Common Board Exam

7/17/2019 Common Board Exam

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Common Board Questions (CBQ)

in Nurse Licensure Examination

(CARDIOVASCULAR SYSE!)

CBQ no" # $o% do c&ients ex'eriencin anina Descri*e t+at 'ain"

Answers: Described as squeezing, heavy, burning, radiates to left arm or shoulder, transient or prolonged.

CBQ no" , De-e&o' a teac+in '&an .or t+e c&ient ta/in nitro&0cerin"

Answers: Take at first sign of anginal pain. Take no more than 3, five minutes apart. Call for emergency attention if no relief in 1 minutes.

CBQ no" 1 List t+e 'arameters o. *&ood 'ressure .or dianosin +0'ertension"

Answers: !1"#$

CBQ no" 2 Di..erentiate *et%een essentia& and secondar0 +0'ertension"

Answers: %ssential has no kno&n cause &hile secondary hypertension develops in response to an identifiable mechanism.

CBQ no" 3 De-e&o' a teac+in '&an .or t+e c&ient ta/in anti+0'ertensi-e medications"

Answers: %'plain ho& and &hen to take med, reason for med, necessary of compliance, need for follo&(up visits &hile on med, need for certain lab tests, vital sign parameters &hile initiating therapy.

CBQ no" 4 Descri*e intermittent c&audication"

Answers: )ain related to peripheral vascular disease occurring &ith e'ercise and disappearing &ith rest.

CBQ no" 5 Descri*e t+e nurse6s disc+are instructions to a c&ient %it+ -enous 'eri'+era& -ascu&ar disease"

Answers: *eep e'tremities elevated &hen sitting, rest at first sign of pain, keep e'tremities &arm +but do -T use heating pad, change position often, avoid crossing legs, &ear unrestrictive clothing.

CBQ no" 7 8+at is o.ten t+e under&0in cause o. a*domina& aortic aneur0sm Answers: /therosclerosis.

CBQ no" 9 8+at &a* -a&ues s+ou&d *e monitored dai&0 .or t+e c&ient %it+ t+rom*o'+&e*itis %+o is underoin anticoau&ant t+era'0

Answers: )TT, )T, 0gb, and 0ct, platelets.

CBQ no" #: 8+en do ;VCs ('remature -entricu&ar contractions) 'resent a ra-e daner

Answers: hen they begin to occur more often than once in 1 beats, occur in 2s or 3s, land near the T &ave, or take on multiple configurations.

CBQ no" ## Di..erentiate *et%een t+e s0m'toms o. &e.t<sided cardiac .ai&ure and ri+t<sided cardiac .ai&ure"

Answers: eft(sided failure results in pulmonary congestion due to back(up of circulation in the left ventricle. 4ight(sided failure results in peripheral congestion due to back(up of circulation in the right ventricle.

CBQ no" #, List 1 s0m'toms o. diita&is toxicit0"

Answers: Dysrhythmias, headache, nausea and vomiting

CBQ no" #1 8+at condition increases t+e &i/e&i+ood o. diita&is toxicit0 occurrin

Answers: hen the client is hypokalemic +&hich is more common &hen diuretics and digitalis preparations are given together.

CBQ no" #2 %+at &i.e st0&e c+anes can t+e c&ient %+o is at ris/ .or +0'ertension initiate to reduce t+e &i/e&i+ood o. *ecomin +0'ertensi-e

Answers: Cease cigarette smoking if applicable, control weight, exercise regularly, and maintain a low-fat/low-cholesterol diet.

CBQ no" #3 8+at immediate actions s+ou&d t+e nurse im'&ement %+en a c&ient is +a-in a m0ocardia& in.arction

Answers: )lace the client on immediate strict bedrest to lo&er o'ygen demands of heart, administer o'ygen by nasal cannula at 2(5 #min., take measures to alleviate pain and an'iety +administer prn pain medications and anti(an'iety medications.

CBQ no" #4 8+at s0m'toms s+ou&d t+e nurse ex'ect to .ind in t+e c&ient % it+ +0'o/a&emia

Answers: Dry mouth and thirst, dro&siness and lethargy, muscle &eakness and aches, and tachycardia.

