Nursing Final Exam Questions and Answers, Exams of Nursing

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1- What acid-base imbalance would a nurse expect to find in a patient with Myastenia Gravis crisis and decreased pulmonary forced vital capacity? Select one: a. pH 7.26, pO2 86 mmHg, p CO 44 mmHg, HCO3 10 mEq/L b. pH 7.31, pO2 97 mmHg, p CO 30 mmHg, HCO3 19 mEq/L c. pH 7.32, pO2 80 mmHg, p CO2 60 mmHg, HCO3 24 mEq/L

d. pH 7.47, pO2 96 mmHg, p CO2 33 mmHg, HCO3 22 mEq/L Feedback Acute respiratory acidosis The correct answer is: pH 7.32, pO2 80 mmHg, p CO2 60 mmHg, HCO3 24 mEq/L 2- A previously healthy older client's morning urine is amber, with strong odor, and specific gravity 1.040. Which action by the nurse is best?

Select one: a. Place the client on restricted dietary proteins. b. Review the client's creatinine level. c. Obtain an order for urine culture and sensitivity. Feedback Normal specific gravity for urine is 1.005 to 1.030. A high specific gravity can occur with dehydration, decreased kidney d. Increase the client's fluid intake.

blood flow (often because of dehydration), and the presence of antidiuretic hormone (ADH). Increasing the client's fluid intake would be a beneficial intervention. The other interventions are not warranted. The correct answer is: Increase the client's fluid intake. 3- The nurse working in an endocrinology service has assigned four clients. Which

client should the nurse see first?

Select one: a. Type 1diabetic client who is noncompliant with her diet and has proteinuria b. Type 2 diabetic client who presents with a hemoglobin A1c 12.8 % d. Type 2 diabetic client whose capillary glucose immediately after lunch is 65 mg/dL Feedback Presence of ketone bodies in c. Type 1 diabetic client who has positive ++ ketones in urine

urine in type 1 diabetes means the client is developing a diabetic ketoacidosis and is the absolute priority of these four clients. The correct answer is: Type 1 diabetic client who has positive ++ ketones in urine 4- Which of the following measures is most important for the nurse to institute for a client who has Cushing's disease?

Select one: b. Assist the client to stand up changing positions slowly. c. Pad the siderails of the client's bed with pillows. d. Keep suctioning equipment at the client's bedside. Feedback Cushing's syndrome or disease greatly increases the serum levels of cortisol, which a. Enforce standard precautions and updated vaccinations.

contributes to immune suppression, hyperglycemia, hypertension, fluid retention, and excessive bone demineralization and increases the risk for pathologic bone fracture. The client should not require suctioning, padding the siderails or assisting the client to change position because orthostatic hypotension. Risk for infection and its prevention is a priority. The correct answer is: Enforce

standard precautions and updated vaccinations. 5- A male client with Parkinson's disease is newly diagnosed with benign prostatic hypertrophy. When reviewing the client's medication history, which medication is most likely to exacerbate his urologic symptoms? Select one:

a. Bromocriptine, a dopamine receptor agonist.

c. Levodopa, an antiparkinsonian agent. d. Selegiline, a mono amino oxidase B inhibitor. Feedback ANS: A Cogentin (A) is an anticholinergic drug. One of its side effects is urinary retention which could be problematic for a client with benign prostatic hypertrophy. (B, C, and D) are all b. Benztropine,^ an^ anticholinergic.

appropriate drugs for the treatment of Parkinson's disease. The correct answer is: Benztropine, an anticholinergic. 6- A client with a 16-year history of hypertension is having renal function tests because of recent fatigue, weakness, lightly elevated blood urea nitrogen and serum creatinine levels. Which finding should the nurse conclude as an early

symptom of renal insufficiency? Select one: b. Uremic frost c. Confusion and disorientation d. Edema and lung crackles Feedback The capacity of concentration of urine is one of the first renal functions to be lost in the development of renal a. Increased urination at night

insufficiency. Normally the urine is concentrated during the sleep hours, being nocturia an early manifestation of the loss of this function. The correct answer is: Increased urination at night 7- A patient with primary hyperparathyroidism has a serum calcium level of 14 mg/dL and a phosphorus of 1.7 mg/dL. Which nursing action should be included in

the plan of care? Select one: a. Monitor for positive Chvostek's sign. c. Have a tracheostomy kit available. d. Encourage the patient to remain on bed rest. b. Encourage 3000 to 4000 mL of oral fluids daily.

Feedback The patient with hypercalcemia is at risk for kidney stones, which may be prevented by a high fluid intake. Seizure precautions and monitoring for Chvostek's or Trousseau's sign are appropriate for hypocalcemic patients. The patient should engage in weight-bearing exercise to decrease calcium loss from bone. The correct answer is:

Encourage 3000 to 4000 mL of oral fluids daily. 8- Which assessment finding has the highest priority when assessing and planning nursing care for a client recently admitted with a peptic ulcer disease (PUD) with risk of bleeding? Select one: a. Very dark color stools. b. Dizziness when rising from a sitting position.

c. Hemoglobin 10 g/dL, hematocrit 29%. d. Epigastric pain two hours after eating. Feedback Active bleeding and hypovolemia are priorities in patients with PUD. The presence of dizziness with changes of position suggests orthostatic hypotension and hypovolemia secondary to actual bleeding. Dark tarry

stools mean the presence of digested blood in the stools, but not necessarily implies present active bleeding or hypovolemia. The correct answer is: Dizziness when rising from a sitting position. 9- The nurse is caring for a patient who has returned from the operating room having undergone a supratentorial craniotomy. The nurse,

knowing that brain surgery produces brain swelling, should position the patient in which of the following positions? Select one: b. supine with bed flat; head and neck in neutral midline position c. head of bed elevated 45 degrees; legs elevated to prevent DVT a. head of bed elevated 30 degrees; head and neck in midline position

d. head of bed elevated 30 degrees; head turned toward non-operative side

Feedback Head of bed elevated with neck in neutral position to facilitate venous drainage The correct answer is: head of bed elevated 30 degrees; head and neck in midline position 10- A client is diagnosed with liver cirrhosis. Which laboratory alterations does the nurse expect to find? Select all that apply

Select one or more: a. Elevated blood urea nitrogen and creatinine c. Hyperalbuminemia Feedback b. Prolonged prothrombin time and INR d. Hyperammonemia e. Hypoglycemia f. Hyperbilirubinemia