Monahan Phipps Medical Surgical 8th Edition By Monahan -Test Bank

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Monahan Phipps Medical Surgical 8th Edition By Monahan -Test Bank

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Monahan Phipps Medical Surgical 8th Edition By Monahan -Test Bank

Monahan: Phipps Medical-Surgical Nursing: Health and Illness

Perspectives, 8th Edition

 

Test Bank

Chapter 2: The Aging Population

 

MULTIPLE CHOICE

 

  1.   Which is the primary goal of gerontologic care today?
1. Enhancing functional ability
2. Controlling chronic illness
3. Preventing depression
4. Reducing stress

 

 

ANS: 1                    PTS:   1                    DIF:   Category: No applicable category

TOP:  Nursing Process: Planning             MSC: Client Needs: Health Promotion and Maintenance

 

  1.  The nurse recognizes which finding as a secondary change of aging?
1. Vertebral disk shrinkage
2. Calcium loss from bones
3. Weakened hip and knee joints
4. Decreased pulmonary capacity

 

 

ANS: 3                    PTS:   1                    DIF:   Category: Neuromuscular

TOP:  Nursing Process: Assessment        MSC: Client Needs: Physiological Integrity

 

  1.  The nurse suspects the presence of infection when which finding is noted in an older adult patient?
1. Change in appetite
2. Constipation
3. Bradycardia
4. Dyspnea

 

 

ANS: 1                    PTS:   1                    DIF:   Category: Blood and immunity

TOP:  Nursing Process: Analysis/Nursing Diagnosis

MSC: Client Needs: Safe Effective Care Environment

 

  1.      Sexual interest:
1. Diminishes after menopause for women
2. Ends by age 60 or 70 for most men
3. May continue into late adulthood
4. Wanes during middle adulthood

 

 

ANS: 3                    PTS:   1                    DIF:   Category: Reproductive and genitourinary

TOP:  Nursing Process: Analysis/Nursing Diagnosis

MSC: Client Needs: Psychosocial Integrity

 

  1.  The risk for abuse of an older adult family member is greatest when the:
1. Caregiver lives alone with the older adult
2. Caregiver is close in age to the older adult
3. Older adult has decreased functional abilities
4. Older adult has more than one chronic illness

 

 

ANS: 4                    PTS:   1                    DIF:   Category: No applicable category

TOP:  Nursing Process: Assessment        MSC: Client Needs: Safe Effective Care Environment

 

  1.  Which is the best combination of foods for the older adult who complains of bloating, abdominal discomfort, and chronic constipation?
1. Iced tea, fried chicken, and macaroni
2. Oatmeal, applesauce, and green beans
3. Custard, cheese slices, and pureed chicken
4. Hamburger, gelatin, and enriched white bread

 

 

ANS: 2                    PTS:   1                    DIF:   Category: Gastrointestinal

TOP:  Nursing Process: Planning             MSC: Client Needs: Physiological Integrity

 

  1. Which is the best question to ask an older adult when assessing short-term memory?
1. Do you know what day it is today?
2. How are beds, tables, and chairs similar?
3. Who was president during World War II?
4. What news item did you hear about today?

 

 

ANS: 4                    PTS:   1                    DIF:   Category: No applicable category

TOP:  Nursing Process: Assessment        MSC: Client Needs: Physiological Integrity

 

  1.  An older adult patient with diabetes mellitus is prone to forgetfulness and is occasionally confused. Which nursing activity may help reduce her confusion?
1. Placing family photos in her line of sight
2. Standing directly in front of her and speaking loudly
3. Providing thorough explanations about procedures
4. Ensuring that she wears her glasses and hearing aid

 

 

ANS: 4                    PTS:   1                    DIF:   Category: No applicable category

TOP:  Nursing Process: Implementation  MSC: Client Needs: Safe Effective Care Environment

 

  1. Which observation alerts the nurse to the possibility that an older adult is contemplating suicide? The older adult:
1. Seeks spiritual comfort on a regular basis
2. Frequently talks about death and deceased relatives
3. Verbalizes being tired of dealing with a chronic illness
4. Stops verbalizing feelings and exhibits reduced activity

 

 

ANS: 4                    PTS:   1

DIF:   Category: Emotional needs related to health problems

TOP:  Nursing Process: Assessment        MSC: Client Needs: Psychosocial Integrity

 

  1. Which statement about the use of prescription and over-the-counter drugs by older adults is true?
1. Decreased drug duration and increased drug intensity occur when older adults are given the same drug dosage as are younger adults.
2. Older adults consume disproportionately more drugs than younger adults because they suffer more chronic illnesses.
3. Drug dependency is rare among older adults because they do not metabolize drugs as efficiently as younger people.
4. Prescription drugs are better tolerated and produce fewer side effects than over-the-counter drugs.

