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Free med surg test bank

Uploaded: 2 years ago
Contributor: csinkovec
Category: Medicine
Type: Lecture Notes
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Filename:   exam 1.docx (65.37 kB)
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User Christine Ellen Behm Course (2015 Fall, Term C) NU 216-KEN/W/1: Adult Health I Test Exam 1 updated/taken Started 9/23/15 1:18 PM Submitted 9/23/15 2:09 PM Status Completed Attempt Score 130 out of 150 points   Time Elapsed 50 minutes out of 1 hour and 15 minutes Instructions You will have 75 minutes to complete this exam. The exam contains 55 questions that are worth a little over three points each for a total of 170 points. Please make sure you read the question carefully and in it's entirety.  This exam contains questions that are multiple choice, select all that apply, True/False, and math dosage calculations. For multiple choice questions choose the best response to each question. For all that apply questions choose all that apply. Results Displayed All Answers, Submitted Answers, Correct Answers, Feedback, Incorrectly Answered Questions Question 1 When communcating with a patient who speaks a language that the nurse does not understand. It is important to first attempt to: Selected Answer: a.  use a trained medical interpreter. Answers: a.  use a trained medical interpreter. b.  use specific medication terminology so there will be no mistakes. c.  have a family memeber translate. d.  focus on the translation rather than nonverbal communication. Question 2 What is the first step in developing cultural competence? Selected Answer: d.  Create opportunities to interact with a variety of cultural groups. Answers: a.  Learn about a multitude of folk medicines and herbal substances that different cultures use for self-care. b.  Learn assessment skills for different cultural groups, including cultural beliefs and practices and physical assessments. c.  Avoid learning about your own cultural background, values, and beliefs about health and health care. d.  Create opportunities to interact with a variety of cultural groups. Question 3 To decrease the risk for future hearing loss, which action should the nurse who is working with college students at the on-campus health clinic implement? Selected Answer: a.  Discuss the importance of limiting exposure to amplified music. Answers: a.  Discuss the importance of limiting exposure to amplified music. b.  Administer influenza immunizations to all students at the clinic. c.  Arrange to include otoscopic examinations for all patients. d.  Perform tympanometry on all patients between the ages of 18 to 24. Question 4 Which explains the quality of a patient's pain?   throbbing Answers: the number 8 using a 0-10 pain scale tool and a B/P pf 150/64 left lower quadrant of the abdomen   throbbing chronic Question 5 Determination of whether an event is a stressor is based on a person's: Selected Answer: b.  perception. Answers: a.  tolerance. b.  perception. c.  adaptation. d.  stubborness. Question 6 Which of the following requires more teaching? Selected Answers:   "I will test my blood sugar within 30 minutes of having taken my insulin" Answers:   "I will test my blood sugar within 30 minutes of having taken my insulin" "I will rotate the site in which I give myself my insulin injection" "I should draw up the clear (regular insulin) frst so that I do contaminate it with the cloudy NPH" I should only use my insulin meedle and syrigne once and immediately dispose of them after i have given my injection Question 7 A patient on the surgical unit has a history of parasomnia (sleep walking). Which statement best describes parasomnia? Selected Answer: d.  The patient is often unaware of the activity on awakening. Answers: a.  Hypnotic medications reduce the risk of sleepwalking. b.  The potential for sleepwalking is reduced by exercise before sleep. c.  The patient should be restrained at night to prevent personal harm. d.  The patient is often unaware of the activity on awakening. Question 8 A characteristic of a chronic illness is that it (select all that apply) Selected Answers: a.  results in permanent deviation from normal in which the patient will never be able to live a normal lifestyle. c.  is assciated with many stable phase as well as unstabel phases which could include repeated exacerbations of the acute illness Answers: a.  results in permanent deviation from normal in which the patient will never be able to live a normal lifestyle. b.  follow a consistent and predictable trajectory, or course of illness c.  is assciated with many stable phase as well as unstabel phases which could include repeated exacerbations of the acute illness d.  has reversible pathologic changes. Question 9 A patient complains of difficulty falling asleep and daytime fatigue for the past 6 weeks. What is the best initial action for the nurse to take in determining whether this patient has chronic insomnia? Selected Answer: b.  