ANP 650 MIDTERM EXAM LATEST 2024-2025 ACTUAL EXAM TEST BANK 100 QUESTIONS AND CORRECT DETA, Exams of Nursing

Download ANP 650 MIDTERM EXAM LATEST 2024-2025 ACTUAL EXAM TEST BANK 100 QUESTIONS AND CORRECT DETA and more Exams Nursing in PDF only on Docsity! ANP 650 MIDTERM EXAM LATEST 2024-2025 ACTUAL EXAM TEST BANK 100 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES 1.A client is diagnosed with strabismus. Which of the following will the client most likely experience with this disorder? 1. Nystagmus 2. Diplopia 3. Aphakic vision 4. Ptosis - correct answer-ANS: 2 Diplopia, or double vision, is the primary symptom of strabismus. Nystagmus is a disorder that causes involuntarily rhythmic movements in the eye. Aphakic vision occurs when the lens of the eye is removed. Ptosis is drooping of the eyelid. 2.A client is experiencing a gradual blurring of vision in both eyes not associated with any pain. The nurse suspects the client is experiencing: 1. glaucoma. 2. cataracts. 3. macular degeneration. 4. retinal detachment. - correct answer-ANS: 2 Cataracts occur as the opacity of the lens becomes cloudy, blurring the vision. It occurs in both eyes but is usually worse in one eye. Gradual eye blurring is not associated with glaucoma, macular degeneration, or retinal detachment. 3.The nurse should instruct a client, diagnosed with glaucoma, that the purpose of medication is to: 1. help dry up excess secretions. 2. lower the intraocular pressure. 3. strengthen the muscles of the eye. 4. improve the vision in the eye. - correct answer-ANS: 2 Glaucoma is a disease that relates to the increase of intraocular pressure. The medication given will decrease this intraocular pressure. Medication for glaucoma is not used to help dry up excess secretions, strengthen the eye muscles, or improve vision. 4.After surgery to remove a cataract, which of the following should the nurse instruct the client? ANP 650 MIDTERM EXAM LATEST 2024-2025 ACTUAL EXAM TEST BANK 100 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES 1. Be sure to follow the schedule for the prescribed eyedrop medication. 2. Sleep on the right side to promote drainage. 3. It is okay to rub the eye because the surgery was on the inside. 4. This is an outpatient procedure, and there are no instructions for the patient. - correct answer-ANS: 1 Client education is extremely important in the aftercare of cataract surgery. There is a need to emphasize the postoperative care of eyedrop instillation. The client should not place any pressure near or on the eye. Postoperative instructions are highly important for the client having an outpatient surgical procedure. 5.A tonometry test has been performed with a client and the results are 25 mmHg. The nurse know that: 1. the reading is low and there is no problem. 2. the reading is normal and nothing needs to be done at this time. 3. the results are high and follow-up readings and tests are needed. 4. the results are high and there is no cure to bring the pressure down. - correct answer-ANS: 3 Several reading need to be taken throughout the day to establish the highest reading to be the treated pressure. Normal intraocular pressure ranges from 12 to 16 mmHg. The reading of 25 mmHg is not low or normal. Medication can be prescribed to reduce the pressure. 6.A client has been diagnosed with cataracts. The nurse realizes that the only treatment for this disorder is? 1. Medical management with eyedrops 2. Surgical removal of the lens 3. Cryopexy 4. Phototherapy - correct answer-ANS: 2 Surgical treatment for cataracts begins when vision is sufficiently impaired. The lens is removed and the replacement artificial intraocular lens is put in place. Cataracts cannot be treated with medication alone. Cryopexy and phototherapy are not used to treat cataracts. ANP 650 MIDTERM EXAM LATEST 2024-2025 ACTUAL EXAM TEST BANK 100 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES 1. timolol (Timoptic) eyedrops. 2. latanoprost (Xalatan) eyedrops. 3. timolol (Timoptic) and Latanoprost (Xalatan) eyedrops. 4. metoprolol oral medication. - correct answer-ANS: 3 For the best effect in the treatment of open-angle glaucoma, timolol (Timoptic) and latanoprost (Xalatan) should be prescribed together. Metoprolol is not prescribed for open-angle glaucoma. 1.A client tells the nurse that he does not want to develop macular degeneration like his mother. Which of the following should the nurse instruct the client as being risk factors for the development of this disorder? (Select all that apply.) 1. There is greater risk as people age. 2. Women are at greater risk than men. 3. African Americans are at greater risk than Caucasians. 4. Family history of macular degeneration increases risk. 5. Smoking does not increase risk. 6. Alcohol prevents the onset of this disorder. - correct answer-ANS: 1, 2, 4 Recent statistics show that macular degeneration is age related and that women are at greater risk than men. Family history and smoking are also significant risk factors. Caucasians are at greater risk than African Americans. Alcohol does not prevent the onset of this disorder. 2.A client is receiving tests to diagnose glaucoma. Which of the following diagnostic tests will be used to identify this disorder in the client? (Select all that apply.) 1. Visual acuity 2. Visual field test 3. Tonometry 4. Weber test 5. Rinne test 6. Electroencephalogram - correct answer-ANS: 1, 2, 3 ANP 650 MIDTERM EXAM LATEST 2024-2025 ACTUAL EXAM TEST BANK 100 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES Glaucoma is determined through a comprehensive eye exam including a visual acuity test, visual fields test, dilated eye exam, and tonometry. The Weber and Rinne tests are used in an ear assessment. An electroencephalogram is not used to diagnose glaucoma. 