Textbook of Basic Nursing (Lippincott’s Practical Nursing) Tenth Edition by Caroline Bunker Rosdahl, Mary T. Kowalski – Test Bank

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Textbook of Basic Nursing (Lippincott’s Practical Nursing) Tenth Edition by Caroline Bunker Rosdahl, Mary T. Kowalski – Test Bank

Chapter 6- Health and Wellness

1. Global health concerns are closely related to local health concerns because of ever-growing physical, environmental, and societal changes on a worldwide scale. The World Health Organization (WHO) has promoted a global social conscience of healthcare and health reform. A nursing student is preparing a short postconference clinical report on health. The student nurse needs to include various definitions of health. The nurse looked up the WHO definition of health. What should the student nurse state that is the WHO definition of health?
  A) Balance of all of the components of the human organism
  B) Change in the structure or function of body tissues, biological systems, or the human mind
  C) State of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity
  D) A state of health in which a structural cause cannot be identified

 

 

2. Health influences everything in our lives. Health must be considered in its broadest, holistic sense. The student nurse asks the nursing instructor because health is holistic, what is included in the emotional health component. What is emotional health?
  A) Feelings and attitudes that make one comfortable with oneself
  B) A mind that grows and adjusts, is in control, and is free of serious stress
  C) A sense of responsibility and caring for the health and welfare of others
  D) Inner peace and security and comfort with one’s higher power, as one perceives it

 

 

3. Health influences everything in our lives. Health must be considered in its broadest, holistic sense. The student nurse is looking for the social health for a client in the electronic medical record. What type of information would the student nurse locate about a client’s social health?
  A) Feelings and attitudes of being comfortable with oneself
  B) A mind that grows and adjusts to changing family situations and is in control, and free of serious stress
  C) A sense of responsibility for one’s own actions and caring for the health and welfare of other family members
  D) Inner peace and security and comfort with one’s religious beliefs

 

 

4. Health influences everything in our lives. Health must be considered in its broadest, holistic sense. A female client tells the nurse of attending classes on how to make cards and finds that this activity helps keep her mind free of serious stress. The nurse documents in the electronic medical record that the client is meeting which component of health?
  A) Spiritual
  B) Social
  C) Psychological or mental health
  D) Emotional

 

 

5. Health influences everything in our lives. Health must be considered in its broadest, holistic sense. A client tells the nurse of being at peace and very happy to find comfort in higher power to consult during the day as needed. The nurse documents in the electronic medical record that the client is meeting which component of health?
  A) Spiritual
  B) Social
  C) Psychological or mental health
  D) Emotional

 

 

6. The nursing instructor has requested that students conduct research about influenza in their state. The student research revealed that influenza for the older population was 25% in 2011, but only 5% of the younger population had influenza for the same year in this state. This information provides which statistic about influenza?
  A) Mortality
  B) Morbidity
  C) Disease
  D) Acute illness

 

 

7. The nursing instructor has requested that students conduct research about influenza in their state. The student research revealed that influenza deaths for the older population were 35% in 2011, but only 1% of the younger population for the same year in their state. This information provides which statistic about influenza?
  A) Mortality
  B) Morbidity
  C) Disease
  D) Acute illness

 

 

8. The student nurse is preparing a postclinical report on the 10 leading causes of morbidity and mortality in the United States. The student located information from the National Center for Health Statistics that includes the ten leading causes of morbidity and mortality in the United States. Based on this information, what should the nurse include in the report as one of the 10 leading causes of morbidity and mortality in the United States?
  A) Heart disease
  B) Parkinson’s disease
  C) Suicide
  D) Chronic liver disease

 

 

9. The United States spends more on health than other industrialized countries. Funding issues in healthcare are major concerns to clients and healthcare professionals. Many individuals have lifelong, recurring problems that tend to worsen in severity over time. The costs of care for long-term or chronic illnesses are huge. The student nurse asks the nursing instructor about the annual costs and number of individuals infected by HIV/AIDS. Based on the research, the nursing instructor would correctly answer the student’s question by stating how many individuals are affected every year with HIV/AIDS in the United States?
  A) 30,000
  B) 40,000
  C) 50,000
  D) 60,000

 

 

10. A nurse admits an older client to the long-term care unit for rehabilitation after a total knee replacement and subsequent fall owing to dementia. What is the highest major healthcare concern for many older clients in the United States?
  A) Lack of modern healthcare facilities
  B) Lack of funding sources
  C) Inadequate number of healthcare providers
  D) Lack of general health education

 

 

11. Today’s healthcare system emphasizes prevention rather than treatment of disease. The benefits of preventative education cannot be underestimated. What are examples of primary healthcare services that nurses can provide?

1. Prenatal care for mothers and infants

2. Antismoking campaigns

3. Mammography for women

4. Specific medical or surgical therapies

  A) 1, 2, 3
  B) 1, 2, 4
  C) 1, 3, 4
  D) 2, 3, 4

 

 

12. A nurse is caring for a client who uses smokeless tobacco extensively, which he believes is harmless. What advice should the nurse give this client regarding the use of smokeless tobacco?
  A) It is as dangerous as regular tobacco or nicotine use
  B) It is better choice than regular tobacco or nicotine
  C) It reduces the risk of heart disease
  D) It is more addictive than nicotine

 

 

13. Today’s healthcare system emphasizes prevention rather than treatment of disease. The benefits of preventative education cannot be underestimated. What is an example of  secondary healthcare services that nurses contribute as nursing interventions to help the client achieve the highest level of health?
  A) Prenatal care for mothers and infants
  B) Antismoking campaigns
  C) Mammography for women
  D) Specific medical or surgical therapies

 

 

14. A female client is admitted with a number of diagnoses to the long-term care facility. The client is very upset about having to give up her own apartment. The nurse is reviewing the list of medical diagnoses in helping to collect data for the nursing care plan. Which diagnosis has the highest potential to result in long-term impairment for the client?
  A) Cellulitis of the left leg
  B) Arthritis
  C) Influenza
  D) Fracture of the femur

 

 

15. The nurse is assigned to work in the local health department and is instructing student nurses on how to prevent disease and subsequent disabilities for clients. What should the nurse identify as the highest priority in the session to student nurses on how to encourage clients to prevent disease and disabilities?
  A) Good eating habits
  B) Health education
  C) Regular primary care visits
  D) Vitamin supplements

