Hospital Nursing Practice
Exam Materials
Course Introduction
Hospital Nursing Practice is a comprehensive course designed to equip students with the knowledge and skills necessary for effective nursing care in hospital settings. The course covers fundamental concepts such as patient assessment, care planning, and implementation of evidence-based interventions for diverse patient populations. Students will explore procedures related to medication administration, wound care, infection control, and the use of medical technology. Emphasis is placed on interprofessional communication, ethical decision-making, and the management of acute and chronic conditions within the hospital environment. Through both theoretical instruction and hands-on clinical experiences, students develop competence in critical thinking, clinical judgment, and compassionate patient-centered care.
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
Source URL: https://quizplus.com/study-set/252 Page 2
Chapter 1: Health Promotion and Disease Prevention
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21 Verified Questions
21 Flashcards
Source URL: https://quizplus.com/quiz/3999
Sample Questions
Q1) Strategies a nurse should use when teaching a client include (select all that apply)
A) using plain, lay language.
B) providing comprehensive information at each session.
C) having the client "teach back" what has been taught.
D) using written material written at a low literacy level.
Answer: A, C, D
Q2) The nurse understands that the document he/she can use to plan community teaching projects addressing the federal population-based health objectives is
A) Healthy People 2010.
B) Nursing's Agenda for Healthcare.
C) the federal Medicare/Medicaid Acts.
D) the Goldmark Report.
Answer: A
Q3) The nurse recognizes the activity that reflects primary prevention is A) a self-initiated walking regimen.
B) collaboration with a physical therapist.
C) physician-prescribed exercise after a heart attack.
D) tuberculosis screening.
Answer: A
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Page 3
Chapter 2: Health Assessment
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14 Verified Questions
14 Flashcards
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Sample Questions
Q1) Inspection
A) 1
B) 2
C) 3
D) 4
Answer: C
Q2) 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
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
Source URL: https://quizplus.com/quiz/4001
Sample Questions
Q1) At the beginning of the shift a student nurse is meeting with the registered nurse (RN) assigned to the student's client. The student nurse should provide the RN with which information? (Select all that apply.)
A) Assessments the student will make
B) Documentation the student will complete
C) Medications the student will administer
D) Treatments the student can perform
E) What time the student is going to lunch
Answer: A, B, C, D
Q2) It is crucial for the nurse to be able to make sound decisions using critical thinking because
A) it is the most efficient use of the nurse's time and resources.
B) it uses previously learned knowledge in predictable situations.
C) most clients have problems for which there are no textbook answers.
D) nurses can recognize problems rapidly and provide speedy responses to situations.
Answer: C
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5
Chapter 4: Complementary and Alternative Therapies
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12 Verified Questions
12 Flashcards
Source URL: https://quizplus.com/quiz/4002
Sample Questions
Q1) When the client asks the nurse what "placebo effect" means, the nurse includes in the response that the placebo effect describes a
A) deterioration of the product to the point that it renders the product incapable of offering any therapeutic benefit.
B) phenomenon of a person taking the placebo and claiming positive effects because of psychological factors unrelated to the product.
C) practice of manufacturers to make hugely inflated claims to induce the potential user to believe in the worth of the product.
D) product that, although producing therapeutic effects for many users, has no effect on others.
Q2) 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.
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6
Chapter 5: Ambulatory Health Care
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20 Verified Questions
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) The nurse contacts a client by follow-up telephone call after the client's visit to an ambulatory care center. The client who would benefit most from this intervention
A) has undergone cast removal.
B) has undergone same-day surgery.
C) is having blood pressure monitored.
D) is having blood sugar monitored.
Q3) 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.
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Chapter 6: Acute Health Care
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14 Verified Questions
14 Flashcards
Source URL: https://quizplus.com/quiz/4004
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 registered nurse (RN) seeking work in a voluntary health agency would choose a A) church-affiliated hospital.
B) proprietary hospital.
C) state university hospital.
D) veterans administration (VA) hospital.
Q3) Using a nursing intensity classification system, the nurse manager assesses that the client requiring the greatest amount of care is the
A) 24-year-old with a 3-day-old fractured femur in Russell's traction.
B) 37-year-old in isolation for hepatitis who is vomiting.
C) 42-year-old 1 day after a craniotomy.
D) 76-year-old 4 days after a cerebrovascular accident (CVA) who is comatose.
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8
Chapter 7: Critical Care
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10 Verified Questions
10 Flashcards
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Sample Questions
Q1) 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.
Q2) 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.
Q3) A nurse working in the critical care unit would assess the client's complexity by asking questions related to
A) ability of the client and family to make sound decisions.
B) effect of family, stress, and environmental factors on the client.
C) interplay of multiple medical problems on the current condition.
D) the client's ability to use compensatory coping mechanisms.
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Page 9
Chapter 8: Home Health Care
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12 Verified Questions
12 Flashcards
Source URL: https://quizplus.com/quiz/4006
Sample Questions
Q1) 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.
Q2) A home health nurse has a client with permanent left-sided weakness after a stroke; the client is cared for by his wife and daughter. The nurse will design the plan of care to A) help the wife manage the home.
B) limit input from the wife and daughter.
C) reduce the impact of the client's health care beliefs.
D) stimulate the client to become independent.
Q3) The service requested and needed by an applicant to home health that would not be eligible for coverage under Medicare is A) home health aide.
B) housekeeping services.
C) physical therapy.
D) speech therapy.
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10
Chapter 9: Long-Term Care
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12 Verified Questions
12 Flashcards
Source URL: https://quizplus.com/quiz/4007
Sample Questions
Q1) Historically, European countries in the 1700s housed older persons in institutions with A) farmers, who could use them as labor.
B) mentally ill persons.
C) older people of the same gender.
D) those of the same socioeconomic class.
Q2) 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.
Q3) 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.
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Chapter 10: Rehabilitation
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10 Verified Questions
10 Flashcards
Source URL: https://quizplus.com/quiz/4008
Sample Questions
Q1) The rehabilitation nurse uses the Functional Independence Measures (FIM) tool to assess the client's
A) attitude.
B) physical strength.
C) rehabilitation goals.
D) self-care capabilities.
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 nurse clarifies that the Medicare criteria to qualify for rehabilitation services include that a client will
A) communicate adequately to be understood.
B) participate in 3 hours of therapy daily.
C) require three or more therapeutic modalities.
D) walk independently with crutches, cane, or walker.
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Chapter 11: Clients with Fluid Imbalances
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17 Verified Questions
17 Flashcards
Source URL: https://quizplus.com/quiz/4009
Sample Questions
Q1) The nurse anticipates that an order for an isotonic intravenous (IV) solution will read
A)0.45% sodium chloride.
B)0.9% sodium chloride.
C) 3% sodium chloride.
D) 5% dextrose in water.
Q2) 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.
Q3) 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.
