Questions and Answers 100% Pass
Which description of symptoms is characteristic of a client diagnosed with
trigeminal neuralgia (tic douloureux)?
A) Tinnitus, vertigo, and hearing difficulties.
B) Sudden, stabbing, severe pain over the lip and chin.
C) Facial weakness and paralysis.
D) Difficulty in chewing, talking, and swallowing. - ✔✔B) Sudden, stabbing, severe
pain over the lip and chin.
Trigeminal neuralgia is characterized by paroxysms of pain, similar to an electric
shock, in the area innervated by one or more branches of the trigeminal nerve (5th
cranial) (B). (A) would be characteristic of Méniére's disease (8th cranial nerve). (C)
would be characteristic of Bell's palsy (7th cranial nerve). (D) would be characteristic
of disorders of the hypoglossal cranial nerve (12th).
A 67-year-old woman who lives alone is admitted after tripping on a rug in her
home and fractures her hip. Which predisposing factor probably led to the fracture
in the proximal end of her femur?
A) Failing eyesight resulting in an unsafe environment.
B) Renal osteodystrophy resulting from chronic renal failure.
C) Osteoporosis resulting from hormonal changes.
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,D) Cardiovascular changes resulting in small strokes which impair mental acuity. -
✔✔C) Osteoporosis resulting from hormonal changes.
The most common cause of a fractured hip in elderly women is osteoporosis,
resulting from reduced calcium in the bones as a result of hormonal changes in later
life (C). (A) may or may not have contributed to the accident, but it had nothing to
do with the hip being involved. (B) is not a common condition of the elderly; it is
common in chronic renal failure. (D) may occur in some people, but does not affect
the fragility of the bones as osteoporosis does.
The nurse is assisting a client out of bed for the first time after surgery. What action
should the nurse do first?
A) Place a chair at a right angle to the bedside.
B) Encourage deep breathing prior to standing.
C) Help the client to sit and dangle legs on the side of the bed.
D) Allow the client to sit with the bed in a high Fowler's position. - ✔✔D) Allow the
client to sit with the bed in a high Fowler's position.
The first step is to raise the head of the bed to a high Fowler's position (D), which
allow venous return to compensate from lying flat and vasodilating effects of
perioperative drugs. (A, B, and C) are implemented after (D).
A 20-year-old female client calls the nurse to report a lump she found in her breast.
Which response is the best for the nurse to provide?
A) Check it again in one month, and if it is still there schedule an appointment.
B) Most lumps are benign, but it is always best to come in for an examination.
C) Try not to worry too much about it, because usually, most lumps are benign.
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,D) If you are in your menstrual period it is not a good time to check for lumps. -
✔✔B) Most lumps are benign, but it is always best to come in for an examination.
(B) provides the best response because it addresses the client's anxiety most
effectively and encourages prompt and immediate action for a potential problem.
(A) postpones treatment if the lump is malignant, and does not relieve the client's
anxiety. (C and D) provide false reassurance and do not help relieve anxiety.
A female client is brought to the clinic by her daughter for a flu shot. She has lost
significant weight since the last visit. She has poor personal hygiene and inadequate
clothing for the weather. The client states that she lives alone and denies problems or
concerns. What action should the nurse implement?
A) Notify social services immediately of suspected elderly abuse.
B) Discuss the need for mental health counseling with the daughter.
C) Explain to the client that she needs to take better care of herself.
D) Collect further data to determine whether self-neglect is occurring. - ✔✔D)
Collect further data to determine whether self-neglect is occurring.
Changes in weight and hygiene may be indicators of self-neglect or neglect by family
members. Further assessment is needed (D) before notifying social services (A) or
discussing a need for counseling (B). Until further information is obtained,
explanations about the client's needs are premature (C).
A client is admitted to the medical intensive care unit with a diagnosis of myocardial
infarction. The client's history indicates the infarction occurred ten hours ago. Which
laboratory test result should the nurse expect this client to exhibit?
A) Elevated LDH.
B) Elevated serum amylase.
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, C) Elevated CK-MB.
D) Elevated hematocrit. - ✔✔C) Elevated CK-MB.
The cardiac isoenzyme CK-MB (C) is the most sensitive and most reliable indicator
of myocardial damage of all the cardiac enzymes. It peaks within 12 to 20 hours after
myocardial infarction (MI). (A) is a cardiac enzyme that peaks around 48 hours after
an MI. (B) is expected with acute pancreatitis. (D) would be expected in a client with
a fluid volume deficit, which is not a typical finding in MI.
A splint is prescribed for nighttime use by a client with rheumatoid arthritis. Which
statement by the nurse provides the most accurate explanation for use of the splints?
A) Prevention of deformities.
B) Avoidance of joint trauma.
C) Relief of joint inflammation.
D) Improvement in joint strength. - ✔✔A) Prevention of deformities.
Splints may be used at night by clients with rheumatoid arthritis to prevent
deformities (A) caused by muscle spasms and contractures. Splints are not used for
(B). (C) is usually treated with medications, particularly those classified as non-
steroidal antiinflammatory drugs (NSAIDs). For (D), a prescribed exercise program
is indicated.
The nurse should be correct in withholding a dose of digoxin in a client with
congestive heart failure without specific instruction from the healthcare provider if
the client's
A) serum digoxin level is 1.5.
B) blood pressure is 104/68.
C) serum potassium level is 3.
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