Nursing Process and Clinical Decision Making Textbook Exam Questions - 1998 Verified Questions

Nursing Process and Clinical Decision Making

Textbook Exam Questions

Course Introduction

This course explores the foundational elements of the nursing process and its critical role in effective clinical decision making. Students will learn to apply systematic assessment, diagnosis, planning, implementation, and evaluation to provide patient-centered care across diverse settings. Emphasizing evidence-based practice, the course develops clinical reasoning and problem-solving skills, preparing students to make informed judgments, prioritize patient needs, and adapt interventions in dynamic healthcare environments. Ethical, legal, and cultural considerations are integrated to ensure holistic decision making and the promotion of safe, high-quality nursing care.

Recommended Textbook

Medical Surgical Nursing 10th Edition by Lewis

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68 Chapters

1998 Verified Questions

1998 Flashcards

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Page 2

Chapter 1: Professional Nursing Practice

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21 Verified Questions

21 Flashcards

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Sample Questions

Q1) Which nursing diagnosis statement is written correctly?

A)Altered tissue perfusion related to heart failure

B)Risk for impaired tissue integrity related to sacral redness

C)Ineffective coping related to response to biopsy test results

D)Altered urinary elimination related to urinary tract infection

Answer: C

Q2) A patient who is paralyzed on the left side of the body after a stroke develops a pressure ulcer on the left hip. Which nursing diagnosis is most appropriate?

A)Impaired physical mobility related to left-sided paralysis

B)Risk for impaired tissue integrity related to left-sided weakness

C)Impaired skin integrity related to altered circulation and pressure

D)Ineffective tissue perfusion related to inability to move independently

Answer: C

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3

Chapter 2: Health Disparities and Culturally Competent Care

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Sample Questions

Q1) Which strategy should be a priority when the nurse is planning care for a diabetic patient who is uninsured?

A)Obtain less expensive medications.

B)Follow evidence-based practice guidelines.

C)Assist with dietary changes as the first action.

D)Teach about the impact of exercise on diabetes.

Answer: B

Q2) The nurse working in a clinic in a primarily African American community notes a higher incidence of uncontrolled hypertension in the patients. To correct this health disparity,which action should the nurse take first?

A)Initiate a regular home-visit program by nurses working at the clinic.

B)Schedule teaching sessions about low-salt diets at community events.

C)Assess the perceptions of community members about the care at the clinic.

D)Obtain low-cost antihypertensive drugs using funding from government grants. Answer: C

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4

Chapter 3: Health History and Physical Examination

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Sample Questions

Q1) When assessing a patient's abdomen during the admission assessment,which action should the nurse take first?

A)Feel for any masses.

B)Palpate the abdomen.

C)Listen for bowel sounds.

D)Percuss the liver borders.

Answer: C

Q2) The nurse records the following general survey of a patient: "The patient is a 50-yr-old Asian female attended by her husband and two daughters. Alert and oriented. Does not make eye contact with the nurse and responds slowly,but appropriately,to questions. No apparent disabilities or distinguishing features." What additional information should the nurse add to this general survey?

A)Nutritional status

B)Intake and output

C)Reasons for contact with the health care system

D)Comments of family members about his condition

Answer: A

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Chapter 4: Patient and Caregiver Teaching

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Sample Questions

Q1) The nurse is planning a teaching session with a patient newly diagnosed with migraine headaches. To assess a patient's readiness to learn,which question should the nurse ask first?

A)"What kind of work and leisure activities do you do?"

B)"What information do you think you need right now?"

C)"Can you describe the types of activities that help you learn new information?"

D)"Do you have any religious beliefs that are inconsistent with the planned treatment?"

Q2) A patient who smokes a pack of cigarettes per day tells the nurse,"I enjoy smoking and have no plans to quit." Which nursing diagnosis is most appropriate?

A)Health-seeking behaviors related to cigarette use

B)Ineffective health maintenance related to tobacco use

C)Readiness for enhanced self-health management related to smoking

D)Deficient knowledge related to long-term effects of cigarette smoking

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Chapter 5: Chronic Illness and Older Adults

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Q1) The nurse performs a comprehensive assessment of an older patient who is considering admission to an assisted living facility. Which question is the most important for the nurse to ask?

A)"Have you had any recent infections?"

B)"How frequently do you see a doctor?"

C)"Do you have a history of heart disease?"

D)"Are you able to prepare your own meals?"

Q2) The family of an older patient with chronic health problems and increasing weakness is considering placement in a long-term care (LTC)facility. Which action by the nurse will be most helpful in assisting the patient to make this transition?

A)Have the family select a LTC facility that is relatively new.

B)Ask the patient's preference for the choice of a LTC facility.

C)Explain the reasons for the need to live in LTC to the patient.

D)Request that the patient be placed in a private room at the facility.

Q3) Which patient is most likely to need long-term nursing care management?

A)72-yr-old who had a hip replacement after a fall at home

B)64-yr-old who developed sepsis after a ruptured peptic ulcer

C)76-yr-old who had a cholecystectomy and bile duct drainage

D)63-yr-old with bilateral knee osteoarthritis who weighs 350 lb (159 kg)

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Page 7

Chapter 6: Stress and Stress Management

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Sample Questions

Q1) An obese female patient who had enjoyed active outdoor activities is stressed because osteoarthritis in her hips now limits her activity. Which action by the nurse will best assist the patient to cope with this situation?

A)Have the patient practice frequent relaxation breathing.

B)Ask the patient what outdoor activities she misses the most.

C)Teach the patient to use imagery for reducing pain and stress.

D)Encourage the patient to consider weight loss to improve symptoms.

Q2) A patient who has frequent migraines tells the nurse,"My life feels chaotic and out of my control. I could not manage if anything else happens." Which response should the nurse make initially?

A)"Regular exercise may get your mind off the pain."

B)"Guided imagery can be helpful in regaining control."

C)"Tell me more about how your life has been recently."

D)"Your previous coping resources can be helpful to you now."

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Chapter 7: Sleep and Sleep Disorders

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Sample Questions

Q1) The nurse cares for an unstable patient in the intensive care unit (ICU). Which intervention should the nurse include in the plan of care to improve this patient's sleep quality?

A)Ask all visitors to leave the ICU for the night.

B)Lower the level of lighting from 8:00 PM until 7:00 AM.

C)Avoid the use of opioids for pain relief during the evening.

D)Schedule assessments to allow 4 hours of uninterrupted sleep.

Q2) Which information regarding a patient's sleep is most important for the nurse to communicate to the health care provider?

A)A 21-yr-old student who takes melatonin to assist in sleeping when traveling from the United States to Europe

B)A 64-yr-old nurse who works the night shift reports drinking hot chocolate before going to bed in the morning

C)A 41-yr-old librarian who has a body mass index (BMI) of 42 kg/m2 says that the spouse complains about snoring

D)A 32-yr-old accountant who is experiencing a stressful week uses diphenhydramine (Benadryl) for several nights

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Page 9

Chapter 8: Pain

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Sample Questions

Q1) The nurse is caring for a patient who had abdominal surgery yesterday and is receiving morphine through patient-controlled analgesia (PCA). What action by the nurse is a priority?

A)Assessing for nausea

B)Auscultating bowel sounds

C)Checking the respiratory rate

D)Evaluating for sacral redness

Q2) A nurse assesses a patient with chronic cancer pain who is receiving imipramine (Tofranil)in addition to long-acting morphine (MS Contin). Which statement,if made by the patient,indicates to the nurse that the patient is receiving adequate pain control?

A)"I'm not anxious during the day."

B)"Every night I get 8 hours of sleep."

C)"I can accomplish activities without much discomfort."

D)"I feel less depressed since I've been taking the Tofranil."

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Chapter 9: Palliative Care at End of Life

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Sample Questions

Q1) Which action is most important for the nurse to take to ensure culturally competent care for an alert,terminally ill Filipino patient?

A)Let the family decide how to tell the patient about the terminal diagnosis.

B)Ask the patient and family about their preferences for care during this time.

C)Obtain information from Filipino staff members about possible cultural needs.

D)Remind family members that dying patients prefer to have someone at the bedside.

