Advanced Medical-Surgical Nursing
Final Exam Questions
Course Introduction
Advanced Medical-Surgical Nursing delves into the complex care of adult patients experiencing acute and chronic health conditions across a variety of clinical settings. This course emphasizes critical thinking, clinical judgment, and evidence-based practice in managing complications related to multiple organ systems, perioperative care, trauma, oncology, and infectious diseases. Students are expected to integrate advanced assessment skills, interdisciplinary collaboration, and patient teaching to enhance outcomes and promote holistic care. Ethical, legal, and cultural considerations are also explored, preparing nurses for leadership roles in decision-making and advanced patient management.
Recommended Textbook
Medical Surgical Nursing Clinical Management for Positive Outcomes Single Volume 8th Edition
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82 Chapters
1873 Verified Questions
1873 Flashcards
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Chapter 1: Health Promotion and Disease Prevention
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21 Verified Questions
21 Flashcards
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Sample Questions
Q1) A nurse is teaching women breast self-examination (BSE). When designing a teaching program, the nurse is aware that the biggest barrier to women doing BSE is
A) better screening tools like mammograms.
B) discomfort and pain when doing the exam.
C) lack of confidence when performing the exam.
D) realization that breast cancer is not a leading cause of cancer death in women.
Answer: C
Q2) During a nursing history before a physical exam, a nurse identifies a client as being in a violent relationship. The most important intervention by the nurse at this time is to
A) ask the physician to order a series of x-rays to look for old broken bones.
B) call the police if the abusive partner is in the waiting room.
C) help the woman develop an individual plan to diminish future abuse.
D) refer her to the local battered women's shelter.
Answer: C
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Chapter 2: Health Assessment
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14 Verified Questions
14 Flashcards
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Sample Questions
Q1) Palpation
A) 1
B) 2
C) 3
D) 4
Answer: D
Q2) Percussion
A) 1
B) 2
C) 3
D) 4
Answer: A
Q3) To assess precipitating factors, the nurse interviewer would ask
A) "Do you remember the first time you had this problem?"
B) "How many times has the problem been related to activity?"
C) "What measures relieve this problem for you?"
D) "What were you doing when you first noticed the problem?"
Answer: D
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Chapter 3: Critical Thinking
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8 Verified Questions
8 Flashcards
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Sample Questions
Q1) A nurse who is alert to changes, confident, open-minded, proactive, and questioning is displaying which characteristics?
A) Alfaro's Attitudes and Characteristics of a Critical Thinker
B) Benner's Five Levels of Competency in Nurses
C) Hawk's Model of Critical Thinking in Registered Nurses
D) Universal Intellectual Standards
Answer: A
Q2) A nurse with 6 year's labor and delivery experience is floated to the intensive care unit. In this situation, the nurse would most likely function at the level of A) advanced beginner.
B) competent.
C) novice.
D) proficient.
Answer: C
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Chapter 4: Complementary and Alternative Therapies
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12 Verified Questions
12 Flashcards
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Sample Questions
Q1) Because of the repetitive, slow, controlled movement involved, the nurse suggests that a client with arthritis may benefit from the CAM therapy of A) Ayurveda.
B) biofeedback.
C) Reiki.
D) Tai Chi.
Q2) A nurse understands that many conventional drugs are derived from plants, such as A) meperidine (Demerol).
B) penicillin.
C) quinine.
D) steroids.
Q3) A young Hispanic woman tells the nurse that she is going to have a healing ritual to center her spirit after the recent death of her husband. The nurse recognizes the alternative medicine system of A) Ayurveda.
B) Curanderismo.
C) Reiki.
D) Tai Chi.
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6
Chapter 5: Ambulatory Health Care
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20 Flashcards
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Sample Questions
Q1) The nurse instructor describes an integrated delivery system and cites the example of
A) a hospital's alignment with several physician groups to increase hospital referral.
B) an outpatient clinic in the hospital.
C) enrollees of the system being "locked" into the system of care for services.
D) providers concerned about generating revenue.
Q2) In a telephone consultation, the ambulatory care center nurse may
A) assess cardiac or fetal monitoring.
B) decide how soon the client should be seen at the center.
C) give advice based on the nurse's phone assessment.
D) teach a specific procedure based on approved protocols.
Q3) Ambulatory care centers include
A) care available 24 hours a day, 7 days a week.
B) care for short-term medical-surgical procedures.
C) services for those unable to provide self-care after a procedure.
D) sleeping accommodations for a family member.
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Chapter 6: Acute Health Care
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14 Flashcards
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Sample Questions
Q1) A planned program of loss prevention and liability control best defines
A) client satisfaction.
B) clinical pathway.
C) quality assurance.
D) risk management.
Q2) A hospital staff nurse is collaborating with a nurse case manager in planning the care of a client with a below-the-knee amputation. The primary role of the case manager is
A) client education on specialized care.
B) coordination of care for the client.
C) direct care of the client's medical problems.
D) education of the staff nurse.
Q3) A client experiences chest pain with electrocardiographic changes during an appointment with the primary care physician, and the physician orders hospital admission for cardiac monitoring. This type of admission is a(n)
A) elective admission.
B) emergency admission.
C) direct admission.
D) scheduled admission.
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Page 8
Chapter 7: Critical Care
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10 Verified Questions
10 Flashcards
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Sample Questions
Q1) The nurse admitting clients to the critical care unit understands that priority clients for this area are those who need
A) a cleaner environment to prevent nosocomial infections.
B) continuous physiologic monitoring.
C) frequent vital sign checks.
D) private rooms conducive to rest and sleep.
Q2) The essential nurse competency that the critical care nurse uses when providing best care practices is
A) advocacy.
B) clinical inquiry.
C) clinical judgment.
D) systems thinking.
Q3) The nurse admitting clients to an intensive care unit understands that research demonstrates best client outcomes when clients
A) are in an area that allows liberal family visitation.
B) have consistent nurses caring for them.
C) have state of the art physiologic monitoring.
D) receive multidisciplinary care led by an intensivist.
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9
Chapter 8: Home Health Care
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12 Verified Questions
12 Flashcards
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Sample Questions
Q1) The home health nurse explains that her philosophy is based on the belief that clients should
A) adhere to the care plan generated by the nurse.
B) alter cultural practices to meet health needs.
C) be knowledgeable about their health care.
D) feel no responsibility for their health care.
Q2) The domain of the Omaha System that the nurse would reference in making her assessment relative to caretaking/parenting is
A) Environment.
B) Health-Related Behaviors.
C) Physiological.
D) Psychosocial.
Q3) The home health nurse uses the Omaha System for planning care and is able to evaluate the client's health status with the portion of that tool known as A) Assessment and Analysis.
B) Intervention Scheme.
C) Problem Classification.
D) Problem Rating Scale.
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Chapter 9: Long-Term Care
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Sample Questions
Q1) A nurse teaching a new resident and family about the Resident Rights outlined by OBRA would include which information? A resident has the right to A) be informed of rights, rules, and responsibilities.
B) choose activities and care.
C) have clean, safe, home-like environment.
D) organize and participate in resident groups.
Q2) The Omnibus Budget Reconciliation Act of 1987 (OBRA) affected nursing homes by A) allowing residents more choice in the selection of a nursing home. B) mandating that each resident have a private room and bath.
C) producing profound reforms in nursing home care.
D) providing for better funding to meet the needs of the residents.
Q3) After a long-term care facility nurse receives a phone order from the physician, the nurse must ensure that the order is countersigned in A) 8 hours.
B) 12 hours.
C) 24 hours.
D) 48 hours.
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Chapter 10: Rehabilitation
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10 Flashcards
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Sample Questions
Q1) The rehabilitation nurse reminds a client that according to the International Classification of Functioning, Disability and Health (ICF), the broad theoretical qualification criterion for rehabilitation services is that the client
A) has impaired mobility in two limbs.
B) has impairments that lead to reduced ability to engage in activities.
C) is no longer capable of independent living.
D) requires assistance in mobility, dressing, and toileting.
Q2) The rehabilitation nurse stresses that the major focus in a rehabilitation setting is A) acquisition of services for the newly discharged client.
B) elimination of clinical manifestations.
C) prevention of disease progression.
D) skills' instruction for independence.
Q3) The nurse makes sure that the client and the family understand that in the transdisciplinary approach, the entire team
A) estimates the time required for full functioning.
B) identifies a primary therapist.
C) limits what each discipline will offer.
D) sets team goals during transdisciplinary meetings.
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Chapter 11: Clients with Fluid Imbalances
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17 Verified Questions
17 Flashcards
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Sample Questions
Q1) A client with hyponatremia is on a fluid restriction diet and complains of extreme dry mouth. Interventions the nurse can include in the plan of care include (Select all that apply)
A) encouraging the client to take warm, not cold, fluids.
B) giving the client ice chips instead of water.
C) increasing the frequency of oral care.
D) instructing the client to hold ice chips in the mouth.
E) using a commercial mouthwash every 2 hours.
