TEST III - Care of Clients with nitroglycerin, Nurse Arthur should
Physiologic and Psychosocial know that it reduces preload and
Alterations relieves angina by:
a. Increasing contractility
1. Nurse Michelle should know that the and slowing heart rate.
drainage is normal 4 days after a b. Increasing AV conduction and
sigmoid colostomy when the stool is: heart rate.
a. Green liquid c. Decreasing contractility
b. Solid formed and oxygen consumption.
c. Loose, bloody d. Decreasing venous
d. Semiformed return through
vasodilation.
2. Where would nurse Kristine place
the call light for a male client with a 5. Nurse Patricia finds a female client
right-sided brain attack and left who is post- myocardial infarction
homonymous hemianopsia? (MI) slumped on the side rails of
a. On the client’s right side the bed and unresponsive to
b. On the client’s left side shaking or shouting. Which is the
c. Directly in front of the client nurse next action?
d. Where the client like a. Call for help and note the
time.
3. A male client is admitted to the b. Clear the airway
emergency department following an c. Give two sharp thumps
accident. What are the first nursing to the precordium, and
actions of the nurse? check the pulse.
a. Check respiration, d. Administer two quick blows.
circulation,
neurological response.
b. Align the spine, check pupils,
and check for hemorrhage.
c. Check respirations, stabilize
spine, and check circulation.
d. Assess level of
consciousness and
circulation.
4. In evaluating the effect of
290
,6. Nurse Monett is caring for a client
recovering from gastro-intestinal 9. A client undergone spinal
bleeding. The nurse should: anesthetic, it will be important that
a. Plan care so the client can the nurse immediately position the
receive 8 hours of uninterrupted client in:
sleep each night. a. On the side, to prevent
b. Monitor vital signs every 2 hours. obstruction of airway by
c. Make sure that the client takes tongue.
food and medications at b. Flat on back.
prescribed intervals. c. On the back, with knees
d. Provide milk every 2 to 3 hours. flexed 15 degrees.
d. Flat on the stomach, with
7. A male client was on warfarin the head turned to the
(Coumadin) before admission, and has side.
been receiving heparin I.V. for 2 days.
The partial thromboplastin time (PTT) is 10. While monitoring a male client
68 seconds. What should Nurse Carla several hours after a motor vehicle
do? accident, which assessment data
a. Stop the I.V. infusion of suggest increasing intracranial
heparin and notify the pressure?
physician. a. Blood pressure is
b. Continue treatment as ordered. decreased from 160/90 to
c. Expect the warfarin to increase the 110/70.
PTT. b. Pulse is increased from 87 to
d. Increase the dosage, because the 95, with an occasional skipped
level is lower than normal. beat.
c. The client is oriented when
8. A client undergone ileostomy, when aroused from sleep, and
should the drainage appliance be goes back to sleep
applied to the stoma? immediately.
a. 24 hours later, when
edema has subsided.
b. In the operating room.
c. After the ileostomy begin to
function.
d. When the client is able to begin
self-care procedures.
,
, 291
d. The client refuses dinner 14. Marichu was given morphine sulfate for
because of anorexia. pain.
She is sleeping and her respiratory rate
11. Mrs. Cruz, 80 years old is diagnosed is 4
with pneumonia. Which of the breaths/minute. If action isn’t taken
following symptoms may appear quickly, she
first? might have which of the following
a. Altered mental status and reactions?
dehydration a. Asthma attack
b. Fever and chills b. Respiratory arrest
c. Hemoptysis and Dyspnea c. Seizure
d. Pleuritic chest pain and cough d. Wake up on his own
12. A male client has active tuberculosis 15. A 77-year-old male client is admitted
(TB). Which of the following for elective knee surgery. Physical
symptoms will be exhibit? examination reveals shallow
a. Chest and lower back pain respirations but no sign of respiratory
b. Chills, fever, night distress. Which of the following is a
sweats, and hemoptysis normal physiologic change related to
c. Fever of more than 104°F aging?
(40°C) and nausea a. Increased elastic recoil of the
d. Headache and photophobia lungs
b. Increased number of
13. Mark, a 7-year-old client is brought to functional capillaries in
the emergency department. He’s the alveoli
tachypneic and afebrile and has a c. Decreased residual volume
respiratory rate of 36 breaths/minute d. Decreased vital capacity
and has a nonproductive cough. He
recently had a cold. Form this history;
the client may have which of the
following conditions?
a. Acute asthma
b. Bronchial pneumonia
c. Chronic obstructive
pulmonary disease (COPD)
d. Emphysema
Physiologic and Psychosocial know that it reduces preload and
Alterations relieves angina by:
a. Increasing contractility
1. Nurse Michelle should know that the and slowing heart rate.
drainage is normal 4 days after a b. Increasing AV conduction and
sigmoid colostomy when the stool is: heart rate.
a. Green liquid c. Decreasing contractility
b. Solid formed and oxygen consumption.
c. Loose, bloody d. Decreasing venous
d. Semiformed return through
vasodilation.