Q2) The nurse is caring for an unresponsive terminally ill patient who has 20-second periods of apnea followed by periods of deep and rapid breathing. Which action by the nurse would be appropriate?

A)Suction the patient's mouth.

B)Administer oxygen via face mask.

C)Document Cheyne-Stokes respirations.

D)Place the patient in high Fowler's position.

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Chapter 10: Substance Use Disorders

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Sample Questions

Q1) A newly admitted patient complains of waking frequently during the night. The nurse observes the patient wearing a nicotine patch on the right upper arm. Which action should the nurse take first?

A)Question the patient about use of the patch at night.

B)Suggest that the patient go to bed earlier in the evening.

C)Ask the health care provider about prescribing a sedative drug for nighttime use.

D)Remind the patient that the benefits of the patch outweigh the short-term insomnia.

Q2) A patient who has inhaled cocaine is admitted to the emergency department with palpitations and shortness of breath. What should the nurse do first?

A)Infuse normal saline.

B)Check oxygen saturation.

C)Draw blood for drug screening.

D)Obtain a 12-lead echocardiogram (ECG).

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Chapter 11: Inflammation and Wound Healing

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Sample Questions

Q1) A patient with rheumatoid arthritis has been taking oral corticosteroids for 2 years. Which nursing action is most likely to detect early signs of infection in this patient?

A)Monitor white blood cell counts.

B)Check the skin for areas of redness.

C)Measure the temperature every 2 hours.

D)Ask about feelings of fatigue or malaise.

Q2) The nurse will perform which action when doing a wet-to-dry dressing change on a patient's stage III sacral pressure ulcer?

A)Administer prescribed PRN hydrocodone 30 minutes before the change.

B)Pour sterile saline onto the new dry dressings after the wound has been packed.

C)Apply antimicrobial ointment before repacking the wound with moist dressings.

D)Soak the old dressings with sterile saline 30 minutes before the dressing change

Q3) The nurse should plan to use a wet-to-dry dressing for which patient?

A)A patient who has a pressure ulcer with pink granulation tissue

B)A patient who has a surgical incision with pink, approximated edges

C)A patient who has a full-thickness burn filled with dry, black material

D)A patient who has a wound with purulent drainage and dry brown areas

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13

Chapter 12: Genetics and Genomics

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Sample Questions

Q1) A male patient with hemophilia asks the nurse if his children will be hemophiliacs. Which response by the nurse is accurate?

A)"All of your children will be at risk for hemophilia."

B)"Hemophilia is a multifactorial inherited condition."

C)"Only your male children are at risk for hemophilia."

D)"Your female children will be carriers for hemophilia."

Q2) The sister of a patient diagnosed with BRCA gene-related breast cancer asks the nurse,"Do you think I should be tested for the gene?" Which response by the nurse is most appropriate?

A)"In most cases, breast cancer is not caused by having the BRCA gene."

B)"It depends on how you will feel if the test is positive for the BRCA gene."

C)"There are many things to consider before deciding to have genetic testing."

D)"You should decide first whether you are willing to have a bilateral mastectomy."

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Chapter 13: Altered Immune Responses and Transplantation

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Sample Questions

Q1) A clinic patient is experiencing an allergic reaction to an unknown allergen. Which action is appropriate for the registered nurse (RN)to delegate to a licensed practical/vocational nurse (LPN/LVN)?

A)Perform a focused physical assessment.

B)Obtain the health history from the patient.

C)Teach the patient about the various diagnostic studies.

D)Administer a skin test by the cutaneous scratch method.

Q2) Ten days after receiving a bone marrow transplant,a patient develops a skin rash. What would the nurse suspect is the cause of the rash?

A)The donor T cells are attacking the patient's skin cells.

B)The patient needs treatment to prevent hyperacute rejection.

C)The patient's antibodies are rejecting the donor bone marrow.

D)The patient is experiencing a delayed hypersensitivity reaction.

Q3) A patient is anxious and reports difficulty breathing after being stung by a wasp. What is the nurse's priority action?

A)Provide high-flow oxygen.

B)Administer antihistamines.

C)Assess the patient's airway.

D)Remove the stinger from the site.

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Chapter 14: Infection and Human Immunodeficiency Virus

Infection

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Sample Questions

Q1) A patient who is human immunodeficiency virus (HIV)-infected has a CD₄+ cell count of 400/µL. Which factor is most important for the nurse to determine before the initiation of antiretroviral therapy (ART)for this patient?

A)CD₄+ cell count trajectory

B)HIV genotype and phenotype

C)Patient's tolerance for potential medication side effects

D)Patient's ability to follow a complex medication regimen

Q2) An older adult with chronic human immunodeficiency virus (HIV)infection who takes medications for coronary artery disease and hypertension has chosen to begin early antiretroviral therapy (ART). Which information will the nurse include in patient teaching?

A)Many drugs interact with antiretroviral medications.

B)HIV infections progress more rapidly in older adults.

C)Less frequent CD₄+ level monitoring is needed in older adults.

D)Hospice care is available for patients with terminal HIV infection.

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Chapter 15: Cancer

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Sample Questions

Q1) A patient who is scheduled for a breast biopsy asks the nurse the difference between a benign tumor and a malignant tumor. Which answer by the nurse is correct?

A)"Benign tumors do not cause damage to other tissues."

B)"Benign tumors are likely to recur in the same location."

C)"Malignant tumors may spread to other tissues or organs."

D)"Malignant cells reproduce more rapidly than normal cells."

Q2) A patient with leukemia is considering whether to have hematopoietic stem cell transplantation (HSCT). The nurse will include which information in the patient's teaching plan?

A)Donor bone marrow is transplanted through a sternal or hip incision.

B)Hospitalization is required for several weeks after the stem cell transplant.

C)The transplant procedure takes place in a sterile operating room to minimize the risk for infection.

D)Transplant of the donated cells can be very painful because of the nerves in the tissue lining the bone.

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Chapter 16: Fluid, electrolyte, and Acid-Base Imbalances

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Sample Questions

Q1) A patient who had a transverse colectomy for diverticulosis 18 hours ago has nasogastric suction. The patient complains of anxiety and incisional pain. The patient's respiratory rate is 32 breaths/min,and the arterial blood gases (ABGs)indicate respiratory alkalosis. Which action should the nurse take first?

A)Check to make sure the nasogastric tube is patent.

B)Give the patient the PRN IV morphine sulfate 4 mg.

C)Notify the health care provider about the ABG results.

D)Teach the patient how to take slow, deep breaths when anxious.

Q2) A patient who is lethargic and exhibits deep,rapid respirations has the following arterial blood gas (ABG)results: pH 7.32,PaO₂ 88 mm Hg,PaCO₂ 37 mm Hg,and HCO₃ 16 mEq/L. How should the nurse interpret these results?

A)Metabolic acidosis

B)Metabolic alkalosis

C)Respiratory acidosis

D)Respiratory alkalosis

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18

Chapter 17: Preoperative Care

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Sample Questions

Q1) When caring for a preoperative patient on the day of surgery,which actions included in the plan of care can the nurse delegate to unlicensed assistive personnel (UAP)?

A)Teach incentive spirometer use.

B)Explain routine preoperative care.

C)Obtain and document baseline vital signs.

D)Remove nail polish and apply pulse oximeter.

E)Transport the patient by stretcher to the operating room.

Q2) A 38-yr-old woman is admitted for an elective surgical procedure. Which information obtained by the nurse during the preoperative assessment is most important to communicate to the anesthesiologist and surgeon before surgery?

A)The patient's lack of knowledge about postoperative pain control

B)The patient's history of an infection following a cholecystectomy

C)The patient's report that her last menstrual period was 8 weeks ago

D)The patient's concern about being able to resume lifting heavy items

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19

Chapter 18: Intraoperative Care

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Sample Questions

Q1) The operating room nurse is providing orientation to a student nurse. Which action would the nurse list as a major responsibility of a scrub nurse?

A)Document all patient care accurately.

B)Label all specimens to send to the laboratory.

C)Keep both hands above the operating table level.

D)Take the patient to the postanesthesia recovery area.

Q2) Which action describes how the scrub nurse protects the patient with aseptic technique during surgery?

