ExN106A

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Author:
ndarlenebeck
ID:
295755
Filename:
ExN106A
Updated:
2015-02-14 16:53:51
Tags:
Excelsior
Folders:
Excelsior
Description:
Excelsior Form A
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  1. Which is the most appropriate task for the registered nurse to delegate to unlicensed assistive personnel?
    A) Determine if a patient can see better with clean glasses
    B) Evaluate if a patient is properly using his contact lens.
    C) Test a patient's visual acuity using a Snellen Chart
    D) Teach a patient to administer his own eyedrop medications.
    A) Determine if a patient can see better with clean glasses.
    (this multiple choice question has been scrambled)
  2. What should the clinic nurse teach the parent of a child newly diagnosed with acute otitis externa?
    A) administer acetaminophen (Tylenol) for fever
    B) Keep the ear dry when bathing
    C) Arrange for a hearing test when antibiotics are completed.
    D) Dry the ear canal with a cotton-tipped applicator.
    B) Keep the ear dry when bathing
    (this multiple choice question has been scrambled)
  3. The nurse teaches parents to administer ear drops to their one-year-old child. Which action by the parents during administration of the drops indicates that they have understood the instruction?
    A) down and forward
    B) up and forward
    C) up and back
    D) down and back
    D) down and back
    (this multiple choice question has been scrambled)
  4. Sustained noise at what level can lead to progressive hearing loss?
    A) 60 decibels
    B) 75 decibels
    C) 90 decibels
    D) 120 decibels
    C) 90 decibels
    (this multiple choice question has been scrambled)
  5. Which assessment data is crucial prior to the administration of the first dose of an antibiotic eye ointment?
    A) Knowledge of the infection process
    B) History of antibiotic allergies of sensitivity
    C) Knowledge of antibiotic medication self-administration
    D) Current use of oral antibiotics
    B) History of antibiotic allergies of sensitivity
    (this multiple choice question has been scrambled)
  6. Which disorder is associated with a conductive hearing loss of the middle ear?
    A) damage to the vestibular cochlear nerve
    B) functional
    C) Eustachian tube dysfunction
    D) external ear disorder
    A) damage to the vestibular cochlear nerve
    (this multiple choice question has been scrambled)
  7. What are the symptoms of acute angle-closure glaucoma?
    A) dark spots and blurred vision
    B) floaters and flashing lights
    C) pain and halo vision
    D) exudate and subretinal hemorrhage
    C) pain and halo vision
    (this multiple choice question has been scrambled)
  8. A patient shows normal vision and hearing but has difficulty making decisions.  He is often drowsy and appears depressed.  Which sensory concern does the patient most likely have?
    A) deficit
    B) overload
    C) enhancement
    D) deprivation
    D) deprivation
    (this multiple choice question has been scrambled)
  9. Which adverse systemic effect may occur when using pilocarpine eye drops?
    A) hypotension
    B) constipation
    C) tachycardia
    D) obiguria
    C) tachycardia
    (this multiple choice question has been scrambled)
  10. Following a trauma to the eye, a patient experiences a mild hyphema.  The nurse instructs the patient to maintain an upright position and rest in bed for a few days.  Which rationale supports this intervention?
    A) maintains the eye's natural barrier to microorganisms
    B) minimizes the patient's urge to rub the injured eye
    C) enhances the pooling of blood in the anterior chamber
    D) decreases the risk for damage to the eighth cranial nerve.
    C) enhances the pooling of blood in the anterior chamber
    (this multiple choice question has been scrambled)
  11. A patient who has a moderate hearing loss is receiving instructions from the nurse on the correct use of a new in the ear hearing aid.  Which response made by the patient indicates a need for further instruction?
    A) "I should not wear my hearing aid if I'm sitting under a hair dryer."
    B) "If I use my hearing aid on a regular basis, the batteries will need to be replaced about once a week."
    C) "I should gradually increase the time I wear my hearing aid by 15 minutes a day until I'm wearing it up to 12 hours."
    D) "A whistling sound means that my hearing aid needs to be cleaned."
    D) "A whistling sound means that my hearing aid needs to be cleaned."
    (this multiple choice question has been scrambled)
  12. The nurse should give priority to which nursing diagnosis for a patient with Meniere's disease?
    A) sensory and perceptual alterations related to tinnitus
    B) risk for injury related to vertigo
    C) knowledge deficit related to onset of the disease process
    D) altered nutrition: less than body requirements related to nausea and vomiting
    B) risk for injury related to vertigo
    (this multiple choice question has been scrambled)
  13. The nurse teaches the patient with glaucoma to take the prescribed medication in order to prevent which adverse effects?
