Nursing Fundamentals
Exam Materials
Course Introduction
Nursing Fundamentals introduces students to the essential principles and skills required in the practice of nursing. This course covers foundational topics such as the nursing process, patient safety, communication techniques, basic patient care procedures, and ethical and legal considerations in nursing. Students gain hands-on experience in clinical settings, learning how to assess patient needs, provide personal care, and work as effective team members within healthcare environments. Emphasis is placed on developing critical thinking, compassion, and professionalism, setting the stage for advanced nursing coursework and practice.
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) 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
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
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Chapter 2: Health Assessment
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14 Verified Questions
14 Flashcards
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Sample Questions
Q1) Which principles of assessment does the nurse use when working with hospitalized clients? (Select all that apply.)
A) Assess each client at the beginning of each shift.
B) Base the frequency of assessment on client condition.
C) Begin with the most seriously ill client.
D) Record findings as they are assessed, not later.
E) Wait for physician orders to determine the frequency of assessments.
Answer: A, B, C, D
Q2) Auscultation
A) 1
B) 2
C) 3
D) 4
Answer: B
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Chapter 3: Critical Thinking
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8 Verified Questions
8 Flashcards
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Sample Questions
Q1) A nurse is working in the intensive care unit. When assessing the clients, the nurse notes one of them, who was scheduled to transfer to a step-down unit as soon as a bed becomes available, has a respiratory rate change from 18 to 20 breaths/min and an oxygen saturation (O<sub>2</sub> sat) of 92%, when earlier it was 93%. The client denies complaints. The nurse calls the physician and requests a chest x-ray and arterial blood gases (ABGs). This nurse is working at which Benner Level of Competency in Nurses?
A) Advanced beginner
B) Competent
C) Expert
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 Verified Questions
12 Flashcards
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Sample Questions
Q1) An elderly Chinese woman tells the nurse that she must improve the flow of her Qi. The nurse asks the client how long she has been using A) acupuncture.
B) Ayurveda.
C) Tai Chi.
D) yoga.
Q2) 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.
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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) One challenge for nurses working in ambulatory care centers is A) clients give overall responsibility for self-care to the center.
B) duties are rigidly defined within the interdisciplinary team.
C) length of client visit is short, reducing assessment time.
D) use of telephones and computers eases assessment potential.
Q2) The ambulatory care center nurse assures a dubious client that she has been certified as an ambulatory nurse by
A) application to the Accreditation Association for Ambulatory Health Care.
B) membership in the National Committee for Quality Assurance.
C) passing a specialized examination.
D) working as an ambulatory care nurse for 5 years.
Q3) An ambulatory care center nurse who is counseling a young client with sickle cell anemia can best access evidence-based practice (EBP) guidelines from A) consulting current nursing texts or journals.
B) integrated hospital care plans and protocols.
C) the Occupational Safety and Health Administration (OSHA).
D) the Agency for Healthcare Research and Quality (AHRQ).
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Page 7
Chapter 6: Acute Health Care
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14 Verified Questions
14 Flashcards
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Sample Questions
Q1) A client experiences chest pain with electrocardiographic changes during an appointment with the primary care physician, and the physician orders hospital admission for cardiac monitoring. This type of admission is a(n)
A) elective admission.
B) emergency admission.
C) direct admission.
D) scheduled admission.
Q2) A planned program of loss prevention and liability control best defines A) client satisfaction.
B) clinical pathway.
C) quality assurance.
D) risk management.
Q3) A hospital staff nurse is collaborating with a nurse case manager in planning the care of a client with a below-the-knee amputation. The primary role of the case manager is
A) client education on specialized care.
B) coordination of care for the client.
C) direct care of the client's medical problems.
D) education of the staff nurse.
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Page 8
Chapter 7: Critical Care
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10 Verified Questions
10 Flashcards
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Sample Questions
Q1) 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.
Q2) A nurse who is acting in a manner that respects and supports the client's and family's basic rights, values, and beliefs is functioning in which professional role?
A) Advocate
B) Caregiver
C) Critical thinker
D) Manager
Q3) The nurse admitting clients to the critical care unit understands that priority clients for this area are those who need
A) a cleaner environment to prevent nosocomial infections.
B) continuous physiologic monitoring.
C) frequent vital sign checks.
D) private rooms conducive to rest and sleep.
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9
Chapter 8: Home Health Care
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12 Verified Questions
12 Flashcards
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Sample Questions
Q1) The 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.
Q2) The home health nurse explains that her philosophy is based on the belief that clients should
A) adhere to the care plan generated by the nurse.
B) alter cultural practices to meet health needs.
C) be knowledgeable about their health care.
D) feel no responsibility for their health care.
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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Chapter 9: Long-Term Care
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12 Verified Questions
12 Flashcards
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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) Transfer from a long-term care facility is being considered for a combative resident.OBRA Resident Rights that impact this decision include
A) a legitimate and documented reason for the transfer.
B) addressing the problem behavior in the care plan.
C) the family preventing the discharge through litigation.
D) the resident has the right to delay the transfer for 20 days.
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Chapter 10: Rehabilitation
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10 Verified Questions
10 Flashcards
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Sample Questions
Q1) The rehabilitation nurse ensures that teaching is (Select all that apply)
A) designed, delivered, and reinforced in ways that are meaningful.
B) designed to cover all aspects of the rehabilitation process.
C) individualized to the client and family even when standardized material is used.
D) presented in appropriate levels and formats.
E) readily available so that learning can occur when the learner is ready.
Q2) The rehabilitation nurse stresses that the major focus in a rehabilitation setting is
A) acquisition of services for the newly discharged client.
B) elimination of clinical manifestations.
C) prevention of disease progression.
D) skills' instruction for independence.
Q3) The nurse 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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Page 12
Chapter 11: Clients with Fluid Imbalances
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17 Verified Questions
17 Flashcards
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Sample Questions
Q1) A client with severe malnutrition has pedal edema and ascites. The nurse notes that the weight is unchanged for the last 2 days. The most appropriate action by the nurse is to
A) ask the assistive personnel to re-weigh the client.
B) assess vital signs, level of consciousness, and urine output.
C) call the physician to request IV diuretics.
D) have biomedical engineering check the scale.
Q2) A client is taking an IV diuretic for fluid volume excess. Which of the following assessments should the nurse report to the physician?
A) Decrease in edema
B) Decrease in potassium level
C) Increase in urine output
D) Weight loss
Q3) The nurse who is caring for a client prescribed diuretics and fluid restriction to control edema can most easily evaluate the effectiveness of the medical protocol by
A) calculating plasma osmolality.
B) careful weight assessment.
C) checking the lab report on serum sodium level.
D) measuring the ankle circumference.
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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) 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.
Q2) 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.
Q3) A client is hypokalemic and the physician leaves an order for the nurse to infuse a bolus of 30 mEq of potassium in 100 ml of NS over 30 minutes. The most appropriate action by the nurse is to
A) administer the potassium as ordered.
B) clarify the order with the physician.
C) order an infusion pump to give the potassium.
D) request the pharmacy send 250 ml of saline instead.
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Page 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 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.