 

 

ANS: 2                    PTS:   1                    DIF:   Category: Drug-related responses

TOP:  Nursing Process: Planning             MSC: Client Needs: Safe Effective Care Environment

 

Monahan: Phipps Medical-Surgical Nursing: Health and Illness

Perspectives, 8th Edition

 

Test Bank

Chapter 16: Pain

MULTIPLE CHOICE

 

  1. A 4-year-old who has recently undergone tonsillectomy begins crying. Her mother tells the nurse that the child is in pain. The child received Tylenol oral suspension 4 hours ago. The nurse instructs the mother to rock the child to encourage sleep. The nurses action is based on:
1. Inadequate knowledge of pain management
2. Evidence-based practice
3. The gate control theory of pain
4. Experience with other patients with tonsillectomies

 

 

ANS: 1                    PTS:   1                    DIF:   Category: No applicable category

TOP:  Nursing Process: Implementation  MSC: Client Needs: Physiological Integrity

 

  1. The gate control theory of pain implies that effective pain management plans should:
1. Deal primarily with emotional aspects of the patients pain experience
2. Focus chiefly on altering pain perception through behavior modification
3. Restrict analgesic use to pure opioid drugs that act centrally to close the gate
4. Include a combination of pharmacologic agents and noninvasive interventions

 

 

ANS: 4                    PTS:   1                    DIF:   Category: Neuromuscular

TOP:  Nursing Process: Implementation  MSC: Client Needs: Physiological Integrity

 

  1. A patient is seen in the health clinic with a complaint of low back pain of 5 months duration. Vital signs are stable. An accurate nursing diagnosis is:
1. Chronic pain: low back, unclear etiology
2. Deficient knowledge regarding pain management
3. Acute pain related to low back strain
4. Anxiety related to acute pain

 

 

ANS: 1                    PTS:   1                    DIF:   Category: Neuromuscular

TOP:  Nursing Process: Analysis/Nursing Diagnosis

MSC: Client Needs: Physiological Integrity

 

  1. A patient complains of pain in the chest and left arm and a diagnosis of myocardial infarction is made. This type of pain is:
1. Psychogenic
2. Localized
3. Referred
4. Somatic

 

 

ANS: 3                    PTS:   1                    DIF:   Category: Cardiovascular

TOP:  Nursing Process: Assessment        MSC: Client Needs: Physiological Integrity

 

  1. A patient receiving an agonist opioid such as morphine sulfate IV is at risk for a state of withdrawal with concurrent administration of which drug?
1. Transdermal fentanyl (Duragesic)
2. Hydromorphone (Dilaudid)
3. Meperidine (Demerol)
4. Butorphanol (Stadol)

 

 

ANS: 4                    PTS:   1                    DIF:   Category: Drug-related responses

TOP:  Nursing Process: Analysis/Nursing Diagnosis

MSC: Client Needs: Physiological Integrity

 

  1. The analgesic order for a patient with cancer pain is changed from oral morphine sulfate 30 mg/day to morphine sulfate IV 2 to 15 mg/dose. How many milligrams per dose of IV morphine does the nurse select to achieve the same analgesic effect provided by the oral route?
1. 2 mg
2. 5 mg
3. 10 mg
4. 15 mg

 

 

ANS: 2                    PTS:   1                    DIF:   Category: Drug-related responses

TOP:  Nursing Process: Implementation  MSC: Client Needs: Physiological Integrity

 

  1. Which assessment is essential to evaluate whether a dose of IV naloxone (Narcan) has been excessive?
1. Pain
2. Sedation
3. Constipation
4. Respiratory depression

 

 

