Critical Care Nursing
Midterm Exam
Course Introduction
Critical Care Nursing is a specialized course designed to equip nursing students with the knowledge and skills necessary to care for patients with life-threatening conditions in intensive care settings. The course covers the assessment, monitoring, and management of critically ill patients, focusing on complex pathophysiology, advanced pharmacology, and the use of sophisticated medical technologies. Emphasis is placed on rapid clinical decision-making, interdisciplinary collaboration, and effective communication with patients families. Students also learn about ethical dilemmas, end-of-life care, and the psychological impact of critical illness on both patients and caregivers, preparing them for the unique challenges of critical care environments.
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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Page 2
Chapter 1: Health Promotion and Disease Prevention
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21 Verified Questions
21 Flashcards
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Sample Questions
Q1) The nurse can "empower" a client in adjusting to the changes associated with the chronic effects of non-insulin-dependent diabetes mellitus by
A) explaining that concerns about vision changes are premature at this point.
B) explaining the pathophysiology of the disease.
C) informing the client about the different types of insulin.
D) teaching the client how to minimize complications.
Answer: D
Q2) The nurse is planning a community STD (sexually transmitted disease) screening fair. This activity would be considered
A) epidemiologic prevention.
B) primary prevention.
C) secondary prevention.
D) tertiary prevention.
Answer: C
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Chapter 2: Health Assessment
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14 Flashcards
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Sample Questions
Q1) A client had surgery yesterday and is complaining of pain. The best action by the nurse is to
A) ask the patient which pain medication she/he took last.
B) do a complete assessment of the pain.
C) prepare to administer the ordered pain medication.
D) record the client's complaints thoroughly and get the pain medication.
Answer: B
Q2) The nurse is collecting a health history on a middle-aged African American male. The nurse asks about past blood pressure screening because the incidence of hypertension is higher in this ethnic group than in others. This is an example of
A) a generalization based on the nurse's limited experience with African Americans.
B) bias, and the nurse should not question the client about blood pressure screening.
C) stereotyping the client based on the client's ethnic/racial group.
D) using valid research data to focus questions on the client's specific risks.
Answer: D
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Chapter 3: Critical Thinking
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8 Flashcards
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Sample Questions
Q1) 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
Q2) 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
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Chapter 4: Complementary and Alternative Therapies
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12 Flashcards
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Sample Questions
Q1) When the client asks the nurse about the use of therapeutic herbs, the nurse's most instructional response would be
A) "Herbs are not regulated and may pose health risks if used with prescribed drugs."
B) "Herbs have many qualities; some effects are good, and some are not."
C) "I have heard many people have used some herbal remedies and had good results."
D) "If you are getting relief from some herbal remedy, there is probably no harm in it."
Q2) A nurse understands that many conventional drugs are derived from plants, such as A) meperidine (Demerol).
B) penicillin.
C) quinine.
D) steroids.
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6
Chapter 5: Ambulatory Health Care
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20 Flashcards
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Sample Questions
Q1) The facility least suited to the provision of primary health care is a(n)
A) ambulatory care center.
B) emergency department.
C) HMO.
D) hospital outpatient clinic.
Q2) When considering culture as the nurse is designing health plans for clients, the ambulatory care center nurse will consider least the cultural concept of
A) making food modifications culturally appropriate.
B) recognizing that cultural family roles may be rigidly defined.
C) reflecting on research data describing culturally motivated responses.
D) understanding that some cultures reject female authority.
Q3) The nurse manager of an ambulatory care center assesses the center for environmental hazards to comply with guidelines of both the local state health department and the
A) Ambulatory Care Nursing Administration and Practice.
B) American Nurse's Credentialing Center.
C) Nurse Practice Act.
D) Occupational Safety and Health Administration.
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7
Chapter 6: Acute Health Care
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14 Flashcards
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Sample Questions
Q1) A client for whom the nurse would provide post-acute care is the
A) 38-year-old following cesarean birth.
B) 40-year-old recovering from kidney stone removal.
C) 60-year-old receiving a regulated regimen of anti-hypertensive medication.
D) 76-year-old needing rehabilitation after cardiac surgery.
Q2) A client injured in an automobile accident is now stable but permanently ventilator-dependent and has little potential for further improvement. The client is to be transferred to post-acute care services. The nurse manager recommends a A) general medical-surgical unit.
B) long-term care unit.
C) rehabilitation unit.
D) transitional unit.
Q3) The prepayment plan developed in 1929 is
A) Blue Cross Health Insurance.
B) Medicare Insurance.
C) Medicaid Insurance.
D) Health Maintenance Organization.
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8
Chapter 7: Critical Care
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Sample Questions
Q1) Critical care units (CCUs) have been developed in almost all hospitals because such units
A) allow for concentration of expert personnel.
B) can offer special services to the family.
C) contain costs.
D) separate the seriously ill from the other clients.
Q2) A critical care nurse understands that stressors affecting both the client and the client's family include (Select all that apply)
A) disorientation.
B) fear.
C) immobility.
D) pain.
E) privacy.
Q3) 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.
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Page 9
Chapter 8: Home Health Care
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Sample Questions
Q1) An experienced home health care nurse explains to a client about safety in the community. One difference the nurse emphasizes that home health care has over hospital-based health care is that with home health care (Select all that apply)
A) "always be prepared" is a good motto.
B) disasters can occur while the nurse is in the community.
C) needed help may not be immediately available.
D) the central location of most staff during the day can provide assistance.
E) the nurse is usually on his/her own.
Q2) The Henry Street Settlement in New York City, which offered public health nursing to clients with chronic health problems, was established by
A) Clara Barton.
B) Dorothea Dix and Sojourner Truth.
C) Frances Root.
D) Lillian Wald and Mary Brewster.
Q3) The component that is not part of the Omaha System is
A) Intervention Scheme.
B) Problem Classification Scheme.
C) Problem Rating Scale for Outcomes.
D) Rating Scale for Client Satisfaction.
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Page 10
Chapter 9: Long-Term Care
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Sample Questions
Q1) The nurse plans programming at a nursing home understanding that the defining impairment that affects almost all residents in a nursing home is
A) Alzheimer's disease or other cognitive deficit.
B) impairment in ability to perform activities of daily living (ADL).
C) profound hearing loss or other unspecified sensory deficit.
D) severe, progressive visual deficit.
Q2) The Hill-Burton Hospital Survey and Construction Act of 1946 provided building funds and resulted in nursing homes that
A) allowed for flexible visiting hours.
B) resembled hospitals.
C) were located only in rural settings.
D) were to have at least 100 beds.
Q3) 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.
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11
Chapter 10: Rehabilitation
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Sample Questions
Q1) A nurse incorporating a client's psychosocial reaction to a disabling illness into the plan of care would use a staging model because the model
A) allows the nurse to group the client with peers for socializing.
B) describes the process of adaptation as a standardized process.
C) explains some common reactions to the disabling condition.
D) predicts the experience of psychosocial adaptation.
Q2) A rehabilitation nurse scores the client at "1" in a functional area on the FIM. This means the client has
A) full independence in that area.
B) independence in that area with use of an assistive device.
C) partial dependence in need of significant assistance.
D) total dependence.
Q3) 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.
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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) The nurse makes the evaluation that the intake of one of the adult clients in her care is adequate when she measures the total daily intake as
A) 750 ml.
B) 900 ml.
C) 1000 ml.
D) 2000 ml.
Q2) A client has hypervolemic hyponatremia. The assessment finding the nurse would find inconsistent with this condition is
A) dysrhythmias
B) hypotension.
