Pre-board Exam For June 2009 NLE (Practice Mode)- Www.Rnpedia.Com

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Pre-board Exam For June 2009 NLE (Practice Mode)- Www.Rnpedia.Com - Quiz

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Questions and Answers
  • 1. 

    A 10 year old who has sustained a head injury is brought to the emergency department by his mother. A diagnosis of a mild concussion is made. At the time of discharge, nurse Ron should instruct the mother to:

    • A.

      Withhold food and fluids for 24 hours.

    • B.

      Allow him to play outdoors with his friends.

    • C.

      Arrange for a follow up visit with the child’s primary care provider in one week.

    • D.

      Check for any change in responsiveness every two hours until the follow-up visit.

    Correct Answer
    D. Check for any change in responsiveness every two hours until the follow-up visit.
    Explanation
    Signs of an epidural hematoma in children usually do not appear for 24 hours or more hours; a follow-up visit usually is arranged for one to two days after the injury.

    Rate this question:

  • 2. 

    A male client has suffered a motor accident and is now suffering from hypovolemic shock. Nurse Helen should frequency assess the client’s vital signs during the compensatory stage of shock, because:

    • A.

      Arteriolar constriction occurs

    • B.

      The cardiac workload decreases

    • C.

      Decreased contractility of the heart occurs

    • D.

      The parasympathetic nervous system is triggered

    Correct Answer
    A. Arteriolar constriction occurs
    Explanation
    The early compensation of shock is cardiovascular and is seen in changes in pulse, BP, and pulse pressure; blood is shunted to vital centers, particularly heart and brain.

    Rate this question:

  • 3. 

    A paranoid male client with schizophrenia is losing weight, reluctant to eat, and voicing concerns about being poisoned. The best intervention by nurse Dina would be to:

    • A.

      Allow the client to open canned or pre-packaged food

    • B.

      Restrict the client to his room until 2 lbs are gained

    • C.

      Have a staff member personally taste all of the client’s food

    • D.

      Tell the client the food has been x-rayed by the staff and is safe

    Correct Answer
    A. Allow the client to open canned or pre-packaged food
    Explanation
    The client’s comfort, safety, and nutritional status are the priorities; the client may feel comfortable to eat if the food has been sealed before reaching the mental health facility.

    Rate this question:

  • 4. 

    One day the mother of a young adult confides to nurse Frida that she is very troubled by he child’s emotional illness. The nurse’s most therapeutic initial response would be:

    • A.

      “You may be able to lessen your feelings of guilt by seeking counseling”

    • B.

      “It would be helpful if you become involved in volunteer work at this time”

    • C.

      “I recognize it’s hard to deal with this, but try to remember that this too shall pass”

    • D.

      “Joining a support group of parents who are coping with this problem can be quite helpful.

    Correct Answer
    D. “Joining a support group of parents who are coping with this problem can be quite helpful.
    Explanation
    Taking with others in similar circumstances provides support and allows for sharing of experiences.

    Rate this question:

  • 5. 

    To check for wound hemorrhage after a client has had a surgery for the removal of a tumor in the neck, nurse grace should:

    • A.

      Loosen an edge of the dressing and lift it to see the wound

    • B.

      Observe the dressing at the back of the neck for the presence of blood

    • C.

      Outline the blood as it appears on the dressing to observe any progression

    • D.

      Press gently around the incision to express accumulated blood from the wound

    Correct Answer
    B. Observe the dressing at the back of the neck for the presence of blood
    Explanation
    Drainage flows by gravity.

    Rate this question:

  • 6. 

    A 16-year-old primigravida arrives at the labor and birthing unit in her 38th week of gestation and states that she is labor. To verify that the client is in true labor nurse Trina should:

    • A.

      Obtain sides for a fern test

    • B.

      Time any uterine contractions

    • C.

      Prepare her for a pelvic examination

    • D.

      Apply nitrazine paper to moist vaginal tissue

    Correct Answer
    C. Prepare her for a pelvic examination
    Explanation
    Pelvic examination would reveal dilation and effacement

    Rate this question:

  • 7. 

    As part of the diagnostic workup for pulmonic stenosis, a child has cardiac catheterization. Nurse Julius is aware that children with pulmonic stenosis have increased pressure:

    • A.

