Free Printable NCM 112 RLE Final Exam

1.

Which laboratory test results indicates cirrhosis of the liver?

a)

Decreased red blood cell count

b)

Decreased serum acid phosphatase level

c)

Elevated white blood cell count

d)

Elevated serum alanine amninotransferase (Formerly serum glutamic-pyruvic transaminase) level

2.

The physician schedules Mr. G for a liver biopsy to confirm the diagnosis of cirrhosis. Which crucial information should the nurse tell Mr. G before the procedure?

a)

He should hold his breath on exhalation when the biopsy needle is inserted

b)

The procedure is painless

c)

He must maintain a side lying position after the procedure

d)

Pressure will be applied to his right side after the procedure

3.

The biopsy confirms the diagnosis of cirrhosis to Mr. G is at increased risk for excessive bleeding primarily because of?

a)

Impaired clotting mechanism

b)

Inadequate nutrition

c)

Varix Formation

d)

Trauma from invasive procedures

4.

Mr. G develops hepatic encephalopathy. Which clinical manifestations are most common with this condition?

a)

Increased urine output

b)

Decreased tendon reflex

c)

Altered attention span

d)

Hypotension

5.

Once Mr. G has regained consciousness the physician orders 50 ml of lactulose P.O every 2 hours. Later in the day Mr. G complains of diarrhea. The nurse best response would be:

a)

I’ll see if your physician is in the hospital

b)

Maybe you’re reacting to the drug. I’ll withhold the next dose

c)

I’ll lower the dosage as ordered. The drug causes 2-4 stools daily

d)

Frequent bowel movements are needed to reduce sodium

6.

Which of the following drug is the most important intervention for Risk of injury secondary to altered clotting mechanism in a client with hepatic cirrhosis?

a)

Allow client’s complete independence of mobility

b)

Apply pressure to injection site

c)

Administer antibiotics as prescribed

d)

Increase nutritional intake

7.

The pathophysiologic problem in cirrhosis of the liver causing esophageal varices is

a)

Dilated veins and varicosities

b)

Portal hypertension

c)

Ascites and edema

d)

Loss of regeneration

8.

When assessing a client with liver insufficiency. The nurse would expect:

a)

Anuria

b)

Fetor hepaticus

c)

Globus hystericus

d)

Blephaneospasm

9.

In an effort to prevent hepatic coma in a client with liver dysfunction it may become necessary to:

a)

Eliminate protein from the diet

b)

Eliminate carbohydrate from the diet

c)

Give fleet enemas

d)

Prepare for emergency surgery

10.

SITUATION: Mr. Usher 56 years old is a suspected HIV patient. Admitted in an Isolation ward , private room. In assessing Mr. Usher’s condition for possible HIV positive. The least expected symptoms to occur is:

a)

Night sweating

b)

Fever

c)

Fungal infection in the mouth

d)

Acute diarrhea

11.

He is tentatively scheduled for blood transfusion. The test used in screening donated blood for antibody is:

a)

· Culture and sensitivity test

b)

· SGPT

c)

· ELISA

d)

· Schick’s Test

12.

Which of the following is the least that you would do if you’re suspecting him of developing an infection?

a)

· Report findings to the doctor

b)

· Get a piece of tissue from suspected site for biopsy

c)

· Immediately culture the suspected site

d)

· Document any evidence that you have

13.

Pulmonary complications are most common problems in caring for AIDS patient. This is caused by

a)

· Kaposi’s Sarcoma

b)

· Filtrable Virus

c)

· Pneumocystis Carinii

d)

· Staphylococcus bacteria

14.

Your nursing care plan for Usher includes the following EXCEPT:

a)

· Monitor the occurrence of seizures

b)

· Monitoring of fluid and electrolyte

c)

· Nutritional support

d)

· Protection from skin breakdown

15.

1. SITUATION: Leo lives in the squatter’s area, He goes to a nearby school helps his mother gather mollusks after school. One day he was absent because of fever, malaise, anorexia, nausea and abdominal discomfort. Upon assessment, Leo was diagnosed to have Hepatitis A. Which mode of transmission has the infectious agent taken?

a)

· Fecal-oral 2 weeks before onset

b)

· Fecal-oral after appearance of jaundice

c)

· Homologous after attack

d)

· General Susceptivity

16.

