NUR2790 STUDY GUIDE EXAM 4/NUR2790 STUDY GUIDE EXAM 4, Exams of Health sciences

Download NUR2790 STUDY GUIDE EXAM 4/NUR2790 STUDY GUIDE EXAM 4 and more Exams Health sciences in PDF only on Docsity! NUR2790 STUDY GUIDE EXAM 4 NUR2790 STUDY GUIDE EXAM 4. Neuro  For the client who is at risk for stroke, the most important guideline the nurse should teach is to: A. monitor weight and activity. B. increase drinks with caffeine. C. increase amounts of sodium in the diet. D. monitor blood pressure.  A client is being evaluated for a stroke. The nurse knows that one of the easiest and most common diagnostic tests used to differentiate between strokes is: A. magnetic resonance imaging (MRI). B. positron emission tomography (PET). C. electrocardiography (EEG). D. computed tomography (CT).  While instructing a client on stroke prevention, the nurse mentions medications that are useful in stroke prevention. The following medications are effective in preventing a stroke, EXCEPT: NUR2790 STUDY GUIDE EXAM 4 A. anticholinergics. B. antiplatelets. C. anticoagulants. D. neuroprotective agents.  A client is being seen in the emergency department experiencing symptoms of a stroke. The nurse realizes that the administration of a medication to break clots, such as tPA, should be administered within how many minutes of the client presenting to the emergency department? A. 120 minutes B. 90 minutes C. 30 minutes D. 60 minutes  A client diagnosed with an embolic stroke is not a candidate for tPA. The nurse realizes that the client might be eligible for which of the following forms of treatment? A. Intravenous fluid therapy B. Carotid endarterectomy C. Carotid stenting D. Antiarrhythmic medication NUR2790 STUDY GUIDE EXAM 4 C. surgery. D. chemotherapy.  The nurse is caring for a patient with increased intracranial pressure. Which action is considered unsafe? A. Clustering many nursing activities B. Aligning the neck with the body C. Elevating the head of the bed 30 degrees D. Providing stool softeners or laxatives as ordered  The earliest and most sensitive assessment finding that would indicate an alteration in intracranial regulation would be? A, inability to focus visually B. loss of primitive reflexes. C. unequal pupil size. NUR2790 STUDY GUIDE EXAM 4 D. change in level of consciousness.  A school age child is placed on a waiting list for a liver transplant. The nurse knows that the most common reason for children to need this type of transplant is because of: A. cirrhosis due to hepatitis C B. diabetes. C. Crohn's disease. D. biliary atresia.  Components of the GCS the nurse would use to assess a patient after a head injury include: A. head circumference. B. verbal responsiveness. C. cranial nerve function. Liver D. Blood pressure NUR2790 STUDY GUIDE EXAM 4  A child care worker complains of flu-like symptoms. On further assessment, hepatitis is suspected. The nurse realizes that this individual is at risk for which type of hepatitis? A. Hepatitis A B. Hepatitis D C. Hepatitis C D. Hepatitis B  An older male is diagnosed with cirrhosis of the liver. The nurse knows that the most likely cause of this problem is: A. drinking excessive alcohol. B. eating bad food. C. traveling to a foreign country. D. being in the military.  A client is scheduled for a liver biopsy. The nurse realizes that the most important sign to assess for is: A. Bleeding. B. Nausea and vomiting. NUR2790 STUDY GUIDE EXAM 4 E. "All women have the disorder but not the symptoms." F. "Females often do not experience the effects of the disease until menopause." G. "It doesn't affect people until they are in their 50s." H. Posticteric  A client is diagnosed with liver disease. Which of the following is one impact of this disorder on a client's fluid and electrolyte status? A. Hyponatremia B. Hypernatremia C. Hypercalcemia D. Hyperkalemia  The nurse, caring for a client recovering from the placement of a shunt to treat portal hypertension, should assess the client for which of the following complications associated with this surgery? A. Pulmonary edema B. Pulmonary emboli C. Myocardial infarction D. Decreased peripheral pulses NUR2790 STUDY GUIDE EXAM 4  A client is diagnosed with macrovesicular fatty liver. Which of the following should the nurse instruct this client? A. Increase exercise. B. Avoid all alcohol. C. Expect to develop jaundice. D. Treatment includes antibiotic therapy.  