NURS 1130 EXAM 3 QUESTIONS WITH COMPLETE
SOLUTIONS
A 72-year-old patient asks the nurse about using an over-the-
counter antihistamine pill to help her get to sleep. What is the
nurses best response? Correct Answer "Antihistamines should
not be used because they can cause confusion and increase your
risk of falls"
A client is receiving an enteral tubing at 65 mL/hr. The gastric
residual volume in 4 hours was 125 mL. What is the priority
nursing intervention? Correct Answer Continue the feedings;
this is normal gastric residual for this feeding
A client is receiving parenteral nutrition (PN) and enteral
nutrition (EN). When would the nurse collaborate with the
health care provider and request a discontinuation of parenteral
nutrition? Correct Answer When 75% of the patients
nutritional needs are met by the tube feedings
A client who is receiving parenteral nutrition (PN) through a
central venous catheter (CVC) has an air embolus. What should
be the nurses priority action? Correct Answer - have the
patient turn on the left side and perform a Valsalva maneuver.
A community health nurse is providing an education session at
the senior center on how to promote sleep. Which practices
should the nurse recommend? (Select all that apply)
A) take a nap in the afternoon
B) sleep where you sleep best
C) use sedatives as a last resort
,D) watch television right before sleep
E) decrease fluids 2 to 4 hours before sleep
F) get up if unable to fall asleep in 15 to 30 mins Correct
Answer B, C, E, F
A female patient is having difficulty voiding in a bedpan but
states her bladder feels full. To stimulate micturition, which
nursing intervention should the nurse try first? Correct Answer
Utilizing the power of suggestion by turning on the faucet and
letting the water run
A guaiac test is ordered for a patient. Which type of blood is the
nurse checking for in this patients stool? Correct Answer
microscopic
A health care provider writes the following order for a patient
who is opioid-naive who returned from the operating room
following a total hip replacement: "fentanyl patch 100 mcg,
change every 3 days." On the basis of this order, the nurse takes
the following action: Correct Answer Calls the health care
provider and questions the order
A Native American patient is asking for a spiritual healer.
Which person should the nurse try to contact for the patient?
Correct Answer Shaman
A new medical resident writes an order for oxycodone CR 10
mg PO q2hr PRN. Which part of the order does the nurse
question? Correct Answer The time interval
,A nurse administers an antimuscarinic to a patient. Which
findings indicate the patient is having therapeutic effect from
this medication? (Select all that apply)
A. Decrease in dysuria
B. Decrease in urgency
C. Decrease in frequency
D. Decrease in prostate size
E. Decrease in bladder infection Correct Answer B, C
A nurse is asked how many kcal per grams fats provide. How
should the nurse answer? Correct Answer 9
A nurse is assessing a patient who started to have severe pain 3
days ago. When the nurse asks the patient to describe the pain,
the patient states, "The pain feels like it is in my stomach. It is a
burning pain, and it spreads out in a circle around the spot where
it hurts the most." Which type of pain does the nurse document
the patient is having at this time? Correct Answer Visceral
pain
A nurse is assisting a patient in making dietary choices to
promote healthy bowel elimination. Which menu option should
the nurse recommend? Correct Answer Grape and walnut
chicken salad sandwich on whole wheat bread
A nurse is caring for a group of patients. Which patient will the
nurse see first? Correct Answer A patient who received
morphine and has a pulse of 62 beats/min, respirations 10
breaths/min, and blood pressure 110/60 mm Hg
, A nurse is caring for a group of patients. Which patient will the
nurse see first? Correct Answer Patient receiving total
parenteral nutrition infusing with same tubing for 26 hours
A nurse is caring for a male patient with urinary retention.
Which action should the nurse take first? Correct Answer
Assist to a standing position.
A nurse is caring for a patient experiencing a stress response.
The nurse plans care with the knowledge that systems respond to
stress in what manner? (Select all that apply)
A. Always fail and cause illness and disease
B. Cause negative responses over time
C. React the same way for all individuals
D. Protect an individual from harm in the short term
E. Tolerate the stress response indefinitely Correct Answer B,
D
A nurse is caring for a patient who fell on the ice and has
connective tissue damage in the wrist and hand. The patient
describes the pain as throbbing. Which type of pain does the
nurse document in the patients medical record? Correct Answer
Somatic pain
A nurse is caring for a patient who has had diarrhea for the past
week. Which additional assessment will the nurse expect?
