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Final Examination NCM112

Total questions: 50

Worksheet time: 1hrs 24mins

Name
Class
Date
1.

1.      Which statement would be the nurse’s best response when a 28 year old woman asks the nurse, “what can I do to make sure I don’t get breast cancer like my mother and sister?”

a)

“There is nothing you can do to make sure you don’t get breast cancer.”

b)

“You can detect the cancer early with monthyly self breast examination and yearly mammograms”

c)

“You’re frightened that you may get breast cancer like your mother and sister”

d)

You should get a rectal digital examination every year and a yearly pelvic examination with a pap smear”

2.

1.      Roxy is admitted to the hospital with a possible diagnosis of appendicitis. On physical examination, the nurse should be looking for tenderness on palpation at McBurney’s point, which is located in the

(a)  

3.

  A primi at 34 weeks gestation has been diagnosed with herpes. The patient asks the nurse, how will this affect my pregnancy and delivery? The best response by the nurse is to instruct the patient that?

a)

  Treatment during pregnancy includes zidovudine

b)

A cesarean delivery is needed if active lesions are present

c)

Breast feeding is contraindicated even for a patient without lesions

d)

More than half of infected newborns suffer from hearing loss

4.

Which of the following is a common manifestation of BPH?

a)

  Painful hematuria

b)

Polyuria

c)

  Dribbling urine

d)

  Dysuria

5.

The client is undergoing brachytherapy and experiences irritation in the perineal skin. Which of the following should the nurse teach the client?

a)

  Use a mild cleanser and lukewarm water for cleansing

b)

Use cold water and mild cleanser for cleansing

c)

Wear restrictive clothing

d)

All of the above

6.

Radiation treatments also produce fatigue and loss of appetite. The client asks you what would be the appropriate diet for him, your response would be?

a)

High protein, high fat

b)

Low protein, high carbohydrates

c)

High protein, high carbohydrates

d)

Low protein, low fat

7.

Infection is another complication of radiation therapy. The appropriate nursing measure for the prevention of this problem would be:

a)

Handwashing

b)

Good oral hygiene (using alcohol-based mouthwash)

c)

Fresh flowers should be displayed at home

d)

Use antipyretics regularly

8.

  Mang Tomas, a 58 year old patient and an account executive has been diagnosed with Benign Prostatic Hyperplasia. During your history taking with the client, what assessment area would be most significant?

a)

The force of urine stream

b)

Symptoms of priapism

c)

History of smoking

d)

History of heavy alcohol

9.

Policy and procedure dictate that handwashing is a requirement when caring for clients. Which statement about handwashing is true

a)

Frequent hand washing reduces transmission of pathogens from one client to another

b)

Wearing gloves is a substitute for handwashing

c)

Bar soap, which is generally available should be used for handwashing

d)

  Waterless products shouldn’t be used in situations in which running water is unavailable.

10.

   A sexually active woman with history of a mucopurulent discharge and bleeding associated with cervical dysplasia and dysuria will receive Azithromycin (Zithromax) for the treatment of:

(a)  

11.

  A client finds a lump in her breast and is hospitalized for a biopsy and possible mastectomy. As the nurse is preparing for her surgery, the client says, “I’m really scared. My mother and sister went through this. It was awful.” The nurse’s most appropriate response would be:

a)

“You know, most breast lumps are benign.”

b)

“Breast cancer has an excellent cure rate.”

c)

“You are worried about the results tomorrow?”

d)

“What happened with your mother and sister?”

12.

  In preparing to discharge a client with gonococcal pelvic inflammatory disease (PID), the nurse would intervene if the client made which statement?

a)

“I should douche after every episode of intercourse.”

b)

Using condoms will decrease the risk of this happening again.”

c)

“My boyfriend and I should be monogamous.”

d)

“The sexual position I use won’t prevent this infection.”

13.

A male client has been diagnosed with Chlamydia trachomatis infection. The plan of care should include which of the following?

a)

Instructions to take all of the doxycycline that was ordered.

b)

Encouragement to use condoms with most episodes of intercourse

c)

Obtaining the names of sexual contacts if client desires.

d)

Teaching of testicular self-exam (TSE) for diagnosis

14.

Which client is at the lowest risk for developing breast cancer?

a)

Client with BRCA1 gene mutation

b)

Older women who are overweight

c)

Client who had first child at 18, breastfed for 2 years

d)

Client who is a smoker, age 74

15.

   Female clients with Chlamydia trachomatis infections will most likely present with which signs and symptoms?

a)

Painful perineal blisters and sudden high fever

b)

Painless crater-like lesion on the labia that lasts 6 weeks

c)

Rapidly progressing pruritic rash on labia and buttocks

d)

Yellow-green vaginal discharge, dysuria and pelvic pain

16.

