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1. Blood and urine analysis confirm a diagnosis of salicylate overdose. Josie is treated with activated charcoal, which would be administered by
Intravenous infusion
Nasogastric tube
Rectal infusior
Oral tablets
2. When interviewing James, the nurse should anticipate that the most difficult problem is likely to be
Motivating the client to undergo treatment
Obtaining a list of the clients sexual contacts
Increasing the clients knowledge of the disease
Assuring the client that records are confidential
3. While helping bill change position in bed, you note bill has muscle twitching in his bands and forearms. These symptoms are significant because clients who suffer from pancreatitis are at risk of
Hypermagnisemia
Hypoglycaemia
Hypocalcaemia
Hyponatremia
4. The nursing goal for performing passive range of motion exercises for an unconscious client such as josie would be to
Preserve muscle mass
Prevent bone demineralisation
Increase muscle tone
Maintain joint mobility
5. in education this client, the nurse should emphasise that in women gonorrhoea
is often marked by symptoms of dysuria or vaginal bleeding
does not lead to serious complications
can be treated but not cured
may not cause symptoms until complications occur
6. Probenecid is prescribed in conjunction with penicillin as treatment for syphilis because probenecid helps
Delay detoxification of penicillin
Inhibit excretion of penicillin
Maintain sensitivity of organisms to penicillin
Decrease the likelihood of an allergic reaction to penicillin
7. You monitor bills vital signs frequently, observing for the signs of shock. Shock is extremely difficult to manage in pancreatitis primarily because of the
Frequency and severity of gastrointestinal haemorrhage
Vasodilating effects of kinin peptides
Tendency towards congestive heart failure
Frequent incidence of acute tubular necrosis
8. An 18 year old female college student is seen at the university health centre. She undergoes a pelvic examination and is diagnosed with gonorrhoea Which of the following responses by the nurse would be best when the client says that she is nervous about the upcoming pelvic examination
can you tell me more about how you‟re feeling
you‟re not alone. Most women feel uncomfortable about this examination
do not worry about Dr smith. He‟s a specialist in female problems
we‟ll do everything we can to avoid embarrassing you
9. What specific potential adverse effect of charcoal administration to josie must the nurse be aware and guard against
Anaphylaxis
Renal failure
Aspiration
Cardiac arrest
10. A 24 year old female client, who is on her honeymoon, comes to an ambulatory care clinic in moderate distress with a probable diagnosis of acute cystitis Which of the following symptoms would the nurse expect the client to report during the assessment
fever and chills
frequency and burning on urination
suprapubic pain and nausea
dark, concentrated urine
11. James, a 34 year old man attending a sexual health clinic, is diagnosed with syphilis. The organism responsible for causing syphilis is classified as a
Virus
Fungus
Rickettsia
Spirochete
12. A 34 year old Japanese tourist, takayuki hamadi, is admitted to the hospital after experiencing multiple trauma as a result of an automobile accident. He has three fractured ribs, a hairline fracture of the pelvis, a compound fracture of his right tibia and fibula, and soft tissue injuries. He is in severe pain when he arrives on the unit after emergency surgery Takayuki reports severe pain and requests frequent medication. A nursing assistant expresses her surprise, saying, „I thought asian people were very stoic about pain. „ your initial course of action should be
Reprimand her immediately and apologise to takayuk‟s family
Discuss her behaviour with her after you leave the room
Do nothing as takayuk‟s understanding of English is poor
Report her to the charge nurse
13. which of the following respiratory signs would indicate increasing intracranial pressure in the brain stem
slow, irregular respirations
rapid, shallow respirations
asymmetric chest expansion
nasal flaring
14. After stabilisation and treatment, Elizabeth is discharged from the hospital. At her follow up appointment, she is discouraged because she is experiencing pain with increasing frequency. She states that she visits an invalid friend twice a week and now cannot walk up the second flight of steps to the friends apartment without pain. Which action can the nurse could suggest that would most likely help the client deal with this problem
Visit her friend early in the day
Rest for at least an hour before climbing the stairs
Take a nitro-glycerine tablet before climbing the stairs
Lie down once she reaches the friends apartment
15. The client is given a prescription for co trimoxazole (bactrim) for her infection. Which of the following statements would indicate that she understands the principles of antibiotic therapy
I‟ll take the pills until I feel better and keep the rest for recurrences
I‟ll take all the pills as directed on the label
I‟ll take the pills until the symptoms pass, then reduce the dose by half
I‟ll take all the pills and then have the prescription renewed once