    A) an increased loss of peripheral vision
    B) a thickening of the lenses
    C) perception of floaters in the visual field
    D) a decreased ability to focus on objects
    A) an increased loss of peripheral vision
    (this multiple choice question has been scrambled)
  14. Which patient statement about vision is of greatest concern to the nurse?
    A) "Words look blurry to me when I try to read."
    B) "My peripheral vision is not as good as it was last year."
    C) "I now have a shadow spreading over one eye's vision."
    D) "I have a black blurry hole in the center of my vision."
    C) "I now have a shadow spreading over one eye's vision."
    (this multiple choice question has been scrambled)
  15. Which is an appropriate nursing diagnosis for a patient with vertigo?
    A) fear related to the emotional impact of the illness and the potential of falling
    B) powerlessness related to inability to communicate
    C) altered body image related to dizziness, staggering, and lack of body orientation
    D) risk for fluid volume deficit related to increased fluid output, altered intake, and medications.
    D) risk for fluid volume deficit related to increased fluid output, altered intake, and medications.
    (this multiple choice question has been scrambled)
  16. During an office visit, a patient with chronic glaucoma had an elevated ocular pressure measurement.  She confides to the nurse that she does not take her eye drops regularly.  Which nursing action is a priority"
    A) Record the patient's noncompliance in the medical record.
    B) Attempt to identify why the patient is not taking her eye drops.
    C) Explore the financial assistance available for purchasing the eye drops.
    D) Remind the patient of the importance of control to prevent complications.
    B) Attempt to identify why the patient is not taking her eye drops.
    (this multiple choice question has been scrambled)
  17. The nurse is assessing a patient following the removal of a cataract.  Which observation indicates a complication?
    A) Photophobia is not relieved by an eye shield.
    B) Dry conjunctiva is not relieved by eye drops.
    C) Eye pain is not relieved by the ordered analgesic.
    D) Itching is not relieved by cool compresses.
    C) Eye pain is not relieved by the ordered analgesic.
    (this multiple choice question has been scrambled)
  18. Mydriatics are used during eye surgery for which purpose?
    A) to induce relaxation of the iris sphincter
    B) to induce relaxation of the ciliary muscle
    C) to induce papalysis of the iris sphincter
    D) to sustain pupil dilation
    B) in induce relaxation of the ciliary muscle
    (this multiple choice question has been scrambled)
  19. During a nursing history, a patient indicates high-dosage use of furosemide (Lasix) for serveral years.  The nurse should assess this patient for which side effect of the medications?
    A) vision loss
    B) altered touch perception
    C) hearing loss
    D) skin impairment
    C) hearing loss
    (this multiple choice question has been scrambled)
  20. Which instruction for postoperative care should the nurse provide to the patient who has undergone middle ear and mastoid surgery?
    A)"You should expect large amounts of purulent drainage after surgery."
    B)"You should blow your nose as needed to allieviate feelings of fullness."
    C) "You should remove packing from the external ear canal before taking a shower."
    D) "You should cough and sneeze with your mouth open."
    D) "You should cough and sneeze with your mouth open>"
    (this multiple choice question has been scrambled)
  21. A patient with terminal cancer says, "I feel so guilty. I should have done better for my family." The patient's comment is an example of which phase of the grief process?
    A) reorganization
    B) development of awareness
    C) restitution
    D) shock and disbelief
    B) development of awareness
    (this multiple choice question has been scrambled)
  22. The nurse is developing a care plan for a family with a nursing diagnosis of anticipatory grieving related to a diagnosis of advanced ovarian cancer in the mother.  The nurse should consider which intervention to be of primary importance?
    A) Discuss treatment modalities.
    B) Establish a trusting relationship
    C) Request that a member of the clergy visit.
    D) Refer the family to social services
    B) Establish a trusting relationship
    (this multiple choice question has been scrambled)
  23. Which psychosocial nursing intervention best supports a dying patient's preferences?
    A) Inform the patient of available resources.
    B) Explore meanings, relationship, and hope with the patient.
    C) Assess the patient's ability to psychologically adapt to the situation
    D) Provide education and reassurance about patient's state of health
    B) Explore meanings, relationship, and hope with the patient.
    (this multiple choice question has been scrambled)
  24. A clinic nurse is evaluation an older adult patient whose spouse has recently died.  The nurse suspects that the patient is at risk for depression.  Which patient behavior confirms the nurse's suspicions?
    A) The patient frequently gestures when responding to questions.
    B) The patient's eyes dart around the room during the interview.
    C) The patient hesitates when trying to remember her last clinic visit.
    D) The patient sits while the nurse undresses her for the examination
    D) The patient sits while the nurse undresses her for the examination.