Ask the patient to keep a 2-week sleep diary. Answers: a.  Arrange for the patient to have a sleep study. b.  Ask the patient to keep a 2-week sleep diary. c.  Schedule a polysomnography (PSG) study. d.  Teach the patient about the use of an actigraph. Question 10 When starting a peripheral IV the nurse needs to do which of the following?   make sure that the bevel of the needle is facing up Answers: Make sure that the tourniquet is applied at the lowest position on the arm make sure that the patient is not allergic to iodine   make sure that the bevel of the needle is facing up remove the tourniquet once the IV is secured and the  tegaderm dressing has been applied Question 11 Sleep is best described as a: Selected Answer: d.  state in which an individual lacks conscious awareness of the environment. Answers: a.  state in which pain sensitivity decreases. b.  loosely organized state similar to coma. c.  quiet state in which there is no  brain activity. d.  state in which an individual lacks conscious awareness of the environment. Question 12 Order: Lisinopril 40mg by mouth twice daily for edema. Drug available: Lisinopril 20mg tablets. How many tablets are you going to give? Selected Answer:  2 Correct Answer:  2 Answer range +/- 0 (2.0 - 2.0) Question 13 What teaching should be included in the plan of care for a patient with narcolepsy? Selected Answer: b.  Driving an automobile may be possible with appropriate treatment of narcolepsy. Answers: a.  Changes in sleep hygiene are ineffective in improving sleep quality in narcolepsy. b.  Driving an automobile may be possible with appropriate treatment of narcolepsy. c.  Antidepressant drugs are prescribed to treat the depression caused by the disorder. d.  Stimulant drugs should be used for only a short time because of the risk for abuse. Question 14 A patient who uses a fentanyl (Duragesic) patch for chronic cancer pain suddenly complains of rapid onset pain at a level 9 (0 to 10 scale) and requests "something for pain that will work now." How will the nurse document the type of pain reported by this patient? Selected Answer: b.  Breakthrough pain Answers: a.  Nueropathic pain b.  Breakthrough pain c.  Referred pain d.  Somatic pain Question 15 What is the appropriate technique when suctioning a tracheostomy when a patient has excessive respiratory secretions? Selected Answer: d.  if the patient's pulse ox drops stop suctioning immediately Answers: a.  manually apply suction only as you withdraw the suction catheter for approximately 8 to 10 seconds with each pass of the catheter b.  encourage the patient to cough and deep breath in order to mobilize their own secretions c.  maintain low to moderate suction (about 100- 120 mmHg) continously as you suction the patient's airway d.  if the patient's pulse ox drops stop suctioning immediately Question 16 What is a common symptom of someone suffering from obstructive sleep apnea?   waking up with a headache Answers: obesity   waking up with a headache enlarged tonsils dizziness Question 17 The nurse cares for an older adult patient who lives in a rural area. Which intervention should the nurse plan to implement to best meet this patient's needs? Selected Answer: d.  Obtain adequate medications for the patient to last for 4 to 6 months. Answers: a.  Ensure transportation to appointments with the health care provider. b.  Suggest that the patient move to an urban area. c.  Assess the patient for chronic diseases that are unique to rural areas. d.  Obtain adequate medications for the patient to last for 4 to 6 months. Question 18 Which is the priority patient teaching strategy when limited time is available? Selected Answer: b.  Setting realistic goals that have high priority for the patient. Answers: a.  Observing more experience nurse-teachers to learn how to teach faster and more efficiently. b.  Setting realistic goals that have high priority for the patient. c.  Providing reading materials for the patient instead of discussing information the patient needs to learn. d.  Referring the patient to a nurse educator in private practice for teaching. Question 19 The nurse educator teaches students how to be more assertive. Which teaching strategy, if implemented by the nurse educator, would be most effective? Selected Answer: b.  Role playing Answers: a.  Peer conflict b.  Role playing c.  Lecture-discussion d.  