Which of the following is concurrent disinfection in the care of Leo?

a)

· Intervention of contact

b)

· Sanitary disposal of feces, urine and blood

c)

· Infection of powerful Hepatitis A

d)

· Quarantine of sick individual

17.

Which of the following must be emphasized during the health teaching of Leo’s mother?

a)

· Administration of immunoglobulin to families

b)

· Thorough handwashing before eating and after toileting

c)

· Use of attenuated vaccine

d)

· Boiling of food especially meat

18.

How should Disaster control be undertaken when there are 3 or more hepatitis?

a)

· Eliminate fecal contamination with food

b)

· Health education every week

c)

· Disseminate printed materials

d)

· Mass administration of Immunoglobulin

19.

What is the average incubation period of Hepatitis A?

a)

· 30 days

b)

· 60 days

c)

· 50 days

d)

· 14 days

20.

Mr. Aldrin age 18 is admitted to the hospital with a fractured nose and other minor abrasions. Sustained in a sledding accident. The physician orders an ice pack to be applied over the patient’s nose. The nurse should tell Mr. Aldrin that the Ice-pack will help:

a)

· Maintain alignment of the fracture

b)

· Relieve and prevent edema by reducing local blood flow

c)

· Prevent skin by maceration at the injury site

d)

· Reduce pain by enhancing vasodilation

21.

After 30 mins, the nurse removes the ice pack and explains to Mr. Aldrin that it will be replaced later. The most important rationale for this nursing action is that

a)

· Cold can retard edema and bleeding after injury

b)

· Cold anesthetizes underlying tissues

c)

· Ice needs to be replenished about every 30 mins

d)

· Prolonged exposure to cold can cause tissue ischemia

22.

1. Cold application is often used to treat:

a)

· Open wounds

b)

· Impaired circulation

c)

· Fever

d)

· Sprained ankle

23.

How many milligrams are contained in 0.005g?

a)

· 0.05mg

b)

· 0.5mg

c)

· 5mg

d)

· 50mg

24.

The physician orders and Intravenous solution of Dextrose 5% in water at 100ml/hr. What would the flow rate be if the drop factor is 15gtts/min?

a)

· 5 gtts/min

b)

· 13 gtts/min

c)

· 25 gtts/min

d)

· 60 gtts/min

25.

A patient must receive 50 units of Hamulin regular insulin. The label reads 100 units= 1ml. how many milliliters should the nurse administer?

a)

· 0.5ml

b)

· 0.75ml

c)

· 1ml

d)

· 2ml

26.

SITUATION: Mr. De Castro is admitted to medical ward. The medical doctor ordered “Prepare patient for thoracentesis this afternoon to remove excess air from the pleural cavity”. Which of the following nursing responsibilities is essential in Mr. De Castro who will undergo thoracentesis?

a)

· Support and Reassure client during procedure

b)

· Ascertain if chest X-rays and other tests have been prescribed and completed

c)

· Ensure that informed consent has been signed

d)

· Determine if client has allergic reaction to local anesthesia

27.

Mr. De Castro who is for thoracentesis is assisted by the nurse to any of the following position except

a)

· Lying on the unaffected side with the bed elevated 30-40 degrees

b)

· Straddling a chair with arms and head resting on the back of the chair

c)

· Lying prone with the head of bed lowered 15-30 degrees

d)

· Sitting on the edge of the bed with her foot supported and arms and head on a paddled overhead table

28.

During thoracentesis which of the following nurse interventions will be most crucial?

a)

· Place patient in a quiet and cool room

b)

· Maintain strict aseptic technique

c)

· Apply pressure over the puncture site as soon as the needle is withdrawn

d)

· Advise patient to sit perfectly still during needle insertion until it has been withdrawn from the client

29.

To prevent leakage of fluid in the thoracic cavity, how will you position the client after thoracentesis?

a)

· On bed rest

b)

· Turn on the unaffected side

c)

· Turn on the affected side

d)

· Place flat on bed

30.

Chest X-ray was ordered after thoracentesis. When your client asks what is the reason for another chest X-ray, you will explain:

a)

· To rule out any possible perforation

b)

· To decongest

c)

· To rule out any foreign body

d)

· To rule out pneumothorax

31.