CBQ no" #5 Brad0cardia is de.ined as a +eart rate *e&o% === B;!" ac+0cardia is de.ined as a +eart rate a*o-e === B;!"

Answers: bradycardia 6 bpm7 tachycardia 1 bpm

CBQ no" #7 8+at 'recautions s+ou&d c&ients %it+ -a&-e disease ta/e 'rior to in-asi-e 'rocedures or denta& %or/

Answers: Take prophylactic antibiotics.



Common Board Questions (CBQ)in Nurse Licensure Examination

(RENAL SYSE!)

CBQ no" # Di..erentiate *et%een acute rena& .ai&ure and c+ronic rena& .ai&ure" Answers: /cute renal failure8 often reversible, abrupt deterioration of kidney function. 9 Chronic renal failure8 irreversible, slo& deterioration of kidney function characterized by increasing :; and creatinine. %ventually dialysis is required.

CBQ no" , Durin t+e o&iuric '+ase o. rena& .ai&ure> 'rotein s+ou&d *e se-ere&0 restricted" 8+at is t+e rationa&e .or t+is restriction Answer: To'ic metabolites that accumulate in the blood +urea, creatinine are derived mainly from protein catabolism.

CBQ no" 1 Identi.0 , nursin inter-entions .or t+e c&ient on +emodia&0sis" Answer: Do -T take :) or perform venipunctures on the arm &ith the /(< shunt, fistula, or graft. /ssess access site for thrill or bruit.

CBQ no" 2 8+at is t+e +i+est 'riorit0 nursin dianosis .or c&ients in an0 t0'e o. rena& .ai&ure Answer: /lteration in fluid and electrolyte balance.

CBQ no" 3 A c&ient in rena& .ai&ure as/s %+0 +e is *ein i-en antacids" $o% s+ou&d t+e nurse re'&0 Answer: Calcium and aluminum antacids bind phosphates and help to keep phosphates from being absorbed into blood stream thereby preventing rising phosphate levels, and must be taken &ith meals.

CBQ no" 4 List 2 essentia& e&ements o. a teac+in '&an .or c&ients %it+ .re?uent urinar0 tract in.ections" Answer: =luid intake 3 liters#day7 good hand&ashing7 void every 2(3 hours during &aking hours7 take all prescribed medications7 &ear cotton undergarments.

CBQ no" 5 8+at are t+e most im'ortant nursin inter-entions .or c&ients %it+ 'ossi*&e rena& ca&cu&iAns%er@ >train all urine is the ?->T @?)-4T/T intervention. -ther interventions include accurate intake and output documentation and administer analgesics as needed.

CBQ no" 7 8+at disc+are instructions s+ou&d *e i-en to a c&ient %+o +as +ad urinar0 ca&cu&i Answer: ?aintain high fluid intake 3(" liters per day. =ollo&(up care +stones tend to recur. =ollo& prescribed diet based in calculi content. /void supine position.

CBQ no" 9 o&&o%in transuret+ra& resection o. t+e 'rostate &and (UR;)> +ematuria s+ou&d su*side *0 %+at 'ost<o' da0 Answer: =ourth day

CBQ no" #: A.ter t+e urinar0 cat+eter is remo-ed in t+e UR; c&ient> %+at are 1 'riorit0 nursin actions Answer: Continued strict @A-7 continued observations for hematuria7 inform client burning and frequency may last for a &eek.

CBQ no" ## A.ter /idne0 surer0> %+at are t+e 'rimar0 assessments t+e nurse s+ou&d ma/e Answer: 4espiratory status +breathing is guarded because of pain7 circulatory status +the kidney is very vascular and e'cess bleeding can occur7 pain assessment7 urinary assessment most importantly, assessment of urinary output.





(RES;IRAORY SYSE!)

CBQ n:" # List 2 common s0m'toms o. 'neumonia t+e nurse mi+t note on a '+0sica& exam"

Answer: Tachypnea, fever &ith chills, productive cough, bronchial breath sounds.

CBQ no" , State 2 nursin inter-entions .or assistin t+e c&ient to cou+ 'roducti-e&0"

Answer: Deep breathing, fluid intake increased to 3 liters#day, use humidity to loosen secretions, suction air&ay to stimulate coughing.

