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وبلاگ پرستاری ایران

وبلاگ پرستاری ایران

شروع بکار وب سایت انجمن پرستاران ایران

وب سایتی با عنوان انجمن پرستاران ایران توسط اینجانب راه اندازی شد و از این پس مطالب مورد نظر خود را در مورد پرستاری در این وب سایت جستجو کنید.

Iranian Nuses Association website has just started it's work.You can find free NCLEX-RN questions with answers there and also there will be a lot of new things soon. For more information click this link:

http://ina.hostzi.com

+ نوشته شده در  جمعه سی ام مرداد 1388ساعت 16:38  توسط علی خواجوی  | 

NCLEX Free Questions With Answer

Free NCLEX_RN questions with answer for all nurses around the world.Free nursing articles.

Please help the manager of this weblog with your views and comments about this weblog.

سولا ت امتحانات RN  و مقالات پرستاري رايگان.

لطفا پس از بازديد نظرات خود را با مدير وبلاگ با E-mail در ميان بگذاريد

+ نوشته شده در  دوشنبه پنجم مرداد 1388ساعت 16:51  توسط علی خواجوی  | 

Influenza A (H1N1) update

Influenza A (H1N1) update

 

 

Geneva, Switzerland, 12 June 2009 – WHO has been carefully monitoring the spread of influenza A (H1N1) and has now raised the alert level to level 6. Raising the alert to level 6 is a measure of geographical spread of the virus and not a measure of its severity.   
At this time, WHO considers the overall severity of the situation to be moderate. This assessment is based on scientific evidence as well as input from countries on the impact of the pandemic on their health systems, and their social and economic functioning.
The current assessment reflects that:

  1. Most people recover from infection without the need for hospitalization or medical care.
  2. Overall, national levels of severe illness from influenza A (H1N1) appear similar to levels seen during local seasonal influenza periods, although high levels of disease have occurred in some local areas and institutions.
  3. Overall, hospitals and health care systems in most countries have been able to cope with the numbers of people seeking care, although some facilities and systems have been stressed in some localities.

What you can do to protect yourself and others from catching influenza A (H1N1)  
The main route of transmission of the new influenza A (H1N1) virus seems to be similar to seasonal influenza, via droplets that are expelled by speaking, sneezing or coughing. You can prevent getting infected by avoiding close contact with people who show influenza-like symptoms and by taking the following measures:

  • avoid touching your mouth and nose;
  • clean hands thoroughly with soap and water, or cleanse them with an alcohol-based hand rub on a regular basis (especially if touching the mouth and nose, or surfaces that are potentially contaminated);
  • avoid close contact with people who might be ill;
  • reduce the time spent in crowded settings if possible;
  • improve airflow in your living space by opening windows;
  • practise good health habits including adequate sleep, eating nutritious food, and keeping physically active.

Do I need to use a mask?

If you are not sick you do not have to wear a mask. If you are caring for a sick person, you can wear a mask when you are in close contact with the ill person and dispose of it immediately after contact, and cleanse your hands thoroughly afterwards. If you are sick and must travel or be around others, cover your mouth and nose.  More information is available at the WHO web site: www.who.int
ICN is carefully monitoring the situation and we have put in place a system for early detection, comprehensive assessment and referral to a health facility during the CNR and Congress in Durban, South Africa.  WHO is not recommending travel restrictions.

+ نوشته شده در  پنجشنبه بیست و پنجم تیر 1388ساعت 19:19  توسط علی خواجوی  | 

Nurses Survey

Nurses Survey: Patients Pay the Price for Insufficient Staff, High Workloads

Global survey of nurses highlights views of profession, health care environments

July 1, 2009 – DURBAN, SOUTH AFRICA – Nurses believe that heavy workloads and insufficient staff are impacting patient care and health outcomes around the world, according to research presented today at the International Council of Nurses (ICN) 24th Quadrennial Congress. The results are part of an extensive global attitudinal survey, which asked more than 2,000 nurses about the challenges and opportunities that face nurses.

“Nurses represent the largest group of healthcare providers in the world,” said ICN Chief Executive Officer, David Benton. “We are keen to better understand nurses’ views of their work and the environments in which they practice across the world. These results will inform the Positive Practice Environment campaign ICN and partners are implementing to improve the practice environment and with it the quality of care.”

An estimated 13 million nurses form the backbone of health care systems, working in hospitals, clinics, communities and other settings around the world. ICN and Pfizer Inc. External Medical Affairs collaborated on a global representative survey of 2,203 nurses in eleven countries, including Brazil, Canada, Colombia, Japan, Kenya, Portugal, South Africa, Taiwan, Uganda, the UK, and the U.S. The survey was conducted by APCO Insight. Collated global results and methodology can be viewed at http://www.icn.ch/Workplace_survey2009.htm.

The survey finds that nine in ten (92%) nurses face time constraints that prevent them spending enough time with individual patients as they think necessary. Nearly all nurses surveyed (96%) say that spending more time with individual patients would have a significant impact on patient health.

“Nurses are key patient advocates and have always been patient-focused. The research shows that for nurses, the most favourable aspect of their profession is indeed patient contact,” said Paula DeCola, R.N., M.Sc., from the office of the Chief Medical Officer at Pfizer, Inc. External Medical Affairs. “This survey supports the research of Dr. Linda Aiken at the University of Pennsylvania – nurses perceive that inadequate staffing and high workloads are having a negative impact on the quality of care patients receive.”

Other key findings from the research provide a glimpse into the challenges nurses face, and opportunities for improvements:

  • Nearly half of nurses (46%) say their workload is worse today compared to five years ago, potentially impacting the quality of patient care.

  • Nurses are most concerned with heavy workloads (42%), insufficient pay and benefits (22%), a lack of recognition for their work (15%) and too much bureaucracy (13%). The best part of their profession is helping patients; nurses are most likely to say that patient contact (37%) is the most favorable aspect of their work experience.

  • Nursing as a career is viewed as worse today than it was five years ago in Canada (52%), the U.S. (46%), Taiwan (45%), and the UK (39%); however nurses in Kenya (71%), Brazil (64%) and South Africa (63%) are more likely to see their roles improving over this time.

  • When asked to rate the likelihood they will still be practicing nursing in five years, 53% say it is ‘very likely.’ However, the commitment varies significantly by country. Nurses in Portugal (77%), Brazil (75%), Canada (71%), and the U.S. (68%) say they are very likely to stay in nursing for the next five years, while nurses in countries with severe health human resource shortages and heavy disease burdens such as Kenya (38%), South Africa (33%), Taiwan (33%), and Uganda (32%), say they are less likely to do so.

  • Nurses favor expanding their health care responsibilities, including the authority to prescribe medicines to patients. Eight in ten (83%) nurses surveyed say they currently do not have the authority to prescribe medicines to patients. Nevertheless, seven in ten (70%) say they favour nurses having this authority. Nurses in Colombia (61%), the U.S. (59%) and Taiwan (57%) are most likely to oppose nurses having this authority, while those in Kenya (94%), the UK (87%), Canada (87%), Uganda (84%) and South Africa (83%) are most in favour of it.

  • The research shows that having greater independence and control over their practice area, sufficient staff, greater involvement in decisions impacting their work and patient care, and improved work-life balance have a significant impact on nurses’ likelihood to remain in nursing.

  • Nurses around the world see their professional associations as effective in advancing their interests (64%) and supportive of their needs (76%).

“Nurses globally are thinking about leaving the profession, which will further impact already burdened healthcare systems, including in countries such as Kenya, Uganda and South Africa. It is urgent to respond to their needs with adequate staffing, greater independence and greater involvement in decision-making. Nurses must be involved in crucial policy conversations as healthcare systems are growing, developing and changing,” added Mr. Benton.

+ نوشته شده در  پنجشنبه بیست و پنجم تیر 1388ساعت 19:15  توسط علی خواجوی  | 

Lymphatic System

1. Which of the following is not directly associated with the lymphatic pathway?

A. Lymphatic trunk
B. Collecting duct
C. Subclavian vein
D. Carotid arteries

2. The thymus is responsible for secreting _____ from epithelial cells.

A. Thymosin
B. Growth hormone
C. Macrophages
D. Plasma cells

3. Which of the following types of cytokines is responsible for the growth and maturation of B cells?

A. Interleukin-1
B. Interleukin-2
C. Interleukin-4
D. Interleukin-7

4. Which of the following types of immunoglobulins is the most responsible for promoting allergic reactions?

A. IgA
B. IgM
C. IgD
D. IgE

5. Which of the following types of immunoglobulins is located on the surface of most B-lymphocytes?

A. IgA
B. IgM
C. IgD
D. IgE

6. Which of the following types of immunoglobulins does not cross the barrier between mother and infant in the womb?

A. IgA
B. IgM
C. IgD
D. IgE

7. Which of the following is not an autoimmune disease?

A. Graves disease
B. Myasthenia gravis
C. Insulin-dependent diabetes mellitus
D. Alzheimer's disease

8. T-cell activation requires a/an _______ cell.

A. Activation
B. Accessory
C. Plasma
D. Helper

9. The thymus is located with the _______.

A. Mediastinum
B. Peristinum
C. Epistinum
D. Endostinum

10. Which of the following statements is false regarding the spleen?

A. Divided up into lobules
B. Similar to a large lymph node
C. Contains macrophages
D. Limited blood within the lobules

11. Which of the following is not considered a central location of lymph nodes?

A. Cervical
B. Axillary
C. Inguinal
D. Tibial

12. Lymphocytes that reach the thymus become _____.

A. T-cells
B. B-cells
C. Plasma cells
D. Beta cells

13. Lymphocytes that do not reach the thymus become _____.

A. T-cells
B. B-cells
C. Plasma cells
D. Beta cells

14. Which of the following is associated with a B cell deficiency?

A. Job's syndrome
B. Chronic granulomatous disease
C. Bruton's agammaglobulinemia
D. Wiskott-Aldrich syndrome

15. Which of the following is the autoantibody for systemic lupus?

A. Anti-microsomal
B. Antinuclear antibodies
C. Anti-gliadin
D. Anti-histone

16. The TB skin test is an example of ______.

A. Delayed hypersensitivity
B. Serum sickness
C. Cytotoxic reaction
D. Arthus reaction

17. Which of the following types of cytokines is secreted by macrophages?

A. IL-1
B. IL-2
C. IL-3
D. IL-4

18. Which of the following types of immunoglobulins binds complement?

A. IgA
B. IgD
C. IgE
D. IgG

19. Which of the following is a key component of cytotoxic T cells?

A. CD2
B. CD4
C. CD8
D. CD10

20. Which of the following is not a primary target group of T cells?

A. Viruses
B. Toxins
C. Fungi
D. TB

Answer Key
1. D
2. A
3. C
4. D
5. C
6. A
7. D
8. B
9. A
10. D
11. D
12. A
13. B
14. C
15. B
16. A
17. A
18. D
19. C
20. B
+ نوشته شده در  پنجشنبه بیست و پنجم تیر 1388ساعت 15:7  توسط علی خواجوی  | 

Respiration

1. Which of the following conditions correlate with the following information:
High pH
High HCO3
High BE
Neutral pCO2

A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic acidosis
D. Metabolic alkalosis

2. Which of the following conditions correlate with the following information:
High pH
Neutral HCO3
Neutral BE
Low pCO2

A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic acidosis
D. Metabolic alkalosis

3. Which of the following conditions correlate with the following information:
Low pH
Low HCO3
Low BE
Neutral pCO2

A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic acidosis
D. Metabolic alkalosis

4. Which of the following information corresponds with a negative TB test?

A. 0-4 mm induration at 48 hours
B. 0-5 mm induration at 48 hours
C. 0-6 mm induration at 48 hours
D. 0-7 mm induration at 48 hours

5. Which of the following is the most common type of lung cancer?

A. Large cell
B. Adenocarcinoma
C. Oat cell
D. Squamous cell

6. What cell type secrets surfactant?

A. Plasma cell
B. Type I alveolar cell
C. Type II alveolar cell
D. Type III alveolar cell

7. Which of the following pulmonary term correlates with the definition: noted obstruction of the trachea or larynx.

A. Rhonchi
B. Stridor
C. Wheezes
D. Vesicular

8. Normal values for pCO2 are considered:

A. 20-40 mm Hg
B. 25-30 mm Hg
C. 30-40 mm Hg
D. 35-45 mm Hg

9. Normal values for HCO3 are considered:

A. 15-30 mEq/L
B. 20-35 mEq/L
C. 22-26 mEq/L
D. 24-29 mEq/L

10. Pneumoncystis carinii infections are commonly treated with which of the following medications?

A. Pentamidine
B. Allopurinol
C. Iorazepam
D. Chlorpropamide

11. Which of the following is not generally caused by COPD?

A. Pneumonia
B. Right sided heart failure
C. Headaches
D. Cor pulmonale

12. Which of the following is not considered a COPD related disease?

A. Bronchiectasis
B. Bronchial asthma
C. Bronchitis
D. Bronchial hypotension

13. Which of the following pulmonary term correlates with the definition: bronchospasm of the bronchial walls?

A. Wheezes
B. Rhonchi
C. Stridor
D. Pleural Rub

14. Which of the following is considered an expectorant?

A. Acetylcysteine
B. Guaifenesin
C. Theophylline
D. Epinephrine HCL

15. Which of the following is considered a bronchodilator?

A. Acetylcysteine
B. Guaifenesin
C. Theophylline
D. Epinephrine HCL

16. Which of the following is considered a xanthine?

A. Acetylcysteine
B. Guaifenesin
C. Theophylline
D. Epinephrine HCL

17. Which of the following is considered a mucolytic?

A. Acetylcysteine
B. Guaifenesin
C. Theophylline
D. Epinephrine HCL

18. Which of the following matches the definition: The volume of air that can be inhaled following exhalation of tidal volume?

A. Expiratory reserve volume
B. Inspiratory capacity
C. Inspiratory reserve volume
D. Vital capacity

19. Which of the following matches the definition: The maximum volume of air that can be exhaled after taking the deepest breath possible?

A. Expiratory reserve volume
B. Inspiratory capacity
C. Inspiratory reserve volume
D. Vital capacity

20. The respiratory center is located in the ____ and ______.

A. Midbrain and pons
B. Pons and Medulla oblongata
C. Midbrain and Medulla oblongata
D. Pons and Hypothalamus

Answer Key
1. D
2. A
3. C
4. A
5. D
6. C
7. B
8. D
9. C
10. A
11. C
12. D
13. A
14. B
15. D
16. C
17. A
18. B
19. D
20. B
+ نوشته شده در  پنجشنبه بیست و پنجم تیر 1388ساعت 15:6  توسط علی خواجوی  | 

Integumentary

. Which of the following is a longitudinal incision through eschar and down to subcutaneous tissue?

A. Escharotomy
B. Dehiscence
C. Transection
D. Escharotic's procedure

2. Which of the following types of wounds match the criteria: plantar aspect of foot, met heads, heel?

A. Arterial
B. Plantar
C. Venous
D. Diabetic

3. Which of the following terms matches: water and electrolytes (clear)?

A. Exudate
B. Transudate
C. Serosanguineous
D. Induration

4. Which of the following edema assessment levels corresponds with: Depression resolving in 10-15 sec?

A. +1
B. +2
C. +3
D. +4

5. Which of the following terms matches the statement: to increase the fibrous element; to make hard as in the presence of cellulites?

A. Induration
B. Necrosis
C. Eschar
D. Maceration

6. Following the rule of nines. What percent would a third degree burn to the entire arm and back cover?

A. 28%
B. 27%
C. 20%
D. 18%

7. Which of the following matches the defintion: A full thickness skin loss involving damage or necrosis of subcutaneous tissue that may extend down to but not through underlying fascia, infection and/or necrosis may be present?

A. Stage I wound
B. Stage II wound
C. Stage III wound
D. Stage IV wound

8. Which of the following types of wound is indicated by the definition: relatively painless, decreased with elevation?

A. Arterial
B. Plantar
C. Venous
D. Diabetic

9. Which of the following matches the definition: The loss of circulatory fluids into interstitial spaces?

A. Hypovolemia
B. Necrosis
C. Eschar
D. Maceration

10. An emollient has a/an _____ effect.

A. Pruritic
B. Antipruritic
C. Rupture
D. Impetigo

11. Which of the following is the outermost layer of the epidermis?

A. Stratum spinosum
B. Stratum corneum
C. Stratum granulosum
D. Stratum basale

12. Which of the following is the deepest layer of the epidermis?

A. Stratum spinosum
B. Stratum corneum
C. Stratum granulosum
D. Stratum basale

13. Which of the following is beneath the stratum corneum?

A. Stratum spinosum
B. Stratum corneum
C. Stratum granulosum
D. Stratum basale

14. Vitamin D is created from _________ by skin cells.

A. Dehydrocholesterol
B. Cholesterol
C. Hydrocholesterol
D. Hydrodermis

15. Which of the following is another name for blackheads associated with acme?

A. Pustules
B. Sebaceous
C. Eccrine
D. Comedones

16. Which of the following identifies skin from a cadaver used in a burn graft?

A. Homograft
B. Autograft
C. Allograft
D. Xenograft

17. Which of the following is a disease characterized by hyperactive sebaceous glands and often associated with dandruff?

A. Keloid
B. Seborrhea
C. Eczema
D. Urticaria

18. Which of the following is a disease characterized by the presence of hives?

A. Keloid
B. Seborrhea
C. Eczema
D. Urticaria

19. Which of the following is a disease characterized by a skin rash that is blistering and itchy?

A. Keloid
B. Seborrhea
C. Eczema
D. Urticaria

20. Sebaceous glands secrete _______.

A. Sebum
B. Impetigo
C. Serous
D. Sirius

Answer Key
1. A
2. D
3. B
4. B
5. A
6. B
7. C
8. B
9. A
10. A
11. B
12. D
13. C
14. A
15. D
16. A
17. B
18. D
19. C
20. A
+ نوشته شده در  پنجشنبه بیست و پنجم تیر 1388ساعت 14:40  توسط علی خواجوی  | 

Gastrointestinal

. Which of the following is not a specific element of duodenal ulcers?

