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Questions in this quiz (130)
1A student nurse who works in a pediatric clinic is assisting with an assessment on a young child who is not yet walking. She knows that it is considered a delayed gross motor ability if the child does not walk by _____ months.
- A16
- B18
- C20
- D22
2According to one growth and development theorist, individuals need to accomplish a particular task before successfully completing the stage of growth and development. Each task is framed with opposing conflicts, such as trust versus mistrust. Who developed this theory?
- ASigmund Freud
- BJean Piaget
- CErik Erikson
- DLawrence Kohlberg
3This model of personality development is grounded in the belief that two internal biological forces drive the psychological change in a child: sexual (libido) and aggressive energies. Who is responsible for developing this theory?
- ASigmund Freud
- BJean Piaget
- CErik Erikson
- DLawrence Kohlberg
4Which of the following people developed the theory of cognitive development that describes children’s intellectual organization and how they think, reason, and perceive the world?
- ASigmund Freud
- BJean Piaget
- CErik Erikson
- DLawrence Kohlberg
5According to one theorist, moral development depends on the child’s ability to accept social responsibility and to integrate personal principles of justice and fairness. Which of the following individuals is responsible for the theory of moral development?
- ASigmund Freud
- BJean Piaget
- CErik Erikson
- DLawrence Kohlberg
6A patient is experiencing incisional pain after an operation. When using Maslow’s hierarchy of needs, the nurse realizes that for the patient to return to a prehospitalized status, the patient needs to progress beyond which of the following?
- ABelonging
- BSelf-esteem
- CSelf-actualization
- DSafety and security
7The transition from childhood to adulthood, in terms of the psychological maturation of the individual, is known as which of the following?
- APuberty
- BAdolescence
- CMenarche
- DPreadolescence
8A specific phase or period when the presence of a function or reasoning has its greatest effect on a specific aspect of development is referred to as:
- AFreud’s psychoanalytic model of personality.
- Ba critical period of development.
- CErikson’s stages of development.
- DPiaget’s theory of cognitive development.
9Preconception counseling is a growing trend in health care with the goal being to secure the best outcome for mother, fetus, and significant others through good prenatal care and teaching that:
- Ateratogens can affect fetal development during any trimester.
- Bthe placenta prevents teratogens from passing to the fetus.
- Cteratogens are all man-made, preventable, and do not include viruses or bacteria.
- Dsmoking has been shown to have no effect on fetal development.
10The nurse obtains information about all these areas during the health interview for a new patient. Which area will be the focus of patient teaching?
- AAge and gender
- BHispanic/Latino ethnicity
- CFamily history of diabetes
- DRefined carbohydrate intake
11When developing strategies to decrease health care disparities, the nurse working in a clinic located in a neighborhood with many Vietnamese individuals will include
- Aimproving public transportation.
- Bobtaining low-cost medications.
- Cupdating equipment and supplies for the clinic.
- Deducating staff about Vietnamese health beliefs.
12Which information will the nurse need to collect when assessing the health status of a community?
- AAverage income of community members
- BMorning traffic patterns in the community
- CMedian life expectancy for the community
- DOccupations of individuals in the community
13When caring for a patient who is Native American, the best initial action by the nurse is to
- Aavoid all eye contact with the patient.
- Bobserve the patient’s use of eye contact.
- Clook directly at the patient when interacting.
- Dask the family about the patient’s cultural beliefs.
14A new RN graduate is assessing a newly admitted non–English-speaking Chinese patient who complains of severe headaches. The charge nurse should intervene if the new RN’s first action is to
- Asit down at the bedside.
- Bpalpate the patient’s scalp.
- Ccall for a medical interpreter.
- Davoid eye contact with the patient.
15If an interpreter is not available when a patient speaks a language different from the nurse’s language, it is appropriate for the nurse to
- Ause specific medical terms in the Latin form.
- Btalk slowly so that each word is clearly heard.
- Crepeat important words so that the patient recognizes their importance.
- Duse simple gestures to demonstrate meaning while talking to the patient.
16When planning care for a hospitalized patient who uses culturally based treatments, the most appropriate action by the nurse is to
- Acoordinate the use of folk treatments with ordered medical therapies.
- Bdiscourage the use of culturally based treatments for Western diseases.
- Cteach the patient that folk remedies will interfere with Western treatments.
- Dask the patient to discontinue the cultural treatments during hospitalization.
17When planning health care for a community with a large number of recent immigrants from China, the most important intervention for the nurse to include is
- Apregnancy testing.
- Btuberculosis screening.
- Ccontraceptive teaching.
- Dcolonoscopy information.
18Which of these strategies should be a priority when the nurse is planning care for a hypertensive patient who is uninsured?
- AFollow evidence-based national guidelines.
- BAssist with dietary changes as the first action.
- CTeach about the impact of exercise on hypertension.
- DObtain less expensive antihypertensive medications.
19The nurse working in a clinic in a primarily African American community notes a higher incidence of uncontrolled hypertension in clinic patients than the national average. To correct this health disparity, which action should the nurse take first?
- AInitiate a regular home-visit program by nurses working at the clinic.
- BSchedule teaching sessions about hypertension at community events.