Correct Answer Decreased skin turgor
A nurse is caring for a patient who is experiencing pain
following an abdominal surgery. Which information is important
for the nurse to share with the patient when providing patient
SOLUTIONS
A 72-year-old patient asks the nurse about using an over-the-
counter antihistamine pill to help her get to sleep. What is the
nurses best response? Correct Answer "Antihistamines should
not be used because they can cause confusion and increase your
risk of falls"
A client is receiving an enteral tubing at 65 mL/hr. The gastric
residual volume in 4 hours was 125 mL. What is the priority
nursing intervention? Correct Answer Continue the feedings;
this is normal gastric residual for this feeding
A client is receiving parenteral nutrition (PN) and enteral
nutrition (EN). When would the nurse collaborate with the
health care provider and request a discontinuation of parenteral
nutrition? Correct Answer When 75% of the patients
nutritional needs are met by the tube feedings
A client who is receiving parenteral nutrition (PN) through a
central venous catheter (CVC) has an air embolus. What should
be the nurses priority action? Correct Answer - have the
patient turn on the left side and perform a Valsalva maneuver.
A community health nurse is providing an education session at
the senior center on how to promote sleep. Which practices
should the nurse recommend? (Select all that apply)
A) take a nap in the afternoon
B) sleep where you sleep best
C) use sedatives as a last resort
,D) watch television right before sleep
E) decrease fluids 2 to 4 hours before sleep
F) get up if unable to fall asleep in 15 to 30 mins Correct
Answer B, C, E, F
A female patient is having difficulty voiding in a bedpan but
states her bladder feels full. To stimulate micturition, which
nursing intervention should the nurse try first? Correct Answer
Utilizing the power of suggestion by turning on the faucet and
letting the water run
A guaiac test is ordered for a patient. Which type of blood is the
nurse checking for in this patients stool? Correct Answer
microscopic
A health care provider writes the following order for a patient
who is opioid-naive who returned from the operating room
following a total hip replacement: "fentanyl patch 100 mcg,
change every 3 days." On the basis of this order, the nurse takes
the following action: Correct Answer Calls the health care
provider and questions the order
A Native American patient is asking for a spiritual healer.
Which person should the nurse try to contact for the patient?
Correct Answer Shaman
A new medical resident writes an order for oxycodone CR 10
mg PO q2hr PRN. Which part of the order does the nurse
question? Correct Answer The time interval
,A nurse administers an antimuscarinic to a patient. Which
findings indicate the patient is having therapeutic effect from
this medication? (Select all that apply)
A. Decrease in dysuria
B. Decrease in urgency
C. Decrease in frequency
D. Decrease in prostate size
E. Decrease in bladder infection Correct Answer B, C
A nurse is asked how many kcal per grams fats provide. How
should the nurse answer? Correct Answer 9
A nurse is assessing a patient who started to have severe pain 3
days ago. When the nurse asks the patient to describe the pain,
the patient states, "The pain feels like it is in my stomach. It is a
burning pain, and it spreads out in a circle around the spot where
it hurts the most." Which type of pain does the nurse document
the patient is having at this time? Correct Answer Visceral
pain
A nurse is assisting a patient in making dietary choices to
promote healthy bowel elimination. Which menu option should
the nurse recommend? Correct Answer Grape and walnut
chicken salad sandwich on whole wheat bread
A nurse is caring for a group of patients. Which patient will the
nurse see first? Correct Answer A patient who received
morphine and has a pulse of 62 beats/min, respirations 10
breaths/min, and blood pressure 110/60 mm Hg
, A nurse is caring for a group of patients. Which patient will the
nurse see first? Correct Answer Patient receiving total
parenteral nutrition infusing with same tubing for 26 hours
A nurse is caring for a male patient with urinary retention.
Which action should the nurse take first? Correct Answer
Assist to a standing position.
A nurse is caring for a patient experiencing a stress response.
The nurse plans care with the knowledge that systems respond to
stress in what manner? (Select all that apply)
A. Always fail and cause illness and disease
B. Cause negative responses over time
C. React the same way for all individuals
D. Protect an individual from harm in the short term
E. Tolerate the stress response indefinitely Correct Answer B,
D
A nurse is caring for a patient who fell on the ice and has
connective tissue damage in the wrist and hand. The patient
describes the pain as throbbing. Which type of pain does the
nurse document in the patients medical record? Correct Answer
Somatic pain
A nurse is caring for a patient who has had diarrhea for the past
week. Which additional assessment will the nurse expect?
Correct Answer Decreased skin turgor
A nurse is caring for a patient who is experiencing pain
following an abdominal surgery. Which information is important
for the nurse to share with the patient when providing patient