Printed materials Question 20 The nurse teaches a patient who is experiencing stress at work how to use imagery as a relaxation technique. Which statement by the nurse would be most appropriate? Selected Answer: c.  "Think of a place where you feel peaceful and comfortable." Answers: a.  "If your work environment is stressful, continue visualizing to overcome the distress." b.  "Bring what you hear and sense in your present work environment into your image." c.  "Think of a place where you feel peaceful and comfortable." d.  "Place the stress in your life in an image that you can destroy." Question 21 A middle-aged patient who has diabetes tells the nurse, "I want to know how to give my own insulin so I don't have to bother my wife all the time." What is the priority action of the nurse? Selected Answer: b.  Demonstrate how to draw up and administer insulin. Answers: a.  Discuss the use of exercise to decrease insulin needs. b.  Demonstrate how to draw up and administer insulin. c.  Provide handouts about therapeutic and adverse effects of insulin. d.  Teach about differences between the various types of insulin. Question 22 Order: Isosorbide dinitrate (Isordil) 10mg PO. Drug available: Isordil 2.5mg per tablet. How many tablets are you going to give? Selected Answer:  4 Correct Answer:  4 Answer range +/- 0 (4.0 - 4.0) Question 23 A patient with chronic neck pain is seen in the pain clinic for follow-up. In order to evaluate whether the pain management is effective, which question is best for the nurse to ask? Selected Answer: c.  "Does the pain keep you from doing things you enjoy?" Answers: a.  "How would you rate your pain on a 0 to 10 scale?" b.  "Can you describe the quality of your pain?" c.  "Does the pain keep you from doing things you enjoy?" d.  "Has there been a change in the pain location?" Question 24 During which sleep state do people dream?   REM Answers: N-REM 1   REM Awakening people dream throughout all stages of sleep Question 25 What should be included in the nursing care plan for a patient who needs to administer antibiotic eardrops? Selected Answer: d.  Keep the head tilted 5 to 7 minutes after admnistration of the drops. Answers: a.  Cool the drops so that they decrease swelling in the canal. b.  Be careful to avoid touching the tip of the dropper bottle to the ear. c.  Avoid placing a cotton wick to assist in administering the drops. d.  Keep the head tilted 5 to 7 minutes after admnistration of the drops. Question 26 The nurse plans care for a hospitalized patient who uses culturally based treatments. Which action by the nurse is best? Selected Answer: d.  Coordinate the use of folk treatments with ordered medical therapies. Answers: a.  Encourage the use of diagnostic procedures. b.  Teach the patient that folk remedies will interfere with orders by the health care provider. c.  Ask the patient to discontinue the cultural treatments during hospitalization. d.  Coordinate the use of folk treatments with ordered medical therapies. Question 27 The nurse recognizes that a person who is subjected to chronic stress could be higher at risk for: Selected Answer: d.  colds and flu. Answers: a.  high serum cholesterol. b.  osteoporosis. c.  low blood pressure. d.  colds and flu. Question 28 A patient is extremely anxious about having a biopsy on a femoral lymph node in the groin area. Which relaxation technique would be best for the nurse to use at this time? Selected Answer: a.  Relaxation breathing Answers: a.  Relaxation breathing b.  Yoga stretching c.  Warm shower or bath d.  Have her discuss her anxieties in a group Question 29 The nurse is caring for an Asian patient who is being admitted to the hospital. Which action would be most appropriate for the nurse to take when interviewing this patient? Selected Answer: a.  Observe the patient's use of eye contact. Answers: a.  Observe the patient's use of eye contact. b.  Dart your eyes from side to side, but avoid looking at the patient. c.  Ask a family member about the patient's cultural beliefs. d.  Stare at the patient as they talk. Question 30 Cultural Conflict is when miscommunication and conflict occur among health care providers from different cultures when they work together as members of the health care team. Selected Answer:  False Answers:  True False Question 31 Which of the following are examples of chronic illness? Selected Answers:   CHF Answers:   CHF Traumatic motor vehicle accident strep throat Otitis Media Question 32 The nurse developing a teaching plan for a patient with herpes simplex keratitis (of the eye) should include which instruction? Selected Answer: b.  Wash hands frequently and avoid touching the eyes. Answers: a.  Apply tear eyes drops to the eye several times daily. b.  Wash hands frequently and avoid touching the eyes. c.  