PNLE PRACTICE QUESTIONS WITH
CORRECT ANSWERS
Following |surgery, |Mario |complains |of |mild |incisional |pain |while |performing |deep- |breathing |
and |coughing |exercises. |The |nurse's |best |response |would |be:
A. |"Pain |will |become |less |each |day."
B. |"This |is |a |normal |reaction |after |surgery."
C. |"With |a |pillow, |apply |pressure |against |the |incision."
D. |"I |will |give |you |the |pain |medication |the |physician |ordered."
Answer: |(C) |"With |a |pillow, |apply |pressure |against |the |incision."
Applying |pressure |against |the |incision |with |a |pillow |will |help |lessen |the |intra-abdominal |
pressure |created |by |coughing |which |causes |tension |on |the |incision |that |leads |to |pain.
The |nurse |needs |to |carefully |assess |the |complaint |of |pain |of |the |elderly |because |older |people
A. |are |expected |to |experience |chronic |pain
B. |have |a |decreased |pain |threshold
C. |experience |reduced |sensory |perception
D. |have |altered |mental |function
Answer: |(C) |experience |reduced |sensory |perception
Degenerative |changes |occur |in |the |elderly. |The |response |to |pain |in |the |elderly |maybe |
lessened |because |of |reduced |acuity |of |touch, |alterations |in |neural |pathways |and |diminished |
processing |of |sensory |data
Mary |received |AtropineSO4 |as |a |pre-medication |30 |minutes |ago |and |is |now |complaining |of |
dry |mouth |and |her |PR |is |higher, |than |before |the |medication |was |administered. |The |nurse's |
best
A. |The |patient |is |having |an |allergic |reaction |to |the |drug.
B. |The |patient |needs |a |higher |dose |of |this |drug
C. |This |is |normal |side-effect |of |AtSO4
D. |The |patient |is |anxious |about |upcoming |surgery
,Answer: |(C) |This |is |normal |side-effect |of |AtSO4
Atropine |sulfate |is |a |vagolytic |drug |that |decreases |oropharyngeal |secretions |and |increases |the |
heart |rate.
Ana's |postoperative |vital |signs |are |a |blood |pressure |of |80/50 |mm |Hg, |a |pulse |of |140, |and |
respirations |of |32. |Suspecting |shock, |which |of |the |following |orders |would |the |nurse |question?
A. |Put |the |client |in |modified |Trendelenberg's |position.
B. |Administer |oxygen |at |100%.
C. |Monitor |urine |output |every |hour.
D. |Administer |Demerol |50mg |IM |q4h
Answer: |(D) |Administer |Demerol |50mg |IM |q4h
Administering |Demerol, |which |is |a |narcotic |analgesic, |can |depress |respiratory |and |cardiac |
function |and |thus |not |given |to |a |patient |in |shock. |What |is |needed |is |promotion |for |adequate |
oxygenation |and |perfusion. |All |the |other |interventions |can |be |expected |to |be |done |by |the |
nurse.
Mr. |Pablo, |diagnosed |with |Bladder |Cancer, |is |scheduled |for |a |cystectomy |with |the |creation |of |
an |ileal |conduit |in |the |morning. |He |is |wringing |his |hands |and |pacing |the |floor |when |the |nurse |
enters |his |room. |What |is |the |best |approach?
A. |"Good |evening, |Mr. |Pablo. |Wasn't |it |a |pleasant |day, |today?"
B. |"Mr, |Pablo, |you |must |be |so |worried, |I'll |leave |you |alone |with |your |thoughts.
C. |"Mr. |Pablo, |you'll |wear |out |the |hospital |floors |and |yourself |at |this |rate."
D. |"Mr. |Pablo, |you |appear |anxious |to |me. |How |are |you |feeling |about |tomorrow's |surgery?
Answer: |(D) |"Mr. |Pablo, |you |appear |anxious |to |me. |How |are |you |feeling |about |tomorrow's |
surgery?"