C) jugular vein distention.
D) S3 gallop.
Q3) A nurse is caring for four clients who are at risk for or who have an actual fluid volume deficit. Which client should the nurse assess first? The nurse should first assess the client who
A) is confused and spits out oral foods/fluids.
B) is on a tube-feeding running at 85 ml/hour.
C) was admitted with polyuria.
D) has diarrhea and now is restless.
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Page 13
Chapter 12: Clients with Electrolyte Imbalances
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21 Verified Questions
21 Flashcards
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Sample Questions
Q1) The nurse reviewing a client's serum electrolytes notes a phosphorus level of 1.0 mEq/L. The nurse will assess the client for a history of A) chronic respiratory acidosis.
B) malnutrition.
C) morbid obesity.
D) recent thyroidectomy.
Q2) A client is being discharged from the hospital and will be taking oral potassium chloride. The nurse should teach the client to take this medication
A) at bedtime.
B) between meals.
C) on an empty stomach.
D) with a glass of juice.
Q3) For a client in renal failure with an abnormally elevated serum potassium level, the priority assessment by the nurse would be the client's
A) electrocardiogram (ECG) strips.
B) level of consciousness.
C) serial BUN and creatinine levels.
D) urine output.
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14
Chapter 13: Acid-Base Balance
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20 Verified Questions
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Sample Questions
Q1) The nurse caring for a client who experienced cardiopulmonary arrest and has a mixed respiratory/metabolic acidosis explains to a concerned family member that the mechanical ventilator can eliminate
A) carbonic acid.
B) lactic acid.
C) phosphoric acid.
D) sulfuric acid.
Q2) The nurse teaching a 32-year-old man with renal failure about the pathophysiologic mechanism of acid-base balance recognizes that the instructions have been understood when the client says
A) "Acidic foods must be eliminated from my diet."
B) "I lose too much acid through my kidneys."
C) "My breathing increases to correct imbalances."
D) "My urine output will increase when my pH falls."
Q3) To prevent error in sampling arterial blood gases (ABGs), the nurse will
A) place the sample immediately in ice water.
B) shake the sample to mix in heparin.
C) transfer the sample from syringe to air-tight glass test tube.
D) use a large beveled needle to withdraw the sample.
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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) The recovery room nurse places the client in the lateral Sims position on admission to the post-anesthesia care unit (PACU) because this position
A) allows the tongue to fall forward.
B) discourages thrombophlebitis.
C) helps stabilize blood pressure.
D) prevents abdominal distention.
Q2) A client has the nursing diagnosis Fear related to the unknown regarding upcoming surgery. The nurse would know that goals for this diagnosis have been met when the client says "I feel a little better now because
A) a nurse will be with me during the entire experience."
B) I can tolerate anything for 2-3 hours."
C) I know I won't have any complications."
D) this operation is really routine and done all the time."
Q3) Which action should receive high priority in an elderly client being placed on the operating room table?
A) Attach the client to a cardiac monitor.
B) Ensure that the correct operative site is exposed.
C) Provide extra padding for joints and bony prominences.
D) Understand which anesthetic agents are being used.
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Page 16
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 nurse counseling a couple that wish to obtain genetic testing before starting a family explains that the purpose of such screening is to
A) allow genetic-defect-free individuals to obtain insurance discounts.
B) identify individuals who are healthy but carry a disease-carrying gene.
C) prevent genetically-based diseases from being transmitted.
D) provide genetic analysis to anyone who desires it.
Q3) Autosomes are the chromosomes that
A) are common to males and females.
B) are inherited from the paternal side.
C) determine gender.
D) exist in paired forms.
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Chapter 16: Perspectives in Oncology
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14 Verified Questions
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Sample Questions
Q1) After explaining how malignant cells differ from normal cells to a client with breast cancer, the nurse knows the client understands the characteristics of malignant cells when the client says "Malignant cells
A) are larger than normal cells and have designated purposes."
B) cannot grow if inflammation is present."
C) develop chromosomal abnormalities as they mature."
D) develop the same antigens as normal cells do."
Q2) A client angrily tells the nurse that he cannot understand why he has liver cancer when he started out with bladder cancer. The nurse would recognize that the client misunderstands how a malignant tumor metastasizes when he states that cancer can spread by
A) attaching to white blood cells.
B) direct extension into the lymphatic system.
C) invasion into the blood vessels.
D) new growths into internal body cavities.
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18
Chapter 17: Clients with Cancer
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Sample Questions
Q1) The nurse assesses that the client most at risk for breast cancer is the
A) 26-year-old multipara whose father died from lung cancer.
B) 38-year-old primigravida who had menarche at age 9.
C) 42-year-old multipara who had menarche at age 14.
D) 68-year-old nullipara receiving treatment for osteoporosis.
Q2) The nurse is developing a long-term plan for a 45-year-old client with a malignancy. The factor that would disqualify this client from receiving hospice services is A) a life expectancy of less than 6 months.
B) an annual income of more than $30,000.
C) initiation of a course of curative chemotherapy.
D) living alone in an apartment complex.
Q3) A client is receiving interleukin-2 (IL-2) as part of the therapeutic plan to manage malignant melanoma. The nurse should emphasize the ability of this agent to A) increase oxygenation to cells that are not malignant.
B) physically dissolve the tumor mass.
C) replace damaged and diseased cells from bone marrow.
D) strengthen the client's immune response.
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Chapter 18: Clients with Wounds
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Sample Questions
Q1) On a client's admission to the hospital, the nurse notes that the client has a yellow sacral decubitus ulcer. The nurse anticipates that the most appropriate wound treatment would be
A) applying antibiotic ointment.
B) surgical removal of eschar.
C) using wet-to-dry dressings.
D) vigorous cleansing with a Water Pik.
Q2) On removing a dressing from a client on the third postoperative day, the nurse notes thin, pink-colored drainage and documents this as
A) serous.
B) sanguineous.
C) serosanguineous.
D) purulent.
Q3) Four days after a client's surgery, the nurse assesses a collagen mass under the client's suture line as an indication of A) abscess.
B) edema.
C) healing ridge.
D) infection.
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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 assesses for surgical wound infection particularly closely in the client who has undergone
A) craniotomy for tumor removal.
B) hysterectomy.
C) repair of a perforated bowel.
D) tonsillectomy.
Q2) An elderly client is admitted and placed into contact and respiratory isolation. The client's spouse becomes upset seeing health care providers in gowns and masks and demands they refrain from wearing them because it is confusing to the client and the spouse thinks the health care providers are scaring the client. The best response by the nurse to help the client and spouse would be to say
A) "Has anyone explained the reason for the isolation to you?"
B) "I understand you are upset, but we have to protect other clients from infection."
C) "It's hospital policy and we all have to abide by the isolation precautions."
D) "Let me show you the items we need when we come in the room."
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Chapter 20: Clients with Pain
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Sample Questions
Q1) The nurse instructs the client taking ibuprofen that the drug is effective for pain relief because it acts to
A) interfere with the relay of pain information through the dorsal horn.
B) interrupt the transmission of pain impulses.
C) reduce inflammation and block prostaglandins.
D) slow painful stimuli through type A-delta pain fibers.
Q2) The client with neuropathic pain develops allodynia, which A) can be relieved by daily doses of opioids.
B) is a vague pain that is difficult for the client to describe.
C) is pain due to a stimulus that does not normally cause pain.
D) responds to NSAIDs taken several times a day.
