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Nursing and Sleep-Related Multiple Choice Questions

Total questions: 75

Worksheet time: 38mins

Name
Class
Date
1.

A 72-year-old female patient with a history of type 2 diabetes and hypertension was admitted to the medical-surgical unit due to a minor stroke. On assessment, the nurse noted generalized skin dryness, particularly on the arms, legs, and face. The nurse understands the importance of skin integrity, especially considering the patient’s age and comorbidities. Which of the following nursing interventions should the nurse consider when addressing the patient’s skin dryness? Select all that apply.

a)

Consult the dietitian about increasing the patient’s fat intake, and take necessary measures to prevent infection.

b)

Frequently apply a hydrating lotion to the patient's skin.

c)

Coordinate with the physician to refer the patient to a dermatologist.

d)

Use hypoallergenic soap when bathing the patient.

e)

Encourage the patient to drink at least 2 liters of water per day.

2.

A 68-year-old male patient was admitted to the cardiac unit following a recent myocardial infarction. The patient has a history of chronic venous insufficiency in both lower extremities. The nurse is preparing to provide a bed bath to the patient. The charge nurse advises the nurse to use long, firm strokes from the distal to the proximal areas when washing the patient’s extremities. The primary reason for this technique is to:

a)

Facilitate thorough examination and skin assessment.

b)

Induce vasoconstriction, thereby augmenting peripheral circulation.

c)

Prevent musculoskeletal injuries for the nurse during the procedure.

d)

Enhance venous blood return and reduce the risk of venous stasis.

e)

Stimulate the lymphatic system and reduce potential edema.

3.

Vivid dreaming occurs in which stage of sleep?

a)

Stage I non-REM

b)

Rapid eye movement (REM) stage

c)

Stage II non-REM

d)

Delta stage

4.

The natural sedative in meat and milk products (especially warm milk) that can help induce sleep is:

a)

Flurazepam

b)

Temazepam

c)

Methotrimeprazine

d)

Tryptophan

5.

Nursing interventions that can help the patient to relax and sleep restfully include all of the following except:

a)

Have the patient take a 30- to 60-minute nap in the afternoon.

b)

Turn on the television in the patient’s room.

c)

Provide quiet music and interesting reading material.

d)

Massage the patient’s back with long strokes.

6.

Restraints can be used for all of the following purposes except to:

a)

Prevent a confused patient from removing tubes, such as feeding tubes, I.V. lines, and urinary catheters.

b)

Prevent a patient from falling out of bed or a chair.

c)

Discourage a patient from attempting to ambulate alone when he requires assistance for his safety.

d)

Prevent a patient from becoming confused or disoriented.

7.

Which of the following is the nurse’s legal responsibility when applying restraints?

a)

Document the patient’s behavior.

b)

Document the type of restraint used.

c)

Obtain a written order from the physician except in an emergency, when the patient must be protected from injury to himself or others.

d)

All of the above.

8.

Kubler-Ross’s five successive stages of death and dying are:

a)

Anger, bargaining, denial, depression, acceptance

b)

Denial, anger, depression, bargaining, acceptance

c)

Denial, anger, bargaining, depression acceptance

d)

Bargaining, denial, anger, depression, acceptance

9.

A terminally ill patient usually experiences all of the following feelings during the anger stage except:

a)

Rage

b)

Envy

c)

Numbness

d)

Resentment

10.

Nurses and other healthcare providers often have difficulty helping a terminally ill patient through the necessary stages leading to acceptance of death. Which of the following strategies is most helpful to the nurse in achieving this goal?

a)

Taking psychology courses related to gerontology.

b)

Reading books and other literature on the subject of thanatology.

c)

Reflecting on the significance of death.

d)

Reviewing varying cultural beliefs and practices related to death.

11.

The best indicator of imminent death is:

a)

A weak, slow pulse

b)

Increased muscle tone

c)

Fixed, dilated pupils

d)

Slow, shallow respirations

12.

A nurse caring for a patient with an infectious disease who requires isolation should refer to guidelines published by the:

a)

National League for Nursing (NLN)

b)

Centers for Disease Control (CDC)

c)

American Medical Association (AMA)

d)

American Nurses Association (ANA)

13.

To institute appropriate isolation precautions, the nurse must first know the:

a)

Organism’s mode of transmission

b)

Organism’s Gram-staining characteristics

c)

Organism’s susceptibility to antibiotics

d)

Patient’s susceptibility to the organism

14.

