Medical-Surgical Nursing Exam 1: Chapters 1, 2, 6, 7, 8 - Questions and Answers, Exams of Nursing

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EXAM 1 MEDICAL SURGICAL (CH.

1,2,6,7,8) QUESTIONS AND COMPLETE

ANSWERS 2024-2025 UPDATED GRADED

A+.

A nurse working in an emergency dept. Is caring for a client who has benzodiazepine toxicity due to an overdose. Which actions is the nurse’s priority? A- administer flumazenil B- identify the clients level of orientation C- infuse iv fluids D- prepare the client for gastric lavage - Answer B- identify the clients level of orientation A nurse is teaching a client who has a new prescription for escitalopram for treatment of generalized anxiety disorder. Which of the following statements by the client indicates understanding of the teaching? A- i should take the medication on an empty stomach B- i will follow a low-sodium diet while taking this med C- i need to discontinue this med slowly? D- i should not crush this med before swallowing - Answer C- i need to discontinue this med slowly? A nurse is providing teaching to a client who has a new prescription for buspirone to treat anxiety. Which info should the nurse include? A- take this med on an empty stomach B- expect optimal therapeutic effects within 24hr C- take this med when needed for anxiety D- this med has a low risk for dependency - Answer D- this med has a low risk for dependency A nurse is teaching a client who obsessive compulsive disorder and has a new prescription for paroxetine which of the following instructions should the nurse include? A. It can take several weeks before you feel like the medication is helping B. Take the medication just before bedtime to promote sleep

C. you should take the medication when needed for obsessive urges D. Monitor for weight gain while taking this medication - Answer A. It can take several weeks before you feel like the medication is helping A nurse is caring for a client who takes peroxidation to treat post dramatic stress disorder he reports that he grinds his teeth during the night the nurse should identify which of the following interventions to manage bruxism (select all that apply) A. Concurrent administration of buspirone B. administration of a different SSRI C. use of a mouth guard D. changing to a different class of anti-depressant medication E. increasing the dose of paroxetine - Answer A,C,D A nurse is providing instructions to a client has been experiencing insomnia and has a new prescription for to Maza Pam the nurse should inform the client that which of the following manifestations are adverse affects (select all apply ) A. Incoordination B. Hypertension C. Pruritis D. Sleep driving E. Amnesia - Answer A,D,E A nurse is caring for a client who is receiving moderate sedation with diazepam IV the client is oversedated which of the following medications should the nurse anticipate administering to this client A. Ketamine B. Naltrexone C. Flumazenil D. Fluvoxamine - Answer C. Flumazenil A nurse is teaching a client who has a new prescription for remelton. The nurse should instruct the client to avoid which of the following foods while taking this medication A. Baked potato B. Fried chicken C. Whole grain bread D. Citrus fruits - Answer B

A nurse is caring for a client who is admitted to undergo a surgical procedure which of the following pre-existing conditions can be a contraindication for the use of ketamine as an intravenous anesthetic A. Peptic ulcer disease B. Breast cancer C. Diabetes mellitus D. Schizophrenia - Answer D A nurse is providing instructions to a female client who has a new prescription for zolpidem, what instructions should the nurse include A. Notify the provider if you plan to become pregnant B. Take the medication one hour before you plan to go to sleep C. Allow at least six hours for sleep when taking zolpidem D. To increase the effectiveness of zolpidem take it with a bedtime snack - Answer A A nurse is assessing a client who has salicylism which of the following findings should the nurse expect (select all apply ) A. Dizziness B. diarrhea C. jaundice D. Tinnitus E. headache - Answer A,D,E A nurse is admitting a toddler to the hospital after and acetaminophen overdose which of the following medications should the nurse anticipate administering to this client A. Acetylcysteine B. Pegfilgrastim C. Misoprostol D. Naltrexone - Answer A A nurse is teaching a client about a new prescription for celecoxib which of the following information should she include in the teaching A. Increases the risk for a myocardial in farction B. Decreases the risk of stroke C. Inhibits COX- D. Increases platelet aggregation - Answer A

