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Practice exam for first exam of NURS 310

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NURS 310 EXAM 1 PRACTIC EXAM

Frage 1 von 48

1

A client is taking several prescribed oral medications for treatment of congestive heart failure. He tells the nurse, "I'm going to take these at breakfast". Which response by the nurse is most appropriate?

Wähle eine der folgenden:

  • "Let's look at each medication to determine the best time to take it"

  • "That depends on what you eat for breakfast"

  • "That's a great idea so you won't forget any medications"

  • "What time do you usually have breakfast?"

Erklärung

Frage 2 von 48

1

In addition to less efficient renal excretion, what other physical change in aging may lead to a need to reduce medication dosage in an elderly client?

Wähle eine der folgenden:

  • Increased rate of drug absorption

  • Decreased total body fluid proportionate to body mass

  • Decreased efficiency in drug distribution

  • Increased rate of drug metabolism by the liver

Erklärung

Frage 3 von 48

1

A nurse is administering medication to a hospitalized client. Which of the following is the most accurate way to assure that the right patient gets the medication?

Wähle eine der folgenden:

  • Ask the client, "are you Dale Jones?"

  • Check the client's identification band

  • Check the client's room number and bed assignment

  • Ask the client why he or she is getting the medication

Erklärung

Frage 4 von 48

1

A client asks, "what's the difference between Advil and ibuprofen?" The nurse responds by saying which of the following?

Wähle eine der folgenden:

  • "There is no difference between them"

  • "Advil and ibuprofen are two different drugs with similar effects"

  • "This question should be answered by your doctor"

  • "If you doctor orders Advil, you should not substitute any other medication"

Erklärung

Frage 5 von 48

1

The nurse would expect the dose of morphine for a postoperative patient to be higher than usual for the patient's size and age is prescribed for a patient who routinely uses:

Wähle eine der folgenden:

  • alprazolam (Xanax)

  • ethanol (Alcohol)

  • oxycodone (OxyContin)

  • temazepam (Restoril)

Erklärung

Frage 6 von 48

1

The decreased lean body mass common in the elderly is likely to affect:

Wähle eine der folgenden:

  • absorption of drugs

  • distribution of drugs

  • metabolism of drugs

  • elimination of drugs

Erklärung

Frage 7 von 48

1

Which of the following is an example of a primary prevention measure?

Wähle eine der folgenden:

  • Participating in cardiac rehabilitation

  • Getting an annual physical examination

  • Avoiding excessive sun exposure

  • Practicing monthly self-breast examinations

Erklärung

Frage 8 von 48

1

An older adult client who experiences several adverse effects of medications could benefit from:

Wähle eine der folgenden:

  • Reduced drug dosages

  • Nursing home placement

  • Increased drug dosages at less frequent intervals

  • More frequent physician visits

Erklärung

Frage 9 von 48

1

One day after surgery, the nurse inspects the client's incision. Which of the following is evidence of a local inflammatory response?

Wähle eine der folgenden:

  • Clear yellow drainage from the surgical wound

  • Redness and warmth around the incision

  • Pallor at the suture line

  • Brown exudate at the wound edges

Erklärung

Frage 10 von 48

1

Which is the best way to increase client compliance with a medication regimen?

Wähle eine der folgenden:

  • Give all the instructions at least three times

  • Encourage the client to hire a visiting nurse

  • Use a medication organizer

  • Devise the simplest schedule possible

Erklärung

Frage 11 von 48

1

Which of the following provides the best rationale for encouraging a client with a wound to consume a diet high in vitamin C?

Wähle eine der folgenden:

  • Restoration of the inflammatory response

  • Enhancement of oxygen transport

  • Reduction of edema

  • Increased protein synthesis

Erklärung

Frage 12 von 48

1

The nurse is concerned about urinary retention in a client who has not voided for 8 hours since undergoing surgery. Which assessment finding is most likely?

Wähle eine der folgenden:

  • The nurse will be unable to palpate the bladder

  • The bladder will be smooth to palpation

  • The nurse can palpate the bladder at the symphysis pubis

  • The bladder will be felt at the umbilicus

Erklärung

Frage 13 von 48

1

A client who has had surgery has a poor cough effort due to incisional pain. He has crackles in his lower lobes bilaterally. Which of the following non-pharmacological interventions would be most effective in dealing with this problem?

