Nursing NSG430 Questions with Answers for Final Exam Preparations, Exams of Nursing

Download Nursing NSG430 Questions with Answers for Final Exam Preparations and more Exams Nursing in PDF only on Docsity! Question 2 Complete Points out of 1.00 Flag question NURSING NSG430 QUESTIONS WITH ANSWERS BEST FOR FINAL EXAM PREPARATIONS Question 1 Complete Points out of 1.00 Flag question Question text The nurse is admitting a client with a diagnosis of myxedema coma. During the initial assessment, which findings would the nurse be most concerned about? Select one: a. hypertension and weight loss b. heat intolerance and anxiety c. corneal ulcerations and polyphagia d. Bradycardia, hypotension, and decreased level of consciousness Question text Which of the following signs of increased intracranial pressure (ICP) would appear first after head trauma? Select one: a. Widened pulse pressure. b. Restlessness and confusion c. Large amounts of very dilute urine Question 3 Complete Question 4 Complete Points out of 1.00 Flag question Question 5 Complete Points out of 1.00 b) Large amounts of very dilute urine. d. Bradycardia Points out of 1.00 Flag question Question text A patient has sustained a fracture to the femur. The patient has suddenly become confused, restless, petechial rash on chest, and has a respiratory rate of 30 breaths per minute. Based on the location of fracture and the presenting symptoms, this patient may be experiencing what type of complication? Select one: a. Fat embolism b. Hypovolemia c. Osteomyelitis d. Compartment Syndrome Question text A trauma patient in the emergency department (ED) is showing signs of acute renal failure that the care team suspects are due to rhabdomyolosis. The ED nurse knows the proper treatment to prevent further renal damage would be Select one: a. Treat refractory hypertension with antihypertensives b. Only monitor BUN/CR for further deterioration to prevent fluid overload c. Treat with NSS solution with acetylcysteine at 150 hr to maintain urine output more than 100/hr Flag question Question text Question 10 Complete Points out of 1.00 Flag question Question 11 Complete Points out of 1.00 After receiving report the nurse is reviewing the history of the patient and understands that acute adrenal Crisis is caused by? Select one: a. Acute kidney failure b. High dose of corticosteroids c. Deficiency of corticosteroids d. Overdose of testosterone Question text A patient has been admitted to the critical care unit after a stroke. After “failing” a swallow study, the patient is placed on enteral feedings. Following placement of a nasogastric tube for tube feeding, what is the next critical step in being able to utilize this tube? Select one: a. Obtain a chest radiograph. b. check the residual c. Cap off and wait 24 hours before starting feedings d. Let drain for the first 24 hours Question 12 Complete Points out of 1.00 Remove flag Question 13 Complete Points out of 1.00 Remove flag Question text A 45-year-old male post-surgical patient is on a ventilator in the critical care unit. He has been tolerating the ventilator well and has not required any sedation. He becomes tachycardic and hypertensive. His respiratory rate has increased to 28 breaths/min. The patient has been suctioned recently via his endotracheal tube, and his airway is clear. He responds appropriately to the nurse’s commands. What is the priority nursing action: Select one: a. provide sedation as ordered b. decrease the rate on the ventilator c. suction the patient again d. assess the patient’s level of pain Question text An Hyperglycemic Hyperosmolar Syndrome client, laboratory results are similar to those in DKA. Which lab findings should the nurse anticipate in a patient with HHS? Select one: a. Lower serum glucose, lower osmolality, and greater ketosis b. Higher serum glucose, higher osmolality, and greater ketosis c. Lower serum glucose, lower osmolality, and minimal ketosis d. Higher serum glucose, higher osmolality, and minimal ketosis Flag question Question text Question 14 Complete Points out of 1.00 Flag question The client has received exogenous vasopressin or DDAVP for diabetes insipidus. Which assessment finding indicates a therapeutic response to this therapy? Select one: a. Urine output is decreased; specific gravity is decreased. b. Urine output is