Q2) A client with a diagnosis of chronic renal failure has pH of 7.35, PaCO<sub>2</sub> of 29 mm Hg, and bicarbonate level of 16 mEq/L. The nurse interprets these ABG results as
A) compensated metabolic acidosis.
B) compensated respiratory acidosis.
C) uncompensated metabolic acidosis.
D) uncompensated respiratory acidosis.
Q3) 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.
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15
Chapter 14: Clients Having Surgery
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38 Verified Questions
38 Flashcards
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Sample Questions
Q1) For a client admitted to the PACU with an oral airway in place, the nursing intervention that would be inappropriate is
A) allowing the client to spit out the airway.
B) removing the airway when the client becomes responsive.
C) suctioning the client's secretions as needed.
D) taping the airway in place so it does not fall out.
Q2) In the first 3 days after surgery, the nurse would anticipate the fluid and electrolyte adjustment of
A) elevated hematocrit level.
B) fluid retention.
C) increase in serum potassium level.
D) increased urine output.
Q3) When teaching the proper method of coughing, the nurse should instruct the client to
A) breathe in and out through the nose.
B) deep-breathe after coughing.
C) relax the abdominal muscles.
D) splint the incision.
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16
Chapter 15: Perspectives in Genetics
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12 Verified Questions
12 Flashcards
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Sample Questions
Q1) 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).
Q2) A nurse educating clients in a genetic screening clinic explains that recessive genes on autosomal chromosomes can be passed on A) to children of either gender.
B) only to males.
C) only to females.
D) to females after skipping a generation.
Q3) The nurse working on a general medical-surgical unit in the hospital cares for clients with a variety of diseases that have a genetic component, including (Select all that apply)
A) Alzheimer's disease.
B) chronic obstructive pulmonary disease.
C) diabetes.
D) heart disease.
E) sickle cell anemia.
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Chapter 16: Perspectives in Oncology
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14 Verified Questions
14 Flashcards
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Sample Questions
Q1) A nurse is conducting a smoking cessation clinic. What information about smoking does the nurse include in the teaching component of the program?
A) A pack-year history is the length of time, in years, a person has smoked.
B) Smokeless tobacco is harmless because the carcinogens have been removed.
C) Smoking causes more cancer in the United States than do all other causes combined.
D) The risk of cancer for someone who stops smoking does not improve.
Q2) A nurse preparing a teaching plan for a client recently diagnosed with cancer will include the fact about growth patterns of cancer that cancer cells
A) exhibit contact inhibition.
B) grow in adverse conditions, such as lack of nutrients.
C) have a growth rate equal to or less than cell death rate.
D) proliferate in response to specific stimuli.
Q3) The nurse reviewing a research report recognizes that a discussion of oncogenes will address
A) a chemotherapeutic agent that eradicates viruses that cause cancer.
B) factors in the immune system protecting the client from malignant growths.
C) risk factors in cancer development.
D) segments of DNA that transform normal cells into malignant cells.
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Chapter 17: Clients with Cancer
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30 Verified Questions
30 Flashcards
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Sample Questions
Q1) The nurse should closely assess a client undergoing chemotherapy for a tumor that is responding to the therapy for any indication of tumor lysis syndrome, which is marked by
A) hypercalcemia.
B) hyperkalemia.
C) increase in antidiuretic hormone (ADH).
D) platelet count below 20,000/mm<sup>3</sup>.
Q2) When the client questions why the chemotherapeutic drug is being administered by intracavitary instillation, the nurse could best answer by explaining that this approach is a
A) cost-effective and more rapidly-acting method of treatment.
B) diffuse method of systemic administration that avoids side effects.
C) means to allow high concentrations of drugs to be directed at the tumor.
D) non-invasive method of administration.
Q3) The nursing action that has the highest priority for a 32-year-old client with an implanted radiation source should focus on
A) assessing the client's reaction to the diagnosis and treatment.
B) preventing skin problems related to radiation.
C) promoting regular activity while confined to the room.
D) safeguarding the client and others from unnecessary radiation exposure.
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Chapter 18: Clients with Wounds
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24 Verified Questions
24 Flashcards
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Sample Questions
Q1) A client is being discharged and will need to perform wound care and dressing changes in the home on a large, open wound. When designing a teaching plan for discharge, the nurse should include which of the following elements? (Select all that apply.)
A) A videotape of the wound care procedure if possible
B) Appropriate ways to irrigate the wound
C) Cost of wound care supplies
D) Detailed written instructions
E) Types of supplies the client will need
Q2) A client must do dressing changes at home on a clean, but open, surgical wound. The nurse determines that goals for discharge instructions have been met when the client says:
A) "I will be sure to keep the skin surrounding the wound dry."
B) "I will sit under a heat lamp for 30 minutes a day to help dry up the drainage."
C) "If I run out of saline, I can irrigate the wound with half strength peroxide."
D) "Pulling out the dried up dressings will help clean the wound out."
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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 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.
Q2) 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.
Q3) The nurse assesses a client's systemic manifestations of fever and malaise as the line of defense known as A) complete.
B) partial.
C) primary.
D) secondary.
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Page 21
Chapter 20: Clients with Pain
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29 Verified Questions
29 Flashcards
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Sample Questions
Q1) A client with metastatic cancer is being dismissed to home health care. The client's orders include both a long-acting opioid analgesic and a short-acting analgesic for breakthrough pain. In addition, the client will be taking an NSAID every 8 hours. The client's spouse is very upset with these directions and voices concern to the nurse that the client "will become an addict." Which information will best help the spouse and client maintain the medication schedule? The nurse should
A) call the physician and ask him/her to come speak to the family.
B) help them understand the need for such strong medications.
C) inform them that in time, the medications can be decreased.
D) initiate a referral to a pain specialist.
Q2) A postoperative client has liberal orders for pain medication and the nurse is delivering them on a strict schedule. The client denies pain when assessed but appears worried, is fidgeting in bed, cries occasionally, and uses the call light frequently for "minor" requests. When analyzing this situation, which component of the pain medication plan might the nurse discover needs revision?
A) The doses of medications are too low.
B) The interval between doses is too long.
C) The nurse needs a better therapeutic relationship with the client.
D) The route of administration should be changed to a faster acting route.
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Chapter 21: Perspectives in Palliative Care
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18 Flashcards
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Sample Questions
Q1) A hospice nurse explains to a client that one of the underlying reasons for the underutilization of hospice services is the difficulty in determining life expectancy prognoses of
A) 1 year or less.
B) 8 months or less.
C) 6 months or less.
D) 3 months or less.
Q2) The nurse caring for a terminally ill client with cancer would assess a key indicator of clinical depression as being the client's
A) anger over the pain experience.
B) anorexia and weight loss.
C) feelings of hopelessness.
D) inability to provide physical self-care.
Q3) A client on hospice service reports experiencing a "colicky" type of pain. To relieve this clinical manifestation, the hospice nurse would request an order for a(n)
A) anticholinergic.
B) nonsteroidal anti-inflammatory drug.
C) opioid analgesic.
D) salicylate.
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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) During rapid eye movement (REM) sleep, there is an increase in the neurotransmitter A) acetylcholine.
B) dopamine.
C) norepinephrine.
D) serotonin.