 

 

16. The client is admitted to the emergency department with a number of diagnoses and is being admitted for observation. On the wellness–illness continuum, what is the implication for the acute illness that the client is being admitted?
  A) Occurrence of detectable structural change in one or more organs that also alters usual function
  B) Interferes with the wellness–illness continuum for a short period of time
  C) A disorder in which a structural cause cannot be identified
  D) Results in long-term health impairment

 

 

17. The nursing instructor asks a group of nursing students to relate the concept of wellness to Maslow’s hierarchy of human needs. What statement by the nursing students needs further explanation about Maslow’s theory on the wellness–illness continuum state?
  A) “If people find their needs blocked or threatened, they move toward the health end of the continuum.”
  B) “If their basic needs are satisfied and they move toward self-actualization, they move toward the wellness end.”
  C) “The body adapts and changes to maintain homeostasis.”
  D) “High-level wellness is optimum health.”

 

 

18. Lifestyle factors and risk factors can directly affect health. Lifestyle factors and risk factors influence the numbers of illnesses and deaths. A nurse is reviewing with the client aspects of the client’s current lifestyle. What is the highest priority example of a risk factor that this client cannot control?
  A) Smoking
  B) Nutrition
  C) Genetic makeup
  D) Stress

 

 

19. Lifestyle factors and risk factors can directly affect health. Lifestyle factors and risk factors influence the numbers of illnesses and deaths. A nurse is reviewing with the client aspects the client’s current lifestyle. What is the highest priority lifestyle and risk factor that this client can control?
  A) Smoking
  B) Nutrition
  C) Genetic makeup
  D) Stress

 

 

20. A woman is admitted to the healthcare facility after being abused by her partner. What nursing intervention is highest priority for this client?
  A) Suggest that the client separate from her partner
  B) Encourage the client to reflect on why the abuse occurred
  C) Offer the client referrals to local shelters
  D) Suggest that the client spend more time with her partner

 

 

21. A nurse is caring for a middle-age client with stress. Stress has physical and psychological causative factors. Which should the nurse identify as the highest priority physical causative factor of this client’s stress?
  A) Peer pressure
  B) Anxiety
  C) Recent influenza
  D) Finances

 

 

22. A client had surgery to remove a lump in the upper region of the arm. The physician informed the client that the tumor was benign. The client asks the nurse about the chances of a favorable response to the therapy. What should the nurse’s reply include?
  A) “A benign tumor is the result of growth of cells; if removed, it usually does not recur.”
  B) “A benign tumor is the result of infection and requires regular medication.”
  C) “A benign tumor is the result of imbalanced metabolism and recurs gradually.”
  D) “A benign tumor is the result of occupational factors and may undergo metastasis.”

 

 

23. A client expecting a baby informed the nurse that she occasionally smokes and drinks alcohol. Which risk associated with smoking and drinking alcohol is of highest priority and to which the nurse should alert the client?
  A) The newborn may develop a genetic disorder.
  B) The newborn may develop hip dysplasia.
  C) The newborn may have a low birth weight.
  D) The newborn may develop blurred vision.

 

 

24. The nurse is educating a pregnant client about possible complications. The nurse tells the client about possible congenital disorders. The client correctly understands the information presented when the client identifies which disorder as a congenital disorder?
  A) Clubbed feet
  B) Chickenpox
  C) Scarlet fever
  D) Whooping cough

 

 

25. The nurse is preparing a public education information program about ways to minimize the risk of developing cancer. What information is of highest priority that the nurse should emphasize in the public education program regarding minimizing the risk of developing cancer?
  A) Practice safe sex
  B) Avoid overexposure to the sun
  C) Increase activity levels
  D) Eat foods high in calcium

 

 

 

Answer Key

 

1. C
2. A
3. C
4. C
5. A
6. B
7. A
8. A
9. D
10. B
11. A
12. A
13. D
14. B
15. B
16. B
17. A
18. C
19. A
20. C
21. C
22. A
23. C
24. A
25. B

Chapter 16- The Integumentary System

1. The nurse answers a client’s questions regarding the integumentary system. The client asks about the epidermis layer of the skin. Based on this information, how would the nurse best describe stratum basale or stratum germinativum?

1.     Relatively waterproof

2.     Provides a barrier against light, heat, bacteria, and other foreign substances

3.     Innermost layer of the epidermis

4.     Plays a role in germinating new cells

  A) 1, 2
  B) 1, 4
  C) 2, 3
  D) 3, 4

 

 

2. The nurse answers a client’s questions regarding the integumentary system and helps the client understand its primary functions. Based on this information, what should the nurse tell the client are the primary functions of the integumentary system?

1.     Protection

2.     Thermoregulation

3.     Metabolism

4.     Sensation

5.     Maintain pH balance

  A) 1, 2, 3, 4
  B) 1, 2, 4, 5
  C) 1, 2, 3, 5
  D) 2, 3, 4, 5

 

 

3. The student nurse is reviewing with a client that the skin is divided into layers. Which information is the best description of the dermis layer?
  A) Made up of the skin’s thin, superficial outer layer
  B) Contains important structures of hair, glands, blood vessels, and nerves
  C) Cushions, supports, nourishes, and insulates the skin
  D) Anchors the skin to underlying tissues and organs

 

 

4. The nurse is collecting data from a client and is completing a review of the client’s skin. The client asks the nurse what the term keratin means in the pamphlet on skin given by the primary care provider. Based on this information, what would be the best response by the nurse?

1.     Body’s true protector

2.     Most microorganisms cannot penetrate unbroken skin

3.     Gives color to the hair, skin, and other structures in the body

4.     Help detect foreign substances to defend against infection

  A) 1, 2
  B) 1, 4
  C) 2, 3
  D) 3, 4

 

 

5. The nurse is collecting data from a client and is completing a review of the client’s skin. The client asks the nurse what the term melanin means in the pamphlet on skin given by the primary care provider. Based on this information, what would be the best response by the nurse?
  A) Body’s true protector
  B) Most microorganisms cannot penetrate unbroken skin
  C) Gives color to the hair, skin, and other structures in the body
  D) Help detect foreign substances to defend against infection

 

 

6. A client is complaining about having to do frequent public presentations. The client tells the nurse of breaking into a “cold sweat” before the presentation. Based on this information, what is the best description for the sweat glands that the nurse can share with the client that causes the “cold sweat?”
  A) Sudoriferous glands are located in the epidermis.
  B) Apocrine sweat glands are stimulated by anxiety or fear.
  C) Mammary sweat glands secrete sweat into numerous ducts that empty into pores.
  D) Eccrine sweat glands respond to external and internal heat.

