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Final Review Fall 21

Total questions: 56

Worksheet time: 56mins

Name
Class
Date
1.

A nurse is making her morning rounds on a pediatric unit. Which patient would be priority for intervention, concerning lung sounds?

a)

A 2-year-old with wheezing on expiratory and inspiratory. The patient is lethargic

b)

A 10-year-old with crackles on both lung bases. The patient is coughing up thick secretions.

c)

A 14-year-old with a harsh grunting noise. The patient is sleeping with drool noted on the pillow.

d)

A 7-year-old with a rattling, low-pitched snoring wheeze. The patient is playing with her baby doll.

2.

Which stage of hepatic encephalopathy is characterized by increased drowsiness, disorientation, inappropriate behavior, mood swings, agitation, and asterixis?

a)

Stage 1

b)

Stage 2

c)

Stage 3

d)

Stage 4

3.

1.      Which of the following are triggers for hepatic encephalopathy? Select all that apply

a)

Excessive protein intake

b)

   Hypervolemia

c)

Diuretics

d)

Excessive sodium intake

e)

Mood stabilizers

4.

A nurse has taught a female client on ways to manage discomfort caused by dysmenorrhea. Which statement made by the client needs further instruction?

a)

“Applying localized heat can help decrease the pain.”

           

b)

  “Taking Ibuprofen or Motrin will help with painful cramps.”

c)

   “Decreasing activity entirely will help decrease symptoms.”

d)

“A low-dose oral contraceptive may help provide some relief.”

5.

Which of the following are true regarding the term amenorrhea? Select all that apply

a)

Painful monthly menses

b)

The absence of menses.

c)

Primary amenorrhea results when there is a delayed cycle by the age of 15 with no secondary characteristics.

d)

 Secondary amenorrhea results when a female has never had a cycle.

e)

Primary amenorrhea results when there is no cycle by the age of 16 with secondary characteristics.

6.

A patient discovers a new mole that has appeared on her left calf, she consults her PCP and scheduled an appointment, what assessment findings lead you to believe that the mole is malignant in nature. Select all that apply.

a)

The note is symmetric

        

b)

 The borders of the mole are even  

c)

 The mole is two or more different colors

d)

      The mole is changing in size and shape

e)

The mole’s diameter is greater than 6mm (1/4 inch)

7.

What is the NADIR Point?

a)

The point at which the patient is in the middle of their chemotherapy

b)

The lowest number of neutrophils that occurs months after chemotherapy

c)

    The lowest blood cell count that occurs 7-10 days after the initiation of chemotherapy

d)

The point of maximum intake of chemotherapy

8.

The nurse is caring for an infant with myelomeningocele who is going to surgery

later today for closure of the sac. Which of the following would be a priority nursing

diagnosis before surgery?

a)

Alteration in parent-infant bonding

b)

Altered growth and development

c)

Risk of infection

d)

Risk for weight loss

9.

A patient is newly diagnosed with Hepatitis A. The patient then asks how a person becomes infected with this. As a nurse, you know the most common route of transmission for Hepatitis A is:

a)

Blood  

b)

  Sweat

c)

Drug Use

d)

Fecal- Oral

10.

A patient with a hepatitis diagnosis has a bilirubin of 6 ml/dl. What findings correlate with this result?

Select all that apply:

a)

The level is normal 

b)

Yellowing of the skin and sclera

c)

Clay colored/whitish stools

d)

Bluish coloring around the flank area

e)

Dark amber urine

11.

A nurse is caring for a client recently diagnosed with major depressive disorder, what signs and symptoms would the nurse expect to see in this patient?  Select all that apply.

a)

Weight gain

b)

Open body language

c)

Insomnia

d)

Weight loss

e)

Disheveled appearance

12.

When caring for a client with OCD, what nursing interventions are expected to be performed? Select all that apply.

a)

Offer encouragement and support to patient.

b)

Encourage the client to express their feelings and talk about their rituals in detail.

c)

Encourage the client to develop a written schedule that has specified times for activities.

d)

Encourage client to use techniques to manage anxiety responses.

e)

  Gradually increase time for client to carry out ritualistic behavior.

13.

A client with a forceful, pounding heartbeat is diagnosed with mitral valve prolapse. Which client statement indicates to the nurse a need for additional teaching?

a)

“I should increase my fluid intake.”

b)

“I’ll enroll in an aerobic exercise program.”

c)

“I can still drink coffee and tea.”

d)

“I should eat foods rich in protein.”