A)Uses waterproof shoe covers

B)Wears personal protective equipment

C)Changes gloves after touching the upper arm of the surgeon's gown

D)Requires that all operating room (OR) staff perform a surgical scrub

Q3) Which actions will the nurse include in the surgical time-out procedure before surgery ?

A)Check for patency of IV lines.

B)Have the surgeon identify the patient.

C)Have the patient state name and date of birth.

D)Verify the patient identification band number.

E)Ask the patient to state the surgical procedure.

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Page 20

Chapter 19: Postoperative Care

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Sample Questions

Q1) A postoperative patient has not voided for 8 hours after return to the clinical unit. Which action should the nurse take first?

A)Perform a bladder scan.

B)Insert a straight catheter.

C)Encourage increased oral fluid intake.

D)Assist the patient to ambulate to the bathroom.

Q2) Which action by the nurse will be most helpful to a patient who is expected to ambulate,deep breathe,and cough on the first postoperative day?

A)Schedule the activity to begin after the patient has taken a nap.

B)Administer prescribed analgesic medications before the activities.

C)Ask the patient to state two possible complications of immobility.

D)Encourage the patient to state the purpose of splinting the incision.

Q3) A patient is transferred from the postanesthesia care unit (PACU)to the clinical unit. Which action by the nurse on the clinical unit should be performed first?

A)Assess the patient's pain.

B)Orient the patient to the unit.

C)Take the patient's vital signs.

D)Read the postoperative orders.

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21

Chapter 20: Assessment of Visual and Auditory Systems

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Sample Questions

Q1) A patient complains of dizziness when bending over and of nausea and dizziness associated with physical activities. The nurse will plan to teach the patient about A)tympanometry.

B)rotary chair testing.

C)pure-tone audiometry.

D)bone-conduction testing.

Q2) When the nurse is taking a health history of a new patient at the ear clinic,the patient states,"I have to sleep with the television on." Which follow-up question is appropriate to obtain more information about possible hearing problems?

A)"Do you grind your teeth at night?"

B)"What time do you usually fall asleep?"

C)"Have you noticed ringing in your ears?"

D)"Are you ever dizzy when you are lying down?"

Q3) Which equipment will the nurse obtain to perform a Rinne test?

A)Otoscope

B)Tuning fork

C)Audiometer

D)Ticking watch

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Chapter 21: Visual and Auditory Problems

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Q1) A patient with Ménière's disease is admitted with vertigo,nausea,and vomiting. Which nursing intervention will be included in the care plan?

A)Dim the lights in the patient's room.

B)Encourage increased oral fluid intake.

C)Change the patient's position every 2 hours.

D)Keep the head of the bed elevated 45 degrees.

Q2) A patient with glaucoma who has been using timolol (Timoptic)drops for several days tells the nurse that the eye drops cause eye burning and visual blurriness for a short time after administration. The best response to the patient's statement is

A)"Those symptoms may indicate a need for a change in dosage of the eye drops."

B)"The drops are uncomfortable, but it is important to use them to retain your vision."

C)"These are normal side effects of the drug, which should be less noticeable with time."

D)"Notify your health care provider so that different eye drops can be prescribed for you."

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23

Chapter 22: Assessment of Integumentary System

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Sample Questions

Q1) During assessment of the patient's skin,the nurse observes a similar pattern of discrete,small,raised lesions on the left and right upper back areas. Which term should the nurse use to document the distribution of these lesions?

A)Confluent

B)Symmetric

C)Zosteriform

D)Generalized

Q2) When performing a skin assessment,the nurse notes angiomas on the chest of an older patient. Which action should the nurse take next?

A)Suggest an appointment with a dermatologist.

B)Assess the patient for evidence of liver disease.

C)Teach the patient about skin changes with aging.

D)Discuss the use of sunscreen to prevent skin cancers.

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24

Chapter 23: Integumentary Problems

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Q1) The nurse notes the presence of white lesions that resemble milk curds in the back of a patient's throat. Which question by the nurse is appropriate at this time?

A)"Are you taking any medications?"

B)"Do you have a productive cough?"

C)"How often do you brush your teeth?"

D)"Have you had an oral herpes infection?"

Q2) A patient who has severe refractory psoriasis on the face,neck,and extremities is socially withdrawn because of the appearance of the lesions. Which action should the nurse take first?

A)Discuss the possibility of participating in an online support group.

B)Encourage the patient to volunteer to work on community projects.

C)Suggest that the patient use cosmetics to cover the psoriatic lesions.

D)Ask the patient to describe the impact of psoriasis on quality of life.

Q3) A patient in the dermatology clinic has a thin,scaly erythematous plaque on the right cheek. Which action should the nurse take?

A)Prepare the patient for a skin biopsy.

B)Teach the use of corticosteroid cream.

C)Explain how to apply tretinoin (Retin-A) to the face.

D)Discuss the need for topical application of antibiotics.

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Page 25

Chapter 24: Burns

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Q1) A patient with circumferential burns of both legs develops a decrease in dorsalis pedis pulse strength and numbness in the toes. Which action should the nurse take first?

A)Monitor the pulses every hour.

B)Notify the health care provider.

C)Elevate both legs above heart level with pillows.

D)Encourage the patient to flex and extend the toes.

Q2) A nurse is caring for a patient who has burns of the ears,head,neck,and right arm and hand. The nurse should place the patient in which position?

A)Place the right arm and hand flexed in a position of comfort.

B)Elevate the right arm and hand on pillows and extend the fingers.

C)Assist the patient to a supine position with a small pillow under the head.

D)Position the patient in a side-lying position with rolled towel under the neck.

Q3) An 80-kg patient with burns over 30% of total body surface area (TBSA)is admitted to the burn unit. Using the Parkland formula of 4 mL/kg/%TBSA,what is the IV infusion rate (mL/hour)for lactated Ringer's solution that the nurse will give during the first 8 hours?

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Chapter 25: Assessment of Respiratory System

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Sample Questions

Q1) A patient in metabolic alkalosis is admitted to the emergency department and pulse oximetry (SpO₂)indicates that the O₂ saturation is 94%. Which action should the nurse expect to take next?

A)Complete a head-to-toe assessment.

B)Administer an inhaled bronchodilator.

C)Place the patient on high-flow oxygen.

D)Obtain repeat arterial blood gases (ABGs).

Q2) A patient is scheduled for a computed tomography (CT)scan of the chest with contrast media. Which assessment findings should the nurse report to the health care provider before the patient goes for the CT ?

A)Allergy to shellfish

B)Patient reports claustrophobia

C)Elevated serum creatinine level

D)Recent bronchodilator inhaler use

E)Inability to remove a wedding band

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Chapter 26: Upper Respiratory Problems

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Sample Questions

Q1) A patient arrives in the ear,nose,and throat clinic complaining of a piece of tissue being "stuck up my nose" and with foul-smelling nasal drainage from the right nare. Which action should the nurse take first?

A)Notify the clinic health care provider.

B)Obtain aerobic culture specimens of the drainage.

C)Ask the patient about how the cotton got into the nose.

D)Have the patient occlude the left nare and blow the nose.

Q2) After a laryngectomy,a patient coughs violently during suctioning and dislodges the tracheostomy tube. Which action should the nurse take first?

A)Arrange for arterial blood gases to be drawn immediately.

B)Cover stoma with sterile gauze and ventilate through stoma.

C)Attempt to reinsert the tracheostomy tube with the obturator in place.

D)Assess the patient's oxygen saturation and notify the health care provider.

Q3) Which action should the nurse take first when a patient develops epistaxis?

A)Pack the affected nare tightly with an epistaxis balloon.

B)Apply squeezing pressure to the nostrils for 10 minutes.

C)Obtain silver nitrate that may be needed for cauterization.

D)Instill a vasoconstrictor medication into the affected nare.

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Chapter 27: Lower Respiratory Problems

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51 Verified Questions

51 Flashcards

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Sample Questions

Q1) A patient is admitted to the emergency department with an open stab wound to the left chest. What action should the nurse take?

A)Keep the head of the patient's bed positioned flat.

B)Cover the wound tightly with an occlusive dressing.

C)Position the patient so that the left chest is dependent.

D)Tape a nonporous dressing on three sides over the wound.