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Page 13
Chapter 12: Clients with Electrolyte Imbalances
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21 Verified Questions
21 Flashcards
Source URL: https://quizplus.com/quiz/4010
Sample Questions
Q1) The factor in the client's history that the nurse assesses as a risk for the development of hypermagnesemia is
A) Addison's disease.
B) gastrointestinal disease.
C) vomiting.
D) water intoxication.
Q2) 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.
Q3) When giving IV potassium, the nurse takes the precaution of A) agitating the bag to prevent bolus administration.
B) ensuring potassium dilution with glucose solution.
C) leaving the IV cannula inserted as long as possible.
D) using a large cannula for infusion.
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14
Chapter 13: Acid-Base Balance
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20 Verified Questions
20 Flashcards
Source URL: https://quizplus.com/quiz/4011
Sample Questions
Q1) The nurse is caring for an 80-year-old client admitted to the hospital with pneumonia and who is becoming progressively more confused. Her vital signs are as follows: T, 101° F; P, 112 beats/min; R, 28 breaths/min; BP, 100/70 mm Hg. ABG results are pH 7.50, PaCO<sub>2</sub> 25 mm Hg, and bicarbonate level 18 mEq/L. The nurse interprets these findings to indicate
A) metabolic acidosis secondary to fever.
B) metabolic alkalosis secondary to bicarbonate excess.
C) respiratory acidosis secondary to anxiety.
D) respiratory alkalosis secondary to hypoxemia.
Q2) For a 34-year-old client in renal failure who develops acidosis, the nurse would assess for
A) drowsiness.
B) hypoventilation.
C) muscle hyperactivity.
D) paresthesias.
Q3) The nurse performs Allen's test before obtaining an ABG specimen to determine A) if an allergy to heparin is present. B) if ulnar circulation is adequate.
C) the patency of the radial artery.
D) the presence of neuromuscular weakness.
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Chapter 14: Clients Having Surgery
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38 Verified Questions
38 Flashcards
Source URL: https://quizplus.com/quiz/4012
Sample Questions
Q1) A client who is extremely overweight has been advised to lose weight before surgery. To encourage the client, the nurse knows that the most appropriate statement is
A) "It will decrease the operating room time by half if you lose weight."
B) "Surgery requires more anesthesia if you are overweight."
C) "With the weight loss, you decrease the chance of complications after surgery."
D) "You'll feel better after surgery if you lose the weight before."
Q2) The nursing action that should receive highest priority when a client returns from the OR to the PACU is
A) checking the postoperative orders.
B) observing the operative site.
C) positioning the client.
D) receiving the report from OR personnel.
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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Chapter 15: Perspectives in Genetics
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12 Verified Questions
12 Flashcards
Source URL: https://quizplus.com/quiz/4013
Sample Questions
Q1) 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.
Q2) A nurse counseling a couple about genetic disorders explains that Tay-Sachs disease is a genetically linked disorder seen in 7% of the A) African-American ethnic group.
B) Ashkenazi Jewish ethnic group.
C) Hispanic ethnic group.
D) Northern European ethnic group.
Q3) 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).
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Chapter 16: Perspectives in Oncology
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14 Verified Questions
14 Flashcards
Source URL: https://quizplus.com/quiz/4014
Sample Questions
Q1) A client has worked for 2 years installing insulation containing asbestos. The nurse will determine further assessment questions based on the understanding that occupational exposure to carcinogens represents _____% of all human cancers.
A) <2
B) 2-8
C) 10-12
D) >12
Q2) 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."
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18
Chapter 17: Clients with Cancer
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30 Verified Questions
30 Flashcards
Source URL: https://quizplus.com/quiz/4015
Sample Questions
Q1) Yesterday a 28-year-old client was diagnosed with rectal cancer. The nurse has made the nursing diagnosis of Anxiety Related to Fear of the Unknown, as manifested by anger. The best approach for the nurse to take in relation to the client's need for information is to
A) offer suggestions to modify the client's expressions of anger.
B) provide the client with a detailed plan for future interventions.
C) provide the client with simple explanations of proposed treatments.
D) specifically discuss the scientific facts related to rectal cancer.
Q2) The recommendation the nurse should share with a 22-year-old sexually active client who is seeking information on the prevention of cervical cancer is that a Pap smear
A) is needed annually by all women over age 18.
B) should be done annually until two tests are negative, then once every 2-3 years, in women over 30.
C) should be done biannually for clients who have been sexually active for 3 years but not later than age 21.
D) should be performed twice a year for all sexually active women over age 18.
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Page 19
Chapter 18: Clients with Wounds
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24 Verified Questions
24 Flashcards
Source URL: https://quizplus.com/quiz/4016
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) 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) The nurse who is using an enzymatic debridement ointment will
A) apply the ointment liberally over large areas.
B) keep the area moist after application.
C) medicate the client before applying ointment to viable tissue.
D) use the ointment cautiously on neoplastic ulcers.
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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) A client has been exposed to an infectious organism but has no clinical manifestations of disease. The nurse cautions the client that this period of time is the A) cell gap.
B) immune response.
C) infection curve.
D) latent period.
Q2) A notation on a client's health record notes that she has a subclinical infection. The nurse assessing this client would expect
A) clinical manifestations of the disease that are not as dramatic as usual.
B) fever with no elevation in the white blood cell count.
C) no systemic manifestations of disease.
D) reports of fatigue and lassitude after the infection.
Q3) The nurse can best instruct a client to avoid the acquisition of hookworm by A) advising the client not to eat raw pork products.
B) advising the client to drink only bottled water when traveling.
C) encouraging the client to wear shoes outdoors.
D) teaching the client good hand-washing technique.
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Page 21
Chapter 20: Clients with Pain
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29 Verified Questions
29 Flashcards
Source URL: https://quizplus.com/quiz/4018
Sample Questions
Q1) The client who had a right below-the-knee amputation 2 days ago is requesting pain medication for pain in his right foot. The nurse should
A) administer the prescribed analgesic.
B) elevate the stump on pillows and apply ice.
C) offer an alternative therapy such as a massage.
D) tell the client that he cannot be medicated for pain in the absent foot.
Q2) To provide the best care to a client having pain, the nurse must assess which information in addition to using a pain measuring scale?
A) A record of any healing taking place in damaged tissue
B) Objective measurements of the tissue damage
C) The client's perception of the pain
D) The type of pain fibers conducting the pain
Q3) 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.
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Chapter 21: Perspectives in Palliative Care
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18 Verified Questions
18 Flashcards
Source URL: https://quizplus.com/quiz/4019
Sample Questions
Q1) 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.
Q2) A client on the hospice service is experiencing nausea and vomiting as the result of pain management using opioids. The nurse should attempt to minimize this adverse effect by using the
A) intramuscular route.
B) intravenous route.
C) oral route.
D) subcutaneous route.
Q3) The hospice nurse supports the family coping task of establishing a relationship with the health care team by
A) discussing the functioning of the family unit without the loved one.
B) explaining the roles of all interdisciplinary team members.