 

 

7. A student nurse is reviewing information on the sudoriferous glands and the ceruminal glands for a postclinical presentation. The student nurse has to provide a chart that outlines information about these glands. Based on this information, what information should the nurse include about the ceruminal glands?
  A) Secrete a thick, oily, milky sweat into the hair follicle
  B) Distributed widely over the body, especially numerous on the upper lip, forehead, back, palms, and soles
  C) Regulation of body temperature by providing a cooling effect
  D) Protect the tympanic membrane

 

 

8. One important nursing technique is the measurement of accurate body temperature. The body loses heat through four processes. The nurse is reviewing the four processes with her high school child. Based on the nurse’s information, which is an example of convection that the nurse can provide to the high school child?
  A) The body gives off waves of heat from uncovered surfaces.
  B) An oscillating fan blows currents of cool air across the surface of a warm body.
  C) Body fluid in the form of perspiration and insensible loss is vaporized from the skin.
  D) The body transfers heat to an ice pack, causing the ice to melt.

 

 

9. The nurse answers a client’s questions regarding the integumentary system and helps the client learn about the mechanisms of heat loss, heat production, and heat conservation. Based on this information, what is an example of the mechanism of heat transfer by conduction?
  A) The body gives off waves of heat from uncovered surfaces.
  B) An oscillating fan blows currents of cool air across the surface of a warm body.
  C) Body fluid in the form of perspiration and insensible loss is vaporized from the skin.
  D) The body transfers heat to an ice pack, causing the ice to melt.

 

 

10. A client complains to the nurse about getting “goose bumps.” The client wants to know what causes the “goose bumps.” Based on this information, what would be the best information the nurse could give to the client about “goose bumps”?

1.     Stimulated by cold or fear

2.     Voluntary muscles contract

3.     Erect hairs provide an “air cushion” for the skin

4.     Pilomotor reflex

  A) 1, 2, 3
  B) 1, 2, 4
  C) 1, 3, 4
  D) 2, 3, 4

 

 

11. The skin receives stimuli from the outside world, providing a dynamic interaction between external and internal environments. Based on this information, what is the best nursing action that a nurse can implement for a client who has a loss of sensation to the integumentary system?
  A) Be careful when handling the arms of clients.
  B) Inspect for skin tears.
  C) Inspect skin frequently, especially bony prominences.
  D) Discourage smoking and exposure to the sun.

 

 

12. An older client asks the nurse about changes that occur in aging skin. Based on this information, what teaching consideration should the nurse incorporate into her plan of care for review with this client about changes that occur in aging skin?
  A) Epidermal and dermal layers of the skin are raised.
  B) Melanin is either lost or migrates and clusters in the dermal layer.
  C) Capillary bed in epidermis becomes more friable.
  D) Capillaries leak small amount of blood into tissues.

 

 

13. A 55-year-old woman likes to play golf every day during the summer months. Based on this information what should the nurse review with the client about ways to protect the skin from damage?

1.     SPF determines the amount of UV rays that reach the skin.

2.     SPF 45–70 is most often used.

3.     Apply sunscreen thoroughly and evenly.

4.     Reapply sunscreen after sweating.

  A) 1, 2, 3
  B) 1, 2, 4
  C) 1, 3, 4
  D) 2, 3, 4

 

 

14. The nurse is reviewing with a client the ways for the client to maintain healthy skin. Which instructions are the most important for the nurse to review with the client to help maintain healthy skin?

1.     Consume a well-balanced diet.

2.     Drink plenty of fluids every day.

3.     Limit exposure to the sun.

4.     Use herbal products on the skin.

  A) 1, 2, 3
  B) 1, 2, 4
  C) 1, 3, 4
  D) 2, 3, 4

 

 

15. A client meets a former classmate at a 10-year college reunion. The client tells the nurse that the classmate was bald. The classmate had a full head of red hair when they graduated from college. Based on this information, the client asks the nurse what might cause alopecia. What could be a possible reason the nurse could identify as a cause of the classmate’s alopecia?
  A) High secretion of melanin
  B) Hereditary factors
  C) Use of hair care products
  D) Active lifestyle

 

 

16. A client whose skin has developed a bluish hue is diagnosed by the primary care provider as having cyanosis. What action should the nurse take in this case ?
  A) The nurse should give the client a tepid bath.
  B) The nurse should monitor for a sudden increase in temperature.
  C) The nurse should monitor the oxygen level in the client’s bloodstream.
  D) The nurse should place a cool cloth on the client’s forehead.

 

 

17. The nurse is teaching the client about various aspects of the skin. What should the nurse review with the client about the importance of sebum?
  A) Prevents hardening of collagen
  B) Prevents drying of skin
  C) Keeps skin bacteria free
  D) Prevents diaphoresis

 

 

18. A nurse is caring for a client with vitiligo. The client wants to know the reason for the white patches on his skin. What is the best response by the nurse to the client about the white patches?
  A) “The white patches are caused by a deficiency of vitamin D.”
  B) “The white patches occur when melanocytes stop making melanin.”
  C) “The white patches occur when there is a low carotene level.”
  D) “The white patches occur as a result of the lack of calcitriol in the body.”

 

 

19. A 65-year-old male client complains to the nurse about often feeling cold and wants to know the reason. What would be the best reason that the nurse could provide in the response to the client’s question?
  A) The skin of an elderly person tends to be more fragile.
  B) Elderly people usually have impaired circulation.
  C) Elderly people have less subcutaneous fat.
  D) Epidermal turnover decreases in elderly people.

