Advanced Medical-Surgical Nursing Final Test Solutions - 1873 Verified Questions

Advanced Medical-Surgical Nursing

Final Test Solutions

Course Introduction

Advanced Medical-Surgical Nursing explores complex health conditions and management strategies encountered in adult patient care. This course deepens understanding of pathophysiology, advanced assessment, critical thinking, and clinical decision-making required for nursing patients with acute and chronic multi-system disorders. Emphasizing evidence-based practice, collaborative interprofessional care, and use of advanced technology, students apply concepts through case studies, simulations, and clinical experiences, preparing them to manage rapidly changing situations, prevent complications, and promote optimal 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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Page 2

Chapter 1: Health Promotion and Disease Prevention

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21 Verified Questions

21 Flashcards

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Sample Questions

Q1) A nurse is teaching women breast self-examination (BSE). When designing a teaching program, the nurse is aware that the biggest barrier to women doing BSE is

A) better screening tools like mammograms.

B) discomfort and pain when doing the exam.

C) lack of confidence when performing the exam.

D) realization that breast cancer is not a leading cause of cancer death in women.

Answer: C

Q2) Strategies a nurse should use when teaching a client include (select all that apply)

A) using plain, lay language.

B) providing comprehensive information at each session.

C) having the client "teach back" what has been taught.

D) using written material written at a low literacy level.

Answer: A, C, D

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3

Chapter 2: Health Assessment

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14 Verified Questions

14 Flashcards

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Sample Questions

Q1) A client had surgery yesterday and is complaining of pain. The best action by the nurse is to

A) ask the patient which pain medication she/he took last.

B) do a complete assessment of the pain.

C) prepare to administer the ordered pain medication.

D) record the client's complaints thoroughly and get the pain medication.

Answer: B

Q2) Palpation

A) 1

B) 2

C) 3

D) 4

Answer: D

Q3) To assess precipitating factors, the nurse interviewer would ask

A) "Do you remember the first time you had this problem?"

B) "How many times has the problem been related to activity?"

C) "What measures relieve this problem for you?"

D) "What were you doing when you first noticed the problem?"

Answer: D

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Chapter 3: Critical Thinking

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8 Verified Questions

8 Flashcards

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Sample Questions

Q1) A nurse who is alert to changes, confident, open-minded, proactive, and questioning is displaying which characteristics?

A) Alfaro's Attitudes and Characteristics of a Critical Thinker

B) Benner's Five Levels of Competency in Nurses

C) Hawk's Model of Critical Thinking in Registered Nurses

D) Universal Intellectual Standards

Answer: A

Q2) It is crucial for the nurse to be able to make sound decisions using critical thinking because

A) it is the most efficient use of the nurse's time and resources.

B) it uses previously learned knowledge in predictable situations.

C) most clients have problems for which there are no textbook answers.

D) nurses can recognize problems rapidly and provide speedy responses to situations.

Answer: C

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5

Chapter 4: Complementary and Alternative Therapies

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12 Verified Questions

12 Flashcards

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Sample Questions

Q1) An elderly Chinese woman tells the nurse that she must improve the flow of her Qi. The nurse asks the client how long she has been using A) acupuncture.

B) Ayurveda.

C) Tai Chi.

D) yoga.

Q2) A young Hispanic woman tells the nurse that she is going to have a healing ritual to center her spirit after the recent death of her husband. The nurse recognizes the alternative medicine system of A) Ayurveda.

B) Curanderismo.

C) Reiki.

D) Tai Chi.

Q3) The nurse reminds a client that the Dietary Supplement and Health Act of 1994 prevented manufacturers of dietary supplements from A) making specific therapeutic claims for the product on their labels.

B) manufacturing products that are not tested or proven.

C) offering products for sale except through pharmacies.

D) publishing outrageous claims for the product on promotional materials.

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Chapter 5: Ambulatory Health Care

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Sample Questions

Q1) The nurse contacts a client by follow-up telephone call after the client's visit to an ambulatory care center. The client who would benefit most from this intervention

A) has undergone cast removal.

B) has undergone same-day surgery.

C) is having blood pressure monitored.

D) is having blood sugar monitored.

Q2) A health care service that provides a defined population with a stated range of services through prepayment of an annual or monthly capitation fee is a(n)

A) health maintenance organization (HMO).

B) nurse-managed ambulatory center.

C) outpatient service of a community hospital.

D) preferred provider organization (PPO).

Q3) 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.

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Chapter 6: Acute Health Care

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Sample Questions

Q1) Using a nursing intensity classification system, the nurse manager assesses that the client requiring the greatest amount of care is the

A) 24-year-old with a 3-day-old fractured femur in Russell's traction.

B) 37-year-old in isolation for hepatitis who is vomiting.

C) 42-year-old 1 day after a craniotomy.

D) 76-year-old 4 days after a cerebrovascular accident (CVA) who is comatose.

Q2) An applicant was denied employment with a health care agency because she is a recovering alcoholic. This action by the agency violates the

A) Age Discrimination and Employment Act.

B) Americans with Disabilities Act.

C) Civil Rights Act.

D) Occupational Safety and Health Act.

Q3) A registered nurse (RN) seeking work in a voluntary health agency would choose a A) church-affiliated hospital.

B) proprietary hospital.

C) state university hospital.

D) veterans administration (VA) hospital.

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Page 8

Chapter 7: Critical Care

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10 Flashcards

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Sample Questions

Q1) 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.

Q2) The population that is increasingly using critical care units and needing specialized nursing care is the population of A) elderly.

B) middle-age adults.

C) underserved pregnant women.

D) uninsured.

Q3) The ICU nurse planning care for a critically ill client tries to arrange care to minimize the most disruptive stressor for the client, which is A) alteration in sleep.

B) fear of the unknown.

C) persistent pain.

D) sense of isolation.

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9

Chapter 8: Home Health Care

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Sample Questions

Q1) The program that had the greatest influence on the number of agencies providing community health care is

A) ADC.

B) Medicaid.

C) Medicare.

D) Social Security.

Q2) A home health nurse has a client with permanent left-sided weakness after a stroke; the client is cared for by his wife and daughter. The nurse will design the plan of care to A) help the wife manage the home.

B) limit input from the wife and daughter.

C) reduce the impact of the client's health care beliefs.

D) stimulate the client to become independent.

Q3) The domain of the Omaha System that the nurse would reference in making her assessment relative to caretaking/parenting is

A) Environment.

B) Health-Related Behaviors.

C) Physiological.

D) Psychosocial.

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10

Chapter 9: Long-Term Care

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12 Verified Questions

12 Flashcards

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Sample Questions

Q1) 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.

Q2) The nurse admitting a new resident to a long-term care facility is mindful that after the resident is assessed, a care plan must be written within A) 1 day.

B) 3 days.

C) 5 days.

D) 7 days.

Q3) In 1965 the enactment of Medicare and Medicaid provided older adults and poor persons with the assurance of A) a minimal level of health care.

B) a reasonable standard of living.

C) guaranteed housing.

D) increased food allowance funding.

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Chapter 10: Rehabilitation

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Sample Questions

Q1) 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.

Q2) The rehabilitation nurse ensures that teaching is (Select all that apply)

A) designed, delivered, and reinforced in ways that are meaningful.

B) designed to cover all aspects of the rehabilitation process.

C) individualized to the client and family even when standardized material is used.

D) presented in appropriate levels and formats.

E) readily available so that learning can occur when the learner is ready.

Q3) The rehabilitation nurse uses the Functional Independence Measures (FIM) tool to assess the client's A) attitude.

B) physical strength.

C) rehabilitation goals.

D) self-care capabilities.

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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 is taking an IV diuretic for fluid volume excess. Which of the following assessments should the nurse report to the physician?

A) Decrease in edema

B) Decrease in potassium level

C) Increase in urine output

D) Weight loss

Q2) The nurse makes the evaluation that the intake of one of the adult clients in her care is adequate when she measures the total daily intake as

A) 750 ml.

B) 900 ml.

C) 1000 ml.

D) 2000 ml.

Q3) A client has gastroenteritis and frequent diarrhea. The nurse should assess the client for (Select all that apply)

A) bradycardia.

B) decrease in blood pressure.

