VN224 Unit 1 Exam

DRAFT Do Not Use Until Posted. ____________________________________________________________________________ Course Name: - ____________________________________________________________________________ Question #: 1 Following a femur fracture surgical repair, the client develops hemoptysis, wheezing, and cyanosis. The nurse suspects a pulmonary embolus that originated from which site? A. Deep veins of the legs B. bone marrow C. myocardial tissue D. superior vena cava ____________________________________________________________________________ Question #: 2 The nurse is obtaining data from a client with a respiratory disorder. Which information would be considered a part of the functional assessment and assist in the diagnosis of occupational lung disease? A. Cough and dyspnea B. Black-streaked sputum C. Tenacious secretions D. Barrel chest ____________________________________________________________________________ Question #: 3 Upon assessing a client with emphysema, the nurse notes increased difficulty with inspiration. What is the likely cause of this finding? A. Prolonged tobacco use B. Rigid chest cage C. Saccular dilation D. Inflammation of the bronchioles ____________________________________________________________________________ Question #: 4 The client has been self-medicating with antitussives. Which assessment finding would alert the nurse to an adverse effect of this medication? A. crackles in the bases B. increased coughing C. temperature 1010F D. nausea and vomiting ____________________________________________________________________________ Question #: 5 A teenaged client with hemophilia sustains a leg laceration after falling off of his skateboard and is brought to the emergency department. The laceration is bleeding profusely even with direct pressure to the site. What does the nurse anticipate will be ordered for administration to control bleeding? A. Fresh frozen plasma B. A colloid solution such as hetastarch C. a crystalloid solution such as lactated ringers D. albumin ____________________________________________________________________________ Question #: 6 A client is suspected of having leukemia and is having a series of laboratory and diagnostic studies performed. What does the nurse recognize as the hallmark signs of leukemia? (Select all that apply) A. Diarrhea B. Nausea and Vomiting C. Frequent infections D. Fatigue from anemia E. Easy bruising ____________________________________________________________________________ Question #: 7 Parents arrive at the clinic with their young child and inform the nurse the child has just been diagnosed with sickle cell disease. The parents ask the nurse how could this happen and which one of them is the carrier. What is the best response by the nurse? A. "Most likely, the father is the carrier of the gene." B. "The trait is passed down through the mother." C. "The child must inherit two defective genes, one from each parent." D. "It is an acquired, not hereditary disorder." ____________________________________________________________________________ Question #: 8 The nurse is caring for four clients on the medical-surgical unit of the hospital. What client is most likely to be receiving treatment for sickle cell crisis? A. A 29-year-old Caucasian male B. A 19-year-old African American male C. A 24-year-old Native American Female D. A 36-year-old Eastern European female ____________________________________________________________________________ Question #: 9 The nurse is instructing a client about taking a liquid iron preparation for the treatment of iron-deficiency anemia. What should the nurse include in the instructions? A. Do not take the medication with orange juice because it will delay absorption of the iron B. Iron may cause indigestion and should be taken with an antacid such as Mylanta C. Dilute the liquid preparation with another liquid such a juice and drink it with a straw D. Discontinue the use of iron if your stools turn black ____________________________________________________________________________ Question #: 10 The registered nurse (RN) and licensed practical nurse (LPN) are preparing an educational program for clients who may be at risk for the development of iron-deficiency anemia. Which clients would receive the greatest benefit from this program? (Select all that apply) A. A young female client with bulimia nervosa B. An older adult client on a fixed income C. A client with Crohn's disease D. A client who lives in a nursing home E. A client who is a vegetarian ____________________________________________________________________________ Question #: 11 The LPN is following a plan of care for a client who is being treated for hypovolemic anemia and is at risk for hypovolemic shock. The nurse assesses vital signs and O2 saturation and observes the saturation at 83% for 3 minutes. What should the first action by the nurse be? A. Notify the charge nurse B. Prepare to assist with intubation C. Give oxygen per nasal cannula D. Place the client in the supine position ____________________________________________________________________________ Question #: 12 A client is