Nursing Process and Health Promotion
Pre-Test Questions
Course Introduction
This course provides an in-depth exploration of the nursing process as the foundational framework for delivering patient-centered care and promoting health across the lifespan. Emphasis is placed on assessment, diagnosis, planning, implementation, and evaluation, enabling students to apply critical thinking in clinical decision-making. The course integrates principles of health promotion and disease prevention, addressing holistic needs of individuals, families, and communities. Through case studies, practical scenarios, and health education strategies, students develop essential skills for fostering health behaviors, empowering patients, and supporting optimal health outcomes in diverse healthcare settings.
Recommended Textbook
Medical Surgical Nursing Clinical Management for Positive Outcomes Single Volume 8th Edition
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82 Chapters
1873 Verified Questions
1873 Flashcards
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Chapter 1: Health Promotion and Disease Prevention
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21 Verified Questions
21 Flashcards
Source URL: https://quizplus.com/quiz/3999
Sample Questions
Q1) During a nursing history before a physical exam, a nurse identifies a client as being in a violent relationship. The most important intervention by the nurse at this time is to A) ask the physician to order a series of x-rays to look for old broken bones.
B) call the police if the abusive partner is in the waiting room.
C) help the woman develop an individual plan to diminish future abuse.
D) refer her to the local battered women's shelter.
Answer: C
Q2) When the nurse encourages a Native American to seek health counsel from the tribe's shaman, the nurse is following the tenets of A) King.
B) Leninger.
C) Pender.
D) Rogers.
Answer: B
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Chapter 2: Health Assessment
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14 Verified Questions
14 Flashcards
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Sample Questions
Q1) To assess precipitating factors, the nurse interviewer would ask
A) "Do you remember the first time you had this problem?"
B) "How many times has the problem been related to activity?"
C) "What measures relieve this problem for you?"
D) "What were you doing when you first noticed the problem?"
Answer: D
Q2) Percussion
A) 1
B) 2
C) 3
D) 4
Answer: A
Q3) Palpation
A) 1
B) 2
C) 3
D) 4
Answer: D
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Chapter 3: Critical Thinking
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8 Verified Questions
8 Flashcards
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Sample Questions
Q1) A nurse 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) The process by which a nurse uses purposeful thinking, informed reasoning, reflections, and thinking about thinking in clinical situations is called A) clinical judgment.
B) critical thinking.
C) decision making.
D) problem solving.
Answer: B
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Chapter 4: Complementary and Alternative Therapies
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12 Verified Questions
12 Flashcards
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Sample Questions
Q1) Because of the repetitive, slow, controlled movement involved, the nurse suggests that a client with arthritis may benefit from the CAM therapy of A) Ayurveda.
B) biofeedback.
C) Reiki.
D) Tai Chi.
Q2) The nurse cautions that, when consumed in large quantities, antioxidants can become pro-oxidants, which
A) absorb large quantities of free radicals.
B) can produce free radicals.
C) create a free radical "shield."
D) enhance the immune system.
Q3) A nurse understands that many conventional drugs are derived from plants, such as A) meperidine (Demerol).
B) penicillin.
C) quinine.
D) steroids.
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Chapter 5: Ambulatory Health Care
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) The nurse-manager explains to a new nurse at the ambulatory clinic that the service for which the telephone nursing practice is not feasible is
A) assessing a client's needs based on the nurse's perception.
B) developing a collaborative plan of care with a client.
C) evaluating outcomes of practice and care.
D) prioritizing the urgency of a client's needs.
Q2) After each telehealth communication the nurse should
A) immediately document the content of the call in the client's record.
B) inform the physician of the information or teaching given.
C) schedule a later call to check on the client's progress.
D) send the client a written form of the pertinent information.
Q3) The nurse manager of an ambulatory care center assesses the center for environmental hazards to comply with guidelines of both the local state health department and the
A) Ambulatory Care Nursing Administration and Practice.
B) American Nurse's Credentialing Center.
C) Nurse Practice Act.
D) Occupational Safety and Health Administration.
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Chapter 6: Acute Health Care
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14 Verified Questions
14 Flashcards
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Sample Questions
Q1) A client for whom the nurse would provide post-acute care is the
A) 38-year-old following cesarean birth.
B) 40-year-old recovering from kidney stone removal.
C) 60-year-old receiving a regulated regimen of anti-hypertensive medication.
D) 76-year-old needing rehabilitation after cardiac surgery.
Q2) A hospital staff nurse is collaborating with a nurse case manager in planning the care of a client with a below-the-knee amputation. The primary role of the case manager is
A) client education on specialized care.
B) coordination of care for the client.
C) direct care of the client's medical problems.
D) education of the staff nurse.
Q3) A planned program of loss prevention and liability control best defines A) client satisfaction.
B) clinical pathway.
C) quality assurance.
D) risk management.
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8
Chapter 7: Critical Care
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10 Verified Questions
10 Flashcards
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Sample Questions
Q1) The nurse admitting clients to the critical care unit understands that priority clients for this area are those who need
A) a cleaner environment to prevent nosocomial infections.
B) continuous physiologic monitoring.
C) frequent vital sign checks.
D) private rooms conducive to rest and sleep.
Q2) A nurse working in critical care would plan interactions with clients' families based on the understanding that families most need
A) knowledge.
B) respect.
C) sleep.
D) spiritual support.
Q3) 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
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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) A home health nurse explains to a client that the Omaha System was designed to facilitate
A) client understanding of the overall health care plan.
B) documentation of unusual events and associated malpractice risks.
C) nursing practice, documentation, and data management.
D) the nurse's ability to visit more clients during the workday.
Q2) An experienced home health care nurse explains to a client about safety in the community. One difference the nurse emphasizes that home health care has over hospital-based health care is that with home health care (Select all that apply)
A) "always be prepared" is a good motto.
B) disasters can occur while the nurse is in the community.
C) needed help may not be immediately available.
D) the central location of most staff during the day can provide assistance.
E) the nurse is usually on his/her own.
Q3) The component that is not part of the Omaha System is
A) Intervention Scheme.
B) Problem Classification Scheme.
C) Problem Rating Scale for Outcomes.
D) Rating Scale for Client Satisfaction.
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Page 10
Chapter 9: Long-Term Care
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12 Verified Questions
12 Flashcards
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Sample Questions
Q1) 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.
Q2) The nurse plans programming at a nursing home understanding that the defining impairment that affects almost all residents in a nursing home is A) Alzheimer's disease or other cognitive deficit.
B) impairment in ability to perform activities of daily living (ADL).
C) profound hearing loss or other unspecified sensory deficit.
D) severe, progressive visual deficit.
Q3) The form of residential long-term care facility that offers the most personal freedom, as well as provision of meals, medication supervision, and personal care assistance, is A) adult day care center.
B) assisted living center.
C) nursing home.
D) transitional care setting.
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11
Chapter 10: Rehabilitation
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10 Verified Questions
10 Flashcards
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Sample Questions
Q1) The rehabilitation nurse reminds a client that according to the International Classification of Functioning, Disability and Health (ICF), the broad theoretical qualification criterion for rehabilitation services is that the client A) has impaired mobility in two limbs.
B) has impairments that lead to reduced ability to engage in activities. C) is no longer capable of independent living.
D) requires assistance in mobility, dressing, and toileting.
Q2) To set the stage for a successful rehabilitation experience, the rehabilitation nurse helps the client and the family conceptualize their definition of A) activity participation.
B) independence.
C) quality of life.
D) wellness.
Q3) The rehabilitation nurse stresses that the major focus in a rehabilitation setting is A) acquisition of services for the newly discharged client. B) elimination of clinical manifestations.
C) prevention of disease progression.
D) skills' instruction for independence.
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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 has a serum sodium level of 115 mEq/L. The nurse has initiated a slow IV infusion of hypertonic saline solution per IV pump in a large vein. Which other intervention should the nurse implement as a priority?
A) Assess the client for dysphagia.
B) Have on-hand a calcium-channel blocker in case of overdose.
C) Initiate seizure and safety precautions.
D) Start a second IV in case the first one infiltrates.
