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Second test

QuestionAnswer
Sue has blue eyes and is 5 feet tall. Tom has brown eyes and is 6 feet tall. These physical characteristics are primarily determined by Genetic information on chromosomes
The developing fetus exhibits a common trend in growth and development. Which of the following growth and development trends initially occurs? Cephalocaudal
A 2-year-old grabs a handful of cake sitting on the table and stuffs it is his mouth. According to Freud, the child is satisfying his Id (concerned with self-gratification by the easiest and quickest available means.)
The primary developmental stage of the preschool age child, as described by Erikson, is Initiative versus guilt
An older adult smiles as she talks about her life events. This, according to Erikson, is demonstrating Ego integrity
Havighurst defined a developmental task of the adolescent as Accepting one's body and using it effectively
Based on Piaget's theory, children between the ages of 2 and 7 years use play to Understand life events and relationships (preoperational stage)
Moral development as defined in Kohlberg's theory is initially influenced by Parent–child communications
In Gilligan's theory, women develop morality differently than do men. She described this morality in women as one of Response and care
During the development of faith, described by Fowler, the teenager commonly Questions previously accepted values
Infections in the neonate are less likely in mothers who provided nutrition through Breast milk
At what point during the first year of life would you normally expect bonding to occur? Soon after birth
Parents of hospitalized infants should be encouraged to stay with their child to help decrease Separation anxiety
The toddler has the cognitive development necessary to Identify and name body parts
Based on Freud's theory, the preschool-aged child is in the Phallic stage
Which of the following best describes the moral and spiritual development of the school-aged child? Faith involves reciprocal fairness
The ability to reproduce in the adolescent is defined as Puberty
A primary developmental task of the adolescent is to Achieve new and more mature relationships
Which of the following nursing diagnoses should be considered for the obese adolescent? Disturbed Body Image
What is the leading cause of death in adolescents and young adults? Accidents
When assessing a 48-year-old woman, she tells you she is having hot flashes, fatigue, and mood swings. You recognize these manifestations as those of Menopause
Based on Erikson's theory, middle adults who do not achieve their developmental tasks may be termed as being in stagnation. One example of this would be the following statement: “I spend all of my time going to the doctor to be sure I am not sick.” (overly concerned about their own physical and emotional health needs)
Which of the following nursing diagnoses would be appropriate for the middle adult? Risk for Imbalanced Nutrition: More Than Body Requirements (continue to maintain previous eating patterns while being less active)
Older adults may be stereotyped as different from other age groups and having outlived their usefulness. The term for this is Ageism
Which of the following statements is a myth about older adults? Old age means mental deterioration.
The leading cause of cognitive impairment in old age is Alzheimer's disease
Which of the following questions would encourage reminiscence? “Tell me about how you celebrated Christmas when you were young.” (open-ended questions)
A 90-year-old man who lives alone tells you he has no family or friends. Based on this information, what nursing diagnoses would be appropriate for him? Social Isolation
When teaching the older adult who is recovering from surgery, you remember to Repeat information as often as necessary
Which statement by an 85-year-old woman would demonstrate that she has met an expected outcome of the plan of care for safety? “I am going to take up all my little scatter rugs.”