Q2) The nurse who is caring for a client prescribed diuretics and fluid restriction to control edema can most easily evaluate the effectiveness of the medical protocol by A) calculating plasma osmolality.
B) careful weight assessment.
C) checking the lab report on serum sodium level.
D) measuring the ankle circumference.
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13
Chapter 12: Clients with Electrolyte Imbalances
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21 Verified Questions
21 Flashcards
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Sample Questions
Q1) A client has been admitted in a hypercalcemic crisis and the family is distraught. One family member grabs the nurse's hand and states "I just don't know what I'll do if he/she dies!" The best response by the nurse is
A) "Don't worry. We see this and treat it all the time in clients just like this."
B) "I know that you are upset, but I have to take care of the client first."
C) "What has your loved one been eating and drinking during the last week?"
D) "Yes, this is serious but I can come back and answer some questions for you."
Q2) A client is being discharged after successful treatment for hyperphosphatemia. The nurse would know that diet teaching has been effective when the client says, "I can't eat large amounts of
A) bananas."
B) dairy products."
C) fatty foods."
D) green leafy vegetables."
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14
Chapter 13: Acid-Base Balance
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) A client in diabetic ketoacidosis has an elevated serum potassium ion (K<sup>+</sup>) level. The nurse explains to the client that this is caused by
A) bicarbonate loss in the urine instead of K+ loss.
B) binding of H+ to blood proteins.
C) increased reabsorption of K+ in the distal tubule of the nephron.
D) secretion by the kidneys of H<sup>+</sup> and retention of K+.
Q2) A client has a blood pH of 7.30 and is being treated with an infusion of sodium bicarbonate. The nurse should assess this client for a possible delayed reaction of increasing levels of which component in the blood?
A) Bicarbonate
B) Calcium
C) Carbon dioxide
D) Glucose
Q3) The nurse explains to a concerned family member of a client who has developed respiratory acidosis that the kidneys
A) achieve optimal compensation immediately.
B) are unable to compensate.
C) can achieve optimal compensation in about 3 days.
D) will compensate within 24 hours.
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Page 15
Chapter 14: Clients Having Surgery
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38 Verified Questions
38 Flashcards
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Sample Questions
Q1) On the preoperative assessment, the nurse notes the suggestion of susceptibility to malignant hyperthermia during surgery in the client's statement that
A) "I frequently have numbness and tingling in my hands."
B) "I usually feel very warm and tend to perspire heavily."
C) "My mother died from anesthesia problems."
D) "On occasion I've had muscle tenderness around my jaw."
Q2) The PACU nurse is informed that the client being admitted has not recovered his pharyngeal reflex. The nursing action that should receive greatest priority is to
A) check for the gag reflex frequently.
B) maintain an oral airway.
C) remain with the client at all times.
D) suction the client frequently.
Q3) Assessing unilateral leg edema and warmth in a postoperative client complaining of pain, the surgical unit nurse suspects the complication of A) hypovolemia.
B) myocardial infarction.
C) pneumonia.
D) thrombophlebitis.
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Chapter 15: Perspectives in Genetics
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12 Verified Questions
12 Flashcards
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Sample Questions
Q1) A nurse explains to a family that if a man has a recessive gene on his X chromosome, that characteristic can be passed on to
A) any child of either gender.
B) his daughters.
C) his sons.
D) no child as it is a random mutation.
Q2) The Human Genome Project (HGP) was begun in 1990 to
A) alter the course of inherited disorders.
B) clone an animal, then a human.
C) determine the location of genes on chromosomes.
D) replicate the structure of deoxyribonucleic acid (DNA).
Q3) The nurse obtaining consent for genetic testing realizes that the elements of informed consent include (Select all that apply)
A) other options for risk assessment.
B) the possibility that the results will be ambiguous.
C) procedures for giving results to insurance companies.
D) risks that nonrelatedness will be discovered.
E) the purpose of the test.
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Chapter 16: Perspectives in Oncology
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14 Flashcards
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Sample Questions
Q1) A client has a benign tumor that has originated in adipose tissue. The nurse explains that this type of tumor is classified as a A) fibroma.
B) lipoma.
C) leiomyoma.
D) carcinoma.
Q2) A nurse is administering IV chemotherapy. What personal protective equipment (PPE) should the nurse use when doing this task?
A) A gown and gloves
B) Gloves and a mask
C) No special PPE is needed
D) Only gloves
Q3) The number of new cancer cases diagnosed has increased steadily since 1900. The nurse explains to a client that one of the reasons for this increase is that A) cancer is related to most birth defects.
B) many false-positive cancer results are reported.
C) people who live longer are less prone to cancer.
D) statistical analysis and reporting are more accurate.
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18
Chapter 17: Clients with Cancer
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30 Verified Questions
30 Flashcards
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Sample Questions
Q1) The specially prepared nurse administering chemotherapeutic drugs should A) administer intravenous medications only through VADs.
B) apply ice to the area after an intramuscular injection of chemotherapy.
C) wear a mask during administration of the agent.
D) wear gloves and a gown during preparation and administration of the drugs.
Q2) The nurse has assigned the nursing diagnosis Imbalanced Nutrition: Less than Body Requirements, Related to Anorexia for a client with colon cancer. Nursing goals include the maintenance of present body weight. To achieve this goal, the nurse should suggest a diet that is high in
A) calories and low in cholesterol.
B) fat and calories.
C) fat and low in bulk.
D) protein and calories.
Q3) The nurse is administering medication in phase III trials to a client with lung cancer. Assessments made in this phase of the drug investigation involve
A) determination of the maximum tolerated dose.
B) evaluation of the drug's general effectiveness.
C) explanation of how the drug compares with standard treatments.
D) description of the type and severity of side effects.
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Page 19
Chapter 18: Clients with Wounds
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24 Verified Questions
24 Flashcards
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Sample Questions
Q1) The nurse caring for a client receiving wet-to-dry dressings for mechanical debridement of a large wound would be aware that proper technique requires that the dressing should
A) be left in place about 12 hours.
B) be removed when it is totally dry.
C) cause slight bleeding when removed to be effective.
D) only be moist, not wet, when applied.
Q2) When caring for a client with a wound healing by secondary intention, the nurse considers during care planning that this type of wound is
A) healed with skin grafts.
B) prone to dehiscence.
C) sealed with sutures.
D) susceptible to infection.
Q3) A nurse is changing a dressing over a client's abdominal surgical incision. Which action by the nurse is most important?
A) Apply dressings using aseptic or sterile technique.
B) Irrigate the wound with copious amounts of solution.
C) Use strict sterile technique, including sterile gloves.
D) Wash the suture line carefully to remove debris.
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Page 20
Chapter 19: Perspectives on Infectious Disease and Bioterrorism
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23 Verified Questions
23 Flashcards
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Sample Questions
Q1) The nurse is aware that anthrax is at the top of the threat list for bioterror weapons because (Select all that apply)
A) early manifestations are vague and look like a cold.
B) it would have a high mortality rate.
C) the attack would be invisible and odorless.
D) there is no vaccination available.
Q2) The nurse caring for a client who develops a urinary tract infection during hospitalization explains that the infection is likely a
A) consequence of bacteremia.
B) nidus formation.
C) nosocomial infection.
D) viral infection.
Q3) The nurse explaining an infection to a client with the flu would describe an infection as a/an
A) defect in the immune system.
B) hypersensitivity reaction between a human antigen and a biologic agent.
C) inflammatory response to an irritant.
D) parasitic relationship between an organism and host.
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Chapter 20: Clients with Pain
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29 Verified Questions
29 Flashcards
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Sample Questions
Q1) A nurse is describing a client to a nursing student as "watching the clock" for the next dose of pain medication, "liking pain medication too much," and being overly dramatic when expressing pain. This nurse described the client as addicted. The nursing instructor conferences with the student later, describing the client's behavior as
A) addicted, because the instructor agrees with the staff nurse's opinion.
B) consistent with increasing tolerance to the ordered pain medication.
C) displaying behaviors consistent with pseudoaddiction.
D) requiring the assistance of a psychiatric social worker.
Q2) A client who had surgery refuses pain medication. The nurse assessing this client would first ask questions regarding the client's (select all that apply)
A) beliefs about the benefits of placebos.
B) cultural expectations regarding pain behaviors and pain treatment.
C) interpretation or meaning the client gives to the pain.
D) prior experiences with pain and pain relief.
E) understanding how different pain medications work.
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22
Chapter 21: Perspectives in Palliative Care
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Sample Questions
Q1) A client using a new opioid analgesic for pain becomes drowsy after the first two doses. The nurse explains to the client and family that the dose may be too high if this persists for more than
A) 1 day.
B) 2 to 3 days.
C) 5 to 7 days.
D) 7 to 10 days.
Q2) A client on hospice service reports experiencing a "colicky" type of pain. To relieve this clinical manifestation, the hospice nurse would request an order for a(n)
A) anticholinergic.
B) nonsteroidal anti-inflammatory drug.
C) opioid analgesic.
D) salicylate.
Q3) A hospice nurse reevaluates the pain management plan for a client who requires more than
A) four rescue doses in a 24-hour period.
