C) Tells the home care nurse that furosemide is taken daily at bedtime
D) Makes an appointment to see the doctor at least once yearly
Q3) What is the most common form of initial heart failure?
A) Left-sided
B) Right-sided
C) Biventricular
D) All types occur equally;there is no one common form of heart failure.
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Chapter 38: Nursing Management: Dysrhythmias
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26 Flashcards
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Sample Questions
Q1) A patient has a permanent pacemaker inserted for treatment of chronic atrial fibrillation with slow ventricular response.The nurse recognizes that the pacemaker is used for the patient to do which of the following?
A) Prevent ventricular irritability.
B) Override the ectopic stimulus in the atria.
C) Fire an impulse every second to maintain a heart rate of 60 beats/min.
D) Discharge an electrical stimulus when no ventricular depolarization is sensed.
Q2) A patient with diabetes mellitus is admitted unresponsive to the emergency department (ED).Initial laboratory findings are serum potassium 2.8 mmol/L,serum sodium 138 mmol/L,serum chloride 90 mmol/L,and blood glucose 34.9 mmol/L (628 mg/dL).Cardiac monitoring shows multifocal premature ventricular contractions (PVCs).What does the nurse understand that the patient's PVCs are most likely caused by?
A) Hypoxemia
B) Dehydration
C) Hypokalemia
D) Hyperglycemia
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Chapter 39: Nursing Management: Inflammatory and Structural
Heart Disorders
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28 Verified Questions
28 Flashcards
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Sample Questions
Q1) Which of the following is the primary symptom of mitral stenosis?
A) Tachypnea
B) Exertional dyspnea
C) Atrial fibrillation
D) Hemoptysis
Q2) Which assessment information obtained by the nurse for a patient with aortic stenosis would be most important to report to the physician?
A) A loud systolic murmur is audible along the right sternal border.
B) The patient complains of chest pain associated with ambulation.
C) The point of maximum impulse is at the left midclavicular line.
D) A thrill is palpable at the second intercostal space,right sternal border.
Q3) A 22-year-old patient with rheumatic fever has subcutaneous nodules,erythema marginatum,and polyarthritis of multiple joints.What would the nurse document as an appropriate nursing diagnosis based on these findings?
A) Activity intolerance related to fatigue and arthralgia
B) Risk for infection related to open skin lesions
C) Risk for impaired skin integrity related to pruritus and scratching
D) Risk for impaired physical mobility related to permanent joint fixation
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Chapter 40: Nursing Management: Vascular Disorders
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31 Verified Questions
31 Flashcards
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Sample Questions
Q1) After repair of an AAA,the nurse notes that the patient does not have popliteal,posterior tibial,or dorsalis pedis pulses.The legs are cool and mottled.Which action is appropriate for the nurse to take first?
A) Review the preoperative assessment form for data about the pulses.
B) Notify the surgeon and anaesthesiologist.
C) Document that the pulses are absent,and recheck in 30 minutes.
D) Elevate the lower extremities on pillows.
Q2) A patient admitted to the hospital with a chronic venous insufficiency has physician's orders for bed rest with the feet elevated.How should the nurse elevate the patient's feet?
A) Place two pillows under the calf of her affected leg.
B) Elevate the foot of the bed above the level of her heart.
C) Elevate the bed at the knee,and place pillows under her feet.
D) Place one pillow under her thighs and two pillows under her lower legs.
Q3) Which of the following is a characteristic of PAD?
A) Normal peripheral pulse
B) Capillary refill 2 seconds
C) Ankle-brachial index 0.98
D) No lower leg edema
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Page 42
Chapter 41: Nursing Assessment: Gastrointestinal System
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17 Verified Questions
17 Flashcards
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Sample Questions
Q1) Which major GI hormone is responsible for stimulating pancreatic bicarbonate secretion?
A) Gastrin
B) Secretin
C) Cholecystokinin
D) Gastric inhibitory peptide
Q2) The nurse documents the absence of bowel sounds in all quadrants of a patient's abdomen.How long should the nurse have auscultated the patient's abdomen?
A) 8 minutes
B) 10 minutes
C) 16 minutes
D) 20 minutes
Q3) Following an episode of vomiting bright red blood,a patient is hospitalized for evaluation.During physical assessment of the patient,which of the following findings does the nurse identify as abnormal?