A client with history of chest trauma with pneumothorax has a chest tube inserted that is connected to a water seal chest tube drainage system. The nurse notes that the fluid in the water seal column is fluctuating with each breath that the client takes. What is the significance of this fluctuation?

a)

· An obstruction is present in the test tube

b)

· The client is developing subcutaneous emphysema

c)

· The chest tube system is functioning properly

d)

· There is a leak in the chest tube system

32.

A client who is recovering from chest trauma is to be discharged home with a chest tube drainage system intact. The nurse should instruct the client to call the physician for which of the following?

a)

· Respiratory rate greater than 16 breaths/minute

b)

· Continuous bubbling in the water seal chamber

c)

· Fluid in the chest tube

d)

· Fluctuation of fluid in the water seal chamber

33.

Which of the following findings would suggest pneumothorax in a trauma victim?

a)

· Pronounced crackles

b)

· Respiratory wheezing

c)

· Dullness on percussion

d)

· Absent breath sounds

34.

A chest tube is inserted in a client with a pneumothorax for which of the following reasons?

a)

· For administration of oxygen

b)

· To promote formation of lung scar tissues

c)

· To insert antibodies into the pleural space

d)

· To remove air and fluid

35.

A client’s chest tube is to be removed by the physician. Which of the following items should the nurse have ready to placed directly over the end when the chest tube is removed?

a)

· Butterfly dressing

b)

· Montgomery strap

c)

· Fine- mesh gauze dressing

d)

· Petrolatum gauze dressing

36.

In planning the post-operative care for a client with colostomy, the nurse would select which of the following is the priority nursing diagnosis?

a)

· Disturbed body image related to the ostomy

b)

· Risk for deficient fluid volume related to excess fluid loss

c)

· Ineffective sexuality patterns related to loss of sexual desire

d)

· Risk for impaired skin integrity related to fecal drainage

37.

The nurse is caring for a client one week post-operatively following a colostomy. Which of the following assessment findings would be a priority for the nurse to report?

a)

· The client is experiencing flatulence

b)

· The color of the stoma is dusky blue

c)

· The skin under the colostomy bag is red

d)

· The client appears depressed

38.

After being scheduled for a colostomy, a client is obviously anxious. What is the most effective way for the nurse to help the client?

a)

· Administer a prescribed PRN sedative

b)

· Encourage the client to express feelings

c)

· Explain the procedure and post-operative course

d)

· Reassure the client that many people cope with this problem

39.

When teaching a client who goes to work everyday to care for a new colostomy, the nurse should recommend that the irrigations be implemented at the same time every day. Which time should the nurse discuss with the client?

a)

· Approximately 30 minutes after breakfast

b)

· When it is most convenient for the client

c)

· Halfway between the two largest meals of the day

d)

· At the time the client had bowel movement before surgery

40.

The nurse is teaching a client with permanent colostomy about self-care in preparation for discharge from the hospital. Which should the nurse discuss with the client?

a)

· Need for special clothing

b)

· Periodic dilation of the stoma

c)

· Importance of limiting activity

d)

· Bland low residue diet regimen

41.

A client has transverse loop colostomy. What should the nurse do when inserting a catheter for the colostomy irrigation?

a)

· Used an oil-based lubricant

b)

· Instruct the client to bear down

c)

· Apply gentle but continuous force

d)

· Direct it toward the client’s right side

42.

During a colostomy irrigation, a client complains of abdominal cramps. What action should the nurse employ in response to the client’s complaints?

a)

· Discontinue the irrigation

b)

· Lower the container of fluid

c)

· Clamp the catheter for a few minutes

d)

· Advance the catheter approximately 1 inch

43.

Post-operative fever can be alarming and may cause several implications, you are aware that the earliest cause is usually:

a)

· DVT (deep vein thrombosis)

b)

· Atelectasis

c)

· UTI

d)

· Wound infection

44.

One of the earliest sign of oxygen toxicity is:

a)

· A productive cough

b)

· A dry cough

c)

· Loss of consciousness

d)

· Flushing of the skin

45.

When creating a sterile field, the nurse should open the sterile package in such a way that:

a)

· The outermost triangle edge is moved away from nurse

b)

· The outermost triangle is moved to the left of the nurse

c)

· The outermost triangle is moved to the right of the nurse

d)

· The outermost triangle is moved toward the nurse

46.