Wähle eine der folgenden:

  • Increasing fluids to 2500cc/day

  • Using incentive spirometry every 2 hours

  • Suctioning the client every 2 hours

  • Splinting the abdominal incisional

Erklärung

Frage 14 von 48

1

The client is ordered to have morphine sulfate 2 mg IV every 6 minutes via PCA pump. However, the client has refused to take the medication. Which of the following actions by the nurse is most appropriate?

Wähle eine der folgenden:

  • Pushing the PCA pump button for him

  • Calling the physician to request medication by mouth

  • Giving the medication in an intramuscular injection

  • Exploring why he does not want to take the medication

Erklärung

Frage 15 von 48

1

A nurse is evaluating a client for a post-operative infection. Which of the following signs is most indicative of an infection?

Wähle eine der folgenden:

  • Presence of an indwelling foley catheter

  • Rectal temperature of 37.8 C (100 F)

  • Productive cough with yellow mucous

  • White blood cell count of 8,000/mm^3

Erklärung

Frage 16 von 48

1

A client is at risk for hypovolemia in the postoperative period. Which of the following would insure the most accurate monitoring of fluid balance?

Wähle eine der folgenden:

  • Measuring and recording intake and output

  • Monitoring skin turgor for tenting

  • Assessing the vital signs every hour hours

  • Checking the lungs for crackles

Erklärung

Frage 17 von 48

1

Which member of the healthcare team is responsible for obtaining informed consent from a client prior to a surgical procedure?

Wähle eine der folgenden:

  • The primary nurse

  • The surgeon

  • The nurse at the physician's office

  • The surgeon's assistant

Erklärung

Frage 18 von 48

1

The nurse inadvertently gives the client a double dose of the medication. Who should be notified first?

Wähle eine der folgenden:

  • The client

  • The prescriber

  • The nurse's lawyer

  • The nursing supervisor

Erklärung

Frage 19 von 48

1

Of the following clients, who is at the greatest risk for developing wound infection?

Wähle eine der folgenden:

  • One who requires frequent pain medication

  • One who is 25 lbs. overweight

  • One who walks shortly after surgery

  • One who is 10 lbs. underweight

Erklärung

Frage 20 von 48

1

A client had surgery two hours ago. Vital signs at that time were BP 140/74, P 82, R 16, skin warm and dry. Vitals signs are now BP 110/62, P 102, R 22, skin cool. Which of the following should the nurse do first?

Wähle eine der folgenden:

  • Re-checking of vital signs to verify they are correct

  • Evaluate the head of the bed to help the client breath more effectively

  • Check the client's urine output for more than 30mL/hour

  • Administer pain medication

Erklärung

Frage 21 von 48

1

Which of the following is a form of secondary prevention?

Wähle eine der folgenden:

  • Getting a tetanus booster

  • Losing 10 pounds

  • Getting mammograms and pap smears regularly

  • Having physical therapy for low back pain

Erklärung

Frage 22 von 48

1

Which nursing action may help decrease the anxiety of a pre-operative client?

Wähle eine der folgenden:

  • Encouraging her to sleep until it is time for surgery

  • Reassuring her that she will be fine and has no need to worry

  • Spending time with her and answering all of her questions

  • Teaching her how to avoid postoperative complications

Erklärung

Frage 23 von 48

1

Regular use of which of the following places a surgical client at increased risk for bleeding?

Wähle eine der folgenden:

  • Ginseng

  • Omega 3 fatty acids

  • Echinacea

  • Kava kava

Erklärung

Frage 24 von 48

1

A client is experiencing confusion in the immediate post-operative period. Which of the following assessments is most essential to determine the reason for confusion?

Wähle eine der folgenden:

  • airway status

  • cardiac rhythm

  • level of anxiety

  • body temperature

Erklärung

Frage 25 von 48

1

The nurse is caring for a client post-operatively. Which of the following indicates that the client has a compromised airway?

Wähle eine der folgenden:

  • The client states he is anxious

  • The client rates his pain a 6 out of 10

  • His pulse oximetry reading is 90%

  • His skin is cool and clammy

Erklärung

Frage 26 von 48

1

In reviewing the chart of a patient about to undergo general anesthesia, which of the following is the greatest risk factor?