A nurses taking history for a client who reports that he is taking aspirin about four times daily for a sprained wrist which of the following prescribe medications taken for the client is contra indicated with aspirin A. Digoxin B. metformim C. warfarin D. nitroglycerin - Answer C nurses in an emergency department performing admission assessment for a client who has severe aspirin toxicity which of the following findings should she expect A. Body temperature 35°C 95 Fahrenheit B. lung crackles C. cool dry skin D. respiratory depression - Answer D nurse is preparing to administer an opioid agonist to a client who has acute pain which of the following complications should the nurse monitor A. Urinary retention B. Tachy apnea C. hypertension D. irritating cough - Answer A A nurse is caring for a client who has and stage cancer and is receiving morphine the clients daughter asks why the provider prescribed myethylnaltrexone which of the following responses to the nurse make A. The medication will increase your mothers respirations B. Medication will prevent dependent on the morphine C. The medication to relieve your mothers constipation D. Medication works with the morphine to increased pain relief - Answer C A nurse is preparing to administer Butorfanol to a client who has a history of substance use disorder the nurse should I didn't file which of the following information is true regarding Butorphanol A. It has a greater risk for abuse than morphine B. It causes a higher incidence of respiratory depression than morphine C. It cannot be reversed with an opiate antagonist D. It can cause abstinence syndrome in opiod dependent clients - Answer D

A nurse is planning to administer morphine IV to a client who is postoperative which actions should the nurse take A. Monitor for seizures and confusion with repeated doses B. protect the client skin from the severe diarrhea that occurs with morphine C. withhold this medication is respiratory rate is less than 12 per minute D. give morphine intermittent via IV bolus over 30 seconds or less - Answer C A nurse is reviewing the medication administration record for a client who is receiving trans dermal Fentanyl for severe pain which of the following medications should the nurse expect to cause an adverse effect when administered concurrently with fentanyl A. Ampicillin B. diazepam C. Furosemide D. prednisone - Answer B I nurse is caring for a client who has cancer and is taking morphine and Carbamazepine for pain which of the following affects the nurse monitor when given these medications together (select all apply ) A. Need for reduced dosage of the opioid B. reduced adverse affects of the opioid C. increased analgesic effects D. enhanced CNS stimulation E. increased opioid tolerance - Answer A,B,C A nurse is planning care for a client has brain cancer and is experiencing headaches which of the following adjuvant medications are indicated for this client A. Dexamethasone B. Methylphenidate C. Hydroxyzine D. Amitriptyline - Answer A A nurse is preparing to administer pamidronate to a client who has bone pain related to cancer which of the following precautions should the nurse take when administering pamidronate A. Inspect the skin for redness and irritation when changing the intradermal patch

B. assess the IV site for thrombophlebitis frequently during administration C. instruct the client to sit upright or stand for 30 minutes following oral administration D. watch for manifestations of anaphylaxis for 20 minutes after IM administration - Answer B A nurse is planning care for a client who has cancer and is taking a glucocorticoid as a adjuvant medication for pain control which of the following interventions the nurse include in the plan of care (select all apply) A. Monitor for urinary retention B. monitor serum glucose C. monitor serum potassium level D. monitor for gastric bleeding E. monitor for respiratory depression - Answer B,C,D A nurses in ministering amitriptyline to a client who is experiencing cancer pain for which of the following adverse effects of the nurse monitor A. Decreased appetite B. explosive diarrhea C. decreased pulse rate D. Orthostatic hypotension - Answer D A nurse is providing teaching to a client who is experiencing migraine headaches which of the following instructions to the nurse provide (select all apply ) A. Take ergotamine as a prophylaxis to prevent a migraine headache B. identify and avoid trigger factors C. lie down in a dark quiet room at the onset of a migraine D. avoid foods that contain tyramine E. avoid exercise that can increase heart rate - Answer B,C,D The nurse is planning care for a client who is to receive tetracaine prior to a bronchoscopy which of the following actions should the nurse include in the plan care A. Keep the client NPO until pharyngeal response returns B. monitor the insertion site for hematoma C. palpate the bladder to detect urinary retention D. maintain the client on bed rest for 12 hours following the procedure - Answer A