A) Tympany on percussion of the abdomen
B) The liver edge 3 cm below the costal margin
C) Aortic pulsations visible in the epigastric area
D) Bowel sounds of 30 per minute in each quadrant
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43
Chapter 42: Nursing Management: Nutritional Problems
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27 Verified Questions
27 Flashcards
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Sample Questions
Q1) The nurse is teaching a community group to evaluate the nutritional content of food.If the label on a jar of peanut butter states that each serving contains 16 g of fat and 190 calories,what is the percentage of fat per serving?
A) 34%
B) 59%
C) 76%
D) 88%
Q2) When using a soft silicone nasogastric tube for enteral feedings,the nurse will need to do which of the following?
A) Flush the tubing after checking for residual volumes.
B) Administer continuous feedings using an infusion pump.
C) Replace the tube every 3 to 5 days to avoid mucosal damage.
D) Avoid giving medications through the feeding tube.
Q3) When using a nutrition screening tool,how can the nurse identify a patient at nutritional risk without further assessment?
A) Pressure ulcers
B) A recent hip fracture
C) Vomiting for 3 days
D) A laparoscopic cholecystectomy 1 week ago
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Page 44
Chapter 43: Nursing Management: Obesity
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23 Flashcards
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Sample Questions
Q1) The nurse has completed initial instruction with a patient regarding a weight-loss program.The nurse determines that the teaching has been effective when the patient makes which following statement?
A) "I will keep a diary of daily weights to illustrate my weight loss."
B) "I plan to lose 1.8 kg a week until I have lost the 27-kg goal."
C) "I should not exercise more than what is required because increased activity increases the appetite."
D) "I plan to join a behaviour modification group to help establish long-term behaviour changes necessary for weight control."
Q2) When teaching a patient about recording the weight during a weight-loss program,how often would the nurse recommend that the patient get weighed?
A) Daily for the first 2 weeks,and then weekly thereafter
B) Every other day,in the morning
C) Once a week
D) Twice a week
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Chapter 44: Nursing Management: Upper Gastrointestinal
Problems
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43 Verified Questions
43 Flashcards
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Sample Questions
Q1) The following orders are received for a patient who has vomited 1500 mL of bright-red blood.Which order will the nurse act on first?
A) Infuse 1000 mL of lactated Ringer's solution.
B) Administer IV famotidine 40 mg.
C) Insert an NG tube,and connect it to suction.
D) Type and crossmatch for 4 units of packed red blood cells.
Q2) A patient who uses an NSAID for management of severe osteoarthritis has recently developed melena.Which of the following changes in the treatment plan would the nurse expect to be made by the physician?
A) Administration of ranitidine
B) Substitution of corticosteroids for the NSAID
C) Substitution of acetaminophen for the NSAID
D) Administration of misoprostol (Cytotec)with the NSAID
Q3) Which information will the nurse include when teaching a patient with newly diagnosed GERD?
A) "Peppermint tea may be helpful in reducing your symptoms."
B) "You will need to keep the head of your bed elevated on blocks."
C) "You should avoid eating between meals to reduce acid secretion."
D) "Vigorous physical activities may increase the incidence of reflux."
Page 46
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Chapter 45: Nursing Management: Lower Gastrointestinal
Problems
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45 Verified Questions
45 Flashcards
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Sample Questions
Q1) A patient with Crohn's disease develops a fever and symptoms of a urinary tract infection.The nurse recognizes that this complication may occur as a result of which of the following events?
A) Perianal irritation from frequent diarrhea
B) Fistula formation between the bowel and the bladder
C) Extraintestinal manifestations of the bowel disease
D) Impaired immunological response to infectious microorganisms
Q2) During the initial postoperative assessment of a patient's stoma formed with a transverse colostomy,the nurse finds it to be red with moderate edema and a small amount of bleeding.What is the most appropriate nursing action?
A) Document the stoma assessment.
B) Notify the surgeon about the stoma appearance.
C) Monitor the stoma every 30 minutes.
D) Place an ice pack on the stoma to reduce swelling.
Q3) Which of the following is a neoplastic polyp of the large intestine?