    (this multiple choice question has been scrambled)
  25. Which nursing action best relieves stress for a newly admitted dying patient and his family?
    A) Leave them alone to decrease stimuli.
    B) Explain the procedures to the patient and family on arrival.
    C) Stay at the bedside as much as possible.
    D) Sedate the patient with medications.
    C) Stay at the bedside as much as possible.
    (this multiple choice question has been scrambled)
  26. Which is the nurse's primary goal in treating the unconscious patient?
    A) The patient will maintain effective airway clearance throughout the shift.
    B) The nurse will provide mouth care every two hours.
    C) The patient will not experience respiratory distress by the end of the shift.
    D) The patient will be kept NPO.
    A) The patient will maintain effective airway clearance throughout the shift.
    (this multiple choice question has been scrambled)
  27. Which description best describes a substantial resolution of grieving?
    A) The person is no longer conscious of the loss.
    B) The acute phase of grieving is shorter in older adults.
    C) Grief reactions are not affected by previous grief experiences.
    D) Brief periods of intense feeling may occur at significant times.
    D) Brief periods of intense feeling may occure at significant times.
    (this multiple choice question has been scrambled)
  28. Which is the appropriate intervention for a dying patient who has difficulty breathing and is experiencing copious secretions?
    A) Give oxygen by mask.
    B) Administer anticholinergic medication.
    C) Recommend Fowler's position while resting.
    D) Use a fan to circulate air in the room.
    B) Administer anticholinergic medication.
    (this multiple choice question has been scrambled)
  29. What is the most distressing change for parents to observe in a dying child?
    A) change in respiratory patterns
    B) loss of lower extremity movement
    C) slurred speech
    D) loss of bowel and bladder control
    A) change in respiratory patterns
    (this multiple choice question has been scrambled)
  30. Which nursing statement demonstrates appropriate communication strategies when providing end of life care to a patient and his family?
    A) "You should know from being with your mother when someone dies."
    B) "Tell me about your feelings."
    C) "I promise that I will be here when you die."
    D) "I am not allowed  to discuss your prognosis."
    B) "Tell me about your feelings."
    (this multiple choice question has been scrambled)
  31. On a patient's medical chart is a document identifying the patient's eldest child as responsible for making decisions on the patient's behalf.  What is the name of this document?
    A) living will
    B) informed consent
    C) last will and testament
    D) durable power of attorney
    D) durable power of attorney
    (this multiple choice question has been scrambled)
  32. Which is a belief in the Hispanic culture related to the care of the dying patient?
    A) Funerals are unimportant; grieving is private.
    B) The patient should readily accept pain medication.
    C) Assistance should be sought outside of the immediate family.
    D) The patient does not need to know the prognosis.
    D) The patient does not need to know the prognosis.
    (this multiple choice question has been scrambled)
  33. "I used to perform with the New York City Ballet, and look at me now!" sobs an 83 year old patient who is wheelchair bound.  Which is the nurse's best response?
    A) "I thought you might have been a dancer. You are still very graceful when you participate in our exercise class."
    B) "Would you like to watch the ballet video we have?"
    C) "Let's plan your exercises so that you can develop enough muscle strength to get back on your feet."
    D) "What kind of dancing did you do?"
    D) "What kind of dancing did you do?"
    (this multiple choice question has been scrambled)
  34. The hospice nurse is teaching the daughter of a patient with signs of impending death. Which sign would the nurse emphasize as one that will occur shortly before death?
    A) difficulty swallowing
    B) vomiting
    C) slow respiration
    D) drowsiness
    C) slow respiration
    (this multiple choice question has been scrambled)
  35. Which type of food should be offered as a patient nears death?
    A) citrus juice
    B) soups
    C) red meats
    D) fresh vegetables
    B) soups
    (this multiple choice question has been scrambled)
  36. An adolescent patient with terminal cancer says. "I just have no interest in doing anything of having any visitor." The patient's comment is an example of which grief response?
    A) anger
    B) denial
    C) guilt
    D) depression
    D) depression
    (this multiple choice question has been scrambled)
  37. When assessing the significance of a loss, who provides the most significant data?
    A) the primary caregiver for the patient experiencing the loss
    B) the adult children of the patient experiencing the loss
    C) the patient who is experiencing the loss
    D) the spouse of the patient experiencing the loss
    C) the patient who is experiencing the loss
    (this multiple choice question has been scrambled)
  38. Which symptom should the nurse report as a common side effect associated with the use of narcotic analgesics in a dying patient?
    A) dry mouth
    B) tachypnea
    C) constipation
    D) constricted pupils
    C) constipation
    (this multiple choice question has been scrambled)
  39. A three year old child has a terminal illness.  The child's father tells the nurse, "I've had it with you incompetent nurses and doctors!" Which would be an appropriate response by the nurse?
