1. People 2020 is the name of a campaign with the goal of:
Ï Improving vision care among Americans using pre- scription lenses until vision is
as close
... [Show More] to normal as possible.
ÏUltimately reduc- ing the need for costly acute ser- vices by wide- spread
Ï Screening the population to determine candidates foradoption of pre-
heart surgery and
transplants of organs such as kidney or pancreas.
vention pro- grams in target-
Ï Raising awareness of gun violence across the Uniteded high-risk be-
States.
Ï Ultimately reducing the need for costly acute services by widespread
adoption of prevention programs in targeted high-risk behaviors.
2. 2. A nurse is assessing a client to determine level of wellness. The client practices
yoga for relaxation several times a week, follows a nutritionally sound diet, and
has a supportive, sound relationship with a spouse and several children. Based
on this data, which does this client exemplify?
haviors.
ÏUltimately reduc- ing the need for costly acute ser- vices by wide- spread
adoption of pre- vention pro- grams in target-
Ï An emergent high level of wellness in an unfavorableed high-risk be-
environment.
Ï A high level of wellness in a favorable environment. Ï Protected poor health in a favorable environment.
Ï An emergent high level of wellness in a favorable environment.
3. A nurse is promoting participation in The Great Amer- ican Smokeout for clients
who are participating in a smoking cessation class.
The nurse knows this event
may motivate many individuals to stop smoking by promoting self-efficacy. At
the conclusion of the class, which statement leads the nurse to expect a
positive outcome for this particular client?
haviors.
Ï "I know that this time I will
quit smoking per- manently."
Ï "I am afraid of getting lung cancer like my father." Ï "I think this time will be different."
Ï "I am going to do the best that I can, so that I won't get lung cancer."
Ï "I know that this time I will quit smoking permanent- ly."
4. The nurse is working in the role of client health ed- ucator. Based on the information in the image, these concepts are components of which topic?
Ï health
Ï wellness
Ï well-being Ï fitness
5. A nurse is teaching a group of couples a class on building positive relationships
at a local community center. The nurse is focusing this session on learning skills
to be open-minded and respectful to those with op- posing opinions. Based on
this data, on which component of wellness is the nurse focusing this session?
A. Physical
B. Social
C. Environment
D. Emotional
6. A nurse is working with a group of older adult clients at a community health
center. Several clients report growing concerns about their dental health. They
state they need to have dental work done despite continuing the same hygiene
habits they have employed for years. They inquire about the underlying cause
for these changes. Based on this data, which re- sponse by the nurse is the most
appropriate?
Ïwellness
B. Social
"A decrease in bone density is as- sociated with ag- ing, which can result in tooth de- cay and break- age."
o "It is common for dental health to decline with ag- ing."
o Aging increases saliva production, which increase exposure of the tooth's
enamel to corrosive agents."
o "Metabolic changes in aging contribute to dental destruction."
o "A decrease in bone density is associated with ag- ing, which can
result in tooth decay and breakage."
7. A client with glaucoma is experiencing sensory over- load. What can the nurse suggest to reduce this client's visual overstimulation?
Ï Do not go outside during the daytime.
Ï Wear sunglasses that block UVA and UVB rays . Ï Insert artificial tears several times a day.
Ï Use an over-the-counter eye drop for irritation.
8. After being diagnosed with cataracts, a client believes the right eye has a cataract but not the left eye, as there are no vision changes with the left eye. Which response by the nurse is appropriate?
Ï "Only your doctor can tell if you have a cataract in your left eye."
Ï "Cataracts develop at different rates, so one eye will be more affected than
the other."
Ï "Don't worry about it until you can't see out of your left eye."
Ï "Your doctor must have made an error."
9. After conducting a physical assessment, the nurse determines that the client is
at risk for developing cataract. Which item in the health history support that the
client is at risk for developing cataracts? Ï Age 75 years
ÏWear sunglasses that block UVA and UVB rays .
Ï "Cataracts de- velop at different rates, so one eye will be more affect- ed than
the other."
