NSG 351 TEST BANK TEST 2 QUESTIONS WITH
COMPLETE SOLUTIONS
A 10 year old is at the clinic for a sore throat that has lasted 6
days. Which of these findings would be consistent with an acute
infection?
a. Tonsils 1+/1-4+ and pink; the same color as the oral mucosa
b. Tonsils 2+/1-4+ with small plugs of white debris
c. Tonsils 3+/1-4+ with large white spots
d. Tonsils 3+/1-4+ with pale coloring Correct Answer c.
Tonsils 3+/1-4+ with large white spots
A 14-year-old boy who has been diagnosed with Osgood-
Schlatter disease reports painful swelling just below the knee for
the past 5 months. Which response by the nurse is appropriate?
a. If these symptoms persist, you may need arthroscopic surgery.
b. You are experiencing degeneration of your knee, which may
not resolve.
c. Your disease is due to repeated stress on the patellar tendon. It
is usually self-limited, and your symptoms should resolve with
rest.
d. Increasing your activity and performing knee-strengthening
exercises will help decrease the inflammation and maintain
mobility in the knee. Correct Answer c. Your disease is due to
repeated stress on the patellar tendon. It is usually self-limited,
and your symptoms should resolve with rest.
A 17-year-old student is a swimmer on her high schools swim
team. She has had three bouts of otitis externa this season and
wants to know what to do to prevent it. The nurse instructs her
to:
,a. Use a cotton-tipped swab to dry the ear canals thoroughly
after each swim.
b. Use rubbing alcohol or 2% acetic acid eardrops after every
swim.
c. Irrigate the ears with warm water and a bulb syringe after
each swim.
d. Rinse the ears with a warmed solution of mineral oil and
hydrogen peroxide. Correct Answer b. Use rubbing alcohol or
2% acetic acid eardrops after every swim.
A 19-year-old college student is brought to the emergency
department with a severe headache he describes as, Like nothing
Ive ever had before. His temperature is 40 C, and he has a stiff
neck. The nurse looks for other signs and symptoms of which
problem?
a. Head injury
b. Cluster headache
c. Migraine headache
d. Meningeal inflammation Correct Answer d. Meningeal
inflammation
A 19-year-old woman comes to the clinic at the insistence of her
brother. She is wearing black combat boots and a black lace
nightgown over the top of her other clothes. Her hair is dyed
pink with black streaks throughout. She has several pierced
holes in her nares and ears and is wearing an earring through her
eyebrow and heavy black makeup. The nurse concludes that:
a. She probably does not have any problems.
b. She is only trying to shock people and that her dress should be
ignored.
,c. She has a manic syndrome because of her abnormal dress and
grooming.
d. More information should be gathered to decide whether her
dress is appropriate. Correct Answer d. More information
should be gathered to decide whether her dress is appropriate.
A 2-week-old infant can fixate on an object but cannot follow a
light or bright toy. The nurse would:
a. Consider this a normal finding.
b. Assess the pupillary light reflex for possible blindness.
c. Continue with the examination, and assess visual fields.
d. Expect that a 2-week-old infant should be able to fixate and
follow an object. Correct Answer a. Consider this a normal
finding.
A 20-year-old construction worker has been brought into the
emergency department with heat stroke. He has delirium as a
result of a fluid and electrolyte imbalance. For the mental status
examination, the nurse should first assess the patients:
a. Affect and mood
b. Memory and affect
c. Language abilities
d. Level of consciousness and cognitive abilities Correct
Answer d. Level of consciousness and cognitive abilities
A 21-year-old patient has a head injury resulting from trauma
and is unconscious. There are no other injuries. During the
assessment what would the nurse expect to find when testing the
patients deep tendon reflexes?
a. Reflexes will be normal.
b. Reflexes cannot be elicited.
, c. All reflexes will be diminished but present.
d. Some reflexes will be present, depending on the area of
injury. Correct Answer a. Reflexes will be normal.
A 23-year-old patient in the clinic appears anxious. Her speech
is rapid, and she is fidgety and in constant motion. Which of
these questions or statements would be most appropriate for the
nurse to use in this situation to assess attention span?
a. How do you usually feel? Is this normal behavior for you?
b. I am going to say four words. In a few minutes, I will ask you
to recall them.
c. Describe the meaning of the phrase, Looking through rose-
colored glasses.
d. Pick up the pencil in your left hand, move it to your right
hand, and place it on the table. Correct Answer d. Pick up the
pencil in your left hand, move it to your right hand, and place it
on the table.
A 25-year-old woman in her fifth month of pregnancy has a
blood pressure of 100/70 mm Hg. In reviewing her previous
examination, the nurse notes that her blood pressure in her
second month was 124/80 mm Hg. In evaluating this change,
what does the nurse know to be true?
a. This decline in blood pressure is the result of peripheral
vasodilation and is an expected change.
b. Because of increased cardiac output, the blood pressure
should be higher at this time.
c. This change in blood pressure is not an expected finding
because it means a decrease in cardiac output.
d. This decline in blood pressure means a decrease in circulating
blood volume, which is dangerous for the fetus. Correct Answer
COMPLETE SOLUTIONS
A 10 year old is at the clinic for a sore throat that has lasted 6
days. Which of these findings would be consistent with an acute
infection?
a. Tonsils 1+/1-4+ and pink; the same color as the oral mucosa
b. Tonsils 2+/1-4+ with small plugs of white debris
c. Tonsils 3+/1-4+ with large white spots
d. Tonsils 3+/1-4+ with pale coloring Correct Answer c.
