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NKU
The nurse knows that the client understands effective treatment of laryngitis when the client responds:
1. I will talk/sing frequently during this time to make sure I don’t lose my voice.
2. I will avoid eating/drinking after taking the Vanceril inhaler to avoid rinsing away the medication.
3. I will rest my voice to make sure I don’t aggravate the laryngitis.
4. To avoid aggravating the laryngitis, I will keep the air dry and warm.
What is a primary nursing intervention for Laryngeal Paralysis?
1. monitor vital signs each shift
2. accurately monitor and record I & O ‘s
3. monitor and protect air way
4. assess for pain
Rationale Monitoring and protecting the patients air
way with Laryngeal Paralysis is most important because they are at risk for aspiration.
What are patients with Laryngeal Paralysis most at risk for?
1. ineffective breathing2. aspiration pneumonia3. sleep apnea4. slight hoarseness of
voice
Rationale Patients are most at risk for aspiration
pneumonia due to the aretyniod cartilage of the larynx not functioning and remaining loose in a neutral position. This leave the air way unprotected when swallowing.
If drug therapy is used for the treatment of laryngitis, the nurse would expect the physician to order what medication?
1. IV Epinephrine 2. Salagen3. Vanceril4. Medication is not used in
the treatment of laryngitis
A high priority nursing diagnosis for a person with chronic bronchitis would be
1. Nutrition imbalance2. Self-care deficit3. Ineffective airway
clearance4. Nausea
Rationale With chronic bronchitis the airway becomes
inflamed and thickened. Increase in the number and size of mucus-producing cells results in excessive mucus production and a cough. The cough makes it difficult to get air in and out of the lungs.
People with chronic bronchitis tend to be blue bloaters. All of the following are characteristics of blue bloaters except
CO2 rete
ntion
Compensate
d re...
ABGs show hypo...
pursed lip
bre...
25% 25%25%25%30
1. CO2 retention 2. Compensated respiratory
acidosis3. ABGs show hypoxemia4. pursed lip breathing
Rationale Pursed lip breathing is a characteristic of
pink puffers, a person with emphysema.
Which factor should be checked when evaluating the effectiveness of an alpha-adrenergic blocker given to a client with BPH?
Voiding pattern
Size
of the pro
state
Creatinine cl
earance
Seru
m testo
stero
ne leve
l
25% 25%25%25%30
1. Voiding pattern2. Size of the prostate3. Creatinine clearance4. Serum testosterone level
Rationale Voiding pattern; The prostate glad has alpha-
adrenergic receptors. Alpha-adrenergic blockers relax the smooth muscle of the bladder neck and prostate, so the urinary symptoms of BPH (frequency, urgency, hesitancy) are reduced in many clients. These drugs don't affect the size of the prostate, renal function, or production or metabolism of testosterone
Which one of the following drugs is used to treat BPH?
Danocri
ne
Prosc
ar
Halote
stin
Android
25% 25%25%25%30
1. Danocrine2. Proscar3. Halotestin4. Android
Rationale Proscar; Proscar is used to treat BPH.
Android and Halotestin are synthetic testosterone hormones. Danocrine is used to treat endometriosis
What does a radical hysterectomy consist of?
removal
of ute
...
removal
of ute
...
lymph nodes n
o...
Ovarie
s and fa
...
25% 25%25%25%30
1. removal of uterus2. removal of uterus, cervix,
supporting tissues, distal vagina, adnexa, pelvic lymph nodes
3. lymph nodes not removed4. Ovaries and fallopian
tubes
Rationale removal of uterus, cervix, supporting tissues,
distal vagina, adnexa, pelvic lymph nodes.rational: removal of uterus is known as a
simple hysterectomy. Lymph nodes not removed is known as a total abdominal hysterectomy (TAH).
According to The American Cancer Society, screening and diagnosing of breast ca are all done for early detection except for?
retra
ction of ..
.
yearly
mammogr..
.
yearly
clinica
...
month
ly breast.
..
ultraso
und dis...
biopsy
17% 17% 17%17%17%17%
301. retraction of nipple2. yearly mammogram @ 40
yrs. with doctor exam3. yearly clinical breast
exam4. monthly breast self exam5. ultrasound distinguishes
fluid filled cysts from solid mass
6. biopsy
Rationale retraction of nipple is a sign of breast cancer,
all others are preventative screenings that are recommended by ACS
Mary, a 45 yr female who has vaginal cancer is receiving external radiation treatment, There are 4 family members want to visit her. Which visitor should be able to visit Mary?