- CAssess the perceptions of community members about the care at the clinic.
- DObtain low-cost antihypertensive drugs using funding from government grants.
20A nurse is caring for a patient who is suffering from kidney failure and is receiving peritoneal dialysis. The nurse explains that peritoneal dialysis works by instilling a solution into the abdomen that contains dextrose that will pull extra fluid into the abdominal cavity. What is the name of this process?
- ADiffusion
- BOsmosis
- CFiltration
- DActive transport
21A 7-year-old patient was admitted to the hospital with a high fever. The nurse caring for the child knows that the child has increased insensible water loss resulting from the fever and should receive additional water to prevent hypernatremia. Insensible water loss occurs through which organ?
- AKidneys
- BGI tract
- CSkin
- DStomach
22A patient presents to the emergency department complaining of increased urine output. The patient has been drinking alcohol and is still visibly impaired. He is aware of his condition and apologizes, stating that he has never gotten drunk before and if he survives he never will again, but he knows that if he drinks too much he will lose potassium and die. The nurse realizes that the patient is dealing with:
- Aantidiuretic hormone (ADH) suppression.
- BADH stimulation.
- Cinsensible water loss.
- Dangiotensin II release.
23A 15-year-old patient suffered a head injury as the result of a bicycle accident. The nurse is concerned about potential fluid complications caused by the injury. What should the nurse monitor most closely?
- AAldosterone release
- BUrine output
- CRenin release
- DBody temperature
24The patient is taking furosemide (Lasix) and has been complaining of muscle weakness. The nurse should be most concerned about which imbalance?
- AHyponatremia
- BHypokalemia
- CHypochloremia
- DHyperchloremia
25A 76-year-old patient is hospitalized with pneumonia and has become increasingly confused throughout the shift. The nurse becomes concerned about the patient’s condition and contacts the health care provider, who orders arterial blood gas analysis. The blood gas report shows a pH of 7.33, PaCO2 of 47, PaO2 of 78, and bicarbonate of 26. This indicates which imbalance?
- ARespiratory alkalosis
- BRespiratory acidosis
- CMetabolic alkalosis
- DMetabolic acidosis
26A college freshman has bulimia. She vomits after eating and has recently noticed tingling of her fingers and toes and muscle cramps. Her roommate is a nursing student and is concerned about which imbalance?
- ARespiratory acidosis
- BMetabolic acidosis
- CRespiratory alkalosis
- DMetabolic alkalosis
27A patient’s arterial blood gas levels indicate a pH of 7.51, PaCO2 of 40 mm Hg, PaO2 of 85 mm Hg, and HCO3 of 32 mEq/L. The patient has been vomiting. The nurse knows the patient has which imbalance?
- AMetabolic acidosis
- BMetabolic alkalosis
- CRespiratory acidosis
- DRespiratory alkalosis
28During a clinical rotation at an orthopedic unit, a nursing student is caring for a 67-year-old patient who has undergone a knee replacement. The patient is complaining of pain at the IV site. The nursing student assesses the site and finds that the site is cool and pale. The student stops the IV and reports the situation to the nurse. What does the nursing student suspect?
- APhlebitis
- BInfiltration
- CThrombophlebitis
- Dinflammation
29When a nurse is selecting a vein for IV placement, what is the most appropriate action?
- ASelect a vein that appears to be well dilated.
- BElevate the extremity to visualize the vein.
- CTap and rub the vein vigorously with friction.
- DStroke from proximal to distal above the site.
30The nurse suspects that the patient is experiencing a blood transfusion reaction. The nurse stops the infusion but is concerned about losing the IV line if blood clots in the catheter. The nurse should:
- Areplace the entire transfusion line with a new set primed with normal saline.
- Bturn off the blood and turn on the normal saline infusion to flush the tubing.
- Cdiscontinue the IV and start a new IV of lactated Ringer’s in the other extremity.
- Dmaintain the patency of the current IV line by hanging a new IV bag of D5W.
31A nurse is mentoring a new nurse who is learning to start IVs. The nurse tells the new nurse that in case the patient needs subsequent venipuncture sites, the best place to initially start an IV is the:
- Aantecubital vein of the patient’s nondominant arm.
- Bmost appropriate distal vein on the nondominant arm.
- Cmost appropriate proximal vein available on either arm.
- Dantecubital vein of the patient’s dominant arm.
32The nurse is caring for an 84-year-old patient who gets hemodialysis 3 days a week. He is taking corticosteroids and has multiple bruises on his extremities. The patient needs an IV started. When starting the IV, the nurse should:
- Aattempt to start the IV in the dorsum of the patient’s hand.
- Bavoid areas of skin that are red and warm to the touch.
- Cuse the arm on the side of the patient’s dialysis fistula.
- Dstart the IV in the patient’s foot after patient teaching.
33The nurse works on the cardiac unit of a hospital. The health care provider has ordered 20 mEq of KCl per L to be added to the fluids that the patient is receiving. The patient currently has a bag of D5W IV fluid infusing. Which action is most appropriate?
- AAdminister 20 mEq KCl diluted in 5 mL of fluid by IV push in 5 minutes.