3.A client is diagnosed with ocular cancer. The nurse realizes this client could be treated with: (Select all that apply.) 1. Enucleation 2. Laser surgery 3. Plaque brachytherapy 4. Block incision 5. Trabeculoplasty 6. Trabeculectomy - correct answer-ANS: 1, 3, 4 Surgical options for a client diagnosed with ocular cancer include enucleation, plaque brachytherapy, or block incision. Laser surgery, trabeculoplasty, and trabeculectomy would be used to treat glaucoma. 4.A client, diagnosed with keratoconus, asks the nurse what caused the disorder to develop. The nurse should instruct the client on which of the following as risk factors for the development of this disorder? (Select all that apply.) 1. Sun exposure 2. Ocular allergies 3. Wearing rigid contact lenses 4. Vigorous eye rubbing 5. Herpes simplex virus 6. Dry eyes - correct answer-ANS: 2, 3, 4 Risk factors for the development of keratoconus include ocular allergies, rigid contact lens wear, and vigorous eye rubbing. Sun exposure, herpes simplex virus, and dry eyes are not risk factors for this disorder. 5.The nurse is planning instruction for a client experiencing dry eyes. Which of the following should be included in these instructions? (Select all that apply.) 1. Drink 8 to 10 glasses of water each day. ANP 650 MIDTERM EXAM LATEST 2024-2025 ACTUAL EXAM TEST BANK 100 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES 2. Apply petroleum jelly to the eyelids. 3. Blink more frequently. 4. Avoid sun exposure. 5. Avoid rubbing the eyes. 6. Avoid dry air. - correct answer-ANS: 1, 3, 5, 6 Interventions to improve dry eyes include drink 8 to 10 glasses of water each day; blink more frequently; avoid rubbing the eyes; and know that dry air makes the condition worse. Petroleum jelly is not a treatment for dry eyes. Avoiding the sun is good advice; however, it is not proven to help with dry eyes. 6.Which of the following should the nurse instruct a client diagnosed with type 2 diabetes mellitus regarding vision care? (Select all that apply.) 1. Maintain good glucose control. 2. Stop smoking. 3. Limit exercise. 4. Reduce reading. 5. Frequently rest the eyes. 6. Rub eyes daily. - correct answer-ANS: 1, 2 To preserve vision and reduce the onset of diabetic retinopathy, the nurse should instruct the client to control blood glucose level, manage other complications, and stop smoking. The client should not be instructed to limit exercise, reduce reading, rest the eyes, or rub the eyes to prevent the onset of diabetic retinopathy. 1.A client is not able to successfully pass the whisper test. Which of the following would be indicated for this client? 1. Head CT scan 2. Audiometry 3. MRI of the brain 4. Electroencephalogram - correct answer-ANS: 2 Failure to pass the whisper test would indicate the need for formal audiometry testing. The client would not need a head CT or MRI at this time. An electroencephalogram is not necessary. ANP 650 MIDTERM EXAM LATEST 2024-2025 ACTUAL EXAM TEST BANK 100 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES 2. The sound will be louder in the good ear. 3. Air conduction is shorter than bone conduction. 4. No sounds will be heard. - correct answer-ANS: 1 During a Weber test, which tests bone conduction, a client with a conductive hearing loss hears louder sounds on the affected side. Hearing louder sounds on the unaffected side is sensorineural loss. The Rinne test compares bone with air conduction. The client will hear sounds louder in the affected ear. 9.The nurse is performing postoperative teaching with a client recovering from a stapedectomy. Which of the following instructions would the nurse want to include in the teaching? 1. It is okay to resume exercise the next day. 2. It is okay to resume work the same day. 3. It is okay to shower and shampoo the next day. 4. It is okay to blow the nose gently one side at a time. - correct answer-ANS: 4 Care must be taken not to disturb the ossicles from their position, so exercise and work should not be resumed until healing is complete. It is also important to keep the ear dry. The client should be taught to blow the nose gently on one side at a time so as not to increase the pressure in the ear. 10.After a mastoidectomy, the most important complication for the nurse to assess for is: 1. vomiting. 2. headache. 3. fever. 4. stiff neck. - correct answer-ANS: 3 All are complications that can occur following this type of surgery. Fever is of extra importance because of its possible link to infection. The mastoid bone is in direct contact with the brain, and therefore any infection can travel to the brain. 11.When instructing a client on cleaning the ear, the nurse should instruct the client to clean: 1. only the outer ear. 2. all the way to the middle ear. 3. all parts of the ear outer, middle, and inner ear. ANP 650 MIDTERM EXAM LATEST 2024-2025 ACTUAL EXAM TEST BANK 100 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES 4. just the tympanic membrane. - correct answer-ANS: 1 Only the outer portion of the ear should be cleaned. Inserting different objects into the ear canal may result in injury and damage. 12.Which of the following would prohibit an elderly client from wanting to obtain and use a hearing aid? 1. Fears sounds will be too loud 2. Thinks not necessary for a temporary problem 3. Fears the cost 4. Prefers silence - correct answer-ANS: 3 Some of the problems encountered by clients obtaining hearing aids include appearance, cost, education, unrealistic expectations, and difficulty with the care and maintenance of the hearing aids. The other choices are not problems encountered by clients obtaining hearing aids. 13.Which of the following should the nurse instruct a client who is being fitted for a hearing aid? 1. Keep the appliance turned on at all times. 2. Store the hearing aid in a warm, moist place. 3. Batteries last for at least 1 month. 