NSG 3250 Unit 1 Practice Questions Student test questions PDF

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Adult health practice questions for chapter 14 15 16...

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Unit 1 Practice Multiple Choice Identify the choice that best completes the statement or answers the question. ____

1. An older patient is hospitalized after an operation. When assessing the patient for postoperative

infection, the nurse places priority on which assessment? a. Change in behavior b. Daily white blood cell count c. Presence of fever and chills d. Tolerance of increasing activity ____

2. An inpatient nurse brings an informed consent form to a patient for an operation scheduled for

tomorrow. The patient asks about possible complications from the operation. What response by the nurse is best? a. Answer the questions and document that teaching was done. b. Do not have the patient sign the consent and call the surgeon. c. Have the patient sign the consent, and then call the surgeon. d. Remind the patient of what teaching the surgeon has done. ____

3. A patient has a great deal of pain when coughing and deep breathing after abdominal surgery despite

having pain medication. What action by the nurse is best? Call the provider to request more analgesia. Demonstrate how to splint the incision. Have the patient take shallower breaths. Tell the patient that a little pain is expected.

a. b. c. d. ____

4. A nurse is giving a patient instructions for showering with special antimicrobial soap the night

before surgery. What instruction is most appropriate? “After you wash the surgical site, shave that area with your own razor.” “Be sure to wash the area where you will have surgery very thoroughly.” “Use a washcloth to wash the surgical site; do not take a full shower or bath.” “Wash the surgical site first, then shampoo and wash the rest of your body.”

a. b. c. d. ____

5. A postoperative patient has an abdominal drain. What assessment by the nurse indicates that goals

for the priority patient problems related to the drain are being met? Drainage from the surgical site is 30 mL less than yesterday. There is no redness, warmth, or drainage at the insertion site. The patient reports adequate pain control with medications. Urine is clear yellow and urine output is greater than 40 mL/hr.

a. b. c. d. ____

6. A patient who collapsed during dinner in a restaurant arrives in the emergency department. The

patient is going to surgery to repair an abdominal aortic aneurysm. What medication does the nurse prepare to administer as a priority for this patient? a. Hydroxyzine (Atarax) b. Lorazepam (Ativan) c. Metoclopramide (Reglan) d. Morphine sulfate

____

7. A patient in the preoperative holding room has received sedation and now needs to urinate. What

action by the nurse is best? Allow the patient to walk to the bathroom. Delegate assisting the patient to the nurse’s aide. Give the patient a bedpan or urinal to use. Insert a urinary catheter now instead of waiting.

a. b. c. d. ____

8. A student is caring for patients in the preoperative area. The nurse contacts the surgeon about a

patient whose heart rate is 120 beats/min. After consulting with the surgeon, the nurse administers a beta-blocker to the patient. The student asks why this was needed. What response by the nurse is best? a. “A rapid heart rate requires more effort by the heart.” b. “Anesthesia has bad effects if the patient is tachycardic.” c. “The patient may have an undiagnosed heart condition.” d. “When the heart rate goes up, the blood pressure does too.” ____

9. A patient has been given hydroxyzine (Atarax) in the preoperative holding area. What action by the

nurse is most important for this patient? Document giving the drug. Raise the side rails on the bed. Record the patient’s vital signs. Teach relaxation techniques.

a. b. c. d.

____ 10. A patient is on the phone when the nurse brings a preoperative antibiotic before scheduled surgery.

The circulating nurse has requested the antibiotic be started. The patient wants the nurse to wait before starting it. What response by the nurse is most appropriate? a. Explain the rationale for giving the medicine now. b. Leave the room and come back in 15 minutes. c. Provide holistic patient care and come back later. d. Tell the patient you must start the medication now. ____ 11. The circulating nurse is plugging in a piece of equipment and notes that the cord is frayed. What

action by the nurse is best? Call maintenance for repair. Check the machine before using. Get another piece of equipment. Notify the charge nurse.

a. b. c. d.

____ 12. The circulating nurse and preoperative nurse are reviewing the chart of a patient scheduled for

minimally invasive surgery (MIS). What information on the chart needs to be reported to the surgeon as a priority? a. Allergies noted and allergy band on b. Consent for MIS procedure only c. No prior anesthesia exposure d. NPO status for the last 8 hours

____ 13. The circulating nurse is in the operating room and sees the surgeon don gown and gloves using

appropriate sterile procedure. The surgeon then folds the hands together and places them down below the hips. What action by the nurse is most appropriate? a. Ask the surgeon to change the sterile gown. b. Do nothing; this is acceptable sterile procedure. c. Inform the surgeon that the sterile field has been broken. d. Obtain a new pair of sterile gloves for the surgeon to put on. ____ 14. A patient is in stage 2 of general anesthesia. What action by the nurse is most important? a. Keeping the room quiet and calm b. Being prepared to suction the airway c. Positioning the patient correctly d. Warming the patient with blankets ____ 15. A patient has received intravenous anesthesia during an operation. What action by the postanesthesia

care nurse is most important when the patient arrives in the PACU? Assist with administering muscle relaxants to the patient. Place the patient on a cardiac monitor and pulse oximeter. Prepare to administer intravenous antiemetics to the patient. Prevent the patient from experiencing postoperative shivering.

a. b. c. d.