A client is demonstrating yellow pigmentation of the skin and sclera. Which of the following can be used to describe this client's symptoms? (Select all that apply.) A. Icterus B. Cirrhosis C. Dyspepsia D. Sclerosis E. Jaundice F. Kernicterus  A client is diagnosed with a disorder of the liver. The nurse realizes this client might experience which of the following? (Select all that apply.) A. Elevated levels of vitamin E NUR2790 STUDY GUIDE EXAM 4 B. Poor digestion of fats C. Increased bleeding D. Insulin resistance E. Nerve damage F. Low vitamin A levels  A client is diagnosed with portal hypertension. The nurse should assess the client for which of the following disorders associated with this diagnosis? (Select all that apply.) A. Esophag eal varices B. Splenomegaly C. Caput medusae D. Hemorrhoid s E. Gastritis F. Gallstone formation Musculoskeletal NUR2790 STUDY GUIDE EXAM 4 client? A. "It immobilizes the muscles and joints." B. "It prevents the need for surgery." C. "It reduces the need for a cast." D. "It reduces bleeding, swelling and pain." 1. A client has had a cast applied to immobilize a right ulnar fracture. Which of the following nursing interventions is most important? A. Giving pain medication B. Starting discharge teaching C. Checking capillary refill time D. Calling physical therapy for a sling 35. A client with a right arm cast is experiencing signs of a serious complication. Which of the following would cause the nurse the most concern? A. Severe pain to the right arm continues after receiving pain medication B. Itching under the cast C. Finger movement D. Capillary refill time less than 3 seconds NUR2790 STUDY GUIDE EXAM 4 36. A client has been wearing a splint for carpal tunnel syndrome for 7 weeks. The nurse realizes that which of the following would be the next course of treatment for this client? A. Corticosteroid injection B. Casting C. Exercises D. Surgery 37. The nurse is planning care for a client recovering from a meniscal injury. Which of the following should be included as strategies to avoid future injuries? A. Avoid skiing. B. Wear similar shoes for all activities. C. Avoid hamstring muscle exercises. D. Stretch before and after exercise. 38. A client with an ankle sprain is instructed to follow RICE. Which of NUR2790 STUDY GUIDE EXAM 4 the following should the nurse instruct the client regarding this process? A. "Apply an elastic bandage to the site." B. "Apply ice to the ankle once a day." C. "Maintain your normal level of activity." D. "Elevate the extremity every day for 20 to 30 minutes." 39. The nurse is instructing a client on ways to prevent the onset of stress fractures. Which of the following should be included in these instructions? A. Increase intensity of training 10% each day B. Avoid overtraining C. Limit warm up exercises D. Avoid shock absorbing footwear 40. The nurse suspects a client, recovering from hip replacement surgery, is experiencing an infection when which of the following is assessed? NUR2790 STUDY GUIDE EXAM 4 A client with osteoporosis suffers a fracture, then falls. This type of fracture is called: Selected Answer: Pathologi cal fracture Answers: Pathologi cal fracture Greenstic k fracture Comminuted fracture Impacted fracture 43. Pt with #pelvis, dyspnea, and restlessness- what are S/S fat emboli: Sz, NUR2790 STUDY GUIDE EXAM 4 upper body petechiae, temp NUR2790 STUDY GUIDE EXAM 4 A client, recovering from a fractured pelvis, begins to have dyspnea and restlessness. The nurse is concerned that the client is experiencing a fat emboli when which of the following are assessed? SATA Upper body petechia Seizures Temp 102 MISCELLANEOUS 44. The nurse is admitting an older adult with decompensated congestive heart failure. The nursing assessment reveals adventitious lung sounds, dyspnea, and orthopnea. The nurse should question which doctor's order? A. Oxygen via face mask at 8 L/min B. Intravenous (IV) 500 mL of 0.9% NaCl at 125 mL/hr C. Furosemide (Lasix) 20 mg PO now D. KCl 20 mEq PO two times per day NUR2790 STUDY GUIDE EXAM 4 D. "Diarrhea removes fluid from the body, so I should drink more ice water." 