B) one rescue dose in a 48-hour period.
C) three rescue doses in a 48-hour period.
D) two rescue doses in a 24-hour period.
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Page 23
Chapter 22: Clients with Sleep and Rest Disorders and Fatigue
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Sample Questions
Q1) A hospitalized client complains that the loud noise and activity outside the room hinders sleep. The physician leaves an order for a hypnotic agent. The night nurse administering this medication needs to monitor client safety afterwards because these medications may cause (Select all that apply)
A) antegrade amnesia.
B) hangover effects.
C) increased falls and hip fractures.
D) less time in REM sleep.
E) restless leg syndrome.
Q2) When a client tells the nurse that she has been experiencing early-morning awakening, the nurse should assess the client for manifestations of A) depression.
B) psychophysiologic insomnia.
C) respiratory problems.
D) sleep deprivation.
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Chapter 23: Clients with Psychosocial and Mental Health
Concerns
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Sample Questions
Q1) A nurse questions a client with panic disorder about whether a parent or sibling also has a panic disorder. This nurse is using a
A) behavioral approach.
B) biologic approach.
C) psychoanalytic approach.
D) psychodynamic approach.
Q2) A nurse observes that an older client is laughing forcefully when describing the strain of caring for the spouse, who has Alzheimer's disease. The client states that neither one of them goes to church or participates in any social events any longer. Other than caring for the person with Alzheimer's disease, the spouse spends much free time sleeping. The nurse would need to assess this client more for (Select all that apply)
A) changes in appetite.
B) decreased ability to concentrate.
C) excessive spending sprees.
D) feeling guilt or hopelessness.
E) suicidal thoughts.
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25
Chapter 24: Clients with Substance Abuse Disorders
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Sample Questions
Q1) During history-taking, a client tells the nurse that he is addicted to caffeine and that he drinks 10 to 12 cups of coffee a day as well as several cola drinks and iced tea. The nurse would warn the client that during his NPO status for surgery, he should expect to experience
A) diarrhea.
B) euphoria.
C) headache.
D) itching.
Q2) For a client experiencing alcohol withdrawal, the action that the nurse would include in the client's plan of care is to
A) describe how the alcohol is causing the withdrawal effects.
B) leave the client by him/herself so as not to cause agitation.
C) promote a safe, calm, and comfortable environment.
D) refer the client to an alcohol-abuse counselor.
Q3) The theory that describes substance abuse as a learned behavior is called the A) biologic model.
B) family system model.
C) psychological model.
D) sociocultural model.
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Page 26
Chapter 25: Assessment of the Musculoskeletal System
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Sample Questions
Q1) A client with a new cast for his fractured ulna tells the nurse that he cannot feel his fingers. The nurse should initially
A) check for capillary refill in the client's fingers.
B) notify the physician immediately.
C) reassure the client that this is normal.
D) remove the padding around the fingers to increase space.
Q2) The nurse is performing a musculoskeletal assessment on a client who is right-hand dominant. The variation in muscle mass the nurse expects to find is A) atrophy.
B) fasciculations.
C) hypertrophy.
D) tremors.
Q3) The client who has osteoarthritis describes a grating sound in the hip. The nurse explains that this bothersome manifestation is related to A) bursa enlargement.
B) joint irregularities.
C) normal findings with age.
D) the presence of fluid.
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Chapter 26: Management of Clients with Musculoskeletal Disorders
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Sample Questions
Q1) The nurse counseling a client with osteoporosis identifies one of the medications that may have contributed to the condition as
A) aspirin.
B) colchicine.
C) ibuprofen.
D) prednisone.
Q2) A client wears joint-protecting splints and needs assistance with some ADLs and mobility. The nurse delegating this care to an unlicensed assistive personnel (UAP) should (Select all that apply)
A) allow the UAP to do as much for the client as possible.
B) assess the client's baseline status and make modifications to the care plan.
C) instruct the UAP to have the client stop activities that cause new pain.
D) tell the UAP to report any redness or skin irritation under the splint to the nurse.
E) verify the UAP's competency to do the assigned tasks.
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Chapter 27: Management of Clients with Musculoskeletal
Trauma or Overuse
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Sample Questions
Q1) The nursing intervention that would be most appropriate for a client who has entered the emergency department with a severe strain to the knee is A) apply a heat pack to reduce swelling.
B) elevate the leg and apply ice.
C) manipulate the knee in the full range of motion. D) teach the client exercises to speed healing.
Q2) A client who has undergone repair of the anterior cruciate ligament complains that the use of the continuous passive motion (CPM) machine causes pain and asks how long he is expected to use the machine. The nurse's most appropriate response would be
A) "I will give you pain medication to make you comfortable, since you should use the machine at least 8 hours out of 24."
B) "Try using the machine for 1 hour of every 4 hours, and see if that schedule reduces your discomfort."
C) "You do not have to use the machine for the next few days. You can resume after the pain subsides."
D) "You should use the machine continuously. I will ask the physician to increase your dose of analgesics."
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Chapter 28: Assessment of Nutrition and the Digestive System
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Sample Questions
Q1) The nurse is assessing the abdomen of an obese 67-year-old client who is admitted to the emergency department. The finding noted during the abdominal examination that requires further assessment is
A) flat appearance below the umbilicus.
B) rounded abdominal contour.
C) umbilicus that is concave.
D) visible peristalsis.
Q2) For a client taking a histamine H? blocker to reduce clinical manifestations of gastritis, the nurse would clarify that the client is at risk for a possible deficiency of vitamin
A) A.
B) B<sub>12</sub>.
C) C.
D) D.
Q3) When preparing a client for gastric analysis, the nurse should plan for A) antacid administration.
B) fluoroscopic examination.
C) frequent expectoration for samples.
D) nasogastric tube insertion.
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Chapter 29: Management of Clients with Malnutrition
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21 Verified Questions
21 Flashcards
Source URL: https://quizplus.com/quiz/4027
Sample Questions
Q1) A client with anorexia nervosa has a nursing diagnosis of Imbalanced Nutrition: Less than Body Requirements related to inadequate food intake. The client's current weight is 92 pounds. The nurse would evaluate that the client is making safe progress if the weight after 1 week is
A) 107 pounds.
B) 102 pounds.
C) 97 pounds.
D) 94 pounds.
Q2) The nurse's action that will best prevent clogging of a gastric feeding tube is to A) adhere to the tube flushing protocol.
B) apply intermittent suction.
C) check tube placement every 4 hours.
D) periodically reposition the tube.
Q3) A client who is diagnosed with bulimia would be most likely to manifest the psychosocial alteration of A) denial.
B) depression.
C) self-mutilation.
D) social withdrawal.
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Page 31
Chapter 30: Management of Clients with Ingestive Disorders
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29 Verified Questions
29 Flashcards
Source URL: https://quizplus.com/quiz/4028
Sample Questions
Q1) The nurse would assess the client with an early mechanical obstruction of the esophagus for
A) aspiration.
B) coughing.
C) dysphagia.
D) vomiting.
Q2) A client admitted for evaluation of gastroesophageal reflux disease (GERD) begins to complain of severe "heartburn" in the chest that radiates to the jaw. The client asks for the nitroglycerin (NTG) tablets brought in from home. The nurse realizes that the clinical manifestations demonstrated by the client are
A) classic manifestations of a myocardial infarction, and the physician should be paged immediately.
B) greatly influenced by fear related to the location of the pain, and the use of NTG should be discouraged.
C) indications that a thorough pain assessment should be done to determine the etiology of the pain, and the NTG should be given at once.
D) specifically associated with GERD and not myocardial infarction, but the NTG should be allowed if the client wants to use it.
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Chapter 31: Management of Clients with Digestive Disorders
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23 Verified Questions
23 Flashcards
Source URL: https://quizplus.com/quiz/4029
Sample Questions
Q1) A nurse is teaching health promotion measures to a support group for clients who are at high risk for gastric cancer. Important health promotion measures to advise the clients include (select all that apply)
A) avoiding alcohol.
B) eating a diet high in nitrites.
C) limiting salted fish and pickled foods.
D) quitting smoking.
Q2) A client in the emergency department is hemorrhaging from a peptic ulcer and is being prepared quickly for emergency surgery. The nurse notes that the client is crying and reaches for the nurse frequently. The best response by the nurse to this client is to
A) continue working efficiently to get the client ready for the operating room.
B) make eye contact, touch the client, and say, "This must be very scary for you."
C) send someone to find the chaplain to discuss advance directives.
D) sit by the client and say, "I have some time that I can spend with you."
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Chapter 32: Assessment of Elimination
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27 Verified Questions
27 Flashcards
Source URL: https://quizplus.com/quiz/4030
Sample Questions
Q1) A woman who delivered a baby 10 hours ago has not been able to void. She is complaining of severe abdominal pain and feels the need to urinate but cannot. The nurse should anticipate an order for A) anti-anxiety medication.
B) antibiotics.
C) immediate catheterization.
D) sitz bath.