 

 

20. A 55-year-old female client complains of increased facial hair growth in her nose, ears, and eyebrows. The hair has also become coarser. What would be the best reason that the nurse could provide in the response to the client’s concern about the increase in facial hair?
  A) Loss of female hormones
  B) Excess exposure to sunlight
  C) Loss of skin turgor
  D) Unhealthy diet

 

 

21. A nurse on the burn unit is reviewing with a group of nursing students the role of the hypodermis. Based on this information, what would be the best explanation to the nursing students about the role of the hypodermis?
  A) Acts as a waterproof barrier protecting the inside of the body
  B) Restricts penetration from microorganisms
  C) Nourishes and supports the epidermis
  D) Anchors the skin to the underlying tissues and organs

 

 

22. The nurse is educating a client about vitamins and their importance to the body. The nurse is reviewing with the client about blood tests and reasons to maintain adequate  vitamin D in the body. What information is essential for the nurse to include when client teaching about vitamin D?
  A) Prevents aging of skin
  B) Facilitates absorption of calcium and phosphorus
  C) Helps in the heat loss mechanism
  D) Increases body metabolism

 

 

23. A 35-year-old female client complains of a lightening of her skin color when she moves to a city where the temperature is very low. Based on this information, what can the nurse explain as the best reason for the cause of changes in skin color in the client?
  A) Low level of calcitriol
  B) Lack of oxygen in blood stream
  C) Constriction of capillaries
  D) Loss of subcutaneous fat

 

 

24. A client with an infection in the ears visits a healthcare facility. The client wants to know the cause of the infection. Based on this data collection from the client, which reason should the nurse identify as the most likely cause of the ear infection to the client?
  A) Insertion of a pointed object in the ear
  B) Infection in the sebaceous gland
  C) Secretion from the eccrine glands
  D) Accumulation of cerumen

 

 

 

Answer Key

 

1. D
2. A
3. B
4. A
5. C
6. B
7. D
8. B
9. D
10. C
11. C
12. D
13. C
14. A
15. B
16. C
17. B
18. B
19. C
20. A
21. D
22. B
23. C
24. D

Chapter 42- Infection Control

1. A nurse is caring for a client with streptococcal pharyngitis. The nurse has to initiate precautions for the client. Based on this information, what type of precautions should the nurse initiate and review the procedures with staff members?
  A) Droplet Precautions
  B) Contact Precautions
  C) Airborne Precautions
  D) Protective Precautions

 

 

2. A client is to be admitted to a local healthcare facility for protective isolation. What should the nurse make sure is outside the client’s room before initiating care?
  A) Wash basin
  B) Soap dish
  C) Personal protective equipment
  D) Urinal

 

 

3. A nurse is caring for a client in isolation. What guideline should the nurse follow when taking the vital signs of the client in the isolation room?
  A) Bring items from outside into the isolation room.
  B) Wear gloves and other personal protective equipment as indicated.
  C) Use unit thermometers and stethoscopes.
  D) Choose oral temperature measurement over rectal.

 

 

4. A nurse is caring for a client in a healthcare facility. When should the nurse implement Transmission-Based Precautions?
  A) When caring for clients with insect-borne diseases
  B) When caring for clients with hematologic diseases
  C) When caring for client with life-threatening diseases
  D) When caring for clients with known or suspected infectious diseases

 

 

5. A nurse implements Airborne Precautions for a client with tuberculosis. How does airborne transmission occur?
  A) When tiny microorganisms from evaporated droplets remain suspended in air
  B) When tiny microorganisms get transmitted through insect bites
  C) When droplets containing microorganisms get propelled through air
  D) When disease-causing agents spread through air pollution

 

 

6. A nurse is caring for a client with drug-resistant gastroenteritis. The nurse has to initiate precautions for the client. Based on this information, what type of precautions should the nurse initiate and review the procedures with staff members?
  A) Droplet precautions
  B) Contact precautions
  C) Airborne precautions
  D) Protective precautions

 

 

7. A nurse is caring for a client with tuberculosis. The nurse has to initiate precautions for the client. Based on this information, what type of precautions should the nurse initiate and review the procedures with staff members?
  A) Droplet precautions
  B) Contact precautions
  C) Airborne precautions
  D) Protective precautions

 

 

8. A nurse is caring for a client on contact isolation. What guidelines should the nurse follow when taking the vital signs of the client in the isolation room?
  A) Bring items from outside into the isolation room.
  B) Wear mask, as indicated.
  C) Use disposable thermometers and stethoscopes.
  D) Choose oral temperature measurement over rectal.

 

 

9. A nurse caring for infected clients in a local healthcare facility is expected to follow stringent precautions. The nurse is reviewing these guidelines with a new group of employees. Based on this information, which guideline should the nurse include in the in-service presentation on two-tier precautions for infection control?
  A) Transmission-Based Precautions
  B) Allergy-Based Precautions
  C) Contraindication-Based Precautions
  D) Complication-Based Precautions

 

 

10. A nurse is caring for a client with chickenpox. What precaution should the nurse take when caring for this client?
  A) Place client with other clients infected with the same microorganisms.
  B) Wear a mask when within 3 feet of the client.
  C) Change gloves after contact with a client’s infective material.
  D) Place the client in a room that has negative airflow pressure.

 

 

11. A nurse is caring for a client with a draining abscess. What precautions should the nurse take when caring for this client?

1.     Place client with other clients infected with the same microorganisms.

2.     Wear a mask when within 3 feet of the client.

3.     Change gloves after contact with a client’s infective material.

4.     Place the client in a room that has negative airflow pressure.

  A) 1, 2
  B) 1, 3
  C) 2, 3
  D) 3, 4

 

 

12. Droplet precautions are being followed for a client in a healthcare facility. The nurse is reviewing key information about droplet precautions with a group of nursing students. What should the nurse give as an example to the students about an illness that requires droplet precautions?
  A) Pediculosis
  B) Scabies
  C) Pertussis
  D) Impetigo

 

 

13. A nurse is employed with the infection control committee of a healthcare facility. Based on this information, what should the nurse tell the new employees about the goal of the infection control committee in the healthcare agency?
  A) Determining the history of clients’ illnesses
  B) Maintaining hygiene in the healthcare facility
  C) Providing a central place for reporting infections
  D) Improving coordination between nurses and physicians

 

 

14. Each accredited healthcare facility must have an infection control committee that monitors and evaluates any infection occurring in the facility. The nurse is reviewing with a group of nursing students the goals of the infection control committee. Based on this information, what would be the best answer by the nursing student about the goals of the infection control committee?

