NURS 370 Practice Questions With Correct
Answers
A |4-year-old |is |brought |to |Emergency |by |his |parents, |who |report |he |swallowed |a |small |toy. |
What |symptom |suggests |complete |airway |obstruction |by |a |foreign |body? |
A. |Gagging
B. |Coughing
C. |Inability |to |speak
D. |Rapid |respirations |- |CORRECT |ANSWER✔✔-C. |Inability |to |speak
The |adult |client |is |newly |admitted |to |the |ward |following |surgery. |Which |assessment |finding |
should |be |the |RN's |priority?
A.The |surgical |site |dressing |has |a |scant |amount |of |bright |red |blood.
B.The |client |is |sleeping |but |easily |arouses |when |touched.
C.The |client's |respirations |are |6 |to |8 |breaths |per |minute.
D.The |client's |blood |pressure |is |100/68 |mm |Hg. |- |CORRECT |ANSWER✔✔-C. |The |client's |
respirations |are |6 |to |8 |breaths |per |minute.
The |nurse |is |caring |for |a |client |who |had |a |total |hip |replacement |four |days |ago. |Which |
assessment |requires |the |nurse's |immediate |attention?
A."I |have |bad |pain |in |my |lower |leg"
B."I |just |can't |'catch |my |breath"
C. |"I |have |to |use |the |bedpan |to |pee |at |least |every |hour."
D. |"The |pain |medication |is |not |working |today." |- |CORRECT |ANSWER✔✔-B. |"I |just |can't |'catch |
my |breath"
,There |has |been |a |train |derailment |and |four |people |are |injured. |Which |patient |should |the |RN |
see |first?
A.Client |who |is |20 |years |of |age |who |has |unequal |pupils |and |is |tachypneic
B.Client |who |is |80 |years |old |complaining |of |a |"racing |heart" |and |has |a |laceration |on |his |arm
C.Client |who |is |10 |years |old |with |a |swollen |wrist
D.Client |who |is |25 |years |old |with |an |open |chest |wall |wound |- |CORRECT |ANSWER✔✔-D. |Client |
who |is |25 |years |old |with |an |open |chest |wall |wound
Because |of |open-chest |wall |wound |= |at |risk |for |pneumothorax |or |hemothorax |= |life-
threatening.
The |client |just |returned |to |the |nursing |unit |following |surgery. |Which |observation |by |the |RN |
requires |the |most |immediate |intervention?
A. |The |client |is |sleepy
B. |The |client |coughed |up |blood-tinged |sputum
C. |Oxygen |saturation |level |is |82%
D. |Jackson-Pratt |wound |drain |is |half |full |- |CORRECT |ANSWER✔✔-C. |Oxygen |saturation |level |is |
82%
At |0730 |hours, |the |oncoming |RN |is |planning |care |for |four |clients. |Which |client |should |the |RN |
plan |to |assess |first?
A.The |23-year-old |client |with |cystic |fibrosis |who |has |pulmonary |function |tests |scheduled |in |ten
|minutes
B.The |35-year-old |client |admitted |the |previous |day |with |bacterial |pneumonia |and |now |has |a |
temperature |of |39.4oC
C.The |46-year-old |client |who |had |a |chest |tube |removed |an |hour |ago |and |now |has |dyspnea
D.The |77-year-old |client |with |tuberculosis |who |has |four |anti-tubercular |medications |due |at |
08:00 |hours |- |CORRECT |ANSWER✔✔-C. |The |46-year-old |client |who |had |a |chest |tube |removed |
an |hour |ago |and |now |has |dyspnea
,What |is |the |purpose |of |the |ABCDE |approach? |- |CORRECT |ANSWER✔✔-To |provide |life-saving |
treatment
To |break |down |complex |clinical |situations |into |more |manageable |parts
To |serve |as |an |assessment |and |treatment |algorithm
To |establish |common |situational |awareness |among |all |treatment |providers
To |buy |time |to |establish |a |final |diagnosis |and |treatment |(identifies |priority |needs |and |guides |
nursing |practice)
Can |be |initiated |without |any |equipment |and |more |advanced |interventions |can |be |applied |on |
arrival |of |emergency |medical |services, |in |a |clinic, |or |at |the |hospital.
Assessments |should |be |repeated |until |the |patient |is |stable, |regularly, |and/or |at |any |sign |of |
deterioration.