C) giving permission to take time to maintain friendships.
D) providing brief explanations about the care being delivered.
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Page 23
Chapter 22: Clients with Sleep and Rest Disorders and Fatigue
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20 Verified Questions
20 Flashcards
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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) A nurse is teaching a community group good sleep hygiene practices. Steps that individuals can take to improve their sleep include (Select all that apply)
A) allowing for one or two restful daytime naps per day.
B) avoiding vigorous exercise within 3 hours of bedtime.
C) establishing a regular bedtime routine associated with preparing for sleep.
D) if you wake at night, work quietly in bed and avoid getting up.
E) maintaining a regular sleep-wake pattern throughout the week.
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Chapter 23: Clients with Psychosocial and Mental Health
Concerns
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18 Verified Questions
18 Flashcards
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Sample Questions
Q1) The client begins to cry as she speaks of her several miscarriages during the last 2 years. The nurse assesses the crying as a(n)
A) emotion-focused coping mechanism.
B) inappropriate coping mechanism.
C) lack of coping mechanism.
D) problem-focused coping mechanism.
Q2) A client being admitted for surgery has a concurrent history of bipolar disorder. The nurse would assess this client for manifestations of mania that include A) crying spells.
B) decreased energy level.
C) excessive, rapid speech.
D) sad mood.
Q3) 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.
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Chapter 24: Clients with Substance Abuse Disorders
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18 Verified Questions
18 Flashcards
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Sample Questions
Q1) A client who was admitted 2 days ago for assessment after a fall in his home has become increasingly irritable and now says there are bugs on his bed. He is diaphoretic and has a blood pressure of (200/136)mm Hg. The nurse assesses
A) alcohol-induced psychosis.
B) delirium tremens.
C) neurologic injury related to the fall.
D) post-traumatic stress reaction.
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 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.
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Page 26
Chapter 25: Assessment of the Musculoskeletal System
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10 Verified Questions
10 Flashcards
Source URL: https://quizplus.com/quiz/4023
Sample Questions
Q1) The nurse assisting with an arthrocentesis provides which intervention after the procedure is over? The nurse
A) applies a compression dressing.
B) gives the client a tetanus shot.
C) teaches the client crutch-walking.
D) wraps a heating pad around the knee.
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) A client complains of deep aching in his lower leg. The nurse completes an assessment focusing on other indicators of A) bone cancer.
B) infection.
C) muscle strain.
D) neuromuscular impairment.
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Chapter 26: Management of Clients with Musculoskeletal Disorders
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31 Verified Questions
31 Flashcards
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Sample Questions
Q1) A client has septic arthritis of the knee and the inflammation is beginning to subside. The best nursing action to prevent joint contractures at this point is to
A) encourage the client to get out of bed and ambulate.
B) have physical therapy plan an active ROM regimen.
C) immobilize the joint in a sling until the infection resolves.
D) provide passive ROM for the affected joint.
Q2) The client returns from surgery for a THA with a Hemovac in place. The nurse assesses the first 6 hours drainage as 350 ml. The most appropriate action by the nurse is to
A) change the client's position to supine.
B) drain the Hemovac and record the amount.
C) notify the physician of the amount of drainage.
D) report the excessive drainage to the oncoming nurse.
Q3) 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.
Page 28
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Chapter 27: Management of Clients with Musculoskeletal
Trauma or Overuse
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32 Verified Questions
32 Flashcards
Source URL: https://quizplus.com/quiz/4025
Sample Questions
Q1) In the emergent care of a client with a pelvic fracture, the nurse must be especially alert for indications of the complication of A) deep vein thrombosis.
B) hyperthermia.
C) hypovolemic shock.
D) infection.
Q2) 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.
Q3) The nurse notices a stain on a newly dried plaster cast over a client's fracture site. The most appropriate method to assess this finding is to
A) assess for a "hot spot" over the stain.
B) bivalve the cast and inspect the site.
C) draw around the circumference with a pen and record.
D) dry the stained area of the cast with a hair dryer.
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Chapter 28: Assessment of Nutrition and the Digestive System
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18 Verified Questions
18 Flashcards
Source URL: https://quizplus.com/quiz/4026
Sample Questions
Q1) A client who had a barium swallow 4 days earlier calls the nurse in the GI clinic to ask, "Is there anything I can do about my constipation? I have not had a bowel movement since the x-ray, and my stomach is so big that I look pregnant." The most appropriate response for the nurse to make is
A) "Do you normally have more frequent bowel movements?"
B) "Increase fluids in your diet to 10 glasses of water a day."
C) "Take a strong laxative immediately."
D) "You need to be examined in the clinic today."
Q2) The amount of calories and protein that a client weighing 185 pounds would require is at least
A) 1575 calories and 53 g of protein.
B) 2394 calories and 62 g of protein.
C) 2520 calories and 67 g of protein.
D) 2743 calories and 73 g of protein.
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.
Page 30
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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) The nurse preparing a postoperative teaching plan for a client who had a gastric stapling would include that
A) dumping syndrome is a common side effect.
B) fluids must be taken in liberal amounts.
C) exercise is prohibited after meals.
D) small, frequent feedings must become a habit.
Q2) Before administering enteral feeding, the nurse can ensure proper tube placement by
A) asking the client to swallow.
B) auscultating the stomach as 10 ml of water is injected.
C) extracting stomach contents from the tube.
D) holding the end of the tube under water to check for bubbling.
Q3) A nurse is caring for several clients with small-bore feeding tubes and nasogastric (NG) tubes. Which of the following activities can the nurse delegate to the unlicensed assistive personnel?
A) Assessing placement of the nasoenteric feeding tube
B) Reattaching suction to a nasogastric tube after the client ambulates
C) Refilling the tube-feeding bag for a small-bore gastrostomy tube
D) Performing skin care at the exit site of a jejunostomy tube
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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 encourages the client to obtain routine dental care because plaque formation can lead to
A) herpes simplex infection.
B) oral cancer.
C) periodontal disease.
D) stomatitis.
Q2) A nurse is conducting smoking cessation clinics and educates the clients they should report which finding in their mouths to their physicians immediately?
A) A patch that is red and has a velvety appearance
B) Elevated yellow-white lesions with a roughened, leathery appearance
C) Lesions that look like milk curds and adhere firmly to tissue
D) Multiple, concave, ulcer-like lesions
Q3) Reviewing a client's chart, the nurse finds that the client has odynophagia. The nurse questions the client about experience with
A) dulled taste.
B) intermittent difficulty with swallowing.
C) knife-like pain.
D) throbbing sensations in the throat.
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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) 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.
Q2) The nurse planning to irrigate a nasogastric (NG) tube prepares to use A) half-strength peroxide.
B) normal saline.
C) sterile water.
D) tap water.
Q3) The nurse administers alternating doses of two antacids into the NG tube of a client with a duodenal ulcer. The finding that best indicates that this drug regimen has been successful is
A) absent NG tube drainage.