      In the pulmonary vein

    • B.

      In the pulmonary artery

    • C.

      On the left side of the heart

    • D.

      On the right side of the heart

    Correct Answer
    D. On the right side of the heart
    Explanation
    Pulmonic stenosis increases resistance to blood flow, causing right ventricular hyperthropy; with right ventricular failure there is an increase in pressure on the right side of the heart.

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  • 8. 

    An obese client asks nurse Elmer how to lose weight. Before answering, the nurse should remember that long-term weight loss occurs best when:

    • A.

      Eating patterns are altered

    • B.

      Fats are limited in the diet

    • C.

      Carbohydrates are regulated

    • D.

      Exercise is a major component

    Correct Answer
    A. Eating patterns are altered
    Explanation
    A new dietary regimen, with a balance of foods from the food pyramid, must be established and continued for weight reduction to occur and be maintained.

    Rate this question:

  • 9. 

    As a very anxious female client is talking to the nurse May, she starts crying. She appears to be upset that she cannot control her crying. The most appropriate response by the nurse would be:

    • A.

      “Is talking about your problem upsetting you?”

    • B.

      “It is Ok to cry; I’ll just stay with you for now”

    • C.

      “You look upset; lets talk about why you are crying.”

    • D.

      “Sometimes it helps to get it out of your system.”

    Correct Answer
    B. “It is Ok to cry; I’ll just stay with you for now”
    Explanation
    This portrays a nonjudgmental attitude that recognizes the client’s needs.

    Rate this question:

  • 10. 

    A patient has partial-thickness burns to both legs and portions of his trunk.  Which of the following I.V. fluids is given first?

    • A.

      Albumin

    • B.

      D5W

    • C.

      Lactated Ringer’s solution

    • D.

      0.9% sodium chloride solution with 2 mEq of potassium per 100 ml

    Correct Answer
    C. Lactated Ringer’s solution
    Explanation
    Lactated Ringer’s solution replaces lost sodium and corrects metabolic acidosis, both of which commonly occur following a burn. Albumin is used as adjunct therapy, not primary fluid replacement. Dextrose isn’t given to burn patients during the first 24 hours because it can cause pseudodiabetes. The patient is hyperkalemic from the potassium shift from the intracellular space to the plasma, so potassium would be detrimental.

    Rate this question:

  • 11. 

    During the first 48 hours after a severe burn of 40% of the clients body surface, the nurse’s assessment should include observations for water intoxication. Associated adaptations include:

    • A.

      Sooty-colored sputum

    • B.

      Frothy pink-tinged sputum

    • C.

      Twitching and disorientation

    • D.

      Urine output below 30ml per hour

    Correct Answer
    C. Twitching and disorientation
    Explanation
    Excess extracellular fluid moves into cells (water intoxication); intracellular fluid excess in sensitive brain cells causes altered mental status; other signs include anorexia nervosa, nausea, vomiting, twitching, sleepiness, and convulsions.

    Rate this question:

  • 12. 

    After a muscle biopsy, nurse Willy should teach the client to:

    • A.

      Change the dressing as needed

    • B.

      Resume the usual diet as soon as desired

    • C.

      Bathe or shower according to preference

    • D.

      Expect a rise in body temperature for 48 hours

    Correct Answer
    B. Resume the usual diet as soon as desired
    Explanation
    As long as the client has no nausea or vomiting, there are no dietary restriction.

    Rate this question:

  • 13. 

    Before a client whose left hand has been amputated can be fitted for a prosthesis, nurse Joy is aware that:

    • A.

      Arm and shoulder muscles must be developed

    • B.

      Shrinkage of the residual limb must be completed

    • C.

      Dexterity in the other extremity must be achieved

    • D.

      Full adjustment to the altered body image must have occurred

    Correct Answer
    B. Shrinkage of the residual limb must be completed
    Explanation
    Shrinkage of the residual limb, resulting from reduction of subcutaneous fat and interstitial fluid, must occur for an adequate fit between the limb and the prosthesis.

    Rate this question:

  • 14. 

