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Practice exam for first exam of NURS 310

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NURS 310 EXAM 1 PRACTIC EXAM

Questão 1 de 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?

Selecione uma das seguintes:

  • "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?"

Explicação

Questão 2 de 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?

Selecione uma das seguintes:

  • 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

Explicação

Questão 3 de 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?

Selecione uma das seguintes:

  • 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

Explicação

Questão 4 de 48

1

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

Selecione uma das seguintes:

  • "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"

Explicação

Questão 5 de 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:

Selecione uma das seguintes:

  • alprazolam (Xanax)

  • ethanol (Alcohol)

  • oxycodone (OxyContin)

  • temazepam (Restoril)

Explicação

Questão 6 de 48

1

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

Selecione uma das seguintes:

  • absorption of drugs

  • distribution of drugs

  • metabolism of drugs

  • elimination of drugs

Explicação

Questão 7 de 48

1

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

Selecione uma das seguintes:

  • Participating in cardiac rehabilitation

  • Getting an annual physical examination

  • Avoiding excessive sun exposure

  • Practicing monthly self-breast examinations

Explicação

Questão 8 de 48

1

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

Selecione uma das seguintes:

  • Reduced drug dosages

  • Nursing home placement

  • Increased drug dosages at less frequent intervals

  • More frequent physician visits

Explicação

Questão 9 de 48

1

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

Selecione uma das seguintes:

  • Clear yellow drainage from the surgical wound

  • Redness and warmth around the incision

  • Pallor at the suture line

  • Brown exudate at the wound edges

Explicação

Questão 10 de 48

1

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

Selecione uma das seguintes:

  • 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

Explicação

Questão 11 de 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?

Selecione uma das seguintes:

  • Restoration of the inflammatory response

  • Enhancement of oxygen transport

  • Reduction of edema

  • Increased protein synthesis

Explicação

Questão 12 de 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?

Selecione uma das seguintes:

  • 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

Explicação

Questão 13 de 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?

Selecione uma das seguintes:

  • Increasing fluids to 2500cc/day

  • Using incentive spirometry every 2 hours

  • Suctioning the client every 2 hours

  • Splinting the abdominal incisional

Explicação

Questão 14 de 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?

Selecione uma das seguintes:

  • 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

Explicação

Questão 15 de 48

1

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

Selecione uma das seguintes:

  • 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

Explicação

Questão 16 de 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?

Selecione uma das seguintes:

  • Measuring and recording intake and output

  • Monitoring skin turgor for tenting

  • Assessing the vital signs every hour hours

  • Checking the lungs for crackles

Explicação

Questão 17 de 48

1

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

Selecione uma das seguintes:

  • The primary nurse

  • The surgeon

  • The nurse at the physician's office

  • The surgeon's assistant

Explicação

Questão 18 de 48

1

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

Selecione uma das seguintes:

  • The client

  • The prescriber

  • The nurse's lawyer

  • The nursing supervisor

Explicação

Questão 19 de 48

1

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

Selecione uma das seguintes:

  • One who requires frequent pain medication

  • One who is 25 lbs. overweight

  • One who walks shortly after surgery

  • One who is 10 lbs. underweight

Explicação

Questão 20 de 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?

Selecione uma das seguintes:

  • 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

Explicação

Questão 21 de 48

1

Which of the following is a form of secondary prevention?

Selecione uma das seguintes:

  • Getting a tetanus booster

  • Losing 10 pounds

  • Getting mammograms and pap smears regularly

  • Having physical therapy for low back pain

Explicação

Questão 22 de 48

1

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

Selecione uma das seguintes:

  • 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

Explicação

Questão 23 de 48

1

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

Selecione uma das seguintes:

  • Ginseng

  • Omega 3 fatty acids

  • Echinacea

  • Kava kava

Explicação

Questão 24 de 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?

Selecione uma das seguintes:

  • airway status

  • cardiac rhythm

  • level of anxiety

  • body temperature

Explicação

Questão 25 de 48

1

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

Selecione uma das seguintes:

  • 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

Explicação

Questão 26 de 48

1

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

Selecione uma das seguintes:

  • 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

Explicação

Questão 27 de 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?

Selecione uma das seguintes:

  • 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

Explicação

Questão 28 de 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?

Selecione uma das seguintes:

  • 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

Explicação

Questão 29 de 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:

Selecione uma das seguintes:

  • "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"

Explicação

Questão 30 de 48

1

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

Selecione uma das seguintes:

  • Alterations in BUN and creatinine

  • Low potassium level

  • Elevated AST and ALT levels

  • Low hemoglobin and hematocrit

Explicação

Questão 31 de 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?

Selecione uma das seguintes:

  • 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

Explicação

Questão 32 de 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?

Selecione uma das seguintes:

  • Confusion

  • Fever

  • Hypotension

  • Urinary retention

Explicação

Questão 33 de 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?

Selecione uma das seguintes:

  • 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

Explicação

Questão 34 de 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?

Selecione uma das seguintes:

  • 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

Explicação

Questão 35 de 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?

Selecione uma das seguintes:

  • Immunostimulant

  • Antitussive

  • Anti-infective

  • Immunosuppressant

Explicação

Questão 36 de 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?

Selecione uma das seguintes:

  • Administer the anti-nausea medication

  • Assist the client to sit down

  • Get an emesis basin

  • Walk the client back to his room

Explicação

Questão 37 de 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?

Selecione uma das seguintes:

  • 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

Explicação

Questão 38 de 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:

Selecione uma das seguintes:

  • "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"

Explicação

Questão 39 de 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?

Selecione uma das seguintes:

  • Dilated pupils

  • Constricted pupils

  • Hypotension

  • Slow respiration

Explicação

Questão 40 de 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.

Selecione uma das seguintes:

  • "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"

Explicação

Questão 41 de 48

1

Select the most accurate description of physical dependence.

Selecione uma das seguintes:

  • 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

Explicação

Questão 42 de 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?

Selecione uma das seguintes:

  • Flumazenil (Romazicon)

  • Naloxone (Narcan)

  • Atropine

  • Vitamin K

Explicação

Questão 43 de 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?

Selecione uma das seguintes:

  • 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

Explicação

Questão 44 de 48

1

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

Selecione uma das seguintes:

  • 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

Explicação

Questão 45 de 48

1

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

Selecione uma ou mais das seguintes:

  • Constipation

  • Pupillary dilation

  • Urinary retention

  • Slowed respiratory rate

  • Rapid pulse

  • Headache

  • Drowsiness

  • Increased blood pressure

  • Dry mouth

Explicação

Questão 46 de 48

1

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

Selecione uma das seguintes:

  • 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

Explicação

Questão 47 de 48

1

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

Selecione uma ou mais das seguintes:

  • Age

  • Gender

  • Body mass index

  • Time of day medication is given

  • Nutritional status

  • Generic substitution

Explicação

Questão 48 de 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?

Selecione uma das seguintes:

  • 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

Explicação