ANS: 1                    PTS:   1                    DIF:   Category: Drug-related responses

TOP:  Nursing Process: Assessment        MSC: Client Needs: Physiological Integrity

 

  1. Discharge teaching for the patient receiving an NSAID includes notifying the physician when which occurs?
1. Nausea
2. Anorexia
3. Restlessness
4. Abnormal bleeding

 

 

ANS: 4                    PTS:   1                    DIF:   Category: Drug-related responses

TOP:  Nursing Process: Evaluation          MSC: Client Needs: Safe Effective Care Environment

 

  1. The nurse observing self-administered transcutaneous electrical nerve stimulation determines that more teaching is required if the patient:
1. Places the electrodes over the painful area
2. Applies the electrodes along trigger points
3. Cannot identify when to change the battery
4. Cleanses the area before electrode application

 

 

ANS: 3                    PTS:   1                    DIF:   Category: Neuromuscular

TOP:  Nursing Process: Evaluation          MSC: Client Needs: Safe Effective Care Environment

 

  1. An appropriate goal following rhizotomy for pain management is that the patient will be able to explain:
1. The importance of avoiding extremes in temperature
2. Methods to protect against electrical shock
3. The need for a high-fiber diet
4. Infection control measures

 

 

ANS: 1                    PTS:   1                    DIF:   Category: Neuromuscular

TOP:  Nursing Process: Planning             MSC: Client Needs: Safe Effective Care Environment

 

  1. The patient describes postoperative pain as a dull ache located in the upper right abdomen and rates it at 5 on a scale of 1 to 5. What information is still missing for the nurses assessment?
1. Provoking factors
2. Quality of the pain
3. Severity or intensity
4. Region or radiation

 

 

ANS: 1                    PTS:   1                    DIF:   Category: Neuromuscular

TOP:  Nursing Process: Assessment        MSC: Client Needs: Physiological Integrity

 

  1. To minimize pain while changing a postoperative knee dressing, nursing interventions should include:
1. Administering an analgesic immediately following the procedure
2. Selecting Demerol IM as the preprocedural analgesic
3. Having the nursing assistant support the leg under the knee
4. Placing a pillow under the calf of the affected leg

 

 

ANS: 3                    PTS:   1                    DIF:   Category: Neuromuscular

TOP:  Nursing Process: Implementation  MSC: Client Needs: Physiological Integrity

 

  1. Evidence-based practice shows that opioid addiction occurs:
1. Less frequently if opioids are discontinued after 3 days
2. In fewer than 1% of hospitalized patients
3. Primarily in patients with chronic pain
4. Chiefly in the young adult population

 

 

ANS: 2                    PTS:   1                    DIF:   Category: Drug-related responses

TOP:  Nursing Process: Assessment        MSC: Client Needs: Physiological Integrity

 

  1. The standard of care for any patient experiencing severe pain includes:
1. Analgesic decisions based on continuing assessment
2. Selecting oral analgesics following major surgery
3. Using low starting doses to minimize tolerance
4. Use of prn administration schedules

 

 

ANS: 1                    PTS:   1                    DIF:   Category: Drug-related responses

TOP:  Nursing Process: Implementation  MSC: Client Needs: Physiological Integrity

 

  1. Which statement regarding opioid use in the elderly is true?
1. Opioid analgesics are too dangerous.
2. Subjective pain reports are not reliable.
3. Administration may need to be decreased.
4. Body surface area should be used to calculate dosages accurately.

 

 

ANS: 3                    PTS:   1                    DIF:   Category: Drug-related responses

TOP:  Nursing Process: Planning             MSC: Client Needs: Physiological Integrity

 

  1. Guidelines for application of ice to a painful body part include:
1. Avoiding direct application of ice over the painful site
2. Leaving the ice in place for a minimum of 20 minutes
3. Applying enough cold to create mild discomfort
4. Placing cold between the painful area and the brain

 

 

ANS: 4                    PTS:   1                    DIF:   Category: Neuromuscular

TOP:  Nursing Process: Implementation  MSC: Client Needs: Safe Effective Care Environment

 

Monahan: Phipps Medical-Surgical Nursing: Health and Illness

Perspectives, 8th Edition

 

