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    Exam Review

    1. A nurse's plan of care for a patient with rheumatoid arthritis includes several exercise-based interventions. Exercises for patients with rheumatoid disorders should have which of the following goals?
      A)
      Maximize range of motion while minimizing exertion.
      B)
      Increase joint size and strength.
      C)
      Limit energy output in order to preserve strength for healing.
      D)
      Preserve and increase range of motion while limiting joint stress.
    2. The nurse is reviewing a newly admitted patient's electronic health record, which notes a history of orthopnea. What nursing action is most clearly indicated?
      A)
      Teach the patient deep breathing and coughing exercises.
      B)
      Administer supplemental oxygen at all times.
      C)
      Limit the patient's activity level.
      D)
      Avoid positioning the patient supine.
    3. The nurse is assessing a patient with chronic hyperinflation of the lungs. What would the nurse most likely assess in this patient?
      A)
      A hypersternal chest.
      B)
      A kyphotic chest.
      C)
      A barrel chest.
      D)
      A pigeon chest.
    4. A nurse is caring for a patient who just has been diagnosed with a peptic ulcer. When teaching the patient about his new diagnosis, how should the nurse best describe a peptic ulcer?
      A)
      Inflammation of the lining of the stomach.
      B)
      Erosion of the lining of the stomach or duodenum.
      C)
      Bleeding from the mucosa in the stomach.
      D)
      Viral invasion of the stomach wall.
    Page 1 of 20

    Exam Review

    1. A patient has been diagnosed with uterine and ovarian cancer. The nurse is preparing her for surgery prior to her hysterectomy and oophorectomy. The nurse is witnessing the patient's signature on a consent form. Which comment by the patient would best indicate informed consent?
      A)
      "I know I will be fine because the physician said he has done this procedure hundreds of times.”.
      B)
      "I know I will have pain after the surgery but they will do their best to keep it to a minimum.”.
      C)
      "The physician is going to remove my uterus and ovaries and told me about the risk of bleeding.”.
      D)
      "Because the physician isn't taking my ovaries, I will still be able to have children.”.
    2. An oncology patient has begun to experience skin reactions to radiation therapy, prompting the nurse to make the diagnosis Impaired Skin Integrity: erythematous reaction to radiation therapy. What intervention best addresses this nursing diagnosis?
      A)
      Apply a heating pad PRN to relieve pain and pruritus.
      B)
      Massage the area to enhance blood flow to the area.
      C)
      Apply hydrocortisone cream PRN.
      D)
      Avoid rubbing or scratching the affected area.
    3. The nurse is caring for a patient who has just been transferred to the PACU from the OR. What is the highest nursing priority?
      A)
      Assessing for hemorrhage.
      B)
      Maintaining a patent airway.
      C)
      Managing the patient's pain.
      D)
      Assessing vital signs every 30 minutes.
    4. A patient seeking care because of recurrent heartburn and regurgitation is subsequently diagnosed with a hiatal hernia. Which of the following should the nurse include in health education?
      A)
      "Drinking beverages after your meal, rather than with your meal, may bring some relief.”.
      B)
      "It is best to avoid dry foods, such as rice and chicken, because they are harder to swallow.”.
      C)
      "Many patients obtain relief by taking over-the-counter antacids 30 minutes before eating.”.
      D)
      "Instead of eating three meals a day, try eating smaller amounts more often.”
    Page 2 of 20

    Exam Review

    1. Which client is at highest risk of compromised immunity?
      A)
      A client who has just had surgery due to an open femur fracture.
      B)
      A client with diabetes with fasting blood glucose of 102 and A1C of 5.5 percent.
      C)
      A client who has an elevated BNP.
      D)
      A client who has atrial fibrillation.
    2. A patient is receiving warfarin therapy. Which lab should be reviewed to indicate the medication is therapeutic?
      A)
      Platelets.
      B)
      INR.
      C)
      Hemoglobin.
      D)
      PTT.
    3. A female patient has been experiencing recurrent urinary tract infections. What health education should the nurse provide to this patient?
      A)
      Bathe weekly to keep the perineal region clean.
      B)
      Avoid voiding immediately after sexual intercourse.
      C)
      Drink large amounts of fluids throughout the day.
      D)
      Void at least every 6 to 8 hours.
    4. A patient is having a fight or flight response after receiving bad news about his prognosis. What effect will this have on the patient's sympathetic nervous system?
      A)
      Decreased cortisol secretion.
      B)
      Increased heart rate.
      C)
      Decrease in the adrenergic stimulation.
      D)
      Constriction of pupils.
    Page 3 of 20