A) Familial juvenile polyps
B) Pseudopolyps
C) Hereditary polyposis syndromes
D) Leiomyomas
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Tract Problems
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Sample Questions
Q1) Serological testing of a patient reveals the presence of antibodies to the hepatitis C virus (anti-HCV).Which following nursing action is appropriate?
A) Schedule the patient for HCV genotype testing.
B) Teach the patient that the HCV infection will resolve in 2 to 4 months.
C) Administer immunoglobulin and the HCV vaccine.
D) Instruct the patient on self-administration of ?-interferon.
Q2) A patient with acute hepatitis B asks the nurse if treatment is available for the condition.What should the nurse explain to the patient?
A) Patients with acute hepatitis B can be given HBIG to help reduce the symptoms.
B) A variety of antiviral medications are available to treat acute hepatitis B,but serious side effects limit their use.
C) No medication is available for treatment of HBV infection.
D) Chronic HBV infection can be treated with interferon and lamivudine (Heptovir)and adefovir (Hepsera).
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Chapter 47: Nursing Assessment: Urinary System
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21 Verified Questions
21 Flashcards
Source URL: https://quizplus.com/quiz/78717
Sample Questions
Q1) Which one of the following tests identifies changes in cellular structures that are indicative of malignancy?
A) Concentration test
B) Residual urine
C) Quantitative test
D) Urine cytology
Q2) A patient with a possible renal cell tumour who is scheduled for an intravenous pyelogram (IVP)and computed tomography (CT)scanning of the abdomen gives the nurse all the following data.Which information has the most immediate implications for the patient's care?
A) The patient has not had anything to eat or drink for 8 hours.
B) The patient used a bisacodyl (Dulcolax)tablet the previous night.
C) The patient describes allergies to shellfish and penicillin.
D) The patient complains of CVA tenderness.
Q3) A patient's urine dipstick reveals a large amount of protein in the urine.What is the next nursing action?
A) Check which medications the patient is currently taking.
B) Ask the patient about any family history of chronic renal failure.
C) Send a urine specimen to the laboratory to test for ketones and glucose.
D) Obtain a clean-catch urine specimen for culture and sensitivity testing.
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Chapter 48: Nursing Management: Renal and Urological Problems
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34 Flashcards
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Sample Questions
Q1) A patient with a neurogenic bladder is to be taught intermittent catheterization for bladder emptying.What should the nurse teach the patient to do?
A) Use a clean procedure with a new catheter each day.
B) Use a new,sterile catheter and sterile gloves and procedure for each catheterization.
C) Request prophylactic antibiotics if clean,rather than sterile,technique is going to be used.
D) Wash and rinse the catheter and the hands with soap and water before and after each catheterization.
Q2) The nurse anticipates that the patient with Goodpasture syndrome will be prescribed which one of the following medications?
A) A diuretic
B) An antihypertensive
C) A corticosteroid
D) Vitamin K injections
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Chapter 49: Nursing Management: Acute Kidney Injury and Chronic Kidney Disease
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35 Verified Questions
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Sample Questions
Q1) As the nurse and the dietitian review a diet plan with a patient with diabetes with newly diagnosed renal insufficiency,the patient becomes very angry,shouting that with her diabetes and now the kidney failure,there is just nothing she can eat.She says she might as well eat what she wants because these diseases will kill her anyway.Based on the patient's response,the nurse identifies which of the following nursing diagnoses?
A) Ineffective coping related to emotional lability
B) Risk for noncompliance related to feelings of anger
C) Anticipatory grieving related to actual and perceived losses
D) Risk for ineffective health maintenance related to complexity of therapeutic regimen
Q2) Before administering sodium polystyrene sulphonate (Kayexalate)to a patient with hyperkalemia,what should the nurse assess for?
A) BUN and creatinine
B) Blood glucose level
C) Patient's bowel sounds
D) Level of consciousness
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Chapter 50: Nursing Assessment: Endocrine System
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19 Flashcards
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Sample Questions
Q1) Use of nursing interventions to decrease the patient's physical and emotional stress is most important when the patient is undergoing which of the following tests?
A) A water deprivation test
B) Testing for serum T<sub>3</sub> and T<sub>4</sub> levels
C) A 24-hour urine test for free cortisol
D) A radioactive iodine uptake test
Q2) What is the most common type of feedback system in the regulation of hormones?