Q2) The history finding in a client with elevated carcinoembryonic antigen (CEA) that suggests to the nurse that this result might not be related to colorectal cancer is a A) high-fiber diet.
B) history of heavy smoking.
C) regular exercise program.
D) sedentary lifestyle.
Q3) Percussion
A) 1
B) 2
C) 3
D) 4
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34
Chapter 33: Management of Clients with Intestinal Disorders
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25 Verified Questions
25 Flashcards
Source URL: https://quizplus.com/quiz/4031
Sample Questions
Q1) For a client who has returned to the nursing unit after creation of a continent ileostomy (Kock pouch), the action the nurse would include in the plan of care is
A) attach the catheter to straight drainage initially for several days.
B) irrigate the pouch daily with sterile solutions only.
C) provide a permanent appliance and assist the client in application.
D) restrict oral intake until ileal drainage is profuse.
Q2) A client with ulcerative colitis has severe diarrhea. Further assessments by the nurse are aimed at early recognition of A) dehydration.
B) hemorrhoids.
C) metabolic alkalosis.
D) nephrolithiasis.
Q3) To help a client with a new ostomy integrate its appearance into the client's body image, the home health nurse would
A) discourage the client's negative remarks about the stoma.
B) discuss clothing options that will hide the appliance.
C) limit family interaction in the client's stomal care.
D) use humor and jokes regarding the ostomy.
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Chapter 34: Management of Clients with Urinary Disorders
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30 Verified Questions
30 Flashcards
Source URL: https://quizplus.com/quiz/4032
Sample Questions
Q1) The nurse who is teaching methods of micturition stimulation would stress that the method that may have genitourinary risks is
A) the Credé maneuver.
B) the Valsalva maneuver.
C) "trigger" stimulation.
D) vagal stimulation.
Q2) To determine if a client has an initial manifestation typically seen in clients with bladder neoplasm, the nurse would ask
A) "Do you have pain when you urinate?"
B) "Do you produce larger amounts of urine than you have in the past?"
C) "Have you noticed any blood in your urine?"
D) "Have you noticed that you urinate more frequently than you used to?"
Q3) A client with urinary incontinence is scheduled for surgery. The client states "This will fix my incontinence." The nurse should assess this client for the presence of A) an anatomic defect.
B) an infection.
C) pyelonephritis.
D) the presence of residual urine.
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Chapter 35: Management of Clients with Renal Disorders
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25 Verified Questions
25 Flashcards
Source URL: https://quizplus.com/quiz/4033
Sample Questions
Q1) Acute renal artery obstruction would be suspected in a client if the nurse assessed sudden
A) flank pain over the affected kidney.
B) hypothermia.
C) increase in urine output.
D) intermittent fever and sweating.
Q2) A client has nephritis. Which intervention can the nurse institute to best encourage the client to attain adequate emotional rest?
A) Encourage the family to visit often.
B) Have the client schedule specific rest periods.
C) Help the client deal with emotional reactions.
D) Request anti-anxiety medication from the physician.
Q3) A female client has recurrent urinary tract infections (UTIs). Important self-care measures the nurse could teach this client to protect her kidneys include (Select all that apply)
A) acidifying the urine by drinking cranberry juice.
B) ensuring adequate fluid intake.
C) seeking medical attention at the first sign of UTI.
D) wiping the perineal area from front to back.
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Page 37
Chapter 36: Management of Clients with Renal Failure
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30 Verified Questions
30 Flashcards
Source URL: https://quizplus.com/quiz/4034
Sample Questions
Q1) A client with renal failure has an order to infuse dopamine (Intropin) to activate the dopamine receptors in the kidney. The nurse would set the infusion rate for
A) 21 to 25 mg/kg/minute.
B) 11 to 20 mg/kg/minute.
C) 6 to 10 mg/kg/minute.
D) 1 to 5 mg/kg/minute.
Q2) While caring for a client in the oliguric phase of ARF, the nurse's plan of care should include
A) encouraging fluid intake to prevent dehydration.
B) increasing the client's protein intake to prevent muscle wasting.
C) maintaining reverse isolation to prevent infection.
D) meticulous skin care to prevent skin breakdown.
Q3) The nurse performing intermittent peritoneal dialysis notes that the medical record shows the client has not had a bowel movement for 3 days. The nurse would be careful to assess the client for
A) cloudy dialysate output.
B) fluid leakage.
C) increased thirst.
D) reduced catheter outflow.
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Page 38
Chapter 37: Assessment of the Reproductive System
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17 Verified Questions
17 Flashcards
Source URL: https://quizplus.com/quiz/4035
Sample Questions
Q1) The nurse observes a red glow during transillumination of a client's scrotum. The nurse would interpret this finding as
A) a hematoma.
B) a scrotal mass.
C) normal findings.
D) serous fluid.
Q2) A female client scheduled for her first mammography needs the information that A) no pain or discomfort is involved.
B) results are available within 60 days.
C) she cannot wear deodorant on the day of the test.
D) the procedure takes 15 to 30 minutes.
Q3) The nurse obtaining a health history from a male client with a history of hypertension should ask the client about A) renal functioning.
B) sexual functioning.
C) testicular problems. D) voiding problems.
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Chapter 38: Management of Men with Reproductive Disorders
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30 Verified Questions
30 Flashcards
Source URL: https://quizplus.com/quiz/4036
Sample Questions
Q1) In counseling a couple who want to conceive, the appropriate recommendation that the nurse would make to the man is
A) avoid using recreational drugs and alcohol.
B) have intercourse every 24 hours during ovulation.
C) take hot, soaking baths several times a week.
D) wear jockey shorts instead of boxer type.
Q2) After a transurethral resection, the nurse notes that the client's urinary catheter is blocked and his bladder is overdistended. The initial nursing action should be to A) change the catheter.
B) irrigate the catheter.
C) milk the catheter tubing.
D) notify the physician.
Q3) To provide protection against development of BPH, the nurse would encourage men in a community health education class to increase their intake of A) citrus juices.
B) dairy products.
C) red meat.
D) yellow vegetables.
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Chapter 39: Management of Women with Reproductive Disorders
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28 Verified Questions
28 Flashcards
Source URL: https://quizplus.com/quiz/4037
Sample Questions
Q1) A client complains of a cloudy vaginal discharge with a slight odor. Microscopic examination reveals epithelial cells, leukocytes, and normal vaginal flora. Given these findings, the nurse would assesses that the discharge is A) candidiasis.
B) Chlamydia.
C) Gardnerella. D) leukorrhea.
Q2) The nurse is providing health education to a group of women about ovarian cancer. The nurse would include information on health maintenance activities for both low- and high-risk women, because ovarian cancer
A) grows and spreads without manifestations.
B) is the most common genital cancer.
C) treatment is generally ineffective.
D) tumors grow rapidly.
Q3) The nurse would assess a client with leiomyoma for a history of A) abnormal vaginal discharge.
B) amenorrhea.
C) excessive uterine bleeding. D) severe menstrual pain.
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Chapter 40: Management of Clients with Breast Disorders
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25 Verified Questions
25 Flashcards
Source URL: https://quizplus.com/quiz/4038
Sample Questions
Q1) The nurse explains to a client following mastectomy with lymph node dissection that care of the operative arm should include
A) avoiding heavy lifting and trauma to the arm.
B) having blood pressure taken on the operative arm.
C) limiting all movement until the incision is healed.
D) wearing an Ace bandage wrap for 2 years.
Q2) The client discovered a stone-hard lump during breast self-examination (BSE) that has been determined to be confined to the lobular unit without permeating the basement membrane. Reinforcing the physician's explanation, the nurse would clarify that this type of tumor is
A) intraductal carcinoma.
B) infiltrating ductal carcinoma.
C) lobular carcinoma in situ.
D) tubular carcinoma.
Q3) In a client receiving chemotherapy for breast cancer, the nurse would assess for A) back pain.
B) confusion.
C) infection.
D) weight gain.
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Page 42
Chapter 41: Management of Clients with Sexually
Transmitted Infections
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24 Verified Questions
24 Flashcards
Source URL: https://quizplus.com/quiz/4039
Sample Questions
Q1) In teaching a client receiving doxycycline for the treatment of chlamydial infection, the nurse should include
A) avoidance of alcoholic beverages while taking doxycycline.
B) increasing fluid intake while taking doxycycline.
C) protecting the medication from sunlight.
D) using a condom as a birth control method.
Q2) A client is receiving metronidazole (Flagyl) orally for treatment of trichomoniasis. The nurse should explain to the client that
A) alcoholic beverages and products containing alcohol should be avoided.
B) douching is necessary after sexual contact.
C) recurrence generally is rare.
D) the medication must be taken for 14 days.
Q3) The nurse working in an ambulatory clinic explains that the most common bacterial STD in the United States is A) chlamydia.
B) genital herpes.
C) gonorrhea. D) syphilis.
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Chapter 42: Assessment of the Endocrine and Metabolic Systems
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15 Verified Questions
15 Flashcards
Source URL: https://quizplus.com/quiz/4040
Sample Questions
Q1) A client is having a physical examination and tells the nurse about a painful area in the right upper quadrant of the abdomen. Based on this information, the nurse would A) avoid any manipulation or contact with the painful area.