The |client |is |showing |signs |of |anxiety |reaction |to |a |stressful |event. |Recognizing |the |client's |
anxiety |conveys |acceptance |of |his |behavior |and |will |allow |for |verbalization |of |feelings |and |
concerns.
After |surgery, |Gina |returns |from |the |Post-anesthesia |Care |Unit |(Recovery |Room) |with |a |
nasogastric |tube |in |place |following |a |gall |bladder |surgery. |She |continues |to |complain |of |
nausea. |Which |action |would |the |nurse |take?
A. |Call |the |physician |immediately.
,B. |Administer |the |prescribed |antiemetic.
C. |Check |the |patency |of |the |nasogastric |tube |for |any |obstruction.
D. |Change |the |patient's |position.
Answer: |(C) |Check |the |patency |of |the |nasogastric |tube |for |any |obstruction.
Nausea |is |one |of |the |common |complaints |of |a |patient |after |receiving |general |anesthesia. |But |
this |complaint |could |be |aggravated |by |gastric |distention |especially |in |a |patient |who |has |
undergone |abdominal |surgery. |Insertion |of |the |NGT |helps |relieve |the |problem. |Checking |on |
the |patency |of |the |NGT |for |any |obstruction |will |help |the |nurse |determine |the |cause |of |the |
problem |and |institute |the |necessary |intervention.
Mr. |Perez |is |in |continuous |pain |from |cancer |that |has |metastasized |to |the |bone. |Pain |
medication |provides |little |relief |and |he |refuses |to |move. |The |nurse |should |plan |to:
A. |Reassure |him |that |the |nurses |will |not |hurt |him
B. |Let |him |perform |his |own |activities |of |daily |living
C. |Handle |him |gently |when |assisting |with |required |care
D. |Complete |A.M. |care |quickly |as |possible |when |necessary
Answer: |(C) |Handle |him |gently |when |assisting |with |required |care
Patients |with |cancer |and |bone |metastasis |experience |severe |pain |especially |when |moving. |
Bone |tumors |weaken |the |bone |to |appoint |at |which |normal |activities |and |even |position |
changes |can |lead |to |fracture. |During |nursing |care, |the |patient |needs |to |be |supported |and |
handled |gently.
A |client |returns |from |the |recovery |room |at |9AM |alert |and |oriented, |with |an |IV |infusing. |His |
pulse |is |82, |blood |pressure |is |120/80, |respirations |are |20, |and |all |are |within |normal |range. |At |
10 |am |and |at |11 |am, |his |vital |signs |are |stable. |At |noon, |however, |his |pulse |rate |is |94, |blood |
pressure |is |116/74, |and |respirations |are |24. |What |nursing |action |is |most |appropriate?
A. |Notify |his |physician.
B. |Take |his |vital |signs |again |in |15 |minutes.
C. |Take |his |vital |signs |again |in |an |hour.
D. |Place |the |patient |in |shock |position.
Answer: |(B) |Take |his |vital |signs |again |in |15 |minutes.
Monitoring |the |client's |vital |signs |following |surgery |gives |the |nurse |a |sound |information |about
|the |client's |condition. |Complications |can |occur |during |this |period |as |a |result |of |the |surgery |or |
, the |anesthesia |or |both. |Keeping |close |track |of |changes |in |the |VS |and |validating |them |will |help
|the |nurse |initiate |interventions |to |prevent |complications |from |occurring
A |56 |year |old |construction |worker |is |brought |to |the |hospital |unconscious |after |falling |from |a |
2-story |building. |When |assessing |the |client, |the |nurse |would |be |most |concerned |if |the |
assessment |revealed:
A. |Reactive |pupils
B. |A |depressed |fontanel
C. |Bleeding |from |ears
D. |An |elevated |temperature
Answer: |(C) |Bleeding |from |ears
The |nurse |needs |to |perform |a |thorough |assessment |that |could |indicate |alterations |in |cerebral |
function, |increased |intracranial |pressures, |fractures |and |bleeding. |Bleeding |from |the |ears |
occurs |only |with |basal |skull |fractures |that |can |easily |contribute |to |increased |intracranial |
pressure |and |brain |herniation
10. |Which |of |the |ff. |statements |by |the |client |to |the |nurse |indicates |a |risk |factor |for |CAD?
