NSG EXAM 3 question and answers
What phase of the nursing process is the
B nurse in when he determines a medication
is effective and documents this in the
patient's
record?
A) Analysis
B) Evaluation
C) Assessment
D) Data collection
,11. A
patient admitted with right leg D
thrombophlebitis is to be discharged from
an acute-care facility. The nurse notes that
the patient's leg is pain-free, without
redness or edema. Which step of the
nursing process does this reflect?
A) Assessment
B)Analysis
C) Implementation
D) Evaluation
. The nurse, in collaboration with the C
patient's family, is assigning priorities related
to the care of the patient. The nurse
explains that when setting priorities it is
important to look at the urgency of
specific problems.
What provides the best framework for
prioritizing patient problems?
A) Availability of hospital resources
B) Family member statements
C) Maslow's hierarchy of needs
D) Nursing skill
Before making a nursing diagnosis, what C
must a nurse do?
C) Collect and analyze data
1. A
n understanding of the pathophysiologic
B rationale behind shock is something
every
nurse needs to have. Which of the following
statements best describes the
pathophysiology for shock?
A) Blood is shunted from vital organs
to peripheral areas of the body.
B) Cells lack an adequate blood supply and
are deprived of oxygen and nutrients.
C) Circulating blood volume is decreased.
D) Hemorrhage occurs as a result of trauma.
2. Y
ou are assessing your patient. When A
prioritizing the patient's care, you recognize
that your patient is at risk for
hypovolemic shock when
A) fluid circulating in the blood
vessels decreases.
B) cardiac output is increased.
C) blood pressure increases.
D) pulse is fast and bounding
,3.You are admitting a patient with a D
diagnosis of a gastrointestinal bleed who is
in the compensatory stage of shock.
You know that an early sign that
accompanies initial shock is what?
A) Increased urine output
B) Decreased heart rate
C) Hyperactive bowel sounds
D) Cool, clammy skin
4.You are caring for a patient in liver failure
A who is exhibiting signs and symptoms of
hypovolemic shock. You anticipate that
the physician will order the
administration of a crystalloid for the
management of this
patient. Which crystalloid fluid is
most commonly used to treat
hypovolemic shock?
A) Lactated Ringer's
B)Albumin
C) Dextran
D) 3% NaCl
5.A patient is receiving dopamine, a
B vasoactive drug used for shock, to
increase
her stroke volume. What should the
nurse be aware of when monitoring a
vasoactive drug?
A) The drug should be discontinued
immediately after blood pressure increases.
B)The drug dose should be weaned
down prior to discontinuing.
C) The drug may cause respiratory alkalosis.
D) The drug reduces oxygen demands
of the heart.
6.A nurse in the ICU receives report from
B the nurse in the emergency department
about a new patient being admitted with a
neck injury he received while diving into
a lake. The emergency-department
nurse reports that his blood pressure is
85/54,
heart rate is 53 beats per minute, and
his skin is warm and dry. What does the
ICU
nurse recognize that that patient is probably
experiencing?
A) Anaphylactic shock
B) Neurogenic shock
C) Septic shock
D) Hypovolemic shock
, 8.You are transferring a patient who is in B
the progressive stage of shock into ICU
from your medical-surgical unit. You are
aware
that the shock affects many organ
systems and that nursing management of
the patient will focus on what?
A) Reviewing the cause of shock and
trying to limit the progression
B)Assessing and understanding shock
and the significant changes in
assessment data to guide the plan of
care
C) Giving the prescribed treatment but
shifting focus to providing family time as
the patient is unlikely to survive
D) Giving progressive care to the patient
and family using critical pathways for
shock therapy
9.When caring for a patient in shock, one D
of the major nursing goals is to reduce
the risk that the patient will develop
complications
from shock. What does this require the
nurse to do?
A) Provide an accurate diagnosis, plan of
care, and appropriate interventions to
allow the patient the best chance for
survival
B) Keep the physician updated with the
most accurate information; in shock
the nurse is often powerless to
help.
C) Monitor for significant changes and
evaluate patient outcomes on a scheduled
basis focusing on blood pressure and
skin temperature
D) Understand the underlying
mechanisms of shock, recognize the
subtle and more
obvious signs, and then provide
rapid assessment and response
What phase of the nursing process is the
B nurse in when he determines a medication
is effective and documents this in the
patient's
record?
