Question 1

A nurse is admitting a patient with suspected TB. What should the nurse do first before the patient arrives?

Accepted Answer

The nurse should notify the engineering department and central supply first. This reflects the nurse's assessment of the patient. The engineering department needs to be notified so they can confirm the room the adequacy of the negative pressure status of the room. The correct isolation for a diagnosis of TB or suspected TB is airborne, not contact.

Question 2

A new nurse is on the floor and has been verbally belittled and rudely treated by a small group of senior nurses. What is the most effective way to deal with this horizontal violence?

Accepted Answer

The most effective way to deal with horizontal violence between staff is to recognize its harm and deal with it directly. By addressing the actions promptly, others are encouraged to do the same and accountability for professional behavior is established. Working with the manager to promote education is important, but it does not help the nurse being hurt directly.

Question 3

A patient being is being admitted to the floor after 4 days of nausea, vomiting and diarrhea with a diagnosis of Hypernatremia. What signs and symptoms would you expect to see?

Accepted Answer

The signs and symptoms one would expect to see in a patient with Hypernatremia include confusion, dry and sticky mucous membranes, lethargy, decrease in level of consciousness, postural hypotension and lethargy.

Question 4

Extravasation has occurred in the 20 gauge IV site in the left arm of the patient who just received a dose of Vancomycin. What is the best way to treat the site to minimize pain to the patient?

Accepted Answer

The best way to treat the site to minimize pain is to apply warm or ice packs to the site. The other answers are all actions that need to be done but do little to directly affect the patient's pain.

Question 5

A patient has a new diagnosis of generalized anxiety disorder with panic attacks is being prescribed the anti anxiety agent Buspirone. What is the best way to teach the patient about taking the medication?

Accepted Answer

The best way to teach the patient about the medication is to reinforce that it takes time for the medication to take effect. This will encourage the patient to continue taking the medication (compliance) and corrects any misconceptions that it will help right away.

Question 6

Guided exposure therapy is usually used for patients with this time of anxiety disorder:

Accepted Answer

Guided exposure therapy is usually used for patients with specific phobias. Guided exposure therapy includes teaching relaxation and imagery techniques and educating the patient about their problem, treatment and signs and symptoms.

Question 7

226)The nurse has received a patient who was admitted with a vitamin B12 deficiency. What would the nurse specifically do in her assessment?

Accepted Answer

The nurse would specifically look at the tongue in her assessment of the patient who has a vitamin B12 deficiency. The tongue is beefy red (tongue turns sore and tender dark red in color) and has a smooth appearance specific to Vitamin B12 deficiency.

Question 8

A patient has been admitted with a diagnosis of Addison's disease and vomiting and nausea for 2 days. The doctor has prescribed IV Glucocorticoids. Which is the most appropriate intervention to monitor the patient?

Accepted Answer

The most appropriate intervention would be to monitor the blood glucose levels using a Glucometer. Glucocorticoids raise the blood sugar and the patient may need insulin to balance out the harmful effects of an elevated blood sugar.

Question 9

The nurse is taking care of a patient who is post operative day one for a total Thyroidectomy. He calls the nurse into the room and states that he has tingling around his mouth and in his fingers and toes. What are the next actions of the nurse?

Accepted Answer

The next action the nurse should take in response to the patient's complaint of tingling in his mouth and fingers and toes is to check the calcium level. The parathyroid glands are responsible for the calcium production and a common risk of a Thyroidectomy is damage to these glands. Tingling is a symptom of low calcium.

Question 10

A patient admitted with acute asthma exacerbation is preparing to be discharged. The nurse is teaching the patient about a peak flow meter. What is the best way to explain what it does?

Accepted Answer

The best way for the nurse to explain the peak flow monitor to the patient is to tell him how to use it correctly so he will be able to determine when his asthma symptoms are getting worse.

