Which ego-defense mechanisms are most prominently used in obsessive-compulsive disorders?

introjection is defined as a psychic representation of a loved or hated object taken into one's ego system; in projection, a person attributes to another ideas, thoughts, feelings, and impulses that are a part of his or her inner perception, but are unacceptable

compensation is a conscious or unconscious defense mechanism by which a person tries to make up for an imagined or real deficiency that is physical, psychologic, or both

displacement of the ego-dystonic idea into an unrelated and senseless activity temporarily lowers the anxiety of the individual. By carrying out the act, the client attempts to undo the uncontrollable impulse. Counting compulsions and rituals are examples of undoing

rationalization is unconscious defense mechanism in which an irrational behavior, motive, or feeling is made to appear reasonable; suppression is a conscious defense mechanism by which a person deliberately forgets those ideas, impulses, and affects that are unacceptable

2. Three of the following conditions are frequently characteristic of the client with anorexia nervosa. Which one is not?

hoarding food

eating only low-calorie foods

napping frequently to conserve energy

abusing laxatives and diuretics

3. Lorazepam (Ativan) is primarily effective in treating which of the following?

hallucinations

delusions

anxiety

incoherent speech

4. In severe, major depression, which of the following defense mechanisms is most prominent?

introjection

projection

sublimation

rationalization

5. The ego-defense mechanism thought to be used by clients with phobic disorders is which of the following?

sublimation

displacement

substitution

suppression

6. Of the following side effects, which one is not expected with nortriptyline (Aventyl) 100 mg daily?

blurred vision

dry mouth

urinary retention

restlessness

7. The most common side effects of ECT include which of the following?

aphasia and gait difficulties

nausea and vomiting

confusion and memory loss

diarrhea and GI distress

8. Which of the following medications is used in conjunction with ECT?

succinylcholine (Anectine) as a muscle relaxant

methohexital (Brevital) as an anesthetic

AtSO4 as an anticholinergic

All of the above

9. The most important advantage a depressed client gains from a group therapy is:

improved social interactions and focus on other's problems

improved reality orientation

greater insights into problems through the concept of universality

greater insight and knowledge of self through feedback provided by group members

10. Dry mouth, constipation, and blurred vision are characteristic symptoms of the action of imipramine (Tofranil) on which of the following body systems?

cardiovascular system

endocrine system

autonomic nervous system

respiratory system

11. The therapeutic blood level for lithium therapy is maintained between which of the following?

0.8 and 1.8 mEq/L

2.5 and 3.5 mEq/L

5.0 and 7.5 mg/ml

0.3 and 0.75 mg/ml

12. As part of a teaching plan on lithium carbonate, clients are instructed to have lithium levels determined every 1 to 3 months when they are outpatients. Which statement best describes the reason for this?

lithium carbonate can produce potassium and magnesium depletion

triglyceride levels can increase as the lithium level increases

lithium carbonate in large quantities produces sedation resulting in safety risks

a narrow margin of safety exists between therapeutic and toxic levels of lithium carbonate

13. The initial treatment of a rape survivor can significantly affect the psychologic impact the assault will have on the survivor. The first information elicited from the client should be which of the following?

marital state of the survivor

survivor's perception of what occurred

whether the rapist was known to her

how she feels about having an abortion of she becomes pregnant

14. The initial signs and symptoms of alcohol withdrawal are:

hypotension, bradycardia, and decreased salivation

fever, dehydration, and convulsions

tremors, nervousness, and diaphroresis

permanent cognitive impairment and ataxia

15. If a client experiences hallucinations during alcohol withdrawal, which would be the most appropriate nursing intervention?

a.a quiet room and PRN benzodiazepine medication

bed rest, soft music, and fluids

hot tea every 2 hours, blood pressure check every 30 minutes, and restraints

ice cream every 2 hours, blood pressure check every 15 minutes, and restraints

16. Select the medication that best helps control

hallucinations and delusions:

haloperidol (Haldol)

isocarboxazid (Marplan)

alprazolam (Xanax)

paroxetine (Paxil)

17. Which of the following activities attended by a client with agoraphobia indicates an improvement in the client's condition?