The client with a new diagnosis of genital herpes simplex virus 1 (HSV1) wants to know how she contracted the infection. The nurse’s best answer is based on which of the following?

a)

Inanimate objects can harbor HSV1 for several hours

b)

HSV1 is found only in the genital tract and not orally

c)

Sexual contact is the most common mode of transmission

d)

Immune system suppression is needed to contract the infection

17.

Ma'am D, a clinical instructor is conducting a lecture about chemotherapy. Which of the following statements is correct about the rate of cell growth in relation to chemotherapy?

a)

Faster growing cells are more susceptible to chemotherapy

b)

  Faster growing cells are less susceptible to chemotherapy

c)

Slower growing cells are more susceptible to chemotherapy

d)

Non-dividing cells are more susceptible to chemotherapy

18.

During a routine physical examination, a firm mass is palpated in the right breast of a 35-year-old woman. Which of the following findings or client history would suggest cancer of the breast as opposed to fibrocystic disease?

a)

   Increased vascularity of the breast

b)

  History of anovulatory cycles

c)

Cyclic changes in mass size

d)

  History of early menarche

19.

The client with which of the following types of lung cancer has the best prognosis?

(a)  

20.

Which of the following interventions is the key to increasing the survival rates of clients with lung cancer?

a)

   High-dose chemotherapy

b)

Early bronchoscopy

c)

  Smoking cessation

d)

Early detection

21.

The nurse is caring for a patient diagnosed with breast cancer who just underwent an axillary lymph node dissection. What intervention should the nurse use to decrease the lymphedema?

a)

Keep affected arm flat at the patient's side.

b)

Apply an elastic bandage on the affected arm.

c)

Assess blood pressure only on unaffected arm.

d)

   Restrict exercise of the affected arm for 1 week.

22.

The nurse has been asked to participate in a healthy living workshop. While teaching about women's health, which guidelines should the nurse provide to the audience?

a)

"Mammograms are necessary if you have a family history of breast cancer."

b)

"It's recommended that you get a mammogram each year after you turn 40."

c)

"If you are not able to perform breast self-examination (BSE), you should go for regular mammograms."

d)

"You should ensure that your primary care provider performs a breast exam each time you visit."

23.

When doing breast self-examination, the female patient should report which findings to her physician?

a)

Palpable rib margins

b)

Denser breast tissue

c)

Left nipple deviation

d)

Different sized breasts

24.

To determine the severity of the symptoms for a patient with benign prostatic hyperplasia (BPH), the nurse will ask the patient about

a)

the presence of blood in the urine

b)

any erectile dysfunction (ED).

c)

occurrence of a weak urinary stream

d)

lower back and hip pain.

25.

Which statements below are INCORRECT about Systemic Lupus Erythematosus? Select all that apply:

a)

Lupus mainly affects Black, Asian, and Hispanic men. 

b)

Lupus is a chronic condition that has periods of flare-ups and remission. 

c)

The joints and skin are rarely affected in lupus. 

d)

  Systemic Lupus Erythematosus (SLE) is the most common form of lupus.

26.

A patient with Systemic Lupus Erythematosus is experiencing a complication called Lupus Nephritis. Which of the following signs and symptoms is not correlated with this complication?

a)

Decreased Creatinine

b)

Increased BUN

c)

Proteinuria

d)

Edema in upper and lower extremities

27.

A patient with Systemic Lupus Erythematosus is prescribed Hydroxychloroquine. The following educational points should be included in the patient’s education except:

a)

It is used long-term to help prevent flares.

b)

The patient must have their eyes checked regularly to monitor the retina while taking this medication.

c)

This medication binds with a protein that supports the activity of B-cells, which decreases the activity of B-cells.

d)

None of the above

28.

 

You're providing education to a Systemic Lupus Erythematosus support group about preventing flares. Which statement by a participant requires re-education about this topic?

a)

"Emotional stress and illness are triggers for a flare-up." 

b)

"I always wear large-brimmed hats and long sleeves when I'm outside."

c)

"Exercise should be avoided due to the physical stress it causes on the body."

d)

"I will make it priority to receive my yearly influenza vaccine.

29.

A client comes to the clinic for treatment of recurrent pelvic inflammatory disease. The nurse recognizes that this condition most frequently follows which type of infection?

(a)  

30.

A few hours after the evening meal your patient developed pain around his umbilicus which later moved to the lower right quadrant. The pain is now one-third of the distance between the anterior superior iliac spine and the umbilicus. What are the implications of these symptoms?

a)

The patient is experiencing an exacerbation of Crohn's disease

b)

This is a symptom of food poisoning with intestinal involvement

c)

The patient's kidneys are compromised

d)

This indicates the development of appendicitis

31.

The following are possible complications of Chlamydia except:

a)

Pelvic Inflammatory Disease

b)

Ectopic Pregnancy

c)

Fallopian tube abscess

d)

Amenorrhea

32.

What two STDs cause PID when left untreated?

