CRNE Exam MCQ Quiz! Trivia

1. Which of the following should be the next action of a nurse whose client's venipuncture site has a low temperature and is swollen, the vein proximal is occluded to the intravenous site by the nurse and the intravenous fluid continues to flow?

Rub the infiltrated area.

Apply compress.

Remove the intravenous device.

Elevate the extremity.

If a client's venipuncture site has a low temperature and is swollen, and the vein proximal is occluded to the intravenous site, it indicates that the client has an infiltrated intravenous site. Infiltration occurs when the intravenous fluid leaks into the surrounding tissue instead of entering the vein. This can cause swelling, coolness, and occlusion of the vein. The appropriate action in this situation is to remove the intravenous device to prevent further complications and assess the client's condition. Rubbing the infiltrated area or applying a compress may worsen the condition. Elevating the extremity may be helpful in some cases, but removing the intravenous device is the priority.

Explanation

If a client's venipuncture site has a low temperature and is swollen, and the vein proximal is occluded to the intravenous site, it indicates that the client has an infiltrated intravenous site. Infiltration occurs when the intravenous fluid leaks into the surrounding tissue instead of entering the vein. This can cause swelling, coolness, and occlusion of the vein. The appropriate action in this situation is to remove the intravenous device to prevent further complications and assess the client's condition. Rubbing the infiltrated area or applying a compress may worsen the condition. Elevating the extremity may be helpful in some cases, but removing the intravenous device is the priority.

2. Which of the subsequent options should signal the labor nurse that her patient has commenced the second stage of labor?

The presenting part is below the ischial spines

The woman tells you she needs to push.

The amniotic membranes have ruptured.

The cervix is thin and fully dilated.

The correct answer is "The cervix is thin and fully dilated." This is because the second stage of labor begins when the cervix is fully dilated and the woman is ready to push. The thinning of the cervix indicates that it has progressed and is ready for the next stage of labor. The other options do not necessarily indicate the start of the second stage of labor. The presenting part being below the ischial spines can happen earlier in labor, the woman feeling the need to push can occur before the cervix is fully dilated, and the rupture of the amniotic membranes can happen at any stage of labor.

Explanation

The correct answer is "The cervix is thin and fully dilated." This is because the second stage of labor begins when the cervix is fully dilated and the woman is ready to push. The thinning of the cervix indicates that it has progressed and is ready for the next stage of labor. The other options do not necessarily indicate the start of the second stage of labor. The presenting part being below the ischial spines can happen earlier in labor, the woman feeling the need to push can occur before the cervix is fully dilated, and the rupture of the amniotic membranes can happen at any stage of labor.

3. Which of the following clients in a hospital unit is a physician most likely to order a therapeutic diet which is a low-residue diet that consists of foods low in residue and high in carbohydrates?

A client with dysphasia

A client with an inflammatory bowel disease

A client with reflux esophagitis

A client ordered for an initial feeding after a complete bowel rest

A client with an inflammatory bowel disease is most likely to be ordered a low-residue diet because this type of diet helps to reduce the amount of undigested food and fiber in the intestines, which can be beneficial for individuals with inflammatory bowel diseases such as Crohn's disease or ulcerative colitis. This diet consists of foods that are low in residue, meaning they are easily digested and leave minimal waste in the intestines. Additionally, the high carbohydrate content in this diet provides a good source of energy for the body.

Explanation

A client with an inflammatory bowel disease is most likely to be ordered a low-residue diet because this type of diet helps to reduce the amount of undigested food and fiber in the intestines, which can be beneficial for individuals with inflammatory bowel diseases such as Crohn's disease or ulcerative colitis. This diet consists of foods that are low in residue, meaning they are easily digested and leave minimal waste in the intestines. Additionally, the high carbohydrate content in this diet provides a good source of energy for the body.

4. Cecelia, a 47-year-old patient, complains of a sense of a veil covering her vision. She experiences flashes of floaters, light, and blurry vision. Based on the stated symptoms, what is the patient most likely diagnosed with?

Glaucoma

Retinal detachment

Cataract

Hyphema

Based on the symptoms described, the patient is most likely diagnosed with retinal detachment. Retinal detachment occurs when the retina, the tissue at the back of the eye responsible for vision, becomes separated from its normal position. Symptoms such as a sense of a veil covering the vision, flashes of floaters, light, and blurry vision are commonly associated with retinal detachment. Prompt medical attention is necessary to prevent permanent vision loss.

Explanation

Based on the symptoms described, the patient is most likely diagnosed with retinal detachment. Retinal detachment occurs when the retina, the tissue at the back of the eye responsible for vision, becomes separated from its normal position. Symptoms such as a sense of a veil covering the vision, flashes of floaters, light, and blurry vision are commonly associated with retinal detachment. Prompt medical attention is necessary to prevent permanent vision loss.

5. A client with symptoms of diabetic ketoacidosis is diagnosed with metabolic acidosis after the results of the arterial blood gas test were reviewed. Which of the following laboratory results in the client's chart is a nurse expected to note?

High pH; high bicarbonate concentration

Low pH; high PCO2

High pH; low PCO2

Low pH; low bicarbonate concentration

A client with symptoms of diabetic ketoacidosis is diagnosed with metabolic acidosis. Metabolic acidosis is characterized by a low pH and low bicarbonate concentration. In this condition, the body is unable to effectively remove acid or produce enough bicarbonate to neutralize the acid, leading to an imbalance in the body's pH levels. Therefore, the nurse would expect to note a low pH and low bicarbonate concentration in the client's laboratory results.

