Font size
WorksheetsNUR2006 fall 25 final review
Total questions: 75
Worksheet time: 12hrs 21mins
The wife of a patient with end-stage chronic obstructive pulmonary disease (COPD) tells the nurse that she wishes her husband were eligible for hospice care, but she thinks that hospice is only available for cancer patients and would require a change in healthcare providers. Which responses by the nurse are appropriate? Select all that apply.
Inform her that hospice care is very expensive
Inform her that a diagnosis of cancer is not required for hospice care.
Inform her that all hospice programs provide care 24/7.
Informer her that her husband can retain his provider when transitioning to hospice care.
Inform her that her husband is not eligible for hospice care with the current diagnosis of COPD.
A competent older adult patient has an advance directive that expresses the patient’s desire to avoid resuscitation and heroic life support measures. The patient’s family, however, is not supportive of this directive and plans to contest the living will. Which nursing action is appropriate based on the current situation?
Notify the hospital attorney
Contact the social services department
Place the document on the patient's medical record
Explain to the patient that the conflict could invalidate the document
The nurse is planning an interprofessional care conference for a patient who is approaching discharge from the hospital. Which members of the interprofessional team should the nurse invite to attend? Select all that apply.
Physician
Pharmacist
Unit Secretary
Social Worker
Home care aide
The staff nurse is teaching a group of student nurses the situations that necessitate hand-off communication. Which student responses indicate the need for further education related to this procedure? Select all that apply.
"hand-off is required before administering a medication?
"Hand-off is required during change of shift."
"Hand-off is required for a pt who is transferred to the surgical suite"
"Hand-off is required whenever the nurse receives a new pt assignment."
"Hand-off is required before family visitation."
To deliver patient-centered care, the nurse needs to understand the implications of findings from which organization that provides a standardized approach to the collection of data from patients regarding their experiences within the healthcare system?
The Joint Commission
Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)
The Nursing Executive Center of the Advisory Board
American Nurse Credentialing Center Magnet Recognition program
The nurse is providing care to an older adult patient with terminal cancer who has opted to discontinue treatment and go home. The patient’s family, however, wants to continue treatment. The nurse agrees to be present while the patient tells the family. Which ethical patient principle is the nurse supporting? (a)
Which is the priority nursing action in the ethical decision-making process?
Determine exactly what needs to be decided
Formulate alternative to solve the issue
Implement an action to achieve the greatest benefit with the least amount of risk
Ascertain if new information is available regarding the issue
The nurse is providing care to a patient who states, “My doctor is refusing to treat me because I am noncompliant with his recommendations.” Which is the priority nursing action in this situation?
Advise the patient to contact the local medical board.
Advise the patient to contact their insurance company.
Refer the patient's issue to the hospital ethics committee.
Notify the healthcare provider of the patient's complaints.
The nurse is planning care for the patient with acute renal failure and incorporates the nursing diagnosis of Excess Fluid Volume. Which assessment data support this nursing diagnosis?
Wheezing in Lungs
Generalized weakness
Urine output of 20mL/hour
Pitting edema in the lower extremities
The nurse correlates which clinical manifestations to the patient at risk for hypovolemic shock? Select all that apply. (a) (b) (c)
The nurse is caring for a patient admitted with hypertension and chronic renal failure who receives hemodialysis three times per week. The nurse is assessing the patient's diet and notes the use of salt substitutes. When teaching the patient to avoid salt substitute, which rationale supports this teaching point?
They can potentiate hyperkalemia
They may cause the client to retain fluid
They may interfere with hemodialysis
They may interact with the client's antihypertensive medications
A patient is admitted for evaluation of a bowel obstruction and has a nasogastric tube placed to low intermittent suction. The physician orders arterial blood gases, and the following results are reported:
pH--7.37 (7.35-7.45)
PaCO2---33 mm Hg (35-45)
PaO2--94 mm Hg (80-100)
HCO3---19 mm Hg (22-26)
SaO2--98% (95-100)
What is the nurse's interpretation of these results?
Fully compensated metabolic acidosis
Uncompensated metabolic acidosis
Uncompensated respiratory alkalosis
Partially compensated respiratory alkalosis
The nurse is providing care to a patient who is admitted after a morphine overdose. Which acid–base imbalance does the nurse assess for in this patient? (a)
Organize these options into the right categories
Which risk factors exhibited by the patient presenting in the emergency department (ED) would place the patient at risk for metabolic acidosis or respiratory acidosis.
