NURS 403 REVIEW FINAL EXAM

NURS 403 REVIEW FINAL EXAM NURS 403/2020 PRIMERA PARTE NURS 403/2020 1. A community health nurse in a pediatric clinic is reviewing the history of a 12-year-old client. Which of the following immunizations should the nurse expect to administer? A. Meningococcal conjugate B. Herpes Zoster C. Rotavirus D. Pneumococcal polysaccharide 2. Nurse is preparing a community health program for adults at risk for cardiovascular disease. Which of the following should the nurse include as a modifiable risk factor? A. Diagnosis of diabetes Miletus B. Family history of cardiac disease C. Increase age D. Cigarette smoking 3. An occupational health nurse in the clinic of an industrial plant is developing a guidebook for clinic workers. Which of the following actions should the nurse include as a secondary prevention strategy? A. Teach plant workers about proper lifting techniques B. Set up an influenza immunization campaign C. Help plant workers identify signs of carpal tunnel syndrome D. Collaborate with physical therapists to develop program for injured employees to return to work 4. A school nurse receives a call that some children and teachers report being exposed to an undetermined noxious gas odor presenting in the classrooms and are experiencing dizziness. Which of the following actions should the nurse take? A. Have students evacuated from the school and establish a triage area in the school parking lot. B. Move individual who are reporting symptoms to one of the affected classrooms and create a triage area inside C. Arrange for children transportation to the nearest emergency department and the group triage will occur there. D. Transport all children and school personnel to the nearest medical facility school busses 5. The nurse is participating in a biological disaster simulation where citizens are exposed to pneumonic plague. Which of the following interventions should the nurse plan to use while caring for these clients? A. Initiate airborne precaution B. Administer an antitoxin C. Initiate droplet precautions D. Destroy the lines after use 6. A nurse is among the first responders to a mass-casualty incident and does not know what type of personal protection equipment (PPE) is needed. Which of the following actions should the nurse take? A. Wait until the type of equipment needed is known B. Decontaminate victims before intervening C. Choose the highest level of protection equipment available. D. Use a dosimeter to measure the level of radiation in the area before intervening 7. A charge nurse is making a room assignment for a client who has scabies. In which of the following rooms should the nurse place the client? A. A negative pressure isolation room B. A semiprivate room with a client who has pediculosis capitis C. A positive pressure isolation room D. A private room. 8. A nurse is performing triage for a group of clients following a mass casualty incident (MCI). Which of the following clients should the nurse plan to care for first? A. A client experiencing a tension pneumothorax B. A client who has a closed upper extremity fracture C. A client who has full thickness burns over 80% of this body D. A client who has agonal respirations 9. a nurse is helping to triage a group of clients at a mass casualty incident who were involved in an explosion at a local factory. Which of the following clients should the nurse tag to be the priority for care? A. A client who has severe head injury respiratory rate 6/min and unresponsive B. A client who has a simple fracture of the femur, multiple scratches on both legs, and crying hysterically C. A client who has a piece of wood punctured into the chest wall and has an audible hissing sound coming from the wound site. D. A female who is pregnant at 20 weeks of gestation has multiple cuts and abrasions and is walking around 10. A nurse is triaging victims of a multiple motor-vehicle crash. The nurse assesses a client trapped under a car who is apneic and has a weak pulse at 120/min. After repositioning his upper airway, the client remains apneic. Which of the following actions should the nurse take? A. Start CPR B. Place a red tag on the client’s upper body and attempt to help the next client in need C. Place a black tag on the client’s upper body and attempt to help the next client in need. D. Reposition the client upper airway a second time before assessing his respirations 11. A nurse is reviewing the guidelines for reporting nationally notifiable infectious diseases. Which of the following diseases should the nurse plan to report to the Centers for Disease Control and Prevention (CDC)? A. Lyme disease B. Cytomegalovirus C. Streptococcus pharyngitis D. Toxoplasmosis 12. A community health nurse is reviewing the levels of disease prevention. Which of the following activities