NUR280 PATHO/ Exam Practice Questions with Correct
Detailed Answers/ Latest 2024- Rated A+
The community health nurse is caring for the following clients. It would be a priority for the nurse to
initiate a multidisciplinary conference for the client who is
(a) 12 years old with Autism who is starting a new school and recently had a URI (upper respiratory tract
infection)
(b) 16 years old, has type 1 Diabetes Mellitus, is unemployed and had a recent Hemoglobin A1c of 13%
(c) 52 years old, with Myasthenia Gravis, recently prescribed Mestinon (pyridostigmine) and employed as
a mail carrier
(d) 70 years old, has schizophrenia, lives alone and reports hearing non threatening voices. - ANSWER -
3. B. An adolescent with uncontrolled Diabetes Mellitus would require the greatest number of disciplines
(multidisciplinary) to manage their care i.e. Medicine, Nursing, Social Work, Nutritionist; the other
choices do not require as many providers of care to meet their needs.
The nurse in a well baby clinic has assessed several children today. It would be a priority for the nurse to
suggest follow up for the child who is
(a) 2 months old with a positive babinski reflex
(b) 5 months old and does not hold their own bottle
(c) 10 months old who cries around strangers
(d) 18 months old who needs support while ambulating - ANSWER - 5. D. A child experiencing normal
growth and development should be ambulating independently by 12 months; the Babinski reflex
disappears after 2 years of age; an infant typically holds their own bottle by 6 months; stranger anxiety
usually develops at approximately 7 months
The nurse is caring for a mechanically ventilated client who was declared brain dead. An Advance
Directive is not documented on the medical record. It would be most appropriate to obtain consent for
organ donation from the
(a) client's primary care provider
pg. 1
,(b) client's nurse manager
(c) closest living family member
(d) hospital's ethics committee - ANSWER - 6. C. Consent for organ donation is given by a client's next of
kin in the absence of an Advance Directive
The nurse is assessing a child with coarctation of the aorta. Which of the following would be an
expected finding?
(a) diminished blood pressure in the upper extremities
(b) excessive weight gain
(c) high pitched murmur
(d) absence of femoral pulses - ANSWER - D. Coarctation of the aorta is characterized by narrowing of
the aorta. As a result of this narrowing, absent femoral pulses, poor weight gain and increased blood
pressure in the upper extremities are expected findings. A high pitched murmur is not present.
Physiological Integrity; Physiological Adaptation
The nurse is caring for a child with an acyanotic heart defect. Which of the following would be an
expected finding. Select all that apply.
(a) poor suck reflex
(b)tachycardia
(c) increased respiratory rate
(d) bradycardia
(e) fainting spells
(f) delayed growth and development - ANSWER - B, C, and F. Children experiencing acyanotic defects
may experience tachycardia, tachypnea and delay in growth and development; poor suck reflex,
bradycardia, and fainting spells are indicative of cyanotic defects. Physiological Integrity; Physiological
Adaptation
The nurse is teaching a new mother about immunizations. Which of the following should the nurse
include in the teaching?
(a) "Your baby should wait six months to receive any immunizations since the baby was born preterm."
(b) "Your baby will receive the first hepatitis B vaccine after one year of age."
(c) "Acellular Pertussis vaccine has less side effects than whole-cell pertussis vaccine."
pg. 2
,(d) The Haemophilus Influenza Type b (HIB) is given annually to protect against the flu." - ANSWER - C.
Safety data from several studies show that acellular pertussis vaccine cause fewer adverse reactions than
whole-cell vaccines. Pre term infants generally do not wait 6 months before beginning vaccinations; the
first Hepatitis B vaccine is given at birth; the Haemophilus influenzae type b (HIB) is given at 2 months, 4
months, and 6 months and between 12 - 15 months. Health Promotion and Maintenance
The mother of an infant tells the nurse that the baby has not been tolerating feedings lately and she
noticed an olive-shaped mass in the infant's abdomen. The nurse recognizes that this could be an
expected finding if the infant has
(a) intussusception
(b) Hirschsprung's disease
(c) umbilical hernia
(d) pyloric stenosis - ANSWER - D. Pyloric Stenosis is hypertrophy of the muscles of the pylorus causing
narrowing of the pyloric canal between the stomach and duodenum. A characteristic olive shaped mass
may be palpated in the epigastrium to the right of the umbilicus. Intussusception is characterized by
currant jelly stools. Hirschprung's disease (congenital mega colon) results in ribbon-like foul smelling
stools; a child with an umbilical hernia has swelling or protrusion around the umbilicus that is reducible.