Apply a new occlusive dressing to the affected eye at bedtime. d.  Use corticosteroid ophthalmic ointment to decrease inflammation. Question 33 While admitting a patient to the medical unit, the nurse determines that the patient is hard of hearing. How should the nurse use this information to plan teaching and learning strategies? Selected Answer: a.  Written materials should be provided with verbal instructions. Answers: a.  Written materials should be provided with verbal instructions. b.  The patient will have problems understanding information. c.  Motivation and readiness to learn will be affected. d.  The family must be included in the teaching process. Question 34 Heatlh promotion and prevention of health problems for older adults focus on three areas: Selected Answer:   reduction in diseases and problems, increased participation in health promotion activities, and increased targeted services that reduce health hazards. Answers: teaching how to use assistive devices, providing challenging motivational opportunities, assisting in mobility.   reduction in diseases and problems, increased participation in health promotion activities, and increased targeted services that reduce health hazards. reducing use of over the counter medications, developing home bound activities, increasing hospital stays. elimination of health disparities, finding able bodied medical professionals, teaching medication management. Question 35 The nurse needs to include carefivers in patient teaching primarily because (select all that apply) b.  patients have better outcomes when their caregivers are involved. d.  the patient may be too ill or too stressed to fully understand the teaching. Answers: a.  caregivers are responsible for the overall management of the patients' care. b.  patients have better outcomes when their caregivers are involved. c.  they provide most of the care for patients after discharge. d.  the patient may be too ill or too stressed to fully understand the teaching. Question 36 The family of an older patient with chronic health problems and increasing weakness is considering placement in a long-term care (LTC) facility. Which action by the nurse will be most helpful in assisting the patient to make this transition? Selected Answer: a.  Obtain the patient's input about the choice of a LTC facility. Answers: a.  Obtain the patient's input about the choice of a LTC facility. b.  Ask that the patient be placed in a private room at the facility. c.  Explain the reasons for the need to live in LTC to the patient. d.  Have the family select a LTC facility that is relatively new. Question 37 Order: Cefprozil (Cefzil) 200mcg, PO, every twelve hours. Drug available: Cefzil: 0.3mg/1.5mL. How many mLs are you going to give? Selected Answer:  1 Correct Answer:  1 Answer range +/- 0.1 (0.9 - 1.1) Question 38 It is 1600 and your patient has an IV antibiotic that needs to be administered.  0.9 Normal saline is running at a rate of 100cc/hr.  What is the correct action of the nurse as she/he plans to administer the scheduled piggyback medication. Selected Answer: b.  Hang the antibiotc on an extension so that it is lower than the promary IV fluids Answers: a.  Make sure to change the IV tubing in case of incompatibility b.  Hang the antibiotc on an extension so that it is lower than the promary IV fluids c.  Make sure the primary bag of IV fluids is lower than the piigyback with the scheduled anitbiotic d.  Flush the IV with 3ml of sterile normal saline before you administer the antibiotic Question 39 Which of the following are personal tips for handling stress? Selected Answer:   Exercise regularly. Answers: Drink plenty of alcohol when going out to parties.   Exercise regularly. Spend time independently alone. Eat out at restaurants regularly. Question 40 The nurse is assessing a patient who has recently been treated with amoxicillin for acute otitis media of the right ear. Which finding is a priority to report to the health care provider? Selected Answer: a.  The patient has a temperature of 101.6° F. Answers: a.  The patient has a temperature of 101.6° F. b.  The patient frequently asks the nurse to repeat information. c.  The patient complains of "popping" in the ear. d.  The patient states that the right ear has a feeling of fullness. Question 41 A patient with sleep apnea who uses a continuous positive airway pressure (CPAP) device is preparing to have inpatient surgery. Which instructions should the nurse provide to the patient? Selected Answer: d.  Remind the patient to take the CPAP device to the hospital. Answers: a.  Plan to schedule a nighttime polysomnography (PSG) study before surgery. b.  Discourage the patient from requesting pain medication while hospitalized. c.  