is an example of tertiary prevention? A. Providing treatment for clients who have chronic obstructive pulmonary disease. B. Performing screening for sexually transmitted infections C. Administering influenza immunizations at local health fair D. Testing new nurses for exposure to TB 13. A charge nurse is discussing staff nurses’ responsibilities in preplanning for response to a disaster. Which of the following responsibilities should the nurse include in the discussion? A. Identify community resources that are available. B. Evaluate the impact of a disaster on the community C. Asses survivors of a disaster for level of psychological stress D. Link victims with support agencies to help with food clothing shelter and counseling needs 14. A nurse is reviewing treatment protocols for clients exposed to bioterrorism agents. For which of the following agents should the nurse plan to administer a vaccine following exposure? A. Anthrax B. Botulism C. Plague D. Smallpox 15. A nurse is providing staff education about smallpox as a bioterrorism threat. Which of the following statements indicates an understanding of this agent? (Select all that apply) A. Smallpox is transmitted person to person B. Infection is characterized by severe respiratory distress C. Smallpox vaccination ensures lifelog immunity D. Naturally occurring smallpox has been eradicated from the world. E. Smallpox is often confused with varicella. 16. A nurse is preparing to care for a client who has suspected exposure to plague as a result of bites from infected fleas. Which of the following actions should the nurse plan to take first? A. Prepare for drainage of lesions B. Initiate contact precautions. C. Notify the CDC control and preventions D. Decontaminate the client 17. A nurse is reinforcing teaching with a group of adolescent females who are pregnant about expected changes related to pregnancy. Which of the following client statements indicates understanding of the teaching? A. It is normal to have a white vaginal discharge. B. I should recognize fetal movement by 12 weeks C. I will take fluid pills if my ankles begin to swell D. My nipples and areolae will become pale as my breast enlarge 18. A nurse is preparing to administer ciprofloxacin to a client. The nurse identify that the medication is treated for exposure to which of the following agents? A. Smallpox B. Sarin gas C. Ebola virus D. Antrax 19. A nurse is caring for a client who suspects recent exposure to inhalation anthrax. Which of the following findings indicate possible exposure? A. Flu-like symptoms. B. Sloughing of skin C. Vesicles on the skin D. Respiratory failure 20. A nurse is reviewing information about the Health Insurance Portability and Accountability Act (HIPAA) with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates a need for further teaching? A. Information about a client can be disclosed to family members at any time. B. HIPAA established regulations of individually identifiable health information in verbal electronic or written form C. A client address would be an example of personally identifiable information D. HIPAA is a federal law not a state low 21. A nurse is preparing to perform hand hygiene. Which of the following actions should the nurse take? A. Adjust the water temperature to feel hot B. Apply 4 to 5 ml of liquid soap to the hands. C. Hold the hands higher than to the elbows D. Rub hands and arm to dry 22. A nurse is preparing to administer three liquid medications to a client who has an NG feeding tube with continuous enteral feeding. Which of the following actions should the nurse take? A. Mix the three medications together prior to administering B. Dilute each medication with 10 ML of tap water C. Maintain the head of the bed in a flat position for 30 min following medications administration D. Flush the NG feeding tube with 30 ml of water immediately following medication administration. 23.- a nurse is administering nasal decongestant drops for a client. Which of the following actions should the nurse take? A. Tell the client to blow her nose gently before the instillation. B. Assistant the client to a side lying position C. Hold the dropper 2 cm (1in) above the naris D. Instruct the client to say in the same position for 2 min 24.- A nurse is performing tracheostomy care for a client and suctioning to remove copious secretions. Which of the following actions should the nurse take? A. Suction two to three times with a 60-second pause between passes. B. Perform chest physiotherapy prior to suctioning C. Lubricate the suction catheter tip with sterile saline D. Hyperventilate the client on 100% oxygen prior to suctioning 25.