Mary's
broth
er...
Mary's
daughte...
Mary's
father ..
.
Mary's
husban
d...
25% 25%25%25%30
1. Mary's brother who had flu a week ago.
2. Mary's daughter who is 18.
3. Mary's father who is suffering fungus infection.
4. Mary's husband who has genital herpes.
Nursing intervention during internal radiation should NOT include:
Talk w
ith pati...
Enco
urage pati...
Restrict
visit..
.
Restrict
fluid...
25% 25%25%25%30
1. Talk with patient at least 6 feet from source and sand behind lead shield.
2. Encourage patient self care.
3. Restrict visitors under 18.4. Restrict fluid intake.
A client is diagnosed with multiple myeloma. The client asks a nurse about the diagnosis. The nurse bases the response on which of the following descriptions of this disorder?
malig
nant e
xac...
altere
d RBC pr...
altere
d produc..
.
malig
nant p
rol...
25% 25%25%25%30
1. malignant exacerbation in the number of leukocytes
2. altered RBC production3. altered production of
lymph nodes4. malignant proliferation of
plasma cells and tumors within the bone
Rationale multiple myeloma is a B cell neoplastic
condition characterized by abnormal malignant proliferation of plasma cells and the accumulation of abnormal plasma cells in the bone marrow.
A nurse is reviewing the laboratory results of a client diagnosed with multiple myeloma. Which of the following would the nurse expect to specifically note in this disorder?
decrease
d numb...
incre
ased w
hit...
incre
ased ca
lc...
decrease
d bloo...
25% 25%25%25%30
1. decreased number of plasma cells in the bone marrow
2. increased white blood cells
3. increased calcium level4. decreased blood urea
nitrogen (BUN)
Rationale Findings indicative of multiple myeloma are
an increased number of plasma cells in the bone marrow, anemia, hypercalcemia resulting from the release of calcium from the deteriorating bone tissue, and an elevated BUN. An increased white blood cell count may or may not be present and is not specifically related to multiple myeloma.
Which of the following is true regarding tracheostomy care?
A Passy-M
uir v...
The client w
il...
The cuff needs..
.
The client's
t...
25% 25%25%25%1. A Passy-Muir valve needs to be placed over the hub of the trach before the cuff is deflated.
2. The client will need to cover his/her trach while taking a shower.
3. The cuff needs to be inflated at less than 15 mm Hg to prevent aspiration.
4. The client's trach will only need suctioned once a week.
30
Rationale A shower cover is necessary to prevent water
from getting into the trach.
The nurse performs the following to prevent complications associated with tracheostomy tubes except:
Inse
rt th
e dec...
Maintai
n steri..
.
Change trac
h d...
Administer a
de...
25% 25%25%25%30
1. Insert the decannulation plug in the trach while the cuff is inflated.
2. Maintain sterile technique when suctioning and performing trach care.
3. Change trach dressing once every 8 hours and as needed.
4. Administer adequate warmed humidified air.
Rationale Insertion of the decannulation plug before
deflating the cuff will not allow the client to be able to breathe.
People with empysema have which type of presentation:
Blue Bloaters
Purple Bloate
r...
Red Puffers
Pink Puffers
25% 25%25%25%30
1. Blue Bloaters2. Purple Bloaters3. Red Puffers4. Pink Puffers
Rationale People with emphysema have a reddish
complexion, tachypnea, pursed lip breathing, ABGs show no CO2 retention and less hypoxemia than blue bloaters
People with empysema have:
incre
ase th
e n...
inflammed airw
...
a few la
rge al...
producti
ve co
u...
25% 25%25%25%30
1. increase the number of mucus producing cells
2. inflammed airways3. a few large alveoli instead
of many tiny ones4. productive cough that
lasts 3 months or longer within a 2 year period
Rationale The walls between many of the alveoli are
detroyed. The large alveoli have less surface area for the exchange of oxygen and carbon dioxide than healthy alveoli.
Which is the American Cancer Society's recommendation for early detection of prostate cancer?
a yearly PSA l..
.
a Biannual re
c...
A semi-a
nnual ...
A yearly urin
a...