Q3) The teaching plan for an individual receiving transcutaneous electrical nerve stimulation (TENS) should include the information that
A) one electrode only is used over the painful site.
B) the client can adjust both voltage and pulsation.
C) the electrode wires should be visible to detect early problems.
D) this therapy is useful for very few clients.
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Chapter 21: Perspectives in Palliative Care
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Sample Questions
Q1) A hospice client is clearly dehydrated and the family is arguing over whether or not the client should receive intravenous fluids. The nurse would guide this discussion based on what knowledge about dehydration in the terminally ill client?
A) If the terminally ill client complains of thirst, he/she is dehydrated.
B) Peripheral edema in the terminally ill client indicates fluid overload.
C) The emphasis of all treatments should be on comfort and reduction of symptoms.
D) The only choices for hydration are oral and intravenous.
Q2) The nurse suggests that the client should try a mu-agonist type of opioid, which is often effective in managing pain, such as
A) acetaminophen.
B) hydromorphone.
C) ibuprofen.
D) naproxen.
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23
Chapter 22: Clients with Sleep and Rest Disorders and Fatigue
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Sample Questions
Q1) During assessment of a client who complains of frequent sleep starts, the nurse should question the client regarding
A) alcohol intake.
B) caffeine intake.
C) food intake before bedtime.
D) medication intake.
Q2) The substance produced in the body that acts a strong sleep inducer is A) acetylcholine.
B) melanin.
C) melatonin.
D) serotonin.
Q3) Most sleeping time is spent in A) REM sleep.
B) stages 1 and 2 sleep.
C) stage 4 sleep.
D) very light sleep.
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Chapter 23: Clients with Psychosocial and Mental Health
Concerns
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Sample Questions
Q1) A client's scheduled discharge home has been postponed because his mother was unable to come until tomorrow. After hearing the news, the client says his "doctor is a fool" and the care in the facility is very poor. The nurse assesses the client's behavior as A) displacement.
B) intellectualization.
C) rationalization.
D) regression.
Q2) A mental health nurse assessing a client with schizophrenia finds that the client exhibits positive manifestations of the disorder after noting A) avoidance of social contact.
B) blunted affect.
C) delusions.
D) lack of attention to hygiene.
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Chapter 24: Clients with Substance Abuse Disorders
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Sample Questions
Q1) The assessment by the nurse that would be significant to help prevent a complication from amphetamine use is to
A) check oxygen levels frequently.
B) keep the lights on continuously.
C) measure intake and output.
D) perform neurologic assessments.
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 nurse reminds the client that in the United States, the most widely used psychoactive substance is
A) alcohol.
B) amphetamines.
C) caffeine.
D) marijuana.
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Chapter 25: Assessment of the Musculoskeletal System
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Sample Questions
Q1) A client describes ripping sounds in his knee during a fall while skiing. The nurse explains to the client that the diagnostic test that will provide the best data is a(n)
A) arthrogram.
B) bone scan.
C) myelogram.
D) x-ray film.
Q2) To evaluate a client's swollen right knee further, the nurse should first A) compare the right knee to the left knee.
B) palpate for crepitus.
C) put the knee through range of motion.
D) test muscle strength.
Q3) The nurse preparing a client for a dual-energy x-ray absorptiometry (DEXA) test explains that the purpose of this test is to measure A) amount of joint deformity.
B) degree of bone loss.
C) degree of fracture healing.
D) presence of bone infection.
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Chapter 26: Management of Clients with Musculoskeletal Disorders
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Sample Questions
Q1) After surgical debridement of diseased bone, a client with acute osteomyelitis asks how long antibiotics will be administered. The nurse should respond that the antibiotic protocol will be
A) oral antibiotics for 2-4 weeks.
B) oral antibiotics for 4-8 weeks.
C) parenteral for 4-8 weeks, then oral for 4-8 weeks.
D) parenteral for 4-8 weeks, then oral for 1 year.
Q2) The nursing care of a client with muscular dystrophy is focused on symptomatic treatment and supportive care, with a major emphasis on problems pertinent to A) ambulation.
B) elimination.
C) nutrition.
D) respiration.
Q3) The nurse explains that the most common early manifestation of a primary bone tumor is
A) fever.
B) fracture.
C) mass.
D) redness.
28
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Chapter 27: Management of Clients with Musculoskeletal
Trauma or Overuse
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Sample Questions
Q1) A client with long-standing dementia is sent to the emergency department from the nursing home in which the client resides. The report from the nursing staff states that the client is complaining of vague pain in the buttocks but seems to be ambulating without problems. The family requested the transfer. The emergency department nurse would suspect
A) an overprotective family.
B) arthritis pain the client cannot articulate.
C) possible hip fracture.
D) worsening dementia.
Q2) In the application of a plaster cast, the most appropriate nursing intervention is to A) allow excess casting material to dry on the skin before removal.
B) carefully cut the stockinette to the exact length of the cast.
C) gently support the extremity from underneath.
D) flush plaster-laden water down the toilet rather than the sink.
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Chapter 28: Assessment of Nutrition and the Digestive System
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Sample Questions
Q1) In collecting a 24-hour urine specimen to determine nitrogen balance for a client, the nurse would
A) conduct the urine collection before a 24-hour food record.
B) correct the results by multiplying by 0.13 for clients with renal disease.
C) instruct the client on foods to eat containing specified amounts of protein.
D) start the urine collection at the same time a 24-hour food record starts.
Q2) A hospitalized client has lost several pounds in the last week. The nurse reviews the client's lab results understanding that which test is the best indicator of acute nutritional changes?
A) Albumin level
B) Pre-albumin level
C) RBC count
D) Total protein level
Q3) 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.
Page 30
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Chapter 29: Management of Clients with Malnutrition
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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 explains that in the administration of total parenteral nutrition (TPN), options for infusion do not include which of the following?
A) Central venous access device inserted through the jugular vein
B) Peripheral IV catheter in the back of the hand
C) PICC line inserted peripherally and threaded to the subclavian vein
D) Totally implanted ports or external tunneled central venous catheters
Q3) To help prevent hyperglycemia in a client receiving TPN, the nurse would
A) administer the solution slowly.
B) keep the infusion at room temperature.
C) protect the solution from light.
D) use an infusion pump.
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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) Priority nursing interventions for a client immediately after glossectomy include measures to
A) assist with body image issues.
B) maintain a patent airway.
C) monitor for hemorrhage.
D) provide analgesia.
Q2) A client has undergone radiation therapy to reduce the size of an esophageal tumor. The nurse should be especially vigilant in assessing for
A) prolonged epistaxis.
B) sudden onset of diarrhea.
C) esophageal stenosis.
D) projectile vomiting.
Q3) The nurse should be aware that the dental problem most likely to cause a person with periodontitis to seek treatment is
A) decay.
B) headaches.
C) loose teeth.
D) pain.
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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 caring for a patient who had surgery and will be receiving chemotherapy and radiation treatment for stage III gastric cancer. The client is planning several extensive trips after the chemotherapy and radiation are finished. Which statement by the nurse is most appropriate at this time?
A) "Before you leave, be sure your will and other advance directives are up to date."
B) "What does your family think of your travel plans?"
C) "What has the physician told you about your disease and treatment?"
D) "Your trip sounds wonderful! Tell me more about it."
Q2) The nurse is caring for a client with chronic atrophic gastritis. When taking an admission history, the nurse would anticipate a history of A) cardiac disease.
B) emphysema.
C) intestinal parasites.
D) pernicious anemia.