Q2) The nurse explains to a client with severe depression and who takes tricyclic antidepressants that the effectiveness of this type of medication may be a result of A) increased stage 4 sleep.
B) prevention of night awakenings.
C) prevention of sleep terrors.
D) suppression of REM sleep.
Q3) A client with severe emphysema had a myocardial infarction and is hospitalized on the telemetry unit. The night nurse notices that the client has frequent dysrhythmias. The priority action for the nurse would be to check the client's A) cardiac enzymes.
B) electrocardiogram.
C) electrolyte values.
D) oxygen saturation.
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Chapter 23: Clients with Psychosocial and Mental Health
Concerns
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18 Flashcards
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Sample Questions
Q1) A client with depression says to the nurse, "I have been on this antidepressant for 5 days and I still feel awful." The nurse can be most supportive by responding
A) "Depression is a horrible feeling. I am sure that you will be getting results from your medication in a few days."
B) "Depressive feelings make you feel hopeless. I will call your doctor and see if I can get an order for something to make you feel better."
C) "It's tough to wait for relief. Many drugs take several weeks to manage symptoms."
D) "You mustn't feel so down. Everyone reacts to medications in a slightly different way."
Q2) 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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Sample Questions
Q1) The nurse explains that disorienting flashbacks may be experienced by a client under the influence of A) alcohol.
B) cocaine.
C) heroin.
D) LSD.
Q2) A client taking the drug ReVia for alcohol abuse tells the nurse that he wants to join AA as an added support for his recovery. The nurse's best response would be
A) "Although AA is a support toward sobriety, the fact that you are presently taking ReVia would probably make you ineligible for membership."
B) "AA has been able to help many people stay sober, but it does require that you have a sponsor. Do you know of someone who is a member?"
C) "Joining AA is going to involve your family to some degree. Have you discussed your plans with them?"
D) "That sounds like a very good idea. Shall we try to locate a chapter near you and see when they meet?"
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Chapter 25: Assessment of the Musculoskeletal System
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Sample Questions
Q1) 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.
Q2) 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.
Q3) 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.
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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) Psychosocial implications of a diagnosis of osteoporosis the nurse should assess for can include (Select all that apply)
A) anxiety over disfigurement.
B) chronic pain.
C) fear of falling.
D) poor quality of life.
E) self-esteem problems.
Q2) A client is being managed for prevention of gout and the nurse is reviewing the client's medication list and teaching about the medications. The nurse evaluates that the client understands the medication when the client says
A) "Allopurinol blocks production of uric acid."
B) "Colchicine can be used with probenecid."
C) "Long-term steroids are needed to prevent attacks."
D) "NSAIDs are not effective against the pain of gout."
Q3) The nurse assesses that the individual most susceptible to osteoporosis is the
A) muscular 50-year-old man with diabetes.
B) obese 50-year-old woman who is allergic to milk.
C) thin 70-year-old man with gout.
D) very slender 75-year-old woman.
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) The nurse in the emergency department caring for a client with an anterior dislocation of the knee should have as a priority the assessment of A) capillary refill of the toes.
B) degree of misalignment in the limb.
C) degree of pain in the joint.
D) mobility in the affected limb.
Q2) The nurse explains to the client that in addition to approximating the bone fragments, traction also
A) increases blood supply to the fracture site.
B) increases speed of bone healing.
C) reduces muscle spasm.
D) reduces neuromuscular dysfunction.
Q3) A client is considering running as an exercise. The nurse counsels that to prevent injuries, it is important before running to
A) consume a large amount of carbohydrates, such as cereal or pasta.
B) do 30 minutes of isometric leg exercises using weights.
C) engage in a series of stretching and relaxing movements.
D) perform static stretching exercises for 10 minutes.
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Chapter 28: Assessment of Nutrition and the Digestive System
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18 Flashcards
Source URL: https://quizplus.com/quiz/4026
Sample Questions
Q1) For a client having all the following GI tests, which test should the nurse schedule last?
A) Barium swallow
B) Computed tomography scan
C) Flat plate of abdomen
D) Ultrasound
Q2) The nurse is assessing the abdomen of an obese 67-year-old client who is admitted to the emergency department. The finding noted during the abdominal examination that requires further assessment is
A) flat appearance below the umbilicus.
B) rounded abdominal contour.
C) umbilicus that is concave.
D) visible peristalsis.
Q3) The nurse administers an anticholinergic drug to a client scheduled for an endoscopy in order to provide
A) decreased secretions.
B) increased peristalsis.
C) muscle relaxation.
D) sedation.
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Chapter 29: Management of Clients with Malnutrition
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21 Verified Questions
21 Flashcards
Source URL: https://quizplus.com/quiz/4027
Sample Questions
Q1) A client who is diagnosed with bulimia would be most likely to manifest the psychosocial alteration of A) denial.
B) depression.
C) self-mutilation.
D) social withdrawal.
Q2) When assisting a dysphagic client to eat, the nurse should
A) have the client slightly flex the neck for swallowing.
B) place the client in Sims position for 15 minutes after meals.
C) position the client in the semi-Fowler position.
D) use the fingers to check the client's mouth for food.
Q3) A client who has begun receiving TPN with lipids develops shaking chills, shortness of breath, and chest pain. The priority action by the nurse is to immediately
A) call the physician.
B) obtain a 12-lead ECG.
C) stop the infusion.
D) take a set of vitals.
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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) When developing the care plan for a client with leukoplakia, the nurse would focus interventions on the primary problem leukoplakia poses to the client, which is
A) cancer risk.
B) discomfort.
C) infection.
D) purulent secretions.
Q2) The nurse should anticipate that a client with mechanical obstruction of the esophagus would initially have difficulty swallowing
A) bread.
B) carbonated beverages.
C) mashed potatoes.
D) saliva.
Q3) The nursing instruction that would be included in a client's teaching plan to prevent or delay the development of hiatal hernia is
A) avoid drinking carbonated beverages rapidly.
B) avoid heavy lifting and stooping.
C) consume a high-carbohydrate, low-fat diet.
D) sit in an upright position in a straight-backed chair.
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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 client with a duodenal ulcer complains of a sudden onset of severe pain. In which order should the nurse perform the following activities? (select all that apply)
A) Assess the patency of the patient's IV line.
B) Call the physician.
C) Have the nurses' aid obtain a set of vital signs.
D) Perform a complete abdominal examination.
E) Prepare to administer IV pain medication.
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) A client asks the nurse about the prescribed diet after gastric surgery. The nurse clarifies that a high-protein, high-fat, low-carbohydrate, dry diet is the best choice after gastric surgery because this diet
A) does not cause diarrhea.
B) does not dilate the stomach.
C) is quickly digested.
D) is slow to leave the stomach.
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Page 33
Chapter 32: Assessment of Elimination
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27 Verified Questions
27 Flashcards
Source URL: https://quizplus.com/quiz/4030
Sample Questions
Q1) For a client who has just undergone cystourethroscopy with biopsy, the nurse should
A) encourage the client to drink fluids to flush the dye from the renal system.
B) instruct the client that strict bed rest will be needed after the procedure.
C) offer throat lozenges to help with the client's sore throat.