25% 25%25%25%30
1. a yearly PSA level and DRE beginning at age 50
2. a Biannual rectal exam beginning at age 40
3. A semi-annual alkaline phosphatase level beginning at age 45
4. A yearly urinalysis to determine the presence of prostatic fluid.
Rationale Answer: A- Men in high risk groups such as
African American men should begin at 45 b- A biannual exam isn't recommended c.-Alkaline phosphatase levels are preformed on men with known prostate cancer to determine bone involvement. d.- This test is done if the client has signs and symptoms of prostatitis
The school nurse is preparing a class on testicular cancer for male high school seniors. Which information regarding testicular self-exam should the nurse include?
Perform
the ex..
.
Any lump sh
oul...
Disc
uss having...
The proce
dure ...
25% 25%25%25%30
1. Perform the exam in a cool room under a fan
2. Any lump should be examined by a HCP as soon as possible
3. Discuss having a second person to confirm a negative result
4. The procedure will cause a milk discomfort if done correctly
Rationale Answer: B- The pt should note a cordlike
structure; this is a normal finding. Any lump or mass is abnormal and should be checked by a HCP asap. a. the body temp should be warm for the scrotum to relax. The best place to perform an exam is a warm hot shower c.- The client can confirm his own negative results d.- The procedure is painless. If pain is elicited then an HCP should examine the pt.
A client labs showed that decreased blood flow and fibrin and leukocytes settled in the affected area, which stage of pneumonia is he/she in?
Resolution
Gray
hepatizat..
.
Congestion
Red hepatizati...
25% 25%25%25%30
1. Resolution2. Gray hepatization3. Congestion4. Red hepatization
Which is a priority nursing intervention to prevent pneumonia in the post-op client?
Coughing and d...
Ambulation aft...
Ince
ntive spir.
..
Proper o
ral h
y...
25% 25%25%25%30
1. Coughing and deep breathing
2. Ambulation after surgery3. Incentive spirometer4. Proper oral hygiene and
adequate pain control
Patients with ARDS are going to receive this type of care?
Exerci
se pro
gr...
Positive
End E...
Fluid Restr
ict...
Antihypertensi.
..
25% 25%25%25%30
1. Exercise program2. Positive End Expiratory
Pressure3. Fluid Restrictions4. Antihypertensives
Rationale PEEP is a special mode of ventilation that
keeps the alveoli partially inflated so they don't collapse and can participate in air exchange.
The first sign of ARDS is
Incre
ased Temp...
Incre
ased Puls.
..
Incre
ased Pain
Incre
ased re
sp...
25% 25%25%25%30
1. Increased Temperature2. Increased Pulse3. Increased Pain4. Increased respirations as
fluid fills their lungs.
An elderly client with pneumonia may appear with which of the following symptoms first?
Altere
d menta
l...
Fever a
nd chil..
.
Hemoptys
is and...
Pleuritic c
hes...
25% 25%25%25%30
1. Altered mental status and dehydration
2. Fever and chills3. Hemoptysis and dyspnea4. Pleuritic chest pain and
cough
Rationale A- fever, chills, hemoptysis, dyspnea, cough,
and pleuritic chest pain are the common symptoms of pneumonia, but elderly clients may first appear with only an altered mental status and dehydration due to a blunted immune response.
A client had been treated with antibiotics therapy for right lower-lobe pneumonia for 10 days and will be discharged today. Which off the following physical findings would lead the nurse to believe it is appropriate to discharge this client?
Continued dysp...
Fever o
f 102de...
Respira
tory
ra...
Vesicular b
rea...
25% 25%25%25%30
1. Continued dyspnea2. Fever of 102degrees F
(38.9 degrees Celsius)3. Respiratory rate of 32
breaths/minute4. Vesicular breath sounds
in right base
Rationale If the client still has pneumonia, the breath
sounds is in the right base will be bronchial, not the normal vesicular breath sounds. If the client still has dyspnea, fever, and increased respiratory rate, he should be examined by the physician before discharge because he may have another source of infection or still have pneumonia.
Of the following a symptom of a concussion, which is not something to report immediately to a physican?
Diffi
culty
spe...
Vomiting
Weakness
of on...
Depre
ssion
25% 25%25%25%30
1. Difficulty speaking2. Vomiting3. Weakness of one side of
the body4. Depression
Rationale Depression is not a symptom that is needed
report immediately to physician.(pg. 1913 in the med-surg volume 2 10 edition.)
Monitoring ICP is important part of the assessment for a patient with a brain injuries which of the following would help manage increase ICP?
Have
the patie...
Maintai
n adequ...
Have
the perso
...
IV of h
ypoto
ni...