B) examine the painful area at the end of the assessment.
C) examine the right upper quadrant area first.
D) notify the physician to complete the examination.
Q2) The nurse performing an assessment of a 69-year-old man with a long history of complex medical problems would be aware that a systemic manifestation suggestive of hepatic dysfunction is A) gynecomastia.
B) hematuria.
C) melena.
D) oily skin.
Q3) A client being assessed for adrenal medulla function through the use of a urinalysis involves measuring A) catecholamines and metabolites. B) diurnal excretion of glucose.
C) calcitonin and parathyroid hormone.
D) growth hormone and ADH.
Page 44
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Chapter 43: Management of Clients with Thyroid and Parathyroid Disorders
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19 Verified Questions
19 Flashcards
Source URL: https://quizplus.com/quiz/4041
Sample Questions
Q1) To aid in immobilizing the head of a client after thyroidectomy, the nurse would obtain
A) a headboard.
B) hand towels.
C) Kerlix rolls.
D) sandbags.
Q2) In the initial treatment of a teenager with hyperthyroidism, the nurse would anticipate using
A) levothyroxine sodium (Synthroid).
B) liothyronine sodium (Cytomel).
C) methimazole (Tapazole).
D) radioactive iodine (131I).
Q3) A nurse is caring for a client with Graves' disease. Based on clinical manifestations, which nursing diagnosis would be most appropriate?
A) Altered Body Image
B) Constipation
C) Fluid Volume Deficit
D) Impaired Nutrition-More Than Body Requirements
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Chapter 44: Management of Clients with Adrenal and Pituitary Disorders
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20 Verified Questions
20 Flashcards
Source URL: https://quizplus.com/quiz/4042
Sample Questions
Q1) Critical actions the nurse takes specifically when caring for the client with Cushing's syndrome who had an adrenalectomy include (Select all that apply)
A) ambulate the client as soon as the client is able.
B) begin discharge planning on admission for the operation.
C) use strict aseptic technique when changing dressings.
D) strongly encourage client to cough and deep breathe.
Q2) Health promotion activities a school nurse could teach the student athletes that will help them avoid endocrine problems in the future include
A) avoiding alcohol.
B) getting plenty of rest.
C) not smoking.
D) not using steroids.
Q3) When formulating the teaching plan for a client with hyperpituitarism being prepared for transsphenoidal hypophysectomy, the nurse would give priority to
A) alerting the client to the need for constant monitoring after surgery.
B) instructing the client to avoid activities such as coughing and sneezing.
C) reviewing the clinical manifestations of infection.
D) teaching coughing and deep-breathing techniques.
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Chapter 45: Management of Clients with Diabetes Mellitus
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44 Verified Questions
44 Flashcards
Source URL: https://quizplus.com/quiz/4043
Sample Questions
Q1) The nurse counsels a client that in the beta-cell destruction process toward type 1 diabetes, the client may experience a "honeymoon period," during which the pancreas
A) becomes desensitized to high levels of blood glucose.
B) compensates with adequate amounts of insulin for 3 to 12 months.
C) produces proinsulin in greater quantities for about 3 months.
D) regenerates and produces adequate amounts of insulin indefinitely.
Q2) For a client with diabetes mellitus scheduled for surgery at 8 AM, the nurse would plan to check the client's blood glucose level on the day of surgery between
A) 12 midnight and 2 AM.
B) 2 and 4 AM.
C) 4 and 6 AM.
D) 7 and 8 AM.
Q3) The nurse would be most vigilant in assessing for hypoglycemia in a client taking the oral antidiabetic agent
A) acarbose (Precose).
B) chlorpropamide (Diabinese).
C) metformin (Glucophage).
D) repaglinide (Prandin).
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Page 47
Chapter 46: Management of Clients with Exocrine
Pancreatic and Biliary Disorders
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31 Verified Questions
31 Flashcards
Source URL: https://quizplus.com/quiz/4044
Sample Questions
Q1) A client who had pancreatic surgery has been started on medication therapy with pancrelipase (Pancrease). The manifestation that the nurse would report as an indication that the dosage may be insufficient is
A) black, tarry stools.
B) clay-colored stools.
C) constipation.
D) steatorrhea.
Q2) A client returned to the nursing unit after cholecystectomy with common bile duct exploration has bile leaking from around the wound. The most appropriate nursing intervention at this time would be to
A) assess the client further, asking about pain.
B) reassure the client that this is normal and reinforce the dressing.
C) monitor the client for elevations in blood pressure and pulse.
D) encourage the client to change position in bed.
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Chapter 47: Management of Clients with Hepatic Disorders
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34 Verified Questions
34 Flashcards
Source URL: https://quizplus.com/quiz/4045
Sample Questions
Q1) The nurse caring for a client with jaundice would assess for other findings frequently associated with this condition, such as
A) a change in the texture of the hair.
B) clay-colored stools.
C) excess pigmentation to the hands.
D) friable, ridged nails.
Q2) The nurse notes on a client's chart a report revealing unconjugated hyperbilirubinemia. The nurse explains the presence of unconjugated bilirubin indicates A) a decreased amount of red cells are being destroyed.
B) biliary obstruction is preventing blood flow through the liver.
C) conjugated bilirubin must be converted to unconjugated bilirubin in the liver.
D) the kidneys are not converting unconjugated to conjugated bilirubin.
Q3) The nurse would counsel a client that the portosystemic shunt will A) eliminate the danger of hepatic failure.
B) reduce ascites.
C) reduce portal hypertension only.
D) reverse effects of cirrhosis.
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Chapter 48: Assessment of the Integumentary System
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13 Verified Questions
13 Flashcards
Source URL: https://quizplus.com/quiz/4046
Sample Questions
Q1) On examination of a client, the nurse notes elevated, solid, brown skin lesions that are each 0.5 cm in size. The nurse would describe these lesions as A) papules.
B) plaques.
C) macules.
D) nodules.
Q2) A client is undergoing a lengthy series of treatments for a skin disorder. The best method of documenting the client's experience with the treatments is for the nurse to A) document the lesions clearly at each visit using proper terminology.
B) draw the distribution and characteristics of the lesions occasionally.
C) have the client record ongoing changes and include them in the record.
D) photograph the lesions at each clinic visit and use them for comparison.
Q3) After a client's surgical excisional biopsy, the nurse would apply
A) antibiotic ointment and a dry dressing.
B) Band-Aids only.
C) hydrocolloid dressing only.
D) petrolatum gauze and paper tape.
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Chapter 49: Management of Clients with Integumentary Disorders
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38 Verified Questions
38 Flashcards
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Sample Questions
Q1) The nursing care for a client after rhinoplasty would include
A) administering aspirin to decrease inflammation.
B) changing nasal packing daily to prevent infection.
C) maintaining the client flat in bed to reduce edema.
D) observing for excessive swallowing to assess for bleeding.
Q2) Oral antiviral therapy is prescribed for a client with herpes zoster. The nurse would explain to the client that the medication is used to decrease (Select all that apply)
A) itching.
B) pain.
C) postherpetic neuralgia.
D) recurrence.
E) spreading.
Q3) Nursing care for a client with atopic dermatitis would focus primarily on A) decreasing pain.
B) decreasing pruritus.
C) preventing infection.
D) promoting drying of lesions.
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Page 51
Chapter 50: Management of Clients with Burn Injury
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30 Verified Questions
30 Flashcards
Source URL: https://quizplus.com/quiz/4048
Sample Questions
Q1) The nurse would perform close respiratory assessment for a client with inhalation injuries because lung tissue injury resulting from inhalation of smoke is caused by
A) anoxia from lowered blood oxygen content.
B) carbon monoxide poisoning.
C) chemical action on lung tissues.
D) heat damage from superheated air.
Q2) A severely burn-injured client is being discharged at the end of the week. Important interventions the nurse can provide to assist the client with re-integration into society include (Select all that apply)
A) down-playing the appearance of the burned areas to prevent discouragement.
B) encouraging the client to interact with people outside the hospital setting.
C) making the client totally responsible for all physical care to improve confidence.
D) role-playing potentially difficult social interactions with the client.
Q3) The nurse would assess that the client with a "major burn" is
A) 60 years old with a 20% burn.
B) 32 years old with a 14 % burn.
C) 18 years old with an 18% burn.
D) 10 years old with a 15% burn.
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Chapter 51: Assessment of the Vascular System
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12 Verified Questions
12 Flashcards
Source URL: https://quizplus.com/quiz/4049
Sample Questions
Q1) When a female client tells the nurse, "I always get pains in my legs when walking," the nurse would question her about
A) amount of activity required to cause pain.
B) history of hypertension.
C) number of pregnancies.
D) presence of swelling.
Q2) The nurse tests the capillary refill on a client's lower extremity and notes that it takes 4 seconds for the color to return to baseline. It would be most important for the nurse to then check for
A) constricting clothing.
B) other indicators of peripheral perfusion.
C) presence of venous ulcers.
