5/8/2022 AT 10AM
MAKE SURE TO ANSWER THE FOLLOWING CAREFULL AND CORRECTLY.
1. The nurse is assessing a client who reports being struck in the face and head several times. During the assessment, the nurse observes pink-tinged drainage from the client’s nares.
What nursing action provides relevant assessment data?
A. Have the client gently blow their nose and observe for bloody mucus
B.Test the drainage with reagent to check the ph.
C. Ask the client to describe the appearance of the face before the injury
D. Place a drop of the drainage on filter paper and look for a yellow ring
2. A nurse is providing discharge instruction to a client recently diagnosed with tuberculosis (TB). Which statements by the client indicates correct understanding of the teaching (select all that apply)
A. I will visit the clinic every week for injection of medication.
B. I will avoid alcoholic beverage while on this treatment plan
C. My family does not require testing.
D. Will follow up with my healthcare provider regularly
E. I need to strictly adhere to my medication schedule
3. A nurse is caring for a client who recently underwent a laryngectomy for neck cancer. Which of the following multidimensional nursing strategies would be appropriate for the postoperative care of this client? (select all that apply)
A. Alternative means of communication
B. Diet modification
D. pain management
E. Aerobic exercise
4. A nurse is assessing a client admitted with status asthmatics. Initially the nurse heard wheezes in the lungs, but now the lungs sounds are inaudible.What is the priority intervention?
A. Education to prevent future exacerbations
B. Administration of a long- acting bronchodilator
C. Measures to reduce anxiety
D. Activation of the rapid response term to secure an airway
5. Which of the following is a major diagnostic test for cystic fibrosis?
A. Sweat chloride test
B. Arterial blood gas
C. Chest x-ray
D. CT scan of the chest
6. A client has a positive Mantoux skin test result. What explanation does the nurse give to the client?
A. There is active disease, but you are not infectious to others.
B. There is active disease, and you need immediate treatment.
C. You have been infected. But this does not mean active disease is present
D. A repeat skin test is necessary because the test could give a false- positive result.
7. A client with suspected tuberculosis (TB) is admitted to the hospital. Along with a private room, which of the following is appropriate related to isolation percussion?
A. Respiratory isolation and contact isolation sputum only
B. Negative airflow room with a specially fitted respirator
C. Respiratory isolation with surgical masks until diagnosis is confirmed
D. No respiratory isolation necessary until diagnosis is confirmed
8. The nurse knows which of the following is the purpose of a fluticasone inhaler for a client with asthma?
A. Relaxes smooth muscles of the airway
B. Act as a bronchodilator in severe episodes
C. Reduces obstruction of the airways by decreasing agent
D. Reduces histamine effect of the triggering agent.
9. A nurse is teaching a 78-year-old client about the importance of the pneumonia vaccination. Which statement by the client indicates an understanding of the teaching?
A. Only the flu vaccination is recommended at my age.
B. I only need pneumonia vaccination upon admission to a nursing home.
C. I need two different vaccination to prevent pneumonia
D. I’ve already had pneumonia, so I only need one vaccination.
10. In plaining care for client with chronic obstructive pulmonary disease (COPD) and chronic difficulty breathing, the nurse acknowledges what condition is present in the client?
A. Decreased level of calories and protein since dyspnea cause activity intolerance
B. COPD has no effect on calories and protein needs, meal tolerance appetite and weight.
C. Increase metabolism and the need for additional calories and protein supplements
D. Anabolic state, which creates conditions for building body strength and muscle mass.
11. A nurse admitted a client from the emergency department with new onset of dyspnea and productive cough with suspected pneumonia, the client has an oxygen saturation of 96% on and 2 L of O2 via nasal cannula and crackles in bilateral bases. Oral temperature 98.9 degrees F, heart rate 103 beats per minute and respiration rate 18 breaths per minute. The provider enters the following orders, which the nurse perform first?