milieu group in the dayroom

occupational therapy in the adjunctive therapy room

recreational therapy on the outside volleyball court

Friday lunch in the hospital cafeteria

18. When planning the initial nursing care plan of a client with obsessive-compulsive handwashing behavior, which of the following should receive the highest priority?

client will maintain a role in the family

client will discontinue the handwashing behavior

client will verbalize major causes of the handwashing behavior

client will reestablish skin integrity

19. A male lawyer has been committed to a psychiatric facility after being diagnosed with schizophrenia. One morning while walking outside with the nurse, the client runs away. The immediate responsibility of the nurse would be to notify the:

Client's psychiatrist of the elopement

Probate judge who committed the client

Client's family that the client has left the hospital

Local law enforcement officers of the client's escape

20. When planning care for a client with severe agoraphobia, the nurse should first:

Determine the client's degree of impairment

Support the client's self-esteem through verbal interactions

Teach the client biofeedback techniques to reduce anxiety

Expose the client gradually to anxiety-provoking situations

21. Although upset by a young client's continuous complaints about all aspects of care, the nurse ignores them and attempts to divert the conversation. Immediately following this exchange, the nurse discusses with a friend the various stages of development of young adults. The defense mechanism the nurse is using is

Substitution

Sublimation

Identification

Intellectualization

22. The best initial approach to take with a self-accusatory, guilt-ridden client would be to:

Contradict the client's persecutory delusions

Accept the client's statements as his beliefs

Medicate the client when these thoughts are expressed

Redirect the client whenever a negative topic is mentioned

23. A client with a bipolar mood disorder, manic phase, had been hyperactive and sarcastic to the nurse and other clients. This behavior has been decreasing and the client tells the nurse, "My husband and I have problems getting along sometimes. We see things differently." The response by the nurse that would be the least therapeutic would be:

"Explain what you mean by seeing things differently."

"Not getting along with one's spouse can be upsetting."

"You are calmer today. What has made the difference?"

"Tell me about a specific time when you and your husband had problems."

24. Some clients repeatedly perform ritualistic behaviors throughout the day to limit anxious feelings. The nurse recognizes that these behaviors are:

Obsessions

Compulsions

Under personal control

Related to rebelliousness

25. The nurse plans to teach a client to use healthier coping behaviors that consciously can be used to reduce anxiety. These include:

Eating, dissociation, fantasy

Sublimation, fantasy, rationalization

Exercise, talking to friends, suppression

Repression, intellectualization, smoking

1. A woman of 38 weeks AOG is experiencing true labor when her contraction pattern shows:

occasional irregular contractions

irregular contractions that increase in intensity

regular contractions that remain the same

regular contractions that increase in frequency and duration

2. The nurse should encourage her gravid patient to void frequency during labor, primarily to:

prevent urinary infections

enhance fetal descent

strengthen the vaginal and perineal muscles

assess urine specimens for albumin

3. The placenta forms from the:

chorionic villi and deciduas vera

chorionic villi and decidua capsularis

deciduas basalis and deciduas vera

chorionic villi and decidua basalis

4. When performing Leopold's maneuvers, which of the following would the nurse ask the client to do to ensure optimal comfort and accuracy?

breathe deeply for one minute

empty her bladder

drink a full glass of water

lie on her left side

5. The nurse instructs a primigravid patient to increase her intake of Magnesium because of its role with which of the following?

prevention of demineralization of the mother's bones

synthesis of proteins and nucleic acids and fats

amino acid metabolism

synthesis of neural pathways in the fetus

6. After instructing a primigravid client about the functions of the placenta, the nurse determines that the client needs additional teaching when she says that which of the following hormones is produced by the placenta:

testosterone

estrogen

progesterone

HcG

7. During a childbirth preparation class, a primigravid

client at 36 weeks gestation tells the nurse, "My lower back has really been bothering me lately." Which of the following exercises suggested by the nurse would be most helpful?

