Nursing 1010 Exam 2

Nursing 1010 Exam 2 Based on the latest textbook information. c. Easily attained at the bedside. d. Always right for all situations. - ANSWER a. A guide for nurses in making clinical decisions. 2. In caring for patients, it is important for the nurse to realize that evidence-based practice is a. The only valid source of knowledge that should be used. b. Secondary to traditional or standard care knowledge. c. Dependent on patient values and expectations. d. Not shown to provide better patient outcomes. - ANSWER c. Dependent on patient values and expectations. Even when the best evidence available is used, application and outcomes will differ based on patient values, preferences, concerns, and/or expectations. 11. Which of the following is the primary function of the kidney? a. Metabolizing and excreting medications b. Maintaining fluid and electrolyte balance c. Storing and excreting urine d. Filtering blood cells and proteins - ANSWER b. Maintaining fluid and electrolyte balance The main purpose of the kidney is to maintain fluid and electrolyte balance by filtering waste products and regulating pressures. The kidneys filter the byproducts of medication metabolism. The bladder stores and excretes urine. The kidneys help to maintain red blood cell volume by producing erythropoietin. A 19-year-old male has sustained a transaction of C-7 in an MVA rendering him a quadriplegic. He describes his pain as burning, sharp, and shooting. This is characteristic of a. neuropathic pain. b. ghost pain. c. Nursing 1010 Exam 2 mixed pain syndrome. d. nociceptive pain. - ANSWER a. neuropathic pain. Neuropathic pain results from the abnormal processing of sensory input by the nervous system as a result of damage to the brain, spinal cord, or peripheral nerves. Simply put, neuropathic pain is pathologic. Examples of neuropathic pain include postherpetic neuralgia, diabetic neuropathy, phantom pain, and post stroke pain syndrome. Patients with neuropathic pain use very distinctive words to describe their pain, such as "burning," "sharp," and "shooting." Ghost pain is pain associated with loss of a limb or digit. Mixed pain syndrome is not easily recognized, is unique with multiple underlying and poorly understood mechanisms like fibromyalgia and low back pain. Nociceptive pain refers to the normal functioning of physiological systems that leads to the perception of noxious stimuli (tissue injury) as being painful. Patients describe this type of pain as aching, cramping, or throbbing. Neuropathic pain is pathologic and results from abnormal processing of sensory input by the nervous system as a result of damage to the brain, spinal cord, or peripheral nerves. Patients describe this type of pain as burning, sharp, and shooting. A 24-year-old Asian woman is in labor and refuses to receive any sort of anesthesia medication. Which alternative treatment is best for this patient? a. Relaxation and guided imagery b. Transcutaneous electrical nerve stimulation (TENS) c. Herbal supplements with analgesic effects d. Pudendal block - ANSWER a. Relaxation and guided imagery A client requires urinary catheterization but has difficulty keeping her legs in the usual position needed for this procedure. The nurse has worked for many years and adapts the procedure to allow the client to lie on her side. This action is based on the critical thinking element of: 1. Curiosity 2. Experience 3. Perseverance 4. Scientific knowledge - ANSWER 2. Nursing 1010 Exam 2 Experience A clinical nursing instructor asks the nursing students to describe a critical thinker. Which of the following represents the best response? 1. "A person with the educational background to solve problems." 2. "A person who finds the problem and does what is best to fix it." 3. "It's someone who uses the scientific method to solve problems." 4. "Someone who uses a system to work through and solve a problem." - ANSWER 2. "A person who finds the problem and does what is best to fix it." A critical thinker considers what is important in a situation, imagines and explores alternatives, considers ethical principles, and then makes informed decisions. A confused older adult patient is wearing thick glasses and a hearing aid. Which intervention is priority to facilitate communication? a. Focus on tasks to be completed. b. Allow time for the patient to respond. c. Limit conversations with the patient. d. Use gestures and other nonverbal cues. - ANSWER b. Allow time for the patient to respond. A GN appears to be second-guessing herself and is constantly calling on the other nurses to double-check their plan of care or rehearse what they will say to the doctor before she call on the patient's behalf. This seems to be annoying some of the nurse's coworkers. The nurse manager's best response to this situation is to a. explain to coworkers that this is a characteristic of critical thinking and is important for the GN to improve reasoning skills. b. agree with the staff and have someone follow and work more closely with a preceptor. c. have a talk with the nurse and suggest asking fewer questions. d. tell the staff that all new nurses go through this phase, and ignore their behavior. - ANSWER a. Nursing 1010 Exam 2 explain to coworkers that this is a characteristic of critical thinking and is important for the GN to improve reasoning skills. Reflection-on-action is critical for development of knowledge and improvement in reasoning. It is where learning from practice is incorporated into experience. Inquisitiveness is a characteristic of critical thinking and reflects a desire to learn even when the knowledge may not appear readily useful. The manager should promote this. A guaiac test has been ordered. The nurse knows that this is a test for a. Bright red blood. b. Dark black blood. c. Blood that contains mucus. d. Blood that cannot be seen. ` - ANSWER d. Blood that cannot be seen. Fecal occult blood tests are used to test for blood that may be present in stool that cannot be seen by the naked eye. This is usually indicative of a GI bleed. All other options are incorrect. A home care nurse receives a physician order for a medication that the patient does not want to take because the patient has a history of side effects from this medication. The nurse carefully listens to the patient, considers it in light of the patient's condition, questions its appropriateness, and examines alternative treatments. This nurse would most likely a. call the physician, explain rationale, and suggest a different medication. b. consult an experienced nurse on whether there are other similar treatments. c. hold the drug until the physician returns to the unit and can be questioned. d. question other staff as to the physician's acceptance of nursing input. - ANSWER a. call the physician, explain rationale, and suggest a different medication. A new graduate nurse (GN) is working with an experienced nurse to chart assessment findings. The GN notes that the physical therapist wrote on the chart th