    Nurse Zen applies a fetal monitor to the abdomen of a client in active labor. When the client has contractions, the nurse notes a 15 beat per minute deceleration of the fetal heart rate below the baseline lasting 15 seconds. Nurse Cathy should:

    • A.

      Change the maternal position

    • B.

      Prepare for an immediate birth

    • C.

      Call the physician immediately

    • D.

      Obtain the client’s blood pressure

    Correct Answer
    A. Change the maternal position
    Explanation
    Stimulation of the sympathetic nervous system is an initial response to mild hypoxia that accompanies partial cord compression (umbilical vein) during contractions; changing the maternal position can alleviate the compression.

    Rate this question:

  • 15. 

    A male client receiving prolonged steroid therapy complains of always being thirsty and urinating frequently. The best initial action by the nurse would be to:

    • A.

      Perform a finger stick to test the client’s blood glucose level

    • B.

      Have the physician assess the client for an enlarged prostate

    • C.

      Obtain a urine specimen from the client for screening purposes

    • D.

      Assess the client’s lower extremities for the presence of pitting edema

    Correct Answer
    A. Perform a finger stick to test the client’s blood glucose level
    Explanation
    The client has signs of diabetes, which may result from steroid therapy, testing the blood glucose level is a method of screening for diabetes, thus gathering more data.

    Rate this question:

  • 16. 

    Nurse Leslie recognizes that a pacemaker is indicated when a client is experiencing:

    • A.

      Angina

    • B.

      Chest pain

    • C.

      Heart block

    • D.

      Tachycardia

    Correct Answer
    C. Heart block
    Explanation
    This is the primary indication for a pacemaker because there is an interfere with the electrical conduction system of the heart.

    Rate this question:

  • 17. 

    When administering pancrelipase (Pancreases capsules) to child with cystic fibrosis, nurse Faith knows they should be given:

    • A.

      With meals and snacks

    • B.

      Every three hours while awake

    • C.

      On awakening, following meals, and at bedtime

    • D.

      After each bowel movement and after postural draianage

    Correct Answer
    A. With meals and snacks
    Explanation
    Pancreases capsules must be taken with food and snacks because it acts on the nutrients and readies them for absorption.

    Rate this question:

  • 18. 

    A preterm neonate is receiving oxygen by an overhead hood. During the time the infant is under the hood, it would be appropriate for nurse Gian to:

    • A.

      Hydrate the infant q15 min

    • B.

      Put a hat on the infant’s head

    • C.

      Keep the oxygen concentration consistent

    • D.

      Remove the infant q15 min for stimulation

    Correct Answer
    B. Put a hat on the infant’s head
    Explanation
    Oxygen has cooling effect, and the baby should be kept warm so that metabolic activity and oxygen demands are not increased.

    Rate this question:

  • 19. 

    A client’s sputum smears for acid fast bacilli (AFB) are positive, and transmission-based airborne precautions are ordered. Nurse Kyle should instruct visitors to:

    • A.

      Limit contact with non-exposed family members

    • B.

      Avoid contact with any objects present in the client’s room

    • C.

      Wear an Ultra-Filter mask when they are in the client’s room

    • D.

      Put on a gown and gloves before going into the client’s room

    Correct Answer
    C. Wear an Ultra-Filter mask when they are in the client’s room
    Explanation
    Tubercle bacilli are transmitted through air currents; therefore personal protective equipment such as an Ultra-Filter mask is necessary.

    Rate this question:

  • 20. 

    A client with a head injury has a fixed, dilated right pupil; responds only to painful stimuli; and exhibits decorticate posturing. Nurse Kate  should recognize that these are signs of:

    • A.

      Meningeal irritation

    • B.

      Subdural hemorrhage

    • C.

      Medullary compression

    • D.

      Cerebral cortex compression

    Correct Answer
    D. Cerebral cortex compression
    Explanation
    Cerebral compression affects pyramidal tracts, resulting in decorticate rigidity and cranial nerve injury, which cause pupil dilation.

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  • 21. 

    After a lateral crushing chest injury, obvious right-sided paradoxic motion of the client’s chest demonstrates multiple rib fraactures, resulting in a flail chest. The complication the nurse should carefully observe for would be:

    • A.

