Nursing Final Exam Questions and Answers, Exams of Nursing

Download Nursing Final Exam Questions and Answers and more Exams Nursing in PDF only on Docsity! Nursing Final Exam Roberto Questions with Accurate Answers Solved by Expert 1. The male client asks the nurse, “Why am I experiencing erectile dysfunction (ED)?” The nurse reviews the client’s medications. The nurse recognizes that which classification increases the risk for ED? a. Non-steroidal anti-inflammatory drugs. b. Antihypertensive medications. c. Anticoagulant medications. d. Histamine H2 inhibitors. Answer: B 2. The nurses care for the client diagnosed with tuberculosis. Before discontinuing airborne precautions, the nurse must confirm which? a. The tuberculin skin test is negative b. No acid-fast bacteria are in the sputum. c. The client has received anti-tuberculin medication for three days. d. The client’s temperature has returned to normal. Answer: B 3. The risk management department plans a program to reduce errors. Which is the most common cause of errors in medication administration? a. Failure to follow routine policy and procedures. b. Caring for too many clients. c. Responsible for administering numerous medications. d. Unfamiliar with monk of the new pharmaceuticals ordered. Answer: A 4. The nurse prepared to administer buspirone 15 mg to the client. The nurse recognized this medication is MOST appropriate for which client? 1. The 45 year old woman diagnosed with pancreatitis reporting nausea and vomiting. 2. The 27 year old woman diagnosed with panic attacks. 3. The 60 year old man diagnosed with coronary artery disease with a blood pressure of 172/94. 4. The 38 year old man diagnosed with schizophrenia reporting auditory hallucinations. Answer#2 Page 1 of 21 5. The home care nurse instructs the client receiving long-term prednisone therapy. Which information should the nurse include? a. There is an increased risk for developing infections. b. There is a resistance to developing infections. c. The client should follow a high-protein diet. d. There are changes in fat distribution over several areas of the body. Answer: D 6. After receiving report from the evening shift charge nurse, which client should the nurse see FIRST? 1. A 69-year –old diagnosed with chronic obstructive pulmonary disease requesting a sleeping pill. 2. A 52-year old client diagnosed with pancreatitis reporting abdominal pain. 3. A 67-year old client diagnosed with pneumonia with a pulse oximeter reading of 88% 4. A 78 year old client diagnosed with coronary artery disease with a blood pressure of 155/88. Answer#3 SAO2 95-99% 7. The nurse cares for the client diagnosed with spinal cord injury at the level of T1. The nurse notes the client is flushed and sweating profusely. The client reports a headache and nausea. The vital signs are blood pressure 140/98 and heart rate 38 beats per minute. Which action should the nurse take FIRST? 1. Administer antihypertensive medication. 2. Palpate the client’s bladder. 3. Position the client in a supine position. 4. Place the client on a cardiac monitor. Answer#2 ASSESS FIRST ;IPPA (she inspected and now palpate) 8. The nurse cares for the client just admitted to the surgical unit from recovery after a total hip replacement. It is MOST important for the nurse to take which action? 1. Elevate the affected extremity on pillows. 2. Position the client in high Fowler’s position. 3. Place the client in Buck’s traction. Page 2 of 21 Answer#2 17. The psychiatric nursing team consists of one registered nurse and three nursing assistants. Which patient should be assigned to the registered nurse? 1. A 56-year-old male alcoholic who will attend his first Alcoholics Anonymous meeting tomorrow. 2. A 16-year-old girl with anorexia nervosa who is showing a daily weight gain. 3. A 40-year-old man receiving clozapine (Clozaril) who is complaining of a sore throat and fine hand tremors. 4. A 50-year-old woman with a history of depression who received her third dose of amitriptyline (Elavil) yesterday. Answer#3 18. A client is admitted to the emergency department with deep partial- thickness burns of the arms and chest sustained in a house fire. The nurse notes that the client is very restless and anxious. Which action should the nurse take FIRST? 1. Administer morphine 5 mg IV 2. Ask the patient to verbalize what is bothering her. 3. Teach the patient diaphragmatic and pursed-lip breathing. 4. Listen to breath sounds Answer#4 19. A client diagnosed with type 1 diabetes comes to the outpatient clinic with complaints of pain of the right leg and foot. If a diagnosis of peripheral arterial occlusion is made, which of the following symptoms does the nurse expect to see? 1. The skin on the right lower leg appears flushed and diaphoretic. 2. The patient cannot distinguish between sharp and dull pressure on his right leg. 3. The patient says his right leg is larger than his left leg. 4. The patient has moderate swelling distal to the malleols on his right foot. Answer#2 Page 5 of 21 20. A patient is admitted to the psychiatric unit with depression and suicidal ideation. Which action is MOST important for the nurse to take? 1. Instruct the patient to check in with the staff every 15 minutes, and encourage her to comply 2. Ask the staff to assess the patient’s suicidal thoughts every 30 minutes 3. Observe the patient every 15 minutes, and add several unscheduled observations 4. Establish a schedule for the staff to check the patient every 15 minutes Answer#3 21. The physician order phenytoin (Dilantin) 200 mg PO daily for a teenager. It is MOST important for the nurse to include which of the following instructions when teaching the client? 