1.     Investigate cases of infection

2.     Determine the cause of infection

3.     Maintain total statistics related to the numbers and types of infections that occur in the facility

4.     Report diseases to local authorities

  A) 1, 2, 3
  B) 1, 2, 4
  C) 1, 3, 4
  D) 2, 3, 4

 

 

15. Which items would most likely be included in the room of a client who is on contact precautions?

1.     Stethoscope

2.     BP apparatus

3.     Sign on the door

4.     Medical administration records

  A) 1, 2
  B) 1, 4
  C) 2, 3
  D) 3, 4

 

 

16. The nurse is reviewing with the students steps to avoid accidental needlestick injuries. What are key points to include on avoiding accidental needlestick injuries with the group of student nurses?
  A) Break needles after use.
  B) Recap needles after use.
  C) Detach the needle from the syringe.
  D) Use safety syringes.

 

 

17. Although refuse and linen from all clients are considered contaminated, in some types of isolation these items are “double bagged” out of the room. Based on this information, which are correct steps in the double-bagging procedure?

1.     The nurse inside the room is considered contaminated and the nurse outside the room is considered clean.

2.     The nurse inside the room wears gloves and, if specified, gown and/or mask.

3.     The contaminated nurse places dirty items into a bag and closes the top.

4.     The clean nurse has a second bag that is considered dirty.

  A) 1, 3
  B) 1, 4
  C) 2, 3
  D) 3, 4

 

 

18. Each accredited healthcare facility must have an infection control committee that monitors and evaluates any infection occurring in the facility. The nurse is reviewing with a group of nursing students the goals of the infection control committee. Based on this information, what would be the best answer by the nursing student about the goals of the infection control committee?

1.     Offer continuing education for nursing students to prevent infections

2.     Serve as consultants in cases of questions or concerns by healthcare personnel

3.     Establish employee health and wellness programs

4.     Work to prevent further recurrences

  A) 1, 2
  B) 1, 4
  C) 2, 4
  D) 3, 4

 

 

19. The nurse is reviewing with a group of nursing students about Standards Precautions. Which information is important to include in the presentation?
  A) Combination of Universal Precautions and Body Substance Precautions
  B) Combination of Standard Precautions and Transmission-Based Precautions
  C) Combination of Universal Precautions and Contact Precautions
  D) Combination of Airborne Precautions and Droplet Precautions

 

 

20. A registered nurse is reviewing key principles of Standard Precautions with a group of nursing students. Which statement by a student nurses most accurately describes a nursing action to take with Standard Precautions?
  A) Cut the needle off a syringe after using it to administer an IM injection to a client.
  B) Blood-contaminated materials are disposed of in a biohazard container.
  C) Gloves are not required to be worn for client care unless body fluids are seen.
  D) A mask is worn when in direct contact with clients.

 

 

21. A client has been placed on Droplet Precautions for meningococcal meningitis. The nurse must wear a mask when entering the room and especially within which distance of taking care of the infected client?
  A) 1 foot
  B) 2 feet
  C) 3 feet
  D) 4 feet

 

 

22. The clinical unit has been notified of a client being admitted with tuberculosis. Which action best demonstrates the correct measure for prevention of transmission of the disease?
  A) Stock the supply cart with masks at the beginning of every shift.
  B) Wash hands after completion of client care.
  C) Wear a surgical mask in the care of the client.
  D) Have the client wear a mask when coming up from the admitting office.

 

 

23. The clinical unit has been notified of a client being admitted with tuberculosis. Which action best demonstrates the correct measure for prevention of transmission of the disease?
  A) Admission to a semiprivate room
  B) Admission to a negative air flow pressure room
  C) Keep client’s door open for discharge of room air to environment
  D) Air filtered after each circulation in the negative air flow pressure room

 

 

24. A client is admitted to a unit with influenza. What is the most appropriate type of precautions that should be initiated by the nurse for this client?
  A) Droplet Precautions
  B) Contact Precautions
  C) Airborne Precautions
  D) Protective Precautions

 

 

25. A client has been placed on protective isolation. Which actions have to be implemented with the care of a client on protective isolation?

1.     Client requires a private room

2.     Healthcare workers cannot take care of the client if they have a cold or influenza

3.     Anyone entering the room must wear a gown and practice strict handwashing before coming in contact with the client

4.     Client cannot receive fresh fruit, fresh vegetables, or flowers

  A) 1, 2, 3
  B) 1, 2, 4
  C) 1, 3, 4
  D) 2, 3, 4

 

 

 

Answer Key

 

1. A
2. C
3. B
4. D
5. A
6. B
7. C
8. C
9. A
10. D
11. D
12. C
13. C
14. A
15. A
16. D
17. A
18. C
19. A
20. B
21. C
22. D
23. B
24. A
25. B

Chapter 80- Sensory System Disorders

1. A nurse is assisting a healthcare provider during a refractive error examination for a client with complaints of visual impairment. Which of the following measures should the nurse employ during the procedure?
  A) Position the client 10 feet from the phoropter.
  B) Place the phoropter at the sides of the client’s eyes.
  C) Position the client 20 feet from the phoropter.
  D) Place the phoropter in front of the client’s eyes.

 

 

2. The nurse is assisting an ophthalmologist with a test to measure the pressure in the eyes of a client in order to detect glaucoma. Which of the following tests is being performed?
  A) Tonometry
  B) Slit lamp examination
  C) Ophthalmoscopic examination
  D) Refractive Examination

 

 

3. The nurse is preparing a client for an electroretinogram (ERG) to confirm a diagnosis of retinitis pigmentosa. Which of the following explanations would be appropriate preparation for this client?
  A) “You will be placed in a brightly lit room for this test.”
  B) “Radiopaque dye will be injected into your eye before the test.”
  C) “A contact lens containing an electrode will be placed on your eye.”
  D) “You will see a bright beam of light directed at your eye.”

 

 

4. The nurse is assisting with a caloric test to determine if an alteration exists in the vestibular origin of the acoustic nerve. Which of the following accurately describes a step in this procedure?
  A) Place the client in a prone position to perform the examination.
  B) Instill cold and/or warm water into the external ear canal.
  C) Test the affected side after testing the normal side.
  D) Replace water with hot air for a client with a punctured eardrum.