A nurse is caring for a client who receives a local anesthetic of light Okane during the repair of the skin laceration which of the following adverse reactions should the nurse monitor for the client A. Seizures B. TachyCardia C. hypertension D. fever - Answer A A nurse is reviewing the health history of a client who has migraine headache and is to begin prophylaxis therapy with Propanolol which of the following findings is a clot history should the nurse report to the provider A. The client had a prior myocardial infarction B. the client takes warfarin for arterial fibrillation C. the client takes an SSRI for depression D. an ECG indicates a 1st° heart block - Answer D A nurse is providing teaching to a client who has migraine headaches and a new prescription for ergotamine for which of the following adverse effects should the nurse instruct the client to stop taking the medication and notify the provider (select all apply ) A. Nausea B. visual disturbances C. positive home pregnancy test D. numbness in tingling in fingers E. muscle pain - Answer C,D,E A nurse is caring for an older adult client who has a new diagnosis of type 2 diabetes mellitus and reports difficulty following the diet and remembering to take the prescribed medication. Which of the following are appropriate actions by the nurse? (Select all that apply.) A. Ask the dietitian to assist with meal planning. B. Contact the client's support system. C. Assess for age-related cognitive awareness. D. Encourage the use of a daily medication dispenser. E. Provide educational materials for home use. - Answer a,b,d,e A nurse in a health care clinic is evaluating the level of wellness for clients using the health/wellness/illness continuum tool. Which of the following clients is measured at the center of the continuum?

A. A college student who has influenza B. An older adult who is newly diagnosed with type 2 diabetes mellitus C. A new mother who has a urinary tract infection D. A young male who has a long history of well-controlled rheumatoid arthritis - Answer D A nurse is evaluating clients at a health fair for modifiable variables affecting health and wellness. The nurse identifies which of the following as a modifiable variable? (Select all that apply.) A. A male who smokes on social occasions B. A female with a BMI of 28 C. An adult with alopecia D. An adolescent with Trisomy 21 E. An infant with reflux - Answer A,B,E A nurse is caring for a client who was just told she has breast cancer and the nurse evaluates the client's response. Which of the following statements by the client reflects a lack of understanding of an illness perspective? A."I have no family history of breast cancer." B."I need a second opinion there is no lump." C."I am glad we live in the city near several large hospitals." D."I will schedule surgery next week, over the holidays. - Answer B A nurse is assessing the pain level of a client who has come to the emergency department reporting severe abdominal pain. The nurse asks the client whether he has nausea and has been vomiting. The nurse is assessing which of the following? A. Presence of associated symptoms B. Location of the pain C. Pain quality D. Aggravating and relieving factors - Answer A A nurse is assessing a client who is reporting pain despite analgesia. The nurse can best assess the intensity of the client's pain by A. asking what precipitates the pain. B. questioning the client about the location of the pain. C. offering the client a pain scale to measure his pain. D. using open-ended questions to identify the sensation. - Answer C

A nurse is caring for a client who is receiving morphine via a patient- controlled analgesia (PCA) infusion device after abdominal surgery. Which of the following statements indicates that the client knows how to use the device? A. "I'll wait to use the device until it's absolutely necessary." B. "I'll be careful about pushing the button so I don't get an overdose." C. "I should tell the nurse if the pain doesn't stop after I use this device." D. "I will ask my son to push the dose button when I am sleeping." - Answer C A nurse is monitoring a client who is receiving opioid analgesia for adverse effects of the medication. Which of the following effects should the nurse anticipate? (Select all that apply.) A. Urinary incontinence B. Diarrhea C. Bradypnea D. Orthostatic hypotension E. Nausea - Answer D Which important aspect of coordinating care within the interdisciplinary team is facilitated by use of the "SBAR" and "PACE" procedures? Communication Implementation Policymaking Protocol development - Answer Communication The nurse educator is instructing newly hired registered nurses about patient-centered care. Which competency categories are included in this content? Select all that apply. Attitudes Environments Judgments Knowledge Skills

Values - Answer Knowledge Skills Bedside computers are an example of informatics used in health care primarily for which purpose? Documenting interdisciplinary care Enhancing collaboration and coordination of care Offering clients access to e-mail and the Internet Retrieving data for evidence-based practice - Answer Documenting interdisciplinary care The nurse has recently been assigned to a medical-surgical clinical rotation. According to the scope of medical-surgical nursing, what type of client assignments does the nurse expect to see? Hospitalized children with acute and chronic illnesses Hospitalized adults with acute and chronic illnesses Older adults in a nursing home Working adults in a corporate setting - Answer Hospitalized adults with acute and chronic illnesses Which of these hospital staff members will the nurse manager assign to coordinate the discharge of a client who will need community-based rehabilitation services after a traumatic injury? The nurse responsible for the client's case management The physical therapist who developed the client's exercise program The health care provider assigned as the client's medical resident The unit-based RN who has cared for the client during the hospital stay - Answer The nurse responsible for the client's case management