D) plan care for a client having general anesthesia.
Q2) A client was released from the hospital following a lengthy course of IV antibiotics. The home health care nurse assesses that the client has been having new-onset diarrhea. What would the nurse suspect to be the cause of this problem?
A) C. difficile infection
B) Contaminated water supply
C) Noncompliance with ordered diet
D) Not spacing medications properly
Q3) In the post-procedural nursing care of a client who has undergone a cystourethroscopy, the nurse would include
A) ambulating the client 8 hours after the procedure.
B) maintaining a pressure dressing at the puncture site for 8 hours.
C) monitoring the client for manifestations of urinary tract infection.
D) obtaining a 24-hour urine specimen.
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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) The nurse caring for a client with an intestinal malignancy assesses for bleeding, which would most likely be manifested by A) abdominal discomfort.
B) hematemesis.
C) hematochezia.
D) hypotension.
Q2) The nurse is instructing a client with a new colostomy on its care and notes that the stoma is large and dusky. The most appropriate nursing intervention at this time is to A) assess the client's reaction to the ostomy site.
B) assist the client to irrigate the colostomy.
C) notify the surgeon immediately.
D) reassure the client that the stoma will decrease in size.
Q3) A client with ulcerative colitis has severe diarrhea. Further assessments by the nurse are aimed at early recognition of A) dehydration.
B) hemorrhoids.
C) metabolic alkalosis.
D) nephrolithiasis.
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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) A male client has come to the clinic with complaints of urethritis and urinary frequency with burning. The nurse should assess this client for the presence of
A) a sexually transmitted disease.
B) chronic urinary tract infections.
C) congenital bladder defects.
D) reflux and distended bladder.
Q2) Noting that the client's stoma is red and moist 8 hours after urinary diversion surgery, the nurse would
A) continue to make hourly assessments of the stoma.
B) notify the surgeon immediately.
C) remove the pouch and reapply it correctly.
D) remove the pouch to expose the stoma to air.
Q3) The nurse would realize that additional teaching is needed when the client with a ureteroileostomy says "I
A) am going shopping for new clothing that will better accommodate the pouch."
B) will change the pouch when it begins to leak."
C) won't drink too much so the amount of urine I make will be less."
D) am going to cut down on eating dairy products."
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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 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.
Q2) A client with hydronephrosis has undergone stent placement to relieve the obstruction. The priority action of the nurse is to
A) assess serum electrolytes and glucose levels.
B) monitor for manifestations of urinary tract infection.
C) monitor vital signs every 30 minutes for the first 4 hours.
D) provide accurate hourly fluid volume replacement.
Q3) An 88-year-old client has glomerulonephritis, is quite edematous, and has an order for large doses of diuretics. Before administering the first dose, the most appropriate action by the nurse would be to
A) call the physician to clarify the order.
B) educate the client as to the drug's effects.
C) have the unlicensed assistive personnel take a set of vital signs.
D) plan to administer the diuretics evenly spaced throughout the day.
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Page 37
Chapter 36: Management of Clients with Renal Failure
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30 Verified Questions
30 Flashcards
Source URL: https://quizplus.com/quiz/4034
Sample Questions
Q1) A client is at a follow-up appointment and confesses that s/he does not take medications as prescribed. When planning a teaching strategy to address this problem, the nurse understands that clients often do not adhere to self-care guidelines because (Select all that apply)
A) a good understanding of the consequences leads them to skip meds.
B) clients may believe they no longer need the medications.
C) side effects may be disruptive and unpleasant.
D) the economic costs are too high for them to absorb.
Q2) The nurse explains to a client with chronic renal failure that the rationale for receiving calcium carbonate is that it
A) binds with phosphorus to eliminate it from the body.
B) binds with potassium to eliminate it from the body.
C) helps prevent constipation.
D) helps prevent ulcer formation.
Q3) A client with oliguric ARF would exhibit
A) a BUN/creatinine ratio of 30:1.
B) hematuria.
C) proteinuria.
D) a urine specific gravity of 1.001.
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Page 38
Chapter 37: Assessment of the Reproductive System
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17 Verified Questions
17 Flashcards
Source URL: https://quizplus.com/quiz/4035
Sample Questions
Q1) The nurse observes a red glow during transillumination of a client's scrotum. The nurse would interpret this finding as
A) a hematoma.
B) a scrotal mass.
C) normal findings.
D) serous fluid.
Q2) While physical examination of his reproductive system is being conducted, the client has an erection. The most appropriate action by the nurse is
A) advise the client to breathe through his mouth to relax.
B) leave the room and return when the exam is completed.
C) say nothing and stay while the exam is being conducted.
D) tell the client this reaction is normal and has no sexual meaning.
Q3) The nurse notices that a client performing a BSE is failing to palpate her breast and axillae completely. To improve her technique, the nurse should teach the client to A) compress the nipple downward.
B) gently slide her fingers over the breast tissue.
C) palpate the breast using a systematic approach.
D) start her examination when standing.
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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) Considering the potential long-term side effects of a radical prostectomy, the nurse would make the nursing diagnosis of
A) Deficient Fluid Volume
B) Impaired Urinary Elimination
C) Risk for Sexual Dysfunction
D) Social Isolation
Q2) A nurse counsels a client who smokes cigarettes and uses alcohol daily that he should be aware that these substances have been known to cause
A) decreased erectile ability.
B) decreased sperm count.
C) gynecomastia.
D) increased ejaculatory ability.
Q3) For a client with radioactive iodine seeds implanted for local control of a prostate tumor, the nurse would address radiation precautions by
A) isolating the client while the implants are intact.
B) limiting time spent with the client.
C) not allowing children to sit on his lap.
D) treating all urine as radioactive.
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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) 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.
Q2) The client tells the nurse that she is experiencing pain on her left side during the entire time of menstrual flow. The nurses assesses the possibility of A) endometriosis.
B) pelvic inflammatory disease.
C) uterine myoma.
D) uterine prolapse.
Q3) Reading in the client record that a female client has undergone type II excision of the genitalia, the nurse would understand that there has been excision of the A) clitoris and labia minora.
B) clitoris only.
C) entire vulva.
D) labia minora and labia majora.
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Page 41
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) 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.
Q2) In a client receiving chemotherapy for breast cancer, the nurse would assess for A) back pain.
B) confusion.
C) infection.
D) weight gain.
Q3) When the client asks the nurse when she can purchase a permanent breast prosthesis, the nurse explains that a prosthesis can be obtained when A) a year has passed.
B) all the sutures and drains are removed.
C) the client is discharged.
D) the wound has healed completely.
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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 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.
Q2) The nurse is teaching a client with herpes simplex virus (HSV) type 2 appropriate methods to prevent further spread of the virus while lesions are present. The nurse stresses that clients should
A) apply warm soaks to the lesions.
B) complete antibiotic therapy.
C) maintain separate towels and other personal items.
D) stop using condoms because they are irritating.
Q3) The nurse working in an ambulatory clinic explains that the most common bacterial STD in the United States is
A) chlamydia.
B) genital herpes.
C) gonorrhea.
D) syphilis.