    A) "What exactly about your child's situation is depressing you?"
    B) "You're angry at us. I can understand how you feel."
    C)"You seem to be experiencing some strong feelings."
    D) "We're more competent than you think. Tell me about your grief."
    C) "You seem to be experiencing some strong feelings."
    (this multiple choice question has been scrambled)
  40. What statement shows that a family member correctly understands the transplant coordinator's explanation about organ donation?"
    A) "It's too bad the funeral will be delayed."
    B) "This donation is going to cost a lot of money."
    C) "I'm glad the casket can remain open."
    D) "It's too bad that only major organs can be used."
    C) "I'm glad the casket can remain open."
    (this multiple choice question has been scrambled)
  41. Which assessment of a four year old patient with severe abdominal pain will provide objective information about the exact location of the pain?
    A) Have the patient point to where the pain is felt.
    B) Observe for nonverbal behaviors such as guarding.
    C) Ask the patient to draw a picture of the pain.
    D) Ask the parent for assistance to locating the pain.
    A) Have the patient point to where the pain is felt.
    (this multiple choice question has been scrambled)
  42. A patient is receiving a narcotic analgesic via an epidural catheter. Which clinical manifestation indicates a possible side effect of this therapy?
    A) urinary retention
    B) tachycardia
    C) hypertension
    D) sleep disturbance
    A) urinary retention
    (this multiple choice question has been scrambled)
  43. The nurse assesses a patient who reports experiencing intermittent pain for the past two months. Which clinical manifestation will be present?
    A) increased heart rate
    B) decreased gastrointestinal motility
    C) decreased appetite
    D) increased blood pressure
    C) decreased appetite
    (this multiple choice question has been scrambled)
  44. How does a transcutaneous electric nerve stimulation (TENS) unit relieve pain?
    A) depresses central nervous system activity through membrane stabilization.
    B) increases release of anti-inflammatory chemicals at site of injury.
    C) blocks small nerve fibers by stimulating large ones.
    D) blocks pain by stimulating opiate receptors.
    C) blocks small nerve fibers by stimulating large ones.
    (this multiple choice question has been scrambled)
  45. The nurse is caring for a patient who is receiving a nonsteroidal anti-inflammatory drug(NSAID). The nurse should give priority to which nursing diagnosis?
    A) risk for altered oral mucous membranes related to decreased gastric motility.
    B) ineffective breathing pattern related to respiratory distress
    C) risk for injury related to gastrointestinal irritation
    D) urinary retention related to anticholinergic side effects of medication
    C) risk for injury related to gastrointestinal irritation
    (this multiple choice question has been scrambled)
  46. Using a backrub to reduce pain intensity is based on which theory?
    A) gate control
    B) stimulus based
    C) general adaptation
    D) transactional stress
    A) gate control
    (this multiple choice question has been scrambled)
  47. The nurse is planning home care for a patient with chronic pain related to degeneration of the vertebrae. Which assessment is a priority?
    A) the family's knowledge of alternative therapies.
    B) if the physician has ordered prn analgesics for the pain.
    C) the patient's daily elimination pattern.
    D) how the pain affects self-care abilities.
    D) how the pain affects self-care abilities.
    (this multiple choice question has been scrambled)
  48. A patient is receiving morphine sulfate via a patient controlled analgesia (PCA) pump. The patient states, "I have been pushing the button and I still have pain." The nurse should take which initial action?
    A) contact the physician
    B) Instruct the patient to wait 10 minutes before trying to use the pump again.
    C) check to ensure the pump is properly programmed.
    D) change the pump's lockout interval setting from 10 minutes to 5 minutes.
    C) check to ensure the pump is properly programmed.
    (this multiple choice question has been scrambled)
  49. Which statement reflects an unbiased understanding of pain?
    A) People who abuse drugs overreact to painful stimuli.
    B) Patients with less tissue damage will have less pain intensity.
    C) Euphoria is an expected side effect of proper analgesic control.
    D) Chronic pain is largely psychological.
    C) Euphoria is an expected side effect of proper analgesic control.
    (this multiple choice question has been scrambled)
  50. The nurse teaches the family of a patient who is being cared for at home how to manage the patient's pain.  Which finding would best indicate that the nurse's teaching was successful?
    A) The patient states that the stabbing pain are now aching pains.
    B) The patient's pain diary indicates pain-free intervals during the day.
    C) The patient indicates satisfaction with pain control options.
    D) The patient's family uses prayer on a daily basis to deal with the patient's pain.
    C) The patient indicates satisfaction with pain control options.
    (this multiple choice question has been scrambled)

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