Physiological Integrity; Physiological Adaptation
The nurse is teaching a group of parents about the expected growth and
development of three-year-old children. The nurse should include that a three-year-
old should
(a) discriminate between fantasy and reality
(b) ride a tricycle independently
(c) have a vocabulary of 7,000 words
(d) play in a group of two or three with one being the leader - ANSWER - D. By the age of 3, a toddler
should be able to ride a tricycle independently; the pre- school child is not able to discriminate between
fantasy and reality. This is the developmental task of a school age child; at 3 years of age the vocabulary
is at about 900 words; cooperative play with the incorporation of imaginary friends is common in this
age group. Health Promotion and Maintenance
The nurse has received report on four clients. The nurse should first
pg. 3
, assess the client who has:
(a) Chronic Obstructive Pulmonary Disease (COPD) with a pulse oximetry reading of 90%
(b) Parkinson's Disease and is demanding to leave the hospital against medical advice (AMA)
(c) been admitted with suspected Guillian Barre Syndrome and has begun plasmapheresis therapy
(d) Congestive Heart Failure (CHF) whose pitting edema has increased to 2(+) - ANSWER - 7. C. The client
admitted with Guillain-Barre' Syndrome should be assessed first because of the possibility of rapid
progression of this illness and neuromuscular respiratory failure; clients with COPD are likely to have
pulse oximetry readings of 90% related to chronic hypoxia; this client along with the other two choices
are important, but not the priority.
It would be appropriate to assign which of these tasks to the CNA?
(a) Feeding a client who is experiencing dysphagia
(b) One-on-one client observation for safety
(c) Removal of an indwelling catheter
(d) Performing a simple dressing change - ANSWER - B. The Certified Nursing Assistant may be assigned
to a client that requires one- to-one observation for safety; the other choices require skilled nursing
intervention by a LPN (Licensed Practical Nurse) or RN (Registered Nurse).
The nurse should intervene if a staff member is observed:
(a) discussing a client's diagnosis with visiting family members
(b) collaborating with another nurse to review a prescription for blood transfusion
(c) interrupting other staff members discussing a client in the cafeteria
(d) reviewing a clients lab values with the nutritionist - ANSWER - 9. A. To maintain confidentiality the
nurse should not discuss the client's diagnosis with family members; it is advisable that two nurses
review the prescription for blood transfusion to identify the client, blood type, Rh factor, expiration date
and the blood numbers; interrupting staff members discussing a client in a public place should be done
to maintain client confidentiality; collaborating with the nutritionist is an appropriate nursing
intervention. Safe Effective Care Environment; Management of Care
The nurse is preparing a staff presentation on legal and ethical issues in nursing. The nurse would be
correct to include which of the following examples?
(a) Putting a client in a geriatric chair with the lap tray in front of the client in the day room to watch
television is false imprisonment
pg. 4
Detailed Answers/ Latest 2024- Rated A+
The community health nurse is caring for the following clients. It would be a priority for the nurse to
initiate a multidisciplinary conference for the client who is
(a) 12 years old with Autism who is starting a new school and recently had a URI (upper respiratory tract
infection)
(b) 16 years old, has type 1 Diabetes Mellitus, is unemployed and had a recent Hemoglobin A1c of 13%
(c) 52 years old, with Myasthenia Gravis, recently prescribed Mestinon (pyridostigmine) and employed as
a mail carrier
(d) 70 years old, has schizophrenia, lives alone and reports hearing non threatening voices. - ANSWER -
3. B. An adolescent with uncontrolled Diabetes Mellitus would require the greatest number of disciplines
(multidisciplinary) to manage their care i.e. Medicine, Nursing, Social Work, Nutritionist; the other
choices do not require as many providers of care to meet their needs.
The nurse in a well baby clinic has assessed several children today. It would be a priority for the nurse to
suggest follow up for the child who is
(a) 2 months old with a positive babinski reflex
(b) 5 months old and does not hold their own bottle
(c) 10 months old who cries around strangers
(d) 18 months old who needs support while ambulating - ANSWER - 5. D. A child experiencing normal
growth and development should be ambulating independently by 12 months; the Babinski reflex
disappears after 2 years of age; an infant typically holds their own bottle by 6 months; stranger anxiety
usually develops at approximately 7 months
The nurse is caring for a mechanically ventilated client who was declared brain dead. An Advance
Directive is not documented on the medical record. It would be most appropriate to obtain consent for
organ donation from the
(a) client's primary care provider
pg. 1
,(b) client's nurse manager
(c) closest living family member
(d) hospital's ethics committee - ANSWER - 6. C. Consent for organ donation is given by a client's next of
kin in the absence of an Advance Directive
The nurse is assessing a child with coarctation of the aorta. Which of the following would be an
expected finding?
(a) diminished blood pressure in the upper extremities
(b) excessive weight gain
(c) high pitched murmur
(d) absence of femoral pulses - ANSWER - D. Coarctation of the aorta is characterized by narrowing of
the aorta. As a result of this narrowing, absent femoral pulses, poor weight gain and increased blood
pressure in the upper extremities are expected findings. A high pitched murmur is not present.
Physiological Integrity; Physiological Adaptation
The nurse is caring for a child with an acyanotic heart defect. Which of the following would be an
expected finding. Select all that apply.