Q2) The health care provider writes an order for bacteriologic testing for a patient who has a positive tuberculosis skin test. Which action should the nurse take?

A)Teach about the reason for the blood tests.

B)Schedule an appointment for a chest x-ray.

C)Teach the patient about providing specimens for 3 consecutive days.

D)Instruct the patient to collect several separate sputum specimens today.

Q3) A patient with newly diagnosed lung cancer tells the nurse,"I don't think I'm going to live to see my next birthday." Which is the best initial response by the nurse?

A)"Are you ready to talk with your family members about dying now?"

B)"Would you like to talk to the hospital chaplain about your feelings?"

C)"Can you tell me what it is that makes you think you will die so soon?"

D)"Do you think that taking an antidepressant medication would be helpful?"

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29

Chapter 28: Obstructive Pulmonary Diseases

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44 Verified Questions

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Sample Questions

Q1) The nurse interviews a patient with a new diagnosis of chronic obstructive pulmonary disease (COPD). Which information is most specific in confirming a diagnosis of chronic bronchitis?

A)The patient tells the nurse about a family history of bronchitis.

B)The patient indicates a 30 pack-year cigarette smoking history.

C)The patient reports a productive cough for 3 months every winter.

D)The patient denies having respiratory problems until the past 12 months.

Q2) The nurse completes an admission assessment on a patient with asthma. Which information given by patient is indicates a need for a change in therapy?

A)The patient uses albuterol (Ventolin HFA) before aerobic exercise.

B)The patient says that the asthma symptoms are worse every spring.

C)The patient's heart rate increases after using the albuterol (Ventolin HFA) inhaler.

D)The patient's only medications are albuterol (Ventolin HFAl) and salmeterol (Serevent).

Q3) A patient with asthma has a personal best peak expiratory flow rate (PEFR)of 400 L/min. When explaining the asthma action plan,the nurse will teach the patient that a change in therapy is needed when the PEFR is less than ___ L/minute

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Chapter 29: Assessment of Hematologic System

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Sample Questions

Q1) The nurse is caring for a patient who is being discharged after an emergency splenectomy following a motor vehicle crash. Which instructions should the nurse include in the discharge teaching?

A)Check often for swollen lymph nodes.

B)Watch for excess bleeding or bruising.

C)Take iron supplements to prevent anemia.

D)Wash hands and avoid persons who are ill.

Q2) The nurse notes pallor of the skin and nail beds in a newly admitted patient. The nurse should ensure that which laboratory test has been ordered?

A)Platelet count

B)Neutrophil count

C)Hemoglobin level

D)White blood cell count

Q3) The nurse assesses a patient who has numerous petechiae on both arms. Which question should the nurse ask the patient?

A)"Are you taking any oral contraceptives?"

B)"Have you been prescribed antiseizure drugs?"

C)"Do you take medication containing salicylates?"

D)"How long have you taken antihypertensive drugs?"

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Page 31

Chapter 30: Hematologic Problems

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Sample Questions

Q1) Which action will the nurse include in the plan of care for a patient who has thalassemia major?

A)Teach the patient to use iron supplements.

B)Avoid the use of intramuscular injections.

C)Administer iron chelation therapy as needed.

D)Notify health care provider of hemoglobin 11 g/dL.

Q2) Which action will the nurse include in the plan of care for a patient admitted with multiple myeloma?

A)Monitor fluid intake and output.

B)Administer calcium supplements.

C)Assess lymph nodes for enlargement.

D)Limit weight bearing and ambulation.

Q3) Which patient requires the most rapid assessment and care by the emergency department nurse?

A)The patient with hemochromatosis who reports abdominal pain

B)The patient with neutropenia who has a temperature of 101.8° F

C)The patient with thrombocytopenia who has oozing gums after a tooth extraction

D)The patient with sickle cell anemia who has had nausea and diarrhea for 24 hours

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Chapter 31: Assessment of Cardiovascular System

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Sample Questions

Q1) When auscultating over the patient's abdominal aorta,the nurse hears a loud humming sound. The nurse documents this finding as a A)thrill.

B)bruit.

C)murmur.

D)normal finding.

Q2) When assessing a newly admitted patient,the nurse notes a murmur along the left sternal border. To acquire more information about the murmur,which action will the nurse take?

A)Palpate the peripheral pulses.

B)Determine the timing of the sound.

C)Find the point of maximal impulse.

D)Compare apical and radial pulse rates.

Q3) To determine the effects of therapy for a patient who is being treated for heart failure,which laboratory test result will the nurse plan to review?

A)Troponin

B)Homocysteine (Hcy)

C)Low-density lipoprotein (LDL)

D)B-type natriuretic peptide (BNP)

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Page 33

Chapter 32: Hypertension

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Sample Questions

Q1) After the nurse teaches the patient with stage 1 hypertension about diet modifications that should be implemented,which diet choice indicates that the teaching has been most effective?

A)The patient avoids eating nuts or nut butters.

B)The patient restricts intake of chicken and fish.

C)The patient drinks low-fat milk with each meal.

D)The patient has two cups of coffee in the morning.

Q2) The nurse is reviewing the laboratory test results for a patient who has recently been diagnosed with hypertension. Which result is most important to communicate to the health care provider?

A)Serum creatinine of 2.8 mg/dL

B)Serum potassium of 4.5 mEq/L

C)Serum hemoglobin of 14.7 g/dL

D)Blood glucose level of 96 mg/dL

Q3) The nurse obtains a blood pressure of 176/82 mm Hg for a patient. What is the patient's mean arterial pressure (MAP)?

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Chapter 33: Coronary Artery Disease and Acute Coronary Syndrome

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Sample Questions

Q1) Which nursing intervention is likely to be most effective when assisting the patient with coronary artery disease to make appropriate dietary changes?

A)Inform the patient about a diet containing no saturated fat and minimal salt.

B)Help the patient modify favorite high-fat recipes by using monounsaturated oils.

C)Emphasize the increased risk for heart problems unless the patient makes the dietary changes.

D)Give the patient a list of low-sodium, low-cholesterol foods that should be included in the diet.

Q2) A patient admitted to the coronary care unit (CCU)with an ST-segment-elevation myocardial infarction (STEMI)is restless and anxious. The blood pressure is 86/40 mm Hg,and heart rate is 132 beats/min. Based on this information,which nursing diagnosis is a priority for the patient?

A)Acute pain related to myocardial infarction

B)Anxiety related to perceived threat of death

C)Stress overload related to acute change in health

D)Decreased cardiac output related to cardiogenic shock

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Chapter 34: Heart Failure

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Sample Questions

Q1) After receiving change-of-shift report on a heart failure unit,which patient should the nurse assess first?

A)Patient who is taking carvedilol (Coreg) and has a heart rate of 58

B)Patient who is taking digoxin and has a potassium level of 3.1 mEq/L

C)Patient who is taking captopril and has a frequent nonproductive cough

D)Patient who is taking isosorbide dinitrate/hydralazine (BiDil) and has a headache

Q2) Which topic will the nurse plan to include in discharge teaching for a patient with heart failure with reduced ejection fraction (HFrEF)?

A)Need to begin an aerobic exercise program several times weekly

B)Use of salt substitutes to replace table salt when cooking and at the table

C)Importance of making an annual appointment with the health care provider

D)Benefits and side effects of angiotensin-converting enzyme (ACE) inhibitors

Q3) When teaching the patient with newly diagnosed heart failure about a 2000-mg sodium diet,the nurse explains that foods to be restricted include

A)canned and frozen fruits.

B)yogurt and milk products.

C)fresh or frozen vegetables.

D)eggs and other high-protein foods.

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Chapter 35: Dysrhythmias

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Sample Questions

Q1) The nurse has received change-of-shift report about the following patients on the progressive care unit. Which patient should the nurse see first?

A)A patient with atrial fibrillation, rate 88 and irregular, who has a dose of warfarin (Coumadin) due

B)A patient with second-degree atrioventricular (AV) block, type 1, rate 60, who is dizzy when ambulating

C)A patient who is in a sinus rhythm, rate 98 and regular, recovering from an elective cardioversion 2 hours ago

D)A patient whose implantable cardioverter-defibrillator (ICD) fired twice today and has a dose of amiodarone (Cordarone) due

Q2) A patient who is on the telemetry unit develops atrial flutter,rate 150,with associated dyspnea and chest pain. Which action that is included in the hospital dysrhythmia protocol should the nurse do first?

A)Obtain a 12-lead electrocardiogram (ECG).

B)Notify the health care provider of the change in rhythm.

C)Give supplemental O2 at 2 to 3 L/min via nasal cannula.

D)Assess the patient's vital signs including O2 saturation.

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Chapter 36: Inflammatory and Structural Heart Disorders

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Sample Questions

Q1) The nurse has identified a nursing diagnosis of acute pain related to inflammatory process for a patient with acute pericarditis. An appropriate intervention by the nurse for this problem is to

A)teach the patient to take deep, slow breaths to control the pain.

B)force fluids to 3000 mL/day to decrease fever and inflammation.

C)provide a fresh ice bag every hour for the patient to place on the chest.

D)place the patient in Fowler's position, leaning forward on the overbed table.

Q2) Which action could the nurse delegate to unlicensed assistive personnel (UAP)trained as electrocardiogram (ECG)technicians working on the cardiac unit?

A)Select the best lead for monitoring a patient with an admission diagnosis of Dressler syndrome.

B)Obtain a list of herbal medications used at home while admitting a new patient with pericarditis.

C)Teach about the need to monitor the weight daily for a patient who has hypertrophic cardiomyopathy.

D)Watch the heart monitor for changes in rhythm while a patient who had a valve replacement ambulates.

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Chapter 37: Vascular Disorders

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Sample Questions

Q1) An older patient with a history of an abdominal aortic aneurysm arrives at the emergency department (ED)with severe back pain and absent pedal pulses. Which action should the nurse take first?

A)Check the blood pressure.

B)Draw blood for laboratory testing.

C)Assess for the presence of an abdominal bruit.

D)Determine any family history of heart disease.

Q2) The nurse is caring for a patient with a descending aortic dissection. Which assessment finding is most important to report to the health care provider?

A)Weak pedal pulses

B)Absent bowel sounds

C)Blood pressure of 138/88 mm Hg

D)25 mL of urine output over the past hour

Q3) When assessing a patient with possible peripheral artery disease (PAD),the nurse obtains a brachial blood pressure (BP)of 147/82 mm Hg and an ankle pressure of 112/74 mm Hg. The nurse calculates the patient's ankle-brachial index (ABI)as ________ (round up to the nearest hundredth).

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Page 39

Chapter 38: Assessment of Gastrointestinal System

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Sample Questions

Q1) The nurse receives the following information about a 51-yr-old female patient who is scheduled for a colonoscopy. Which information should be communicated to the health care provider before sending the patient for the procedure?

A)The patient has a permanent pacemaker to prevent bradycardia.

B)The patient is worried about discomfort during the examination.

C)The patient has had an allergic reaction to both shellfish and iodine in the past.

D)The patient declined to drink the prescribed polyethylene glycol (GoLYTELY).

Q2) A 30-yr-old male patient with a body mass index (BMI)of 22 kg/m² is being admitted to the hospital for elective knee surgery. Which assessment finding is important to report to the health care provider?

A)Tympany on percussion of the abdomen

B)Liver edge 3 cm below the costal margin

C)Bowel sounds of 20/minute in each quadrant

D)Aortic pulsations visible in the epigastric area

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Chapter 39: Nutritional Problems

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Sample Questions

Q1) After change-of-shift report,which patient will the nurse assess first?

A)A 40-yr-old woman whose parenteral nutrition infusion bag has 30 minutes of solution left

B)A 40-yr-old man with continuous enteral feedings who has developed pulmonary crackles

C)A 30-yr-old man with 4+ generalized pitting edema and severe protein-calorie malnutrition

D)A 30-yr-old woman whose gastrostomy tube is plugged after crushed medications were administered

Q2) When caring for a patient with a soft,silicone nasogastric tube in place for enteral feedings,the nurse will

A)avoid giving medications through the feeding tube.

B)flush the tubing after checking for residual volumes.

C)replace the tube every 3 days to avoid mucosal damage.

D)administer continuous feedings using an infusion pump.

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Chapter 40: Obesity

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Sample Questions

Q1) Which finding for a patient who has been taking orlistat (Xenical)is most important to report to the health care provider?

A)The patient frequently has liquid stools.

B)The patient is pale and has many bruises.

C)The patient complains of bloating after meals.

D)The patient is experiencing a weight loss plateau.

Q2) A 40-yr-old obese woman reports that she wants to lose weight. Which question should the nurse ask first?

A)"What factors led to your obesity?"

B)"Which types of food do you like best?"

C)"How long have you been overweight?"

D)"What kind of activities do you enjoy?"

Q3) After the nurse teaches a patient about the recommended amounts of foods from animal and plant sources,which menu selections indicate that the initial instructions about diet have been understood?

A)3 oz of lean beef, 2 oz of low-fat cheese, and a sliced tomato

B)3 oz of roasted pork, a cup of corn, and a cup of carrot sticks

C)Cup of tossed salad and nonfat dressing topped with a chicken breast

D)Half cup of tuna mixed with nonfat mayonnaise and a half cup of celery

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Page 42

Chapter 41: Upper Gastrointestinal Problems

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Sample Questions

Q1) A patient who has gastroesophageal reflux disease (GERD)is experiencing increasing discomfort. Which patient statement to the nurse indicates that additional teaching about GERD is needed?

A)"I take antacids between meals and at bedtime each night."

B)"I sleep with the head of the bed elevated on 4-inch blocks."

C)"I eat small meals during the day and have a bedtime snack."

D)"I quit smoking several years ago, but I still chew a lot of gum."

Q2) The nurse and a licensed practical/vocational nurse (LPN/LVN)are working together to care for a patient who had an esophagectomy 2 days ago. Which action by the LPN/LVN requires that the nurse intervene?

A)The LPN/LVN uses soft swabs to provide oral care.

B)The LPN/LVN positions the head of the bed in the flat position.

C)The LPN/LVN includes the enteral feeding volume when calculating intake.

D)The LPN/LVN encourages the patient to use pain medications before coughing.

Q3) When a patient is diagnosed with achalasia,the nurse will teach the patient that A)lying down after meals is recommended.

B)a liquid or blenderized diet will be necessary.

C)drinking fluids with meals should be avoided.

D)treatment may include endoscopic procedures.

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Page 43

Chapter 42: Lower Gastrointestinal Problems

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Sample Questions

Q1) A patient preparing to undergo a colon resection for cancer of the colon asks about the elevated carcinoembryonic antigen (CEA)test result. The nurse explains that the test is used to

A)identify any metastasis of the cancer.

B)monitor the tumor status after surgery.

C)confirm the diagnosis of a specific type of cancer.

D)determine the need for postoperative chemotherapy.

Q2) After a patient has had a hemorrhoidectomy at an outpatient surgical center,which instructions will the nurse include in discharge teaching?

A)Maintain a low-residue diet until the surgical area is healed.

B)Use ice packs on the perianal area to relieve pain and swelling.

C)Take prescribed pain medications before you expect a bowel movement.

D)Delay having a bowel movement for several days until you are well healed.

Q3) Which patient statement indicates that the nurse's teaching about sulfasalazine (Azulfidine)for ulcerative colitis has been effective?

A)"The medication will be tapered if I need surgery."

B)"I will need to use a sunscreen when I am outdoors."

C)"I will need to avoid contact with people who are sick."

D)"The medication prevents the infections that cause diarrhea."

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Page 44

Chapter 43: Liver, pancreas, and Biliary Tract Problems

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Sample Questions

Q1) During change-of-shift report,the nurse learns about the following four patients. Which patient requires assessment first?

A)A 40-yr-old patient with chronic pancreatitis who has gnawing abdominal pain

B)A 58-yr-old patient who has compensated cirrhosis and is complaining of anorexia

C)A 55-yr-old patient with cirrhosis and ascites who has an oral temperature of 102° F (38.8° C)

D)A 36-yr-old patient recovering from a laparoscopic cholecystectomy who has severe shoulder pain

Q2) A patient with cirrhosis has ascites and 4+ edema of the feet and legs. Which nursing action will be included in the plan of care?

