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NEW QUESTION # 50
A pregnant client is having a nonstress test (NST). It is noted that the fetal heart beat rises 20 bpm, lasting 20 seconds, every time the fetus moves. The nurse explains that:
- A. The test is inconclusive and should be repeated
- B. The test is normal and the fetus is reacting appropriately
- C. The fetus is distressed
- D. Further testing is needed
Answer: B
Explanation:
Section: Questions Set G
Explanation:
(A) The test results were normal, so there would be no need to repeat to determine results. (B) There are no data to indicate further tests are needed, because the result of the NST was normal. (C) An NST is reported as reactive if there are two to three increases in the fetal heart rate of 15 bpm, lasting at least 15 seconds during a
15-minute period. (D) The NST results were normal, so there was no fetal distress.
NEW QUESTION # 51
Parents of a child with rheumatic fever express concern that she will always be arthritic. The nurse discusses their concerns and tells them the joint pain usually:
- A. Subsides in 3-6 days
- B. Subsides in<3 weeks
- C. Is responsive to ibuprofen (Motrin)
- D. Is relieved by aspirin
Answer: B
NEW QUESTION # 52
Which of the following would the nurse expect to find following respiratory assessment of a client with advanced emphysema?
- A. Decreased anteroposterior chest diameter
- B. Increased heart sounds
- C. Collapsed neck veins
- D. Distant breath sounds
Answer: D
Explanation:
Explanation/Reference:
Explanation:
(A) Distant breath sounds are found in clients with emphysema owing to increased anteroposterior chest diameter, overdistention, and air trapping. (B) Deceased heart sounds arepresent because of the increased anteroposterior chest diameter. (C) A barrel- shaped chest is characteristic of emphysema. (D) Increased distention of neck veins is found owing to right-sided heart failure, which may be present in advanced emphysema.
NEW QUESTION # 53
What is the appropriate nursing action for a child with increased intracranial pressure?
- A. Head of bed elevated 45 degrees with child's head maintained in a neutral position
- B. Child lying flat
- C. Head turned to side
- D. Frequent visitation for stimulation
Answer: A
Explanation:
(A) Elevation of head of bed and neutral head position promote drainage of cerebrospinal fluid. (B) Flat position increases intracranial pressure and impedes cerebrospinal fluid drainage. (C) Head turned to either side impedes cerebrospinal fluid drainage. (D) Child should be in a calm, quiet environment with minimal stimulation.
NEW QUESTION # 54
A 67-year-old postoperative TURP client has hematuria. The nurse caring for him reviews his postoperative orders and recognizes that which one of the following prescribed medications would best relieve this problem?
- A. Meperidine 50 mg IM
- B. Acetaminophen suppository 650 mg
- C. Promethazine 25 mg IM
- D. Aminocaproic acid (Amicar) 6 g/24 hr
Answer: D
Explanation:
Explanation/Reference:
Explanation:
(A) Acetaminophen (Tylenol) has analgesic and antipyretic actions approximately equivalent to those of aspirin. It produces analgesia possibly by action on the peripheral nervous system. It reduces fever by direct action on the hypothalamus heat-regulating center with consequent peripheral vasodilation. It is generally used for temporary relief of mild to moderate pain, such as a simple headache, minor joint and muscle pains, and control of fever. (B) Meperidine is a narcotic agonist analgesic with properties similar to morphine except that it has a shorter duration of action and produces less depression of urinary retention and smooth muscle spasm. It is used for moderate to severe pain, for a preoperative medication, for support of anesthesia, and for obstetrical analgesia. In a postoperative TURP client, it would be used in conjunction with other medications for relief of moderate to severe pain, but not specifically for bladder spasms associated with TURP surgery. (C) Promethazine hydrochloride is an antihistamine, antiemetic preparation. It exerts antiserotonin, anticholinergic, and local anesthetic actions. It is used for symptomatic relief of various allergic conditions, motion sickness, nausea, and vomiting. It is used for preoperative, postoperative, and obstetrical sedation and as an adjunct to analgesics for control of pain. (D) This answer is correct because aminocaproic acid is prescribed specifically for hematuria. Aminocaproic acid is excreted in the urine. The nurse should be alert for possible signs of thrombosis, particularly in the extremities.