Acute Renal Failure
Abdominal Fistulas
Hypovolemic Shock
Chronic Obstructive Pulmonary Disease
Pneumonia
The nurse is caring for a patient with leukemia who is experiencing neutropenia as a result of chemotherapy. Which action should the nurse include in the plan of care for this patient?
Restricting fluid intake
Replacing hand hygiene with gloves
Restricting visitors with communicable illnesses
Inserting an indwelling urinary catheter to prevent skin breakdown
The nurse provides education to a patient who is diagnosed with breast cancer and asks about sites of metastases. Which is the best response by the nurse?
"Your type of cancer rearely spreads outside the chest."
"Your type of cancer may spread to the skin."
"Your type of cancer may spread to the bones."
"Your type of cancer may spread to the stomach."
The nurse correlates an increased risk of colon cancer in patients with which of the following factors? Select all that apply.
Low-fat diet
Alcohol in excess of two to three drinks per day
History of Polyps
History of hepatitis
Obesity
The nurse provides care to patients in the urgent care center. Which patient has the greatest risk for developing influenza?
Pt age 26 w/ history of systemic lupus erythematosus, works as accountant
Pt age 44 who is a nurse
Pt age 60 with history of asthma
Pt age 66 with history of diabetes mellitus.
Organize these options into the right categories
The nurse is preparing a young adult client for an urgent surgery. The client lives in a traditional eastern Asian culture and has weak English-speaking and -reading skills and depends on a school-age child for translation. For each nursing action, place an “X” in the column to specify whether it is appropriate or inappropriate.
Have the child assist w/ transation
Use hand gestures to communicate
Give written instruction in pt's preferred language
Speak loud & slow when communicating
Slow doen and be an active listener
Obtain an interpreter if needed
3. An older adult client arrives in the emergency department with shortness of breath, chills, weakness, and a productive cough of yellow/green sputum. There are crackles in the lower bases of the lungs with an occasional expiratory wheeze. An indwelling urinary catheter is placed and 80 mL of dark, amber-colored urine is drained. Vital signs include BP 100/68, P 110, RR 24, temp 102.2°F (39°C), SpO2 90%, fingerstick blood glucose 140 mg/dL. Orders are received. The nurse should first initiate ____ (a) _____ because of the ____ (b) ____. Complete the sentences by choosing from the list of options.
Organize these options into the right categories
Medical/Surgical history: Coronary artery disease (stents ´ 2), hypertension, heart failure (EF 30%), renal insufficiency (GFR 35%), type 2 diabetes (A1c 7.9%)
Social history: 82-year-old lives in assisted-living center for medication management and ADLs. Denies smoking, drinking, herbal use, or illicit drugs.
Family history: Orphaned at the age of 6, family history is unknown. Widowed 6 years ago, 2 adult living children who are healthy.
Physical Assessment: Admitted to medical unit after 15 pound weight gain in 2 weeks. Short of breath, crackles bilaterally, 3+ bilateral pretibial and pedal edema, 3-cm jugular vein distention, abdominal distention. Na 134 mEq/L, K 4.9 mEq/L, serum osmolality 275 mOsm/kg, BP 180/98, P 114, RR 24, SpO2 91%, fingerstick blood glucose 238 mg/dL.
Medications: Furosemide 20 mg daily, potassium 10 mEq twice daily, digoxin 0.25 mg daily, lisinopril 10 mg twice daily, spironolactone 25 mg twice daily.
The nurse reviews the client’s history. Drag and drop all the findings that indicate the client is experiencing fluid volume excess and move the others to not pertinent at this time
Weight Change
Lung sounds
Sodium level
Osmolality
Blood Pressure
EF
GFR
Family History
Potassium level
Glucose level
Organize these options into the right categories
Medical/Surgical history: Hypertension for 12 years, diabetes for 1 year. Hyperthyroidism treated with a partial thyroidectomy 5 years ago, benign prostatic hypertrophy.
Social history: Smokes 1 pack of cigarettes per week because “smoking helps me relax from my high stress job.” Drinks 2 to 3 alcoholic beverages a month. Denies illicit drug use.
Family history: Mother died of an acute myocardial infarction at age 73 years while in surgery. Brother died suddenly at age 39 of a brain aneurysm. Father alive and healthy.