- BEstimate the amount of fluid in the IV bag and add KCl to equal 20 mEq/L.
- CGive the KCl undiluted by IV push in 5 minutes for the most rapid action.
- DCheck the patient’s potassium level before hanging the new IV solution.
34The nurse obtains all of the following assessment data about a patient with deficient fluid volume caused by a massive burn injury. Which of the following assessment data will be of greatest concern?
- AThe blood pressure is 90/40 mm Hg.
- BUrine output is 30 ml over the last hour.
- COral fluid intake is 100 ml for the last 8 hours.
- DThere is prolonged skin tenting over the sternum.
35A recently admitted patient has a small cell carcinoma of the lung, which is causing the syndrome of inappropriate antidiuretic hormone (SIADH). The nurse will monitor carefully for
- Aincreased total urinary output.
- Belevation of serum hematocrit.
- Cdecreased serum sodium level.
- Drapid and unexpected weight loss.
36When the nurse is evaluating the fluid balance for a patient admitted for hypovolemia associated with multiple draining wounds, the most accurate assessment to include is
- Askin turgor.
- Bdaily weight.
- Cpresence of edema.
- Dhourly urine output.
37Intravenous potassium chloride (KCl) 60 mEq is prescribed for treatment of a patient with severe hypokalemia. Which action should the nurse take?
- AAdminister the KCl as a rapid IV bolus.
- BInfuse the KCl at a rate of 20 mEq/hour.
- CGive the KCl only through a central venous line.
- DAdd no more than 40 mEq/L to a liter of IV fluid.
38A postoperative patient who has been receiving nasogastric suction for 3 days has a serum sodium level of 125 mEq/L (125 mmol/L). Which of these prescribed therapies that the patient has been receiving should the nurse question?
- AInfuse 5% dextrose in water at 125 ml/hr.
- BAdminister IV morphine sulfate 4 mg every 2 hours PRN.
- CGive IV metoclopramide (Reglan) 10 mg every 6 hours PRN for nausea.
- DAdminister 3% saline if serum sodium drops to less than 128 mEq/L.
39A patient who has required prolonged mechanical ventilation has the following arterial blood gas results: pH 7.48, PaO2 85 mm Hg, PaCO2 32 mm Hg, and HCO3 25 mEq/L. The nurse interprets these results as
- Ametabolic acidosis.
- Bmetabolic alkalosis.
- Crespiratory acidosis.
- Drespiratory alkalosis.
40The nurse notes that a patient who was admitted with diabetic ketoacidosis has rapid, deep respirations. Which action should the nurse take?
- ANotify the patient’s health care provider.
- BGive the prescribed PRN lorazepam (Ativan).
- CStart the prescribed PRN oxygen at 2 to 4 L/min.
- DEncourage the patient to take deep, slow breaths.
41A patient is receiving 3% NaCl solution for correction of hyponatremia. During administration of the solution, the most important assessment for the nurse to monitor is
- Alung sounds.
- Burinary output.
- Cperipheral pulses.
- Dperipheral edema.
42A patient has the following arterial blood gas (ABG) results: pH 7.32, PaO2 88 mm Hg, PaCO2 37 mm Hg, and HCO3 16 mEq/L. The nurse interprets these results as
- Ametabolic acidosis.
- Bmetabolic alkalosis.
- Crespiratory acidosis.
- Drespiratory alkalosis.
43A patient with hypercalcemia is being cared for on the medical unit. Nursing actions included on the care plan will include
- Amaintaining the patient on bed rest.
- Bauscultating lung sounds every 4 hours.
- Cmonitoring for Trousseau’s and Chvostek’s signs.
- Dencouraging fluid intake up to 4000 ml every day.
44A patient who has been hospitalized for 2 days has been receiving normal saline IV at 100 ml/hr, has a nasogastric tube to low suction, and is NPO. Which assessment finding by the nurse is the priority to report to the health care provider?
- ASerum sodium level of 138 mEq/L (138 mmol/L)
- BGradually decreasing level of consciousness (LOC)
- COral temperature of 100.1° F with bibasilar lung crackles
- DWeight gain of 2 pounds (1 kg) above the admission weight
45When assessing a patient with increased extracellular fluid (ECF) osmolality, the priority assessment for the nurse to obtain is
- Askin turgor.
- Bheart sounds.
- Cmental status.
- Dcapillary refill.
46Which assessment finding about a patient who has a serum calcium level of 7.0 mEq/L is most important for the nurse to report to the health care provider?
- AThe patient is experiencing laryngeal stridor.
- BThe patient complains of generalized fatigue.
- CThe patient’s bowels have not moved for 4 days.
- DThe patient has numbness and tingling of the lips.
47Following a thyroidectomy, a patient complains of “a tingling feeling around my mouth.” The nurse will immediately check for
- Aan elevated serum potassium level.
- Bthe presence of Chvostek’s sign.
- Ca decreased thyroid hormone level.
- Dbleeding on the patient’s dressing.
48The following data are obtained by the nurse when assessing a pregnant patient with eclampsia who is receiving IV magnesium sulfate. Which finding is most important to report to the health care provider immediately?