4. Clean ear molds at least once a week. - correct answer-ANS: 4 The nurse should instruct the client to turn off the appliance when not in use; store in a cool, dry place; change the batteries at least once per week; and clean ear molds at least once per week. 1.The nurse is instructing a client diagnosed with otitis media on management during the acute phase. Which of the following should the nurse include in the teaching? (Select all that apply.) 1. Take the antibiotics as ordered. 2. Take over-the-counter analgesics for mild pain as recommended. 3. It is okay to go swimming. 4. It is okay to go on vacation and trips that require flying. 5. If excruciating pain develops, seek medical care. ANP 650 MIDTERM EXAM LATEST 2024-2025 ACTUAL EXAM TEST BANK 100 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES 6. Limit fluids. - correct answer-ANS: 1, 2, 5 Clients must complete the medication as ordered to kill the infection. Mild analgesics for pain are often needed. If excruciating ear pain develops, the client should seek medical care to rule out perforation of the eardrum. It is important to keep the ear dry, so the client should not swim at this time. Flying is not recommended at this time. Limiting fluids is not necessary with otitis media. 2.When caring for a client with total hearing loss, the nurse is instructing the client about the many options that are available to function in a hearing world. Which of the following should the nurse include? (Select all that apply.) 1. Flashing lights for alarms 2. TV with closed captions 3. Talking computer 4. Lip reading and sign language 5. Cell phones with headsets 6. Loud ringers on telephones - correct answer-ANS: 1, 2, 4 Patients who have no hearing have access to various mechanisms to alert them to various sounds. Flashing lights for alarms to phones and doorbells, TV with closed captions for the hearing impaired, and classes in lip reading and sign language are some options. Talking computers and cell phones with headsets are advancements for the hearing, not for the hearing impaired. Loud ringers on telephones would also be helpful to the client with some hearing and not a total hearing loss. 3.A client is diagnosed with a congenital hearing loss. Which causes does the nurse realize are reasons for this type of hearing loss? (Select all that apply.) 1. Genetics 2. Natal infections 3. Physical deformities 4. Noise levels 5. Maternal ototoxic drugs 6. Maternal TORCH infections - correct answer-ANS: 1, 2, 3, 5, 6 ANP 650 MIDTERM EXAM LATEST 2024-2025 ACTUAL EXAM TEST BANK 100 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES 4.A client diagnosed with hypertension is experiencing allergic rhinitis. The nurse realizes that the medication that would not be indicated for this client would be: 1. loratadine. 2. montelukast. 3. pseudoephedrine. 4. zafirlukast. - correct answer-ANS: 3 Pseudoephedrine can be contraindicated for the patient with hypertension. Loratadine, montelukast, and zafirlukast should be used cautiously for patients with hepatic impairment. 5.A 16-year-old client is being prescribed a medication to treat acute sinusitis. The nurse realizes that this client should not be prescribed: 1. amoxicillin. 2. cefuroxime. 3. ciprofloxacin. 4. erythromycin. - correct answer-ANS: 3 Quinolones such as ciprofloxacin (Cipro) and levofloxacin (Levaquin) are contraindicated in children younger than 17 years of age. 6.The nurse is caring for a client diagnosed with acute sinusitis. Which of the following symptoms is the client most likely experiencing? 1. Anosmia 2. Fever 3. Halitosis 4. Metallic taste - correct answer-ANS: 1 Clients often complain of unilateral face pain, purulent nasal discharge, pain during mastication, anosmia (absence of smell), and headache. Less common symptoms include fever, nasal congestion, halitosis, toothache, metallic taste, and cough. 7.The nurse is planning care for the client diagnosed with viral rhinitis. Which of the following would be the best goal of care for this client? 1. Prevent secondary bacterial infection. ANP 650 MIDTERM EXAM LATEST 2024-2025 ACTUAL EXAM TEST BANK 100 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES 2. Prevent rhinitis medicamentosa. 3. Refrain from use of analgesics. 4. Encourage complete participation in activities. - correct answer-ANS: 1 Treatment of acute rhinitis, or the common cold, is aimed at decreasing the impact of the symptoms and preventing secondary bacterial infection. Rhinitis medicamentosa occurs from misuse of nasal decongestants. Acetaminophen or a nonsteroidal anti-inflammatory agent is useful for fever, aches, and pain. Rest is encouraged. 8.The nurse is instructing the mother of a client recovering from a tonsillectomy. Which of the following should the nurse instruct the mother to report? 1. Difficulty swallowing 2. Difficulty talking 3. Excessive swallowing 4. Pain - correct answer-ANS: 3 Excessive swallowing is a sign of bleeding and should be reported. Pain and difficulty talking and swallowing are expected. 9.Which of the following should the nurse instruct a client recovering from a tonsillectomy? 1. Drink milk to promote healing. 2. Gargle with salt water. 3. Maintain good hydration. 4. Use a straw to drink. - correct answer-ANS: 3 Drinking milk does not promote healing and may encourage production of mucus. Gargling and drinking with a straw may disrupt the clot at the operative site and cause bleeding. Maintaining good hydration and eating soft foods are encouraged. 10.A client is experiencing epistaxis. Which of the following interventions would the nurse complete? 1. Call the doctor. 2. Check laboratory test results. 