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NUR 202 Final Review for test 1-2 exam with
correct answers
.The |nurse |assesses |a |patient |who |has |numerous |petechiae |on |both |arms. |Which |question |should |the |nurse |ask |the |patient? a. |"Do |you |take |salicylates?" | b. |"Are |you |taking |any |oral |contraceptives?" | c. |"Have |you |been |prescribed |antiseizure |drugs?" | d. |"How |long |have |you |taken |antihypertensive |drugs?" |- |✔✔A The |nurse |assesses |a |patient |with |pernicious |anemia. |Which |assessment |finding |would |the |nurse | expect? a. |Yellow-tinged |sclerae | b. |Shiny, |smooth |tongue | c. |Numbness |of |the |extremities | d. |Gum |bleeding |and |tenderness |- |✔✔C A |patient's |complete |blood |count |(CBC) |shows |a |hemoglobin |of | 19 |g/dL |and |a |hematocrit |of |54%. | Which |question |should |the |nurse |ask |to |determine |possible |causes |of |this |finding? a. |"Have |you |had |a |recent |weight |loss?" | b. |"Do |you |have |any |history |of |lung |disease?" | c. |"Have |you |noticed |any |dark |or |bloody |stools?" | d. |"What |is |your |dietary |intake |of |meats |and |protein?" |- |✔✔B The |nurse |is |reviewing |laboratory |results |and |notes |an |aPTT |level |of | 28 |seconds. |The |nurse |should | notify |the |health |care |provider |in |anticipation |of |adjusting |which |medication? a. |Aspirin |
b. |Heparin | c. |Warfarin | d. |Erythropoietin |- |✔✔B A |patient |with |a |history |of |a |transfusion-related |acute |lung |injury |(TRALI) |is |to |receive |a |transfusion | of |packed |red |blood |cells |(PRBCs). |Which |action |by |the |nurse |will |decrease |the |risk |for |TRALI |for |this | patient? a. |Infuse |the |PRBCs |slowly |over | 4 |hours. | b. |Transfuse |only |leukocyte-reduced |PRBCs. | c. |Administer |the |scheduled |diuretic |before |the |transfusion. | d. |Give |the |PRN |dose |of |antihistamine |before |the |transfusion. |- |✔✔B Which |action |will |the |nurse |include |in |the |plan |of |care |for |a |72-year-old |woman |admitted |with | multiple |myeloma? a. |Monitor |fluid |intake |and |output. | b. |Administer |calcium |supplements. | c. |Assess |lymph |nodes |for |enlargement. | d. |Limit |weight |bearing |and |ambulation. |- |✔✔A A |postoperative |patient |receiving |a |transfusion |of |packed |red |blood |cells |develops |chills, |fever, | headache, |and |anxiety | 35 |minutes |after |the |transfusion |is |started. |After |stopping |the |transfusion, | what |action |should |the |nurse |take? a. |Draw |blood |for |a |new |crossmatch. | b. |Send |a |urine |specimen |to |the |laboratory. | c. |Administer |PRN |acetaminophen |(Tylenol). | d. |Give |the |PRN |diphenhydramine |(Benadryl). |- |✔✔C A |19-year-old |woman |with |immune |thrombocytopenic |purpura |(ITP) |has |an |order |for |a |platelet | transfusion. |Which |information |indicates |that |the |nurse |should |consult |with |the |health |care |provider | before |obtaining |and |administering |platelets? a. |The |platelet |count |is |42,000/mL. |
c. |Increased |suicidal |ideation d. |Presence |of |abdominal |pain |and |diarrhea e. |Hyperactivity |or |feelings |of |restlessness |- |✔✔A |D |E A |tearful, |anxious |patient |at |the |outpatient |clinic |reports, |"I |should |be |dead." |The |initial |task |of |the | nurse |conducting |the |assessment |interview |is |to: a. |assess |the |lethality |of |a |suicide |plan. b. |encourage |expression |of |anger. c. |establish |a |rapport |with |the |patient. d. |determine |risk |factors |for |suicide. |- |✔✔C A |patient |with |mania |relapsed |after |discontinuing |lithium. |New |orders |are |written |to |resume |lithium | twice |daily |and |begin |olanzapine |(Zyprexa). |The |addition |of |olanzapine |to |the |medication |regimen | will: a. |minimize |the |side |effects |of |lithium. b. |bring |hyperactivity |under |rapid |control. c. |enhance |the |antimanic |actions |of |lithium. d. |be |used |for |long-term |control |of |hyperactivity. |- |✔✔B A |patient |with |bipolar |disorder |has |rapid |cycles. |The |health |care |provider |prescribes |an | anticonvulsant |medication. |To |prepare |teaching |materials, |which |drug |should |the |nurse |anticipate |will |be |prescribed? a. |phenytoin |(Dilantin) b. |clonidine |(Catapres) c. |carbamazepine |(Tegretol) d. |chlorpromazine |(Thorazine) |- |✔✔C
