Diabetes
Respiratory
Pain/Pre-Op/Post-Op
Neuro
Cardiac
100
When taking a health history, the nurse screens for manifestations suggestive of diabetes type I. Which of the following manifestations are considered the primary manifestations of diabetes type I and would be most suggestive of diabetes type I and require follow-up investigation?
a. Excessive intake of calories, rapid weight gain, and difficulty losing weight

b. Poor circulation, wound healing, and leg ulcers,

c. Lack of energy, weight gain, and depression

d. An increase in three areas: thirst, intake of fluids, and hunger
What is d. An increase in three areas: thirst, intake of fluids, and hunger
100
A nurse instructs a female client to use the pursed-lip method of breathing and the client asks the nurse about the purpose of this type of breathing. The nurse responds, knowing that the primary purpose of pursed-lip breathing is to:
a. Promote oxygen intake.

b. Strengthen the diaphragm.

c. Strengthen the intercostal muscles.

d. Promote carbon dioxide elimination.
What is d. Promote carbon dioxide elimination.
100
The nurse is assessing a patient's pain. The patient is tearful, hesitant to move, and grimacing. When asked, the patient rates the pain as a two at this time using a zero-to-ten pain scale. What conclusion would be most accurate?

a. The patient has rated the pain as minimal according to the scale.

b. The nurse should reinforce teaching about the pain scale number system.

c. The nurse should reassess the pain in 30 minutes.

d. The medication the patient is receiving is not adequate for pain relief.
What is b. The nurse should reinforce teaching about the pain scale number system
100
A patient admitted with a stroke is coming to your unit from the emergency department. The nurse assigned to care for the new patient knows that what assessment finding is indicative of a stroke?

A) Facial droop

B) Increase in heart rate

C) Facial edema

D) Electrolyte imbalance
What is a. facial droop
100
A 47-year-old male patient calls the nurse and asks about the risk factors of hypertension. What should the nurse list as risk factors for primary hypertension?

a. Obesity, high intake of sodium and saturated fat

b. Diabetes mellitus, oral contraceptives

c. Metabolic syndrome, smoking

d. Renal disease, coarctation of the aorta
What is a. Obesity, high intake of sodium and saturated fat
200
The nurse is working with an overweight client who has a high-stress job and smokes. This client has just received a diagnosis of Type II Diabetes and has just been started on an oral hypoglycemic agent. Which of the following goals for the client which if met, would be most likely to lead to an improvement in insulin efficiency to the point the client would no longer require oral hypoglycemic agents?
a. Comply with medication regimen 100% for 6 months

b. Quit the use of any tobacco products by the end of three months

c. Lose a pound a week until weight is in normal range for height and exercise 30 minutes daily

d. Practice relaxation techniques for at least five minutes five times a day for at least five months
What is c. Lose a pound a week until weight is in normal range for height and exercise 30 minutes daily
200
A female client is suspected of having a pulmonary embolus. A nurse assesses the client, knowing that which of the following is a common clinical manifestation of pulmonary embolism?

a. Dyspnea

b. Bradypnea

c. Bradycardia

d. Decreased respiratory sounds
What is a. Dyspnea
200
You are discussing pain relief in the elderly with your senior nursing students. When administering an analgesic to an elderly patient for pain, what interventions would you teach your students should be implemented in the plan of care for the patient?

a. Monitor for signs of drug toxicity due to a decrease in metabolism.

b. Monitor for an increase in absorption of the drug due to increased metabolism.

c. Monitor for an increase in respiratory rates.

d. Analgesics should be given every 4 to 6 hours as ordered to control pain.
What is a. Monitor for signs of drug toxicity due to a decrease in metabolism.
200
A nurse is caring for a patient diagnosed with a hemorrhagic stroke. What goal is a priority for this patient?

a. Maintain adequate urine output.

b. Maintain and improve cerebral tissue perfusion.

c. Relieve anxiety.

Relieve sensory deprivation.
What is b. Maintain and improve cerebral tissue perfusion.
200
The nurse is caring for a patient admitted with unstable angina. The laboratory result for the initial troponin I is elevated in this patient. The nurse recognizes what?

A) This is only an accurate indicator of myocardial damage when it reaches its peak in 24 hours.

B) Because the entry diagnosis is unstable angina, this is a poor indicator of myocardial injury.

C) This is an accurate indicator of myocardial injury.

D) It is only an accurate indicator of skeletal muscle injury.
What is C) This is an accurate indicator of myocardial injury.
300
Which of the following things must the nurse working with diabetic clients keep in mind about Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS)?
A. This syndrome occurs mainly in people with Type I Diabetes

B. It has a higher mortality rate than Diabetic Ketoacidosis

C. The client with HHNS is in a state of overhydration

D. This condition develops very rapidly
What is B. It has a higher mortality rate than Diabetic Ketoacidosis
300
You are the clinic nurse caring for a patient who has just had a pulmonary function test ordered. The patient asks you what this test is for. What would be your best answer?

a. “A PFT measures lung volumes, ventilatory function, and the mechanics of breathing.”

b. “A PFT measures how deep you breathe.”

c. “A PFT measures how elastic your lungs are.”

d. “A PFT measures whether you have adequate gas exchange.”
What is a. “A PFT measures lung volumes, ventilatory function, and the mechanics of breathing.”
300
You are preparing your patient for surgery. Prior to obtaining your patient's signature on the operative permit, you ask the patient if she understands all aspects of the surgical procedure. The patient replies that she is very nervous and really does not understand what the surgical procedure is or how it will be performed. What is the most appropriate nursing action for you to take?