A. Primarily affects males
B. Occasional malignancy
C. Can lead to weight gain
D. Affects people over 65

2. Which of the following is not a specific element of Hepatitis C?

A. Vaccine available
B. May be transmitted with sexual contact
C. Inflammation of the liver
D. Lifetime carrier

3. Which of the following Vitamins is not stored in the Liver?

A. Vitamin A
B. Vitamin B
C. Vitamin C
D. Vitamin D

4. Which of the following is not a contributor to a condition of ascites?

A. Elevated levels of aldosterone
B. Hypertension
C. Low levels of albumin
D. Elevated levels of angiotension I

5. Which of the following drugs is a histamine blocker and reduces levels of gastric acid?

A. Omeprazole (Prilosec)
B. Metoclopramide (Reglan)
C. Cimetidine (Tagamet)
D. Magnesium Hydroxide (Maalox

6. Which of the following drugs is an antacid?

A. Omeprazole (Prilosec)
B. Metoclopramide (Reglan)
C. Cimetidine (Tagamet)
D. Magnesium Hydroxide (Maalox)

7. Which of the following drugs is a dopamine antagonist?

A. Omeprazole (Prilosec)
B. Metoclopramide (Reglan)
C. Cimetidine (Tagamet)
D. Magnesium Hydroxide (Maalox)

8. Another name for the Whipple procedure is a ________.

A. Cholangiopancreatography
B. Pancreatoduodenectomy
C. Cholangiogram
D. Cholecystogram

9. Which of the following microorganisms has been linked to Parotitis?

A. Staphylococcus aureus
B. Schistosoma
C. Wucheria bancrofti
D. Trypanosoma cruzi

10. What type of cell releases somatostatin?

A. b cells
B. a cells
C. plasma cells
D. D cells

11. What type of cell releases glucagon?

A. b cells
B. a cells
C. plasma cells
D. D cells

12. What type of cell releases insulin?

A. b cells
B. a cells
C. plasma cells
D. D cells

13. Another name for the (Billroth II)procedure is a ________.

A. Gastrojejunostomy
B. Gastroduodenostomy
C. Cholangiogram
D. Cholecystogram

14. Another name for the (Billroth I)procedure is a ________.

A. Gastrojejunostomy
B. Gastroduodenostomy
C. Cholangiogram
D. Cholecystogram

15. Which of the following arteries supplies blood primarily to the Midgut?

A. IMA
B. Celiac
C. SMA
D. Axillary

16. Which of the following is not considered a right of medication?

A. Dose
B. Time
C. Route
D. Limit

17. Another name for the Myenteric plexus is the ________.

A. Submucosal plexus
B. Branchial plexus
C. Auerbach's plexus
D. Lumbar plexus

18. Which of the following enzyme breaks down starches to maltose.

A. Amylase
B. Lipase
C. Trypsinogen
D. Pepsin

19. Which of the following is not considered an H2 blocker?

A. Ranitidine (Zantac)
B. Famotidine (Pepcid)
C. Cimetidine (Tagament)
D. Sucralfate (Carafate)

20. Which of the following drugs aids in gastric emptying?

A. Cisapride (Propulsid)
B. Ranitidine (Zantac)
C. Famotidine (Pepcid)
D. Tranylcypromine sulfate (Parnate)

Answer Key
1. D
2. A
3. C
4. D
5. C
6. D
7. B
8. B
9. A
10. D
11. B
12. A
13. A
14. B
15. C
16. D
17. C
18. A
19. D
20. A
+ نوشته شده در  پنجشنبه بیست و پنجم تیر 1388ساعت 14:21  توسط علی خواجوی  | 

NCLEX-RN Question 125-250 plus Answers

  1. After the physician performs an amniotomy, the nurse's first action should be to assess the:

    1. Degree of cervical dilation

    2. Fetal heart tones

    3. Client's vital signs

    4. Client's level of discomfort

  2. A client is admitted to the labor and delivery unit. The nurse performs a vaginal exam and determines that the client's cervix is 5cm dilated with 75% effacement. Based on the nurse's assessment the client is in which phase of labor?

    1. Active

    2. Latent

    3. Transition

    4. Early

  3. A newborn with narcotic abstinence syndrome is admitted to the nursery. Nursing care of the newborn should include:

    1. Teaching the mother to provide tactile stimulation

    2. Wrapping the newborn snugly in a blanket

    3. Placing the newborn in the infant seat

    4. Initiating an early infant-stimulation program

  4. A client elects to have epidural anesthesia to relieve the discomfort of labor. Following the initiation of epidural anesthesia, the nurse should give priority to:

    1. Checking for cervical dilation

    2. Placing the client in a supine position

    3. Checking the client's blood pressure

    4. Obtaining a fetal heart rate

  5. The nurse is aware that the best way to prevent post- operative wound infection in the surgical client is to:

    1. Administer a prescribed antibiotic

    2. Wash her hands for 2 minutes before care

    3. Wear a mask when providing care

    4. Ask the client to cover her mouth when she coughs

  6. The elderly client is admitted to the emergency room. Which symptom is the client with a fractured hip most likely to exhibit?

    1. Pain

    2. Disalignment

    3. Cool extremity

    4. Absence of pedal pulses

  7. The nurse knows that a 60-year-old female client's susceptibility to osteoporosis is most likely related to:

    1. Lack of exercise

    2. Hormonal disturbances

    3. Lack of calcium

    4. Genetic predisposition

  8. A 2-year-old is admitted for repair of a fractured femur and is placed in Bryant's traction. Which finding by the nurse indicates that the traction is working properly?

    1. The infant no longer complains of pain.

    2. The buttocks are 15° off the bed.

    3. The legs are suspended in the traction.

    4. The pins are secured within the pulley.

  9. A client with a fractured hip has been placed in Buck's traction. Which statement is true regarding balanced skeletal traction? Balanced skeletal traction:

    1. Utilizes a Steinman pin

    2. Requires that both legs be secured

    3. Utilizes Kirschner wires

    4. Is used primarily to heal the fractured hips

  10. The client is admitted for an open reduction internal fixation of a fractured hip. Immediately following surgery, the nurse should give priority to assessing the:

    1. Serum collection (Davol) drain

    2. Client's pain

    3. Nutritional status

    4. Immobilizer

  11. Which statement made by the family member caring for the client with a percutaneous gastrostomy tube indicates understanding of the nurse's teaching?

    1. "I must flush the tube with water after feedings and clamp the tube."

    2. "I must check placement four times per day."

    3. "I will report to the doctor any signs of indigestion."

    4. "If my father is unable to swallow, I will discontinue the feeding and call the clinic."

  12. The nurse is assessing the client with a total knee replacement 2 hours post-operative. Which information requires notification of the doctor?

    1. Bleeding on the dressing is 3cm in diameter.

    2. The client has a temperature of 6°F.

    3. The client's hematocrit is 26%.

    4. The urinary output has been 60 during the last 2 hours.

  13. The nurse is caring for the client with a 5-year-old diagnosis of plumbism. Which information in the health history is most likely related to the development of plumbism?

    1. The client has traveled out of the country in the last 6 months.

    2. The client's parents are skilled stained-glass artists.

    3. The client lives in a house built in 1

    4. The client has several brothers and sisters.

  14. A client with a total hip replacement requires special equipment. Which equipment would assist the client with a total hip replacement with activities of daily living?

    1. High-seat commode

    2. Recliner

    3. TENS unit

    4. Abduction pillow

  15. An elderly client with an abdominal surgery is admitted to the unit following surgery. In anticipation of complications of anesthesia and narcotic administration, the nurse should:

    1. Administer oxygen via nasal cannula

    2. Have narcan (naloxane) available

    3. Prepare to administer blood products

    4. Prepare to do cardioresuscitation

  16. Which roommate would be most suitable for the 6-year-old male with a fractured femur in Russell's traction?

    1. 16-year-old female with scoliosis

    2. 12-year-old male with a fractured femur

    3. 10-year-old male with sarcoma

    4. 6-year-old male with osteomylitis

  17. A client with osteoarthritis has a prescription for Celebrex (celecoxib). Which instruction should be included in the discharge teaching?

    1. Take the medication with milk.

    2. Report chest pain.

    3. Remain upright after taking for 30 minutes.

    4. Allow 6 weeks for optimal effects.

  18. A client with a fractured tibia has a plaster-of-Paris cast applied to immobilize the fracture. Which action by the nurse indicates understanding of a plaster-of-Paris cast? The nurse:

    1. Handles the cast with the fingertips

    2. Petals the cast

    3. Dries the cast with a hair dryer

    4. Allows 24 hours before bearing weight

  19. The teenager with a fiberglass cast asks the nurse if it will be okay to allow his friends to autograph his cast. Which response would be best?

    1. "It will be alright for your friends to autograph the cast."

    2. "Because the cast is made of plaster, autographing can weaken the cast."

    3. "If they don't use chalk to autograph, it is okay."

    4. "Autographing or writing on the cast in any form will harm the cast."

  20. The nurse is assigned to care for the client with a Steinmen pin. During pin care, she notes that the LPN uses sterile gloves and Q-tips to clean the pin. Which action should the nurse take at this time?

    1. Assisting the LPN with opening sterile packages and peroxide

    2. Telling the LPN that clean gloves are allowed

    3. Telling the LPN that the registered nurse should perform pin care

    4. Asking the LPN to clean the weights and pulleys with peroxide

  21. A child with scoliosis has a spica cast applied. Which action specific to the spica cast should be taken?

    1. Check the bowel sounds

    2. Assess the blood pressure

    3. Offer pain medication

    4. Check for swelling

  22. The client with a cervical fracture is placed in traction. Which type of traction will be utilized at the time of discharge?

    1. Russell's traction

    2. Buck's traction

    3. Halo traction

    4. Crutchfield tong traction

  23. A client with a total knee replacement has a CPM (continuous passive motion device) applied during the post-operative period. Which statement made by the nurse indicates understanding of the CPM machine?

    1. "Use of the CPM will permit the client to ambulate during the therapy."

    2. "The CPM machine controls should be positioned distal to the site."

    3. "If the client complains of pain during the therapy, I will turn off the machine and call the doctor."

    4. "Use of the CPM machine will alleviate the need for physical therapy after the client is discharged."

  24. A client with a fractured hip is being taught correct use of the walker. The nurse is aware that the correct use of the walker is achieved if the:

    1. Palms rest lightly on the handles

    2. Elbows are flexed 0°

    3. Client walks to the front of the walker

    4. Client carries the walker

  25. When assessing a laboring client, the nurse finds a prolapsed cord. The nurse should:

    1. Attempt to replace the cord

    2. Place the client on her left side

    3. Elevate the client's hips

    4. Cover the cord with a dry, sterile gauze

  26. The nurse is caring for a 30-year-old male admitted with a stab wound. While in the emergency room, a chest tube is inserted. Which of the following explains the primary rationale for insertion of chest tubes?

    1. The tube will allow for equalization of the lung expansion.

    2. Chest tubes serve as a method of draining blood and serous fluid and assist in reinflating the lungs.

    3. Chest tubes relieve pain associated with a collapsed lung.

    4. Chest tubes assist with cardiac function by stabilizing lung expansion.

  27. A client who delivered this morning tells the nurse that she plans to breastfeed her baby. The nurse is aware that successful breastfeeding is most dependent on the:

    1. Mother's educational level

    2. Infant's birth weight

    3. Size of the mother's breast

    4. Mother's desire to breastfeed

  28. The nurse is monitoring the progress of a client in labor. Which finding should be reported to the physician immediately?

    1. The presence of scant bloody discharge

    2. Frequent urination

    3. The presence of green-tinged amniotic fluid

    4. Moderate uterine contractions

  29. The nurse is measuring the duration of the client's contractions. Which statement is true regarding the measurement of the duration of contractions?

    1. Duration is measured by timing from the beginning of one contraction to the beginning of the next contraction.

    2. Duration is measured by timing from the end of one contraction to the beginning of the next contraction.

    3. Duration is measured by timing from the beginning of one contraction to the end of the same contraction.

    4. Duration is measured by timing from the peak of one contraction to the end of the same contraction.

  30. The physician has ordered an intravenous infusion of Pitocin for the induction of labor. When caring for the obstetric client receiving intravenous Pitocin, the nurse should monitor for:

    1. Maternal hypoglycemia

    2. Fetal bradycardia

    3. Maternal hyperreflexia

    4. Fetal movement

  31. A client with diabetes visits the prenatal clinic at 28 weeks gestation. Which statement is true regarding insulin needs during pregnancy?

    1. Insulin requirements moderate as the pregnancy progresses.

    2. A decreased need for insulin occurs during the second trimester.

    3. Elevations in human chorionic gonadotrophin decrease the need for insulin.

    4. Fetal development depends on adequate insulin regulation.

  32. A client in the prenatal clinic is assessed to have a blood pressure of 180/96. The nurse should give priority to:

    1. Providing a calm environment

    2. Obtaining a diet history

    3. Administering an analgesic

    4. Assessing fetal heart tones

  33. A primigravida, age 42, is 6 weeks pregnant. Based on the client's age, her infant is at risk for:

    1. Down syndrome

    2. Respiratory distress syndrome

    3. Turner's syndrome

    4. Pathological jaundice

  34. A client with a missed abortion at 29 weeks gestation is admitted to the hospital. The client will most likely be treated with:

    1. Magnesium sulfate

    2. Calcium gluconate

    3. Dinoprostone (Prostin E.)

    4. Bromocrystine (Pardel)

  35. A client with preeclampsia has been receiving an infusion containing magnesium sulfate for a blood pressure that is 160/80; deep tendon reflexes are 1 plus, and the urinary output for the past hour is 100mL. The nurse should:

    1. Continue the infusion of magnesium sulfate while monitoring the client's blood pressure

    2. Stop the infusion of magnesium sulfate and contact the physician

    3. Slow the infusion rate and turn the client on her left side

    4. Administer calcium gluconate IV push and continue to monitor the blood pressure

  36. Which statement made by the nurse describes the inheritance pattern of autosomal recessive disorders?

    1. An affected newborn has unaffected parents.

    2. An affected newborn has one affected parent.

    3. Affected parents have a one in four chance of passing on the defective gene.

    4. Affected parents have unaffected children who are carriers.

  37. A pregnant client, age 32, asks the nurse why her doctor has recommended a serum alpha fetoprotein. The nurse should explain that the doctor has recommended the test:

    1. Because it is a state law

    2. To detect cardiovascular defects

    3. Because of her age

    4. To detect neurological defects

  38. A client with hypothyroidism asks the nurse if she will still need to take thyroid medication during the pregnancy. The nurse's response is based on the knowledge that:

    1. There is no need to take thyroid medication because the fetus's thyroid produces a thyroid-stimulating hormone.

    2. Regulation of thyroid medication is more difficult because the thyroid gland increases in size during pregnancy.

    3. It is more difficult to maintain thyroid regulation during pregnancy due to a slowing of metabolism.

    4. Fetal growth is arrested if thyroid medication is continued during pregnancy.

  39. The nurse is responsible for performing a neonatal assessment on a full-term infant. At 1 minute, the nurse could expect to find:

    1. An apical pulse of 100

    2. An absence of tonus

    3. Cyanosis of the feet and hands

    4. Jaundice of the skin and sclera

  40. A client with sickle cell anemia is admitted to the labor and delivery unit during the first phase of labor. The nurse should anticipate the client's need for:

    1. Supplemental oxygen

    2. Fluid restriction

    3. Blood transfusion

    4. Delivery by Caesarean section

  41. A client with diabetes has an order for ultrasonography. Preparation for an ultrasound includes:

    1. Increasing fluid intake

    2. Limiting ambulation

    3. Administering an enema

    4. Withholding food for 8 hours

  42. An infant who weighs 8 pounds at birth would be expected to weigh how many pounds at 1 year?

    1. 14 pounds

    2. 16 pounds

    3. 18 pounds

    4. 24 pounds

  43. A pregnant client with a history of alcohol addiction is scheduled for a nonstress test. The nonstress test:

    1. Determines the lung maturity of the fetus

    2. Measures the activity of the fetus

    3. Shows the effect of contractions on the fetal heart rate

    4. Measures the neurological well-being of the fetus

  44. A full-term male has hypospadias. Which statement describes hypospadias?

    1. The urethral opening is absent.

    2. The urethra opens on the dorsal side of the penis.

    3. The penis is shorter than usual.

    4. The urethra opens on the ventral side of the penis.

  45. A gravida III para II is admitted to the labor unit. Vaginal exam reveals that the client's cervix is 8cm dilated, with complete effacement. The priority nursing diagnosis at this time is:

    1. Alteration in coping related to pain

    2. Potential for injury related to precipitate delivery

    3. Alteration in elimination related to anesthesia

    4. Potential for fluid volume deficit related to NPO status

  46. The client with varicella will most likely have an order for which category of medication?

    1. Antibiotics

    2. Antipyretics

    3. Antivirals

    4. Anticoagulants

  47. A client is admitted complaining of chest pain. Which of the following drug orders should the nurse question?

    1. Nitroglycerin

    2. Ampicillin

    3. Propranolol

    4. Verapamil

  48. Which of the following instructions should be included in the teaching for the client with rheumatoid arthritis?

    1. Avoid exercise because it fatigues the joints.

    2. Take prescribed anti-inflammatory medications with meals.

    3. Alternate hot and cold packs to affected joints.

    4. Avoid weight-bearing activity.

  49. A client with acute pancreatitis is experiencing severe abdominal pain. Which of the following orders should be questioned by the nurse?

    1. Meperidine 100mg IM q 4 hours PRN pain

    2. Mylanta 30 ccs q 4 hours via NG

    3. Cimetadine 300mg PO q.i.d.

    4. Morphine 8mg IM q 4 hours PRN pain

  50. The client is admitted to the chemical dependence unit with an order for continuous observation. The nurse is aware that the doctor has ordered continuous observation because:

    1. Hallucinogenic drugs create both stimulant and depressant effects.

    2. Hallucinogenic drugs induce a state of altered perception.

    3. Hallucinogenic drugs produce severe respiratory depression.

    4. Hallucinogenic drugs induce rapid physical dependence.

  51. A client with a history of abusing barbiturates abruptly stops taking the medication. The nurse should give priority to assessing the client for:

    1. Depression and suicidal ideation

    2. Tachycardia and diarrhea

    3. Muscle cramping and abdominal pain

    4. Tachycardia and euphoric mood

  52. During the assessment of a laboring client, the nurse notes that the FHT are loudest in the upper-right quadrant. The infant is most likely in which position?

