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DUNPHY EXAM 2 - PRIMARY CARE TEST QUESTIONS, Exams of Nursing

United States International UniversityNursing

DUNPHY EXAM 2 - PRIMARY CARE TEST QUESTIONS

Typology: Exams

2023/2024

Available from 11/15/2024

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DUNPHY EXAM 2 - PRIMARY CARE: TEST QUESTIONS
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 - Answers- 1. Physiological
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 - Answers- 2. Aura
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. - Answers- 1.
Protect the clients head
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.
4. The client is eating more food - Answers- 2. The client is not experiencing seizures.
A client is being seen in the emergency department experiencing symptoms of a stroke.
The nurse realizes that the administration of a medication to break clots, such as tPA,
should be administered within how many minutes of the client presenting to the
emergency department?
1. 30 minutes
2. 60 minutes
3. 90 minutes
4. 120 minutes - Answers-
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DUNPHY EXAM 2 - PRIMARY CARE: TEST QUESTIONS

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 - Answers- 1. Physiological 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?
  5. Prodromal phase
  6. Aural phase
  7. Ictal phase
  8. Postictal phase - Answers- 2. Aura A client is experiencing a grand mal seizure. Which of the following should the nurse do during this seizure?
  9. Protect the clients head.
  10. Leave the client alone.
  11. Give water to the client to avoid dehydration.
  12. Place a finger in the clients mouth to avoid swallowing the tongue. - Answers- 1. Protect the clients head 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?
  13. The client is sleepy.
  14. The client is not experiencing seizures.
  15. The client no longer has headaches.
  16. The client is eating more food - Answers- 2. The client is not experiencing seizures. A client is being seen in the emergency department experiencing symptoms of a stroke. The nurse realizes that the administration of a medication to break clots, such as tPA, should be administered within how many minutes of the client presenting to the emergency department?
  17. 30 minutes
  18. 60 minutes
  19. 90 minutes
  20. 120 minutes - Answers-