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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) An 83-year-old client is seen for urinary frequency and burning. A dipstick urine test reveals positive nitrates. Which action by the nurse is most appropriate?
A) Assume the client has a UTI.
B) Catheterize the client for a sterile specimen.
C) Nothing; this is a normal finding.
D) Send the urine for a culture.
Q2) 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.
Q3) Inspection
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) A client is admitted with appendicitis and is awaiting surgery. The client states, "Now instead of pain in just one spot, the pain is kind of all over my abdomen." Which action by the nurse takes priority?
A) Assess the client's abdomen.
B) Get a set of vital signs.
C) Call the physician.
D) Prepare the client for another x-ray.
Q2) A 13-year-old client with ulcerative colitis says, "I am so glad I will grow out of this disease. It's so embarrassing at school." Which action by the nurse would best address this statement?
A) Ask the client to explain what he/she means.
B) Encourage the client to become active in school activities or sports.
C) Review the pathophysiology of ulcerative colitis.
D) Tell the client about other people who live successfully with the disease.
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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) In a client with a history of frequent urinary tract infections (UTIs), the nurse would note the need for further teaching when the client says "I
A) am on an oral contraceptive."
B) often take baths instead of showers."
C) use unscented tampons during my period."
D) use a water-soluble lubricant for intercourse."
Q2) A client has an autonomous neurogenic bladder. The nurse plans care for this client understanding that the client
A) cannot perceive bladder fullness or initiate or maintain urination.
B) feels no bladder-filling sensation but empties the bladder reflexively.
C) feels the sensation of the bladder filling but cannot initiate micturition.
D) has a temporary problem with initiating micturition.
Q3) A nurse is caring for a client with an indwelling Foley catheter. Which intervention takes highest priority?
A) Administer antispasmotics for bladder spasms.
B) Provide meticulous perineal care.
C) Provide privacy when assessing the catheter's patency.
D) Record accurate I&O.
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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) The nurse who notes documentation of Grey Turner's sign in a client who experienced renal trauma would interpret this to be a manifestation of A) increased blood urea nitrogen.
B) proteinuria.
C) retroperitoneal hemorrhage.
D) urine specific gravity of 1.20.
Q2) 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.
Q3) The nurse warns a client with insulin-dependent diabetes mellitus (IDDM) who has developed proteinuria that this finding is significant because A) insulin requirements should be lowered.
B) it indicates that the client's diabetes is uncontrolled.
C) renal failure will most likely develop in 5 to 10 years.
D) renal failure will result if diabetes is not well controlled.
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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) The nurse assesses the client for the electrolyte imbalance that tends to occur in the earlier stages of chronic renal failure, which is
A) hypercalcemia.
B) hypocalcemia.
C) hypokalemia.
D) hyponatremia.
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) To assess the effect of epoetin alfa on a client with chronic renal failure, the nurse would monitor
A) blood urea nitrogen level.
B) hematocrit level.
C) leukocyte count.
D) serum creatinine level.
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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 is teaching a client to perform testicular self-examination (TSE). The nurse is aware that this procedure is an example of
A) primary prevention.
B) quaternary prevention.
C) secondary prevention.
D) tertiary prevention.
Q2) 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.
Q3) During history-taking on a client considering pregnancy, the nurse should inquire whether the client has ever had
A) diphtheria.
B) mumps.
C) rubella.
D) typhoid fever.
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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 notices that the client's urine in the Foley catheter bag is bright red, has numerous clots, and is viscous. The priority nursing action at this time is to
A) add fluid to the balloon end of the catheter.
B) call the physician immediately.
C) force fluids for the next 8 hours.
D) irrigate the catheter with sterile saline.
Q3) A client who had prostate surgery asks the nurse when the suprapubic catheter will be removed. The nurse would reply that it will be left in place until A) about 2 weeks after the surgery.
B) antibiotic therapy is completed.
C) no pain medication is necessary.
D) the client is voiding well.
Page 40
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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 nurse is counseling an adolescent and her mother about preventing cervical cancer. The most important health promotion action the nurse could suggest is to
A) abstain from alcohol.
B) avoid sexual intercourse.
C) do not start smoking.
D) get the HPV vaccine.
Q2) A woman is being taught self-care for a vaginal pessary to treat vaginal prolapse. The nurse would realize that additional discharge instructions are needed when the woman says
A) "I can use estrogen cream in my vagina at night."
B) "If I have trouble removing or inserting the pessary, I will call the doctor."
C) "My follow-up appointment is in 2 months."
D) "The pessary needs to be washed daily with mild soap."
Q3) The assessment that would alert the nurse to vulvar carcinoma is
A) lichen sclerosa.
B) reduced libido.
C) vaginal atrophy.
D) white, frothy vaginal discharge.
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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 that a breast tumor that is estrogen receptor positive (ER+) is associated with
A) faster tumor growth rates.
B) longer survival.
C) more aggressive behavior.
D) poor response to hormonal manipulation.
Q2) In the discharge teaching plan for a client with breast augmentation, the nurse would explain that the client should
A) avoid touching the breasts.
B) perform full range-of-motion arm exercises a week after surgery.
C) sleep on her back in a head-elevated position for a week.
D) take aspirin for pain relief and to decrease inflammation.
Q3) The nurse explains that the most frequent breast mass is A) carcinoma.
B) fibroadenoma.
C) fibrocystic disease.
D) mastitis.
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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) The nurse caring for clients with STDs knows that which diseases are reportable in all states? (Select all that are correct.)
A) Chlamydia
B) Gonorrhea
C) Herpes simplex virus (genital)
D) Human papilloma virus
E) Syphilis
Q2) A client with genital herpes asks the nurse what effect the herpes will have on her becoming pregnant and having a child. The nurse's response is based on the fact that active genital herpes lesions can cause
A) birth defects.
B) infection of the fetus in utero.
C) infection of the newborn during vaginal delivery.
D) sterility.
Q3) The nurse conducting health education about gonorrhea would teach a client that A) gonorrhea is difficult to treat effectively.
B) gram-negative organisms multiply rapidly.
C) the organisms can survive for a long period outside the body.
D) there is a large carrier population because it can be asymptomatic in women.
Page 43
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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) Explaining a paracentesis to an anxious client, the nurse states that the purpose is to A) collect fluid accumulations from the pleura.
B) evaluate secretions of the gallbladder.
C) extract fluid sequestered in the pancreas.
D) remove excess fluid from the peritoneum.
Q2) 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.
Q3) A client is having a physical examination and the nurse notes that the client's hands and feet are large compared to the rest of the body. The nurse should suspect A) acromegaly.
B) congenital disorders.
C) diabetes.
D) muscle deformity.
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Page 44
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) In a client with hyperthyroidism, the nurse would expect to see
A) anorexia, constipation, and cold extremities.
B) blurred vision, night sweats, and palpitations.
C) heat intolerance, weight loss, and diarrhea.
D) muscle cramps, paresthesias, and numbness of the fingers and toes.
Q2) The nurse caring for a client after a thyroidectomy plans care understanding that which of the following nursing diagnoses takes priority?
A) Acute Pain
B) Imbalanced Nutrition
C) Impaired Skin Integrity
D) Risk for Suffocation
Q3) In a client with Graves' disease receiving radioiodine, the nurse would monitor for the common treatment complication of
A) hypothyroidism.
B) pulmonary emboli.
C) skin breakdown.
D) urinary tract infection.
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Page 45
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) In a client with addisonian crisis, assessment would indicate that the drug Kayexalate is not effective when the nurses assesses the clinical manifestation of A) decreasing blood pressure.