A)Restrict daily dietary protein intake.

B)Reposition the patient every 4 hours.

C)Perform passive range of motion twice daily.

D)Place the patient on a pressure-relief mattress.

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Chapter 44: Assessment of Urinary System

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Sample Questions

Q1) When a patient's urine dipstick test indicates a small amount of protein,the nurse's next action should be to

A)send a urine specimen to the laboratory to test for ketones.

B)obtain a clean-catch urine for culture and sensitivity testing.

C)inquire about which medications the patient is currently taking.

D)ask the patient about any family history of chronic renal failure.

Q2) Which nursing action is essential for a patient immediately after a renal biopsy?

A)Insert a urinary catheter and test urine for microscopic hematuria.

B)Apply a pressure dressing and keep the patient on the affected side.

C)Check blood glucose to assess for hyperglycemia or hypoglycemia.

D)Monitor blood urea nitrogen (BUN) and creatinine to assess renal function.

Q3) The nurse completing a physical assessment for a newly admitted patient is unable to feel either kidney on palpation. Which action should the nurse take?

A)Obtain a urine specimen to check for hematuria.

B)Document the information on the assessment form.

C)Ask the patient about any history of recent sore throat.

D)Ask the health care provider about scheduling a renal ultrasound.

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Chapter 45: Renal and Urologic Problems

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Sample Questions

Q1) When preparing a female patient with bladder cancer for intravesical chemotherapy,the nurse will teach about

A)premedicating to prevent nausea.

B)obtaining wigs and scarves to wear.

C)emptying the bladder before the medication.

D)maintaining oral care during the treatments.

Q2) When planning teaching for a patient with benign nephrosclerosis,the nurse should include instructions regarding

A)preventing bleeding with anticoagulants.

B)monitoring and recording blood pressure.

C)obtaining and documenting daily weights.

D)measuring daily intake and output volumes.

Q3) A patient who had surgery for creation of an ileal conduit 3 days ago will not look at the stoma and requests that only the ostomy nurse specialist does the stoma care. The nurse identifies a nursing diagnosis of

A)anxiety related to effects of procedure on lifestyle.

B)disturbed body image related to change in function.

C)readiness for enhanced coping related to need for information.

D)self-care deficit (toileting) related to denial of altered body function.

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Page 47

Chapter 46: Acute Kidney Injury and Chronic Kidney Disease

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Sample Questions

Q1) The nurse is titrating the IV fluid infusion rate immediately after a patient has had kidney transplantation. Which parameter will be most important for the nurse to consider?

A)Heart rate

B)Urine output

C)Creatinine clearance

D)Blood urea nitrogen (BUN) level

Q2) A 74-yr-old patient who is progressing to stage 5 chronic kidney disease asks the nurse,"Do you think I should go on dialysis? Which initial response by the nurse is best?

A)"It depends on which type of dialysis you are considering."

B)"Tell me more about what you are thinking regarding dialysis."

C)"You are the only one who can make the decision about dialysis."

D)"Many people your age use dialysis and have a good quality of life."

Q3) Which menu choice by the patient who is receiving hemodialysis indicates that the nurse's teaching has been successful?

A)Split-pea soup, English muffin, and nonfat milk

B)Oatmeal with cream, half a banana, and herbal tea

C)Poached eggs, whole-wheat toast, and apple juice

D)Cheese sandwich, tomato soup, and cranberry juice

Page 48

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Chapter 47: Assessment of Endocrine System

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Sample Questions

Q1) A patient has been newly diagnosed with type 2 diabetes mellitus. Which information about the patient will be most useful to the nurse who is helping the patient develop strategies for successful adaptation to this disease?

A)Ideal weight

B)Value system

C)Activity level

D)Visual changes

Q2) A patient is admitted with tetany. Which laboratory value should the nurse plan to monitor?

A)Total protein

B)Blood glucose

C)Ionized calcium

D)Serum phosphate

Q3) The nurse reviews a patient's glycosylated hemoglobin (A1C)results to evaluate

A)fasting preprandial glucose levels.

B)glucose levels 2 hours after a meal.

C)glucose control over the past 90 days.

D)hypoglycemic episodes in the past 3 months.

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Chapter 48: Diabetes Mellitus

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Sample Questions

Q1) After change-of-shift report,which patient will the nurse assess first?

A)A 19-yr-old patient with type 1 diabetes who was admitted with possible dawn phenomenon

B)A 35-yr-old patient with type 1 diabetes whose most recent blood glucose reading was 230 mg/dL

C)A 60-yr-old patient with hyperosmolar hyperglycemic syndrome who has poor skin turgor and dry oral mucosa

D)A 68-yr-old patient with type 2 diabetes who has severe peripheral neuropathy and complains of burning foot pain

Q2) The nurse has been teaching a patient with type 2 diabetes about managing blood glucose levels and taking glipizide (Glucotrol). Which patient statement indicates a need for additional teaching?

A)"If I overeat at a meal, I will still take the usual dose of medication."

B)"Other medications besides the Glucotrol may affect my blood sugar."

C)"When I am ill, I may have to take insulin to control my blood sugar."

D)"My diabetes won't cause complications because I don't need insulin."

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Page 50

Chapter 49: Endocrine Problems

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Sample Questions

Q1) Which information obtained by the nurse in the endocrine clinic about a patient who has been taking prednisone 40 mg daily for 3 weeks is most important to report to the health care provider?

A)Patient's blood pressure is 148/94 mm Hg.

B)Patient has bilateral 2+ pitting ankle edema.

C)Patient stopped taking the medication 2 days ago.

D)Patient has not been taking the prescribed vitamin D.

Q2) A patient develops carpopedal spasms and tingling of the lips following a parathyroidectomy. Which action will provide the patient with rapid relief from the symptoms?

A)Administer the prescribed muscle relaxant.

B)Have the patient rebreathe from a paper bag.

C)Start the PRN O₂ at 2 L/min per cannula.

D)Stretch the muscles with passive range of motion.

Q3) The nurse will plan to monitor a patient diagnosed with a pheochromocytoma for A)flushing.

B)headache.

C)bradycardia.

D)hypoglycemia.

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Page 51

Chapter 50: Assessment of Reproductive System

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Sample Questions

Q1) The nurse explains to a patient being prepared for colposcopy with a cervical biopsy that the procedure

A)involves dilation of the cervix and biopsy of the tissue lining the uterus.

B)will take place in a same-day surgery center so that local anesthesia can be used.

C)requires that the patient have nothing to eat or drink for 6 hours before the procedure.

D)is similar to a speculum examination of the cervix and should result in little discomfort.

Q2) Which question should the nurse ask when assessing a 60-yr-old patient who has a history of benign prostatic hyperplasia (BPH)?

A)"Have you noticed any unusual discharge from your penis?"

B)"Has there been any change in your sex life in the past year?"

C)"Has there been a decrease in the force of your urinary stream?"

D)"Have you been experiencing any difficulty in achieving an erection?"

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Chapter 51: Breast Disorders

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Sample Questions

Q1) The outpatient clinic receives telephone calls from four patients. Which patient should the nurse call back first?

A)A 57-yr-old patient with ductal ectasia who has sticky multicolored nipple discharge and severe nipple itching

B)A 21-yr-old patient with a family history of breast cancer who wants to discuss genetic testing for the BRCA gene

C)A 40-yr-old patient who still has left side chest and arm pain 2 months after a left modified radical mastectomy

D)A 50-yr-old patient with stage 2 breast cancer who is receiving doxorubicin and has ankle swelling and fatigue

Q2) During a well-woman physical examination,a 43-yr-old patient asks about her risk for breast cancer. Which question is most pertinent for the nurse to ask?

A)"Do you currently smoke tobacco?"

B)"Have you ever had a breast injury?"

C)"At what age did you start having menstrual periods?"

D)"Is there a family history of fibrocystic breast changes?"

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Chapter 52: Sexually Transmitted Infections

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Sample Questions

Q1) A patient is diagnosed with primary syphilis during her eighth week of pregnancy. The nurse will plan to teach the patient about the A)likelihood of a stillbirth.