increased; specific gravity is increased c. Urine output is decreased; specific gravity is increased. d. Urine output is increased; specific gravity is decreased. Question text The healthcare provider is teaching a student about the cardiac cycle and how it relates to the electrocardiogram (EKG). What will the healthcare provider tell the student about the cardiac events that occur during the waveform contained in the shaded area of the EKG? Question 19 Complete Points out of 1.00 Flag question Question 20 Complete Points out of 1.00 Flag question Question 21 Complete Points out of 1.00 c. A bone fragment has injured the nerve supply in the area Question text While positioning a patient in bed with increased ICP, it important to avoid? Select one: a. Flexion of the hips b. Preventing flexion of the neck c. Placing the HOB at 30-35 degrees d. Midline positioning of the head Question text A client is experiencing Cushing's Triad due to a recent head trauma. The patient would experience what following vital signs: Select one: a. BP 80/40, HR 49, RR 12 b. BP 200/60, HR 50, RR 8 c. BP 90/60, HR 80, RR 22 d. BP 150/112, HR 110, RR 8 Question 22 Complete Points out of 1.00 Flag question Question 23 Complete Points out of 1.00 Flag question Flag question Question text A client is diagnosed with a spontaneous pneumothorax necessitating the insertion of a chest tube. What is the BEST explanation for the nurse to provide this client? Select one: a. “The tube will drain fluid from your chest.” b. “The tube controls the amount of air that enters your chest.” c. “The tube will remove excess air from your chest.” d. “The tube will seal the hole in your lung.” Question text The nurse is caring for a client on Proprofol and is instructed to do a “vacation from sedation”. That term describes: Select one: a. Stop the sedative while continuing to administer neuromuscular blockade b. Spontaneous awakening trials consist of a daily interruption of continuous sedative infusions to help determine the patient’s sedation requirements c. only give intermittent boluses of sedation Question text Question 24 Complete Points out of 1.00 Flag question Question 25 Complete Points out of 1.00 Flag question A 32 year old man is intubated and placed on mechanical ventilation. The nurse is aware that the normal tidal volumes that are exchanged with each breath are: Select one: a. 400-500 ml b. 550-600ml c. 650-700ml d. 200-300 ml Question text After taking all the necessary steps for a patient who has developed autonomic dysreflexia. What should the nurse assess FIRST as a possible cause of this condition? Select one: a. Possible bladder infection b. Skin break down c. Bowel impaction d. Blood glucose Question text . A 68 year old male patient has partial thickness burns to the front and back of the right and left leg, front of right arm, and all of anterior trunk. Using the Rule of Nines, calculate the total body surface area percentage that is burned? Select one: Question 31 Not answered Points out of 1.00 Question 32 Complete Points out of 1.00 Question 30 Complete Points out of 1.00 Flag question Question text A male client has been admitted with chest trauma after a motor vehicle accident and has undergone subsequent intubation. A nurse checks the client when the high-pressure alarm on the ventilator sounds, and notes that the client has absence of breathe sounds in right upper lobe of the lung. The nurse immediately assesses for other signs of: Select one: a. Displaced endotracheal tube b. Pulmonary embolism c. Left pneumothorax d. Acute respiratory distress syndrome Question text A patient is on mechanical ventilation with PEEP (positive end-expiratory pressure). Which finding below indicates the patient is developing a complication related to their therapy and requires immediate treatment? Select one: a. HCO3 26 mmHg b. PaO2 80 mmHg c. PaCO2 38 mmHg d. Blood pressure 70/45 Flag question Question text Question 33 Complete Points out of 1.00 Flag question Question 34 Complete Points out of 1.00 Which of the following would lead the nurse to suspect that a child with meningitis has developed disseminated intravascular coagulation? Select one: a. Cyanosis b. Hemorrhagic skin rash c. Dyspnea on exertion d. Edema Question text 60-year-old woman with a severe drug-induced reaction Steven Johnson syndrome on both