    Exam Review

    1. A patient scheduled for magnetic resonance imaging (MRI) has arrived at the radiology department. The nurse who prepares the patient for the MRI should prioritize which of the following actions?
      A)
      Withholding stimulants 24 to 48 hours prior to exam.
      B)
      Removing all metal-containing objects.
      C)
      Instructing the patient to void prior to the MRI.
      D)
      Initiating an IV line for administration of contrast.
    2. A 50-year-old man diagnosed with leukemia will begin chemotherapy. What would the nurse do to combat the most common adverse effects of chemotherapy?
      A)
      Administer an antiemetic.
      B)
      Administer steroid cream to decrease redness at the site.
      C)
      Administer an antibiotic.
      D)
      Administer an anticoagulant.
    3. The surgeon's preoperative assessment of a patient has identified that the patient is at a high risk for venous thromboembolism. Once the patient is admitted to the postsurgical unit, what intervention should the nurse prioritize to reduce the patient's risk of developing this complication?
      A)
      Encourage the use of the incentive spirometer every 1-2 hours.
      B)
      Encourage early ambulation.
      C)
      Encourage oral fluid intake.
      D)
      Perform passive range-of-motion exercises every 8 hours.
    4. You are to give 1000ml of IV fluid over 8 hours. You hung a new bag at 2200. At 0100 you found that 425ml has infused. To finish the fluids on time, what would your adjusted hourly rate be?
    Page 4 of 20

    Exam Review

    1. A patient returns to the floor after a laparoscopic cholecystectomy. The nurse should assess the patient for signs and symptoms of what serious potential complication of this surgery?
      A)
      Diabetic coma.
      B)
      Decubitus ulcer.
      C)
      Wound evisceration.
      D)
      Bile duct injury.
      E)
      Bile duct injury.
    2. A young adult client newly diagnosed with type 1 diabetes mellitus has been taught about self-care. Which statement by the client indicates a good understanding of needed eye examinations?
      A)
      At my age, I should continue seeing the ophthalmologist as I usually do.
      B)
      I will see the eye doctor whenever I have a vision problem and yearly after age 40.
      C)
      My vision will change quickly now.
      D)
      I should see the ophthalmologist twice a year.
    3. Your client has been on long-term oral steroids to manage end-stage COPD. You know that utilizing steroids for a long period will decrease immunity and potentially cause which of the following?
      A)
      Osteoarthritis.
      B)
      Osteoporosis.
      C)
      Rheumatoid arthritis.
      D)
      Systemic lupus erythematosus.
    4. You are providing education to a client with diabetes regarding hypoglycemia. Which of the following statements would be included in the teaching?
      A)
      Hypoglycemia triggers the parasympathetic nervous system which causes bradycardia.
      B)
      Hypoglycemia can be caused by too little food or excessive activity.
      C)
      Hypoglycemia will resolve with rest and increased fluid intake.
      D)
      If your blood glucose levels are low, you will need to increase your evening Lantus (glargine).
    Page 5 of 20

    Exam Review

    1. The nurse is caring for a patient who underwent lithotripsy for kidney stones earlier in the day. What instruction should the nurse give the patient?
      A)
      Limit oral fluid intake for 1 to 2 days.
      B)
      Report the presence of fine, sand-like particles in the urine.
      C)
      Notify the physician about cloudy or foul-smelling urine.
      D)
      Report any pink-tinged urine within 24 hours after the procedure.
    2. You suspect your client has cholecystitis. Where would the client complain of pain?
      A)
      Right upper quadrant radiating to the right shoulder.
      B)
      Left lower quadrant with radiation to the groin.
      C)
      Periumbilical area moving to McBurney's point.
      D)
      Epigastric area radiating to the left scapula.
      E)
      Epigastric area radiating to the left scapula.
    3. An adult patient is in the post-anesthesia recovery room following a nephrectomy performed for the treatment of renal cell carcinoma. The patient's vital signs and level of consciousness stabilized, but the patient then complains of severe nausea and begins to vomit. What is the nurse's immediate next action?
      A)
      Administer a dose of IV ondansetron.
      B)
      Apply a cool cloth to the patient's forehead.
      C)
      Offer the patient a small amount of ice chips.
      D)
      Turn the patient completely to one side.
    4. An older adult patient has been diagnosed with COPD. What characteristic of the patient's current health status would hinder the safe and effective use of a metered-dose inhaler (MDI)?
      A)
      The patient has not yet quit smoking.
      B)
      The patient has severe arthritis in her hands.
      C)
      The patient requires both corticosteroids and beta-agonists.
      D)
      The patient has cataracts.
      E)
      The patient has cataracts.
    Page 6 of 20