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Summative Test

Total questions: 50

Worksheet time: 25mins

Name
Class
Date
1.

The nurse is caring for a patient who describes changes in his voiding patterns. The patient states, I feel the urge to empty my bladder several times an hour and when the urge hits me I have to get to the restroom quickly. But when I empty my bladder, there doesnt seem to be a great deal of urine flow. What would the nurse expect this patients physical assessment to reveal?

a)

Hematuria

b)

Urine Retention

c)

Dehydration

d)

Renal Failure

2.

The nurse is caring for a patient with a nursing diagnosis of deficient fluid volume. The nurses assessment reveals a BP of 98/52 mm Hg. The nurse should recognize that the patients kidneys will compensate by secreting what substance?

a)

ADH

b)

Aldosterone

c)

Renin

d)

Angiotensin

3.

A patient with elevated BUN and creatinine values has been referred by her primary physician for further evaluation. The nurse should anticipate the use of what initial diagnostic test?

a)

Ultrasound

b)

Xray

c)

Computed Tomography

d)

NUclear Scan

4.

A patient is complaining of genitourinary pain shortly after returning to the unit from a scheduled cystoscopy. What intervention should the nurse perform?

a)

Encourage Mobilization

b)

Apply Topical Lidocaine to he patiens Meatus as ordered

c)

Apply moist heat to the patients lower abdomen

d)

apply an ice pack to the patients perineum

5.

Diagnostic testing of an adult patient reveals renal glycosuria. The nurse should recognize the need for the patient to be assessed for what health problem?

a)

Diabetes Insipidus

b)

SIADH

c)

Diabetes Mellitus

d)

Renal Carcinoma

6.

Jennylyn Abad, 40 years old woman, has a history of Rheumatoid Arthritis for the last ten years. The following refer to this situation.Which of the following is common sign/symptom of rheumatoid arthritis?

a)

A. Presence of crepitus over joints

b)

B. Symptoms aggravated by humidity

c)

C. Deformity and displacement of proximal joints

d)

D. Presence of Heberden’s nodes

7.

Jennylyn Abad, 40 years old woman, has a history of Rheumatoid Arthritis for the last ten years. The following refer to this situation. Which of the following would NOT be a common laboratory findings in rheumatoid arthritis?

a)

A. Low hemoglobin

b)

B. Positive RA factor

c)

C. Positive Lupus Erythematosus (LE) prep

d)

D. Increase white blood count

8.

Situation – Jennylyn Abad, 40 years old woman, has a history of Rheumatoid Arthritis for the last ten years. The following refer to this situation. Jennylyn has been taking steroids for the last five years to control her arthritis. Which of the following is

a common side effects of steroid therapy?

a)

A. Hyponatremia

b)

B. Hyperkalemia

c)

C. Increase blood glucose

d)

D. Protein anabolism

9.

Jennylyn Abad, 40 years old woman, has a history of Rheumatoid Arthritis for the last ten years. The following refer to this situation.Which of the following diet is best suited to decrease the side effects of Jennylyn’s steroid therapy?

a)

A. Normal carbohydrate, high protein, high potassium

b)

B. Low carbohydrate, high protein, high potassium

c)

C. Low carbohydrate, high protein, low potassium

d)

D. High carbohydrate, low protein, low potassium

10.

Jennylyn was on Ibuprofen which has been stopped when the steroid therapy was started. Which was the main reason for stopping the Ibuprofen once the steroid therapy was started?

a)

A. The two drugs taken together increase the risk of GI bleeding

b)

B. The Ibuprofen would interfere with the action of the steroid

c)

C. The Ibuprofen was not needed with the steroid

d)

D. The two drugs together would cause severe liver damage

11.

Which of the following is NOT considered a conservative treatment for inflammatory conditions of the shoulder?

a)

A. Non-steroid Anti-inflammatory Drugs

b)

B. Intermittent ice and heat application to the joint

c)

C. Laser photo-therapy

d)

D. Resting of the extremity

12.

Impaired movement of the rotator cuff of the shoulder is generally termed as Impingement Syndrome.

Edema, which is an early manifestation of this syndrome, is due to _______

a)

A. acute trauma of the shoulder

b)

B. muscle spasm

c)

C. hemorrhage of the structures involved

d)

D. atrophy due to disuse

13.