49. The patient has type B chronic obstructive pulmonary disease (COPD) exacerbated by an acute upper respiratory infection. Which blood gas values should the nurse expect to see? A. pH low, PaCO2 high, HCO3- high B. pH low, PaCO2 high, HCO3- normal C. pH low, PaCO2 low, HCO3- low D. pH high, PaCO2 high, HCO3- high 50. The nurse has telephone messages from four patients who requested information and assistance. Which one should the nurse refer to a social worker or community agency first? A. "Is there a place that I can dispose of my unused morphine pills?" NUR2790 STUDY GUIDE EXAM 4 B. "I ran out of money and am cutting my insulin dose in half." C. "I want to lose at least 20 pounds without getting sick this time." D. "I think I have asthma because I cough when dogs are near." NUR2790 STUDY GUIDE EXAM 4 51. The nurse would incorporate which of the following into the plan of care as a primary prevention strategy for reduction of the risk for cancer? A. Colonoscopy at age 50 and every 10 years as follow-up B. Yearly prostate specific antigen (PSA) and digital rectal exam for men aged 50 and over C. Yearly mammography for women aged 40 years and older D. Using skin protection during sun exposure while at the beach 52. While collecting a health history on a patient admitted for colon cancer, which of the following questions would be a priority to ask this patient? A. "Have you noticed any blood in your stool?" B. "Have you been experiencing nausea?" C. "Do you have back pain?" NUR2790 STUDY GUIDE EXAM 4 D. Confusion 55. While the nurse is obtaining the health history of a 75-year-old female patient, which of the following has the greatest implication for the development of cancer? A. Cigarette smoking as a teenager B. Being a 75-year-old woman C. Advancing age D. Family history of hypertension (Note: I’m sure about this question and how it will be asked. On the study guide (Misc. #13), she has D, B, and C.) 56. In caring for a patient following lobectomy for lung cancer, which of the following should the nurse include in the plan of care? A. Position the patient on the operative side only. NUR2790 STUDY GUIDE EXAM 4 B. Instruct the patient to cough and deep breathe. C. Avoid administering narcotic pain medications. D. Keep the patient on strict bed rest. 57. The patient asks the nurse to explain the sinoatrial node in the heart. The nurse's best response would be, "The sinoatrial node A. protects the heart from infection." B. provides the heart with oxygenated blood." C. provides the heart with the stimulation to beat in a normal rhythm." D. protects the heart from atherosclerotic changes." 58. A patient's serum electrolytes are being monitored. The nurse notices that the potassium level is low. The nurse knows that the patient should be observed for NUR2790 STUDY GUIDE EXAM 4 A. tissue ischemia. NUR2790 STUDY GUIDE EXAM 4 B. "I will restrict the intake of foods high in vitamin C." NUR2790 STUDY GUIDE EXAM 4 C. "I will increase the intake of green, leafy vegetables for a more healthful diet." D. "I will increase the amount of protein in my diet to protect my kidneys." 63. The nurse would expect to administer an anticoagulant to a patient following which surgery? A. Appendectomy B. Hip replacement C. Abdominal aorta aneurism (AAA) repair D. Hysterectomy 64. A patient on a medical surgical unit has a platelet count of 90,000 per mm3. The nurse knows to include which of the following precautions in discharge instructions? A. Have aggressive dental care immediately to prevent dental caries. NUR2790 STUDY GUIDE EXAM 4 B. Use a soft bristle toothbrush. C. Do not eat fresh fruit. D. Use a standard safety razor for shaving. 65. The nurse is presenting an in-service on the importance of collaborative communication. The nurse includes which critical event identified by the Joint Commission as an outcome of poor communication among health care team members? A. Decreased ability to document expenses of care provided B. Increased time to discharge patients to outpatient care C. Longer time to begin surgical cases D. The occurrence of a patient event resulting in death or serious injury 66. A client asks the nurse to pray with him. The nurse is an atheist. Which statement by the nurse is the correct response? A. "No, I'm sorry, I can't do that." NUR2790 STUDY GUIDE EXAM 4 B. "My goal is to achieve the highest level of functioning that I can." C. "I am fully recovered when all the wounds are closed." D. "Full recovery from a major burn injury never occurs." 