Physical Assessment: Arrived in the emergency department with palpitations and “I can’t seem to catch my breath.” Overweight male with a BMI of 35. Alert and oriented. Mild diaphoresis. Lungs clear, irregular heart sounds with a murmur. New onset of atrial fibrillation on the ECG monitor with a ventricular rate of 110. BP 110/78 mm Hg. 2+ pedal pulses with 2+ edema of both lower extremities.
Medications: lisinopril 10 mg daily, atorvastatin 40 mg daily, baby aspirin daily, metformin 1000 mg twice daily, levothyroxine 100 mcg daily.
The nurse reviews the client’s history. Drag and drop all the factors that contribute to the cardiac dysrhythmia.
Thyroid disorder
Hypertension history
Obesity
Diabetes
Smoking habit
Alcohol use
Peripheral edema
BPH
Drug use
Family health history
The patient recently released from the hospital after recovering from complications related to influenza is being seen in the outpatient clinic. Which patient statement indicates the need for further intervention?
"I went back to work"
"I am drinking at least 8 glasses of water daily."
"I continue to wake up coughing at night."
I only had a low-grade fever once since i left the hospital."
Which statement made by the patient with an active tuberculosis (TB) infection who is discharged to home receiving directly observed therapy indicates that teaching was effective?
"The home-health nurse will come to my home daily to make sure that I take my meds."
"I need to be on home isolation for about 2 weeks."
"I only have to take these meds for about 6 months."
"I will not need to be tested for TB after the infection is cured."
The school nurse is planning a teaching session with the parents of students to reduce the spread of the influenza virus throughout the school. What should the nurse include when teaching the parents about minimizing the chance of spread of influenza? Select all that apply.
"Cover your cough" education
Appropriate hand hygiene
Safe food preparation and storage
Sanitizing high-touch items to kill pathogens
Getting the influenza vaccine in the early summer
Which patient requires immediate intervention by the nurse to decrease the risk for developing a deep vein thrombosis (DVT)?
Patient who is immobile due to a fractured hip
Patient who is admitted for an exacerbation of asthma
Patient who is obese and scheduled for laparoscopic day surgery
Patient who is admitted for an exacerbation of CHF.
The nurse monitors for which clinical manifestations in the patient experiencing intermediate respiratory failure?
Dyspnea
Lethargy
Tachycardia
Restlessness
The nurse caring for a patient admitted with septic shock is aware of the need to assess for the development of acute respiratory distress syndrome (ARDS). The nurse will monitor for (a) as an early clinical manifestation indicating the development of ARDS.
The patient is prescribed a heparin infusion at start at 2,000 units/hour. If 50,000 units are mixed in 250 mL, at what rate (mL/hour) does the nurse set the pump? (Enter the number with no spaces or units of measurement.)
The nurse caring for a tele patient, knows that the initial electrical impulse begins.
Reorder the following
The nurse is preparing a teaching tool about the cardiac electrical conduction system. In which order should the nurse explain the route of the action potential?
Sinoatrial node fires in the right atrium
Impulse travels to the atrioventricular node
Impulse travels to the bundle of His
Impulse travels through bundle branches
Impulse extends through Purkinje fibers
The nurse is reviewing the anatomy of the heart with a patient scheduled for cardiac surgery. Which patient statement indicates additional teaching is required?
"Oxygenated blood returns to the left atrium through the pulmonary vein."
"The right atrium receives blood from the superior and inferior vena cava."
"Blood leaves the right ventricle and travels through the pulmonary vein to the lungs."
"Blood leaves the right ventricle and travels through the pulmonary artery to the lungs."
The nurse is preparing to determine a patient's cardiac output. He/she knows that (a) measurement is used for preload.
The nurse correlates which variables as directly influencing stroke volume? Select all that apply
Afterload
Conductivity
Contractility
Coronary circulation
Preload
A patient’s heart rate is 48 beats per minute. The nurse correlates this heart rate to the inherent rate of which structure? (a)
A patient is in normal sinus rhythm with prolonged PR intervals. What prescribed treatment does the nurse plan for this patient?
Continue to monitor
Prepare for defibrillation
Prepare for cardioversion
Prepare for Pacemaker insertion
Organize these options into the right categories
A patient with a cardiac dysrhythmia asks why it is important to recognize the signs of a stroke. What is the best response by the nurse?