      Mediastinal shift

    • B.

      Tracheal laceration

    • C.

      Open pneumothorax

    • D.

      Pericardial tamponade

    Correct Answer
    A. Mediastinal shift
    Explanation
    Mediastinal structures move toward the uninjured lung, reducing oxygenation and venous return.

    Rate this question:

  • 22. 

    When planning care for a client at 30-weeks gestation, admitted to the hospital after vaginal bleeding secondary to placenta previa, the nurse’s primary objective would be:

    • A.

      Provide a calm, quiet environment

    • B.

      Prepare the client for an immediate cesarean birth

    • C.

      Prevent situations that may stimulate the cervix or uterus

    • D.

      Ensure that the client has regular cervical examinations assess for labor

    Correct Answer
    C. Prevent situations that may stimulate the cervix or uterus
    Explanation
    Stimulation of the cervix or uterus may cause bleeding or hemorrhage and should be avoided.

    Rate this question:

  • 23. 

    When planning discharge teaching for a young female client who has had a pneumothorax, it is important that the nurse include the signs and symptoms of a pneumothorax and teach the client to seek medical assistance if she experiences:

    • A.

      Substernal chest pain

    • B.

      Episodes of palpitation

    • C.

      Severe shortness of breath

    • D.

      Dizziness when standing up

    Correct Answer
    C. Severe shortness of breath
    Explanation
    This could indicate a recurrence of the pneumothorax as one side of the lung is inadequate to meet the oxygen demands of the body.

    Rate this question:

  • 24. 

    After a laryngectomy, the most important equipment to place at the client’s bedside would be:

    • A.

      Suction equipment

    • B.

      Humidified oxygen

    • C.

      A nonelectric call bell

    • D.

      A cold-stream vaporizer

    Correct Answer
    A. Suction equipment
    Explanation
    Respiratory complications can occur because of edema of the glottis or injury to the recurrent laryngeal nerve.

    Rate this question:

  • 25. 

    Nurse Oliver interviews a young female client with anorexia nervosa to obtain information for the nursing history. The client’s history is likely to reveal a:

    • A.

      Strong desire to improve her body image

    • B.

      Close, supportive mother-daughter relationship

    • C.

      Satisfaction with and desire to maintain her present weight

    • D.

      Low level of achievement in school, with little concerns for grades

    Correct Answer
    A. Strong desire to improve her body image
    Explanation
    Clients with anorexia nervosa have a disturbed self image and always see themselves as fat and needing further reducing.

    Rate this question:

  • 26. 

    Nurse Bea should plan to assist a client with an obsessive-compulsive disorder to control the use of ritualistic behavior by:

    • A.

      Providing repetitive activities that require little thought

    • B.

      Attempting to reduce or limit situations that increase anxiety

    • C.

      Getting the client involved with activities that will provide distraction

    • D.

      Suggesting that the client perform menial tasks to expiate feelings of guilt

    Correct Answer
    B. Attempting to reduce or limit situations that increase anxiety
    Explanation
    Persons with high anxiety levels develop various behaviors to relieve their anxiety; by reducing anxiety, the need for these obsessive-compulsive action is reduced.

    Rate this question:

  • 27. 

    A 2 ½ year old child undergoes a ventriculoperitoneal shunt revision. Before discharge, nurse John, knowing the expected developmental behaviors for this age group, should tell the parents to call the physician if the child:

    • A.

      Tries to copy all the father’s mannerisms

    • B.

      Talks incessantly regardless of the presence of others

    • C.

      Becomes fussy when frustrated and displays a shortened attention span

    • D.

      Frequently starts arguments with playmates by claiming all toys are “mine”

    Correct Answer
    C. Becomes fussy when frustrated and displays a shortened attention span
    Explanation
    Shortened attention span and fussy behavior may indicate a change in intracranial pressure and/or shunt malfunction.

    Rate this question:

  • 28. 

    A urinary tract infection is a potential danger with an indwelling catheter. Nurse Gina can best plan to avoid this complication by:

    • A.

      Assessing urine specific gravity

    • B.

      Maintaining the ordered hydration

    • C.

      Collecting a weekly urine specimen

    • D.