1. Visit your dentist frequently 2. If you miss a dose, take an extra one the next day 3. Avoid contact sports for the next several weeks 4. Be sure to take the medication between meals Answer#1 (causes gingival hyperplasia and bleeding). 22. A client with a history of liver disease is brought to the hospital by her family. The family is frightened because the client has become increasingly drowsy, gets disoriented and agitated, and sleeps during the day and is awake at night. The nurse expects the physician to order which of the following? 1. Soapsuds enemas until clear in A.M. 2. A barium enema in A.M. 3. Magnesium hydroxide (Milk of Magnesia) 25 g PO daily 4. Lactulose (Chronulac) 200 g retention enema q 6 h. Answer#4 Hepatic portal hypertension (increase in pressure in portal vein 23. An elderly client returns to the room after a colostomy. Because the client has become confused and repeatedly climbs over the side rails, the physician orders a Posey vest restraint. The nurse should take which of the following actions? 1. Check the patient every 30 to 60 minutes and release the restraint every 2 hours. Page 6 of 21 2. Place the patient’s hospital gown over the restraint so that the restraint is not noticeable to his visitors. 3. Apply the Posey vest restraint loosely so the patient doesn’t feel restricted. 4. Place a sign over the patient’s bed explaining the use of the Posey vest restraint. Answer#1 24. A newborn receives an Apgar score of 3 at 1 minute after birth. The nurse knows that a score of 3 indicates which of the following? 1. The newborn has a congenital defect. 2. The newborn is in a state of acidosis. 3. The newborn requires resuscitation. 4. The newborn has a life-threatening anomaly. 25. The nurse teaches the client about albuterol 2 inhalations every 6 hours by metered dose inhaler. Which statement, if made by the client, indicates to the nurse that further teaching is necessary? 1. “While I am taking this medicine, I may have bad dreams and diarrhea.” 2. “If I forget to take this medicine, I should take it as soon as possible.” 3. “I should hold my breath for 5 seconds after I breathe in the medicine.” 4. “When I take the medicine I should inhale and then compress the container.” Answer#4 26. An older client is brought to the emergency department by the client’s spouse. The client complains of severe headache. The nurse notes the client has slurred speech, as well as facial droop and weak hand grip on the left side. The nurse expects the physician to order which of the following tests? 1. Lumbar puncture 2. CT scan 3. Myelogram 4. Endoscopy 27. A patient is displaying muscle spasms of the tongue, face, and neck, and his eyes are locked in an upward gaze. He has been prescribed haloperidol (Haldol). What is the priority action? Page 7 of 21 32. You are monitoring the cardiac rhythms of clients in the coronary care unit. Which client will need immediate intervention? 1. Client admitted with heart failure who has atrial fibrillation with a rate of 88 beats/min while at rest 2. Client with a newly implanted demand ventricular pacemaker who has occasional periods of sinus rhythm at a rate of 90 to 100 beats/min 3. 4. Client who recently started taking atenolol (Tenormin) and has a first-degree heart block, with a rate of 58 beats/min 33. A 25-year-old G2P1 patient has come to the obstetric triage room at 32 weeks reporting painless vaginal bleeding. You are providing orientation for a new RN on the unit. Which statement by the new RN to the patient would require your prompt intervention? 1. "I'm going to check your vital signs." 2. "I'm going to apply a fetal monitor to check the baby's heart rate and to see if you are having contractions." 3 "I'm going to perform a vaginal Page 10 of 21 Client who has just arrived on the unit with an acute MI and has sinus rhythm at a rate of 76 beats/min with frequent premature ventricular contractions . examination to see if your cervix is dilated." 4. "I'm going to feel your abdomen to check the position of the baby." 34. You are working as the triage nurse in the ED when the following four clients arrive. Which client requires the most rapid action to protect other clients in the ED from infection? 1. 3-year-old who has paroxysmal coughing and whose sibling has pertussis 2 . 5-year-old who has a new pruritic rash and a possible chickenpox infection 3. 62-year-old who has a history of a methicillinresistant Staphylococcus aureus (MRSA) abdominal wound infection 4. 74-year-old who needs tuberculosis (TB) testing after being exposed to TB during a recent international airplane flight 35. the nurse is performing an assessment on a child admitted to the hospital with a probable diagnosis of nephrotic syndrome. Which assessment finding should the nurse expect to observe? SATA Page 11 of 21 1. pallor 2. edema 3.anorexia 4. proteinuria 5. weight loss 6. decrese serum lipids 36. Ventricular fibrillation is identified in an unresponsive 50-year-old client who has just arrived in the ED. Which action will you take first? Defibrillate at 200 J. 2. Start cardiopulmonary resuscitation (CPR). 