(a)  

33.

What are some of the symptoms that occur when having PID?

a)

Fever and chills

b)

Pain during sex

c)

Irregular menstrual bleeding

d)

All of the above

34.

True or False: A patient with Crohn's Disease can experience inflammation in the large intestine that affects mainly the mucosa (inner layer) of the bowel.

a)

True

b)

False

35.

A patient with Crohn's Disease is MOST likely to have the disease is what part of the GI tract?

a)

Rectum

b)

Duodenum of the small intestine

c)

Terminal Ileum

d)

Descending Colon

36.

You're providing teaching to a patient who has been newly diagnosed with Crohn's Disease. Which statement by the patient's spouse requires re-education?

a)

   "Crohn's Disease can be scattered throughout the GI tract in patches with some areas appearing healthy while others are diseased." 

b)

  "There is no cure for Crohn's Disease."

c)

  "Strictures are a common complication with Crohn's Disease."

d)

  "Crohn's Disease can cause the haustra of the large intestine to lose its form."

37.

A physician is explaining to a patient that the patient has a type of Crohn's Disease that is found in both the ileum and colon. As the nurse, you know this type of Crohn's Disease is called?

(a)  

38.

 

A patient experiencing a flare-up with Crohn's Disease is ordered complete bowel rest by the physician. You are administering TPN (total parental nutrition) per physician order. When developing the patient's nursing plan of care, which nursing diagnosis is MOST important to include in the care plan?

a)

Risk for allergy response

b)

Risk for unstable blood glucose level

c)

Risk for imbalance nutrition: more than body requirements

d)

Risk for imbalanced nutrition: less than body requirements

39.

A patient with Crohn's Disease is taking corticosteroids. The patient is complaining of extreme thirst, polyuria, and blurred vision. What is your next nursing action?

a)

Check the patient's blood glucose 

b)

Give the patient a food containing sugar (ex: orange juice)

c)

Administer oxygen via nasal cannula

d)

Assess bowel sounds

40.

 

True or False: Ulcerative colitis is a type of inflammatory bowel disease that causes inflammation and ulcer formation in the inner lining of the small intestine, specifically the terminal ileum.

a)

True

b)

False

41.

A patient is admitted with ulcerative colitis. In the physician's notes, it is stated that the patient's barium enema results showed the patient has colitis that starts in the rectum and extends into the sigmoid and descending colon. As the nurse, you know that this is what type of ulcerative colitis?

(a)  

42.

Which of the following symptoms would a client in the early stages of peritonitis exhibit?

a)

Abdominal Distention

b)

Abdominal pain and rigidity

c)

Hyperactive bowel sounds

d)

Right upper quadrant pain

43.

Which of the following aspects is the priority focus of nursing management for a client with peritonitis?

a)

Fluid and electrolyte balance

b)

Pain Management

c)

Gastric Irrigation

d)

Psychosocial issues

44.

What condition would most likely cause peritonitis?

(a)  

45.

Give the three substances that is released by the acinar cells of the Pancreas

(a)  

46.

A patient with acute pancreatitis is reporting excessive thirst, excessive voiding, and blurred vision. As the nurse, it is priority you?

a)

Reassure the patient this is normal with pancreatitis 

b)

Check the patient's blood glucose

c)

Assist the patient with drinking a simple sugar drink like orange juice

d)

Provide a dark and calm environment

47.

A patient who received treatment for pancreatitis is being discharged home. You're providing diet teaching to the patient. Which statement by the patient requires immediate re-education about the diet restrictions?

a)

"It will be hard but I will eat a diet low in fat and avoid greasy foods."

b)

"It is very important I limit my alcohol intake to no more than 2-3 glasses of wine a week."

c)

  "I will concentrate on eating complex carbohydrates rather than refined carbohydrates."

d)

"I will purchase foods that are high in protein."

48.

The physician orders a patient with pancreatitis to take a pancreatic enzyme. What assessment finding demonstrates the pancreatic enzymes are working properly?

a)

Abdominal girth is decreased 

b)

Skin turgor is less than 2 seconds

c)

Blood glucose is 250

d)

Stools appear formed and solid

49.

"A patient contracts hepatitis from contaminated food. During the acute (icteric) phase of the patient's illness, the nurse would expect serologic testing to reveal...

a)

hepatitis B surface antigen (HBsAg).

b)

anti-hepatitis B core immunoglobulin M (anti-HBc IgM).

c)

anti-hepatitis A virus immunoglobulin G (anti-HAV IgG).

d)

anti-hepatitis A virus immunoglobulin M (anti-HAV IgM)."

50.

"The female nurse sticks herself with a dirty needle. Which action should the nurse implement FIRST?

a)

Notify the infection control nurse.

b)

Cleanse the area with soap and water.

c)

Request post-exposure prophylaxis.

d)

Check the hepatitis status of the client.