B) low back pain.
C) pedal edema.
D) rapid or erratic pulse.
Q2) The nurse recognizes that the manifestations of Addison's disease are primarily related to the pathophysiology of A) adrenal insufficiency.
B) increased intracranial pressure.
C) renal disease.
D) thyroid hyperfunction.
Q3) 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.
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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) A client with diabetes mellitus recently discharged from the hospital calls the nursing unit to report that she is nauseated and cannot remember what she has to do about her insulin injection. The nurse should remind the client to
A) call the physician at once.
B) omit her insulin until she is able to eat her normal diet.
C) review the material she was given at the hospital.
D) take her insulin and monitor her blood sugar frequently.
Q2) Evaluating a young man with type 1 diabetes, the nurse would consider a classic clinical manifestation of diabetes to be the client's
A) excessive thirst.
B) gradual weight gain.
C) overwhelming fatigue.
D) recurrent blurred vision.
Q3) The nurse would encourage the client who is attempting to lose weight to reduce the intake of
A) broccoli.
B) cheese.
C) chicken.
D) oranges.
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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 being discharged after an episode of acute pancreatitis asks the nurse why items such as coffee/tea, spicy foods, and heavy meals should be avoided. The nurse should reply
A) "Eating these items may disrupt your sleep and you will need lots of rest."
B) "So that you won't get reflux disease, which is a common complication."
C) "Those things stimulate the pancreas too much and may give you another attack."
D) "Your sense of taste has been altered, and often people don't like these any more."
Q2) A client with acute pancreatitis has developed a Cullen's sign. Which nursing diagnosis takes priority for this client?
A) Acute Pain
B) Altered Nutrition
C) Imbalanced Fluid Volume
D) Ineffective Breathing Patterns
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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) A client has been admitted for suspected hepatic carcinoma. The client and family are anxious and agitated. Which intervention by the nurse would best support them?
A) Bring the client and family coffee and food from the cafeteria.
B) Educate the client and family about upcoming procedures and tests.
C) Plan care so the family has uninterrupted time with the client.
D) Have the medical social worker stop by and discuss advance directives.
Q3) The nursing intervention that takes priority for the nursing diagnosis High Risk for Injury related to presence of Sengstaken-Blakemore tube is
A) massaging bony prominences frequently.
B) offering fluids frequently.
C) placing a pair of scissors at the bedside.
D) restraining the client's hands.
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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) The nurse would record the presence of a lichenification as a A) complicated lesion.
B) primary lesion.
C) secondary lesion.
D) simple lesion.
Q2) 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.
Q3) When the nurse lifts the client's foot to clean it during bathing, the nurse notices that it is cool to the touch. The nurse's most appropriate initial action would be to
A) compare the temperature of the foot with the client's other foot.
B) document the finding on the client's chart.
C) inspect hair distribution on the lower half of the leg.
D) Place the extremity under a blanket and continue the bath.
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Chapter 49: Management of Clients with Integumentary Disorders
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38 Verified Questions
38 Flashcards
Source URL: https://quizplus.com/quiz/4047
Sample Questions
Q1) The nurse would record the assessment of a nonblanching reddened area on an older client's sacrum as
A) atopic dermatitis.
B) intertrigo.
C) stage 1 pressure ulcer.
D) xerotic eczema.
Q2) Discharge teaching for a client following rhytidectomy would include the instruction to
A) sleep in the prone position only.
B) practice coughing and deep breathing.
C) maintain a liquid diet for 1 week.
D) exercise the facial muscles daily.
Q3) The client is to apply topical 5-fluorouracil to a lesion diagnosed as actinic keratosis. The nurse would explain that the client should expect the skin to develop A) desquamation.
B) dryness.
C) erosion and necrosis.
D) itching.
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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) A client admitted to the emergency department (ED) with burns of the chest and neck exhibits a wet, shiny, weeping surface with some blistering. The nurse would document these burn injuries as
A) full thickness, fourth degree.
B) full thickness, third degree.
C) partial thickness, second degree.
D) superficial, first degree.
Q2) The nurse caring for a burn client would monitor the client's stools for occult blood as assessment for development of A) bleeding caused by bowel distention.
B) gastric irritation related to smoke.
C) intestinal ileus.
D) stress ulcers.
Q3) The physician orders 1% silver sulfadiazine cream applied to a client's burn wound two times daily. The nurse would be aware that this medication can affect A) blood pH.
B) hemoglobin level.
C) serum electrolyte levels.
D) white blood cell count.
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Chapter 51: Assessment of the Vascular System
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12 Flashcards
Source URL: https://quizplus.com/quiz/4049
Sample Questions
Q1) For a client admitted to the hospital with chronic venous disease, the nurse's assessment of the client's legs would most likely reveal
A) decreased pulses.
B) erythema.
C) overgrowth of hair.
D) reduced muscle mass.
Q2) A client is taking garlic and hawthorn supplements. The nurse would ask further questions to elicit information on a possible history of A) atherosclerosis.
B) hypertension.
C) smoking.
D) varicose veins.
Q3) A client with venous disease is scheduled for impedance plethysmography. Before the study the nurse would explain that
A) an intravenous dye may be used.
B) the procedure is uncomfortable.
C) venous blood flow quality will be measured.
D) walking on a treadmill is required.
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53
Chapter 52: Management of Clients with Hypertensive Disorders
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17 Verified Questions
17 Flashcards
Source URL: https://quizplus.com/quiz/4050
Sample Questions
Q1) A client has two BP readings of (134/84) and 9138/86) at a community screening event. The client smokes and has "some sort of eye disease like my grandma had" plus the client states, "I might have high sugar." The most appropriate action by the nurse would be to (Select all that apply)
A) advise the client to return tomorrow for repeat blood pressure readings.
B) arrange for the client to be seen at a local urgent care center today.
C) inform the client about the high risk of developing hypertension.
D) tell the client that the blood pressure readings are not considered high.
E) work with the client to identify risk factors and create a plan to address them.
Q2) For a client who wants to walk for exercise to reduce hypertension, the nurse would offer the guideline to walk
A) at the highest possible speed for 20 minutes, two or three times a week.
B) briskly for 30 to 45 minutes most days of the week.
C) slowly for 1 to 2 hours most days of the week.
D) with variable speeds and on hills at least twice a week.
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Page 54
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) In teaching the preoperative ambulatory surgery client scheduled for vein ligation and stripping, the nurse would include that immediately after surgery, the client will
A) experience pain and swelling in the leg.
B) have legs wrapped with Ace bandages from heel to groin.
C) have the head of the bed put on blocks to elevate it 6 to 9 inches.
D) need to sit in a comfortable chair with legs dependent.
Q2) When a client complains of heaviness, aching, and itching of both legs for the past year, the nurse recognizes these complaints as being most suggestive of A) Buerger's disease.
B) deep vein thrombosis.
C) Raynaud's phenomenon.
D) varicose veins.
Q3) The nurse teaches the client with intermittent claudication that the pain results from A) lactic and pyruvic acid buildup.
B) muscle cramps.
C) rapid vasodilation in the legs.
D) venous stasis.
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Page 55
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) The nurse evaluating the head and neck of a client would assess the carotid arteries by
A) asking the client to bear down and hold the breath while observing the arteries.
B) auscultating the arteries with the diaphragm of the stethoscope.
C) instructing the client to lie down and examining the arteries with oblique lighting.
D) palpating the arteries simultaneously, comparing amplitudes, rates, and rhythms.