3. Obtain an emesis basin. ANP 650 MIDTERM EXAM LATEST 2024-2025 ACTUAL EXAM TEST BANK 100 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES 4. Show the patient how to pinch the nose. - correct answer-ANS: 4 The initial intervention for a client with epistaxis is to show the client how to lean forward and pinch the nose against the nasal septum for about 5 to 10 minutes continuously. The other interventions are not necessary at this time. 11.A client has been diagnosed with stage IV cancer of the larynx. The nurse realizes that which of the following surgeries is recommended for this type of cancer? 1. Hemilaryngectomy 2. Partial laryngectomy 3. Supraglottic laryngectomy 4. Total laryngectomy - correct answer-ANS: 4 In clients diagnosed with invasive or infiltrating tumors such as those of stage III or stage IV, the entire larynx is removed. The other surgeries only remove portions of the larynx and would be appropriate for lesser stages of the disease. 12.A client is recovering from a total laryngectomy with the placement of a tracheostomy. The nurse should include which of the following instructions to this client? 1. Clean the tracheostomy tube with soap and water daily. 2. Limit protein in the diet. 3. Restrict fluids. 4. The nasogastric tube will be in for 2 weeks. - correct answer-ANS: 4 Clients recovering from a laryngectomy are unable to take nutrition orally for about 10 to 14 days. During this time the client will receive nutrition via intravenous fluids, enteral feedings through a nasogastric tube, or parenteral nutrition. Protein and fluids are not limited. The tracheostomy tube is not cleaned with soap and water. 13.A client diagnosed with viral rhinitis tells the nurse that she has been using a decongestant nasal spray for several weeks and the symptoms are getting worse. Which of the following does the nurse suspect is occurring with this client? 1. Developing pneumonia 2. Subacute rhinitis 3. Rhinitis medicamentosa ANP 650 MIDTERM EXAM LATEST 2024-2025 ACTUAL EXAM TEST BANK 100 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES Although all are major causes of traumatic brain injury, motor vehicle crashes account for 20% of all traumatic brain injuries. Reasons for motor vehicle accidents causing the most traumatic brain injuries include not wearing seat belts and driving while intoxicated. 7.A client is diagnosed with a mild brain injury. Which of the following is an example of a mild injury? 1. Coma 2. Locked-in syndrome 3. Vegetative state 4. Concussion - correct answer-ANS: 4 A concussion is a mild form of brain trauma, and it accounts for 75% of all brain injuries. A moderate brain injury would result in the loss of consciousness ranging from a few minutes to hours and days or weeks of confusion. Coma, locked-in syndrome, and a vegetative state are all examples of severe brain injury. 8.The nurse, caring for a client recovering from a traumatic brain injury, knows the client and the family are eligible for specific federal programs because of the: 1. Health Brain Act. 2. Associated Brain Act. 3. Traumatic Brain Injury Act of 2008. 4. Brain Protection Act. - correct answer-ANS: 3 The Traumatic Brain Injury Act of 2008 is legislation that provides a framework for prevention of, education about, and research on traumatic brain injuries. The act also supports community living for people who have sustained a traumatic brain injury and their families. The other choices are not programs to assist clients who have sustained a traumatic brain injury or their families. 9.The nurse is planning care for a client diagnosed with increased intracranial pressure after a head injury. Which of the following interventions can be used to reduce increased intracranial pressure? 1. Administer antibiotics as prescribed. 2. Keep the head of the bed in the flat position. 3. Administer corticosteroids and osmotic diuretics as prescribed. ANP 650 MIDTERM EXAM LATEST 2024-2025 ACTUAL EXAM TEST BANK 100 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES 4. Perform range-of-motion exercises every hour. - correct answer-ANS: 3 The administration of corticosteroids will decrease the swelling of the brain, and osmotic diuretics will decrease the fluid that is building up. This intervention will decrease the intracranial pressure. Antibiotics do not reduce intracranial pressure. Keeping the head of the bed in the flat position can increase intracranial pressure and not decrease it. Performing range-ofmotion exercises every hour will not reduce intracranial pressure. 10.Which of the following should be avoided when caring for a client diagnosed with increased intracranial pressure? 1. Starting an intravenous access line 2. Administering oxygen 3. Placing the bed in Trendelenburg 4. Placing the client on bed rest - correct answer-ANS: 3 Intravenous access and supplemental oxygen are common interventions in the treatment of increased intracranial pressure. Placing the client on bed rest is a proper safety measure. Placing the bed in Trendelenburg position will increase blood flow to the brain and increase ICP. 11.A client is being instructed on treatments available for a newly diagnosed brain tumor. The nurse realizes that this clients treatment could include all of the following EXCEPT: 1. photo DNA therapy. 2. radiation. 3. chemotherapy. 4. surgery. - correct answer-ANS: 1 Photo DNA therapy is not a therapy. The other answers are common treatment modalities for patients with brain tumors in addition to photodynamic and adjunctive medication therapy. 12.A client diagnosed with an embolic stroke is not a candidate for tPA. The nurse realizes that the client might be eligible for which of the following forms of treatment? 1. Carotid stenting 2. Antiarrhythmic medication 3. Intravenous fluid therapy 4. Carotid endarterectomy - correct answer-ANS: 1 ANP 650 MIDTERM EXAM LATEST 2024-2025 ACTUAL EXAM TEST BANK 100 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES In clients who are ineligible for tPA therapy, catheter-based treatment such as stenting may be an option. Carotid endarterectomy is used to prevent a stroke. Antiarrhythmic medication does not prevent a stroke. Intravenous fluid therapy does not prevent a stroke. 