C) decrease in urine output.

D) temperature of 96° F.

E) tenting of skin.

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Page 13

Chapter 12: Clients with Electrolyte Imbalances

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21 Verified Questions

21 Flashcards

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Sample Questions

Q1) 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.

Q2) The nurse is instructing a client to eat foods that are high in potassium, such as (Select all that apply)

A) bananas.

B) broccoli.

C) cantaloupe.

D) corn.

E) cranberry juice.

F) lima beans.

Q3) A client has been admitted with hypokalemia but all treatments have failed to raise the potassium level suitably. The nurse would assess the client further and report findings of

A) chronic insomnia.

B) estrogen use.

C) laxative abuse.

D) recent leg fracture.

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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) A client is admitted to the hospital with severe vomiting and is diagnosed with metabolic alkalosis. The nurse anticipates that the laboratory value that would support this diagnosis is

A) arterial carbon dioxide tension (PaCO₂) of 30 mm Hg.Q

B) arterial pH of 7.30.

C) serum calcium level of 9.0 mEq/L.

D) serum potassium level of 3.0 mEq/L.

Q2) A client with a diagnosis of chronic renal failure has pH of 7.35, PaCO₂ 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 explains to a concerned family member of a client who has developed respiratory acidosis that the kidneys

A) achieve optimal compensation immediately.

B) are unable to compensate.

C) can achieve optimal compensation in about 3 days.

D) will compensate within 24 hours.

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Page 15

Chapter 14: Clients Having Surgery

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38 Verified Questions

38 Flashcards

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Sample Questions

Q1) Important actions the nurse takes to avoid "wrong site surgery" include (Select all that apply)

A) asking the surgeon to initial the marked site and operate through the initials.

B) calling a time-out to verify right client, right surgical site before starting the operation.

C) having the client mark the surgical site with permanent marker.

D) involving multiple surgeons in the case to check each other.

Q2) The nurse explains to a preoperative class of six clients awaiting surgery that studies indicate the primary benefit of the class is to

A) distribute information to the most individuals in a short time.

B) explain legal responsibilities.

C) promote a less complicated postoperative course.

D) provide uniform information.

Q3) Before administering the preoperative medication, the nurse should

A) ensure that the permit has been properly signed.

B) have the unlicensed assistive personnel call for transportation.

C) make sure there is nothing else left to do.

D) take and record a set of vital signs.

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Chapter 15: Perspectives in Genetics

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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) A nurse counseling a couple about genetic disorders explains that Tay-Sachs disease is a genetically linked disorder seen in 7% of the

A) African-American ethnic group.

B) Ashkenazi Jewish ethnic group.

C) Hispanic ethnic group.

D) Northern European ethnic group.

Q3) The nurse explains to a client that the condition of a sperm or egg having an irregular number of chromosomes is called

A) aneuploidy.

B) genotype.

C) phenotype.

D) polypeptide.

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Page 17

Chapter 16: Perspectives in Oncology

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14 Flashcards

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Sample Questions

Q1) A nurse is conducting a smoking cessation clinic. What information about smoking does the nurse include in the teaching component of the program?

A) A pack-year history is the length of time, in years, a person has smoked.

B) Smokeless tobacco is harmless because the carcinogens have been removed.

C) Smoking causes more cancer in the United States than do all other causes combined.

D) The risk of cancer for someone who stops smoking does not improve.

Q2) After discussing the difference between benign and malignant tumors with a client, the nurse would know that the client understood the discussion when the client says

A) "A benign tumor does not invade other tissue."

B) "Malignant tissue is not found far from the original site of the tumor."

C) "Malignant tumors do not respond well to chemotherapy."

D) "The control of growth is impaired only in malignant tissue."

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Chapter 17: Clients with Cancer

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Sample Questions

Q1) The nurse assesses that the client most at risk for breast cancer is the

A) 26-year-old multipara whose father died from lung cancer.

B) 38-year-old primigravida who had menarche at age 9.

C) 42-year-old multipara who had menarche at age 14.

D) 68-year-old nullipara receiving treatment for osteoporosis.

Q2) A client with an advanced stage laryngeal cancer with widespread metastases is scheduled for surgery tomorrow morning. The nurse realizes that preoperative teaching has been effective when the client states

A) "After the operation, how soon will I know if they got it all?"

B) "I will be glad to have this tumor removed so I can breathe better."

C) "My family can't wait for this to be over so we can travel to Europe."

D) "So what is the cure rate for this kind of cancer?"

Q3) After a client has a series of diagnostic tests, the studies confirm the presence of rectal cancer. The nurse's primary intervention should be to A) assess the meaning and effect of cancer as perceived by the client.

B) determine if the client is emotionally ready to deal with the diagnosis of cancer.

C) reassure the client that many treatment modalities are available.

D) support the physician when the client is informed of the diagnosis.

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Chapter 18: Clients with Wounds

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Sample Questions

Q1) A client has a chronic, nonhealing ulcer on the lower leg. The nurse thinks the client could benefit from negative-pressure wound therapy. The most appropriate action by the nurse would be to

A) ask the charge nurse to discuss the matter with the physician.

B) call the physician and request an order for a negative pressure machine.

C) keep track of supplies used currently to estimate the cost of continuing the present regimen.

D) request the physician write an order to consult the wound care nurse.

Q2) A client must do dressing changes at home on a clean, but open, surgical wound. The nurse determines that goals for discharge instructions have been met when the client says:

A) "I will be sure to keep the skin surrounding the wound dry."

B) "I will sit under a heat lamp for 30 minutes a day to help dry up the drainage."

C) "If I run out of saline, I can irrigate the wound with half strength peroxide."

D) "Pulling out the dried up dressings will help clean the wound out."

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Chapter 19: Perspectives on Infectious Disease and Bioterrorism

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23 Verified Questions

23 Flashcards

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Sample Questions

Q1) The nurse collaborating on a community committee designing responses for a bioterrorism attack would understand that an attack by smallpox (Select all that apply) A) can be perpetuated through contact with infected items.

B) could be made with only a small amount of the virus.

C) is predicted to be deadly because there is no vaccine available.

D) will create terror because there is no effective treatment for smallpox. E) would be hard to control because of the long time between infection and illness.

Q2) A nurse is concerned about caring for three postoperative clients and one client with an infectious disease. The nursing manager educates the nurse about the most effective way to prevent the spread of infectious diseases, which is to A) care for the postoperative clients first, and then see the infected client.

B) place the infected client in the appropriate isolation.

C) practice appropriate hand-washing and sanitation.

D) transfer the infected client to a private room at the end of the hallway.

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21

Chapter 20: Clients with Pain

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Sample Questions

Q1) A client who has been in chronic pain after an automobile accident successfully reduces his pain through a combination of biofeedback and meditation. The conclusion the nurse may draw from his success is that the A) pain was acute in nature.

B) pain was psychological in nature.

C) placebo effect occurred.

D) therapy caused physiologic changes.

Q2) A client who has been dealing with chronic pain for the past 2 years would like to try biofeedback as a method of pain relief. The statement that indicates that the client understands this method of treatment is

A) "I want to give my attention to something other than my pain."

B) "I work really well with groups. I think that support will be just what I need."

C) "I'm willing to try to control how blood flows to different parts of my body."

D) "It will be nice to try something that won't cost me anything."

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Chapter 21: Perspectives in Palliative Care

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Sample Questions

Q1) The nurse alerts a family member about the client's imminent death because the nurse has assessed the cardiovascular indicator of

A) bradycardia.

B) fluctuating blood pressure.

C) irregular heart rate.

D) narrowing pulse pressure.

Q2) A client on the hospice service develops dyspnea related to the disease process. The nurse checks the order sheet for a(n) (Select all that apply)

A) anti-anxiety agent.

B) bronchodilator.

C) corticosteroid.

D) opioid analgesic.

Q3) The family member of a client who had a terminal illness and died 18 months ago is still actively grieving over the loss. The nurse assesses that this individual may be experiencing

A) a psychological disorder.

B) delayed grief.

C) exaggerated grief.

D) normal grief.