A school nurse reviewing healthcare topics for adolescents should be aware that: Alcopops contain more alcohol than beer
When transporting a toddler in a motor vehicle, car seats are mandatory: In all 50 states
Which child has the greatest risk for choking and suffocating? A toddler playing with his 9-year-old brother's construction set
Nursing consideration regarding the use of side rails for a confused patient is based on the knowledge that: A person of small stature is at increased risk for injury from entrapment
The leading cause of accidental death for people 79 years of age and older is: Falls
Nursing education efforts that focus on prevention of firearm injuries are important because: Nearly 25% of those who die of firearm injuries are between the ages of 15 and 24 years
Preparation for a terrorist attack includes knowledge that: The FDA has collaborated with drug companies to create stockpiles of emergency drugs
Mr. Kennedy is a disoriented older resident who likes to wander the halls of his long-term care facility. As an alternative to using restraints, the nurse might: Identify his door with his picture and a balloon
While discussing home safety with the nurse, Mrs. Fuller admits that she always smokes a cigarette in bed before falling asleep at night. An appropriate nursing diagnosis would be: Risk for Suffocation related to unfamiliarity with fire prevention guidelines
Mr. D'Ambro has weakened knees due to arthritis. The home healthcare nurse is aware that he understands the need for safety modifications at home because he: Sits only in chairs with armrests
When a fire occurs in a patient's room, the nurse's priority should be to: Rescue the patient
The nurse is planning a health teaching session for new parents about poisoning emergencies. She should tell the parents that their initial response should be to: Call the poison control center
JCAHO guidelines regarding the use of restraints recommend that: Alternative measures must be attempted first
The nurse orients an older patient to the safety features in her hospital room. A vital component of this admission routine is to: Explain how to operate the call bell
When completing an incident report, the nurse should: Objectively describe the incident in detail
The internal structures of the eye can be visualized using which of the following instruments? Ophthalmoscope
To make accurate assessments during inspection, the nurse must Compare bilateral body parts
Palpation is a physical assessment technique that uses the sense of: Touch
When percussing over the stomach, the nurse notes a loud, drum-like sound. The term to document this percussion tone is: Tympany
The bell of the stethoscope is used to hear: Heart sounds
Skin turgor may be assessed by which of the following techniques? Lightly pinching a skin fold
Visual acuity may be assessed by using a Snellen chart. If a patient has acuity of 20/40 in both eyes, this means: The patient has less than normal vision
When using an otoscope to assess the tympanic membrane of an adult, the ear canal is straightened by gently pulling the pinna: a. The ear canal of an adult is straightened by gently pulling the pinna of the ear up and back. In children younger than 3 years of age, the ear canal is straightened by pulling the pinna gently down and back.
When percussing the thorax and lungs, a dull sound indicates: Fluid or a solid mass
When auscultating the thorax and lungs, coarse gurgling sounds are heard on expiration. These sounds can be broadly labeled as: Adventitious breath sounds
Heart sounds are the result of: Closure of the heart valves
When palpating the breast, the assessment should be conducted by which division of areas? Quadrants
When assessing the abdomen, which assessment technique should be conducted after inspection? Auscultation (sequence is inspection, auscultation, percussion, and palpation).
Which of the following assessments of mental status is not an assessment of orientation? Consciousness
As part of the assessment of the cranial nerves, the nurse asks the patient to raise the eyebrows, smile, and show the teeth. These actions provide information about which cranial nerve? Facial
The smallest infectious agents capable of causing an infection are: Viruses
Your patient has developed a low-grade fever and states that she has felt very tired lately. This phase of an infection is known as the: Prodromal stage
Efforts by healthcare facilities to reduce the incidence of HAIs include an awareness that: Death or serious injury caused by HAIs is considered a sentinel event by JCAHO.
A patient develops a urinary tract infection after an indwelling urinary catheter has been inserted. This would most accurately be termed: iatrogenic
The nurse has opened the sterile supplies and donned two sterile gloves to complete a sterile dressing change. Maintaining surgical asepsis requires the nurse to: Consider the outer 1 inch of the sterile field as contaminated
The CDC standard precaution recommendations apply to: All patients receiving care in hospitals
In addition to standard precautions, the nurse caring for a patient with rubella would plan to implement: Droplet precautions (illness transmitted by large-particle droplets)
When caring for a patient with latex allergy, the nurse creates a latex-safe environment by: Using a latex-free pharmacy protocol
The guidelines for minimum protection standards for infection prevention and control were initially developed by: CDC
The recommended sequence for removing soiled personal protective equipment when the nurse prepares to leave the patient's room is to remove: Gloves, goggles, gown, mask, and wash hands
For a nurse under normal conditions with unsoiled hands, effective hand hygiene between patients requires: Use of an alcohol-based antiseptic handrub
Which hospitalized patient is most at risk for developing a healthcare-associated infection? Mr. L, a 65-year-old patient who has an indwelling urinary catheter in place
A patient develops food poisoning from contaminated potato salad. The means of transmission for the infecting organism is: Vehicle
A nurse is caring for an obese 62-year-old patient with arthritis who has developed an open reddened area over his sacrum. A priority nursing diagnosis is: Risk for Infection related to altered skin integrity
The nurse teaches a patient at home to use clean technique when changing a wound dressing. This is: Safe for the home setting
Which CAT uses meridian energy circuits to nourish and support all cells and organs of the body? Acupuncture
Complementary and alternative therapies are: Recognized by half of the state Boards of Nursing
A combination of traditional medical care and CAT is called: Integrative care
This CAT uses the Law of Similars and the Law of Infinitesimals: Homeopathy
Which CAT is most similar to the current health promotion/ disease prevention models? Naturopathic medicine
Neuropeptides are messenger molecules for which type of CAT? Mind–body modalities
A CAT that involves active participation by the patient and is often used in pre- and postoperative pain control is: Guided imagery
The relaxation response is opposite of which person's ideas? Selye
Energy healing approaches: Have a North American Nursing Diagnosis Association (NANDA)-recognized nursing diagnosis
positive self-concept “I'm a good helper”
high self-esteem realizes his strengths and limitations
Joe was asked to make a list of 20 words that describe him. After 15 minutes, Joe listed the following: 25 years old, male, named Joe; then declared he couldn't think of anything else. Joe has demonstrated Deficient self-knowledge
Low self-esteem characterized by great discrepancy between the ideal and real selves.