Wähle eine der folgenden:

  • He expresses anxiety about the upcoming procedure

  • He ate a snack two hours ago

  • He smokes and states his last cigarette was 6 hours ago

  • He has a history of hypertension controlled by diet

Erklärung

Frage 27 von 48

1

Which of the following instructions should be included in the medication teaching for an older adult who has back pain who is prescribed an opioid with codeine?

Wähle eine der folgenden:

  • Check your breathing rate three times a day

  • Increase your intake of fiber and fluids

  • Limit taking the medication unless pain is severe

  • Avoid taking the medication more than twice a day

Erklärung

Frage 28 von 48

1

The nurse is preparing to administer Clarinex (desloratadine) to an adult with seasonal allergies. The order reads 15mg once/day but the acceptable dose is 5mg/day. What should the nurse do next?

Wähle eine der folgenden:

  • Hold the medication and check the original order

  • Call the prescriber

  • Ask the client if this is his usual dose

  • Administer the dose because it was prescribed

Erklärung

Frage 29 von 48

1

A patient is taking lovastatin (Mevacor) for cholesterol control. She asks what might happen if she takes the medication with grapefruit juice. The nurse replies:

Wähle eine der folgenden:

  • "The medication will not get to its site of action"

  • "You may build up toxic levels of the medication"

  • "The liver can be damaged"

  • "The medication cannot be absorbed properly"

Erklärung

Frage 30 von 48

1

Before administering acetaminophen (Tylenol) the nurse reviews the patient's lab results. Which of the following is the nurse specifically looking for?

Wähle eine der folgenden:

  • Alterations in BUN and creatinine

  • Low potassium level

  • Elevated AST and ALT levels

  • Low hemoglobin and hematocrit

Erklärung

Frage 31 von 48

1

Warfarin sodium (Coumadin) is a highly protein bound drug. When the nurse gives this medication to a client with a low serum protein level, which of the following responses is expected?

Wähle eine der folgenden:

  • More intense drug response and greater risk for bleeding

  • Less intense drug response and greater risk for bleeding

  • More intense drug response and less risk for bleeding

  • Less intense drug response and less risk for bleeding

Erklärung

Frage 32 von 48

1

A client develops a rash after receiving the medication Oxycodone. The prescriber discontinues the oxycodone and orders diphenhydramine (Benadryl). The nurse must be alert for which drug-drug interaction?

Wähle eine der folgenden:

  • Confusion

  • Fever

  • Hypotension

  • Urinary retention

Erklärung

Frage 33 von 48

1

A client is scheduled for an elective surgical procedure. He tells the nurse that he usually takes gingko biloba to help his memory but he hasn't taken it for three days. What action should the nurse take?

Wähle eine der folgenden:

  • Document this information in the chart

  • Notify the nurse anesthetist immediately

  • Request a stat electrocardiogram and chest x-ray

  • Determine how long the client has taken the gingko

Erklärung

Frage 34 von 48

1

The client has had a general anesthetic for an exploratory laparotomy. The nurse notes that there is no antiemetic medication ordered for post-op care. Which action should the nurse take?

Wähle eine der folgenden:

  • Ask the anesthesiologist if the client was nauseated during surgery

  • Tell the client to report any nausea

  • Contact the surgeon and request an order for an antiemetic

  • Give the client sips of ginger ale to reduce nausea

Erklärung

Frage 35 von 48

1

A patient admitted to the hospital with a diagnosis of pneumonia asks the nurse, "Why am I receiving codeine? I don't have any pain." The nurse's response is based on knowledge that codeine also has what effect?

Wähle eine der folgenden:

  • Immunostimulant

  • Antitussive

  • Anti-infective

  • Immunosuppressant

Erklärung

Frage 36 von 48

1

The nurse is walking in the hallway with a client who had surgery yesterday. The client is receiving morphine sulfate via a patient controlled analgesia system. The client complains of nausea. Of the following, which should the nurse do first?

Wähle eine der folgenden:

  • Administer the anti-nausea medication

  • Assist the client to sit down

  • Get an emesis basin

  • Walk the client back to his room

Erklärung

Frage 37 von 48

1

A patient who has received morphine sulfate becomes becomes slightly disoriented. If this effect is due to the morphine, which intervention by the nurse would be most likely to reverse this adverse effect?