A) Negative
B) Positive
C) Complex
D) Chemical
Q3) When evaluating the laboratory findings of a patient with increased secretion of the anterior pituitary hormones,what would the nurse expect to find?
A) Increased urinary free cortisol
B) Decreased serum thyroxine (T<sub>4</sub>)levels
C) Low urinary excretion of catecholamines
D) Increased serum aldosterone levels
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52
Chapter 51: Nursing Management: Endocrine Problems
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39 Flashcards
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Sample Questions
Q1) A patient seeks care at the clinic because of increasing speech difficulties and hoarseness,telling the nurse his tongue has gotten so big that he can hardly talk.The physician suspects acromegaly.During the nursing history,which of the following should the nurse specifically ask the patient whether he has experienced?
A) A recent head injury
B) An increase in shoe size
C) A family history of endocrine problems
D) Symptoms of hypoglycemia,such as hunger and nervousness
Q2) A patient with Cushing's syndrome returns to the surgical unit following an adrenalectomy.During the initial postoperative period,the nurse gives the highest priority to which of the following actions?
A) Monitoring for infection
B) Protecting the patient's skin
C) Monitoring fluid and electrolyte status
D) Preventing severe emotional disturbances
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Chapter 52: Nursing Management: Diabetes Mellitus
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Sample Questions
Q1) A patient using a split mixed-dose insulin regimen tells the nurse that he is interested in using intensive insulin therapy because he has read that it promotes fewer and less severe complications of diabetes.In response to the patient's comment,what should the nurse explain?
A) Intensive insulin therapy requires three or more injections a day in addition to an injection of a basal long-acting insulin.
B) Intensive insulin therapy is indicated only for patients who have recently received a diagnosis of type 1 diabetes and who have never experienced ketoacidosis.
C) Studies have shown that intensive insulin therapy is most effective in preventing the macrovascular complications characteristic of type 2 diabetes.
D) The use of an insulin pump does not require as much attention as intensive insulin therapy and offers the same protection against long-term complications.
Q2) Which of the following is a common side effect of metformin?
A) Nausea and diarrhea
B) Edema and weight gain
C) Upper respiratory tract infections
D) Hypoglycemia
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Chapter 53: Nursing Assessment: Reproductive System
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19 Flashcards
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Sample Questions
Q1) When the nurse is performing a physical assessment of a male patient's reproductive system,which of the following findings does the nurse identify as abnormal?
A) Absence of a prepuce
B) Clear penile discharge
C) One testis descended lower than the other
D) Ability to palpate the abdominal wall along the inguinal canal
Q2) When is menopause usually considered to be complete?
A) Cessation of menses for a period of 1 year
B) Once a woman turns 55 years of age
C) When estrogen levels drop 10% below normal
D) Once ovulation has ceased for a period of 2 years
Q3) When the nurse obtains a health history from a patient,the patient reports that she had cryosurgery 1 year ago.What does the nurse anticipate that the patient most likely has a history of?
A) Obstructed fallopian tubes
B) Abnormal menstrual cycles
C) Abnormal cells detected by a Pap smear
D) A protrusion of the urinary bladder through the vaginal wall
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55
Chapter 54: Nursing Management: Breast Disorders
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23 Verified Questions
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Q1) Following a modified radical mastectomy for cancer of the breast in a 39-year-old woman,the physician recommends chemotherapy even though the lymph nodes were negative for cancer cells.The patient tells the nurse that she does not know what to do about chemotherapy because she has heard the side effects from the drugs are very uncomfortable.What nursing diagnosis would the nurse document that best reflects the patient's problem?
A) Anxiety related to prospect of additional cancer therapy
B) Fear related to uncomfortable side effects of chemotherapy
C) Decisional conflict related to lack of knowledge about treatment options and prognosis risks
D) Risk for ineffective therapeutic regimen management related to reluctance to consider additional treatment
Q2) A patient has a permanent breast implant inserted in an outpatient surgery area.What should the nurse include in the discharge teaching?
A) Resume normal activities 2 to 3 days after the mammoplasty.
B) Check wound drains for excessive blood or any foul odour.
C) Wear a loose-fitting bra to decrease irritation of the sutures.
D) Take aspirin every 4 hours to reduce inflammation.