Q2) 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.
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Chapter 55: Management of Clients with Structural
Cardiac Disorders
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21 Verified Questions
21 Flashcards
Source URL: https://quizplus.com/quiz/4053
Sample Questions
Q1) The nurse teaching a class on long-term effects of rheumatic fever would stress that the most common problem following bouts of rheumatic fever is A) cardiac tamponade.
B) coronary artery disease.
C) pericarditis.
D) valvular disorders.
Q2) The physician has expressed concern about the development of rheumatic fever in a client with a throat infection. The nurse would explain to the client that the organism causing the infection is A) a respiratory virus.
B) beta-hemolytic streptococcus.
C) Escherichia coli.
D) Streptococcus pneumoniae.
Q3) Examining the electrocardiogram strips of a client with mitral stenosis, the nurse would recognize the characteristic dysrhythmia of A) atrial fibrillation.
B) artial flutter.
C) sinus tachycardia.
D) ventricular tachycardia.
Page 57
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Chapter 56: Management of Clients with Functional
Cardiac Disorders
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28 Verified Questions
28 Flashcards
Source URL: https://quizplus.com/quiz/4054
Sample Questions
Q1) A client is scheduled to have a PTCA. The nurse brings the consent forms and the client questions why he/she has to sign a consent form for possible coronary artery bypass grafting too. The nurse's response should be based on understanding that (Select all that apply)
A) a separate consent must be signed for each procedure.
B) education will only have to be done one time if the client signs both now.
C) in case of a complication, there may not be time to have a consent signed.
D) the client will be sedated during the PTCA and cannot sign another consent form.
Q2) The nurse would recognize that the client at greatest risk for CHD is a
A) 35-year-old man who is 15 pounds overweight.
B) 40-year-old woman who repeatedly gains and loses 15 pounds.
C) 45-year-old man who lost 30 pounds by following a strenuous diet.
D) 50-year-old man 20 pounds overweight but a lifelong swimmer.
Q3) The nurse would explain to a client who smokes that the nicotine in cigarette smoke increases the prevalence of CHD by
A) causing proliferation of smooth muscle cells.
B) decreasing the oxygen-carrying capacity of the blood.
C) increasing fat deposits along the intima of blood vessels.
D) increasing the heart rate and the risk of dysrhythmia.
Page 58
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Chapter 57: Management of Clients with Dysrhythmias
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Source URL: https://quizplus.com/quiz/4055
Sample Questions
Q1) When a client in the cardiac care unit (CCU) suddenly develops paroxysmal atrial tachycardia (PAT) of 200 beats/min and clinical manifestations of severe dizziness, the nurse would help decrease the heart rate by A) administering digitalis intravenously.
B) asking the client to perform the Valsalva maneuver.
C) increasing the client's oxygen.
D) lowering the head of the bed.
Q2) 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.
Q3) If the first defibrillation shock at 200 J is not successful on a client with ventricular fibrillation, the nurse in charge of the code would A) administer a second shock at 300 J. B) reinitiate CPR.
C) reposition the client and shock at 200 J.
D) set the defibrillator to synchronous.
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Page 59
Chapter 58: Management of Clients with Myocardial Infarction
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25 Verified Questions
25 Flashcards
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Sample Questions
Q1) When the immediate post-MI client complains about the high-fiber diet and being encouraged to drink water, the nurse would inform the client that the purpose of such a diet is to
A) create a high-bulk, soft stool.
B) lower cholesterol levels.
C) maintain bowel health to decrease gas.
D) promote easy digestion.
Q2) A client in intensive care has had an STEMI. The client is alternately yelling out and crying. The client states "I'll never be able to go back to work again!" The most appropriate nursing diagnosis for this client is
A) Altered Body Image.
B) Anxiety.
C) Fear.
D) Powerlessness.
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.
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Chapter 59: Assessment of the Respiratory System
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17 Verified Questions
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Sample Questions
Q1) The nurse reviews the results of the arterial carbon dioxide tension (PaCO<sub>2</sub>) of a client with asthma to obtain information relative to the A) contribution of gas exchange.
B) effectiveness of alveolar ventilation.
C) evidence of atelectasis.
D) presence of respiratory alkalosis.
Q2) Before drawing blood for an arterial blood gas (ABG), the nurse would perform a/an A) Allen's test.
B) incentive spirometer assessment.
C) Schilling's test.
D) test for peripheral perfusion.
Q3) 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.
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Chapter 60: Management of Clients with Upper Airway Disorders
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Sample Questions
Q1) The measure that would best aid the nurse in removing heavy, tenacious secretions during suctioning is
A) encouraging frequent coughing and deep breathing.
B) employing postural drainage before suctioning.
C) hyperinflating the lungs before suctioning.
D) instilling sterile saline directly into the trachea.
Q2) The observation that would require an immediate nursing intervention for a client recently returned to the unit following partial laryngectomy is
A) blood-tinged sputum.
B) copious respiratory secretions.
C) difficulty swallowing.
D) pulsating tracheostomy tube.
Q3) When a friend comes to the nurse's apartment to seek help to stop the bleeding from a broken nose, the nurse would attempt to convince the friend to seek treatment in the emergency department primarily because
A) cosmetic results are poor when treatment is delayed.
B) general anesthesia may be needed to locate the bleeding vessels.
C) it will be very difficult to stop the bleeding if the nose is fractured.
D) the nose cannot be set for 2 to 3 days if edema develops.
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Chapter 61: Management of Clients with Lower Airway and Pulmonary Vessel
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27 Flashcards
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Sample Questions
Q1) The nurse working with a depressed client who has COPD realizes that many factors negatively affect the client's quality of life, including (Select all that apply)
A) familial support systems.
B) loss of control over their bodies.
C) reduced activity tolerance.
D) social isolation.
Q2) In assessing a client for emphysema, the nurse would know that a physical finding commonly associated with this condition is
A) barrel chest.
B) bulbous nose.
C) spider angiomas.
D) varicose veins.
Q3) A nurse is conducting community wellness seminars and teaches that a primary prevention activity for chronic obstructive pulmonary disease (COPD) is A) avoiding alcohol.
B) genetic testing.
C) not smoking.
D) regular exercise.
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Chapter 62: Management of Clients with Parenchymal and Pleural Disorders
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34 Flashcards
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Sample Questions
Q1) The nurse writing an infection control policy for a home health care agency would include the information that the rise in TB cases in recent years is related to the A) aging of the U.S. population.
B) emergence of antibiotic-resistant bacteria.
C) increase in HIV infection.
D) rise in illegal drug use.
Q2) A young female client with cystic fibrosis (CF) wishes to become pregnant but is concerned about the effect of CF on fertility. The nurse bases a response with the understanding that
A) breastfeeding will not be possible because of plugged milk glands.
B) only about 20% of women with CF are infertile.
C) pregnancy carries a high risk of spontaneous abortion (miscarriage).
D) women with CF are unlikely to become pregnant.
Q3) A client has been diagnosed with histoplasmosis lung infection. The nurse would anticipate treatment to include
A) amphotericin B.
B) corticosteroids.
C) isoniazid.
D) morphine.
Page 64
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Chapter 63: Management of Clients with Acute Pulmonary Disorders
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28 Verified Questions
28 Flashcards
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Sample Questions
Q1) In the nursing care of a client recently intubated and placed on mechanical ventilation, the nursing action that would take highest priority is
A) assessing for pedal pulses regularly.
B) monitoring blood pressure frequently.