- The newly licensed nurse is applying prescribed wrist restraints on a client. Which of the following action should the nurse take? A. Secure the restraints using a quick-release tie. B. Ensure four fingers fit under the restraints to prevent constriction C. Secure the restraints to the lowest bar of the side rail D. Anticipate removing the restraints every 4 hours 26.- A nurse is preparing a client for outpatient surgery. After the nurse inserts the IV catheter, the client reports pain in the insertion area. Which of the following actions should the nurse take? A. Remove the catheter and insert another into a different site. B. Administer an analgesic PO C. Request a prescription for placement of a central venous access device D. Administer local anesthetic 27.- A client smoking in his bathroom has dropped a cigarette butt into a wastepaper basket, which begins to smolder. Which of the following actions is the nurse`s priority? A. Close the fire doors on the unit B. Activate the alarm C. Remove any client in the immediate vicinity D. Use the fire extinguisher to put out the fire 28. A nurse is caring for a client who refuses treatment and asks to be discharged from the hospital against medical advice. The nurse notifies the client’s provider, who tells the nurse to restrain the client. If necessary, to keep her from leaving the hospital. The nurse understands that restraining this client would be considered which type of civil action by the nurse? A. Invasion of privacy B. Assault C. Battery D. False imprisonment 29.- A nurse is inserting an IV catheter for an older client in preparation for an outpatient procedure. Which of the following veins should the nurse select? A. Dorsal metacarpal vein B. Radial vein in the wrist C. Antecubital vein D. Median vein in the forearm. 30. A nurse is providing oral care for a client who is immobile. Which of the following actions should the nurse take? A. Use a stiff toothbrush to clean the client teeth B. Use the thumb and index to keep the client mouth open C. Turn the client on his side before starting oral care D. Apply petroleum jelly to the client lips after oral care 31. A nurse is caring for a client who has a prescription for a stool test for guaiac. The nurse understands the purpose of the test is to check the stool for which of the following substances? A. Steatorrhea B. Blood C. Bacteria D. Parasites 32.- A nurse is instructing a client who has a new diagnosis of Raynaud`s disease about preventing the onset of manifestations. Which of the following client statements should indicate to the nurse the need for additional teaching? A. I will wear gloves when removing food from the freezer B. I will try anticipating and avoid stressful situation when possible C. I will complete the smoking cessation program I started D. I will take my medications at the first sign of an attack. 33.- A nurse is caring for a client who experienced a lacerated spleen and has been on bedrest for several days. The nurse auscultates decreased breath sounds in the lower lobes of both lungs. The nurse should realize that this finding is most likely an indication of which of the following conditions. A. An upper respiratory infection B. Pulmonary edema C. Atelectasis. D. Hypertension and crackles 34. The nurse is assessing a client and discovers the infusion pump with the client’s total parenteral nutrition (TPN) solution is infusing. The nurse should monitor the client for which of the following conditions? A. Excessive thirst and urination B. Shakiness and diaphoresis C. Fever and chills D. Hypertension and crackles 35. A nurse is caring for four clients who have drainage tubes. Which of the following clients should the nurse recognize as being at risk for hypokalemia? A. The client who has a tracheostomy tube attached to humidified oxygen B. The client who has an indwelling urinary catheter to gravity drainage C. The client who has a chest tube to water seal D. The client who has a nasogastric (NG) tube to suction. 36.- A nurse is caring for a client who has an indwelling unitary catheter and notes blood-tinged urine in the catheter bag. The nurse recognizes this finding can be a manifestation of which of the following urinary alterations? A. Pernicious anemia B. Dehydration C. Prostate enlargement D. Bladder infection 37.- A nurse is assessing a client`s cranial nerves as part of a neurological examination. Which of the following actions should the nurse take to assess cranial nerve III? A. Testing visual acuity B. Observing for facial symmetry C. Eliciting the gag reflex D. checking the pupillary response to light. 38.- A nurse is caring for a client who has had an allogeneic hematopoietic stem-cell transplant. Which of the following infection-control precautions should the nurse use while caring for this client? A. Airborne B. Protective. C. Contact D. Droplet 39.