Which is the correct procedure for collecting a sputum specimen for culture and sensitivity testing?

a)

Have the patient place the specimen in a container and enclose the container in a plastic bag.

b)

Have the patient expectorate the sputum while the nurse holds the container.

c)

Have the patient expectorate the sputum into a sterile container.

d)

Offer the patient an antiseptic mouthwash just before he expectorate the sputum.

15.

An autoclave is used to sterilize hospital supplies because:

a)

More articles can be sterilized at a time.

b)

Steam causes less damage to the materials.

c)

A lower temperature can be obtained.

d)

Pressurized steam penetrates the supplies better.

16.

The best way to decrease the risk of transferring pathogens to a patient when removing contaminated gloves is to:

a)

Wash the gloves before removing them.

b)

Gently pull on the fingers of the gloves when removing them.

c)

Gently pull just below the cuff and invert the gloves when removing them.

d)

Remove the gloves and then turn them inside out.

17.

After having an I.V. line in place for 72 hours, a patient complains of tenderness, burning, and swelling. Assessment of the I.V. site reveals that it is warm and erythematous. This usually indicates:

a)

Phlebitis (inflammation of the vein)

b)

Infiltration

c)

Air embolism

d)

Fluid overload

18.

To ensure homogenization when diluting powdered medication in a vial, the nurse should:

a)

Shake the vial vigorously.

b)

Roll the vial gently between the palms.

c)

Invert the vial and let it stand for 1 minute.

d)

Do nothing after adding the solution to the vial.

19.

The nurse is teaching a patient to prepare a syringe with 40 units of U-100 NPH insulin for self-injection. The patient’s first priority concerning self-injection in this situation is to:

a)

Assess the injection site.

b)

Select the appropriate injection site.

c)

Check the syringe to verify that the nurse has removed the prescribed insulin dose.

d)

Clean the injection site in a circular manner with an alcohol sponge.

20.

The physician’s order reads “Administer 1 g cefazolin sodium (Ancef) in 150 ml of normal saline solution in 60 minutes.” What is the flow rate if the drop factor is 10 gtt = 1 ml?

a)

25 gtt/minute

b)

37 gtt/minute

c)

50 gtt/minute

d)

60 gtt/minute

21.

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

a)

0.5 ml

b)

0.75 ml

c)

1 ml

d)

2 ml

22.

How should the nurse prepare an injection for a patient who takes both regular and NPH insulin?

a)

Draw up the NPH insulin, then the regular insulin, in the same syringe.

b)

Draw up the regular insulin, then the NPH insulin, in the same syringe.

c)

Use two separate syringes.

d)

Check with the physician.

23.

A patient has just received 30 mg of codeine by mouth for pain. Five minutes later he vomits. What should the nurse do first?

a)

Call the physician

b)

Remedicate the patient

c)

Observe the emesis

d)

Explain to the patient that she can do nothing to help him.

24.

A patient is catheterized with a #16 indwelling urinary (Foley) catheter to determine if:

a)

Trauma has occurred.

b)

His 24-hour output is inadequate.

c)

He has a urinary tract infection.

d)

Residual urine remains in the bladder after voiding.

25.

A staff nurse who is promoted to assistant nurse manager may feel uncomfortable initially when supervising her former peers. She can best decrease this discomfort by:

a)

Writing down all assignments.

b)

Making changes after evaluating the situation and having discussions with the staff.

c)

Telling the staff nurses that she is making changes to benefit their performance.

d)

Evaluating the clinical performance of each staff nurse in a private conference.

26.

Nurse Clarisse is teaching a patient about a newly prescribed drug. What could cause a geriatric patient to have difficulty retaining knowledge about prescribed medications?

a)

Decreased plasma drug levels

b)

Sensory deficits

c)

Lack of family support

d)

History of Tourette syndrome

27.

When examining a patient with abdominal pain the nurse in charge should assess:

a)

Any quadrant first

b)

The symptomatic quadrant first

c)

The symptomatic quadrant last

d)

The symptomatic quadrant either second or third

28.

The nurse is assessing a postoperative adult patient. Which of the following should the nurse document as subjective data?

a)

Vital signs

b)

Laboratory test result

c)

Patient’s description of pain

d)

Electrocardiographic (ECG) waveforms

29.

