NR 341/ NR341 THE ULTIMATE A – LEVEL
NURSING AND PHARMACY REVISION
QUESTIONS AND THEIR ANSWERS
1. A hospice nurse who has become close to a terminally ill patient is presented
in the home when the patient dies and feels saddened and tearful as the
family members begin to cry. Which action should the nurse take at this
time? - Answer Cry along with the patient's family members
2. The son of a dying patient tells the nurse, "Mother doesn't respond any more
when I visit, I don't think she knows that I am here". Which response by the
nurse is appropriate? - Answer "Withdrawal can be a normal response in the
process of dying."
3. A patient who was involved in a motor vehicle crash has had a tracheostomy
placed to allow for mechanical ventilation. How should the nurse interpret
the following arterial blood gas results: pH 7.48, paO2 32 mmHG, and
HCO3 25 mEq/L? - Answer Respiratory Alkalosis
4. An older adult patient receiving iso-osmolar continuous enteral nutrition
develops restlessness, agitation, and weakness. Which laboratory result
should the nurse report to the health care provider immediately? - Answer
Na 154 mEq/L (154 mmo/L)
5. A patient undergoing an emergency appendectomy has been using St. Johns
wart to prevent depression. Which complication should the nurse expect in
the post anesthesia care unit? - Answer Increased anesthesia recovery time
,6. A patient who takes a diuretic and a B-blocker to control blood pressure is
scheduled for breast reconstruction surgery. Which patient information is
most important to communicate to the health care provider before surgery? -
Answer Serum potassium 3.2 mEq/L
7. While in the holding area, a patient revels to the nurse that his father had a
high fever immediately after surgery. What action by the nurse is a priority?
- Answer Alert the anesthesia care provider of the family member's reaction
to surgery.
8. A patient in surgery receives a neuromuscular blocking agent as an adjunct
to general anesthesia. Which in the post anesthesia care unit (PACU). What
assessment finding is most important for the nurse to report? - Answer Weak
chest movement
9. A patient who has begun to awaken after 30 minutes in the post anesthesia
care unit (PACU) is restless and shouting at the nurse. The patient's oxygen
saturation is 96%, and recent laboratory results are all normal. Which action
by the nurse is most appropriate? - Answer Assess for bladder distension
10.A patient who is just waking up after having hip replacement surgery is
agitated and confused. Which action should the nurse take first? - Answer
Check the oxygen (O2) saturation
11.On admission to the burn unit, a patient with an approximate 25% total body
surface area (TBSA) burn has the following initial laboratory results: Hct
58%, Hgb 18.2 mg/dL (172 d/L), Serum K+ 4.9 mEq/L (4.8 mmol/L and
serum Na+ 1345 mEq/L (135 mmo/L). Which of the following prescribed
actions should be the nurse's priority? - Answer Increasing the rate of the
ordered IV solution
,12.A patient with severe burns has crystalloid fluid replacement ordered using
the Parkland formula. The initial volume of fluid to be given in the first 24
hrs. Is 30,000 mL. The initial rate of administration is 1875, L/hr. After the
first 8 hours, what rate should the nurse infuse the IV fluids? - Answer 938
mL/hr.
13.A patient arrives in the emergency department with facial and chest burns
caused by a house fire. Which actions should the nurse take first? - Answer
Auscultate for breath sounds
14.Which nursing action is a priority for a patient who has suffered a burn
injury while working on an electrical power line? - Answer Stabilize the
cervical spine
15.The nurse is caring for a patient who has a right-sided chest tube after a right
lower lobectomy. Which nursing action can the nurse delegate to the
unlicensed assistive personnel (UAP)? - Answer document the amount of
drainage every 8 hours.
16.A patient who has had chest pain for several hours is admitted with a
diagnosis of rule out acute myocardial infarction (AMI). Which laboratory
test is most specific for the nurse to monitor in determining whether the
patient has had an AMI? - Answer Cardiac-specific troponin
17.Which electrocardiographic (ECG) change by a patient with chest pain is
most important for the nurse to report rapidly to the health care provider? -
Answer St-segment elevation
, 18.Which assessment finding in a patient admitted with acute decompensated
heart failure) ADHF) requires the most immediate action by the nurse? -
Answer O2 saturation of 88%
19.After receiving change -of-shift report on a heart failure unit, which patient
should the nurse assess first? - Answer Patient who is taking digoxin and has
a potassium level of 3.1 mEq/L.
20.A patient with supraventricular tachycardia who is alert and has a blood
pressure of 110/66 mmHg is being prepared for cardioversion. Which action
should the nurse take? - Answer Give a sedative before cardioversion is
implemented.
21.Which laboratory result for a patient with multifocal premature ventricular
contractions (PVCs) is most important for the nurse to communicate to the
health care provider? - Answer Serum potassium of 2.9 mEq/L.
22.A 70-year-old female client is being treated for diverticulitis. The nurse
explains that there are several complications associates with this disease.
The nurse informs the patient that diverticulitis is most common cause of
what complication? - Answer Lower gastrointestinal bleeding
23.A young adult patient is hospitalized with massive abdominal trauma from a
motor vehicle crash the patient asks the nurse about the purpose of receiving
famotidine (Pepcid). What should the nurse explain about the action of the
medication? - Answer "It inhibits development of stress ulcers."
24.A 72-yr-old male patient with dehydration caused by an exacerbation of
ulcerative colitis is receiving 5% dextrose in normal saline at 125 mL/hour.
