Nursing 112 Uworld part 2 Questions & Answers
A nurse is administering a rituximab infusion to a client with lymphoma in an oncology clinic. Which
... [Show More] client symptom would be a priority to report to the health care provider?
Dizziness and sudden diarrhea [1%] 1.
Nausea and onset of vomiting [0%] 2.
New-onset tachypnea and dyspnea [81%]
3.
Temperature of 101 F (38.3 C) [17%]
4.
Explanation:
Correct
Answered correctly
81%
Time: 12 seconds Updated: 10/14/2017
Rituximab (Rituxan) is a monoclonal antibody (end in -mab) that affects the lymphocytes. It is commonly prescribed to treat certain forms of cancer (eg, lymphoma) and autoimmune diseases (eg, lupus). Like many monoclonal antibodies, rituximab can produce a powerful immune response (eg, bronchospasm, dyspnea, tachypnea, hypotension,
angioedema) (Option 3). The nurse should closely monitor the client during and after the infusion. If life-threatening symptoms develop, the nurse should stop the infusion and immediately notify the health care provider. The symptoms will be treated (eg, corticosteroids) and, when resolved, the infusion is usually restarted at a slower rate.
(Options 1, 2, and 4) In many clients, monoclonal antibody therapies, like many oncology pharmaceuticals, invoke flu-like responses (eg, fever, chills, diarrhea, nausea, vomiting).
Clients are often pretreated with acetaminophen and diphenhydramine in anticipation of these reactions. Clients' symptoms are treated as needed (eg, antiemetics, antidiarrheals).
Educational objective:
Rituximab can produce a powerful immune response (eg, bronchospasm, dyspnea, tachypnea, hypotension, angioedema). Clients should be closely monitored during and after the infusion.
.
0
The student nurse plans postmortem care for an Orthodox Jewish client hospitalized for the last week with heart failure who did not sign consents for any postmortem actions. Which statement by the student would require further education by the supervising nurse?
"I will allow the family to remain with the client at all times." [3%] 1.
"I will call the next of kin before providing any postmortem care." [7%]
2.
"I will prepare the client for transfer to the morgue for autopsy." [81%]
3.
"I will provide a sheet to be placed over the client's face." [7%] 4.
Explanation:
Incorrect
Correct answer
3
Answered correctly
81%
Time: 24 seconds Updated: 11/01/2017
Traditional Orthodox Jews believe that the body of the deceased should not be desecrated and is to be treated with respect. Therefore, autopsies are generally not permitted (Option 3). An autopsy is performed only when required by law, if the client provided consent before death, or if the client had a hereditary disease and an autopsy would help save others.
Orthodox Jews believe that the body belongs to God and that a complete burial is required to enter heaven. In the event that an autopsy is required, all fluids and body parts are to be returned to the body before burial.
(Option 1) It is customary for a member of the client's family to remain with the body until burial to ensure that it is not dishonored.
(Option 2) Many cultures and religions prefer to take part in postmortem care (eg, cleansing of the body, dressing). Family beliefs should be clarified before postmortem care is performed.
(Option 4) Orthodox Jews believe the dead are disrespected if the effects of death present on the face are seen by others. Therefore, a sheet is placed over the face after death.
Educational objective:
Orthodox Jews do not permit autopsies unless certain conditions are met (eg, required by law, consent signed by client, investigating hereditary disease to benefit others). Often, the client's family performs postmortem care, covers the face with a sheet, and remains with the body until burial. Families should always be consulted for specific beliefs prior to providing postmortem care.
.
0
The nurse is caring for a client with chronic pancreatitis. Which meal should the nurse recommend when assisting the client in selecting food items from a menu?
Baked tilapia with lemon wedge, sweet potatoes, and green peas [80%]
1.
Cream of potato soup and roast beef sandwich on a croissant [11%]
2.
Sautéed salmon, macaroni and cheese, string beans, and a biscuit [4%] 3.