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Chapter 55: Nursing Management: Sexually Transmitted
Infections
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15 Verified Questions
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Sample Questions
Q1) Which of the following is the most appropriate question for the nurse to ask when obtaining a detailed and accurate sexual history?
A) "Are you a homosexual?"
B) "Do you only have sex with those of the opposite sex?"
C) "Do you have sex with men or women or both?"
D) "Have you ever had anal sex?"
Q2) The incidence of syphilis has steadily increased in Canada since 1999.Which of the following groups would be at highest risk of contracting syphilis?
A) Men having sex with men
B) Married men having casual affairs
C) Women having sex with women
D) University students
Q3) The nurse should inform women who have a history of STIs that the risk of infertility or ectopic pregnancies is highest following infection by which of the following STIs?
A) Treponema pallidum
B) N.gonorrhoeae
C) Condylomata acuminata
D) Herpes simplex virus type 2 (HSV-2)
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Chapter 56: Nursing Management: Female Reproductive Problems
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40 Flashcards
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Q1) A 46-year-old woman tells the nurse that she has not had a menstrual period for 3 months and asks whether she is going into menopause.What is the best response?
A) "What other signs of decreasing estrogen production have you been experiencing?"
B) "What was your menstrual pattern before the absence of your periods the last 3 months?"
C) "You are probably starting menopause,but it will be several years before your periods stop completely."
D) "You are too young to be menopausal,and you should see your physician to determine whether other factors are causing the absence of periods."
Q2) When the nurse is caring for a patient with pelvic inflammatory disease requiring hospitalization,which of the following interventions is used to promote healing and prevent complications?
A) Encouraging fluid intake of 3000 mL/day
B) Promoting bed rest in a semi-Fowler's position
C) Promoting frequent ambulation to increase pelvic circulation
D) Teaching pelvic-strengthening exercises to be performed six to eight times a day
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Chapter 57: Nursing Management: Male Reproductive Problems
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26 Verified Questions
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Q1) Which of the following is the term given to a narrowing of the retracted uncircumcised foreskin that prevents its normal return over the glans and can cause strangulation?
A) Phimosis
B) Priapism
C) Paraphimosis
D) Hypospadias
Q2) A patient scheduled for a transurethral resection of the prostate (TURP)for BPH tells the nurse that he has delayed having surgery because he is afraid it will affect his sexual function.When responding to his concern,what should the nurse explain?
A) Many methods of sexual expression can be used as alternatives to sexual intercourse. B) Sperm production is not affected by this surgery,so he should not worry about sterility.
C) With this type of surgery,erectile problems are rare,but retrograde ejaculation may occur.
D) Information about penile implants used for erectile dysfunction is available if he is interested.
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Chapter 58: Nursing Assessment: Nervous System
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Sample Questions
Q1) When interviewing an acutely confused patient who has a head injury,which question will provide the most useful information?
A) "Have you ever been hospitalized for a neurological problem?"
B) "Do you have any pain at the present time?"
C) "What have you had to eat in the last 24 hours?"
D) "Can you describe your usual pattern for coping with injury?"
Q2) The charge nurse is observing a new staff nurse who is assessing a patient with a possible spinal cord lesion for sensation.Which action by the new nurse indicates a need for further teaching about neurological assessment?
A) Tests for light touch before testing for pain
B) Has the patient close the eyes during testing
C) Tells the patient,"You may feel a pinprick now."
D) Uses an irregular pattern to test for intact touch
Q3) For a patient who has a corticospinal tract lesion,the nurse should assess for which of the following?
A) Extremity movement and strength
B) Cranial nerve function
C) Peripheral sensitivity to pain
D) Level of consciousness
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Page 60
Chapter 59: Nursing Management: Acute Intracranial Problems
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Sample Questions
Q1) A patient with a serum sodium level of 115 mmol/L has a decreasing level of consciousness (LOC)and complains of a headache.Which of the following orders should be the priority?
A) Administer acetaminophen (Tylenol)650 mg orally.
B) Administer 5% hypertonic saline intravenously.
C) Draw blood for arterial blood gases (ABGs).
D) Send the patient to the radiology department for computed tomography of the head.
Q2) When the nurse applies a painful stimulus to an unconscious patient,the patient responds by stiffly extending and abducting the arms and hyperpronating the wrists.How should the nurse interpret this finding?
A) Decorticate posturing indicating an interruption of voluntary motor tracts
B) Decerebrate posturing indicating an interruption of voluntary motor tracts
C) Decorticate posturing indicating a disruption of motor fibres in the midbrain and brainstem
D) Decerebrate posturing indicating a disruption of motor fibres in the midbrain and brainstem
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Chapter 60: Nursing Management: Stroke
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28 Flashcards
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Sample Questions
Q1) The nurse identifies the nursing diagnosis of imbalanced nutrition: less than body requirements related to inability to feed self for a patient with right-sided hemiplegia.What is an appropriate nursing intervention to help improve the patient's nutrition?
A) Assist the patient to eat with her left hand.
B) Provide a puréed diet that is easy for the patient to swallow.
C) Stroke the patient's throat while feeding her to stimulate swallowing of food.
D) Provide a wide variety of food choices on the meal tray to stimulate her appetite.
Q2) Twenty-four hours after admission,a patient with a stroke has progressive development of neurological deficits with increasing weakness and decreased level of consciousness.What is the primary goal of nursing management of the patient at this time?
A) Protecting the skin from breakdown
B) Monitoring for changes in neurological status
C) Maintaining the patient's respiratory function
D) Preventing joint contractures and muscle atrophy
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Chapter 61: Nursing Management: Chronic Neurological Problems
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Sample Questions
Q1) A patient with MG has a nursing diagnosis of altered nutrition: less than body requirements related to impaired swallowing.To promote nutrition,the nurse suggests that before meals,the patient should avoid which of the following actions?
A) Writing letters
B) Talking on the telephone
C) Typing on the computer
D) Taking pyridostigmine (Mestinon)
Q2) A patient with Parkinson's disease has decreased tongue mobility and an inability to move his facial muscles.The nurse documents which of the following nursing diagnoses that reflects these impairments?
A) Disuse syndrome related to loss of muscle control
B) Self-care deficit related to bradykinesia and rigidity
C) Impaired verbal communication related to difficulty swallowing
D) Impaired oral mucous membranes related to inability to swallow saliva
Q3) Which of the following is a clinical manifestation of myasthenia gravis (MG)?
A) Bulging eyes
B) Scotoma
C) Unstable gait
D) Hypertension
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Chapter
Disease,and Other Dementias
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Sample Questions
Q1) When assessing a patient with Alzheimer's disease who is being admitted to a long-term care facility,the nurse learns that the patient has had several episodes of wandering away from home.Which nursing action will the nurse include in the plan of care?
A) Ask the patient why the wandering episodes have occurred.
B) Reorient the patient to the new living situation several times daily.
C) Place the patient in a room close to the nurses' station.
D) Have the family bring in familiar items from the patient's home.
Q2) Which of the following is a rare and fatal infectious brain disorder that progresses rapidly to death within 1 year?
A) Vascular dementia
B) Dementia with Lewy bodies
C) Creutzfeldt-Jakob disease
D) Neurofibrillary tangle disease
Q3) Which of the following is a modifiable risk factor for reducing the risk for getting Alzheimer's disease?
A) Type 1 diabetes
B) Hypotension
C) Inadequate intellectual stimulation
D) Inadequate nutrition
Page 64
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Chapter 63: Nursing Management: Peripheral Nerve and Spinal Cord Problems
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Sample Questions
Q1) The nurse discusses long-range goals with a patient with a C6 spinal cord injury.What is an appropriate patient outcome for the patient?
A) Transfers independently to a wheelchair
B) Drives a car with powered hand controls
C) Feeds himself with powered hand splints
D) Pushes a wheelchair on flat,smooth surfaces
Q2) A patient with a T2 spinal cord injury is beginning intensive rehabilitation.One morning as the nurse prepares to assist her to transfer to the wheelchair,the patient tells the nurse that she does not feel like getting up,that she has a throbbing headache,and that she is slightly nauseated.What is it most important that the nurse do?
A) Notify the physician.
B) Check the patient's blood pressure.
C) Tell her she will feel better if she sits upright in her wheelchair.
D) Do a digital rectal examination for the presence of an impaction.
Q3) Spinal cord injuries occur most frequently in which age group?
A) 1 to 8 years
B) 10 to 15 years
C) 15 to 25 years
D) 35 to 50 years
Page 65
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Chapter 64: Nursing Assessment: Musculoskeletal System
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Sample Questions
Q1) Which type of bone cell plays a role in bone remodelling?
A) Osteoblast
B) Osteoclast
C) Osteocyte
D) Osteon
Q2) When assessing the musculoskeletal system,what is the nurse's initial action?
A) Have the patient move the extremities against resistance.
B) Feel for the presence of crepitus during joint movement.
C) Observe the patient's body build and muscle configuration.
D) Check active and passive range of motion for the extremities.
Q3) A patient is seen at the urgent care centre following a blunt injury to his left knee.The knee is grossly swollen and very painful,but the skin is intact.During an arthrocentesis on the patient's knee,how would the nurse expect the aspirated fluid to appear?
A) Sanguineous
B) Purulent and thick
C) Light yellow in colour
D) White,thick,and ropelike
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Chapter 65: Nursing Management: Musculoskeletal
Trauma and Orthopedic Surgery
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Sample Questions
Q1) A 20-year-old baseball pitcher has an arthroscopic repair of a rotator cuff injury performed as same-day surgery.When the nurse plans postoperative teaching for the patient,which information will be included?
A) "You have an appointment with a physiotherapist for tomorrow."
B) "Leave the shoulder immobilizer on for the first few days to minimize pain."
C) "The doctor will use the drop-arm test to determine the success of the procedure."
D) "You should try to find a different position to play on the baseball team."
Q2) A cashier in a grocery store has muscle and tendon tears that have become inflamed,causing pain and weakness in her left hand and elbow.What should the nurse identify these symptoms as being related to?
A) Bursitis
B) Meniscus injury
C) Repetitive strain injury (RSI)
D) Carpal tunnel syndrome
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Chapter 66: Nursing Management: Musculoskeletal
Problems
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Sample Questions
Q1) Which of the following foods would the nurse recommend to the patient as having the highest amount of calcium per serving,to increase the patient's nutritional intake of calcium?
A) Yogourt
B) Whole milk
C) Shrimp
D) Salmon
Q2) Which statement by a patient who is scheduled for an above-the-knee amputation for treatment of osteosarcoma of the right tibia indicates that patient teaching is needed?
A) "I wish that I did not have to have chemotherapy after this surgery."
B) "I do not mind the surgery because it will finally cure the cancer."
C) "I know that I will need a lot of physiotherapy after surgery."
D) "I will use the patient-controlled analgesia to help control my pain level after surgery."
Q3) Which reflex is affected in a patient with a disc herniation at the level of L3?
A) None
B) Patellar
C) Achilles
D) Deep-tendon reflex
Page 68
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Chapter 67: Nursing Management: Arthritis and Connective
Tissue Diseases
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Sample Questions
Q1) A 58-year-old woman has been diagnosed with primary OA of her hands and feet.She is very upset about the diagnosis and tells the nurse she is too young to have arthritis and at this rate she will be hopelessly crippled by the time she is 70.What is the best response to the patient?
A) Osteoarthritis can be well controlled with a regimen of exercise,diet,and medications.
B) Osteoarthritis is an inflammatory disease of the joints,which may occur at any age.
C) Joint degeneration with pain and deformity occurs in the majority of people by the age of 60.
D) Osteoarthritis is more common with aging but usually is localized and does not cause deformity.
Q2) When reviewing laboratory data for a patient who is taking methotrexate,which information is most important to communicate to the physician?
A) The platelet count is 130,000 cells/microlitre.
B) The white blood cell (WBC)count is 1500 cells/microlitre.
C) The blood glucose is 7.2 mmol/L (130 mg/dL).
D) The potassium concentration is 5.2 mmol/L.
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Chapter 68: Nursing Management: Critical Care Environment
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Q1) A patient with a subarachnoid hemorrhage is intubated and placed on a mechanical volume-cycled ventilator in the spontaneous intermittent mandatory volume mode,FIO<sub>2</sub> 40%,rate 14,tidal volume 700,with 10 cm of PEEP.Which of the following indicates a need for the nurse to notify the physician?