Q2) The nurse anticipates that an order for an isotonic intravenous (IV) solution will read
A)0.45% sodium chloride.
B)0.9% sodium chloride.
C) 3% sodium chloride.
D) 5% dextrose in water.
Q3) When assessing the laboratory values for an assigned client with fluid excess, the nurse finds the value that is consistent with this diagnosis to be
A) BUN 12 mg/dl.
B) hematocrit of 46%.
C) plasma osmolality of 285 mOsm/kg.
D) plasma sodium level of 129 mEq/L.
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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) A client is being discharged from the hospital and will be taking oral potassium chloride. The nurse should teach the client to take this medication
A) at bedtime.
B) between meals.
C) on an empty stomach.
D) with a glass of juice.
Q2) Self-care teaching for a client with hypercalcemia should include
A) administering antidiarrheal medications.
B) decreasing sodium and calcium intake.
C) encouraging foods that increase urine acidity.
D) restricting fluid intake to less than 1 liter a day.
Q3) The factor in the client's history that the nurse assesses as a risk for the development of hypermagnesemia is
A) Addison's disease.
B) gastrointestinal disease.
C) vomiting.
D) water intoxication.
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Chapter 13: Acid-Base Balance
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) Age-related physiologic changes the nurse would consider when planning care for an elderly client admitted with an acid-base abnormality include (Select all that apply)
A) decreased pulmonary and renal function limit the ability to compensate.
B) hypermetabolism predisposes the elderly to metabolic acidosis.
C) hypoventilation can easily cause respiratory acidosis in the elderly.
D) renal perfusion is diminished because of decreased cardiac output.
E) there is decreased alveolar surface area for gas exchange.
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) The nurse performs Allen's test before obtaining an ABG specimen to determine
A) if an allergy to heparin is present.
B) if ulnar circulation is adequate.
C) the patency of the radial artery.
D) the presence of neuromuscular weakness.
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Chapter 14: Clients Having Surgery
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38 Verified Questions
38 Flashcards
Source URL: https://quizplus.com/quiz/4012
Sample Questions
Q1) Which action should receive high priority in an elderly client being placed on the operating room table?
A) Attach the client to a cardiac monitor.
B) Ensure that the correct operative site is exposed.
C) Provide extra padding for joints and bony prominences.
D) Understand which anesthetic agents are being used.
Q2) A client who is extremely overweight has been advised to lose weight before surgery.
To encourage the client, the nurse knows that the most appropriate statement is
A) "It will decrease the operating room time by half if you lose weight."
B) "Surgery requires more anesthesia if you are overweight."
C) "With the weight loss, you decrease the chance of complications after surgery."
D) "You'll feel better after surgery if you lose the weight before."
Q3) The nursing action that should receive highest priority when a client returns from the OR to the PACU is
A) checking the postoperative orders.
B) observing the operative site.
C) positioning the client.
D) receiving the report from OR personnel.
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Chapter 15: Perspectives in Genetics
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12 Verified Questions
12 Flashcards
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Sample Questions
Q1) The nurse obtaining consent for genetic testing realizes that the elements of informed consent include (Select all that apply)
A) other options for risk assessment.
B) the possibility that the results will be ambiguous.
C) procedures for giving results to insurance companies.
D) risks that nonrelatedness will be discovered.
E) the purpose of the test.
Q2) The nurse working with clients who seek genetic testing has an important role in (Select all that apply)
A) ensuring privacy and confidentiality.
B) helping the client negotiate disruptions in family dynamics.
C) recognizing the potential for stigmatization.
D) understanding the process of informed consent.
Q3) Autosomes are the chromosomes that
A) are common to males and females.
B) are inherited from the paternal side.
C) determine gender.
D) exist in paired forms.
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17
Chapter 16: Perspectives in Oncology
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14 Verified Questions
14 Flashcards
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Sample Questions
Q1) A nurse is administering IV chemotherapy. What personal protective equipment (PPE) should the nurse use when doing this task?
A) A gown and gloves
B) Gloves and a mask
C) No special PPE is needed
D) Only gloves
Q2) A client has worked for 2 years installing insulation containing asbestos. The nurse will determine further assessment questions based on the understanding that occupational exposure to carcinogens represents _____% of all human cancers.
A) <2
B) 2-8
C) 10-12
D) >12
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
Source URL: https://quizplus.com/quiz/4015
Sample Questions
Q1) The nurse caring for a client with cancer of the thyroid gland has a tumor classified as T2, N1, M0. The nurse explains that the "T" in this classification schema represents
A) number of years the tumor has been present.
B) site of the tumor.
C) size of the tumor.
D) virulence of malignancy.
Q2) The client is receiving a drug in a phase I clinical trial. Regarding the type of malignancy for which the client is being treated, the nurse makes the assumption that the cancer
A) and its treatment are not covered by the client's insurance.
B) is limited in size and virulence.
C) is not following the expected disease course.
D) will not respond to other known treatments for cancer.
Q3) The nurse can best avoid catheter occlusion in a client with a recently inserted venous access device (VAD) by
A) administering medications in small volumes.
B) flushing the catheter per agency protocol.
C) instructing the client to keep the arm extended during administration.
D) using the catheter only for vesicant drugs.
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Page 19
Chapter 18: Clients with Wounds
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24 Verified Questions
24 Flashcards
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Sample Questions
Q1) When caring for a client with a wound healing by secondary intention, the nurse considers during care planning that this type of wound is
A) healed with skin grafts.
B) prone to dehiscence.
C) sealed with sutures.
D) susceptible to infection.
Q2) A nurse is caring for four clients. Which client should the nurse assess first? The client with a/an
A) eviscerated abdominal wound from surgery yesterday.
B) infected lower leg ulcer and diabetes, who needs a blood sugar measurement.
C) large open infected wound and temperature of 99.9° F.
D) operative incision covered with a clean, dry dressing from surgery 8 hours ago.
Q3) The nurse informs the client that to reduce scarring, facial sutures are removed in A) 1 to 2 days.
B) 4 to 7 days.
C) 8 to 10 days.
D) 12 to 14 days.
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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 working on a community initiative to respond to pandemic flu would design priority interventions that would
A) bolster the communication network with the federal government.
B) educate the public on what to do in a pandemic.
C) limit person-to-person transmission.
D) provide antiviral medications to every person in the community.
Q2) The infection control nurse in a long-term care facility (LTCF) understands that infection control procedures have to be adopted for use in the LTCF because
A) elderly clients are much less likely to acquire an infectious disease in a LTCF.
B) residents are usually not allowed to enter LTCFs with infectious diseases.
C) they must balance the need for infection control and socialization in the LTCF.
D) with fewer staff, it is difficult for a staff member to transmit an infectious disease.
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Chapter 20: Clients with Pain
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29 Verified Questions
29 Flashcards
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Sample Questions
Q1) A client is receiving an opioid analgesic through an epidural catheter. The nurse places the highest priority on
A) assessing for respiratory depression.
B) assisting the client with frequent position changes.
C) establishing a baseline laboratory profile.
D) performing hourly inspection of the catheter insertion site.
Q2) The nurse caring for a client with suspected appendicitis knows that the pain associated with appendicitis is
A) cutaneous pain.
B) somatic pain.
C) superficial pain.
D) visceral pain.
Q3) A client with end-stage cancer is on a continuous IV of morphine to control intractable pain. The family is concerned that the client has a decreasing level of consciousness and has shallow respirations. Which action by the nurse is most appropriate?
A) Call the physician and report the family's concerns.
B) Prepare to administer naloxone (Narcan).
C) Review the goals of end-of-life care with the family.
D) Slow the rate of the IV infusion.
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Chapter 21: Perspectives in Palliative Care
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18 Verified Questions
18 Flashcards
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Sample Questions
Q1) A client using a new opioid analgesic for pain becomes drowsy after the first two doses. The nurse explains to the client and family that the dose may be too high if this persists for more than
A) 1 day.
B) 2 to 3 days.
C) 5 to 7 days.
D) 7 to 10 days.
Q2) A nurse working with clients on a hospice service understands that a client's quality of life is often linked to
A) projections about the amount of time that the client can expect to live.
B) strength and remaining physical ability to perform self-care.