D) prior surgery on this extremity.
Q3) When assessing a client with arterial insufficiency, the nurse would expect
A) bounding arterial pulses.
B) cool, pale skin.
C) muscular atrophy.
D) warm, erythematous legs.
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Chapter 52: Management of Clients with Hypertensive Disorders
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17 Verified Questions
17 Flashcards
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Sample Questions
Q1) The nurse providing care to a client being treated for a hypertensive emergency would monitor the blood pressure to ensure that it is slowly reduced during the therapy to prevent
A) myocardial infarction.
B) pulmonary embolism.
C) renal ischemia.
D) vascular collapse.
Q2) An African-American male is being started on medication for hypertension, and the physician has prescribed a beta blocker as first-line therapy. The most appropriate action by the nurse is to
A) consult with the physician about the choice of drug.
B) have the pharmacist review the client's other meds for interactions.
C) help the client plan ways to remain compliant with therapy.
D) provide appropriate education on the medication and its side effects.
Q3) The nurse would explain to a client that the most common cause of secondary hypertension is
A) chronic renal disease.
B) oral contraceptive use.
C) pregnancy.
D) primary hyperaldosteronism.
Page 54
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Chapter 53: Management of Clients with Vascular Disorders
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38 Verified Questions
38 Flashcards
Source URL: https://quizplus.com/quiz/4051
Sample Questions
Q1) An appropriate nursing diagnosis to guide self-care teaching for a client who has lymphedema is
A) Impaired Adjustment.
B) Risk for Disuse Syndrome.
C) Risk for Fluid Volume Excess.
D) Risk for Infection.
Q2) For a client admitted with a history of chronic arterial insufficiency, the nurse would anticipate that physical assessment will reveal
A) rubor with elevation of feet.
B) pallor when feet are dependent.
C) diminished pedal pulses.
D) warm, edematous skin.
Q3) A client is scheduled to have a femoral-popliteal bypass with a synthetic graft. The nurse's preoperative teaching would include information about preoperative
A) antibiotics.
B) anticoagulants.
C) platelets.
D) skin preparation.
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Chapter 54: Assessment of the Cardiac System
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30 Verified Questions
30 Flashcards
Source URL: https://quizplus.com/quiz/4052
Sample Questions
Q1) During the physical examination of a client, the nurse checks the client for neck vein distention. To perform this assessment properly, the client should be positioned
A) first lying, then sitting, then standing.
B) in a side-lying position with knees flexed.
C) lying supine with head of bed elevated 15-30 degrees.
D) sitting upright with neck flexed slightly forward.
Q2) The nurse would explain to a client who reports being frequently short of breath that the most common form of dyspnea associated with cardiac disorders is A) exertional dyspnea.
B) idiopathic dyspnea.
C) orthopnea.
D) paroxysmal nocturnal dyspnea.
Q3) The nurse establishing teaching priorities for a community health program would rank cardiovascular disease as a cause of death as A) first.
B) fifth.
C) seventh.
D) tenth.
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Chapter 55: Management of Clients with Structural
Cardiac Disorders
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21 Verified Questions
21 Flashcards
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Sample Questions
Q1) To help relieve the discomfort of a client with pericarditis who is experiencing pain, the nurse would position the client
A) flat in bed.
B) in semi-Fowler's position.
C) prone.
D) sitting upright.
Q2) The nurse would recognize that splinter hemorrhages in the nails, painful swollen nodules on the fingertips, and splenomegaly indicate
A) infective endocarditis.
B) mitral stenosis.
C) mitral valve prolapse.
D) pericarditis.
Q3) When a client is hospitalized with dilated cardiomyopathy, the nurse would examine the client's record for the characteristic history of
A) long-term alcohol abuse.
B) previous streptococcal infection.
C) resistant hypertension.
D) uncontrolled diabetes.
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Chapter 56: Management of Clients with Functional
Cardiac Disorders
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28 Verified Questions
28 Flashcards
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Sample Questions
Q1) A client is scheduled to have CABG surgery next week. To best meet the client's need for psychosocial support, which intervention by the nurse would be best?
A) Ask the client and family to relay fears and questions.
B) Discuss the possible need for blood products during or after the operation.
C) Provide written and oral instructions along with contact phone numbers.
D) Refer the client to the preoperative educational classes at the hospital.
Q2) The nurse would caution a client with arthritis that this chronic inflammatory disease increases the risk for CHD through the
A) amount of aspirin taken as a remedy for arthritis.
B) decreased physical activity relative to arthritic discomfort.
C) increased level of C-reactive protein.
D) increased release of histamines.
Q3) The nurse would explain the etiology of heart failure after myocardial infarction (MI) as
A) impairment of the contractile function of the ventricle.
B) inability of the heart chambers to fill adequately.
C) increased myocardial workload.
D) increased oxygen demands of the myocardium.
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Chapter 57: Management of Clients with Dysrhythmias
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Sample Questions
Q1) When a client develops sinus bradycardia after a myocardial infarction (MI), the nurse would anticipate the administration of A) atropine.
B) digitalis.
C) procainamide.
D) propranolol.
Q2) The nurse working on a telemetry floor would recognize that most dangerous dysrhythmias are A) atrial dysrhythmias.
B) junctional dysrhythmias.
C) nodal dysrhythmias.
D) ventricular dysrhythmias.
Q3) The client's ECG shows normal-appearing P waves that occur at regular intervals. Every third impulse from the atria is missing a QRS complex. The nurse would recognize this pattern as the dysrhythmia of A) first-degree AV block.
B) second-degree AV block.
C) third-degree AV block.
D) fourth-degree AV block.
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Page 59
Chapter 58: Management of Clients with Myocardial Infarction
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Sample Questions
Q1) For a client whose resting pulse rate is 71 beats/min, the nurse would check the client's pulse rate to ensure that during post-MI activities, the client's heart rate does not exceed
A) 89 beats/min.
B) 96 beats/min.
C) 101 beats/min.
D) 112 beats/min.
Q2) A client presents to the emergency department complaining of chest pain that began 2 hours earlier; the client's electrocardiogram (ECG) is consistent with acute myocardial infarction. The nurse would know that the standard treatment at this time is A) diazepam.
B) lidocaine.
C) streptokinase.
D) verapamil.
Q3) The nurse would explain to a client that the most common site for MI is the
A) anterior wall of the left ventricle.
B) anterior wall of the right ventricle.
C) inferior (diaphragmatic) surface.
D) posterior wall of the left ventricle.
Page 60
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Chapter 59: Assessment of the Respiratory System
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Sample Questions
Q1) When the nurse hears a high, hollow, drum-like sound while percussing the right chest of a young man with a right pneumothorax, the nurse would record this finding as A) dullness.
B) flatness.
C) resonance.
D) tympany.
Q2) The nurse would explain to a client that the most helpful test in the evaluation of a possible pulmonary embolus is A) alveolar lavage.
B) bronchoscopy.
C) gallium scan.
D) ventilation-perfusion scan.
Q3) An older adult client says, "I need to get a shot so that I'll never get pneumonia again." The most helpful response by the nurse would be A) "Immunization for pneumonia must be repeated every year."
B) "Most older people get flu shots, but they don't protect you from pneumonia."
C) "Pneumovax vaccine can protect you against one type of pneumonia."
D) "You cannot get a shot, or immunization, for pneumonia."
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Chapter 60: Management of Clients with Upper Airway Disorders
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Sample Questions
Q1) The nurse explaining the pieces of a tracheostomy to a client would note that the portion of the tracheostomy apparatus used to round the end of the tube for insertion is the
A) flange.
B) inner cannula.
C) obturator.
D) pilot tube.
Q2) When feeding a client with a tracheostomy, the nurse would
A) follow each spoon of food with liquid.
B) have the client in an upright sitting position.
C) inflate the cuff before the meal.
D) thin the food to liquid consistency.
Q3) Which intervention would probably help most when teaching a client to speak again after a laryngectomy?
A) Give the client contact information so speech therapy can continue at home.
B) Help the client and family understand that this is a frustrating experience.
C) Make sure the client has a supply of paper and pens.
D) Obtain several different speaking aids for the client to try at home.
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Chapter 61: Management of Clients with Lower Airway and Pulmonary Vessel
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Sample Questions
Q1) A client is being worked up for possible pulmonary hypertension. The nurse prepares the client for the definitive diagnostic test for this condition, which is
A) arterial blood gas measurements.
B) pulmonary function studies.
C) right heart catheterization.
D) spiral computed tomography.
Q2) A nurse is drawing a blood sample from a client's central line and the client suddenly becomes dyspneic and complains of chest pain. The priority action by the nurse is to A) obtain blood pressure readings in both arms.
B) notify the physician immediately.
C) put the client in a left lateral Trendelenburg position.
D) terminate the procedure and clamp the central line.
Q3) Important health promotion measures the nurse should encourage the client with COPD to consider are
A) getting influenza and pneumonia vaccinations.
B) increasing ambient humidity in the house or apartment.
C) installing a UV filter in the heating and air conditioning system.
D) moving to an area of the country with a dry climate.
