QUESTION 1
Which of the following is an appropriate nursing goal for a client at risk for nutritional problems?
A. provide oxygen
B. promote healthy nutritional practices
C. treat complications of malnutrition
D. increase weight
Answer: B
Explanation:
Promoting healthy nutritional practices is an appropriate nursing goal for a client at risk for nutritional
problems. Choice 1 is incorrect because it is a nursing intervention, not a goal statement. Choice 3 is incorrect
because it is a therapeutic treatment. Choice 4 is incorrect because weight gain is an appropriate goal only if the
client is underweight.Basic Care and Comfort
QUESTION 2
Major competencies for the nurse giving end-oflife care include:
A. demonstrating respect and compassion, and applying knowledge and skills in care of the family and the
client.
B. assessing and intervening to support total management of the family and client.
C. setting goals, expectations, and dynamic changes to care for the client.
D. keeping all sad news away from the family and client.
Answer: A
Explanation:
There are many competencies that the nurse must have to care for families and clients at the end of life.
Demonstration of respect and compassion as well as using knowledge and skills in the
care of the client and
family are major competencies.Basic Care and Comfort
QUESTION 3
Which of the following lab values is associated with a decreased risk of cardiovascular disease?
A. high HDL cholesterol
B. low HDL cholesterol
C. low total cholesterol
D. low triglycerides
Answer: A
Explanation:
High HDL cholesterol and low LDL cholesterol are associated with a decreased risk of cardiovascular
disease.Reduction of Risk Potential
QUESTION 4
The goals of palliative care include all of the following except:
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A. giving clients with life-threatening illnesses the best quality of life possible.
B. taking care of the whole person—body, mind, spirit, heart, and soul.
C. no interventions are needed because the client is near death.
D. support of needs of the family and client.
Answer: C
Explanation:
The goals of palliative care include choices 1, 2, and 4. Choice 3 is not part of palliative care. All aspects of
medical, emotional, social, and spiritual needs of the dying client should be focused on until the end of
life.Basic
Care and Comfort
QUESTION 5
All of the following factors, when identified in the history of a family, are correlated with poverty except:
A. high infant mortality rate.
B. frequent use of Emergency Departments.
C. consultation with folk healers.
D. low incidence of dental problems.
Answer: D
Explanation:
Dental problems are prevalent because of the lack of preventive care and access to care. High infant mortality
is one of the most significant problems correlated with poverty. Pregnant women who do not have access to
care might come to the Emergency Department when in labor. Those in poverty are likely to use Emergency
Departments because they may not be turned away. Those in poverty might also turn to folk healers or other
persons in their community for care who might be easier to access and might not demand payment.Health
Promotion and Maintenance
QUESTION 6
What interpersonal relief behavior is Ashley using?
A. acting out
B. somatizing
C. withdrawal
D. problem-solving
Answer: B
Explanation:
Somatizing means one experiences an emotional conflict as a physical symptom. Ashley
manifests several
physical symptoms associated with severe anxiety. Acting out refers to behaviors such as anger, crying, laughter,
and physical or verbal abuse. Withdrawal is a reaction in which psychic energy is withdrawn from the
environment
and focused on the self in response to anxiety. Problem-solving takes place when anxiety is identified and the
unmet need is met.Psychosocial Integrity
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QUESTION 7
A client who is immobilized secondary to traction is complaining of constipation. Which of the following
medications should the nurse expect to be ordered?
A. Advil
B. Anasaid
C. Clinocil
D. Colace
Answer: D
Explanation:
Colace is a stool softener that acts by pulling more water into the bowel lumen, making the stool soft and
easier to evacuate.Basic Care and Comfort
QUESTION 8
A client is taking hydrocodone (Vicodin) for chronic back pain. The client has required an increase in the dose
and asks whether this means he is addicted to Vicodin. The nurse should base her reply on the knowledge that:
A. the client’s body has developed tolerance, requiring more drug to produce the same effect.
B. the client is preoccupied with getting the drug and is experiencing loss of control, indicating drug
dependence.
C. addiction is the term used to describe physical dependence with withdrawal symptoms
and tolerance.
D. the client has a dual diagnosis of substance abuse and chronic back pain.
Answer: A
Explanation:
Drug tolerance is characterized by the ability to ingest a larger dose without adverse effect and decreased
sensitivity to the substance. Substance dependence is a severe condition indicating physical problems and
disruption of the person’s social, family, and work life. The psychological behaviors related to substance use are
termed addiction. Dual diagnosis is the coexistence of substance abuse and psychiatric disorders.Psychosocial
Integrity
QUESTION 9
A client has been taking alprazolam (Xanax) for four years to manage anxiety. The client reports taking 0.5 mg
four times a day. Which statement indicates that the client understands the nurse’s teaching about discontinuing
the medication?
A. “I can drink alcohol now that I am decreasing my Xanax.”
B. “I should not take another Xanax pill. Here is what is left of my last prescription.”
C. “I should take three pills per day next week, then two pills for one week, then one pill for one week.”
D. “I can expect to be sleepy for several days after stopping the medicine.”
Answer: C
Explanation:
Xanax, like other benzodiazepines, can cause withdrawal symptoms that include agitation,
insomnia,
hypertension, seizures, and abdominal pain. The drug must be slowly decreased to prevent
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withdrawal symptoms.
Psychosocial Integrity
QUESTION 10
The nurse wexplains wto wa wclient wwho wunderwent wgastric wresection wthat wwhich wof wthe wfollowing wmeals
wis wmost wlikely wto wcause wrapid wemptying wof wthe wstomach?
A. a whigh-protein wmeal
B. a whigh-fat wmeal
C. a wlarge wmeal wregardless wof wnutrient wcontent
D. a whigh-carbohydrate wmeal
Answer: wD
wExplanation:
Meals wthat ware whigh win wcarbohydrates wpromote wrapid wgastric wemptying. wThe wother woptions ware
wassociated wwith wdecreased wemptying wtime.Basic wCare wand wComfort
QUESTION w11
Light wtherapy wcan wbe weffective wfor:
A. overcoming wweight wproblems.
B. helping wwith wallergies.
C. use win walternative wmedical wtreatments.
D. working wwith wsleep wpatterns.
Answer: wD
wExplanation:
Light wtherapy wcan wbe weffective win wtreating wproblems wassociated wwith wsleep wpatterns, wstress, wmoods,
wjaundice win wnewborns, wand wseasonal waffective wdisorders.Nonpharmacological wTherapies
QUESTION w12
A wsafety wmeasure wto wimplement wwhen wtransferring wa wclient wwith whemiparesis wfrom wa wbed wto wa
wwheelchair wis:
A. standing wthe wclient wand wwalking whim wor wher wto wthe wwheelchair.
B. moving wthe wwheelchair wclose wto wclient’s wbed wand wstanding wand wpivoting wthe
wclient won whis wunaffected wextremity wto wthe wwheelchair.
C. moving wthe wwheelchair wclose wto wclient’s wbed wand wstanding wand wpivoting wthe wclient won whis
waffected wextremity wto wthe wwheelchair.
D. having wthe wclient wstand wand wpush whis wbody wto wthe wwheelchair.
Answer: wB
wExplanation:
Moving wthe wwheelchair wclose wto wclient’s wbed wand whaving whim wstand wand wpivot won whis wunaffected
wextremity wto wthe wwheelchair wis wsafer wbecause wit wprovides wsupport wwith wthe wunaffected wlimb.Basic wCare
wand wComfort
QUESTION w13