The nurse is asked to collaborate with others to implement an interdisciplinary plan of care for a client. Which health care team members are essential for the client's daily care regimen? Select all that apply. Anesthesiologist Case manager Health care provider Occupational therapist Chaplain - Answer Case manager Health care provider Which principal nursing actions best support a focus on client safety? Select all that apply. Client restraints Handwashing Preoperative checklists Respect for others Five rights of drug administration - Answer Handwashing Five rights of drug administration preoperative checklists The nurse is appointed to a hospital committee whose goal is to "improve the safety of nursing practice." Which areas of practice are included in the committee's task? Select all that apply. Attentiveness/surveillance of clients Mandatory reporting Medication administration Participation in professional organizations Prevention of errors or complications Teaching clients about their care regimens - Answer Attentiveness/surveillance of clients Mandatory reporting Medication administration Prevention of errors or complications

An older client who has had a total hip replacement will be transferred to a rehabilitation center for continuing care before going home. The Joint Commission, along with National Patient Safety Goal standards, mandates communication between hospital nurses and other providers to ensure adequate transition management. Which aspects of this client's care plan are most important for the nurse to communicate to the rehabilitation center care team? Third-party payer information Pain medication needs Primary care provider Medical history of osteoarthritis - Answer Pain medication needs The nurse supports the client and family in deciding on a "Do Not Resuscitate" order. Which ethical principle that guides nursing clinical decision making is demonstrated in this situation? Beneficence Justice Legality Self-determination - Answer Self-determination The nursing student asks the supervising nurse whether a certain fall protocol used on the nursing unit is effective. To demonstrate effectiveness, what does the supervising nurse identify? Information about how to implement a fall protocol and what nurses need to document Data about the number of falls after the protocol was introduced compared with previous fall rates The number of clients who currently have a fall protocol in place

National statistics about the use of fall protocols to prevent serious injury from falls - Answer Data about the number of falls after the protocol was introduced compared with previous fall rates A previously stable postoperative client on the medical-surgical unit now has a blood pressure of 88/40 mm Hg and a heart rate of 124 beats/min. After placing the client in Trendelenburg position, which action does the nurse perform next? Activate the Rapid Response Team. Call for a Code Blue. Determine the cause of the changes. Re-check the vital signs in 5 minutes. - Answer Activate the Rapid Response Team. When developing a standardized plan of care for clients with a diagnosis of pneumonia, how does the nurse find the best information about providing optimal nursing care? Access a website that reports on randomized controlled studies on nursing care for clients with pneumonia. Research the most recent articles in nursing magazines that discuss care for clients with pneumonia. Review the chart to determine what primary health care provider's prescriptions are frequently written for clients with pneumonia. Survey experienced RNs about which nursing actions are effective when caring for clients with pneumonia. - Answer Access a website that reports on randomized controlled studies on nursing care for clients with pneumonia. Which nursing activity is best for the charge nurse on the medical-surgical unit to delegate to staff members who are unlicensed assistive personnel (UAPs)?

Feeding a client whose hands are affected by rheumatoid arthritis Increasing the oxygen flow rate for a client who has wheezes Positioning a client who has just returned from hip surgery Taking vital signs for a client who is having acute chest pain - Answer Feeding a client whose hands are affected by rheumatoid arthritis Which nursing action demonstrates use of the principle of justice? A 32-year-old client is prevented from falling during the initial postoperative period following her hysterectomy. A 67-year-old client with dementia is shown the same respect as his 47- year-old roommate with prostate cancer. An 82-year-old client is provided access to the hospital Patient Advocate for processing of a complaint. The parents of a 13-year-old are included in discussions about the course of their teen's treatment and care. - Answer A 67-year-old client with dementia is shown the same respect as his 47-year-old roommate with prostate cancer. Which role of the medical-surgical nurse is demonstrated when writing a plan of care for a client who is newly admitted to the hospital? Advocate Caregiver Communicator Educator - Answer Caregiver When transferring a client who was admitted with chest pain from the emergency department (ED), which information is essential for the ED nurse to communicate to the nurse on the medical-surgical unit? Select all that apply.