      Emptying the drainage bag frequently

    Correct Answer
    B. Maintaining the ordered hydration
    Explanation
    Promoting hydration maintains urine production at a higher rate, which flushes the bladder and prevents urinary stasis and possible infection.

    Rate this question:

  • 29. 

    A client has sustained a fractured right femur in a fall on stairs. Nurse Troy with the emergency response team assess for signs of circulatory impairment by:

    • A.

      Turning the client to side lying position

    • B.

      Asking the client to cough and deep breathe

    • C.

      Taking the client’s pedal pulse in the affected limb

    • D.

      Instructing the client to wiggle the toes of the right foot

    Correct Answer
    C. Taking the client’s pedal pulse in the affected limb
    Explanation
    Monitoring a pedal pulse will assess circulation to the foot.

    Rate this question:

  • 30. 

    To assess orientation to place in a client suspected of having dementia of the alzheimers type, nurse Chris should ask:

    • A.

      “Where are you?”

    • B.

      “Who brought you here?”

    • C.

      “Do you know where you are?”

    • D.

      “How long have you been there?”

    Correct Answer
    A. “Where are you?”
    Explanation
    “Where are you?” is the best question to elicit information about the client’s orientation to place because it encourages a response that can be assessed.

    Rate this question:

  • 31. 

    Nurse Acel assesses a postpartum client who had an abruption placentae and suspects that disseminated intravascular coagulation (DIC) is occurring when assessments demonstrate:

    • A.

      A boggy uterus

    • B.

      Multiple vaginal clots

    • C.

      Hypotension and tachycardia

    • D.

      Bleeding from the venipuncture site

    Correct Answer
    D. Bleeding from the venipuncture site
    Explanation
    This indicates a fibrinogenemia; massive clotting in the area of the separation has resulted in a lowered circulating fibrinogen.

    Rate this question:

  • 32. 

    When a client on labor experiences the urge to push a 9cm dilation, the breathing pattern that nurse Rhea should instruct the client to use is the:

    • A.

      Expulsion pattern

    • B.

      Slow paced pattern

    • C.

      Shallow chest pattern

    • D.

      Blowing pattern

    Correct Answer
    D. Blowing pattern
    Explanation
    Clients should use a blowing pattern to overcome the premature urge to push.

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  • 33. 

    Nurse Ronald should explain that the most beneficial between-meal snack for a client who is recovering from the full-thickness burns would be a:

    • A.

      Cheeseburger and a malted

    • B.

      Piece of blueberry pie and milk

    • C.

      Bacon and tomato sandwich and tea

    • D.

      Chicken salad sandwich and soft drink

    Correct Answer
    A. Cheeseburger and a malted
    Explanation
    Of the selections offered, this is the highest in calories and protein, which are needed for increased basal metabolic rate and for tissue repair.

    Rate this question:

  • 34. 

    Nurse Wilma recognizes that failure of a newborn to make the appropriate adaptation to extrauterine life would be indicated by:

    • A.

      Flexed extremities

    • B.

      Cyanotic lips and face

    • C.

      A heart rate of 130 beats per minute

    • D.

      A respiratory rate of 40 breath per minute

    Correct Answer
    B. Cyanotic lips and face
    Explanation
    Cenral cyanosis (blue lips and face) indicates lowered oxygenation of the blood, caused by either decreased lung expansion or right to left shunting of blood.

    Rate this question:

  • 35. 

    The laboratory calls to state that a client’s lithium level is 1.9 mEq/L after 10 days of lithium therapy. Nurse Reese should:

    • A.

      Notify the physician of the findings because the level is dangerously high

    • B.

      Monitor the client closely because the level of lithium in the blood is slightly elevated

    • C.

      Continue to administer the medication as ordered because the level is within the therapeutic range

    • D.

      Report the findings to the physician so the dosage can be increased because the level is below therapeutic range

    Correct Answer
    A. Notify the pHysician of the findings because the level is dangerously high
    Explanation
    Levels close to 2 mEq/L are dangerously close to the toxic level; immediate action must be taken.

    Rate this question:

  • 36. 

    A client has a regular 30-day menstrual cycles. When teaching about the rhythm method, Which the client and her husband have chosen to use for family planning, nurse Dianne should emphasize that the client’s most fertile days are:

    • A.

