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Nur 273 Exam Questions with Correctly Solved
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1.A few hours after returning to the surgical nursing unit, a patient who has undergone a subtotal thyroidectomy develops laryngeal stridor and a cramp in the right hand. The nurse anticipates that intervention will include: Select one: a. administration of IV calcium gluconate b. an immediate tracheostomy c. endotracheal intubation with mechanical ventilation d. administration of intravenous (IV) morphine: a. administration of IV calcium gluconate 2.After 5 years of experiencing depression, fatigue, and lethargy, an elderly woman is diagnosed with hypothyroidism, and levothyroxine is prescribed. During the initiation of thyroid replacement for the patient, it is most important for the nurse to assess: Select one: a. cardiovascular function b. nutritional status c. fluid and electrolyte balance d. mental status: a. cardiovascular function 3.A patient is admitted to the hospital in addisonian crisis 1 month after a diagnosis of Addison's disease. The nurse identifies the nursing diagnosis of ineffective therapeutic regimen management related to lack of knowledge of management of the condition when the patient says: Select one: a. 'I double my dose of hydrocortisone if I am experiencing moderate stress.' b. 'I measure and record my blood pressure daily and notify my doctor if it is out of the range specified.' c. 'I have learned to control some major stresses in my life and use relaxation techniques on a daily basis.' d. 'If I take too much of my medication I have vomiting and diarrhea, so I reduce the dosage a little.': d. 'If I take too much of my medication I have vomiting and diarrhea, so I reduce the dosage a little.' 4.A patient is suspected of having a pituitary tumour causing panhypopitu- itarism. During assessment of the patient, the nurse would
2 / 42 expect to find: Select one: a. elevated plasma glucose levels and hyperlipidaemia b. hypertension resulting from increased water reabsorption in the kidney c. changes in secondary sex characteristics and loss of libido d. evidence of hypofunction of the adrenal, thyroid and parathyroid glands: c. changes in secondary sex characteristics and loss of libido 5.A patient takes high dosages of glucocorticoids to control the symptoms of systemic lupus erythematosus. The nurse teaches the patient not to stop the medication abruptly, knowing that a hypocortisolism crisis could occur because: Select one: a. negative feedback of high glucocorticoid levels inhibits adrenocorti- cotrophic hormone (ACTH) secretion, with resultant atrophy of cortisol- secret- ing cells b. high glucocorticoid levels cause cellular damage to the adrenal glands themselves, decreasing cortisol secretion c. high levels of glucocorticoids cause a positive feedback to the anterior pituitary gland, causing decreased release of ACTH d. the positive feedback of high glucocorticoid levels creates a greater de- mand for cortisol than can be met by the adrenal glands: a. negative feedback of high glucocorticoid levels inhibits adrenocorticotrophic hormone (ACTH) secretion, with resultant atrophy of cortisol-secreting cells 6.A patient who is seen at the clinic for an upper respiratory tract infection reports receiving subcutaneous somatotrophin when asked by the nurse about his current medications. The nurse questions the patient further about a history of: Select one: a. diabetes insipidus b. untreated acromegaly c. adrenal disease d. a pituitary tumour: d. a pituitary tumour 7.During the nursing assessment of a patient with Graves' disease, the nurse notes a bounding, rapid pulse and systolic hypertension. An additional man- ifestation of the disorder that the nurse would expect to find includes:
4 / 42 b. provide a circulatory bypass around thrombotic plaques obstructing cranial circulation c. prevent a stroke by removing atherosclerotic plaques blocking a cerebral blood flow d. decrease cerebral oedema: c. prevent a stroke by removing atherosclerotic plaques blocking a cerebral blood flow 12.During the assessment of the patient with motor neuron disease, the nurse would expect to find: Select one: a. emotional lability b. muscle weakness and wasting c. sensory loss in the extremities d. mental deterioration: b. muscle weakness and wasting 13.During assessment of the patient with trigeminal neuralgia, the nurse should: Select one: a. test for temperature and sensation perception on the face b. lightly palpate the affected side of the face for oedema c. ask the patient to describe factors that initiate an episode d. inspect all aspects of the mouth and teeth: c. ask the patient to describe factors that initiate an episode 14.During routine assessment of a patient with Guillain-Barre syndrome, the nurse finds the patient to be short of breath. The patient's respiratory distress is caused by: Select one: a. immobility resulting from ascending paralysis b. elevated protein levels in the cerebrospinal fluid c. degeneration of motor neurons in the brain stem and spinal cord d. paralysis ascending to the nerves that stimulate the thoracic area: d. paral- ysis ascending to the nerves that stimulate the thoracic area 15.The nurse assesses Mrs Jacobs' speech pattern. Mrs Jacobs is unable to speak and follow directions. The nurse determines that Mrs Jacobs has: Select one: a. expressive-receptive aphasia b. expressive aphasia c. amnesic aphasia
5 / 42 d. receptive dysphasia: a. expressive-receptive aphasia