Test Bank

Chapter 32: Assessment of the Hematologic System

 

MULTIPLE CHOICE

 

  1.    Which function does hemoglobin serve in the body?
1. Stimulates release of red blood cells from the bone marrow
2. Transports oxygen and carbon dioxide to and from cells
3. Converts oxygen to methemoglobin
4. Carries oxygen to cells

 

 

ANS: 2                    PTS:   1                    DIF:   Category: Blood and immunity

TOP:  Nursing Process: Assessment        MSC: Client Needs: Physiological Integrity

 

  1.    Patients are at increased risk for anemia if they cannot produce:
1. Renin
2. Aldosterone
3. Erythropoietin
4. Antidiuretic hormone

 

 

ANS: 3                    PTS:   1                    DIF:   Category: Blood and immunity

TOP:  Nursing Process: Assessment        MSC: Client Needs: Physiological Integrity

 

  1.    Which cells are increased in a person who has an active infection?
1. Basophils
2. Eosinophils
3. Neutrophils
4. Plasma cells

 

 

ANS: 3                    PTS:   1                    DIF:   Category: Blood and immunity

TOP:  Nursing Process: Assessment        MSC: Client Needs: Physiological Integrity

 

  1.    Which organ is most likely diseased when a patient experiences an overall decrease in white blood cell count?
1. Lymph nodes
2. Bone marrow
3. Spleen
4. Liver

 

 

ANS: 2                    PTS:   1                    DIF:   Category: Blood and immunity

TOP:  Nursing Process: Assessment        MSC: Client Needs: Physiological Integrity

 

  1. Which is an abnormal finding that needs to be reported immediately?
1. WBC 9500/mm3
2. Hematocrit 43%
3. Hemoglobin 12 g/dl
4. Platelets 100,000/mm3

 

 

ANS: 1                    PTS:   1                    DIF:   Category: Blood and immunity

TOP:  Nursing Process: Implementation  MSC: Client Needs: Safe Effective Care Environment

 

  1. Which statement regarding changes in white blood cell counts due to the aging process is true? There is (or are):
1. Variations in percentages allotted to each blood cell category
2. An accelerated response to infection by basophils
3. A decreased total number of white blood cells
4. No significant changes

 

 

ANS: 4                    PTS:   1                    DIF:   Category: Blood and immunity

TOP:  Nursing Process: Assessment        MSC: Client Needs: Health Promotion and Maintenance

 

  1. Which objective data substantiates the presence of a hematologic condition?
1. Weakness and lethargy
2. History of exposure to chemicals
3. Pain on palpation of the abdomen
4. Enlarged cervical and inguinal lymph nodes

 

 

ANS: 2                    PTS:   1                    DIF:   Category: Blood and immunity

TOP:  Nursing Process: Assessment        MSC: Client Needs: Health Promotion and Maintenance

 

  1. Which skin assessment finding is consistent with thrombocytopenia?
1. Petechiae, ecchymoses
2. Pallor, spider angiomas
3. Cyanosis, dullness
4. Jaundice, purpura

 

 

ANS: 1                    PTS:   1                    DIF:   Category: Blood and immunity

TOP:  Nursing Process: Assessment        MSC: Client Needs: Physiological Integrity

 

  1. Which lymph node is normally palpable during a physical examination?
1. Supraclavicular
2. Thoracic
3. Inguinal
4. Cervical

 

 

ANS: 3                    PTS:   1                    DIF:   Category: Blood and immunity

TOP:  Nursing Process: Assessment        MSC: Client Needs: Physiological Integrity

 

  1. Which instruction is given to the patient being prepared for a bone marrow aspiration?
1. You will not feel any pain, since this is not an invasive procedure.
2. There will be a brief, sharp pain during aspiration of the bone marrow.
3. You will be given a general anesthetic before the performance of this procedure.
4. It is normal to bleed for a while following the procedure, so you will be monitored closely.