____ 16. A circulating nurse wishes to provide emotional support to a patient who was just transferred to the

operating room. What action by the nurse would be best? Administer anxiolytics. Give the patient warm blankets. Introduce the surgical staff. Remain with the patient.

a. b. c. d.

____ 17. The post-anesthesia care unit (PACU) charge nurse notes vital signs on four postoperative patients.

Which patient would the nurse assess first? a. Patient with a blood pressure of 100/50 mm Hg b. Patient with a pulse of 118 beats/min c. Patient with a respiratory rate of 6 breaths/min d. Patient with a temperature of 96 F (35.6 C) ____ 18. A postoperative nurse is caring for a patient whose oxygen saturation dropped from 98% to 95%.

What action by the nurse is most appropriate? Assess other indicators of oxygenation. Call the Rapid Response Team. Notify the anesthesia provider. Prepare to intubate the patient.

a. b. c. d.

____ 19. A patient had a surgical procedure with spinal anesthesia. The nurse raises the head of the patient’s

bed. The patient’s blood pressure changes from 122/78 mm Hg to 102/50 mm Hg. What action by the nurse is best? a. Call the Rapid Response Team. b. Increase the IV fluid rate. c. Lower the head of the bed.

d. Nothing; this is expected. ____ 20. A postoperative patient vomited. After cleaning and comforting the patient, which action by the

nurse is most important? Allow the patient to rest. Auscultate lung sounds. Document the episode. Encourage the patient to eat dry toast.

a. b. c. d.

____ 21. A nurse is preparing a patient for discharge after surgery. The patient needs to change a large

dressing and manage a drain at home. What instruction by the nurse is most important? “Be sure you keep all your postoperative appointments.” “Call your surgeon if you have any questions at home.” “Eat a diet high in protein, iron, zinc, and vitamin C.” “Wash your hands before touching the drain or dressing.”

a. b. c. d.

____ 22. A registered nurse (RN) is watching a nursing student change a dressing and perform care around a

Penrose drain. What action by the student warrants intervention by the RN? Cleaning around the drain per agency protocol Placing a new sterile gauze under the drain Securing the drain’s safety pin to the sheets Using sterile technique to empty the drain

a. b. c. d.

____ 23. A client is admitted to the ED complaining of severe abdominal pain, stating that he has been

vomiting “coffee-ground” like emesis. The client is diagnosed with a perforated gastric ulcer and is informed that he needs surgery. When can the client most likely anticipate that the surgery will be scheduled? a. Within 24 hours b. Within the next week c. Without delay because the bleed is emergent d. As soon as all the day's elective surgeries have been completed ____ 24. The nurse is performing a preoperative assessment on a client going to surgery. The client informs

the nurse that he drinks approximately two bottles of wine each day and has for the last several years. What postoperative difficulties should the nurse anticipate for this client? a. Nonadherence to prescribed treatment after surgery following surgery b. Increased risk for postoperative complications c. Alcohol withdrawal syndrome upon administration of general anesthesia d. Increased risk for allergic reactions ____ 25. The nurse is preparing a client for surgery prior to her hysterectomy without oophorectomy. The

nurse is witnessing the client's signature on a consent form. Which comment by the client would best indicate informed consent? a. “I know I'll be fine because the physician said he has done this procedure hundreds of times.” b. “I know I'll have pain after the surgery but they'll do their best to keep it to a minimum.” c. “The physician is going to remove my uterus and told me about the risk of

bleeding.” d. “Because the physician isn't taking my ovaries, I'll still be able to have children.” ____ 26. The OR nurse is taking the client into the OR when the client informs the operating nurse that his

grandmother spiked a very high temperature in the OR and nearly died 15 years ago. What relevance does this information have regarding the client? a. The client may be experiencing presurgical anxiety. b. The client may be at risk for malignant hyperthermia. c. The grandmother's surgery has minimal relevance to the client's surgery. d. The client may be at risk for a sudden onset of postsurgical infection. ____ 27. The nurse is caring for a male client who has had spinal anesthesia. The client is under a physician's

order to lie flat postoperatively. When the client asks to go to the bathroom, you encourage him to adhere to the physician's order. What rationale for complying with this order should the nurse explain to the client? a. Preventing the risk of hypotension b. Preventing respiratory depression c. Preventing the onset of a headache d. Preventing pain at the lumbar injection site ____ 28. The perioperative nurse is constantly assessing the surgical client for signs and symptoms of

complications of surgery. Which symptom should first signal to the nurse the possibility that the client is developing malignant hyperthermia? a. Increased temperature b. Oliguria c. Tachycardia d. Hypotension ____ 29. The nurse is caring for a client on the medical–surgical unit postoperative day 5. During each client