NURSING AND PHARMACY REVISION
QUESTIONS AND THEIR ANSWERS
1. A hospice nurse who has become close to a terminally ill patient is presented
in the home when the patient dies and feels saddened and tearful as the
family members begin to cry. Which action should the nurse take at this
time? - Answer Cry along with the patient's family members
2. The son of a dying patient tells the nurse, "Mother doesn't respond any more
when I visit, I don't think she knows that I am here". Which response by the
nurse is appropriate? - Answer "Withdrawal can be a normal response in the
process of dying."
3. A patient who was involved in a motor vehicle crash has had a tracheostomy
placed to allow for mechanical ventilation. How should the nurse interpret
the following arterial blood gas results: pH 7.48, paO2 32 mmHG, and
HCO3 25 mEq/L? - Answer Respiratory Alkalosis
4. An older adult patient receiving iso-osmolar continuous enteral nutrition
develops restlessness, agitation, and weakness. Which laboratory result
should the nurse report to the health care provider immediately? - Answer
Na 154 mEq/L (154 mmo/L)
5. A patient undergoing an emergency appendectomy has been using St. Johns
wart to prevent depression. Which complication should the nurse expect in
the post anesthesia care unit? - Answer Increased anesthesia recovery time
,6. A patient who takes a diuretic and a B-blocker to control blood pressure is
scheduled for breast reconstruction surgery. Which patient information is
most important to communicate to the health care provider before surgery? -
Answer Serum potassium 3.2 mEq/L
7. While in the holding area, a patient revels to the nurse that his father had a
high fever immediately after surgery. What action by the nurse is a priority?
- Answer Alert the anesthesia care provider of the family member's reaction
to surgery.
8. A patient in surgery receives a neuromuscular blocking agent as an adjunct
to general anesthesia. Which in the post anesthesia care unit (PACU). What
assessment finding is most important for the nurse to report? - Answer Weak
chest movement
9. A patient who has begun to awaken after 30 minutes in the post anesthesia
care unit (PACU) is restless and shouting at the nurse. The patient's oxygen
saturation is 96%, and recent laboratory results are all normal. Which action
by the nurse is most appropriate? - Answer Assess for bladder distension
10.A patient who is just waking up after having hip replacement surgery is
agitated and confused. Which action should the nurse take first? - Answer
Check the oxygen (O2) saturation
11.On admission to the burn unit, a patient with an approximate 25% total body
surface area (TBSA) burn has the following initial laboratory results: Hct
58%, Hgb 18.2 mg/dL (172 d/L), Serum K+ 4.9 mEq/L (4.8 mmol/L and
serum Na+ 1345 mEq/L (135 mmo/L). Which of the following prescribed
actions should be the nurse's priority? - Answer Increasing the rate of the
ordered IV solution
,12.A patient with severe burns has crystalloid fluid replacement ordered using
the Parkland formula. The initial volume of fluid to be given in the first 24
hrs. Is 30,000 mL. The initial rate of administration is 1875, L/hr. After the
first 8 hours, what rate should the nurse infuse the IV fluids? - Answer 938
mL/hr.
13.A patient arrives in the emergency department with facial and chest burns
caused by a house fire. Which actions should the nurse take first? - Answer
Auscultate for breath sounds
14.Which nursing action is a priority for a patient who has suffered a burn
injury while working on an electrical power line? - Answer Stabilize the
cervical spine
15.The nurse is caring for a patient who has a right-sided chest tube after a right
lower lobectomy. Which nursing action can the nurse delegate to the
unlicensed assistive personnel (UAP)? - Answer document the amount of
drainage every 8 hours.
16.A patient who has had chest pain for several hours is admitted with a
diagnosis of rule out acute myocardial infarction (AMI). Which laboratory
test is most specific for the nurse to monitor in determining whether the
patient has had an AMI? - Answer Cardiac-specific troponin
17.Which electrocardiographic (ECG) change by a patient with chest pain is
most important for the nurse to report rapidly to the health care provider? -
Answer St-segment elevation
, 18.Which assessment finding in a patient admitted with acute decompensated
heart failure) ADHF) requires the most immediate action by the nurse? -
Answer O2 saturation of 88%
19.After receiving change -of-shift report on a heart failure unit, which patient
should the nurse assess first? - Answer Patient who is taking digoxin and has
a potassium level of 3.1 mEq/L.
20.A patient with supraventricular tachycardia who is alert and has a blood
pressure of 110/66 mmHg is being prepared for cardioversion. Which action
should the nurse take? - Answer Give a sedative before cardioversion is
implemented.
21.Which laboratory result for a patient with multifocal premature ventricular
contractions (PVCs) is most important for the nurse to communicate to the
health care provider? - Answer Serum potassium of 2.9 mEq/L.
22.A 70-year-old female client is being treated for diverticulitis. The nurse
explains that there are several complications associates with this disease.
The nurse informs the patient that diverticulitis is most common cause of
what complication? - Answer Lower gastrointestinal bleeding
23.A young adult patient is hospitalized with massive abdominal trauma from a
motor vehicle crash the patient asks the nurse about the purpose of receiving
famotidine (Pepcid). What should the nurse explain about the action of the
medication? - Answer "It inhibits development of stress ulcers."
24.A 72-yr-old male patient with dehydration caused by an exacerbation of
ulcerative colitis is receiving 5% dextrose in normal saline at 125 mL/hour.