Which of the following statements made by the parent of a child you are seeing in clinic needs to be followed up with teaching about how to foster healthy development of the self in children? “My husband and I both grew up in very restrictive families. We want our children to be free to do whatever they want.”
Which intervention would you take first to assist a woman who states that she feels incompetent as the mother of a teenage daughter? Assist the mother to identify both what she believes is preventing her success and what she can do to improve
Which of the following patients is least likely to develop problems related to self-concept? 55-year-old woman television news reporter undergoing a hysterectomy (removal of uterus)
self-concept disturbance one that concerns role performance
self-esteem disturbance one of devaluing herself and thinking that she is no good
Stress is a condition in which the human system: b. Responds to changes in its normal balanced state
Stress evokes both positive and negative responses to changes in the internal and external environment.
Which of the following is an external stressor? High environmental temperature
The body maintains the internal environment at a constant state through: Homeostasis
Which of the following is developmental stress? An adolescent gets a job.
The reflex pain response and the inflammatory response are examples of: Localized responses of the body to stress
What response is expected during the shock phase of the general adaptation syndrome? Increasing energy levels
A vague feeling of discomfort or dread with an unknown source is: Anxiety
Panic an experience of terror
concern a worry
Fear has a known cause
Toward the end of the semester, as final examinations near, you find yourself sleeping more than usual. This behavior is probably your form of a: Coping mechanism
Mild anxiety often handled without conscious thought through the use of coping mechanisms
Sleeping coping mechanism
Your patient has just been diagnosed with cancer but responds as though this is impossible. Which of the defense mechanisms is being demonstrated here? Denial
Home care of patients by family members for long periods of time can cause long-term stress and increased risk for illness. The name for this stress response is: Caregiver burden
Caregiver burden include chronic fatigue, sleep disorders, and an increased incidence of stress-related illnesses, such as hypertension and heart disease.
All but one of the following responses are typical of relaxation techniques. Which is not typical? An increased pulse rate
relaxation involves rhythmic breathing, reduced muscle tension, and an altered state of consciousness.
Which type of stress reduction activity would probably be most useful for a patient before an unfamiliar or painful event? Anticipatory guidance
What is the first step in crisis intervention through problem solving? Identify the problem.
Biofeedback is a method of gaining mental control of what part of the body? Autonomic nervous system (regulating body responses to stress such as increased blood pressure, increased heart rate, and headaches.)
What setting is considered most stressful for nurses? Intensive care unit
elements of the loss actual, perceived, and psychological.
The period of acceptance of loss and grief during which the person learns to deal with experienced loss is best termed: Mourning
Which definition of death is gaining in popularity, as more people believe that critical human functions are personality, conscious life, and the capacity for remembering, judging, reasoning, acting, enjoying, and worrying? Higher-brain death
If your patient tells you that he has no one he trusts to make healthcare decisions for him should he become incapacitated, you should help him to prepare: Living will
living will a document whose precise purpose is to allow individuals to record specific instructions about the type of healthcare they would like to receive in particular end-of-life situations.