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Page 23

Chapter 22: Clients with Sleep and Rest Disorders and Fatigue

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Sample Questions

Q1) A client with severe emphysema had a myocardial infarction and is hospitalized on the telemetry unit. The night nurse notices that the client has frequent dysrhythmias. The priority action for the nurse would be to check the client's A) cardiac enzymes.

B) electrocardiogram.

C) electrolyte values.

D) oxygen saturation.

Q2) During assessment of a client who complains of frequent sleep starts, the nurse should question the client regarding A) alcohol intake.

B) caffeine intake.

C) food intake before bedtime.

D) medication intake.

Q3) Most sleeping time is spent in

A) REM sleep.

B) stages 1 and 2 sleep.

C) stage 4 sleep.

D) very light sleep.

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Chapter 23: Clients with Psychosocial and Mental Health

Concerns

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Sample Questions

Q1) A client's scheduled discharge home has been postponed because his mother was unable to come until tomorrow. After hearing the news, the client says his "doctor is a fool" and the care in the facility is very poor. The nurse assesses the client's behavior as A) displacement.

B) intellectualization.

C) rationalization.

D) regression.

Q2) The newly diagnosed diabetic client asks the nurse many questions about management of diet and insulin protocols. The nurse assesses that the client is using A) cause-and-effect coping mechanisms.

B) defense mechanisms.

C) delaying mechanisms.

D) problem-focused coping mechanisms.

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25

Chapter 24: Clients with Substance Abuse Disorders

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Sample Questions

Q1) A nurse works with another nurse who has been coming to work with red eyes and flushed face and is increasingly irritable. Which action by the nurse is most appropriate?

A) Ask another co-worker what he/she thinks about the situation.

B) Document questionable incidents and relay them to the manager.

C) Leave the co-worker alone as it is obvious he/she has personal problems.

D) Work alongside the colleague so there are no mistakes.

Q2) A client taking the drug ReVia for alcohol abuse tells the nurse that he wants to join AA as an added support for his recovery. The nurse's best response would be

A) "Although AA is a support toward sobriety, the fact that you are presently taking ReVia would probably make you ineligible for membership."

B) "AA has been able to help many people stay sober, but it does require that you have a sponsor. Do you know of someone who is a member?"

C) "Joining AA is going to involve your family to some degree. Have you discussed your plans with them?"

D) "That sounds like a very good idea. Shall we try to locate a chapter near you and see when they meet?"

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Chapter 25: Assessment of the Musculoskeletal System

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Sample Questions

Q1) To evaluate a client's swollen right knee further, the nurse should first A) compare the right knee to the left knee.

B) palpate for crepitus.

C) put the knee through range of motion.

D) test muscle strength.

Q2) The nurse is performing a musculoskeletal assessment on a client who is right-hand dominant. The variation in muscle mass the nurse expects to find is A) atrophy.

B) fasciculations.

C) hypertrophy.

D) tremors.

Q3) A client complains of deep aching in his lower leg. The nurse completes an assessment focusing on other indicators of A) bone cancer.

B) infection.

C) muscle strain.

D) neuromuscular impairment.

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Chapter 26: Management of Clients with Musculoskeletal Disorders

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Sample Questions

Q1) A client is being managed for prevention of gout and the nurse is reviewing the client's medication list and teaching about the medications. The nurse evaluates that the client understands the medication when the client says

A) "Allopurinol blocks production of uric acid."

B) "Colchicine can be used with probenecid."

C) "Long-term steroids are needed to prevent attacks."

D) "NSAIDs are not effective against the pain of gout."

Q2) The nurse instructing a client on considerations regarding the medication calcium carbonate would include in the teaching plan that the client

A) has to wait 1 hour after meals to take the medication.

B) may experience nausea or diarrhea.

C) needs to take the calcium with an 8-ounce glass of water.

D) should take the calcium carbonate with food.

Q3) The nurse is counseling a client at risk of osteoporosis that one of the most beneficial exercises is A) cycling.

B) swimming.

C) walking.

D) water aerobics.

Page 28

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Chapter 27: Management of Clients with Musculoskeletal

Trauma or Overuse

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Sample Questions

Q1) The nurse notices a stain on a newly dried plaster cast over a client's fracture site. The most appropriate method to assess this finding is to

A) assess for a "hot spot" over the stain.

B) bivalve the cast and inspect the site.

C) draw around the circumference with a pen and record.

D) dry the stained area of the cast with a hair dryer.

Q2) Two days after an accident in which a client sustained multiple injuries, including fractures, the client becomes confused and dyspneic and has a fever of 103.4° F. The nurse assesses that the client has developed

A) a fat embolism.

B) a pulmonary embolism.

C) compartment syndrome.

D) wound infection.

Q3) The nurse explains to a client with delayed union of a fractured femur that treatment for this complication is based on A) finding and correcting the cause.

B) physical therapy using deep-heat modalities.

C) realigning the fracture with traction.

D) stabilizing the fracture with a metal plate.

Page 29

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Chapter 28: Assessment of Nutrition and the Digestive System

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Sample Questions

Q1) When the nurse measures waist-to-hip ratio and calculates the midarm muscle circumference (MAMC), the nurse is assessing

A) overall muscle strength and density compared to fat stores.

B) proportion and distribution of muscle mass and body fat.

C) reserves of protein and calories stores in the muscle.

D) the size of the body frame related to body weight.

Q2) For a client taking a histamine H? blocker to reduce clinical manifestations of gastritis, the nurse would clarify that the client is at risk for a possible deficiency of vitamin

A) A.

B) B₁₂.

C) C.

D) D.

Q3) In collecting a 24-hour urine specimen to determine nitrogen balance for a client, the nurse would

A) conduct the urine collection before a 24-hour food record.

B) correct the results by multiplying by 0.13 for clients with renal disease.

C) instruct the client on foods to eat containing specified amounts of protein.

D) start the urine collection at the same time a 24-hour food record starts.

Page 30

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Chapter 29: Management of Clients with Malnutrition

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21 Verified Questions

21 Flashcards

Source URL: https://quizplus.com/quiz/4027

Sample Questions

Q1) When planning care for the client with obesity who is having a gastric restrictive procedure, the nurse would include interventions designed to (Select all that apply)

A) encourage the client to lose 4-6 pounds a week.

B) ensure client and nurse safety.

C) monitor the client while taking weight loss medication.

D) prevent wound and skin complications.

Q2) Before administering enteral feeding, the nurse can ensure proper tube placement by

A) asking the client to swallow.

B) auscultating the stomach as 10 ml of water is injected.

C) extracting stomach contents from the tube.

D) holding the end of the tube under water to check for bubbling.

Q3) 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.

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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) 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.

Q2) A client has oral cancer and is scheduled for a radical neck dissection. The priority intervention to address this client's psychosocial needs is to

A) arrange a visit from someone who has recovered from this kind of operation. B) be aware of the tendency to treat people who cannot talk like they are deaf.

C) keep the call light within reach and respond to the client's call light promptly. D) provide an alternate means of communication like paper and pencil.

Q3) The nurse would assess the client with an early mechanical obstruction of the esophagus for

A) aspiration.

B) coughing.

C) dysphagia.

D) vomiting.

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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) An older male client with chronic gastritis asks the nurse, "Do you think I'll get gastric cancer?" The most accurate response by the nurse is

A) "As long as the chronic gastritis is diagnosed early, there is little risk of gastric cancer."

B) "Chronic gastritis is not associated with the development of gastric cancer in men over 40."

C) "Individual predictions are not possible, but chronic gastritis is associated with the development of gastric cancer."

D) "Women with chronic gastritis are more likely to get gastric cancer than men who have chronic gastritis."

Q2) The nurse administers alternating doses of two antacids into the NG tube of a client with a duodenal ulcer. The finding that best indicates that this drug regimen has been successful is

A) absent NG tube drainage.

B) decreased abdominal rigidity.

C) increased gastric pH.mild diarrhea.

D) mild diarrhea.

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Chapter 32: Assessment of Elimination

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27 Verified Questions

27 Flashcards

Source URL: https://quizplus.com/quiz/4030

Sample Questions

Q1) A woman who delivered a baby 10 hours ago has not been able to void. She is complaining of severe abdominal pain and feels the need to urinate but cannot. The nurse should anticipate an order for A) anti-anxiety medication.