CBQ no" 1 8+at s0m'toms o. 'neumonia mi+t t+e nurse ex'ect to see in an o&der c&ient

Answer: Confusion, lethargy, anore'ia, rapid respiratory rate.

CBQ no" 2 8+at s+ou&d t+e O, .&o% rate *e .or t+e c&ient %it+ CO;D

Answer: 1(2 liters per nasal cannula, too much -2 may eliminate the C-)D clientBs stimulus to breathe, a C-)D client has hypo'ic drive to breathe.

CBQ no" 2 $o% does t+e nurse 're-ent +0'oxia durin suctionin

Answer: Deliver 1 o'ygen +hyperinflating before and after each endotracheal suctioning.

CBQ no" 3 Durin mec+anica& -enti&ation> %+at are t+ree maor nursin inter-ention

Answer: ?onitor clientBs respiratory status and secure connections, establish a communication mechanism &ith the client, keep air&ay clear by coughing#suctioning.

CBQ no" 4 8+en examinin a c&ient %it+ em'+0sema> %+at '+0sica& .indins is t+e nurse &i/e&0 to see

Answer: :arrel chest, dry or productive cough, decreased breath sounds, dyspnea, crackles in lung fields.

CBQ no" 5 8+at is t+e most common ris/ .actor associated %it+ &un cancer

Answeer: >moking

CBQ no" 7 Descri*e t+e 're<o' nursin care .or a c&ient underoin a &ar0nectom0"

Answer: @nvolve family#client in manipulation of tracheostomy equipment before surgery, plan acceptable communication method, refer to speech pathologist, discuss rehabilitation program.

CBQ no" 9 List 3 nursin inter-entions a.ter c+est tu*e insertion"

Answer: ?aintain a dry occlusive dressing to chest tube site at all times. Check all connections every " hours. ?ake sure bottle @@@ or end of chamber is bubbling. ?easure chest tube drainage by marking level on outside of drainage unit. %ncourage use of incentive spirometry every 2 hours.

CBQ no" #: 8+at immediate action s+ou&d t+e nurse ta/e %+en a c+est tu*e *ecomes disconnected .rom a *ott&e or a suction a''aratus 8+at s+ou&d t+e nurse do i. a c+est tu*e is accidenta&&0 remo-ed .rom t+e c&ient

Answer: )lace end in container of sterile &ater. /pply an occlusive dressing and notify physici an >T/T.

CBQ no" ## 8+at instructions s+ou&d *e i-en to a c&ient .o&&o%in radiation t+era'0

Answer: Do -T &ash off lines7 &ear soft cotton garments, avoid use of po&ders#creams on radiation site.

CBQ no" #, 8+at 'recautions are re?uired .or c&ients %it+ B %+en '&aced on res'irator0 iso&ation

Answer: ?ask for anyone entering room7 private room7 client must &ear mask if leaving room.

CBQ no" #1 List 2 com'onents o. teac+in .or t+e c&ient %it+ tu*ercu&osis"

Answer: Cough into tissues and dispose immediately into special bags. ong(term need for daily medication. ood hand&ashing technique. 4eport symptoms of deterioration, i.e., blood in secretions.





(ENDOCRINE SYSE!)

CBQ" no #" 8+at dianostic test is used to determine t+0roid acti-it0

Answers: T3 and T"

CBQ" no ," 8+at condition resu&ts .rom a&& treatments .or +0'ert+0roidism

Answers: 0ypothyroidism, requiring thyroid replacement

CBQ" no 1" State 1 s0m'toms o. +0'ert+0roidism and 1 s0m'toms o. +0'ot+0roidism"

Answers: 0yperthyroidism8 &eight loss, heat intolerance, diarrhea. 0ypothyroidism8 fatigue, cold intolerance, &eight gain.