B)plans for cesarean section

C)intramuscular injection of penicillin.

D)antibiotic eye drops for the newborn.

Q2) A 29-yr-old female patient is diagnosed with Chlamydia during a routine pelvic examination. The nurse knows that teaching regarding the management of the condition has been effective when the patient says which of the following?

A)"My partner will need to take antibiotics at the same time I do."

B)"Go ahead and give me the antibiotic injection, so I will be cured."

C)"I will use condoms during sex until I finish taking all the antibiotics."

D)"I do not plan on having children, so treating the infection is not important."

Q3) Which patient will the nurse plan on teaching about the Gardasil vaccine?

A)A 24-yr-old female patient who has not been sexually active

B)A 34-yr-old female patient who has multiple sexual partners

C)A 24-yr-old female patient who is pregnant for the first time

D)A 34-yr-old female patient who is in a monogamous relationship

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54

Chapter 53: Female Reproductive and Genital Problems

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49 Flashcards

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Sample Questions

Q1) A 34-yr-old patient who is discussing contraceptive options with the nurse says,"I want to have children but not for a few years." Which response by the nurse is accurate?

A)"If you do not become pregnant within the next few years, you never will."

B)"Women often have more difficulty becoming pregnant after about age 35."

C)"Stop taking oral contraceptives several years before you want to have a child."

D)"You have many more years of fertility left, so there is no rush to have children."

Q2) A 28-yr-old patient reports anxiety,headaches with dizziness,and abdominal bloating occurring before her menstrual periods. Which action is best for the nurse to take at this time?

A)Ask the patient to keep track of her symptoms in a diary for 3 months.

B)Suggest that the patient try aerobic exercise to decrease her symptoms.

C)Teach the patient about appropriate lifestyle changes to reduce premenstrual syndrome (PMS) symptoms.

D)Advise the patient to use nonsteroidal antiinflammatory drugs (NSAIDs) such as ibuprofen to control symptoms.

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Chapter 54: Male Reproductive and Genital Problems

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35 Verified Questions

35 Flashcards

Source URL: https://quizplus.com/quiz/25389

Sample Questions

Q1) The nurse will plan to teach the patient scheduled for photovaporization of the prostate (PVP)

A)that urine will appear bloody for several days.

B)how to care for an indwelling urinary catheter.

C)that symptom improvement takes 2 to 3 weeks.

D)about complications associated with urethral stenting.

Q2) The health care provider prescribes finasteride (Proscar)for a patient who has benign prostatic hyperplasia (BPH). When teaching the patient about the drug,the nurse informs him that

A)he should change position from lying to standing slowly to avoid dizziness.

B)his interest in sexual activity may decrease while he is taking the medication.

C)improvement in the obstructive symptoms should occur within about 2 weeks.

D)he will need to monitor his blood pressure frequently to assess for hypertension.

Q3) Which information will the nurse teach a patient who has chronic prostatitis?

A)Ibuprofen (Motrin) should provide good pain control.

B)Prescribed antibiotics should be taken for 7 to 10 days.

C)Intercourse or masturbation will help relieve symptoms.

D)Cold packs used every 4 hours will decrease inflammation.

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Chapter 55: Assessment of Nervous System

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Sample Questions

Q1) Which equipment will the nurse obtain to assess vibration sense in a patient with diabetes who has peripheral nerve dysfunction?

A)Sharp pin

B)Tuning fork

C)Reflex hammer

D)Calibrated compass

Q2) Which action will the nurse include in the plan of care for a patient with impaired functioning of the left glossopharyngeal nerve (CN IX)and vagus nerve (CN X)?

A)Assist to stand and ambulate.

B)Withhold oral fluids and food.

C)Insert an oropharyngeal airway.

D)Apply artificial tears every hour.

Q3) Which cerebrospinal fluid analysis result should the nurse recognize as abnormal and communicate to the health care provider?

A)Specific gravity of 1.007

B)Protein of 65 mg/dL (0.65 g/L)

C)Glucose of 45 mg/dL (1.7 mmol/L)

D)White blood cell (WBC) count of 4 cells/mL

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Chapter 56: Acute Intracranial Problems

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Sample Questions

Q1) A patient with increased intracranial pressure after a head injury has a ventriculostomy in place. Which action can the nurse delegate to unlicensed assistive personnel (UAP)who regularly work in the intensive care unit?

A)Document intracranial pressure every hour.

B)Turn and reposition the patient every 2 hours.

C)Check capillary blood glucose level every 6 hours.

D)Monitor cerebrospinal fluid color and volume hourly.

Q2) Which action will the public health nurse take to reduce the incidence of epidemic encephalitis in a community?

A)Teach about prophylactic antibiotics after exposure to encephalitis.

B)Encourage the use of effective insect repellent during mosquito season.

C)Remind patients that most cases of viral encephalitis can be cared for at home.

D)Arrange to screen school-age children for West Nile virus during the school year.

Q3) An unconscious patient with a traumatic head injury has a blood pressure of 130/76 mm Hg and an intracranial pressure (ICP)of 20 mm Hg. The nurse will calculate the cerebral perfusion pressure (CPP)as ____ mm Hg.

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Chapter 57: Stroke

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Sample Questions

Q1) A patient arrives in the emergency department with hemiparesis and dysarthria that started 2 hours previously,and health records show a history of several transient ischemic attacks (TIAs). The nurse anticipates preparing the patient for A)surgical endarterectomy.

B)transluminal angioplasty.

C)intravenous heparin drip administration.

D)tissue plasminogen activator (tPA) infusion.

Q2) When caring for a patient with a new right-sided homonymous hemianopsia resulting from a stroke,which intervention should the nurse include in the plan of care?

A)Apply an eye patch to the right eye.

B)Approach the patient from the right side.

C)Place needed objects on the patient's left side.

D)Teach the patient that the left visual deficit will resolve.

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Chapter 58: Chronic Neurologic Problems

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Sample Questions

Q1) After a thymectomy,a patient with myasthenia gravis receives the usual dose of pyridostigmine (Mestinon). An hour later,the patient complains of nausea and severe abdominal cramps. Which action should the nurse take first?

A)Auscultate the patient's bowel sounds.

B)Notify the patient's health care provider.

C)Administer the prescribed PRN antiemetic drug.

D)Give the scheduled dose of prednisone (Deltasone).

Q2) The home health registered nurse (RN)is planning care for a patient with a seizure disorder related to a recent head injury. Which nursing action can be delegated to a licensed practical/vocational nurse (LPN/LVN)?

A)Make referrals to appropriate community agencies.

B)Place medications in the home medication organizer.

C)Teach the patient and family how to manage seizures.

D)Assess for use of medications that may precipitate seizures.

Q3) A patient who is having an acute exacerbation of multiple sclerosis has a prescription for methylprednisolone (Solu-Medrol)150 mg IV. The label on the vial reads: methylprednisolone 125 mg in 2 mL. How many mL will the nurse administer?

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Chapter 59: Dementia and Delirium

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Sample Questions

Q1) A patient who is hospitalized with pneumonia is disoriented and confused 3 days after admission. Which information indicates that the patient is experiencing delirium rather than dementia?

A)The patient was oriented and alert when admitted.

B)The patient's speech is fragmented and incoherent.

C)The patient is oriented to person but disoriented to place and time.

D)The patient has a history of increasing confusion over several years.

Q2) The spouse of a 67-yr-old male patient with early stage Alzheimer's disease (AD)tells the nurse,"I am exhausted from worrying all the time. I don't know what to do."

Which actions are best for the nurse to take next ?

A)Suggest that a long-term care facility be considered.

B)Offer ideas for ways to distract or redirect the patient.

C)Teach the spouse about adult day care as a possible respite.

D)Suggest that the spouse consult with the physician for antianxiety drugs.

E)Ask the spouse what she knows and has considered about dementia care options.

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Chapter 60: Spinal Cord and Peripheral Nerve Problems

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Sample Questions

Q1) A patient with a T4 spinal cord injury asks the nurse if he will be able to be sexually active. Which initial response by the nurse is best?

A)Reflex erections frequently occur, but orgasm may not be possible.

B)Sildenafil (Viagra) is used by many patients with spinal cord injury.

C)Multiple options are available to maintain sexuality after spinal cord injury.