B) antibiotics.

C) immediate catheterization.

D) sitz bath.

Q2) Percussion

A) 1

B) 2

C) 3

D) 4

Q3) 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."

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Chapter 33: Management of Clients with Intestinal Disorders

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25 Verified Questions

25 Flashcards

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Sample Questions

Q1) The nurse taking the history of an 80-year-old woman diagnosed with gastroenteritis would recognize that the most significant factor in determining potential for complications in this client is

A) age.

B) family history.

C) gender.

D) prior bouts of gastroenteritis.

Q2) To help a client with a new ostomy integrate its appearance into the client's body image, the home health nurse would

A) discourage the client's negative remarks about the stoma.

B) discuss clothing options that will hide the appliance.

C) limit family interaction in the client's stomal care.

D) use humor and jokes regarding the ostomy.

Q3) A client recovering from a recent colostomy is very reluctant to participate in self-care. To initiate the client's interaction, the nurse should

A) allow care to be deferred until the client will participate.

B) evaluate the level to which the client can tolerate participation.

C) insist the client become involved in self-care.

D) provide the client with a mirror to observe the stoma.

Page 35

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Chapter 34: Management of Clients with Urinary Disorders

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30 Verified Questions

30 Flashcards

Source URL: https://quizplus.com/quiz/4032

Sample Questions

Q1) A client has an autonomous neurogenic bladder. The nurse plans care for this client understanding that the client

A) cannot perceive bladder fullness or initiate or maintain urination.

B) feels no bladder-filling sensation but empties the bladder reflexively.

C) feels the sensation of the bladder filling but cannot initiate micturition.

D) has a temporary problem with initiating micturition.

Q2) A nurse in a long-term care facility has several residents who are incontinent. Which of the following actions can this nurse delegate to the unlicensed assistive personnel? (Select all that apply.)

A) Assist residents with exercises to strengthen pelvic muscles.

B) Assist the resident to the bathroom on a set schedule.

C) Increase the time interval for bathroom trips as the resident becomes continent.

D) Measure intake and output and report cloudy urine.

E) Teach residents how to do Kegel exercises to strengthen pelvic muscles.

Q3) The nurse reinforces explanations that the procedure for lithotripsy involves

A) capturing of stones via a scope.

B) dissolution of stones with medication.

C) fragmenting of stones by shock waves.

D) surgical removal of stones.

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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) Acute renal artery obstruction would be suspected in a client if the nurse assessed sudden

A) flank pain over the affected kidney.

B) hypothermia.

C) increase in urine output.

D) intermittent fever and sweating.

Q2) The nurse caring for a client admitted for massive blood loss from ruptured esophageal varices would assess closely for A) albuminuria related to renal hypertension.

B) decreasing urine output related to hypovolemia.

C) hematuria related to glomerular damage.

D) urine changes related to rhabdomyolysis.

Q3) The nurse explains that polycystic kidney disease ultimately results in A) acute renal failure.

B) chronic renal failure.

C) glomerulonephritis.

D) pyelonephritis.

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Chapter 36: Management of Clients with Renal Failure

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30 Verified Questions

30 Flashcards

Source URL: https://quizplus.com/quiz/4034

Sample Questions

Q1) The nurse explains to a client's family that the most common overall manifestation of ARF is that

A) expected urine output is altered.

B) the client's breath develops a fruity odor.

C) urine specific gravity is greater than 1.040.

D) urine develops a "root beer" color.

Q2) A client with ARF is allowed a specific amount of fluid by mouth during 24 hours in order to

A) compensate for insensible and measured fluid losses during the previous 24 hours.

B) equal the expected urine output for the next 24 hours.

C) prevent hyperkalemia, which could lead to serious cardiac dysrhythmia.

D) prevent the development of complicating hypostatic pneumonia.

Q3) For a client with chronic renal failure who is experiencing insomnia, the least helpful strategy would be

A) establishing a pre-sleep quiet time.

B) planning on a standard time to go to bed.

C) setting up a bedtime routine.

D) taking an over-the-counter sedative drug.

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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) During palpation of a client's testes, the nurse notes a small, hard lump on the anterior aspect of one testis. The nurse's most appropriate action would be to

A) do nothing, since this is a normal finding.

B) palpate the groin for an associated hernia.

C) perform transillumination of the scrotum.

D) recommend the client take antibiotics.

Q2) The nurse explains to a client undergoing her first gynecologic examination that the American Cancer Society recommends an annual Pap test for women (Select all that apply)

A) every year until the woman experiences menopause.

B) once the woman reaches the age of 16.

C) starting at the age of 21 unless sexually active earlier.

D) who are or who have been sexually active.

E) who have been exposed to a sexually transmitted disease.

Q3) When obtaining a sexual history from a female client, a nurse should first

A) ask general questions regarding current sexual activity.

B) ask the client if she would like to talk about her sex life.

C) share his or her own feelings about sexuality.

D) tell the client that she should not be embarrassed.

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Page 39

Chapter 38: Management of Men with Reproductive Disorders

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30 Verified Questions

30 Flashcards

Source URL: https://quizplus.com/quiz/4036

Sample Questions

Q1) A 45-year-old client says to the nurse, "I'm really worried about occasional impotence." The most appropriate response by the nurse would be

A) "Do you feel you should see a sex therapist?"

B) "Impotence is usually caused by psychogenic causes."

C) "This is not unusual after age 40."

D) "You should see your doctor to determine if the cause is physical."

Q2) A nurse teaches a client who underwent insertion of a prostatic stent 5 weeks ago to be sure to tell all care providers about this procedure. When the client asks about the reason for this instruction, the nurse would reply that

A) increased frequency of assessment for prostatic cancer is needed.

B) ongoing antibiotic therapy will be needed for 1 year.

C) the client should not be catheterized through the stent for at least 3 months.

D) the client should not undergo magnetic resonance imaging.

Q3) Nursing management of a client with acute bacterial prostatitis would include

A) catheterizing as needed.

B) encouraging ambulation.

C) limiting fluid intake.

D) providing fiber and fluid intake.

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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 scheduled to have a vulvectomy for vulvar cancer. Important interventions by the nurse to help her cope with this diagnosis and treatment include (Select all that apply)

A) encouraging her and her partner to discuss sexuality.

B) encouraging her to see that being a "woman" means more than having genitals.

C) helping her adapt by limiting talk about grief and mourning.

D) providing a referral to a qualified sex therapist.

E) suggesting alternative forms of sexual pleasure.

Q2) Reading in the client record that a female client has undergone type II excision of the genitalia, the nurse would understand that there has been excision of the A) clitoris and labia minora.

B) clitoris only.

C) entire vulva.

D) labia minora and labia majora.

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.

Page 41

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Chapter 40: Management of Clients with Breast Disorders

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25 Verified Questions

25 Flashcards

Source URL: https://quizplus.com/quiz/4038

Sample Questions

Q1) A male client has been diagnosed with metastatic breast cancer. The nurse would understand that this client most likely may have feelings of sexual inadequacy because

A) breast cancer is a "female" disease.

B) decreased libido is common in male breast cancer clients.

C) radiation therapy produces unwanted skin side effects.

D) treatment includes medical orchiectomy.

Q2) In caring for a client with post-mastectomy breast reconstruction using a subpectoral implant, the nurse would stress that the client can prevent capsule formation by

A) using daily heat applications.

B) keeping the implant very soft.

C) not wearing a bra until the implant drops.

D) wearing a bra at all times.

Q3) For a client receiving cyclophosphamide (Cytoxan) as part of chemotherapy for her breast cancer, the nurse would include the instruction to

A) drink eight glasses of water daily.

B) eat iron-rich foods.

C) practice good skin care.

D) take high-fiber laxatives.

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Page 42

Chapter 41: Management of Clients with Sexually

Transmitted Infections

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24 Verified Questions

24 Flashcards

Source URL: https://quizplus.com/quiz/4039

Sample Questions

Q1) As part of health teaching for a female client with genital warts, the nurse would explain that

A) condom use is recommended.

B) genital warts are cured after medication therapy.

C) testing for warts eliminates the need for Pap smears.

D) this disorder is unrelated to development of genital cancers.