Shrimp enchiladas with tomato salsa, rice, cornbread, and refried beans [3%] 4.
Incorrect
Correct answer
Explanation:
1
Answered correctly
80%
Time: 40 seconds Updated: 08/02/2017
Chronic pancreatitis is an inflammatory disease that causes the tissue of the pancreas to become fibrotic, impairing pancreatic endocrine and exocrine functions. Chronic pancreatitis is most commonly caused by alcohol abuse, but may also result from biliary tract
disease (eg, cholelithiasis), autoimmune processes, or cystic fibrosis. Lifestyle modification is a key component of treatment and includes cessation of alcohol and smoking as well as dietary modifications.
Clients with pancreatitis often cannot secrete lipase in sufficient quantities to digest consumed fats. Therefore, clients should follow a low-fat diet, with the degree of fat restriction based on the severity of disease. Due to lack of endogenous lipase, oral supplementation of pancreatic enzymes is often required before meals. To avoid exacerbating gastric discomfort, the client should avoid spicy and gas-forming foods.
Low-fat food choices include lean meats (eg, fish, chicken), nonfat dairy products, vegetables/fruits prepared without added fat, and low-fat carbohydrates (eg, green peas) (Option 1).
(Options 2, 3, and 4) Dairy-containing foods (eg, macaroni and cheese, creamed soup), baked goods (eg, biscuits, cornbread, croissants), and some meats (eg, roast beef) are high in fat. Refried beans also contribute to gas formation and promote bloating. Salsas and spicy foods should be avoided.
Educational objective:
Clients with pancreatitis often cannot secrete lipase in sufficient quantities to digest consumed fats, requiring the client to follow a low-fat diet. Low-fat food choices include lean meats, non-fat dairy products, vegetables/fruits prepared without added fat, and low-fat carbohydrates.
.
0
The nurse is preparing to change the dressing of a client's subclavian central venous catheter using a chlorhexidine gluconate (CHG)-impregnated patch and transparent adhesive dressing. Place the procedural steps in the correct order. All options must be used.
Your Response/ Incorrect Response
• Perform hand hygiene, don face mask, place a mask on the client, and apply clean gloves
• Remove old dressing and CHG-impregnated patch; assess insertion site
• Cleanse the site with CHG for at least 30 seconds using friction; allow to air dry completely
• Apply CHG patch over catheter insertion site and cover with a sterile transparent dressing
• Discard the clean gloves, perform hand hygiene, and apply sterile gloves
Correct Response
• Perform hand hygiene, don face mask, place a mask on the client, and apply clean gloves
• Remove old dressing and CHG-impregnated patch; assess insertion site
• Discard the clean gloves, perform hand hygiene, and apply sterile gloves
• Cleanse the site with CHG for at least 30 seconds using friction; allow to air dry completely
• Apply CHG patch over catheter insertion site and cover with a sterile transparent dressing
Incorrect
Correct answer
4,5,3,2,1
Answered correctly
78%
Time: 71 seconds
Explanation:
Central line dressing changes are sterile procedures and must be performed correctly to prevent infection. Steps should be performed in the following order:
• Perform meticulous hand hygiene.
• Don a surgical mask, and apply a mask to the client (or ask client to turn the head away from the dressing). Apply clean gloves (Option 4).
• Remove the old dressing, including the chlorhexidine gluconate (CHG)-impregnated patch, making sure not to touch the insertion site (Option 5).
• Inspect the site for drainage, erythema, heat, or inflammation.
• Discard the clean gloves, perform hand hygiene, and apply sterile gloves (Option 3).
• Cleanse the site with antimicrobial solution (eg, CHG) in a back-and-forth motion, using friction, for at least 30 seconds; allow to completely air dry (Option 2).
• Apply the CHG-impregnated patch over the catheter insertion site and cover with the sterile transparent dressing (or use CHG gel transparent dressing), making certain the edges of the dressing adhere well (Option 1).
• Sign, date, and initial the dressing.
• Document the procedure.
