FINAL REVIEW RNSG 1430 questions with verified
answers
. A patient asks the nurse why a dose of hydromorphone (Dilaudid) by IV push is
given before starting the medication via PCA. Which response is most
appropriate?
a. "PCA will never be effective unless a loading dose is given first."
b. "The IV push dose will enhance the effects of the PCA for the next 8 hours."
c. "The IV push dose will provide for immediate pain relief, which can be
maintained by using the PCA."
d. "PCA takes at least 2 hours to begin working, so the IV push dose will provide
pain relief in the interim." Ans✓✓✓ C
65 year old woman has fallen while sweeping her driveway, sustaining a tissue
injury. She describes her condition as an aching, throbbing back. Which type of
pain are the complaints most indicative of.
a. Neuropathic
b. Nociceptive
c. Chronic
d. Mixed pain Ans✓✓✓ B
75-year-old women walks into the ER with complaints of "not feeling well." Her
blood pressure is 145/95, pulse 85 beats/min, respirations 24 breaths/min, and
blood sugar 300. Upon inspection, the nurse notices that the woman has an open
wound on the bottom of her foot, but the patient states she is not aware of this.
How should the nurse interpret these findings?
a. Normal in the older adult
b. A need for the patient to be evaluated for cognitive impairment
,c. A side effect of anti-hypertensive medication
d. Pathologic impairment of sensory responses Ans✓✓✓ D
This degree of sensory impairment at this age is not expected. Lack of sensation
does not imply lack of knowledge, but rather decreased ability to perceive the
stimuli. Anti-hypertensive medication does not typically cause decreased skin
sensation. This is more common in antineoplastic drugs. Most likely the patient
has diabetes, which is causing decreased sensation. Not feeling well is secondary
to a change in blood sugar as a result of the wound response
A 17-year-old girl is hospitalized for appendicitis, and her mother asks the nurse
why she is so needy and acting like a child. The best response of the nurse is that
in the hospital, adolescents
a. have separation anxiety.
b. rebel against rules.
c. regress because of stress.
d. want to know everything. Ans✓✓✓ C
Regression to an earlier stage of development is a common response to stress.
Separation anxiety is most common in infants and toddlers. Rebellion against
hospital rules is usually not an issue if the adolescent understands the rules and
would not create childlike behaviors. An adolescent may want to "know
everything" with their logical thinking and deductive reasoning, but that would
not explain why they would act like a child.
A 19-year-old male has sustained a transection of C-7 in a motor vehicle crash
rendering him a quadriplegic. He describes his pain as burning, sharp, and
shooting. What type of pain is this patient describing?
a. Neuropathic pain
b. Visceral pain
c. Eudynic pain
,d. Nociceptive pain Ans✓✓✓ A
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.´ Visceral pain
arises from the body cavities and responds to stretching, swelling and decreased
oxygen levels. Eudynic pain refers to the normal transmission of pain via
nociceptive receptors. 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
A 60-year-old Italian immigrant presents for an annual physical. He is counseled
about diagnostic testing including laboratory testing, colonoscopy, influenza
vaccination, and pneumococcal vaccination. His reply is "if it ain't broke, don't try
to fix it." when developing a plan of care, the nurse should consider which cultural
orientation for this patient?
a.Short term
b. Long term
c. Leisurely term
d. Noncommittal Ans✓✓✓ A
Short-term cultural orientation focuses on the present or past and emphasizes
quick results. Long-term cultural orientation focuses the future and long-term
rewards. Long-term-oriented cultures favor thrift, perseverance, and adopting to
changing circumstances. Leisurely term and noncommittal are undefined in
cultural orientation.
, A 65-year-old female patient has been admitted to the medical/surgical unit. The
nurse is assessing the patients risk for falls so that falls prevention can be
implemented if necessary. Select all the risk factors that apply from this patient's
history and physical. (Select all that apply.)
a. Being a woman
b. Taking more than six medications
c. Having hypertension
d. Having cataracts
e. Muscle strength 3/5 bilaterally
f. Incontinence Ans✓✓✓ b,d,e,f
Adverse effects of medications can contribute to falls. Cataracts impair vision,
which is a risk factor for falls. Poor muscle strength is a risk factor for falls.
Incontinence of urine or stool increases risk for falls. Men have a higher risk for
falls. Hypertension itself does not contribute to falls. Taking medications to treat
hypertension that may lead to hypotension and dizziness is a fall risk. Dizziness
does contribute to falls.