C) symptom distress and the meanings attached to these physical sensations.
D) the number of family and friends who remain as a support system.
Q3) The hospice nurse supports the family coping task of establishing a relationship with the health care team by
A) discussing the functioning of the family unit without the loved one.
B) explaining the roles of all interdisciplinary team members.
C) giving permission to take time to maintain friendships.
D) providing brief explanations about the care being delivered.
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Page 23
Chapter 22: Clients with Sleep and Rest Disorders and Fatigue
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) A nurse is teaching a community group good sleep hygiene practices. Steps that individuals can take to improve their sleep include (Select all that apply)
A) allowing for one or two restful daytime naps per day.
B) avoiding vigorous exercise within 3 hours of bedtime.
C) establishing a regular bedtime routine associated with preparing for sleep.
D) if you wake at night, work quietly in bed and avoid getting up.
E) maintaining a regular sleep-wake pattern throughout the week.
Q2) A client with chronic fatigue syndrome is crying and says "I can't do anything anymore. I can't even walk up a flight of stairs because I am so tired all the time. My spouse thinks I am just lazy, but I simply can't do anything that requires physical activity."
Nursing interventions for this client should focus on
A) discovering the cause of the fatigue and correcting it.
B) helping the client manage and cope effectively.
C) showing the client how to plan and group activities.
D) working with the client to improve communicating needs to the spouse.
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Page 24
Chapter 23: Clients with Psychosocial and Mental Health
Concerns
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18 Flashcards
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Sample Questions
Q1) A home health nurse is visiting a client living with his parents who has severe depression and is considered at risk of suicide. When the client refuses to sign a "no harm" contract, the most appropriate action by the nurse is to
A) call 911, explaining that there is a psychiatric emergency.
B) instruct family members to keep a close watch on the client.
C) schedule another visit for the following day.
D) telephone the physician for a referral to a psychiatric nurse.
Q2) A client has continued to seek medical attention over the last 8 months regarding his health status, despite physical examination findings being consistently negative. The nurse concludes that this client's behavior is consistent with A) compulsive disorder.
B) generalized anxiety disorder.
C) panic disorder.
D) post-traumatic stress disorder.
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25
Chapter 24: Clients with Substance Abuse Disorders
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Sample Questions
Q1) When the school nurse hears a student conversation that is centered on "having some hog," the nurse knows the students are referring to
A) going on a cigarette break.
B) inhaling nitrous oxide.
C) injecting heroin.
D) taking phencyclidine (PCP).
Q2) To prevent a severe withdrawal reaction from alcohol, the nurse explains that drugs from the benzodiazepine group are given because these agents
A) cause less nausea and vomiting.
B) cause less respiratory depression.
C) inhibit the urge to drink.
D) raise the blood pressure.
Q3) The nurse teaching a client taking disulfiram (Antabuse) should focus on A) abstaining from alcohol ingestion.
B) daily exercise.
C) emotional support for the family.
D) skin care.
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26
Chapter 25: Assessment of the Musculoskeletal System
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10 Flashcards
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Sample Questions
Q1) A client with a new cast for his fractured ulna tells the nurse that he cannot feel his fingers. The nurse should initially
A) check for capillary refill in the client's fingers.
B) notify the physician immediately.
C) reassure the client that this is normal.
D) remove the padding around the fingers to increase space.
Q2) A client has had a cast for a week and returns to the orthopedic clinic complaining of an increased level of pain. The most appropriate action by the nurse is to
A) administer a stronger analgesic.
B) notify the physician immediately.
C) remove the cast and inspect the skin.
D) send the client for an x-ray.
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) The nursing care of a client with muscular dystrophy is focused on symptomatic treatment and supportive care, with a major emphasis on problems pertinent to A) ambulation.
B) elimination.
C) nutrition.
D) respiration.
Q2) A client with osteoporosis complains that avoiding coffee will be very difficult. To offset coffee consumption, the nurse might suggest that for every cup of coffee consumed, the client should
A) add 1 serving of leafy green vegetables.
B) combine 20 minutes of exercise to the daily program.
C) drink 1 glass of orange juice or grapefruit juice.
D) take 40 mg of over-the-counter calcium.
Q3) A nurse admitting a 22-year-old client with septic arthritis in the knees would inquire about recent infection with A) a respiratory tract virus.
B) gonorrhea.
C) strep throat.
D) urinary tract manifestations.
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Chapter 27: Management of Clients with Musculoskeletal
Trauma or Overuse
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32 Verified Questions
32 Flashcards
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Sample Questions
Q1) A client is admitted to the emergency department with a complete fracture of the left radius. The nurse understands that with this type of fracture, the bone is
A) displaced with fragments out of normal position.
B) fractured only through one cortex of bone.
C) fractured through the entire bone.
D) fragmented with multiple pieces of bone.
Q2) A client who has undergone repair of the anterior cruciate ligament complains that the use of the continuous passive motion (CPM) machine causes pain and asks how long he is expected to use the machine. The nurse's most appropriate response would be
A) "I will give you pain medication to make you comfortable, since you should use the machine at least 8 hours out of 24."
B) "Try using the machine for 1 hour of every 4 hours, and see if that schedule reduces your discomfort."
C) "You do not have to use the machine for the next few days. You can resume after the pain subsides."
D) "You should use the machine continuously. I will ask the physician to increase your dose of analgesics."
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Chapter 28: Assessment of Nutrition and the Digestive System
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18 Verified Questions
18 Flashcards
Source URL: https://quizplus.com/quiz/4026
Sample Questions
Q1) When preparing a client for gastric analysis, the nurse should plan for A) antacid administration.
B) fluoroscopic examination.
C) frequent expectoration for samples.
D) nasogastric tube insertion.
Q2) The nurse conducting a physical assessment on a client with ascorbic acid (vitamin C) deficiency would assess that the clinical manifestation associated with this problem is
A) bumpy or scaly skin.
B) ecchymotic skin lesions.
C) extremity edema.
D) muscle tetany.
Q3) A client has the following lab results. Which would alert the nurse to a possible nutrition problem?
A) Albumin 5.0 g/dl
B) Pre-albumin 12 mg/dl
C) Retinol-binding protein 5 mg/dl
D) Transferrin 200 mg/dl
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Chapter 29: Management of Clients with Malnutrition
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21 Verified Questions
21 Flashcards
Source URL: https://quizplus.com/quiz/4027
Sample Questions
Q1) The nurse can reduce the risk of access site infection in a client receiving TPN by A) adding antibiotics to the TPN fluid.
B) changing the catheter every 48 hours.
C) changing the transparent dressing every 72 hours.
D) using a semipermeable dressing on the insertion site.
Q2) In feeding a client with a cognitive impairment, the least helpful nursing action is to A) create a quiet, unhurried environment.
B) distract the client with conversation.
C) orient the client to the feeding equipment.
D) provide several small meals.
Q3) The nurse teaching a family member how to position a client who is to receive tube feedings would suggest
A) allowing the client to assume a position of comfort during the feeding.
B) elevating the head of the bed at least 45 degrees before the feeding.
C) encouraging the client to move out of bed into a chair for the feeding.
D) placing the client in a left side-lying position with the head of the bed flat.
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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 planning a teaching program for a client about postoperative care after a thoracotomy approach to an esophagomyotomy would include information about A) application of a Hemovac.
B) drainage from a T tube.
C) insertion of a Blakemore tube.
D) presence of closed-chest drainage.
Q3) 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.
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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) Ranitidine (Zantac) is prescribed for a client with a gastric ulcer. The statement that best indicates to the nurse that the client understands the action of this drug is
A) "I will take this medication at bedtime to relieve pain."
B) "Ranitidine will activate protective mucous barriers."
C) "Stomach acids are neutralized by this medication."
D) "This drug reduces the acid in my stomach."
Q2) Priority nursing actions to achieve critical goals in the postoperative period for a client who has just returned from a Billroth II procedure should include
A) encouraging oral intake.
B) ensuring frequent coughing and deep breathing.
C) irrigating the client's NG tube every hour.
D) maintaining the client in the semi-Fowler position.
Q3) Before tube insertion, the nurse performs the NEX measurement, which is the
A) distance from the tip of the nose to the ear lobe and to the xiphoid.