Educational objective:
The correct order for a sterile central line dressing change is: perform hand hygiene; apply
surgical masks (nurse and client) and clean gloves; remove the old dressing; assess the insertion site; perform hand hygiene; apply sterile gloves; clean site with antimicrobial solution; allow to completely air dry; apply the new dressing; and sign, date, and initial the new dressing.
7
0
Four clients enter the pediatric emergency department at the same time. Which client should the nurse see first?
2-week-old with tricuspid atresia who has dusky lips and nailbeds [13%] 1.
5-week-old with forceful vomiting after every feeding who is crying [5%] 2.
12-month-old who was wheezing at home and is now lethargic with no wheezing [78%]
3.
3-year-old with fever who had a brief seizure at home and is asleep [3%] 4.
Explanation:
Correct
Answered correctly
78%
Time: 29 seconds Updated: 05/23/2017
Wheezing is caused by air moving through narrow airway passages. As long as wheezing is heard, ventilation is occurring. A client who was initially wheezing loudly and suddenly has no audible wheezing may be exhibiting signs of worsening airway obstructionand should be assessed immediately (Option 3). Wheezing can occur in clients as the result of an asthma attack or other airway obstruction (eg, foreign body aspiration, tumor).
(Option 1) Tricuspid atresia is a congenital heart defect in which the tricuspid valve does not develop; therefore, blood is unable to flow from the right atrium to the right ventricle and on to the lungs. Cyanosis would be a normal finding as deoxygenated blood from the right atrium flows through a patent foramen ovale and mixes with oxygenated blood in the left ventricle before being pumped throughout the body.
(Option 2) Projectile vomiting that occurs after feeding is a sign of pyloric stenosis or obstruction. This client could be dehydrated but would not be a priority over a client with an airway obstruction.
(Option 4) Febrile seizures are benign seizures that occur in response to an elevated temperature. A child with a febrile seizure would not take priority over a child with an obstructed airway.
Educational objective:
A client who suddenly stops wheezing may be experiencing impending respiratory failure and should be assessed immediately.
.
0
The unlicensed assistive personnel (UAP) reports being splashed in the eye while emptying urine from the catheter bag of a client with AIDS. The UAP is afraid of becoming infected with HIV and requests immediate testing. What is the nurse's priority action?
Direct the UAP to immediately flush the eye with water at the unit's eyewash station [78%]
1.
Reassure the UAP that the risk for HIV is low as urine does not transmit the virus [12%] 2.
Refer the UAP to the occupational health department for postexposure prophylaxis [6%] 3.
Send the UAP to the facility's emergency department for medical evaluation [1%] 4.
Explanation:
Correct
Answered correctly
78%
Time: 24 seconds Updated: 07/12/2017
Following accidental eye exposure to body fluids (eg, blood, urine) or chemicals, health care workers should immediately flush the affected eye with water or saline for at least 10 minutes to reduce exposure to potentially infected material and prevent/reduce injury (eg, burn). The risk of HIV transmission through urine is low unless there is visible blood in the fluid; however, flushing the eye is the priority action with any accidental exposure.
(Option 2) The nurse should address the fears of the unlicensed assistive personnel (UAP), but the most urgent action is for the UAP to flush the eye.
(Option 3) All exposure incidents should be reported to appropriate personnel, including the occupational health department, which is responsible for managing immediate postexposure (eg, testing, prophylaxis) and follow-up care (eg, testing, counseling). However, flushing the eye is the priority.
(Option 4) Depending on the facility, the UAP may have additional eye irrigation in the emergency department, confidential medical evaluation for HIV by a qualified heath care provider, and occupational HIV postexposure prophylaxis if medically indicated. However, these actions are not the priority.
Educational objective:
Following accidental eye exposure to body fluids or chemicals, the health care worker should immediately flush the eye with water or saline. After reporting the incident to appropriate personnel, the health care worker may be sent to the facility's emergency or occupational health department to receive postexposure care.
