Revised NU 665 Final Exam (600 Questions With 100% Correct Answers) 2024 Latest Updated Gr, Exams of Nursing

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Revised NU 665 Final Exam (600 Questions

With 100% Correct Answers) 2024 Latest

Updated Graded A+

A school-age child has a fractured wrist with a Salter Harris Type II fracture, according to the radiologist. What is true about this type of

fracture? - Correct answer There is a metaphyseal fragment on the

compression side of fracture. What will the primary care pediatric nurse practitioner elicit when obtaining a positive Barlow maneuver when screening for developmental dysplasia of

the hip? - Correct answer Dislocation of an unstable hip

A 3-year-old child is brought to the clinic by a parent who reports that the child refuses to use the right arm after being swung by both arms while playing. The child is sitting with the right arm held slightly flexed and close to the body. There is no swelling or ecchymosis present. What will the

primary care pediatric nurse practitioner do? - Correct answer Gently

attempt a supination and flexion technique. A school-age child falls off a swing and suffers a closed fracture of the right

clavicle. How will this be managed? - Correct answer Immobilization

with a sling to support the affected extremity A young adolescent reports chest pain associated with coughing and lifting. Physical examination reveals tenderness over several ribs, radiating to the back. Auscultation of the heart, lungs, and abdomen are normal. There is no history of injury. What will the primary care pediatric nurse practitioner

do? - Correct answer Recommend NSAIDs, stretching exercises, and

ice packs to the area. A young adolescent female is observed to have mild unequal scapula prominences on gross examination while standing. In the Adams forward bending position, this inequality disappears. What will the primary care

pediatric nurse practitioner do? - Correct answer Discuss posture and

exercise and ask about backpacks and books.

The primary care pediatric nurse practitioner elicits positive Ortolani and Barlow signs in a 6-month-old infant not previously noted in the medical

record. What is the correct treatment? - Correct answer Surgical

intervention A 14-year-old boy who is overweight develops a unilateral limp with pain in the hip and knee on the affected side. An exam reveals external rotation of the hip when flexed and pain associated with attempts to internally rotate the hip. What is most important initially when managing this child's

condition? - Correct answer Place the child on crutches or in a

wheelchair to prevent weight-bearing. A parent is concerned that a 12-month-old child is "bowlegged." A physical examination reveals internal tibial torsion bilaterally. A radiograph reveals asymmetric bowing of the legs with an angle greater than 15 degrees. What is the correct action for the primary care pediatric nurse practitioner?

• Correct answer Refer to a pediatric orthopedic specialist for treatment. A child who plays soccer is in the clinic reporting pa in and swelling in both knees. A physical examination reveals swelling and focal tenderness at the tibial tuberosities, with pain worsening when asked to extend the knees

against resistance. What is the treatment for this condition? - Correct

answer Apply ice packs to both knees and avoid activities that cause

pain. During a well baby examination of a newborn, the primary care pediatric nurse practitioner notes adduction of the right forefoot, with normal position of the mid and hindfoot, along with a convex shaped lateral border of the foot. What will the nurse practitioner do to evaluate this deformity? -

Correct answer Grasp the heel with one hand and abduct the forefoot

with the other hand. During a well child examination on a 4-month-old infant, the primary care pediatric nurse practitioner evaluates mental health issues. Which statement by the parent indicates a potential problem with the parent-infant

relationship? - Correct answer "I let my baby cry a while to learn to be

patient."

A child has a difficult temperament. What will the primary care pediatric nurse practitioner tell the parent about managing this child's behavior? -

Correct answer It is important for the parent to learn to manage criticism

and power struggles. During a well child assessment of a preschool-age child, the parent voices concerns that because the child has behavior problems at school, the child may have a mental health disorder. Which initial approach will provide the best information? JJJJ. Ask the parent whether other caregivers have

voiced similar concerns. - Correct answer Take time to actively listen to

the parent's and child's perceptions of the problem. The primary care pediatric nurse practitioner attempts to learn more about the emotional health of an 18-month-old child through which assessment

strategy? - Correct answer Observation of the child with caretakers in

structured and unstructured situations A middle school age child is skipping school frequently and getting poor grades since the child's father was killed while deployed in the military. How will the primary care pediatric nurse practitioner manage this situation? -

Correct answer Refer the child to a mental health specialist for

evaluation and treatment. The parent of a 4-year-old child reports that the child seems to be having trouble adjusting to a new daycare and reportedly is always engaging in solitary play when the parent arrives to pick up the child. What will the

primary care pediatric nurse practitioner do? - Correct answer Ask the

parent if the child is slow to warm up to other new situations. The parent of a school-age child is concerned because the child has started to express anger about a grandparent's death even though this occurred when the child was a toddler. What will the primary care pediatric

nurse practitioner tell the parent? - Correct answer The significance of

this loss must be reworked at each developmental level. The parent of a school-age child reports that the child doesn't like being alone in rooms because of a fear of aliens hiding in closets. What will the

primary care pediatric nurse practitioner tell the parent? - Correct

answer "Fear of imaginary creatures does not usually occur at this age."