13.A client diagnosed with a brain tumor is going to receive chemotherapy. The nurse realizes that which of the following medications would most likely be prescribed for this clients treatment? 1. Carmustine 2. Digoxin 3. Aminophylline 4. Acetaminophen - correct answer-ANS: 1 One of the biggest obstacles for chemotherapeutic agents when treating brain tumors is selecting a medication that will cross the blood-brain barrier. Carmustine can cross the blood- brain barrier. The other medications are not used as chemotherapy for brain tumors. 1.A client, being tested for a stroke, is not a candidate for tPA. Which of the following would be contraindicated for the use of tPA? (Select all that apply.) 1. Minor ischemic stroke within 30 days 2. Glucose level 120 mg/dL 3. Blood pressure 190/120 mmHg 4. Lumbar puncture 2 days ago 5. Stroke onset 5 hours ago 6. INR 1.0 - correct answer-ANS: 1, 3, 4, 5 Contraindications of tPA to treat an embolic stroke include minor ischemic stroke within the last 30 days, blood pressure greater an 185 mmHg systolic or greater than 110 mmHg diastolic, lumbar puncture within the last 3 days, and onset of stroke greater than 3 hours. Glucose level of 120 mg/dL and INR of 1.0 would not be contraindications for tPA therapy. 2.The nurse, planning care for a client recovering from a traumatic brain injury, is including interventions to prevent sympathetic storming. Which of the following should be included in this clients plan of care? (Select all that apply.) 1. Medicate for pain prior to conducting a painful procedure. 2. Elevated blood pressure indicates a sympathetic storm is ending. ANP 650 MIDTERM EXAM LATEST 2024-2025 ACTUAL EXAM TEST BANK 100 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES 6. Instruct the client to sit in an upright position when eating. - correct answer-ANS: 1, 3, 4, 6 Interventions to assist a client with swallowing and prevent aspiration include have the client tuck the chin with each swallow, turn the head to the weak side to swallow, hold the breath while swallowing, and sitting in an upright position to swallow. The client should not be instructed to turn the head toward the strong side to swallow or to eat in a reclining position. 1.A client is diagnosed with a headache from a secondary cause. The nurse realizes this type of headache can be caused by: 1. a tumor. 2. tension. 3. a migraine. 4. cluster - correct answer-ANS: 1 Primary headaches are identified when no organic cause can be found. A tumor headache is caused by a tumor and is classified as a secondary headache. 2.The nurse should instruct a client diagnosed with migraine headaches to be careful not to overdose on acetaminophen (Tylenol). Which drug should the nurse tell the patient to avoid? 1. Aleve 2. Aspirin 3. Ibuprofen 4. Vicodin - correct answer-ANS: 4 Vicodin, although a narcotic analgesic, also contains acetaminophen (Tylenol). It is very easy to overdose on the acetaminophen (Tylenol) component, which can lead to kidney damage. Aleve does not contain acetaminophen (Tylenol). Aspirin and ibuprofen do not contain acetaminophen (Tylenol). 3.A client is diagnosed with seizures occurring because of hepatic encephalopathy. The nurse realizes that the cause for this clients seizures would be: 1. physiological. 2. iatrogenic. 3. idiopathic. 4. psychokinetic. - correct answer-ANS: 1 ANP 650 MIDTERM EXAM LATEST 2024-2025 ACTUAL EXAM TEST BANK 100 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES The three major causes for seizures are physiological, iatrogenic, and idiopathic. Physiological seizures include those that occur with an acquired metabolic disorder such as hepatic encephalopathy. Iatrogenic causes include new medications or drug or alcohol use. Idiopathic causes include fevers, fatigue, or strong emotions. Psychokinetic is not a cause for seizures. 4.A client tells the nurse that he sees flashing lights that occur prior to the onset of a seizure. Which of the following phases of a seizure is this client describing to the nurse? 1. Prodromal phase 2. Aural phase 3. Ictal phase 4. Postictal phase - correct answer-ANS: 2 In the aural phase a sensation or warning occurs, which the patient often remembers. This warning can be visual, auditory, gustatory, or visceral in nature. The prodromal phase of a seizure includes the signs or activity before the seizure such as a headache or feeling depressed. The ictal phase of a seizure is the actual seizure. The postictal phase is the period immediately following the seizure. 5.A client is experiencing a grand mal seizure. Which of the following should the nurse do during this seizure? 1. Protect the clients head. 2. Leave the client alone. 3. Give water to the client to avoid dehydration. 4. Place a finger in the clients mouth to avoid swallowing the tongue. - correct answer-ANS: 1 One of the most important interventions for a nurse to perform during a seizure is to protect the clients head from injury. Never give a client a drink during a seizure. Placing a finger in the clients mouth could be very dangerous to the client and the nurse. Do not leave the client unattended during a seizure 6.A client is prescribed phenytoin (Dilantin) for a seizure disorder. Which of the following would indicate that the client is adhering to the medication schedule? 1. The client is sleepy. 2. The client is not experiencing seizures. 3. The client no longer has headaches. ANP 650 MIDTERM EXAM LATEST 2024-2025 ACTUAL EXAM TEST BANK 100 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES 4. The client is eating more food. - correct answer-ANS: 2 Phenytoin (Dilantin) is a medication to control seizures. The absence of seizures indicates that the client is adhering to the medication schedule. Sleepiness, lack of headaches, or improved appetite are not indications that the medication is being used as prescribed. 