Nursing 112 Uworld part 2 Questions & Answers
A nurse is administering a rituximab infusion to a client with lymphoma in an oncology clinic. Which client symptom would be a priority to report to the health care provider?
Dizziness and sudden diarrhea [1%] 1.
Nausea and onset of vomiting [0%] 2.
New-onset tachypnea and dyspnea [81%]
3.
Temperature of 101 F (38.3 C) [17%]
4.
Explanation:
Correct
Answered correctly
81%
Time: 12 seconds Updated: 10/14/2017
Rituximab (Rituxan) is a monoclonal antibody (end in -mab) that affects the lymphocytes. It is commonly prescribed to treat certain forms of cancer (eg, lymphoma) and autoimmune diseases (eg, lupus). Like many monoclonal antibodies, rituximab can produce a powerful immune response (eg, bronchospasm, dyspnea, tachypnea, hypotension,
angioedema) (Option 3). The nurse should closely monitor the client during and after the infusion. If life-threatening symptoms develop, the nurse should stop the infusion and immediately notify the health care provider. The symptoms will be treated (eg, corticosteroids) and, when resolved, the infusion is usually restarted at a slower rate.
(Options 1, 2, and 4) In many clients, monoclonal antibody therapies, like many oncology pharmaceuticals, invoke flu-like responses (eg, fever, chills, diarrhea, nausea, vomiting).
Clients are often pretreated with acetaminophen and diphenhydramine in anticipation of these reactions. Clients' symptoms are treated as needed (eg, antiemetics, antidiarrheals).
Educational objective:
Rituximab can produce a powerful immune response (eg, bronchospasm, dyspnea, tachypnea, hypotension, angioedema). Clients should be closely monitored during and after the infusion.
.
0
The student nurse plans postmortem care for an Orthodox Jewish client hospitalized for the last week with heart failure who did not sign consents for any postmortem actions. Which statement by the student would require further education by the supervising nurse?
"I will allow the family to remain with the client at all times." [3%] 1.
"I will call the next of kin before providing any postmortem care." [7%]
2.
"I will prepare the client for transfer to the morgue for autopsy." [81%]
3.
"I will provide a sheet to be placed over the client's face." [7%] 4.
Explanation:
Incorrect
Correct answer
3
Answered correctly
81%
Time: 24 seconds Updated: 11/01/2017
Traditional Orthodox Jews believe that the body of the deceased should not be desecrated and is to be treated with respect. Therefore, autopsies are generally not permitted (Option 3). An autopsy is performed only when required by law, if the client provided consent before death, or if the client had a hereditary disease and an autopsy would help save others.
Orthodox Jews believe that the body belongs to God and that a complete burial is required to enter heaven. In the event that an autopsy is required, all fluids and body parts are to be returned to the body before burial.
(Option 1) It is customary for a member of the client's family to remain with the body until burial to ensure that it is not dishonored.
(Option 2) Many cultures and religions prefer to take part in postmortem care (eg, cleansing of the body, dressing). Family beliefs should be clarified before postmortem care is performed.
(Option 4) Orthodox Jews believe the dead are disrespected if the effects of death present on the face are seen by others. Therefore, a sheet is placed over the face after death.
Educational objective:
Orthodox Jews do not permit autopsies unless certain conditions are met (eg, required by law, consent signed by client, investigating hereditary disease to benefit others). Often, the client's family performs postmortem care, covers the face with a sheet, and remains with the body until burial. Families should always be consulted for specific beliefs prior to providing postmortem care.
.
0
The nurse is caring for a client with chronic pancreatitis. Which meal should the nurse recommend when assisting the client in selecting food items from a menu?
Baked tilapia with lemon wedge, sweet potatoes, and green peas [80%]
1.
Cream of potato soup and roast beef sandwich on a croissant [11%]
2.
Sautéed salmon, macaroni and cheese, string beans, and a biscuit [4%] 3.