 

 

5. A client has an eye patch to allow the eye to rest following an injury playing soccer. Which of the following is a teaching point for a client with one eye patch?
  A) Warn the client not to drive a car or other machinery.
  B) Tell the client to remove the patch at night.
  C) Tell the client to report any changes in depth perception.
  D) Tell the client to report any changes in peripheral vision.

 

 

6. A nurse is irrigating the ear of a client to clear an external auditory canal obstruction. Which of the following measures should the nurse employ when caring for this client?
  A) Warm the irrigating solution to body temperature.
  B) Straighten the client’s ear canal down and back.
  C) Place the syringe at the tip of the external auditory meatus.
  D) Keep the ear canal wet to promote client comfort.

 

 

7. The nurse is providing preoperative teaching for a client undergoing eye surgery. Which of the following are accurate teaching points to prepare this client following the surgery? Select all that apply.
  A) Remove the dressings when alert.
  B) Wear a metal shield, if prescribed, for up to 4 weeks.
  C) Sleep on the operative side for the first week.
  D) On the second postoperative day, clean the eye with moist cotton balls.
  E) Avoid sudden movements and straining at stool.
  F) Do not lift more that 20–30 pounds for about a week.

 

 

8. The nurse is caring for a client with a prosthetic eye. Which of the following is a recommended guideline for inserting a prosthetic eye?
  A) Make sure the prosthesis is dry when inserting it.
  B) Close the eyelid and slip the prosthesis under the top lid.
  C) Press inward on the bottom of the prosthesis to seat it in place.
  D) Ask the client to blink to seat the prosthesis in place.

 

 

9. The nurse caring for a client following eye surgery reports to the surgeon that the client is showing signs of ptosis (drooping eyelid). What might this finding indicate?
  A) Dehydration
  B) Paralysis
  C) Edema
  D) Hemorrhage

 

 

10. The nurse is providing discharge teaching for a client following ear surgery in an ambulatory care center. Which of the following would the nurse include in the teaching plan for this client?
  A) When changing positions, sit or stand up quickly to force the ears to adjust.
  B) Report any fever, headache, vertigo, or ear pain immediately.
  C) When lying down, lie on the operative side to facilitate drainage.
  D) Resume normal activities after about 1 week following a check-up.

 

 

11. The nurse is caring for a patient in the hospital who is visually impaired. Which of the following nursing considerations would be appropriate for this client? Select all that apply.
  A) Let the client know when you are leaving the room.
  B) Speak in a louder tone to compensate for loss of vision.
  C) Touch clients before speaking to them to keep from frightening them.
  D) Identify self when entering the room.
  E) Place food on the plate in a “clock position” and identify the food.
  F) Lightly push the client from behind when helping the client to ambulate.

 

 

12. The nurse is entering the hospital room of a client who has a severe hearing deficit. Which of the following nursing considerations would be appropriate for this client?

Select all that apply.

  A) Speak first and then get the client’s attention.
  B) Face the client on the same level.
  C) Speak slowly and clearly.
  D) Repeat specific words rather than entire phrases.
  E) Do not use hand motions to facilitate the conversation.
  F) Verify that the person understood the conversation.

 

 

13. Several specialists are involved in the treatment of the eye. Which of the following would be licensed to perform cataract surgery?
  A) Ophthalmologist
  B) Optometrist
  C) Optician
  D) Ophthalmic technician

 

 

14. The ophthalmologist examining a client’s eyes documents that the client has astigmatism. Which of the following describes this condition?
  A) Elongation of the eyeball
  B) Shorter than normal eyeball
  C) Loss of elasticity of the lens
  D) Unequal curvature in shape of the lens

 

 

15. An older adult is diagnosed with the condition known as presbyopia, and is experiencing errors in far and near vision. Which of the following is the most common treatment option for this client?
  A) Eye surgery
  B) Hard contact lenses
  C) Bifocals
  D) Lens implants

 

 

16. A hospitalized client wakes up in the morning with his eyelids sticking together from a thick and copious discharge. After the nurse applies warm soaks to help remove the crusts, the client further complains of pain, redness, and itching of the eyes. What inflammatory disorder would the nurse suspect?
  A) Hordeolum
  B) Conjunctivitis
  C) Chalazion
  D) Keratitis

 

 

17. The nurse performing a physical assessment of an 80-year-old client documents the structural disorder known as entropion. What occurs in this condition?
  A) There is an outward turning of the eyelid caused by the aging process.
  B) There is drooping of the upper eyelid owing to muscle weakness or nerve damage.
  C) There is an inward turning of the lid margin common in older adults
  D) There is increased fluid pressure within the eye.

 

 

18. An elderly client is diagnosed with cataracts. The client complains of double vision and says he sees halos around lights. What should the nurse expect to find in the client’s eyes during the nursing assessment?
  A) Redness of lid margins
  B) Cloudiness of the lens
  C) Drooping of the eyelid
  D) Dilation of the pupils

 

 

19. A nurse is caring for a client with a sty on his left upper eyelid. Which of the following measures should the nurse employ when caring for this client?
  A) Compress the sty to prevent spread of infection.
  B) Apply pressure patching for 24 to 48 hours.
  C) Apply warm, moist compresses over the eyelid.
  D) Administer miotic drops, as ordered.

 

 

20. During a routine eye examination, an elderly client provides a family history of wide-angle glaucoma. What early symptoms of wide-angle glaucoma should the nurse assess for in this client?
  A) Temporary blurring of vision
  B) Central blindness
  C) Halos around lights
  D) Flashers and floaters

 

 

21. A client who was in a motor vehicle accident has a “black eye.” What nursing intervention is appropriate for this client?
  A) Apply warm packs to the eye for the first 24 to 48 hours.
  B) Apply cold packs to the eye for the first 24 to 48 hours.
  C) Soak the eye with normal saline for the first 24 to 48 hours.
  D) Apply warm packs to the eye once the swelling has stopped.