Which of the following nurse responses would be endorsed by the American Nurses Association? A nurse promises a dying patient that he will do everything possible to keep her comfortable but that he cannot administer an injection or overdose to cause her death.
nurse-assisted suicide and participation in active euthanasia violate the Code for Nurses and the ethical traditions of the profession.
comfort-measures-only order all aggressive treatment to be stopped at this point and all care to be directed to a comfortable, dignified death.
Which of the nursing actions described below would you correct if you saw a nursing assistant doing this? Telling a dying patient to sit back and relax and that she will wash him because it's easier that way
Which of the following nursing actions violates the standards of caring for the body after a patient has been pronounced dead? Keeping the patient in a comfortable sitting position until the family has arrived and said their good-byes
The family of a patient who has just died asks to be alone with the body and asks for supplies to wash the body. You know that the mortician usually washes the body. Your best response is: Provide the requested supplies and ask if this request is linked to their religious or cultural customs and if there is anything else you can do to be of assistance
When patient is competent has the right to refuse therapy that she finds to be disproportionately burdensome, even if this hastens her death.
When assessing a patient's sensory experience, which of the following would the nurse identify as the major components? Reception and perception
When evaluating a patient's sensory experience, which four conditions would be essential for a person to receive data and experience the world? A stimulus, a receptor, an intact nerve pathway, and a functioning brain
When planning the care for a patient related to disturbed sensory perception, the nurse would integrate knowledge of which system as responsible for monitoring and regulating incoming sensory stimuli to maintain, enhance, or inhibit cortical arousal? Reticular activating system
The general adaptation system is the system responsible for responding to stress.
Kinesthetic and visceral are senses that arise internally from muscles and hollow organs and are the body's basic orienting systems.
Sensory and perceptual systems are the two components of the sensory experience.
You notice that Mr. Wong, who has cataracts, is sitting closer to the television than usual. The nurse would interpret the etiologic basis of his sensory problem is an alteration in which of the following? Sensory reception
Which of the following would be most important to include in the plan of care for a patient who is 85 years old and has presbycusis? Speaking distinctly using lower frequencies
presbycusis is a normal loss of hearing as a result of the aging process
Which factor is least likely to place a patient at high risk for sensory deprivation? Impaired ability to respond to environmental stimuli
Which patient would the nurse assess as being at greatest risk for sensory deprivation? An elderly man confined to bed at home after a stroke
Richard's spinal cord was severed, and he is paralyzed from the waist down. When obtaining data about this patient, which component of the sensory experience would be most important to assess? Transmission of tactile stimuli
An 11-year-old 6th grader whose grades have dropped has difficulty completing her work on time, frequently rubs her eyes, and squints. Her visual acuity on a Snellen's eye chart was 160/20. Which nursing diagnosis would be most appropriate? Ineffective Role Performance (Student) related to visual impairment
Of the four items listed below, which nursing intervention would be best to prevent sensory alterations for a man with a severe hearing deficit who reads lips well? Provide daily opportunity for him to participate in a social hour with six or eight people.
In a boarding home where most patients have slight to moderate visual or hearing impairment and some are periodically confused, which of the following would be the nurse's first priority in caring for sensory concerns? Maintaining safety and prevent sensory deterioration
prevent embarrassment Even if well motivated, ignoring a patient's confusion to prevent embarrassment may be dangerous,
A patient's body temperature is 37.2°C (99°F) in the late afternoon. This is most likely: Result of a normal circadian rhythm
hyperpyrexia high fever
Muscle tone is recorded by the: Electromyograph (EMG)
EEG records electrical currents from the brain
EOG records eye movements
ECG records cardiac activity.
The nurse observes some involuntary muscle jerking in a sleeping patient. The patient is most likely in: Stage I NREM sleep
The nurse observes a slight increase in a patient's vital signs while he is sleeping during the night. According to the patient's stage of sleep, the nurse expects that: It would be most difficult to awaken him at this time
REM sleep difficult to arouse a person, and the vital signs increase.
How many cycles of sleep does a person typically go through each night? 4 or 5
cycles of sleep each cycle lasting 90 to 100 minutes.
While discussing with an older woman the factors that induce sleep, the nurse teaches her that: The amount of REM sleep decreases with age.
Physical activity increases both REM and NREM sleep.