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Chapter 42: Assessment of the Endocrine and Metabolic Systems
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15 Verified Questions
15 Flashcards
Source URL: https://quizplus.com/quiz/4040
Sample Questions
Q1) A client is having a physical examination and tells the nurse about a painful area in the right upper quadrant of the abdomen. Based on this information, the nurse would
A) avoid any manipulation or contact with the painful area.
B) examine the painful area at the end of the assessment.
C) examine the right upper quadrant area first.
D) notify the physician to complete the examination.
Q2) The nurse assessing a client knows that endocrine disorders can present with which of the following manifestations? (Select all that apply.)
A) Dark or tea-colored urine
B) Decreased libido
C) Impotence or infertility
D) Irregular menstrual cycle
E) Muscle wasting and atrophy
Q3) 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.
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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) In a client admitted to the clinical unit with a sporadic goiter, the nurse might expect to find that the client
A) frequently travels in foreign countries.
B) has a large intake of aspirin.
C) ingests a large amount of cabbage.
D) lives in the Great Lakes region.
Q2) A client just returned from surgery for a thyroid disorder and complains that his/her mouth has an odd sensation. Which medication should the nurse anticipate administering?
A) Calcium gluconate
B) Epinephrine
C) Potassium chloride
D) Rectal aspirin
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.
Page 45
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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) A client has Addison's disease. The nurse should teach the client to carry an injection kit at all times with the medication
A) adrenaline.
B) Benadryl.
C) epinephrine.
D) hydrocortisone.
Q2) In reviewing laboratory data for a client with Cushing's syndrome, the nurse might expect to see the laboratory abnormalities of (Select all that apply)
A) hypercalcemia.
B) hyperglycemia.
C) hyperproteinemia.
D) hypoglycemia.
E) hypokalemia.
F) hyponatremia.
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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) For a client with diabetes mellitus scheduled for surgery at 8 AM, the nurse would plan to check the client's blood glucose level on the day of surgery between
A) 12 midnight and 2 AM.
B) 2 and 4 AM.
C) 4 and 6 AM.
D) 7 and 8 AM.
Q2) A client with diabetes who has properly learned the principles of foot care would be most likely to say
A) "A mirror will be very helpful so I can look at all parts of my feet each day."
B) "I should limit walking barefoot to a half hour a day."
C) "I should wear nice, tight shoes for firm support."
D) "The best method of testing bath temperature is with the toes."
Q3) In a client who needs fluid replacement therapy for DKA, the nurse would evaluate the best indicator of rehydration as A) a balance of intake and output.
B) improving skin turgor.
C) moistness of tongue and mucous membranes.
D) urine output at least 0.5 ml/kg/hr.
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Chapter 46: Management of Clients with Exocrine
Pancreatic and Biliary Disorders
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31 Verified Questions
31 Flashcards
Source URL: https://quizplus.com/quiz/4044
Sample Questions
Q1) A client who had pancreatic surgery has been started on medication therapy with pancrelipase (Pancrease). The manifestation that the nurse would report as an indication that the dosage may be insufficient is
A) black, tarry stools.
B) clay-colored stools.
C) constipation.
D) steatorrhea.
Q2) A client who had onset of acute pancreatitis 6 days ago has a respiratory rate of 26 with fine crackles throughout lung fields, and seems a little confused and agitated. The nurse would continue to assess this client for manifestations of A) adult respiratory distress syndrome.
B) atelectasis and pneumonitis.
C) pneumonia.
D) tension pneumothorax.
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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 providing information about the hepatitis B vaccine would include the information that the inoculation
A) consists of a single injection but is extremely uncomfortable.
B) is given by three separate injections over 6 months.
C) is recommended only for adults and those at risk.
D) works best when it is given in the gluteal muscle.
Q2) 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.
Q3) A client has ascites and the nursing diagnosis Excess Fluid Volume. The nurse has orders to administer albumin and furosemide (Lasix). Which action by the nurse regarding this order is correct?
A) Call the physician to clarify the order.
B) Give the albumin first and then give the furosemide.
C) Give the furosemide first and then give the albumin.
D) Have the pharmacy mix both drugs in the same IV bag.
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Page 49
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) When the client taking chlorpromazine (Thorazine), phenytoin (Dilantin), penicillin, and a multivitamin complains of a sunburn-like rash on the face and arms, the nurse would suspect the cause to be the A) dilantin.
B) multivitamin.
C) penicillin.
D) tetracycline.
Q2) After a client's surgical excisional biopsy, the nurse would apply A) antibiotic ointment and a dry dressing.
B) Band-Aids only.
C) hydrocolloid dressing only.
D) petrolatum gauze and paper tape.
Q3) A client has elevated lesions that contain serous fluid. The nurse would document these as A) nodules.
B) pustules.
C) vesicles.
D) wheals.
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50
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) When providing topical treatment of lesions for a client with intertrigo, the nurse would avoid the use of
A) Burrow's solution.
B) cornstarch.
C) talc-containing powder.
D) topical steroids.
Q2) A client is expressing great disappointment that the plastic surgery did not turn out as well as expected. The client is distressed over visible scarring and lingering edema. The most appropriate nursing diagnosis for this client is
A) Altered Coping
B) Disturbed Body Image
C) Fear
D) Situational Low Self Esteem
Q3) Before a client has blepharoplasty, the nurse would assess the client for A) ability to close eyes completely.
B) extraocular movement in each eye.
C) facial symmetry and muscle strength.
D) near and distant vision in each eye.
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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) When caring for a severely burned client, the nurse notes that the client's urine is dark brown. The priority action by the nurse would be to
A) check the urinary catheter for patency and irrigate it if needed.
B) monitor vital signs more frequently to detect hypovolemia.
C) notify the physician immediately and request an order for urinalysis.
D) titrate intravenous (IV) fluids to maintain urine output of 75-100 ml/hour.
Q2) A client was found unconscious in a burning wooden shed and is admitted to the intensive care unit. The client is tachypneic and restless, with a respiratory rate of 32 breaths/min. The client's oxygen saturation is 99%. The most appropriate action by the nurse is to
A) administer morphine for both pain and anxiety control.
B) apply oxygen at 2 L by nasal cannula.
C) check the oximeter to see if it is working.
D) request the physician order a carboxyhemoglobin level.
Q3) The nurse would assess that the client with a "major burn" is
A) 60 years old with a 20% burn.
B) 32 years old with a 14 % burn.
C) 18 years old with an 18% burn.
D) 10 years old with a 15% burn.
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Page 52
Chapter 51: Assessment of the Vascular System
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12 Verified Questions
12 Flashcards
Source URL: https://quizplus.com/quiz/4049
Sample Questions
Q1) When a female client tells the nurse, "I always get pains in my legs when walking," the nurse would question her about
A) amount of activity required to cause pain.
B) history of hypertension.
C) number of pregnancies.
D) presence of swelling.
Q2) 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.
Q3) To determine if a client with complaints of pain after walking 5 blocks is experiencing intermittent claudication, the nurse would ask
A) "Do you experience leg swelling?"
B) "Does pain go away when you rest?"
C) "Is the pain cramp-like?"
D) "Is the pain in the calf muscle?"
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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) 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.
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.