    1. Right breech presentation

    2. Right occipital anterior presentation

    3. Left sacral anterior presentation

    4. Left occipital transverse presentation

  53. The primary physiological alteration in the development of asthma is:

    1. Bronchiolar inflammation and dyspnea

    2. Hypersecretion of abnormally viscous mucus

    3. Infectious processes causing mucosal edema

    4. Spasm of bronchiolar smooth muscle

  54. A client with mania is unable to finish her dinner. To help her maintain sufficient nourishment, the nurse should:

    1. Serve high-calorie foods she can carry with her

    2. Encourage her appetite by sending out for her favorite foods

    3. Serve her small, attractively arranged portions

    4. Allow her in the unit kitchen for extra food whenever she pleases

  55. To maintain Bryant's traction, the nurse must make certain that the child's:

    1. Hips are resting on the bed, with the legs suspended at a right angle to the bed

    2. Hips are slightly elevated above the bed and the legs are suspended at a right angle to the bed

    3. Hips are elevated above the level of the body on a pillow and the legs are suspended parallel to the bed

    4. Hips and legs are flat on the bed, with the traction positioned at the foot of the bed

  56. Which action by the nurse indicates understanding of herpes zoster?

    1. The nurse covers the lesions with a sterile dressing.

    2. The nurse wears gloves when providing care.

    3. The nurse administers a prescribed antibiotic.

    4. The nurse administers oxygen.

  57. The client has an order for a trough to be drawn on the client receiving Vancomycin. The nurse is aware that the nurse should contact the lab for them to collect the blood:

    1. 15 minutes after the infusion

    2. 30 minutes before the infusion

    3. 1 hour after the infusion

    4. 2 hours after the infusion

  58. The client using a diaphragm should be instructed to:

    1. Refrain from keeping the diaphragm in longer than 4 hours

    2. Keep the diaphragm in a cool location

    3. Have the diaphragm resized if she gains 5 pounds

    4. Have the diaphragm resized if she has any surgery

  59. The nurse is providing postpartum teaching for a mother planning to breastfeed her infant. Which of the client's statements indicates the need for additional teaching?

    1. "I'm wearing a support bra."

    2. "I'm expressing milk from my breast."

    3. "I'm drinking four glasses of fluid during a 24-hour period."

    4. "While I'm in the shower, I'll allow the water to run over my breasts."

  60. Damage to the VII cranial nerve results in:

    1. Facial pain

    2. Absence of ability to smell

    3. Absence of eye movement

    4. Tinnitus

  61. A client is receiving Pyridium (phenazopyridine hydrochloride) for a urinary tract infection. The client should be taught that the medication may:

    1. Cause diarrhea

    2. Change the color of her urine

    3. Cause mental confusion

    4. Cause changes in taste

  62. Which of the following tests should be performed before beginning a prescription of Accutane?

    1. Check the calcium level

    2. Perform a pregnancy test

    3. Monitor apical pulse

    4. Obtain a creatinine level

  63. A client with AIDS is taking Zovirax (acyclovir). Which nursing intervention is most critical during the administration of acyclovir?

    1. Limit the client's activity

    2. Encourage a high-carbohydrate diet

    3. Utilize an incentive spirometer to improve respiratory function

    4. Encourage fluids

  64. A client is admitted for an MRI. The nurse should question the client regarding:

    1. Pregnancy

    2. A titanium hip replacement

    3. Allergies to antibiotics

    4. Inability to move his feet

  65. The nurse is caring for the client receiving Amphotericin B. Which of the following indicates that the client has experienced toxicity to this drug?

    1. Changes in vision

    2. Nausea

    3. Urinary frequency

    4. Changes in skin color

  66. The nurse should visit which of the following clients first?

    1. The client with diabetes with a blood glucose of 95mg/dL

    2. The client with hypertension being maintained on Lisinopril

    3. The client with chest pain and a history of angina

    4. The client with Raynaud's disease

  67. A client with cystic fibrosis is taking pancreatic enzymes. The nurse should administer this medication:

    1. Once per day in the morning

    2. Three times per day with meals

    3. Once per day at bedtime

    4. Four times per day

  68. Cataracts result in opacity of the crystalline lens. Which of the following best explains the functions of the lens?

    1. The lens controls stimulation of the retina.

    2. The lens orchestrates eye movement.

    3. The lens focuses light rays on the retina.

    4. The lens magnifies small objects.

  69. A client who has glaucoma is to have miotic eyedrops instilled in both eyes. The nurse knows that the purpose of the medication is to:

    1. Anesthetize the cornea

    2. Dilate the pupils

    3. Constrict the pupils

    4. Paralyze the muscles of accommodation

  70. A client with a severe corneal ulcer has an order for Gentamycin gtt. q 4 hours and Neomycin 1 gtt q 4 hours. Which of the following schedules should be used when administering the drops?

    1. Allow 5 minutes between the two medications.

    2. The medications may be used together.

    3. The medications should be separated by a cycloplegic drug.

    4. The medications should not be used in the same client.

  71. The client with color blindness will most likely have problems distinguishing which of the following colors?

    1. Orange

    2. Violet

    3. Red

    4. White

  72. The client with a pacemaker should be taught to:

    1. Report ankle edema

    2. Check his blood pressure daily

    3. Refrain from using a microwave oven

    4. Monitor his pulse rate

  73. The client with enuresis is being taught regarding bladder retraining. The nurse should advise the client to refrain from drinking after:

    1. 1900

    2. 1200

    3. 1000

    4. 0700

  74. Which of the following diet instructions should be given to the client with recurring urinary tract infections?

    1. Increase intake of meats.

    2. Avoid citrus fruits.

    3. Perform pericare with hydrogen peroxide.

    4. Drink a glass of cranberry juice every day.

  75. The physician has prescribed NPH insulin for a client with diabetes mellitus. Which statement indicates that the client knows when the peak action of the insulin occurs?

    1. "I will make sure I eat breakfast within 2 hours of taking my insulin."

    2. "I will need to carry candy or some form of sugar with me all the time."

    3. "I will eat a snack around three o'clock each afternoon."

    4. "I can save my dessert from supper for a bedtime snack."

  76. A client with pneumacystis carini pneumonia is receiving trimetrexate. The rationale for administering leucovorin calcium to a client receiving Methotrexate is to:

    1. Treat anemia.

    2. Create a synergistic effect.

    3. Increase the number of white blood cells.

    4. Reverse drug toxicity.

  77. A client tells the nurse that she is allergic to eggs, dogs, rabbits, and chicken feathers. Which order should the nurse question?

    1. TB skin test

    2. Rubella vaccine

    3. ELISA test

    4. Chest x-ray

  78. The physician has prescribed rantidine (Zantac) for a client with erosive gastritis. The nurse should administer the medication:

    1. 30 minutes before meals

    2. With each meal

    3. In a single dose at bedtime

    4. 60 minutes after meals

  79. A temporary colostomy is performed on the client with colon cancer. The nurse is aware that the proximal end of a double barrel colostomy:

    1. Is the opening on the client's left side

    2. Is the opening on the distal end on the client's left side

    3. Is the opening on the client's right side

    4. Is the opening on the distal right side

  80. While assessing the postpartal client, the nurse notes that the fundus is displaced to the right. Based on this finding, the nurse should:

    1. Ask the client to void

    2. Assess the blood pressure for hypotension

    3. Administer oxytocin

    4. Check for vaginal bleeding

  81. The physician has ordered an MRI for a client with an orthopedic ailment. An MRI should not be done if the client has:

    1. The need for oxygen therapy

    2. A history of claustrophobia

    3. A permanent pacemaker

    4. Sensory deafness

  82. A 6-month-old client is placed on strict bed rest following a hernia repair. Which toy is best suited to the client?

    1. Colorful crib mobile

    2. Hand-held electronic games

    3. Cars in a plastic container

    4. 30-piece jigsaw puzzle

  83. The nurse is preparing to discharge a client with a long history of polio. The nurse should tell the client that:

    1. Taking a hot bath will decrease stiffness and spasticity.

    2. A schedule of strenuous exercise will improve muscle strength.

    3. Rest periods should be scheduled throughout the day.

    4. Visual disturbances can be corrected with prescription glasses.

  84. A client on the postpartum unit has a proctoepisiotomy. The nurse should anticipate administering which medication?

    1. Dulcolax suppository

    2. Docusate sodium (Colace)

    3. Methyergonovine maleate (Methergine)

    4. Bromocriptine sulfate (Parlodel)

  85. A client with pancreatic cancer has an infusion of TPN (Total Parenteral Nutrition). The doctor has ordered for sliding-scale insulin. The most likely explanation for this order is:

    1. Total Parenteral Nutrition leads to negative nitrogen balance and elevated glucose levels.

    2. Total Parenteral Nutrition cannot be managed with oral hypoglycemics.

    3. Total Parenteral Nutrition is a high-glucose solution that often elevates the blood glucose levels.

    4. Total Parenteral Nutrition leads to further pancreatic disease.

  86. An adolescent primigravida who is 10 weeks pregnant attends the antepartal clinic for a first check-up. To develop a teaching plan, the nurse should initially assess:

    1. The client's knowledge of the signs of preterm labor

    2. The client's feelings about the pregnancy

    3. Whether the client was using a method of birth control

    4. The client's thought about future children

  87. An obstetric client is admitted with dehydration. Which IV fluid would be most appropriate for the client?

    1. .45 normal saline

    2. Dextrose 1% in water

    3. Lactated Ringer's

    4. Dextrose 5% in .45 normal saline

  88. The physician has ordered a thyroid scan to confirm the diagnosis. Before the procedure, the nurse should:

    1. Assess the client for allergies

    2. Bolus the client with IV fluid

    3. Tell the client he will be asleep

    4. Insert a urinary catheter

  89. The physician has ordered an injection of RhoGam for a client with blood type A negative. The nurse understands that RhoGam is given to:

    1. Provide immunity against Rh isoenzymes

    2. Prevent the formation of Rh antibodies

    3. Eliminate circulating Rh antibodies

    4. Convert the Rh factor from negative to positive

  90. The nurse is caring for a client admitted to the emergency room after a fall. X-rays reveal that the client has several fractured bones in the foot. Which treatment should the nurse anticipate for the fractured foot?

    1. Application of a short inclusive spica cast

    2. Stabilization with a plaster-of-Paris cast

    3. Surgery with Kirschner wire implantation

    4. A gauze dressing only

  91. A client with bladder cancer is being treated with iridium seed implants. The nurse's discharge teaching should include telling the client to:

    1. Strain his urine

    2. Increase his fluid intake

    3. Report urinary frequency

    4. Avoid prolonged sitting

  92. Following a heart transplant, a client is started on medication to prevent organ rejection. Which category of medication prevents the formation of antibodies against the new organ?

    1. Antivirals

    2. Antibiotics

    3. Immunosuppressants

    4. Analgesics

  93. The nurse is preparing a client for cataract surgery. The nurse is aware that the procedure will use:

    1. Mydriatics to facilitate removal

    2. Miotic medications such as Timoptic

    3. A laser to smooth and reshape the lens

    4. Silicone oil injections into the eyeball

  94. A client with Alzheimer's disease is awaiting placement in a skilled nursing facility. Which long-term plans would be most therapeutic for the client?

    1. Placing mirrors in several locations in the home

    2. Placing a picture of herself in her bedroom

    3. Placing simple signs to indicate the location of the bedroom, bathroom, and so on

    4. Alternating healthcare workers to prevent boredom

  95. A client with an abdominal cholecystectomy returns from surgery with a Jackson-Pratt drain. The chief purpose of the Jackson-Pratt drain is to:

    1. Prevent the need for dressing changes

    2. Reduce edema at the incision

    3. Provide for wound drainage

    4. Keep the common bile duct open

  96. The nurse is performing an initial assessment of a newborn Caucasian male delivered at 32 weeks gestation. The nurse can expect to find the presence of:

    1. Mongolian spots

    2. Scrotal rugae

    3. Head lag

    4. Vernix caseosa

  97. The nurse is caring for a client admitted with multiple trauma. Fractures include the pelvis, femur, and ulna. Which finding should be reported to the physician immediately?

    1. Hematuria

    2. Muscle spasms

    3. Dizziness

    4. Nausea

  98. A client is brought to the emergency room by the police. He is combative and yells, "I have to get out of here. They are trying to kill me." Which assessment is most likely correct in relation to this statement?

    1. The client is experiencing an auditory hallucination.

    2. The client is having a delusion of grandeur.

    3. The client is experiencing paranoid delusions.

    4. The client is intoxicated.

  99. The nurse is preparing to suction the client with a tracheotomy. The nurse notes a previously used bottle of normal saline on the client's bedside table. There is no label to indicate the date or time of initial use. The nurse should:

    1. Lip the bottle and use a pack of sterile 4x4 for the dressing

    2. Obtain a new bottle and label it with the date and time of first use

    3. Ask the ward secretary when the solution was requested

    4. Label the existing bottle with the current date and time

  100. An infant's Apgar score is 9 at 5 minutes. The nurse is aware that the most likely cause for the deduction of one point is:

    1. The baby is cold.

    2. The baby is experiencing bradycardia.

    3. The baby's hands and feet are blue.

    4. The baby is lethargic.

  101. The primary reason for rapid continuous rewarming of the area affected by frostbite is to:

    1. Lessen the amount of cellular damage

    2. Prevent the formation of blisters

    3. Promote movement

    4. Prevent pain and discomfort

  102. A client recently started on hemodialysis wants to know how the dialysis will take the place of his kidneys. The nurse's response is based on the knowledge that hemodialysis works by:

    1. Passing water through a dialyzing membrane

    2. Eliminating plasma proteins from the blood

    3. Lowering the pH by removing nonvolatile acids

    4. Filtering waste through a dialyzing membrane

  103. During a home visit, a client with AIDS tells the nurse that he has been exposed to measles. Which action by the nurse is most appropriate?

    1. Administer an antibiotic

    2. Contact the physician for an order for immune globulin

    3. Administer an antiviral

    4. Tell the client that he should remain in isolation for 2 weeks

  104. A client hospitalized with MRSA (methicillin-resistant staph aureus) is placed on contact precautions. Which statement is true regarding precautions for infections spread by contact?

    1. The client should be placed in a room with negative pressure.

    2. Infection requires close contact; therefore, the door may remain open.

    3. Transmission is highly likely, so the client should wear a mask at all times.

    4. Infection requires skin-to-skin contact and is prevented by hand washing, gloves, and a gown.

  105. A client who is admitted with an above-the-knee amputation tells the nurse that his foot hurts and itches. Which response by the nurse indicates understanding of phantom limb pain?

    1. "The pain will go away in a few days."

    2. "The pain is due to peripheral nervous system interruptions. I will get you some pain medication."

    3. "The pain is psychological because your foot is no longer there."

    4. "The pain and itching are due to the infection you had before the surgery."

  106. A client with cancer of the pancreas has undergone a Whipple procedure. The nurse is aware that during the Whipple procedure, the doctor will remove the:

    1. Head of the pancreas

    2. Proximal third section of the small intestines

    3. Stomach and duodenum

    4. Esophagus and jejunum

  107. The physician has ordered a minimal-bacteria diet for a client with neutropenia. The client should be taught to avoid eating:

    1. Fruits

    2. Salt

    3. Pepper

    4. Ketchup

  108. A client is discharged home with a prescription for Coumadin (sodium warfarin). The client should be instructed to:

    1. Have a Protime done monthly

    2. Eat more fruits and vegetables

    3. Drink more liquids

    4. Avoid crowds

  109. The nurse is assisting the physician with removal of a central venous catheter. To facilitate removal, the nurse should instruct the client to:

    1. Perform the Valsalva maneuver as the catheter is advanced

    2. Turn his head to the left side and hyperextend the neck

    3. Take slow, deep breaths as the catheter is removed

    4. Turn his head to the right while maintaining a sniffing position

  110. A client has an order for streptokinase. Before administering the medication, the nurse should assess the client for:

    1. Allergies to pineapples and bananas

    2. A history of streptococcal infections

    3. Prior therapy with phenytoin

    4. A history of alcohol abuse

  111. The nurse is providing discharge teaching for the client with leukemia. The client should be told to avoid:

    1. Using oil- or cream-based soaps

    2. Flossing between the teeth

    3. The intake of salt

    4. Using an electric razor

  112. The nurse is changing the ties of the client with a tracheotomy. The safest method of changing the tracheotomy ties is to:

    1. Apply the new tie before removing the old one.

    2. Have a helper present.

    3. Hold the tracheotomy with the nondominant hand while removing the old tie.

    4. Ask the doctor to suture the tracheostomy in place.

  113. The nurse is monitoring a client following a lung resection. The hourly output from the chest tube was 300mL. The nurse should give priority to:

    1. Turning the client to the left side

    2. Milking the tube to ensure patency

    3. Slowing the intravenous infusion

    4. Notifying the physician

  114. The infant is admitted to the unit with tetrology of falot. The nurse would anticipate an order for which medication?

    1. Digoxin

    2. Epinephrine

    3. Aminophyline

    4. Atropine

  115. The nurse is educating the lady's club in self-breast exam. The nurse is aware that most malignant breast masses occur in the Tail of Spence. On the diagram, place an X on the Tail of Spence.

  116. The toddler is admitted with a cardiac anomaly. The nurse is aware that the infant with a ventricular septal defect will:

    1. Tire easily

    2. Grow normally

    3. Need more calories

    4. Be more susceptible to viral infections

  117. The nurse is monitoring a client with a history of stillborn infants. The nurse is aware that a nonstress test can be ordered for this client to:

    1. Determine lung maturity

    2. Measure the fetal activity

    3. Show the effect of contractions on fetal heart rate

    4. Measure the well-being of the fetus

  118. The nurse is evaluating the client who was admitted 8 hours ago for induction of labor. The following graph is noted on the monitor. Which action should be taken first by the nurse?

    1. Instruct the client to push

    2. Perform a vaginal exam

    3. Turn off the Pitocin infusion

    4. Place the client in a semi-Fowler's position

  119. The nurse notes the following on the ECG monitor. The nurse would evaluate the cardiac arrhythmia as:

    1. Atrial flutter

    2. A sinus rhythm

    3. Ventricular tachycardia

    4. Atrial fibrillation

  120. A client with clotting disorder has an order to continue Lovenox (enoxaparin) injections after discharge. The nurse should teach the client that Lovenox injections should:

    1. Be injected into the deltoid muscle

    2. Be injected into the abdomen

    3. Aspirate after the injection

    4. Clear the air from the syringe before injections

  121. The nurse has a preop order to administer Valium (diazepam) 10mg and Phenergan (promethazine) 25mg. The correct method of administering these medications is to:

    1. Administer the medications together in one syringe

    2. Administer the medication separately

    3. Administer the Valium, wait 5 minutes, and then inject the Phenergan

    4. Question the order because they cannot be given at the same time

  122. A client with frequent urinary tract infections asks the nurse how she can prevent the reoccurrence. The nurse should teach the client to:

    1. Douche after intercourse

    2. Void every 3 hours

    3. Obtain a urinalysis monthly

    4. Wipe from back to front after voiding

  123. Which task should be assigned to the nursing assistant?

    1. Placing the client in seclusion

    2. Emptying the Foley catheter of the preeclamptic client

    3. Feeding the client with dementia

    4. Ambulating the client with a fractured hip

  124. The client has recently returned from having a thyroidectomy. The nurse should keep which of the following at the bedside?

    1. A tracheotomy set

    2. A padded tongue blade

    3. An endotracheal tube

    4. An airway

  125. The physician has ordered a histoplasmosis test for the elderly client. The nurse is aware that histoplasmosis is transmitted to humans by:

    1. Cats

    2. Dogs

    3. Turtles

    4. Birds

Quick Check Answer Key

  1. D

  2. D

  3. B

  4. C

  5. C

  6. C

  7. D

  8. D

  9. C

  10. B

  11. A

  12. C

  13. D

  14. B

  15. B

  16. A

  17. A

  18. A

  19. C

  20. B

  21. C

  22. A

  23. A

  24. B

  25. D

  26. A

  27. B

  28. C

  29. C

  30. C

  31. B

  32. A

  33. B

  34. B

  35. D

  36. B

  37. A

  38. B

  39. D

  40. A

  41. B

  42. A

  43. A

  44. C

  45. B

  46. A

  47. B

  48. C

  49. C

  50. D

  51. B

  52. B

  53. B

  54. C

  55. D

  56. A

  57. B

  58. C

  59. C

  60. B

  61. D

  62. A

  63. C

  64. B

  65. A

  66. D

  67. B

  68. C

  69. A

  70. C

  71. C

  72. D

  73. B

  74. D

  75. D

  76. B

  77. D

  78. D

  79. A

  80. B

  81. A

  82. A

  83. D

  84. D

  85. B

  86. B

  87. B

  88. B

  89. D

  90. B

  91. A

  92. C

  93. C

  94. B

  95. C

  96. A

  97. B

  98. C

  99. D

  100. C

  101. B

  102. D

  103. B

  104. D

  105. B

  106. B

  107. D

  108. D

  109. C

  110. D

  111. C

  112. B

  113. C

  114. C

  115. D

  116. C

  117. B

  118. B

  119. C

  120. B

  121. B

  122. A

  123. D

  124. A

  125. A

  126. B

  127. A

  128. B

  129. C

  130. B

  131. B

  132. B

  133. B

  134. A

  135. A

  136. A

  137. C

  138. B

  139. A

  140. B

  141. B

  142. B

  143. D

  144. A

  145. A

  146. A

  147. C

  148. B

  149. A

  150. C

  151. B

  152. D

  153. C

  154. C

  155. B

  156. D

  157. A

  158. A

  159. C

  160. A

  161. C

  162. D

  163. B

  164. C

  165. A

  166. A

  167. D

  168. B

  169. B

  170. A

  171. C

  172. B

  173. B

  174. D

  175. B

  176. B

  177. A

  178. D

  179. A

  180. B

  181. B

  182. B

  183. B

  184. C

  185. A

  186. B

  187. B

  188. D

  189. A

  190. D

  191. C

  192. B

  193. C

  194. C

  195. A

  196. B

  197. D

  198. A

  199. D

  200. C

  201. D

  202. B

  203. B

  204. C

  205. A

  206. C

  207. C

  208. C

  209. B

  210. C

  211. B

  212. A

  213. A

  214. B

  215. B

  216. A

  217. C

  218. A

  219. C

  220. C

  221. C

  222. A

  223. C

  224. B

  225. C

  226. A

  227. D

  228. B

  229. D

  230. B

  231. A

  232. C

  233. A

  234. A

  235. B

  236. B

  237. A

  238. D

  239. A

  240. See diagram.

  241. A

  242. B

  243. C

  244. C

  245. B

  246. B

  247. B

  248. C

  249. A

  250. D

+ نوشته شده در  پنجشنبه بیست و پنجم تیر 1388ساعت 14:14  توسط علی خواجوی  | 

NCLEX-RN Questions 1-125

  1. A 43-year-old African American male is admitted with sickle cell anemia. The nurse plans to assess circulation in the lower extremities every 2 hours. Which of the following outcome criteria would the nurse use?

    1. Body temperature of 99°F or less

    2. Toes moved in active range of motion

    3. Sensation reported when soles of feet are touched

    4. Capillary refill of < 3 seconds

  2. A 30-year-old male from Haiti is brought to the emergency department in sickle cell crisis. What is the best position for this client?

    1. Side-lying with knees flexed

    2. Knee-chest

    3. High Fowler's with knees flexed

    4. Semi-Fowler's with legs extended on the bed

  3. A 25-year-old male is admitted in sickle cell crisis. Which of the following interventions would be of highest priority for this client?

    1. Taking hourly blood pressures with mechanical cuff

    2. Encouraging fluid intake of at least 200mL per hour

    3. Position in high Fowler's with knee gatch raised

    4. Administering Tylenol as ordered

  4. Which of the following foods would the nurse encourage the client in sickle cell crisis to eat?

    1. Peaches

    2. Cottage cheese

    3. Popsicle

    4. Lima beans

  5. A newly admitted client has sickle cell crisis. The nurse is planning care based on assessment of the client. The client is complaining of severe pain in his feet and hands. The pulse oximetry is 92. Which of the following interventions would be implemented first? Assume that there are orders for each intervention.

    1. Adjust the room temperature

    2. Give a bolus of IV fluids

    3. Start O2

    4. Administer meperidine (Demerol) 75mg IV push

  6. The nurse is instructing a client with iron-deficiency anemia. Which of the following meal plans would the nurse expect the client to select?

    1. Roast beef, gelatin salad, green beans, and peach pie

    2. Chicken salad sandwich, coleslaw, French fries, ice cream

    3. Egg salad on wheat bread, carrot sticks, lettuce salad, raisin pie

    4. Pork chop, creamed potatoes, corn, and coconut cake

  7. Clients with sickle cell anemia are taught to avoid activities that cause hypoxia and hypoxemia. Which of the following activities would the nurse recommend?

    1. A family vacation in the Rocky Mountains

    2. Chaperoning the local boys club on a snow-skiing trip

    3. Traveling by airplane for business trips

    4. A bus trip to the Museum of Natural History

  8. The nurse is conducting an admission assessment of a client with vitamin B12 deficiency. Which of the following would the nurse include in the physical assessment?

    1. Palpate the spleen

    2. Take the blood pressure

    3. Examine the feet for petechiae

    4. Examine the tongue

  9. An African American female comes to the outpatient clinic. The physician suspects vitamin B12 deficiency anemia. Because jaundice is often a clinical manifestation of this type of anemia, what body part would be the best indicator?

    1. Conjunctiva of the eye

    2. Soles of the feet

    3. Roof of the mouth

    4. Shins

  10. The nurse is conducting a physical assessment on a client with anemia. Which of the following clinical manifestations would be most indicative of the anemia?

    1. BP 146/88

    2. Respirations 28 shallow

    3. Weight gain of 10 pounds in 6 months

    4. Pink complexion

  11. The nurse is teaching the client with polycythemia vera about prevention of complications of the disease. Which of the following statements by the client indicates a need for further teaching?

    1. "I will drink 500mL of fluid or less each day."

    2. "I will wear support hose when I am up."

    3. "I will use an electric razor for shaving."

    4. "I will eat foods low in iron."

  12. A 33-year-old male is being evaluated for possible acute leukemia. Which of the following would the nurse inquire about as a part of the assessment?

    1. The client collects stamps as a hobby.

    2. The client recently lost his job as a postal worker.

    3. The client had radiation for treatment of Hodgkin's disease as a teenager.

    4. The client's brother had leukemia as a child.

  13. An African American client is admitted with acute leukemia. The nurse is assessing for signs and symptoms of bleeding. Where is the best site for examining for the presence of petechiae?

    1. The abdomen

    2. The thorax

    3. The earlobes

    4. The soles of the feet

  14. A client with acute leukemia is admitted to the oncology unit. Which of the following would be most important for the nurse to inquire?

    1. "Have you noticed a change in sleeping habits recently?"

    2. "Have you had a respiratory infection in the last 6 months?"

    3. "Have you lost weight recently?"

    4. "Have you noticed changes in your alertness?"

  15. Which of the following would be the priority nursing diagnosis for the adult client with acute leukemia?

    1. Oral mucous membrane, altered related to chemotherapy

    2. Risk for injury related to thrombocytopenia

    3. Fatigue related to the disease process

    4. Interrupted family processes related to life-threatening illness of a family member

  16. A 21-year-old male with Hodgkin's lymphoma is a senior at the local university. He is engaged to be married and is to begin a new job upon graduation. Which of the following diagnoses would be a priority for this client?

    1. Sexual dysfunction related to radiation therapy

    2. Anticipatory grieving related to terminal illness

    3. Tissue integrity related to prolonged bed rest

    4. Fatigue related to chemotherapy

  17. A client has autoimmune thrombocytopenic purpura. To determine the client's response to treatment, the nurse would monitor:

    1. Platelet count

    2. White blood cell count

    3. Potassium levels

    4. Partial prothrombin time (PTT)

  18. The home health nurse is visiting a client with autoimmune thrombocytopenic purpura (ATP). The client's platelet count currently is 80, It will be most important to teach the client and family about:

    1. Bleeding precautions

    2. Prevention of falls

    3. Oxygen therapy

    4. Conservation of energy

  19. A client with a pituitary tumor has had a transphenoidal hyposphectomy. Which of the following interventions would be appropriate for this client?

    1. Place the client in Trendelenburg position for postural drainage

    2. Encourage coughing and deep breathing every 2 hours

    3. Elevate the head of the bed 30°

    4. Encourage the Valsalva maneuver for bowel movements

  20. The client with a history of diabetes insipidus is admitted with polyuria, polydipsia, and mental confusion. The priority intervention for this client is:

    1. Measure the urinary output

    2. Check the vital signs

    3. Encourage increased fluid intake

    4. Weigh the client

  21. A client with hemophilia has a nosebleed. Which nursing action is most appropriate to control the bleeding?

    1. Place the client in a sitting position with the head hyperextended

    2. Pack the nares tightly with gauze to apply pressure to the source of bleeding

    3. Pinch the soft lower part of the nose for a minimum of 5 minutes

    4. Apply ice packs to the forehead and back of the neck

  22. A client has had a unilateral adrenalectomy to remove a tumor. To prevent complications, the most important measurement in the immediate post-operative period for the nurse to take is:

    1. Blood pressure

    2. Temperature

    3. Output

    4. Specific gravity

  23. A client with Addison's disease has been admitted with a history of nausea and vomiting for the past 3 days. The client is receiving IV glucocorticoids (Solu-Medrol). Which of the following interventions would the nurse implement?

    1. Glucometer readings as ordered

    2. Intake/output measurements

    3. Sodium and potassium levels monitored

    4. Daily weights

  24. A client had a total thyroidectomy yesterday. The client is complaining of tingling around the mouth and in the fingers and toes. What would the nurses' next action be?

    1. Obtain a crash cart

    2. Check the calcium level

    3. Assess the dressing for drainage

    4. Assess the blood pressure for hypertension

  25. A 32-year-old mother of three is brought to the clinic. Her pulse is 52, there is a weight gain of 30 pounds in 4 months, and the client is wearing two sweaters. The client is diagnosed with hypothyroidism. Which of the following nursing diagnoses is of highest priority?

    1. Impaired physical mobility related to decreased endurance

    2. Hypothermia r/t decreased metabolic rate

    3. Disturbed thought processes r/t interstitial edema

    4. Decreased cardiac output r/t bradycardia

  26. The client presents to the clinic with a serum cholesterol of 275mg/dL and is placed on rosuvastatin (Crestor). Which instruction should be given to the client?

    1. Report muscle weakness to the physician.

    2. Allow six months for the drug to take effect.

    3. Take the medication with fruit juice.

    4. Ask the doctor to perform a complete blood count before starting the medication.

  27. The client is admitted to the hospital with hypertensive crises. Diazoxide (Hyperstat) is ordered. During administration, the nurse should:

    1. Utilize an infusion pump

    2. Check the blood glucose level

    3. Place the client in Trendelenburg position

    4. Cover the solution with foil

  28. The 6-month-old client with a ventral septal defect is receiving Digitalis for regulation of his heart rate. Which finding should be reported to the doctor?

    1. Blood pressure of 126/80

    2. Blood glucose of 110mg/dL

    3. Heart rate of 60bpm

    4. Respiratory rate of 30 per minute

  29. The client admitted with angina is given a prescription for nitroglycerine. The client should be instructed to:

    1. Replenish his supply every 3 months

    2. Take one every 15 minutes if pain occurs

    3. Leave the medication in the brown bottle

    4. Crush the medication and take with water

  30. The client is instructed regarding foods that are low in fat and cholesterol. Which diet selection is lowest in saturated fats?

    1. Macaroni and cheese

    2. Shrimp with rice

    3. Turkey breast

    4. Spaghetti

  31. The client is admitted with left-sided congestive heart failure. In assessing the client for edema, the nurse should check the:

    1. Feet

    2. Neck

    3. Hands

    4. Sacrum

  32. The nurse is checking the client's central venous pressure. The nurse should place the zero of the manometer at the:

    1. Phlebostatic axis

    2. PMI

    3. Erb's point

    4. Tail of Spence

  33. The physician orders lisinopril (Zestril) and furosemide (Lasix) to be administered concomitantly to the client with hypertension. The nurse should:

    1. Question the order

    2. Administer the medications

    3. Administer separately

    4. Contact the pharmacy

  34. The best method of evaluating the amount of peripheral edema is:

    1. Weighing the client daily

    2. Measuring the extremity

    3. Measuring the intake and output

    4. Checking for pitting

  35. A client with vaginal cancer is being treated with a radioactive vaginal implant. The client's husband asks the nurse if he can spend the night with his wife. The nurse should explain that:

    1. Overnight stays by family members is against hospital policy.

    2. There is no need for him to stay because staffing is adequate.

    3. His wife will rest much better knowing that he is at home.

    4. Visitation is limited to 30 minutes when the implant is in place.

  36. The nurse is caring for a client hospitalized with a facial stroke. Which diet selection would be suited to the client?

    1. Roast beef sandwich, potato chips, pickle spear, iced tea

    2. Split pea soup, mashed potatoes, pudding, milk

    3. Tomato soup, cheese toast, Jello, coffee

    4. Hamburger, baked beans, fruit cup, iced tea

  37. The physician has prescribed Novalog insulin for a client with diabetes mellitus. Which statement indicates that the client knows when the peak action of the insulin occurs?

    1. "I will make sure I eat breakfast within 10 minutes of taking my insulin."

    2. "I will need to carry candy or some form of sugar with me all the time."

    3. "I will eat a snack around three o'clock each afternoon."

    4. "I can save my dessert from supper for a bedtime snack."

  38. The nurse is teaching basic infant care to a group of first-time parents. The nurse should explain that a sponge bath is recommended for the first 2 weeks of life because:

    1. New parents need time to learn how to hold the baby.

    2. The umbilical cord needs time to separate.

    3. Newborn skin is easily traumatized by washing.

    4. The chance of chilling the baby outweighs the benefits of bathing.

  39. A client with leukemia is receiving Trimetrexate. After reviewing the client's chart, the physician orders Wellcovorin (leucovorin calcium). The rationale for administering leucovorin calcium to a client receiving Trimetrexate is to:

    1. Treat iron-deficiency anemia caused by chemotherapeutic agents

    2. Create a synergistic effect that shortens treatment time

    3. Increase the number of circulating neutrophils

    4. Reverse drug toxicity and prevent tissue damage

  40. A 4-month-old is brought to the well-baby clinic for immunization. In addition to the DPT and polio vaccines, the baby should receive:

    1. Hib titer

    2. Mumps vaccine

    3. Hepatitis B vaccine

    4. MMR

  41. The physician has prescribed Nexium (esomeprazole) for a client with erosive gastritis. The nurse should administer the medication:

    1. 30 minutes before meals

    2. With each meal

    3. In a single dose at bedtime

    4. 30 minutes after meals

  42. A client on the psychiatric unit is in an uncontrolled rage and is threatening other clients and staff. What is the most appropriate action for the nurse to take?

    1. Call security for assistance and prepare to sedate the client.

    2. Tell the client to calm down and ask him if he would like to play cards.

    3. Tell the client that if he continues his behavior he will be punished.

    4. Leave the client alone until he calms down.

  43. When the nurse checks the fundus of a client on the first postpartum day, she notes that the fundus is firm, is at the level of the umbilicus, and is displaced to the right. The next action the nurse should take is to:

    1. Check the client for bladder distention

    2. Assess the blood pressure for hypotension

    3. Determine whether an oxytocic drug was given

    4. Check for the expulsion of small clots

  44. A client is admitted to the hospital with a temperature of 99.8°F, complaints of blood-tinged hemoptysis, fatigue, and night sweats. The client's symptoms are consistent with a diagnosis of:

    1. Pneumonia

    2. Reaction to antiviral medication

    3. Tuberculosis

    4. Superinfection due to low CD4 count

  45. The client is seen in the clinic for treatment of migraine headaches. The drug Imitrex (sumatriptan succinate) is prescribed for the client. Which of the following in the client's history should be reported to the doctor?

    1. Diabetes

    2. Prinzmetal's angina

    3. Cancer

    4. Cluster headaches

  46. The client with suspected meningitis is admitted to the unit. The doctor is performing an assessment to determine meningeal irritation and spinal nerve root inflammation. A positive Kernig's sign is charted if the nurse notes:

    1. Pain on flexion of the hip and knee

    2. Nuchal rigidity on flexion of the neck

    3. Pain when the head is turned to the left side

    4. Dizziness when changing positions

  47. The client with Alzheimer's disease is being assisted with activities of daily living when the nurse notes that the client uses her toothbrush to brush her hair. The nurse is aware that the client is exhibiting:

    1. Agnosia

    2. Apraxia

    3. Anomia

    4. Aphasia

  48. The client with dementia is experiencing confusion late in the afternoon and before bedtime. The nurse is aware that the client is experiencing what is known as:

    1. Chronic fatigue syndrome

    2. Normal aging

    3. Sundowning

    4. Delusions

  49. The client with confusion says to the nurse, "I haven't had anything to eat all day long. When are they going to bring breakfast?" The nurse saw the client in the day room eating breakfast with other clients 30 minutes before this conversation. Which response would be best for the nurse to make?

    1. "You know you had breakfast 30 minutes ago."

    2. "I am so sorry that they didn't get you breakfast. I'll report it to the charge nurse."

    3. "I'll get you some juice and toast. Would you like something else?"

    4. "You will have to wait a while; lunch will be here in a little while."

  50. The doctor has prescribed Exelon (rivastigmine) for the client with Alzheimer's disease. Which side effect is most often associated with this drug?

    1. Urinary incontinence

    2. Headaches

    3. Confusion

    4. Nausea

  51. A client is admitted to the labor and delivery unit in active labor. During examination, the nurse notes a papular lesion on the perineum. Which initial action is most appropriate?

    1. Document the finding

    2. Report the finding to the doctor

    3. Prepare the client for a C-section

    4. Continue primary care as prescribed

  52. A client with a diagnosis of HPV is at risk for which of the following?

    1. Hodgkin's lymphoma

    2. Cervical cancer

    3. Multiple myeloma

    4. Ovarian cancer

  53. During the initial interview, the client reports that she has a lesion on the perineum. Further investigation reveals a small blister on the vulva that is painful to touch. The nurse is aware that the most likely source of the lesion is:

    1. Syphilis

    2. Herpes

    3. Gonorrhea

    4. Condylomata

  54. A client visiting a family planning clinic is suspected of having an STI. The best diagnostic test for treponema pallidum is:

    1. Venereal Disease Research Lab (VDRL)

    2. Rapid plasma reagin (RPR)

    3. Florescent treponemal antibody (FTA)

    4. Thayer-Martin culture (TMC)

  55. A 15-year-old primigravida is admitted with a tentative diagnosis of HELLP syndrome. Which laboratory finding is associated with HELLP syndrome?

    1. Elevated blood glucose

    2. Elevated platelet count

    3. Elevated creatinine clearance

    4. Elevated hepatic enzymes

  56. The nurse is assessing the deep tendon reflexes of a client with preeclampsia. Which method is used to elicit the biceps reflex?

    1. The nurse places her thumb on the muscle inset in the antecubital space and taps the thumb briskly with the reflex hammer.

    2. The nurse loosely suspends the client's arm in an open hand while tapping the back of the client's elbow.

    3. The nurse instructs the client to dangle her legs as the nurse strikes the area below the patella with the blunt side of the reflex hammer.

    4. The nurse instructs the client to place her arms loosely at her side as the nurse strikes the muscle insert just above the wrist.

  57. A primigravida with diabetes is admitted to the labor and delivery unit at 34 weeks gestation. Which doctor's order should the nurse question?

    1. Magnesium sulfate 4gm (25%) IV

    2. Brethine 10mcg IV

    3. Stadol 1mg IV push every 4 hours as needed prn for pain

    4. Ancef 2gm IVPB every 6 hours

  58. A diabetic multigravida is scheduled for an amniocentesis at 32 weeks gestation to determine the L/S ratio and phosphatidyl glycerol level. The L/S ratio is 1:1 and the presence of phosphatidylglycerol is noted. The nurse's assessment of this data is:

    1. The infant is at low risk for congenital anomalies.

    2. The infant is at high risk for intrauterine growth retardation.

    3. The infant is at high risk for respiratory distress syndrome.

    4. The infant is at high risk for birth trauma.

  59. Which observation in the newborn of a diabetic mother would require immediate nursing intervention?

    1. Crying

    2. Wakefulness

    3. Jitteriness

    4. Yawning

  60. The nurse caring for a client receiving intravenous magnesium sulfate must closely observe for side effects associated with drug therapy. An expected side effect of magnesium sulfate is:

    1. Decreased urinary output

    2. Hypersomnolence

    3. Absence of knee jerk reflex

    4. Decreased respiratory rate

  61. The client has elected to have epidural anesthesia to relieve labor pain. If the client experiences hypotension, the nurse would:

    1. Place her in Trendelenburg position

    2. Decrease the rate of IV infusion

    3. Administer oxygen per nasal cannula

    4. Increase the rate of the IV infusion

  62. A client has cancer of the pancreas. The nurse should be most concerned about which nursing diagnosis?

    1. Alteration in nutrition

    2. Alteration in bowel elimination

    3. Alteration in skin integrity

    4. Ineffective individual coping

  63. The nurse is caring for a client with ascites. Which is the best method to use for determining early ascites?

    1. Inspection of the abdomen for enlargement

    2. Bimanual palpation for hepatomegaly

    3. Daily measurement of abdominal girth

    4. Assessment for a fluid wave

  64. The client arrives in the emergency department after a motor vehicle accident. Nursing assessment findings include BP 80/34, pulse rate 120, and respirations 20. Which is the client's most appropriate priority nursing diagnosis?

    1. Alteration in cerebral tissue perfusion

    2. Fluid volume deficit

    3. Ineffective airway clearance

    4. Alteration in sensory perception

  65. The home health nurse is visiting an 18-year-old with osteogenesis imperfecta. Which information obtained on the visit would cause the most concern? The client:

    1. Likes to play football

    2. Drinks several carbonated drinks per day

    3. Has two sisters with sickle cell tract

    4. Is taking acetaminophen to control pain

  66. The nurse working the organ transplant unit is caring for a client with a white blood cell count of During evening visitation, a visitor brings a basket of fruit. What action should the nurse take?

    1. Allow the client to keep the fruit

    2. Place the fruit next to the bed for easy access by the client

    3. Offer to wash the fruit for the client

    4. Tell the family members to take the fruit home

  67. The nurse is caring for the client following a laryngectomy when suddenly the client becomes nonresponsive and pale, with a BP of 90/40 systolic. The initial nurse's action should be to:

    1. Place the client in Trendelenburg position

    2. Increase the infusion of Dextrose in normal saline

    3. Administer atropine intravenously

    4. Move the emergency cart to the bedside

  68. The client admitted 2 days earlier with a lung resection accidentally pulls out the chest tube. Which action by the nurse indicates understanding of the management of chest tubes?

    1. Order a chest x-ray

    2. Reinsert the tube

    3. Cover the insertion site with a Vaseline gauze

    4. Call the doctor

  69. A client being treated with sodium warfarin has a Protime of 120 seconds. Which intervention would be most important to include in the nursing care plan?

    1. Assess for signs of abnormal bleeding

    2. Anticipate an increase in the Coumadin dosage

    3. Instruct the client regarding the drug therapy

    4. Increase the frequency of neurological assessments

  70. Which selection would provide the most calcium for the client who is 4 months pregnant?

    1. A granola bar

    2. A bran muffin

    3. A cup of yogurt

    4. A glass of fruit juice

  71. The client with preeclampsia is admitted to the unit with an order for magnesium sulfate. Which action by the nurse indicates understanding of the possible side effects of magnesium sulfate?

    1. The nurse places a sign over the bed not to check blood pressure in the right arm.

    2. The nurse places a padded tongue blade at the bedside.

    3. The nurse inserts a Foley catheter.

    4. The nurse darkens the room.

  72. A 6-year-old client is admitted to the unit with a hemoglobin of 6g/dL. The physician has written an order to transfuse 2 units of whole blood. When discussing the treatment, the child's mother tells the nurse that she does not believe in having blood transfusions and that she will not allow her child to have the treatment. What nursing action is most appropriate?

    1. Ask the mother to leave while the blood transfusion is in progress

    2. Encourage the mother to reconsider

    3. Explain the consequences without treatment

    4. Notify the physician of the mother's refusal

  73. A client is admitted to the unit 2 hours after an explosion causes burns to the face. The nurse would be most concerned with the client developing which of the following?

    1. Hypovolemia

    2. Laryngeal edema

    3. Hypernatremia

    4. Hyperkalemia

  74. The nurse is evaluating nutritional outcomes for an elderly client with bulimia. Which data best indicates that the plan of care is effective?

    1. The client selects a balanced diet from the menu.

    2. The client's hemoglobin and hematocrit improve.

    3. The client's tissue turgor improves.

    4. The client gains weight.

  75. The client is admitted following repair of a fractured tibia and cast application. Which nursing assessment should be reported to the doctor?

    1. Pain beneath the cast

    2. Warm toes

    3. Pedal pulses weak and rapid

    4. Paresthesia of the toes

  76. The client is having an arteriogram. During the procedure, the client tells the nurse, "I'm feeing really hot." Which response would be best?

    1. "You are having an allergic reaction. I will get an order for Benadryl."

    2. "That feeling of warmth is normal when the dye is injected."

    3. "That feeling of warmth indicates that the clots in the coronary vessels are dissolving."

    4. "I will tell your doctor and let him explain to you the reason for the hot feeling that you are experiencing."

  77. The nurse is observing several healthcare workers providing care. Which action by the healthcare worker indicates a need for further teaching?

    1. The nursing assistant wears gloves while giving the client a bath.

    2. The nurse wears goggles while drawing blood from the client.

    3. The doctor washes his hands before examining the client.

    4. The nurse wears gloves to take the client's vital signs.

  78. The client is having electroconvulsive therapy for treatment of severe depression. Which of the following indicates that the client's ECT has been effective?

    1. The client loses consciousness.

    2. The client vomits.

    3. The client's ECG indicates tachycardia.

    4. The client has a grand mal seizure.

  79. The 5-year-old is being tested for enterobiasis (pinworms). To collect a specimen for assessment of pinworms, the nurse should teach the mother to:

    1. Examine the perianal area with a flashlight 2 or 3 hours after the child is asleep

    2. Scrape the skin with a piece of cardboard and bring it to the clinic

    3. Obtain a stool specimen in the afternoon

    4. Bring a hair sample to the clinic for evaluation

  80. The nurse is teaching the mother regarding treatment for enterobiasis. Which instruction should be given regarding the medication?

    1. Treatment is not recommended for children less than 10 years of age.

    2. The entire family should be treated.

    3. Medication therapy will continue for 1 year.

    4. Intravenous antibiotic therapy will be ordered.

  81. The registered nurse is making assignments for the day. Which client should be assigned to the pregnant nurse?

    1. The client receiving linear accelerator radiation therapy for lung cancer

    2. The client with a radium implant for cervical cancer

    3. The client who has just been administered soluble brachytherapy for thyroid cancer

    4. The client who returned from placement of iridium seeds for prostate cancer

  82. The nurse is planning room assignments for the day. Which client should be assigned to a private room if only one is available?

    1. The client with Cushing's disease

    2. The client with diabetes

    3. The client with acromegaly

    4. The client with myxedema

  83. The nurse caring for a client in the neonatal intensive care unit administers adult-strength Digitalis to the 3-pound infant. As a result of her actions, the baby suffers permanent heart and brain damage. The nurse can be charged with:

    1. Negligence

    2. Tort

    3. Assault

    4. Malpractice

  84. Which assignment should not be performed by the licensed practical nurse?

    1. Inserting a Foley catheter

    2. Discontinuing a nasogastric tube

    3. Obtaining a sputum specimen

    4. Starting a blood transfusion

  85. The client returns to the unit from surgery with a blood pressure of 90/50, pulse 132, and respirations 30. Which action by the nurse should receive priority?

    1. Continuing to monitor the vital signs

    2. Contacting the physician

    3. Asking the client how he feels

    4. Asking the LPN to continue the post-op care

  86. Which nurse should be assigned to care for the postpartal client with preeclampsia?

    1. The RN with 2 weeks of experience in postpartum

    2. The RN with 3 years of experience in labor and delivery

    3. The RN with 10 years of experience in surgery

    4. The RN with 1 year of experience in the neonatal intensive care unit

  87. Which information should be reported to the state Board of Nursing?

    1. The facility fails to provide literature in both Spanish and English.

    2. The narcotic count has been incorrect on the unit for the past 3 days.

    3. The client fails to receive an itemized account of his bills and services received during his hospital stay.

    4. The nursing assistant assigned to the client with hepatitis fails to feed the client and give the bath.

  88. The nurse is suspected of charting medication administration that he did not give. After talking to the nurse, the charge nurse should:

    1. Call the Board of Nursing

    2. File a formal reprimand

    3. Terminate the nurse

    4. Charge the nurse with a tort

  89. The home health nurse is planning for the day's visits. Which client should be seen first?

    1. The 78-year-old who had a gastrectomy 3 weeks ago and has a PEG tube

    2. The 5-month-old discharged 1 week ago with pneumonia who is being treated with amoxicillin liquid suspension

    3. The 50-year-old with MRSA being treated with Vancomycin via a PICC line

    4. The 30-year-old with an exacerbation of multiple sclerosis being treated with cortisone via a centrally placed venous catheter

  90. The emergency room is flooded with clients injured in a tornado. Which clients can be assigned to share a room in the emergency department during the disaster?

    1. A schizophrenic client having visual and auditory hallucinations and the client with ulcerative colitis

    2. The client who is 6 months pregnant with abdominal pain and the client with facial lacerations and a broken arm

    3. A child whose pupils are fixed and dilated and his parents, and a client with a frontal head injury

    4. The client who arrives with a large puncture wound to the abdomen and the client with chest pain

  91. The nurse is caring for a 6-year-old client admitted with a diagnosis of conjunctivitis. Before administering eyedrops, the nurse should recognize that it is essential to consider which of the following?

    1. The eye should be cleansed with warm water, removing any exudate, before instilling the eyedrops.

    2. The child should be allowed to instill his own eyedrops.

    3. The mother should be allowed to instill the eyedrops.

    4. If the eye is clear from any redness or edema, the eyedrops should be held.

  92. The nurse is discussing meal planning with the mother of a 2-year-old toddler. Which of the following statements, if made by the mother, would require a need for further instruction?

    1. "It is okay to give my child white grape juice for breakfast."

    2. "My child can have a grilled cheese sandwich for lunch."

    3. "We are going on a camping trip this weekend, and I have bought hot dogs to grill for his lunch."

    4. "For a snack, my child can have ice cream."

  93. A 2-year-old toddler is admitted to the hospital. Which of the following nursing interventions would you expect?

    1. Ask the parent/guardian to leave the room when assessments are being performed.

    2. Ask the parent/guardian to take the child's favorite blanket home because anything from the outside should not be brought into the hospital.

    3. Ask the parent/guardian to room-in with the child.

    4. If the child is screaming, tell him this is inappropriate behavior.

  94. Which instruction should be given to the client who is fitted for a behind-the-ear hearing aid?

    1. Remove the mold and clean every week.

    2. Store the hearing aid in a warm place.

    3. Clean the lint from the hearing aid with a toothpick.

    4. Change the batteries weekly.

  95. A priority nursing diagnosis for a child being admitted from surgery following a tonsillectomy is:

    1. Body image disturbance

    2. Impaired verbal communication

    3. Risk for aspiration

    4. Pain

  96. A client with bacterial pneumonia is admitted to the pediatric unit. What would the nurse expect the admitting assessment to reveal?

    1. High fever

    2. Nonproductive cough

    3. Rhinitis

    4. Vomiting and diarrhea

  97. The nurse is caring for a client admitted with epiglottis. Because of the possibility of complete obstruction of the airway, which of the following should the nurse have available?

    1. Intravenous access supplies

    2. A tracheostomy set

    3. Intravenous fluid administration pump

    4. Supplemental oxygen

  98. A 25-year-old client with Grave's disease is admitted to the unit. What would the nurse expect the admitting assessment to reveal?

    1. Bradycardia

    2. Decreased appetite

    3. Exophthalmos

    4. Weight gain

  99. The nurse is providing dietary instructions to the mother of an 8-year-old child diagnosed with celiac disease. Which of the following foods, if selected by the mother, would indicate her understanding of the dietary instructions?

    1. Ham sandwich on whole-wheat toast

    2. Spaghetti and meatballs

    3. Hamburger with ketchup

    4. Cheese omelet

  100. The nurse is caring for an 80-year-old with chronic bronchitis. Upon the morning rounds, the nurse finds an O2 sat of 76%. Which of the following actions should the nurse take first?

    1. Notify the physician

    2. Recheck the O2 saturation level in 15 minutes

    3. Apply oxygen by mask

    4. Assess the child's pulse

  101. A gravida III para 0 is admitted to the labor and delivery unit. The doctor performs an amniotomy. Which observation would the nurse be expected to make after the amniotomy?

    1. Fetal heart tones 160bpm

    2. A moderate amount of straw-colored fluid

    3. A small amount of greenish fluid

    4. A small segment of the umbilical cord

  102. The client is admitted to the unit. A vaginal exam reveals that she is 2cm dilated. Which of the following statements would the nurse expect her to make?

    1. "We have a name picked out for the baby."

    2. "I need to push when I have a contraction."

    3. "I can't concentrate if anyone is touching me."

    4. "When can I get my epidural?"

  103. The client is having fetal heart rates of 90–110bpm during the contractions. The first action the nurse should take is:

    1. Reposition the monitor

    2. Turn the client to her left side

    3. Ask the client to ambulate

    4. Prepare the client for delivery

  104. In evaluating the effectiveness of IV Pitocin for a client with secondary dystocia, the nurse should expect:

    1. A painless delivery

    2. Cervical effacement

    3. Infrequent contractions

    4. Progressive cervical dilation

  105. A vaginal exam reveals a footling breech presentation. The nurse should take which of the following actions at this time?

