- In
reducing the risk of endocarditis, good dental care is an important
measure. To promote good dental care in client with mitral stenosis in
teaching plan should include proper use of…
- Dental floss
- Electric toothbrush
- Manual toothbrush
- Irrigation device
- A
female client is experiencing painful and rigid abdomen and is diagnosed
with perforated peptic ulcer. A surgery has been scheduled and a
nasogastric tube is inserted. The nurse should place the client before
surgery in
- Sims position
- Supine position
- Semi-fowlers position
- Dorsal recumbent position
- A
client has Gastroesophageal Reflux Disease (GERD). The nurse should teach
the client that after every meals, the client should…
- Rest in sitting position
- Take a short walk
- Drink plenty of water
- Lie down at least 30 minutes
- A
client suffered from a lower leg injury and seeks treatment in the
emergency room. There is a prominent deformity to the lower aspect of the
leg, and the injured leg appears shorter that the other leg. The affected
leg is painful, swollen and beginning to become ecchymotic. The nurse
interprets that the client is experiencing:
- Fracture
- Strain
- Sprain
- Contusion
- A
client who has undergone a cholecystectomy asks the nurse whether there
are any dietary restrictions that must be followed. Nurse Hilary would
recognize that the dietary teaching was well understood when the client
tells a family member that:
- “Most people need to eat a high
protein diet for 12 months after surgery”
- “I should not eat those foods
that upset me before the surgery”
- “I should avoid fatty foods as
long as I live”
- “Most people can tolerate regular
diet after this type of surgery”
- Smoking
cessation is critical strategy for the client with Burgher’s disease,
Nurse Jasmin anticipates that the male client will go home with a
prescription for which medication?
- Paracetamol
- Ibuprofen
- Nitroglycerin
- Nicotine (Nicotrol)
- A
68 year old client is diagnosed with a right-sided brain attack and is
admitted to the hospital. In caring for this client, the nurse should plan
to:
- Application of elastic stockings
to prevent flaccid by muscle
- Use hand roll and extend the left
upper extremity on a pillow to prevent contractions
- Use a bed cradle to prevent
dorsiflexion of feet
- Do passive range of motion
exercise
- Nurse
Linda is caring for a client with head injury and monitoring the client
with decerebrate posturing. Which of the following is a characteristic of
this type of posturing?
- Upper extremity flexion with
lower extremity flexion
- Upper extremity flexion with
lower extremity extension
- Extension of the extremities
after a stimulus
- Flexion of the extremities after
stimulus
- Nurse
Perry is evaluating the renal function of a male client. After documenting
urine volume and characteristics, Nurse Perry assesses which signs as the
best indicator of renal function.
- Blood pressure
- Consciousness
- Distension of the bladder
- Pulse rate
- Nurse
Liza is assigned to care for a client who has returned to the nursing unit
after left nephrectomy. Nurse Liza’s highest priority would be…
- Hourly urine output
- Temperature
- Able to turn side to side
- Able to sips clear liquid
- A
client has 15% blood loss. Which of the following nursing assessment
findings indicates hypovolemic shock?
- Systolic blood pressure less than
90mm Hg
- Pupils unequally dilated
- Respiratory rate of 4 breath/min
- Pulse rate less than 60 bpm
- Kate
who has undergone mitral valve replacement suddenly experiences continuous
bleeding from the surgical incision during postoperative period. Which of
the following pharmaceutical agents should Nurse Aiza prepare to
administer to Kate?
- Protamine Sulfate
- Quinidine Sulfate
- Vitamin C
- Coumadin
- Which
nursing intervention ensures adequate ventilating exchange after surgery?
- Remove the airway only when
client is fully conscious
- Assess for hypoventilation by
auscultating the lungs
- Position client laterally with
the neck extended
- Maintain humidified oxygen via
nasal cannula
- George
who has undergone thoracic surgery has chest tube connected to a
water-seal drainage system attached to suction. Presence of excessive
bubbling is identified in water-seal chamber, the nurse should…
- “Strip” the chest tube catheter
- Check the system for air leaks
- Recognize the system is
functioning correctly
- Decrease the amount of suction
pressure
- Among
the following signs and symptoms, which would most likely be present in a
client with mitral regurgitation?
- Altered level of consciousness
- Exceptional Dyspnea
- Increase creatine phosphokinase
concentration
- Chest pain
- Mrs.
Chua a 78 year old client is admitted with the diagnosis of mild chronic
heart failure. The nurse expects to hear when listening to client’s lungs
indicative of chronic heart failure would be:
- Stridor
- Crackles
- Wheezes
- Friction rubs
- Nurse
Lucy is planning to give preoperative teaching to a client who will be
undergoing rhinoplasty. Which of the following should be included?