Shrimp enchiladas with tomato salsa, rice, cornbread, and refried beans [3%] 4.
Incorrect
Correct answer
Explanation:
1
Answered correctly
80%
Time: 40 seconds Updated: 08/02/2017
Chronic pancreatitis is an inflammatory disease that causes the tissue of the pancreas to become fibrotic, impairing pancreatic endocrine and exocrine functions. Chronic pancreatitis is most commonly caused by alcohol abuse, but may also result from biliary tract
disease (eg, cholelithiasis), autoimmune processes, or cystic fibrosis. Lifestyle modification is a key component of treatment and includes cessation of alcohol and smoking as well as dietary modifications.
Clients with pancreatitis often cannot secrete lipase in sufficient quantities to digest consumed fats. Therefore, clients should follow a low-fat diet, with the degree of fat restriction based on the severity of disease. Due to lack of endogenous lipase, oral supplementation of pancreatic enzymes is often required before meals. To avoid exacerbating gastric discomfort, the client should avoid spicy and gas-forming foods.
Low-fat food choices include lean meats (eg, fish, chicken), nonfat dairy products, vegetables/fruits prepared without added fat, and low-fat carbohydrates (eg, green peas) (Option 1).
(Options 2, 3, and 4) Dairy-containing foods (eg, macaroni and cheese, creamed soup), baked goods (eg, biscuits, cornbread, croissants), and some meats (eg, roast beef) are high in fat. Refried beans also contribute to gas formation and promote bloating. Salsas and spicy foods should be avoided.
Educational objective:
Clients with pancreatitis often cannot secrete lipase in sufficient quantities to digest consumed fats, requiring the client to follow a low-fat diet. Low-fat food choices include lean meats, non-fat dairy products, vegetables/fruits prepared without added fat, and low-fat carbohydrates.
.
0
The nurse is preparing to change the dressing of a client's subclavian central venous catheter using a chlorhexidine gluconate (CHG)-impregnated patch and transparent adhesive dressing. Place the procedural steps in the correct order. All options must be used.
Your Response/ Incorrect Response
• Perform hand hygiene, don face mask, place a mask on the client, and apply clean gloves
• Remove old dressing and CHG-impregnated patch; assess insertion site
• Cleanse the site with CHG for at least 30 seconds using friction; allow to air dry completely
• Apply CHG patch over catheter insertion site and cover with a sterile transparent dressing
• Discard the clean gloves, perform hand hygiene, and apply sterile gloves
Correct Response
• Perform hand hygiene, don face mask, place a mask on the client, and apply clean gloves
• Remove old dressing and CHG-impregnated patch; assess insertion site
• Discard the clean gloves, perform hand hygiene, and apply sterile gloves
• Cleanse the site with CHG for at least 30 seconds using friction; allow to air dry completely
• Apply CHG patch over catheter insertion site and cover with a sterile transparent dressing
Incorrect
Correct answer
4,5,3,2,1
Answered correctly
78%
Time: 71 seconds
Explanation:
Central line dressing changes are sterile procedures and must be performed correctly to prevent infection. Steps should be performed in the following order:
• Perform meticulous hand hygiene.
• Don a surgical mask, and apply a mask to the client (or ask client to turn the head away from the dressing). Apply clean gloves (Option 4).
• Remove the old dressing, including the chlorhexidine gluconate (CHG)-impregnated patch, making sure not to touch the insertion site (Option 5).
• Inspect the site for drainage, erythema, heat, or inflammation.
• Discard the clean gloves, perform hand hygiene, and apply sterile gloves (Option 3).
• Cleanse the site with antimicrobial solution (eg, CHG) in a back-and-forth motion, using friction, for at least 30 seconds; allow to completely air dry (Option 2).
• Apply the CHG-impregnated patch over the catheter insertion site and cover with the sterile transparent dressing (or use CHG gel transparent dressing), making certain the edges of the dressing adhere well (Option 1).
• Sign, date, and initial the dressing.
• Document the procedure.