3. Administer epinephrine (Adrenalin) 1 mg IV. 4. Intubate and manually ventilate. 37. At 9:00 PM, you admit a 63-year-old with a diagnosis of acute MI. Which finding is most important to communicate to the health care provider who is considering the use of fibrinolytic therapy with tissue plasminogen activator (alteplase [Activase]) for the client? 1. The client was treated with alteplase about 8 months ago. 2. The client takes famotidine (Pepcid) for esophageal reflux. 3. The client has ST-segment elevations on the 12-lead ECG. 4. The client has had continuous chest pain since 8:00 AM. Page 12 of 21 1 . assessments with this medication? (Select all that apply.) Check deep tendon reflexes. 2. Observe for vaginal bleeding Check the respiratory rate. Note the urine output. 5. Monitor for calf pain. 43. You have just admitted a client with bacterial meningitis who reports a severe headache with photophobia and has a temperature of 102.6° F (39.2° C) orally. Which prescribed intervention should be implemented first? 1. Administer codeine 15 mg orally for the client's headache. 2 . Infuse ceftriaxone (Rocephin) 2000 mg IV to treat the infection. 3. Give acetaminophen (Tylenol) 650 mg orally to reduce the fever. 4. Give furosemide (Lasix) 40 mg IV to decrease intracranial pressure. 44.The nurse is caring for the following patients with endocrine disorders. Which patient must the nurse assess first? Select one: A 55-year-old patient with syndrome of inappropriate antidiuretic hormone secretion (SIADH) who is demanding Page 15 of 21 3 .4. that the unlicensed assistive personnel refill his water pitcher b. A 65-year-old patient with Addison disease whose morning potassium level is 6.2 mEq/L (6.2 mmol/L) A 48-year-old patient with Cushing disease with a weight gain of 1.5 lb (0.7 kg) over the past 4 days A 21-year-old patient with diabetes insipidus whose urine output overnight was 2000 mL 45. the nurse is monitoring a client receiving levothyroxine sodium for hypothyroidism. Which finding indicate the presence of a side effect associated with this medication? SATA 1. insomni a 2. weight loss 3. bradycardia 4.constipation 5.mild heat intolerance 46. The charge nurse is making assignments for the next shift. Which patient should be assigned to the fairly new nurse (6 months of experience) floated from the surgical unit to the medical unit? 1. 58-year-old on airborne precautions for tuberculosis (TB) 2. 65-year-old who just returned from bronchoscopy and biopsy Page 16 of 21 3 . 72-year-old who needs teaching about the use of incentive spirometry 4. 69-year-old with COPD who is ventilator dependent 47. As the shift begins, you are assigned to care for the following patients. Which patient should you assess first? 1. 38-year-old with Graves disease and a heart rate of 94 beats/min 2. 63-year-old with type 2 diabetes and fingerstick glucose level of 137 mg/dL 3 . 58-year-old with hypothyroidism and a heart rate of 48 beats/min 4. 49-year-old with Cushing disease and dependent edema rated as 1+ 48. which of the following assessments is most appropriate for determining the correct placement of an endotracheal tube in a mechanically ventilated client? 1. Auscultating breath sounds bilaterally. 2. monitoring the respiratory rate 3. Verifying the amount of cuff inflation 4. assessing the client’s skin color 49. You are caring for a client with multiple injuries sustained during a head-on car collision. Which assessment finding takes priority? A deviated trachea 2. Unequal pupils 3. Ecchymosis in the flank area Page 17 of 21 1 . Monitor the infant's temperature closely. 3. Keep the infant "nothing by mouth" (NPO) during the treatment. 4. Apply ointment to the infant's skin prior to light exposure. 5. Offer the infant sterile water feedings during the treatment. 56. While assessing a 29-year-old G2P2 patient who had a normal spontaneous vaginal delivery 30 minutes ago, you note a large amount of red vaginal bleeding. What would be your first priority nursing action? 1. Check vital signs. 2. Notify the provider. Firmly massage the uterine fundus. 4. Put the baby to breast. 57. A patient who was an unrestrained driver in a high-speed, head-on motor vehicle collision presents with dyspnea, tachycardia, hypotension, jugular venous distention, tracheal deviation to the left, and decreased breath sounds on the right side. What is the most likely diagnosis? Select one: Cardiac tamponade Tension pneumothorax x Ruptured diaphragm d. Simple pneumothorax Page 20 of 21 2 . 3 . 58. A 32-year-old primigravida is admitted with a diagnosis of ectopic pregnancy. Nursing care is based on the knowledge that: Select one: a. Bed rest and analgesics are the recommended treatment. b. She will be unable to conceive in the future. Hemorrhage is the major concern. x d. A D&C will be performed to remove the products of conception. 59. The nurse is preparing to care for a client who is being admitted to the hospital with a possible diagnosis of ectopic pregnancy. The nurse develops a plan of care for the client and determines that which of the following is the priority nursing action? a. Monitoring the apical pulse Monitoring the temperature Assessing for edema d. Monitoring daily weight Page 21 of 21