    1. Anticipate the need for a Caesarean section

    2. Apply the fetal heart monitor

    3. Place the client in Genu Pectoral position

    4. Perform an ultrasound exam

  106. A vaginal exam reveals that the cervix is 4cm dilated, with intact membranes and a fetal heart tone rate of 160–170bpm. The nurse decides to apply an external fetal monitor. The rationale for this implementation is:

    1. The cervix is closed.

    2. The membranes are still intact.

    3. The fetal heart tones are within normal limits.

    4. The contractions are intense enough for insertion of an internal monitor.

  107. The following are all nursing diagnoses appropriate for a gravida 1 para 0 in labor. Which one would be most appropriate for the primagravida as she completes the early phase of labor?

    1. Impaired gas exchange related to hyperventilation

    2. Alteration in placental perfusion related to maternal position

    3. Impaired physical mobility related to fetal-monitoring equipment

    4. Potential fluid volume deficit related to decreased fluid intake

  108. As the client reaches 8cm dilation, the nurse notes late decelerations on the fetal monitor. The FHR baseline is 165–175bpm with variability of 0–2bpm. What is the most likely explanation of this pattern?

    1. The baby is asleep.

    2. The umbilical cord is compressed.

    3. There is a vagal response.

    4. There is uteroplacental insufficiency.

  109. The nurse notes variable decelerations on the fetal monitor strip. The most appropriate initial action would be to:

    1. Notify her doctor

    2. Start an IV

    3. Reposition the client

    4. Readjust the monitor

  110. Which of the following is a characteristic of a reassuring fetal heart rate pattern?

    1. A fetal heart rate of 170–180bpm

    2. A baseline variability of 25–35bpm

    3. Ominous periodic changes

    4. Acceleration of FHR with fetal movements

  111. The rationale for inserting a French catheter every hour for the client with epidural anesthesia is:

    1. The bladder fills more rapidly because of the medication used for the epidural.

    2. Her level of consciousness is such that she is in a trancelike state.

    3. The sensation of the bladder filling is diminished or lost.

    4. She is embarrassed to ask for the bedpan that frequently.

  112. A client in the family planning clinic asks the nurse about the most likely time for her to conceive. The nurse explains that conception is most likely to occur when:

    1. Estrogen levels are low.

    2. Lutenizing hormone is high.

    3. The endometrial lining is thin.

    4. The progesterone level is low.

  113. A client tells the nurse that she plans to use the rhythm method of birth control. The nurse is aware that the success of the rhythm method depends on the:

    1. Age of the client

    2. Frequency of intercourse

    3. Regularity of the menses

    4. Range of the client's temperature

  114. A client with diabetes asks the nurse for advice regarding methods of birth control. Which method of birth control is most suitable for the client with diabetes?

    1. Intrauterine device

    2. Oral contraceptives

    3. Diaphragm

    4. Contraceptive sponge

  115. The doctor suspects that the client has an ectopic pregnancy. Which symptom is consistent with a diagnosis of ectopic pregnancy?

    1. Painless vaginal bleeding

    2. Abdominal cramping

    3. Throbbing pain in the upper quadrant

    4. Sudden, stabbing pain in the lower quadrant

  116. The nurse is teaching a pregnant client about nutritional needs during pregnancy. Which menu selection will best meet the nutritional needs of the pregnant client?

    1. Hamburger pattie, green beans, French fries, and iced tea

    2. Roast beef sandwich, potato chips, baked beans, and cola

    3. Baked chicken, fruit cup, potato salad, coleslaw, yogurt, and iced tea

    4. Fish sandwich, gelatin with fruit, and coffee

  117. The client with hyperemesis gravidarum is at risk for developing:

    1. Respiratory alkalosis without dehydration

    2. Metabolic acidosis with dehydration

    3. Respiratory acidosis without dehydration

    4. Metabolic alkalosis with dehydration

  118. A client tells the doctor that she is about 20 weeks pregnant. The most definitive sign of pregnancy is:

    1. Elevated human chorionic gonadatropin

    2. The presence of fetal heart tones

    3. Uterine enlargement

    4. Breast enlargement and tenderness

  119. The nurse is caring for a neonate whose mother is diabetic. The nurse will expect the neonate to be:

    1. Hypoglycemic, small for gestational age

    2. Hyperglycemic, large for gestational age

    3. Hypoglycemic, large for gestational age

    4. Hyperglycemic, small for gestational age

  120. Which of the following instructions should be included in the nurse's teaching regarding oral contraceptives?

    1. Weight gain should be reported to the physician.

    2. An alternate method of birth control is needed when taking antibiotics.

    3. If the client misses one or more pills, two pills should be taken per day for 1 week.

    4. Changes in the menstrual flow should be reported to the physician.

  121. The nurse is discussing breastfeeding with a postpartum client. Breastfeeding is contraindicated in the postpartum client with:

    1. Diabetes

    2. Positive HIV

    3. Hypertension

    4. Thyroid disease

  122. A client is admitted to the labor and delivery unit complaining of vaginal bleeding with very little discomfort. The nurse's first action should be to:

    1. Assess the fetal heart tones

    2. Check for cervical dilation

    3. Check for firmness of the uterus

    4. Obtain a detailed history

  123. A client telephones the emergency room stating that she thinks that she is in labor. The nurse should tell the client that labor has probably begun when:

    1. Her contractions are 2 minutes apart.

    2. She has back pain and a bloody discharge.

    3. She experiences abdominal pain and frequent urination.

    4. Her contractions are 5 minutes apart.

  124. The nurse is teaching a group of prenatal clients about the effects of cigarette smoke on fetal development. Which characteristic is associated with babies born to mothers who smoked during pregnancy?

    1. Low birth weight

    2. Large for gestational age

    3. Preterm birth, but appropriate size for gestation

    4. Growth retardation in weight and length

  125. The physician has ordered an injection of RhoGam for the postpartum client whose blood type is A negative but whose baby is O positive. To provide postpartum prophylaxis, RhoGam should be administered:

    1. Within 72 hours of delivery

    2. Within 1 week of delivery

    3. Within 2 weeks of delivery

    4. Within 1 month of delivery

+ نوشته شده در  پنجشنبه بیست و پنجم تیر 1388ساعت 14:11  توسط علی خواجوی  | 

Diabet CGFNS-RN questions

1. Insulin inhibits the release of _______.

A. Glucagon
B. ADH
C. Beta cells
D. Somatostatin

2. Which of the following is caused by insulin release?

A. Increased breakdown of fats
B. Increase breakdown of proteins
C. Decreased blood sugar
D. Causes glucose to be phosphorylated in kidney

3. Glucagon causes increased blood sugar and causes slow breakdown of glycogen in the liver.

A. TRUE
B. FALSE

4. As blood glucose decreases glucagon is inhibited.

A. TRUE
B. FALSE

5. Glucagon increases blood levels of glucose by causing liver to breakdown glycogen.

A. TRUE
B. FALSE

6. Which of the following is not true about Type I DM?

A. May be linked to autoimmunity
B. Onset usually prior to age 20
C. Beta islet cells destroyed
D. Does not require insulin injections

7. Which of the following is not true about Type II DM?

A. Considered adult onset diabetes
B. Cause unknown may be due to genetics
C. Require insulin 80% of cases
D. May take a drug that sensitize cells or increase insulin release

8. Which of the following is not an effect of diabetes?

A. Small vessel occlusion
B. Necrosis of extremities
C. Ketone Body production
D. Decreased fat metabolism

9. Which of the following is not an indicator of a hypoglycemic condition?

A. Fatigue
B. Poor appetite
C. Tachycardia
D. Confusion

10. Which of the following is not an adverse effect of oral hypoglycemics?

A. Hypoglycemia
B. Headache
C. Rashes
D. Projectile vomiting

11. Which of the following is not an adverse effect of glucagon?

A. Allergic reaction
B. Vomiting
C. Nausea
D. Fever

12. Which of the following drugs may be given as an immunosuppressant soon after onset of Type I Diabetes?

A. Torsemide
B. Cyclosporine
C. Clofibrate
D. Ceftriaxone

13. Which of the following is not considered an endocrine hormone?

A. Renin
B. Insulin
C. Glucagon
D. Somatostatin

14. What type of cells secrete glucagon?

A. Beta cells
B. Alpha cells
C. Plasma cells
D. Acinar cells

15. What type of cells secrete insulin?

A. Beta cells
B. Alpha cells
C. Plasma cells
D. Acinar cells

16. Which of the following would not be considered an acute effect of diabetes mellitus?

A. Polyuria
B. Weight gain
C. Polydipsia
D. Polyphagia

17. Which of the following is not an accurate test for diabetes?

A. Glucose tolerance test
B. HbA
C. Fasting serum glucose
D. Fasting glucagon test

18. Which of the following is not an indicator of diabetic ketoacidosis?

A. Hyperthermia
B. Nausea/Vomiting
C. Slow and shallow breathing
D. Psychosis leading to dementia

19. Which of the following is not related to a chronic diabetes mellitus condition?

A. Atherosclerosis
B. Neuropathy
C. Glaucoma
D. Hypotension

20. Which of the following conditions is not linked to diabetic ketoacidosis?

A. Cerebral edema
B. Arrhythmias
C. Peptic ulcers
D. Mucormycosis

Answer Key
1. A
2. C
3. B
4. B
5. A
6. D
7. C
8. D
9. B
10. D
11. D
12. B
13. A
14. B
15. A
16. B
17. D
18. C
19. D
20. C
+ نوشته شده در  پنجشنبه بیست و پنجم تیر 1388ساعت 14:3  توسط علی خواجوی  | 

نکات روانپرستاری Psychiatric Nursing Notes 1

• Psych focuses in feelings or self awareness.
• Beliefs determine feelings which affects behavior (manifestation of feelings)
• Sigmund Freud is the father of PSYCHOANALYSIS.
• What happens to childhood will affect adulthood.


STRUCTURE OF PERSONALITY

ID

• impulsive, want to, wants pleasure.
• PLEASURE PRINCIPLE.
• Guiding principle is PAIN AVOIDANCE.

SUPEREGO
• should not
• small voice of God
• to stop

EGO• executive decision maker.
• In touch with reality principle.

ID DOMINANT PERSONALITIES
Manic
Anti – Social – experienced by serial killers
Narcissistic

SUPEREGO DOMINANT PERSONALITIES
Obsessive Compulsive
Anorexia Nervosa

EGO – if destroyed result in impaired reality perception.
Schizophrenia

LIBIDO
• Sexual energy responsible for survival.

Oral Stage• 0 – 18 months evident.
• ID is developed.

*FIXATION – Person is stuck in certain developmental shape.
*REGRESSION – Return to an earlier developmental stage.
EGO – Developed on the 6th month.

Anal Stage
• 18 months – 3 years old.
• Able to control bladder, bowel.
• Best time for toilet training.
SUPEREGO is developed.

TOILET TRAINING

Good Mother------------------------ Bad MotherSuccessful -----------------Dirty ---------------------- Clean
-------------------------disorganized --------------- organized
------------------------- disobedient ---------------- obedient
------------------------- Anti-social ------------------- O.C
----------------------- Anal expulsive ----------- Anal retentive

PHALLIC STAGE
• 3 – 6 years old.
• Experience pleasure by manipulating genitals.
• Love – hate relationship.
• Oedipus Complex boy loves parent of the opposite sex.
• Imitates daddy called identification.
• Castration fears.
• Electra Complex girl loves parent of the opposite sex.
• Imitates mommy called identification.
• Penis envy.
*Conscious – upper level of thinking.
*Preconscious – tip of tongue.
*Unconscious – protects us from traumatic experiences.


LATENCY STAGE
• 6 – 12 years old.
• School age.
• Separation anxiety.
• Reading, Writing, Arithmetic.
• Lasts for 6 years.


GENITAL STAGE
• 12 years old and above
• Sexual reawakening.
• Very important stage.

PHARMA NOTES:
ANTI - ANXIETY DRUGS
• Valium
• Librium
• Ativan
• Serax
• Tanxene
• Miltown
• Equanil
• Vistaril
• Atarax
• Ideral
• Buspar

ERIC ERIKSON• There is more to life than just sex.
• Psychosocial Theory of development.
• You can develop a positive side or a negative side.
• Developmental task begins at 0 – 18 months.

-------------------- POSITIVE ------NEGATIVE -------- FACTOR0 – 18 mos. ----------Trust ------------ Mistrust ------------ Feeding
18 mos. – 3 yrs. ----Autonomy -------Shame & Doubt ---- Toilet Training
3 yrs. – 6 yrs. -------Initiative ---------- Guilt --------------Independence
6 yrs. – 12 yrs. -----Industry ---------Inferiority ------------ School
12 yrs. – 20 yrs. ----Identity ---------Role Confusion --------- Peers
20 yrs. – 25 yrs. ----Intimacy -----------Isolation --------------Love
25 yrs. – 45 yrs. ---Generativity --------Stagnation -----------Parenting
45 yrs. - above ----Ego Integrity --------- Despair

+ نوشته شده در  یکشنبه بیست و یکم تیر 1388ساعت 19:26  توسط علی خواجوی  | 

Nclex Rn Review

Most reliable early indicator of myocardial insult would be
* Troponin T and I

rationale: Troponin I and Troponin T are proteins in the striated cells of cardiac tissue and are therefore unique markets for cardiac damage; elevations occur within 1 hour of a myocardial infarction and persist for 7 to 15 days.
Creatine kinas (CK) isoenzyme levels, especially the MB subunit, begin to rise wintin 3 to 6 hours, peak in 12 to 18 hours and are elevated for 48 hours after the occurence of the infarct.


Client has had myocardial infarction develops cardiogenic shock, when assessing this client the nurse would expect to find:
* Warm moist skin

rationale: The skin becomes cool and paale as blood shunts from the peripheral blood vessels to the vital organs.


Possibility of death from complications always accompanies an acute MI. The nurse should monitor the client for during the first 48 hours is:
* Ventricular tacycardia

rationale: At least one half of all deaths occur from the life-threatening dysrhythmia of ventricular tacycardia.

Because a client with MI can develop left ventricular failure, the nurse should assess this client for:
*Paroxysmal nocturnal dyspnea

rationale:
L = LUNGS
R = ExTREMITIES

Dyspnea at night, which usually requires the assumption of the orthopneic position, is a sign of left ventricular failure; orthopnea, a compensatory mechanism, limits venous return, which decrease pulmonary congestion and promotes ventilation, easing the dyspnea.

What would pose the greatest threat to the baby's health with Down Syndrome?
*Pneumonia

Rationale: Respiratory infection is most common in children with Down Syndrome (secondary hypotonia and ineffective airway clearance) and is the leading cause of death in children with Down Syndrome


Newborn with Hypospadias, nurse expects to observe:
*Urethral opening located along the ventral surface of the penis.


A Toddler who was hospitalized with AIDS and is stroking a dirty, torn blanket. The nurse should:
*Allow the toddler to keep the blanket

Rationale: Because toddler has a "security object" such as a blanket, which helps them feel safe and secure.


Nurse should advice the parents that dental screening should begin at
* 12 - 18 months

Rationale: 12 - 18 month is the current recommended age for the first dental screening.


At what age should the nurse counsel parents that a child is capable of learning and repeating the family's telephone number?
* 5 years old

Rationale: The average 5 year old is capable of verbalizing number sequences, or repeating the telephone number.


When preparing a preschooler for a tonsillectomy, the nurse should:
* Use an anatomically correct model to demonstrate the procedure.

Rationale: The nurse should use medical play or therapeutic play to teach the child what will happen during surgery.


6 year old proudly tells the nurse that he has a loose tooth, and then ask the nurse how many of his baby teeth he is going to loose?
* 20 baby teeth

Rationale: 20 of his baby teeth or primary teeth.


A parent with Hemophilia wants to know whats the cause of their disease.
*The mother transmit the gene to his son. There is also a 50% chance that the mother will pass the traits to each of his children.


A 48 year old man with an endotracheal tube need suctioning. How should the nurse perform the procedure?
*Insert the suction catheter until resistance is met, then withdraw it slightly. Apply suction intermittently as the catheter is withdrawn.

Rationale: withdraw 0.4-0.8 in (1-2 cm), apply intermittent suction with twirling motion.


A 47 year old woman comes to the outpatient psychiatric clinic for treatment of a fear of heights. The nurse knows that phobias involve.
* Projection and displacement

Rationale: Projection (attribute one's thoughts or impulse to another) and displacement (shifting of emotion concerning person or object to another neutral or less dangerous object or person)



The prenatal client at eight-weeks gestation has positive VDRL. In preparing for teaching plan, what will be the most appropriate to include:
* Instructing the client on the importance of taking the penicillin for the prescribe time.

Rationale: physical, vitally important to complete all the penicillin.


Infant with fetal alcohol syndrome. The nurse would expect to see.
* An infant with a small head circumference, low birth weight, and undeveloped cheekbones.

Rationale: Seen in fetal alcholol syndrome.


Hydromorphone hydrochloride (Diladid) side effect.
* hypotension and respiratory depression

Rationale: narcotic analgesic used for moderate to severe pain, monitor vital signs frequently


66 year old client with Insulin-dependent diabetes mellitus (IDDM). Client is unwilling to perform blood glucose monitoring, she test her urine for sugar and acetone. The nurse knows that bloods glucose monitoring is preferred over urine testing for glucose because
* the renal threshold for glucose is elevated in the elderly

Rationale: The level at which glucose starts to appear in the urine increases, leading to false-negative reading, result in elevated glucose level.


18 month old with diagnose with laryngotracheobronchitis (LTB). Initial assessment, the nurse expects to find.
* Inspiratory stridor and restlessness

Rationale: This condition is characterized by edema and inflamation of upper airways.
+ نوشته شده در  یکشنبه بیست و یکم تیر 1388ساعت 19:20  توسط علی خواجوی  | 

مروری بر مطالب امتحان NCLEX-RN

Reflection statements tend to elicit deeper awareness of feelings. A well-timed reflection can reveal an emotion that has escaped the client’s notice.

Bell’s palsy is an inflammatory condition involving the facial nerve (cranial nerve VII). Although it results in facial paralysis, it is not the same as a stroke or cerebrovascular accident (CVA). Many clients fear that they have had a CVA when the symptoms of Bell’s palsy appear, and they commonly believe that the paralysis is permanent. Symptoms resolve, although it may take several weeks.

Abdominal peritoneoscopy is performed to directly visualize the liver, gallbladder, spleen, and stomach after the insufflation of nitrous oxide. During the procedure, a rigid laparoscope is inserted through a small incision in the abdomen. A microscope in the endoscope allows visualization of the organs and provides a way to collect a specimen for biopsy or to remove small tumors.

The client experiencing a precipitate labor may have more difficulty maintaining control because of the abrupt onset and quick progression of the labor. This may be very different from previous labor experiences; therefore, the client needs support from the nurse in order to understand and adapt to the rapid progression. The contractions often increase in intensity quickly, adding to the pain, anxiety, and lack of control. The client may also have an increased amount of concern about the effect of the labor on the newborn infant. Lack of control over the situation combined with increased pain and anxiety can result in a decreased level of satisfaction with the labor and delivery experience.

Clients have a concern for the safety of their baby during labor and delivery, especially when a problem arises. Empathy and a calm attitude with realistic reassurances are an important aspect of client care. Dismissing or ignoring the client’s concerns can lead to increased fear and lack of cooperation.

When caring for individuals from a different culture, it is important to ask questions about their specific cultural needs and means of treatment. An understanding of the family’s beliefs and health practices is essential to successful interventions for that particular family.

Clients with MI often have a nursing diagnosis of Anxiety or Fear. The nurse allows the client to express concerns by showing genuine interest and concern and by facilitating communication using therapeutic communication techniques.

In the adjustment period during the first few weeks after spinal cord injury, clients may use denial as a defense mechanism. Denial may decrease anxiety temporarily and is a normal part of grieving. After the spinal shock resolves, prolonged or excessive use of denial may impair rehabilitation. However, rehabilitation programs include psychological counseling to deal with denial and grief.

Surgical incisions or loss of a body part can alter a client’s body image. The onset of problems coping with these changes may occur in the immediate or extended postoperative stage. Nursing interventions primarily involve providing psychological support. The nurse should encourage the client to express how he or she feels these postoperative changes will affect his or her life.

Impetigo (sometimes impetaigo) is a superficial bacterial skin infection most common among children 2 to 6 years old.

Pulmonary edema is accompanied by extreme fear and anxiety. Because the client typically experiences a sense of impending doom, the nurse should remain with the client as much as possible.

The use of flexible visiting hours meets the needs of both the client and family in reducing the anxiety levels of both.

When a client experiences fear, the nurse can provide a calm, safe environment by offering appropriate reassurance, using therapeutic touch, and by having someone remain with the client as much as possible.

Stress can trigger the vasospasm that occurs with Raynaud’s disease, so referral to stress management programs or the use of biofeedback training may be helpful.

Antianxiety medications and narcotic analgesics are used cautiously in the client being weaned from a mechanical ventilator. These medications may interfere with the weaning process by suppressing the respiratory drive. The client may exhibit anxiety during the weaning process as well for a variety of reasons, and therefore distractions such as radio, television, and visitors are still very useful.

Pulmonary angiography involves minimal exposure to radiation. The procedure is painless, although the client may feel discomfort with insertion of the needle for the catheter that is used for dye injection.

Staying with the client has a two-fold benefit. First, it relieves the anxiety of the dyspneic client. In addition, the nurse must stay with the client to observe respiratory status after application of the occlusive dressing. It is possible that the dressing could convert the open pneumothorax to a closed (tension) pneumothorax, resulting in a sudden decline in respiratory status and mediastinal shift. If this occurs, the nurse is present and able to remove the dressing immediately.

If the client tests positive with the ELISA, the test is repeated. If it is positive a second time, the Western blot (a more specific test) is done to confirm the finding. The client is not diagnosed as HIV positive unless the Western blot is positive. (Some laboratories also run the Western blot a second time with a new specimen before making a final determination.)

A lethality assessment requires direct communication between the client and the nurse concerning the client’s intent. It is important to provide a question that is directly related to lethality. Euphemisms should be avoided.

A euphemism is a substitution of an agreeable or less offensive expression in place of one that may offend or suggest something unpleasant to the listener;[1] or in the case of doublespeak, to make it less troublesome for the speaker.

In order for Fear to be an actual diagnosis, the client must be able to identify the object of fear.

Powerlessness is used when the client believes that personal actions will not affect an outcome in any significant way. Ineffective coping is used when the client has impaired adaptive abilities or behaviors in meeting the demands or roles expected. Anxiety is used when the client has a feeling of unease with a vague or undefined source. Disturbed body image occurs when there is an alteration in the way the client perceives body image.

Fears about having only one functioning kidney are common in clients who must undergo nephrectomy for renal cancer. These clients need emotional support and reassurance that the remaining kidney should be able to fully meet the body’s metabolic needs, as long as it has normal function.

When cardiac output falls as a result of acute pulmonary edema, the sympathetic nervous system is stimulated. Stimulation of the sympathetic nervous system results in the flight-or-fight reaction, which further impairs cardiac function. The goal of treatment is to increase cardiac output and decrease fluid volume.

Acknowledging the client’s feelings without inserting your own values or judgments is a method of therapeutic communication. Therapeutic communication techniques assist the flow of communication and always focus on the client.

Imipramine (Tofranil), Bupropion (Wellbutrin), and Doxepin (Sinequan) are classified as antidepressants and act by stimulating the central nervous system (CNS) to elevate mood. Alprazolam (Xanax), a benzodiazepine antianxiety agent, depresses the CNS and induces relaxation in panic disorders.

The client undergoing decortication to treat empyema needs ongoing support by the nurse. This is especially true because the client will have chest tubes in place after surgery, which must remain until the former pus-filled space is completely obliterated. This may take some time and may be discouraging to the client. Progress is monitored by chest x-ray.

Maprotiline (Ludiomil) is a tricyclic antidepressant used to treat various forms of depression and anxiety. The client is also often in psychotherapy while on this medication. Expected effects of the medication include improved sense of well-being, appetite, and sleep, as well as a reduced sense of anxiety. Common side effects to report to the health care provider include drowsiness, lethargy, and fatigue.

The needle insertion for thoracentesis is painful for the client. The nurse tells the client how important it is to remain still during the procedure, so the needle doesn’t injure visceral pleura or lung tissue. The nurse reassures the client during the procedure and helps the client hold the proper position.

The anxious client with dyspnea should be taught interventions to decrease anxiety, which include relaxation, biofeedback, guided imagery, and distraction. This will stop the escalation of feelings of anxiety and dyspnea. The dyspnea can be further controlled by teaching the client breathing techniques, which include pursed lip and diaphragmatic breathing. Coughing techniques are useful, but breathing techniques are more effective. Limiting fluids will thicken secretions and increased dietary carbohydrates will increase production of CO2 by the body.

The pain associated with drainage of pleural effusion is minimized by positioning the client for comfort and administering analgesics for relief of pain. The nurse also offers verbal support and reassurance. All of these measures help the client cope with the pain and discomfort associated with this problem. It is least helpful to leave the client alone for extended periods, because the client may experience continued pain, which may be augmented by isolation.

Pleural effusion is excess fluid that accumulates in the pleural cavity, the fluid-filled space that surrounds the lungs. Excessive amounts of such fluid can impair breathing by limiting the expansion of the lungs during inhalation.

The client who has suffered pulmonary embolism is fearful and apprehensive. The nurse effectively communicates with this client by staying with the client, providing simple, clear, and accurate information, and displaying a calm, efficient manner

Sarcoidosis, also called sarcoid (from the Greek sarx, meaning "flesh") or Besnier-Boeck disease, is an immune system disorder characterized by non-caseating granulomas (small inflammatory nodules). It most commonly arises in young adults. The cause of the disease is still unknown. Virtually any organ can be affected; however, granulomas most often appear in the lungs or the lymph nodes.

The client with Powerlessness expresses feelings of having no control over a situation or outcome. Ineffective Health Maintenance involves the inability to seek out help that is needed to maintain health. Anxiety is a vague sense of unease. Disturbed Thought Processes involves disruption in cognitive abilities or thought.

+ نوشته شده در  یکشنبه بیست و یکم تیر 1388ساعت 19:14  توسط علی خواجوی  | 

NLE test

Situation 1 - Jimmy developed this goal for hospitalization. "To get a handle on my nervousness." The nurse is going to collaborate with him to reach his goal. Jimmy was admitted to the hospital because he called his therapist that he planned to asphyxiate himself with exhaust from his car but frightened instead. He realized he needed help.

1. The nurse recognized that Jimmy had conceptualized his problem and the next priority goal in the care plan is:

a. help the client find meaning in his experience
b. help the client to plan alternatives
c. help the client cope with present problem
d. help the client to communicate

2. The nurse is guided that Jimmy is aware of his concerns of the "here and now" when he crossed out which item from this "list of what to know"

a. anxiety laden unconscious conflicts
b. subjective idea of the range of mild to severe anxiety
c. early signs of anxiety
d. physiological indices of anxiety

3. While Jimmy was discussing the signs and symptoms of anxiety with his nurse, he recognized that complete disruption of the ability to perceive occurs in:

a. panic state of anxiety
b. severe anxiety
c. moderate anxiety
d. mild anxiety

4. Jimmy initiates independence and takes an active part in his self care with the following EXCEPT:

a. agreeing to contact the staff when he is anxious
b. becoming aware of the conscious feeling
c. assessing need for medication and medicating himself
d. writing out a list of behaviors that he identifies as anxious

5. The nurse notes effectiveness of Interventions in using subjective and objective data in the:

a. initial plans or order
b. database
c. problem list
d. progress notes

Situation 2 - A research study was under taken in order to identify and analyze a disabled boy's coping reaction pattern during stress.

6. This study which is a depth study of one boy is a:

a. case study
b. longitudinal study
c. cross-sectional study
d. evaluative study

7. The process recording was the principal tool for data collection. Which of the following is NOT a part of a process recording?

a. Non verbal narrative account
b. Audio and interpretation
c. Audio-visual recording
d. Verbal narrative account

8. Which of these does NOT happen in a descriptive study?

a. Exploration of relationship between two or more phenomena
b. Exploration of relationships between two or more phenomena
c. Manipulation of phenomenon in real life context
d. Manipulation of a variable

9. The investigator also provided the nursing care of the subject. The investigator is referred to as a/an.

a. Participant-observer
b. Observer researcher
c. Caregiver
d. Advocate

10. To ensure reliability of the study, the investigator analysis and interpretations were:

a. subjected to statistical treatment
b. correlated with a list coping behaviors
c. subjected to an inter-observe agreement
d scored and compared standard criteria

Situation 3 - During the morning endorsement, the' outgoing nurse informed the nursing staff that Regina, 5 years old, was given Flurazepam (Dalmane) 15 mg at 10:00pm because she had trouble going to sleep. Before approaching Regina, the nurse read the observation of the night nurse.

11. Which of the following approaches of the nurse validates the data gathered?

a. "I learned that you were up till ten last night, tell me what happened before you were finally able to sleep and how was your sleep?"
b. "Hmm...You look like you had a very sound sleep. That pill you were given last night is effective isn't it?"
c. "Regina, did you sleep we!!?"
d. "Regina, how are you?"

12. Regina is a high school teacher. Which of these information LE^ST communicate attention and care for her needs for information about her medicine?

a. Guided by a medication teaching plan go over with her the purpose, indications and special instructions, about the medication and provide her a checklist
b. Provide a drug literature
c. Have an informal conversation about the medication and its effects
d. Ask her what time she would like to watch the informative video about the medication

13. The nurse engages Regina in the process of mutual inquiry to provide an opportunity for Regina to

a. face emerging problems realistically
b. conceptualize her problem
c. cope with her present problem
d. perceive her participation in an experience

14. Which of these responses indicate that Regina needs further discussion regarding special instructions?

a. "I have to take this medicine judiciously."
b. "I know 1 will stop taking the medicine when there is an advice form the doctor for me to discontinue."
c. "I will inform you and the doctor any untoward reactions I have."
d. "I like taking this sleeping pill. It solves my problem of insomnia. I wish I can take it for life."

15. Regina commits to herself that she understood and will observe all the medicine precautions by;

a. affixing her signature to the teaching plan that she has understood the nurse
b. committing what she learned to her memory
c. verbally agreeing with the nurse
d. relying on her husband to remember the precautions

Situation 4 - The nurse-patient relationship is a modality through which the nurse meets the client's needs.

16. The nurse's most unique tool in working with the emotionally ill client is his/her:

a. theoretical knowledge
b. personality make up
c. emotional reactions
d. communication skills

17. The psychiatric nurse who is alert to both the physical and emotional needs of clients is working from the philosophical framework that states:

a. All behavior is meaningful, communicating a message or a need
b. Human beings are systems of interdependent and interrelated parts
c. Each individual has the potential for growth and change in the direction of positive mental health
d. There is a basic similarity among all human beings

18. One way to increase objectivity in dealing with one’s fears and anxieties is through the process of:

a. observation
b. intervention
c. validation
d. collaboration

19. All of the following response are non therapeutic. Which is the MOST direct violation of the concept, congruence of behavior?

a. Responding in a punitive manner to the client
b. Rejecting the client as a unique human being
c. Tolerating all behavior in the client
d. Communicating ambivalent messages to the client

20. The rnentally ill person responds positively to the nurse who is warm and caring. This demonstration of the nurse’s role as:

a. counselor
b. mother surrogate
c. therapist
d. socializing agent

Situation 5 - The nurse engages the client in a. nurse-patient interaction.

21. The best time to inform the client about terminating the nurse-patient relationship is

a. when the client asks, how long one relationship would be
b. during the working phase
c. towards the end of the relationship
d. at the start of the relationship

22. The client says, "I want to tell you something but can you promise that you will keep this, a secret?" A therapeutic response of the nurse is:

a. "Yes, our interaction is confidential provided the information you tell me is not detrimental to your safety."
b. "Of course yes, this is just between you and me. Promise!"
c. "Yes, it is my principle to uphold my client's rights."
d. "Yes, you have the right to invoke confidentiality of our interaction."

23. When the nurse respects the client's self-disclosure, this is a gauge for the nurse's:

a. trustworthiness
b. loyalty
c. integrity
d. professionalism

24. Rapport has been established in the nurse-client interaction time. I am committed to have this time available for us while you are at the hospital and ends after your discharge."

a. "The best time to talk is during the nurse-client interaction time. I am committed to have this time available for us while you are at the hospital and ends after your discharge."
b. "Yes, if you keep it confidential, this is part of privileged communication."
c. "I am committed for your care."
d. "I am sorry, though I would want to, it is against hospital policy."

25. The client has not been visited by relatives for months. He gives a, telephone number and requests the nurse to call. An appropriate action of the nurse would be:

a. Inform the attending psychiatric about the request of the client
b. Assist the client to bring his concern to the attention of the social worker
c. "Here (gives her mobile phone). You may call this number now."
d. Ask the client what is the purpose of contacting his relatives

Situation 6 - Camila, 25 years old, was reported to be gradually withdrawing and isolating herself from friends and family members. She became neglectful of her personal hygiene. She was observed to be talking irrelevantly and incoherently. She was diagnosed as schizophrenia

26. The past history of Camila would most probably reveal that her premorbid personality is:

a. schizoid
b. extrovert
c. ambivert
d. cycloid

27. Camila refuses to relate with others because she:

a. is irritable
b. feels superior of others
c. anticipates rejection
d. is depressed

28. Which of the following disturbances in interpersonal relationships MOST often predispose, to the development of schizophrenia?

a. Lack of participation in peer groups
b. Faulty family atmosphere and interaction
c. Extreme rebellion towards authority figures
d. Solo parenting

29. Camila's indifference toward the environment is a compensatory behavior to overcome:

a. Guilt feelings
b. Ambivalence
c. Narcissistic behavior
d. Insecurity feelings

30. Schizophrenia is a/an:

a. anxiety disorder
b. neurosis
c. psychosis
d. personality/disorder

Situation 7 - Salome, 80 year old widow, has been observed to be irritable, demanding and speaking louder than usual. She would prefer to be alone and take her meals by herself, minimized receiving visitors al home and no longer bothers to answer telephone calls because of deterioration of her hearing. 'She was brought by her daughter to, the Geriatic clinic for assessment and treatment.

31. The nurse counsels Salome's daughter that Salome's becoming very loud and tendency to become aggressive is a/an:

a. beginning indifference to the world around her
b. attempt to maintain authoritative role
c. overcompensation for hearing loss
d. behavior indicative of unresolved repressed conflict of the part

32. A nursing diagnosis for Salome is:

a. sensory deprivation
b. social isolation
c. cognitive impairment
d. ego despair

33. The nurse will assist Salome and her daughter to plan a goal which is:

a. adjust to the loss of sensory and .perceptual function
b. participate in conversation and other social situations
c. accept the steady loss of hearing that occurs with aging
d. increase her self-esteem to maintain her authoritative role

34. The daughter understood, the following ways to assist Salome meet her needs and avoiding which of the following:

a. Using short simple sentences
b. Speaking distinctly and slowly
c. Speaking at eye level and having the client's attention
d. Allowing her to take her meals alone

35. Salome was fitted a hearing aid. She understood the proper .use and wear of this device when she ways that the battery should be functional, the device is turned on and adjusted to a:

a. therapeutic level
b. comfortable level
c. prescribed level
d. audible level

Situation 8 - For more than a month now, Cecilia is persistently feeling restless, worried and feeling as if something dreadful is going to happen. She fears being alone in places and situations where she thinks that no one might come to rescue her just in case something happens to her.

36. Cecilia is demonstrating:

a. acrophobia
b. claustrophobia
c. agoraphobia
d. xenophobia

37. Cecilia's problem is that she always sees and thinks negative hence she is always fearful Phobia is a symptom described as:

a. organic
b. psychosomatic
c. psychotic
d. neurotic

38. Cecilia has a lot of irrational thoughts: The goal of therapy is to modify her:

a. communication
b. cognition
c. observation
d. perception

39. Cognitive therapy is indicated for Cecilia when she is already able to handle anxiety reactions. Which of the following should the nurse implement?

a. assist her in recognizing irrational beliefs, and thoughts
b. help find meaning in her behavior
c. provide positive reinforcement for acceptable behavior
d. administer anxiolytic drug

40. After discharge, which of these behaviors indicate a positive result of being able to overcome her phobia?

a. she read a book in the public library
b. she drives alone along the long expressway
c. she watches television with the family in the recreation room
d. she joint an art therapy group

Situation 9 - it is the first day of clinical experience of nursing students at the Psychiatry Ward- During the orientation, the nurse emphasizes that the team members including nursing students are legally responsible to safeguard patient's records from loss or destruction or from people not authorized to bead it.