C) monitoring temperature every 4 hours.
D) turning the client every 2 hours.
Q2) A client's ventilator alarm begins to ring. The nurse enters the room and notes that the "low expired minute volume" alarm is sounding. After quickly determining that the client is in no acute distress, the nurse would
A) add more water to the humidifier.
B) look for a kink in the tubing.
C) look for a leak or disconnection in the system.
D) suction the client's secretions.
Q3) When a client is admitted to the ED with a sucking chest wound, the nurse initially would
A) cover the wound with whatever is available.
B) leave the wound open.
C) notify the physician.
D) obtain a sterile gauze petroleum dressing to cover the wound.
Page 65
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Chapter 64: Assessment of the Eyes and Ears
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Sample Questions
Q1) The nurse conducting a physical examination is assessing a client's pupillary reactions. To do this correctly, the nurse would
A) ask the client to open the eyes and stare into the penlight.
B) ask the client to stare straight ahead and then turn on the penlight.
C) bring the penlight up from the client's chin to shine directly over the pupil.
D) bring the penlight in from the side to shine directly over the pupil.
Q2) When a nurse testing visual acuity is using a Snellen chart, the distance that the client would be positioned from the chart is
A) 5 feet.
B) 10 feet.
C) 15 feet.
D) 20 feet.
Q3) The nurse would ask a client with the diagnosis of myopia about a family history of A) central vision loss.
B) color blindness.
C) farsightedness.
D) nearsightedness.
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Chapter 65: Management of Clients with Visual Disorders
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21 Verified Questions
21 Flashcards
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Sample Questions
Q1) 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.
Q2) The nurse would consider that discharge teaching for a client after cataract surgery was not effective when the client states "I will
A) avoid lifting more than 5 pounds for a while."
B) only experience mild pain."
C) sleep on the side they operated on."
D) wear my eye shield to protect my eye."
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Chapter 66: Management of Clients with Hearing and Balance Disorders
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23 Verified Questions
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Sample Questions
Q1) The occupational health nurse evaluating a factory where the noise level is high would recommend noise abatement or use of earplugs when the noise level exceeds A) 47 dB.
B) 64 dB.
C) 72 dB.
D) 80 dB.
Q2) The nurse caring for a client with a conductive hearing loss would enhance communication by facing the client and A) lowering the pitch of the voice.
B) speaking loudly.
C) speaking slowly.
D) using lip movement to shape words.
Q3) The nurse is assigning an unlicensed assistive personnel (UAP) to work with a client who has a hearing aid. Which action by the UAP is inconsistent with appropriate delegation? The nurse asks the UAP to
A) cleanse the ear mold if needed with mild soap and water.
B) evaluate how well the client understood the nurse's earlier instructions.
C) help the client insert the ear mold into the ear.
D) turn the hearing aid off before removing it at bedtime.
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Chapter 67: Assessment of the Neurologic System
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Sample Questions
Q1) A nurse assessing a client's neurologic function. Which assessment is specifically added for the client who is suspected to have a spinal cord injury?
A) Bowel and bladder function
B) Cranial nerve function
C) Motor and sensory function
D) Pathologic reflexes
Q2) The nurse would point out to a client that the advantage of magnetic resonance spectroscopy (MRS) is that the procedure
A) assesses markers for neurodegenerative diseases.
B) can be used during pregnancy.
C) provides detailed images of bone tissue.
D) uses only small doses of radiation.
Q3) If the client has adequate proprioception, the nurse would know that the client can
A) bend over at a 90-degree angle and return to ab upright position.
B) stand steady with feet together.
C) touch nose with eyes closed.
D) touch top lip with tip of tongue.
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Chapter 68: Management of Comatose or Confused
Clients
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Sample Questions
Q1) The nurse assisting with the oculovestibular response (OVR) test on a client recognizes that the brain stem is intact when the client's eyes
A) demonstrate sustained nystagmus.
B) do not deviate with the instillation of ice water.
C) rapidly move toward the ear irrigated with warm water.
D) slowly move toward the ear irrigated with ice water.
Q2) A nurse preparing to give mouth care to a comatose client should first place this client into the position of A) high Fowler. B) lateral.
C) low Fowler. D) prone.
Q3) The nursing action contraindicated in the care of a client with a severe basilar skull fracture is
A) nasal suctioning.
B) pharyngeal suctioning.
C) raising the head of his bed.
D) tooth brushing.
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Chapter 69: Management of Clients with Cerebral Disorders
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Sample Questions
Q1) Three days following intracranial surgery a client develops fever, nuchal rigidity, and headache. The nurse would suspect
A) cerebral emboli.
B) extradural hematoma.
C) increased ICP.
D) meningitis.
Q2) A week after a client experienced a ruptured cerebral aneurysm, he becomes extremely indecisive and has frequent episodes of incontinence. The nurse reports these events as probable A) vasospasm.
B) automatisms.
C) focal seizures.
D) early-stage dementia.
Q3) The nurse observes for manifestations of typical migraine headaches, which include A) aura, visual disturbances, and nausea.
B) bilateral pain, abrupt onset, and tinnitus.
C) diarrhea, nasal congestion, and eye redness.
D) scalp tenderness, sensation of pressure, and nighttime onset.
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Chapter 70: Management of Clients with Stroke
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Sample Questions
Q1) A client is admitted to the hospital with right-sided hemiplegia as a result of a stroke. To help prevent contractures, the nurse should employ which of the following interventions? (Select all that apply.)
A) Give the client a ball to hold to keep fingers in the flexed position.
B) Perform passive ROM to affected limbs at least twice a day after the first 24 hours.
C) Support a completely flaccid arm with pillows when in bed or in a chair.
D) Try placing the client in the prone position for 15-30 minutes at a time.
E) Use high-top tennis shoes or orthotics while in bed to prevent footdrop.
Q2) A client with stroke has a nursing diagnosis of Impaired Verbal Communication and has specific difficulty in verbal expression. The most helpful strategy by the nurse would be to
A) give the client practice in repeating words after the nurse.
B) point to objects and state their names.
C) repeat directions until they are understood.
D) try to do all the speaking for the client.
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Chapter 71: Management of Clients with Peripheral Nervous
System Disorders
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Sample Questions
Q1) To promote back health, nursing personnel are instructed in good body mechanics, which include (Select all that apply)
A) avoid twisting the body when lifting.
B) hold objects away from the body when lifting in case they are dropped.
C) keep heavy objects close to the body when lifting.
D) participate in exercises to strengthen abdominal and back muscles.
Q2) The nurse points out the physical therapy modality that would be avoided in the treatment for a client with Bell's palsy is
A) cold packs.
B) facial nerve stimulation with faradic current.
C) gentle massage.
D) moist heat.
Q3) The point the nurse should stress in giving home instructions to the client regarding home care following carpal tunnel release surgery is
A) flex and extend the fingers every 4 hours while awake.
B) notify the physician if part of the hand becomes cold or tingly.
C) restrict lifting for 2 weeks.
D) wear a splint for 24 to 48 hours.
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Chapter 72: Management of Clients with Degenerative Neurologic Disorders
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Sample Questions
Q1) A client with AD begins to tell the nurse about his early-married life. The nurse should
A) assess orientation to time and place.
B) distract the client from this activity.
C) encourage the client to talk about recent memories.
D) listen to his stories.
Q2) A nurse is caring for a client diagnosed with Creutzfeldt-Jakob Disease (CJD).
Appropriate nursing care includes
A) administering broad-spectrum antibiotics until culture results are known.