The parent of a preschool age child reports that the child often appears anxious and nervous and that this is associated occasionally with a rapid heart rate and tremors. What is the best type of referral that the primary

care pediatric nurse practitioner could recommend? - Correct answer

Play therapy A 9-year-old child exhibits school refusal and a reluctance to attend sleepovers with classmates. The parent is concerned because the child has recently begun sleeping in the parents' bed. Which initial action by the

primary care pediatric nurse practitioner is appropriate? - Correct

answer Assess for environmental stress, parental dysfunction, and

maternal depression. The parent of a school-age child reports that the child becomes frustrated when unable to perform tasks well and often has temper tantrums and difficulty sleeping. Which disorder may be considered in this child? -

Correct answer Generalized anxiety disorder (GAD)

The parent of a school-age girl reports that the child has difficulty getting ready for school and is often late because of a need to check and recheck whether her teeth are clean and her room light has been turned off. What will the primary care pediatric nurse practitioner recommend to this parent?

• Correct answer Cognitive behavioral therapy The parents of a 4-year-old boy are concerned because he has begun twisting and pulling out his hair, especially when he is tired or stressed. What will the primary care pediatric nurse practitioner recommend as part

of an initial approach to treat this behavior? - Correct answer Cutting his

hair so that it is too short to pull A newly divorced mother of a toddler reports that the child began having difficulty sleeping and nightmares along with exhibiting angry outbursts and tantrums 2 months prior. The primary care pediatric nurse practitioner learns that the child refuses to play with usual playmates and often spends

time sitting quietly. What will the nurse practitioner do initially? - Correct

answer Ask the mother about the child's relationship with the father.

An adolescent has recently begun doing poorly in school and has stopped participating in sports and other extracurricular activities. During the history interview, the adolescent reports feeling tired, having difficulty concentrating, and experiencing a loss of appetite for the past few weeks but cannot attribute these changes to any major life event. Which is an

important next step in managing this patient? - Correct answer

Determining suicidal ideation and risk of suicide An adolescent is diagnosed with major depression, and the mental health specialist has prescribed fluoxetine. What other treatment is important to

protect against suicide risk? - Correct answer Cognitive behavioral

therapy A 13-year-old child has exhibited symptoms of mild depression for several weeks. The parent reports feeling relieved that the symptoms have passed but concerned that the child now seems to have boundless energy and an inability to sit still. What will the primary care pediatric nurse practitioner

do? - Correct answer Refer the child to a child psychiatrist for

evaluation of bipolar disorder. A toddler has begun hitting and biting other children at a day care center and is exhibiting temper tantrums and bad language at home. The parent reports that these behaviors began shortly after a sibling was born. What

will the primary care pediatric nurse practitioner do? - Correct answer

Engage the parent in positive parenting strategies to facilitate appropriate child coping. A 14-year-old female comes to the clinic with amenorrhea for 3 months. A pregnancy test is negative. The adolescent's body weight is at 82% of expected for height and age. The mother reports that her daughter often throws up and refuses to eat most foods. Which condition does the primary

care pediatric nurse practitioner suspect? - Correct answer Anorexia

nervosa Which type of heat-related illness involves a core body temperature of at least 104.9°F, acute mental status changes, absent sweat, and tachypnea?

• Correct answer Heat stroke

What percentage of burns is involved using the rule of nines if both front

legs are burned? - Correct answer 18%

Which drug commonly prescribed for burns is active against a wide spectrum of microbial pathogens and is the most frequently used agent for

partial- and full-thickness thermal injuries? - Correct answer Silver

sulfadiazine (Silvadene) A sunscreen with a sun-protection factor of at least what number will block

most harmful ultraviolet radiation? - Correct answer 15

Which clinical feature is the first to be affected in increased intracranial

pressure? - Correct answer Decrease in level of consciousness

What is the normal number for the Glasgow Coma Scale? - Correct

answer 15

Which diagnostic test is the best to diagnose a subdural hematoma? -

Correct answer Magnetic resonance imaging (MRI)

Patients with a spontaneous pneumothorax should be counseled that up to what percentage may experience a reoccurrence at some point? -

Correct answer 30%

Most adult poisonings are: - Correct answer Intentional and self-inflicted

Which method is used to remove heavy metals, such as lead, that are

ingested as poisons? - Correct answer Chelation

If a previously frostbitten area becomes frostbitten again after it has healed,

what might occur? - Correct answer Permanent tissue damage may

occur, resulting in necrosis to that body part. What percentage of all visits to the emergency department (ED) are related

to wounds? - Correct answer 12%

Which solution should be used when irrigating lacerated tissue over a

wound on the arm? - Correct answer Saline irrigation or soapy water

Which type of burn injury results in destruction of the epidermis with most of the dermis, yet the epidermal cells lining hair follicles and sweat glands

remain intact? - Correct answer Deep partial-thickness burns

Which carboxyhemoglobin (COHb) level correlates with the clinical symptoms of confusion, lethargy, and ST-segment depression on the

