CEN - practice exam A level Based

CEN - practice exam The nurse is caring for a patient who has a high fever, central nervous system dysfunction and tachycardia. The nurse should recognize that the patient may be experiencing A. myxedema crisis. B. Beck's triad. C. thyroid storm. D. hyperosmolar hyperglycemic nonketotic syndrome (HHNS). - C. Thyroid storm Which of the following assessment findings associated with a skull fracture indicate the need for further intervention? A. otorrhea, nausea, and vomiting B. decreasing level of consciousness and restlessness C. early evidence of periorbital ecchymosis and photophobia D. rhinorrhea and headache or dizziness - B. decreasing level of consciousness and restlessness Upon initial assessment of a male patient involved in a motor vehicle crash, the nurse observes bruises in various stages of healing to his torso. He denies any medical history. When asked about the bruising, the patient avoids eye contact, states that he fell yesterday, and asks if his male partner has arrived to the ED. The nurse suspects: A. the patient may have undiagnosed coagulopathy. B. the bruising was sustained during the motor vehicle crash. C. the patient may be a victim of domestic violence. D. the bruising is a result of the stated fall. - C. the patient may be a victim of domestic violence. The nurse is caring for a patient who became unresponsive after diving head-first into a shallow pool. The patient is experiencing refractory hypotension. The nurse should prepare for the administration of a. lactated Ringers. b. norepinephrine. c. normal saline. d. epinephrine. - b. norepinephrine A 3-year-old child who has acute respiratory distress is admitted to the emergency department. The child is sitting forward and drooling, and the neck is extended. These findings support the diagnosis of A. epiglottitis. B. bronchiolitis. C. croup. D. aspiration of a foreign body. - A. epiglottitis The nurse understands that adenosine is administered A. IV push over 1-2 seconds. B. as a bolus over 10-15 minutes. C. as a bolus over 1 hour. D. IV push over 1-2 minutes. - A. IV push over 1-2 seconds. A man who briefly lost consciousness after a motor vehicle crash is alert and oriented upon arrival at the emergency department. The patient states that he is fine except for an abrasion where his head hit the door frame of the vehicle. The patient complains of blurred vision 1 hour later. The nurse should FIRST A. repeat the neurologic assessment. B. obtain orthostatic vital signs. C. assess visual acuity. D. obtain blood glucose measurement. - A. repeat the neurologic assessment. After a non-traumatic resuscitation, the patient has a perfusing ECG rhythm and a stable blood pressure, but the patient remains comatose. The nurse should NEXT prepare for A. initiation of targeted temperature management. B. initiation of stroke protocol. C. transport to the cardiac catheterization lab. D. transport to the neurovascular suite. - A. initiation of targeted temperature management. After a patient has an episode of violent behavior in the waiting room, an important intervention is to A. tell the patient to get himself under control. B. instruct the patient to be quiet and speak only when spoken to. C. allow the patient to go home as soon as possible. D. encourage the patient to verbalize his feelings about the situation. - D. encourage the patient to verbalize his feelings about the situation. The nurse is caring for a patient with complaints of progressive, ascending paralysis starting from the feet and progressing over the last week. It would be a PRIORITY for the nurse to monitor the patient's A. pupillary response. B. peripheral pulses. C. respiratory status. D. Blood glucose - C. respiratory status. A patient with acute cocaine intoxication should be expected to have A. rising core body temperature. B. drowsiness. C.flaccid extremities. D. first-degree AV block. - A. rising core body temperature. Which of the following ocular conditions requires the HIGHEST treatment priority? A. periorbital hematoma with edema B. hyphema following a blow to the eye C. a retained metal foreign body D. sudden, painless loss of vision in one eye - D. sudden, painless loss of vision in one eye A patient presents with complaints of fatigue and exhaustion, and reveals a recent move across country for a new high stress job. The patient admits to recent increase in alcohol consumption. The nurse suspects the patient is experiencing: A. schizophrenia. B. situational crisis. C. psychotic depression. D. acute mania. - B. situational crisis. The nurse is caring for a patient who suddenly stops breathing and is in ventricular fibrillation. The nurse should FIRST A. perform synchronized cardioversion at 200 joules. B. provide oxygen and ventilation via a bag-mask device. C. start chest compressions. D. administer 1 mg of intravenous epinephrine. - C. start chest compressions. A patient presents with his family members, who state that he has struck his brother and has been violent and paranoid. The nurse should FIRST A. place the patient into a treatment room with the door open. B. assess the brother for possible injuries. C. escort the patient to the quiet room to await the social worker. D. notify police of the assault. - A. place the patient into a treatment room with the door open. Human tetanus immune globulin provides passive immunity for A. 1 year. B. 30 days. C. 6 months. D. 72 hours. - B. 30 days. A patient who is trembling, sweating, and hyperventilating is having an anxiety attack. Arterial blood gas analysis is likely to show which of the following? A. oxygen saturation 96% B. pH 7.35 C. HCO3-level 26 mEq/L D. PaCO2 35 mm Hg - D. PaCO2 35 mm Hg A pediatric patient is treated for otitis media complicated by a ruptured tympanic membrane. Discharge education is proven effective when the patient's father states, A. I will position my son upright in bed when he goes to sleep. B. I will keep my son from getting his ear wet. C. I will feed him soft foods until the ear drum heals itself. D. I will use antibiotic ear drops four times a day for one week. - B. I will keep my son from getting his ear wet. Assessment of a patient who has acute cholecystitis is MOST likely to reveal A. pain that radiates to the left shoulder and positive results on a stool guaiac test. B. pain in the left upper quadrant of the abdomen and positive results on a guaiac test of vomitus. C. pain in the right upper quadrant of the abdomen and slight scleral icterus. D. epigastric pain that radiates to the back and watery stools. - C. pain in the right upper quadrant of the abdomen and slight scleral icterus. Manual uterine massage is recommended for early postpartum hemorrhage because massage will A. enhance uterine atony. B. improve bladder tone. C. expel retained products of conception. D. stimulate uterine contractions. - D. stimulate uterine contractions. A child with an extremity fracture is being prepared for admission prior to surgery. The child has a low-grade fever and may have been exposed to chickenpox. The nurse should A. isolate the patient in a negative-pressure room. B. anticipate administering diphenhydramine (Benadryl). C. advise the receiving nurse to initiate isolation if vesicles develop. D. anticipate administering methylprednisolone (SoluMedrol). - A. isolate the patient in a negative-pressure room. A patient who has ingested antifreeze is undergoing treatment. An indication that further treatment is needed is A. metabolic acidosis. B. pupillary constriction. C. rotary nystagmus. D. hyperreflexia. - A. metabolic acidosis. Cerebrospinal fluid found in the ears indicates A. pharyngeal trauma. B. a subarachnoid hemorrhage. C. injury to the cervical spine. D. a basilar skull fracture. - D. a basilar skull fracture. A pediatric patient is diagnosed and treated for conjunctivitis. What statement made by the caregivers indicates understanding of discharge instructions? A. "My child cannot return to school until the infection has resolved." B. "My child can return to school immediately because this is a viral infection." C. "My child needs to practice good hand hygiene after using the bathroom." D. "My child can sleep in the same bed as her sister during nap time." - A. "My child cannot return to school until the infection has resolved." A patient with tuberculosis is considered infectious as long as A. the tuberculin skin test is positive. B. a productive cough is present. C. pulmonary tuberculosis is evident on the chest radiograph. D. viable tubercle bacilli are discharged in the sputum - D. viable tubercle bacilli are discharged in the sputum