 For a persistent shoulder pain and weakness, this usual treatment modality performed is _______.

a)

A. Pulse-magnetic field

b)

B. Laser photo-therapy

c)

C. Radio-frequency ablation

d)

D. Arthroscopic Synovectomy

14.

One of the most common foot problems is Callus. This condition precedes the formation of a Callus

_____

a)

A. External pressure on the foot

b)

B. Faulty foot mechanics

c)

C. Flexion deformity of the interphalangeal joint

d)

D. Penetrating nail plate in the surrounding skin of the foot

15.

Ramon, 6 years old has been recently diagnosed to have Acute Lymphocytic

leukemia. The child has undergone chemotherapy, however the father is witnessing before

his very eyes his first child dying, the father is very much depressed. In what way will the nurse handle the situation?

a)

A. Tell her to trust in God's love and mercy.

b)

B. Tell her that death is a reality.

c)

C. Encourage her to keep calm because the healthcare team is doing their best to help

Ramon recover.

d)

D. Encourage the mother to express more about her thoughts and feelings.

16.

Ramon, 6 years old has been recently diagnosed to have Acute Lymphocytic

leukemia. The child has undergone chemotherapy, however the father is witnessing before

his very eyes his first child dying, the father is very much depressed. This appropriate nursing diagnosis to protect the patient from further injury is,

which of the following?

a)

A. Altered mucous membrane related to chemotherapy.

b)

B. Interrupted family processes related to life threatening illness of a family member.

c)

C. Fatigue related to disease process

d)

D. Risk for injury related to thrombocytopenia.

17.

The concept of Reproductive Health is introduced as early as primary and

secondary levels with different degrees of concentration. Students, interested to continue

health courses were asking questions on human sexuality. Nurse Hailey discusses the 2020 National Health Goals. Which of the following

statements is an EXCEPTION in planning sexual health programs?

a)

A. Make sexual educations program voluntary

b)

B. Increase the proportion of adolescents who have never engaged in sexual intercourse

c)

C. Reduce deaths from cancer resulting from uterine myomas

d)

D. Reduce deaths from cancer of the uterine cervix

18.

Crisostomo a 40 y/o employee has been complaining of difficult painful

urination for almost a week now. He said he saw some fresh blood in his urine but was

afraid to see a physician, instead, he went to his neighbor who is a herbalist. After a

week his condition worsened and his wife brought him to a community clinic. A community clinic does primary care for patients. Most often the one who manages this

is which of the following?

a)

A. Physician

b)

B. Barangay Health Worker

c)

C. Nurse

d)

D. Midwife

19.

Patient Lola, a 53 y/o mother of 5, has been having involuntary urine leaks

aggravated whenever she sneezes or cough. She is diagnosed with urinary incontinence. The type of incontinence patient Lola manifest, where there is involuntary loss of

urine as a result of sneezing, coughing or even change in position is called ______.

a)

A. overflow

b)

B. reflex

c)

C. Stress

d)

D. functional

20.

The nurse is aware that urinary incontinence brings about psychosocial cost, including

the following except _______.

a)

A. increase expenses

b)

B. social isolation

c)

C. embarrassment

d)

D. loss of self-esteem

21.

The nurse instructs the patients that the BEST time for an incontinent patient to take

his diuretics is _______.

a)

A. Any time of the day

b)

B. After 4pm

c)

C. In the morning

d)

D. At bedtime

22.

When providing health teaching to the patient with urinary incontinence, the nurse

must STRESS that it is _______.

a)

A. Only surgery can alleviate the condition

b)

B. Often reversible and treatable

c)

C. treatable with drugs all the time

d)

D. controlled with the aid of alcohol

23.

The aim of pelvic muscle exercise for patient with urinary incontinence is to

strengthen the muscle that control the _________.

a)

A. vagina and rectum

b)

B. perineal area

c)

C. bowel and bladder

d)

D. vagina and urethra

24.

Elmo, 69 y/o, is diagnosed with Benign Prostatic Hyperplasia (BPH). The Nurse anticipates that the sign and symptoms of BPH do NOT include_______.

a)

A. Frequency in Urination

b)

B. Pain on urination

c)

C. Dribbling urine

d)

D. Hesitancy in starting urination

25.