ÏAge 75 years
Ï Hypertension
Ï Minimal direct sun exposure Ï Nonsmoker
10. An older adult client, reporting a significant loss of hearing after being involved in an explosion, asks when hearing will return. Which response by the nurse is most appropriate?
Ï Surgery will help restore the hearing you have lost. Ï The most common cause of hearing impairments is exposure to loud noises.
Ï Loud noises can cause immediate, permanent loss of hearing.
Ï Hearing loss attributed to loud noises is normally reversible.
11. A young school-age child is seen in a pediatric clinic for a well-child checkup.
The parent tells the nurse that they live in the country and use well water. Based on this data, which state- ment by the nurse is the priority when conducting client teaching?
Ï "Your child will need to use a teeth whitener in the fu- ture because well water is your primary water source." Ï Your child will need to be placed on a fluoride supple- ment because your
primary water source is from a well."
Ï "I will recommend some mouthwashes that are ap- propriate for clients that drink well water."
Ï "It will be very important that your child does not eat sugary foods because you drink well water."
12. A female client has returned to the unit following a hysterectomy. The nurse knows that which interven- tion will provide the most pain relief for the client?
Ï Offer pain relief before the client complains of pain.
ÏLoud noises can cause immediate, permanent loss of hearing.
Your child will need to be placed on a fluoride sup- plement because your primary water source is from a well."
ÏOffer pain relief before the client complains of pain.
Ï Assess the pain level every 4 hours around the clock. Ï Wait until the client can describe the pain specifically. Ï Allow the client to "sleep off" the anesthesia, and then offer pain medication.
13. The nurse is identifying nursing diagnoses appropri- ate for a client with severe symptoms of tinnitus, ver- tigo, sensorineural hearing deficit, nausea, and vom- iting. Which diagnosis would be a priority for this client?
Ï Imbalanced Nutrition: Less than Body Requirements Ï Disturbed Sleep Pattern
Ï Risk for Injury
Ï Disturbed Sensory Perception: Auditory
14. A nurse is talking with the spouse of a patient who has
ÏDisturbed Senso- ry Perception: Au- ditory
"He may be stop-
agreed to stop further medical treatment because the ping medical treat-
doctor says the patient is now in the end-of-life phase of illness. The spouse states, "I feel so hopeless when all we are going to do is watch him die." The nurse's best response would be:
ment, but he will still receive com- fort
care. Let me go over with you how
Ï "It is terrible. It's okay if you want to go home and we'llwe will help him be
call you when it's over."
Ï "He may be stopping medical treatment, but he will still receive comfort
care. Let me go over with you how we will help him be comfortable and
have his psychological needs met. "
Ï "We will be giving him pain medicine so he will stay unconscious the whole
time."
Ï "Tell me what you know about the process of dying."
15. A competent older adult client has a living will that expresses the client's desire to avoid resuscitation and heroic life support measures. The family members are not supportive of this directive and plan to contest
comfortable and have his psy- chological needs met. "
o Place the docu- ment on the chart.
the living will. Which nursing action is the most appro- priate?
o Place the document on the chart.
o Contact the Social Services department.
o Explain to the client that the conflict could invalidate the document.
o Notify the hospital attorney.
16. The nurse, caring for a 1-year-old client recovering from a tonsillectomy, assesses the child for pain. If pain level is not addressed, what additional health problem could occur?
Ï Urinary retention
Ï Bowel obstruction
Ï Respiratory compromise Ï Bradycardia
17. A client is experiencing severe pain in the left lower quadrant of the abdomen that is rated as a 10 on a pain scale of 0-10. The client is also experiencing nausea, vomiting, and restlessness. Based on this data, the nurse concludes that the client is experiencing which phenomenon?
Ï acute pain
Ï chronic pain
Ï end of life pain
Ï fibromyalgia pain
18. A client is admitted with severe back pain and is requesting pain medication. During her assessment, the nurse notes the client has been taking 650mg of Acetaminophen every 4 hours at home with minimal relief. Based on this information, which of the follow- ing PRN (as needed) ordered drug(s) should the nurse consider administering?
