NUR 258 Exam #4 Study Guide Questions With Complete
Solutions
___ is a key component of disaster management Correct
Answer Communication
___, ___, and ___ are hallmarks of the severity of atelectasis
Correct Answer Tachypnea
Dyspnea
Mild to moderate hypoxemia
"Radiation is used to shrink the tumor size and is an adjunct to
surgery." Correct Answer A patient with an advanced
laryngeal tumor is to have radiation therapy. The patient tells the
nurse, "If I am going to have radiation, I won't need surgery."
What is the best response by the nurse?
A female patient was sexually assaulted when leaving work.
When assisting the physician with a physical exam, what
nursing interventions should be performed? Correct Answer
Assess and document any bruises and laceration
Record a history of the event, using the patient's own words
Label all torn or bloody clothes and place each item in a separate
brown bag so that any evidence can be given to the police
A nuclear reactor overheated, releasing radiation throughout the
plant. A worker close to the reactor received at least 800 rads
and has had an onset of vomiting, steatorrhea, and was brought
in in shock. What is this patient's predicted survival? Correct
Answer Likely
,A nurse is working as a camp nurse during the summer. A camp
counselor comes to the clinic after receiving a snakebite on the
arm. What is the first action by the nurse? Correct Answer
Have the patient lie down and place the arm below the level of
the heart
A patient arrives in the ED after being involved in a motor
vehicle accident. The nurse observes paradoxical chest
movement when removing the patient's shirt. What does the
nurse know that this finding indicates? Correct Answer Flail
chewst
A patient comes to the clinic with fever, cough, and chest
discomfort. The nurse auscultates crackles in the left lower base
of the lung and suspects that the patient may have pneumonia.
What does the nurse recognize is the most common organism
that causes community-acquired pneumonia? Correct Answer
Streptococcus pneumoniae
A patient has a Mantoux skin test prior to being placed on an
immunosuppressant for the treatment of Crohn's disease. What
results would the nurse determine is not significant for holding
the medication? Correct Answer 0-4 mm
A patient has experienced blunt abdominal trauma from a MVA.
The nurse assesses the patient, knowing that which organ is
most frequently injured? Correct Answer Liver
A patient is admitted to the hospital with pulmonary arterial
hypertension. What assessment finding by the nurse is a
significant finding in this patient? Correct Answer Dyspnea
, A patient is being brought into the ED who is probably infected
with anthrax. The nurse should ensure what level of PPE to wear
for everyone who will come into contact with this patient?
Correct Answer Level D
A patient is brought to the ED by a friend who states that a tree
fell on the patient's leg and crushed it while they were cutting
fire-wood. What priority nursing actions should the nurse
perform? Correct Answer Applying a clean dressing to protect
the wound
Elevating the site to limit the accumulation of fluid in the
interstitial spaces
Splinting the wound in a position of rest to prevent motion
A patient is brought to the ED by the rescue squad after getting
off a plane at the airport with reports of severe joint pain,
numbness, and an inability to move the arms. The patient was on
a diving vacation and went for a last dive this morning before
flying home. What is a priority action by the nurse? Correct
Answer Ensure a patent airway and that the patient is receiving
100% O2
A patient is suspected to have an air embolus after being in close
proximity to an explosion at a sports arena. What position
should the nurse place the patient in to prevent migration of the
embolus? Correct Answer Prone left lateral
A patient taking INH therapy for TB demonstrates
understanding when making which statement? Correct Answer
"It is alright if I have a grilled cheese with American cheese."
Solutions
___ is a key component of disaster management Correct
Answer Communication
___, ___, and ___ are hallmarks of the severity of atelectasis
Correct Answer Tachypnea
Dyspnea
Mild to moderate hypoxemia
"Radiation is used to shrink the tumor size and is an adjunct to
surgery." Correct Answer A patient with an advanced
laryngeal tumor is to have radiation therapy. The patient tells the
nurse, "If I am going to have radiation, I won't need surgery."
What is the best response by the nurse?
A female patient was sexually assaulted when leaving work.
When assisting the physician with a physical exam, what
nursing interventions should be performed? Correct Answer
Assess and document any bruises and laceration
Record a history of the event, using the patient's own words
Label all torn or bloody clothes and place each item in a separate
brown bag so that any evidence can be given to the police
A nuclear reactor overheated, releasing radiation throughout the
plant. A worker close to the reactor received at least 800 rads
and has had an onset of vomiting, steatorrhea, and was brought
in in shock. What is this patient's predicted survival? Correct
Answer Likely
,A nurse is working as a camp nurse during the summer. A camp
counselor comes to the clinic after receiving a snakebite on the
arm. What is the first action by the nurse? Correct Answer
Have the patient lie down and place the arm below the level of
the heart
A patient arrives in the ED after being involved in a motor
vehicle accident. The nurse observes paradoxical chest
movement when removing the patient's shirt. What does the
nurse know that this finding indicates? Correct Answer Flail
chewst
A patient comes to the clinic with fever, cough, and chest
discomfort. The nurse auscultates crackles in the left lower base
of the lung and suspects that the patient may have pneumonia.
What does the nurse recognize is the most common organism
that causes community-acquired pneumonia? Correct Answer
Streptococcus pneumoniae
A patient has a Mantoux skin test prior to being placed on an
immunosuppressant for the treatment of Crohn's disease. What
results would the nurse determine is not significant for holding
the medication? Correct Answer 0-4 mm
A patient has experienced blunt abdominal trauma from a MVA.
The nurse assesses the patient, knowing that which organ is
most frequently injured? Correct Answer Liver
A patient is admitted to the hospital with pulmonary arterial
hypertension. What assessment finding by the nurse is a
significant finding in this patient? Correct Answer Dyspnea
, A patient is being brought into the ED who is probably infected
with anthrax. The nurse should ensure what level of PPE to wear
for everyone who will come into contact with this patient?
Correct Answer Level D
A patient is brought to the ED by a friend who states that a tree
fell on the patient's leg and crushed it while they were cutting
fire-wood. What priority nursing actions should the nurse
perform? Correct Answer Applying a clean dressing to protect
the wound
Elevating the site to limit the accumulation of fluid in the
interstitial spaces
Splinting the wound in a position of rest to prevent motion
A patient is brought to the ED by the rescue squad after getting
off a plane at the airport with reports of severe joint pain,
numbness, and an inability to move the arms. The patient was on
a diving vacation and went for a last dive this morning before
flying home. What is a priority action by the nurse? Correct
Answer Ensure a patent airway and that the patient is receiving
100% O2
A patient is suspected to have an air embolus after being in close
proximity to an explosion at a sports arena. What position
should the nurse place the patient in to prevent migration of the
embolus? Correct Answer Prone left lateral
A patient taking INH therapy for TB demonstrates
understanding when making which statement? Correct Answer
"It is alright if I have a grilled cheese with American cheese."