CBQ" no 2" List 3 im'ortant teac+in as'ects .or c&ients %+o are *einnin corticosteroid t+era'0"

Answers: Continue medication until &eaning plan is begun by physician, monitor serum potassium, glucose, and sodium frequently7 &eigh daily, and report gain of !5lbs.#&k7 monitor :) and pulse closely7 teach symptoms of CushingBs syndrome

CBQ" no 3" Descri*e t+e '+0sica& a''earance o. c&ients %+o are Cus+inoid"

Answers: ?oon face, obesity in trunk, buffalo hump in back, muscle atrophy, and thin skin.

CBQ" no 4" 8+ic+ t0'e o. dia*etic a&%a0s re?uires insu&in re'&acement

Answers: Type @, @nsulin(dependent diabetes mellitus +@DD?

CBQ" no 5" 8+at t0'e o. dia*etic sometimes re?uires no medication

Answers: Type @@, on(insulin dependent diabetes mellitus +@DD?

CBQ" no 7" List 3 s0m'toms o. +0'er&0cemia" Answers:)olydipsia, polyuria, polyphagia, &eakness, &eight loss

CBQ" no 9" List 3 s0m'toms o. +0'o&0cemia"

Answers: 0unger, lethargy, confusion, tremors or shakes, s&eating

CBQ" no #:" Name t+e necessar0 e&ements to inc&ude in teac+in t+e ne% dia*etic"

Answers: Teach the underlying pathophysiology of the disease, its management# treatment regime, meal planning, e'ercise program, insulin administration, sick(day management, symptoms of hyperglycemia +not enough insulin

CBQ" no ##" In &ess t+an ten ste's> descri*e t+e met+od .or dra%in u' a mixed dose o. insu&in (reu&ar %it+ N;$)"

Answers: @dentify the prescribed dose#type of insulin per physician order7 store unopened insulin in refrigerator. @f opened, may be kept at room temperature for up to 3 months. Dra& up regular insulin =@4>T. 4otate inEection sites. ?ay reuse syringe by recapping and storing in refrigerator.

CBQ" no #," Identi.0 t+e 'ea/ action time o. t+e .o&&o%in t0'es o. insu&in@ ra'id<actin reu&ar insu&in> intermediate<actin> &on<actin"

Answers: 4apid(acting regular insulin8 2(" hrs. @mmediate(acting8 6(12 hrs. ong(acting8 1"(2 hrs.

CBQ" no #1" 8+en 're'arin t+e dia*etic .or disc+are> t+e nurse teac+es t+e c&ient t+e re&ations+i' *et%een stress> exercise> *edtime snac/in> and &ucose *a&ance" State t+e re&ations+i' *et%een eac+ o. t+ese"

Answers: >tress and stress hormones usually increase glucose production and increase insulin need7 e'ercise can increase the chance for an insulin reaction, therefore, the client should al&ays have a sugar snack available &hen e'ercising +to treat hypoglycemia7 bedtime snacking can prevent insulin reactions &hile

&aiting for long(acting insulin to peak.

CBQ" no #2" 8+en ma/in rounds at ni+t> t+e nurse notes t+at an insu&in<de'endent c&ient is com'&ainin o. a +eadac+e> s&i+t nausea> and minima& trem*&in" +e c&ient6s +and is coo& and moist" 8+at is t+e c&ient most &i/e&0 ex'eriencin

Answers: 0ypoglycemia#insulin reaction.

CBQ" no #" Identi.0 3 .oot<care inter-entions t+at s+ou&d *e tau+t to t+e dia*etic c&ient"

Answers: Check feet daily A report any breaks, sores, or blisters to health care provider, &ear &ell(fitting shoes7 never go barefoot or &ear sandals, never personally remove corns or calluses, cut or file nails straight across7 &ash daily &ith mild soap A &arm &ater.





(NEUROLOICAL SYSE!)

CBQ" no #" What are the classifications of the commonly prescribed eye drops for glaucoma?

Answers: Parasympathominetics for pupillary constriction. Beta-adrenergic receptor-blocking agents to inhibit formation of aqueous humor. Carbonic anhydrase inhibitors to reduce aqueous humor production, and prostaglandin agonists to increase aqueous humor outflow.

CBQ" no ," dentify ! types of hearing loss.

Answers: Conducti"e #transmission of sound to inner ear is blocked$ and sensorineural #damage to %th cranial ner"e$

CBQ" no 1" Write & nursing inter"entions for the care of the blind person and & nursing inter"entions for the care of the deaf person.

