GNRS 558: EXAM 2|ACTUAL 180Qs&As WITH
RATIONALES|GRADED A+|AZUSA PACIFIC
UNIVIVESITY
A 53-year-old male patient with deep partial-thickness burns from a chemical
spill in the workplace experiences severe pain followed by nausea during
dressing changes. Which action will be most useful in decreasing the patient's
nausea?
a. Keep the patient NPO for 2 hours before and after dressing changes.
b. Avoid performing dressing changes close to the patient's mealtimes.
c. Administer the prescribed morphine sulfate before dressing changes.
d. Give the ordered prochlorperazine (Compazine) before dressing changes.
ANS: C
Because the patient's nausea is associated with severe pain, it is likely that it is
precipitated by stress and pain. The best treatment will be to provide adequate
pain medication before dressing changes. The nurse should avoid doing
painful procedures close to mealtimes, but nausea/vomiting that occur at
other times also should be addressed. Keeping the patient NPO does not
address the reason for the nausea and vomiting and will have an adverse effect
on the patient's nutrition. Administration of antiemetics is not the best choice
for a patient with nausea caused by pain
Which item should the nurse offer to the patient who is to restart oral intake
after being NPO due to nausea and vomiting?
,a. Glass of orange juice
b. Dish of lemon gelatin
c. Cup of coffee with cream
d. Bowl of hot chicken broth
ANS: B
Clear cool liquids are usually the first foods started after a patient has been
nauseated. Acidic foods such as orange juice, very hot foods, and coffee are
poorly tolerated when patients have been nauseated
A 38-year old woman receiving chemotherapy for breast cancer develops a
Candida albicans oral infection. The nurse will anticipate the need for
a. hydrogen peroxide rinses.
b. the use of antiviral agents.
c. administration of nystatin (Mycostatin) tablets.
d. referral to a dentist for professional tooth cleaning.
ANS: C
Candida albicans is treated with an antifungal such as nystatin. Oral saltwater
rinses may be used but will not cure the infection. Antiviral agents are used for
viral infections such as herpes simplex. Referral to a dentist is indicated for
gingivitis but not for Candida infection
,Which finding in the mouth of a patient who uses smokeless tobacco is
suggestive of oral cancer?
a. Bleeding during tooth brushing
b. Painful blisters at the lip border
c. Red, velvety patches on the buccal mucosa
d. White, curdlike plaques on the posterior tongue
ANS: C
A red, velvety patch suggests erythroplasia, which has a high incidence
(greater than 50%) of progression to squamous cell carcinoma. The other
lesions are suggestive of acute processes (e.g., gingivitis, oral candidiasis,
herpes simplex).
Which information will the nurse include when teaching adults to decrease the
risk for cancers of the tongue and buccal mucosa?
a. Avoid use of cigarettes and smokeless tobacco.
b. Use sunscreen when outside even on cloudy days.
c. Complete antibiotic courses used to treat throat infections.
d. Use antivirals to treat herpes simplex virus (HSV) infections.
ANS: A
Tobacco use greatly increases the risk for oral cancer. Acute throat infections
do not increase the risk for oral cancer, although chronic irritation of the oral
mucosa does increase risk. Sun exposure does not increase the risk for cancers
of the buccal mucosa. Human papillomavirus (HPV) infection is associated
with an increased risk, but HSV infection is not a risk factor for oral cancer
, A 46-year-old female with gastroesophageal reflux disease (GERD) is
experiencing increasing discomfort. Which patient statement indicates that
additional teaching about GERD is needed?
a. "I take antacids between meals and at bedtime each night."
b. "I sleep with the head of the bed elevated on 4-inch blocks."
c. "I eat small meals during the day and have a bedtime snack."
d. "I quit smoking several years ago, but I still chew a lot of gum."
ANS: C
GERD is exacerbated by eating late at night, and the nurse should plan to teach
the patient to avoid eating at bedtime. The other patient actions are
appropriate to control symptoms of GERD
A 68-year-old male patient with a stroke is unconscious and unresponsive to
stimuli. After learning that the patient has a history of gastroesophageal
reflux disease (GERD), the nurse will plan to do frequent assessments of the
patient's
a. apical pulse.
b. bowel sounds.
c. breath sounds.
d. abdominal girth.
ANS: C
Because GERD may cause aspiration, the unconscious patient is at risk for
developing aspiration pneumonia. Bowel sounds, abdominal girth, and apical
pulse will not be affected by the patient's stroke or GERD and do not require
more frequent monitoring than the routine
RATIONALES|GRADED A+|AZUSA PACIFIC
UNIVIVESITY
A 53-year-old male patient with deep partial-thickness burns from a chemical
spill in the workplace experiences severe pain followed by nausea during
dressing changes. Which action will be most useful in decreasing the patient's
nausea?
a. Keep the patient NPO for 2 hours before and after dressing changes.
b. Avoid performing dressing changes close to the patient's mealtimes.
c. Administer the prescribed morphine sulfate before dressing changes.
d. Give the ordered prochlorperazine (Compazine) before dressing changes.
ANS: C
Because the patient's nausea is associated with severe pain, it is likely that it is
precipitated by stress and pain. The best treatment will be to provide adequate
pain medication before dressing changes. The nurse should avoid doing
painful procedures close to mealtimes, but nausea/vomiting that occur at
other times also should be addressed. Keeping the patient NPO does not
address the reason for the nausea and vomiting and will have an adverse effect
on the patient's nutrition. Administration of antiemetics is not the best choice
for a patient with nausea caused by pain
Which item should the nurse offer to the patient who is to restart oral intake
after being NPO due to nausea and vomiting?
,a. Glass of orange juice
b. Dish of lemon gelatin
c. Cup of coffee with cream
d. Bowl of hot chicken broth
ANS: B
Clear cool liquids are usually the first foods started after a patient has been
nauseated. Acidic foods such as orange juice, very hot foods, and coffee are
poorly tolerated when patients have been nauseated
A 38-year old woman receiving chemotherapy for breast cancer develops a
Candida albicans oral infection. The nurse will anticipate the need for
a. hydrogen peroxide rinses.
b. the use of antiviral agents.
c. administration of nystatin (Mycostatin) tablets.
d. referral to a dentist for professional tooth cleaning.
ANS: C
Candida albicans is treated with an antifungal such as nystatin. Oral saltwater
rinses may be used but will not cure the infection. Antiviral agents are used for
viral infections such as herpes simplex. Referral to a dentist is indicated for
gingivitis but not for Candida infection
,Which finding in the mouth of a patient who uses smokeless tobacco is
suggestive of oral cancer?
a. Bleeding during tooth brushing
b. Painful blisters at the lip border
c. Red, velvety patches on the buccal mucosa
d. White, curdlike plaques on the posterior tongue
ANS: C
A red, velvety patch suggests erythroplasia, which has a high incidence
(greater than 50%) of progression to squamous cell carcinoma. The other
lesions are suggestive of acute processes (e.g., gingivitis, oral candidiasis,
herpes simplex).
Which information will the nurse include when teaching adults to decrease the
risk for cancers of the tongue and buccal mucosa?
a. Avoid use of cigarettes and smokeless tobacco.
b. Use sunscreen when outside even on cloudy days.
c. Complete antibiotic courses used to treat throat infections.
d. Use antivirals to treat herpes simplex virus (HSV) infections.
ANS: A
Tobacco use greatly increases the risk for oral cancer. Acute throat infections
do not increase the risk for oral cancer, although chronic irritation of the oral
mucosa does increase risk. Sun exposure does not increase the risk for cancers
of the buccal mucosa. Human papillomavirus (HPV) infection is associated
with an increased risk, but HSV infection is not a risk factor for oral cancer
, A 46-year-old female with gastroesophageal reflux disease (GERD) is
experiencing increasing discomfort. Which patient statement indicates that
additional teaching about GERD is needed?
a. "I take antacids between meals and at bedtime each night."
b. "I sleep with the head of the bed elevated on 4-inch blocks."
c. "I eat small meals during the day and have a bedtime snack."
d. "I quit smoking several years ago, but I still chew a lot of gum."
ANS: C
GERD is exacerbated by eating late at night, and the nurse should plan to teach
the patient to avoid eating at bedtime. The other patient actions are
appropriate to control symptoms of GERD
A 68-year-old male patient with a stroke is unconscious and unresponsive to
stimuli. After learning that the patient has a history of gastroesophageal
reflux disease (GERD), the nurse will plan to do frequent assessments of the
patient's
a. apical pulse.
b. bowel sounds.
c. breath sounds.
d. abdominal girth.
ANS: C
Because GERD may cause aspiration, the unconscious patient is at risk for
developing aspiration pneumonia. Bowel sounds, abdominal girth, and apical
pulse will not be affected by the patient's stroke or GERD and do not require
more frequent monitoring than the routine