- AThe bibasilar breath sounds are decreased.
- BThe patellar and triceps reflexes are absent.
- CThe patient has been sleeping most of the day.
- DThe patient reports feeling “sick to my stomach.”
49When reading a patient’s chart, the nurse notes that the patient has dysuria. To assess whether there is any improvement, which question will the nurse ask?
- A“Do you have any blood in your urine?”
- B“Do you have to urinate very frequently?”
- C“Do you have any pain when you urinate?”
- D“Do you have to get up at night to urinate?”
50During assessment of a patient with decreased renal function, which of these medications taken by the patient at home will be of most concern to the nurse?
- Aibuprofen (Motrin)
- Bwarfarin (Coumadin)
- Cfolic acid (vitamin B9)
- Dpenicillin (Bicillin LA)
51How will the nurse assess the flank area of a patient with pyelonephritis for tenderness?
- APush gently into the two lowest intercostal spaces.
- BPalpate along both sides of the lumbar vertebral column.
- CPosition one hand flat at the costovertebral angle (CVA) and strike it with the other fist.
- DUse two fingers to percuss the area between the iliac crest and ribs along the midaxillary line.
52The nurse uses auscultation during assessment of the urinary system to
- Acheck for ureteral peristalsis.
- Bassess for bladder distention.
- Cidentify renal artery or aortic bruits.
- Ddetermine the position of the kidneys.
53A patient who is scheduled for an intravenous pyelogram (IVP) gives the nurse the following information. Which information has the most immediate implications for the patient’s care?
- AThe patient describes allergies to shellfish and penicillin.
- BThe patient has not had anything to eat or drink for 8 hours.
- CThe patient complains of costovertebral angle (CVA) tenderness.
- DThe patient used a bisacodyl (Dulcolax) tablet the previous night.
54The nurse informs the patient undergoing cystoscopy that following the procedure, the patient
- Awill be NPO for 8 hours to prevent nausea and vomiting.
- Bis expected to be on strict bed rest for about 4 to 6 hours.
- Cshould ask for the ordered narcotics as necessary for pain.
- Dmay experience blood-tinged urine and urinary frequency.
55Following an intravenous pyelogram (IVP), all of the following assessment data are obtained. Which one requires immediate action by the nurse?
- AThe heart rate is 58 beats/minute.
- BThe respiratory rate is 38 breaths/minute.
- CThe patient complains of a dry mouth.
- DThe urine output is 400 mL in the first 2 hours.
56When caring for a patient with type 2 diabetes who has been hospitalized with severe hyperglycemia, which topic will be most important to include in discharge teaching?
- AEffect of endogenous insulin on transportation of glucose into cells
- BFunction of the liver in formation of glycogen and gluconeogenesis
- CImpact of the patient’s family history on likelihood of developing diabetes
- DSymptoms indicating that the patient should contact the health care provider
57Which question will provide the most useful information when the nurse is performing a comprehensive geriatric assessment of an older adult who is being assessed for admission to an assisted-living facility?
- A“Have you had any recent infections?”
- B“How frequently do you see a doctor?”
- C“Do you have a history of heart disease?”
- D“Are you able to prepare your own meals?”
58The nurse is planning care for an alert and active 85-year-old patient who takes multiple medications for chronic cardiac and respiratory disease and lives with a daughter who works during the day. Which nursing diagnosis is most appropriate?
- ARisk for injury related to drug-drug interactions
- BSocial isolation related to weakness and fatigue
- CCompromised family coping related to the patient’s many care needs
- DCaregiver role strain related to need to adjust family employment schedule
59To obtain the most complete information when doing an assessment for an 81-year-old patient, the nurse will
- Ainterview both the patient and the primary patient caregiver.
- Buse a geriatric assessment instrument to evaluate the patient.
- Creview the patient’s chart for the history of medical problems.
- Dask the patient to write down medical problems and medications.
60When developing the plan of care for an older adult who is hospitalized for an acute illness, the nurse should
- Ause a standardized geriatric nursing care plan.
- Bminimize activity level during hospitalization.
- Cplan for transfer to a long-term care facility after the hospitalization.
- Dconsider the preadmission functional abilities when setting patient goals.
61When caring for an older adult who lives in a rural area, the nurse will plan to
- Aassess the patient for chronic diseases that are unique to rural areas.
- Bensure transportation to appointments with the health care provider.
- Csuggest that the patient move to an urban area for better health care.
- Dobtain adequate medications for the patient to last for 4 to 6 months.
62A patient with deep partial-thickness burns experiences severe pain associated with nausea during dressing changes. Which action will be most useful in decreasing the patient’s nausea?
- AThe patient NPO for 2 hours before and after dressing changes.
- BAvoid performing dressing changes close to the patient’s mealtimes.
- CAdminister the prescribed morphine sulfate before dressing changes.
- DGive the ordered prochlorperazine (Compazine) before dressing changes.
63A patient who has been NPO during treatment for nausea and vomiting caused by gastric irritation is to start oral intake. Which of these should the nurse offer to the patient?