7.The nurse is unable to insert an intravenous access line into a client who is currently experiencing a seizure. Which of the following routes can the nurse use to provide medication to the client at this time? 1. Oral 2. Intranasal 3. Rectal 4. Intramuscular - correct answer-ANS: 2 For a client experiencing a seizure, oral medications and sharp objects can be dangerous and should not be used. Intranasally administered drugs are rapid and effective in treating a client experiencing an acute seizure. Intranasal delivery is more effective than rectal. 8.One of the most important things a nurse can teach a client about seizure control is to: 1. take the medication every day as prescribed by the doctor. 2. eat a balanced diet. 3. get lots of exercise. 4. take naps during the day. - correct answer-ANS: 1 Medication is effective only if it is taken as prescribed, and suddenly stopping the medication can trigger an increase in seizure activity. Diet and exercise are important to a healthy lifestyle but do little to control seizure activity. 9.The nurse is instructing a client newly diagnosed with multiple sclerosis (MS). To determine the effectiveness of his teaching, the nurse would expect the client to state: 1. It is best for me to be in a cold environment. 2. I should avoid taking a hot bath. 3. I should eat foods low in salt. 4. I should be better in a week. - correct answer-ANS: 2 ANP 650 MIDTERM EXAM LATEST 2024-2025 ACTUAL EXAM TEST BANK 100 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES 2.Which of the following nursing interventions would be appropriate for a client diagnosed with Alzheimers disease? (Select all that apply.) 1. Make changes to the room often to stimulate memory function. 2. Assign simple tasks to be completed by the client. 3. Assist the client with any needs associated with activities of daily living (ADLs). 4. Have personal/familiar items around the client. 5. Do complex games and puzzles to improve memory. - correct answer-ANS: 2, 3, 4 Alzheimers disease progressively alters the clients ability to function in the normal ways of living. Personal and familiar items help to keep the client oriented, and simple tasks keep the client functioning at the highest levels as long as possible. 3.A client has been diagnosed with Parkinsons disease. Which of the following will the nurse most likely assess in this client? (Select all that apply.) 1. Tremor 2. Muscle rigidity 3. Akinesia 4. Mask-like face 5. Dysphagia 6. Reduced appetite - correct answer-ANS: 1, 2, 3, 4, 5 Signs and symptoms of Parkinsons disease include tremor, muscle rigidity, akinesia, mask-like face, and dysphagia. Reduced appetite is not a sign or symptom of Parkinsons disease. 4.The nurse is planning care for a client diagnosed with myasthenia gravis. Which of the following should be included in this clients plan of care? (Select all that apply.) 1. Monitor activities frequently and assist as needed. 2. Encourage progressive increase in activities. 3. Determine the best communication method. 4. Monitor weight. 5. Restrict fluids. 6. Instruct in energy conservation measures. - correct answer-ANS: 1, 3, 4, 6 ANP 650 MIDTERM EXAM LATEST 2024-2025 ACTUAL EXAM TEST BANK 100 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES Care for the client diagnosed with myasthenia gravis includes frequent monitoring of activities and assisting as needed, determining the best communication method, monitoring weight, and instructing in energy conservation methods. Encouraging a progressive increase in activities and restricting fluids are not appropriate interventions for a client diagnosed with myasthenia gravis. 5.The nurse is instructing a client and family regarding the diagnosis of amyotrophic lateral sclerosis. Which of the following should be included in this teaching? (Select all that apply.) 1. The length of the curative treatment 2. That exercise and physical therapy can help the patient maximize function 3. The physical, emotional, and social aspects of the disease 4. End-of-life issues 5. The use of devices to prevent aspiration pneumonia 6. The use of a speech therapist to aid with communication - correct answer-ANS: 2, 3, 4, 5, 6 Currently, no cure for this disease exists. Because of the progressive, degenerative nature of the disease, the supportive and educative role of the nurse is important. End-of-life issues need to be discussed before an emergency situation occurs. Other topics of instruction should include the purpose of physical therapy and speech therapy; the use of devices to prevent aspiration; and the emotional and social aspects of the disease 6.The nurse is caring for a client diagnosed with Huntingtons disease. Which of the following are considered hallmark clinical manifestations of this disorder? (Select all that apply.) 1. Intellectual decline 2. Weight loss 3. Decreased appetite 4. Reduced blood pressure 5. Nausea 6. Abnormal movements - correct answer-ANS: 1, 6 The hallmark clinical manifestations of Huntingtons disease are intellectual decline and abnormal movements. Weight loss, decreased appetite, reduced blood pressure, and nausea are not clinical manifestations of this disorder. 1.What are the two divisions of the nervous system? a. Somatic and the autonomic ANP 650 MIDTERM EXAM LATEST 2024-2025 ACTUAL EXAM TEST BANK 100 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES b. Cerebellum and the brainstem c. Medulla oblongata and the diencephalon d. Central and the peripheral - correct answer-ANS: D The central and the peripheral are the two divisions of the nervous system. The autonomic and the somatic are the division of the peripheral nervous system. 