electrocardiogram? - Correct answer 30% COHb

Which causes the greatest percentage of mammalian bites? - Correct

answer Dogs

Which arthropod bite can contain cytotoxic and hemolytic toxins that may

destroy tissue? - Correct answer Brown recluse spider

Which of the following characteristics separates anaphylaxis from a

vasovagal reaction? - Correct answer Severe bronchoconstriction

Delayed serum sickness-type reactions in response to multiple bee, wasp,

or fire ant stings can be managed with which of the following? - Correct

answer A corticosteroid such as prednisone (Deltasone), 60 to 100 mg,

tapered over 2 weeks After a head injury, what is it called when air enters into the cerebrospinal

fluid (CSF)-filled spaces within the head? - Correct answer

Pneumocephalus Cerebrospinal fluid (CSF) may leak through the cribriform plate region of the skull following a head injury and cause which of the following? -

Correct answer Nasal CSF rhinorrhea

Which classic feature of an epidural hematoma may distinguish it from

other skull hematomas? - Correct answer A brief loss of consciousness,

then a brief "lucid" moment, followed by momentary unconsciousness minutes after the injury

A patient with a basilar skull fracture may experience an impaired

downward gaze or diplopia from which affected cranial nerve? - Correct

answer CN IV

A history of overuse or excessive force, as opposed to a fall, hyperextension, or the twisting of a joint, is more likely related to which

musculoskeletal injury? - Correct answer A strain

In a healthy adult, the process of remodeling after a fracture of the humerus

takes how long? - Correct answer 2 months

A patient who sustains blunt chest trauma and/or penetrating chest trauma

must have which of the following imaging examinations? - Correct

answer Upright chest x-ray film

Josie, age 30, has a pneumothorax. It may be treated conservatively

without a chest tube if it is deflated by what percentage? - Correct

answer 30%

Hepatic necrosis with jaundice may occur after ingesting massive doses of

which medication? - Correct answer Acetaminophen

Pink, cherry red tissues and skin may result from which type of poisoning? -

Correct answer Carbon monoxide

In which type of burn is the injury more extensive than it appears, and the cardiac conduction system may be affected, leading to sudden death or

arrhythmias? - Correct answer Electrical burns

Eddie, age 4, presents to the ED with a live insect trapped in his ear canal

causing a lot of distress. What should be your first step? - Correct

answer Immobilize the insect with 2% lidocaine.

When giving discharge instructions to a patient with a laceration injury to

his lower leg, which is the most important one? - Correct answer

Recommend cleansing the wound every 4 hours to prevent an infection.

Cerebellar function may be assessed by performing which

examination/test? - Correct answer Romberg's test

In the epithelialization phase of wound healing, the wound will have only

what percent of its normal tensile strength at 3 weeks? - Correct answer

15% to 20% Which of the following statements is true about antibiotic prophylaxis for

most wounds? - Correct answer It is not indicated for most wounds and

does not affect the infection rate. A patient sustained injuries in a motor vehicle accident and is in the Emergency Department. A CT scan of the head and neck have been

ordered. What part of the survey is this? - Correct answer Secondary

A patient who is in the Emergency Department was attacked in a parking lot and suffered several stab wounds to various areas on the chest and abdomen; BP 100/60, heart rate 108, respiratory rate 20, pulse oximetry 98%. In order to counteract the blood loss and restore circulating volume

for this patient, what priority intervention will the nurse perform? - Correct

answer Start lactated ringers at 150 mL/hr

The nurse is assigned to a patient in the Emergency Department who exhibits paradoxical chest movement. What intervention by the nurse can

help improve oxygenation in this patient? - Correct answer Turn the

patient with the injured side down A patient has been involved in a motor vehicle accident. The patient, who was driving, was unrestrained by a seat belt when hitting the car in front of him. The patient is complaining of midsternal pain, restlessness, and difficulty breathing. What is the priority nursing diagnosis for this patient? -

Correct answer Impaired gas exchange

A patient has suffered a mild pulmonary contusion from a jet ski accident.

What nursing interventions are appropriate for this patient? - Correct

answer Frequent pulse oximetry monitoring, assessment of lung sounds

every 2 hours, continuous epidural analgesia

A patient sustained an injury to the right arm after falling off a motorcycle. The patient is complaining of severe pain and is unable to feel the fingers of the right hand. Radial pulse is absent. What is the priority intervention by

the nurse? - Correct answer Notify the physician

The nurse is caring for a patient with deep vein thrombosis of the left lower extremity. The patient exhibits a decrease in pulse oximetry readings from 98% to 86%, shortness of breath with a respiratory rate of 34, and is now disoriented to place. The nurse recognizes that these findings are caused

by what complication? - Correct answer Pulmonary embolus

The nurse is assigned to care for a patient who was admitted 2 days previous after a four- wheeler accident. The patient sustained a closed fracture to the left femur and had an open reduction with internal fixation the same day. What is a priority for the nurse to assess for this patient? -

