NURS 400 Midterm Questions With Complete Solutions
A 25-year-old client taking hydroxychloroquine for rheumatoid
arthritis reports difficulty seeing out of their left eye. What does
this finding indicate? Correct Answers possible retinal
degeneration
Difficulty seeing out of one eye, when evaluated in conjunction
with the client's medication therapy regimen, leads to the
suspicion of possible retinal degeneration. The possibility of an
irreversible retinal degeneration caused by deposits of
hydroxychloroquine in the layers of the retina requires an
ophthalmologic examination before therapy is begun and at 6-
month intervals.
A 29-year-old client is concerned about their personal risk
factors for malignant melanoma. They are upset because their
49-year-old sibling was recently diagnosed with the disease.
After gathering information about the client's history of sun
exposure, the nurse should tell the client which information?
Correct Answers Some melanomas have a familial component,
and the client should seek medical advice.
Malignant melanoma may have a familial basis, especially in
families with dysplastic nevi syndrome. First-degree relatives
should be monitored closely. Malignant melanoma occurs most
often in the 20- to 45-year-old age group. Severe sunburn as a
child does increase the risk; however, this client is at increased
risk because of their family history.
,A 35-year-old client is brought to the emergency department
with second- and third-degree burns over 15% of the body.
Admission vital signs are blood pressure 100/50 mm Hg, heart
rate 130 beats/minute, and respiratory rate 26 breaths/minute.
Which nursing interventions are appropriate for this client?
Select all that apply. Correct Answers Begin an intravenous
(I.V.) infusion of lactated Ringer's solution.
Administer 6 mg of IV morphine.
Administer tetanus prophylaxis, as ordered.
A 35-year-old client is diagnosed with aplastic anemia. Which
nursing measure should the nurse incorporate into the client's
plan of care? Correct Answers Alternate periods of activity with
rest to decrease fatigue
Activity intolerance is a common problem for clients with
aplastic anemia due to decreased hemoglobin. Alternating
activity with periods of rest and assisting the client with
activities of daily living are appropriate nursing interventions.
Antibiotics will not be administered prophylactically. The client
should be taught self-care activities to decrease the likelihood of
developing an infection.
Adequate fluid intake is important, but the client does not need
to force fluids. Hemoconcentration is not a problem in aplastic
anemia.
The client should be taught good handwashing techniques and
limit contact with individuals who have respiratory illnesses;
however, the client does not have to avoid all social situations.
,A client admitted with a massive myocardial infarction rapidly
develops cardiogenic shock. Ideally, the health care provider
would use the intra-aortic balloon pump (IABP) to support the
injured myocardium. However, this client has a history of
unstable angina pectoris, aortic insufficiency, hypertension, and
diabetes mellitus. Which condition is a contraindication for
IABP use? Correct Answers aortic insufficiency
A history of aortic insufficiency contraindicates use of the
IABP. Other contraindications for this therapy include aortic
aneurysm, central or peripheral atherosclerosis, chronic end-
stage heart disease, multisystemic failure, chronic debilitating
disease, bleeding disorders, and a history of emboli.
A client arrives via ambulance with a suspected pelvic fracture
from a motor vehicle collision. The client's vital signs are: blood
pressure 85/50 mm Hg, heart rate 120 beats/min, respiratory rate
22 breaths/min, and an oxygen saturation of 98% on room air.
The client is afebrile. The health care provider has written
several prescriptions. What is the nurse's priority action? Correct
Answers Obtain STAT hemoglobin and group and match.
A client being discharged after treatment for a compound
fracture asks why antibiotics are needed for a broken bone.
Which response by the nurse is most appropriate? Correct
Answers "This prophylactic antibiotic therapy is required
because your bone broke through your skin."
A client being treated for leukemia has an absolute neutrophil
count of 400 cells/mm3. What precautions would the nurse
, include in the plan of care? Correct Answers Place sign on
client's door reminding all persons to wash hands prior to
entering
Neutrophils fall below 1000 or less than 500 reflects a severe
risk of infection. Positive pressure isolation room.
A client comes to the emergency department reporting pain in
the right leg. When obtaining the history, the nurse learns that
the client has a history of obesity and hypertension. Based on
this information the nurse anticipates the client having which
musculoskeletal disorder? Correct Answers degenerative joint
disease
A client comes to the emergency department stating, "I was
cleaning the bathroom and dropped the open container of
bathroom cleaner on the floor. I felt a fair amount of the cleaner
hit the right side of my face. I brushed it off my face, but now
my face is burning, and so is my right eye." Inspection reveals a
bright reddened area about the size of a baseball on the right
cheek and redness and irritation of the right eye. Irrigation of the
burn area is ordered. When implementing this order, the nurse
should take which action? Correct Answers positioning the
right side of the face and eye lower than the left
A client developed cardiogenic shock after a severe myocardial
infarction and has now developed acute kidney failure. The
client's family asks the nurse why the client has developed acute
renal failure. What should the nurse tell the family?