14.

A client is admitted to the hospital with aortic stenosis. What assessment findings would indicate the development of left ventricular failure?

a)

Dyspnea, orthopnea, pulmonary edema,

b)

Distended jugular veins, pedal edema, nausea

c)

Dyspnea, distended jugular veins, orthopnea

d)

Orthopnea, nausea, pedal edema

15.

A nurse is caring for a client who has been diagnosed with syndrome of inapproriate anti-diurectic hormone (SIADH). What type of electrolyte imbalance would the nurse most likely see in this situation?

a)

Hyponatremia

b)

Hypocalcemia

c)

Hyperkalemia

d)

Hypermagnesemia

16.

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

a)

Measure the urinary output

b)

Weigh the clien

c)

Check the vital sign

d)

Encourage increased fluid intake

17.

A 55-year-old patient with a diagnosis of prostate cancer is scheduled to have an interstitial implant for high-dose radiation (HDR). What safety measure should the nurse include in this patient’s plan of care?

a)

Teach the patient to preform all aspects of basic care independently.  

b)

Assign male nurses to the patient’s care whenever possible.

c)

Limit the time that visitors spend visiting the patient.

d)

Situate the patient in a shared room with other patients receiving brachytherapy.

18.

Which of the following menu selections would be the best choice for potentially reducing the risks of cancer?

a)

Liver, onions, and steamed peas

b)

Smoked salmon and spinach

c)

Pork chops and fried okra

d)

Baked chicken and steamed broccoli

19.

A client asks the nurse not to tell his wife that he has cancer. What would be the most appropriate response by the nurse?

a)

 "I'm sorry, but the doctor already told her.”

b)

“Why are you afraid to tell her?”

c)

“Don’t you think she has a right to know?”

d)

  “What benefits do you see from not telling your wife your diagnosis?”

20.

The nurse is admitting a patient who is scheduled to undergo a Cardiac Catheterization. Which of the following allergies is most important for the nurse to assess before this procedure?  

a)

Aspirin

b)

Penicillin

c)

Iodine

d)

Iron

21.

If an infant was born at 28 weeks and has been in the NICU for 12 weeks now how old would this infant adjusted age be?

a)

12 weeks

b)

  6 weeks

c)

Newborn

d)

3 months

22.

If an Infant was 20 inches in length at birth by 12 months old what would the expected length be?

a)

30 inches    

b)

25 inches

c)

40 inches

d)

45 inches

23.

A client with calculi in the gallbladder is said to have

a)

Cholecystitis

b)

Cholelithiasis

c)

Choledocholithiasis

d)

Choledochotomy

24.

A nurse is providing preoperative teaching to a client undergoing a cholecystectomy. Which topic should the nurse include in her teaching plan?

a)

Increase respiratory effectiveness.  

b)

Eliminate the need for nasogastric intubation. 

c)

Improve nutritional status during recovery.

d)

Decrease the amount of postoperative analgesia needed.

25.

Which finding in a client with aortic stenosis will be the most important for the nurse to report to the HCP?

a)

Temperature of 102.1 F

b)

Loud systolic murmur over sternum

c)

Blood pressure of 110/88 mmHg

d)

Weak radial and pedal pulses to palpation

26.

A nurse is assessing an infant who has coarctation of the aorta. Which of the following findings should the nurse expect? (Select all that apply)

a)

Weak femoral pulses

b)

Cool skin of lower extremities

c)

Severe Cyanosis

d)

Clubbing of the fingers

e)

Heart Failure

27.

What type of pneumothorax is often accompanied by hemothorax? 

a)

Simple

b)

Tension

c)

Traumatic

d)

Hemothorax

28.

Which of these symptoms are included in the Seven S’s (clinical manifestations of Rheumatoid Arthritis- RA)? Select all that apply:

a)

Systemic involvement

b)

Sunrise stiffness

c)

Sudden weight loss

d)

Swelling

e)

Symmetrical presentation

29.

True or False: Systemic Lupus Erythematosus (SLE) affects men more  than women.

a)

True

b)

False

c)

Don't pick me

d)

Don't pick me either

30.