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 - Answers- 1. Carotid stenting A patient with a temporary loss of motor function is diagnosed with a transient ischemic attack (TIA). What should the nurse include when assisting in the teaching about this health problem?
  5. You had a small hemorrhage in your brain.
  6. Your brain was temporarily deprived of oxygen.
  7. The neurons in your brain are tangled, so messages get mixed up.
  8. You have a vessel that is occluded, blocking the blood supply to your brain. - Answers- 2. Your brain was temporarily deprived of oxygen. The nurse is assisting with teaching a patient who has had a transient ischemic attack (TIA). On which understanding should the nurse base teaching?
  9. TIAs are not serious, and the patient should have no further problems.
  10. A TIA is predictive that the patient will have a heart attack within 1 year.
  11. A TIA is a medical emergency that requires immediate surgical intervention.
  12. A TIA is a forewarning that the patient is at risk for a cerebrovascular accident (stroke). - Answers- 4. A TIA is a forewarning that the patient is at risk for a cerebrovascular accident (stroke). The nurse is planning care for a client with right-sided weakness and aphasia from a transient ischemic attack (TIA). Which area of the brain should the nurse realize was affected in this client?
  13. Medulla
  14. Occipital lobe
  15. Left hemisphere
  16. Right hemisphere - Answers- 3. Left hemisphere A patient with a cerebrovascular accident (stroke) has left-sided flaccidity and is unable to speak but seems to understand everything the nurse says. Which term should the nurse use to document the patients communication impairment?
  17. Sensory aphasia
  18. Motor dysphagia
  19. Expressive aphasia
  20. Receptive dysphagia - Answers- 3. Expressive aphasia
  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 - Answers- 1. take the medication every day as prescribed by the doctor For the client who is at risk for stroke, the most important guideline the nurse should teach is to:
  5. increase drinks with caffeine.
  6. monitor blood pressure.
  7. increase amounts of sodium in the diet.
  8. monitor weight and activity. - Answers- 2. monitor blood pressure. The family of a client diagnosed with a stroke asks the nurse if this health problem is very common. The nurse should respond that in the United States a person has a stroke every:
  9. 40 seconds.
  10. 1 minutes.
  11. 2 minutes.
  12. 5 minutes. - Answers- 1. 40 seconds. A client is being evaluated for a stroke. The nurse knows that one of the easiest and most common diagnostic tests used to differentiate between strokes is:
  13. computed tomography (CT).
  14. magnetic resonance imaging (MRI).
  15. electrocardiography (EEG).
  16. positron emission tomography (PET). - Answers- 1. computed tomography (CT). While instructing a client on stroke prevention, the nurse mentions medications that are useful in stroke prevention. The following medications are effective in preventing a stroke, EXCEPT:
  17. anticoagulants.
  18. antiplatelets.
  19. anticholinergics.
  20. neuroprotective agents. - Answers- 3. anticholinergics. The nurse is caring for a hospitalized patient who has had a stroke and is waiting to be transferred to a rehabilitation facility. What nursing action can best maximize the patients rehabilitation potential while awaiting the transfer?
  21. Teach the patient what to expect at the rehabilitation facility.
  1. Keep the patient on bedrest to conserve energy for rehabilitation.
  2. Call the physical therapist for bedside rehabilitation until the transfer.
  3. Turn the patient every 2 hours to prevent pressure ulcers and contractures. - Answers- 3. Call the physical therapist for bedside rehabilitation until the transfer. The nurse is assisting in preparing a patient for transfer to a rehabilitation facility after a stroke. What should the nurse explain as the goal for rehabilitation?
  4. To monitor neurological status
  5. To cure any effects of the stroke
  6. To maximize remaining abilities
  7. To determine the extent of neurological deficits - Answers- 3. To maximize remaining abilities A patient is admitted to the hospital with a severe headache and photophobia. A lumbar puncture confirms a bleeding aneurysm. What nursing interventions should the nurse anticipate assisting with to prevent increased intracranial pressure (ICP) during the acute phase of illness?
  8. Morphine, dark glasses, and expectorants
  9. Quiet room, head of bed up, and stool softeners
  10. Coughing and deep breathing exercises and tranquilizers
  11. Range of motion exercises, bedside commode, and suctioning as needed - Answers-
  12. Quiet room, head of bed up, and stool softeners A client with a subarachnoid bleed refuses to use a bedpan and becomes angry when denied permission to walk to the bathroom. While waiting to hear from the health care provider (HCP), which action should the nurse take?
  13. Help the patient to get up on a bedside commode
  14. Wait for the neurosurgeon to call back with orders
  15. Page security to restrain the patient from harming the nurse
  16. Administer an as-needed dose of a sedative that is ordered - Answers- 4. Administer an as-needed dose of a sedative that is ordered A patient is experiencing bilateral hemiparesis, dysphasia, visual changes, and altered level of consciousness, ataxia, and dysphagia. Which artery was most likely affected in this patients stroke?
  17. Carotid
  18. Middle cerebral
  19. Posterior cerebral
  20. Vertebrobasilar/cerebellar - Answers- 4. Vertebrobasilar/cerebellar Carotid or Midline have no dysphagia or ataxia

The nurse is planning care for a patient with an intracerebral hemorrhage. What should be identified as a goal for this patient?