- Results of the surgery will be
immediately noticeable postoperatively
- Normal saline nose drops will
need to be administered preoperatively
- After surgery, nasal packing will
be in place 8 to 10 days
- Aspirin containing medications
should not be taken 14 days before surgery
- Paul
is admitted to the hospital due to metabolic acidosis caused by Diabetic
ketoacidosis (DKA). The nurse prepares which of the following medications
as an initial treatment for this problem?
- Regular insulin
- Potassium
- Sodium bicarbonate
- Calcium gluconate
- Nurse
Bea should instruct the male client with an ileostomy to report
immediately which of the following symptom?
- Absence of drainage from the
ileostomy for 6 or more hours
- Passage of liquid stool in the
stoma
- Occasional presence of undigested
food
- A temperature of 37.6 °C
- Nurse
Rachel teaches a client who has been recently diagnosed with hepatitis A
about untoward signs and symptoms related to Hepatitis that may develop.
The one that should be reported immediately to the physician is:
- Restlessness
- Yellow urine
- Nausea
- Clay- colored stools
- Which
of the following symptoms during the icteric phase of viral hepatitis
should the nurse expect the client to inhibit?
- Watery stool
- Yellow sclera
- Tarry stool
- Shortness of breath
- A
64 year old male client with a long history of cardiovascular problem
including hypertension and angina is to be scheduled for cardiac catheterization.
During pre cardiac catheterization teaching, Nurse Cherry should inform
the client that the primary purpose of the procedure is…..
- To determine the existence of CHD
- To visualize the disease process
in the coronary arteries
- To obtain the heart chambers
pressure
- To measure oxygen content of
different heart chambers
- The
client asks Nurse Annie the causes of peptic ulcer. Nurse Annie responds
that recent research indicates that peptic ulcers are the result of which
of the following:
- Genetic defect in gastric mucosa
- Stress
- Diet high in fat
- Helicobacter pylori infection
- Nurse
Jenny is instilling an otic solution into an adult male client left ear.
Nurse Jenny avoids doing which of the following as part of the procedure
- Pulling the auricle backward and
upward
- Warming the solution to room
temperature
- Pacing the tip of the dropper on
the edge of ear canal
- Placing client in side lying
position
- A
client who has been diagnosed of hypertension is being taught to restrict
intake of sodium. The nurse would know that the teachings are effective if
the client states that…
- I can eat celery sticks and
carrots
- I can eat broiled scallops
- I can eat shredded wheat cereal
- I can eat spaghetti on rye bread
- During
the second day of hospitalization of the client after a Myocardial
Infarction. Which of the following is an expected outcome?
- Able to perform self-care
activities without pain
- Severe chest pain
- Can recognize the risk factors of
Myocardial Infarction
- Can Participate in cardiac
rehabilitation walking program
- A
newly admitted client is diagnosed with Hodgkin’s disease undergoes an
excisional cervical lymph node biopsy under local anesthesia. What does
the nurse assess first after the procedure?
- Vital signs
- Incision site
- Airway
- Level of consciousness
- Which
of the following should the nurse teach the client about the signs of
digitalis toxicity?
- Increased appetite
- Elevated blood pressure
- Skin rash over the chest and back
- Visual disturbances such as
seeing yellow spots
- Nurse
Joan is assigned to come for client who has just undergone eye surgery.
Nurse Joan plans to teach the client activities that are permitted during
the postoperative period. Which of the following is best recommended for
the client?
- Watching circus
- Bending over
- Watching TV
- Lifting objects
- Jerry
has diagnosed with appendicitis. He develops a fever, hypotension and
tachycardia. The nurse suspects which of the following complications?
- Intestinal obstruction
- Peritonitis
- Bowel ischemia
- Deficient fluid volume
- Ryan
has undergone subtotal gastrectomy. The nurse should expect that
nasogastric tube drainage will be what color for about 12 to 24 hours
after surgery?
- Bile green
- Bright red
- Cloudy white
- Dark brown
- Nurse
Jamie should explain to male client with diabetes that self-monitoring of
blood glucose is preferred to urine glucose testing because…
- More accurate
- Can be done by the client
- It is easy to perform
- It is not influenced by drugs
- Kris
with a history of chronic infection of the urinary system complains of
urinary frequency and burning sensation. To figure out whether the current
problem is in renal origin, the nurse should assess whether the client has
discomfort or pain in the…
- Urinary meatus
- Pain in the Labium
- Suprapubic area
- Right or left costovertebral
angle
- What
would be the primary goal of therapy for a client with pulmonary edema and
heart failure?