Q3) The nurse would consider referring a hypertensive client for step-down therapy when the blood pressure has been effectively controlled for at least
A) 3 months.
B) 6 months.
C) 1 year.
D) 2 years.
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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) The nurse would explain to a client that anticoagulant therapy is used in the treatment of thromboembolic disease because anticoagulants can A) decrease blood viscosity.
B) dissolve the thrombi.
C) inhibit the synthesis of clotting factors.
D) prevent absorption of vitamin K.
Q2) A client is wearing sequential compression devices (SCDs) on the bilateral lower legs. Nursing care for these devices includes
A) not allowing the client to ambulate.
B) pre-wrapping the legs with Ace bandages.
C) removing them twice a day to inspect skin.
D) turning them off every 2 hours for 10 minutes.
Q3) A client scheduled for a repair of an abdominal aortic aneurysm reports increased abdominal pain accompanied by new onset of intense back and flank pain. The priority action by the nurse would be to
A) administer a prescribed analgesic.
B) notify the physician immediately.
C) reassess the client in another 5 minutes.
D) take another set of vital signs.
Page 55
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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 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.
Q2) In evaluating a client's ECG tracing, the nurse notes three small squares between the upstroke and downstroke of the QRS wave. The nurse would record the QRS interval as
A)0.04 second.
B)0.06 second.
C)0.08 second.
D)0.12 second.
Q3) The nurse would explain to a client that an electrical representation of the cardiac cycle shows that a normal PR interval is between 0.12 second and A)0.15 second.
B)0.16 second.
C)0.18 second.
D)0.20 second.
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Chapter 55: Management of Clients with Structural
Cardiac Disorders
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21 Verified Questions
21 Flashcards
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Sample Questions
Q1) The nurse auscultating heart sounds notes that a client has an opening snap and a low-pitched, rumbling murmur over the apex. This assessment would indicate
A) aortic stenosis.
B) mitral stenosis.
C) pulmonic prolapse.
D) tricuspid regurgitation.
Q2) 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.
Q3) To encourage a client recovering from endocarditis, the nurse would stress that new guidelines for home care are less restrictive than in the past and the client no longer needs to
A) observe complete bed rest.
B) restrict the amount of activity.
C) take 2 to 5 weeks of antibiotic therapy.
D) take precautions against emboli formation.
Page 57
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Chapter 56: Management of Clients with Functional
Cardiac Disorders
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28 Verified Questions
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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 advise a group of diabetic clients that primary prevention for CHD can be achieved by keeping their fasting blood sugar levels below
A) 56 mg/dl.
B) 72 mg/dl.
C) 105 mg/dl.
D) 126 mg/dl.
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Chapter 57: Management of Clients with Dysrhythmias
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Sample Questions
Q1) A client is being discharged with a prescription for procainamide to treat atrial fibrillation. An important self-care measure the nurse would explain about this medication is to
A) avoid milk products.
B) drink large amounts of citrus juice.
C) have blood pressure monitored frequently.
D) take the medication with meals.
Q2) A client with no history of heart disease is seen in the clinic for periodic episodes of tachycardia with a regular rate. When taking the nursing history, the nurse would question the client about the existence of A) asthma.
B) diabetes.
C) stress.
D) weight gain.
Q3) Before a client receives cardioversion, the nurse should ensure that the client
A) ate only a light breakfast.
B) has signed a consent form.
C) is not wearing jewelry.
D) skipped today's digoxin dose.
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Chapter 58: Management of Clients with Myocardial Infarction
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Sample Questions
Q1) A client admitted for angina reports experiencing pain of long duration while at rest and also early in the morning. The nurse would recognize this pattern as
A) angina decubitus.
B) nocturnal angina.
C) unstable angina.
D) variant angina.
Q2) 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.
Q3) In the discharge teaching plan for a client after MI, the nurse would include that the client should
A) begin walking for short periods every day.
B) continue previous lifestyle when ready.
C) resume sexual intercourse in 3 months.
D) take 1 aspirin every 8 hours as ordered.
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Page 60
Chapter 59: Assessment of the Respiratory System
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Sample Questions
Q1) A client being treated for emphysema has a chronic productive cough. The nurse would assess a characteristic feature of clients with long-term emphysema, which is A) barrel chest.
B) broken vessels in the nose.
C) erythematous ear lobes.
D) pectus excavatum.
Q2) An older adult client says, "I need to get a shot so that I'll never get pneumonia again." The most helpful response by the nurse would be
A) "Immunization for pneumonia must be repeated every year."
B) "Most older people get flu shots, but they don't protect you from pneumonia."
C) "Pneumovax vaccine can protect you against one type of pneumonia."
D) "You cannot get a shot, or immunization, for pneumonia."
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) 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."
Q2) When feeding a client with a tracheostomy, the nurse would A) follow each spoon of food with liquid.
B) have the client in an upright sitting position.
C) inflate the cuff before the meal.
D) thin the food to liquid consistency.
Q3) In planning postoperative nursing care for a client who has undergone radical neck dissection and total laryngectomy, the nurse would give priority to the fact that A) esophageal speech is relatively difficult to learn and takes practice.
B) prognosis after treatment is moderate, depending on findings.
C) the stoma should never be covered after this type of surgery.
D) there is a radical change in appearance as a result of this type of surgery.
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Page 62
Chapter 61: Management of Clients with Lower Airway and Pulmonary Vessel
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Sample Questions
Q1) The nurse is caring for a client with a pulmonary embolism who is receiving heparin and must have an arterial blood gas (ABG) sample drawn. The nurse would arrange to remain in the room to be available to hold pressure on the puncture site for at least
A) 1 minute.
B) 2 minutes.
C) 5 minutes.
D) 10 minutes.
Q2) A client tells the nurse that he read something about "dead space" in an article about emphysema and asks the nurse to explain it to him. The nurse's most accurate answer would be the following:
A) "Any part of your lungs that contains mucous secretions is called dead space."
B) "Dead space is an area of your lung that does not participate in air exchange."
C) "Parts of the lower airway that serve as a conduit for fresh air."
D) "This is a small area of necrotic tissue that can cause infection."
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63
Chapter 62: Management of Clients with Parenchymal and Pleural Disorders
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Sample Questions
Q1) The nurse would assess a client with severe acute respiratory syndrome (SARS) for the major clinical manifestation indicating the onset of the lower respiratory phase, which is
A) dry, nonproductive cough.
B) hemoptysis.
C) pleuritic pain.
D) rapid temperature elevation.
Q2) A client had chest surgery this morning and has a chest tube attached to a closed-chest drainage system. When the nurse notes no tidaling of fluid, the nurse would first
A) attach the system to suction.
B) milk the chest tube.
C) notify the physician immediately.
D) reposition the client.
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.
64
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Chapter 63: Management of Clients with Acute Pulmonary Disorders
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28 Verified Questions
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Sample Questions
Q1) A client with ARDS has severe air hunger and is extremely anxious. The nurse would administer which medication to help both problems?
A) Lorazepam (Ativan)
B) Morphine sulfate (morphine)
C) Furosemide (Lasix)
D) Nitroglycerin (Tridil)
Q2) The nurse would explain that the use of positive end-expiratory pressure (PEEP) assists the client on mechanical ventilation by
A) gradually increasing the amount of oxygen delivered.