"To help you respond quickly to these signs & symptoms."
"To encourage you to take your medications as prescribed."
"Stroke is very rare in pts w/ cardiac dysrhythmias, this is important info."
"Most people w/ heart dysrhythmias develop strokes."
In assessing a patient with a heart rate of 132 beats per minute, the nurse assesses for which causes of this elevated heart rate? Select all that apply. (a) (b) (c)
The nurse counts eight QRS complexes in a 6-second period on the patient’s electrocardiogram (ECG) strip. The nurse documents the patient’s pulse as ____________________ bpm.
In providing care to a patient diagnosed with atherosclerosis, the nurse correlates the initiation of this disease to which process?
Oxidation
Inflammatory process
Injury to the vessel wall
Trapping of low-density lipoproteins
The nurse is preparing teaching for a patient being treated for coronary artery disease. What dietary information should the nurse emphasize?
Restrict carbohydrate intake
Limit calorie intake to less than 1,000/day
Reduce saturated fat and sodium intake
Limit fluid intake
A patient is admitted for treatment of pericarditis. For which additional health problem should the nurse expect the patient to be evaluated?
Asthma
Myocardial infarction
Infective endocarditis
Chronic Obstructive Pulmonary Disease
A patient with heart failure is having a B-type natriuretic peptide (BNP) level drawn. The nurse correlates that the results of this diagnostic provide which data? What is the purpose of this laboratory test?
Measure Ejection fraction
Rule out an ischemic event
Differentiate right- from left-sided heart failure
Measure "overstretching" of the ventricles
While planning care, the nurse identified interventions to reduce a patient’s risk for developing heart failure. Which assessment findings did the nurse use to make this clinical determination? Select all that apply. 1,2,4,5
BMI 31.3
Smokes half a pack of cigarettes
BP 168/90
Fasting blood glucose 125 mg/dL
Employed in a textile factory
The nurse correlates increased circulating levels of triiodothyronine (T3) and thyroxine (T4) to which physiological response? (a)
The nurse monitors for which clinical manifestation in the patient with a decrease in antidiuretic hormone (ADH) secretion?
Increased sodium excretion
Increased potassium excretion
Increased urine output
Increased urine specific gravity
The nurse notes that a patient has a tumor on the thyroid gland. Where should the nurse expect to palpate this tumor?
Anteriorly below the chin
At the level of the clavicle
Below the cricoid cartilage
At the level of sternal notch
The nurse correlates which clinical manifestation to the presentation of a patient with elevated levels of growth hormone?
Truncal obesity
Facial puffiness
Thinning of hair
A broad forehead
The nurse correlated a vitamin D deficiency in the patient with a disorder of which endocrine gland?
(a)
The nurse recognizes which hormones as being secreted from the hypothalamus? Select all that apply.
Follicle-Stimulating hormone
Thyrotropin-releasing hormone
Corticotropin-releasing hormone
Gonadotropin-releasing hormone
Adrenocorticotropic hormone
In the patient with increasing serum calcium levels, the nurse correlates which physiological responses to maintain homeostasis? Select all that apply.
The thyroid gland releases calcitonin.
Calcium uptake is increased in the intestines
Calcium reuptake is reduced in the kidneys
The parathyroid gland releases parathyroid hormone
Calcitonin stimulates calcium deposition in the bones
A patient is demonstrating signs of hypopituitarism. The nurse monitors results from which diagnostic test for this disorder?
magnetic resonance imaging (MRI)/ Lumbar puncture/ Cerebral angiogram/ Carotid Doppler studies (a)
The nurse is calculating the fluid intake for a patient after a transsphenoidal hypophysectomy. The patient has received 75 mL/hour of intravenous fluids for the last 24 hours and consumed two 8-ounce cups of water. What is the total fluid intake in mls? (NUMBERS ONLY!)
A male patient presents to the clinic with complaints of changes in his facial features and enlarged, painful hands. The nurse correlates these clinical manifestations with a disorder of which hormone?
Testosterone
Growth Hormone
Thyroid-stimulating hormone
Adrenocorticotropic hormone (ACTH)
A patient is being discharged after surgery for hyperpituitarism. The nurse incorporates which information to reduce the risk of postoperative complications?