A male patient has a soft wrist-safety device. Which assessment finding should the nurse consider abnormal?

a)

A palpable radial pulse

b)

A palpable ulnar pulse

c)

Cool, pale fingers

d)

Pink nail beds

30.

Which of the following planes divides the body longitudinally into anterior and posterior regions?

a)

Frontal plane

b)

Sagittal plane

c)

Midsagittal plane

d)

Transverse plane

31.

A female patient with a terminal illness is in denial. Indicators of denial include:

a)

Shock dismay

b)

Numbness

c)

Stoicism

d)

Preparatory grief

32.

The nurse in charge is transferring a patient from the bed to a chair. Which action does the nurse take during this patient transfer?

a)

Position the head of the bed flat.

b)

Helps the patient dangle the legs.

c)

Stands behind the patient.

d)

Place the chair facing away from the bed.

33.

A female patient who speaks a little English has emergency gallbladder surgery, during discharge preparation, which nursing action would best help this patient understand wound care instruction?

a)

Asking frequently if the patient understands the instruction.

b)

Asking an interpreter to replay the instructions to the patient.

c)

Writing out the instructions and having a family member read them to the patient.

d)

Demonstrating the procedure and having the patient return the demonstration.

34.

Before administering the evening dose of a prescribed medication, the nurse on the evening shift finds an unlabeled, filled syringe in the patient’s medication drawer. What should the nurse in charge do?

a)

Discard the syringe to avoid a medication error.

b)

Obtain a label for the syringe from the pharmacy.

c)

Use the syringe because it looks like it contains the same medication the nurse was prepared to give.

d)

Call the day nurse to verify the contents of the syringe.

35.

When administering drug therapy to a male geriatric patient, the nurse must stay especially alert for adverse effects. Which factor makes geriatric patients have adverse drug effects?

a)

Faster drug clearance

b)

Aging-related physiological changes

c)

Increased amount of neurons

d)

Enhanced blood flow to the GI tract

36.

A female patient is being discharged after cataract surgery. After providing medication teaching, the nurse asks the patient to repeat the instructions. The nurse is performing which professional role?

a)

Manager

b)

Educator

c)

Caregiver

d)

Patient advocate

37.

A female patient exhibits signs of heightened anxiety. Which response by the nurse is most likely to reduce the patient’s anxiety?

a)

Everything will be fine. Don’t worry.

b)

Read this manual and then ask me any questions you may have.

c)

Why don’t you listen to the radio?

d)

Let’s talk about what’s bothering you.

38.

A scrub nurse in the operating room has which responsibility?

a)

Positioning the patient

b)

Assisting with gowning and gloving

c)

Handling surgical instruments to the surgeon

d)

Applying surgical drapes

39.

A patient is in the bathroom when the nurse enters to give a prescribed medication. What should the nurse in charge do?

a)

Leave the medication at the patient’s bedside.

b)

Tell the patient to be sure to take the medication. And then leave it at the bedside.

c)

Return shortly to the patient’s room and remain there until the patient takes the medication.

d)

Wait for the patient to return to bed, and then leave the medication at the bedside.

40.

The physician orders heparin, 7,500 units, to be administered subcutaneously every 6 hours. The vial reads 10,000 units per milliliter. The nurse should anticipate giving how much heparin for each dose?

a)

¼ ml

b)

½ ml

c)

¾ ml

d)

1 ¼ ml

41.

The nurse in charge measures a patient’s temperature at 102 degrees F. what is the equivalent Centigrade temperature?

a)

39 degrees C

b)

47 degrees C

c)

38.9 degrees C

d)

40.1 degrees C

42.

To evaluate a patient for hypoxia, the physician is most likely to order which laboratory test?

a)

Red blood cell count

b)

Sputum culture

c)

Total hemoglobin

d)

Arterial blood gas (ABG) analysis

43.

The nurse uses a stethoscope to auscultate a male patient’s chest. Which statement about a stethoscope with a bell and diaphragm is true?

a)

The bell detects high-pitched sounds best.

b)

The diaphragm detects high-pitched sounds best.

c)

The bell detects thrills best.

d)

diaphragm detects low-pitched sounds best.

44.

A male patient is to be discharged with a prescription for an analgesic that is a controlled substance. During discharge teaching, the nurse should explain that the patient must fill this prescription how soon after the date on which it was written?

a)

Within 1 month

b)

Within 3 months

c)

Within 6 months

d)

Within 12 months

45.