2.What is the cranial nerve that supplies most of the organs in the thoracic and abdominal cavities and also carries motor fibers to glands that produce digestive juices and other secretions? a. Somatic motor nerve b. Visceral sensory nerve c. Abducens nerve d. Vagus nerve - correct answer-ANS: D The vagus nerve extends from the throat, larynx, and organs in the thoracic and abdominal cavities. It is responsible for sensations and will accelerate peristalsis when stimulated. 3.The newly admitted patient to the emergency room 30 minutes ago after a fall off a ladder has gradually decreased in consciousness and has slowly reacting pupils, a widening pulse pressure, and verbal responses that are slow and unintelligible. What is the most appropriate position for the patient? a. Neck placed in a neutral position b. Head raised slightly with hips flexed c. Supine in gravity neutral position d. Turn on right side with head elevated - correct answer-ANS: A Place the neck in a neutral position (not flexed or extended) to promote venous drainage. 4.Which question is likely to elicit the most valid response from the patient who is being interviewed about a neurologic problem? a. Do you have any sensations of pins and needles in your feet? b. Does the pain radiate from your back into your legs? c. Can you describe the sensations you are having? ANP 650 MIDTERM EXAM LATEST 2024-2025 ACTUAL EXAM TEST BANK 100 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES b. Agnosia c. Aphasia d. Dysphagia - correct answer-ANS: B Agnosia is a total or partial loss of the ability to recognize familiar objects or people through sensory stimuli as a result of organic brain damage. 13.Which symptom is specific to migraine headaches? a. Tachycardia b. They become worse in the evening c. They involve the entire head d. They are preceded by an aura - correct answer-ANS: D Migraine headaches are unusual in that signs and symptoms occur before the acute attack. 1.A male client is diagnosed with hyperprolactinemia. The nurse realizes that which of the following clinical manifestations occurs less frequently in men? 1. A decrease in testosterone 2. Erectile dysfunction 3. Gynecomastia 4. Infertility - correct answer-ANS: 3 In men, hyperprolactinemia causes a decrease in testosterone secondary to an inhibition of gonadotropin secretion, leading to decreased facial and body hair, erectile dysfunction, decreased libido, small testicles, and infertility. Gynecomastia occurs less frequently in men. 2.A female client is admitted with hyperprolactinemia. Which of the following would not be a clinical manifestation of the disorder in this client? 1. Excessive estrogen 2. Hirsutism 3. Osteoporosis 4. Weight gain - correct answer-ANS: 1 ANP 650 MIDTERM EXAM LATEST 2024-2025 ACTUAL EXAM TEST BANK 100 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES Hyperprolactinemia is associated with a decrease in estrogen, resulting in symptoms of vaginal dryness, hot flashes, osteopenia, and osteoporosis. The patient may also experience weight gain, irritability, hirsutism, anxiety, and depression. 3.A client has been instructed regarding a prolactin level to be drawn the next day. Which of the following statements indicate that the client will need further instruction? 1. I will be on time, in the afternoon. 2. I will be relaxed. 3. I will make sure not to take my antihistamine. 4. I will practice another method of birth control rather than the pill. - correct answer-ANS: 1 Certain medications (e.g., antihistamines and oral contraceptives) and fear can increase the prolactin level. The prolactin level is drawn in the morning. 4.An adult client is complaining of vision changes and difficulty speaking because the tongue is larger. The client also states that his shoes no longer fit. Based on these symptoms, the client is most likely to be diagnosed with: 1. acromegaly. 2. cretinism. 3. gigantism. 4. Graves disease. - correct answer-ANS: 1 Acromegaly is caused by a hypersecretion of the pituitary growth hormone over a long period. This hypersecretion causes a coarsening of the features, including soft tissue overgrowth such as the tongue. Shoes and rings may no longer fit due to tissue and bone overgrowth. In children, hypersecretion of growth hormone causes gigantism. Cretinism and Graves disease are caused by a thyroid hormone imbalance. 5.A client is prescribed medication after recovering from surgery to treat acromegaly. Which of the following medications would the nurse expect to see prescribed? 1. None 2. Cabergoline (Dostinex) 1 mg PO twice a week 3. Cortisone acetate (Cortone) 100 mg PO three times a day 4. Octreotide (Sandostatin) 20 mg IM every 4 weeks - correct answer-ANS: 4 ANP 650 MIDTERM EXAM LATEST 2024-2025 ACTUAL EXAM TEST BANK 100 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES Sandostatin is used for residual growth hormone hypersecretion following surgery. Cortone is used to treat adrenocorticotropic dysfunction, and Dostinex is used to treat hyperprolactinemia. 6.A client, complaining of weight gain, has thin extremities, a buffalo hump, and a protruding abdomen. The nurse realizes that this client is most likely to be diagnosed with which disease process? 1. Addisons disease 2. Cretinism 3. Cushings syndrome 4. Obesity - correct answer-ANS: 3 Even though the client has gained weight (obesity), the distribution of that weight is characteristic for the disease process of Cushings syndrome. Cretinism and Addisons disease do not exhibit those symptoms. 7.The nurse is providing instructions to a client receiving treatment for Cushings syndrome. Which of the following instructions would not be appropriate for this client? 1. Monitor glucose levels. 2. Implement safety precautions. 3. Wear medical identification. 