Call the hospital to ensure that mechanical ventilation will be available for the patient. d.  Remind the patient to take the CPAP device to the hospital. Question 42 When assisting a blind patient in ambulating to the bathroom, the nurse should: Selected Answer: b.  walk slightly ahead of the patient and allow the patient to hold the nurse's elbow. Answers: a.  take the patient by the arm and lead the patient slowly to the bathroom. b.  walk slightly ahead of the patient and allow the patient to hold the nurse's elbow. c.  stay beside the patient and describe any obstacles on the path to the bathroom. d.  have the patient place a hand on the nurse's shoulder and guide the patient. Question 43 Order: Augmentin 0.4g PO every eight hours. Drug available: Augmentin 500mg/2mL. How many mLs are you going to give? Selected Answer:  20 Correct Answer:  1.6 Answer range +/- 0.1 (1.5 - 1.7) Question 44 Which needle is most appropriate when preparing to give a patient their sliding scale insulin?   a 28 gauge needle attached to a 1ml syringe measuring in units Answers: use a 28 gauge filter needle with cloudy insulins a half inch 18 gauge needle attached to a 1ml insulin syringe   a 28 gauge needle attached to a 1ml syringe measuring in units a tuberculin syringe and attached needle Question 45 Pain is best described as: Selected Answer: a.  an unpleasant, subjective experience. Answers: a.  an unpleasant, subjective experience. b.  a creation of a person's imagination. c.  a maladaptive response to a stimulu. d.  a neurologic event resulting from activation of nociceptors. Question 46 In identifying patients at the greatest risk for health disparities, the nurse would note that: Selected Answer: c.  cultural differences exist in patients' ability to communicate with their health care provider. Answers: a.  patients who live in urban areas have readily available access to health care services. b.  a patient receiving care from a health care provider of a different culture would have decreased quality of care. c.  cultural differences exist in patients' ability to communicate with their health care provider. d.  men are more likely than women to have their cardivascular disease symtoms ignored by their health care provider. Question 47 A patient with glaucoma who has been using timolol (Timoptic) drops for several days tells the nurse that the eye drops cause eye burning and visual blurriness for a short time after administration. The best response to the patient's statement is: Selected Answer: b.  "The drops are uncomfortable, but it is important to use them to retain your vision." Answers: a.  "Those symptoms may indicate a need for an increased dosage of the eye drops." b.  "The drops are uncomfortable, but it is important to use them to retain your vision." c.  "Notify your health care provider so that different eye drops can be prescribed for you." d.  "These are abnormal side effects of the drug, you should stop taking them immediately!" Question 48 Which patient with pain should the nurse assess first? Selected Answer: a.  Patient who returned from the postanesthesia care unit 2 hours ago and has a respiratory rate of 10 Answers: a.  Patient who returned from the postanesthesia care unit 2 hours ago and has a respiratory rate of 10 b.  Patient with postoperative pain who received morphine sulfate IV 15 minutes ago c.  Patient with neuropathic pain who has a dose of hydrocodone (Lortab) scheduled now d.  Patient who received hydromorphone (Dilaudid) 1 hour ago and currently has a sedation scale of 2 Question 49 An appropriate nursing intervention for a hospitalized patient who states she cannot cope with her illness is: Selected Answer: a.  asking the patient to describe previous stressful situations and how she managed to resolve them. Answers: a.  asking the patient to describe previous stressful situations and how she managed to resolve them. b.  arranging the patient to phone family and friends to maintain emotional bonds. c.  encouraging the patient's family to offer emotional support by frequent visits. d.  controlling the environment to prevent sensory overload and promote sleep. Question 50 A middle-aged male patient with usually well-controlled hypertension and diabetes visits the clinic. Today he has a blood pressure of 174/94 and a blood glucose level of 190 mg/dL. What additional patient information may indicate that an intervention by the nurse is needed? Selected Answer: c.  The patient reports that he and his wife are getting divorced and are in a custody battle over their 12-year-old son. Answers: a.  The patient indicates that he usually does blood glucose monitoring several times each day. b.  