A. |"I |exercise |every |other |day."
B. |"My |father |died |of |Myasthenia |Gravis."
C. |"My |cholesterol |is |180."
D. |"I |smoke |1 |1/2 |packs |of |cigarettes |per |day."
Answer: |(D) |"I |smoke |1 |1/2 |packs |of |cigarettes |per |day."
Smoking |has |been |considered |as |one |of |the |major |modifiable |risk |factors |for |coronary |artery |
disease. |Exercise |and |maintaining |normal |serum |cholesterol |levels |help |in |its |prevention.
Mr. |Braga |was |ordered |Digoxin |0.25 |mg. |OD. |Which |is |poor |knowledge |regarding |this |drug?
A. |It |has |positive |inotropic |and |negative |chronotropic |effects
B. |The |positive |inotropic |effect |will |decrease |urine |output
C. |Toxixity |can |occur |more |easily |in |the |presence |of |hypokalemia, |liver |and |renal |problems
D. |Do |not |give |the |drug |if |the |apical |rate |is |less |than |60 |beats |per |minute
Answer: |(B) |The |positive |inotropic |effect |will |decrease |urine |output
Inotropic |effect |of |drugs |on |the |heart |causes |increase |force |of |its |contraction. |This |increases |
cardiac |output |that |improves |renal |perfusion |resulting |in |an |improved |urine |output.
Mental |health |is |defined |as:
A. |The |ability |to |distinguish |what |is |real |from |what |is |not.
B. |A |state |of |well-being |where |a |person |can |realize |his |own |abilities |can |cope |with |normal |
stresses |of |life |and |work |productively.
C. |Is |the |promotion |of |mental |health, |prevention |of |mental |disorders, |nursing |care |of |patients |
CORRECT ANSWERS
Following |surgery, |Mario |complains |of |mild |incisional |pain |while |performing |deep- |breathing |
and |coughing |exercises. |The |nurse's |best |response |would |be:
A. |"Pain |will |become |less |each |day."
B. |"This |is |a |normal |reaction |after |surgery."
C. |"With |a |pillow, |apply |pressure |against |the |incision."
D. |"I |will |give |you |the |pain |medication |the |physician |ordered."
Answer: |(C) |"With |a |pillow, |apply |pressure |against |the |incision."
Applying |pressure |against |the |incision |with |a |pillow |will |help |lessen |the |intra-abdominal |
pressure |created |by |coughing |which |causes |tension |on |the |incision |that |leads |to |pain.
The |nurse |needs |to |carefully |assess |the |complaint |of |pain |of |the |elderly |because |older |people
A. |are |expected |to |experience |chronic |pain
B. |have |a |decreased |pain |threshold
C. |experience |reduced |sensory |perception
D. |have |altered |mental |function
Answer: |(C) |experience |reduced |sensory |perception
Degenerative |changes |occur |in |the |elderly. |The |response |to |pain |in |the |elderly |maybe |
lessened |because |of |reduced |acuity |of |touch, |alterations |in |neural |pathways |and |diminished |
processing |of |sensory |data
Mary |received |AtropineSO4 |as |a |pre-medication |30 |minutes |ago |and |is |now |complaining |of |
dry |mouth |and |her |PR |is |higher, |than |before |the |medication |was |administered. |The |nurse's |
best
A. |The |patient |is |having |an |allergic |reaction |to |the |drug.
B. |The |patient |needs |a |higher |dose |of |this |drug
C. |This |is |normal |side-effect |of |AtSO4
D. |The |patient |is |anxious |about |upcoming |surgery
,Answer: |(C) |This |is |normal |side-effect |of |AtSO4
Atropine |sulfate |is |a |vagolytic |drug |that |decreases |oropharyngeal |secretions |and |increases |the |
heart |rate.