69. A client with a new burn injury asks the nurse why he is receiving intravenous cimetidine (Tagamet). What is the nurse's best response? A. "This will help prevent stomach ulcers, which are common after burns." B. "Tagamet can help prevent hypovolemic shock, which can be fatal." C. "This drug will help prevent kidney damage caused by dehydration." D. "Tagamet will stimulate intestinal movement so you can eat more." NUR2790 STUDY GUIDE EXAM 4 70. A client who is burned is drooling and is having difficulty swallowing. Which action does the nurse take first? A. Measure abdominal girth and auscultate bowel sounds. B. Assess level of consciousness and pupillary reactions. NUR2790 STUDY GUIDE EXAM 4 C. Auscultate breath sounds over the trachea and mainstem bronchi. D. Ascertain the time food or liquid was last consumed. 71. The nurse assesses a client who suffered chest trauma and finds that the left chest sucks in during inhalation and out during exhalation. The client's oxygen saturation has dropped from 94% to 86%. What is the priority action by the nurse? A. Encourage the client to take deep, controlled breaths. B. Stabilize the chest wall with rib binders. C. Document findings and continue to monitor the client. D. Notify the health care provider and prepare for intubation. 72. What is the best way for the nurse to communicate with a client who is intubated and is receiving mechanical ventilation? A. Ask the client to blink for "yes" and "no." B. Teach the client some simple sign language. NUR2790 STUDY GUIDE EXAM 4 B. Administer the prescribed IV vancomycin (Vancocin). C. Administer the prescribed IV norepinephrine (Levophed). D. Obtain central venous pressure (CVP) measurements. 77. The nurse is caring for a client who had a myocardial infarction. The client develops increased pulmonary congestion; an increase in heart rate from 80 to 102 beats/min; and cold, clammy skin. Which action does the nurse implement before notifying the health care provider? A. Increase the IV flow rate. B. Prepare the client for surgery. C. Place the client in supine position. D. Administer oxygen. 78. A client has received vasopressin (DDAVP) for diabetes insipidus. Which assessment finding indicates a therapeutic response to this therapy? NUR2790 STUDY GUIDE EXAM 4 A. Urine output is decreased; specific gravity is increased. NUR2790 STUDY GUIDE EXAM 4 B. Urine output is increased; specific gravity is decreased. C. Urine output is increased; specific gravity is increased. D. Urine output is decreased; specific gravity is decreased. 79. Which client is most at risk for developing postrenal kidney failure? A. Client with congestive heart failure B. Client taking NSAIDs for arthritis pain C. Client recovering from glomerulonephritis D. Client diagnosed with renal calculi 80. The nurse, planning care for a client recovering from a traumatic brain injury, is including interventions to prevent sympathetic NUR2790 STUDY GUIDE EXAM 4 C. Glucose level 120 mg/dL D. Lumbar puncture 2 days ago E. Stroke onset 5 hours ago F. INR 1.0 82. A client is being instructed on treatments available for a newly diagnosed brain tumor. The nurse realizes that this client's treatment could include all of the following EXCEPT: A. photo DNA therapy. B. radiation. C. surgery. D. chemotherapy. 83. A client diagnosed with cirrhosis is experiencing the complication of ascites. Which of the following would be considered treatment for this complication? (Select all that apply.) A. Pain medication NUR2790 STUDY GUIDE EXAM 4 B. Diuretic therapy C. Low-sodium diet D. Bed rest E. Fluid restriction F. Increased exercise 84. Most common complication of Endoscopic Retrograde cholangiopancreatography (ERCP)? Bleeding Perforation of stomach and duodenum, pancreatitis, aspirate gastric content, anaphylactic reaction to contrast dye (**cannot perforate bladder**) 85. S/S of dvt post abdominal sx? Pain, redness, chest pain, dyspnea, hemoptysis 86. The nurse is planning care for a client recovering from an amputation. NUR2790 STUDY GUIDE EXAM 4 Which of the following should be included in this plan of care? (Select all that apply.) NUR2790 STUDY GUIDE EXAM 4 The nurse is assessing a client for the adequacy of ventilation. What assessment findings would indicate the client has good ventilation? (SATA) Oxygen saturation level is 98% NUR2790 STUDY GUIDE EXAM 4 Nail beds are pink with good capillary refill There is presence of quiet, effortless breath sounds at lung base bilaterally