lower limbs with erosions and peeling lesions elsewhere in addition to mucosal involvement of the mouth of two days duration that occurred within 48 hours of taking the drug. What drug below is not part of the offending medications that can cause this skin reaction? Select one: a. Valproic acid b. allopurinol c. Sulfonamides d. Clarithromycin Question 35 Complete Points out of 1.00 Remove flag Question 36 Complete Points out of 1.00 Flag question Question text The lipoprotein produced by the alveoli that is lacking in cystic fibrosis and COPD patients is: Select one: a. Leukotrienes b. Beta natrieutric peptide c. Surfactant d. CO2 Question text A 24-year-old male arrives to the emergency department (ED) after a motor vehicle collision. Initial workup reveals pelvic fractures with a small amount of retroperitoneal bleeding that is managed conservatively. A few hours later, the patient begins to feel very weak and complains of worsening abdominal pain. Physical exam reveals diffuse abdominal tenderness and distension.PThe nurse is suspecting intra-abdominal compartment syndrome. The nurse is aware of what signs and symptoms would be exhibited? Mark all that apply? Select one or more: a. oliguria, b. sustained IAP > 20 mm Hg, c. decreased sodium levels d. worsening lactic acidosis e. increased glomerular filtration rate Question 41 Complete Points out of 1.00 Flag question Question 42 Complete Points out of 1.00 Remove flag Question text In applying the principles of pain treatment, what is the nurses first consideration? Select one: a. The client must be believed about perceptions of own pain b. Drug side effects must be prevented and managed. c. A multidisciplinary approach is needed d. Treatment is based on client goals. Question text A patient was admitted into the critical care unit 3 days ago. She has just been weaned from mechanical ventilation. She suddenly becomes confused, seeing nonexistent animals in her room and pulling at her gown. Her oxygen saturation is 98% and respiration's unlabored. The nurses first priority in care for this patient is Select one: a. Maintaining a safe environment. b. Provide non pharmacological therapy to distract the patient. c. Recommend to the healthcare provider that the patient should be reintubated and placed on mechanical ventilation. d. Providing pain medication to reduce symptoms. Flag question Question text Question 43 Complete Points out of 1.00 Flag question Question 44 Complete Points out of 1.00 The patient is receiving neuromuscular blockade. Which nursing assessment indicates a optimal level of paralysis? Select one: a. Train-of-four yields two twitches out of four b. CAM-ICU positive c. Glasgow Coma Scale score of 3 d. Bispectral index of 60 Question text The most important nursing intervention for patients receiving neuro-muscular blocking agents is to: Select one: a. Restrain the patient to avoid self-extubation b. Assess neurological status every 30 minutes. c. Administer sedatives in conjunction with the neuromuscular blocking agents d. Avoid interaction with the patient, because he or she won't be able to hear Question 45 Complete Points out of 1.00 Flag question Flag question Question text The client newly diagnosed with chronic renal failure recently has begun hemodialysis. Knowing that the client is at risk for disequilibrium syndrome, the nurse assesses the client during dialysis for: Select one: a. Hypotension, bradycardia, and hypothermia b. Hypertension, tachycardia, and fever c. Restlessness, irritability, and generalized weakness d. Headache, deteriorating level of consciousness, and twitching Question text Mr. Wales, who underwent post-abdominal surgery, has a nasogastric tube. The nurse on duty notes that the nasogastric tube (NGT) is draining a large amount (900 cc in 2 hours) of coffee ground secretions. The client is not oriented to person, place, or time. The nurse contacts the attending physician and STAT ABGs are ordered. The results from the ABGs show pH 7.57, PaCO2 37 mmHg and HCO3 30 mEq/L. What is the nurses assessment? Select one: a. Metabolic Alkalosis, Partially Compensated b. Respiratory Alkalosis, Uncompensated c. Metabolic Alkalosis, Uncompensated d. Metabolic Acidosis, Uncompensated Question 46 Complete Points out of 1.00 Question 51 Complete Points out of 1.00 Flag question Question 52 