The primary cause of pressure sore is:

a)

· Unrelieved compression of skin cells and muscle tissues

b)

· Unrelieved compression of muscle cells and subcutaneous tissue

c)

· Unrelieved compression of capillaries supplying bone and muscle tissue

d)

· Unrelieved compression of capillaries supplying the skin and underlying tissue

47.

When a client is fluid deficit a typical sign:

a)

· Light colored urine

b)

· Frequent, moist bowel movements

c)

· Warm, flushed and dry skin

d)

· Distended veins in the neck

48.

SITUATION: Marian,16 years old is admitted to the hospital for observation due to epigastric pain. The doctor’s impression is appendicitis. Based on the initial assessment on admission the nurse is looking for manifestation of appendicitis which include the following EXCEPT:

a)

· Low grade fever

b)

· Nausea and vomiting

c)

· Thrombocytopenia

d)

· Abdominal tenderness

49.

A positive sign of appendicitis is localized and rebound tenderness on palpation at which quadrant of abdomen

a)

· Left lower quadrant

b)

· Right upper quadrant

c)

· Right lower quadrant

d)

· Left upper quadrant

50.

The nurse would monitor for the sign of peritonitis potential post-operative complications. The manifestation includes the following EXCEPT:

a)

· Fever

b)

· Soft abdomen

c)

· Tachycardia

d)

· Abdominal tenderness

51.

HIV patients are very susceptible to infection because of their decreased immune system. Which of the following mechanisms would prevent the transmission of the disease?

a)

· Using gowns

b)

· Disposing needle and syringe separate on proper sharp containers

c)

· Closing the door of the patients at all times

d)

Putting the patient on a negative pressure room

52.

The patient has herpes zoster. Which of the following is unnecessary for the care of the client?

a)

· Put patient in a negative pressure room

b)

· Use of surgical mask on client when out of the room

c)

· Use of particulate respirator for overall care

d)

· Ensure use of n95 on the client

53.

Standard precaution dictates that the nurse observes which of the following when caring for a client with streptococcal pneumonia?

a)

· Use of regular mask

b)

· Use of sterile gloves

c)

· Observe two-feet distance when giving care

d)

· Use clean gloves

54.

Your patient has EBOLA infection. Which of the following should not be included in her care plan?

a)

· Intensive fluid replacement

b)

· Standby blood transfusion

c)

· Standard home care

d)

· Precautions on body fluids

55.

What is the main consequence of MERS-COV in fluid balance?

a)

· Respiratory impairment that leads to fluid accumulation

b)

· Significant damage on kidney functioning

c)

· Damage on the albumin levels that leads to third spacing

d)

· Skin irritation similar to burn injury that leads to fluid losses

56.

H1N1 is one of the most recent new strains of a flu virus. What is the best way to prevent contacting the disorder?

a)

· Flu shots and flu vaccine

b)

· Wash hands frequently

c)

· Avoid touching mouth and face

d)

· Use masks on public places

57.

The patient has hepatitis C. What should be taught to the client to prevent transmission?

a)

· Wash hands

b)

· Wash fruits and vegetables before consumption

c)

· Use condoms

d)

· Use of gown and mask

58.

STDs can be differentiated based on the color and characteristic of their discharges. Which of the following is related to bacterial vaginosis?

a)

· Cloudy-yellow discharge

b)

· Yellow-green malodorous discharge

c)

· Pinkish red discharge

d)

· White-gray or yellow discharge

59.

Pelvic inflammatory disease is one of the leading cause of infertility to women. Which of the following predisposing factor is the leading cause of this disorder?

a)

· Unsafe sex

b)

· Chronic UTI

c)

· History of gonorrhea

d)

· History of bacterial vaginosis

60.

On auscultation, which finding suggests a right pneumothorax?

a)

· Bilateral inspiratory and expiratory crackles

b)

· Absence of breaths sound in the right thorax

c)

· Inspiratory wheezes in the right thorax

d)

· Bilateral pleural friction rub

61.

Nurse Lei caring for a client with a pneumothorax and who has had a chest tube inserted notes continues gentle bubbling in the suction control chamber. What action is appropriate?

a)

· Do nothing, because this is an expected finding

b)

· Immediately clamp the chest tube and notify the physician

c)

· Check for an air leak because the bubbling should be intermittent

d)

· Increase the suction pressure so that the bubbling becomes vigorous

62.