Restrict fluids
Avoid strain on the suture line
Maintain bedrest for several days
Expect clear nasal drainage to occur
A patient with osteoarthritis develops syndrome of inappropriate antidiuretic hormone (SIADH). What information in the patient’s history does the nurse correlate to the development of this disorder?
Male gender
age 70 years
Use of NSAIDS
use of diuretics
A patient’s thyroid-stimulating hormone (TSH) is below normal. The nurse correlates which findings to this decreased hormone level? Select all that apply.
Weight gain
Thinning hair
Decreased bone density
Decreased muscle strength
Complaints of decreased libido
The nurse is preparing discharge teaching for a patient recovering from a transsphenoidal hypophysectomy for a pituitary tumor. What should the nurse emphasize in this teaching? Select all that apply.
Limit reading
Avoid coughing
Do not bend over
Hold the nose when sneezing
Avoid driving for several weeks
Which statement by the patient diagnosed with gastritis indicates the need for further teaching?
"I will eat bland, nonspicy foods."
"I will eat smaller, more frequent meals."
"I will take aspirin for headaches."
"I will take an antacid if my symptoms continue."
(a) is a diagnostic test the nurse correlates to the diagnosing an active infection with Helicobacter pylori for a patient diagnosed with gastritis.
In providing care to the patient admitted for gastritis, which clinical manifestation requires immediate notification of the healthcare provider?
Nausea
Anorexia
Hematemesis
Epigastric pain
Organize these options into the right categories
In collecting a health history, the nurse correlates which risk factor to the development of peptic ulcer disease?
Sarcoidosis
Acetaminophen use for pain
Hypoparathyroidism
Social Drinking
Crohn's disease
Critically ill pts
Other rare infections
The nurse monitors for which clinical manifestations of organ penetration in the patient who is hospitalized for complications associated with peptic ulcer disease? (a)
The nurse monitors for which clinical manifestations in the patient diagnosed with a perforation secondary to peptic ulcer disease? Select all that apply.
Sudden onset of pain
Early satiety
Intense epigastric discomfort
Rigid abdominal muscles
Vomiting
A patient is being evaluated for chest pain in the emergency department. Which laboratory test is the best to determine if this patient has experienced an acute myocardial infarction?
Troponin
Creatine Kinase
Creatine Kinase MB
Serum lactate level
The nurse is providing care for a patient ordered a heparin infusion after suffering a myocardial infarction. The heparin is infusing at 20 mL/hour with 25,000 units of heparin in 500 mL of D5W. The nurse calculates that the patient is receiving how many units/hour?
Organize these options into the right categories
The nurse is assigned to a patient with a newly inserted central line. What actions should be taken to prevent the patient from developing an infection? Select all that apply 1 2 3 5
Performing line care
Using aseptic technique
minimizing handling of the line
Ensuring an occlusive dressing is applied
Using normal saline to flush the line
The nurse assesses a patient who is admitted after a traumatic brain injury (TBI) to the frontal lobe. The nurse correlates which clinical manifestations to damage to this area of the brain?
Sensation difficulty
Expressive speech difficulty
Color perception impairment
Long-term memory impairment
The nurse correlates a change in the taste of food to which cranial nerve (CN)? (a)
A patient is scheduled for an electroencephalogram. What pre-procedure information does the nurse emphasize with this patient? (a)
The nurse recognizes which of the following structures as parts of the brainstem?
Thalamus
Basal ganglia
Medulla oblongata
Midbrain
Pons
The nurse notes that a patient has a positive Babinski response. The nurse correlates this finding to which of the following disorders? Select all that apply.
Chronic alcohol use
Substance abuse
Multiple sclerosis
Parkinson's disease
Traumatic brain injury
The nurse correlates a husky voice in the patient with hypothyroidism to which assessment finding?
Chronic fatigue
Enlarged thyroid gland
Edema of the tongue and larynx
Dry mucous membranes from dehydration
The nurse monitors for which clinical manifestations in the patient with hypothyroidism? Select all that apply.
Fatigue
Weight gain
Increased sleep
Decreased energy
Increased appetite
A patient with chronic renal failure is diagnosed with hyperparathyroidism. Which treatment approach is most effective in this patient?
Increased oral fluid intake
Oral thiazide diurectics twice a day
High-volume normal saline infusions
Discontinued calcium and vitamin D supplements