7 / 42 b. placing a pillow between the patient's legs and turning the entire body as a
8 / 42 unit. c. instructing the patient to move the legs before turning the rest of the body. d. having the patient turn by grasping the side rails and pulling the shoulders over.: b. placing a pillow between the patient's legs and turning the entire body as a unit. 20.An assessment finding for a 55-year-old patient that alerts the nurse to the presence of osteoporosis is Select one: a. a measurable loss of height. b. the presence of bowed legs. c. the aversion to dairy products. d. a statement about frequent falls.: a. a measurable loss of height. 21.When administering alendronate (Fosamax) to a patient with osteoporosis, the nurse will Select one: a. administer the ordered calcium carbonate. b. ask about any leg cramps or hot flashes. c. be sure that the patient has recently eaten. d. assist the patient to sit up at the bedside.: d. assist the patient to sit up at the bedside. 22.Which action will the nurse take when caring for a patient with osteomala- cia? Select one: a. Discuss the use of medications such as bisphosphonates. b. Emphasize the importance of sunscreen use when outside. c. Teach about the use of vitamin D supplements. d. Educate about the need for weight-bearing exercise.: c. Teach about the use of vitamin D supplements. 23.21. Which actions will the nurse include in the plan of care when caring for a patient with metastatic bone cancer of the left femur (select all that apply)? Select one or more: a. Teach about the need for strict bed rest. b. Support the left leg when repositioning the patient. c. Monitor serum calcium level. d. Support family as they discuss the prognosis of the patient
10 / 42 is diagnosed with hypothyroidism. A drug ordered for the patient at the time
11 / 42 of admission that the nurse recognizes should not be administered without consulting the doctor is: Select one: a. diazepam b. cefoxitin c. ibuprofen d. docusate: a. diazepam 29.When teaching a patient with newly diagnosed hypothyroidism about man- agement of the condition, the nurse should: Select one: a. schedule daily home visits by homecare nurses to repeat the necessary instructions b. designate a family member to teach the patient about the condition when forgetfulness has improved c. delay teaching about the condition until the patient has responded to replacement therapy d. provide written handouts of all instructions for continued reference as the patient improves: d. provide written handouts of all instructions for continued reference as the patient improves 30.The first nursing action indicated when a patient returns to the surgical nursing unit following a thyroidectomy is to Select one: a. ask the patient whether there is any tingling in the toes or fingers b. assess respiratory status for signs of obstruction c. check the back of the neck for haemorrhage d. determine whether the patient can speak normally: b. assess respiratory sta- tus for signs of obstruction 31.A 48-year-old patient has been diagnosed with diabetes mellitus, which will require major lifestyle changes and compliance with prescribed thera- py. During assessment of the patient's functional health patterns, the nurse recognises that an ability to manage the diabetes is best reflected by the patient's responses to questions related to Select one: a. role-relationship b. nutritional—-metabolic c. value—belief d. activity—exercise: a. role-relationship
- A patient has been using a self-prescribed fasting diet for weight reduction. The nurse recognises that a hormonal change stimulated by
13 / 42 Select one: a. decreased release of glucocorticoids as a result of hypoglycaemia b. increased release of insulin to promote gluconeogenesis from protein c. increased synthesis and release of glucagon, which stimulates liver glycogenolysis d. increased somatostatin release from delta cells to inhibit insulin release: c. increased synthesis and release of glucagon, which stimulates liver glycogenolysis 33.Oxytocin represents which of the following Select one: a. Negative feedback - stimulus decreases levels of oxytocin b. None of the above are correct c. Positive feedback - stimulus results in higher levels of oxytocin d. Negative feedback- stimulus increases levels of oxytocin: c. Positive feed- back - stimulus results in higher levels of oxytocin 34.10. The nurse recognises that a 78-year-old woman is at risk of osteoporo- sis because a normal hormonal change associated with ageing includes: Select one: a. decreased production of oestrogen b. decreased production of parathyroid hormone c. increased production of testosterone d. increased production of calcitonin: a. decreased production of oestrogen 35.When a patient is taking spironolactone, a drug that blocks the action of aldosterone on the kidney, the nurse would expect the patient to experience: Select one: a. increased vascular fluid volume b. increased serum potassium levels c. increased serum sodium levels d. decreased urinary output: a. increased vascular fluid volume 36.12. The doctor has ordered a serum cortisol level to rule out adrenal dysfunction in a patient who is a night security guard who works from 11 pm to 7 am and normally sleeps from 8 am to 4 pm. To ensure the most reliable test results, the nurse arranges the blood specimen to be drawn: Select one: a. in the early morning b. in the late afternoon c. at 3 am d. at 11 pm: b. in the late afternoon 37.13. A person experiencing delirium would
14 / 42 be: Select one:
16 / 42 42.18. The Glasgow coma scale (GCS) is used to grade neurological respons- es to which three parameters? Select one: a. pupil response, motor response, reflexes b. motor movement and strength, reflexes, pupillary size and cranial nerve assessment c. motor movement and strength, reflexes, pupillary size and reaction d. eye-opening, verbal response, motor response e. verbal response, pain response, reflexes: d. eye opening, verbal response, motor response 43.19. When light is directed in the patient's left eye, both pupils constrict. The nurse knows that this means: Select one: a. astigmatism is present b. the right oculomotor nerve is damaged c. consensual light reaction is normal d. the patient may have a neurological disease: c. consensual light reaction is normal 44.A patient with acute osteomyelitis of the left femur is hospitalized for antibiotic irrigation. Which intervention will be included in the initial plan of care? Select one: a. Assisted weight-bearing ambulation b. Immobilization of the left leg c. Positioning the left leg in flexion d. Quadriceps-setting exercise repetitions: b. Immobilisation of the left leg 45.21. A 50-year-old patient is being discharged after a week of IV antibiotic therapy for acute osteomyelitis in the right leg. Which information will be included in the discharge teaching? Select one: a. How to monitor and care for the long-term IV catheter b. How to apply warm packs to the leg to reduce pain c. The reason for taking oral antibiotics for 7 to 10 days after discharge d.The need for daily aerobic exercise to help maintain muscle strength: a. How to monitor and care for the long-term IV catheter 46.22. A 67-year-old patient is receiving IV antibiotics at home to treat chronic osteomyelitis of the left femur. The nurse chooses a nursing diagnosis of ineffective health maintenance when the nurse finds that the patient
17 / 42 Select one:
19 / 42 d. check the chart for preoperative assessment data.: d. check the chart for preoperative assessment data. 51.27. A 54-year-old woman who recently reached menopause and has a family history of osteoporosis is diagnosed with osteopenia following den- sitometry testing. In teaching the woman about her osteoporosis, the nurse explains that Select one: a. with a family history of osteoporosis, there is no way to prevent or slow gradual bone resorption. b. calcium loss from bones can be slowed by increasing calcium intake and weight-bearing exercise. c. continuous, low-dose corticosteroid treatment is effective in stopping the course of osteoporosis. d. estrogen replacement therapy must be started to prevent rapid progression to osteoporosis.: b. calcium loss from bones can be slowed by increasing calcium intake and weight-bearing exercise. 52.An assessment finding for a 55-year-old patient that alerts the nurse to the presence of osteoporosis Select one: a. a measurable loss of height. b. a statement about frequent falls. c. the presence of bowed legs. d. the aversion to dairy products.: a. a measurable loss of height. 53.The nurse should reposition the patient who has just had a laminectomy and diskectomy by Select one: a. instructing the patient to move the legs before turning the rest of the body. b. having the patient turn by grasping the side rails and pulling the shoulders over. c. placing a pillow between the patient's legs and turning the entire body as a unit. d. turning the patient's head and shoulders first, followed by the hips, legs, and feet.: c. placing a pillow between the patient's legs and turning the entire body as a unit. 54.A 23-year-old patient with a history of muscular dystrophy is hospitalized with pneumonia. Which 4 nursing actions will be included in the plan of care? Select one: a. Teach the patient about the muscle biopsy procedure. b. Discuss the need for genetic testing with the patient.
20 / 42 c. Assist the patient with ambulation. d. Logroll the patient every 2 hours.: c. Assist the patient with ambulation. Notes on answer: Because the goal for the patient with muscular dystrophy is to keep the patient active for as long as possible, assisting the patient to ambulate will be part of the care plan. The patient will not require logrolling. Muscle biopsies are necessary to confirm the diagnosis but are not necessary for a patient who already has a diagnosis. There is no need for genetic testing because the patient already knows the diagnosis. 55.All the following are cardinal manifestations of Parkinson disease except: Select one: a. Rest tremor b. Intentional tremor c. Rigidity d. bradykinesia: b. Intentional tremor 56.31. A 42-year-old male patient complains of shoulder pain when the nurse moves his arm behind the back. Which question should the nurse ask? Select one: a. "Are you able to sleep through the night without waking?" b. "Do you ever have trouble lowering yourself to the toilet?" c. "Do you have difficulty when you are putting on a shirt?" d. "Are you able to feed yourself without difficulty?": c. "Do you have difficulty when you are putting on a shirt?" 57.32. A patient with left knee pain is diagnosed with bursitis. The nurse will explain that bursitis is an inflammation of Select one: a. any connective tissue that is found supporting the joints of the body. b. the synovial membrane that lines the joint. c. a small, fluid-filled sac found at some joints. d. the fibrocartilage that acts as a shock absorber in the knee joint.: c. a small, fluid-filled sac found at some joints. 58.34. Which information obtained during the nurse's assessment of a 30-year-old patient's nutritional metabolic pattern may indicate the risk for musculoskeletal problems? Select one:
