NSG 4100 EXAM 3 LATEST 2026-2027
UPDATE GALEN COLLEGE OF NURSING
|200 QUESTIONS WITH ADDITIONAL
STUDY GUIDE |GRADED A
The nurse is providing care for a pt who has just been admitted to the post surgical unit
following a laryngecotomy. What assessment should the nurse prioritize?
a. the pt's swallowing ability
b. the pt's airway patency
c. the pt's carotid pulses
d. s/s of infection
B
The nurse has noted the emergency of a significant amount of fresh blood at the drain site of
a pt who is postoperative day 1 following total laryngecomy. How should the nurse respond
to this development?
a. remove the pt's drain and apply pressure w/ a sterile gauze
b. assess the pt, reposition the pt supine, and apply wall suction to the drain
c. rapidly assess the pt and notify the surgeon about the pt's bleeding
d. administer a STAT dose of vitamin K to aid coagulation
C
The nurse is creating a care plan for a pt who is status post-total laryngectomy. Much of the
plan consists of a ling-term postoperative communication plan for alaryngeal communication.
What form of alaryngeal communication will likely be chosen?
a. esophageal speech
b. electric larynx
c. tracheoesophageal puncture
d. American sign language (ASL)
C
,The nurse is performing preoperative teaching w/ a pt who has cancer of the larynx. After
completing the pt teaching, what would be most important for the nurse to do?
a. give the pt his/her cell phone number
b. refer pt to a social worker or psychologist
c. provide the pt w/ audiovisual materials about the surgery
d. reassure the pt and family that everything will be alright
C
A pt's total laryngectomy has created a need for alaryngeal speech which will be achieved
through the use of tracheoesophageal puncture. What action should the nurse describe to
the pt when teaching him about this process?
a. training on how to perform controlled bleeding
b. use of an electronically enhanced artificial pahrynx
c. insertion of a specialized nasogastric tube
d. fitting for a voice prosthesis
D
A preoperative nurse is caring for a postop pt. The pt has a shallow respiratory pattern and is
reluctant to cough or to begin mobilizing. The nurse should address the pt's increased risk for
what complication?
a. Acute respiratory distress syndrome (ARDS)
b. atelectasis
c. aspiration
d. pulmonary embolism
B
The nurse caring for a pt w/ and endotracheal tube recognizes several disadvantages of an
endotracheal tube. What would the nurse recognize as a disadvantage?
a. cognition is decreased
b. Daily ABGs are necessary
c. slight tracheal bleeding is anticipated
d. the cough reflex is depressed
D
,What would the critical care nurse recognize as a condition that may indicate a pt's need to
have a tracheotomy?
a. a pt has a respiratory rate of 10 breaths/min
b. a pt required permanent ventilation
c. a pt exhibits sx of dyspnea
d. a pt has respiratory acidosis
B
The nurse is caring for a pt who is scheduled to have a thoracotomy. When planning
preoperative teaching, what info should the nurse communicate to the pt?
a. how to milk the chest tubing
b. how to splint the incision when coughing
c. how to take prophylactic antibiotics correctly
d. how to manage the need for fluid restriction
B
A nurse is educating a pt in anticipation of a procedure that will require a water-sealed chest
drainage system. What should the nurse tell the pt and the family that this drainage system is
used for?
a. maintaining a positive chest-wall pressure
b. monitoring pleural fluid osmolarity
c. providing passive intrathoracic pressure
d. removing excess air and fluid
D
A pt is exhibiting signs of a pneumothorax following tracheostomy. The surgeon inserts a
chest tube into the anterior chest wall. What should the nurse tell the family is the primary
purpose of this chest tube?
a. to remove air from the pleural space
b. to drain copious sputum secretions
c. to monitor bleeding around the lungs
d. to assist with mechanical ventilation
A
, A pt's plan of care specifies postural drainage. What action should the nurse perform when
providing this noninvasive therapy?
a. administer the tx w/ the pt in a high Fowler's or semi-fowlers position
b. perform the procedure immediately following the pt's meals
c. apply percussion firmly to bare skin to facilitate drainage
d. assist the pt into a position that will allow gravity to move secretions
D
While assessing the pt, the nurse observes constant bubbling in the water-seal chamber of
the pt's closed chest-drinagae system. What should the Nurs conclude?
a. the system is functioning normally
b. pt has a pneumothorax
c. system has a leak
d. chest tube is obstructed
C
The nurse has admitted a pt who is scheduled for a thoracic resection. The nurse is providing
preoperative teaching and is discussing several diagnostic studies that will be required prior
to surgery. Which study will be performed to determine whether the panned resection will
leave sufficient functioning lung tissue?
a. pulmonary function studies
b. exercise tolerance tests
c. arterial blood gas values
d. chest x-ray
A
The nurse is discussing activity management w/ a pt who is postoperative following
thoracotomy. What instructions should the nurse give to the pt regarding activity
immediately following discharge?
a. walk 1 mile 3-4x a week
b. use wights daily to increase arm strength
c. walk on a treadmill 30min daily
d. perform shoulder exercises 5x daily
D
UPDATE GALEN COLLEGE OF NURSING
|200 QUESTIONS WITH ADDITIONAL
STUDY GUIDE |GRADED A
The nurse is providing care for a pt who has just been admitted to the post surgical unit
following a laryngecotomy. What assessment should the nurse prioritize?
a. the pt's swallowing ability
b. the pt's airway patency
c. the pt's carotid pulses
d. s/s of infection
B
The nurse has noted the emergency of a significant amount of fresh blood at the drain site of
a pt who is postoperative day 1 following total laryngecomy. How should the nurse respond
to this development?
a. remove the pt's drain and apply pressure w/ a sterile gauze
b. assess the pt, reposition the pt supine, and apply wall suction to the drain
c. rapidly assess the pt and notify the surgeon about the pt's bleeding
d. administer a STAT dose of vitamin K to aid coagulation
C
The nurse is creating a care plan for a pt who is status post-total laryngectomy. Much of the
plan consists of a ling-term postoperative communication plan for alaryngeal communication.
What form of alaryngeal communication will likely be chosen?
a. esophageal speech
b. electric larynx
c. tracheoesophageal puncture
d. American sign language (ASL)
C
,The nurse is performing preoperative teaching w/ a pt who has cancer of the larynx. After
completing the pt teaching, what would be most important for the nurse to do?
a. give the pt his/her cell phone number
b. refer pt to a social worker or psychologist
c. provide the pt w/ audiovisual materials about the surgery
d. reassure the pt and family that everything will be alright
C
A pt's total laryngectomy has created a need for alaryngeal speech which will be achieved
through the use of tracheoesophageal puncture. What action should the nurse describe to
the pt when teaching him about this process?
a. training on how to perform controlled bleeding
b. use of an electronically enhanced artificial pahrynx
c. insertion of a specialized nasogastric tube
d. fitting for a voice prosthesis
D
A preoperative nurse is caring for a postop pt. The pt has a shallow respiratory pattern and is
reluctant to cough or to begin mobilizing. The nurse should address the pt's increased risk for
what complication?
a. Acute respiratory distress syndrome (ARDS)
b. atelectasis
c. aspiration
d. pulmonary embolism
B
The nurse caring for a pt w/ and endotracheal tube recognizes several disadvantages of an
endotracheal tube. What would the nurse recognize as a disadvantage?
a. cognition is decreased
b. Daily ABGs are necessary
c. slight tracheal bleeding is anticipated
d. the cough reflex is depressed
D
,What would the critical care nurse recognize as a condition that may indicate a pt's need to
have a tracheotomy?
a. a pt has a respiratory rate of 10 breaths/min
b. a pt required permanent ventilation
c. a pt exhibits sx of dyspnea
d. a pt has respiratory acidosis
B
The nurse is caring for a pt who is scheduled to have a thoracotomy. When planning
preoperative teaching, what info should the nurse communicate to the pt?
a. how to milk the chest tubing
b. how to splint the incision when coughing
c. how to take prophylactic antibiotics correctly
d. how to manage the need for fluid restriction
B
A nurse is educating a pt in anticipation of a procedure that will require a water-sealed chest
drainage system. What should the nurse tell the pt and the family that this drainage system is
used for?
a. maintaining a positive chest-wall pressure
b. monitoring pleural fluid osmolarity
c. providing passive intrathoracic pressure
d. removing excess air and fluid
D
A pt is exhibiting signs of a pneumothorax following tracheostomy. The surgeon inserts a
chest tube into the anterior chest wall. What should the nurse tell the family is the primary
purpose of this chest tube?
a. to remove air from the pleural space
b. to drain copious sputum secretions
c. to monitor bleeding around the lungs
d. to assist with mechanical ventilation
A
, A pt's plan of care specifies postural drainage. What action should the nurse perform when
providing this noninvasive therapy?
a. administer the tx w/ the pt in a high Fowler's or semi-fowlers position
b. perform the procedure immediately following the pt's meals
c. apply percussion firmly to bare skin to facilitate drainage
d. assist the pt into a position that will allow gravity to move secretions
D
While assessing the pt, the nurse observes constant bubbling in the water-seal chamber of
the pt's closed chest-drinagae system. What should the Nurs conclude?
a. the system is functioning normally
b. pt has a pneumothorax
c. system has a leak
d. chest tube is obstructed
C
The nurse has admitted a pt who is scheduled for a thoracic resection. The nurse is providing
preoperative teaching and is discussing several diagnostic studies that will be required prior
to surgery. Which study will be performed to determine whether the panned resection will
leave sufficient functioning lung tissue?
a. pulmonary function studies
b. exercise tolerance tests
c. arterial blood gas values
d. chest x-ray
A
The nurse is discussing activity management w/ a pt who is postoperative following
thoracotomy. What instructions should the nurse give to the pt regarding activity
immediately following discharge?
a. walk 1 mile 3-4x a week
b. use wights daily to increase arm strength
c. walk on a treadmill 30min daily
d. perform shoulder exercises 5x daily
D