 

 

ANS: 2                    PTS:   1                    DIF:   Category: Blood and immunity

TOP:  Nursing Process: Implementation  MSC: Client Needs: Health Promotion and Maintenance

 

  1. Which is the correct sequence for coagulation following trauma or surgery?
1. Prothrombin, thrombin, fibrinogen, fibrin
2. Prothrombin, fibrinogen, thrombin, fibrin
3. Fibrin, prothrombin, thrombin, fibrinogen
4. Fibrinogen, fibrin, thrombin, prothrombin

 

 

ANS: 1                    PTS:   1                    DIF:   Category: Blood and immunity

TOP:  Nursing Process: Analysis/Nursing Diagnosis

MSC: Client Needs: Physiological Integrity

 

 

Monahan: Phipps Medical-Surgical Nursing: Health and Illness

Perspectives, 8th Edition

 

Test Bank

 

Chapter 48: Traumatic and Neoplastic Problems of the Brain

 

MULTIPLE CHOICE

 

  1.    An important principle for neurologic assessment of the patient with a head injury is:
1. Establish trends in signs and symptoms
2. Vigorously stimulate the patient before neurologic assessment
3. Limit the frequency of neurologic checks to prevent overstimulation
4. Sensory assessment should be consistently performed before motor assessment

 

 

ANS: 1                    PTS:   1                    DIF:   Category: Neuromuscular

TOP:  Nursing Process: Assessment        MSC: Client Needs: Physiological Integrity

 

  1.    Which entry in the nursing notes is most helpful to the oncoming shift? The patient:
1. opened eyes after their name was called three times
2. responds slowly to stimulation
3. is obtunded
4. appears confused

 

 

ANS: 1                    PTS:   1                    DIF:   Category: Neuromuscular

TOP:  Nursing Process: Evaluation          MSC: Client Needs: Safe Effective Care Environment

 

  1. Nursing assessment reveals that the patient moans in response to a painful stimulus. This level of consciousness (LOC) is called:
1. Deep coma
2. Obtunded
3. Stuporous
4. Confused

 

 

ANS: 3                    PTS:   1                    DIF:   Category: Neuromuscular

TOP:  Nursing Process: Analysis/Nursing Diagnosis

MSC: Client Needs: Physiological Integrity

 

  1. Criteria used to determine brain death include:
1. Known cause of coma, absence of reflexes and respirations
2. Decerebrate posturing and flat-line electrocardiogram
3. One or more flat electroencephalograms
4. Absent heartbeat

 

 

ANS: 1                    PTS:   1                    DIF:   Category: Neuromuscular

TOP:  Nursing Process: Evaluation          MSC: Client Needs: Physiological Integrity

 

  1. Which nursing notation provides the best assessment information regarding level of consciousness in the comatose patient?
1. Attempts to push nurses hand away when fingernail pressure applied
2. Grimaces and makes nonpurposeful movements
3. Unresponsive to painful stimulus
4. Responds to painful stimulus

 

 

ANS: 1                    PTS:   1                    DIF:   Category: Neuromuscular

TOP:  Nursing Process: Evaluation          MSC: Client Needs: Safe Effective Care Environment

 

  1. Which finding is an early indicator of altered level of consciousness?
1. Difficulty pronouncing words
2. Localizes to painful stimulus
3. Inability to state the date
4. Dilation of pupils

 

 

ANS: 3                    PTS:   1                    DIF:   Category: Neuromuscular

TOP:  Nursing Process: Analysis/Nursing Diagnosis

MSC: Client Needs: Physiological Integrity

 

  1. To achieve accuracy in the assessment of head-injured patients, the nurse realizes it is important that:
1. The same evaluation tool be used by all personnel to assess the patient
2. LOC be assessed at the same time every day
3. Each assessment be conducted by two nurses
4. The Glasgow Coma Scale be used

 

 

ANS: 1                    PTS:   1                    DIF:   Category: Neuromuscular

TOP:  Nursing Process: Assessment        MSC: Client Needs: Safe Effective Care Environment

 

  1. A plan for safe care in a patient experiencing dysphagia includes:
1. Restricting intake to clear liquids
2. Stroking the throat to promote swallowing
3. Restricting liquids and encouraging soft foods
4. Assessing the mouth for pocketed food and medication

 

 

ANS: 4                    PTS:   1                    DIF:   Category: Neuromuscular

TOP:  Nursing Process: Planning             MSC: Client Needs: Safe Effective Care Environment

 