25% 25%25%25%30
1. Have the patient in supine position.
2. Maintain adequate oxygenation.
3. Have the person cough and deep breathe.
4. IV of hypotonic solution.
Rationale The only answer that is correct is maintain
adequate oxygenation. for (a) you should elevate HOB. (c) coughing can increase icp. (d) only normal saline or ringers lactate should be used because hypotonic solution decreases plasma osmolality.
What instructions should the nurse not provide to someone newly diagnosed with epilepsy.
Keep a reco
rd ...
Take bath
s onl...
Avoid OTC m
eds...
When driv
ing h...
25% 25%25%25%30
1. Keep a record of seizure activity and report it to the neurologist.
2. Take baths only do not take showers.
3. Avoid OTC meds.4. When driving have
someone in the car with you.
Rationale New medications may cause drowsiness and
meds may not have reached therapeutic level and therefore patient may still be at risk for seizure. Driving laws dictate that a therapeutic level must be reached for the AED and that is determined by the physician. A newly diagnosed client may not be therapeutic and unless released by the physician- having a person with them is not enough to ensure safety.
The nurse enters a patients room and finds her sitting in the chair convulsing with rigid arms and legs and making sounds. The patient seems unaware. What should be the nurses first action?
Place th
e pati...
Assess
patient...
Gently
place p...
Move th
e furn
i...
25% 25%25%25%30
1. Place the patient on her side
2. Assess patients vitals3. Gently place patient on
floor4. Move the furniture away
from the patient
Rationale Place patient on floor for free movement, and
try to keep her safe.
Which of the following leukemias have low red blood cells, low H&H, low platelet count along with high myeloblast cells?
Chronic
myeloi...
Acute ly
mphocy...
Chronic
lympho...
Acute m
yeloid ...
25% 25%25%25%30
1. Chronic myeloid leukemia (CML)
2. Acute lymphocytic leukemia (ALL)
3. Chronic lymphocytic leukemia (CLL)
4. Acute myeloid leukemia (AML)
Rationale (Lab results will show low RBCs, low H&H,
low platelet count, low to high WBCs with high myeloblast cells.
The nurse is reviewing the lab report of a client who underwent a bone marrow biopsy. The findings that would most strongly support a diagnosis of acute leukemia is the existence of a large number of immature :
Thrombocy
tes
Leukocy
tes
Lymphocy
tes
reticu
locyte
s
25% 25%25%25%30
1. Thrombocytes2. Leukocytes3. Lymphocytes4. reticulocytes
Rationale (leukemia is manifested by an abnormal
overproduction of immature leukocytes in the bone marrow)
The nurse is caring for a patient that is suffering from an acute onset of larnygeal edema as a result of chronic laryngitis. Which medication should the nurse expect to administer?
Cortico
stero
id...
IV epinephrin
e
Racemic
epinep...
Epi- P
EN
25% 25%25%25%30
1. Corticosteroids2. IV epinephrine3. Racemic epinephrine4. Epi- PEN
Rationale corticosteriods are treatment for slow
onset edema, IV epinephrine and the Epi-PEN are treatment for fast onset related to allergic reaction
The nurse caring for a patient that is suffering from slow onset laryngeal edema can expect to administer which medication?
Cortico
sterio
d...
IV epinephrin
e
Epi-P
EN
Racemic
epinep...
25% 25%25%25%30
1. Corticosteriods2. IV epinephrine3. Epi-PEN4. Racemic epinephrine
Rationale b and c are treatment for acute onset, and
racemic epinephrine is for acute r/t chronic laryngitis
Which diagnostic test for Chronic Glomerularonephritis (CGN) is difficult to do because of the signs and symptoms of CGN?
UA - fi
xed sp
e...
24 hour urin
e
renal b
iopsy
seru
m BUN/ cre
...
25% 25%25%25%30
1. UA - fixed specific gravity2. 24 hour urine3. renal biopsy4. serum BUN/ creatine
Rationale answer: c renal biopsy; rationale: becuase of
atrophy of the kidneys (one of the S/S of CGN) its difficult to do renal biopsy
Which clinical manifestation of Nephrotic syndrome would the nurse question?
severe genera
l...
pronounce
d pro...
diarrhea an
d l...
hypolipidemia
25% 25%25%25%30
1. severe generalized edema2. pronounced proteinuria3. diarrhea and loss of
appetite4. hypolipidemia
Rationale A clinical manifestation of Nephrotic
syndrome is hyperlipidemia.