Correct answer Pulse oximetry

A patient has been brought into the Emergency Department via ambulance with resuscitation efforts being performed. It is unlikely that the patient will survive the severe injuries sustained. Two adult children of the patient are present and are requesting to be with the patient at this time. What is the

best response by the nurse? - Correct answer You may come in with

your parent and I will have someone stay with you to explain what is happening. The nurse is caring for the patient with chest tubes. Which observation by

the nurse is a priority concern? - Correct answer 250 mL/hr of blood in

drainage collection system A patient is admitted to the emergency department after he was hit by a car. The car was going about 30 mph and was braking at the time of impact. The patient was struck just above the right knee, fell forward over the hood of the car, striking his anterior chest, and then slipped off the hood of the car and hit the pavement head first. Based on the mechanism of injury and transfer of force, what injuries does the nurse most expect?

Select all that apply. - Correct answer Fracture of the left femur and

damage to the left knee, fractured ribs and cardiac and lung contusion, closed head injury and cervical spine fracture

The patient has received a gunshot wound. To help predict the amount of

damage, what information does the nurse collect? - Correct answer

Type of weapon and caliber of bullet A patient was in a serious motor vehicle crash. At the scene, what is the

highest priority of care? - Correct answer Cervical spine protection

On initial admission of a trauma victim to the emergency department, the nurse completes a primary survey. The patient is awake and tachypneic, is using accessory muscles of respiration, has unequal chest expansion, and is very anxious. There are absent breath sounds on the right and cyanosis on 100% oxygen, and the trachea is deviated to the left. What action takes

the highest priority during the primary survey? - Correct answer Chest

tube insertion A patient has been admitted to the emergency department after being in a severe motor vehicle crash. The patient was a passenger and had a lap and seat belt in place. The patient is lethargic and moaning. Initial exposure and head-to-toe examination reveals scattered minor abrasions and contusions and bruising over the upper abdomen. The patient moans more when the abdomen is palpated, and the abdomen is rigid. Heart rate is 110, capillary refill is greater than 4 seconds, and blood pressure is 140/88 mm

Hg. What is the nursing priority of care? - Correct answer Increase rate

of IV crystalloid As part of a major trauma, a patient has suffered a flail chest injury. What

hallmark sign of flail chest does the nurse expect to find? - Correct

answer Flail segment depression during inhalation

A patient is admitted to the CCU after experiencing blunt trauma to the chest. Among other injuries, the patient has a flail chest on the left and several extremity fractures. About 12 hours after admission, the patient is tachypneic and complaining of shortness of breath. Breath sounds are present bilaterally with scattered fine crackles. Chest radiograph shows an ill-defined, patchy, ground-glass area of density on the left. If the patient

has a pulmonary contusion, what is the nursing priority? - Correct

answer Monitor pulse oximetry and arterial blood gases closely

A patient has suffered severe blunt trauma to the abdomen with bruising, diffuse pain, guarding, and rigidity evident. Damage to which structure is

most likely? - Correct answer Liver

As part of a multiple trauma injury, the patient has suffered a closed fracture of the radius. What nursing assessment finding indicates a

significant complication warranting immediate treatment? - Correct

answer Loss of pulses distal to the fracture

A patient has experienced multiple fractures, including pelvic and long bone fractures. After 72 hours, the patient complains of tachypnea and dyspnea and is found to have cyanosis, tachycardia, confusion, and fever. Laboratory analysis reveals a normal complete blood count except for thrombocytopenia and progressive respiratory insufficiency. What is the

nursing care priority? - Correct answer Administer oxygen and monitor

pulse oximetry During a motor vehicle accident, a patient sustained blunt trauma to the head and face, resulting in hairline skull fracture and a LeFort III maxillofacial fracture. The patient also has bruising across the chest and upper abdomen and multiple small superficial bleeding abrasions and lacerations. On admission to the emergency department, what is the

nursing care priority? - Correct answer Perform endotracheal intubation

As part of a multiple trauma injury, a patient developed hemorrhagic hypovolemic shock, necessitating fluid resuscitation with massive amounts of intravenous crystalloid fluids and blood products as well as extensive surgical repair under general anesthesia. Twenty- four hours later, the patient develops hypoxia unresponsive to oxygen therapy and diffuse white, ground-glass infiltrates of the lung fields on a chest radiograph. Development of this complication has what effect on the patients recovery?

• Correct answer Significantly greater chance of death

Which of the following is likely to result from lead poisoning? - Correct

answer Damage to the brain and peripheral nerves

During the development of hyperthermia, the state of heat exhaustion is

indicated when: - Correct answer hypovolemia and fainting occur

What is/are signs of hypothermia? - Correct answer Lethargy and

confusion Which of the following types of cells are most likely to be damaged by

exposure to radiation? - Correct answer Epithelial tissue and bone

marrow Which of the following events would most likely cause a person to faint and

experience difficulty breathing? - Correct answer An insect sting

Bites and stings cause disease in which three ways? - Correct answer

Injection of toxins, transmission of infectious agents, or allergic reactions

Which statement applies to food poisoning? - Correct answer It results

from consuming contaminated food and water. It often causes gastroenteritis, including vomiting and diarrhea. Outbreaks occur frequently in institutions. Institutions frequently have outbreaks of infection associated with poultry

products contaminated by: - Correct answer Salmonella

The amount of radiation absorbed by the body is measured in rads, or __ -

Correct answer radiation-absorbed doses.