A patient falls asleep in the middle of a conversation. This disorder is called: Narcolepsy
Hypersomnia refers to excessive sleep
somnambulism is sleepwalking
sleep apnea breathing ceases for a period of time between snoring
A sleep diary is a diagnostic tool that: includes a record of daily physical activity
sleep diary includes activities during the day because they have an effect on sleep, is usually kept for at least 14 days, and is more helpful if objective comments from a bed partner are included.
To help a patient get to sleep, the nurse suggests that he: Follow his usual bedtime routine if possible
The most common complaint of patients visiting sleep disorder clinics is: Chronic insomnia
A prolonged pattern of REM deprivation may result in: symptoms of psychosis. With REM deprivation, dreaming is absent, sensitivity to pain increases, and mental alertness decreases.
Active dreaming occurs during: REM sleep
Illness is a stressor and can influence sleep during various stages. An example is that: Asthma attacks appear to occur less frequently during stage IV NREM sleep.
REM sleep Chest pain occurs more frequently and Gastric secretions increase
NREM sleep Epileptic seizures occur more frequently
Caffeine is a known stimulant, and its intake should be: Avoided at least 4 to 5 hours before bedtime
Medications that induce sleep (sedative-hypnotics) may disturb REM or NREM sleep. The nurse should be aware that: They usually become ineffective after several weeks.
A patient complains of abdominal pain that is difficult to localize. The nurse categorically interprets this as Visceral
Visceral pain poorly localized and can originate in body organs in the abdomen.
Complex regional pain syndrome (causalgia) is pain that occurs in the area of injured peripheral nerves,
cutaneous pain is superficial and usually involves the skin or subcutaneous tissue.
psychogenic pain When a physical cause for the pain cannot be identified
A patient complains of pain in a site that is different from where it originates. The nurse documents this as Referred pain
transient pain is brief and passes quickly
Phantom pain may occur in a person who has had a body part amputated, either surgically or traumatically.
A patient who has fallen and injured his wrist carefully cradles it with the other hand. The patient is demonstrating which of the following responses to pain? Behavioral
Affective responses to pain are psychological ones
physiologic or involuntary response to pain response would be increased blood pressure and dilation of the pupils.
To help relieve her pain, Ann concentrates on a favorite vacation setting. The nurse interprets this technique as Imagery
The nurse best describes intractable pain as being Resistant to treatment
Applying the gate control theory of pain, an effective nursing intervention for a patient with lower back pain would be Applying a moist heating pad to the area at prescribed intervals
Which of the following would the nurse expect to assess as a physiologic response to moderate pain? Increased blood pressure
Mrs. Young is receiving ATC medication for treatment of terminal cancer. She has recently reported several episodes of breakthrough pain. What treatment is most effective to manage these sudden flare-ups of pain? Supplementing with doses of a short-acting opioid
When assessing pain in a child, the nurse needs to be aware that Inadequate or inconsistent relief of pain is widespread.
Mr. Wright is recovering from abdominal surgery. When the nurse assists him to walk, she observes that he grimaces, moves stiffly, and becomes pale. She is aware that he has consistently refused his pain medication. A priority nursing diagnosis would be Acute Pain related to fear of taking prescribed medications in the postoperative period
When planning strategies for pain control in older patients, the nurse should be aware that Denial of pain may occur.
Chronic pain is most effectively relieved when analgesics are administered Around the clock (ATC)
Using a placebo for pain control without the patient's consent is Deceptive and unethical
The patient receiving epidural analgesia requires vigilant monitoring to prevent the occurrence of Respiratory depression
When assessing a patient receiving a continuous opioid infusion, the nurse immediately notifies the physician when the patient has A sedation level of 4
Plasma, the liquid constituent of blood, is correctly identified as Intravascular fluid
Intravascular fluid or plasma extracellular fluid and composes 5% of total body fluid.
Potassium functions as the Major cation of intracellular fluid
Sodium is the chief electrolyte of extracellular fluid
calcium is the most abundant electrolyte in the body
chloride is the chief extracellular anion
The movement of the solvent water from an area of lesser solute concentration to an area of greater solute concentration until equilibrium is established is known as Osmosis
Gases move by by diffusion
Active transport is a process that requires energy for the movement of substances through a cell membrane from an area of lesser to higher concentration.
Filtration is the passage of fluids through a permeable membrane from an area of high pressure to one of low pressure.