What “IMMIDIATE” danger should the nurse anticipate post Transurethral Resection of

the Prostate?

a)

A. Infection

b)

B. Bleeding

c)

C. Thrombosis

d)

D. Shock

26.

A patient was prescribed an oral antibiotic for the treatment of sinusitis. The patient has now stopped, stating she developed a rash shortly after taking the first dose of the drug. What is the nurses most appropriate response?

a)

Encourage the woman to continue with the medication while monitoring her skin condition closely.

b)

Refer the woman to her primary care provider to have the medication changed.

c)

Arrange for the woman to go to the nearest emergency department.

d)

Encourage the woman to take an OTC antihistamine with each dose of the antibiotic.

27.

A patient has sought care, stating that she developed hives overnight. The nurses inspection confirms the presence of urticaria. What type of allergic hypersensitivity reaction has the patient developed?

a)

Type I

b)

Type II

c)

Type III

d)

Type IV

28.

The nurse is providing care for a patient who has a diagnosis of hereditary angioedema. When planning this patients care, what nursing diagnosis should be prioritized?

a)

Risk for Infection Related to Skin Sloughing

b)

Risk for Acute Pain Related to Loss of Skin Integrity

c)

Risk for Impaired Skin Integrity Related to Cutaneous Lesions

d)

Risk for Impaired Gas Exchange Related to Airway Obstruction

29.

A junior nursing student is having an observation day in the operating room. Early in the day, the student tells the OR nurse that her eyes are swelling and she is having trouble breathing. What should the nurse suspect?

a)

Cytotoxic reaction due to contact with the powder in the gloves

b)

Immune complex reaction due to contact with anesthetic gases

c)

Anaphylaxis due to a latex allergy

d)

Delayed reaction due to exposure to cleaning products

30.

A nurse is caring for a patient who has allergic rhinitis. What intervention would be most likely to help the patient meet the goal of improved breathing pattern?

a)

Teach the patient to take deep breaths and cough frequently.

b)

Use antihistamines daily throughout the year.

c)

Teach the patient to seek medical attention at the first sign of an allergic reaction.

d)

Modify the environment to reduce the severity of allergic symptoms.

31.

The nurse is creating a care plan for a patient suffering from allergic rhinitis. Which of the following outcomes should the nurse identify?

a)

Appropriate use of prophylactic antibiotics

b)

Safe injection of corticosteroids

c)

Improved skin integrity

d)

Improved coping with lifestyle modifications

32.

A 5-year-old boy has been diagnosed with a severe food allergy. What is an important parameter to address when educating the parents of this child about his allergy and care?

a)

Wear a medical identification bracelet.

b)

Know how to use the antihistamine pen.

c)

Know how to give injections of lidocaine.

d)

Avoid live attenuated vaccinations.

33.

A patient is brought to the emergency department (ED) in a state of anaphylaxis. What is the ED nurses priority for care?

a)

Monitor the patients level of consciousness.

b)

Protect the patients airway.

c)

Provide psychosocial support.

d)

Administer medications as ordered.

34.

A patient is undergoing diagnostic testing to determine the etiology of recent joint pain. The patient asks the nurse about the difference between osteoarthritis (OA) and rheumatoid arthritis (RA). What is the best response by the nurse?

a)

OA is a considered a noninflammatory joint disease. RA is characterized by inflamed, swollen joints.

b)

OA and RA are very similar. OA affects the smaller joints such as the fingers, and RA affects the larger, weight-bearing joints like the knees.

c)

OA originates with an infection. RA is a result of your bodys cells attacking one another.

d)

OA is associated with impaired immune function; RA is a consequence of physical damage.

35.

Allopurinol (Zyloprim) has been ordered for a patient receiving treatment for gout. The nurse caring for this patient knows to assess the patient for bone marrow suppression, which may be manifested by which of the following diagnostic findings?

a)

Hyperuricemia

b)

Increased erythrocyte sedimentation rate

c)

Elevated serum creatinine

d)

Decreased platelets

36.