Wähle eine der folgenden:

  • Assist the patient to walk

  • Instruct the patient to change positions slowly

  • Instruct the patient to take slow, deep breaths

  • Keep the room well lit

Erklärung

Frage 38 von 48

1

The caregiver of a patient calls to report, "My mother just took her first dose of the prescribed opioid and became very nauseated." Select the nurse's best response:

Wähle eine der folgenden:

  • "She is probably allergic to the agent and should discontinue it now"

  • "If the nausea is not as bad as the pain, she should continue the opioid as prescribed"

  • "This is generally a temporary effect and is lessened by keeping still"

  • "Try cutting the dose in half and take the medication on an empty stomach"

Erklärung

Frage 39 von 48

1

A nurse suspects that a patient is still in pain because of non-adherance to the opioid regimen. Which physical sign would help confirm this suspicion?

Wähle eine der folgenden:

  • Dilated pupils

  • Constricted pupils

  • Hypotension

  • Slow respiration

Erklärung

Frage 40 von 48

1

While reviewing discharge instructions, a patient asks the nurse why the oral dose of the opioid is so much higher than the intravenous dose was. Select the nurse's best response.

Wähle eine der folgenden:

  • "When patients go home, they need higher doses of medication"

  • "The oral form of the drug passes through the liver, and a lot is metabolized before it can achieve the desired effect"

  • "When the physician converted the dosages, there was an error in calculation"

  • "The doses should be the same. The physician must think your pain is not well controlled"

Erklärung

Frage 41 von 48

1

Select the most accurate description of physical dependence.

Wähle eine der folgenden:

  • It is a state in which larger doses are required to produce the same response formerly produced by a smaller dose.

  • It is a state in which an individual will seek and use the drug despite physical, psychological, or social harm

  • It is a state in which pain is undertreated and the patient appears to be drug seeking

  • It is a state in which an abstinence syndrome will occur if the drug is abruptly discontinued

Erklärung

Frage 42 von 48

1

In the emergency department a nurse assesses a stuporous patient who is suspected of overdosing on opioids. The nurse should prepare to administer which agent if the patient becomes comatose or develops respiratory depression?

Wähle eine der folgenden:

  • Flumazenil (Romazicon)

  • Naloxone (Narcan)

  • Atropine

  • Vitamin K

Erklärung

Frage 43 von 48

1

A patient who has been taking opioids for 2 years is preparing to stop. How should the nurse instruct the patient to discontinue the opioids after prolonged use?

Wähle eine der folgenden:

  • Stop the agents abruptly

  • Continue a very low dose for 3-6 months

  • Taper slowly over 7-10 days

  • Switch to an equianalgesic dose of another opioid and then discontinue

Erklärung

Frage 44 von 48

1

While caring for an unconscious client, the nurse knows that:

Wähle eine der folgenden:

  • The patient will not feel pain

  • Any noxious stimulus should be treated as potentially painful

  • If pain is perceived the client will always have an observable change in behavior

  • Pain is best assessed by asking a family member

Erklärung

Frage 45 von 48

1

Which of the following are commonly experienced side effects associated with administration of opioid analgesics? (select all that apply)

Wähle eine oder mehr der folgenden:

  • Constipation

  • Pupillary dilation

  • Urinary retention

  • Slowed respiratory rate

  • Rapid pulse

  • Headache

  • Drowsiness

  • Increased blood pressure

  • Dry mouth

Erklärung

Frage 46 von 48

1

Nursing practice should be guided by which of the following principles of pain management?

Wähle eine der folgenden:

  • Pain medication should be used only as needed when pain becomes severe

  • Nurses should give pain medication at the first sign of pain using a large enough dose to obtain relief

  • It is best to begin with a very small dose, adding more as needed for relief

  • Medication should be given no more frequently than every four hours to avoid overdose

Erklärung

Frage 47 von 48

1

Which of the following factors have the most significant effect on a client's response to pain medications? (select all that apply)

Wähle eine oder mehr der folgenden:

  • Age

  • Gender

  • Body mass index

  • Time of day medication is given

  • Nutritional status

  • Generic substitution

Erklärung

Frage 48 von 48

1

An 80 year-old woman is brought to the health center for the first time by her 64 year-old daughter. Which of the following approaches by the nurse would be most appropriate at the time?

Wähle eine der folgenden:

  • Ask the daughter whether the client has any urgent needs or problems

  • Obtain a health history from the client herself

  • Interview the client and daughter together so that pertinent information can be obtained

  • Refer the client for an interdisciplinary comprehensive geriatric assessment since she will have multiple needs

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