B) length of a tube from the hub to the tip converted to centimeters.
C) distance from the ear lobe to the umbilicus.
D) width of the lumen of the tube multiplied by the length.
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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) A client is complaining of "arthritis" in the hands and wrists. The nurse questions the client about bowel habits and the client asks why. The best response by the nurse is
A) "All the Motrin you are taking for your symptoms can cause other problems."
B) "Arthritis complaints often go along with inflammatory bowel conditions."
C) "Often bowel habits change with a change in physical activity."
D) "The stress from your arthritis can cause you to have diarrhea."
Q2) An 83-year-old client is seen for urinary frequency and burning. A dipstick urine test reveals positive nitrates. Which action by the nurse is most appropriate?
A) Assume the client has a UTI.
B) Catheterize the client for a sterile specimen.
C) Nothing; this is a normal finding.
D) Send the urine for a culture.
Q3) A client has an oral intake of 1500 ml and a urine output of 350 ml in a 24-hour period. The nurse can correctly chart that the client is
A) anuric.
B) hematuric.
C) oliguric.
D) polyuric.
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Chapter 33: Management of Clients with Intestinal Disorders
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25 Verified Questions
25 Flashcards
Source URL: https://quizplus.com/quiz/4031
Sample Questions
Q1) A client with an ostomy is irrigating it with about 500 ml of warm tap water and is holding the irrigating container about 36 inches above the stoma. Which nursing diagnosis best fits this situation?
A) Constipation
B) Effective management of therapeutic regimen
C) Enhanced individual coping
D) Knowledge deficit
Q2) A client with ulcerative colitis is scheduled for surgical creation of an ileoanal reservoir (J pouch). What information should the nurse include in this client's teaching plan?
A) The client will need an easily removable appliance.
B) The client will need to plan for a daily irrigation.
C) The stool will be expelled through the rectum eventually.
D) The transverse loop ostomy will be temporary.
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Chapter 34: Management of Clients with Urinary Disorders
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30 Verified Questions
30 Flashcards
Source URL: https://quizplus.com/quiz/4032
Sample Questions
Q1) The nurse who is teaching methods of micturition stimulation would stress that the method that may have genitourinary risks is
A) the Credé maneuver.
B) the Valsalva maneuver.
C) "trigger" stimulation.
D) vagal stimulation.
Q2) A nurse working on a rehabilitation unit is caring for several clients with neurogenic bladder. The client who probably should not be a candidate for intermittent catheterization teaching is the
A) 15-year-old client who cannot understand sterile technique.
B) 26-year-old paraplegic client.
C) 26-year-old woman with an active sex life.
D) 35-year-old man with an erratic work schedule.
Q3) In a client with a history of frequent urinary tract infections (UTIs), the nurse would note the need for further teaching when the client says "I
A) am on an oral contraceptive."
B) often take baths instead of showers."
C) use unscented tampons during my period."
D) use a water-soluble lubricant for intercourse."
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Page 36
Chapter 35: Management of Clients with Renal Disorders
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25 Verified Questions
25 Flashcards
Source URL: https://quizplus.com/quiz/4033
Sample Questions
Q1) The nurse explains that polycystic kidney disease ultimately results in A) acute renal failure.
B) chronic renal failure.
C) glomerulonephritis.
D) pyelonephritis.
Q2) For a client with renal trauma exhibiting gross hematuria, the nurse would enforce the activity limitation of A) ambulation in hall once daily.
B) ambulation in room only.
C) bed rest.
D) bathroom privileges.
Q3) In a client with glomerulonephritis, the nurse would assess for the cardinal manifestation of A) edema.
B) fever.
C) hypertension.
D) pyuria.
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Chapter 36: Management of Clients with Renal Failure
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30 Verified Questions
30 Flashcards
Source URL: https://quizplus.com/quiz/4034
Sample Questions
Q1) A nurse is planning care for a client who has chronic kidney disease. Which of the following interventions would help the client meet a priority outcome?
A) Delegate monitoring vital signs during dialysis to the nurses' aide.
B) Instruct the client not to get out of bed without assistance.
C) Place a sign on the door outlining the fluid allotment for each shift.
D) Plan to weigh the client each morning on the same scale.
Q2) For the nurse trying to assist a client with renal failure to stay within the prescribed fluid restriction, the least helpful strategy would be to
A) give medication at mealtime.
B) provide frequent oral hygiene.
C) put allotted water into a spray bottle.
D) use ice chips liberally instead of fluids.
Q3) 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.
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Chapter 37: Assessment of the Reproductive System
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17 Verified Questions
17 Flashcards
Source URL: https://quizplus.com/quiz/4035
Sample Questions
Q1) The nurse teaches a client scheduled for semen examination that in order to provide an adequate sample, the client should
A) abstain from ejaculating 2 to 5 days before the test.
B) drink plenty of liquids for 24 hours before the test.
C) get plenty of sleep the night before the test.
D) increase intake of red meat 3 days before the test.
Q2) The nurse instructs a client that a normal observation during breast self-examination (BSE) is
A) contour changes.
B) dimpling.
C) nipple deviation.
D) variation in breast size.
Q3) A female client scheduled for her first mammography needs the information that
A) no pain or discomfort is involved.
B) results are available within 60 days.
C) she cannot wear deodorant on the day of the test.
D) the procedure takes 15 to 30 minutes.
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Chapter 38: Management of Men with Reproductive Disorders
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30 Verified Questions
30 Flashcards
Source URL: https://quizplus.com/quiz/4036
Sample Questions
Q1) In counseling a couple who want to conceive, the appropriate recommendation that the nurse would make to the man is
A) avoid using recreational drugs and alcohol.
B) have intercourse every 24 hours during ovulation.
C) take hot, soaking baths several times a week.
D) wear jockey shorts instead of boxer type.
Q2) For a client with mild benign prostatic hypertrophy (BPH) who will be treated conservatively, the nurse would advise the client to A) avoid alcoholic beverages.
B) limit fluid intake.
C) limit sexual intercourse.
D) void every couple of hours.
Q3) To provide protection against development of BPH, the nurse would encourage men in a community health education class to increase their intake of A) citrus juices.
B) dairy products.
C) red meat.
D) yellow vegetables.
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Chapter 39: Management of Women with Reproductive Disorders
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28 Verified Questions
28 Flashcards
Source URL: https://quizplus.com/quiz/4037
Sample Questions
Q1) A woman is being taught self-care for a vaginal pessary to treat vaginal prolapse. The nurse would realize that additional discharge instructions are needed when the woman says
A) "I can use estrogen cream in my vagina at night."
B) "If I have trouble removing or inserting the pessary, I will call the doctor."
C) "My follow-up appointment is in 2 months."
D) "The pessary needs to be washed daily with mild soap."
Q2) To help a client diagnosed with endometrial cancer effectively deal with this disease, the nurse would base supportive interventions on the fact that endometrial cancer
A) has a 90% cure rate.
B) is difficult to treat.
C) metastasizes quickly.
D) spreads slowly.
Q3) The nurse would assess a client with leiomyoma for a history of A) abnormal vaginal discharge.
B) amenorrhea.
C) excessive uterine bleeding.
D) severe menstrual pain.
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Chapter 40: Management of Clients with Breast Disorders
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25 Verified Questions
25 Flashcards
Source URL: https://quizplus.com/quiz/4038
Sample Questions
Q1) The nurse explains to a client following mastectomy with lymph node dissection that care of the operative arm should include
A) avoiding heavy lifting and trauma to the arm.
B) having blood pressure taken on the operative arm.
C) limiting all movement until the incision is healed.
D) wearing an Ace bandage wrap for 2 years.
Q2) The nurse explains that the most frequent breast mass is A) carcinoma.
B) fibroadenoma.
C) fibrocystic disease.
D) mastitis.
Q3) Teaching a client who will soon begin radiation therapy for treatment of breast cancer, the nurse would tell the client that she should expect
A) a low-residue diet to decrease diarrhea.
B) dry, itchy skin changes to develop.
C) pain in the long bones, especially the legs.
D) permanent pigment changes to the breast.