B) decreased abdominal rigidity.
C) increased gastric pH.mild diarrhea.
D) mild diarrhea.
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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 client experiencing hematuria tells the nurse that the bleeding occurs at the end of urination, which could indicate a lesion in the
A) prostate.
B) renal pelvis.
C) upper bladder.
D) upper urinary tract.
Q2) A nurse is taking a history from a middle-age male client. He states that he takes no prescribed medications, but he does take saw palmetto and pumpkin daily. The nurse recognizes these herbs as being used to
A) acidify the urine.
B) maintain prostate health.
C) prevent bladder cancer.
D) ward off sexually transmitted diseases.
Q3) The nurse explains to the client that the glucosuria in the urinalysis indicates that A) a pancreatic disorder is present.
B) the serum glucose level is above the renal threshold.
C) the client is diabetic.
D) the client is experiencing some type of stress.
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Chapter 33: Management of Clients with Intestinal Disorders
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25 Verified Questions
25 Flashcards
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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 client with inflammatory bowel disease (IBD) takes sulfasalazine (Azulfadine) for management of manifestations. To counteract a side effect of this drug, the nurse would encourage the client to increase intake of
A) any citrus fruits.
B) bananas and apples.
C) fish and seafood.
D) peas and beans.
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Chapter 34: Management of Clients with Urinary Disorders
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30 Verified Questions
30 Flashcards
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Sample Questions
Q1) An elderly client who lives at home is brought to the clinic by her daughter. The daughter states that the client no longer goes out to shop for herself and so is not eating right. The daughter is worried about the client losing weight and seeming depressed. The client appears slightly dehydrated. The nurse should assess the client for A) dementia.
B) elder abuse.
C) incontinence.
D) medication misuse.
Q2) 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.
Q3) Nursing care for a client with urinary bladder calculi should include A) checking for abdominal distention.
B) collecting a 24-hour urine specimen for calcium.
C) encouraging fluid intake up to 4000 ml/day.
D) maintaining bed rest.
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Page 36
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) For a client with renal trauma exhibiting gross hematuria, the nurse would enforce the activity limitation of
A) ambulation in hall once daily.
B) ambulation in room only.
C) bed rest.
D) bathroom privileges.
Q2) The nurse explains that polycystic kidney disease ultimately results in A) acute renal failure.
B) chronic renal failure.
C) glomerulonephritis.
D) pyelonephritis.
Q3) The nurse caring for a client admitted for massive blood loss from ruptured esophageal varices would assess closely for A) albuminuria related to renal hypertension.
B) decreasing urine output related to hypovolemia.
C) hematuria related to glomerular damage.
D) urine changes related to rhabdomyolysis.
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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 is conducting peritoneal dialysis for a client with renal failure and finds the drainage tubing has no outflow. The priority action that the nurse would take is to
A) apply a 5-pound sandbag to the abdomen.
B) check the tubing for kinks or obstruction.
C) notify the physician about the problem.
D) try a more concentrated dialysate solution.
Q2) During a client's first dialysis treatment, the client complains of a severe headache and appears somewhat confused. The priority action by the nurse's is to
A) administer oxygen by nasal cannula.
B) encourage the client to drink fluids.
C) notify the physician immediately.
D) slow the rate of the dialysis.
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 instructs a client that a normal observation during breast self-examination (BSE) is
A) contour changes.
B) dimpling.
C) nipple deviation.
D) variation in breast size.
Q2) The nurse informs a client that the factor that places her at risk for cancer of the cervix is
A) a mother who took diethylstilbestrol when pregnant with the client.
B) having a mother of Mediterranean heritage.
C) riding horseback since the client was a child.
D) using herbal remedies for her fertility problems.
Q3) During palpation of a client's testes, the nurse notes a small, hard lump on the anterior aspect of one testis. The nurse's most appropriate action would be to
A) do nothing, since this is a normal finding.
B) palpate the groin for an associated hernia.
C) perform transillumination of the scrotum.
D) recommend the client take antibiotics.
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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) A nurse is collecting a history on a young client being treated for epididymitis. For which past medical condition should the nurse ask if the client has received treatment?
A) Frequent urinary tract infections
B) History of testicular torsion at puberty
C) Problems with erectile dysfunction
D) Sexually transmitted diseases
Q2) A client developed retrograde ejaculation after prostate surgery. In responding to the client's questions regarding this complication, the nurse would be aware that A) the client will not be able to experience orgasm.
B) the problem can be repaired surgically.
C) this condition is a risk of surgery.
D) this condition is usually temporary.
Q3) The nurse providing client teaching about prostate cancer would tell a group of male clients 52 to 67 years old that screening includes
A) colonoscopy.
B) cystoscopy.
C) digital rectal exam.
D) monthly self-examination.
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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 clinic nurse is assessing a 16 year-old girl with menstrual complaints. When the nurse learns that the client has had a recent infibulation, the nurse should
A) call the local authorities.
B) find a smaller speculum.
C) educate the client about perineal hygiene.
D) tell the parents this is not done in this country.
Q2) To help a client diagnosed with endometrial cancer effectively deal with this disease, the nurse would base supportive interventions on the fact that endometrial cancer
A) has a 90% cure rate.
B) is difficult to treat.
C) metastasizes quickly.
D) spreads slowly.
Q3) The postprocedure teaching plan for a client receiving cryosurgery for cervical cancer would include the instruction to
A) avoid vigorous perineal hygiene.
B) report any malodorous discharge immediately.
C) report discharge that continues longer than 8 weeks.
D) take frequent sitz baths to minimize 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) A male client has been diagnosed with metastatic breast cancer. The nurse would understand that this client most likely may have feelings of sexual inadequacy because
A) breast cancer is a "female" disease.
B) decreased libido is common in male breast cancer clients.
C) radiation therapy produces unwanted skin side effects.
D) treatment includes medical orchiectomy.
Q2) Teaching a client who will soon begin radiation therapy for treatment of breast cancer, the nurse would tell the client that she should expect
A) a low-residue diet to decrease diarrhea.
B) dry, itchy skin changes to develop.
C) pain in the long bones, especially the legs.
D) permanent pigment changes to the breast.
Q3) The nursing intervention that would receive the highest priority before discharge of a client following mastectomy is
A) arrange for Reach for Recovery volunteer to visit.
B) describe the plan for follow-up treatment and surveillance.
C) discuss methods of improving self-image.
D) share information about mastectomy support groups.
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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) The ambulatory care nurse is aware that after the appearance of the primary lesions, latent syphilis will begin in approximately
A) 1 month.
B) 3 to 6 months.
C) 1 to 2 years.
D) 3 to 5 years.
Q2) The nurse determines that the woman who least needs screening for chlamydial infection is a
A) 22-year-old with multiple partners.
B) 35-year-old with a single partner
C) high-risk pregnant woman.
D) sexually active 17-year-old.