A patient with polymyositisis experiencing challenges with activities of daily living as a result of proximal muscle weakness. What is the most appropriate nursing action?

a)

Initiate a program of passive range of motion exercises

b)

Facilitate referrals to occupational and physical therapy

c)

Administer skeletal muscle relaxants as ordered

d)

Encourage a progressive program of weight-bearing exercise

37.

A nurse is creating a teaching plan for a patient who has a recent diagnosis of scleroderma. What topics should the nurse address during health education? Select all that apply.

a)

Surgical treatment options

b)

The importance of weight loss

c)

Managing Raynauds-type symptoms

d)

Smoking cessation

e)

The importance of vigilant skin care

38.

An older adult patient has come to the clinic for a regular check-up. The nurses initial inspection reveals an increased thoracic curvature of the patients spine. The nurse should document the presence of which of the following?

a)

Scoliosis

b)

Epiphyses

c)

Lordosis

d)

Kyphosis

39.

A bone biopsy has just been completed on a patient with suspected bone metastases. What assessment should the nurse prioritize in the immediate recovery period?

a)

Assessment for dehiscence at the biopsy site

b)

Assessment for pain

c)

Assessment for hematoma formation

d)

Assessment for infection

40.

 nurse is taking a health history on a new patient who has been experiencing unexplained paresthesia. What question should guide the nurses assessment of the patients altered sensations?

a)

How does the strength in the affected extremity compare to the strength in the unaffected extremity?

b)

Does the color in the affected extremity match the color in the unaffected extremity?

c)

How does the feeling in the affected extremity compare with the feeling in the unaffected extremity?

d)

Does the patient have a family history of paresthesia or other forms of altered sensation?

41.

The nurses musculoskeletal assessment of a patient reveals involuntary twitching of muscle groups. How would the nurse document this observation in the patients chart?

a)

Tetany

b)

Atony

c)

Clonus

d)

Fasciculations

42.

A patient has been experiencing progressive increases in knee pain and diagnostic imaging reveals a worsening effusion in the synovial capsule. The nurse should anticipate which of the following?

a)

Arthrography

b)

Knee biopsy

c)

Arthrocentesis

d)

Electromyography

43.

A patient with renal failure secondary to diabetic nephropathy has been admitted to the medical unit. What is the most life-threatening effect of renal failure for which the nurse should monitor the patient?

a)

Accumulation of wastes

b)

Retention of potassium

c)

Depletion of calcium

d)

Lack of BP control

44.

A patient admitted to the medical unit with impaired renal function is complaining of severe, stabbing pain in the flank and lower abdomen. The patient is being assessed for renal calculi. The nurse recognizes that the stone is most likely in what anatomic location?

a)

Meatus

b)

Bladder

c)

Ureter

d)

Urethra

45.

1. The nurse explains that the primary function of the thymus gland is to:

a)

A. Produce antibodies

b)

B. Mature T lymphocytes

c)

C. Store B lymphocytes

d)

D. Filter foreign particles from the blood

46.

2. A patient is scheduled for serum IgE testing. The nurse understands that this diagnostic test is MOST useful in identifying:

a)

A. Autoimmune disorders

b)

B. Allergic responses

c)

C. Primary immune deficiencies

d)

D. Acquired infections

47.

A newborn presents with recurrent infections, chronic diarrhea, and failure to thrive. These manifestations are MOST consistent with:

a)

A. Selective IgA deficiency

b)

B. Severe Combined Immune Deficiency (SCID)

c)

C. Chronic granulomatous disease

d)

D. Wiskott–Aldrich Syndrome

48.

A nurse caring for a patient with HIV identifies progression from HIV infection to AIDS when:

a)

A. CD4 count is < 500/mm³

b)

B. CD4 count is < 200/mm³

c)

C. Viral load becomes undetectable

d)

D. ELISA test is reactive

49.

A client who develops erythema, vesicles, and intense itching on the hands after using latex gloves MOST likely has:

a)

A. Irritant dermatitis

b)

B. Contact dermatitis

c)

C. Latex anaphylaxis

d)

D. Hereditary angioedema

50.

The nurse correctly identifies that a positive skin-prick test indicates:

a)

A. Current infection

b)

B. Presence of specific IgE antibodies

c)

C. Autoimmune activity

d)

D. Reduced immune response