B) increasing the amount of expired carbon dioxide.
C) keeping the alveoli open.
D) using a pressure of 30 cm H<sub>2</sub>O.
Q3) A nurse is providing community education on home safety. An important safety measure to prevent carbon monoxide poisoning is to instruct clients to
A) have furnaces maintained professionally on a regular basis.
B) inspect all electrical plugs before using them.
C) install smoke detectors on each floor of the house.
D) store a fire extinguisher near or in the kitchen.
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Chapter 64: Assessment of the Eyes and Ears
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Sample Questions
Q1) 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.
Q2) The nurse would interpret a myopic client's (20/30) vision as the client's ability to A) read at 30 feet what a person with normal vision can read at 20 feet.
B) read at 20 feet what a person with normal vision can read at 30 feet.
C) read correctly 30 figures or characters at 20 feet.
D) read 20% of the figures or characters at 30 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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66
Chapter 65: Management of Clients with Visual Disorders
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21 Verified Questions
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Sample Questions
Q1) 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."
Q2) A client wants "eye glasses surgery" to fix nearsightedness, but was told several years ago that the corneas were too thin and flat for traditional laser in situ keratomileusis (LASIK) surgery. The nurse working in an ophthalmologist's office counsels the client to ask about which procedure?
A) Corneal ring implants
B) Laser epithelial keratomileusis (LASEK)
C) Pneumatic retinopexy
D) Radial keratotomy (RK)
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Chapter 66: Management of Clients with Hearing and Balance Disorders
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Sample Questions
Q1) The nurse preparing written discharge instructions for the day-surgery unit where ear surgery is performed would plan to include which instruction?
A) Avoid heavy lifting and do not engage in sports for 3 weeks after surgery.
B) Leave the cotton ball dressing in the ear until your follow-up appointment.
C) Do not sneeze, blow your nose, or cough for 1 week after surgery.
D) Report any decreased hearing in the operative ear.
Q2) The most appropriate action that the nurse working at a camp would take to remove an insect from a camper's ear is
A) gently irrigate the ear canal with sterile water.
B) instill a few drops of mineral oil into the ear.
C) instruct the camper to tilt the affected ear downward.
D) occlude the ear with a medicated cotton pledget.
Q3) The problem with the ear that the nurse would consider to be associated with the aging process is
A) amblyopia.
B) otalgia.
C) presbycusis.
D) tinnitus.
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Chapter 67: Assessment of the Neurologic System
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Sample Questions
Q1) When testing comprehension in a client who is expressively aphasic, the nurse lays out a pencil, a key, and a ball and then would
A) ask the client to pick up the ball.
B) hold up the key and ask, "What do you do with this?"
C) point to the pencil and ask, "What is this?"
D) point to the ball and ask "What can this be used for?"
Q2) In assessing the function of CNs III, IV, and VI, the nurse would ask the client to
A) look straight ahead for examination with an ophthalmoscope.
B) move the eyes in six directions.
C) read a newspaper.
D) shut the eyes tightly.
Q3) 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.
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Chapter 68: Management of Comatose or Confused
Clients
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Sample Questions
Q1) When a client does not respond to verbal stimuli, to determine level of consciousness the nurse should
A) apply pressure across the client's nail bed.
B) ask the client to squeeze the nurse's fingers.
C) check deep tendon reflexes.
D) lightly pinch the skin of the hand.
Q2) 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.
Q3) When caring for an elderly client, the nurse should plan interventions based on the understanding that the elderly often
A) are frequently confused on admission.
B) are particularly at risk for confusion in the hospital.
C) do not seem bothered by changes in routines.
D) have an intact recent memory.
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Chapter 69: Management of Clients with Cerebral Disorders
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Sample Questions
Q1) A client has cyclical headaches accompanied by constricted pupils, unilateral lacrimation, and rhinorrhea. The nurse is exploring ways to prevent these headaches with the client. The nurse could focus questions and interventions on modifying the client's
A) daily level of stress.
B) family history of brain tumors.
C) pattern of caffeine consumption.
D) usual alcohol intake.
Q2) When the client experiences convulsive movement beginning in the hand and progressing to the arm and face, the nurse recognizes this as being consistent with A) clonic seizure.
B) complex partial seizure.
C) partial seizure with motor signs.
D) temporal lobe seizure.
Q3) The nurse should observe a client with bacterial meningitis for A) changes in sensorium.
B) high blood pressure.
C) hypothermia.
D) muscle spasms.
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Chapter 70: Management of Clients with Stroke
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Sample Questions
Q1) A client has a history of experiencing focal neurologic deficits, such as slurred speech and facial weakness, that last for a few hours at a time. The nurse then assesses this client for other possible manifestations of A) embolic stroke.
B) encephalopathy.
C) intracranial hemorrhage.
D) transient ischemic attacks (TIAs).
Q2) The assessment the nurse documents that supports the finding of apraxia would be the client's inability to A) get dressed independently.
B) recognize a pencil.
C) see far objects.
D) understand the spoken word.
Q3) A client had a stroke. A nurse has arranged a consultation with an occupational therapist in order to enhance the client's ability to A) acquire job skills.
B) feed himself.
C) swallow.
D) use a walker.
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Page 72
Chapter 71: Management of Clients with Peripheral Nervous System
Disorders
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Q1) A client has returned to the nursing unit after having a cervical fusion from the anterior approach. What piece of equipment does the nurse ensure is at the bedside?
A) A patient-controlled analgesia (PCA) pump
B) Emergency tracheostomy set
C) Humidified oxygen
D) Suction setup and rigid suction catheter
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) On the first postoperative day, a client who had a cervical surgery requests the bedpan often, but cannot void. Based on these observations, the nurse should
A) assess for bladder distention.
B) assess for manifestations of urinary tract infection.
C) document this outcome as normal.
D) increase fluid intake.
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Chapter 72: Management of Clients with Degenerative Neurologic Disorders
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Q1) Health promotion activities the nurse could suggest to a community group for Huntington's disease include
A) Eating foods high in omega-3 fatty acids.
B) genetic screening for high-risk individuals.
C) limiting exposure to heavy metals.
D) taking 400 International Units of vitamin E daily.
Q2) The nurse formulates the following nursing diagnosis for a client with MS: Impaired Physical Mobility related to muscle weakness. Useful interventions the nurse could plan include
A) encouraging long naps or rest periods.
B) encouraging strengthening exercises for affected muscles every 4 hours.
C) having the client perform ROM exercises at least two times daily.
D) performing all the activities of daily living (ADLs) for the client.
Q3) The most helpful intervention by the nurse for a client experiencing a parkinsonian crisis would be to
A) administer oxygen by nasal catheter.
B) give the client IV fluids that contain potassium.
C) place the client in a nonstimulating environment.
D) provide the client with foods high in calcium.
Page 74
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Chapter 73: Management of Clients with Neurologic
Trauma
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Q1) A priority nursing intervention for a client in the emergency department with a suspected spinal cord injury is to
A) administer mannitol.
B) give a tetanus booster shot.
C) logroll the client.
D) obtain a thorough history.