pelvic rocking

deep breathing

tailor sitting

squatting

8. What is a common endocrine response to pregnancy?

decrease cortisol levels

decrease production of prolactin

increase plasma parathyroid hormone

increase maternal blood glucose level

9. Combined oral contraceptives prevent pregnancy by inhibiting the production of:

FSH & prolactin

LH & estrogen

FSH & LH

Estrogen and progesterone

10. The nurse should instruct her client to discontinue the oral contraceptive and call the physician immediately if she experiences:

hypomenorrhea

dysmenorrhea

severe headache

leucorrhea

11. Assessment of primigravid client reveals cervical dilatation at 8cm and complete effacement. The client complains of severe back pain during this phase of labor. The nurse explains that the client's severe back pain is most likely caused by the fetal occiput being in a position that is identified as which of the

following?

breech

transverse

posterior

anterior

12. While the nurse is caring for a multiparous client in active labor at 37 weeks gestation, the client tells the nurse, "I think my water just broke." Which of the following would the nurse do first?

turn the client on the right side

assess the fetal heart rate pattern

assess the color, amount and odor of fluid

check the client's cervical dilation.

13. The physician orders oxytocin to be added to the IVF of a 26-year old multigravid client at 38 weeks AOG after vaginal delivery. The nurse anticipates administering the oxytocin after delivery of which of the following

first placenta

second placenta

first twin

second twin

14. While making a home visit to a postpartum client on day 10, the nurse would anticipate that the client's lochia would be:

dark red

pink

brown

white

15. Which of the following forms the basis for the teaching plan about avoiding medication use unless prescribed for a primiparous client who is

breastfeeding?

breast milk quality and richness are decreased

the mother's motivation to breastfeed is diminished

medications may be excreted in breastmilk to the nursing neonate

medication interfere with the mother's let-down reflex

16. A client is admitted to the hospital with contractions that are about 1-2 minutes apart and last for 60 seconds. Vaginal exam reveals that her cervix is dilated 8cm. The client is in which stage labor?

latent phase

active phase

third stage

transitional phase

17. During the third postpartum day, which of the following would the nurse be most likely to find in the client:

she's interested in learning more about newborn care

she talks a lot about the birth experience

she sleeps whenever the baby isn't present

she requests help in choosing a name for the baby

18. When assessing a client's episiotomy, the nurse should be especially careful to observe:

location

discharge and odor

edema and approximation

subinvolution

19. In performing a routine fundal assessment, the nurse finds that the client's fundus is boggy. The nurse should first:

call the physician

massage the fundus

assess the lochial flow

obtain an order for methelergonovine

20. Which assessment of a woman in labor can be determined by vaginal examination?

fetal weight

cervical dilatation

strength of contraction

fetal head circumference

21. The postovulation rise in BBT is due to the high blood level of which hormone?

FSH

HPL

estrogen

progesterone

22. A pregnant woman's history reveals one pregnancy, terminated by elective abortion at 10 weeks, birth of twins at 37 weeks and a spontaneous abortion at 12 weeks. According to TPAL system, which of the following describes her present parity.

0-2-2-2

2-0-2-2

0-1-2-2

1-0-2-2

23. Which principal factor cause vaginal patient to be acidic?

cervical mucus changes

secretion from skene's glands

the action of doderlein's bacillus

secretions from Bartholin's gland

24. Which normal assessment finding can the nurse expect in the 34th week of pregnancy?

Braxton-Hicks contractions, joint hypermobility and backache

Dysuria, constipation, hemorrhoids and lightening

Feeling of tranquility and heightened introspection

Morning sickness, breast tenderness

25. What are the 2 fetal membranes?

ectoderm and mesoderm

chorion and amnion

chorion and endoderm

amnion and chorionic villi

1.

A client has returned to the nursing unit following an abdominal hysterectomy. The client is lying supine. To completely assess the client for postoperative bleeding, the nurse should do which of the following?

Check the abdominal dressing

Check the perineal pad

Ask the client about a sensation of moistness

Roll the client to one side after checking the perineal pad and the abdominal dressing

2. A nurse notes redness, warmth, and a purulent drainage at the insertion site of a central venous catheter in a client receiving total parenteral nutrition (TPN). The nurse notices the physician of this finding because:

Infections of a central catheter site can lead to septicemia

The client is experiencing an allergy to the TPN solution

The TPN solution has infiltrated and must be stopped

The client is allergic to the dressing material covering the site

3. A nurse instructs a client about the procedure to perform the Breast Self-Examination (BSE). Which of the following indicates a need for further instructions?