Which of the following would the nurse use as the most reliable indicator of a patient's fluid balance status? Daily weight
Which acid–base imbalance would the nurse suspect after assessing the following arterial blood gas values (pH, 7.30; PaCO2, 36 mm Hg; HCO3-, 14 mEq/L)? Metabolic acidosis
acidosis low pH indicates
Mrs. Podralski, a patient in the hospital, has been encouraged to increase her fluid intake. Which measure would be most effective for the nurse to implement? Keeping fluids readily available for the patient
Which of the following would the nurse need to keep in mind when preparing to assist the physician with insertion of a nontunneled percutaneous central venous catheter? A chest radiograph is required to confirm placement.
The nurse alertly assesses the acid–base balance of a patient because she is aware that the patient will be unable to effectively control his carbonic acid supply. This is most likely a patient with badly damaged Lungs
The kidneys are the primary controller of the body's bicarbonate supply.
The adrenal glands secrete catecholamines and steroid hormones.
The nurse instructs a patient to focus on breathing more slowly as the most effective intervention for which acid–base imbalance? Respiratory alkalosis (carbonic acid deficit)
Which of the following is the most common etiologic factor related to the nursing diagnosis of Excess Fluid Volume? Excessive IV infusion
Which assessment finding would lead the nurse to suspect that a patient's IV has infiltrated? The site is pale, cool, swollen, and painful.
When developing the teaching plan for a patient at risk for hyperkalemia, which foods would the nurse instruct the patient to avoid? Bananas and apricots
Hyperkalemia is an elevated serum potassium level; bananas and apricots are foods high in potassium and should be avoided in this situation.
Which site would be most appropriate for initiating IV therapy for a patient who has sustained multiple injuries after an automobile accident and has a cast on his right arm? Left forearm
When implementing the plan of care for a patient receiving IV therapy, which intervention would be most appropriate? Monitoring the flow rate at least every hour
While administering a blood transfusion, when would the nurse assess the patient for a blood transfusion reaction? Every 15 minutes
The name selected by the pharmaceutical company selling the drug and protected by trademark is the drug's: Trade name
The process by which a drug is transferred from its site of entry into the body to the bloodstream is known as: Absorption
A patient has an abnormal, unexpected response to a drug. This is defined as: An idiosyncratic effect
A medication order reads: “K-Dur, 20 meq PO b.i.d.” The nurse correctly gives this drug Twice a day by the oral route
The correct answer is c. The abbreviation “b.i.d.” refers to twice-a-day administration. Asking the patient his name
You are to administer a medication using a nasogastric tube. Before giving the medication, you should: Check for proper placement of the nasogastric tube
The medication order reads: “Hydromorphone, 2 mg IV every 3 to 4 hours p.r.n. pain.” The prefilled cartridge is available with a label reading “Hydromorphone 2 mg/ 1 mL.” The cartridge contains 1.2 mL of hydromorphone. You should: Dispose of 0.2 mL correctly before administering the drug
A patient requires 40 units of NPH insulin and 10 units of regular insulin daily subcutaneously. The correct sequence when mixing insulins is: Inject air into the NPH insulin vial, being careful not to allow the solution to touch the needle; next, inject air into the regular insulin vial and withdraw 10 units; then, withdraw 40 units of NPH insulin.
Ms.Y has an order for hydromorphone, 2 mg, intravenously, q 4 hours p.r.n. pain. The nurse notes that according to Ms. Hall's chart, she is allergic to Dilaudid. The order for medication was signed by Dr.X . Correct procedure in this situation? Call Dr. X and ask that she change the medication
The nurse manager on your unit prepared medications for Mr. Giles. She is called to the phone and asks you to give the patient his medications. Which is the best response to this request? Tell the nurse manager that because you did not pour the medication, you cannot administer it.
Why is the intravenous method of medication administration called the “most dangerous route of administration”? The drug is placed directly into the bloodstream, and its action is immediate.
Mr. King is receiving heparin subcutaneously. Which of the following demonstrates correct technique for this procedure? Do not aspirate before or massage after the injection.
A patient refuses to take her noon medication, saying that she does not need it. Which of the following would be the best response? Tell her that you will return the medications to the cart but would like to discuss her reasons for refusing to take the medications.
A nurse discovers that she has made a medication error. Which of the following should be her first response? Check the patient's condition to note any possible effect of the error.
Created by: russianalaskan
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