NR 464 - EXAM 4 (WANGS QUESTIONS)
1. The nurse is evaluating a patient's laboratory results. Based upon the laboratory
findings, what results will cause the release of an antidiuretic hormone (ADH)?
a. Increased serum sodium
b. Decreased serum sodium
c. Decrease in serum osmolality
d. Decrease in thirst - Answer -A
2. Your patient has alcoholism, and you may suspect during your assessment that his
serum magnesium is low. What will the nurse potentially expect to assess to
hypomagnesemia?
a. Tremor
b. Pruritus
c. Edema
d. Decreased blood pressure - Answer -A
3. A nurse sees a variety of patients in the community health clinic. Which of the
following patients would be at the greatest risk of dehydration?
a. An 18 year old basketball player with a stress fracture of the right foot
b. An infant with diarrhea
c. A 45 year old with stomach flu
d. An elderly patient living alone - Answer -B
4. The nurse is caring for a post-thyroidectomy patient at risk for hypocalcemia. What
action should the nurse take when assessing for hypocalcemia?
a. Monitor laboratory daily for an elevated thyroid-stimulating hormone
b. Observe for swelling of the neck, tracheal deviation and severe pain
c. Evaluate the quality of the patient's voice postoperatively, noting any drastic changes
d. Observe for muscle twitching and numbness or tingling of the lips, fingers and toes -
Answer -D
5. The nurse in the intensive care unit receives arterial blood gases (ABG) with a patient
who is complaining of being "short of breath." The ABG has the following values: pH =
7.21, PaCO2 = 64 mmHg, HCO3 = 24 mmHg. The labs reflect:
a. Respiratory acidosis
b. Metabolic alkalosis
,c. Respiratory alkalosis
d. Metabolic acidosis - Answer -A
6. A nursing intervention to assess the hemodynamic effects of dysrhythmia on the
patient would be to:
a. Obtain an ECG rhythm strip
b. Obtain a blood level of drugs administered
c. Assess the patients level of anxiety
d. Assess the patients BP and pulse rate - Answer -D
7. The triage nurse notes upon assessment in the emergency room that the patient with
anxiety is hyperventilating. The nurse is aware hat hyperventilation is the most common
cause of which acid-base imbalance?
a. Respiratory acidosis
b. Respiratory alkalosis
c. Increase PaCO2
d. Central nervous system (CNS) distubances - Answer -B
8. The nurse caring for a patient on the telemetry floor who is experiencing symptomatic
sinus bradycardia is aware the medication of choice for treatment of this dysthymia is
atropine. What guidelines will the nurse following when administering atropine?
a. Administer atropine 0.5 mg rapidly as an IV bolus every 3-5 minutes to a maximum
total dose of 3 mg
b. Administer atropine 0.5 mg slowly as an IV bolus every minute to a maximum total
dose of 3 mg
c. Administer atropine 1.0 mg rapidly as an IV bolus every 3-5 minutes to a maximum
total dose of 3 mg
d. Administer atropine 1.0 mg slowly as an IV bolus every minute to a maximum total
dose of 3 mg - Answer -A
9. The nurse caring for a patient in the critical care unit who has a central venous
pressure (CVP) monitoring system notes that the patient's CVP is increasing and is
aware that this increased pressure may be indicative of:
a. Hypovolemia
b. Hypervolemia
c. Hypermagnesemia
, d. Hypomagnesemia - Answer -B
10. The nurse is aware that teaching related to the prevention of HIV should focus on:
a. Vaccinating all individual to decrease their risk of contracting HIV
b. Providing educational programs that focus on control and prevention
c. Instructing sexually active individuals on the proper usage of non-latex condoms
d. Instructing sexually active individuals on the use of microbicide, nonoxynol-9 (N-9) -
Answer -B
11. A 20 year old woman infected with HIV is seen in an outreach clinic symptoms
associated with her disease. The patient is a known IV drug user and has admitted to
several sexual partners in the last year. Which of the following statements would
indicate that the patient understands the risk factors related to HIV?
a. "I should not share cigarettes with people"
b. "I can use a condom lubricated with petroleum jelly for sexual intercourse"
c. "I can have unprotected oral sex"
d. "If I become pregnant, I could pass the virus to my unborn child" - Answer -D
12. Which nursing intervention takes highest priority for the nurse caring for an
unconscious patient?
a. Inserting an indwelling urinary catheter
b. Maintaining a patent airway
c. Putting a NG tube in place
d. Administering an enema daily - Answer -B
13. The nurse caring for a patient with a brain tumor who has increased intracranial
pressure recognizes which of the following as a late sign of increased ICP?