Q2) The nurse working in an ambulatory clinic explains that the most common bacterial STD in the United States is

A) chlamydia.

B) genital herpes.

C) gonorrhea.

D) syphilis.

Q3) When teaching clients strategies for primary prevention of sexually transmitted diseases (STDs), the nurse should

A) encourage compliance with medical treatment.

B) encourage early treatment of infected individuals.

C) provide risk reduction counseling.

D) treat all the client's sexual partners.

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Chapter 42: Assessment of the Endocrine and Metabolic Systems

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15 Verified Questions

15 Flashcards

Source URL: https://quizplus.com/quiz/4040

Sample Questions

Q1) A client is complaining of abdominal pain described as dull, aching, and cramping. The nurse would record this pain as

A) parietal.

B) referred.

C) spasmodic.

D) visceral.

Q2) A nurse is performing a physical examination on an elderly client. The nurse notes the abdomen is rounded and sagging. The most appropriate action by the nurse would be to

A) ask the client about exercise routines.

B) discuss the client's bowel habits.

C) inquire about any abdominal pain.

D) record this as a normal finding.

Q3) A client is having a physical examination and tells the nurse about a painful area in the right upper quadrant of the abdomen. Based on this information, the nurse would

A) avoid any manipulation or contact with the painful area.

B) examine the painful area at the end of the assessment.

C) examine the right upper quadrant area first.

D) notify the physician to complete the examination.

Page 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) A client just returned from surgery for a thyroid disorder and complains that his/her mouth has an odd sensation. Which medication should the nurse anticipate administering?

A) Calcium gluconate

B) Epinephrine

C) Potassium chloride

D) Rectal aspirin

Q2) The nurse counseling a client in the prevention of goiter would suggest an increased intake of

A) calcium.

B) iodine.

C) potassium.

D) protein.

Q3) The nurse should assess a client with a history of hypothyroidism for A) goiter.

B) Graves' disease.

C) Hashimoto's thyroiditis.

D) myxedema.

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Chapter 44: Management of Clients with Adrenal and Pituitary Disorders

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20 Verified Questions

20 Flashcards

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Sample Questions

Q1) The nurse formulating a discharge plan for a client with Addison's disease should place the highest emphasis on

A) compliance with replacement therapy.

B) prevention of the complication of hypertension.

C) teaching the client how to cope with a chronic disease.

D) weight control and the importance of good nutrition.

Q2) During assessment of a 45-year-old man with the medical diagnosis of Cushing's syndrome, the nurse would note the most consistent finding of A) male pattern baldness.

B) peripheral edema.

C) hypertension.

D) jaundice.

Q3) The nurse would assess that the individual most at risk for adrenal insufficiency is the

A) asthmatic client taking hydrocortisone once a week who has emergency surgery. B) athlete who stops daily doses of steroids after taking them for 2 years.

C) COPD client using an aerosol bronchodilator daily who becomes pregnant.

D) hypertensive client taking a diuretic who contracts a febrile illness.

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Chapter 45: Management of Clients with Diabetes Mellitus

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44 Verified Questions

44 Flashcards

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Sample Questions

Q1) The nurse is preparing to care for a client with DKA being admitted from the emergency department (ED). The nurse would anticipate using an intravenous (IV) solution of

A) half-strength saline.

B) isotonic saline.

C) Ringer's solution.

D) serum albumin.

Q2) For a client with DKA receiving insulin to correct hyperglycemia, the nurse knows that the most appropriate route of administration would be

A) intradermal.

B) intramuscular.

C) intravenous.

D) subcutaneous.

Q3) The nurse would explain to a client diagnosed with diabetes and hypertension that the most likely prescribed medication will be a(n)

A) angiotensin-converting enzyme (ACE) inhibitor.

B) beta-adrenergic blocker.

C) direct-acting vasodilator.

D) diuretic.

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Chapter 46: Management of Clients with Exocrine

Pancreatic and Biliary Disorders

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31 Verified Questions

31 Flashcards

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Sample Questions

Q1) A client with acute pancreatitis has a drop in blood pressure from (142/80) to (105/65) mm Hg at 2 hours after admission. The client has not voided and has become short of breath. The nurse would anticipate that the abnormal laboratory value consistent with these manifestations is

A) hypercalcemia.

B) hyperglycemia.

C) hypoalbuminemia.

D) hypokalemia.

Q2) A client is being admitted for the eighth exacerbation of chronic pancreatitis in 2 years. The client is frail and emaciated and becomes agitated when the nurse asks about pain medication. Which referral can the nurse make to best meet this client's needs and address potential complications of the condition? The nurse should request a referral to a

A) chaplain for spiritual distress related to the chronic nature of the disease.

B) chemical dependency counselor to assess and treat substance abuse.

C) medical nutritionist to assess and treat the client's malnutrition.

D) surgeon to assess whether or not this client can be treated surgically.

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Page 48

Chapter 47: Management of Clients with Hepatic Disorders

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34 Verified Questions

34 Flashcards

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Sample Questions

Q1) In caring for a client who has an esophageal tamponade, the nurse would be alerted that the tamponade is inadequate with the assessment of A) diarrhea.

B) increased abdominal girth.

C) increasing jaundice.

D) rising ammonia level.

Q2) A 15-year-old client admitted with severe jaundice is having diagnostic testing. The nursing diagnosis that would have priority is

A) Activity Intolerance related to fatigue

B) Deficient Knowledge related to diet modification

C) Disturbed Body Image related to yellowing of skin and sclera

D) Impaired Skin Integrity related to jaundice

Q3) The nurse assesses asterixis while monitoring the blood pressure of a client with viral hepatitis. The nurse would interpret this finding as an indication of A) fluid volume deficit.

B) hepatic encephalopathy.

C) impending seizure.

D) increased bleeding tendency.

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Chapter 48: Assessment of the Integumentary System

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13 Verified Questions

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Sample Questions

Q1) 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.

Q2) The nurse observes crusty brown lesions covering a client's back. To assist in identifying a possible cause, the most helpful question the nurse would ask the client is

A) "Have you recently changed laundry detergents?"

B) "How much does the rash itch?"

C) "What did the rash look like when you first noticed it?"

D) "What did you eat last night?"

Q3) The nurse caring for a child with impetigo notes that some of the lesions on the child's skin appear elevated and contain purulent material. Secondary lesions are also present and are honey colored. The nurse would document these lesions as

A) cysts and bullae.

B) nodules and scales.

C) pustules and crusts.

D) vesicles and excoriations.

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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) When teaching a client with intermaxillary wiring, the nurse would instruct the client to avoid

A) carbonated beverages.

B) thick drinks.

C) using a water irrigation device.

D) vitamin supplements.

Q2) A nurse is working with a client who has a disfigured face and who is undergoing a series of reconstructive operations. The nurse has formulated the diagnosis: Disturbed Body Image related to perceived disfigurement as a primary problem. The least helpful intervention by the nurse would be to

A) present reality in a kind and compassionate manner.

B) refer the client to a licensed aesthetician to help with makeup.

C) say "I know how you feel" while sitting with the client.

D) tell the client s/he has to look in a mirror to get used to the facial appearance.

Q3) After abdominoplasty, the nurse would place the client in the

A) low-Fowler position.

B) mid-Fowler position with knees bent.

C) side-lying position.

D) supine position with knees bent.

Page 51

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Chapter 50: Management of Clients with Burn Injury

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30 Verified Questions

30 Flashcards

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Sample Questions

Q1) The nurse would perform close respiratory assessment for a client with inhalation injuries because lung tissue injury resulting from inhalation of smoke is caused by A) anoxia from lowered blood oxygen content.

B) carbon monoxide poisoning.

C) chemical action on lung tissues.

D) heat damage from superheated air.

Q2) The physician orders 1% silver sulfadiazine cream applied to a client's burn wound two times daily. The nurse would be aware that this medication can affect A) blood pH.

B) hemoglobin level.

C) serum electrolyte levels.

D) white blood cell count.

Q3) The nurse would know that goals for the diagnosis Disabled Family Coping have been met when the family of a burn-injured client

A) asks frequent questions of all the staff.

B) begins to interact with the local burn support group.

C) insists on participating in the client's care.