  1. Maintain blood pressure below 120/80 mm Hg
  2. Resume activities of daily living as soon as possible
  3. Expect to experience transient numbness and tingling
  4. Receive thrombolytic medication therapy within an hour - Answers- 1. Maintain blood pressure below 120/80 mm Hg What should the nurse do when the child arrives on the floor with the diagnosis of bacterial meningitis?
  5. Arrange for humidified oxygen per mask
  6. Place the child in respiratory isolation
  7. Inquire about drug allergy
  8. Hold NPO until orders arrive - Answers- 2. Place the child in respiratory isolation The use of a continuous positive airway pump in the treatment of sleep apnea will:
  9. reduce bronchospasm.
  10. force expansion of pleural membranes.
  11. maintain an open airway.
  12. awaken the person and increase respirations. - Answers- 3. maintain an open airway. A client diagnosed with chronic obstructive pulmonary disease is experiencing pneumonia. The nurse applies oxygen at 2 L/min via nasal cannula. When the nurse leaves the room, a family member increases the oxygen to 5 L. Which complication may occur?
  13. Angina 2.Apnea
  14. Metabolic acidosis
  15. Respiratory alkalosis - Answers- 2.Apnea Jason, age 62, has obstructive sleep apnea. What do you think is one of his contributing factors?
  16. He is a recovering alcoholic of 6 years.
  17. His collar size is 17 inches.
  18. He is the only person in his family who has this.
  19. He is extremely thin. - Answers- 2. His collar size is 17 inches. Which of the following is a possible consequence of sleep apnea?
  20. Asthma
  21. Increased white blood cells
  22. Insulin resistance
  1. Hyperactivity - Answers- 3. Insulin resistance The nurse is reviewing clients for risk factors in the development of pneumonia. Which of the following clients would be at the highest risk for developing this disorder?
  2. A. 48-year-old client experiencing menopause
  3. An 18-year-old client with abdominal pain
  4. A 23-year-old client diagnosed with sickle-cell anemia and a cough
  5. 3-year-old client with fever - Answers- 3. A 23-year-old client diagnosed with sickle- cell anemia and a cough The nurse has a positive PPD during the last testing cycle for tuberculosis. Which of the following is indicated for this nurse?
  6. Nothing 2.Chest x-rays every 2 months 3.Pharmacological treatment 4.Admission for inpatient treatment - Answers- 3.Pharmacological treatment A client undergoes a purified protein derivative (PPD) test. The test should be read:
  7. .immediately after the test.
  8. 24 to 48 hours after the test.
  9. 48 to 72 hours after the test.
  10. anytime after 72 hours. - Answers- 3. 48 to 72 hours after the test. The nurse is instructing a client on ways to reduce the transmission of tuberculosis. Which of the following should be included in these instructions?
  11. The disease is transmitted by inhaling droplets exhaled by an infected person.
  12. The disease is transmitted by not fully cooking foods.
  13. The disease is transmitted by not washing hands.
  14. The disease is transmitted by sexual contact. - Answers- 1. The disease is transmitted by inhaling droplets exhaled by an infected person. A client receiving oral medications for the treatment of tuberculosis develops hepatitis. Which of the following medications would be indicated for the client at this time?
  15. Ethambutol 2.Isoniazid 3.Rifampin 4.Streptomycin - Answers- 4.Streptomycin The spouse of a client diagnosed with tuberculosis is to begin isoniazid prophylactic therapy. Which of the following should the nurse instruct the spouse regarding length of time to take this medication? The medication should be taken for:
  1. This medication expands the blood vessels.
  2. This medication causes smooth muscle relaxation to reduce pulmonary engorgement.
  3. This medication reduces the amount of water in the body.
  4. This medication keeps the blood from clotting. - Answers- 3. This medication reduces the amount of water in the body. The nurse is assessing a client experiencing manifestations of cor pulmonale. Which of the following will the nurse most likely assess in this client? 1.Low blood pressure 2.Low heart rate 3.Hoarseness 4.Lumbar pain - Answers- 3.Hoarseness How does pursed lip breathing assist patients with asthma during an attack?
  5. It distracts the patient with breathing technique to reduce anxiety.
  6. It gets rid of CO2 faster.
  7. It opens bronchioles by backflow air pressure.
  8. It increases PACO2.. - Answers- 3. It opens bronchioles by backflow air pressure. How do leukotriene modifiers reduce the symptoms of asthma?
  9. By drying up mucus
  10. By causing bronchodilation and anti-inflammation effects
  11. By suppressing cough
  12. By liquefying mucus - Answers- 2. By causing bronchodilation and anti-inflammation effects How should a patient be positioned after a thoracentesis is completed and the dressing applied?
  13. High Fowler
  14. Semi-Fowler
  15. Side lying on unaffected side
  16. Prone - Answers- 3. Side lying on unaffected side .What should the nurse do to keep the chest tubes from becoming occluded?
  17. Irrigate tubes as needed
  18. Prevent dependent loops
  19. Loop the tube over the bed rail
  20. Milk the tube frequently - Answers- 2. Prevent dependent loops Which patient assessment indicates the most severe respiratory distress?
  1. Nasal flaring, symmetrical chest wall expansion, SaO2 88%
  2. Abdominal breathing, SaO2 97%
  3. Substernal retraction, SaO2 84%
  4. Substernal retraction, SaO2 90% - Answers- 3. Substernal retraction, SaO2 84% In caring for a client diagnosed with a small bowel obstruction, what would the nurse expect to do first?
  5. Prepare to put in a nasogastric (NG) tube. 2.Give pain medication. 3.Draw lab work. 4.Start an intravenous (IV) line. - Answers- 4.Start an intravenous (IV) line. The nurse, instructing a client about malabsorption syndrome, should include that food is absorbed in the: 1.mouth. 2.bloodstream. 3.stomach. 4.small intestine. - Answers- 4.small intestine. A client is diagnosed with appendicitis. One of the laboratory tests the nurse would expect to monitor would be: 1.serum sodium. 2.white blood cell (WBC) count. 3.hemoglobin (Hgb) and hematocrit (Hct). 4.bilirubin level. - Answers- 2.white blood cell (WBC) count. When assessing the pain in a client diagnosed with appendicitis, the nurse would expect to assess: 1.extreme pain with slight palpation anywhere on the abdomen. 2.pain in the upper back when the right lower quadrant is palpated. 3.more pain when the pressure is released in the right lower quadrant. 4.no pain when the abdomen is palpated. - Answers- 3.more pain when the pressure is released in the right lower quadrant. A client is being evaluated for symptoms associated with diverticular disease. The nurse realizes that the best diagnostic test to be used to aid in this diagnosis would be: 1.computed tomography (CT) scan. 2.barium enema. 3.ultrasound. 4.x-ray study. - Answers- 1.computed tomography (CT) scan.