For a female patient with pnuemonia, which nursing intervention would help maintain a patent airway?

a)

· promoting fluid intake to 1,000 ml per day

b)

· Enforcing absolute bed rest

c)

· Teaching the patient how to perform controlled coughing

d)

· Administering prescribe sedatives regularly

63.

An African American client with asthma seeks emergency care for acute respiratory distress. Because of this client’s dark skin, the nurse should assess for cyanosis by inspecting the:

a)

Lips

b)

· soft palate

c)

Nail beds

d)

· Earlobes.

64.

A client newly diagnosed with cancer says he does not understand how cancer cells are identified. A nurse in the clinic is conducting physical assessment to clients attending health promotive sessions. What information should the nurse give regarding cancer cells?

a)

· "Cancer cells are immature and vary in size and shape by mutation."

b)

· "Cancer cells multiply at a much slower rate than normal cells."

c)

· "Cancer cells are very well organized and are like the tissue of origin."

d)

· "Cancer cells are oval in shape and are missing the nucleus."

65.

When Kikay performed chest auscultation, she observed short discreet bubbling sounds over the lower region of the right lung. Which of the following abnormal findings will Kikay consider?

a)

· Friction rub

b)

· Rhonchi

c)

· Wheezes

d)

· Rales

66.

1. Which of the following examples relate to medical asepsis to reduce and prevent the spread of microorganisms? Select all that apply.

a)

· Practicing hand hygiene

b)

· Reapplying a sterile dressing

c)

· Sterilizing contaminated items

d)

· Applying a sterile gown and gloves

e)

· Routinely cleaning the hospital environment

67.

The nurse is planning a home visit for a client with hepatitis A. In order to prevent transmission the nurse should focus teaching on:

a)

· Proper food handling.

b)

· Insulin syringe disposal.

c)

· Alpha-interferon.

d)

· Use of condoms.

68.

A nurse is planning care for a 25-year-old female client who has just been diagnosed with human immunodeficiency virus (HIV) infection. The client asks the nurse, “How could this have happened?” The nurse responds to the question based on the most frequent mode of HIV transmission, which is:

a)

Hugging an HIV-positive sexual partner without using barrier precautions

b)

· Inhaling cocaine.

c)

· Sharing food utensils with an HIV-positive person without proper cleaning of the utensils.

d)

· Having sexual intercourse with an HIV-positive person without using a condom.

69.

The nurse should dispose of a used needle and syringe by:

a)

Cutting the needle at the hilt in a needle cutter before disposing of it in the universal precaution container in the client’s room.

b)

· Placing uncapped, used needles and syringes immediately in the universal precaution container in the client’s room.

c)

· Recapping the needle and placing the needle and syringe in the universal precaution container in the client’s room.

d)

· Separating the needle and syringe and placing both in the universal precaution container in the client’s room.

70.

The nurse is interviewing a client with newly diagnosed syphilis. In order to prevent the spread of the disease, the nurse should focus the interview by:

a)

· Motivating the client to undergo treatment.

b)

· Obtaining a list of the client’s sexual contacts.

c)

Increasing the client’s knowledge of the disease

d)

· Reassuring the client that records are confidential.

71.

A nurse assesses a client’s surgical incision for signs of infection. Which finding by the nurse would be interpreted as a normal finding at the surgical site?

a)

· Red, hard skin

b)

· Serous drainage

c)

· Purulent drainage

d)

· Warm, tender skin

72.

An operating room nurse is positioning a client on the operating room table to prevent a client’s extremities from dangling over the sides of the table. A nursing student who is observing for the day asks the nurse why this is so important. The nurse responds that this is done primarily to prevent:

a)

· An increase in pulse rate

b)

· A drop in blood pressure

c)

· Nerve and muscle damage

d)

· Muscle fatigue in the extremities

73.

Surgical conscience is defined by all of the following EXCEPT

a)

· Waiting until the procedure has ended to admit to an error in aseptic technique

b)

· Using proper technique

c)

· Being honest about one’s abilities

d)

· Correcting an error in sterile technique

74.