The nurse is admitting a 19-year-old female the Emergency Room with vital signs BP 90/50, HR 140 and temp 98.4. Patient has a disheveled appearance, wearing oversized clothes and slow to answer questions. The patient reports a weight loss of 25lbs in the last two months. What would the nurse expect the diagnosis to be?

a)

FVD

b)

FVO

c)

Bulimia

d)

Anorexia

31.

You are the nurse providing education to a group of teenagers about eating disorders. What dental disease would you include in your teaching about Bulimia?

a)

Perimyolysis

b)

Gingivitis

c)

Cleft Palate

d)

Perodontitis

32.

A patient is admitted with a long-standing medical history of atrial fibrillation. Which type of stoke is this patient at the highest risk for?

a)

Hemorrhagic  

b)

Ischemic thrombosis

c)

Ischemic embolism

d)

Ischemic Stenosis

33.

A patient diagnosed with meningitis experiences severe pain when the nurse flexes the patients neck upward and the patients’ knees and hips have a spastic reaction to the pain. The nurse recognizes this as what?

a)

Positive Kernig Sign

b)

Positive Babinskis Sign

c)

Positive Turners Sign

d)

Positive Brudzinski’s Sign

34.

A nursing student just attended a lecture on spina bifida. Which of the following statements from the student indicates the need for further teaching?

a)

“In myelomeningocele, bladder and bowl incontinence is often seen”.

b)

“Children with myelomeningocele have a higher risk of developing a latex allergy due to frequent catheterizations”.

c)

“Children with myelomeningocele are at a risk for altered nutrition since there are positioning restrictions”.

d)

“The infant must be placed in a supine position immediately after birth”.

35.

Which of the following statements made by the Registered Nurse are correct regarding muscular dystrophy?

a)

“Muscular dystrophy is progressive muscle weakness and wasting”.

b)

“A hallmark sign for muscular dystrophy is the Gowers sign”.

c)

“A muscle biopsy is done to make a definite diagnosis. The results will demonstrate the absence of dystrophin”.

d)

“Long term bed rest should be implemented to avoid overworking the muscles”.

e)

“Respiratory and cardiac assessments should be done frequently”

36.

A Labor and Delivery nurse is performing an assessment on a baby she believes to have trisomy 21, what are some common signs she may observe. SELECT ALL THAT APPLY.

a)

Large protruding tongue

b)

Congenital heart disease

c)

Small upper lip

d)

Malformed ears

e)

Slanted eyes

37.

A Female patient presents with Anorexia to the med-surg floor, what are some clinical manifestations the nurse would expect to see when assessing this patient. Select all that apply

a)

Decreased muscle mass 

b)

Patient reports pain in their stomach

c)

Hypertension

d)

  Patient reports firm, dark stool  

e)

Bradycardia

38.

Nursing students are reviewing information about childhood cancers. They demonstrate understanding of the information when they identify what as the most frequent type?

a)

Non-Hodgkin lymphoma

b)

Leukemia

c)

Osteosarcoma

d)

Hodgkin lymphoma

39.

The nurse is reviewing the medical record of a child diagnosed with Hodgkin lymphoma at the asymptomatic stage. Which would the nurse identify as typically the first sign reported by the child?

a)

Night sweats

b)

Weight loss

c)

Fever

d)

Painless, enlarged lymph nodes

40.

A nurse is assessing the sexual health of a 53 y.o. male client. The client states, “Sometimes I cannot maintain or achieve an erection when trying to be intimate with my wife, do I have a problem?”. Which response by the nurse is not appropriate?

a)

 “Some medications can have an impact on this. What medications are you currently taking?”

b)

“Tell me more about your medical history. When did this start?”

c)

“it is common in men your age so it is nothing to be concerned about. I am sure you’re fine, it will pass.”

d)

“There may be a psychogenic cause, would you like to talk more about it?”

41.

A pulmonary artery catheter is inserted in a client with severe mitral stenosis and regurgitation. The nurse administers furosemide (Lasix) to treat pulmonary congestion and begins a Nitroprusside (Nipride) drip for afterload reduction per physician orders. The nurse notices a sudden drop in the pulmonary artery diastolic pressure and pulmonary artery wedge pressure. Which of the following has the highest priority?

a)

Assess the 12-lead EKG.

b)

Assess the blood pressure.

c)

Assess the lung sounds.

d)

Assess the urine output.

42.