"I don't need to do that, I'm too old for that."

"I do BSE 7 days after I get my period."

"I examine my breasts in the shower."

"I lie on my back to examine my breasts."

4. A nurse is preparing to administer an intramuscular injection to a 2-year-old child. The best site to select for the injection is the:

Ventral gluteal muscle

Dorsal gluteal muscle

Deltoid muscle

Vastus lateralis muscle

5. A client has a pH of 7.51 with a bicarbonate level of 29 mEq/L. The nurse prepares to administer which of the following medications that would be ordered to treat this acid-base disorder?

Sodium bicarbonate

Furosemide (Lasix)

Acetazolamide (Diamox)

Spironolactone (Aldactone)

6. A nurse is caring for a client with a nursing diagnosis of Altered Oral Mucous Membranes. The nurse would avoid using which of the following items when giving mouth care of this client?

Nonalcoholic mouthwash

Soft toothbrush

Lip moistener

Lemon-glycerin swabs

7. A client has a serum sodium level of 129 mEq/L as a

result of hypervolemia. The nurse consults with the physician to determine whether which of the following most appropriate measures should be instituted?

Providing a 2-g sodium diet

Providing a 4-g sodium diet

Fluid restriction

Administering intravenous hypertonic saline

8. When administering an intramuscular injection in the gluteal muscle, the nurse places the client in which best position to relax the muscle?

With On their side with the knee of the uppermost leg flexed

On their side with the knee of the lowermost leg flexed

Prone with a toe-in position

Sims' with a toe-in position

9. A nurse plans to administer a medication by IV bolus through the IV primary line. The nurse notes that the medication is incompatible with the primary IV solution. The most appropriate nursing action to safety administer the medication is to:

Call the physician for an order to change to route of the medication

Start a new IV line for the medication

Flush the tubing before and after the medication with normal saline

Flush the tubing before and after the medication with sterile water

10. The nurse suspects the occurrence of an air embolism in a client with a triple lumen catheter. If an air embolism were present, the nurse would likely note which of the following?

Hypertension

Diminished breath sounds

A "churning" sound heard over the right ventricle on auscultation

Rales heard in the lung bases on auscultation

11. In a client receiving total parenteral nutrition (TPN), chest pain, dyspnea, tachycardia, cyanosis, and decreased level of consciousness which complication of TPN?

Bibasilar crackles

Weak pulse

Decreased blood pressure

Flat neck veins with the head of the bed at 45 degree

12. A nurse is caring for a client who has an order to receive an intravenous intralipid infusion. Which of the following actions does the nurse take as part of proper procedure before hanging the infusion?

Add 100 mL of normal saline solution to the bottle

Attach the in-line filter

Remove the bottle from the refrigerator

Check the solution for separation or an oily appearance

13. A nurse has an order to infuse a unit of blood. The nurse checks the client's intravenous line to make sure that the gauge of the intravenous catheter is at least:

14 gauge

19 gauge

22 gauge

24 gauge

14. A client began receiving a unit of blood 30 minutes ago. The client rings the call bell and complains of breathing difficulty, itching, and a tight sensation in

the chest. Which of the following is the first action of the nurse?

Recheck the unit of blood for compatibility

Check the client's temperature

Stop the transfusion

Call the physician

15. A home care nurse finds a client in the bedroom, unconscious, with pill bottle in hand. The pill bottle contained the selective serotonin reuptake inhibitor (SSRI) sertraline (Zoloft). The nurse immediately assesses the client's:

Blood pressure

Respirations

Pulse

Unrinary output

16. A nurse is checking a unit of blood received from the blood bank and notes the presence of gas bubbles in the bag. The nurse should take which of the following actions?

Add 10 mL of normal saline solution to the bag

Agitate the bag gently to mix contents

Add 100 units of heparin to the bag

Return the bag to the blood bank

17. A nurse is doing a dressing change on a venous stasis ulcer that is clean and has a growing bed of granulation tissue. The nurse avoids using which of the following dressing materials on this would?