      Days 9 to 11

    • B.

      Days 12 to 14

    • C.

      Days 15 to 17

    • D.

      Days 18 to 20

    Correct Answer
    C. Days 15 to 17
    Explanation
    Ovulation occurs approximately 14 days before the next menses, about the 16th day in 30 day cycle; the 15th to 17th days would be the best time to avoid sexual intercourse.

    Rate this question:

  • 37. 

    Before an amniocentesis, nurse Alexandra should:

    • A.

      Initiate the intravenous therapy as ordered by the physician

    • B.

      Inform the client that the procedure could precipitate an infection

    • C.

      Assure that informed consent has been obtained from the client

    • D.

      Perform a vaginal examination on the client to assess cervical dilation

    Correct Answer
    C. Assure that informed consent has been obtained from the client
    Explanation
    An invasive procedure such as amniocentesis requires informed consent.

    Rate this question:

  • 38. 

    While a client is on intravenous magnesium sulfate therapy for preeclampsia, it is essential for nurse Amy to monitor the client’s deep tendon reflexes to:

    • A.

      Determine her level of consciousness

    • B.

      Evaluate the mobility of the extremities

    • C.

      Determine her response to painful stimuli

    • D.

      Prevent development of respiratory distress

    Correct Answer
    D. Prevent development of respiratory distress
    Explanation
    Respiratory distress or arrest may occur when the serum level of magnesium sulfate reaches 12 to 15 mg/dl; deep tendon reflexes disappear when the serum level is 10 to 12 mg/dl; the drug is withheld in the absence of deep tendon reflexes; the therapeutic serum level is 5 to 8 mg/dl.

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  • 39. 

     A preschooler is admitted to the hospital with a diagnosis of acute glomerulonephritis. The child’s history reveals a 5-pound weight gain in one week and peritoneal edema. For the most accurate information on the status of the child’s edema, nursing intervention should include:

    • A.

      Obtaining the child’s daily weight

    • B.

      Doing a visual inspection of the child

    • C.

      Measuring the child’s intake and output

    • D.

      Monitoring the child’s electrolyte values

    Correct Answer
    A. Obtaining the child’s daily weight
    Explanation
    Weight monitoring is the most useful means of assessing fluid balance and changes in the edematous state; 1 liter of fluid weighs about 2.2 pounds.

    Rate this question:

  • 40. 

    Nurse Mickey is administering dexamethasome (Decadron) for the early management of a client’s cerebral edema. This treatment is effective because:

    • A.

      Acts as hyperosmotic diuretic

    • B.

      Increases tissue resistance to infection

    • C.

      Reduces the inflammatory response of tissues

    • D.

      Decreases the information of cerebrospinal fluid

    Correct Answer
    C. Reduces the inflammatory response of tissues
    Explanation
    Corticosteroids act to decrease inflammation which decreases edema.

    Rate this question:

  • 41. 

    During newborn nursing assessment, a positive Ortolani’s sign would be indicated by:

    • A.

      A unilateral droop of hip

    • B.

      A broadening of the perineum

    • C.

      An apparent shortening of one leg

    • D.

      An audible click on hip manipulation

    Correct Answer
    D. An audible click on hip manipulation
    Explanation
    With specific manipulation, an audible click may be heard of felt as he femoral head slips into the acetabulum.

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  • 42. 

    When caring for a dying client who is in the denial stage of grief, the best nursing approach would be to:

    • A.

      Agree and encourage the client’s denial

    • B.

      Allow the denial but be available to discuss death

    • C.

      Reassure the client that everything will be OK

    • D.

      Leave the client alone to confront the feelings of impending loss

    Correct Answer
    B. Allow the denial but be available to discuss death
    Explanation
    This does not remove client’s only way of coping, and it permits future movement through the grieving process when the client is ready.

    Rate this question:

  • 43. 

    To decrease the symptoms of gastroesophageal reflux disease (GERD), the physician orders dietary and medication management. Nurse Helen should teach the client that the meal alteration that would be most appropriate would be:

    • A.

      Ingest foods while they are hot

    • B.