- Enhance comfort
- Increase cardiac output
- Improve respiratory status
- Peripheral edema decreased
- After
gastroscopy, an adaptation that indicates major complication would be:
- Nausea and vomiting
- Abdominal distention
- Increased GI motility
- Difficulty in swallowing
- Which
of the following compilations should the nurse carefully monitors a client
with acute pancreatitis.
- Myocardial Infarction
- Cirrhosis
- Peptic ulcer
- Pneumonia
- Nurse
Trisha teaches a client with heart failure to take oral Furosemide in the
morning. The reason for this is to help…
- Retard rapid drug absorption
- Excrete excessive fluids
accumulated at night
- Prevents sleep disturbances
during night
- Prevention of electrolyte
imbalance
- During
the first several hours after a cardiac catheterization, it would be most
essential for nurse Cherry to…
- Elevate clients bed at 45°
- Instruct the client to cough and
deep breathe every 2 hours
- Frequently monitor client’s
apical pulse and blood pressure
- Monitor clients temperature every
hour
- Jessie
weighed 210 pounds on admission to the hospital. After 2 days of diuretic
therapy, Jessie weighs 205.5 pounds. The nurse could estimate the amount
of fluid Jessie has lost…
- 0.3 L
- 1.5 L
- 2.0 L
- 3.5 L
- Patrick
who is hospitalized following a myocardial infarction asks the nurse why
he is taking morphine. The nurse explains that morphine:
- Decrease anxiety and restlessness
- Prevents shock and relieves pain
- Dilates coronary blood vessels
- Helps prevent fibrillation of the
heart
- Nurse
Lilly has been assigned to a client with Raynaud’s disease. Nurse Lilly
realizes that the etiology of the disease is unknown but it is
characterized by:
- Episodic vasospastic disorder of
capillaries
- Episodic vasospastic disorder of
small veins
- Episodic vasospastic disorder of
the aorta
- Episodic vasospastic disorder of
the small arteries
- Dr.
Marquez orders a continuous intravenous nitroglycerin infusion for the
client suffering from myocardial infarction. Which of the following is the
most essential nursing action?
- Monitoring urine output
frequently
- Monitoring blood pressure every 4
hours
- Obtaining serum potassium levels
daily
- Obtaining infusion pump for the
medication
- A
male client with a history of cirrhosis and alcoholism is admitted with
severe dyspnea resulted to ascites. The nurse should be aware that the
ascites is most likely the result of increased…
- Pressure in the portal vein
- Production of serum albumin
- Secretion of bile salts
- Interstitial osmotic pressure
- Nurse
Donna is aware that the shift of body fluids associated with Intravenous
administration of albumin occurs in the process of:
- Osmosis
- Diffusion
- Active transport
- Filtration
- A
female client is taking Cascara Sagrada. Nurse Betty informs the client
that the following maybe experienced as side effects of this medication:
- GI bleeding
- Peptic ulcer disease
- Abdominal cramps
- Partial bowel obstruction
- Dr.
Marquez tells a client that an increase intake of foods that are rich in
Vitamin E and beta-carotene are important for healthier skin. The nurse
teaches the client that excellent food sources of both of these substances
are:
- Fish and fruit jam
- Oranges and grapefruit
- Carrots and potatoes
- Spinach and mangoes
- Myrna
a 52 year old client with a fractured left tibia has a long leg cast and
she is using crutches to ambulate. Nurse Joy assesses for which sign and
symptom that indicates complication associated with crutch walking?
- Left leg discomfort
- Weak biceps brachii
- Triceps muscle spasm
- Forearm weakness
- John
suddenly experiences a seizure, and Nurse Gina notice that John exhibits
uncontrollable jerking movements. Nurse Gina documents that John
experienced which type of seizure?
- Tonic seizure
- Absence seizure
- Myoclonic seizure
- Clonic seizure
- Which
of the following statements should the nurse teach the neutropenic client
and his family to avoid?
- Performing oral hygiene after
every meal
- Using suppositories or enemas
- Performing perineal hygiene after
each bowel movement
- Using a filter mask
- Which
of the following antituberculosis drugs can damage the 8th cranial nerve?
- Isoniazid (INH)
- Para Aminosalicylic acid (PAS)
- Ethambutol hydrochloride
(myambutol)
- Streptomycin
ANSWERS;
- 1 C 11 A 21 B 31 D
41 D
- 2 C 12 A 22 B 32 A
42 D
- 3 A 13 C 23 D
33 D 43 A
- 4 A 14 B 24 C
34 B 44 A
- 5 D 15 B 25 C 35 B
45 C
- 6 D 16 B 26 A 36 D 46 D
- 7 B 17 D 27 C
37 C 47 D
- 8 C 18 A 28 D
38 C 48 C
- 9 A 19 A 29 C 39 C 49 B
- 10A 20 D 30
B 40 B 50 D
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