Answers: Care of the blind' announce presence clearly, call by name, orient carefully to surroundings, guide by walki ng in front of client with his(her hand in your elbow. Care of deaf' reduce distraction before beginning con"ersation, look and listen to client, gi"e client full attention if they are a l ip reader, face client directly.

CBQ" no 2" n your own words describe the )lasgow Coma *cale.

Answers: +n obecti"e assessment of the le"el of consciousness based on a score of to /, with scores of 0 or less indicati"e of coma.

CBQ" no 3" 1ist & nursing diagnoses for the comatose client in order of priority.

Answers: neffecti"e breathing pattern, ineffecti"e airway clearance, impaired gas e2change, and decreased cardiac output.

CBQ" no 4" *tate & independent nursing inter"entions to maintain adequate respirations, airway, and o2ygenation in the unconscious client.

Answers: Position for ma2imum "entilation #prone or semi-prone and slightly to one side$, insert airway if tongue obstructing3 suction airway efficiently, monitor arterial p4! and pC4! and hyper"entilate with 556 o2ygen before suctioning.

CBQ" no 5" Who is at risk for cerebral "ascular accidents?

Answers: Persons with history of hypertension, pre"ious 7+s, cardiac disease #atrial flutter(fibrillation$, diabetes, oral contracepti"e use, and the elderly.

CBQ" no 7" Complications of immobility include the potential for thrombus de"elopment. *tate nursing inter"entions to pre"ent thrombi.

Answers: 8requent range of motion e2ercises, frequent #q!h$ position changes, and a"oidance of positions which decrease "enous return.

CBQ" no 9" 1ist & rationales for the appearance of restlessness in the unconscious client.

Answers: +no2ia, distended bladder, co"ert bleeding, or a return to consciousness

CBQ" no #:" What nursing inter"entions pre"ent corneal drying in a comatose client?

Answers: rrigation of eyes P9: with sterile prescribed solution, application of opthalmic ointment q%h, close assessment for corneal ulceration(drying.

CBQ" no ##" When a comatose client on ; hyperalimentation begin to recei"e tube feedings instead?

Answers: When peristalsis resumes as e"idenced by acti"e bowel sounds, passage of flatus or bowel mo"ement.

CBQ" no #," What is the most important principle in a bowel management program for a neurologic client? Answers: <stablishment of 9<)=1+97>

CBQ" no #1" efine cerebral "ascular accident.

Answers: + disruption of blood supply to a part of the brain, which results in sudden loss of brain function.

CBQ" no #2" + client with a diagnosis of C;+ presents with symptoms of aphasia, right hemiparesis, but no memory or hearing deficit. n what hemisphere has the client suffered a lesion?

Answer: 1eft

CBQ" no #3" What are the symptoms of spinal shock?

Answers: @ypotension, bladder and bowel distention, total paralysis, lack of sensation below lesion.

CBQ" no #4" What are the symptoms of autonomic dysrefle2ia?

Answers: @ypertension, bladder and bowel distention, e2aggerated autonomic responses, headache, sweating, goose bumps, and bradycardia

CBQ" no #5" What is the most important indicator of increased CP?

Answers: + change in the le"el of responsi"eness



CBQ" no #7" What "ital sign changes are indicati"e of increased CP?

Answers: ncreased BP, widening pulse pressure, increased or decreased pulse, respiratory irregularities and temperature increase.

CBQ" no #9" + neighbor calls the neighborhood nurse stating that he was knocked hard to the floor by his "ery hyperacti"e dog. @e is wondering what symptoms would indicate the need to "isi t an emergency room. What should the nurse tell him to do?

Answers: Call his physician now and inform him(her of the fall. *ymptoms needing medical attention would include "ertigo, confusion or any subtle beha"ioral change, headache, "omiting, ata2ia #imbalance$, or seiAure.

CBQ" no ,:" What acti"ities and situations should be a"oided that increase CP?

Answers: Change in bed position, e2treme hip fle2ion, endotracheal suctioning, compression of ugular "eins, coughing, "omiting, or straining of any kind.