NEW QUESTION # 55
A 35-year-old primigravida comes to the clinic for her first prenatal visit. The midwife, on examining the client, suspects that she is approximately 11 weeks pregnant. The pregnancy is positively confirmed by finding:
- A. FHR by ultrasound
- B. Chadwick's sign
- C. Enlargement of the uterus
- D. Breast tenderness and enlargement
Answer: A
Explanation:
(A) Chadwick's sign is a presumptive sign of pregnancy. The coloration may not subside from past pregnancy or could be caused by other situations that create vasocongestion. (B) FHR (movement) observed on ultrasound is a positive diagnosis of pregnancy. (C) Enlargement of the uterus may be due to fibroids or infection. It is considered a probable sign. (D) Breast tenderness and enlargement is a presumptive sign because it may be due to other conditions, such as premenstrual changes.
NEW QUESTION # 56
As soon as a child has been diagnosed as "hearing impaired," special education should begin. Which of the following special education tasks is the most difficult for a severely hearing-impaired child?
- A. Auditory training
- B. Lip reading
- C. Speech
- D. Signing
Answer: C
Explanation:
Explanation
(A) With the slight and mild hard of hearing, auditory training is beneficial. (B) Speech is the most difficult task because it is learned by visual and auditory stimulation, imitation, and reinforcement. (C, D) Lip reading and signing are aimed at establishing communicative skills, but they are learned more easily by visual stimulation.
NEW QUESTION # 57
A 54-year-old client is admitted to the hospital with a possible gastric ulcer. He is a heavy smoker. When discussing his smoking habits with him, the nurse should advise him to:
- A. Smoke low-tar, filtered cigarettes
- B. Chew gum instead
- C. Smoke only right after meals
- D. Smoke cigars instead
Answer: C
Explanation:
Explanation
(A, B, D) Cigarettes, cigars, and chewing gum would stimulate gastric acid secretion. (C) Smoking on a full stomach minimizes effect of nicotine on gastric acid.
NEW QUESTION # 58
A 35-year-old client has returned to her room following surgery on her right femur. She has an IV of D5 in onehalf normal saline infusing at 125 mL/hr and is receiving morphine sulfate 10-15 mg IM q4h prn for pain. She last voided 51/2 hours ago when she was given her preoperative medication. In monitoring and promoting return of urinary function after surgery, the nurse would:
- A. Report to the surgeon if the client is unable to void within 8 hours of surgery
- B. Hold morphine sulfate injections for pain until the client voids, explaining to her that morphine sulfate can cause urinary retention
- C. Maintain IV, increasing the rate hourly until the client voids
- D. Provide food and fluids at the client's request
Answer: A
Explanation:
Explanation/Reference:
Explanation:
(A) Provision of food and fluid promotes bowel elimination. Nutritional needs postoperatively are determined by the physician, not the client. (B) Increasing IV fluids postoperatively will not cause a client to void. Any change in rate of administration of IV fluids should be determined by the physician. (C) The postoperative client with normal kidney function who cannot void 8 hours after surgery is retaining urine.
The client may need catheterization or medication. The physician must provide orders for both as necessary. (D) Although morphine sulfate can cause urinary retention, withholding pain medication will not ensure that the client will void. The client with uncontrolled pain will probably not be able to void.
NEW QUESTION # 59
Succinylcholine chloride (Anectine) is ordered prior to electroconvulsive therapy treatment for depressed clients. The nurse explains that the purpose of the drug is to:
- A. Act as an anesthetic
- B. Relax muscles
- C. Relieve anxiety
- D. Reduce secretions
Answer: B
Explanation:
Explanation
(A) Succinylcholine chloride relaxes muscles and decreases the intensity of the seizure. (B) Succinylcholine chloride does not relieve anxiety. (C) Atropine is given to reduce secretions. (D) Thiamylal sodium (Surital) or other phenobarbital preparations are used as brief anesthetics.