 

 

22. A nurse is caring for a client with a contusion injury to his right eye. Which of the following signs would alert the nurse to a detached retina in this client?
  A) Severe eye pain
  B) Flashes of light
  C) Wavy lines
  D) Immediate loss of vision

 

 

23. A client is diagnosed with conductive hearing loss. Which of the following are common causes of this condition? Select all that apply.
  A) Otitis media
  B) Excessive noise
  C) Tumors
  D) Perforated eardrum
  E) Foreign bodies
  F) Viral infections

 

 

24. A client visits the healthcare facility with an insect fluttering in his ear. Which of the following should the nurse do to extract the insect?
  A) Administer a few drops of mineral oil.
  B) Apply eardrops containing acetic acid.
  C) Apply eardrops containing boric acid.
  D) Administer a few drops of glycerin.

 

 

25. A client visits a community clinic with complaints of severe allergies causing a “crackling sensation” in the ear. The diagnosis is serous otitis media. Which of the following is a characteristic of this condition?
  A) Fluid collects in the middle ear, causing an obstruction of the auditory tube.
  B) An upper respiratory infection spreads through the auditory tube.
  C) This condition develops if acute purulent otitis media is not treated promptly.
  D) This condition is usually associated with a punctured eardrum.

 

 

26. The nurse is providing teaching for a 7-year-old child who is having polyethylene (PE) tubes inserted because of recurrent inner ear infections. Which of the following is a teaching point for this client and family?
  A) The child will be on antibiotics for the first month.
  B) The child’s ear should be plugged with cotton.
  C) The child should be trained to lip read.
  D) The child should not use a shower or swim.

 

 

27. A nurse is caring for a client who is diagnosed with Ménière’s disease. Which of the following measures should the nurse take when caring for this client?
  A) Encourage the client to take in more fluids.
  B) Elevate the head of the bed to about 45 degrees.
  C) Explain all actions to the client ahead of time.
  D) Provide the client a diet rich in sodium.

 

 

28. The nurse is aware that clients with tactile difficulties may be in danger because they cannot react appropriately to external injuries or internal disorders. Which of the following clients should the nurse monitor for tactile sense disorders?
  A) A client after a myocardial infarction
  B) A client who has uncontrolled diabetes
  C) A client with renal failure
  D) A client with rheumatoid arthritis

 

 

29. A nurse is caring for a client with gustatory disorder. The nurse knows that which of the following is a sign of gustatory disorder?
  A) Inability to maintain balance
  B) Reduced interest in eating
  C) Lack of pain perception
  D) Inappropriate reaction to injuries

 

 

 

Answer Key

 

1. D
2. A
3. C
4. B
5. A
6. A
7. B, D, E
8. D
9. C
10. B
11. A, D, E
12. B, C, F
13. A
14. D
15. C
16. B
17. C
18. B
19. C
20. A
21. D
22. B
23. A, D, E
24. A
25. A
26. D
27. C
28. B
29. B

Chapter 100- Hospice Nursing

1. The nurse is caring for clients in a hospice setting. Which of the following best describes this type of healthcare?
  A) It is a specific care setting for the dying client.
  B) It is a philosophy of care for dying clients.
  C) It is based on finding a cure for terminal illnesses.
  D) It is based on keeping the dying client as drug-free as possible.

 

 

2. The nurse caring for clients in hospice notes that which of the following is the disease state most commonly seen in this program?
  A) Dementia
  B) Heart disease
  C) Lung disorders
  D) Cancer

 

 

3. A hospice nurse is caring for a 62-year-old female client with metastatic endometrial carcinoma. What is the nursing consideration to be followed when caring for this client in a hospice setting?
  A) Help control the client’s symptoms.
  B) Emphasize a focus on the problems.
  C) Stay with the client when she asks to be alone.
  D) Help in solving family disputes.

 

 

4. A hospice must meet certain criteria to legitimately be called a hospice. Which of the following is one of these criteria?
  A) The goal must be curative measures, not just palliative care.
  B) The hospice must be administered by a hospital staff.
  C) The hospice care is based on a client’s financial resources.
  D) Bereavement care must be provided for the family for at least 1 year.

 

 

5. The hospice nurse provides palliative care for clients. Which of the following are clinical practice guidelines for this type of care? Select all that apply.
  A) Assessing pain
  B) Researching new treatment modalities
  C) Performing life-saving resuscitation measures
  D) Treating pain
  E) Providing symptom relief
  F) Coordinating care

 

 

6. A client who is diagnosed with anaplastic thyroid cancer asks a home nurse whether he is eligible to join a hospice program. What is a criterion for the client to be admitted to a hospice?
  A) A person agrees to take care of the client 12 hours a day.
  B) Curative treatment is not desired by the client’s family.
  C) Admission is directed toward meeting only the family needs.
  D) Life expectancy is at least 2 years from date of admission.

 

 

7. A client with end-stage renal failure is being admitted to a hospice program. Which of the following is a requirement for admission to this type of program?
  A) The client must have a diagnosis of a progressive, terminal illness.
  B) Life expectancy must be under 1 year.
  C) In most cases the client agrees to life-saving resuscitation.
  D) Once started, hospice cannot be discontinued by the client or family.

 

 

8. A client diagnosed with end-stage leukemia is placed in hospice care. In a hospice setting, who is in control of client care?
  A) The physician
  B) The nurse
  C) The family
  D) The client

 

 

9. A woman taking care of her mother who is in a home hospice program is experiencing “compassion fatigue.” Which of the following are signs of this caregiver condition? Select all that apply.
  A) Being oversympathetic to client needs
  B) Having a sense of hopelessness
  C) Making decisions quickly
  D) Having trouble concentrating
  E) Decreasing use of alcohol or tobacco
  F) Considering suicide

 

 

10. A caregiver of a client in hospice tells the nurse that if she “doesn’t get a break from the situation, she will no longer be able to care for her family member.” The nurse recommends respite care. What generally occurs when respite care is initiated?
  A) A new family caregiver is assigned to the client for the duration of hospice care.
  B) The nurse replaces the caregiver for the duration of the hospice care.
  C) The caregiver “takes a break,” usually for a period of less than 30 days.
  D) The client who is being cared for will be rehospitalized for the duration of care.