Q3) When caring for clients with STDs, the nurse is aware that the best method of infection control is
A) good hand-washing.
B) disease-based isolation techniques.
C) no extra infection control measures.
D) universal precautions.
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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) In preparing a client for urine collection in the evaluation of urinary ketosteroids, the nurse would
A) place an indwelling catheter.
B) place a preservative in the collection bottle.
C) measure hourly urine outputs.
D) use a new collection bag.
Q2) A client presents with complaints of fatigue and the nurse notes dry, brittle hair. The nurse would anticipate which of the following laboratory tests?
A) Bilirubin, AST, ALT
B) Serum cortisol and ACTH
C) Serum glucose, hemoglobin A1c
D) Tests of thyroid function
Q3) Important aspects of the social history the nurse should include when examining a client are (Select all that apply)
A) alcohol intake.
B) food preferences.
C) sexual activities.
D) use of items contaminated with body fluids.
E) use of recreational drugs.
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) 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
Q2) 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.
Q3) As part of the care plan to meet the needs of a client with mild hypothyroidism, the nurse would
A) apply an astringent to the client's skin to promote dryness.
B) plan a strenuous exercise regimen to decrease weight.
C) set the thermostat between 75° and 80° F to provide a comfortable climate.
D) suggest the consumption of dense fruit to decrease diarrhea.
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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) Before surgery, a client diagnosed with pheochromocytoma would be instructed to avoid
A) a diet high in vitamins and minerals.
B) coffee, tea, and cola.
C) long rest periods.
D) sedative medications.
Q2) The nurse formulating a discharge plan for a client with Addison's disease should place the highest emphasis on
A) compliance with replacement therapy.
B) prevention of the complication of hypertension.
C) teaching the client how to cope with a chronic disease.
D) weight control and the importance of good nutrition.
Q3) For a client with a pheochromocytoma, the most critical assessment by the nurse is A) abdominal girth.
B) blood pressure.
C) daily weight.
D) pulse quality.
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Page 46
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 is being admitted to the nursing unit with hyperglycemic hyperosmolar nonketotic syndrome (HHNS). The nurse understands that compared with the care of DKA clients, the care of HHNK clients differs in that
A) assessments must be constant.
B) insulin is usually administered at a lower rate.
C) parenteral hyperalimentation will be needed.
D) treatment for dehydration will not be needed.
Q2) The nurse participating in a screening program for persons at risk for diabetes should have a high index of suspicion for a(n)
A) 44-year-old man who is 6 feet tall and weighs 190 pounds.
B) adolescent whose mother has type 2 diabetes.
C) young man complaining of weight loss and joint pain.
D) young woman who has had two babies weighing 7 pounds each.
Q3) The nurse tells a client that the regular insulin the client has taken this morning will begin to act in
A) a few minutes.
B) 30 minutes to 1 hour.
C) 2 to 4 hours.
D) 6 to 8 hours.
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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) The nurse is providing discharge instructions to a client going home with a T tube after an open cholecystectomy. Goals for teaching have been met when the client says
A) "For drainage that is thick with mucus or blood, I can irrigate the T tube."
B) "I will need to milk the tube every 4 hours and record the drainage."
C) "The tube can be used to administer stone dissolving medications"
D) "This tube will stay in for 1-2 weeks and I should watch for diminishing drainage."
Q2) To attempt to alleviate the pain of a client with acute pancreatitis, the nurse would place the client in the
A) prone position with a pillow under the abdomen.
B) semi-Fowler position with a small pillow under the knees.
C) side-lying position with a pillow splinting the abdomen.
D) supine position with a cold pack to the abdomen.
Q3) The nurse would explain that Whipple's operation involves
A) excavation of a pancreatic abscess and implantation of an external drain.
B) removal of the head of the pancreas and portions of the stomach and duodenum.
C) surgical removal of a pancreatic pseudocyst and implantation of an external drain.
D) surgical removal of the tail of the pancreas and portions of the colon.
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Page 48
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) Preparing for travel to an area of Africa where hepatitis A is endemic, a client receives immune serum. The nurse would remind the client that this prophylaxis is effective for up to A) 2 weeks.
B) 1 month.
C) 3 months.
D) 6 months.
Q2) A client experiencing hepatic encephalopathy is receiving lactulose. An irate family member asks, "Why in the world would the doctor give my husband something that gives him diarrhea when he is already so sick?" The nurse's response would include that the purpose of the lactulose is to
A) change ammonia to urea.
B) eliminate ascites.
C) empty the bowel of protein.
D) reduce fluid retention.
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
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Sample Questions
Q1) A client has elevated lesions that contain serous fluid. The nurse would document these as
A) nodules.
B) pustules.
C) vesicles.
D) wheals.
Q2) The nurse caring for a child with impetigo notes that some of the lesions on the child's skin appear elevated and contain purulent material. Secondary lesions are also present and are honey colored. The nurse would document these lesions as
A) cysts and bullae.
B) nodules and scales.
C) pustules and crusts.
D) vesicles and excoriations.
Q3) The nurse would explain to a client that an "allergy" differs from an "irritation" in that an allergy
A) affects the skin and mucous membranes only.
B) is an immune response.
C) is inconsistent.
D) can be totally desensitized.
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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) A client is to have a basal cell carcinoma removed with Mohs' surgery. During preoperative teaching, it would be important for the nurse to explain that
A) liquid nitrogen will be applied to the lesion.
B) no dressing will be necessary.
C) scarring is rare.
D) the procedure may be long.
Q2) The nurse would counsel a client with eczema that the condition that might preclude the use of PUVA, or at least would require extra precautions, is
A) age over 60.
B) cataracts in development.
C) long-term cortisone therapy.
D) presence of open lesions.
Q3) When caring for a client after rhytidectomy, the nurse notes that the left side of the client's face is drooping. The nurse would
A) apply cold compresses.
B) call the surgeon immediately.
C) perform a neurosensory assessment.
D) raise the head of the bed.
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Chapter 50: Management of Clients with Burn Injury
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30 Flashcards
Source URL: https://quizplus.com/quiz/4048
Sample Questions
Q1) The nurse is caring for a client with burns covering the entire surface of both arms and the anterior trunk. Using the rule of nines, the nurse would estimate the percentage of burn surface area to be
A) 18%.
B) 27%.
C) 36%.
D) 45%.
Q2) The nurse would stress to the ancillary staff that the most important means of preventing the spread of infection in the burn unit is A) prophylactic antibiotics.
B) restricting visitors with respiratory tract infections.
C) strict hand-washing.
D) using clean gowns, gloves, and masks.
Q3) A client's burn wound is being treated with enzymatic debridement. At this time the nurse would assess the client for A) allergic reactions.
B) bleeding from the burn wound.
C) increased fluid loss.
D) serum electrolyte imbalances.
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Chapter 51: Assessment of the Vascular System
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12 Flashcards
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Sample Questions
Q1) 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.
Q2) 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.