"The client is being admitted for ongoing monitoring of pain and vital signs." "The client has private insurance and is also covered by Medicare." "Nitroglycerin and morphine sulfate were given to relieve the pain." "Frequent reassurance is needed because the client has a high anxiety level." "The client has a family history of heart disease and hypertension." "A coronary arteriogram should be scheduled as soon as possible." - Answer "The client is being admitted for ongoing monitoring of pain and vital signs." "Nitroglycerin and morphine sulfate were given to relieve the pain." "Frequent reassurance is needed because the client has a high anxiety level." "The client has a family history of heart disease and hypertension." "A coronary arteriogram should be scheduled as soon as possible." Which action does the nurse take first when preparing to do discharge teaching for the 73-year-old client who is being discharged after prostate surgery? Ask what the client knows about self-care after prostate surgery. Have family members available during the teaching. Provide written information about postdischarge care. Plan to teach early in the morning after the client has eaten. - Answer Ask what the client knows about self-care after prostate surgery. The nurse is working in the intensive care unit. When does the nurse call the Rapid Response Team (RRT)?

An 87-year-old client awakens confused, then reorients quickly. A newly admitted client requests pain medication. A postoperative client's dressing has bloody drainage. A postoperative client's blood pressure suddenly drops. - Answer A postoperative client's blood pressure suddenly drops. The nursing student has been assigned to the hospital's Rapid Response Team (RRT). Which statement by the student indicates a correct understanding of the RRT member's purpose? "I will be caring for clients in the hospital." "I will be riding along in the hospital's ambulance." "I will be admitting clients to the hospital." "I will be participating in Code Blue resuscitations." - Answer "I will be caring for clients in the hospital." A patient has a nursing diagnosis of ineffective airway clearance related to retained secretions, excessive mucus, and ineffective cough as evidenced by adventitious breath sounds. What should the nurse include in the NCP as an appropriate NOC outcome and NIC intervention for this nursing diagnosis? Aspiration Prevention (NOC) and Aspiration Procedures (NIC) Respiratory Status: Gas Exchange (NOC) and Oxygen Therapy (NIC) Respiratory Status: Ventilation (NOC) and Respiratory Monitoring (NIC) Respiratory Status: Airway Patency (NOC) and Airway Management (NIC)

• Answer Respiratory Status: Airway Patency (NOC) and Airway Management (NIC)

A nurse teaches a student nurse about evidence-based nursing practice guidelines. Which statement, if made by the student nurse, indicates understanding of the teaching? "Patient care is based on research findings instead of the expertise of the nurse." "Patient preferences should not be considered if guidelines are supported by evidence." "Nursing care provided is based on the best evidence for quality care and desired outcomes." "Practice guidelines are used so that professional decisions about patient care are unnecessary." - Answer "Nursing care provided is based on the best evidence for quality care and desired outcomes." A patient who is newly diagnosed with cancer is scheduled to consult with an oncologist in several days. What would be the best coping strategy for the nurse to recommend at this time? Talk to family and friends about negative feelings. Go away for a few days to forget about the situation. Seek information about the cancer and treatment options. Wait to see what the oncologist recommends for treatment. - Answer Seek information about the cancer and treatment options. The nurse plans to teach a patient how to use imagery to manage pain. Which statement by the nurse would be appropriate? "Place your pain in the image of a form you can destroy." "Tell me what you hear, smell, or feel in your special place." "Listen to music to divert your attention away from the pain."

"Visualize the distress until you feel more calm and relaxed." - Answer "Tell me what you hear, smell, or feel in your special place." The nurse teaches a patient about meditation. Which statement, if made by the patient, indicates an understanding of the instructions? "I can learn how to meditate in 20 minutes or less." "I need to be in a quiet room without distractions." "I will start out by meditating for about 20 minutes." "I should practice meditation three times each week." - Answer "I can learn how to meditate in 20 minutes or less." A patient at the outpatient clinic is complaining of insomnia and anxiety. He tells you that he recently lost his job and is not able to pay the bills. Which response would be the most appropriate? "Can you tell me what is happening in your life?" "You are healthy and will be able to find another job." "If you stop focusing on your problems, you will sleep better." "Did you receive a severance package from your employer?" - Answer "Can you tell me what is happening in your life?" An older adult patient in the hospital complains of sleep deprivation. Which intervention may improve sleep patterns for this patient? Decrease noise and dim the lights at bedtime. Administer an opioid pain medication to induce sleep. Set the room temperature at 78 degrees F to induce drowsiness. Offer to give the patient a back massage until he falls asleep. - Answer Decrease noise and dim the lights at bedtime.