16. As an initial step in treating elizabeths angina, the physician prescribes nitro-glycerine tablets, 0.3 mg given sublingual. This drugs principal effects are produced by
Antispasmodic effects on the pericardium
Stimulation of a- and 13- receptor sites
Vasodilation of peripheral vasculature
Improved conductivity in the myocardium
17. The primary reason that a herpes simplex infection is a serious concern to a client with HIV infection is that herpes simplex
Is an acquired immunodeficiency virus (AIDS) defining illness
Is curable only after 1 year of antiviral therapy
Can lead to cervical cancer
Causes severe electrolyte imbalances
18. Pain control is an important nursing goal. Which of the following medications would be the drug of choice
Pethidine
Cimetidine
Morphine
Codeine
19. Which of the following points should the nurse include when instructing the client with angina about sublingual nitro-glycerine
The drug will cause your urine to turn bright orange
Store the tablets in a tight, light resistant container
Use the tablets only when the pain is severe
The shelf life of nitro-glycerine is up to 2 years
20. the client informs the nurse that she has had sexual intercourse with her boyfriend and asks the nurse „would he have any symptoms?‟ the nurse responds that in males, symptoms of gonorrhoea include
impotence
scrotal swelling
urine retention
dysuria
21. the nurse assesses the client frequently for signs of intracranial pressure, including
unequal pupil size
decreasing systolic blood pressure
tachycardia
decreasing body temperature
22. When the nurse performs oral hygiene for josie, whilst she is still unconscious, which of the following actions would be most appropriate
Use manual instead of mechanical ventilation
Keep suction apparatus available
Place josie in a prone position
Wear sterile gloves
23. The typical chancre of syphilis appears as
A grouping of small, tender pimples
An elevated wart
A painless moist ulcer
An itching, crusted area
24. During the past few months, Elizabeth, a 56 year old woman has felt brief twinges of chest pain while working, in her garden and has had frequent episodes of indigestion. She comes to the hospital after experiencing severe anterior chest pain while raking leaves. Her evaluation confirms a diagnosis of stable angina pectoris Elizabeth states, „I really thought I was having a heart attack. How can you tell the difference?‟ which response by the nurse would provide the client with the most accurate information about the difference between the pain of angina and that of myocardial infarction
The pain associated with a heart attack is much more severe
The pain associated with a heart attack radiates into the jaw and down the left arm
It is impossible to differentiate angina pain from that of a heart attack without an ECG
The pain of angina is usually relieved by resting or lying down
25. Which of the following symptoms should the nurse teach Elizabeth to report immediately to her physician
A change in the pattern of her pain
Pain during sexual activity
Pain during an argument with her husband
During or after an activity such as lawn moving
26. When assessing josies respiratory status, which of the following symptoms may be an early indicator of hypoxia
Cyanosis
Decreased respirations
Restlessness
Hypotension
27. Sublingual nitro-glycerine tablets begin to work within 1 to 2 minutes. How should the nurse instruct the client to use the drug when chest pain occurs
Take one tablet every 2 to 5 minutes until the pain stops
Take one tablet; and rest for 10 minutes. Call the physician if pain persists after 10 minutes
Take one tablet, then an additional tablet every 5 minutes for a total of three tablets. Call the physician if pain persists after 3 tablets
Take one tablet; if pain persists after 5 minutes, take two tablets. If pain still persists 5 minutes later, call the physician
28. Which of the following methods would be best, from a legal standpoint, for obtaining permission to treat Winston
having his sister sign the consent form
having two independent doctors agree on the need for treatment
obtaining a verbal consent by telephone from his mother
obtaining written consent from his fiancée
29. Lydia acquires herpes genitalis and is counselled by the nurse concerning follow up care. Women who have this disease are at risk of developing
Sterility
Cervical cancer
Uterine fibroid rumours
Irregular menses
30. The physician prescribes zidovudine (AZT) a drug that acts to help
Destroy the virus
Enhance the body‟s antibody production
Slow replication of the virus
Neutralise toxin; produced by the causative organism
31. Josie, a 38 year old woman is admitted to the emergency room after being found unconscious at the wheel of her car in the hospital car park. Josie is comatosed and does not respond to stimuli. A drug overdose is suspected Which of the following assessment findings would lead the nurse to suspect that the coma is a result of a toxic drug overdose
Hypertension
Hyperpyrexia
Dilated pupils
Facial asymmetry
32. The nurse teaches Elizabeth that which of the following meals would be best for her low cholesterol diet
Hamburger, salad, and milkshake
Baked liver, green beans, and coffee
Spaghetti with tomato sauce, salad, and coffee
Fried chicken, green beans, and skim milk