- AA glass of orange juice
- BA dish of lemon gelatin
- CA cup of coffee with cream
- DA bowl of hot chicken broth
64A patient who is receiving chemotherapy develops a Candida albicans oral infection. The nurse will anticipate the need for
- Ahydrogen peroxide rinses.
- Bthe use of antiviral agents.
- Creferral to a dentist for professional tooth cleaning.
- Dadministration of nystatin (Mycostatin) oral tablets.
65The nurse is assessing a patient with gastroesophageal reflux disease (GERD) who is experiencing increasing discomfort. Which patient statement indicates that additional patient education about GERD is needed?
- A“I take antacids between meals and at bedtime each night.”
- B“I sleep with the head of the bed elevated on 4-inch blocks.”
- C“I quit smoking several years ago, but I still chew a lot of gum.”
- D“I eat small meals throughout the day and have a bedtime snack.”
66When admitting a patient with a stroke who is unconscious and unresponsive to stimuli, the nurse learns from the patient’s family that the patient has a history of gastroesophageal reflux disease (GERD). The nurse will plan to do frequent assessments of the patient’s
- Aapical pulse.
- Bbowel sounds.
- Cbreath sounds.
- Dabdominal girth.
67A patient with recurring heartburn receives a new prescription for esomeprazole (Nexium). In teaching the patient about this medication, the nurse explains that this drug
- Aneutralizes stomach acid and provides relief of symptoms in a few minutes.
- Breduces the reflux of gastric acid by increasing the rate of gastric emptying.
- Ccoats and protects the lining of the stomach and esophagus from gastric acid.
- Dtreats gastroesophageal reflux disease by decreasing stomach acid production.
68The nurse will plan to teach the patient with newly diagnosed achalasia that
- Aa liquid or blenderized diet will be necessary.
- Bdrinking fluids with meals should be avoided.
- Cendoscopic procedures may be used for treatment.
- Dlying down and resting after meals is recommended.
69 A patient who is nauseated and vomiting up blood-streaked fluid is admitted to the hospital with acute gastritis. To determine possible risk factors for gastritis, the nurse will ask the patient about
- Athe amount of fat in the diet.
- Bhistory of recent weight gain or loss.
- Cany family history of gastric problems.
- Duse of nonsteroidal anti-inflammatory drugs (NSAIDs).
70Cobalamin injections have been prescribed for a patient with chronic atrophic gastritis. The nurse determines that teaching regarding the injections has been effective when the patient states,
- A“The cobalamin injections will prevent me from becoming anemic.”
- B“These injections will increase the hydrochloric acid in my stomach.”
- C“These injections will decrease my risk for developing stomach cancer.”
- D“The cobalamin injections need to be taken until my inflamed stomach heals.”
71A patient with peptic ulcer disease associated with the presence of Helicobacter pylori is treated with triple drug therapy. The nurse will plan to teach the patient about
- Asucralfate (Carafate), nystatin (Mycostatin), and bismuth (Pepto-Bismol).
- Bamoxicillin (Amoxil), clarithromycin (Biaxin), and omeprazole (Prilosec).
- Cfamotidine (Pepcid), magnesium hydroxide (Mylanta), and pantoprazole (Protonix).
- Dmetoclopramide (Reglan), bethanechol (Urecholine), and promethazine (Phenergan).
72A patient who has had several episodes of bloody diarrhea is admitted to the emergency department. Which action should the nurse anticipate taking?
- AObtain a stool specimen for culture.
- BAdminister antidiarrheal medications.
- CTeach about adverse effects of nonsteroidal anti-inflammatory drugs (NSAIDs).
- DProvide education about antibiotic therapy.
73A patient is hospitalized with vomiting of “coffee-ground” emesis. The nurse will anticipate preparing the patient for
- Aendoscopy.
- Bangiography.
- Cgastric analysis testing.
- Dbarium contrast studies.
74A 22-year-old patient with Escherichia coli O157:H7 food poisoning is admitted to the hospital with bloody diarrhea and dehydration. All of the following orders are received. Which order will the nurse question?
- AInfuse lactated Ringer’s solution at 250 mL/hr.
- BMonitor blood urea nitrogen and creatinine daily.
- CAdminister loperamide (Imodium) after each stool.
- DProvide a clear liquid diet and progress diet as tolerated.
75The health care provider orders intravenous (IV) ranitidine (Zantac) for a patient with gastrointestinal (GI) bleeding caused by peptic ulcer disease. When teaching the patient about the effect of the medication, which information will the nurse include?
- A“Ranitidine decreases secretion of gastric acid.”
- B“Ranitidine neutralizes the acid in the stomach.”
- C“Ranitidine constricts the blood vessels in the stomach and decreases bleeding.”
- D“Ranitidine covers the ulcer with a protective material that promotes healing.”
76The family member of a patient who has suffered massive abdominal trauma in an automobile accident asks the nurse why the patient is receiving famotidine (Pepcid). The nurse will explain that the medication will
- Aprevent aspiration of gastric contents.
- Binhibit the development of stress ulcers.
- Clower the chance for H. pylori infection.
- Ddecrease the risk for nausea and vomiting.
77A patient with a peptic ulcer who has a nasogastric (NG) tube develops sudden, severe upper abdominal pain, diaphoresis, and a very firm abdomen. Which action should the nurse take next?