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Chapter 62: Management of Clients with Parenchymal and Pleural Disorders
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Sample Questions
Q1) The nurse notes intermittent bubbling in the water-seal chamber of a chest tube in place for a client with pneumothorax. The nurse's most appropriate action is to A) change the drainage unit.
B) clamp the chest tube.
C) encourage respiratory exercises.
D) place petrolatum gauze around the chest tube.
Q2) A client has accidentally disconnected a chest tube while turning over in bed. The suction tubing is on the floor. The most appropriate action by the nurse is to
A) call the physician immediately and prepare the client for reinsertion.
B) clamp the chest tube just proximal to the open end.
C) reattach the drainage tube to the suction tubing.
D) submerge the end of the drainage tube in a bottle of sterile saline.
Q3) A client is being discharged after treatment for a bronchopleural fistula. Important self-care measures the nurse should teach include
A) improving the client's nutrition.
B) management of the chest tube system.
C) preventing a recurrence.
D) smoking cessation resources.
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Chapter 63: Management of Clients with Acute Pulmonary Disorders
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Sample Questions
Q1) The nurse would explain that emergency treatment of a tension pneumothorax requires
A) a small stab wound with a skin blade made into the pleural space.
B) covering the chest wall wound with gauze.
C) immediate tracheostomy.
D) insertion of an 18-gauge needle into the pleural space.
Q2) A client admitted to the emergency department (ED) with severe chest injuries and significant hypovolemia caused by hemorrhage would be transfused to replace blood loss initially with A) albumin.
B) dextrose 5% in normal saline.
C) type AB-negative blood.
D) type O-negative blood.
Q3) When a client is admitted to the ED with tension pneumothorax and mediastinal shift following an automobile accident, the nurse would know that the client would exhibit A) a sucking chest wound.
B) bradycardia.
C) mediastinal flutter.
D) severe hypotension.
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Chapter 64: Assessment of the Eyes and Ears
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Sample Questions
Q1) After completion of an eye examination using direct ophthalmoscopy, the assessment that the nurse would document as "normal" is
A) irregular margins to optic disc.
B) oval optic disc.
C) physiologic cup 75% of optic disc diameter.
D) retinal veins darker than arteries.
Q2) To evaluate a client's balance using Romberg's test, the nurse would
A) seat the client and request the client touch the nurse's outstretched finger with eyes closed.
B) seat the client upright with eyes closed, and then ask the client to touch the nose.
C) stand the client with feet a foot apart, eyes closed, and arms outstretched.
D) stand the client with feet together, eyes closed, and arms to the side.
Q3) If a client shows intolerance to light during pupil examination, the nurse would record that the client exhibits A) photophobia.
B) reduced accommodation.
C) strabismus.
D) unequal pupil response.
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Chapter 65: Management of Clients with Visual Disorders
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Sample Questions
Q1) The nurse recently diagnosed a client as experiencing Visual Sensory/Perceptual Alterations related to increased intraocular pressure. The priority for the plan of care would be
A) encouraging compliance with drug therapy to prevent loss of vision.
B) managing the severe pain experienced until the optic nerve atrophies.
C) providing anticipatory guidance regarding the eventual loss of peripheral vision.
D) recognizing that damage to the eye caused by glaucoma can be reversed.
Q2) A nurse in an outpatient surgical setting is assessing a client scheduled for cataract removal. The nurse would expect to find that the client has (Select all that apply)
A) a shadow across the visual field.
B) better vision in low light.
C) blurred vision, photophobia, and glare.
D) nausea and vomiting, worse with eye movements.
E) sudden onset of acute eye pain.
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Chapter 66: Management of Clients with Hearing and Balance Disorders
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Sample Questions
Q1) A client has Ménière's disease. Which question by the nurse would elicit the most pertinent information related to client safety?
A) "Are your attacks at certain times of the day?"
B) "Do your attacks come on without warning?"
C) "How long does each attack last?"
D) "What seems to bring on your attacks?"
Q2) The school nurse teaches the young swimmer that the earliest manifestation of external otitis is
A) a low-grade fever.
B) a popping sensation in the ears.
C) pain when the external ear is manipulated.
D) humming or buzzing noises in the ear.
Q3) When communicating with a client who has a significant hearing loss, the nurse would
A) obtain the client's attention by hand clapping.
B) speak as loudly as possible.
C) use an intercommunication system.
D) use phrases to convey meaning rather than one-word answers.
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Chapter 67: Assessment of the Neurologic System
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Sample Questions
Q1) When testing comprehension in a client who is expressively aphasic, the nurse lays out a pencil, a key, and a ball and then would
A) ask the client to pick up the ball.
B) hold up the key and ask, "What do you do with this?"
C) point to the pencil and ask, "What is this?"
D) point to the ball and ask "What can this be used for?"
Q2) A nurse working on a rehabilitation unit is assessing a new admission, a client with a stable spinal cord injury. The nurse notes that the client is unable to shrug the shoulders. This finding indicates to the nurse that the level of spinal cord injury in the client is
A) C4-5.
B) C8-T1.
C) L1-3.
D) S1-2.
Q3) The nurse asking a client questions that test orientation would include
A) "Can you count backward from 100 by 7s?"
B) "Do you have any brothers and sisters?"
C) "What would you do if you lost your house key?"
D) "What year is this?"
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Chapter 68: Management of Comatose or Confused
Clients
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Sample Questions
Q1) The nurse working with an unconscious client to develop a holistic nursing care plan would include the family and which high-priority nursing diagnosis?
A) Anticipatory Grieving
B) Ineffective Therapeutic Regimen Management
C) Interrupted Family Processes
D) Knowledge Deficit
Q2) The nurse points out the important difference between metabolically induced coma and structurally induced coma is that metabolically induced coma results in A) abnormal posturing.
B) absent corneal reflex.
C) exaggerated deep tendon reflexes.
D) symmetrical motor manifestations.
Q3) Before the evacuation of a fecal impaction from a comatose client, the nurse applies an anesthetic jelly to the rectum in order to A) decrease the risk of rectal tearing.
B) lessen the discomfort to hemorrhoids.
C) prevent possible seizures.
D) reduce discomfort of dislodging the fecal mass.
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Chapter 69: Management of Clients with Cerebral Disorders
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Sample Questions
Q1) The cerebrospinal (CSF) fluid laboratory finding the nurse would expect in a client with bacterial meningitis is
A) clear color.
B) decreased glucose level.
C) decreased protein level.
D) negative nitrates.
Q2) A client who has had intracranial surgery develops urine output in excess of 200 ml per hour. The nurse reports the findings, suspecting A) diabetes insipidus.
B) fluid volume excess.
C) hyponatremia.
D) hyperkalemia.
Q3) When a client suffers a tonic-clonic seizure, the nurse should (Select all that apply)
A) insert an oral airway into the client's mouth.
B) move objects out of the client's way.
C) observe and document characteristics of the seizure.
D) place a pillow or some padding under the client's head.
E) turn the client gently on one side.
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Chapter 70: Management of Clients with Stroke
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Sample Questions
Q1) Self-care measures the nurse or speech therapist should teach the client who has residual dysphagia after a stroke include (Select all that apply)
A) chewing each bite thoroughly.
B) placing foods in the unaffected side of the mouth.
C) sticking to only semi-liquids and very soft foods.
D) turning the head to the unaffected side and checking for retained food.
Q2) A client who has left hemiparesis as a result of stroke is getting out of bed to the chair for the first time. The nurse should position the chair
A) at a right angle to the client's left side.
B) at a right angle to the client's right side.
C) facing away from the side of the bed.
D) facing the side of the bed but within 1 foot.
Q3) When the client complains about having to perform quadricep-setting exercises, the nurse reminds him that the exercises will enhance ambulation by A) combating footdrop.
B) diminishing the effects of proprioception.
C) improving balance.
D) strengthening the knee.
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Chapter 71: Management of Clients with Peripheral Nervous System Disorders
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Sample Questions
Q1) When the client who had a cervical spinal fusion this morning complains of a sudden radicular pain, the nurse is
A) alerted because this indicates possible infection.
B) concerned because this indicates possible meningitis.
C) distressed because of the possible need to repeat the surgery.
D) relieved because this indicates a reduction in edema.
Q2) A client with acute disk herniation began using ice for analgesia along with medication therapy. The nurse explains that the client will be switched to heat therapy after
A) 24 hours.
B) 48 hours.
C) 72 hours.
D) 96 hours.
Q3) A client has returned to the nursing unit after having a cervical fusion from the anterior approach. What piece of equipment does the nurse ensure is at the bedside?
A) A patient-controlled analgesia (PCA) pump
B) Emergency tracheostomy set
C) Humidified oxygen
D) Suction setup and rigid suction catheter
Page 73
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Chapter 72: Management of Clients with Degenerative Neurologic Disorders
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Sample Questions
Q1) Important self-care measures a nurse can teach a client with Parkinson's disease in order to prevent contractures and improve mobility include which of the following? (Select all that apply.)
A) Bend over with your head over your toes to get out of chairs.