In educating a client about human immunodeficiency virus (HIV), the nurse should take into account the fact that the most effective method known to control the spread of HIV infection is:

a)

· Premarital serologic screening.

b)

Prophylactic treatment of exposed people

c)

Laboratory screening of pregnant women

d)

Ongoing sex education about preventive behaviors

75.

The client is given the hepatitis B immune globulin serum, which will provide passive immunity. What is an advantage of passive immunity?

a)

· It has effects that last a long time.

b)

· It is highly effective in treatment of disease.

c)

· It offers immediate protection.

d)

· It encourages the body to produce antibodies

76.

You have just admitted a patient with bacterial meningitis to the medical-surgical unit. The patient complains of a severe headache with photophobia and has temperature of 39 degrees. Which collaborative intervention must be accomplished first?

a)

· Administer codeine 15 mg orally for the patient’s headache

b)

· Infuse ceftriaxone 2000 mg IV to treat the infection

c)

Give acetaminophen 650mg orally to reduce the fever

d)

· Give Furosemide 40 mg IV to decrease intracranial pressure

77.

You are mentoring a student in the intensive care unit (ICU) while caring for a patient with meningococcal meningitis. Which action by the student requires that you intervene immediately?

a)

the student enters the room without putting on a mask and gown

b)

· The student requires that family visits are restricted to 10 minutes

c)

· The student gives the patient a blanket when he says he feels cold

d)

· The student checks the patient’s pupil response to light every 30 minutes

78.

The physical therapist reports that with rheumatoid arthritis refuses to do her exercises because she is experiencing too much pain. Which of the following actions would be most effective in getting to help the client comply with the therapy?

a)

· Explain to the client the importance of cooperating in her exercise program

b)

· Suggest to physician that the exercise program be canceled

c)

· Administer pain medication half hour before the start of the exercise

d)

· Advise the therapist to continue encouraging the client to exercise

79.

Nine-Year-Old Edward Cullen has juvenile rheumatoid arthritis. He is to be discharged from the hospital. Edward was very active in sports before his hospitalization. Which of the following would now be appropriate for Edward to participate in?

a)

· Baseball

b)

· Skiing

c)

· Swimming

d)

· Hockey

80.

The parent of a 12 – year old child who is on acetylsalicylic acid (aspirin) therapy for juvenile rheumatoid arthritis, tells a nurse “ I just read an article that said aspirin should not be given to children”. Which of the following responses by the nurse is most appropriate?

a)

· “Stop aspirin only if your child is diagnosed with viral illness”

b)

· Your child can take a different anti-inflammatory drug instead of aspirin”

c)

· “Because the aspirin dose your child receives is so small, the risk is minimal”

d)

· The benefits of Aspirin for your child outweighs the risks”

81.

Karen is a 10 – year old who has juvenile rheumatoid arthritis. She is being seen in a clinic specializing in joint disorders in children. The physician has suggested that karen should be encouraged to move and exercise as much as can be tolerated. Which of the following activities could the nurse suggest as an exercise for Karen?

a)

· Skipping rope for 15 minutes 3x a day

b)

· Participating in sports such as football

c)

· Joining a gymnastic team

d)

· Swimming

82.

A nurse is caring for a client with a diagnosis of Gout. Which of the following lab values would the nurse expect to note in the client?

a)

· Calcium level of 9.0

b)

· Uric Acid level of 8.6 mg/dl

c)

· Potassium level of 4.1 meq/L

d)

· Phosphorus level of 3.1 mg/dl

83.

A nurse is caring for a client with osteoarthritis. The nurse performs an assessment, knowing that which of the following is a clinical manifestation associated with the disorder?

a)

· Morning stiffness

b)

· Decreased sedimentation rate

c)

· Joint pain that diminishes after rest

d)

· Elevated anti-nuclear antibody level

84.

On a visit to the clinic, a client reports the onset of early symptoms of rheumatoid arthritis. Which of the following would the nurse most likely assess?

a)

· Limited moon of joints

b)

Deformed joints and hands

c)

· Early morning stiffness

d)

· Rheumatoid nodules

85.

A client with rheumatoid arthritis states, “I can’t do my households chores without becoming tired. My knees would hurt whenever I walk.” Which nursing diagnosis would be most appropriate?

a)

· Activity intolerance related to fatigue and pain

b)

· Self-care deficit related to increasing joint pain

c)

· Ineffective coping related to chronic pain

d)

· Disturbed body image related to fatigue and joint pain

86.