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
Source URL: https://quizplus.com/quiz/4050
Sample Questions
Q1) The nurse would realize that outcomes for the diagnosis Ineffective Health Maintenance have been partly met when the client (Select all that apply)
A) begins and maintains an exercise program.
B) has ideas for incorporating medications into lifestyle.
C) helps design a diet modification.
D) says he/she will comply with whatever plan the nurse makes.
E) shows the nurse the correct way to take the pulse.
Q2) In an exercise program for weight reduction in a hypertensive client, the nurse would discourage the use of heavy weights because this may cause
A) lactic acid buildup.
B) muscle strain.
C) rapid vasodilation.
D) vasovagal response.
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.
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) 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.
Q2) A client is scheduled for a below-the-knee amputation for treatment of chronic infected arterial ulcers and leg pain. The client seems calm, and even happy. The nurse should respond to this client based on understanding that the client
A) cannot cope effectively with a life-altering procedure.
B) is experiencing dysfunctional grieving for the leg.
C) may prefer an amputation to living with chronic pain.
D) might have cognitive defects preventing full understanding.
Q3) To prevent skin breakdown of a client's stump, the nurse teaches the client to
A) adjust the prosthesis if it causes discomfort.
B) apply alcohol to the stump to toughen the skin.
C) wash the stump daily with mild soap, and then rinse and dry it.
D) wear cotton stump socks.
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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) The nurse would explain to a client that the isoenzyme most useful in the diagnosis of myocardial infarction is
A) CK-MB.
B) CK-MM
C) myoglobin.
D) troponin
Q2) A nurse explains the purpose of echocardiography to a client as
A) a picture of both the structures in the heart and their motion.
B) an image of the heart and great vessels from a posterior view.
C) hemodynamic pressure monitoring and analysis of oxygenation.
D) the use of extra contrast dye to visualize pulmonary arteries.
Q3) The nurse would explain to a client that the benefit of a Holter monitor over an ECG is that the Holter monitor
A) does not require a lengthy hospital stay.
B) is a continuous recording, often for 24 hours.
C) is less expensive than the traditional ECG.
D) provides a two-dimensional view of the coronary arteries.
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Chapter 55: Management of Clients with Structural
Cardiac Disorders
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Q1) 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.
Q2) 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.
Q3) When performing cardiac auscultation on a client with mitral valve prolapse, the nurse would anticipate hearing a A) harsh, systolic murmur.
B) loud S2 heart sound.
C) midsystolic click.
D) prominent S4 heart sound.
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Chapter 56: Management of Clients with Functional
Cardiac Disorders
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Q1) In advising a client with higher levels of high-density lipoproteins (HDLs) in proportion to low-density lipoproteins (LDLs), the nurse would suggest that the client A) consult the physician for an anticholesterol prescription.
B) initiate a moderate exercise program.
C) is less likely to develop CHD.
D) should consider a reduced-fat diet.
Q2) The nurse would clarify to a client considering a MIDCABG that this procedure is less invasive and does not utilize A) anticoagulants.
B) cardiopulmonary bypass.
C) long-term anesthesia.
D) mammary arteries.
Q3) The nurse would clarify for a client that the lipoproteins representing the "good" cholesterol are the A) HDLs.
B) LDLs.
C) VDRLs.
D) VLDLs.
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Chapter 57: Management of Clients with Dysrhythmias
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Q1) Before the insertion of a temporary pacemaker, the nurse should assess the client's (Select all that apply)
A) anxiety level.
B) coping mechanisms.
C) knowledge level.
D) past experience with temporary pacers.
Q2) The nurse quickly calculating a client's heart rate by examining the electrocardiogram (ECG) would count the number of
A) large squares between P waves and multiply by 10.
B) large squares between R waves and multiply by 10.
C) P waves in a 6-inch strip and multiply by 5.
D) R waves in a 6-inch strip and multiply by 10.
Q3) A client's ECG reveals a rapid atrial rate of 300 beats/min, and the P waves resemble a picket fence without 1:1 conduction. The nurse would identify this dysrhythmia as A) atrial fibrillation.
B) atrial flutter.
C) paroxysmal atrial tachycardia.
D) sinoatrial block.
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59
Chapter 58: Management of Clients with Myocardial Infarction
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Q1) Four hours after the onset of pain from an MI, the nurse would expect an increase in which laboratory result?
A) Alkaline phosphatase (ALP)
B) CK-MB
C) Lactate dehydrogenase (LDH)
D) Leukocyte count
Q2) The nurse would remind a client that the cause of sudden death after myocardial infarction is usually A) congestive heart failure.
B) dysrhythmias.
C) myocardial ischemia.
D) stroke.
Q3) A client has received thrombolytic therapy after an ST segment myocardial infarction (STEMI). A half-hour later, the nurse notices frequent PVCs. The most appropriate action by the nurse is to
A) administer lidocaine per the dysrhythmia protocol.
B) document the finding and conclude the therapy worked.
C) prepare to send the client for emergent PTCA.
D) request an order for an anxiolytic medication.
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Chapter 59: Assessment of the Respiratory System
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Q1) A 44-year-old man with active pulmonary tuberculosis is experiencing hemoptysis, which the nurse understands describes
A) bloody sputum.
B) chest pain.
C) constant cough.
D) dyspnea.
Q2) The nurse preparing a client for a bronchoscopy would include information about its (Select all that apply)
A) ability to visualize gas exchange at the alveolar level.
B) limitation of not being able to take tissue biopsies.
C) therapeutic use to remove retained secretions.
D) usefulness in diagnosing tumors, inflammation, and strictures.
Q3) A client has just returned from China and is concerned about possible respiratory disorders. The nurse would advise the client to have a screening to assess for exposure to
A) adult respiratory distress syndrome (ARDS).
B) histoplasmosis.
C) tuberculosis.
D) Valley fever.
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Chapter 60: Management of Clients with Upper Airway Disorders
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Q1) 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.
Q2) For a client who has undergone functional endoscopic sinus surgery (FESS) as part of the surgical management of sinusitis, the nurse would instruct the client
A) "Don't blow your nose for 1 week."
B) "Eat only semi-solid foods."
C) "Lean forward when eating."
D) "Limit the amount of fluids you drink."
Q3) The nurse would explain to a client that laser surgery to remove laryngeal tumors has the major benefit of
A) a usable voice.
B) complete cure.
C) minimal blood loss.
D) reduced edema.
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Chapter 61: Management of Clients with Lower Airway and Pulmonary Vessel
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Q1) A client with COPD has severe shortness of breath at rest and arterial oxygen tension (PaO<sub>2</sub>) of 35 mm Hg. When oxygen via nasal cannula is prescribed, the nurse would assess the client cautiously because
A) regulating oxygen settings can be done by unlicensed staff.
B) some clients with COPD have CO<sub>2</sub> narcosis.
C) skin damage under the nasal cannula is common.
D) the client may try to sneak a cigarette and get burned.