B) Exercise first thing in the morning.
C) Keep a narrow-based gait.
D) Look up when you walk, not down at the floor.
E) Use a firm surface, like the floor, for exercising.
Q2) A client with MS is being taught self-care measures to prevent constipation. The nurse would realize goals for teaching had been met when the client states he/she will avoid
A) a high-fiber diet.
B) citrus fruits.
C) laxatives.
D) stool softeners.
Q3) Nursing activities for a client with ALS and family include helping them
A) decide on an acceptable level of care early in the course of the disease.
B) determine if they want to share the diagnosis to allow genetic testing.
C) incorporate nonpharmacologic pain control techniques in the plan of care.
D) plan for extensive rehabilitation after exacerbations.
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Chapter 73: Management of Clients with Neurologic
Trauma
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Sample Questions
Q1) When the client who has been in flaccid spinal shock dorsiflexes the great toe and fans the other toes when the sole of his foot is stroked, the nurse is
A) alarmed, because this indicates increased ICP.
B) alerted, because this indicates possible meningeal irritation.
C) distressed, because this indicates deterioration.
D) pleased, because this indicates a reduction of spinal shock.
Q2) The nurse explains to the family of a client with a traumatic brain injury (TBI) that research has shown quality of life can be enhanced by rehabilitation in which of the following areas? (Select all that apply)
A) Cognitive skills
B) Emotional adjustment
C) Health maintenance
D) Leisure skills
E) Social skills
Q3) The emergency department nurse should position the client with cranial injuries
A) in high-Fowler position and knees elevated.
B) side-lying with head of bed elevated 20 degrees.
C) supine with head of bed elevated 30 degrees.
D) supine with the bed completely flat.
Page 75
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Chapter 74: Assessment of the Hematopoietic System
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Q1) The nurse is monitoring the laboratory test results for a client receiving anticoagulation therapy. The nurse is aware that the International Normalized Ratio (INR) for most clinical conditions requiring anticoagulation is A) less than 1.
B) 1 to 2.
C) 2 to 3.5.
D) 3 to 5.5.
Q2) The nurse assesses the client who underwent partial removal of the stomach a year ago for the manifestations of A) anemia.
B) high white blood cell count.
C) low platelet count.
D) shortened bleeding times.
Q3) Several employees report allergic manifestations. The occupational health nurse would focus an investigation on the workplace's A) food service vendor.
B) heating and cooling systems.
C) lighting.
D) water supply.
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Page 76
Chapter 75: Management of Clients with Hematologic Disorders
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Q1) The nurse assessing a female client with a hemoglobin level of 11 g/dl would expect the client to report
A) chronic fatigue and activity intolerance.
B) no significant manifestations.
C) shortness of breath, worse on exertion.
D) tachycardia and palpitations.
Q2) When teaching a client who has multiple myeloma about self-care in the home, the nurse should advise the client and family take appropriate precautions to A) alleviate diarrhea.
B) prevent fractures.
C) prevent seizures.
D) protect visitors.
Q3) The nurse can decrease the danger of transfusion reactions in a client by A) adding sterile saline to the blood transfusion.
B) forcing fluids.
C) infusing the blood slowly during the first 15 minutes.
D) monitoring the urine output.
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Page 77
Chapter 76: Management of Clients with Immune Disorders
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Q1) The nurse caring for a client with allergic rhinitis who is using a decongestant nasal spray would determine that teaching goals have been met when the client says
A) "Nasal sprays must be combined with an oral antihistamine to achieve relief."
B) "Overuse can result in nosebleeds and mucosal ulceration."
C) "Rebound rhinitis (rhinitis medicamentosa) is common with continual use."
D) "The spray should be used round-the-clock at equally spaced intervals."
Q2) In teaching self-care measures, the nurse would teach the client who has atopic dermatitis to avoid
A) applying a lubricant after bathing.
B) bathing in hot water.
C) keeping fingernails trimmed.
D) using gentle soaps.
Q3) A client develops a positive reaction to an injection of purified protein derivative, a screening measure for exposure to tuberculosis. The nurse records this reaction as a A) type 1 reaction.
B) type 2 reaction.
C) type 3 reaction.
D) type 4 reaction.
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Chapter 77: Management of Clients with Rheumatic Disorders
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Sample Questions
Q1) To help promote sleep for a client with RA, the nurse would recommend A) exercising just before bedtime.
B) sleeping in thermal underwear.
C) taking a cool shower before bedtime.
D) using a large pillow and warm, heavy blankets.
Q2) A client with RA is anxious to perform all of her activities of daily living. The nurse can best help the client by encouraging
A) a slow, progressive schedule of daily activities.
B) complete rest during periods of exacerbation.
C) performance of activities in the early morning.
D) the use of assistive devices for dressing.
Q3) The nurse planning teaching for the client with ankylosing spondylitis includes information on which drug?
A) Acetaminophen (Tylenol)
B) Antihistamines
C) Etanercept
D) Lorazepam (Ativan)
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Chapter 78: Management of Clients with Acquired
Immunodeficiency Syndrome
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Q1) The nurse is assessing a client with AIDS for the presence of Kaposi's sarcoma (KS). The manifestation the nurse should look for is a
A) crusty lesion on the back and groin.
B) purple-red lesion on the body.
C) pustular lesion with yellow exudate.
D) thick, white exudate in the mouth.
Q2) A client with AIDS is experiencing fever with night sweats. A suggestion the nurse could make is to
A) drink all liquids in the morning.
B) keep liquids at the bedside to drink.
C) limit fluid intake after supper.
D) take aspirin if awakened in the night.
Q3) The nurse understands the most significant laboratory study for the client who is HIV positive is the
A) CD4+ cell count.
B) enzyme-linked immunosorbent assay (ELISA) test.
C) total white blood cell count.
D) Western blot test.
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Chapter 79: Management of Clients with Leukemia and Lymphoma
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Sample Questions
Q1) A client contemplating chemotherapy for acute leukemia tells the nurse that s/he is concerned about the effects of chemotherapy on sexuality. Appropriate interventions by the nurse include (Select all that apply)
A) describing the physical changes that may occur with chemotherapy affecting sexuality.
B) explaining that because of fatigue or other causes, libido may be decreased during chemotherapy.
C) informing the client and partner that you will call a social worker who can address their concerns.
D) informing the client about some reproductive alternatives such as sperm banking and egg harvesting.
E) offering information on alternative sexual positioning and techniques the client can try.
Q2) When the nurse records a platelet count of 20,000/mm³, the most appropriate nursing action is to
A) encourage iron-rich foods.
B) increase fluid intake.
C) institute bleeding precautions.
D) place the client in protective isolation.
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Chapter 80: Management of Clients Requiring
Transplantation
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Sample Questions
Q1) The nurse working with clients who need organ transplant includes in the teaching plan that the primary responsibility of the transplantation team is to
A) determine the histocompatibility of the donor and the recipient.
B) find the best candidate with good immune function and appropriate insurance. C) provide the greatest number of transplants possible because of the ongoing great need.
D) transplant organs into clients with the best chance of long-term success.
Q2) The nurse conducting community education on transplant options would teach that the client who would benefit most from kidney-pancreas transplantation is the client with
A) acute renal failure and pancreatitis.
B) end-stage renal disease and type 1diabetes.
C) glomerulonephritis and pancreatitis.
D) polycystic kidney disease and type 2 diabetes.
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Chapter 81: Management of Clients with Shock and Multisystem
Disorders
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Q1) During treatment for shock, the client receives fluid volume replacement. The nurse determines that renal perfusion is being maintained if the urine output is at least
A)0.25 ml/kg/hour.
B)0.5 ml/kg/hour.
C)1.0 ml/kg/hour.
D)1.5 ml/kg/hour.
Q2) The nurse caring for a client in shock who is being mechanically hyperventilated explains that the rationale for this intervention is to
A) decrease carbon dioxide levels in the blood.
B) prevent atelectasis and respiratory failure.
C) rest the client to decrease metabolism.
D) stimulate endorphin production.
Q3) The nurse explains that an advantage of the use of hemoglobin-based oxygen carriers (HBOCs), such as PolyHeme and Hemopure, is that these products
A) decrease the pH of the blood.
B) do not require type and crossmatch.
C) function as packed cells at less cost.
D) increase hemoglobin.
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Chapter 82: Management of Clients in the Emergency Department
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Sample Questions
Q1) The nurse explains to the family of a client with a spinal cord injury that IV methylprednisolone will reduce
A) pain.
B) possibility of seizure.
C) muscle spasms.
D) spinal cord edema.
Q2) The nurse is caring for a client brought to the ED after suffering amputation of a toe. The nurse should take care to avoid
A) cleansing the stump area with normal saline.
B) placing the toe directly on ice.
C) placing the wrapped toe in a plastic bag.
D) wrapping the toe in sterile gauze moistened with saline.
Q3) After stabilizing a trauma victim's airway, breathing, and circulation, the next item for the ED nurse to assess is
A) abdomen.
B) broken bones.
C) integument.
D) neurologic status.
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