(a) poor suck reflex
(b)tachycardia
(c) increased respiratory rate
(d) bradycardia
(e) fainting spells
(f) delayed growth and development - ANSWER - B, C, and F. Children experiencing acyanotic defects
may experience tachycardia, tachypnea and delay in growth and development; poor suck reflex,
bradycardia, and fainting spells are indicative of cyanotic defects. Physiological Integrity; Physiological
Adaptation
The nurse is teaching a new mother about immunizations. Which of the following should the nurse
include in the teaching?
(a) "Your baby should wait six months to receive any immunizations since the baby was born preterm."
(b) "Your baby will receive the first hepatitis B vaccine after one year of age."
(c) "Acellular Pertussis vaccine has less side effects than whole-cell pertussis vaccine."
pg. 2
,(d) The Haemophilus Influenza Type b (HIB) is given annually to protect against the flu." - ANSWER - C.
Safety data from several studies show that acellular pertussis vaccine cause fewer adverse reactions than
whole-cell vaccines. Pre term infants generally do not wait 6 months before beginning vaccinations; the
first Hepatitis B vaccine is given at birth; the Haemophilus influenzae type b (HIB) is given at 2 months, 4
months, and 6 months and between 12 - 15 months. Health Promotion and Maintenance
The mother of an infant tells the nurse that the baby has not been tolerating feedings lately and she
noticed an olive-shaped mass in the infant's abdomen. The nurse recognizes that this could be an
expected finding if the infant has
(a) intussusception
(b) Hirschsprung's disease
(c) umbilical hernia
(d) pyloric stenosis - ANSWER - D. Pyloric Stenosis is hypertrophy of the muscles of the pylorus causing
narrowing of the pyloric canal between the stomach and duodenum. A characteristic olive shaped mass
may be palpated in the epigastrium to the right of the umbilicus. Intussusception is characterized by
currant jelly stools. Hirschprung's disease (congenital mega colon) results in ribbon-like foul smelling
stools; a child with an umbilical hernia has swelling or protrusion around the umbilicus that is reducible.
Physiological Integrity; Physiological Adaptation
The nurse is teaching a group of parents about the expected growth and
development of three-year-old children. The nurse should include that a three-year-
old should
(a) discriminate between fantasy and reality
(b) ride a tricycle independently
(c) have a vocabulary of 7,000 words
(d) play in a group of two or three with one being the leader - ANSWER - D. By the age of 3, a toddler
should be able to ride a tricycle independently; the pre- school child is not able to discriminate between
fantasy and reality. This is the developmental task of a school age child; at 3 years of age the vocabulary
is at about 900 words; cooperative play with the incorporation of imaginary friends is common in this
age group. Health Promotion and Maintenance
The nurse has received report on four clients. The nurse should first
pg. 3
, assess the client who has:
(a) Chronic Obstructive Pulmonary Disease (COPD) with a pulse oximetry reading of 90%
(b) Parkinson's Disease and is demanding to leave the hospital against medical advice (AMA)
(c) been admitted with suspected Guillian Barre Syndrome and has begun plasmapheresis therapy
(d) Congestive Heart Failure (CHF) whose pitting edema has increased to 2(+) - ANSWER - 7. C. The client
admitted with Guillain-Barre' Syndrome should be assessed first because of the possibility of rapid
progression of this illness and neuromuscular respiratory failure; clients with COPD are likely to have
pulse oximetry readings of 90% related to chronic hypoxia; this client along with the other two choices
are important, but not the priority.
It would be appropriate to assign which of these tasks to the CNA?
(a) Feeding a client who is experiencing dysphagia
(b) One-on-one client observation for safety
(c) Removal of an indwelling catheter
(d) Performing a simple dressing change - ANSWER - B. The Certified Nursing Assistant may be assigned
to a client that requires one- to-one observation for safety; the other choices require skilled nursing
intervention by a LPN (Licensed Practical Nurse) or RN (Registered Nurse).
The nurse should intervene if a staff member is observed:
(a) discussing a client's diagnosis with visiting family members
(b) collaborating with another nurse to review a prescription for blood transfusion
(c) interrupting other staff members discussing a client in the cafeteria
(d) reviewing a clients lab values with the nutritionist - ANSWER - 9. A. To maintain confidentiality the
nurse should not discuss the client's diagnosis with family members; it is advisable that two nurses
review the prescription for blood transfusion to identify the client, blood type, Rh factor, expiration date
and the blood numbers; interrupting staff members discussing a client in a public place should be done
to maintain client confidentiality; collaborating with the nutritionist is an appropriate nursing
intervention. Safe Effective Care Environment; Management of Care
The nurse is preparing a staff presentation on legal and ethical issues in nursing. The nurse would be
correct to include which of the following examples?
(a) Putting a client in a geriatric chair with the lap tray in front of the client in the day room to watch
television is false imprisonment
pg. 4