"Because of the cardiogenic shock, there is: Correct Answers a
decrease in the blood flow through the kidneys
A 25-year-old client taking hydroxychloroquine for rheumatoid
arthritis reports difficulty seeing out of their left eye. What does
this finding indicate? Correct Answers possible retinal
degeneration
Difficulty seeing out of one eye, when evaluated in conjunction
with the client's medication therapy regimen, leads to the
suspicion of possible retinal degeneration. The possibility of an
irreversible retinal degeneration caused by deposits of
hydroxychloroquine in the layers of the retina requires an
ophthalmologic examination before therapy is begun and at 6-
month intervals.
A 29-year-old client is concerned about their personal risk
factors for malignant melanoma. They are upset because their
49-year-old sibling was recently diagnosed with the disease.
After gathering information about the client's history of sun
exposure, the nurse should tell the client which information?
Correct Answers Some melanomas have a familial component,
and the client should seek medical advice.
Malignant melanoma may have a familial basis, especially in
families with dysplastic nevi syndrome. First-degree relatives
should be monitored closely. Malignant melanoma occurs most
often in the 20- to 45-year-old age group. Severe sunburn as a
child does increase the risk; however, this client is at increased
risk because of their family history.
,A 35-year-old client is brought to the emergency department
with second- and third-degree burns over 15% of the body.
Admission vital signs are blood pressure 100/50 mm Hg, heart
rate 130 beats/minute, and respiratory rate 26 breaths/minute.
Which nursing interventions are appropriate for this client?
Select all that apply. Correct Answers Begin an intravenous
(I.V.) infusion of lactated Ringer's solution.
Administer 6 mg of IV morphine.
Administer tetanus prophylaxis, as ordered.
A 35-year-old client is diagnosed with aplastic anemia. Which
nursing measure should the nurse incorporate into the client's
plan of care? Correct Answers Alternate periods of activity with
rest to decrease fatigue
Activity intolerance is a common problem for clients with
aplastic anemia due to decreased hemoglobin. Alternating
activity with periods of rest and assisting the client with
activities of daily living are appropriate nursing interventions.
Antibiotics will not be administered prophylactically. The client
should be taught self-care activities to decrease the likelihood of
developing an infection.
Adequate fluid intake is important, but the client does not need
to force fluids. Hemoconcentration is not a problem in aplastic
anemia.
The client should be taught good handwashing techniques and
limit contact with individuals who have respiratory illnesses;
however, the client does not have to avoid all social situations.
,A client admitted with a massive myocardial infarction rapidly
develops cardiogenic shock. Ideally, the health care provider
would use the intra-aortic balloon pump (IABP) to support the
injured myocardium. However, this client has a history of
unstable angina pectoris, aortic insufficiency, hypertension, and
diabetes mellitus. Which condition is a contraindication for
IABP use? Correct Answers aortic insufficiency
A history of aortic insufficiency contraindicates use of the
IABP. Other contraindications for this therapy include aortic
aneurysm, central or peripheral atherosclerosis, chronic end-
stage heart disease, multisystemic failure, chronic debilitating
disease, bleeding disorders, and a history of emboli.
A client arrives via ambulance with a suspected pelvic fracture
from a motor vehicle collision. The client's vital signs are: blood
pressure 85/50 mm Hg, heart rate 120 beats/min, respiratory rate
22 breaths/min, and an oxygen saturation of 98% on room air.
The client is afebrile. The health care provider has written
several prescriptions. What is the nurse's priority action? Correct
Answers Obtain STAT hemoglobin and group and match.
A client being discharged after treatment for a compound
fracture asks why antibiotics are needed for a broken bone.
Which response by the nurse is most appropriate? Correct
Answers "This prophylactic antibiotic therapy is required
because your bone broke through your skin."
A client being treated for leukemia has an absolute neutrophil
count of 400 cells/mm3. What precautions would the nurse
, include in the plan of care? Correct Answers Place sign on
client's door reminding all persons to wash hands prior to
entering
Neutrophils fall below 1000 or less than 500 reflects a severe
risk of infection. Positive pressure isolation room.
A client comes to the emergency department reporting pain in
the right leg. When obtaining the history, the nurse learns that
the client has a history of obesity and hypertension. Based on
this information the nurse anticipates the client having which
musculoskeletal disorder? Correct Answers degenerative joint
disease
A client comes to the emergency department stating, "I was
cleaning the bathroom and dropped the open container of
bathroom cleaner on the floor. I felt a fair amount of the cleaner
hit the right side of my face. I brushed it off my face, but now
my face is burning, and so is my right eye." Inspection reveals a
bright reddened area about the size of a baseball on the right
cheek and redness and irritation of the right eye. Irrigation of the
burn area is ordered. When implementing this order, the nurse
should take which action? Correct Answers positioning the
right side of the face and eye lower than the left
A client developed cardiogenic shock after a severe myocardial
infarction and has now developed acute kidney failure. The
client's family asks the nurse why the client has developed acute
renal failure. What should the nurse tell the family?
"Because of the cardiogenic shock, there is: Correct Answers a
decrease in the blood flow through the kidneys