2. Where would nurse Kristine place
the call light for a male client with a 5. Nurse Patricia finds a female client
right-sided brain attack and left who is post- myocardial infarction
homonymous hemianopsia? (MI) slumped on the side rails of
a. On the client’s right side the bed and unresponsive to
b. On the client’s left side shaking or shouting. Which is the
c. Directly in front of the client nurse next action?
d. Where the client like a. Call for help and note the
time.
3. A male client is admitted to the b. Clear the airway
emergency department following an c. Give two sharp thumps
accident. What are the first nursing to the precordium, and
actions of the nurse? check the pulse.
a. Check respiration, d. Administer two quick blows.
circulation,
neurological response.
b. Align the spine, check pupils,
and check for hemorrhage.
c. Check respirations, stabilize
spine, and check circulation.
d. Assess level of
consciousness and
circulation.
4. In evaluating the effect of
290
,6. Nurse Monett is caring for a client
recovering from gastro-intestinal 9. A client undergone spinal
bleeding. The nurse should: anesthetic, it will be important that
a. Plan care so the client can the nurse immediately position the
receive 8 hours of uninterrupted client in:
sleep each night. a. On the side, to prevent
b. Monitor vital signs every 2 hours. obstruction of airway by
c. Make sure that the client takes tongue.
food and medications at b. Flat on back.
prescribed intervals. c. On the back, with knees
d. Provide milk every 2 to 3 hours. flexed 15 degrees.
d. Flat on the stomach, with
7. A male client was on warfarin the head turned to the
(Coumadin) before admission, and has side.
been receiving heparin I.V. for 2 days.
The partial thromboplastin time (PTT) is 10. While monitoring a male client
68 seconds. What should Nurse Carla several hours after a motor vehicle
do? accident, which assessment data
a. Stop the I.V. infusion of suggest increasing intracranial
heparin and notify the pressure?
physician. a. Blood pressure is
b. Continue treatment as ordered. decreased from 160/90 to
c. Expect the warfarin to increase the 110/70.
PTT. b. Pulse is increased from 87 to
d. Increase the dosage, because the 95, with an occasional skipped
level is lower than normal. beat.
c. The client is oriented when
8. A client undergone ileostomy, when aroused from sleep, and
should the drainage appliance be goes back to sleep
applied to the stoma? immediately.
a. 24 hours later, when
edema has subsided.
b. In the operating room.
c. After the ileostomy begin to
function.
d. When the client is able to begin
self-care procedures.
,
, 291
d. The client refuses dinner 14. Marichu was given morphine sulfate for
because of anorexia. pain.
She is sleeping and her respiratory rate
11. Mrs. Cruz, 80 years old is diagnosed is 4
with pneumonia. Which of the breaths/minute. If action isn’t taken
following symptoms may appear quickly, she
first? might have which of the following
a. Altered mental status and reactions?
dehydration a. Asthma attack
b. Fever and chills b. Respiratory arrest
c. Hemoptysis and Dyspnea c. Seizure
d. Pleuritic chest pain and cough d. Wake up on his own
12. A male client has active tuberculosis 15. A 77-year-old male client is admitted
(TB). Which of the following for elective knee surgery. Physical
symptoms will be exhibit? examination reveals shallow
a. Chest and lower back pain respirations but no sign of respiratory
b. Chills, fever, night distress. Which of the following is a
sweats, and hemoptysis normal physiologic change related to
c. Fever of more than 104°F aging?
(40°C) and nausea a. Increased elastic recoil of the
d. Headache and photophobia lungs
b. Increased number of
13. Mark, a 7-year-old client is brought to functional capillaries in
the emergency department. He’s the alveoli
tachypneic and afebrile and has a c. Decreased residual volume
respiratory rate of 36 breaths/minute d. Decreased vital capacity
and has a nonproductive cough. He
recently had a cold. Form this history;
the client may have which of the
following conditions?
a. Acute asthma
b. Bronchial pneumonia
c. Chronic obstructive
pulmonary disease (COPD)
d. Emphysema