NEW QUESTION # 60
A client is having an amniocentesis. Prior to the procedure, an ultrasound is performed. In preparing the client, the nurse explains the reason for a sonogram in this situation to be:
- A. Determination of placental location
- B. Determination of multiple gestations
- C. Determination of gross anomalies
- D. Determination of fetal age
Answer: A
Explanation:
Explanation/Reference:
Explanation:
(A) Sonography can be used to determine the presence of multiple gestation. In this question, the sonogram is used as a preparatory step for a specific invasive procedure. (B) Sonography can be used to determine the presence of gross anomalies. In this question, the sonogram is used as a preparatory step for a specific invasive procedure. (C) Prior to amniocentesis, the abdomen is scanned by ultrasound to locate the placenta, thus reducing the possibility of penetrating it with the spinal needle used to obtain amniotic fluid. (D) Sonography can be used to determine fetal age. In this question, the sonogram is used as a preparatory step for a specific invasive procedure.
NEW QUESTION # 61
A 35-year-old client is admitted to the hospital for elective tubal ligation. While the nurse is doing preoperative teaching, the client says, "The anesthesiologist said she was going to give me balanced anesthesia. What exactly is that?" The best explanation for the nurse to give the client would be that balanced anesthesia:
- A. Is a combination of several anesthetic agents or drugs producing a smooth induction and minimal complications
- B. Uses equal amounts of inhalation agents and liquid agents
- C. Does not depress the central nervous system
- D. Is a type of regional anesthesia
Answer: A
Explanation:
(A) Regional anesthesia does not produce loss of consciousness and is indicated for excision of moles, cysts, and endoscopic surgeries. (B) Varying amounts of anesthetic agents are used when employing balanced anesthesia. Amounts depend on age, weight, condition of the client, and surgical procedure. (C) General anesthesia is a drug-induced depression of the central nervous system that produces loss of consciousness and decreased muscle activity. (D) Balanced anesthesia is a combination of a number of anesthetic agents that produce a smooth induction, appropriate depth of anesthesia, and appropriate muscle relaxation with minimal complications.
NEW QUESTION # 62
Which of the following lab data is representative of a client with aplastic anemia?
- A. Hemoglobin 9.2, hematocrit 27, red blood cells 3.2 million
- B. Red blood cells 1 million, white blood cells 1500, thrombocytes 16,000
- C. White blood cells 4000, erythrocytes 2.5 million, thrombocytes 100,000
- D. White blood cells 3000, hematocrit 27, red blood cells 2.8 million
Answer: B
Explanation:
Explanation/Reference:
Explanation:
(A, B, C) Although all of the lab data are abnormal and although these values are decreased in aplastic anemia, the disorder is defined by severe deficits in red cell, white cell, and platelet counts. (D) Aplastic anemia is typically defined in terms of abnormalities of red blood cell count, usually <1 million, white cell count <2,000, and thrombocytes <20,000.
NEW QUESTION # 63
The predominant purpose of the first Apgar scoring of a newborn is to:
- A. Determine the extent of congenital malformations
- B. Determine gross abnormal motor function
- C. Obtain a baseline for comparison with the infant's future adaptation to the environment
- D. Evaluate the infant's vital functions
Answer: D
Explanation:
Explanation
(A) Apgar scores are not related to the infant's care, but to the infant's physical condition. (B) Apgar scores assess the current physical condition of the infant and are not related to future environmental adaptation. (C) The purpose of the Apgar system is to evaluate the physical condition of the newborn at birth and to determine if there is an immediate need for resuscitation. (D) Congenital malformations are not one of the areas assessed with Apgar scores.
NEW QUESTION # 64
The nurse would need to monitor the serum glucose levels of a client receiving which of the following medications, owing to its effects on glycogenolysis and insulin release?
- A. Epinephrine (Adrenalin)
- B. Propranolol (Inderal)
- C. Dobutamine (Dobutrex)
- D. Norepinephrine (Levophed)
Answer: A
Explanation:
(A) Norepinephrine's side effects are primarily related to safe, effective care environment and include decreased peripheral perfusion and bradycardia. (B) Dobutamine's side effects include increased heart rate and blood pressure, ventricular ectopy, nausea, and headache. (C) Propranolol's side effects include elevated blood urea nitrogen, serum transaminase, alkaline phosphatase, and lactic dehydrogenase. (D) Epinephrine increases serum glucose levels by increasing glycogenolysis and inhibiting insulin release. Prolonged use can elevate serum lactate levels, leading to metabolic acidosis, increased urinary catecholamines, false elevation of blood urea nitrogen, and decreased coagulation time.