A 2-day-old infant was just diagnosed with aortic stenosis. What is the most likely nursing assessment finding?

a)

Gallop and rales

b)

Blood pressure discrepancies in the extremities

c)

Right ventricular hypertrophy on ECG

d)

Heart murmur

43.

Which  statement by the client indicates the need for further teaching?

a)

"Menopause will last between 3-6 years before my last menstrual period"

b)

"Menopause will result in a cessation of my menstrual period"

c)

  "Hot flashes is a common side effect of menopause"

d)

"I will need to be screened for osteoporosis"

44.

Which of the following is the least invasive procedure that may indicate the presence of Trisomy 21?

a)

    Amniocentesis

b)

Fetal nuchal translucency test

c)

Percutaneous umbilical blood sampling

d)

Chorionic villus sampling

45.

A client presents to the emergency department with upper right quadrant pain and feeling of dyspepsia and indigestion. The client states they have been feeling this pain for about a week now. The physician presses down on the client's upper abdomen and lets go and the client lets out a yelp. What does the nurse expect the physician is checking for?

a)

Hepatitis B

b)

Cholelithiasis

c)

Cirrhosis

d)

Pancreatitis

46.

The nurse is caring for a client who is diagnosed with Pancreatitis. What lab values will the nurse expect to be elevated?

a)

Serum Lipase, serum WBC, Serum calcium

b)

Serum RBC, serum glucose, Serum Amylase

c)

ALT/AST, serum calcium, serum WBC

d)

ALT/AST, serum amylase, serum lipase

47.

Which of the following signs and symptoms is NOT expected with Diabetes Insipidus?

a)

Polyuria

b)

Polydipsia

c)

Polyphagia

d)

Extreme thirst

48.

The anti-diuretic hormone is __________ in Diabetes Insipidus and _________ in SIADH.

a)

high, low

b)

absent, absent

c)

low, high

d)

low, low

49.

A patient with SIADH is undergoing IV treatment of a hypertonic IV solution of 3% saline and IV Lasix. Which of the following nursing findings requires intervention?

a)

 Sodium level of 136.

b)

Patient reports urinating more frequently.

c)

Potassium level of 5.0.

d)

Assessment finding of crackles throughout the lung fields.

50.

The client Is one day postoperative coronary artery bypass surgery. The client complains of chest pain. Which intervention should the nurse implement first?

a)

Medicate the client with IV morphine

b)

Assess client’s chest dressing and vital signs

c)

Encourage the client to turn from side to side

d)

Check client’s telemetry monitor

51.

Along with persistent, crushing chest pain, which signs/symptoms would make the nurse suspect that a client is experiencing a MI?

a)

Midepigastric pain and pyrosis

b)

Diaphoresis cool, clammy skin

c)

Intermittent Claudication and pallor

d)

Jugular Vein distention and dependent edema

52.

When assessing a client with obstructive jaundice, which of the following stool characteristics is the client likely to report?

a)

Yellow-green    

b)

Black and tarry

c)

Blood tinged

d)

Clay-colored or whitish

53.

The client has finished the first round of chemotherapy. Which statement made by the client indicates a need for further teaching by the nurse?

a)

I will eat clear liquids for the next 24 hours

b)

Hair loss may not occur until after the second round of therapy

c)

I will use birth control until after treatment is complete

d)

  I can continue taking my vitamins and herbs because they make me feel better

54.

The nurse is conducting a community education program using the American Cancer Society’s colorectal screening and prevention guidelines. The nurse determines that the participants understand the teaching when they identify that people over the age of 50(should be 45!) should have which screening test every 10 years?

a)

Fecal occult blood test

b)

Colonoscopy

c)

Prostate-specific antigen (PSA)

d)

Papanicolaou (Pap)

55.

A client comes into the clinic and asks, ”What can I do to prevent cancer?” What should be the nurses’ appropriate response?

a)

“There is nothing to do or worry about if you living right.”

b)

  “Cancer is hereditary, you need to look up your family history.”

c)

“You can reduce your risk by incorporating diet, lifestyle, and physical activity changes along with vaccinations.”

d)

“You can start by not eating red meat.”

56.

The nurse is educating a client on ways to prevent skin cancer. Which of the following would require additional teaching?

a)

  “I apply SPF 15 35 minutes prior to sun exposure.”

b)

“I avoid going out between 10 am-4pm.”

c)

“I reapply sunscreen every 2 hours.”

d)

“I often wear a hat and long-sleeved clothing.”