What are the leading determinants of a patient's health (select all that apply) a. Genetics b. health behaviors c. family history of disease d. social and physical environment e. type and quality of medical care recieved - Answer a,b,d in identifying patients at the greatest risk for health disparities, the nurse would note that a. patients who live in urban areas have readily available access to health services b. cultural differences exist in patients ability to communicate with their health care provider c. a patient is receiving care from a health care provider of a different culture would have decreased quality of care d. men are more likely than women to have their cardiovascular disease symptoms ignored by their health care provider - Answer b forcing ones culture beliefs and practices on another person is an example of a. stereotyping b. ethnocentrism c. cultural relativity d. cultural imposition - Answer d which statement most accurately describes cultural factors that may affect health? a. diabetes and cancer rates differ by cultural. ethnic groups b. most patients find that religious rituals help them during times of illness c. there are limited ethnic variations in physiological responses to medication d. silence during a nurse-patient interaction usually means that the patient understands the instructions - Answer a when communicating with a patient who speaks a language that the nurse does not understand, it is important to first attempt to a. have a family member interpret b. use a trained medical interpreter

c.use specific medical terminology so there will be no mistakes d.focus on the translation rather nonverbal communication - Answer b As part of the nursing process, cultural assessment is best accomplished by a. judging the patients cultural values based on observations b. using a cultural assessment guide as a part of the nursing process c. seeking guidance from a nurse from the patients cultural background d. relying on the nurse's previous experience with patients from that cultural group. - Answer b Nurses play an important role in reducing health disparities. One important mechanism to do this is to a.discourage use of evidence-based practice guidelines b. insist that patients adhere to the healthy people 2020 guidelines c. teach patients to use the internet to find resources related to their health d. engage in active listening and establish relationships with patients and families - Answer d what is the first step in developing cultural competence? a. create opportunities to interact with a variety of cultural groups b examine the nurse's own cultural background, values, and beliefs about health and health care c. learn about a multitude of folk medicines and herbal substances that different cultures use for self-care d. learn assessment skills for different cultural groups, including cultural beliefs and practices and physical assessments - Answer b Determination of whether an event is a stressor is based upon a person's... a.tolerance b.perception c.adaptation d.stubborness - Answer b the nurse would expect which finding in a patient as a result of the physiological effect of stress on the reticular formation? a. an episode of diarrhea while awaiting painful dressing changes b. refusal to communicate with nurses while awaiting a cardiac catheterization

c. inability to sleep the night before beginning to self-administer insulin injection d. increased blood pressure, decreased urine output, and hyperglycemia after a car accident - Answer c the nurse uses knowledge if the effects if stress on the immune system by encouraging patients to a. sleep for 10 to 12 hours per day b. avoid exposure to upper respiratory tract infections c. receive regular immunizations when that are stressed d. use emotion-focused rather than problem-focused coping strategies - Answer b which of the following examples reflects the relationship among the mind- body-spirit (select all that apply) a. 75- year-old man who enjoys doing crossword puzzles everyday b. a 25 year-old man who has been successfully treated for testicular cancer c. a 55 year-old man who is impotent because of his prostate cancer surgery d. a 34 year-old woman who is angry because of her recent diagnosis of breast cancer e. a 65 year-old woman who is struggling with rehabilitation after having hip replacement surgery - Answer a,b,c,d,e the nurse recognizes that a person who experiences chronic stress could be at higher risk for (select all that apply) a. osteoporosis b. fibromyalgia c. colds and flus d. high blood pressure e. high serum cholesterol - Answer b,c,d the nurse recognizes that a patient with newly diagnosed breast cancer s using an emotion-focused coping process when she a. joins a support group for women with breast cancer b. considers the pros and cons of the various treatment options c. delays treatment until her family can take a weekend trip together d. tells the nurse that she has a good prognosis because the tumor is small