4.Small bowel obstruction - Answers- 2.Crohns disease A client has a history of being treated for ulcerative colitis. The nurse realizes that a life- threatening complication of this disorder is: 1.Crohns disease. 2.small bowel obstruction. 3.peptic ulcer disease. 4.toxic megacolon. - Answers- 4.toxic megacolon. The nurse assesses no bowel sounds with occasional splashing sounds over the large intestines. Which of the following do these assessment findings suggest to the nurse? 1.Ulcerative colitis 2.Irritable bowel syndrome 3.Appendicitis 4.Bowel obstruction - Answers- 4.Bowel obstruction The nurse is instructing a client on diagnostic tests used to screen for colorectal cancer. Which of the following should be included in these instructions? 1.A digital rectal exam should be done annually. 2.A test for fecal occult blood should be done annually. 3.A flexible sigmoidoscopy should be done annually. 4.A colonoscopy should be done every 5 years after age 40. - Answers- 2.A test for fecal occult blood should be done annually. Before administering an antacid, the nurse should instruct a client that this medication works in the: 1.blood. 2.stomach. 3.small intestine. 4.esophagus. - Answers- 2.stomach The nurse is assessing a client diagnosed with gastroesophageal reflux disease. Which of the following should be included in this assessment? 1.Degree of mouth burning 2.Difficulty swallowing 3.Presence of pyrosis 4.Painful swallowing - Answers- 3.Presence of pyrosis During an assessment, the nurse determines a client is at risk for ulcerative stomatitis and gum disease because the client has a history of:

1.alcohol intake. 2.smoking. 3.kissing. 4.eating. - Answers- 2.smoking. A client is diagnosed with a swallowing disorder. The nurse realizes that which type of diet would be indicated for this client? 1.Regular diet 2.Clear liquid diet 3.Mechanical soft diet 4.Low-fat diet - Answers- 3.Mechanical soft diet To support the nutritional needs of a client with dysphagia, the nurse realizes that all of the following are mechanisms to provide enteral feeding EXCEPT: 1.nasogastric tube. 2.percutaneous endoscopic gastrostomy (PEG) tube. 3.jejunostomy tube. 4.hyperalimentation. - Answers- 4. hyperalimentation. A client is scheduled for diagnostic tests to determine the ability to swallow. Which of the following diagnostic tests will provide the best information regarding this clients status? 1.Pulse oximetry with water 2.Esophageal transit scintigraphy 3.Videofluoroscopy 4.Esophageal manometry - Answers- 3.Videofluoroscopy A client, diagnosed with a hiatal hernia, will experience which of the following symptoms most frequently? 1.Nausea 2.Vomiting 3.Diarrhea 4.Heartburn - Answers- 4.Heartburn The nurse is instructing a client diagnosed with a hiatal hernia on ways to reduce the symptoms. Which of the following should be included in these instructions? 1.Eat large meals to keep the stomach full. 2.Drink lots of liquids so that the stomach does not have to work so hard. 3.Avoid lying down after meals. 4.Lie down after eating. - Answers- 3.Avoid lying down after meals

2.Hepatitis B 3.Hepatitis C 4.Hepatitis D - Answers- 1.Hepatitis A An older male is diagnosed with cirrhosis of the liver. The nurse knows that the most likely cause of this problem is: 1.being in the military. 2.traveling to a foreign country. 3.drinking excessive alcohol. 4.eating bad food. - Answers- 3.drinking excessive alcohol. When the liver is seriously damaged, ammonia levels can rise in the body. One of the treatments for this is: 1.administering intravenous (IV) neomycin. 2.giving vitamin K. 3.giving lactulose. 4.starting the patient on insulin. - Answers- 3.giving lactulose. A client is scheduled for a liver biopsy. The nurse realizes that the most important sign to assess for is: 1.infection. 2.bleeding. 3.pain. 4.nausea and vomiting. - Answers- 2.bleeding. The nurse realizes that the organ which is a major site for metastases, harboring and growing cancerous cells that originated in some other part of the body, is the: 1.spleen. 2.gallbladder. 3.liver. 4.stomach. - Answers- 3.liver. A school age child is placed on a waiting list for a liver transplant. The nurse knows that the most common reason for children to need this type of transplant is because of: 1.cirrhosis due to hepatitis C. 2.biliary atresia. 3.diabetes. 4.Crohns disease. - Answers- 2.biliary atresia. Because health care workers are at a greater risk of hepatitis B infection, it is recommended that all health care workers:

1.wash their hands often. 2.avoid foreign travel. 3.become vaccinated. 4.drink bottled water only. - Answers- 3.become vaccinated. A client who usually smokes a pack of cigarettes a day tells the nurse that he cannot stand the smell of smoke. The nurse realizes that this client is in which phase of hepatitis? 1.Preicteric 2.Icteric 3.Posticteric 4.Recovery - Answers- 1.Preicteric A female client is surprised to learn that she has been diagnosed with hemochromatosis. Which of the following should the nurse respond to this client? 1.It doesnt affect people until they are in their 50s. 2.I would ask the doctor if he's sure about the diagnosis. 3.Females often do not experience the effects of the disease until menopause. 4.All women have the disorder but not the symptoms. - Answers- 3.Females often do not experience the effects of the disease until menopause. A client is diagnosed with liver disease. Which of the following is one impact of this disorder on a clients fluid and electrolyte status? 1.Hyperkalemia 2.Hypercalcemia 3.Hypernatremia 4.Hyponatremia - Answers- 4.Hyponatremia causes hypokalemia, hypocalemia too The nurse, caring for a client recovering from the placement of a shunt to treat portal hypertension, should assess the client for which of the following complications associated with this surgery? 1.Myocardial infarction 2.Pulmonary emboli 3.Pulmonary edema 4.Decreased peripheral pulses - Answers- 3.Pulmonary edema A client is diagnosed with macrovesicular fatty liver. Which of the following should the nurse instruct this client?