- An assistive personnel (AP) reports a client`s vital signs as tympanic Temperature 37.1º C (98.8º F), pulse 92/min, respiratory rate 18/min, and BP 98/58 mm Hg. Which of the following vital signs should the nurse re-measure? A. BP B. Respiratory rate C. Pulse rate D. temperature 40. A nurse accidentally administers the wrong medication to a client, which results in a severe allergic reaction and prolongs the client’s hospitalization. The client could rightfully sue the nurse for which of the following? A. Battery B. Assault C. Malpractice. D. Abuse 41. A nurse is caring for an older adult client who states, “I am afraid that I may fall white walking to the bathroom during the night.” Which of the following actions should the nurse take? A. Limit the client fluid intake in the evening B. Obtain a bedside commode for the client use C. Leave a nightlight on the client’s room. D. Put the side rails up and tell the client to call the nurse before voiding 42.- A nurse is working with a licensed practical nurse (LPN) to care for a client who is receiving a continuous IV infusion. Which of the following findings reported by the LPN indicated to the nurse the client has phlebitis at the IV insertion side? A. The infusion rate has stopped but the tubing is not kinked B. The area surrounding the insertion site feels warm to the touch. C. There is fluid leaking around the insertion site D. There is not blood return when the tubbing is aspirated 43.- A nurse in the emergency department is caring for a client who collapsed after playing football on a hot day. After reviewing the admission laboratory findings, the nurse recognizes are consistent with which of the following conditions? Sodium 152 mEq/L, Potassium 3.6 mEq/L, Chloride 105 mEq/L, Glucose 102 mg/dL BUN 18 mg/dL, Creatinine 0.7mg/dL A. Renal failure B. Low protein C. Dehydration. D. SIADH 44.- A nurse at an extended- care facility is instructing a class assistive personnel (AP) about client use of assistive devises during ambulation. Which of the following instruction should the nurse give the AP about the clients` use of a cane? A. When the client moves, he should move the cane forward first. B. The client should hold the cane on the strong side of his body C. The grip should be level with the client waist D. The client should first move the strong leg then the weak one 45. The nurse is caring for a client who has active pulmonary tuberculosis (TB). The client requires airborne precautions and is receiving multidrug therapy. Which of the following precautions should the nurse take to transport the client safety to the radiology department for a chest x-ray? A. Ask the X ray technician to come to the client’s room to obtain a portable x ray B. Have the client wear a mask C. Notify the x ray department that the client requires airborne precautions D. Wear a filtration mask and gloves during transport 46. A nurse is assisting with transferring a client from the bed to wheelchair. Which of the following actions should the nurse take? A. Place the wheelchair at 90 grade angles to the bed B. Lock the wheels of the bed and the wheelchair. C. Acquire the help of several people to lift the client D. Elevate the bed to a position of comfort to the nurse MIDTER PIC FROM AM National Prevention Strategy targets intervention in multiple setting to move the health of the populations from A. Poor to rich B. Wellness to health C. Shift from sickness to prevention D. Sadness to happiness Rational: Called for under the Patient Protection and Affordable Care Act Developed by National Prevention Council Four Strategic Directions: 1. Building healthy and safe community environments 2. Expanding quality preventive services in both clinical and community settings 3. Empowering people to make healthy choices 4. Eliminating health disparities To understand the causes of health and disease, epidemiology studies: a. Individuals b. Families c. Groups d. Populations a nurse is teaching a client diagnosed with gonorrhea how to prevent reinfection and further spread. Which of the following describes the action taken by the nurse? Primary prevention Secondary promotion Tertiary prevention Secondary prevention Secondary prevention focuses on early detection and prompt treatment of disease, injury, or disability. Primary prevention refers to those interventions aimed at focuses on chronic care and rehabilitation, Primary health care refers to the first line of care provided to patients typically by a physician or other health care provider. PHNs utilize registries to identify children with delayed or missing immunizations. They subsequently follow up with families by phone calls or home visits. Which of the following levels of practice is being implemented? Policy Systems Individual Community A nurse who is involved in identifying individuals with unrecognized health risk factors or asymptomatic disease