A. Administer broad spectrum antibiotic through Iv
B. Collect sputum sample for culture
C. Administer PO antipyretic for temperature
D. Collect blood sample for complete blood count
12. A client with recent diagnosis of sinus cancer states that he wants another course of antibiotic because he believes he has another sinus infection. What is the nurse’s best response?
A. I will call the physician to request an order for the antibiotic
B. Why are you doubting your doctor’s diagnosis?
C. Let met bring you a brochure about sinus cancer.
D. Tell me your understanding about your diagnosis of sinus cancer?
13. A nurse is providing education to a client recently diagnosed with pulmonary hypertension. What is the goal of drug therapy for this client?
A.Dilate pulmonary vessels and prevent clot formation
B. Decrease pain and make the client comfortable
C. Improve or maintain gas exchange
D. Maintain and manage pulmonary exacerbation
14. The nurse is providing education to a client who is prescribed a long- acting beta- agonist. Which statement by the client indicates the client understands the teaching?
A. I will carry this medication with me at all times in case I need it.
B. I will take this medication when I start to experience an asthma attack.
C. I will take this medication every morning to prevent asthma attack.
D. I will only take this medication when I am admitted to the hospital.
15. The nurse is preforming medication teaching to a client with chronic airflow limitation. What is the correct sequence for administering inhaled medications?
A. Bronchodilator should be taken 5 to 10 minutes after the steroid
B. Bronchodilator should be taken at least 5 minutes before other inhaled drugs
C. Bronchodilator should be taken immediately after the steroid
D. Bronchodilator and steroid are two different classes of drugs, so the sequence is irrelevant.
16. The nurse is caring for a client who was recently diagnosed with asthma and is providing education on causes and trigger of asthma. What risk factor is not related to potential causing or triggering the disease process?
A. Dust or air pollutants
C. Cigarette smoking
D. History of environmental allergies
17. Which statement is true regarding asthma and chronic obstructive disease (COPD)as chronic disease of the lower respiratory system?
A. COPD cause episodes of respiratory distress with no permanent alveoli damage
B.In asthma, the lungs lose elasticity and become hyperinflated.
C. Asthma manifests as acute episodes of reversible airway distress
D. In COPD, a twitchy airway’ can cause airway obstruction.
18. The nurse is caring for a 50-year-old female client who presented to the emergency room status post motor vehicle accident. The client was an unrestrained passenger who hit the windshield, and she has multiple facial lacerations.Which of the following is a priority nursing priority nursing intervention for this client?
A. Maintain a patent airway
B. Pain management
C. Prepare the client for testing
D. Draw labs
19. A client presented to the emergency room with difficulty breathing. Upon examination, the client has pus behind the tonsils and swelling on the right side of his nick. She is diagnosed with peritonsillar abscess. Which of the following is a treatment priority for this client?
A. Maintain a patent airway
B. Oxygen therapy
20. A client arrives in the emergency department with epistaxis. What is the nurse’s priority intervention?
A. Position the client upright with the head forward.
B. Apply an ice pack to the nose.
C. Monitor the color and amount of blood.
D. Place nasal packing.
21. Anxiety is common among client who are diagnosed with chronic obstructive pulmonary disease. Which of the following intervention can assist in reducing a client anxiety? (Select all that apply)
A. Written plan for dealing with anxiety
B. Professional counselling
C. Relaxation techniques
D. Starting a vigorous exercise routine
E. Plan out periods of rest throughout the day.
22. A nurse is caring for a client who has been diagnosed with chronic obstructive pulmonary disease. Which of the following will be a treatment priority for this client?
A. Improve gas exchange
B. Increase activity level
C. Blood pressure control
D. Prevention of infection
23. A nurse student is teaching a client about their new diagnosis of pulmonary fibrosis. The student would include which of the following in their teaching?