Q2) A client who experienced a pulmonary embolus is receiving heparin therapy. The client will now also start receiving sodium warfarin (Coumadin). When the client asks the nurse why both medications are being given, the best response by the nurse is
A) "It takes several days for the warfarin to become therapeutic."
B) "Most clients go home on both drugs for maximal treatment."
C) "The heparin is not working to dissolve the blood clot, so we are adding warfarin."
D) "You are right to ask. You are at increased risk of bleeding with both drugs."
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63
Chapter 62: Management of Clients with Parenchymal and Pleural Disorders
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Q1) 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.
Q2) The nurse notes that a client in a long-term care facility has become increasingly confused in the last few days. The resident's vital signs are temperature 97.7° F, pulse rate 80 beats/min, respirations 20 breaths/min, and blood pressure (90/62) mm Hg. The nurse would suspect
A) cancer of the lung.
B) plural effusion.
C) pneumonia.
D) tuberculosis (TB).
Q3) On physical examination of a client with pneumonia, the nurse would expect A) absence of whispered pectoriloquy over the affected area. B) increased tactile fremitus over the affected area. C) tympanic percussion notes over the affected area. D) vesicular breath sounds over the affected area.
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Chapter 63: Management of Clients with Acute Pulmonary Disorders
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Q1) A client has severe adult (acute) respiratory distress syndrome (ARDS) and has not responded to several different treatments. An independent nursing action that might help the client would be to
A) administer antioxidants as ordered.
B) place the client in a prone position.
C) turn the client every 2 hours.
D) use meticulous hand-washing before client care.
Q2) A client with pulmonary edema is receiving intravenous nitroglycerin. The spouse becomes upset and says "Nobody told me my spouse had a heart attack!" The best response by the nurse is to say "The nitroglycerin
A) can prevent a heart attack brought on by the stress to the heart."
B) helps get rid of extra fluid in the body."
C) helps the heart to not work so hard."
D) treats the chest pain that goes along with pulmonary edema."
Q3) When a client with a cuffed ET tube reports shortness of breath, the nurse would A) give the ordered pain medication.
B) assess for a cuff leak.
C) increase the level of O<sub>2</sub> delivery.
D) elevate the head of the bed.
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Chapter 64: Assessment of the Eyes and Ears
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Q1) A client has severe hearing loss that occurred within the last year. It is important for the nurse to also assess the client for A) accompanying visual losses.
B) frustration and loneliness.
C) hypertension and heart disease.
D) impaired physical mobility.
Q2) A client is complaining of dryness, burning, and grittiness in both eyes. The nurse would conduct further assessments to confirm a suspicion of A) acute angle glaucoma.
B) allergies.
C) hypertensive eye disease.
D) mild corneal abrasion.
Q3) 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.
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Chapter 65: Management of Clients with Visual Disorders
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Q1) A client has had an enucleation for ocular melanoma. Which of the following instructions takes priority when dismissing this client?
A) "Be extra cautious when going up or down stairs."
B) "If the plastic conformer comes out, wash it and replace it."
C) "Keep soap and water out of your eye socket."
D) "You can wear an eye patch sometimes, but not all of the time."
Q2) 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.
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Chapter 66: Management of Clients with Hearing and Balance Disorders
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Q1) The nurse is aware that when speaking with a client who has impaired hearing in the right ear, the behavior that would make it more difficult for the client to understand the communication is
A) directing the voice toward the left ear.
B) speaking in a normal tone.
C) smiling while talking to seem friendly.
D) standing in front of the client.
Q2) 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?"
Q3) The nurse assessing a client with an inner ear disorder would be aware that the presenting clinical manifestation will be
A) conductive hearing disorder.
B) otorrhea.
C) sensorineural hearing loss.
D) severe headache.
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Chapter 67: Assessment of the Neurologic System
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Q1) In assessing function of cranial nerves (CN), the nurse offers a client toothpaste and the client can only identify it by smell. The nurse would record that
A) CN I is functional.
B) CN II is partially functional.
C) CN IV is non-functional.
D) CNs are unable to be assessed this way.
Q2) In assessing the cause of the decreased level of consciousness in a client in a coma, the diagnostic procedure that would provide the most accurate information is A) computed tomography (CT) scan.
B) detailed history of the accident.
C) physical examination.
D) skull x-ray film.
Q3) When the nurse asks the client to raise the eyebrows and grimace or puff the cheeks, the nurse would be assessing the function of cranial nerve
A) VII.
B) VIII.
C) IX.
D) X.
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Chapter 68: Management of Comatose or Confused
Clients
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Q1) The nurse who is beginning oral feedings on a client who is returning to consciousness will
A) begin feedings with water.
B) place about 1 teaspoon of liquid in the front of the mouth.
C) position the client upright.
D) stroke the posterior neck to promote swallowing.
Q2) The nurse closely monitors the intake and output of a comatose client receiving hypertonic tube feedings because such feedings can cause
A) concentration of urine.
B) hypovolemia.
C) renal failure.
D) retention of fluid.
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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Q1) The client with epilepsy asks the nurse if he will have to take antispasmodic medication for the rest of his life. The nurse's most helpful response would be
A) "Maybe. You might be able to stop medication if you are seizure free for 2 years."
B) "No. After a stable pattern is recognized, you can take it sporadically."
C) "Yes. Epilepsy requires compliance to a regimen of lifelong medication."
D) "Yes. Stopping a med after you take it a while makes seizure activity worse."
Q2) When a client is admitted to the hospital in an unconscious state following subarachnoid hemorrhage resulting from a ruptured intracranial aneurysm, the nurse anticipates that the manifestations that preceded the loss of consciousness were A) generalized weakness and fatigue accompanied by anorexia.
B) gradual loss of speech or vision.
C) sudden severe headache accompanied by vomiting.
D) weakness, fever, nausea, and vomiting.
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Chapter 70: Management of Clients with Stroke
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Q1) When a client has undergone a carotid endarterectomy and has been returned to the nursing unit with stable vital signs, the nurse should
A) assess neurologic status every 4 hours.
B) keep the client in a flat, supine position with the head flexed.
C) maintain blood pressure within 20 mm Hg of the preoperative values.
D) provide neck range-of-motion exercises every 8 hours.
Q2) The nurse assesses agnosia in a client who had a CVA. An example of this disturbance would be an inability to
A) read and comprehend writing.
B) recognize eating utensils.
C) see past the midline.
D) use the limbs purposefully.
Q3) A nurse teaches a community class about primary prevention for stroke, which includes (Select all that apply)
A) adequate control of hypertension.
B) keeping tight glycemic control in diabetes.
C) maintaining safe cholesterol levels.
D) not smoking or smoking cessation.
E) reducing heavy alcohol consumption.
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Page 72
Chapter 71: Management of Clients with Peripheral Nervous System Disorders
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Q1) 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.
Q2) The nurse should assess a client who has had unrelieved trigeminal neuralgia for the past 6 months for
A) alcohol consumption.