- |Consider |these |three |drugs: |divalproex |(Depakote), |carbamazepine |(Tegretol), |and |gabapentin | (Neurontin). |Which |drug |also |belongs |to |this |group? a. |clonazepam |(Klonopin) b. |risperidone |(Risperdal) c. |lamotrigine |(Lamictal) d. |aripiprazole |(Abilify) |- |✔✔C
- |A |health |care |provider |considers |which |antipsychotic |medication |to |prescribe |for |a |patient |with | schizophrenia |who |has |auditory |hallucinations |and |poor |social |functioning. |The |patient |is |also | overweight |and |has |hypertension. |Which |drug |should |the |nurse |advocate? a. |clozapine |(Clozaril) b. |ziprasidone |(Geodon) c. |olanzapine |(Zyprexa) d. |aripiprazole |(Abilify) |- |✔✔D
- |A |nurse |observes |a |patient |who |is |in |a |catatonic |state |and |standing |immobile, |facing |the |wall | with |one |arm |extended |in |a |salute. |The |patient |remains |immobile |in |this |position |for | 15 |minutes, | moving |only |when |the |nurse |gently |lowers |the |arm. |What |is |the |name |of |this |phenomenon? a. |Echolalia b. |Waxy |flexibility c. |Depersonalization d. |Thought |withdrawal |- |✔✔B
- |Withdrawn |patients |with |schizophrenia: a. |Universally |fear |sexual |involvement |with |therapists. b. |Are |socially |disabled |by |the |positive |symptoms |of |schizophrenia. c. |Exhibit |a |high |degree |of |hostility |as |evidenced |by |rejecting |behavior. d. |Avoid |relationships |because |they |become |anxious |with |emotional |closeness. |- |✔✔D
- |A |newly |admitted |patient |with |schizophrenia |says, |"The |voices |are |bothering |me. |They |yell |and | tell |me |I'm |bad. |I |have |got |to |get |away |from |them." |Select |the |nurse's |most |helpful |reply. a. |"Do |you |hear |the |voices |often?" b. |"Do |you |have |a |plan |for |getting |away |from |the |voices?" c. |"I'll |stay |with |you. |Focus |on |what |we |are |talking |about, |not |the |voices." d. |"Forget |the |voices, |and |ask |some |other |patients |to |play |cards |with |you." |- |✔✔C
- |A |patient |with |schizophrenia |is |acutely |disturbed |and |violent. |After |several |doses |of |haloperidol | (Haldol), |the |patient |is |calm. |Two |hours |later |the |nurse |sees |the |patient's |head |rotated |to |one |side |in |a |stiff |position; |the |lower |jaw |is |thrust |forward, |and |the |patient |is |drooling. |Which |problem |is |most | likely? a. |Acute |dystonic |reaction b. |Tardive |dyskinesia
a. |Neurobiological b. |Developmental c. |Family |theory d. |Genetic e. |Stress |- |✔✔A |D Ten |days |after |receiving |a |bone |marrow |transplant, |a |patient |develops |a |skin |rash. |What |would |the | nurse |suspect |is |the |cause |of |this |patient's |skin |rash? a. |The |donor |T |cells |are |attacking |the |patient's |skin |cells. | b. |The |patient's |antibodies |are |rejecting |the |donor |bone |marrow. | c. |The |patient |is |experiencing |a |delayed |hypersensitivity |reaction. | d. |The |patient |will |need |treatment |to |prevent |hyperacute |rejection. |- |✔✔A An |older |adult |patient |has |a |prescription |for |cyclosporine |following |a |kidney |transplant. |Which | information |in |the |patient's |health |history |has |the |most |implications |for |planning |patient |teaching | about |the |medication |at |this |time? a. |The |patient |restricts |salt |to |treat |prehypertension. | b. |The |patient |drinks | 3 |to | 4 |quarts |of |fluids |every |day. | c. |The |patient |has |many |concerns |about |the |effects |of |cyclosporine. | d. |The |patient |has |a |glass |of |grapefruit |juice |every |day |for |breakfast. |- |✔✔D A |patient |is |admitted |to |the |hospital |with |acute |rejection |of |a |kidney |transplant. |Which |intervention | will |the |nurse |prepare |for |this |patient? a. |Administration |of |immunosuppressant |medications | b. |Insertion |of |an |arteriovenous |graft |for |hemodialysis | c. |Placement |of |the |patient |on |the |transplant |waiting |list | d. |A |blood |draw |for |human |leukocyte |antigen |(HLA) |matching |- |✔✔A A |patient |who |has |received |allergen |testing |using |the |cutaneous |scratch |method |has |developed | itching |and |swelling |at |the |skin |site. |Which |action |should |the |nurse |take |first?