Wet-to-dry saline dressing

Wet-to-wet saline dressing

Hydrocolloid dressing

Vaseline gauze dressing

18. A nurse is preparing to suction a client's

tracheostomy. To promote deep breathing and coughing, the client should be positioned in the:

Supine position

Lateral position

High-fowler's position

Semi-fowler's position

19. A nurse is giving bed bath for a client who is on strict bed rest. To increase venous return, the nurse bathes the client's extremity by using:

Long firm strokes from distal to proximal areas

Firm circular strokes from proximal to distal areas

Short, patting strokes from distal to proximal areas

Smooth, light strokes back and forth smooth proximal to distal areas

20. A nurse is preparing to administer an intermittent tube feeding through a nasogastric tube. The nurse assesses gastric residual before administering the tube feeding to:

a.Confirm proper nasogastric tube placement

Determine patency of the tube

Assess fluid and electrolytes

Evaluate absorption of the last feeding

21. A client is brought into the emergency department after being in a car accident. A neck injury is suspected. The client is unresponsive and pulse less. The nurse opens the client's airway by which method?

Head tilt-chin lift

Lifting the head up, placing the head on two pillows, and attempting ventilate

Jaw-thrust maneuver

Keeping the client flat and grasping the tongue

22. A client receiving total parenteral nutrition (TPN) via central intravenous (IV) line is scheduled to receive an antibiotic by the IV route. Which action by the nurse is appropriate before hanging the antibiotic solution?

Ensure a separate IV access for the antibiotic

Turn off the TPN for 30 minutes before administering the antibiotic

Check with the pharmacy to be sure the antibiotic can be hung through the TPN line

Flush the central line with 60 mL of normal saline solution before hanging the antibiotic

23. A client's nasogastric (NG) feeding tube has become clogged. The nurse's first action is to:

Flush the tube with warm water

Aspirate the tube

Flush with carbonated liquids, such as cola

Replace the tube

24. A nurse has an order to obtain a 24-hour urine collection on a client with a renal urine collection on a client with a renal disorder. The nurse avoids which of the following to ensure proper collection of the 24-hour specimen?

Have the client void at the start time, and place this specimen in the container

Discard the first voiding, save all subsequent voiding during the 24-hour time period

Place the container on ice, or in a refrigerator

Have the client void at the time, and place this medication in the container

25. A nurse suspects that an air embolism has occurred in a client receiving total parenteral nutrition (TPN) through a central venous catheter when the central line disconnects from the IV tubing. The nurse immediately turns the client to the:

Left side with the head higher than the feet

Right side with the head higher than the feet

Left side with the feet higher than the head

Right side with the feet higher than the head

A baby born today at 38 weeks gestation weighs 5 lb 2 oz (2335 g). the nurse should describe the baby as:

A normal newborn

Chronically ill

Low birth weight

Very low birth weight

2. In a neonate at 36 weeks gestation, the nurse would anticipate implementation of nursing care for which disorder?

Acne

Chickenpox

Jaundice

Scoliosis

3. The nurse would clean a neonate with clean water or non alkaline cleanser two or three per week because:

Cleaning stimulates circulation

Growth of bacteria is minimized

Oils provide nourishment to tissues

Regular cleansing prevents irritation

4. If a neonate develops respiratory distress syndrome the nurse should include as an evaluation outcome:

Neonates breathes without effort

Neonates recover from surgery uneventfully

Family seeks genetic counseling

Others do not contract disease

5. A 2 years old infant is diagnosed with severe croup (laryngotracheobronchitis). The nurse caring for this child identifies essential therapeutic measures as being hospitalization and:

Corticosteroid

Cool humidification

Intubation

Whirlpool bath

6. When a nurse observes sign and symptoms of child neglect, appropriate action includes which of the following?

Ensure involvement of variety caregivers

Oppose parental decision-making

Promote a trusting relationship

Provide extra stimulation

7. A 6 years old child is admitted to the pediatric unit with partial and full thickness third degree burns. From this information the nurse can plan burn care that affects:

Dermis only

Epidermis only

All layers of skin

All layers of skin, subcutaneous tissues and muscles

8. Nursing care for child with a third degree burn on the body would focus on:

Encouraging mobility

Helping the child to scratch the wound

Limiting fluid intake

Removing crust and eschar

9. A 10-year-old child broke her left leg and the whole

end of the bone protrudes through the skin. The nurse understand this fracture to be:

Compound

Greenstick

Incomplete

Simple

10. A 14-year-old adolescent has a new diagnosis of diabetes. The nurse would expect this to be:

Glucose intolerance

Insulin dependent diabetes

Maturity onset diabetes

Plain diabetes

11. Sign and symptoms of ketoacidosis that the nurse would teach a diabetic with a new diagnosis of diabetes would include:

Glucose in urine

Headache

Low blood sugar

Thirst

12. A teenage girl is admitted to the adolescent unit with a diagnosis of cystic fibrosis. The nurse determines that the adolescent has a typical sign of this disease when which of the following is noted?

Cool, dry skin

Frequent urination

Large bulky foul smelling stool

Poor appetite

13. The nurse knows that the primary cause of the serious pulmonary problems that children with cystic fibrosis can develop is:

Bronchial constriction

Inadequate surfactant

Pulmonic stenosis

Thick tenacious mucus

14. If pancreatic enzymes are prescribed for a child with cystic fibrosis, the nurse should administer these by which route?

Intramuscularly

Intravenously

Orally

Intradermally

15. The nurse promotes exercise in an adolescent with cystic fibrosis because it is therapeutically important to help promote a sense of well being and to:

Aid digestion and absorption of nutrients

Enhance heart muscle and muscular tone

Promote mobilization of lung secretion

Stimulate exocrine gland secretions

16. A child with cystic fibrosis may be treated with a mist tent at home. The nurse would want the family to identify the reason for the mist to help:

Dilate alveoli

Minimize secretions

Prevent dehydration

Relieve dyspnea

17. Postural drainage is prescribed for home care. The family and child need to learn about the therapy and all positions for treatments. The nurse would teach the family and child which position to help move secretions from the right lower lobes.

Lying on back with head lowered

Lying on the left side with head lowered

Lying on the left with head raised

Sitting with left knee bent

18. As a nurse you know that the child with cystic fibrosis must learn to avoid:

Dog and cat hair

Bacterial infections

Sodium chloride

Ultraviolet light

19. A child is admitted with bronchial asthma. The respiratory sign that the nurse would expect to see includes:

Sleep apnea

Inspiratory stridor

Productive cough

Prolonged expiration

20. In the management of an episode of acute asthma, the nurse would not expect to include:

Antibiotics

Antiemetics

Corticosteroids

Bronchodilators

21. The nurse knows that which of the following is frequently associated with myelomeningoceles?

Hydrocephalus

Intussusceptions

Mental retardation

Pneumonia

22. A mother brings her 2-year-old child to the clinic. The child is drooling, agitated, and appears to be in respiratory distress. The pediatrician suspects epiglottis. Which action of the nurse is best?

Allow the mother to hold the child

Insist that the mother leave the examination room

Give the child cool fruit to drink

Obtain a throat culture

23. The nurse explains to the mother that the usual cause of epiglottis is:

B haemolytic streptococcus

Haemophillus influenaza

Respiratory synctial virus

Staphylococcus aureus

24. An infant is being admitted for cleft lip repair tomorrow morning. The nurse collecting data from the mother will expect to obtain information about:

Drooling

Noisy respiration

Sucking problems

Swallowing difficulty

25. During the first 24 hours postoperatively after a cleft lip repair, the nurse would:

Apply elbow restraints to the infant

Position the infant prone

Keep the infant upright in an infant seat

Use a mist tent to facilitate the infants breathing

When the fetal position is LOA, the point of maximum intensity of the FHR would be located in the ______ quadrant of the maternal abdomen.

Left Upper

Right Upper

Left Lower

Right Lower

2. Which of the following arteries primarily feeds the anterior wall of the heart?

Circumflex artery

Internal mammary artery

Left anterior descending artery

Right coronary artery

3. Ms. C is admitted to the hospital with a bleeding ulcer. She is to receive 4 units of packed cells. Which nursing intervention is of primary importance in the administration of blood?