4. Volunteer at the hospital to prevent depression. - correct answer-ANS: 4 A client diagnosed with Cushings syndrome is predisposed to falls, injury, and increased glucose levels. The client should wear an identification bracelet indicating her disease process. The client should avoid crowds and persons with infections. 8.The nurse is assessing a client diagnosed with hyperaldosteronism. Which of the following would take the least priority during this period? 1. Assessment of breath sounds 2. Cardiac monitoring 3. Assistance with activities of daily living (ADLs) 4. Review of electrolyte levels - correct answer-ANS: 3 ANP 650 MIDTERM EXAM LATEST 2024-2025 ACTUAL EXAM TEST BANK 100 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES 3. Hypothyroidism 4. Renal failure - correct answer-ANS: 3 The client diagnosed with chronic lymphocytic thyroiditis will most often progress to hypothyroidism, which is permanent 95% of the time. The nurse should instruct the client regarding signs and symptoms of hypothyroidism. Chronic lymphocytic thyroiditis will not cause type 2 diabetes mellitus, heart failure, or renal failure. 1.Which of the following symptoms would suggest to the nurse that a client is experiencing symptoms of pheochromocytoma? (Select all that apply.) 1. Severe headache 2. Decreased urine output 3. Palpitations 4. Diarrhea 5. Profuse sweating 6. Weight gain - correct answer-ANS: 1, 3, 5 Severe headache, palpitations, and profuse sweating are the most common symptoms of pheochromocytoma. Decreased urine output, diarrhea, and weight gain are not associated with this disorder. 2.A client is receiving diagnostic tests to determine the presence of a malignant thyroid lesion. Which of the following are symptoms that are usually associated with a malignant thyroid? (Select all that apply.) 1. Hoarseness 2. Onset of dysphagia 3. Age 20; male gender 4. Thyroid scan revealing a cold nodule 5. Soft nodules 6. Presence of a single firm nodule - correct answer-ANS: 1, 2, 3, 4, 6 Assessment findings consistent with a malignant thyroid lesion include hoarseness, dysphagia, young adult male; thyroid scan revealing a cold nodule; and the presence of a single firm nodule. Multiple soft nodules are indicative of benign thyroid lesions. ANP 650 MIDTERM EXAM LATEST 2024-2025 ACTUAL EXAM TEST BANK 100 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES 3.The nurse suspects a client is experiencing the early signs of myxedema coma when which of the following is assessed? (Select all that apply.) 1. Reduced level of consciousness 2. Hypothermia 3. Hypoventilation 4. Hypotension 5. Bradycardia 6. Reduced urine output - correct answer-ANS: 1, 2, 3, 4, 5 Myxedema is a medical emergency. The client will present with a diminished level of consciousness, hypothermia, hypoventilation, hypotension, and bradycardia. Prior to the coma, the client may be depressed, confused, paranoid, or even manic. Reduced urine output is not associated with this disorder. 4.The nurse is planning care for a client diagnosed with hypercalcemia caused by hyperparathyroidism. Which of the following should the nurse add as interventions to this clients care plan? (Select all that apply.) 1. Administer high volume intravenous fluids as prescribed. 2. Monitor arterial blood gases. 3. Calculate sodium chloride intake to achieve 400 mEq each day. 4. Provide low rates of intravenous fluids. 5. Provide thyroid replacement medication orally. 6. Monitor body temperature. - correct answer-ANS: 1, 3 Management of fluid and electrolytes is the priority for a client diagnosed with hypercalcemia caused by hyperparathyroidism. The client needs intensive hydration with intravenous normal saline. The nurse also needs to ensure that the client receives greater than 400 mEq of sodium chloride each day. The other answer choices are interventions appropriate for a client diagnosed with myxedema. 1.Blood work of a female client shows an increase in the production of estradiol. The nurse realizes that this hormone is controlled by: 1. positive feedback. ANP 650 MIDTERM EXAM LATEST 2024-2025 ACTUAL EXAM TEST BANK 100 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES 2. negative feedback. 3. nervous feedback. 4. reverse feedback. - correct answer-ANS: 1 Even though most of the hormones in the endocrine system are under a negative feedback mechanism, estradiol is not one of those hormones. Estradiol is controlled by a positive feedback WWW.TESTBANKTANK.COM mechanism in that when it increases, there will be in an increase in the production of folliclestimulating hormone by the anterior pituitary. 2.The nurse, instructing a client regarding hormones, would include which of the following in these instructions? 1. Hormones are nonspecific. 2. Hormone release triggers a rapid response. 3. Hormones do not influence other hormones. 4. The nervous system and hormones work together to maintain homeostasis. - correct answer-ANS: 4 A close relationship between the endocrine and nervous systems is required to allow them to control homeostasis. The short-term rapid responses by the nervous system are balanced by the long-term responses from the endocrine system. Hormones are specific and can influence other hormones. This is what the nurse should instruct the client. The other choices are incorrect and should not be included in instructions to the client. 3.A client is experiencing a disorder to the anterior pituitary gland. The nurse realizes that all of the following hormones will be affected by this disorder EXCEPT: 1. adrenocorticotropic hormone. 2. antidiuretic hormone. 3. melanocyte-stimulating hormone. 4. luteinizing hormone. - correct answer-ANS: 2 Antidiuretic hormone is stored by the posterior pituitary. The other choices are under the regulation of the anterior pituitary gland and would be affected by a disorder in this area.