a. Disorientation
b. Tachycardia
c. Widening pulse pressure
d. Headache that is constant - Answer -C
1. The nurse is evaluating a patient's laboratory results. Based upon the laboratory
findings, what results will cause the release of an antidiuretic hormone (ADH)?
a. Increased serum sodium
b. Decreased serum sodium
c. Decrease in serum osmolality
d. Decrease in thirst - Answer -A
2. Your patient has alcoholism, and you may suspect during your assessment that his
serum magnesium is low. What will the nurse potentially expect to assess to
hypomagnesemia?
a. Tremor
b. Pruritus
c. Edema
d. Decreased blood pressure - Answer -A
3. A nurse sees a variety of patients in the community health clinic. Which of the
following patients would be at the greatest risk of dehydration?
a. An 18 year old basketball player with a stress fracture of the right foot
b. An infant with diarrhea
c. A 45 year old with stomach flu
d. An elderly patient living alone - Answer -B
4. The nurse is caring for a post-thyroidectomy patient at risk for hypocalcemia. What
action should the nurse take when assessing for hypocalcemia?
a. Monitor laboratory daily for an elevated thyroid-stimulating hormone
b. Observe for swelling of the neck, tracheal deviation and severe pain
c. Evaluate the quality of the patient's voice postoperatively, noting any drastic changes
d. Observe for muscle twitching and numbness or tingling of the lips, fingers and toes -
Answer -D
5. The nurse in the intensive care unit receives arterial blood gases (ABG) with a patient
who is complaining of being "short of breath." The ABG has the following values: pH =
7.21, PaCO2 = 64 mmHg, HCO3 = 24 mmHg. The labs reflect:
a. Respiratory acidosis
b. Metabolic alkalosis
,c. Respiratory alkalosis
d. Metabolic acidosis - Answer -A
6. A nursing intervention to assess the hemodynamic effects of dysrhythmia on the
patient would be to:
a. Obtain an ECG rhythm strip
b. Obtain a blood level of drugs administered
c. Assess the patients level of anxiety
d. Assess the patients BP and pulse rate - Answer -D
7. The triage nurse notes upon assessment in the emergency room that the patient with
anxiety is hyperventilating. The nurse is aware hat hyperventilation is the most common
cause of which acid-base imbalance?
a. Respiratory acidosis
b. Respiratory alkalosis
c. Increase PaCO2
d. Central nervous system (CNS) distubances - Answer -B
8. The nurse caring for a patient on the telemetry floor who is experiencing symptomatic
sinus bradycardia is aware the medication of choice for treatment of this dysthymia is
atropine. What guidelines will the nurse following when administering atropine?
a. Administer atropine 0.5 mg rapidly as an IV bolus every 3-5 minutes to a maximum
total dose of 3 mg
b. Administer atropine 0.5 mg slowly as an IV bolus every minute to a maximum total
dose of 3 mg
c. Administer atropine 1.0 mg rapidly as an IV bolus every 3-5 minutes to a maximum
total dose of 3 mg
d. Administer atropine 1.0 mg slowly as an IV bolus every minute to a maximum total
dose of 3 mg - Answer -A
9. The nurse caring for a patient in the critical care unit who has a central venous
pressure (CVP) monitoring system notes that the patient's CVP is increasing and is
aware that this increased pressure may be indicative of:
a. Hypovolemia
b. Hypervolemia
c. Hypermagnesemia
, d. Hypomagnesemia - Answer -B
10. The nurse is aware that teaching related to the prevention of HIV should focus on:
a. Vaccinating all individual to decrease their risk of contracting HIV
b. Providing educational programs that focus on control and prevention
c. Instructing sexually active individuals on the proper usage of non-latex condoms
d. Instructing sexually active individuals on the use of microbicide, nonoxynol-9 (N-9) -
Answer -B
11. A 20 year old woman infected with HIV is seen in an outreach clinic symptoms
associated with her disease. The patient is a known IV drug user and has admitted to
several sexual partners in the last year. Which of the following statements would
indicate that the patient understands the risk factors related to HIV?
a. "I should not share cigarettes with people"
b. "I can use a condom lubricated with petroleum jelly for sexual intercourse"
c. "I can have unprotected oral sex"
d. "If I become pregnant, I could pass the virus to my unborn child" - Answer -D
12. Which nursing intervention takes highest priority for the nurse caring for an
unconscious patient?
a. Inserting an indwelling urinary catheter
b. Maintaining a patent airway
c. Putting a NG tube in place
d. Administering an enema daily - Answer -B
13. The nurse caring for a patient with a brain tumor who has increased intracranial
pressure recognizes which of the following as a late sign of increased ICP?
a. Disorientation
b. Tachycardia
c. Widening pulse pressure
d. Headache that is constant - Answer -C