What |are |strategies |for |prioritizing |care? |- |CORRECT |ANSWER✔✔-Central |focus |on |
prioritization |of |Client |care:
-Priority |1 |- |life |threatening |illness |(ex: |airway |obstruction, |myocardial |infarction)
-Priority |2 |- |safety |(ex: |of |patient |and |family, |nurse |and |health |professionals)
-Priority |3 |- |client |priorities |(ex: |pain, |nausea)
-Priority |4 |- |nurse |priorities |(ex: |a |nursing |intervention |appropriate |for |the |situation)
What |are |normal/expected |airway |findings? |- |CORRECT |ANSWER✔✔-Patient |responds |in |a |
normal |voice
Regular |and |visible |respirations
What |are |abnormal/unexpected |airway |findings? |- |CORRECT |ANSWER✔✔-Partial |obstruction |=
|voice |changes, |noisy |breathing, |and |increased |breathing |effort
Complete |obstruction |= |there |is |no |respiration |despite |great |effort, |unconscious
What |are |possible |airway |interventions? |List |them. |- |CORRECT |ANSWER✔✔-Head |tilt |and |chin
|tilt |to |open |airway
, Suction |of |the |airways
Removal |of |foreign |bodies
Conscious |- |5 |back |blows |or |5 |abdominal |thrusts
High |oxygen |flow |should |be |given |ASAP
Endotracheal |tube
What |are |normal/expected |breathing |findings? |- |CORRECT |ANSWER✔✔-Respiratory |rate |
appropriate |for |age, |normal |O2Sat
Symmetrical |and |visible |movements |of |the |thoracic
Percussed |unilateral |dullness |or |resonance
What |are |abnormal/unexpected |breathing |findings? |- |CORRECT |ANSWER✔✔-Cyanosis
Distended |neck |veins
Lateralization |of |the |trachea
Tension |pneumothorax |(air |trapped |in |pleural |space)
Bronchospasms
What |are |possible |breathing |interventions? |List |them. |- |CORRECT |ANSWER✔✔-Seat |
comfortably
Rescue |breaths
Tension |pneumothorax |(relieve |immediately |by |inserting |cannula |between |2nd |intercostal |
space |(needle |thoracentesis)
Treat |with |oxygen
Inhalations |of |meds |(ex: |Ventolin)
Assisted |ventilation |(bag |mask |or |intubation)
Elevate |head |of |bed
Answers
A |4-year-old |is |brought |to |Emergency |by |his |parents, |who |report |he |swallowed |a |small |toy. |
What |symptom |suggests |complete |airway |obstruction |by |a |foreign |body? |
A. |Gagging
B. |Coughing
C. |Inability |to |speak
D. |Rapid |respirations |- |CORRECT |ANSWER✔✔-C. |Inability |to |speak
The |adult |client |is |newly |admitted |to |the |ward |following |surgery. |Which |assessment |finding |
should |be |the |RN's |priority?
A.The |surgical |site |dressing |has |a |scant |amount |of |bright |red |blood.
B.The |client |is |sleeping |but |easily |arouses |when |touched.
C.The |client's |respirations |are |6 |to |8 |breaths |per |minute.
D.The |client's |blood |pressure |is |100/68 |mm |Hg. |- |CORRECT |ANSWER✔✔-C. |The |client's |
respirations |are |6 |to |8 |breaths |per |minute.
The |nurse |is |caring |for |a |client |who |had |a |total |hip |replacement |four |days |ago. |Which |
assessment |requires |the |nurse's |immediate |attention?
A."I |have |bad |pain |in |my |lower |leg"
B."I |just |can't |'catch |my |breath"
C. |"I |have |to |use |the |bedpan |to |pee |at |least |every |hour."
D. |"The |pain |medication |is |not |working |today." |- |CORRECT |ANSWER✔✔-B. |"I |just |can't |'catch |
my |breath"
,There |has |been |a |train |derailment |and |four |people |are |injured. |Which |patient |should |the |RN |
see |first?
A.Client |who |is |20 |years |of |age |who |has |unequal |pupils |and |is |tachypneic
B.Client |who |is |80 |years |old |complaining |of |a |"racing |heart" |and |has |a |laceration |on |his |arm
C.Client |who |is |10 |years |old |with |a |swollen |wrist
D.Client |who |is |25 |years |old |with |an |open |chest |wall |wound |- |CORRECT |ANSWER✔✔-D. |Client |
who |is |25 |years |old |with |an |open |chest |wall |wound
Because |of |open-chest |wall |wound |= |at |risk |for |pneumothorax |or |hemothorax |= |life-
threatening.