      Divide food into four to six meals a day

    • C.

      Eat the last of three meals daily by 8pm

    • D.

      Suck a peppermint candy after each meal

    Correct Answer
    B. Divide food into four to six meals a day
    Explanation
    The volume of food in the stomach should be kept small to limit pressure on the cardiac sphincter.

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  • 44. 

    After a mastectomy or hysterectomy, clients may feel incomplete as women. The statement that should alert nurse Gina to this feeling would be:

    • A.

      “I can’t wait to see all my friends again”

    • B.

      “I feel washed out; there isn’t much left”

    • C.

      “I can’t wait to get home to see my grandchild”

    • D.

      “My husband plans for me to recuperate at our daughter’s home”

    Correct Answer
    B. “I feel washed out; there isn’t much left”
    Explanation
    The client’s statement infers an emptiness with an associated loss.

    Rate this question:

  • 45. 

    A client with obstruction of the common bile duct may show a prolonged bleeding and clotting time because:

    • A.

      Vitamin K is not absorbed

    • B.

      The ionized calcium levels falls

    • C.

      The extrinsic factor is not absorbed

    • D.

      Bilirubin accumulates in the plasma

    Correct Answer
    A. Vitamin K is not absorbed
    Explanation
    Vitamin K, a fat soluble vitamin, is not absorbed from the GI tract in the absence of bile; bile enters the duodenum via the common bile duct.

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  • 46. 

    Realizing that the hypokalemia is a side effect of steroid therapy, nurse Monette should monitor a client taking steroid medication for:

    • A.

      Hyperactive reflexes

    • B.

      An increased pulse rate

    • C.

      Nausea, vomiting, and diarrhea

    • D.

      Leg weakness with muscle cramps

    Correct Answer
    D. Leg weakness with muscle cramps
    Explanation
    Impulse conduction of skeletal muscle is impaired with decreased potassium levels, muscular weakness and cramps may occur with hypokalemia.

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  • 47. 

    When assessing a newborn suspected of having Down syndrome, nurse Rey would expect to observe:

    • A.

      Long thin fingers

    • B.

      Large, protruding ears

    • C.

      Hypertonic neck muscles

    • D.

      Simian lines on the hands

    Correct Answer
    D. Simian lines on the hands
    Explanation
    This is characteristic finding in newborns with Down syndrome.

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  • 48. 

    A 10 year old girl is admitted to the pediatric unit for recurrent pain and swelling of her joints, particularly her knees and ankles. Her diagnosis is juvenile rheumatoid arthritis. Nurse Janah recognizes that besides joint inflammation, a unique manifestation of the rheumatoid process involves the:

    • A.

      Ears

    • B.

      Eyes

    • C.

      Liver

    • D.

      Brain

    Correct Answer
    B. Eyes
    Explanation
    Rheumatoid arthritis can cause inflammation of the iris and ciliary body of the eyes which may lead to blindness.

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  • 49. 

    A disturbed client is scheduled to begin group therapy. The client refuses to attend. Nurse Lolit should:

    • A.

      Accept the client’s decision without discussion

    • B.

      Have another client to ask the client to consider

    • C.

      Tell the client that attendance at the meeting is required

    • D.

      Insist that the client join the group to help the socialization process

    Correct Answer
    A. Accept the client’s decision without discussion
    Explanation
    This is all the nurse can do until trust is established; facing the client to attend will disrupt the group.

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  • 50. 

    Because a severely depressed client has not responded to any of the antidepressant medications, the psychiatrist decides to try electroconvulsive therapy (ECT). Before the treatment the nurse should:

    • A.

      Have the client speak with other clients receiving ECT

    • B.

      Give the client a detailed explanation of the entire procedure

    • C.

      Limit the client’s intake to a light breakfast on the days of the treatment

    • D.

      Provide a simple explanation of the procedure and continue to reassure the client

    Correct Answer
    D. Provide a simple explanation of the procedure and continue to reassure the client
    Explanation
    The nurse should offer support and use clear, simple terms to allay client’s anxiety.

    Rate this question:

Quiz Review Timeline +

Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

  • Current Version
  • Mar 21, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • May 13, 2012
    Quiz Created by
    RNpedia.com
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