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Chapter 41: Management of Clients with Sexually
Transmitted Infections
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24 Verified Questions
24 Flashcards
Source URL: https://quizplus.com/quiz/4039
Sample Questions
Q1) The nurse 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.
Q2) The ambulatory care nurse is aware that after the appearance of the primary lesions, latent syphilis will begin in approximately
A) 1 month.
B) 3 to 6 months.
C) 1 to 2 years.
D) 3 to 5 years.
Q3) A client whose VDRL test was positive asks the nurse if he has syphilis. The nurse's best response is
A) "A blood culture is necessary to make the diagnosis."
B) "A positive VDRL indicates syphilis."
C) "The FTA-ABS test will need to be done."
D) "This study is specific for gonorrhea."
Page 43
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Chapter 42: Assessment of the Endocrine and Metabolic Systems
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15 Verified Questions
15 Flashcards
Source URL: https://quizplus.com/quiz/4040
Sample Questions
Q1) In obtaining a medication history from a client who reports taking all the following medications, the nurse would know that the medication considered hepatotoxic is
A) acetaminophen.
B) digoxin.
C) ferrous sulfate.
D) insulin.
Q2) Important aspects of the social history the nurse should include when examining a client are (Select all that apply)
A) alcohol intake.
B) food preferences.
C) sexual activities.
D) use of items contaminated with body fluids.
E) use of recreational drugs.
Q3) A client being assessed for adrenal medulla function through the use of a urinalysis involves measuring
A) catecholamines and metabolites.
B) diurnal excretion of glucose.
C) calcitonin and parathyroid hormone.
D) growth hormone and ADH.
44
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Chapter 43: Management of Clients with Thyroid and Parathyroid Disorders
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19 Verified Questions
19 Flashcards
Source URL: https://quizplus.com/quiz/4041
Sample Questions
Q1) The nurse should assess a client with a history of hypothyroidism for A) goiter.
B) Graves' disease.
C) Hashimoto's thyroiditis.
D) myxedema.
Q2) In a newly admitted client with thyrotoxicosis, the nurse would plan to address the clinical manifestation of A) fluid overload.
B) hypothermia.
C) respiratory distress.
D) tachycardia.
Q3) A nurse is caring for a client with Graves' disease. Based on clinical manifestations, which nursing diagnosis would be most appropriate?
A) Altered Body Image
B) Constipation
C) Fluid Volume Deficit
D) Impaired Nutrition-More Than Body Requirements
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Page 45
Chapter 44: Management of Clients with Adrenal and Pituitary Disorders
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20 Verified Questions
20 Flashcards
Source URL: https://quizplus.com/quiz/4042
Sample Questions
Q1) 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 making the care plan for a client with Cushing's disease, the nurse would choose which diagnosis as a priority?
A) Activity Intolerance
B) Pain, Chronic
C) Risk for Fluid Volume Deficit
D) Risk for Injury
Q3) The nurse explains the pathophysiology of diabetes insipidus as arising from a deficiency in
A) antidiuretic hormone (ADH).
B) follicle-stimulating hormone (FSH).
C) growth hormone (GH).
D) oxytocin.
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Chapter 45: Management of Clients with Diabetes Mellitus
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44 Verified Questions
44 Flashcards
Source URL: https://quizplus.com/quiz/4043
Sample Questions
Q1) A client who is newly diagnosed with diabetes is in the hospital for initial management of the disease. The nurse is administering an injection of NPH insulin at 7 AM. While the nurse is in the room, the client asks if s/he can go to the cafeteria with family around 2 PM, when they visit. The best response by the nurse is
A) "No, I'd rather you wait until after 5, then you can go."
B) "No, we need to monitor everything you eat for the next few days."
C) "Sure, just be certain you don't eat or drink anything while you're there."
D) "That's fine; let's talk about what kind of snack you can get there."
Q2) The nurse explains to a client that the results of a glycosylated hemoglobin study provide information about the client's control of blood sugar over the last A) week.
B) month.
C) 3 months.
D) 6 months.
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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) The morning after admission, a client being treated for gallstones begins to vomit about every 15 minutes and is complaining of abdominal pain. The most appropriate action by the nurse would be to
A) encourage the client to ambulate.
B) offer clear fluids.
C) prepare to insert a nasogastric tube.
D) turn the client to the right side.
Q2) The nurse would explain that Whipple's operation involves
A) excavation of a pancreatic abscess and implantation of an external drain.
B) removal of the head of the pancreas and portions of the stomach and duodenum.
C) surgical removal of a pancreatic pseudocyst and implantation of an external drain.
D) surgical removal of the tail of the pancreas and portions of the colon.
Q3) When a client is admitted to the hospital for treatment of acute cholecystitis, the nurse would anticipate that the immediate medical management will be
A) antibiotic therapy.
B) provided by a medical nutritionist.
C) systemic corticosteroid administration.
D) total parenteral nutrition.
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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) A client has been admitted for suspected hepatic carcinoma. The client and family are anxious and agitated. Which intervention by the nurse would best support them?
A) Bring the client and family coffee and food from the cafeteria.
B) Educate the client and family about upcoming procedures and tests.
C) Plan care so the family has uninterrupted time with the client.
D) Have the medical social worker stop by and discuss advance directives.
Q2) A client with jaundice is experiencing uncomfortable itching of the skin. The nurse would anticipate an order to administer
A) acetaminophen (Tylenol).
B) diphenhydramine (Benadryl).
C) oral cholestyramine (Questran).
D) phenobarbital (Luminal).
Q3) A client has been admitted with a diagnosis of "fatty liver." The nurse is aware that manifestations of this condition are
A) likely to worsen even after the cause is eliminated.
B) related to the degree of fat infiltration.
C) severe even in mild cases of the condition.
D) vague and nonspecific.
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Chapter 48: Assessment of the Integumentary System
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13 Verified Questions
13 Flashcards
Source URL: https://quizplus.com/quiz/4046
Sample Questions
Q1) After tape is applied for skin patch testing, the nurse would include in the client's instructions to return to the clinic for tape removal and initial reading in
A) 24 hours.
B) 48 hours.
C) 3 days.
D) 7 days.
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) When the nurse lifts the client's foot to clean it during bathing, the nurse notices that it is cool to the touch. The nurse's most appropriate initial action would be to
A) compare the temperature of the foot with the client's other foot.
B) document the finding on the client's chart.
C) inspect hair distribution on the lower half of the leg.
D) Place the extremity under a blanket and continue the bath.
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Chapter 49: Management of Clients with Integumentary Disorders
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38 Verified Questions
38 Flashcards
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Sample Questions
Q1) Discharge teaching for a client following rhytidectomy would include the instruction to
A) sleep in the prone position only.
B) practice coughing and deep breathing.
C) maintain a liquid diet for 1 week.
D) exercise the facial muscles daily.
Q2) 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.
Q3) Methotrexate is prescribed for a female client with psoriasis. When teaching the client about this medication, the nurse would explain that the client should avoid A) aged cheese.
B) alcohol.
C) birth control pills.
D) milk products.
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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) The nurse doing a home safety assessment would conclude that the client at highest risk for burns sustained from clothing ignition during meal preparation is
A) an 18-month-old toddler.
B) a 5-year-old child.
C) a 15-year-old teenager.
D) a 75-year-old adult.
Q2) The nurse teaching a class on burn injury prevention would stress that the leading cause of fire deaths is
A) children playing with matches.
B) cigarettes igniting furniture.
C) kitchen fires igniting other combustibles.
D) space heaters igniting clothing.
Q3) A client admitted to the emergency department (ED) with burns of the chest and neck exhibits a wet, shiny, weeping surface with some blistering. The nurse would document these burn injuries as
A) full thickness, fourth degree.
B) full thickness, third degree.
C) partial thickness, second degree.
D) superficial, first degree.
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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) A client with venous disease is scheduled for impedance plethysmography. Before the study the nurse would explain that
A) an intravenous dye may be used.
B) the procedure is uncomfortable.
C) venous blood flow quality will be measured.
D) walking on a treadmill is required.
Q2) When a female client tells the nurse, "I always get pains in my legs when walking," the nurse would question her about
A) amount of activity required to cause pain.