CBQ" no ,#" @ow do @yperosmotic agents #osmotic diuretics$ used to treat intracranial pressure act?

Answers: ehydrate the brain and reduce cerebral edema by holding water in the renal tubules to pre"ent reabsorption, and by drawing fluid from the e2tra"ascular spaces into the plasma.

CBQ" no ,," Why should narcotics be a"oided in clients with neurologic impairment?

Answers: :arcotics mask the le"el of responsi"eness as well as pupillary response.

CBQ" no ,1" @eadache and "omiting are symptoms of many disorders. What characteristics of these symptoms would alert the nurse to refer a client to a neurologist?

Answers: @eadache which is more se"ere upon awakening and "omiting not associated with nausea are symptoms of a brain tumor.

CBQ" no ,2" @ow should the head of the bed be positioned for post-craniotomy clients with infratentorial lesions?

Answers: nfratentorial 81+73 *upratentorial ele"ated

CBQ" no ,3" s multiple sclerosis thought to occur because of an autoimmune process?

Answer: ><*

CBQ" no ,4" s paralysis always a consequence of spinal cord inury?

Answer: :4

CBQ" no ,5" What types of drugs are used in the treatment of myasthenia gra"is?

Answers: +nticholinesterase drugs, which inhibit the action of cholinesterase at the ner"e endings to promote the accumulation of acetylcholine at receptor sires, which should impro"e neuronal transmission to muscles.





(ASROINESINAL SYSE!)

CBQ n:" # List 2 nursin inter-entions .or t+e c&ient %it+ a +iata& +ernia"

Ans%er@ >it up &hile eating and one hour after eating. %at small, frequent meals. %liminate foods that are problematic.

CBQ n:" , List 1 cateories o. medications used in t+e treatment o. 'e'tic u&cer disease"

Answer: /ntacids, 02 receptor(blockers, mucosal healing agents, proton pump inhibitors.

CBQ no" 1 List t+e s0m'toms o. u''er and &o%er astrointestina& *&eedin"

Answer: ;pper @8 melena, hematemesis, tarry stools. o&er @8 bloddy stools, tarry stools. >imilar8 tarry stools.

CBQ n:" 2 8+at *o%e& sound disru'tions occur %it+ an intestina& o*struction

Answer: %arly mechanical obstruction8 high(pitched sounds7 late mechanical obstruction8 diminished or absent bo&el sounds.

CBQ n:" 3 List 2 nursin inter-entions .or 'ost<o' care o. t+e c&ient %it+ a co&ostom0"

/ns&er8 @rrigate daily at same time7 use &arm &ater for irrigations7 &ash around stoma &ith mild soap#&ater after each colostomy bag change7 pouch opening should e'tend at least 1#F inch around the stoma.

CBQ n:" 4 List t+e common c&inica& mani.estations o. aundice"

Answer: >clera(icteric +yello& sclera, dark urine, chalky or clay(colored stools

CBQ n:" 5 8+at are t+e common .ood into&erances .or c&ients %it+ c+o&e&it+iasis

Answer: =ried#spicy or fatty foods.

CBQ n:" 7 List 3 s0m'toms indicati-e o. co&on cancer" Answer: 4ectal bleeding, change in bo&el habits, sense of incomplete evacuation, abdominal pain &ith nausea, &eight loss.

CBQ n:" 9 In a c&ient %it+ cirr+osis> it is im'erati-e to 're-ent .urt+er *&eedin and o*ser-e .or *&eedin tendencies" List 4 re&e-ant nursin inter-entions"

Answer: /void inEectons, use small bore needles for @< insertion, maintain pressure for 5 minutes on all venipuncture sites, use electric razor, use soft(bristle toothbrush for mouth care, check stools and emesis for occult blood.

CBQ n:" #: 8+at is t+e main side e..ect o. &actu&ose> %+ic+ is used to reduce ammonia &e-e&s in c&ients %it+ cirr+osis

Answer: Diarrhea.

CBQ n:" ## List 2 rou's %+o +a-e a +i+ ris/ o. contractin +e'atitis"

Ans%er@ @omose2ual males, ; drug users, recent ear piercing or tattooing, and health care workers.

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Common Board Exam