The term pica refers to: - Correct answer the consumption of nonfood

substances such as clay.

Inhalants can be: - Correct answer a particulate such as asbestos;

gaseous, such as sulfur dioxide; a solvent, such as benzene. Choose the correct effects of exposure of the ears to very cold

temperatures: - Correct answer Loss of sensation and vascular

occlusions During the development of hyperthermia, the stage of heat stroke is

marked by: - Correct answer shock and coma.

Which of the following is a potential effect of a bite or sting? - Correct

answer Anaphylaxis

Bites from both wild and domesticated animals may cause: - Correct

answer rabies.

Which of the following is considered carcinogenic? - Correct answer

Inhaled particulates

Illness in institutions may be traced back to food handlers who: - Correct

answer are carriers of pathogens. do not practice adequate hand-washing

or sanitization. bring in pathogens from home or the community. A common illness for tourists in developing countries is travelers diarrhea,

often caused by: - Correct answer E. coli

Radiation damage may occur from repeated exposure to: - Correct

answer ultraviolet rays. X-rays. radioactive substances.

Two types of eye damage that can be caused by a laser beam are: -

Correct answer thermal burn and photochemical damage.

A nurse from the ICU is participating in the hospitals disaster response preparedness team. One issue that proves difficult for the team to agree on is a statement regarding the standard of medical care observed during a disaster. Which of the following do you think the nurse should recommend

to the team? - Correct answer The goal should be to provide the highest

care possible, with limited resources and equipment. A nurse learns that local law enforcement officials have informed the hospital that an imminent terrorist attack has been threatened in a building just down the street from the hospital. Which of the following are

appropriate responses? Select all that apply. - Correct answer Review

the hospitals disaster plan and make sure that it is distributed to the rest of the medical staff. Determine what her specific role in the disaster plan is. Check the number of ventilators available in the ICU to determine whether more would be needed in the event of an attack.

The nurse is at the bedside of her 90-year-old patient, Ruth, who is comatose and on life support in the ICU, when she begins to feel the room shaking violently. The power suddenly fails and emergency generators have not started yet. The nurse provides bag-mask resuscitation for Ruth while she waits for the power to be restored. Moments later, the ICU is inundated with patients injured by the collapse of a nearby apartment building as a result of the earthquake. The nurse is called to help. Kevin has been impaled by a metal rod through the chest, is in a state of shock, and will die without immediate intervention. Gwyneth has compound fractures of the femur and a dislocated shoulder, is in pain, but is responsive. Mason is unconscious and unresponsive. Based on the START triage categories, whom should the nurse assist first in this situation? -

Correct answer Kevin

A patient arrives at the ICU after being injured by car bomb that exploded 20 feet away. The patient sustained only primary blast injuries. Which of

the following are injuries he might have sustained? - Correct answer

Perforated eardrum caused by a sudden change in atmospheric pressure. Hemorrhagic contusion of the lungs. Gastrointestinal hemorrhage A group of patients, colleagues from the same office, arrive at the ICU with symptoms of nausea, vomiting, and diarrhea. It is determined that they are suffering from radiation exposure as a result of an inconspicuous device placed in the office that leaked radiation over a period of days. The nurse suspects that which of the following was used in this terrorist attack? -

Correct answer Simple radiological device

A patient arrives at the ICU with symptoms of radiation exposure. While in the ICU, he begins gasping for air and clutching his throat with his hand.

What intervention should take priority at this point? - Correct answer

Perform CPR on the patient to restore normal respiratory function. A woman arrives at the ICU after being the victim of a terrorist attack in a nearby shopping center involving a gas that spewed from a metal canister. The woman complains of a burning sensation in her eyes, mouth, and throat, and the nurse observes blistering on her face and arms. What chemical agent should the nurse suspect, and what intervention should she

implement? - Correct answer Vesicant agent; soap and water blot

A worker at a local chemical plant arrives at the ICU following an industrial accident involving a gas leak. The patient shows signs of pulmonary edema and bronchospasm. What chemical should the nurse suspect is involved,

and what intervention would be most appropriate? - Correct answer

Chlorine; airway management and ventilatory support A man presents to the ICU with a severe case of H1N1 viral infection. What

would be the most appropriate intervention for this patient? - Correct

answer Administer an antiviral agent.