a. Have the patient sign the operative permit and place it in the chart

b. Call the physician to review the procedure with the patient

c. Explain the procedure to the patient and her family

d. Provide the patient with a pamphlet explaining the procedure
What is b. Call the physician to review the procedure with the patient
300
The nurse is performing stroke risk screenings at a hospital open house. Identification of high risk individuals is the goal of the screenings. The nurse has identified four patients who might be at risk for a stroke. Which patient is at highest risk for a stroke?

a. White female, age 60, with history of excessive alcohol intake

b. White male, age 60, with history of uncontrolled hypertension

c. Black male, age 60, with history of diabetes

Black male, age 50, with history of smoking
What is b. White male, age 60, with history of uncontrolled hypertension
300
What part of an ECG is used to identify the presence of myocardial ischemia or injury?

A) ST segments

B) QRS complex

C) Inverted P wave

D) D PVC
What is a. ST segments
400
Blood sugar is well controlled when Hemoglobin A1C is:
a. Below 7%

b. Between 12%-15%

c. Less than 180 mg/dL

d. Between 90 and 130 mg/dL
What is a. Below 7%
400
When caring for a client with COPD, the nurse knows it is important to monitor what?

A) Cognitive changes

B) Support systems

C) Increasing hyperpnea
D) Bradycardia
What is a. Cognitive Changes
400
You are doing preoperative teaching with a patient scheduled for surgery in 1 month. During the preoperative teaching, the patient gives you a list of medications she takes, the dosage, and frequency. Which of the following interventions provides the patient with the most accurate information?

A) Instruct the patient to stop taking St. John's wort at least 2 weeks prior to surgery due to its interaction with anesthetic agents.

B) Instruct the patient to continue taking ephedrine prior to surgery due to its effect on blood pressure.

C) Instruct the patient to discontinue synthroid due to its effect on blood coagulation and potential heart dysrrythmias.

D) Instruct the patient to continue any herbal supplements, and inform the patient that they have no effect on the surgical procedure.
What is A) Instruct the patient to stop taking St. John's wort at least 2 weeks prior to surgery due to its interaction with anesthetic agents.
400
A patient with Parkinson's disease is being cared for on your unit. The nurse would be correct in identifying what neurotransmitter as being decreased in this disease?

A) Acetylcholine

B) Dopamine

C) Neurontin

D) Serotonin
What is B. Dopamine
400
A patient newly diagnosed with hypertension asks the nurse what happens when uncontrolled hypertension is prolonged. The nurse explains that a patient with prolonged uncontrolled hypertension is at risk for developing what?

A) Renal failure

B) Right ventricular hypertrophy

C) Glaucoma

D) Anemia
What is A) renal failure
500
A 37-year-old forklift operator presents with shakiness, sweating, anxiety, and palpitations and tells the nurse he has type 1 diabetes mellitus. Which of the follow actions should the nurse do first?
A. Inject 1 mg of glucagon subcutaneously.

B. Administer 50 mL of 50% glucose I.V.

C. Give 4 to 6 oz (118 to 177 mL) of orange juice.

D. Give the client four to six glucose tablets.
What is C. Give 4 to 6 oz (118 to 177 mL) of orange juice.
500
As an asthma educator, you are teaching a patient newly diagnosed with asthma and her family about the use of a peak flow meter. What does a peak flow meter measure?

A) Highest airflow during a forced inspiration

B) Highest airflow during a forced expiration

C) Highest airflow during a normal inspiration

D) Highest airflow during a normal expiration
What is B) Highest airflow during a forced expiration
500
One of the things taught to a patient during preoperative teaching is to have nothing by mouth for 8 hours before surgery. The patient asks the nurse why this is important. What is the most appropriate response for the patient?

A) “You will need to have food and fluid restricted for 8 hours before surgery so you are not at risk for aspiration.”

B) “The restriction of food or fluid will present the development of pneumonia related to decreased lung capacity.”

C) “The presence of food in the stomach interferes with the absorption of anesthetic agents.”

D) “By withholding food for 8 hours before surgery, you will not develop constipation in the postoperative period.”
What is A) “You will need to have food and fluid restricted for 8 hours before surgery so you are not at risk for aspiration.”
500
A patient with suspected Parkinson's disease is being initially assessed by the nurse. The nurse would expect the patient to have a tremor. When is the best time to assess for the tremor?

a. During a period of time when the patient is resting

b. During a period of time when the patient is brushing the teeth

c. During a period of time when the patient is preparing his or her meal tray to eat

d. During a period of time when the patient is participating in occupational therapy
What is a. During a period of time when the patient is resting
500
The student nurse is doing clinical hours in a walk-in clinic. A patient with primary hypertension, and who has not been adhering to the prescribed dietary regimen, comes in for a follow-up appointment. The student is asked to develop a Nursing Care Plan for this patient. What is one of the measurable patient outcomes the student may include?

a. Patient will reduce Na intake to no more than 2g of sodium.

b. Patient will have a stable BUN and serum creatine levels.

c. Patient will abstain from fat intake and reduce calories.

d. Patient will maintain a normal body weight.
What is a. Patient will reduce Na intake to no more than 2g of sodium.
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