 

 

11. Which of the following hospice care team members provides a constant liaison between the client and the hospice team and may suggest approaches to care that meet with everyone’s approval?
  A) Caregiver
  B) Primary care provider
  C) Nurse
  D) Home health aide

 

 

12. The hospice nurse provides emotional support to clients in hospice care. Which of the following is the greatest fear of most clients in these programs?
  A) Having unbearable pain
  B) Losing control of body functions
  C) Dying alone
  D) Losing control of emotions

 

 

13. The nurse is providing bereavement care for a family who lost a loved one. Which of the following is a role of the nurse in this process?
  A) Set up a memorial service for the client.
  B) Urge family members not to reminisce about their loved one.
  C) Visit the family after the client’s death to evaluate how they are coping.
  D) Follow-up with bereavement care for 3 months following the client’s death.

 

 

14. The hospice nurse is administering dolasetron mesylate (Anzemet) to a client who is in hospice care. Which of the following is a symptom that this medication is designed to control?
  A) Pain
  B) Nausea
  C) Diarrhea
  D) Constipation

 

 

15. A client with end-stage lung cancer who is in hospice care is experiencing severe depression. Which of the following medications might be prescribed to alleviate this symptom? Select all that apply.
  A) Bupropion (Wellbutrin)
  B) Citalopram (Celexa)
  C) Buspirone (BuSpar)
  D) Eszopiclone (Lunesta)
  E) Furosemide (Lasix)
  F) Paroxetine (Paxil, Pexeva)

 

 

16. A client admitted to home care hospice with terminal stage cervical cancer complains of constipation. What should the nurse provide, with orders, to manage constipation in this client?
  A) Low-residue diet
  B) Belladonna suppository
  C) Kaolin and pectin mixture
  D) Milk of Magnesia

 

 

17. The nurse is caring for clients in a hospice program. Which of the following is a recommended nursing care guideline when caring for this population?
  A) Focus on problems.
  B) Try to predict the exact time of death.
  C) Maintain a sense of humor.
  D) Do not allow the client to be alone.

 

 

18. A client admitted to a hospice program for metastatic osteosarcoma and complaining of intense bone pain is given corticosteroids. What is a consequence of corticosteroid administration?
  A) Mood depression
  B) Spinal cord edema
  C) Appetite stimulation
  D) Unresolving emesis

 

 

19. The nurse is providing comfort measures for a client who is in hospice for terminal cancer of the liver. Which of the following is the most important factor in promoting client comfort?
  A) Controlling nausea
  B) Controlling diarrhea
  C) Maintaining adequate hydration
  D) Maintaining a patent airway

 

 

20. The hospice nurse is initiating measures to help with nutrition for a client who has anorexia related to a terminal illness. Which of the following is a recommended guideline when providing nutrition to the terminally ill?
  A) Do not encourage eating or drinking anything unless the client desires it.
  B) Most clients benefit from low oral intake in the last stages of illness.
  C) A large glass of wine may be beneficial to help the client eat.
  D) Vitamins are more effective if taken about 1 hour following a meal.

 

 

21. A 42-year-old male client with metastatic renal carcinoma complains of disturbed sleep. What nursing measure would improve his sleep?
  A) Listening to soft music and relaxation tapes
  B) Avoiding physical exertion
  C) Taking short naps during the day
  D) Consuming a low-carbohydrate diet

 

 

22. A nurse is assessing the pain of a client who is in hospice. Which of the following is the most reliable indicator of pain?
  A) Vital signs
  B) Patient cues
  C) Patient self-report
  D) Inability to sleep

 

 

23. A 56-year-old male client with metastatic lung cancer rates his pain as a 5 on a pain assessment scale. What type of pain medication would be appropriate for this client?
  A) Strong opioid
  B) Weak opioid
  C) Acetaminophen
  D) NSAID

 

 

24. The nurse is administering pain medications to clients in a hospice program. Which of the following is a recommended guideline for this procedure?
  A) Try the highest dose of medication first.
  B) Do not increase dosages of narcotic drugs.
  C) Dosages of opiates should decrease quickly if discontinuing the medication.
  D) Correlate the medication to the client’s report of pain intensity.

 

 

25. The nurse is administering pain medications to clients with severe pain related to end-stage diseases. Which of the following is the first route of choice for these clients?
  A) Oral
  B) Intramuscular
  C) Subcutaneous
  D) Intravenous

 

 

26. A client admitted to a hospice facility for breast carcinoma is prescribed morphine for pain relief. What adverse effect should the nurse monitor for in a client receiving morphine?
  A) Decreased respirations
  B) Watery diarrhea
  C) Hyperactivity
  D) Hyperthermia

 

 

27. A client with pancreatic carcinoma complains of severe abdominal pain radiating to the back. The healthcare provider prescribes a narcotic analgesic for pain relief. What should the nurse take into account when administering pain relief medications?
  A) Dosage will not change with change in route of administration.
  B) Titration of the drug dosage is not necessary on discontinuation.
  C) Pain medication is unaffected by tolerance to other medications.
  D) Dosage of pain medication should be increased gradually.

 

 

28. A nurse places a saline lock to administer IV pain relief medications to a 65-year-old client admitted to home care hospice with a diagnosis of transitional cell carcinoma of the bladder. For what should the nurse use a saline lock?
  A) Faster delivery of medication
  B) Avoidance of medication leak
  C) Avoidance of repeated venipuncture
  D) Prevention of electrolyte imbalance

 

 

29. A 5-year-old child is admitted to a hospice facility with a diagnosis of a metastatic brain tumor. What nursing consideration should be made when dealing with dying children?
  A) Avoid involving them in decision making.
  B) Discourage them from talking about death.
  C) Explain death as similar to going to sleep.
  D) Explain death in terms of the child’s religious beliefs.

 

 

30. An end-stage human immunodeficiency virus (HIV)-positive client admitted to a hospice with metastatic Kaposi sarcoma is found to be unresponsive when the nurse approaches the client for assessing the vitals. The client is declared dead after examination. What is the nurse’s responsibility after the death of the client?
  A) Discontinue hospice program following client’s death.
  B) Avoid showing grief to the family members.
  C) Refer the family to a bereavement support group.
  D) Return the client’s narcotics to the family members.

 

 

 

Answer Key

 

1. B
2. D
3. A
4. D
5. A, D, E, F
6. B
7. A
8. D
9. B, D, F
10. C
11. A
12. C
13. C
14. B
15. A, B, F
16. D
17. C
18. C
19. D
20. B
21. A
22. C
23. B
24. D
25. A
26. A
27. D
28. C
29. D
30. C

 

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