Explanation

A client with symptoms of diabetic ketoacidosis is diagnosed with metabolic acidosis. Metabolic acidosis is characterized by a low pH and low bicarbonate concentration. In this condition, the body is unable to effectively remove acid or produce enough bicarbonate to neutralize the acid, leading to an imbalance in the body's pH levels. Therefore, the nurse would expect to note a low pH and low bicarbonate concentration in the client's laboratory results.

6. A nurse is caring for Kenny, an alcoholic for more than 15 years, who is due for a liver biopsy. Which of the following positions should the nurse place Kenny after the procedure?

Right lateral side-lying position

Sitting on the edge of bed and leaning over the bedside table, with the feet supported on a stool

High-Fowler’s position

Supine, with the right side of the right upper abdomen exposed

The nurse should place Kenny in the right lateral side-lying position after the liver biopsy. This position helps to promote drainage of any excess fluid or blood that may accumulate in the liver area after the procedure. It also helps to prevent any pressure on the liver and reduces the risk of bleeding. Additionally, this position promotes comfort and allows for easier monitoring of vital signs.

Explanation

The nurse should place Kenny in the right lateral side-lying position after the liver biopsy. This position helps to promote drainage of any excess fluid or blood that may accumulate in the liver area after the procedure. It also helps to prevent any pressure on the liver and reduces the risk of bleeding. Additionally, this position promotes comfort and allows for easier monitoring of vital signs.

7. Which of the subsequent assessment findings is most likely noted in the patient chart of the man named Ben who has been on steroid therapy but has been recently diagnosed with a duodenal ulcer?

Pain in the abdomen, relieved by eating

Gnawing pain in the midepigastric area one hour after eating

Sour taste in the mouth

Vomiting

The most likely assessment finding noted in the patient chart of Ben, who has been on steroid therapy and recently diagnosed with a duodenal ulcer, is pain in the abdomen that is relieved by eating. This is because duodenal ulcers are commonly associated with the production of excess stomach acid, which causes pain. Eating can help neutralize the acid and temporarily relieve the pain. Gnawing pain in the midepigastric area one hour after eating is more characteristic of gastric ulcers, sour taste in the mouth can be a symptom of gastroesophageal reflux disease (GERD), and vomiting is not specifically associated with duodenal ulcers.

Explanation

The most likely assessment finding noted in the patient chart of Ben, who has been on steroid therapy and recently diagnosed with a duodenal ulcer, is pain in the abdomen that is relieved by eating. This is because duodenal ulcers are commonly associated with the production of excess stomach acid, which causes pain. Eating can help neutralize the acid and temporarily relieve the pain. Gnawing pain in the midepigastric area one hour after eating is more characteristic of gastric ulcers, sour taste in the mouth can be a symptom of gastroesophageal reflux disease (GERD), and vomiting is not specifically associated with duodenal ulcers.

8. Which should be the initial action of a nurse, if the nurse suspects air embolism for a client with complete parenteral nutrition, who complains of pains in the chest and difficulty breathing?

Place the client in left-side lying position.

Administer oxygen.

Notify the physician.

Clamp the intravenous catheter.

In the given scenario, the correct initial action for the nurse would be to clamp the intravenous catheter. Air embolism occurs when air enters the bloodstream, which can be life-threatening. By clamping the intravenous catheter, the nurse can prevent further air from entering the client's bloodstream. This action should be taken immediately to minimize the risk of complications. Administering oxygen and notifying the physician are important steps, but clamping the catheter takes priority in this situation. Placing the client in a left-side lying position is not the initial action for air embolism.

Explanation

In the given scenario, the correct initial action for the nurse would be to clamp the intravenous catheter. Air embolism occurs when air enters the bloodstream, which can be life-threatening. By clamping the intravenous catheter, the nurse can prevent further air from entering the client's bloodstream. This action should be taken immediately to minimize the risk of complications. Administering oxygen and notifying the physician are important steps, but clamping the catheter takes priority in this situation. Placing the client in a left-side lying position is not the initial action for air embolism.

9. A nurse is taking care of a two-month-old baby boy who has myelomeningocele. Initial findings reveal that the infant boy has a temperature of 36.9°C. What should be the initial action of the nurse?

Decrease the infant’s temperature by sponge bath.

Report the finding to the physician.

Record the infant’s temperature.

Assess the sac for feces or urine contamination.

The nurse should report the finding to the physician because a temperature of 36.9°C in a two-month-old baby may indicate hypothermia, which can be a serious condition requiring medical attention. The physician will need to evaluate the baby's condition and determine the appropriate course of action.

Explanation

The nurse should report the finding to the physician because a temperature of 36.9°C in a two-month-old baby may indicate hypothermia, which can be a serious condition requiring medical attention. The physician will need to evaluate the baby's condition and determine the appropriate course of action.

10. Which of the following hypotonic solutions does a physician order to a client with a fluid volume deficit?

5% dextrose in 0.9% saline

0.45% saline

5% dextrose in water

5% dextrose in lactated Ringer’s solution

A physician would order 5% dextrose in water as a hypotonic solution for a client with a fluid volume deficit because it helps to increase the client's fluid volume. The 5% dextrose provides calories and the water helps to hydrate the client. This solution is hypotonic because it has a lower concentration of solutes compared to the client's body fluids, allowing for the movement of water into the cells to rehydrate them.

Explanation

A physician would order 5% dextrose in water as a hypotonic solution for a client with a fluid volume deficit because it helps to increase the client's fluid volume. The 5% dextrose provides calories and the water helps to hydrate the client. This solution is hypotonic because it has a lower concentration of solutes compared to the client's body fluids, allowing for the movement of water into the cells to rehydrate them.