Educational objective:
The correct order for a sterile central line dressing change is: perform hand hygiene; apply
surgical masks (nurse and client) and clean gloves; remove the old dressing; assess the insertion site; perform hand hygiene; apply sterile gloves; clean site with antimicrobial solution; allow to completely air dry; apply the new dressing; and sign, date, and initial the new dressing.
7
0
Four clients enter the pediatric emergency department at the same time. Which client should the nurse see first?
2-week-old with tricuspid atresia who has dusky lips and nailbeds [13%] 1.
5-week-old with forceful vomiting after every feeding who is crying [5%] 2.
12-month-old who was wheezing at home and is now lethargic with no wheezing [78%]
3.
3-year-old with fever who had a brief seizure at home and is asleep [3%] 4.
Explanation:
Correct
Answered correctly
78%
Time: 29 seconds Updated: 05/23/2017
Wheezing is caused by air moving through narrow airway passages. As long as wheezing is heard, ventilation is occurring. A client who was initially wheezing loudly and suddenly has no audible wheezing may be exhibiting signs of worsening airway obstructionand should be assessed immediately (Option 3). Wheezing can occur in clients as the result of an asthma attack or other airway obstruction (eg, foreign body aspiration, tumor).
(Option 1) Tricuspid atresia is a congenital heart defect in which the tricuspid valve does not develop; therefore, blood is unable to flow from the right atrium to the right ventricle and on to the lungs. Cyanosis would be a normal finding as deoxygenated blood from the right atrium flows through a patent foramen ovale and mixes with oxygenated blood in the left ventricle before being pumped throughout the body.
(Option 2) Projectile vomiting that occurs after feeding is a sign of pyloric stenosis or obstruction. This client could be dehydrated but would not be a priority over a client with an airway obstruction.
(Option 4) Febrile seizures are benign seizures that occur in response to an elevated temperature. A child with a febrile seizure would not take priority over a child with an obstructed airway.
Educational objective:
A client who suddenly stops wheezing may be experiencing impending respiratory failure and should be assessed immediately.
.
0
The unlicensed assistive personnel (UAP) reports being splashed in the eye while emptying urine from the catheter bag of a client with AIDS. The UAP is afraid of becoming infected with HIV and requests immediate testing. What is the nurse's priority action?
Direct the UAP to immediately flush the eye with water at the unit's eyewash station [78%]
1.
Reassure the UAP that the risk for HIV is low as urine does not transmit the virus [12%] 2.
Refer the UAP to the occupational health department for postexposure prophylaxis [6%] 3.
Send the UAP to the facility's emergency department for medical evaluation [1%] 4.
Explanation:
Correct
Answered correctly
78%
Time: 24 seconds Updated: 07/12/2017
Following accidental eye exposure to body fluids (eg, blood, urine) or chemicals, health care workers should immediately flush the affected eye with water or saline for at least 10 minutes to reduce exposure to potentially infected material and prevent/reduce injury (eg, burn). The risk of HIV transmission through urine is low unless there is visible blood in the fluid; however, flushing the eye is the priority action with any accidental exposure.
(Option 2) The nurse should address the fears of the unlicensed assistive personnel (UAP), but the most urgent action is for the UAP to flush the eye.
(Option 3) All exposure incidents should be reported to appropriate personnel, including the occupational health department, which is responsible for managing immediate postexposure (eg, testing, prophylaxis) and follow-up care (eg, testing, counseling). However, flushing the eye is the priority.
(Option 4) Depending on the facility, the UAP may have additional eye irrigation in the emergency department, confidential medical evaluation for HIV by a qualified heath care provider, and occupational HIV postexposure prophylaxis if medically indicated. However, these actions are not the priority.
Educational objective:
Following accidental eye exposure to body fluids or chemicals, the health care worker should immediately flush the eye with water or saline. After reporting the incident to appropriate personnel, the health care worker may be sent to the facility's emergency or occupational health department to receive postexposure care. [Show Less]