A young man arrives at the ICU after being held hostage while a passenger on a commercial airplane. He sustained a bullet wound in his chest and has undergone surgery to repair his lung. He is now receiving an analgesic for his pain. The nurse observes that the patient frequently complains that he is sick to his stomach and has no appetite. His sleep is regularly interrupted by nightmares, and he is prone to outbursts of anger and grief. What is the

most likely cause of these symptoms? - Correct answer Post-traumatic

stress disorder The nurse is caring for a group of patients from the same workplace who have similar symptoms of cough, respiratory distress, and nausea and

vomiting. What should the nurse suspect? - Correct answer Mass

exposure to an inhaled agent The nurse is part of a planning committee developing a disaster response plan for a hospital that serves as the major trauma center for the local area. The committee has identified that the most likely cause of a disaster in the community is a devastating tornado that significantly damages most major structures, including hospitals of all sizes, in the community. What

component of the plan is least likely to be realistic? - Correct answer

Transfer all noncritical patients to smaller hospitals in the community. The nurse is preparing to assist with triage of victims from a large mass casualty incident. The patients are sorted into categories at the door of the

facility. What category will receive care last? - Correct answer

Expectant The nurse is assisting with triage in the emergency department. A large group of patients from a mass casualty incident arrive. These patients have

been classified at the scene as minimal, delayed, immediate, and

expectant. What is the best nursing approach? - Correct answer

Reassess and reclassify patients quickly to determine the order of treatment. The nurse is caring for a patient who was exposed to a high dose of

external radiation. What is the least likely nursing action? - Correct

answer Assist in removing penetrating radioactive materials.

The nurse is caring for a patient who has been exposed to radiation. The patient has been increasingly unstable, with decreasing lymphocytes, leukocytes, thrombocytes, and erythrocytes, along with shock, diarrhea, and altered level of consciousness for some weeks. Today, there is clear evidence of worsening shock, subnormal body temperature, and increased intracranial pressure. The family asks what the patients prognosis is. The

best nursing response is based on what rationale? - Correct answer

Increased intracranial pressure following other symptoms is a sign of impending death. The nurse is caring for a patient with a suspected cyanide exposure. The patient is anxious and hyperventilating. What is the nursing priority of care?

• Correct answer Give cyanide antidote. The nurse is assisting with the initial care and assessment of a group of patients with a massive topical toxic chemical exposure. What is the best

way to decontaminate these patients? - Correct answer Soap-and-water

shower first for most chemicals A worker in a tanning factory comes to the emergency department with itchy, papular lesions on his hands and arms. Some of the lesions have black eschar in the center and some are vesicular. What biological

exposure is most likely? - Correct answer Cutaneous anthrax

A patient and his family have been exposed to probable anthrax spores through contaminated postal contents within the past 8 hours. Upon arrival at the emergency department, all members of the family are anxious and say they are afraid of dying. The best nursing response is based on what

rationale? - Correct answer Antibiotic therapy is very effective for

cutaneous anthrax.

A male client asks the nurse about the purpose of the prostate gland. The

nurse should respond that it is a structure that: - Correct answer

provides a milky alkaline substance that neutralizes the acidity of the male urethra and the female vagina. A 50-year-old male client has had a prostate-specific antigen test. The

nurse realizes that the normal range for this test would be: - Correct

answer 3.0 to 4 ng/mL.

A male client, having difficulty voiding, tells the nurse that he thinks something is wrong with his penis. The nurse reviews the structures of the penis with the client and explains that the structure that surrounds the

urethra is the: - Correct answer corpus spongiosum.

The nurse is preparing to discuss the male reproductive system with a group of adolescent school students. Which of the following would the nurse not include as a primary function of the male reproductive system? -

Correct answer Frequent erectile functioning and increased libido

A male client is diagnosed as being infertile. The nurse realizes which of the following structures of the clients reproductive system is affected? -

Correct answer Seminiferous tubules

The nurse, preparing to discuss the female reproductive system with a group of adolescent females, would include that which of the following is

not a primary function of the female reproductive system? - Correct

answer Sensory innervation

A young adult female client is concerned that she does not have enough eggs since she has not yet become pregnant. The nurse should assure her that the number of ova available to produce a pregnancy would be around:

• Correct answer 300,000. During a gynecological exam, it is noted that a clients os is in the shape of a slit. The nurse realizes that this shape means that the client has: -

Correct answer borne children.

The nurse, reviewing the reproductive hormones needed to produce sperm and ova, realizes that which of the following hormones is not involved in the

formation of sperm and ova? - Correct answer Prolactin

During the examination of the male testes, the nurse should instruct the

client on: - Correct answer monthly testicular self-examinations.