The |client |just |returned |to |the |nursing |unit |following |surgery. |Which |observation |by |the |RN |
requires |the |most |immediate |intervention?
A. |The |client |is |sleepy
B. |The |client |coughed |up |blood-tinged |sputum
C. |Oxygen |saturation |level |is |82%
D. |Jackson-Pratt |wound |drain |is |half |full |- |CORRECT |ANSWER✔✔-C. |Oxygen |saturation |level |is |
82%
At |0730 |hours, |the |oncoming |RN |is |planning |care |for |four |clients. |Which |client |should |the |RN |
plan |to |assess |first?
A.The |23-year-old |client |with |cystic |fibrosis |who |has |pulmonary |function |tests |scheduled |in |ten
|minutes
B.The |35-year-old |client |admitted |the |previous |day |with |bacterial |pneumonia |and |now |has |a |
temperature |of |39.4oC
C.The |46-year-old |client |who |had |a |chest |tube |removed |an |hour |ago |and |now |has |dyspnea
D.The |77-year-old |client |with |tuberculosis |who |has |four |anti-tubercular |medications |due |at |
08:00 |hours |- |CORRECT |ANSWER✔✔-C. |The |46-year-old |client |who |had |a |chest |tube |removed |
an |hour |ago |and |now |has |dyspnea
,What |is |the |purpose |of |the |ABCDE |approach? |- |CORRECT |ANSWER✔✔-To |provide |life-saving |
treatment
To |break |down |complex |clinical |situations |into |more |manageable |parts
To |serve |as |an |assessment |and |treatment |algorithm
To |establish |common |situational |awareness |among |all |treatment |providers
To |buy |time |to |establish |a |final |diagnosis |and |treatment |(identifies |priority |needs |and |guides |
nursing |practice)
Can |be |initiated |without |any |equipment |and |more |advanced |interventions |can |be |applied |on |
arrival |of |emergency |medical |services, |in |a |clinic, |or |at |the |hospital.
Assessments |should |be |repeated |until |the |patient |is |stable, |regularly, |and/or |at |any |sign |of |
deterioration.
What |are |strategies |for |prioritizing |care? |- |CORRECT |ANSWER✔✔-Central |focus |on |
prioritization |of |Client |care:
-Priority |1 |- |life |threatening |illness |(ex: |airway |obstruction, |myocardial |infarction)
-Priority |2 |- |safety |(ex: |of |patient |and |family, |nurse |and |health |professionals)
-Priority |3 |- |client |priorities |(ex: |pain, |nausea)
-Priority |4 |- |nurse |priorities |(ex: |a |nursing |intervention |appropriate |for |the |situation)
What |are |normal/expected |airway |findings? |- |CORRECT |ANSWER✔✔-Patient |responds |in |a |
normal |voice
Regular |and |visible |respirations
What |are |abnormal/unexpected |airway |findings? |- |CORRECT |ANSWER✔✔-Partial |obstruction |=
|voice |changes, |noisy |breathing, |and |increased |breathing |effort
Complete |obstruction |= |there |is |no |respiration |despite |great |effort, |unconscious
What |are |possible |airway |interventions? |List |them. |- |CORRECT |ANSWER✔✔-Head |tilt |and |chin
|tilt |to |open |airway
, Suction |of |the |airways
Removal |of |foreign |bodies
Conscious |- |5 |back |blows |or |5 |abdominal |thrusts
High |oxygen |flow |should |be |given |ASAP
Endotracheal |tube
What |are |normal/expected |breathing |findings? |- |CORRECT |ANSWER✔✔-Respiratory |rate |
appropriate |for |age, |normal |O2Sat
Symmetrical |and |visible |movements |of |the |thoracic
Percussed |unilateral |dullness |or |resonance
What |are |abnormal/unexpected |breathing |findings? |- |CORRECT |ANSWER✔✔-Cyanosis
Distended |neck |veins
Lateralization |of |the |trachea
Tension |pneumothorax |(air |trapped |in |pleural |space)
Bronchospasms
What |are |possible |breathing |interventions? |List |them. |- |CORRECT |ANSWER✔✔-Seat |
comfortably
Rescue |breaths
Tension |pneumothorax |(relieve |immediately |by |inserting |cannula |between |2nd |intercostal |
space |(needle |thoracentesis)
Treat |with |oxygen
Inhalations |of |meds |(ex: |Ventolin)
Assisted |ventilation |(bag |mask |or |intubation)
Elevate |head |of |bed