B) giving the client anti-viral medications as ordered.
C) placing the client in contact and airborne isolation.
D) using standard precautions when handling body fluids.
Q3) To assist the client with Parkinson's disease to reduce tremor, the nurse suggests that the client
A) clasp arms about self and squeeze.
B) sleep on the non-tremorous side.
C) tightly hold change in the pocket.
D) visualize stilling the tremor.
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Page 74
Chapter 73: Management of Clients with Neurologic
Trauma
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Sample Questions
Q1) The nurse is assessing a client for manifestations of recovery from spinal shock. Which of the following assessment findings would indicate that spinal shock is resolving?
A) Flaccid paralysis
B) Hyperreflexia
C) Loss of Babinski's response
D) Urinary retention
Q2) Vital signs on a brain-injured client 1 hour ago were T 98.8° F, P 76, BP 124/72 . When the nurse takes a current set of vital signs that are T 98.4° F, P 56, BP 160/54, the nurse should
A) administer prn pain medications.
B) check the client's blood glucose level.
C) lower the head of the bed.
D) prepare to administer mannitol.
Q3) The nurse working with an ICP monitor institutes which actions? The nurse (Select all that apply)
A) administers prophylactic antibiotics as ordered.
B) limits the number of times the system is opened.
C) manipulates the catheter frequently to ensure patency.
D) uses strict aseptic technique to change dressings.
Page 75
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Chapter 74: Assessment of the Hematopoietic System
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Sample Questions
Q1) 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.
Q2) In evaluating a young woman, the following laboratory result the nurse recognizes as abnormal is
A) hemoglobin 13 g/dl.
B) platelet count 20,000/mm<sup>3</sup>.
C) red blood cell count 5 million/mm<sup>3</sup>.
D) white blood cell count 6000/mm<sup>3</sup>.
Q3) A client has severe anemia and is being treated with transfusion therapy. The nurse should be alert for a complication of transfusion, such as A) flank pain.
B) hearing loss.
C) liver damage.
D) sore throat.
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Chapter 75: Management of Clients with Hematologic Disorders
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Q1) The nurse counsels a client with idiopathic thrombocytopenic purpura (ITP) that if medication therapy is not effective, the surgical procedure most likely to be used in the treatment is
A) bone marrow transplant.
B) exploratory laparotomy.
C) hepatic shunt.
D) splenectomy.
Q2) The nurse assessing a client with sickle cell anemia would recognize the common manifestation of the disease is A) confusion.
B) diarrhea.
C) hypertension.
D) leg ulcers.
Q3) The nurse informs a client suspected of having pernicious anemia that the lab study that will be helpful in the diagnosis is A) clotting studies.
B) endoscopy.
C) hemoglobin levels.
D) Schilling test.
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Chapter 76: Management of Clients with Immune Disorders
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Sample Questions
Q1) The nurse instructs a client diagnosed with urticaria on common self care measures, which include
A) antihistamines.
B) corticosteroids.
C) nonsteroidal anti-inflammatory drugs (NSAIDs).
D) warm oatmeal baths.
Q2) The nurse explains that a type 2 hypersensitivity reaction results in A) antibody formation.
B) cell destruction.
C) mast cell production.
D) T-cell stimulation.
Q3) The nurse concerned about safety encourages a client to stop which medication?
A) Cetirizine (Zyrtec)
B) Diphenhydramine (Benadryl)
C) Fexofenadine (Allegra)
D) Loratadine (Claritin)
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Chapter 77: Management of Clients with Rheumatic Disorders
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Sample Questions
Q1) The intervention the client with rheumatoid arthritis (RA) can do that is most effective in preserving motor function during periods when the affected joints are not inflamed is A) application of moist heat to joints.
B) encouraging moderate increase in activity.
C) promotion of a high-protein diet.
D) restriction of the client's activity.
Q2) The caution the nurse should give the client who is taking nonsteroidal anti-inflammatory drugs (NSAIDs) as a remedy for arthritis is to A) avoid taking NSAIDs with milk.
B) liberalize fluids while taking NSAIDs.
C) take NSAIDs with food.
D) watch for manifestations of skin damage.
Q3) The common complication of ankylosing spondylitis that the nurse should address in the plan of care is
A) cardiac dysrhythmias.
B) respiratory compromise.
C) renal failure.
D) weight gain.
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Chapter 78: Management of Clients with Acquired
Immunodeficiency Syndrome
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Q1) A client is afraid of a recent possible HIV exposure. The nurse should explain that the period of time it takes before HIV antibodies can be detected by laboratory tests is generally
A) 1 to 3 days.
B) 7 to 10 days.
C) 1 to 3 weeks.
D) 4 to 12 weeks.
Q2) A nurse should plan further evaluation of an HIV-positive client when the client exhibits which early manifestation of toxoplasmosis infection?
A) Cardiac dysrhythmias
B) Discoloration of the mucous membranes
C) Headache
D) Lymphadenopathy
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) The nurse preparing a client with acute leukemia for the induction phase of chemotherapy explains that the objective of this phase is to A) decrease the number of monocytes.
B) induce complete remission.
C) reduce long bone pain and splenomegaly.
D) "shock" the marrow into producing normal cells.
Q2) The nurse caring for a client who had a bone marrow transplant this morning should observe the client for manifestations of A) graft-versus-host disease.
B) hemorrhage.
C) pulmonary complications.
D) Sjögren's syndrome.
Q3) The nurse reviewing a hematology report recognizes pancytopenia, which is when A) cellular components of the blood are reduced.
B) platelets are immature and dividing rapidly.
C) red cells have become polymorphic.
D) white cells are poorly undifferentiated.
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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) A nurse working as part of a transplantation team is conducting a group education session. A client waiting for a heart transplant asks why he cannot stay in his rural home to wait. He knows someone who had a kidney transplant and stayed in the same local area waiting for his transplant. The best response by the nurse would be
A) "Because of confidentiality rules, I can't talk about your friend's experience."
B) "How long ago did that occur?"
C) "Different transplant centers have different requirements."
D) "Each organ's viability time is different. Kidneys can last longer than hearts."
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Chapter 81: Management of Clients with Shock and Multisystem
Disorders
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Sample Questions
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) A client is critically ill and in shock. The large, extended family has gathered in the waiting room. Important interventions the nurse can use when working with this family include (Select all that apply)
A) allow the family to ask questions and express concerns.
B) avoid explaining a lot of equipment so as not to worry the family.
C) encourage the family to participate in decision making.
D) let the family visit the client as much as possible.
E) provide frequent explanations of what is happening with the client.
Q3) Distributive shock is primarily due to
A) a fluid shift from the vascular space.
B) an increase in the size of the vascular space.
C) inadequate circulating blood volume.
D) inadequate pumping action of the heart.
Page 83
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Chapter 82: Management of Clients in the Emergency Department
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Sample Questions
Q1) A client with a chest injury develops respiratory distress, distended jugular neck veins, and tracheal deviation. The nurse anticipates the client will receive immediate A) chest tube insertion.
B) chest x-ray.
C) intubation.
D) needle thoracotomy.
Q2) A client is brought to the emergency department complaining of severe chest pain. The triage nurse assigns this client the triage category of A) emergent.
B) non-urgent.
C) urgent.
D) vital.
Q3) A teenage girl brings her newborn baby wrapped in a bloody T-shirt into the ED and says she intends to leave the baby there. The nurse should A) call the police.
B) initiate admission to the pediatric unit.
C) notify social services.
D) restrain the mother.
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