D) only comes to visit when the client requests.

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Chapter 51: Assessment of the Vascular System

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Sample Questions

Q1) The nurse tests the capillary refill on a client's lower extremity and notes that it takes 4 seconds for the color to return to baseline. It would be most important for the nurse to then check for

A) constricting clothing.

B) other indicators of peripheral perfusion.

C) presence of venous ulcers.

D) prior surgery on this extremity.

Q2) When assessing a client with arterial insufficiency, the nurse would expect

A) bounding arterial pulses.

B) cool, pale skin.

C) muscular atrophy.

D) warm, erythematous legs.

Q3) To determine if a client with complaints of pain after walking 5 blocks is experiencing intermittent claudication, the nurse would ask

A) "Do you experience leg swelling?"

B) "Does pain go away when you rest?"

C) "Is the pain cramp-like?"

D) "Is the pain in the calf muscle?"

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Chapter 52: Management of Clients with Hypertensive Disorders

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Sample Questions

Q1) In conducting a health interview with a hypertensive client, the nurse would ask the client about the presence of the typical manifestations of the disorder, which are

A) increasing muscle weakness.

B) nausea, vomiting, and abdominal pain.

C) none unless the hypertension is sustained.

D) peripheral edema and abdominal bloating.

Q2) A client has two BP readings of (134/84) and 9138/86) at a community screening event. The client smokes and has "some sort of eye disease like my grandma had" plus the client states, "I might have high sugar." The most appropriate action by the nurse would be to (Select all that apply)

A) advise the client to return tomorrow for repeat blood pressure readings.

B) arrange for the client to be seen at a local urgent care center today.

C) inform the client about the high risk of developing hypertension.

D) tell the client that the blood pressure readings are not considered high.

E) work with the client to identify risk factors and create a plan to address them.

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Chapter 53: Management of Clients with Vascular Disorders

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38 Verified Questions

38 Flashcards

Source URL: https://quizplus.com/quiz/4051

Sample Questions

Q1) The nurse working in the emergency department (ED) receives a telephone call from an individual who states a co-worker's finger was amputated and asks what should be done. The nurse would tell the caller to immediately

A) pack the finger immediately in a plastic bag filled with ice.

B) place the finger in a bowl full of cool water or normal saline, if available.

C) wash and rinse the finger and wrap it in a clean, warm towel.

D) wrap the finger in a clean cloth and place it in a plastic bag, then on ice.

Q2) A client is scheduled for discharge to home after repair of an abdominal aortic aneurysm. As an acceptable activity during the first 6 to 12 weeks after surgery, the nurse would suggest

A) mowing the lawn.

B) vacuuming the floor.

C) walking.

D) washing windows.

Q3) To prevent skin breakdown of a client's stump, the nurse teaches the client to A) adjust the prosthesis if it causes discomfort.

B) apply alcohol to the stump to toughen the skin.

C) wash the stump daily with mild soap, and then rinse and dry it.

D) wear cotton stump socks.

Page 55

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Chapter 54: Assessment of the Cardiac System

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Sample Questions

Q1) The finding during a routine assessment that would most strongly suggest to the nurse the presence of serious heart or lung disease is

A) blanching of nail beds when compressed.

B) broken vessels in the legs.

C) duskiness of the buccal mucosa.

D) pulse rate greater than 90 beats/min.

Q2) In evaluating a client's ECG tracing, the nurse notes three small squares between the upstroke and downstroke of the QRS wave. The nurse would record the QRS interval as

A)0.04 second.

B)0.06 second.

C)0.08 second.

D)0.12 second.

Q3) The nurse assessing an American Indian client would assess for other cardiovascular risk factors because the prevalence of heart disease in this group is

A) no different from other ethnic groups and all should be assessed.

B) the highest of all ethnic groups in America.

C) the second highest of all ethnic groups in America.

D) varies widely between different geographical locations.

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Chapter 55: Management of Clients with Structural

Cardiac Disorders

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21 Verified Questions

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Sample Questions

Q1) The nurse would recognize that splinter hemorrhages in the nails, painful swollen nodules on the fingertips, and splenomegaly indicate

A) infective endocarditis.

B) mitral stenosis.

C) mitral valve prolapse.

D) pericarditis.

Q2) The nurse teaching a class on long-term effects of rheumatic fever would stress that the most common problem following bouts of rheumatic fever is A) cardiac tamponade.

B) coronary artery disease.

C) pericarditis.

D) valvular disorders.

Q3) 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.

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Chapter 56: Management of Clients with Functional

Cardiac Disorders

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28 Verified Questions

28 Flashcards

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Sample Questions

Q1) A client with heart failure has been prescribed an angiotensin-converting enzyme (ACE) inhibitor. The nurse would explain that this drug alleviates manifestations of heart failure by

A) decreasing circulating volume.

B) increasing myocardial contractility.

C) increasing vasodilation.

D) slowing atrioventricular conduction time.

Q2) 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.

Q3) The nurse would clarify for a client that the lipoproteins representing the "good" cholesterol are the

A) HDLs.

B) LDLs.

C) VDRLs.

D) VLDLs.

Page 58

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Chapter 57: Management of Clients with Dysrhythmias

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Sample Questions

Q1) At the ambulatory care clinic, the nurse counseling a client who has presented with frequent episodes of paroxysmal atrial tachycardia would advise the client to

A) avoid all aspirin and nonsteroidal anti-inflammatory drugs.

B) eat a low-salt, low-fat diet that contains plenty of fiber.

C) get 30 minutes of exercise and drink six glasses of water per day.

D) quit smoking and avoid caffeine and alcohol.

Q2) The nurse would clarify to a client that sinus arrest differs from sinus block in that with sinus arrest, the

A) atrial focus totally takes over pacing responsibility.

B) atrioventricular (AV) node is the primary pacemaker.

C) rhythm is regular.

D) sinoatrial (SA) node occasionally fails to fire.

Q3) 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.

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Page 59

Chapter 58: Management of Clients with Myocardial Infarction

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Sample Questions

Q1) For a 40-year-old client who wants to be more active the first 24 hours after an MI, the nurse could safely suggest that the client

A) ambulate in the hall with supervision.

B) perform gentle isometric exercises.

C) take a bath in the shower.

D) use the bedside commode for bowel movements.

Q2) A client admitted for angina reports experiencing pain of long duration while at rest and also early in the morning. The nurse would recognize this pattern as

A) angina decubitus.

B) nocturnal angina.

C) unstable angina.

D) variant angina.

Q3) After instructing a client with stable angina, the nurse would evaluate that the client has a proper understanding of the condition when the client says

A) "Angina pain usually feels like being stabbed with a knife."

B) "Each time I have angina, my heart is damaged."

C) "If I have chest pain, then I'm probably having another heart attack."

D) "My chest pain can occur if I overexert myself."

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Chapter 59: Assessment of the Respiratory System

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Sample Questions

Q1) When a 49-year-old client tells the nurse he has smoked half a pack of unfiltered cigarettes a day since he was 19 years old, the nurse would record the pack-years as A)15.

B)20.

C)25.

D)30

Q2) A client says to the nurse, "It's hard for me to breathe; I feel winded all the time." The nurse would record this subjective feeling on the chart as A) apnea.

B) dyspnea.

C) respiratory fatigue

D) tachypnea.

Q3) The nurse reviews the results of the arterial carbon dioxide tension (PaCO₂) of a client with asthma to obtain information relative to the A) contribution of gas exchange.

B) effectiveness of alveolar ventilation.

C) evidence of atelectasis.

D) presence of respiratory alkalosis.

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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) For a client who has undergone functional endoscopic sinus surgery (FESS) as part of the surgical management of sinusitis, the nurse would instruct the client

A) "Don't blow your nose for 1 week."

B) "Eat only semi-solid foods."

C) "Lean forward when eating."

D) "Limit the amount of fluids you drink."

Q3) The measure that would best aid the nurse in removing heavy, tenacious secretions during suctioning is

A) encouraging frequent coughing and deep breathing.

B) employing postural drainage before suctioning.

C) hyperinflating the lungs before suctioning.

D) instilling sterile saline directly into the trachea.