Complete Points out of 1.00 Flag question Question text A client with HHS is demonstrating the following: labored respirations with oxygen saturation 79%, blood glucose level of 1800, urine output of 240 cc/4 hours, and blood pressure of 130/88. Which of these findings would be the first priority for nursing care? Select one: a. Blood glucose level b. Blood pressure c. Urine output d. Oxygen saturation 79% Question text The nurse is participating at a health fair at the local mall educating young drivers on car safety such as the use of seat belts. What level of prevention is the nurse practicing? Select one: a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Quaternary prevention Question 53 Complete Points out of 1.00 Flag question Question 54 Complete Points out of 1.00 Flag question Question text A patient experienced a car collision 4 weeks ago and is currently participating in the daily physical therapy rehabilitation sessions at the local fitness center. In what level of prevention is the patient participating? Select one: a. Tertiary prevention b. Primary prevention c. Quaternary prevention d. Secondary prevention Question text The nurses patient is in neurogenic shock and is not responding to IV fluids. The patient is started on vasopressors. What option below, if found in the patient, would indicate the vasopressor medication is working? Select one: a. Serum lactate 6 mmol/L b. Blood pH 7.20 c. Decreased CVP (central venous pressure) d. Mean arterial pressure (MAP) 90 mmHg Question 55 Complete Points out of 1.00 Flag question Question 56 Complete Points out of 1.00 Flag question Question text A patient with neurogenic shock is experiencing a heart rate of 30 bpm. What medication does the nurse anticipate will be ordered by the physician STAT? Select one: a. Atropine b. Norepinephrine c. Amiodorone d. Adenosine Question text The nurse receives a patient in the ER who has sustained a cervical spinal cord injury. The nurse knows that this patient is at risk for neurogenic shock. What hallmark signs and symptoms, if experienced by this patient, would indicate the patient is experiencing neurogenic shock? Select all that apply: Select one or more: a. Heart rate of 48 b. Temperature 104.9 ‘F c. Heart rate 170 bpm d. Blood pressure 69/38 Question 61 Complete Points out of 1.00 Flag question Question 62 Complete Points out of 1.00 Flag question Question text An 18-year-old client is admitted with a closed head injury sustained in a motor vehicle accident. His intracranial pressure (ICP) is increasing. Which medication intervention should the nurse perform to decrease intracranial pressure and intracranial edema? Select one: a. Administer 100 mg of pentobarbital IV as ordered b. Administer 100mg Phenytoin every 6 hours c. Administer 1 gram of Mannitol after checking osmolarity level Question text A client receiving hemodialysis treatment arrives at the hospital with a blood pressure of 200/100, a heart rate of 110, and a respiratory rate of 36. Oxygen saturation on room air is 89%. He complains of shortness of breath, and +2 pedal edema is noted. His last hemodialysis treatment was yesterday. Which of the following interventions should be done first? Select one: a. Restrict the client’s fluids b. Administer oxygen c. Elevate the foot of the bed d. Prepare the client for hemodialysis Question text A client is deficient in the lipoprotein lining the alveoli and is present in COPD and cystic fibrosis. The nurse is aware that this lipoprotein is called? Question 63 Complete Points out of 1.00 Flag question Question 64 Complete Points out of 1.00 Flag question Select one: a. Surfactant b. Alveolar liquid c. Capillary fluid d. Bronchial cilia Question text A client with rapid rate atrial fibrillation asks a nurse why the physician wants the client to do a vagal maneuver. The nurse responds that this procedure may stimulate the: Select one: a. Diaphragmatic nerve to decrease heart rate b. Diaphragmatic nerve to overdrive the rhythm c. d. Vagus Nerve to decrease the heart rate e. Vagus Nerve to increase heart rate Question text The client’s EKG revealed flattened T waves, depressed ST segment and the presence of a U wave. What electrolyte disturbance do you suspect? Question 65 Complete Points out of 1.00 Flag question Question 66 Complete Points out of 1.00 Flag question