Ana's |postoperative |vital |signs |are |a |blood |pressure |of |80/50 |mm |Hg, |a |pulse |of |140, |and |
respirations |of |32. |Suspecting |shock, |which |of |the |following |orders |would |the |nurse |question?
A. |Put |the |client |in |modified |Trendelenberg's |position.
B. |Administer |oxygen |at |100%.
C. |Monitor |urine |output |every |hour.
D. |Administer |Demerol |50mg |IM |q4h
Answer: |(D) |Administer |Demerol |50mg |IM |q4h
Administering |Demerol, |which |is |a |narcotic |analgesic, |can |depress |respiratory |and |cardiac |
function |and |thus |not |given |to |a |patient |in |shock. |What |is |needed |is |promotion |for |adequate |
oxygenation |and |perfusion. |All |the |other |interventions |can |be |expected |to |be |done |by |the |
nurse.
Mr. |Pablo, |diagnosed |with |Bladder |Cancer, |is |scheduled |for |a |cystectomy |with |the |creation |of |
an |ileal |conduit |in |the |morning. |He |is |wringing |his |hands |and |pacing |the |floor |when |the |nurse |
enters |his |room. |What |is |the |best |approach?
A. |"Good |evening, |Mr. |Pablo. |Wasn't |it |a |pleasant |day, |today?"
B. |"Mr, |Pablo, |you |must |be |so |worried, |I'll |leave |you |alone |with |your |thoughts.
C. |"Mr. |Pablo, |you'll |wear |out |the |hospital |floors |and |yourself |at |this |rate."
D. |"Mr. |Pablo, |you |appear |anxious |to |me. |How |are |you |feeling |about |tomorrow's |surgery?
Answer: |(D) |"Mr. |Pablo, |you |appear |anxious |to |me. |How |are |you |feeling |about |tomorrow's |
surgery?"
The |client |is |showing |signs |of |anxiety |reaction |to |a |stressful |event. |Recognizing |the |client's |
anxiety |conveys |acceptance |of |his |behavior |and |will |allow |for |verbalization |of |feelings |and |
concerns.
After |surgery, |Gina |returns |from |the |Post-anesthesia |Care |Unit |(Recovery |Room) |with |a |
nasogastric |tube |in |place |following |a |gall |bladder |surgery. |She |continues |to |complain |of |
nausea. |Which |action |would |the |nurse |take?
A. |Call |the |physician |immediately.
,B. |Administer |the |prescribed |antiemetic.
C. |Check |the |patency |of |the |nasogastric |tube |for |any |obstruction.
D. |Change |the |patient's |position.
Answer: |(C) |Check |the |patency |of |the |nasogastric |tube |for |any |obstruction.
Nausea |is |one |of |the |common |complaints |of |a |patient |after |receiving |general |anesthesia. |But |
this |complaint |could |be |aggravated |by |gastric |distention |especially |in |a |patient |who |has |
undergone |abdominal |surgery. |Insertion |of |the |NGT |helps |relieve |the |problem. |Checking |on |
the |patency |of |the |NGT |for |any |obstruction |will |help |the |nurse |determine |the |cause |of |the |
problem |and |institute |the |necessary |intervention.
Mr. |Perez |is |in |continuous |pain |from |cancer |that |has |metastasized |to |the |bone. |Pain |
medication |provides |little |relief |and |he |refuses |to |move. |The |nurse |should |plan |to:
A. |Reassure |him |that |the |nurses |will |not |hurt |him
B. |Let |him |perform |his |own |activities |of |daily |living
C. |Handle |him |gently |when |assisting |with |required |care
D. |Complete |A.M. |care |quickly |as |possible |when |necessary
Answer: |(C) |Handle |him |gently |when |assisting |with |required |care
Patients |with |cancer |and |bone |metastasis |experience |severe |pain |especially |when |moving. |
Bone |tumors |weaken |the |bone |to |appoint |at |which |normal |activities |and |even |position |
changes |can |lead |to |fracture. |During |nursing |care, |the |patient |needs |to |be |supported |and |
handled |gently.