being treated in the hospital for hypovolemia related to a bleeding peptic ulcer. The nurse obtains a blood pressure reading of 88/62 mm Hg, heart rate of 112 beats/min, and a respiratory rate of 24 breaths/min. What is the first action by the nurse? A. Administer blood B. Notify the physician C. Insert two large-bore intravenous catheters D. Administer a colloid solution ____________________________________________________________________________ Question #: 13 A client is experiencing chronic hypovolemic anemia as evidenced by laboratory results. What symptoms does the nurse expect to find for this client when collecting objective data? A. Postural hypotension B. Urinary output of 10 mL/hr C. Altered consciousness D. Extreme Pallor ____________________________________________________________________________ Question #: 14 A client is found to have low hemoglobin and hematocrit lab values. What does the nurse understand the anemia may have resulted from? (Select all that apply) A. Infection B. Blood loss C. Abnormal erythrocyte production D. Destruction of normally formed red blood cells E. inadequate formed white blood cells ____________________________________________________________________________ Question #: 15 A client diagnosed with polycythemia vera has come to the clinic because he has developed a nighttime cough, fatigue, and shortness of breath. From these clinical manifestations, what complication would the nurse expect in this client? A. Stroke B. Tissue Infarction C. Congestive Heart Failure D. Pulmonary embolus ____________________________________________________________________________ Question #: 16 A client with a diagnosis of pernicious anemia comes to the clinic complaining of numbness and tingling in his arms and legs. What do these symptoms indicate? A. Loss of vibratory and position senses B. Neurologic involvement C. Severity of the disease D. Insufficient intake of dietary nutrients ____________________________________________________________________________ Question #: 17 The client was admitted to the emergency department after an accident with a chain saw. The client is exhibiting signs and symptoms of acute hypovolemic anemia from severe blood loss. What signs and symptoms would the nurse assess for? A. Malabsorption disorders B. Postural hypotension C. Fatigue D. Reduced Urine Output ____________________________________________________________________________ Question #: 18 A client is complaining of a sore throat. The nurse inspects the tonsils for size and appearance. What is the appropriate documentation for an observation of tonsils that touch the uvula? A. 1 B. 2 C. 3 D. 4 ____________________________________________________________________________ Question #: 19 A client informs the nurse that he is having a difficult time coping with seasonal allergies and has taken some overthe-counter medications to assist with control of symptoms. What results would indicate to the nurse that the client does have allergies? A. elevated eosinophils B. elevated basophils C. elevated monocytes D. elevated neutrophils ____________________________________________________________________________ Question #: 20 A client is brought to the emergency department with suspected bleeding esophageal varices. Which hemoglobin level should the nurse immediately report to the physician? A. 13.0 g/dL B. 10.2 g/dL C. 5.0 g/dL D. 11.4 g/dL ____________________________________________________________________________ Question #: 21 A client is seeing the physician at the clinic and tells the nurse he is fatigued and short of breath with minimal exertion. What lab study may reflect a decrease in the transport of oxygen? A. Erythrocyte count B. Leukocyte count C. Platelet count D. Albumin level ____________________________________________________________________________ Question #: 22 When obtaining vital signs from a client who has reduced erythrocyte production and a hemoglobin level of 8.3 g/dL, what results would be indicative of these lab studies? A. A heart rate of 120 beats/min B. Respiratory rate of 16 breaths/min C. blood pressure of 140/90 mm Hg D. Oxygen saturation of 95% ____________________________________________________________________________ Question #: 23 A client is taking a medication that has the side effect of depressing the hematopoietic system. What signs of leukopenia should the nurse monitor for while the client is taking this drug? A. Fever, sore throat, and chills. B. Nausea and vomiting C. Diarrhea, diaphoresis, and fever D. Intolerance to heat and rash ____________________________________________________________________________ Question #: 24 A client is being treated for anemia and has a hemoglobin level of 9.6 g/dL. What does the nurse understand is the basic nutritional component of heme in hemoglobin that the client may be deficient in? A. Folic acid B. Copper C. Protein D. Iron ____________________________________________________________________________ Question #: 25 The nurse is discussing vitamin replacement with a client in the clinic. Which vitamin should the nurse discuss with the client in order to increase the absorption of folic