NEW QUESTION # 65
A female client at 37 weeks' gestation has just undergone a nonstress test. The results were two fetal movements with a corresponding increase in fetal heart rate (FHR) of 15 bpm lasting 15 seconds within a
20-minute period. Her results would be classified as:
- A. Non-reactive; needs follow-up contraction stress test
- B. Reactive; needs follow-up contraction stress test
- C. Non-reactive; no contraction stress test required
- D. Reactive; no contraction stress test required
Answer: D
NEW QUESTION # 66
A husband asks if he can visit with his wife on her ECT treatment days and what to expect after the initial treatment. The nurse's best response is:
- A. "Visitors are not allowed. We will telephone you to inform you of her progress."
- B. "There's really no need to stay with her. She's going to sleep for several hours after the treatment."
- C. "You'll have to get permission from the physician to visit. Clients are pretty sick after the first treatment."
- D. "Yes, you may visit. She may experience temporary drowsiness, confusion, or memory loss after each treatment."
Answer: D
Explanation:
Section: Questions Set F
Explanation:
(A) It is within the nurse's realm of practice to grant visiting privileges according to hospital policy. ECT treatments do not make clients sick. (B) Visitors are allowed and encouraged, particularly family members. (C) Clients are usually awake within 1 hour posttreatment. Drowsiness wanes as the anesthetic wears off. (D) A family member is encouraged to stay with the client after return to the unit. The nurse has used an opportunity to do family teaching and allay fears by explaining temporary side effects of the treatment.
NEW QUESTION # 67
For the past several months, an elderly female client with Alzheimer's disease has experienced paranoia; hallucinations; and aggressive, disruptive behavior. The family is utilizing haloperidol as needed to control her behavior. On nursing assessment, you note that the client demonstrates involuntary movements of the tongue and fingers. This may most likely indicate:
- A. A more advanced stage of Alzheimer's disease than previously experienced by the client
- B. Tardive dyskinesia, which may be a side effect of antipsychotic medication
- C. Early symptoms of Parkinson's disease
- D. The need to change her medication from haloperidol to another antipsychotic drug to lessen symptoms
Answer: B
Explanation:
(A) Tardive dyskinesia is a common side effect of antipsychotic medications such as haloperidol. Discontinuing the medication can alleviate symptoms. (B) Although mild tremors are an early sign of Parkinson's disease, haloperidol must be discontinued first and the client further evaluated. (C) These symptoms do not necessarily indicate a more advanced stage of Alzheimer's disease. (D) Most antipsychotic drugs are chemically similar and will produce the same side effects.
NEW QUESTION # 68
A 26-year-old client is diagnosed with an astrocytoma, a benign brain tumor. From the nurse's knowledge of the central nervous system, the nurse knows that benign tumors:
- A. Do not warrant concern because they do not become malignant tumors
- B. Grow more rapidly than malignant tumors
- C. Can be removed surgically
- D. Can be just as dangerous as malignant tumors
Answer: D
Explanation:
Explanation
(A) Both a benign and a malignant tumor can displace or destroy nearby structures or increase intracranial pressure. (B) Benign or malignant brain tumors grow at different rates depending on the type of tumor. (C) Some benign tumors do become malignant tumors. (D) Whether or not a tumor is operable depends on its location and the amount of damage its removal will cause.
NEW QUESTION # 69
A mother came to the pediatric clinic with her 17- month-old child. The mother would like to begin toilet training. What should the nurse teach her about implementing toilet training?
- A. Explain to the child she is going to "void" and "defecate."
- B. Have a child-sized toilet seat or training potty on hand.
- C. Take two or three favorite toys with the child.
- D. Show disapproval if she does not void or defecate.
Answer: B
Explanation:
Explanation/Reference:
Explanation:
(A) Giving her toys will distract her and interfere with toilet training because of inappropriate reinforcement.
(B) A child-sized toilet seat or training potty gives a child a feeling of security. (C) She should use words that are age appropriate for the child. (D) Children should be praised for cooperative behavior and/or successful evacuation.
NEW QUESTION # 70
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