- AIrrigate the NG tube.
- BObtain the vital signs.
- CListen for bowel sounds.
- DGive the ordered antacid.
78Twelve hours after undergoing a gastroduodenostomy (Billroth I), a patient complains of increasing abdominal pain. The patient has absent bowel sounds and 200 mL of bright red nasogastric (NG) drainage in the last hour. The most appropriate action by the nurse at this time is to
- Anotify the surgeon.
- Birrigate the NG tube.
- Cadminister the prescribed morphine.
- Dcontinue to monitor the NG drainage.
79Which of these assessment findings in a patient with a hiatal hernia who returned from a laparoscopic Nissen fundoplication 4 hours ago is most important for the nurse to address immediately?
- AThe patient is experiencing intermittent waves of nausea.
- BThe patient has absent breath sounds throughout the left lung.
- CThe patient has decreased bowel sounds in all four quadrants.
- DThe patient complains of 6/10 (0 to 10 scale) abdominal pain.
80The health care provider prescribes the following therapies for a patient who has been admitted with dehydration and hypotension after 3 days of nausea and vomiting. Which order will the nurse implement first?
- AInfuse normal saline at 250 mL/hr.
- BAdminister IV ondansetron (Zofran).
- CProvide oral care with moistened swabs.
- DInsert a 16-gauge nasogastric (NG) tube.
81A 67-year-old patient tells the nurse, “I have problems with constipation now that I am older, so I use a suppository every morning.” Which action should the nurse take first?
- AEncourage the patient to increase oral fluid intake.
- BInform the patient that a daily bowel movement is unnecessary.
- CAssess the patient about individual risk factors for constipation.
- DSuggest that the patient increase dietary intake of high-fiber foods.
82In teaching a patient who has chronic constipation about the use of psyllium (Metamucil), which information will the nurse include?
- AAbsorption of fat-soluble vitamins may be reduced by fiber-containing laxatives.
- BDietary sources of fiber should be eliminated to prevent excessive gas formation.
- CUse of this type of laxative to prevent constipation does not cause adverse effects.
- DLarge amounts of fluid should be taken to prevent impaction or bowel obstruction.
83Two days after an exploratory laparotomy with a resection of a short segment of small bowel, a patient complains of gas pains and abdominal distention. Which nursing action is best to take at this time?
- AGive a return-flow enema.
- BAssist the patient to ambulate.
- CAdminister the ordered IV morphine sulfate.
- DInsert the ordered promethazine (Phenergan) suppository.
84Which nursing action will be included in the plan of care for a patient with bowel irregularity and a new diagnosis of irritable bowel syndrome (IBS)?
- AEncourage the patient to express feelings and ask questions about IBS.
- BSuggest that the patient increase the intake of milk and other dairy products.
- CEducate the patient about the use of alosetron (Lotronex) to reduce symptoms.
- DTeach the patient to avoid using nonsteroidal anti-inflammatory drugs (NSAIDs).
85A patient hospitalized with an acute exacerbation of ulcerative colitis is having 14 to 16 bloody stools a day and crampy abdominal pain associated with the diarrhea. The nurse will plan to
- Aplace the patient on NPO status.
- Badminister IV metoclopramide (Reglan).
- Cteach the patient about total colectomy surgery.
- Dadminister cobalamin (vitamin B12) injections.
86Which nursing action will the nurse include in the plan of care when admitting a patient with an exacerbation of inflammatory bowel disease (IBD)?
- ARestrict oral fluid intake.
- BMonitor stools for blood.
- CIncrease dietary fiber intake.
- DAmbulate four times daily.
87After the nurse has finished teaching a patient with ulcerative colitis about sulfasalazine (Azulfidine), which patient statement indicates that the teaching has been effective?
- A“I will need to use a sunscreen when I am outdoors.”
- B“I will need to avoid contact with people who are sick.”
- C“The medication will need to be tapered if I need surgery.”
- D“The medication will prevent infections that cause the diarrhea.”
88A patient who has an exacerbation of ulcerative colitis is having 15 to 20 stools daily and has excoriated perianal skin. Which patient behavior indicates that teaching regarding maintenance of skin integrity has been effective?
- AThe patient uses incontinence briefs to contain loose stools.
- BThe patient asks for antidiarrheal medication after each stool.
- CThe patient uses witch hazel compresses to decrease anal irritation.
- DThe patient cleans the perianal area with soap and water after each stool.
89After the nurse has provided patient teaching about recommended dietary choices for a patient with an acute exacerbation of inflammatory bowel disease (IBD), which diet choice by the patient indicates a need for more teaching?
- AScrambled eggs
- BWhite toast and jam
- COatmeal with cream
- DPancakes with syrup
90A patient with Crohn’s disease develops a fever and symptoms of a urinary tract infection (UTI) with tan, fecal-smelling urine. The nurse will teach the patient
- Ato clean the perianal area carefully after any stools.
- Babout fistula formation between the bowel and bladder.
- Cto empty the bladder before and after sexual intercourse.
- Dabout the effects of corticosteroid use on immune function.