ÏRespiratory com- promise
Ïacute pain
ÏIbuprofen
Ï Hydrocodone with acetaminophen Ï Acetaminophen
Ï Ibuprofen
Ï Acetaminophen with oxycodone
19. In caring for a young child with pain, which assess- ment tool is the most useful?
Ï Simple description pain intensity scale Ï 0-10 numeric pain scale
Ï Faces pain-rating scale
Ï McGill-Melzack pain questionnaire
20. A nurse is caring for a cancer patient receiving sub- cutaneous morphine sulfate for pain. Which of the following nursing actions is most important in the care of this patient?
Ï Monitor urine output
Ï Monitor respiratory rate. Ï Monitor heart Rate
Ï Monitor temperature
21. The client informs the nurse that he has experienced pain in the lower extremities for the past eight months. The nurse recognizes that this pain is classified as:
Ï Moderate Ï Severe
Ï Acute
Ï Chronic
22. A patient takes oxycodone (OxyContin), 40 mg PO twice daily, for the management of chronic pain. Which intervention should be added to the plan of care to minimize the gastrointestinal adverse effects?
Ï Take an antacid with each dose. Ï Eat foods high in lactobacilli.
ÏFaces pain-rating scale
ÏMonitor respirato- ry rate.
ÏChronic
ÏIncrease fluid and fiber in the diet.
Ï Take the medication on an empty stomach. Ï Increase fluid and fiber in the diet.
23. The nurse is working on a postoperative unit where pain management is part of routine care. Which state- ment below is the most helpful in guiding clinical practice in this setting?
Ï At least 30% of the U.S. population is prone to drug addiction and abuse.
Ï The development of opioid dependence is rare when opioids are used for
acute pain.
Ï Morphine is a common drug of abuse in the general population.
Ï The use of PRN (as needed) dosing provides the most consistent pain relief
without risk of addiction.
24. Celecoxib (Celebrex) is added to the treatment regi- men of a client with arthritis. The nurse explains that the major advantage of this drug is:
Ï The drug is less expensive.
Ï The drug has no known side effects.
Ï The drug has anti-inflammatory properties.
Ï The drug's effectiveness is the same as opioids.
25. A patient who is suffering from terminal cancer asks the nurse how massage decreases his pain. The nurse's best explanation is:
ÏThe development of opioid depen- dence is rare when opioids are used for
acute pain.
ÏThe drug
has anti-inflamma- tory properties.
ÏMassage stimu- lates the release of endorphins, which are thought to
Ï Massage blocks endorphins that, when released, areblock
effective in inhibiting pain receptors the transmission
Ï Massage stimulates the release of endorphins, whichof pain by closing
are thought to block
the transmission of pain by closing the gate.
Ï Massage assists endorphins in opening the gates and attaching to opiate
receptors.
the gate.
Ï Massage stimulates opiate or pain receptors to re- lease endorphins to essentially change how the brain identifies pain.
26. A nurse is providing discharge teaching for a patient with a fractured humerus. The patient is going home with Vicodin (5/325) an opioid. What important patient education does the nurse provide?
Ï "Be sure to eat a meal high in fat before taking the medication, to avoid a
stomach ulcer."
Ï "Narcotics can be addictive, so do not take them unless you are in severe pain."
Ï "You need to drink plenty of fluids and eat a diet high in fiber ."
Ï "As your pain severity lessens, you will begin to give yourself once-daily
intramuscular injections."
27. Which assessment question helps the nurse deter- mine the character of the
patient's pain?
Ï "What does the pain feel like, i.e. stabbing, burning or throbbing?"
Ï "When did the pain first start?"
Ï "What interventions make the pain better?"
Ï "Is there any pattern to when the pain occurs?"
28. The nurse teaches a student nurse about how to ap- ply the nursing process when providing patient care. Which statement, if made by the student nurse, indi- cates that teaching was successful?
Ï "You need to drink plenty of fluids and eat a diet high in fiber ."
Ï "What does the pain feel like, i.e. stabbing, burning or throbbing?"