A. This is an incurable, autosomal recessive genetic disease that affects many organs
B. Most clients have progressive disease with a life expectancy of lets than 5 years
C. The use of a flutter- valve device can assist clients to remove thick airway secretions
D. Inflammation of the mucous membranes in the airways can trigger an attack.
24. The nurse teaches a client with asthma to monitor for which problem while exercising?
A. Increased peak expiration flow rate.
B. Wheeze from bronchospasm
C. Swelling in the feet and ankles
D. Respiratory muscle fatigue
25. A client has been taking isoniazid for tuberculosis for 3 weeks. What information gathered by the public health nurse need to be reported to the healthcare provider immediately?
A. Client has been taking isoniazid daily as prescribed
B. Client is drinking 4-6 alcoholic beverages per day
C. Client smokes 1,5 pack of cigarettes per day
D. Client was recently started on varenicline to quit smoking
26. A nurse is caring for a client who has emphysema. Which of the following findings should the nurse expect to assess in this client? (select all that apply)
C. Barrel chest
D. clubbing of the finger
E. deep respirations
27. a 47-year-old male client presented to the emergency room with complaints of nasal and facial pain and bloody discharge. He states the symptom ————— age and have gotten progressively worse. He states that it feels like his nose is blocked up all the time. Based on these symptoms. What of the following order will the nurse expect the provider to order?
A. CT scan of the face
B. Liver function test
C. Complete blood count
D. Tumor mapping
28. The nurse knows that which of the following test is needed to confirm a tuberculosis diagnosis?
A. Complete blood count
B. Chest x-ray
C. Mantoux skill test
D. Sputum culture
29. The nurse is caring for the client with cystic fibrosis. Which of the following are common assessment findings for a client with this disorder? (select all that apply)
A. Distended abdomen
B. Foul-smelling, pale stool with high-fat content
C. Gastroesophageal reflux
D. Weight gain
E. Cough with sputum production
30.A nurse is preparing to administer 750 mg of ceftriaxone IM stat. available is ceftriaxone 1 gram/ 5mL. how many mL should the nurse administer pr dose? Round the answer to the nearest hundredth (two decimal places). Use a leading zero if it applies. Do not use a trailing zero
31. A nurse was recently diagnosed with laryngeal cancer. When the nurse begins taking the clients history. The client asks.’’ Did you know that I have throat cancer and may not survive?
What is the appropriate nursing response?
A. Are you having difficulty swallowing?
B. Have you told your family yet?
C. I know you have been diagnosis with cancer. Are you concerned about what the future may hold?
D. I am sure that we can cure you as long as you follow doctor’s directions
32. A client with chronic bronchitis often shows signs of hypoxia. Which of the following is the priority to monitor for in this client?
A. Large amounts of thick mucus
B. Barrel chest
C. Nutritional status
D. Clubbing of fingers
33. Which statement by the client indicates an understanding of radiation therapy for neck cancer?
A. My voice may initially be hoarse but should improve over time
B. There are no side effect other than a hoarse voice
C. Radiation causes excessive saliva production
D. My throat is not directly affected by radiation
34. Which of the following is a common problem associated with cystic fibrosis in adults?
35. A nurse is preparing to administer hydromorphone 2.5 mg po now. Available is hydromorphone 5 mg/5 mL elixir. How many mL should the nurse administer per dose? Round the answer to the nearest tenth (one decimal places). Use a leading zero if it applies. Do not use a trailing zero
36. The change of shift report has just been completed on the medical-surgical unit. Which client will the oncoming nurse plan to assess first?
A. Client with COPD who is ready for discharge but is unable to afford prescribed medication
B. Client with cystic fibrosis (CF) who has an elevated temperature and a respiratory rate of 38 breaths/min.
C. Hospice client with end state pulmonary fibrosis and an oxygen saturation level of 89%
D. Client with lung cancer who needs an IV antibiotic administered before going to surgery.
37. A client presents with sign and symptoms that are often associated with lung cancer. Which clinical manifestations does the nurse expect to observe in the client?