91A patient has a large bowel obstruction that occurred as a result of diverticulosis. When assessing the patient, the nurse will plan to monitor for
- Areferred back pain.
- Bmetabolic alkalosis.
- Cprojectile vomiting.
- Dabdominal distention.
92During the initial postoperative assessment of a patient’s stoma formed from a transverse colostomy, the nurse finds it to be deep pink with moderate edema and a small amount of bleeding. The nurse should
- Adocument the stoma assessment.
- Bmonitor the stoma every 30 minutes.
- Cnotify the surgeon about the stoma appearance.
- Dplace an ice pack on the stoma to reduce swelling.
93A patient who has ulcerative colitis has a proctocolectomy and ileostomy. Which information will the nurse include in patient teaching?
- ARestrict fluid intake to prevent constant liquid drainage from the stoma.
- BUse care when eating high-fiber foods to avoid obstruction of the ileum.
- CIrrigate the ileostomy daily to avoid having to wear a drainage appliance.
- DChange the pouch every day to prevent leakage of contents onto the skin.
94A patient with Crohn’s disease has megaloblastic anemia. The nurse will anticipate teaching the patient about the ongoing need for
- Aoral ferrous sulfate tablets.
- Bregular blood transfusions.
- Ciron dextran (Imferon) infusion.
- Dcobalamin (B12) nasal spray or injections.
95Which action should the nurse take first when a patient calls the clinic complaining of diarrhea of 24 hours’ duration?
- AAsk the patient to describe the character of the stools and any associated symptoms.
- BInform the patient that laboratory testing of blood and stool specimens will be necessary.
- CSuggest that the patient drink clear liquid fluids with electrolytes, such as Gatorade or Pedialyte.
- DAdvise the patient to use over-the-counter loperamide (Imodium) to slow gastrointestinal (GI) motility.
96A patient with Crohn’s disease who is taking infliximab (Remicade) calls the nurse in the outpatient clinic about all of these symptoms. Which symptom is most important to communicate to the health care provider?
- ANausea
- BJoint pain
- CFrequent headaches
- DElevated temperature
97Which term refers to those times in an individual’s life when he or she is more susceptible to positive or negative influences?
- ASensitive period
- BSequential period
- CTerminal points
- DDifferentiation points
98A mother reports that her 6-year-old child is highly active and irritable and that she has irregular habits and adapts slowly to new routines, people, or situations. According to Chess and Thomas, which category of temperament best describes this child?
- AEasy child
- BDifficult child
- CSlow-to-warm-up child
- DFast-to-warm-up child
99By the time children reach their twelfth birthday, they should have learned to trust others and should have developed a sense of:
- AIdentity.
- BIndustry
- CIntegrity.
- DIntimacy.
100Nurses must be alert for increased fluid requirements when a child has:
- AFever.
- BMechanical ventilation.
- CCongestive heart failure.
- DIncreased intracranial pressure (ICP).
101Which type of dehydration results from water loss in excess of electrolyte loss?
- AIsotonic dehydration
- BIsosmotic dehydration
- CHypotonic dehydration
- DHypertonic dehydration
102A stool specimen from a child with diarrhea shows the presence of neutrophils and red blood cells. This is most suggestive of which condition?
- AProtein intolerance
- BParasitic infection
- CFat malabsorption
- DBacterial gastroenteritis
103Constipation has recently become a problem for a school-age girl. She is healthy except for seasonal allergies, which are now being successfully treated with antihistamines. The nurse should suspect that the constipation is most likely caused by:
- ADiet.
- BAllergies.
- CAntihistamines.
- DEmotional factors.
104A histamine receptor antagonist such as cimetidine (Tagamet) or ranitidine (Zantac) is ordered for an infant with gastroesophageal reflux. The purpose of this is to:
- APrevent reflux.
- BPrevent hematemesis.
- CReduce gastric acid production.
- DIncrease gastric acid production.
105Which clinical manifestation would most suggest acute appendicitis?
- ARebound tenderness
- BBright red or dark red rectal bleeding
- CAbdominal pain that is relieved by eating
- DAbdominal pain that is most intense at McBurney’s point
106When caring for a child with probable appendicitis, the nurse should be alert to recognize that a sign of perforation is:
- ABradycardia.
- BAnorexia.
- CSudden relief from pain.
- DDecreased abdominal distention.
107What is characterized by a chronic inflammatory process that may involve any part of the gastrointestinal (GI) tract from mouth to anus?
- ACrohn’s disease
- BUlcerative colitis
- CMeckel’s diverticulum
- DIrritable bowel syndrome
108A newborn was admitted to the nursery with a complete bilateral cleft lip and palate. The physician explained the plan of therapy and its expected good results. However, the mother refuses to see or hold her baby. Initialtherapeutic approach to the mother should be to:
- ARestate what the physician has told her about plastic surgery.
- BEncourage her to express her feelings.
- CEmphasize the normalcy of her baby and the baby’s need for mothering.
- DRecognize that negative feelings toward the child continue throughout childhood.
109Caring for the newborn with a cleft lip and palate before surgical repair includes:
- AGastrostomy feedings.
- BKeeping the infant in near-horizontal position during feedings.
- CAllowing little or no sucking.