Question 11

A nurse is giving instructions to a patient with an iron deficiency anemia. Which meal plan would reflect the patient's understanding of an appropriate diet?

Accepted Answer

The diet that would reflect the patient's understanding of a iron-rich diet would be the diet that has eggs, wheat bread, carrots, raisins and green leafy vegetables.

Question 12

The nurse is caring for a client with Epiglottis. What equipment should have the nurse have at the bedside because of the risk of complete obstruction of the airway?

Accepted Answer

Because of the risk of complete obstruction, the equipment the nurse should have at the bedside is a Tracheostomy set. The other options will not help with an obstructed airway.

Question 13

You are teaching a continuing education class to the staff regarding the different types of pain. What is the best way to define the sources of somatic pain?

Accepted Answer

The best way to define sources of somatic pain would be to use examples such as incisional pain, pain at the sites of drains and tubes and wound complications. Somatic structures are the first source of pain and affect the most superficial parts of the body.

Question 14

A patient on the unit is confused and a fall risk. He continues to get up out of bed despite verbal instructions and the bed alarm on. The nurse has decided he needs restraints. What should she do first?

Accepted Answer

The first thing is to exhaust all options before applying physical restraints to a patient. Calling the family to see if someone could come in and stay with the patient should be done before obtaining the order for restraints. The patient is confused so educating him about the risks of getting out of bed will probably not benefit him much.

Question 15

The nurse is working with a nursing assistant who has recently successfully completed her orientation. What would be an appropriate task to delegate to the nursing assistant?

Accepted Answer

An appropriate task to delegate to the nursing assistant would be able to ambulate a patient. Assessing and teaching are not within the nursing assistant's scope of practice.

Question 16

A patient who had a massive stroke and end stage cancer has been transferred to the floor with comfort care orders. Which pain medication would the nurse expect the doctor to order?

Accepted Answer

The pain medication that the nurse would expect the doctor to order would be the morphine elixir which can be given sublingually. Extended release morphine is not appropriate. Levsin is for secretions, not pain.

Question 17

The nurse comes on shift and received report that a patient needs to go to surgery. The nurse helps the patient to the bathroom to void, takes vital signs and calls report to the operating room nurse and sends the patient. She receives a phone call from the receiving nurse who yells at her because the consent was not signed and the patient's wedding ring is still on. The nurse threatens to report to the supervisor. What is the most therapeutic response?

Accepted Answer

The most therapeutic response for the nurse in this situation is to diffuse the operating room nurses'stress and take responsibility for the situation. Additional work has been placed on the operating room nurse and a sincere apology is the most therapeutic way to act with the nurse. Identifying the process of change of shift transfers and self- reporting are important but would not be therapeutic actions in working with the angry nurse.

Question 18

You are taking care of a patient with a history of Paroxysmal Atrial Tachycardia. What signs and symptoms would show the patient is experiencing Paroxysmal Atrial Tachycardia (PAT)?

Accepted Answer

The symptoms a patient would experience during Paroxysmal Atrial Tachycardia would be a sudden awareness of a fast heartbeat and palpitations.

Question 19

The nurse is developing a teaching plan for a patient who just received an inserted permanent pacemaker. What important concepts should the nurse teach the patient?

Accepted Answer

It is important for the nurse to teach the patient to avoid tight clothing or direct pressure on the site of the pacemaker as part of the teaching plan. In addition, it is important to avoid magnetic resonance imaging scans.

Question 20

A patient has been in bed two days post operatively a total knee replacement. He is refusing to get up out of bed because of the pain. The nurse is concerned that he is developing pneumonia. What signs and symptoms should be reported to the doctor to explore the possibility of pneumonia?

Accepted Answer

The signs and symptoms that should be reported to the doctor to explore the possibility of pneumonia include the sudden onset of chills with a high fever and a headache. Diminished or absent breath sounds and dullness on percussion of the lungs are signs and symptoms of Atelectasis.

Quiz 1: Adult