  1. Which approach demonstrates an important principle of communication with confused patients?
1. Touch the patients hand and speak quietly
2. Sit in a chair beside the bed and speak loudly
3. Bend close to the patients face and talk in a whisper
4. Ask permission to hold the patients hand and speak slowly

 

 

ANS: 4                    PTS:   1                    DIF:   Category: Neuromuscular

TOP:  Nursing Process: Implementation  MSC: Client Needs: Safe Effective Care Environment

 

  1. Which finding, if exhibited by the patient, is an early indicator of increasing intracranial pressure (ICP)?
1. Papilledema
2. Decreased LOC
3. Projectile vomiting
4. Significant increase in temperature

 

 

ANS: 2                    PTS:   1                    DIF:   Category: Neuromuscular

TOP:  Nursing Process: Analysis/Nursing Diagnosis

MSC: Client Needs: Physiological Integrity

 

  1. An appropriate nursing intervention designed to decrease risk of increased ICP in the patient with a head injury is to:
1. Keep neck in alignment
2. Administer enemas daily
3. Place in Trendelenburgs position
4. Encourage deep breathing and coughing

 

 

ANS: 1                    PTS:   1                    DIF:   Category: Neuromuscular

TOP:  Nursing Process: Implementation  MSC: Client Needs: Safe Effective Care Environment

 

  1. A patient with increased ICP is on a ventilator and requires suctioning. To prevent a rise in ICP, the nurse must:
1. Preoxygenate the patient
2. Administer an analgesic
3. Sedate the patient
4. Suction quickly

 

 

ANS: 1                    PTS:   1                    DIF:   Category: Neuromuscular

TOP:  Nursing Process: Implementation  MSC: Client Needs: Safe Effective Care Environment

 

  1. Which pharmacologic intervention does the nurse expect the physician to order for the patient who is in a coma and has increased ICP?
1. Sedatives and narcotic analgesics
2. Barbiturates and phenothiazines
3. Osmotic diuretics and steroids
4. Antibiotics and vasodilators

 

 

ANS: 3                    PTS:   1                    DIF:   Category: Drug-related responses

TOP:  Nursing Process: Implementation  MSC: Client Needs: Physiological Integrity

 

 

  1. The most significant observations to be reported when monitoring a patient with increased ICP are:
1. Decreasing pulse, respirations, and blood pressure
2. Decreasing pulse and increasing systolic pressure
3. Increasing pulse, respirations, and blood pressure
4. Narrowed pulse pressure and hypothermia

 

 

ANS: 2                    PTS:   1                    DIF:   Category: Neuromuscular

TOP:  Nursing Process: Implementation  MSC: Client Needs: Safe Effective Care Environment

 

  1. A patient with a head injury begins to complain of a headache and cannot remember the date. Vital signs are blood pressure of 174/58 mm Hg, pulse of 50 beats/min, and respirations of 12/min. These signs and symptoms are consistent with:
1. Meningococcal infection
2. Cushings response
3. Diabetes insipidus
4. Encephalitis

 

 

ANS: 2                    PTS:   1                    DIF:   Category: Neuromuscular

TOP:  Nursing Process: Analysis/Nursing Diagnosis

MSC: Client Needs: Physiological Integrity

 

  1. Which statement regarding care of the patient with a subdural hematoma and elevated ICP is correct? The nurse should:
1. Lower the head of the bed to increase cerebral blood flow
2. Encourage Valsalvas maneuver to promote venous outflow
3. Treat fever promptly because it increases the metabolic needs of the brain
4. Encourage hyperventilation because CO2 increases cerebral blood volume

 

 

ANS: 3                    PTS:   1                    DIF:   Category: Neuromuscular

TOP:  Nursing Process: Analysis/Nursing Diagnosis

MSC: Client Needs: Safe Effective Care Environment

 

  1. A patient complaining of episodic headaches describes the pain as a 10 (on a scale of 1 to 10), located on the left side, accompanied by nausea, and lasting 2 to 3 days. These signs and symptoms are consistent with which type of headache?
1. Sinus
2. Cluster
3. Tension
4. Migraine

 

 

ANS: 4                    PTS:   1                    DIF:   Category: Neuromuscular

TOP:  Nursing Process: Analysis/Nursing Diagnosis

MSC: Client Needs: Physiological Integrity

 