A male client has a prostate specific antigen level of 22 nanograms. The nurse realizes that this client will most likely be scheduled for a(n): -

Correct answer bone scan

A female clients Pap test revealed atypical results. The nurse realizes that

this client will most likely be scheduled for a(n): - Correct answer

colposcopy. A female client has an infection of the paraurethral glands. When asked by

the client what these glands do, the nurse should respond: - Correct

answer These glands function like the prostate gland in the male. These

glands secrete mucus. These glands are located inside the urethra. The nurse is instructing a postmenopausal client in the importance of having serum lipid levels analyzed because after menopause, which of the

following changes can occur? - Correct answer Total cholesterol

increases, low-density lipoprotein increases, triglycerides increase, high- density lipoprotein decreases The nurse is reviewing the physiological sexual response pattern within males and females and realizes that which of the following occur in both

genders? - Correct answer Resolution, orgasm, plateau, excitement

A female client is concerned that she has not had sexual intercourse with her husband for over 2 months. Which of the following can the nurse

respond as causes for an alteration in sexual functioning? - Correct

answer Chronic illnesses, physical disabilities, negative body image,

medications, surgical procedures The nurse is concerned that a female client might be experiencing intimate partner violence. Which of the following assessment questions can be used

to gain more information from the client? - Correct answer In the last

year have you been hit, slapped, or physically hurt by someone? Within the last year has someone made you do something sexual that you did not want to do? Are you afraid of your partner or anyone else? A client who has just given birth is planning on breastfeeding the baby. The nurse realizes that which of the following hormones influences breast milk

secretion? - Correct answer Prolactin

The nurse is instructing a female client about breast self-examination. Which of the following instructions would not be correct for the nurse to

provide? - Correct answer An inverted nipple is not a cause for alarm.

A client who has been breastfeeding a newborn for the last 3 months is experiencing an inflammation of the breast. The nurse realizes this client is

experiencing: - Correct answer mastitis.

During the examination of a female clients breasts, the nurse determines that which of the following assessment findings would be normal? -

Correct answer Symmetrical nipples

The nurse is instructing a female client on the importance of having routine

mammograms because mammograms: - Correct answer can detect

masses before they become palpable. The nurse is instructing a female client on what should be done if a lump is discovered while performing breast self-examination (BSE). What should

the nurse instruct the client to do? - Correct answer Call her physician

and immediately schedule an appointment. The nurse determines that a female client has a lower risk for developing

breast cancer when which of the following is assessed? - Correct

answer Breastfeeding

The nurse should instruct the client that when performing a breast self- examination, pay particular attention to which of the following areas since the greatest number of malignancies are found in this breast area? -

Correct answer Upper outer quadrant of the breast to the axilla

The nurse should instruct a client, diagnosed with mastalgia, to do which of

the following? - Correct answer Decrease the intake of caffeine.

A female client tells the nurse that she is planning on having plastic surgery to correct a minor facial defect and then have her breasts done. The nurse would identify which of the following nursing diagnoses as being

appropriate for this client? - Correct answer Body dysmorphic disorder

The nurse is determining if a female client is at risk for benign breast

disease. Which of the following is a risk factor for this disorder? - Correct

answer Caffeine use

A client is scheduled for a prophylactic mastectomy. The nurse should

remind the client that skin flaps will be left after the surgery for: - Correct

answer reconstruction.

When instructing a client on breast self-examination, the nurse reviews the importance of visual inspection of the breasts. Which of the following should the nurse instruct the client to focus on when doing this part of the

examination? - Correct answer Contour and symmetry of the breasts,

Skin changes, Position of the nipples, Presence or absence of masses The nurse is preparing to assess a clients nipples during a breast examination. Which of the following are considered pathological conditions

that affect the nipple? - Correct answer Bleeding, discharge, fissures

Which of the following should the nurse do if a female client is experiencing

nipple discharge? - Correct answer Note the color of the discharge.

Determine if the discharge is from one or both breasts. Obtain a sample of the discharge with a sterile cotton-tipped swab. Assess the nipple drainage for occult blood. A client is experiencing galactorrhea. Which of the following should the

nurse assess in this client? - Correct answer Recent vigorous nipple

stimulation. Prescribed hormones, blood pressure medications, or antidepressants. Intake of herbal remedies such as fennel or anise. Use of street drugs such as opiates and marijuana. Recent chest trauma.

A client is considering breast augmentation surgery. Which of the following postoperative complications should the nurse discuss with the client

regarding this surgery? - Correct answer Change in sensation.

Development of a hematoma. Fibrous tissue around the implant. A 23-year-old sexually active woman presents for her first Pap smear. Her history includes nulligravida, age at first intercourse 14, and more than 10 sexual partners. Which of the following conditions should the clinician be

particularly alert for during her examination? - Correct answer Human

papillomavirus A 20-year-old woman is seen in the clinic because her boyfriend was found to have gonorrhea. Which of the following is the treatment of choice for

gonorrhea? - Correct answer Ceftriaxone

A 24-year-old woman presents to the clinic with dysuria, dyspareunia, and a mucopurulent vaginal discharge. Her boyfriend was recently treated for nongonococcal urethritis. What sexually transmitted disease has she most

probably been exposed to? - Correct answer Chlamydia

A 45-year-old woman is seen in the clinic with complaints of a vaginal discharge. The clinician identifies clue cells on the vaginal smear. Which of

the following diagnoses is associated with this finding? - Correct answer

Bacterial Vaginosis Which of the following medications is the treatment of choice for

trichomonas? - Correct answer Metronidazole

A 58-year-old woman presents with a breast mass. Which of the following

responses by the clinician would be most appropriate? - Correct answer

"We will order a mammogram and ultrasound to help establish a diagnosis." A 26-year-old woman is seen with complaints of irregular vaginal bleeding.