Select one: a. Hyponatremia b. Hypernatremia c. Hyperkalemia d. Hypokalemia Question text A client has a history of chronic renal failure and received hemodialysis treatments three times per week through an arteriovenous (AV) fistula in the left arm. Which of the following interventions is included in this client’s plan of care? Select one: a. Assess the AV fistula for a bruit and thrill b. Keep the AV fistula site dry c. Take the blood pressure in the left arm d. Keep the AV fistula wrapped in gauze Question text What criteria should the nurse use to determine normal sinus rhythm for a client on a cardiac monitor? Check all that apply. Select one or more: a. The RR intervals are relatively consistent b. The ST segment is higher than the PR interval Question 72 Complete Points out of 1.00 Flag question Question 71 Complete Points out of 1.00 Flag question Question text The patient has hypokalemia and is to receive an IV infusion of potassium chloride. The physician orders the KCl to infuse at a rate of 2 mEq/hr. The pharmacy sends KCL 40mEq/L in 1000ml D5W. The nurse will set the infusion pump @ mL/hr Select one: a. 3 b. 5 c. 2.5 d. 10 Question text The physician has ordered nitroglycerin for a patient with chest pain at a rate of 10 mcg/min. The pharmacy provides Nitroglycerin 25 mg in 250 mL of D5W. The nurse will set the infusion pump @ a rate of mL/hr. Select one: a. 3 b. 10 c. 6 d. 4 Question 74 Complete Points out of 1.00 Flag question Question 75 Complete Question 73 Not answered Points out of 1.00 Question text A patient has been admitted to the ICU for alcohol withdrawal and is ordered lorazepam 10 mg/hr. The pharmacy has sent lorazepam 120 mg in 600 mL of D5W. The nurse will infuse the medication on the infusion pump @ the rate of mL/hr Select one: a. 100 b. 75 c. 50 d. 45 Question text The nurse is caring for a client who has been in good health up to the present and is admitted with cellulitis of the hand. The client's serum potassium level was 4.5 mEq/L yesterday. Today the level is 7 mEq/L. Which of the following is the next appropriate nursing action? Select one: a. Encourage the patient to drink more orange juice b. Initiate seizure precautions c. Question the results and redraw d. Call the physician and report results Question 76 Complete Points out of 1.00 Flag question Question 77 Complete Points out of 1.00 Points out of 1.00 Flag question Question text A client with a serum sodium of 115 mEq/L has been receiving 3% NS at 50 ml/hr for 16 hours. This morning the client feels tired and short of breath. Which of the following interventions is a priority? Select one: a. Turn down the infusion b. Call the physician c. Check the sodium level d. Assess for fluid overload Question text A client is having frequent premature ventricular contractions. A nurse would place priority on assessment of which of the following items? Select one: a. Precipitating factors such as infection b. Blood pressure and peripheral perfusion c. Causative factors such as caffeine d. Sensation of palpitations Question 82 Complete Points out of 1.00 Flag question Question 83 Complete Points out of 1.00 Flag question Select one: a. Bicarbonate 23 mEq/L b. Potassium 4.5 mEq/L c. ammonia 18 µ/dL d. Serum Lactate 9 mmol/L Question text A patient who is in hypovolemic shock has the following clinical signs: Heart rate 120 beats/minute, blood pressure 80/55, and urine output 20. After administering an IV fluid bolus, which of these signs if noted by the healthcare provider is the best indication of improved perfusion? Select one: a. Urine output increases to 30mL/hour b. Right atrial pressure increases c. Heart rate drops to 100 beats/minute d. Systolic blood pressure increases to 85 mmHg Question text A patient who has pericarditis related to radiation therapy, becomes dyspneic, and has a rapid, weak pulse. Heart sounds are muffled, and a 12 mmHg drop in blood pressure is noted on inspiration. The healthcare provider’s interventions are aimed at preventing which type of shock? Select one: a. Cardiogenic Question 84 Complete Points out of 1.00 Flag question Question 85 Complete Points out of 1.00 Flag question b. Obstructive c. Neurogenic d. Distributive Question text A patient is being treated for hemorrhagic shock secondary to multiple rib fractures and a lacerated liver. Two units of