A |client |returns |from |the |recovery |room |at |9AM |alert |and |oriented, |with |an |IV |infusing. |His |
pulse |is |82, |blood |pressure |is |120/80, |respirations |are |20, |and |all |are |within |normal |range. |At |
10 |am |and |at |11 |am, |his |vital |signs |are |stable. |At |noon, |however, |his |pulse |rate |is |94, |blood |
pressure |is |116/74, |and |respirations |are |24. |What |nursing |action |is |most |appropriate?
A. |Notify |his |physician.
B. |Take |his |vital |signs |again |in |15 |minutes.
C. |Take |his |vital |signs |again |in |an |hour.
D. |Place |the |patient |in |shock |position.
Answer: |(B) |Take |his |vital |signs |again |in |15 |minutes.
Monitoring |the |client's |vital |signs |following |surgery |gives |the |nurse |a |sound |information |about
|the |client's |condition. |Complications |can |occur |during |this |period |as |a |result |of |the |surgery |or |
, the |anesthesia |or |both. |Keeping |close |track |of |changes |in |the |VS |and |validating |them |will |help
|the |nurse |initiate |interventions |to |prevent |complications |from |occurring
A |56 |year |old |construction |worker |is |brought |to |the |hospital |unconscious |after |falling |from |a |
2-story |building. |When |assessing |the |client, |the |nurse |would |be |most |concerned |if |the |
assessment |revealed:
A. |Reactive |pupils
B. |A |depressed |fontanel
C. |Bleeding |from |ears
D. |An |elevated |temperature
Answer: |(C) |Bleeding |from |ears
The |nurse |needs |to |perform |a |thorough |assessment |that |could |indicate |alterations |in |cerebral |
function, |increased |intracranial |pressures, |fractures |and |bleeding. |Bleeding |from |the |ears |
occurs |only |with |basal |skull |fractures |that |can |easily |contribute |to |increased |intracranial |
pressure |and |brain |herniation
10. |Which |of |the |ff. |statements |by |the |client |to |the |nurse |indicates |a |risk |factor |for |CAD?
A. |"I |exercise |every |other |day."
B. |"My |father |died |of |Myasthenia |Gravis."
C. |"My |cholesterol |is |180."
D. |"I |smoke |1 |1/2 |packs |of |cigarettes |per |day."
Answer: |(D) |"I |smoke |1 |1/2 |packs |of |cigarettes |per |day."
Smoking |has |been |considered |as |one |of |the |major |modifiable |risk |factors |for |coronary |artery |
disease. |Exercise |and |maintaining |normal |serum |cholesterol |levels |help |in |its |prevention.
Mr. |Braga |was |ordered |Digoxin |0.25 |mg. |OD. |Which |is |poor |knowledge |regarding |this |drug?
A. |It |has |positive |inotropic |and |negative |chronotropic |effects
B. |The |positive |inotropic |effect |will |decrease |urine |output
C. |Toxixity |can |occur |more |easily |in |the |presence |of |hypokalemia, |liver |and |renal |problems
D. |Do |not |give |the |drug |if |the |apical |rate |is |less |than |60 |beats |per |minute
Answer: |(B) |The |positive |inotropic |effect |will |decrease |urine |output
Inotropic |effect |of |drugs |on |the |heart |causes |increase |force |of |its |contraction. |This |increases |
cardiac |output |that |improves |renal |perfusion |resulting |in |an |improved |urine |output.
Mental |health |is |defined |as:
A. |The |ability |to |distinguish |what |is |real |from |what |is |not.
B. |A |state |of |well-being |where |a |person |can |realize |his |own |abilities |can |cope |with |normal |
stresses |of |life |and |work |productively.
C. |Is |the |promotion |of |mental |health, |prevention |of |mental |disorders, |nursing |care |of |patients |