A) Analysis
B) Evaluation
C) Assessment
D) Data collection
,11. A
patient admitted with right leg D
thrombophlebitis is to be discharged from
an acute-care facility. The nurse notes that
the patient's leg is pain-free, without
redness or edema. Which step of the
nursing process does this reflect?
A) Assessment
B)Analysis
C) Implementation
D) Evaluation
. The nurse, in collaboration with the C
patient's family, is assigning priorities related
to the care of the patient. The nurse
explains that when setting priorities it is
important to look at the urgency of
specific problems.
What provides the best framework for
prioritizing patient problems?
A) Availability of hospital resources
B) Family member statements
C) Maslow's hierarchy of needs
D) Nursing skill
Before making a nursing diagnosis, what C
must a nurse do?
C) Collect and analyze data
1. A
n understanding of the pathophysiologic
B rationale behind shock is something
every
nurse needs to have. Which of the following
statements best describes the
pathophysiology for shock?
A) Blood is shunted from vital organs
to peripheral areas of the body.
B) Cells lack an adequate blood supply and
are deprived of oxygen and nutrients.
C) Circulating blood volume is decreased.
D) Hemorrhage occurs as a result of trauma.
2. Y
ou are assessing your patient. When A
prioritizing the patient's care, you recognize
that your patient is at risk for
hypovolemic shock when
A) fluid circulating in the blood
vessels decreases.
B) cardiac output is increased.
C) blood pressure increases.
D) pulse is fast and bounding
,3.You are admitting a patient with a D
diagnosis of a gastrointestinal bleed who is
in the compensatory stage of shock.
You know that an early sign that
accompanies initial shock is what?
A) Increased urine output
B) Decreased heart rate
C) Hyperactive bowel sounds
D) Cool, clammy skin
4.You are caring for a patient in liver failure
A who is exhibiting signs and symptoms of
hypovolemic shock. You anticipate that
the physician will order the
administration of a crystalloid for the
management of this
patient. Which crystalloid fluid is
most commonly used to treat
hypovolemic shock?
A) Lactated Ringer's
B)Albumin
C) Dextran
D) 3% NaCl
5.A patient is receiving dopamine, a
B vasoactive drug used for shock, to
increase
her stroke volume. What should the
nurse be aware of when monitoring a
vasoactive drug?
A) The drug should be discontinued
immediately after blood pressure increases.
B)The drug dose should be weaned
down prior to discontinuing.
C) The drug may cause respiratory alkalosis.
D) The drug reduces oxygen demands
of the heart.
6.A nurse in the ICU receives report from
B the nurse in the emergency department
about a new patient being admitted with a
neck injury he received while diving into
a lake. The emergency-department
nurse reports that his blood pressure is
85/54,
heart rate is 53 beats per minute, and
his skin is warm and dry. What does the
ICU
nurse recognize that that patient is probably
experiencing?
A) Anaphylactic shock
B) Neurogenic shock
C) Septic shock
D) Hypovolemic shock
, 8.You are transferring a patient who is in B
the progressive stage of shock into ICU
from your medical-surgical unit. You are
aware
that the shock affects many organ
systems and that nursing management of
the patient will focus on what?
A) Reviewing the cause of shock and
trying to limit the progression
B)Assessing and understanding shock
and the significant changes in
assessment data to guide the plan of
care
C) Giving the prescribed treatment but
shifting focus to providing family time as
the patient is unlikely to survive
D) Giving progressive care to the patient
and family using critical pathways for
shock therapy
9.When caring for a patient in shock, one D
of the major nursing goals is to reduce
the risk that the patient will develop
complications
from shock. What does this require the
nurse to do?
A) Provide an accurate diagnosis, plan of
care, and appropriate interventions to
allow the patient the best chance for
survival
B) Keep the physician updated with the
most accurate information; in shock
the nurse is often powerless to
help.
C) Monitor for significant changes and
evaluate patient outcomes on a scheduled
basis focusing on blood pressure and
skin temperature
D) Understand the underlying
mechanisms of shock, recognize the
subtle and more
obvious signs, and then provide
rapid assessment and response