A. Hemoptysis, hoarseness, cough, and shortness of breath
B. Abdominal distension, steatorrhea, and dyspnea
C. Wheezing, clubbing of the nails, cyanosis, and dyspnea
D. Fever, fatigue, dyspnea, and peripheral edema
38. A nurse is caring for a client with end-stage-emphysema, which of the following would be a expected finding?
A. Increased CO2
B. Increased PO2
C. Increased PH
D. Decreased CO2
39. Which intervention promote comfort in dyspnea management for a client with lung cancer?
A. Administer morphine only when the client requests it
B. Place the client in a supine position with a pillow under the knees and legs
C. Encourage exercise and independent ambulation around the room
D. Provide supplemental oxygen via nasal cannula or mask.
40. A nurse is caring for a client who recently diagnosed with cystic fibrosis.Which of the following treatment option for this disorder?
B. Weight reduction
C. Chest physiotherapy
D. Pain management
41. The nurse is providing discharge instructions, for a client diagnosed with pneumonia. Which information is the nurse sure to include?
A. Complete antibiotic as prescribed, rest, drink fluid and minimize contact with crowds.
B. Take all antibiotic as order, resume diet and all activities as before hospitalization.
C. No restrictions regarding activities, diet, and rest because the client is fully recovered when discharged.
D. Continue antibiotic only no further signs of pneumonia are present avoid exposing immunosuppressed individuals.
42. A nurse is caring for several older clients in the hospital that the nurse identifies as being at high risk for healthcare-associated pneumonia. To reduce this risk, what activity should the nurse delegate to the unlicensed assistive personal (UAP)?
A. Encourage between-meal snacks
B. Monitor temperature every 4 hours.
C. Provide oral care every 4 hours
D. Report any new onset of cough.
43. A client is being discharged on long-term therapy for tuberculosis (TB). What referral by the nurse is most appropriate?
A. Community social worker for meals on wheels
B. Occupational therapy for job retraining
C. Physical therapy for homebound therapy services
D. Visiting public health nurses for directly observed therapy.
44. The nurse is teaching a client post rhinoplasty care. Which statement by the client indicates an understanding of the instructions?
A. I will be able to breathe only from my nose
B. I should try and avoid coughing, sneezing, and blowing my nose
C. I should take over the counter nonsteroidal anti-inflammatory drugs (NSAIDS) for pain
D. I should retain supine if possible
45. A nurse is caring for a 56- year-old male client recently diagnosed with neck cancer. Which of the following assessment findings is most consistent with this diagnosis?
B. Weight gain
C. Nasal congestion
46. An 84-year-old client is diagnosed with rhinosinusitis. The nurse questions which medication that she sees on the client’s PRN medication list?
D. Nasal spray
47. During an admission assessment the client tells the nurse that she was recently prescribed a new medication called montelukast, but she forgot to pick it up at the pharmacy. What is the best response by the nurse to assess the client’s understanding of the montelukast?
A. Don’t you know that montelukast would have prevented you from coming to the hospital
B. Why didn’t you remember to get the prescription filled?
C. Have you been having more problems with your asthma recently?
D. Don’t worry about it, you probably have been busy?
48. Which statement from a client with seasonal influenza requires additional teaching?
A. I’m contagious only when symptoms are present
B. I should receive a new influenza vaccine every year.
C. I can reduce my risk by implementing good hand hygiene
D. I can be diagnosed on presentation of symptoms
49. A nurse is preparing to administer dextromethorphan 30 mg PO now. The amount available is dextromethorphan oral liquid 7.5 mg/5ml. How many ml should the nurse administer per dose? (Record the answer as a whole number. Do not use a training zero)
50. A nurse is providing education to a client recently diagnosed with sleep apnea. Which of the following statements by the client indicates an understanding of the teaching?
A. I should contact the provider for a prescription for sleep medication
B. I should begin treatment only if my snoring impacts my partner
C. Sleep apnea only has an impact on my mental concentration
D. I may be at risk for developing heart disease or stroke.
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