33. The initial diagnosis of pancreatitis would be confirmed if bills blood test showed a significant elevation in serum
Amylase
Glucose
Potassium
Trypsin
34. Lydia becomes depressed about her diagnosis and tells the nurse “I have nothing worth living for now.” Which of the following statements would be the best response by the nurse
There is much to live for; you may not develop AIDS for years
You should not be too depressed; we are searching to find a cure for AIDS
You are right; it is very depressing to have HIV
Tell me more about how you are feeling at being HIV positive
35. Which of the following nursing diagnosis categories would most likely be a priority for a client with herpes genitalis
Alteration in sleep; sleep pattern disturbance
Nutritional deficit
Alteration in comfort pain
Alteration in breathing patterns
36. The nurse teaches Elizabeth that common expected side effects of nitro-glycerine include
Headache, hypotension, and dizziness
Hypertension, flushing and forgetfulness
Hypotension, diplopia and shortness of breath
Stomach cramps, constipation and urinary frequency
37. In providing education to Lydia, the nurse should take into account the fact that the most effective method known to control the spread to HIV infection is
Premarital serologic screening
Prophylactic treatment of exposed people
Laboratory screening of pregnant women
Ongoing sex education about preventive behaviours
38. You are caring for bill, a 50 year old man who has been hospitalised with a possible diagnosis of pancreatitis Which of the following symptoms would you anticipate observing in bill
Elevated white blood cell count, ankle oedema and right groin pain
Left upper quadrant abdominal pain, nausea, and vomiting
Hypoglycaemia, hypertension, and hypochondrial pain
Epigastric pain, pyrexia, and elevated white blood cell count
39. A priority nursing diagnosis for a James would likely be
High risk for infection transmission related to lack of knowledge about mode of spread
Pain related to cutaneous skin lesions on palms and soles
Altered skin tissue perfusion related to a bleeding chancre
Image disturbance related to alopecia
40. As Winston‟s condition worsens, his rising intracranial pressure would be indicated by
rising blood pressure and falling pulse rate
rising pulse rate and falling blood pressure
rising blood pressure and rising pulse rate
falling pulse rate and falling blood pressure
41. The nurse observes that josie‟s right eye does not close totally. Based on this finding, which of the following nursing interventions would be most appropriate
Making sure josie wears dark glasses to avoid photosensitivity
Irrigate her right eye with saline each duty to avoid dryness
Instilling neomycin eye drops to prevent conjunctivitis
Tape the eyelid down to keep it closed between cares
42. Winston, a 22 year old man, is brought to the emergency room with an apparent head injury after being involved in a motor vehicle accident. He is unconscious on arrival and exhibits signs of increasing intracranial pressure. His fiancée and his older sister accompany him On Winston‟s arrival in the emergency room, which of the following considerations should receive the highest priority
establishing an airway
replacing blood losses
stopping bleeding from open wounds
determining whether he has a neck fracture
43. The physician tells the client that the infection has likely been precipitated by sexual intercourse and that an antibiotic will be prescribed. The client becomes upset, and tearfully asks the nurse if this means she should abstain from intercourse for the rest of her honeymoon. What advice should the nurse offer her
avoid intercourse until you‟ve completed the antibiotic therapy and then limit intercourse to once a week
limit intercourse to once a day in the early morning after your bladder has rested
as long as you‟re comfortable you can have intercourse as often as you wish; but be sure to urinate within 15 minutes after intercourse
you and your husband can enjoy intercourse as often as you wish. Just make sure he wears a condom and uses a spermicide
44. A home care nurse begins caring for a 25 year old female called Lydia who has just been diagnosed with human immunodeficiency virus (HIV) Lydia asks the nurse, „how could this have happened?” the nurse responds to the question based on the most frequent mode of HIV transmission, which is
Hugging an HIV positive sexual partner without using barrier precautions
Inhaling cocaine or other recreational drugs
Sharing a drink bottle with an HIV positive person
Sexual intercourse with an HIV positive person without using a condom
45. Bill does not drink alcohol because of his religious beliefs. When the physician persists in asking him about his alcohol intake, bill becomes annoyed. You explain the reasoning behind the questioning by telling bill that
There is a strong link between alcohol use and pancreatitis
Alcohol intake can interfere with some of the tests used to diagnose pancreatitis
Alcoholism is a major health problem and all hospitalised clients are asked about their alcohol intake
The physician must obtain the pertinent facts, and religious beliefs cannot be considered
46. The client asks the nurse, „how did I get this infection?‟ the nurse should explain that in most instances, cystitis is caused by