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Chapter 61: Management of Clients with Lower Airway and Pulmonary Vessel

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Sample Questions

Q1) The ambulatory care nurse would arrange for periodic monitoring of blood levels for a client with COPD who is beginning to use

A) beclomethasone (Vanceril).

B) ipratropium (Atrovent).

C) theophylline (Theo-Dur).

D) zafirlukast (Accolate).

Q2) The nurse working with a depressed client who has COPD realizes that many factors negatively affect the client's quality of life, including (Select all that apply)

A) familial support systems.

B) loss of control over their bodies.

C) reduced activity tolerance.

D) social isolation.

Q3) 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.

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Chapter 62: Management of Clients with Parenchymal and Pleural Disorders

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Sample Questions

Q1) A client has undergone a pleurodesis. The priority nursing action after the procedure is to assess the client's

A) respiratory status.

B) urine output.

C) vital signs.

D) wound site.

Q2) The nurse would explain that the client's diagnosis of interstitial pneumonia means A) pus has accumulated in the major bronchi.

B) the alveoli are filled with fluid.

C) the small bronchioles are inflamed.

D) there is an inflammatory response in the tissue surrounding the air space.

Q3) A client has accidentally disconnected a chest tube while turning over in bed. The suction tubing is on the floor. The most appropriate action by the nurse is to A) call the physician immediately and prepare the client for reinsertion.

B) clamp the chest tube just proximal to the open end.

C) reattach the drainage tube to the suction tubing.

D) submerge the end of the drainage tube in a bottle of sterile saline.

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Page 64

Chapter 63: Management of Clients with Acute Pulmonary Disorders

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Sample Questions

Q1) A client has severe adult (acute) respiratory distress syndrome (ARDS) and has not responded to several different treatments. An independent nursing action that might help the client would be to

A) administer antioxidants as ordered.

B) place the client in a prone position.

C) turn the client every 2 hours.

D) use meticulous hand-washing before client care.

Q2) The nurse would determine that a client is having a dysfunctional ventilatory weaning response if the client's respiratory rate rises to

A) 20 breaths per minute.

B) 25 breaths per minute.

C) 30 breaths per minute.

D) 35 breaths per minute.

Q3) A client has rapidly progressing ARDS. Which actions by the nurse can help the family during this crisis? (Select all that apply.)

A) Avoid disturbing them in the waiting room.

B) Limit visiting time so the family does not fatigue.

C) Provide frequent condition updates.

D) Use clear communication.

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Chapter 64: Assessment of the Eyes and Ears

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Sample Questions

Q1) A nurse is working with a client who has moderate hearing loss. Communication adaptations the nurse uses include (Select all that apply)

A) enunciating words clearly.

B) facing the client directly.

C) slowing the speech down.

D) speaking very loudly.

Q2) Before insertion of the otoscope speculum in the ear of an adult, the nurse would pull the pinna

A) down and back.

B) down and forward, and out.

C) up and back, and out.

D) up and forward.

Q3) Using a Snellen chart, the nurse would credit a client with reading the line of print if the client has correctly read more than

A) 50% of the characters.

B) 60% of the characters.

C) 80% of the characters.

D) 90% of the characters.

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Chapter 65: Management of Clients with Visual Disorders

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Sample Questions

Q1) The nurse evaluating a client's retinal arterioles during a funduscopic examination would record a grade indicating severe hypertensive retinopathy as

A) grade D.

B) grade 1.

C) grade 4.

D) grade 10.

Q2) An elderly client had surgery to repair a retinal detachment and is being discharged to home the next day. The nurse is concerned that the client will not be able to adjust to the decreased vision. The most appropriate action by the nurse is to

A) arrange admission to a long-term care facility.

B) consult with a home health care agency for assistance at home.

C) request the physician keep the client in the hospital for a couple more days.

D) send the client home with instructions written in large type.

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Chapter 66: Management of Clients with Hearing and Balance Disorders

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Sample Questions

Q1) A client with severe hearing loss has the nursing diagnosis: Ineffective Coping related to recent hearing loss. The nurse would assess that goals for this diagnosis have been met when the client (Select all that apply)

A) engages in more activities within the community.

B) is willing to role-play informing others about the hearing loss.

C) self-refers to a university hospital audiology clinic.

D) stores the new hearing aid properly when not in use.

Q2) The nurse preparing written discharge instructions for the day-surgery unit where ear surgery is performed would plan to include which instruction?

A) Avoid heavy lifting and do not engage in sports for 3 weeks after surgery.

B) Leave the cotton ball dressing in the ear until your follow-up appointment.

C) Do not sneeze, blow your nose, or cough for 1 week after surgery.

D) Report any decreased hearing in the operative ear.

Q3) When a client who underwent vestibular surgery complains of thirst, the nurse would avoid offering this client

A) cola.

B) ginger ale.

C) lemonade.

D) mineral water.

Page 68

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Chapter 67: Assessment of the Neurologic System

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Sample Questions

Q1) Which confidence shared by a female client would alter the decision to use magnetic resonance imaging (MRI) as a diagnostic modality?

A) "I was too embarrassed to tell my doctor that I've had my breasts enlarged."

B) "I didn't tell my doctor that I've had my stomach stapled."

C) "My doctor would think I'm silly to have had a 'tummy tuck,' so I didn't tell him."

D) "No one knows I wear dentures, not even my husband. My doctor doesn't either."

Q2) When testing comprehension in a client who is expressively aphasic, the nurse lays out a pencil, a key, and a ball and then would

A) ask the client to pick up the ball.

B) hold up the key and ask, "What do you do with this?"

C) point to the pencil and ask, "What is this?"

D) point to the ball and ask "What can this be used for?"

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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Chapter 68: Management of Comatose or Confused

Clients

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Sample Questions

Q1) The nurse caring for a client in restraints can delegate which of the following activities to an unlicensed assistive personnel? (Select all that apply.)

A) Assistance with ADLs

B) Massaging reddened areas under the restraint

C) Providing for food and elimination

D) Range of motion, both active and passive

E) Turning and repositioning

Q2) The nurse cautions that the OVR test should not be used when assessing a client who exhibits

A) hypotension.

B) irregular respirations.

C) otorrhea.

D) vomiting.

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) The nurse observes for manifestations of typical migraine headaches, which include A) aura, visual disturbances, and nausea.

B) bilateral pain, abrupt onset, and tinnitus.

C) diarrhea, nasal congestion, and eye redness.

D) scalp tenderness, sensation of pressure, and nighttime onset.

Q2) Following surgery for a pituitary tumor, when the client develops diabetes insipidus, the nurse explains that the drug that will be helpful to remedy the manifestations is A) atropine.

B) desmopressin.

C) diazepam (Valium).

D) NPH insulin.

Q3) The cerebrospinal (CSF) fluid laboratory finding the nurse would expect in a client with bacterial meningitis is A) clear color.

B) decreased glucose level.

C) decreased protein level.

D) negative nitrates.

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Page 71

Chapter 70: Management of Clients with Stroke

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Sample Questions

Q1) The assessment the nurse documents that supports the finding of apraxia would be the client's inability to

A) get dressed independently.

B) recognize a pencil.

C) see far objects.

D) understand the spoken word.

Q2) A client who has left hemiparesis as a result of stroke is getting out of bed to the chair for the first time. The nurse should position the chair

A) at a right angle to the client's left side.

B) at a right angle to the client's right side.

C) facing away from the side of the bed.

D) facing the side of the bed but within 1 foot.

Q3) The nursing action that would be appropriate in caring for a client who has experienced stroke because of hemorrhage is to

A) maintain the head of the bed in a flat position.

B) monitor rectal temperature every 4 hours.

C) teach isometric exercises.

D) teach the client to avoid the Valsalva maneuver.

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Chapter 71: Management of Clients with Peripheral Nervous System Disorders

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Sample Questions

Q1) The nurse would recommend that the habit that should be modified to reduce the incidence of back pain is

A) eating a high-fiber diet.

B) mild exercise three times a week.

C) sitting for long periods, rather than standing.

D) using leg muscles when lifting.

Q2) The nurse explains that the client diagnosed with a spinal tumor will receive

A) radiation and/or chemotherapy.

B) radiation therapy and/or immunotherapy.