a. |Administer |epinephrine. | b. |Apply |topical |hydrocortisone. | c. |Monitor |the |patient |for |lower |extremity |edema. | d. |Ask |the |patient |about |exposure |to |any |new |lotions |or |soaps. |- |✔✔A Immediately |after |the |nurse |administers |an |intracutaneous |injection |of |an |allergen |on |the |forearm, |a | patient |complains |of |itching |at |the |site |and |of |weakness |and |dizziness. |What |action |should |the |nurse | take |first? a. |Remind |the |patient |to |remain |calm. | b. |Administer |subcutaneous |epinephrine. | c. |Apply |a |tourniquet |above |the |injection |site. | d. |Rub |a |local |antiinflammatory |cream |on |the |site. |- |✔✔C A |nurse |has |obtained |donor |tissue |typing |information |about |a |patient |who |is |waiting |for |a |kidney | transplant. |Which |results |should |be |reported |to |the |transplant |surgeon? a. |Patient |is |Rh |positive |and |donor |is |Rh |negative | b. |Six |antigen |matches |are |present |in |HLA |typing | c. |Results |of |patient-donor |cross |matching |are |positive | d. |Panel |of |reactive |antibodies |(PRA) |percentage |is |low |- |✔✔C A |patient |who |is |receiving |immunotherapy |has |just |received |an |allergen |injection. |Which |assessment | finding |is |most |important |to |communicate |to |the |health |care |provider? a. |The |patient's |IgG |level |is |increased. | b. |The |injection |site |is |red |and |swollen. | c. |The |patient's |allergy |symptoms |have |not |improved. | d. |There |is |a |2-cm |wheal |at |the |site |of |the |allergen |injection. |- |✔✔D A |patient |who |has |vague |symptoms |of |fatigue, |headaches, |and |a |positive |test |for |human | immunodeficiency |virus |(HIV) |antibodies |using |an |enzyme |immunoassay |(EIA) |test. |What |instructions | should |the |nurse |give |to |this |patient? a. |"The |EIA |test |will |need |to |be |repeated |to |verify |the |results." |
a. |The |patient |will |be |free |from |injury. | b. |The |patient |will |receive |immunizations. | c. |The |patient |will |have |adequate |oxygenation. | d. |The |patient |will |maintain |intact |perineal |skin. |- |✔✔D The |nurse |prepares |to |administer |the |following |medications |to |a |hospitalized |patient |with |human | immunodeficiency |(HIV). |Which |medication |is |most |important |to |administer |at |the |right |time? a. |Oral |acyclovir |(Zovirax) | b. |Oral |saquinavir |(Invirase) | c. |Nystatin |(Mycostatin) |tablet | d. |Aerosolized |pentamidine |(NebuPent) |- |✔✔B An |older |adult |who |takes |medications |for |coronary |artery |disease |has |just |been |diagnosed |with | asymptomatic |chronic |human |immunodeficiency |virus |(HIV) |infection. |Which |information |will |the | nurse |include |in |patient |teaching? a. |Many |medications |have |interactions |with |antiretroviral |drugs. | b. |Less |frequent |CD4+ |level |monitoring |is |needed |in |older |adults. | c. |Hospice |care |is |available |for |patients |with |terminal |HIV |infection. | d. |Progression |of |HIV |infection |occurs |more |rapidly |in |older |patients. |- |✔✔A The |nurse |cares |for |a |patient |infected |with |human |immunodeficiency |virus |(HIV) |who |has |just |been | diagnosed |with |asymptomatic |chronic |HIV |infection. |Which |prophylactic |measures |will |the |nurse | include |in |the |plan |of |care |(select |all |that |apply)? a. |Hepatitis |B |vaccine | b. |Pneumococcal |vaccine | c. |Influenza |virus |vaccine | d. |Trimethoprim-sulfamethoxazole | e. |Varicella |zoster |immune |globulin |- |✔✔A |B |C The |health |care |provider |has |prescribed |the |following |collaborative |interventions |for |a |patient |who |is | taking |azathioprine |(Imuran) |for |systemic |lupus |erythematosus. |Which |order |will |the |nurse |question?