Which of the following tests should be the first priority? - Correct answer

Pregnancy test

A 42-year-old woman presents to the clinic with complaints of painful intercourse for the last month. Which of the following should be explored as

the likely cause of her dyspareunia? - Correct answer Menopause

A 36-year-old woman is seen with complaints of vaginal itching, burning, and discharge. On potassium hydroxide (KOH) wet mount of vaginal discharge, the clinician notices hyphae. Which of the following treatments

would be appropriate? - Correct answer Fluconazole

A 21-year-old woman is seen in the clinic requesting birth control pills. Which of the following tests is essential before prescribing any oral

contraceptive? - Correct answer Pregnancy test

A 40-year-old woman is seen for her yearly examination. She is single and not in a monogamous relationship. Her social history includes smoking cigarettes "occasionally" and drinking about two beers a day. Her body mass index (BMI) is 25. She is requesting birth control. Which of the

following methods would be best for this patient? - Correct answer

Condom A 44-year-old patient with breast cancer is prescribed tamoxifen by her surgeon. She is complaining about hot flashes. Which of the following

responses by the clinician would be most appropriate? - Correct answer

"The hot flashes are a result of the antiestrogenic effects of tamoxifen." A 32-year-old woman is seen in the clinic because she has been unable to get pregnant after 12 months of unprotected sex. In order to determine the cause of the infertility, the clinician should question her about which of

these possible causes? - Correct answer Pelvic inflammatory disease

When assessing a woman for infertility, which of the following tests should

be done first? - Correct answer Analysis of partner's sperm

A 15-year-old girl is seen in the clinic because she has not yet had her first period. Which of the following questions would help the clinician determine

the cause? - Correct answer "How long have you been underweight?"

What is the most common cause of secondary amenorrhea? - Correct

answer Pregnancy

A 22-year-old woman is diagnosed with premenstrual syndrome. Which of the following lifestyle changes should the clinician suggest to help minimize

the patient's symptoms? - Correct answer Regular exercise

A 25-year-old woman is seen in the clinic complaining of painful menstruation. Which of the following pelvic pathologies is the most

common cause of dysmenorrhea? - Correct answer Endometriosis

A 26-year-old woman tells the clinician that she has endometriosis, because she has frequent pelvic pain. The clinician also should consider

which of these differential diagnoses? - Correct answer Ovarian cysts

Which of the following would be appropriate treatment for a woman with

mild endometriosis? - Correct answer Oral contraceptives

A 45-year-old woman is seen in the clinic with abnormal uterine bleeding and pain during intercourse. The clinician should consider which of the

following diagnoses? - Correct answer Leiomyoma, pregnancy, ovarian

cancer A 48-year-old woman is seen in the clinic with complaints of prolonged heavy menstrual periods. She is pale and states she can no longer exercise. Pelvic exam reveals a single, very large mass. Which of the

following diagnostic tests should the clinician order first? - Correct

answer Transvaginal ultrasound

A 45-year-old woman is seen because of irregular menstrual periods. Her follicle-stimulating hormone (FSH) level is 48 mIU/mL, and her luteinizing hormone (LH) level is elevated. She asks the clinician what this means.

Which would be the best response? - Correct answer "You are

approaching menopause." Which of the following tests is essential for a 46-year-old woman who the

clinician suspects is perimenopausal? - Correct answer Pregnancy

A 60-year-old woman is seen for an annual checkup. Her obstetric history reveals para 6, gravida 6. She reports that she went through menopause at age 45. Her grandmother died at age 80 of colon cancer, and her father died of lung cancer. What in her history would be a risk factor for ovarian

cancer? - Correct answer Her grandmother's history of colon cancer

A 58-year-old woman, who had a total abdominal hysterectomy at the age of 45, is diagnosed with atrophic vaginitis. Which of the following is the

most appropriate treatment? - Correct answer Estradiol 7.5 mcg/24 hr

vaginal ring

Oral contraceptive pills can cause endometrial cancer. - Correct answer

False A woman taking estradiol is at risk for developing endometrial cancer. -

Correct answer True

Most breast cancer cases are in women with a family history of breast

cancer. - Correct answer False

A 63-year-old man is seen in the clinic with a chief complaint of nocturia. Which of the following should be included in the differential diagnosis? -

Correct answer Benign prostatic hypertrophy

A 76-year-old man is seen in the office for complaints of urinary incontinence. The clinician should explore which of these causes of

incontinence in men? - Correct answer Urinary tract infection (UTI)

A 14-year-old male is seen with complaints of severe testicular pain. The clinician suspects testicular torsion. Which of the following is the

appropriate action? - Correct answer Refer to a urologist immediately.

An 82-year-old man is seen in the primary care office with complaints of dribbling urine and difficulty starting his stream. Which of the following

should be included in the list of differential diagnoses? - Correct answer

Benign prostatic hyperplasia (BPH), Parkinson's disease, Prostate cancer