41. It is unethical to tell one's friends and family member’s data bout patients because doing so is violation of patients’ rights to:

a. Informed consent
b. Confidentiality
c. Least restrictive environment
d. Civil liberty

42. The nurse must see to it that the written consent of mentally ill patients must be taken from:

a. Doctor
b. Social worker
c. Parents or legal guardian
d. Law enforcement authorities

43. In an extreme situation and when no other resident or intern is available, should a nurse receive, telephone orders, the order has to be correctly written and signed by the physician within.

a. 24 hours
b. 36 hours
c. 48 hours
d. 12 hours

44. The following are SOAP (Subjective - Objective - Analysis - Plan) statements on a problem: Anxiety about diagnosis. What is the objective data?

a. Relate patient's feelings to physician initiate and encourage her to verbalize her fears give emotional support by spending more time with patient, continue to make necessary explanations regarding diagnostic test.
b. Has periods of crying, frequently verbalizes fear of what diagnostic tests will reveal
c. Anxiety due to the unknown
d. "I’m so worried about what else they'll find wrong with me"

45. Nursing care plans provide very meaningful data for the patient profile and initial plan because the focus is on the:

a. Summary of chronological notations made by individuals health team members
b. Identification of patient's responses to medical diagnosis and treatment
c. Patient's responses to health: and illness as a total person in interaction with the environment
d. Step procedures for the management of common problems

Situation 10 - Marie is 5 ½ years old and described by the mother as bedwetting at night.

46. Which of the following is the MOST common physiological cause of night bedwetting?

a. deep sleep factors
b. abnormal bladder development or structure problems
c. infections familial and genetic factors

47. All of the following, EXCEPT one comprise the concepts of behavior therapy program:

a. reward and punishment
b. extinction
c. learning
d. placebo as a form treatment

48. The help Marie who bed wets at night practice acceptable and appropriate behavior, it is important for the parents to be consistent with the following approaches EXCEPT:

a discipline with a king attitude
b matter of fact in handling the behavior
c. sympathize for the child
d. be lowing yet firm

49. A therapeutic verbal approach that communicates strong disapproval is:

a. You are supposed to get up and go in the toilet when you feel you have to go and did not. The next time you bed wet, I’ll tell your friends and hand your sheets out the window for them to see."
b. "You are supposed to get up and go in the toilet when you feel you have to go and you did not. I expect you to from now on without fail."
c. "If you bed wet, you will change your bed linen and wash the sheets."
d. "If you don't make an effort to control your bedwetting, I'd be upset and disappointed."

50. During your conference, the parent inquires how to motivate Marie to be dry in the morning. Your response which is an immediate intervention would be:

a. Give a star each time she wakes up dry and every set of five stars, give a prize
b. Tokens make her materialistic at an early age. Give praise and hugs occasionally
c. What does you child want that you can give every time he/she wakes up dray in the morning
d. Promise him/her a long awaited vacation after school is over.

Situation 11 - The nurse is often met with t-he following situations when clients become angry and hostile.

51. To maintain a therapeutic eye contact and body posture while interacting with angry and aggressive individual, the nurse should:

a. keep an eye contact while staring at the client
b. keep his/her hands behind his/her back or in one's pocket
c. fold his/her arms across his/her chest
c. keep an "open" posture, e.g. Hands by sides but palms turned outwards

52. During the pre-interaction phase of the N-P relationship/the nurse recognizes this normal INITIAL reaction to an assaultive or potentially assaultive person.

a. To remain and cope with the incident
b. Display empathy towards the patient
c. To call for help from the other members of the team
d. To stay and fight or run away

53. Which of the following is an accurate way of reporting and recording an incident?

a. "When asked about his relationship with his father, client became anxious."
b. "When asked about his relationship with his father, client clenched his jaw/teeth made a fist and turned away from the nurse."
c. "When asked about his relationship with his father, client was resistant to respond."
d. "When asked about his relationship with his father, his anger was suppressed."

54. To encourage thought. Which of the following approaches is NOT therapeutic?

a. "Why do you feel angry?"
b. "When do you usually feel angry?"
c. "How do you usually express anger?"
d. "What situations provoke you to be angry?"

55. A patient grabs a chair and about to throw it. The nurse best responds saying.

a. "Stop! Put that chair down."
b. "Don't be silly."
c. "Stop, the security will be here in a minute."
d. "Calm down."

Situation 12 - Nursing care for the elderly.

56. In planning care for a patient with Parkinson's disease, which of these nursing diagnoses should have priority?

a. potential for injury
b. altered nutritional state
c. ineffective coping
d. altered mood state

57. A healthy adaptation to aging is primarily related to an individual.

a. Number of accomplishments
b. Ability to avoid interpersonal conflict
c. Physical health throughout life
d. Personality development in his life span

58. The frequent use of the older client's name by the nurse is MOST effective in alleviating which of the following responses to old age?

a. Loneliness
b. Suspicion
c. Grief
d. Confusion

59. An elderly confused client gets out of bed at night to go to the bathroom and tries to go to another bed when she returns. The MOST appropriate action the nurse would take is to:

a. Assign client to a single room
b. Leave a light on all night
c. Remind client to call the nurse when she wants to get up
d. put side rails on the bed

60. An elderly who has lots of regrets, unhappy and miserable1 is experiencing:

a. Crisis
b. Despair
c. Loss
d. Ambivalence

Situation 13 - Graciela 1 ½ year old is admitted the hospital from the emergency room with a fracture of the left femur due to a Tall down a flight of stairs. Graciela is placed oh Bryant's traction.

61. While on Bryant's traction, which of these observations of Graciela and her traction apparatus would indicate a decrease in the effectiveness of her traction?

a. Graciela's buttocks are resting on the bed
b. The traction weights are hanging 10 inches above the floor
c. Graciela's legs are suspended at a 90 degree angle to her trunk
d. The traction ropes move freely through the pulley

62. The nurse notes that the fall might also cause a possible head injury. She will be observed for signs of increased intracranial pressure which include:

a. Narrowing of the pulse pressure
b. Vomiting
c. Periorbital edema
d. A positive Kernig's sign

63. Graciela is assessed to have no head injury. The Bryant's traction is removed. A plaster of Paris his spica is applied. Which of these finding as a concern of immediate attention that must be reported to the physician immediately?

a. Graciela is scratching the cast over her abdomen
b. The toes of Graciela's left foot blanch when the nurse applies pressure on them
c. Graciela's cast is still damp
d. The nurse is unable to insert a finger under the edge of Graciela's cast on her left foot

64. Part of discharge plan is for the nurse to give instructions about the care of Graciela's cast to the mother. Which of these statements indicate that the mother understood an important aspect of case care?

a. I will use white shoe polish to keep the cast neat
b. I will place plastic sheeting around the perineal area of the cast
c. I will use cool water to wash the cast
d. I will reinforce cracked areas on the cast with adhesive tape

65. The nurse counsels Graciela's mother ways to safeguard safety white providing opportunities of Graciela to develop a sense of:

a. Trust
b. Initiative
c. Industry
d. Autonomy

Situation 14 - Jolina is an 18 year old beginning college student. Her mother observed that she is having problems relating with her friends. She is undecided about her future. She has lost insight, lost interest in anything and complained and complained of constant tiredness.

66. Jolina is out on antidepressant drugs. These drugs act on the brain chemistry, therefore they would be useful in which type of depression?

a. exogenous depression
b. neurotic depression
c. endogenous depression
d. psychotic depression

67. This is a tricyclic antidepressant drug:

a. Venlafaxine (Effexor)
c. Setraline (Zoloft)
b. Flouxetine (Prozac)
d. Imipramine (Tofranil)

68. After one week of antidepressant medication, Jolina still manifests depression. The nurse evaluates this as;

a. Unusual because action of antidepressant drug is immediate
b. Unexpected because therapeutic effectiveness takes within a few days
c. Expected because therapeutic effectiveness takes 2-4 weeks
d. Ineffective result because perhaps the drug's dosage is inadequate

69. Jolina continues to verbalize feeling sad and hopeless. She is not mixing well with other clients. One of the nurse's important consideration for Jolina Initially is to:

a. Formulate a structured schedule so she is able to channel her energies externally
b. Let her alone until she feels like mingling with others
c. Encourage her to join socialization hour so she will start to relate with others
d. Encourage her to join group therapy with other patients

70. During the predischarge conference, the nurse suggests vocational guidance because it should help Jolina to:

a. Find a good job
b. Make some decision about her future
c. Realistically assess her assets and limitations
d Solve her own problems

Situation 15 - Group Approach" in Nursing.

71. Membership dropout generally occurs in group therapy after a member:

a. Accomplishes his goal in joining the group
b. Discovers that his feelings are shared by the group members
c. Experiences feelings of frustration in the group
d. Discusses personal concerns with group members

72. Which of the following questions illustrates the group role of encourager?

a. What were you saying?
b. Who wants to respond next?
c. Where do you go from here?
d. Why haven't we heard from you?

73. The goal of remotivation therapy is to facilitate:

a. Insight
b. Productivity
c. Socialization
d. Intimacy

74. The treatment of the family as a unit is based on the belief that the family:

a. is a social system and all the members are interrelated components of that system
b. as a unit of society needs the opportunity to change its own destiny
c. who has therapy together will tend to remain together
d. is "contaminated" by the presence of deviant member and all members need treatment

75. The working phase in therapy group is usually characterized by which of the following?

a. Caution
b. Cohesiveness
c. Confusion
d. Competition

Situation 16 - The mental health - psychiatric nurse functions in a variety of setting with different types of clients.

76. Poverty as reflected in prevalence of communicable diseases, malnutrition and social ills such as street children, homeless and prostitution is a predisposing factor to mental illness. A community approach to cope with this problem is for the nurse to support:

a. aggressive family planning methods
b. provision of social welfare benefits for the poor
c. social action
d. free clinics and more hospitals

77. The MOST cost effective way to meet the mental health needs of the public is through programs with a priority goal of:

a. treatment
b. prevention
c. rehabilitation
d. research

78. Lorelle upon discharge was referred to a volunteer group where she has learned to read patterns, cut out fabric and use a sewing machine to make simple outfits that will help her earn in the future. What type of activity therapy is this?

a. Recreational therapy
b. Art therapy
c. Vocational therapy
d. Educational therapy

79. In a residential treatment home for adolescent girl's the clients were becoming increasingly tense and upset because of shortening of their recreation time. To die escalate possible anger and aggression among the clients it is BEST to play:

a. religious music
b. relaxation music
c. dance music
d. rock music

80. The parents of special children who are behaviorally disturbed need mental health education. Which of these topics would the school nurse consider as priority for their parents’ class?

a. Drug education
b. Child abuse
c. Effective parenting
d. Sex education

Situation 17 - Nurse's in all practice areas are likely to come in contact with clients suffering from acute or chronic drug abuse.

81. The psychodynamic therapy of substance abuse is based upon the premise that drug abuse is:

a. a common problem brought about by socioeconomic deprivation
b. caused by multiplicity of factors
c. predisposed by an inability to develop appropriate psychological resources to manage developmental stresses
d. due to biochemical factors

82. Being in contact with reality and the environment is a function of the:

a. conscience
b. ego
c. id
d. super ego

83. Substance abuse is different from substance dependence is than, substance dependence:

a. includes characteristics of adverse consequences and repeated use
b. requires long term treatment in a hospital based program
c. produces less severe symptoms than that of abuse
d. includes characteristics of tolerance and withdrawal

84. During the detoxification stage, it is a priority for the nurse to:

a. teach skills to recognize and respond to health threatening situations
b. increase the client's awareness of unsatisfactory protective behaviors
c. implement behavior modification
d. promote homeostasis and minimize the client’s withdrawal symptoms

85. Commonly known as "shabu" is:

a. Cannabis Sativa
b. Lysergic add diethylamide
c. Methylenedioxy, methamphetamine
d. Methamphetamine hydrochloride

Situation 18 - It is common that client ask the nurse personal questions.

86. Anticipation of personal questions is given adequate attention during which phase of the nurse patient relationship?

a. Orientation phase
b. Working phase
c. Pre-interaction phase
d. Termination phase

87. The client asks for the nurse's telephone number, which of these responses is NOT appropriate?

a. "it is confidential I just don't give it to anyone."
b. "What would you do with my number if I give it to you?"
c. "If I say. No to your request, what are your thoughts about it?”
d. "Are you asking for an official number of the hospital/clinic for your reference?"

88. When the client asks about the family of the nurse the MOST appropriate response is:

a. Avoid the situation and redirect the client's attention
b. Give a brief and simple response and focus on the client
c. "Why don't we talk about your family instead?"
d. Introduce another topic like the client's interests

89. When the nurse is asked a personal question, which of these reactions indicate a need her to introspect?

a. The client is simply curious
b. His/her right to privacy is being intruded
c. The client knows no other way to begin a conversation
d. Some patients are like children in seeking recognition from the nurse

90. It is 10 o'clock of your watch. The client asks, "What time is it?" The nurse's appropriate response is:

a. "Are you bored?"
b. "It is 10 o’clock."
c. "Why do you ask?"
d. "Guess, what time is it?"

Situation 19 - Ricky is a 12 year old-boy with Down’s syndrome. He stands 5' ½" and weight 100 lbs. He is slim and walks sluggishly with a limp. He wears a neck brace as support for his neck. X - ray of cervical spine showed "subluxation of CI in relation to C2 with cord compression." He attends a school for special education.

91. The classroom teacher consults the school for guidance on how to take care of Ricky while inside the, classroom. The nurse considers as priority, Ricky's:

a. Physiological needs
b. Need for self-esteem
c. Needs for safety and Security
d. Needs for belonging

92. Ricky's mother visited the school nurse. She asked, " What should I do when Ricky fond his genitalia?" Appropriate response of the nurse is for the mother to:

a. Divert Ricky's attention and engage him in satisfying activities
b. Tell Ricky that it is wrong to keep fondling his genitalia
c. Ignore Ricky's behavior because he will outgrow it later
d. Engage him in computer TV games that engage his hands

93. The nurse has one on one health education sessions with Ricky's mother. The mother understood that for her son to learn to cope and be independent, she should constantly provide activities for Ricky to be able to:

a. socialize with people
b. eventually go to school alone
c. select and prepare his own food
d. do activities of daily living

94. All of the following activities are appropriate for Ricky EXCEPT:

a. Working with clay
b. Competitive sports
c. Preparing and cooking simple menu
d. Card and table games

95. Ricky's IQ falls within the range of 50-55. He can be expected to:

a. Profit from vocational training with moderate supervision
b. Live successfully in the community
c. Perform simple tasks in closely supervised settings
d. Acquire academic skills of 6th grade; level

Situation 20 - The abuse of dangerous drug is a serious public health concern that nurses need to address,

96. The nurse should recognize that the unit primarily responsible for education and awareness of the members of the family on the ill effects of dangerous drugs is the:

a. law enforcement agencies
b. school
c. church
d. family

97. A drug dependent utilizes this defense mechanism and enables him to forget shame and pain.

a. repression
b. rationalization
c. projection
d. sublimation

98. This drug produces mirthfulness, fantasies, flight of ideas, loss of train of thought, distortion of size, distance and time, and "bloodshot eyes", due to dilated pupils.

a. Opiates
b. LSD
c. Marijuana
d. Heroin

99. The nurse evaluates that-.her health teaching to a group of high school boys is effective if these students recognize which of the following dangers of inhalant abuse.

a. Sudden death from cardiac or respiratory depression
b. Danger of acquiring hepatitis or AIDS
c. Experience of "blackout"
d. Psychological dependence after prolonged use

100. The mother of a drug dependent would never consider referring her son to a drug rehabilitation agency because she fears her son might just becomes worse while relating with other drugs users. The mother's behavior can be described as:

a. Unhelpful
b. Codependent
c. Caretaking
d. Supportive


ANSWER KEY:
1. C
2. C
3. B
4. A
5. D
6. A
7. C
8. D
9. D
10. A
11. A
12. D
13. D
14. D
15. A
16. D
17. C
18. B
19.
20.
21.
22.
23.
24.
25. A
26. A
27. A
28. B
29. C
30. C
31. A
32. A
33. A
34. D
35. D
36. C
37. D
38. B
39. A
40. A
41. B
42. C
43. A
44. B
45. C
46.
47.
48.
49.
50.
51. D
52. B
53. B
54. A
55. A
56. A
57. C
58. D
59. A
60. B
61. A
62. B
63. D
64. D
65. D
66. B
67. D
68. C
69. C
70. C
71. C
72. B
73. B
74. A
75. B
76. B
77. B
78. C
79. B
80. C
81. B
82. B
83. D
84. D
85. D
86. B
87. A
88. B
89. D
90. B
91. C
92.
93. D
94. B
95. C
96. D
97. A
98. B
99. A
100. A

+ نوشته شده در  یکشنبه بیست و یکم تیر 1388ساعت 19:3  توسط علی خواجوی  | 

آغاز سخن The first words

"بنام خدا"

دوستان و همکاران عزیز سلام،

با توکل به خدا این وبلاگ را در جهت کمک به افزایش توانایی های علمی و عملی پرستاران این مرز و بوم ایجاد نموده ام. مطالب این وبلاگ شامل مقالات پرستاری داخل، مقالات پرستاری خارج همراه با ترجمه ، اخبار علمی و پرستاری و مرور سوالات امتحانات پرستاری بین المللی RN خواهد بود. در صورت تمایل به همکاری و درج مطلب توسط خودتان در این وبلاگ با e-mail بنده را مطلع سازید.

با سپاس


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Dear friends and colleague from all around the world

This a weblog I just built it and it is going to have a role in rising the level of nursing in Iran.I'll be thankful if you can help me and send me anything relating to nursing,including nursing articles,nursing news and your own comment and ideas.

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+ نوشته شده در  سه شنبه شانزدهم تیر 1388ساعت 0:10  توسط علی خواجوی  |