  1. The pain reliever of choice for patients experiencing mild, infrequent headaches is:
1. Meperidine hydrochloride
2. Morphine sulfate
3. Codeine sulfate
4. Ibuprofen

 

 

ANS: 4                    PTS:   1                    DIF:   Category: Drug-related responses

TOP:  Nursing Process: Implementation  MSC: Client Needs: Safe Effective Care Environment

 

  1. A teaching plan to assist the patient in reducing the incidence of headaches includes instructions to:
1. Avoid large, high-calorie meals
2. Eliminate daily aerobic exercise routine
3. Eliminate all milk products from the diet
4. Minimize alcohol, caffeine, and salt intake

 

 

ANS: 4                    PTS:   1                    DIF:   Category: Neuromuscular

TOP:  Nursing Process: Implementation  MSC: Client Needs: Health Promotion and Maintenance

 

  1. A 15-year-old girl has been seizing for 40 minutes (status epilepticus). Her teeth are clenched. What does the nurse do first?
1. Administer diazepam (Valium)
2. Provide oxygen by mask
3. Establish an intravenous site
4. Insert an airway

 

 

ANS: 2                    PTS:   1                    DIF:   Category: Neuromuscular

TOP:  Nursing Process: Implementation  MSC: Client Needs: Safe Effective Care Environment

 

  1. To interrupt seizure activity in the patient with status epilepticus the patient must receive:
1. Carbamazepine (Tegretol)
2. Valproic acid (Depakene)
3. Phenytoin (Dilantin)
4. Diazepam (Valium)

 

 

ANS: 4                    PTS:   1                    DIF:   Category: Drug-related responses

TOP:  Nursing Process: Implementation  MSC: Client Needs: Safe Effective Care Environment

 

  1. A frequent side effect of most of the common anticonvulsants is:
1. Facial rash
2. Drowsiness
3. Hypotension
4. Discoloration of the gums

 

 

ANS: 2                    PTS:   1                    DIF:   Category: Drug-related responses

TOP:  Nursing Process: Evaluation          MSC: Client Needs: Physiological Integrity

 

  1. A patient on continuous video monitoring is observed having a generalized tonic-clonic seizure. This means that the patient is exhibiting:
1. Brief loss of consciousness
2. Jerking movements throughout the body
3. Rigidity for several seconds, then flaccidity
4. Rigidity of muscles followed by muscle jerking

 

 

ANS: 4                    PTS:   1                    DIF:   Category: Neuromuscular

TOP:  Nursing Process: Analysis/Nursing Diagnosis

MSC: Client Needs: Physiological Integrity

 

  1. During the postictal period of a seizure, an appropriate nursing action is to:
1. Give the patient a sedative
2. Assist the patient to the bathroom
3. Assess the duration of the postictal phase
4. Explain to the patient that a seizure has just occurred

 

 

ANS: 3                    PTS:   1                    DIF:   Category: Neuromuscular

TOP:  Nursing Process: Implementation  MSC: Client Needs: Physiological Integrity

 

  1. A classic sign of an absence (petit mal) seizure is:
1. Tonic-clonic movement
2. Vacant facial expression
3. Urinary incontinence
4. Lip smacking

 

 

ANS: 2                    PTS:   1                    DIF:   Category: Neuromuscular

TOP:  Nursing Process: Assessment        MSC: Client Needs: Physiological Integrity

 

  1. When a patient is experiencing seizure activity, the most appropriate time to clear the airway is:
1. Any time during the seizure
2. Throughout the ictal period
3. During the most intense period of the seizure
4. Immediately after tonic-clonic movements stop

 

 

ANS: 4                    PTS:   1                    DIF:   Category: Neuromuscular

TOP:  Nursing Process: Implementation  MSC: Client Needs: Safe Effective Care Environment

 

  1. The method most commonly used to measure compliance and monitor anticonvulsant drug toxicity is:
1. Electroencephalogram once a month
2. Daily seizure record
3. Evidence of side effects
4. Blood test for drug levels

 

 

ANS: 4                    PTS:   1                    DIF:   Category: Drug-related responses

TOP:  Nursing Process: Evaluation          MSC: Client Needs: Safe Effecti

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