A) Respiratory rate of 18 breaths/min
B) O<sub>2</sub> saturation of 94%
C) Increased jugular vein distension
D) Greenish brown nasogastric tube drainage
Q2) While assessing a patient with a central venous catheter in place in the left subclavian vein,the nurse notes that the catheter insertion site is red and tender and that the patient's temperature is 38.8°C.The nurse will plan to implement which of the following?
A) Change the flush system and monitor the site.
B) Administer analgesics and antibiotics.
C) Discontinue the catheter,and culture the tip.
D) Check the site frequently for any swelling.
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Chapter 69: Nursing Management: Shock,systemic
Inflammatory Response Syndrome,and Multiple-Organ
Dysfunction Syndrome
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24 Verified Questions
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Q1) Which of the following nursing interventions prevents the development of shock?
A) Routine checking of stools for occult blood
B) Keeping patients warm to prevent chilling or shivering
C) Identifying situations in which patients are at risk for shock
D) Frequent monitoring of patient status to detect compensatory changes
Q2) Which hemodynamic results would the nurse anticipate in a patient who is in cardiogenic shock?
A) Increased heart rate (HR),blood pressure (BP),and cardiac output (CO<sub>2</sub>)
B) Increased HR,decreased BP and CO<sub>2</sub>
C) Decreased HR,BP,and CO<sub>2</sub>
D) Decreased HR,increased BP and CO<sub>2</sub>
Q3) The triage nurse receives a call from a community member who is driving an unconscious friend with multiple injuries after a motorcycle accident to the hospital.The caller states that they will be arriving in 1 minute.What will the nurse obtain in preparation for the patient's arrival?
A) A litre of lactated Ringer's solution
B) 500 mL of 5% albumin
C) Two 14-gauge IV catheters
D) A retention catheter
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Chapter 70: Nursing Management: Respiratory Failure and
Acute Respiratory Distress Syndrome
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Sample Questions
Q1) While caring for a patient with a pulmonary embolism,the nurse notes a change in the patient's arterial oxygen saturation by pulse oximetry (SpO<sub>2</sub>)from 94% to 88%.The nurse recognizes that management of this patient's hypoxemia usually requires which of the following treatments?
A) Positive pressure ventilation (PPV)
B) Drugs that relieve bronchospasm
C) Removal of respiratory secretions
D) Administration of supplemental oxygen
Q2) To evaluate both oxygenation and ventilation in a patient with acute respiratory failure,the nurse uses the findings revealed with which of the following monitoring methods?
A) Chest X-ray films
B) Pulse oximetry
C) Arterial blood gas (ABG)analysis
D) Hemodynamic monitoring
Q3) Which assessment finding would the nurse expect in a patient with hypercapnia?
A) Increased tidal volume
B) Increased minute ventilation
C) Dyspnea
D) Bradycardia
Page 72
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Chapter 71: Nursing Management: Emergency Care Situations
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Q1) During immediate care of a victim of a bite or sting to the hands or fingers,it is most important for the nurse to carry out which of the following actions?
A) Elevate the affected extremity.
B) Scrub the wound with an antibacterial solution.
C) Apply ice to the site with ice water or ice packs.
D) Remove rings and watches from the affected extremity.
Q2) Which of the following is a cause of a life-threatening condition that the nurse identifies during the primary survey?
A) Pneumonia
B) Controlled hemorrhage
C) Hyperthermia
D) Flail chest with pulmonary contusion
Q3) Which assessment finding would the nurse anticipate with a patient who is hypothermic?
A) Hyperventilation
B) Hypertension
C) Tachycardia
D) Fixed,dilated pupils
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Chapter 72: Emergency Preparedness and Disaster Management
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Q1) When planning the response to the potential use of smallpox as a biological weapon,the emergency department nurse manager will ensure that sufficient quantities of which of the following are available?
A) Blood
B) Vaccine
C) Antitoxin
D) Antibiotics
Q2) The incident management system (IMS)used in Canada is based on the incident command system that was developed as a result of which event?
A) Tsunami off the coast of Tahiti
B) Wildfires in California
C) Floods in Saskatchewan
D) Drought in Alberta
Q3) Following a national disaster,which government agency is responsible for providing safe drinking water and supportive medical services?
A) Health Canada
B) Public Safety Canada
C) Department of National Defence
D) Canadian Red Cross
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