Ï "The nursing process is a prob- lem-solving tool used to identify and treat
Ï "The nursing process is a scientific-based method ofpatients' health
diagnosing the patient's health care problems."
Ï "The nursing process is a problem-solving tool used
care needs."
to identify and treat patients' health care needs."
Ï "The nursing process is used primarily to explain nursing interventions to other
health care professionals."
Ï "The nursing process is based on nursing theory that incorporates the
biopsychosocial nature of humans."
29. A nurse asks the patient if pain was relieved after receiving medication. What is the purpose of the eval- uation phase of the nursing process?
Ï To determine if interventions have been effective in meeting patient
outcomes
Ï To document the nursing care plan in the progress notes of the medical record
Ï To decide whether the patient's health problems have been completely
resolved
Ï To establish if the patient agrees that the nursing care provided was satisfactory
30. The nurse is caring for a terminally ill patient who is experiencing continuous and severe pain. How
should the nurse schedule the administration of opi- oid pain medications?
Ï Plan around-the-clock routine administration of anal- gesics.
Ï Provide PRN doses of medication whenever the pa- tient requests them.
Ï Suggest small analgesic doses to avoid decreasing the respiratory rate.
Ï Offer enough pain medication to keep the patient sedated and unaware of
stimuli.
ÏTo determine if interventions have been effective in meeting patient outcomes
ÏPlan
around-the-clock routine administration of analgesics.
31. To decrease the risk for future hearing loss, which action should the nurse
implement with college students at the on-campus health clinic?
Ï Perform tympanometry.
Ï Schedule otoscopic examinations.
Ï Administer influenza immunizations. Ï Discuss exposure to amplified music.
32. An older patient who is being admitted to the hospital repeatedly asks the nurse to "speak up so that I can hear you." Which action should the nurse take?
Ï Increase the speaking volume. Ï Over enunciate while speaking
Ï Speak normally but more slowly.
Ï Use more facial expressions when talking.
33. A 75-yr-old patient who lives alone at home tells the nurse, "I am afraid of losing my independence be- cause my eyes don't work as well they used to." Which action should the nurse take first ?
Ï Discuss the increased risk for falls that is associated with impaired vision.
Ï Ask the patient about what type of vision problems are being experienced.
Ï Explain that there are many ways to compensate for decreases in visual acuity.
Ï Suggest ways of improving the patient's safety, such as using brighter lighting.
34. Which question asked by the nurse will give the most information about the
patient's metastatic bone cancer pain?
Ï "How long have you had this pain?"
Ï "How would you describe your pain?"
ÏDiscuss exposure to amplified music.
ÏSpeak normally but more slowly.
ÏAsk the patient about what type of vision problems are being experi- enced.
Ï "How would
you describe your pain?"
Ï "How often do you take pain medication?"
Ï "How much medication do you take for the pain?"
35. A nurse prepares an adult patient with a severe burn injury for a dressing change. The nurse knows that this is a painful procedure and wants to try providing music to help the patient relax. Which action is best for the nurse to take?
Ï Use music composed by Mozart.
Ï Play music that does not have words
Ï Ask the patient about music preferences.
Ï Select music that has 60 to 80 beats/minute..
36. The nurse is caring for a patient who had abdominal surgery yesterday and is receiving morphine through patient-controlled analgesia (PCA). What action by the nurse is a priority ?
Ï Assessing for nausea
Ï Auscultating bowel sounds
Ï Checking the respiratory rate Ï Evaluating for sacral redness
37. The 1948 World Health Organization (WHO) definition of health is:
Ï Not having a chronic illness or deficiency.
ÏAsk the patient about music pref- erences.
ÏAuscultating bow- el sounds
ÏA state of complete physical, mental, and social
Ï Eradication of international infectious diseases suchwell-being and not
as polio, smallpox, tuberculosis, and malaria.
just the
absence of infirmi-
Ï A state of using every power the individual possessesty. to the fullest extent.
Ï A state of complete physical, mental, and social well-being and not just the
absence of infirmity. [Show Less]