is using which intervention? a. Screening b. Referral and follow-up c. Surveillance d. Health teaching The factors, exposures, characteristics, and behaviors that determine patterns of disease are described using: a. descriptive epidemiology. b. analytic epidemiology. c. distribution. d. determinants. Determinants are the factors, exposures, characteristics, and behaviors that determine patterns of disease, which may be individual, relational, social, communal, or environmental. Descriptive epidemiology seeks to describe the occurrence of a disease in terms of person, place, and time. Analytic epidemiology focuses on the investigation of causes and associations. Distribution describes who has the disease and where and when the disease occurs. A client is receiving PHC services. Which of the following expectations would the client have? a. The care would be provided by a physician. b. Private insurance would be necessary to receive care. c. The emphasis of care provided would be on prevention. d. A referral would be made to a specialist after receiving services. The focus of PHC is a broad range of services that are designed to be affordable for the recipients of the care and the governments who provide them. The emphasis of care is on prevention and the means of providing the care is based on practical, scientifically sound, culturally ap-propriate, and socially acceptable methods. All clients can receive PHC services regardless of insurance status. Those receiving primary care services may or may not need referral to a specialist. which of the following is an example of public health agency. Federal Bureau of Investigation (FBI) Drug enforcement administration (DEA) Women, Infants and children (WIC) Medical Center clinics (MCC) the public health care functions are directly linked to the healthcare promotion and prevention levels. The tertiary levels is characterized by The services are designed to treat disease in acute stage The service are designed to limit the progression of the disease or disability The function is to detect and treat disease is early stage Meets the basic needs of health people A school nurse is teaching a group of nurses newly hired to work in the school system about pedi information is appropriate to include in the teaching? Nits that are shed into the environment are capable of hatching for up to 10 days Infestation often appears as grayish brown threadlike burrow along the skin behind the ears Family pets can contribute to the transmission of lice Children from lower socioeconomic areas are more likely to have lice. 1.A community health nurse in a pediatric clinic is reviewing the history of a 12-year-old client. Which of the following immunizations should the nurse expect to administer? a.Meningococcal conjugate 2. Nurse is preparing a community health program for adults at risk for cardiovascular disease. Which of the following should the nurse include as a modifiable risk factor? d. Cigarette smoking 3. An occupational health nurse in the clinic of an industrial plant is developing a guidebook for clinic workers. Which of the following actions should the nurse include as a secondary prevention strategy? c. Help plant workers identify signs of carpal tunnel syndrome 4. A school nurse receives a call that some children and teachers report being exposed to an undetermined noxious gas odor presenting in the classrooms and are experiencing dizziness. Which of the following actions should the nurse take? a. Have students evacuated from the school and establish a triage area in the school parking lot. 5. The nurse is participating in a biological disaster simulation where citizens are exposed to pneumonic plague. Which of the following interventions should the nurse plan to use while caring for these clients? c. Initiate droplet precautions 6. A nurse is among the first responders to a mass-casualty incident and does not know what type of personal protection equipment (PPE) is needed. Which of the following actions should the nurse take? c. Choose the highest level of protection equipment available. 