B) history of hypertension.
C) number of pregnancies.
D) presence of swelling.
Q3) A client has a 30 mm Hg difference in blood pressures in the arms. For subsequent blood pressure readings, the nurse should use
A) a larger blood pressure cuff.
B) a smaller blood pressure cuff.
C) the arm with the higher reading.
D) the arm with the lower reading.
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Chapter 52: Management of Clients with Hypertensive Disorders
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17 Verified Questions
17 Flashcards
Source URL: https://quizplus.com/quiz/4050
Sample Questions
Q1) To reduce the risk of orthostatic hypotension in a client prescribed a diuretic antihypertensive medication, the nurse would teach the client to
A) increase fluid intake.
B) increase intake of potassium.
C) sit up before standing, and stand before walking.
D) stand up quickly using sturdy support.
Q2) An African-American male is being started on medication for hypertension, and the physician has prescribed a beta blocker as first-line therapy. The most appropriate action by the nurse is to
A) consult with the physician about the choice of drug.
B) have the pharmacist review the client's other meds for interactions.
C) help the client plan ways to remain compliant with therapy.
D) provide appropriate education on the medication and its side effects.
Q3) In advising a hypertensive client who is reluctant to give up smoking, the nurse would state that nicotine from smoking
A) causes significant, irreversible changes in blood vessels.
B) does not affect blood pressure but increases risk of cardiovascular disease.
C) increases blood pressure immediately for a short time.
D) is statistically linked to the development of hypertension.
Page 54
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Chapter 53: Management of Clients with Vascular Disorders
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38 Verified Questions
38 Flashcards
Source URL: https://quizplus.com/quiz/4051
Sample Questions
Q1) 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.
Q2) A female client with Raynaud's disease asks the nurse why she is taking the same calcium channel blocker that her brother-in-law takes for a heart condition. The nurse's response would include information that the calcium channel blocker will relieve some clinical manifestations of Raynaud's disease by
A) decreasing vasospasm.
B) increasing cardiac output to increase circulation.
C) increasing vasodilation.
D) reducing the pain in the extremities.
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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 planning a secondary prevention program for risk reduction would focus on clients who
A) already have a diagnosis of cardiovascular disease.
B) do not yet have cardiovascular disease and wish to prevent it.
C) have two or more family members with cardiovascular disease.
D) want information about cardiovascular disease.
Q2) The nurse providing education at a community forum on obesity and heart disease informs the group that "obese" is described as a body mass index greater than
A) 15 kg/m<sup>2</sup>.
B) 20 kg/m<sup>2</sup>.
C) 25 kg/m<sup>2</sup>.
D) 30 kg/m<sup>2</sup>.
Q3) During the physical examination of a client, the nurse checks the client for neck vein distention. To perform this assessment properly, the client should be positioned
A) first lying, then sitting, then standing.
B) in a side-lying position with knees flexed.
C) lying supine with head of bed elevated 15-30 degrees.
D) sitting upright with neck flexed slightly forward.
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Page 56
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) When performing cardiac auscultation on a client with mitral valve prolapse, the nurse would anticipate hearing a
A) harsh, systolic murmur.
B) loud S2 heart sound.
C) midsystolic click.
D) prominent S4 heart sound.
Q2) The nurse would stress in a discharge teaching plan for a client recovering from endocarditis that to avoid further complication, the client should A) become actively involved in social and community activities.
B) drink at least 1000 ml of fluid daily to ensure adequate hydration.
C) initiate a comprehensive daily exercise program.
D) notify the physician when invasive dental procedures are planned.
Q3) A client has dilated cardiomyopathy and is angry and irritable to all the nursing staff. When planning care for this client, which nursing diagnoses would be the priority to address this problem?
A) Altered Body Image
B) Hopelessness
C) Impaired Verbal Communication
D) Risk for Non-compliance
Page 57
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Chapter 56: Management of Clients with Functional
Cardiac Disorders
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Sample Questions
Q1) When auscultating the respirations of a client in left ventricular heart failure, the nurse would most likely detect
A) crackling sounds.
B) diminished sounds.
C) grunting.
D) wheezing.
Q2) A client is admitted to the intensive care unit with severe dyspnea, fear, noisy respirations, sweating, and tachypnea. The nurse would recognize that the client is exhibiting manifestations of
A) acute pulmonary edema.
B) acute myocardial infarction.
C) chronic congestive heart failure.
D) right ventricular failure.
Q3) In advising a client with higher levels of high-density lipoproteins (HDLs) in proportion to low-density lipoproteins (LDLs), the nurse would suggest that the client
A) consult the physician for an anticholesterol prescription.
B) initiate a moderate exercise program.
C) is less likely to develop CHD.
D) should consider a reduced-fat diet.
Page 58
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Chapter 57: Management of Clients with Dysrhythmias
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Sample Questions
Q1) If the first defibrillation shock at 200 J is not successful on a client with ventricular fibrillation, the nurse in charge of the code would
A) administer a second shock at 300 J.
B) reinitiate CPR.
C) reposition the client and shock at 200 J.
D) set the defibrillator to synchronous.
Q2) For a client being prepared to receive an automatic implantable cardioverter-defibrillator (AICD) after surviving two episodes of ventricular fibrillation, the nurse would address the client's
A) acute pain.
B) anxiety.
C) fatigue.
D) decreased cardiac output.
Q3) A client in the CCU goes into sudden ventricular fibrillation. The priority action by the nurse would be to immediately administer
A) a lidocaine bolus.
B) atropine.
C) cardiopulmonary resuscitation (CPR).
D) intravenous (IV) magnesium.
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Page 59
Chapter 58: Management of Clients with Myocardial Infarction
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Sample Questions
Q1) When the immediate post-MI client complains about the high-fiber diet and being encouraged to drink water, the nurse would inform the client that the purpose of such a diet is to
A) create a high-bulk, soft stool.
B) lower cholesterol levels.
C) maintain bowel health to decrease gas.
D) promote easy digestion.
Q2) A client presents to the emergency department complaining of chest pain that began 2 hours earlier; the client's electrocardiogram (ECG) is consistent with acute myocardial infarction. The nurse would know that the standard treatment at this time is A) diazepam.
B) lidocaine.
C) streptokinase.
D) verapamil.
Q3) The nurse would explain to a client that the most common site for MI is the
A) anterior wall of the left ventricle.
B) anterior wall of the right ventricle.
C) inferior (diaphragmatic) surface.
D) posterior wall of the left ventricle.
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Chapter 59: Assessment of the Respiratory System
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Sample Questions
Q1) The nurse preparing to assess a client for the presence of clubbing would instruct the client to
A) place both hands on a flat surface and splay the fingers.
B) place the nails of the ring fingers together.
C) sit upright and lean over the bedside table.
D) walk 50 feet up the hall as quickly as possible.
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) A 44-year-old man with active pulmonary tuberculosis is experiencing hemoptysis, which the nurse understands describes
A) bloody sputum.
B) chest pain.
C) constant cough.
D) dyspnea.
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Chapter 60: Management of Clients with Upper Airway Disorders
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Sample Questions
Q1) A client is trying unsuccessfully to clear the airway with a cough. The measure the nurse would suggest to help the client cough more effectively is
A) cough while leaning forward.
B) drink milk to coat the throat.
C) insert a large-lumen suction catheter before coughing.
D) place a clean finger over the tracheostomy tube and cough.
Q2) A client has a fenestrated tracheostomy tube in place. A tracheostomy plug will be used to allow the client to talk. The intervention by the nurse that would be essential before inserting the plug is
A) alerting the client to a new system of communication.
B) deflating the cuff on the tracheostomy tube.
C) evaluating the client's tidal volume.
D) positioning the client to facilitate air flow.
Q3) Noting the need to use 8 ml rather than 5 ml to inflate the tracheostomy cuff sufficiently, the nurse would
A) ask the client to swallow, and then cough.
B) completely deflate the cuff to relieve the dilation.
C) notify the physician to have an x-ray film obtained.
D) replace the entire tracheostomy tube with a larger size.
Page 62
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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 has chronic obstructive pulmonary disease (COPD). In reviewing this client's laboratory values, the nurse would not be surprised to see a/an
A) decreased sedimentation rate.