acid and iron? A. Vitamin B12 B. Vitamin C C. Vitamin B6 D. Vitamin E ____________________________________________________________________________ Question #: 26 A client with end-stage renal disease has a decreased red blood cell production. What medication can the nurse administer with a physician's order that will increase the production of erythrocytes? A. Filgrastim B. Pegfilgrastim C. Epoetin alfa D. Interleukin 2 ____________________________________________________________________________ Question #: 27 Albumin is a protein in the plasma portion of the blood. Under normal conditions, albumin cannot pass through the wall of the capillary. What significance does this have for the vascular compartment? A. Helps push oxygen into the tissues of the body. B. Retains leukocytes in the vascular compartment. C. Helps retain fluid in the vascular compartment. D. Absorbs carbon dioxide from the tissues for transport to the lungs ____________________________________________________________________________ Question #: 28 Macrophages attack and destroy substances that are foreign to the body. Where does this activity occur? A. At the site of trauma B. In the lymph node C. In the vascular system D. In the thymus ____________________________________________________________________________ Question #: 29 The nursing instructor is teaching her clinical group about laboratory blood tests. What is the major function of erythrocytes? A. Act as mediators for the immune system B. Destroy invading organisms C. Transportation of O2 to the tissues and removal of CO2 from the tissues D. Oxygenation of the brain ____________________________________________________________________________ Question #: 30 A client is admitted to the emergency department with a stab wound in the chest and is now exhibiting dyspnea, tachypnea, and a sucking noise heard on inspiration and expiration. The nurse should care for the wound in which manner? A. Clean the wound and leave open to air B. Apply a vented dressing C. Apply an airtight dressing D. Apply direct pressure to the wound ____________________________________________________________________________ Question #: 31 The client admitted with a deep vein thrombosis (DVT) is now complaining of chest pain and dyspnea. Which is the primary intervention for the nurse to take? A. Apply oxygen via face mask B. Assess and rate the chest pain C. Apply compression stockings D. Prepare for ventilation-perfusion scan ____________________________________________________________________________ Question #: 32 Which statement would indicate that the parents of a child with cystic fibrosis understood the disorder? A. "Early treatment can stop the progression of the disease." B. "The mucus-secreting glands are abnormal." C. "There are fibrous cysts in the lungs." D. "Allergic reactions cause inflammation in the lungs." ____________________________________________________________________________ Question #: 33 Which action should the nurse take first when caring for a client during an acute asthma attack? A. Obtain arterial blood gases B. Send for a STAT chest X-ray C. Administer bronchodilator as ordered D. Initiate oxygen therapy and reassess pulse oximetry in 10 minutes ____________________________________________________________________________ Question #: 34 A client, who is at risk for pneumonia, has been ordered an influenza vaccine. Which statement by the nurse best explains the rationale for this vaccine? A. "Getting the flu can complicate pneumonia." B. "Influenza vaccine will prevent typical pneumonia." C. "Influenza is the major cause of death in the United States." D. "Viruses, like influenza, are the most common cause of pneumonia." ____________________________________________________________________________ Question #: 35 The client with a lower respiratory airway infection is presenting with symptoms such as fever, chills, dry hacking cough, and wheezing. Which nursing diagnosis best supports the assessment by the nurse? A. Risk for infection B. Impaired gas exchange C. Ineffective airway clearance D. Ineffective breathing pattern ____________________________________________________________________________ Question #: 36 The ICU nurse is caring for a client that was admitted with a diagnosis of smoke inhalation. The nurse knows that this client is at an increased risk for which of the following? A. Acute respiratory distress syndrome B. tracheobronchitis C. Lung cancer D. Bronchitis ____________________________________________________________________________ Question #: 37 The nurse is caring for a client who has just been diagnosed with lung cancer. What is a cardinal sign of lung cancer? A. Mucopurulent sputum B. Pain on inspiration C. Obvious trauma D. Shortness of breath ____________________________________________________________________________ Question #: 38 The nurse is assessing a client's potential for pulmonary emboli. WHat finding indicates a possible deep vein thrombosis? A. Pain in the feet B. Coolness to lower extremities C. Decreased urinary output D. Localized calf tenderness ____________________________________________________________________________ Question #: 39 The nurse is caring for a client who is demonstrating signs of increased respiratory distress related to laryngeal obstruction. The nurse is calling the physician to report on the client's condition. Which of the following will the nurse report? ( select all that apply) A. A decreased respiratory rate B. Arterial blood gases reporting a PaCO2 of 48, PaO2, of 84 C. Nasal flaring and abdominal retractions D. Administration of corticosteroid inhaler for quick relief E. Wheezing lung sounds F. Increased respiratory effort ____________________________________________________________________________ Question #: 40 The emergency department nurse is assessing a client following a motor vehicle accident. The nurse notes facial deformities with swelling and bleeding and clear drainage coming from the nares. Which diagnostic test is completed to determine whether the clear drainge is cerebrospinal fluid? A. draw a serum CBC B. Test fluid with nitrazine paper C. Test fluid with a Dextrostix D. Perform a glucometer check ____________________________________________________________________________ Question #: 41 The nurse is obtaining a health history from a client with laryngitis. Which causative factor, stated by the client, is least likely? A. "I have environmental allergies," B. "I smoke a pack of cigarettes a day." C. "I used my voice in excess over the weekend." D. "I was chewing ice chips all day long." ____________________________________________________________________________ Question #: 42 The nurse is providing discharge instructions to a client diagnosed with postoperative tonsillectomy and adenoidectomy. Which discharge instructions would the nurse include? (Select all that apply) A. Postoperative bleeding most often occurs in the hours after surgery B. avoid carbonated fluids C. gradually increase fluids then add soft foods D. apply an ice collar to the neck E. gargle with warm saline water F. limit pain medication to the nighttime ____________________________________________________________________________ Question #: 43 The nurse initiates the following intervention upon receiving a client back to the clinical unit after a procedure on the throat: Elevate the head of the bed (HOB) 45o . Which nursing goal will be met with this intervention? A. The client will have decreased pain B. The client will be alert and oriented C. The client will have decreased edema D. The client will have increased tissue perfussion ____________________________________________________________________________ Question #: 44 The nurse is receiving a client in the PACU (post-anesthesia care unit) status post-tonsillectomy and adenoidectomy. The unlicensed assistive personnel is assisting the client from the stretcher to the bed. The client remains drowsy from the anesthesia. In which position would the nurse instruct the unlicensed assistive personnel to place the client? A. side lying B. supine C. semi-fowler's D. high-fowler's ____________________________________________________________________________ Question #: 45 The nurse is caring for a client diagnosed with coryza, possibly from the rhinovirus. Vital signs are:temperature 102.2F, Pulse 72bpm, Respirations 28, B/P 112/70mm Hg. Upon morning assessment the client reports a sore throat, moist cough, and watery eyes. The lungs are course in the bases. Which afternoon assessment finding suggests the advancement to an infectious process? A. achiness B. headache C. elevated temperature D. increased respiratory rate ____________________________________________________________________________ Question #: 46 The nurse is caring for a client who has just had a tracheostomy. What should the nurse monitor frequently? A. airway patency B. level of consciousness C. psychologic status D. pain level ____________________________________________________________________________ Question #: 47 The nurse is an occupational health nurse who is presenting a workshop on laryngeal cancer. What risk factors would the nurse be sure to include in the workshop? (select all that apply) A. alcohol B. age C. tobacco D. industrial pollutants E. region of the country the clien lives in ____________________________________________________________________________ Question #: 48 The nurse is caring for a client status postnasal polypectomy. What would the nurse instruct this client to report? A. excessive swallowing B. nasal stuffiness C. diarrhea D. coughing ____________________________________________________________________________ Question #: 49 A client comes into the emercency department with epistaxis. What intervention should the nurse perform when caring for a client with epistaxis? A. apply a moustache dressing B. provide a nasal splint C. apply direct continuous pressure D. place the client in a semi-fowler's position ____________________________________________________________________________ Question #: 50 A client in the clinic asks the nurse to explain the function(s) of the skin. The nurse explains to the client all of the following are functions of skin except? A. protection B. temperature regulation C. oxygentation D. sensatio