After teaching a client about the risk factors for rheumatoid arthritis, which of the following, if stated by the client as a risk factor would indicate that the client needs additional teaching?

a)

· History of Epstein-barr virus

b)

· Female gender

c)

· Adults between ages 50-75

d)

· Positive testing for human leukocyte antigen

87.

A client is in acute phase of rheumatoid arthritis. Which of the following should the nurse identify as the lowest priority in the plan of care?

a)

· Relieving pain

b)

· Preserving joint function

c)

· Maintaining usual activities

d)

· Preserving joint

88.

The client teaches a client about heat and cold treatments to manage arthritis pain. Which of the following client statements indicate that the client still has a knowledge deficit?

a)

· “I can use cold and heat application as often as I want”

b)

· “ with heat, I should apply it for no longer than 20 mins at a time”

c)

· “Heat producing liniments can be used with other heat devices”

d)

· “10-15 minutes per application is the maximum time for cold applications”

89.

The client with rheumatoid arthritis tells the nurse “I have a friend who took gold shots and had a wonderful response. Why didn’t my physician let me try that?” Which of the following responses by the nurse would be most appropriate?

a)

· “It’s the physician’s prerogative to decide how to treat you. The physician has chosen what’s best for your situation”

b)

· “Tell me more about your friend’s arthritic condition. Maybe I can answer that question for you.”

c)

· That drug is used for cases that are worse than yours. It wouldn’t help you so don’t worry about it”

d)

· · “Every person is different. What works for one client may not always be effective to another”

90.

1. What is the drug of choice for acute attacks of gouty arthritic pain?

a)

· Allopurinol

b)

· Colchicine

c)

· Ibuprofen

d)

· Mefenamic Acid

91.

When teaching a client about the recommended diet for a patient with gouty arthritis, which of the following indicates that he’s well informed?

a)

· I can still eat legumes like mongo for lunch

b)

· I should increase my oral fluid intake to atleast 2 liters per day

c)

I should refrain from eating too much organ meats

d)

· All of the above

92.

Who among the following clients is/are at risk for pneumonia?

a)

· Client with leukopenia

b)

· Client with prolonged immobility

c)

· Post laparotomy client who received morphine

d)

· All of the above

93.

Which of the physician’s orders should the nurse implement FIRST to improve the gas exchange at the alveolar level?

a)

· Start intravenous fluids

b)

· Administer oxygen via face mask

c)

· Nebulize with salbutamol as prescribed

d)

· Assist with chest physiotherapy 3-4 times daily

94.

Which of the following blood components is decreased in anemia?

a)

· Erythrocytes

b)

· Granulocytes

c)

· Leukocytes

d)

· Platelets

95.

Which of the following cells is the precursor to the red blood cells?

a)

· B cell

b)

· Macrophages

c)

· T cell

d)

· Stem Cell

96.

The nurse understands that in the absence of pathology, the client’s respiratory center is stimulated by:

a)

· Oxygen

b)

· Lactic Acid

c)

· Carbon Dioxide

d)

· Calcium ions

97.

Air rushes into the alveoli as a result of the:

a)

· Relaxation of the diaphragm

b)

· Rising pressure in the alveoli

c)

· Rising pressure in the pleura

d)

· Lowered pressure in the chest cavity

98.

The nurse is preparing to obtain a sputum specimen from a client. Which of the following nursing actions will facilitate the collection of the specimen?

a)

· Limiting fluid intake

b)

· Allowing the client to take deep breaths

c)

· Asking the client to spit in the collection container

d)

· Informing the client that the specimen will be collected after a meal

99.

A client has undergone a thoracentesis. Following the procedure, it is most important for the nurse to observe for:

a)

· Periods of confusion

b)

· Expectoration of blood

c)

· Increased breath sounds

d)

· Increased respiratory rate

100.

A male patient is admitted to the health care facility for treatment of Chronic Obstructive Pulmonary disease (COPD). Which nursing diagnosis is most important to this patient?

a)

· Activity intolerance related to fatigue

b)

· Anxiety related to actual threat to health status

c)

· Risk for infection related to retained secretions

d)

· Impaired gas exchange related to airflow obstruction

NCM 112 RLE Final Exam

Total questions: 100

Worksheet time: 1hrs 11mins

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