B) elevated RBC count.
C) normochromic anemia.
D) therapeutic INR.
Q3) The nurse caring for a client with asthma would place the client in the A) Fowler position.
B) lithotomy position.
C) side-lying position.
D) supine position.
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Chapter 62: Management of Clients with Parenchymal and Pleural Disorders
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Sample Questions
Q1) The nurse would know that the client most likely to exhibit a false-negative Mantoux reaction is the client who is
A) being treated for sickle cell disease.
B) HIV-positive.
C) malnourished.
D) previously diagnosed with TB.
Q2) The nurse writing an infection control policy for a home health care agency would include the information that the rise in TB cases in recent years is related to the A) aging of the U.S. population.
B) emergence of antibiotic-resistant bacteria.
C) increase in HIV infection.
D) rise in illegal drug use.
Q3) In caring for a client scheduled to have chest tubes removed, the nurse's most appropriate action would be to
A) assist the client to a prone position.
B) empty the collection chambers before removal.
C) encourage deep breathing during removal.
D) medicate for pain 1/2 hour before removal.
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Chapter 63: Management of Clients with Acute Pulmonary Disorders
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Q1) As part of the care of a mechanically ventilated client, the nursing action that would be inappropriate is
A) providing oral care every 2 hours.
B) keeping the head of the bed flat while intubated.
C) using aseptic technique for suctioning.
D) washing the hands before and after care.
Q2) Once a near-drowning victim is stabilized, the nurse would continue to assess the client for
A) bronchospasm.
B) dyspnea.
C) electrolyte imbalances.
D) shock.
Q3) A client is being transported to the ED after sustaining carbon monoxide (CO) poisoning in a house fire. The nurse would prepare to administer
A) 100% oxygen therapy.
B) intermittent positive-pressure breathing.
C) suctioning.
D) ventilation with 50% oxygen by manual resuscitation bag.
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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) A client is being treated for arthritis with large doses of aspirin, and the nurse assesses the client for ototoxicity. The most indicative clinical manifestation of damage to the eighth cranial nerve is
A) ear pain.
B) hearing loss.
C) nystagmus.
D) tinnitus.
Q3) The nurse would explain to a client that the voice, rather than a ticking watch, is used to test auditory acuity because watches
A) can be muffled by the examiner's hand.
B) have different sound frequencies.
C) make a familiar and predictable sound.
D) produce a higher pitch.
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Page 66
Chapter 65: Management of Clients with Visual Disorders
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Sample Questions
Q1) 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)
Q2) A client is scheduled for enucleation of the eye because of advanced ocular melanoma. The nurse finds the client crying and saying, "I'm sure I will just look horrid. I can't let anyone see me after the operation ever again!" The best response by the nurse would be
A) "Don't worry. With your prosthetic in, you'll look almost normal."
B) "I'm sure this is very hard for you. I can sit with you for a while."
C) "Let me call our chaplain to come see you; he is very understanding."
D) "Well at least they think they can get all the cancer by removing your eye."
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Chapter 66: Management of Clients with Hearing and Balance Disorders
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Sample Questions
Q1) 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.
Q2) A client has Ménière's disease. Which question by the nurse would elicit the most pertinent information related to client safety?
A) "Are your attacks at certain times of the day?"
B) "Do your attacks come on without warning?"
C) "How long does each attack last?"
D) "What seems to bring on your attacks?"
Q3) The nurse assessing a client with an inner ear disorder would be aware that the presenting clinical manifestation will be
A) conductive hearing disorder.
B) otorrhea.
C) sensorineural hearing loss.
D) severe headache.
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Chapter 67: Assessment of the Neurologic System
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Sample Questions
Q1) In assessing the cause of the decreased level of consciousness in a client in a coma, the diagnostic procedure that would provide the most accurate information is
A) computed tomography (CT) scan.
B) detailed history of the accident.
C) physical examination.
D) skull x-ray film.
Q2) A nurse working on a rehabilitation unit is assessing a new admission, a client with a stable spinal cord injury. The nurse notes that the client is unable to shrug the shoulders. This finding indicates to the nurse that the level of spinal cord injury in the client is
A) C4-5.
B) C8-T1.
C) L1-3.
D) S1-2.
Q3) The nurse asking a client questions that test orientation would include
A) "Can you count backward from 100 by 7s?"
B) "Do you have any brothers and sisters?"
C) "What would you do if you lost your house key?"
D) "What year is this?"
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69
Chapter 68: Management of Comatose or Confused
Clients
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Sample Questions
Q1) The nurse who is beginning oral feedings on a client who is returning to consciousness will
A) begin feedings with water.
B) place about 1 teaspoon of liquid in the front of the mouth.
C) position the client upright.
D) stroke the posterior neck to promote swallowing.
Q2) The nurse 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) The nurse closely monitors the intake and output of a comatose client receiving hypertonic tube feedings because such feedings can cause
A) concentration of urine.
B) hypovolemia.
C) renal failure.
D) retention of fluid.
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Chapter 69: Management of Clients with Cerebral Disorders
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Sample Questions
Q1) A nurse is teaching a client preventive strategies for migraine headaches. The nurse would evaluate that teaching goals have been met when the client says (Select all that apply)
A) "Do you know where I can learn relaxation techniques like yoga?"
B) "Eating on a regular schedule may help prevent some migraines."
C) "I should keep a headache diary to see if I can identify headache triggers."
D) "Small amounts of alcohol should not cause any headaches."
E) "There may be some foods that trigger my headaches that I should avoid."
Q2) A client who has had intracranial surgery develops urine output in excess of 200 ml per hour. The nurse reports the findings, suspecting
A) diabetes insipidus.
B) fluid volume excess.
C) hyponatremia.
D) hyperkalemia.
Q3) The nurse clarifies that a generalized seizure, unlike a partial seizure, involves A) areas of special senses.
B) both hemispheres.
C) only one hemisphere.
D) the autonomic system.
Page 71
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Chapter 70: Management of Clients with Stroke
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Sample Questions
Q1) When the spouse of a client who has had a CVA as a result of a cerebral hemorrhage asks the nurse about the client's chances for recovery, the nurse should base a reply on knowledge that with this type of CVA
A) improvement generally occurs over several days.
B) rapid improvement often occurs.
C) recovery is slow and less complete.
D) there is no way to know for sure.
Q2) To best help the client who has the nursing diagnosis Ineffective Coping after a stroke, the nurse would
A) break a long-term goal into smaller pieces.
B) listen to the client carefully and try to understand.
C) place familiar items, such as photos, near the bed.
D) redirect the client when inappropriate behavior occurs.
Q3) A client has received thrombolytic therapy for treatment of an ischemic stroke. Which intervention takes priority?
A) Assessing nutritional status and planning feeding
B) Consulting with the interdisciplinary stroke team
C) Providing client and family education
D) Stringent blood pressure control
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Page 72
Chapter 71: Management of Clients with Peripheral Nervous
System Disorders
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Sample Questions
Q1) A client's medical record notes a forward slipping of the L5 vertebra. The nurse expects that the diagnosis at the end of the report will state
A) back strain.
B) disk herniation.
C) lordosis.
D) spondylolisthesis.
Q2) The nurse would instruct a client who has undergone microvascular decompression surgery of the trigeminal nerve to
A) chew on the affected side of the mouth.
B) eat foods that are very warm or very cold for better taste.
C) resume a full diet immediately.
D) use a water jet device instead of a toothbrush.
Q3) Before the administration of the first dose of carbamazepine (Tegretol) to a client with trigeminal neuralgia, the nurse should
A) assess the client's deep tendon reflexes.
B) check the client's blood pressure.
C) determine if the client abuses alcohol.
D) remind the client to remain in bed for 20 minutes after receiving the drug.
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Chapter 72: Management of Clients with Degenerative Neurologic Disorders
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Q1) Nursing activities for a client with ALS and family include helping them
A) decide on an acceptable level of care early in the course of the disease.
B) determine if they want to share the diagnosis to allow genetic testing.
C) incorporate nonpharmacologic pain control techniques in the plan of care.