7. A charge nurse is making a room assignment for a client who has scabies. In which of the following rooms should the nurse place the client? d. A private room. 8. A nurse is performing triage for a group of clients following a mass casualty incident (MCI). Which of the following clients should the nurse plan to care for first? a. A client experiencing a tension pneumothorax 9. a nurse is helping to triage a group of clients at a mass casualty incident who were involved in an explosion at a local factory. Which of the following clients should the nurse tag to be the priority for care? c. A client who has a piece of wood punctured into the chest wall and has an audible hissing sound coming from the wound site. 10. A nurse is triaging victims of a multiple motor-vehicle crash. The nurse assesses a client trapped under a car who is apneic and has a weak pulse at 120/min. After repositioning his upper airway, the client remains apneic. Which of the following actions should the nurse take? c. Place a black tag on the client’s upper body and attempt to help the next client in need. 11. A nurse is reviewing the guidelines for reporting nationally notifiable infectious diseases. Which of the following diseases should the nurse plan to report to the Centers for Disease Control and Prevention (CDC)? a. Lyme disease 12. A community health nurse is reviewing the levels of disease prevention. Which of the following activities is an example of tertiary prevention? a. Providing treatment for clients who have chronic obstructive pulmonary disease. 13. A charge nurse is discussing staff nurses’ responsibilities in preplanning for response to a disaster. Which of the following responsibilities should the nurse include in the discussion? a. Identify community resources that are available. 14. A nurse is reviewing treatment protocols for clients exposed to bioterrorism agents. For which of the following agents should the nurse plan to administer a vaccine following exposure? d. Smallpox 15. A nurse is providing staff education about smallpox as a bioterrorism threat. Which of the following statements indicates an understanding of this agent? (Select all that apply) a. Smallpox is transmitted person to person d. Naturally occurring smallpox has been eradicated from the world. E. Smallpox is often confused with varicella. 16. A nurse is preparing to care for a client who has suspected exposure to plague as a result of bites from infected fleas. Which of the following actions should the nurse plan to take first? b. Initiate contact precautions. 17. A nurse is reinforcing teaching with a group of adolescent females who are pregnant about expected changes related to pregnancy. Which of the following client statements indicates understanding of the teaching? a. It is normal to have a white vaginal discharge. 18. A nurse is preparing to administer ciprofloxacin to a client. The nurse identify that the medication is treated for exposure to which of the following agents? d. Antrax 19. A nurse is caring for a client who suspects recent exposure to inhalation anthrax. Which of the following findings indicate possible exposure? a. Flu-like symptoms. 20. A nurse is reviewing information about the Health Insurance Portability and Accountability Act (HIPAA) with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates a need for further teaching? a. Information about a client can be disclosed to family members at any time. 21. A nurse is preparing to perform hand hygiene. Which of the following actions should the nurse take? B.- Apply 4 to 5 ml of liquid soap to the hands. 22. A nurse is preparing to administer three liquid medications to a client who has an NG feeding tube with continuous enteral feeding. Which of the following actions should the nurse take? D.- Flush the NG feeding tube with 30 ml of water immediately following medication administration. 23.- a nurse is administering nasal decongestant drops for a client. Which of the following actions should the nurse take? A.- Tell the client to blow her nose gently before the instillation. 24.- A nurse is performing tracheostomy care for a client and suctioning to remove copious secretions. Which of the following actions should the nurse take? A.- Suction two to three times with a 60-second pause between passes. 25.- The newly licensed nurse is applying prescribed wrist restraints on a client. Which of the following action should the nurse take? a. Secure the restraints using a quick-release tie. 26.- A nurse is preparing a client for outpatient surgery. After the nurse inserts the IV catheter, the client reports pain in the insertion area. Which of the following actions should the nurse take? B.- Remove the catheter and insert another into a different site. 27.- A client smoking in his bathroom has dropped a cigarette butt into a wastepaper basket, which begins to smolder. Which of the following actions is the nurse`s priority? a.Move any clients in the immediate vicinity 28. A nurse is caring for a client who refuses treatment and asks to be discharged from the hospital against medical advice. The nurse notifies the client’s provider, who tells the nurse to restrain the client. If necessary, to keep her from leaving the hospital. The nurse understands that restraining this client would be considered which type of civil action by the nurse? d. False imprisonment 29.- A nurse is inserting an IV catheter for an older client in preparation for an outpatient procedure. Which of the following veins should the nurse select?