D)Penile injection, prostheses, or vacuum suction devices are possible options.

Q2) Which action will the nurse include in the plan of care for a patient who has a cauda equina spinal cord injury?

A)Catheterize patient every 3 to 4 hours.

B)Assist patient to ambulate 4 times daily.

C)Administer medications to reduce bladder spasm.

D)Stabilize the neck when repositioning the patient.

Q3) The nurse assessing a patient with newly diagnosed trigeminal neuralgia will ask the patient about

A)visual problems caused by ptosis.

B)triggers leading to facial discomfort.

C)poor appetite caused by loss of taste.

D)weakness on the affected side of the face.

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62

Chapter 61: Assessment of Musculoskeletal System

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Sample Questions

Q1) The nurse finds that a patient can flex the arms when no resistance is applied but is unable to flex when the nurse applies light resistance. The nurse should document the patient's muscle strength as level

A)0.

B)1.

C)2.

D)3.

Q2) Which finding from analysis of fluid from a patient's right knee arthrocentesis will be of concern to the nurse?

A)Cloudy fluid

B)Scant thin fluid

C)Pale yellow fluid

D)Straw-colored fluid

Q3) A patient with left knee pain is diagnosed with bursitis. The nurse will explain that bursitis is an inflammation of

A)a fluid-filled sac found at some joints.

B)a synovial membrane that lines the joint.

C)the connective tissue joining bones within a joint.

D)the fibrocartilage that acts as a shock absorber in the knee.

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Page 63

Chapter 62: Musculoskeletal Trauma and Orthopedic Surgery

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Sample Questions

Q1) A patient with a right lower leg fracture will be discharged home with an external fixation device in place. Which information will the nurse teach?

A)"Check and clean the pin insertion sites daily."

B)"Remove the external fixator for your shower."

C)"Remain on bed rest until bone healing is complete."

D)"Take prophylactic antibiotics until the fixator is removed."

Q2) Which action will the urgent care nurse take for a patient with a possible knee meniscus injury?

A)Encourage bed rest for 24 to 48 hours.

B)Apply an immobilizer to the affected leg.

C)Avoid palpation or movement of the knee.

D)Administer intravenous opioids for pain management.

Q3) When caring for a patient who is using Buck's traction after a hip fracture,which action can the nurse delegate to unlicensed assistive personnel (UAP)?

A)Remove and reapply traction periodically.

B)Ensure the weight for the traction is hanging freely.

C)Monitor the skin under the traction boot for redness.

D)Check for intact sensation and movement in the affected leg.

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Chapter 63: Musculoskeletal Problems

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Sample Questions

Q1) The nurse should reposition the patient who has just had a laminectomy and diskectomy by

A)instructing the patient to move the legs before turning the rest of the body.

B)having the patient turn by grasping the side rails and pulling the shoulders over.

C)placing a pillow between the patient's legs and turning the entire body as a unit.

D)turning the patient's head and shoulders first, followed by the hips, legs, and feet.

Q2) Which menu choice by a patient with osteoporosis indicates the nurse's teaching about appropriate diet has been effective?

A)Pancakes with syrup and bacon

B)Whole wheat toast and fresh fruit

C)Egg-white omelet and a half grapefruit

D)Oatmeal with skim milk and fruit yogurt

Q3) A patient with osteomyelitis is to receive vancomycin (Vancocin)500 mg IV every 6 hours. The vancomycin is diluted in 100 mL of normal saline and needs to be administered over 1 hour. The nurse will set the IV pump for how many milliliters per minute? (Round to the nearest hundredth.)

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Chapter 64: Arthritis and Connective Tissue Diseases

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Sample Questions

Q1) During assessment of the patient with fibromyalgia,the nurse would expect the patient to report which of the following ?

A)Sleep disturbances

B)Multiple tender points

C)Cardiac palpitations and dizziness

D)Multijoint inflammation and swelling

E)Widespread bilateral, burning musculoskeletal pain

Q2) A patient with two school-age children has recently been diagnosed with rheumatoid arthritis (RA)and tells the nurse that home life is very stressful. Which initial response by the nurse is most appropriate?

A)"You need to see a family therapist for some help with stress."

B)"Tell me more about the situations that are causing you stress."

C)"Your family should understand the impact of your rheumatoid arthritis."

D)"Perhaps it would be helpful for your family to be involved in a support group."

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Chapter 65: Critical Care

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Sample

Questions

Q1) While assisting with the placement of a pulmonary artery (PA)catheter,the nurse notes that the catheter is correctly placed when the balloon is inflated and the monitor shows a

A)typical PA pressure waveform.

B)tracing of the systemic arterial pressure.

C)tracing of the systemic vascular resistance.

D)typical PA wedge pressure (PAWP) tracing.

Q2) When caring for a patient with pulmonary hypertension,which parameter will the nurse use to directly evaluate the effectiveness of the treatment?

A)Central venous pressure (CVP)

B)Systemic vascular resistance (SVR)

C)Pulmonary vascular resistance (PVR)

D)Pulmonary artery wedge pressure (PAWP)

Q3) Which assessment finding obtained by the nurse when caring for a patient receiving mechanical ventilation indicates the need for suctioning?

A)The patient was last suctioned 6 hours ago.

B)The patient's oxygen saturation drops to 93%.

C)The patient's respiratory rate is 32 breaths/min.

D)The patient has occasional audible expiratory wheezes.

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Page 67

Chapter 66: Shock, sepsis, and Multiple Organ Dysfunction Syndrome

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Sample Questions

Q1) A patient who has been involved in a motor vehicle crash arrives in the emergency department (ED)with cool,clammy skin; tachycardia; and hypotension. Which intervention ordered by the health care provider should the nurse implement first?

A)Insert two large-bore IV catheters.

B)Provide O2 at 100% per non-rebreather mask.

C)Draw blood to type and crossmatch for transfusions.

D)Initiate continuous electrocardiogram (ECG) monitoring.

Q2) The nurse is caring for a patient who has septic shock. Which assessment finding is most important for the nurse to report to the health care provider?

A)Skin cool and clammy

B)Heart rate of 118 beats/min

C)Blood pressure of 92/56 mm Hg

D)O2 saturation of 93% on room air

Q3) A 198-lb patient is to receive a dobutamine infusion at 5 mcg/kg/min. The label on the infusion bag states: dobutamine 250 mg in 250 mL of normal saline. When setting the infusion pump,the nurse will set the infusion rate at how many milliliters per hour?

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Chapter 67: Acute Respiratory Failure and Acute

Respiratory Distress Syndrome

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Sample Questions

Q1) The nurse assesses vital signs for a patient admitted 2 days ago with gram-negative sepsis: temperature of 101.2° F,blood pressure of 90/56 mm Hg,pulse of 92 beats/min,and respirations of 34 breaths/min. Which action should the nurse take next?

A)Give the scheduled IV antibiotic.

B)Give the PRN acetaminophen (Tylenol).

C)Obtain oxygen saturation using pulse oximetry.

D)Notify the health care provider of the patient's vital signs.

Q2) A nurse is caring for a patient who is orally intubated and receiving mechanical ventilation. To decrease the risk for ventilator-associated pneumonia,which action will the nurse include in the plan of care?

A)Elevate head of bed to 30 to 45 degrees.

B)Give enteral feedings at no more than 10 mL/hr.

C)Suction the endotracheal tube every 2 to 4 hours.

D)Limit the use of positive end-expiratory pressure.

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69

Chapter 68: Emergency and Disaster Nursing

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Sample Questions

Q1) Gastric lavage and administration of activated charcoal are ordered for an unconscious patient who has been admitted to the emergency department (ED)after ingesting 30 lorazepam (Ativan)tablets. Which prescribed action should the nurse plan to do first?

A)Insert a large-bore orogastric tube.

B)Assist with intubation of the patient.

C)Prepare a 60-mL syringe with saline.

D)Give first dose of activated charcoal.

Q2) Following an earthquake,patients are triaged by emergency medical personnel and transported to the emergency department (ED). Which patient will the nurse need to assess first?

A)A patient with a red tag

B)A patient with a blue tag

C)A patient with a black tag

D)A patient with a yellow tag

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