a. |Draw |anti-DNA |blood |titer. | b. |Administer |varicella |vaccine. | c. |Naproxen |(Aleve) | 200 |mg |BID. | d. |Famotidine |(Pepcid) | 20 |mg |daily. |- |✔✔B In |teaching |a |patient |with |SLE |about |the |disorder, |the |nurse |knows |that |the |pathophysiology |of |SLE | includes a. |circulating |immune |complexes |formed |from |IgG |autoantibodies |reacting |with |IgG b. |an |autoimmune |T-cell |reaction |that |results |in |destruction |of |the |deep |dermal |skin |layer c. |immunologic |dysfunction |leading |to |chronic |inflammation |in |the |cartilage |and |muscles d. |the |production |of |a |variety |of |autoantibodies |directed |against |components |of |the |cell |nucleus |- | ✔✔D The |pathophysiology |of |systemic |lupus |erthematosus |(SLE) |is |characterized |by a. |destruction |of |nucleic |acids |and |other |self-proteins |by |autoantibodies b. |overproduction |of |collagen |that |disrupts |the |functioning |of |internal |organs c. |formation |of |abnormal |IgG |that |attaches |to |cellular |antigens, |activating |complement d. |increased |activity |of |T-suppressor |cells |with |B-cell |hypoactivity, |resulting |in |an |immunodeficiency |- | ✔✔A A |patient |with |newly |diagnosed |SLE |asks |the |nurse |how |the |disease |will |affect |her |life. |The |best | response |by |the |nurse |is a. |You |can |plan |to |have |a |near-normal |life |since |SLE |rarely |causes |death b. |it |is |difficult |to |tell |because |to |disease |is |so |variable |in |its |severity |and |progression c. |life |span |is |shortened |somewhat |in |people |with |SLE, |but |the |disease |can |be |controlled |with |long- term |use |of |corticosteroids d. |most |people |with |SLE |have |alternating |periods |of |remissions |and |exacerbations |with |rapid | progression |to |permanent |organ |damage |- |✔✔B During |an |acute |exacerbation, |a |patient |with |SLE |is |treated |with |corticosteroids. |The |nurse |would | expect |the |steroids |to |begin |to |be |tapered |when |serum |laboratory |results |indicate a. |increased |RBCs b. |decreased |ESR c. |decreased |anti-DNA d. |increased |complement |- |✔✔C
c. |Pinpoint |pupils |and |respiratory |rate |of | 12 |breaths |per |minute d. |Confusion, |mouth |ulcers, |and |ataxia |- |✔✔D
- |While |caring |for |a |patient |with |a |methamphetamine |overdose, |which |tasks |are |the |priority |focuses |of |care? |Select |all |that |apply. a. |Administration |of |naloxone |(Narcan) b. |Vitamin |B12 |and |folate |supplements c. |Restoring |nutritional |integrity d. |Prevention |of |seizures e. |Reduction |of |fever |- |✔✔D |E A |client |diagnosed |with |schizophrenia |is |slow |to |respond |and |appears |to |be |listening |to |unseen | others. |Which |medication |should |a |nurse |expect |a |physician |to |order |to |address |this |type |of | symptom? A. |Haloperidol |(Haldol) |to |address |the |negative |symptom B. |Clonazepam |(Klonopin) |to |address |the |positive |symptom C. |Risperidone |(Risperdal) |to |address |the |positive |symptom D. |Clozapine |(Clozaril) |to |address |the |negative |symptom |- |✔✔C A |client |is |diagnosed |with |schizophrenia. |A |physician |orders |haloperidol |(Haldol) | 50 |mg |bid, | benztropine |(Cogentin) | 1 |mg |prn, |and |zolpidem |(Ambien) | 