- DProviding satisfaction of sucking needs.
110The nurse is caring for an infant whose cleft lip was repaired. Important aspects of this infant’s postoperative care include:
- AArm restraints, postural drainage, and mouth irrigations.
- BCleansing of suture line, supine and side-lying positions, and arm restraints.
- CMouth irrigations, prone position, and cleansing of suture line.
- DSupine and side-lying positions, postural drainage, and arm restraints.
111The nurse is caring for a neonate with a suspected tracheoesophageal fistula. Nursing care should include:
- AElevating the head but giving nothing by mouth.
- BElevating the head for feedings.
- CFeeding glucose water only.
- DAvoiding suctioning unless the infant is cyanotic.
112An infant with short bowel syndrome will be discharged home on total parenteral nutrition (TPN) and gastrostomy feedings. Nursing care should include:
- APreparing the family for impending death.
- BTeaching the family signs of central venous catheter infection.
- CTeaching the family how to calculate caloric needs.
- DSecuring TPN and gastrostomy tubing under diaper to lessen risk of dislodgment.
113Which description of a stool is characteristic of intussusception?
- ARibbon-like stools
- BHard stools positive for guaiac
- C“Currant jelly” stools
- DLoose, foul-smelling stools
114An infant with pyloric stenosis experiences excessive vomiting that can result in:
- AHyperchloremia.
- BHypernatremia.
- CMetabolic acidosis.
- DMetabolic alkalosis.
115Kyle, age 6 months, is brought to the clinic. His parent says, “I think he hurts. He cries and rolls his head from side to side a lot.” This most likely suggests which feature of pain?
- AType
- BSeverity
- CDuration
- DLocation
116The nurse is caring for a child receiving intravenous (IV) morphine for severe postoperative pain. The nurse observes a slower respiratory rate, and the child cannot be aroused. The most appropriate management of this child is for the nurse to:
- AAdminister naloxone (Narcan).
- BDiscontinue the IV infusion.
- CDiscontinue morphine until the child is fully awake.
- DStimulate the child by calling his or her name, shaking gently, and asking the child to breathe deeply.
117In which developmental stage is the child first able to localize pain and describe both the amount and the intensity of the pain felt?
- AToddler stage
- BPreschool stage
- CSchool-age stage
- DAdolescent stage
118A 2-year-old child has been returned to the nursing unit after an inguinal hernia repair. Which pain assessment tool should the nurse use to assess this child for the presence of pain?
- AFACES pain rating tool
- BNumeric scale
- COucher scale
- DFLACC tool
119The nurse is observing parents playing with their 10-month-old daughter. What should the nurse recognize as evidence that the child is developing object permanence?
- AShe looks for the toy the parents hide under the blanket.
- BShe returns the blocks to the same spot on the table.
- CShe recognizes that a ball of clay is the same when flattened out.
- DShe bangs two cubes held in her hands.
120What is characteristic of the preoperational stage of cognitive development
- AThinking is logical.
- BThinking is concrete.
- CReasoning is inductive.
- DGeneralizations can be made.
121Which behavior is most characteristic of the concrete operations stage of cognitive development?
- AProgression from reflex activity to imitative behavior
- BInability to put oneself in another’s place
- CIncreasingly logical and coherent thought processes
- DAbility to think in abstract terms and draw logical conclusions
122According to Kohlberg, children develop moral reasoning as they mature. What is most characteristic of a preschooler’s stage of moral development?
- AObeying the rules of correct behavior is important.
- BShowing respect for authority is important behavior.
- CBehavior that pleases others is considered good.
- DActions are determined as good or bad in terms of their consequences.
123At what age do children tend to imitate the religious gestures and behaviors of others without understanding their significance?
- AToddlerhood
- BYoung school-age period
- COlder school-age period
- DAdolescence
124A toddler playing with sand and water would be participating in _____ play.
- ASkill
- BDramatic
- CSocial-affective
- DSense-pleasure
125In what type of play are children engaged in similar or identical activity without organization, division of labor, or mutual goal?
- ASolitary
- BParallel
- CAssociative
- DCooperative
126Which function of play is a major component of play at all ages?
- ACreativity
- BSocialization
- CIntellectual development
- DSensorimotor activity
127What is probably the single most important influence on growth at all stages of development?
- ANutrition
- BHeredity
- CCulture
- DEnvironment
128The theorist who viewed developmental progression as a lifelong series of conflicts that need resolution is:
- AErikson
- BFreud
- CKohlberg
- DPiaget
129Frequent developmental assessments are important for which reason?
- AStable developmental periods during infancy provide an opportunity to identify any delays or deficits.
- BInfants need stimulation specific to the stage of development.
- CCritical periods of development occur during childhood.
- DChild development is unpredictable and needs monitoring.
130A nurse is gathering a history on a school-age child admitted for a migraine headache. The child states, “I have been getting a migraine every 2 or 3 months for the last year.” The nurse documents this as which type of pain?
- AAcute
- BChronic
- CRecurrent
- DSubacute
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- GRE Health and Physical Education Quiz on Better beetus, created by Alan Alda on 16/02/2020.
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- Alan Alda
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- English
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