4.Expect to be nauseated with this medication. - Answers- 1.Do not take within 2 hours of antacid use. A client is recovering from a cystoscopy. The nurse would expect to assess which of the following regarding the clients urine after the procedure? 1.Anuria 2.Blood clots 3.Hematuria 4.Pink-tinged - Answers- 4.Pink-tinged A client is being treated for interstitial cystitis. Which of the following medications would not be prescribed for this client? 1.Cortisone acetate (Cortone) 2.Dimethyl sulfoxide (DMSO) 3.Pimecrolimus (Elidel) 4.Polysulfate sodium (Elmiron) - Answers- 3.Pimecrolimus (Elidel) After being diagnosed, a client asks the nurse What is pyelonephritis? The nurse should respond: 1.Pyelonephritis is an infection of the bladder. 2.Pyelonephritis is an infection of the urethra. 3.Pyelonephritis is an infection of the prostate. 4.Pyelonephritis is a common infection that needs to be treated to prevent complications. - Answers- 4.Pyelonephritis is a common infection that needs to be treated to prevent complications. The nurse is reviewing the health history of a client diagnosed with glomerulonephritis. Which of the medical conditions would be a risk factor for developing glomerulonephritis? 1.Asthma 2.Hypertension 3.Recent strep throat 4.Renal failure - Answers- 3.Recent strep throat 10.The nurse is assessing a client diagnosed with glomerulonephritis. Which of the following findings is consistent with this disorder? 1.Brown urine 2.Hip pain 3.Hypotension 4.Bradycardia - Answers- 1.Brown urine

A client is diagnosed with nephrotic syndrome. Which of the following is the nurse most likely going to assess in this client? 1.Glucosuria 2.Proteinuria 3.Hematuria 4.Oliguria - Answers- 2.Proteinuria A client is surprised to learn that his acute pain is caused by a kidney stone. The nurse should instruct the client that the most common type of renal calculi is composed of: 1.calcium 2.cystine. 3.struvite. 4.uric acid. - Answers- 1.calcium A client is hospitalized with kidney trauma resulting in lacerations to the parenchyma. Which of the following would be included in the management of this clients care? 1.Bed rest with antibiotic therapy 2.Restrict fluids 3.Encourage early ambulation 4.Nephrectomy - Answers- 1.Bed rest with antibiotic therapy The nurse is reviewing a clients risk factors for the development of renal cancer. Which of the following would be considered a risk factor for the development of this disease? 1.Cigarette smoking 2.Being underweight 3.History of hypotension 4.History of type 2 diabetes mellitus - Answers- 1.Cigarette smoking A client is scheduled for surgery to remove the bladder and create a urinary diversion. If the client has a history of complications after surgery, the type of urinary diversion that might be indicated would be: 1.continent diversion with a surgical opening to the abdomen. 2.continent diversion with a replacement bladder made out of intestine. 3.noncontinent diversion with anastomose of the ureters to the anterior wall. 4.noncontinent diversion with anastomose of the ureters to the rectum. - Answers- 3.noncontinent diversion with anastomose of the ureters to the anterior wall. A patient is seen in the clinic with a chief complaint of hematuria. To make a differential diagnosis, which of the following questions should be asked? a. "Do you have a history of liver disease?"