10 |mg |HS. |Which |client |behavior |would | warrant |the |nurse |to |administer |benztropine? A. |Tactile |hallucinations B. |Tardive |dyskinesia C. |Restlessness |and |muscle |rigidity D. |Reports |of |hearing |disturbing |voices |- |✔✔C After |taking |chlorpromazine |(Thorazine) |for | 1 |month, |a |client |presents |to |an |emergency |department | (ED) |with |severe |muscle |rigidity, |tachycardia, |and |a |temperature |of |105oF |(40.5C). |The |nurse |expects | the |physician |to |recognize |which |condition |and |implement |which |treatment? A. |Neuroleptic |malignant |syndrome |and |treat |by |discontinuing |Thorazine |and |administering | dantrolene |(Dantrium)
B. |Neuroleptic |malignant |syndrome |and |treat |by |increasing |Thorazine |dosage |and |administering |an | antianxiety |medication C. |Dystonia |and |treat |by |administering |trihexyphenidyl |(Artane) D. |Dystonia |and |treat |by |administering |bromocriptine |(Parlodel) |- |✔✔A A |client |has |been |recently |admitted |to |an |inpatient |psychiatric |unit. |Which |intervention |should |the | nurse |plan |to |use |to |reduce |the |client's |focus |on |delusional |thinking? A. |Present |evidence |that |supports |the |reality |of |the |situation B. |Focus |on |feelings |suggested |by |the |delusion C. |Address |the |delusion |with |logical |explanations D. |Explore |reasons |why |the |client |has |the |delusion |- |✔✔B A |nurse |is |administering |risperidone |(Risperdal) |to |a |client |diagnosed |with |schizophrenia. |The | therapeutic |effect |of |this |medication |would |most |effectively |address |which |of |the |following | symptoms? |(Select |all |that |apply.) A. |Somatic |delusions B. |Social |isolation C. |Gustatory |hallucinations D. |Flat |affect E. |Clang |associations |- |✔✔A |C |E The |most |common |type |of |leukemia |in |older |adults |is | a. |acute |myelocytic |leukemia. b. |acute |lymphocytic |leukemia. c. |chronic |myelocytic |leukemia. d. |chronic |lymphocytic |leukemia. |- |✔✔D The |nurse |is |aware |that |a |major |difference |between |Hodgkin's |lymphoma |and |non-Hodgkin's | lymphoma |is |that a. |Hodgkin's |lymphoma |occurs |only |in |young |adults. b. |Hodgkin's |lymphoma |is |considered |potentially |curable. c. |non-Hodgkin's |lymphoma |can |manifest |in |multiple |organs.
- |Apply |a |topical |corticosteroid |cream.
- |Decrease |infection |by |applying |an |antibiotic |ointment. |- |✔✔ 1 A |new |mother |tells |the |clinic |nurse |that |her |6-week-old |infant |was |born |positive |for |human | immunodeficiency |virus |(HIV). |She |asks |the |nurse |how |long |her |baby |has |to |live. |The |nurse's |response |would |be |based |on |the |knowledge |that:
- |The |antibodies |present |in |the |baby's |blood |may |reflect |the |antibodies |received |from |the |mother |at |the |time |of |birth, |and |further |testing |is |required |to |validate |the |presence |of |HIV.
- |If |antibodies |were |present |at |birth, |the |baby |has |acquired |immunodeficiency |syndrome |(AIDS) |and | will |probably |become |symptomatic |within | 6 |months.
- |Because |the |baby |is |HIV |positive |and |the |virus |is |present |this |early, |the |prognosis |is |very |poor; |the | majority |of |the |children |die |within |the |first | 3 |years.