Tonsils 3+/1-4+ with large white spots
A 14-year-old boy who has been diagnosed with Osgood-
Schlatter disease reports painful swelling just below the knee for
the past 5 months. Which response by the nurse is appropriate?
a. If these symptoms persist, you may need arthroscopic surgery.
b. You are experiencing degeneration of your knee, which may
not resolve.
c. Your disease is due to repeated stress on the patellar tendon. It
is usually self-limited, and your symptoms should resolve with
rest.
d. Increasing your activity and performing knee-strengthening
exercises will help decrease the inflammation and maintain
mobility in the knee. Correct Answer c. Your disease is due to
repeated stress on the patellar tendon. It is usually self-limited,
and your symptoms should resolve with rest.
A 17-year-old student is a swimmer on her high schools swim
team. She has had three bouts of otitis externa this season and
wants to know what to do to prevent it. The nurse instructs her
to:
,a. Use a cotton-tipped swab to dry the ear canals thoroughly
after each swim.
b. Use rubbing alcohol or 2% acetic acid eardrops after every
swim.
c. Irrigate the ears with warm water and a bulb syringe after
each swim.
d. Rinse the ears with a warmed solution of mineral oil and
hydrogen peroxide. Correct Answer b. Use rubbing alcohol or
2% acetic acid eardrops after every swim.
A 19-year-old college student is brought to the emergency
department with a severe headache he describes as, Like nothing
Ive ever had before. His temperature is 40 C, and he has a stiff
neck. The nurse looks for other signs and symptoms of which
problem?
a. Head injury
b. Cluster headache
c. Migraine headache
d. Meningeal inflammation Correct Answer d. Meningeal
inflammation
A 19-year-old woman comes to the clinic at the insistence of her
brother. She is wearing black combat boots and a black lace
nightgown over the top of her other clothes. Her hair is dyed
pink with black streaks throughout. She has several pierced
holes in her nares and ears and is wearing an earring through her
eyebrow and heavy black makeup. The nurse concludes that:
a. She probably does not have any problems.
b. She is only trying to shock people and that her dress should be
ignored.
,c. She has a manic syndrome because of her abnormal dress and
grooming.
d. More information should be gathered to decide whether her
dress is appropriate. Correct Answer d. More information
should be gathered to decide whether her dress is appropriate.
A 2-week-old infant can fixate on an object but cannot follow a
light or bright toy. The nurse would:
a. Consider this a normal finding.
b. Assess the pupillary light reflex for possible blindness.
c. Continue with the examination, and assess visual fields.
d. Expect that a 2-week-old infant should be able to fixate and
follow an object. Correct Answer a. Consider this a normal
finding.
A 20-year-old construction worker has been brought into the
emergency department with heat stroke. He has delirium as a
result of a fluid and electrolyte imbalance. For the mental status
examination, the nurse should first assess the patients:
a. Affect and mood
b. Memory and affect
c. Language abilities
d. Level of consciousness and cognitive abilities Correct
Answer d. Level of consciousness and cognitive abilities
A 21-year-old patient has a head injury resulting from trauma
and is unconscious. There are no other injuries. During the
assessment what would the nurse expect to find when testing the
patients deep tendon reflexes?
a. Reflexes will be normal.
b. Reflexes cannot be elicited.
, c. All reflexes will be diminished but present.
d. Some reflexes will be present, depending on the area of
injury. Correct Answer a. Reflexes will be normal.
A 23-year-old patient in the clinic appears anxious. Her speech
is rapid, and she is fidgety and in constant motion. Which of
these questions or statements would be most appropriate for the
nurse to use in this situation to assess attention span?
a. How do you usually feel? Is this normal behavior for you?
b. I am going to say four words. In a few minutes, I will ask you
to recall them.
c. Describe the meaning of the phrase, Looking through rose-
colored glasses.
d. Pick up the pencil in your left hand, move it to your right
hand, and place it on the table. Correct Answer d. Pick up the
pencil in your left hand, move it to your right hand, and place it
on the table.
A 25-year-old woman in her fifth month of pregnancy has a
blood pressure of 100/70 mm Hg. In reviewing her previous
examination, the nurse notes that her blood pressure in her
second month was 124/80 mm Hg. In evaluating this change,
what does the nurse know to be true?
a. This decline in blood pressure is the result of peripheral
vasodilation and is an expected change.
b. Because of increased cardiac output, the blood pressure
should be higher at this time.
c. This change in blood pressure is not an expected finding
because it means a decrease in cardiac output.
d. This decline in blood pressure means a decrease in circulating
blood volume, which is dangerous for the fetus. Correct Answer