A 70 year old who is interested in non drug, mind- body therapies, self
management and alternative strategies to deal with joint pain from rheumatoid
arthritis. Which options should you suggest for her plan of care considering her
wishes
a. Using a stationary bicycle and free weights and attending a spinning class
b. Using mind-body therapies like music
c. Drinking chamomile tea and applying ice /or heat
d. Receiving acupuncture and attending church services Ans✓✓✓ B
A 70-year-old retired patent is interested in nondrug, mind-body therapies, self-
management, and alternative strategies to deal with joint discomfort from
answers
. A patient asks the nurse why a dose of hydromorphone (Dilaudid) by IV push is
given before starting the medication via PCA. Which response is most
appropriate?
a. "PCA will never be effective unless a loading dose is given first."
b. "The IV push dose will enhance the effects of the PCA for the next 8 hours."
c. "The IV push dose will provide for immediate pain relief, which can be
maintained by using the PCA."
d. "PCA takes at least 2 hours to begin working, so the IV push dose will provide
pain relief in the interim." Ans✓✓✓ C
65 year old woman has fallen while sweeping her driveway, sustaining a tissue
injury. She describes her condition as an aching, throbbing back. Which type of
pain are the complaints most indicative of.
a. Neuropathic
b. Nociceptive
c. Chronic
d. Mixed pain Ans✓✓✓ B
75-year-old women walks into the ER with complaints of "not feeling well." Her
blood pressure is 145/95, pulse 85 beats/min, respirations 24 breaths/min, and
blood sugar 300. Upon inspection, the nurse notices that the woman has an open
wound on the bottom of her foot, but the patient states she is not aware of this.
How should the nurse interpret these findings?
a. Normal in the older adult
b. A need for the patient to be evaluated for cognitive impairment
,c. A side effect of anti-hypertensive medication
d. Pathologic impairment of sensory responses Ans✓✓✓ D
This degree of sensory impairment at this age is not expected. Lack of sensation
does not imply lack of knowledge, but rather decreased ability to perceive the
stimuli. Anti-hypertensive medication does not typically cause decreased skin
sensation. This is more common in antineoplastic drugs. Most likely the patient
has diabetes, which is causing decreased sensation. Not feeling well is secondary
to a change in blood sugar as a result of the wound response
A 17-year-old girl is hospitalized for appendicitis, and her mother asks the nurse
why she is so needy and acting like a child. The best response of the nurse is that
in the hospital, adolescents
a. have separation anxiety.
b. rebel against rules.
c. regress because of stress.
d. want to know everything. Ans✓✓✓ C
Regression to an earlier stage of development is a common response to stress.
Separation anxiety is most common in infants and toddlers. Rebellion against
hospital rules is usually not an issue if the adolescent understands the rules and
would not create childlike behaviors. An adolescent may want to "know
everything" with their logical thinking and deductive reasoning, but that would
not explain why they would act like a child.
A 19-year-old male has sustained a transection of C-7 in a motor vehicle crash
rendering him a quadriplegic. He describes his pain as burning, sharp, and
shooting. What type of pain is this patient describing?
a. Neuropathic pain
b. Visceral pain
c. Eudynic pain
,d. Nociceptive pain Ans✓✓✓ A
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.´ Visceral pain
arises from the body cavities and responds to stretching, swelling and decreased
oxygen levels. Eudynic pain refers to the normal transmission of pain via
nociceptive receptors. 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
A 60-year-old Italian immigrant presents for an annual physical. He is counseled
about diagnostic testing including laboratory testing, colonoscopy, influenza
vaccination, and pneumococcal vaccination. His reply is "if it ain't broke, don't try
to fix it." when developing a plan of care, the nurse should consider which cultural
orientation for this patient?
a.Short term
b. Long term
c. Leisurely term
d. Noncommittal Ans✓✓✓ A
Short-term cultural orientation focuses on the present or past and emphasizes
quick results. Long-term cultural orientation focuses the future and long-term
rewards. Long-term-oriented cultures favor thrift, perseverance, and adopting to
changing circumstances. Leisurely term and noncommittal are undefined in
cultural orientation.
, A 65-year-old female patient has been admitted to the medical/surgical unit. The
nurse is assessing the patients risk for falls so that falls prevention can be
implemented if necessary. Select all the risk factors that apply from this patient's
history and physical. (Select all that apply.)
a. Being a woman
b. Taking more than six medications
c. Having hypertension
d. Having cataracts
e. Muscle strength 3/5 bilaterally
f. Incontinence Ans✓✓✓ b,d,e,f
Adverse effects of medications can contribute to falls. Cataracts impair vision,
which is a risk factor for falls. Poor muscle strength is a risk factor for falls.
Incontinence of urine or stool increases risk for falls. Men have a higher risk for
falls. Hypertension itself does not contribute to falls. Taking medications to treat
hypertension that may lead to hypotension and dizziness is a fall risk. Dizziness
does contribute to falls.
A 70 year old who is interested in non drug, mind- body therapies, self
management and alternative strategies to deal with joint pain from rheumatoid
arthritis. Which options should you suggest for her plan of care considering her
wishes
a. Using a stationary bicycle and free weights and attending a spinning class
b. Using mind-body therapies like music
c. Drinking chamomile tea and applying ice /or heat
d. Receiving acupuncture and attending church services Ans✓✓✓ B
A 70-year-old retired patent is interested in nondrug, mind-body therapies, self-
management, and alternative strategies to deal with joint discomfort from