Which human element considered by the nurse in charge during assessment can affect drug administration?

a)

The patient’s ability to recover

b)

The patient’s occupational hazards

c)

The patient’s socioeconomic status

d)

The patient’s cognitive abilities

46.

An employer establishes a physical exercise area in the workplace and encourages all employees to use it. This is an example of which level of health promotion?

a)

Primary prevention

b)

Secondary prevention

c)

Tertiary prevention

d)

Passive prevention

47.

What does the nurse in charge do when making a surgical bed?

a)

Leaves the bed in the high position when finished.

b)

Place the pillow at the head of the bed.

c)

Rolls the patient to the far side of the bed.

d)

Tucks the top sheet and blanket under the bottom of the bed.

48.

The physician prescribes 250 mg of a drug. The drug vial reads 500 mg/ml. How much of the drug should the nurse give?

a)

2 ml

b)

1 ml

c)

½ ml

d)

¼ ml

49.

Nurse Mackey is monitoring a patient for adverse reactions during barbiturate therapy. What is the major disadvantage of barbiturate use?

a)

Prolonged half-life

b)

Poor absorption

c)

Potential for drug dependence

d)

Potential for hepatotoxicity

50.

Which nursing action is essential when providing continuous enteral feeding?

a)

Elevating the head of the bed.

b)

Positioning the patient on the left side.

c)

Warming the formula before administering it.

d)

Hanging a full day’s worth of formula at one time.

51.

When teaching a female patient how to take a sublingual tablet, the nurse should instruct the patient to place the table on the:

a)

Top of the tongue

b)

Roof of the mouth

c)

Floor of the mouth

d)

Inside of the cheek

52.

Which action by the nurse in charge is essential when cleaning the area around a Jackson-Pratt wound drain?

a)

Cleaning from the center outward in a circular motion.

b)

Removing the drain before cleaning the skin.

c)

Cleaning briskly around the site with alcohol.

d)

Wearing sterile gloves and a mask.

53.

The doctor orders dextrose 5% in water, 1,000 ml to be infused over 8 hours. The I.V. tubing delivers 15 drops per milliliter. The nurse in charge should run the I.V. infusion at a rate of:

a)

15 drop per minute

b)

21 drop per minute

c)

32 drop per minute

d)

125 drops per minute

54.

A female patient undergoes a total abdominal hysterectomy. When assessing the patient 10 hours later, the nurse identifies which finding as an early sign of shock?

a)

Restlessness

b)

Pale, warm, dry skin

c)

Heart rate of 110 beats/minute

d)

Urine output of 30 ml/hour

55.

Which pulse should the nurse palpate during rapid assessment of an unconscious male adult?

a)

Radial

b)

Brachial

c)

Femoral

d)

Carotid

56.

Clients should be taught that repeatedly ignoring the sensation of needing to defecate could result in which of the following?

a)

Constipation

b)

Diarrhea

c)

Incontinence

d)

Hemorrhoids

57.

Which statement provides evidence that an older adult who is prone to constipation is in need of further teaching?

a)

I need to drink one and a half to 2 quarts of liquid each day.

b)

I need to take a laxative such as milk of magnesia or if I don't have a BM every day.

c)

If my bowel pattern changes on its own, I should call you.

d)

Eating my meals at regular times is likely to result in regular bowel movements.

58.

A client is scheduled for a colonoscopy. The nurse will provide information to the client about which type of enema?

a)
Oil retention
b)

Return flow

c)

High large volume

d)

Low, small volume

59.

The nurse is most likely to report which finding to the primary care provider for a client who has an established colostomy?

a)

The stoma extends 1/2 inch above the abdomen.

b)

The skin under the appliance looks red briefly after removing the appliance.

c)

The stoma color is a deep red purple.

d)

An ascending colostomy just delivers liquid feces.

60.

Which goal is the most appropriate for clients with diarrhea related to ingestion of an antibiotic for an upper respiratory infection?

a)

The client will wear a medical alert bracelet for antibiotic allergy.

b)

The client will return to his or her previous fecal elimination pattern.

c)

The client verbalizes the need to take an antidiarrheal medication PRN.

d)

The client will increase intake of insoluble fiber such as grains, rice, and cereals.

61.