assessment, the nurse evaluates the client for infection. Which of the following would be most indicative of infection? a. Presence of an indwelling urinary catheter b. Rectal temperature of 99.5F (37.5C) c. Red, warm, tender incision d. White blood cell (WBC) count of 8,000/mL ____ 30. The nurse admits a client to the PACU with a blood pressure of 132/90 mm Hg and a pulse of 68

beats per minute. After 30 minutes, the client's blood pressure is 94/47 mm Hg, and the pulse is 110. The nurse documents that the client's skin is cold, moist, and pale. Of what is the client showing signs? a. Hypothermia b. Hypovolemic shock c. Neurogenic shock d. Malignant hyperthermia ____ 31. A presurgical client asks, “Why will I go to the PACU instead of just going straight up to the

postsurgical unit?” What is the nurse's best response? a. “The PACU allows you to recover from anesthesia in a stimulating environment to

facilitate awakening and reorientation.” b. “The PACU allows you to recover from the effects of anesthesia, and you'll stay in

the PACU until you're oriented, have stable vital signs, and are without complications.” c. “Frequently, clients are placed in the medical–surgical unit to recover, but hospitals are usually short of beds, and the PACU is an excellent place to triage clients.” d. “You'll remain in the PACU for a predetermined time because the surgeon will often need to reinforce or alter the incision in the hours following surgery.” ____ 32. A postoperative client rapidly presents with hypotension; rapid, thready pulse; oliguria; and cold,

pale skin. The nurse suspects that the client is experiencing a hemorrhage. What should be the nurse's first action? a. Leave and promptly notify the physician. b. Quickly attempt to determine the cause of hemorrhage. c. Begin resuscitation. d. Put the client in the Trendelenberg position. ____ 33. The nurse is performing the shift assessment of a postsurgical client. The nurse finds the client's

mental status, level of consciousness, speech, and orientation are intact and at baseline, but the client appears unusually restless. What should the nurse do next? a. Assess the client's oxygen levels. b. Administer antianxiety medications. c. Page the client's physician. d. Initiate a social work referral. ____ 34. A nurse is giving a talk to a local community group whose members advocate for disabled members

of the community. The group is interested in emerging trends that are impacting the care of people who are disabled in the community. The nurse should describe an increasing focus on what aspect of care? a. Extended rehabilitation care b. Independent living c. Acute care center treatment d. State institutions that provide care for life ____ 35. The nurse is caring for an older adult client who is receiving rehabilitation following an ischemic

stroke. A review of the client's electronic health record reveals that the client usually defers her self-care to family members or members of the care team. What should the nurse include as an initial goal when planning this client's subsequent care? a. The client will demonstrate independent self-care. b. The client's family will collaboratively manage the client's care. c. The nurse will delegate the client's care to a nursing assistant. d. The client will participate in a life skills program. ____ 36. An elderly woman diagnosed with osteoarthritis has been referred for care. The client has difficulty

ambulating because of chronic pain. When creating a nursing care plan, what intervention will best promote the client's mobility? a. Motivate the client to walk in the afternoon rather than the morning

b. Encourage the client to push through the pain in order to gain further mobility c. Administer an analgesic as prescribed to facilitate the client's mobility d. Have another person with osteoarthritis visit the client ____ 37. A female client, 47 years old, visits the clinic because she has been experiencing stress incontinence

when she sneezes or exercises vigorously. What is the best instruction the nurse can give the client? Keep a record of when the incontinence occurs Perform clean intermittent self-catheterization Perform Kegel exercises four to six times per day Wear a protective undergarment to address this age-related change

a. b. c. d.

____ 38. The nurse is caring for an elderly client who has been on a bowel training program due to the

neurologic effects of a stroke. In the past several days, the client has begun exhibiting normal bowel patterns. Once a bowel routine has been well established, the nurse should avoid which of the following? a. Use of a bedpan b. Use of a padded or raised commode c. Massage of the client's abdomen d. Use of a bedside toilet Multiple Response Identify one or more choices that best complete the statement or answer the question. ____ 39. The circulating nurse reviews the day’s schedule and notes patients who are at higher risk of

anesthetic overdose and other anesthesia-related complications. Which patients does this include? (Select all that apply.) a. A 75-year-old patient scheduled for an elective procedure b. Patient who drinks a 6-pack of beer each day c. Patient with a serum creatinine of 3.8 mg/dL (336 mcmol/L) d. Patient who is taking birth control pills e. Young male patient with a RYR1 gene mutation ____ 40. A patient is having shoulder surgery with regional anesthesia. What actions by the nurse are most

important to enhance patient safety related to this anesthesia? (Select all that apply.) Assessing distal circulation to the operative arm after positioning Keeping the patient warm during the operative procedure Padding the patient’s shoulder and arm on the operating table Preparing to suction the patient’s airway if the patient vomits Speaking in a low, quiet voice as anesthesia is administered

a. b. c. d. e....