• Answer a

during a stressful circumstance that is unchangeable. which type of coping strategy is most effective? a. avoidance b. coping flexibility c. emotion-focused coping d. problem-focused coping - Answer c An appropriate nursing intervention for a hospitalized patient who states she cannot cope with her illness is a. controlling the environment to prevent sensory overload and promote sleep b. encouraging the patient's family to offer emotional support by frequent visiting c. arranging for the patient to phone family and friends to maintain emotional bonds d. asking the patient to describe previous stressful situations and how she managed to resolve them - Answer d insufficient sleep is associated with (select all that apply) A. increased body mass index b. increased insulin resistance c. impaired cognitive functioning d. increased immune response e. increased daytime body temp - Answer A,B,C when teaching the patient about primary insomnia about sleep hygiene, the nurse should emphasize. a. the importance of daytime naps b. the need to exercise before bedtime c. the need for long-term use of hypnotics d. avoiding caffine- containing beverages 6-9 hours before bedtime - Answer D sleep is best described as a a. loosely organized stste similar to coma b. state in which pain sensitivity decreases c. quite state in which there is little brain activity d. state in which an individual lacks conscious awareness of the environment - Answer d

which statement(s) is/are true regarding rapid eye movement (REM) sleep (select all that apply) a. the EEG pattern is quiescent b. muscle tone is greatly reduced c. it occurs only once in the night d. it is separated by distinct physiological stages e. the most vivid dreaming occurs during this phase - Answer b while caring for a patient with a history of narcolepsy with cataplexy, the nurse can delegate which activity to the unlicensed assistive personnel (UAP)? A. teaching about the timing of medications b. walking the patient to and from the bathroom c. developing a plan of care with a family member d. planning an appropriate diet that avoids caffeine- containing foods - Answer b an overweight patient with sleep apnea would like to avoid using a nasal CPAP device if possible. to help him reach this goal, the nurse suggest that the patient a. lose excess weight b. take a nap during the day c. eat a high-protien snack at bedtime d. use mild sedatives or alcohol at bed time - Answer a a patient on the surgical unit has a history of parasomnia (sleep-walking). what statement describes parasomnia? a.hypnotic medications reduce the risk of sleepwalking b. the patient is often unaware of the activity on awakening c. the patient should be restrained at night to prevent personal harm d. the potential for sleepwalking i reduced by exercise before sleep - Answer b strategies to reduce sleepiness during nighttime woking include a. exercising before work b. taking melatonin before working the night shift c. sleeping for at least 2 hours immediately before work time d. walking for 10 minuets every 4 hours during the night shift - Answer c

pain is best describes as A. a creation of a persons' imagination b. an unpleasant, subjective experience c. a maladaptive response to a stimulus d. a neurologic event resulting from activation of nociceptors - Answer b a patient is receiving a PCA infusion after surgery to repair a hip fracture. she is sleeping soundly but awakens when the nurse speaks to her in a normal tone of voice. her respirations are 8 bpm. the most appropriate nursing action in this situation is to a. stop the PCA infusion b. obtain oxygen saturation level c. continue to closely monitor the patient d. administer naloxone and contact the physician - Answer c which words are most likely to be used to describe neuropathic pain (select all that apply) a. dull b. mild c. burning d. shooting e. shock-like - Answer c,d,e unrelieved pain is a. expected after major surgery b. expected in a person with cancer c. dangerous and can lead to many physical and psychologic complications d. an annoying sensation, but it is not as important as other physical care needs - Answer c a cancer patient who reports ongoing, constant moderate pain with short periods of sever pain during dressing changes is a. probably exaggerating his pain b. best treated by referral for surgical treatment of his pain c. best treated by receiving a long-acting and a short-acting opioid d. best treated by regularly scheduled short-acting opioids plus acetaminophen - Answer c an example of distraction to provide pain relief is a.TENS

b. music c. exercise d. biofeedback - Answer b appropriate nonopioid analgesics for mild pain include (select all that apply) a. oxycodone b. ibuprofen (Advil) c. lorazepam(ativan) d. acetaminophen (Tylenol) e. codeine with acetaminophen (tylenol #3) - Answer b,d