D) plan for extensive rehabilitation after exacerbations.
Q2) A nurse is caring for a client diagnosed with Creutzfeldt-Jakob Disease (CJD). Appropriate nursing care includes
A) administering broad-spectrum antibiotics until culture results are known.
B) giving the client anti-viral medications as ordered.
C) placing the client in contact and airborne isolation.
D) using standard precautions when handling body fluids.
Q3) Important self-care measures a nurse can teach a client with Parkinson's disease in order to prevent contractures and improve mobility include which of the following? (Select all that apply.)
A) Bend over with your head over your toes to get out of chairs.
B) Exercise first thing in the morning.
C) Keep a narrow-based gait.
D) Look up when you walk, not down at the floor.
E) Use a firm surface, like the floor, for exercising.
Page 74
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Chapter 73: Management of Clients with Neurologic
Trauma
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Q1) An elderly client who was found unresponsive at home now opens his eyes when spoken to and answers simple questions when asked; and left alone usually sleeps. The nurse would document this information in the Glasgow Coma Scale using the categories of
A) best verbal response and best motor response.
B) eye opening and best verbal response.
C) eye opening and motor activity.
D) motor activity and motor response.
Q2) When the client who has been in flaccid spinal shock dorsiflexes the great toe and fans the other toes when the sole of his foot is stroked, the nurse is
A) alarmed, because this indicates increased ICP.
B) alerted, because this indicates possible meningeal irritation.
C) distressed, because this indicates deterioration.
D) pleased, because this indicates a reduction of spinal shock.
Q3) The emergency department nurse should position the client with cranial injuries
A) in high-Fowler position and knees elevated.
B) side-lying with head of bed elevated 20 degrees.
C) supine with head of bed elevated 30 degrees.
D) supine with the bed completely flat.
Page 75
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Chapter 74: Assessment of the Hematopoietic System
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Q1) The nurse 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) A client has severe anemia and is being treated with transfusion therapy. The nurse should be alert for a complication of transfusion, such as A) flank pain.
B) hearing loss.
C) liver damage.
D) sore throat.
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Chapter 75: Management of Clients with Hematologic Disorders
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Q1) A client presents to the emergency department having a severe sickle cell crisis. The nurse should be prepared to do which of the following interventions? (Select all that apply.)
A) Administer oxygen.
B) Offer heat therapy.
C) Order hydroxyurea from the pharmacy.
D) Prepare to give IV morphine.
E) Start an IV with normal saline.
Q2) An important self-care measure the nurse teaches a client who has sickle cell disease is to
A) avoid crowds and people who are sick.
B) eat a well-balanced diet with plenty of fiber.
C) get plenty of vigorous exercise daily.
D) have genetic testing done if contemplating children.
Q3) 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.
Page 77
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Chapter 76: Management of Clients with Immune Disorders
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Q1) The nurse assesses an atopic client who has had serious type 1 hypersensitivity reactions. The nurse recognizes that the most severe form of a type 1 hypersensitivity reaction is
A) anaphylaxis.
B) bronchial asthma.
C) cell-mediated sensitivity.
D) dermatitis.
Q2) A client with urticaria is frustrated with the chronic nature of the problem. To enhance coping, which intervention by the nurse would be most effective?
A) Assist the client in identifying and eliminating triggers for outbreaks.
B) Demonstrate to the client measures to increase comfort.
C) Let the client vent frustrations and remain supportive.
D) Teach the client the proper way to take antihistamines.
Q3) The nurse instructs a client diagnosed with urticaria on common self care measures, which include
A) antihistamines.
B) corticosteroids.
C) nonsteroidal anti-inflammatory drugs (NSAIDs).
D) warm oatmeal baths.
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Page 78
Chapter 77: Management of Clients with Rheumatic Disorders
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Q1) The nursing assessment of clients with SLE should focus most intensely on the presence of the common and serious sequela of this disorder, which is
A) difficulty swallowing.
B) interruptions in skin integrity.
C) peripheral neuropathies.
D) renal failure.
Q2) A client newly diagnosed with RA is depressed after the nurse provides education on the disease process. Important interventions the nurse can offer include helping the client
A) choose a high-protein, high-carbohydrate diet to provide energy.
B) find medical supply companies that carry adaptive devices.
C) learn to participate actively in response to their illness.
D) understand the importance of taking medications on time.
Q3) The nurse clarifies that a client can be diagnosed with RA when, out of the seven criteria, the client exhibits
A) two.
B) three.
C) four.
D) five.
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Chapter 78: Management of Clients with Acquired
Immunodeficiency Syndrome
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Q1) When teaching a client who is HIV positive, the nurse should explain that the virus can be transmitted
A) as soon as manifestations of illness appear.
B) once the diagnosis has been made.
C) only to another susceptible host.
D) to anyone having contact with blood or semen.
Q2) The problem the nurse should plan for when a client with AIDS is infected with the Cryptosporidium parasite is A) delirium.
B) painful open lesions.
C) profuse, watery diarrhea.
D) severe respiratory tract infection.
Q3) When a client with AIDS experiences pain while swallowing, the nurse could suggest A) avoiding the use of straws while drinking.
B) drinking acidic juices such as orange juice.
C) eating very cold foods.
D) increasing the intake of well-cooked eggs and noodle dishes.
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Page 80
Chapter 79: Management of Clients with Leukemia and Lymphoma
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Sample Questions
Q1) The nurse preparing a client with acute leukemia for the induction phase of chemotherapy explains that the objective of this phase is to
A) decrease the number of monocytes.
B) induce complete remission.
C) reduce long bone pain and splenomegaly.
D) "shock" the marrow into producing normal cells.
Q2) The nurse reviewing a hematology report recognizes pancytopenia, which is when A) cellular components of the blood are reduced.
B) platelets are immature and dividing rapidly.
C) red cells have become polymorphic.
D) white cells are poorly undifferentiated.
Q3) After a bone marrow transplant, a client develops GVHD and is readmitted to the hospital. The nurse intervenes to prevent which potential complication of treatment for GVHD?
A) Anorexia
B) Bleeding
C) Hypoglycemia
D) Infection
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Chapter 80: Management of Clients Requiring
Transplantation
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Sample Questions
Q1) The nurse counseling a potential organ transplant candidate and his family explains that the evaluation process generally takes about
A) 1 to 2 days.
B) 3 to 5 days.
C) 7 to 10 days.
D) 1 to 2 weeks.
Q2) The most important topic related to health promotion the nurse should teach a client before being discharged after an organ transplant is A) housing options close to the transplant center for the next 1-2 months.
B) how to access funding to pay for lifelong immunosuppressant therapy.
C) primary prevention measures against common infectious diseases.
D) transplant team contact information for the client's primary health care provider.
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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Page 82
Chapter 81: Management of Clients with Shock and Multisystem
Disorders
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Sample Questions
Q1) During the progressive stage of shock, lactic acidosis occurs, resulting in A) arterial pooling in the periphery.
B) constriction of the microcirculation.
C) increased capillary permeability.
D) movement of fluid into the capillaries.
Q2) The nurse caring for a client newly diagnosed with MODS explains that the method of providing nutrition is likely to be
A) enteral nutrition.
B) intravenous fluids.
C) oral diet.
D) parenteral nutrition.
Q3) The nurse suspects that the client who has entered the emergency department with severe uterine bleeding is in the early stages of shock. The nurse's first priority is to A) administer oxygen per nasal cannula.
B) apply super-absorbent perineal pads.
C) place the client in Trendelenburg position.
D) start an intravenous line.
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Chapter 82: Management of Clients in the Emergency Department
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20 Verified Questions
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Sample Questions
Q1) A young man is admitted to the ED after sustaining a gunshot wound and dies within a short time. To prepare the body before the family's viewing, the nurse should A) remove all clothing in order to give it to the family.
B) remove all tubes and instruments used in treatment.
C) wash the body thoroughly.
D) wrap all clothing already removed and place it in a paper bag.
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) For children who need crystalloid fluid resuscitation, the formula is altered to A) 20 ml/kg bolus.
B) 20 ml/kg/hour.
C) 40 ml/kg bolus
D) 40 ml/kg/hour.
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