B) suicidal ideation.
C) vocational rehabilitation.
D) weight gain.
Q3) Before the administration of the first dose of carbamazepine (Tegretol) to a client with trigeminal neuralgia, the nurse should
A) assess the client's deep tendon reflexes.
B) check the client's blood pressure.
C) determine if the client abuses alcohol.
D) remind the client to remain in bed for 20 minutes after receiving the drug.
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Chapter 72: Management of Clients with Degenerative Neurologic Disorders
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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) The nurse explains that the pathology of Huntington's disease involves
A) a decrease in the neurotransmitter norepinephrine.
B) an excess of the neurotransmitter dopamine.
C) destruction of white matter in the brain.
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D) formation of neurofibrillary tangles and plaques.
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Chapter 73: Management of Clients with Neurologic
Trauma
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Q1) The nurse is caring for a spinal cord-injured client in outpatient rehabilitation and evaluates that goals for the diagnosis Anticipatory Grieving have been met when the client
A) can function appropriately in the real world.
B) is able to power his/her own adapted vehicle.
C) starts attending vocational rehabilitation.
D) stops making sexually inappropriate comments.
Q2) To assess motor response, the nurse performing a neurologic assessment on a client in a coma would ask the client to A) cough and deep breathe.
B) grasp the nurse's fingers.
C) repeat a phrase.
D) wiggle the toes.
Q3) When the nurse caring for a client using an ICP monitor reads ICP as 20 mm Hg, the nurse would interpret this as A) an incorrect reading.
B) higher than normal.
C) lower than normal.
D) normal.
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Chapter 74: Assessment of the Hematopoietic System
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Q1) The nurse reads that an assigned client has an immunodeficiency. The nurse reads further in the medical record, anticipating that the client also most likely has a history of A) conjunctivitis.
B) severe headaches.
C) skin eruptions.
D) unexplained weight loss.
Q2) 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.
Q3) A client has a hematocrit (Hct) of 30%. The nurse interprets this to mean A) 30% of the blood will be plasma and plasma products.
B) bleeding disorders are possible.
C) the blood is viscous and concentrated.
D) the individual has fewer red blood cells than normal.
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Chapter 75: Management of Clients with Hematologic Disorders
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Q1) While performing an admission assessment on a moderately anemic client, the nurse would expect to find a history of
A) blurred vision.
B) cardiac palpitations.
C) increased appetite.
D) warm, flushing sensations.
Q2) The nurse explains that the medication essential for a client with pernicious anemia is
A) ferritin.
B) ferrous gluconate.
C) vitamin B12.
D) vitamin K.
Q3) 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.
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Chapter 76: Management of Clients with Immune Disorders
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Q1) A client with urticaria is frustrated with the chronic nature of the problem. To enhance coping, which intervention by the nurse would be most effective?
A) Assist the client in identifying and eliminating triggers for outbreaks.
B) Demonstrate to the client measures to increase comfort.
C) Let the client vent frustrations and remain supportive.
D) Teach the client the proper way to take antihistamines.
Q2) A client with a history of type 1 hypersensitivity reaction is receiving immunotherapy (or desensitization therapy). The nurse administering the allergen injection at 1:00 PM would ask the client to remain in the office until
A) 1:10 PM.
B) 1:20 PM.
C) 1:40 PM.
D) 2:15 PM.
Q3) A client has anaphylaxis. Which action by the nurse takes highest priority?
A) Administering oxygen
B) Giving epinephrine
C) Maintaining an open airway
D) Starting an IV
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Chapter 77: Management of Clients with Rheumatic Disorders
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Q1) When the nurse is caring for a client with progressive systemic sclerosis (PSS), the highest-priority nursing diagnosis would be
A) Constipation.
B) Disturbed Thought Processes.
C) Risk for Imbalanced Body Temperature.
D) Risk for Impaired Skin Integrity.
Q2) A client with ankylosing spondylitis has severe kyphosis. The nurse planning care for this client would provide priority interventions to A) create a safe environment.
B) consult with physical therapy for an exercise regimen.
C) encourage a high-calorie diet with vitamin supplements.
D) use meticulous technique when changing surgical dressings.
Q3) The nursing assessment of clients with SLE should focus most intensely on the presence of the common and serious sequela of this disorder, which is A) difficulty swallowing.
B) interruptions in skin integrity.
C) peripheral neuropathies.
D) renal failure.
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Chapter 78: Management of Clients with Acquired
Immunodeficiency Syndrome
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Q1) The problem the nurse should plan for when a client with AIDS is infected with the Cryptosporidium parasite is
A) delirium.
B) painful open lesions.
C) profuse, watery diarrhea.
D) severe respiratory tract infection.
Q2) When planning a community teaching event, the nurse should recognize that the group in which HIV infection is growing most rapidly is
A) adults older than 50 years.
B) blacks and Hispanics.
C) black teenagers.
D) gay white men.
Q3) The client who has a positive enzyme immunoassay test asks the nurse if that means that he is HIV positive. The nurse's most helpful response would be
A) "No, many people have positive enzyme immunoassays."
B) "No, you need to have the Western blot test to confirm that you are positive."
C) "Yes, but antiretrovirals will probably combat the infection now."
D) "Yes, you should seek medical care for antiretroviral drugs."
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Chapter 79: Management of Clients with Leukemia and Lymphoma
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Q1) A client with Hodgkin's disease is staged at III. The nurse plans care knowing this means there
A) are nodes on both sides of the diaphragm with para-aorta involvement.
B) are nodes on both sides of the diaphragm with portal involvement.
C) is involvement of a single lymphoid structure.
D) might be a single node on one side of the diaphragm.
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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Page 81
Chapter 80: Management of Clients Requiring
Transplantation
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Q1) Important health promotion measures for the client who has received an organ transplant include regularly-scheduled (select all that apply)
A) dental examinations.
B) mammograms.
C) Papanicolaou (Pap smears).
D) substance abuse screening.
E) vaccinations.
Q2) 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.
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Chapter 81: Management of Clients with Shock and Multisystem
Disorders
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Q1) A client in hypovolemic shock has a low pulmonary capillary wedge pressure. This should indicate to the nurse that
A) fluid replacement is needed.
B) pulmonary edema may be developing.
C) resuscitative measures are adequate.
D) the client's left ventricle is failing.
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) Nursing care for a client in hypovolemic shock caused by trauma should include A) giving narcotics for pain relief.
B) maintaining a cool environment.
C) placing the client in Trendelenburg position.
D) providing nasogastric suctioning.
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Chapter 82: Management of Clients in the Emergency Department
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Source URL: https://quizplus.com/quiz/4080
Sample Questions
Q1) 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.
Q2) 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.
Q3) When a client is brought to the ED with chemical injury to the left eye, the nurse would irrigate the eye with normal saline, a minimum of A) 250 ml.
B) 500 ml.
C) 1000 ml.
D) 2000 ml.
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