packed red blood cells have been administered. Which of these measurements is an indication the patient has received adequate volume replacement with CVP measurements? Select one: a. CVP measurements has increased b. CVP measurements has decreased c. CVP measurements remains the same Question text The healthcare provider is caring for a patient who has septic shock. Which of these should the healthcare provider administer to the patient first? Select one: a. Corticosteroids to reduce inflammation. b. Vasopressors to increase blood pressure. c. Rapid infusion of crystalloids IV fluids to increase intravascular volume d. Antibiotics to treat the underlying infection. Question 87 Complete Points out of 1.00 Flag question Question 88 Complete Points out of 1.00 Question 86 Complete Points out of 1.00 Flag question Question text A patient who has experienced a stroke is being monitored during the acute management phase. The clinician notes that the patient’s intracranial pressure (ICP) is 30mm Hg. Which of the following interventions should be taken first? Select one: a. obtain vital signs for narrowing pulse pressure b. assess level of consciousness c. Raise the head of the bed to 30° and make sure that proper position is maintained d. Lay the patient flat Question text During an assessment of a patient’s abdomen, a pulsating abdominal mass is noted by the healthcare provider. Which of the following should be the healthcare provider’s next action? Select one: a. assess femoral pulses for patency b. ask the patient to do a Valsalva maneuver c. measure abdominal circumference Question 93 Complete Points out of 1.00 Flag question Question 94 Not answered Points out of Flag question Question text he healthcare provider is examining the electrocardiogram (EKG) of a patient and notes the PR interval is 6 small boxes in length. What is the significance of this finding? Choose 1 answer: Select one: a. There may be a delay in the conduction through the AV node. b. Stress is causing increased sympathetic stimulation. c. This should be documented as an expected finding. d. There may be some scar tissue in one of the ventricles. Question text Risks and benefits are balanced when giving an antidysrhythmic drug to a treat a cardiac dysrhythmia. When does the need for the drug outweigh the risks? Choose 1 answer: Select one: a. If the heart rate is 50 to 60 beats per minute. b. After the heart rate reaches a rate faster than 100 beats per minute c. When the dysrhythmia becomes chronic. d. When there is impairment in cardiac output. Question 95 Not answered Points out of 1.00 Question 96 Not answered Points out of Flag question Question text The healthcare provider is caring for a patient with a diagnosis of hypomagnesemia and a QT interval of 0.50 seconds. Which of these, if noted on the cardiac monitor, is an indication the patient’s condition is worsening? Choose 1 answer: Select one: a. Narrow QRS complexes b. Premature ventricular contractions c. An PR interval of 14 second d. A polymorphic ventricular tachycardia Question text A nurse is planning care for a client with a diagnosis of thyrotoxicosis (thyroid storm). Which of the following would the nurse include in the plan of care for the client? Select one: a. use of a warming blanket b. restriction of fluid intake c. use of a hypothermic (cooling) blanket d. administration of levothyroxine (synthroid) Question 97 Not answered Points out of 1.00 Question 98 Not answered Points out of Flag question Question text The nurse is administering the initial total parenteral nutrition solution to a client. Which of the following assessments requires the nurse’s immediate attention? Select one: Select one: a. Urine output of 300 cc in 4 hours b. Blood glucose of 350 mg/dl c. Blood pressure 118/56 d. Temperature of 37.5 degrees Celsius Question text The nurse is caring for four patients on the progressive care unit. Which patient is at greatest risk for developing delirium? Select one: Select one: a. 75-year-old recovering from a motor vehicle crash; being treated with an alcohol withdrawal protocol. b. 95-year-old with community-acquired pneumonia; family has brought in eyeglasses and hearing aid c. 80-year-old from nursing home, postoperative from colon resection d. 54-year-old postoperative aortic aneurysm resection with no family at bedside