C) surgery and/or chemotherapy.

D) surgery and/or radiation therapy.

Q3) 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.

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Page 73

Chapter 72: Management of Clients with Degenerative Neurologic Disorders

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Sample Questions

Q1) A client tells the nurse that he is experiencing some leg stiffness when walking and slowness when performing ADLs. Occasionally he has noted slight tremors in his hands at rest. This information leads the nurse to suspect

A) amyotrophic lateral sclerosis (ALS).

B) Huntington's disease.

C) myasthenia gravis (MG).

D) Parkinson's disease (PD).

Q2) A client with MG began to experience a sudden worsening of her condition with difficulty in breathing. The nurse explains that this complication of MG is usually initially treated with

A) admission and administration of IV corticosteroids.

B) an increased dose of anticholinesterase drugs.

C) bolus doses of atropine titrated to effect.

D) rest and increased sleep.

Q3) The nurse explains that the pathology of Huntington's disease involves

A) a decrease in the neurotransmitter norepinephrine.

B) an excess of the neurotransmitter dopamine.

C) destruction of white matter in the brain.

D) formation of neurofibrillary tangles and plaques.

Page 74

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Chapter 73: Management of Clients with Neurologic

Trauma

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Q1) The client with a spinal cord injury asks the nurse why he must stand on the tilt table every day. The nurse should base the answer on the fact that weight-bearing A) decreases leg spasms.

B) improves circulation.

C) prevents bone demineralization.

D) strengthens muscles in the legs.

Q2) The nurse is assessing a client for manifestations of recovery from spinal shock. Which of the following assessment findings would indicate that spinal shock is resolving?

A) Flaccid paralysis

B) Hyperreflexia

C) Loss of Babinski's response

D) Urinary retention

Q3) The nurse explains to a family that immediate medical-surgical stabilization after a severe cervical injury would include A) cervical brace.

B) halo jacket.

C) skeletal traction.

D) spinal fusion.

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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 nurse discovers a client is taking the herb St. John's wort. The nurse cautions that this herb reduces the effectiveness of A) lanoxin.

B) prednisone.

C) theophylline.

D) warfarin.

Q3) A nurse is explaining the purpose of a bone marrow biopsy (BMB) to a client. The information the nurse provides is that a bone marrow biopsy is done to evaluate A) blood dyscrasias such as aplastic anemia or leukemia.

B) hemoglobin and hematocrit production.

C) specific parts of the white cell differentiation.

D) total numbers and types of different lymphocytes.

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Chapter 75: Management of Clients with Hematologic Disorders

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Q1) When assessing the client with multiple myeloma, the nurse would expect to find the manifestation of

A) bone pain.

B) ecchymosis of the skin.

C) painless enlarged lymph nodes.

D) shortness of breath.

Q2) 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.

Q3) The nurse can decrease the danger of transfusion reactions in a client by

A) adding sterile saline to the blood transfusion.

B) forcing fluids.

C) infusing the blood slowly during the first 15 minutes.

D) monitoring the urine output.

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Chapter 76: Management of Clients with Immune Disorders

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Sample Questions

Q1) The nurse concerned about safety encourages a client to stop which medication?

A) Cetirizine (Zyrtec)

B) Diphenhydramine (Benadryl)

C) Fexofenadine (Allegra)

D) Loratadine (Claritin)

Q2) A client with a history of type 1 hypersensitivity reaction is receiving immunotherapy (or desensitization therapy). The nurse administering the allergen injection at 1:00 PM would ask the client to remain in the office until

A) 1:10 PM.

B) 1:20 PM.

C) 1:40 PM.

D) 2:15 PM.

Q3) The home health care nurse who is teaching the client about home environment modifications to self-manage allergies would focus on eliminating allergens that are A) eaten.

B) inhaled.

C) injected.

D) transmitted by direct contact.

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Chapter 77: Management of Clients with Rheumatic Disorders

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Sample Questions

Q1) A client has just been admitted to the nursing unit with the diagnosis of CREST syndrome. The findings the nurse would expect to note during the assessment are (Select all that apply)

A) calcinosis.

B) esophageal dysfunction.

C) rash.

D) Raynaud's phenomenon.

E) spider angiomas.

F) telangiectasia.

Q2) A client has dermatomyositis. The nurse will include priority interventions in the care plan provisions to meet the problem of

A) difficulty ambulating.

B) difficulty swallowing.

C) disorientation.

D) phlebitis.

Q3) To help promote sleep for a client with RA, the nurse would recommend A) exercising just before bedtime.

B) sleeping in thermal underwear.

C) taking a cool shower before bedtime.

D) using a large pillow and warm, heavy blankets.

Page 79

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Chapter 78: Management of Clients with Acquired

Immunodeficiency Syndrome

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Q1) A client with AIDS is experiencing fever with night sweats. A suggestion the nurse could make is to

A) drink all liquids in the morning.

B) keep liquids at the bedside to drink.

C) limit fluid intake after supper.

D) take aspirin if awakened in the night.

Q2) A client is afraid of a recent possible HIV exposure. The nurse should explain that the period of time it takes before HIV antibodies can be detected by laboratory tests is generally

A) 1 to 3 days.

B) 7 to 10 days.

C) 1 to 3 weeks.

D) 4 to 12 weeks.

Q3) 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.

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Chapter 79: Management of Clients with Leukemia and Lymphoma

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Sample Questions

Q1) The nurse reviewing a hematology report 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.

Q2) When the nurse records a platelet count of 20,000/mm³, the most appropriate nursing action is to

A) encourage iron-rich foods.

B) increase fluid intake.

C) institute bleeding precautions.

D) place the client in protective isolation.

Q3) A client with stage I GVHD following a bone marrow transplant is very depressed because he has developed this complication. The nurse should base interactions with this client on the fact that stage I GVHD

A) is likely to prevent successful engraftment.

B) may prevent leukemic relapse.

C) is treatable with steroids.

D) is usually fatal very quickly.

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Chapter 80: Management of Clients Requiring

Transplantation

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Q1) A client who had a liver transplant 4 days ago has developed a fever and decreased biliary tube drainage. The nurse anticipates an order for the client to have a A) liver biopsy.

B) set of blood cultures.

C) ultrasound.

D) white blood cell count.

Q2) A nurse working as part of a transplantation team is conducting a group education session. A client waiting for a heart transplant asks why he cannot stay in his rural home to wait. He knows someone who had a kidney transplant and stayed in the same local area waiting for his transplant. The best response by the nurse would be

A) "Because of confidentiality rules, I can't talk about your friend's experience."

B) "How long ago did that occur?"

C) "Different transplant centers have different requirements."

D) "Each organ's viability time is different. Kidneys can last longer than hearts."

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Chapter 81: Management of Clients with Shock and Multisystem

Disorders

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Sample Questions

Q1) The nurse explains that an advantage of the use of hemoglobin-based oxygen carriers (HBOCs), such as PolyHeme and Hemopure, is that these products

A) decrease the pH of the blood.

B) do not require type and crossmatch.

C) function as packed cells at less cost.

D) increase hemoglobin.

Q2) Nursing care for a client in hypovolemic shock caused by trauma should include

A) giving narcotics for pain relief.

B) maintaining a cool environment.

C) placing the client in Trendelenburg position.

D) providing nasogastric suctioning.

Q3) Distributive shock is primarily due to

A) a fluid shift from the vascular space.

B) an increase in the size of the vascular space.

C) inadequate circulating blood volume.

D) inadequate pumping action of the heart.

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Chapter 82: Management of Clients in the Emergency Department

Available Study Resources on Quizplus for this Chatper

20 Verified Questions

20 Flashcards

Source URL: https://quizplus.com/quiz/4080

Sample Questions

Q1) The nurse is caring for a client brought to the ED after suffering amputation of a toe. The nurse should take care to avoid

A) cleansing the stump area with normal saline.

B) placing the toe directly on ice.

C) placing the wrapped toe in a plastic bag.

D) wrapping the toe in sterile gauze moistened with saline.

Q2) After stabilizing a trauma victim's airway, breathing, and circulation, the next item for the ED nurse to assess is A) abdomen.

B) broken bones.

C) integument.

D) neurologic status.

Q3) 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.

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