A client with a new stoma who has not had a bowel movement since surgery last week reports feeling nauseous. What is the appropriate nursing action?

a)

Prepare to irrigate the colostomy.

b)

After assessing the stoma and surrounding skin, notify the surgeon.

c)

Assess bowel sounds and administer antiemetic.

d)

Administer a bulk forming laxative, and encourage increased fluids and exercise.

62.

The nurse assesses a client’s abdomen several days after abdominal surgery. It is firm, distended, and painful to palpate. The client reports feeling “bloated”. The nurse consults with the surgeon, who orders an enema. The nurse prepares to give what kind of enema?

a)

Soapsuds

b)

Retention

c)

Return flow

d)

Oil retention

63.

Which of the following is most likely to validate that a client is experiencing intestinal bleeding?

a)

Large quantities of fat mixed with pale yellow liquid stool

b)

Brown, formed stool

c)

Semi soft tar colored stools

d)

Narrow, pencil shaped stool

64.

Which nursing diagnosis is/are most applicable to a client with fecal incontinence? Select all that apply.

a)

Bowel incontinence

b)

Risk for deficient fluid volume

c)

Disturbed body image

d)

Social isolation

e)

Risk for impaired skin integrity

65.

A nurse determines that a fracture bedpan should be used for the patient who:

a)

Has a spinal cord injury

b)

Is on bedrest

c)

Has dementia

d)

Is obese

66.

A patient with the diagnosis of diverticulosis is advised to eat a diet high in fiber. What should the nurse recommend that the patient eat to best increase the bulk and fecal material?

a)

Whole wheat bread

b)

White rice

c)

Pasta

d)

Kale

67.

Which statement by a patient with an ileostomy alerts the nurse to the need for further education?

a)

I don't expect to have much of a problem with fecal odor.

b)

I will have to take special precaution to protect my skin around the stoma.

c)

I'm going to have to irrigate my stoma so I have a bowel movement every morning.

d)

I should avoid gas forming foods like beans to limit funny noises from the stoma.

68.

A practitioner orders a return flow enema (Harris flush drip) for an adult patient with flatulence. When preparing to administer this enema the nurse compares the steps of a return flow enema with cleansing enemas. What should the nurse do that is unique to a return flow enema?

a)

Lubricate the last 2 inches of the rectal tube.

b)

Insert the rectal tube about 4 inches into the anus.

c)

Raise the solution container about 12 inches above the anus.

d)

Lower the solution container after instilling about 150 mL of solution.

69.

A nurse discourages a patient from straining excessively when attempting to have a bowel movement. What physiological response primarily may be prevented by avoiding straining on defecation?

a)

Vasovagal response

b)

Increased peristalsis

c)

Dehydration

d)

Electrolyte imbalance

70.

A nurse is caring for a client who will perform fecal occult blood testing at home. Which of the following information should the nurse include when explaining the procedure to the client?

a)

Eating more protein is optimal prior to testing.

b)

One stool specimen is sufficient for testing.

c)

A red color changes indicates a positive test.

d)

The specimen cannot be contaminated with urine.

71.

A nurse is talking with a client who reports constipation. When the nurse discusses dietary changes that can help prevent constipation, which of the following foods should the nurse recommend?

a)

Macaroni and cheese

b)

Fresh fruit and whole-wheat toast

c)

Rice pudding and ripe bananas

d)

Roast chicken and white rice

72.

A nurse is caring for a client who has diarrhea for the past four days. When assessing a client, the nurse should expect which of the following findings? Select all that apply.

a)

Bradycardia

b)

Hypotension

c)

Fever

d)

Poor skin turgor

e)

Peripheral edema

73.

A nurse is preparing to administer a cleansing enema to an adult client in preparation for a diagnostic procedure. Which of the following are appropriate steps for the nurse to take? Select all that apply.

a)

Warm the enema solution prior to installation.

b)

Position the client on the left side with the right leg flexed forward.

c)

Lubricate the rectal tube or nozzle.

d)

Slowly insert the rectal tube about 2 inches.

e)

Hang the enema container 24 inches above the clients anus.

74.

While a nurse is administering a cleansing enema, the client reports abdominal cramping. Which of the following is the appropriate intervention?

a)

Have a client hold his breath briefly.

b)

Discontinue the fluid installation.

75.

A client with chronic pulmonary disease has a bluish tinge around the lips. The nurse charts which term to most accurately describe the client’s condition?

a)

Hypoxia

b)

Hypoxemia

c)

Dyspnea

d)

Cyanosis