- |The |antibodies |detected |at |birth |indicate |the |presence |of |HIV; |the |test |does |not |indicate |when |the |child |will |become |HIV |positive. |- |✔✔ 1 The |nurse |is |assigned |to |care |for |a |client |with |systemic |lupus |erythematosus |(SLE). |The |nurse |plans | care |knowing |that |this |disorder |is:
- |A |local |rash |that |occurs |as |a |result |of |allergy
- |A |disease |caused |by |overexposure |to |sunlight
- |An |inflammatory |disease |of |collagen |contained |in |connective |tissue
- |A |disease |caused |by |the |continuous |release |of |histamine |in |the |body |- |✔✔ 3 Which |interventions |would |apply |in |the |care |of |a |client |at |high |risk |for |an |allergic |response |to |a |latex | allergy. |Select |all |that |apply.
- |Use |non-latex |gloves.
- |Use |medications |from |glass |ampules.
- |Place |the |client |in |a |private |room |only.
- |Do |not |puncture |rubber |stoppers |with |needles.
- |Keep |a |latex-safe |supply |cart |available |in |the |client's |area.
- |Use |a |blood |pressure |cuff |from |an |electronic |device |only |to |measure |the |blood |pressure |- |✔✔ 1 | 2 | 4 | 5 The |home |care |nurse |is |ordering |dressing |supplies |for |a |client |who |has |an |allergy |to |latex. |The |nurse | asks |the |medical |supply |personnel |to |deliver |which |of |the |following?
- |Elastic |bandages
- |Adhesive |bandages
- |Brown |Ace |bandages
- |Cotton |pads |and |silk |tape |- |✔✔ 4 A |client |calls |the |emergency |department |and |tells |the |nurse |that |he |received |a |bee |sting |to |the |arm | while |weeding |a |garden. |The |client |states |that |he |has |received |bee |stings |in |the |past |and |is |not | allergic |to |bees. |The |client |states |that |the |site |is |painful |and |asks |the |nurse |for |advice |to |alleviate |the |pain. |The |nurse |tells |the |client |to |first:
- |Take |two |acetaminophen |(Tylenol).
- |Place |a |heating |pad |to |the |site.
- |Apply |ice |and |elevate |the |site.
- |Lie |down |and |elevate |the |arm. |- |✔✔ 3 A |client |with |acquired |immunodeficiency |syndrome |(AIDS) |is |taking |zidovudine |(Retrovir) | 200 |mg | orally |three |times |daily. |The |client |reports |to |the |health |care |clinic |for |follow-up |blood |studies, |and | the |results |of |the |blood |studies |indicate |severe |neutropenia. |Which |of |the |following |would |the |nurse | anticipate |to |be |prescribed |for |the |client?
- |Reduction |in |the |medication |dosage
- |Discontinuation |of |the |medication
- |The |administration |of |prednisone |concurrent |with |the |therapy
- |Administration |of |epoetin |alfa |(Epogen) |- |✔✔ 2 A |client |with |acquired |immunodeficiency |syndrome |(AIDS) |is |taking |didanosine |(Videx). |The |client |calls |the |nurse |at |the |health |care |provider's |office |and |reports |nausea, |vomiting, |and |abdominal |pain. | Which |of |the |following |instructions |would |the |nurse |provide |to |the |client?
- |This |is |an |expected |side |effect |of |the |medication.
- |Come |to |the |office |to |be |seen |by |the |health |care |provider.
- |Take |crackers |and |milk |with |the |administration |of |the |medication.
- |Decrease |the |dose |of |the |medication |until |the |next |health |care |provider's |visit. |- |✔✔ 2 A |client |with |acquired |immunodeficiency |syndrome |(AIDS) |is |experiencing |shortness |of |breath |related |to |Pneumocystis |jiroveci |pneumonia. |Which |measure |should |the |nurse |suggest |to |assist |the |client |in | performing |activities |of |daily |living?
- |Provide |supportive |care |with |hygiene |needs.
- |Provide |meals |and |snacks |with |high |protein, |high |calorie, |and |high |nutritional |value.
- |Provide |small, |frequent |meals.
- |Offer |low |microbial |food. |- |✔✔ 1