The patient states that he usually takes his prescribed antihypertensive medications on a daily basis. c.  The patient reports that he and his wife are getting divorced and are in a custody battle over their 12-year-old son. d.  The patient states that the results are related to his family history because both of his parents have high blood pressure and diabetes. Question 51 Which patient characteristic enhances the teaching-learning process? Selected Answer: d.  Confidence and self-efficacy Answers: a.  Moderate anxiety b.  Being in the precontemplative stage of change c.  Being able to laugh about the current health problem d.  Confidence and self-efficacy Question 52 The nurse is caring for a 1-day postoperative patient who is receiving morphine through patient-controlled analgesia (PCA). What action by the nurse is a priority? Selected Answer: b.  Check the respiratory rate. Answers: a.  Inspect the abdomen and auscultate bowel sounds. b.  Check the respiratory rate. c.  Evaluate the sacral and heel areas for signs of redness. d.  Assess for nausea after eating. Question 53 The priority nursing diagnosis for a patient experiencing an acute attack with Meniere's disease is: Selected Answer: d.  risk for falls related to dizziness. Answers: a.  imbalanced nutrition: less than body requirements related to nausea. b.  impaired verbal communication related to tinnitus. c.  self-care deficit (bathing and dressing) related to vertigo. d.  risk for falls related to dizziness. Question 54 Which patient statement indicates a need for further teaching about extended-release zolpidem (Ambien CR)? Selected Answer: d.  "I should not take this medication unless I can sleep for at least 6 hours." Answers: a.  "I should take the medication on an empty stomach." b.  "I will take the medication an hour before bedtime." c.  "I will schedule activities that require mental alertness for later in the day." d.  "I should not take this medication unless I can sleep for at least 6 hours." Question 55 Which information regarding a patient's sleep is most important for the nurse to communicate to the health care provider? Selected Answer: d.  41-year-old librarian who has a body mass index (BMI) of 42 kg/m2 says that the spouse complains about snoring Answers: a.  32-year-old accountant who is experiencing a stressful week uses diphenhydramine (Benadryl) for several nights b.  21-year-old student who takes melatonin to assist in sleeping when traveling from the United States to Europe c.  64-year-old nurse who works the night shift reports drinking hot chocolate before going to bed in the morning d.  41-year-old librarian who has a body mass index (BMI) of 42 kg/m2 says that the spouse complains about snoring Question 56 Ageism is a positive attitude with non-discriminating traits based on a person's age. Selected Answer:  False Answers: True  False Question 57 The nurse cares for a patient who speaks a different language. If an interpreter is not available, which action by the nurse is most appropriate? Selected Answer: d.  Use simple gestures to demonstrate meaning while talking to the patient. Answers: a.  Speak loudly in close proximity to the patient's ears. b.  Talk slowly so that each word is clearly heard. c.  Repeat important words so that the patient recognizes their significance. d.  Use simple gestures to demonstrate meaning while talking to the patient. Question 58 Inflammation and infection of the eye: Selected Answer: b.  are caused by irritants and microorganisms. Answers: a.  have a higher incidence in sexually active patients. b.  are caused by irritants and microorganisms. c.  are chronic problems that result in a loss of vision. d.  are frequently treated with cold compresses and antibiotics. Question 59 Which nursing action could the nurse delegate to unlicensed assistive personnel (UAP) when caring for a patient who is using a fentanyl (Duragesic) patch and a heating pad for treatment of chronic back pain? Selected Answer: a.  Take the respiratory rate every 2 hours. Answers: a.  Take the respiratory rate every 2 hours. b.  Check the skin under the heating pad. c.  Monitor sedation using the sedation assessment scale. d.  Ask the patient about whether pain control is effective. Question 60 The occupational health nurse is caring for an employee who is complaining of bilateral eye pain after a cleaning solution splashed into the employee's eyes. Which action will the nurse take first? Selected Answer: d.  Flush the eyes with sterile saline. Answers: a.  Apply ice packs to both eyes. b.  Apply antiseptic ophthalmic ointment to the eyes. c.  Cover the eyes with dry sterile patches and shields. d.  Flush the eyes with sterile saline.

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