Q2) The emergency department nurse should position the client with cranial injuries
A) in high-Fowler position and knees elevated.
B) side-lying with head of bed elevated 20 degrees.
C) supine with head of bed elevated 30 degrees.
D) supine with the bed completely flat.
Q3) The trauma nurse working in the emergency department is aware that caring for elderly clients who have head injuries differs from that given to the general population because (Select all that apply)
A) an older client may be less able to tolerate respiratory problems.
B) automobile accidents are a frequent cause and lead to driver's license revocation.
C) clients often have an atypical presentation.
D) poor stamina may impede participation in rehabilitation.
E) Pre-existing cognitive problems impact recovery potential.
Page 75
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Chapter 74: Assessment of the Hematopoietic System
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Q1) The nurse assesses the client who underwent partial removal of the stomach a year ago for the manifestations of A) anemia.
B) high white blood cell count.
C) low platelet count.
D) shortened bleeding times.
Q2) The manifestation the nurse would question the client about that is characteristically associated with anemia is A) fatigue.
B) pruritus.
C) rash.
D) ruddy skin color.
Q3) The nurse discovers a client is taking the herb St. John's wort. The nurse cautions that this herb reduces the effectiveness of A) lanoxin.
B) prednisone.
C) theophylline.
D) warfarin.
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Chapter 75: Management of Clients with Hematologic Disorders
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Q1) 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.
Q2) A nurse is conducting a home safety check on a client with cobalamin/vitamin
B<sub>12</sub> deficiency. What inquiries should the nurse specifically make?
A) Evidence of adequate lighting
B) How many stairs the client must negotiate to get inside
C) Number and location of throw rugs
D) Temperature setting on the water heater
Q3) The nursing intervention that is the priority when preparing to administer blood is A) administration of pretransfusion antihistamines.
B) asking a second health care professional to confirm blood acceptability.
C) establishing baseline vital signs.
D) obtaining a written order for the transfusion.
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Chapter 76: Management of Clients with Immune Disorders
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Q1) A client will undergo testing for possible food allergy to chocolate. The nurse teaches the client to eliminate chocolate from the diet before the testing for
A) 1 to 2 days.
B) 3 to 5 days.
C) 5 to 10 days.
D) 10 to 14 days.
Q2) 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
Q3) A nurse would observe the client for how long to determine whether there is an immediate reaction to a skin test?
A) 1 to 2 minutes
B) 2 to 5 minutes
C) 5 to 10 minutes
D) 10 to 20 minutes
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Chapter 77: Management of Clients with Rheumatic Disorders
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Sample Questions
Q1) The nurse performing an assessment on a client with fibromyalgia syndrome asks about the most common clinical manifestation, which is
A) deformities of the fingers and toes.
B) fatigue, unrelieved by sleep.
C) migratory areas of numbness.
D) varying degrees of paresthesias.
Q2) A client with RA is anxious to perform all of her activities of daily living. The nurse can best help the client by encouraging A) a slow, progressive schedule of daily activities. B) complete rest during periods of exacerbation.
C) performance of activities in the early morning. D) the use of assistive devices for dressing.
Q3) The nurse cautions a client with RA that uninformed self-treatment that has the potential to make her condition worse is A) application of cold compresses. B) performing isometric exercises.
C) the use of aspirin to mask pain.
D) the use of deep heat.
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Chapter 78: Management of Clients with Acquired
Immunodeficiency Syndrome
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Sample Questions
Q1) 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."
Q2) The nurse is assessing a client with AIDS for the presence of Kaposi's sarcoma (KS). The manifestation the nurse should look for is a
A) crusty lesion on the back and groin.
B) purple-red lesion on the body.
C) pustular lesion with yellow exudate.
D) thick, white exudate in the mouth.
Q3) A client with AIDS has the nursing diagnosis Imbalanced Nutrition: Less Than Body Requirements. The nurse should
A) encourage sweet foods and desserts that appeal to the taste.
B) encourage the client to dine alone to focus on food intake.
C) instruct the client to prepare meals, then divide and freeze them.
D) tell the client to eat large meals to result in greater intake.
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Chapter 79: Management of Clients with Leukemia and Lymphoma
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Sample Questions
Q1) The nurse reviewing a hematology report of a client with chronic leukemia brings to the attention of the physician a change that may indicate a blast crisis may be occurring, which is
A) a drastic decrease in monocytes.
B) a hemoglobin drop to 9 g/dl.
C) myeloid cell precursors >20%.
D) thrombocytic proliferation.
Q2) A client has been receiving MOPP (mechlorethamine, vincristine [Oncovin], procarbazine, prednisone) therapy for treatment of Hodgkin's disease. The treatment has changed to a protocol of ABVD (doxorubicin [Adriamycin], bleomycin, vinblastine, and dacarbazine). When the client asks the nurse for clarification about the change in protocol, the nurse's response will include that ABVD
A) can frequently produce a remission after only 1 cycle.
B) negates the need for radiation therapy.
C) prevents hypercalcemia.
D) reduces the risk of leukemia.
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Chapter 80: Management of Clients Requiring
Transplantation
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Sample Questions
Q1) Basing the assessment on knowledge of cultural customs and beliefs, the nurse would identify the client who would have the greatest conflict with heart transplantation as being from the faith of
A) Black Muslim.
B) Buddhism.
C) Friends (Quakers).
D) Russian Orthodox.
Q2) The nurse teaching a post-transplant client realizes that goals have been met when the client verbalizes understanding that the most common reason for rehospitalization in the post-transplant client is
A) acute rejection.
B) chronic rejection.
C) infection.
D) malignancy.
Q3) The nurse explains that the law prohibiting the buying and selling of organs is the A) National Transplant Act.
B) Organ Procurement and Transplant Network.
C) Uniform Anatomical Gift Act.
D) United Network of Organ Sharing.
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Chapter 81: Management of Clients with Shock and Multisystem
Disorders
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Sample Questions
Q1) A client in the ICU has shock and is getting blood glucose levels drawn and treatment with subcutaneous insulin. The client's spouse is upset seeing this and says "Now s/he's a diabetic, too?" The best response by the nurse is
A) "Blood sugar goes up with physical stress and insulin controls it, and clients seem to do better."
B) "High blood sugar is a common side effect of all these medications we are giving the client."
C) "No, no, s/he is not yet a diabetic. I hope we can prevent it by giving insulin now."
D) "Under great physical stress, blood glucose elevates and people can become diabetic."
Q2) A client is in shock and is receiving naloxone (Narcan). The client's sibling is an EMT and questions why the client is getting medication for "an overdose." The most appropriate response by the nurse is
A) "Because of HIPAA laws, I am not allowed to tell you about his/her care."
B) "I don't know but I can have the doctor come and speak with you."
C) "In clients with shock it helps the hypotension and cardiac output."
D) "The client may have gotten too much morphine in the emergency department."
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Chapter 82: Management of Clients in the Emergency Department
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) When a client is admitted to the ED with respiratory distress and rapid-sequence induction (RSI) is needed to intubate the client, the nurse should first A) apply nasal oxygen.
B) establish intravenous (IV) access.
C) hyperventilate with 50% oxygen.
D) insert a nasogastric tube.
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) 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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