Checking the flow rate

Monitoring the vital signs

Identifying the client

Maintaining blood temperature

4. Systemic lupus erythematous (SLE) primarily attacks which of the following tissues?

Connective

Heart

Lungs

Nerve

5. Which of the following terms is used to describe a thrombus lodged in the lungs?

Hemothorax

Pneumothorax

Pulmonary embolism

Pulmonary hypertension

6. An adult client has just returned to his room following a bowel resection & end to end anastomosis. The nurse can expect the drainage from the NGT in the early post – op period to be:

Clear

Mucoid

Scant

Discolored

7. Which of the following oral medications is administered to prevent further thrombus formation?

Warfarin

Heparin

Furosemide (Lasix)

Metoprolol (Lopressor)

8. Which of the following tests is the major diagnostic test for ulcers?

Abdominal X-ray

Barium swallow

Computed tomography scan

Esophagogastroduodenoscopy (EGD)

9. A child diagnosed with meningitis is restless & irritable when first hospitalized. To promote the child's comfort, which of these actions should the nurse take initially?

Discourage the parents from staying with the child

Keep environmental noise to a minimum

Position the child in a supine position for 12 hours

Postpone all scheduled testing

10. A child is admitted to the pediatric unit for seizure activity. The physician orders Phenobarbital. The nurse provides the parents with instructions regarding the correct administration of this medication. The nurse would evaluate as effective when the parent identify the need to:

Skip dose if child vomits

Discontinue the medication when seizure activity stops

Double the next dose if the child misses a dose

Notify the physician if severe headache & skin rash

11. Which of the following fracture is classic for occurring from trauma?

Brachial and clavicle

Brachial and humerus

Humerus and clavicle

Occipital and humerus

12. A woman who has had rheumatoid arthritis for several years is admitted to the hospital. Upon physical examination of the client, the nurse should expect to find:

Asymmetric joint involvement

Heberden's nodes

Obesity

Small joint involvement

13. Which of the following definitions best describes diverticulosis?

An inflamed out pouching of the intestine

A noninflamed out pouching of the intestine

The partial impairment of the forward flow of intestinal contents

An abnormal protrusion of an organ through the structure that usually holds it

14. Which of the following symptoms indicate diverticulosis?

No symptoms exist

Change in bowel habits

Anorexia and low-grade fever

Episodic, dull or steady midabdominal pain

15. What tests should be ordered if hypothyroidism is suspected?

Liver function tests

Hemoglobin A1C

T4 and thyroid-stimulating hormone

24-hour urine free cortisol measurement

16. A client is being admitted to the antepartum unit for hypovolemia secondary to hyperemesis gravidarum. Which of the following factors predispose to the development of this condition?

Trophoblastic disease

Maternal age older than 35 years

Malnourished or underweight clients

Low levels of human chorionic gonadotrophin (HCG)

17. When giving a postpartum client self-care instructions, the nurse instructs her to report heavy or excessive bleeding. Which of the following would indicate heavy bleeding?

Saturating a pad in 15 minutes

Saturating a pad in 1 hour

Saturating 1 pad in 4 – 6 hours

Saturating a pad in 8 hours

18. When providing information about treatments for diabetes insipidus to parents, a nurse explains the use of nasal spray and injections. Which of the following indications might deter a parent from choosing nasal spray treatment?

Applications must be repeated every 8 to 12 hours

Applications must be repeated every 2 to 4 hours

Nasal sprays can't be used in infants

Measurements are too difficult

19. The discovery of hypospadias is usually made by

which of the following people?

By the primary health care provider when doing a neonatal assessment

By the primary health care provider, just before circumcision

By the mother when she sees her neonate for the first time

By the nurse doing the neonatal assessment

20. Statistics about sexually transmitted diseases (STDs) may not be reliable for which of the following reasons?

Most adolescents seek out treatment for their STD

Adolescents are usually honest with their parents about their sexual behavior

All sexually transmitted diseases must be reported to the Centers for Disease Control and Prevention (CDC)

Chlamydial infections and human papillomavirus (HPV) infections aren't required to be reported to the CDC

21. A nurse is developing a plan of care for a client with multiple myeloma. The nurse should include which priority intervention in the plan of care?

Coughing & deep breathing

Forcing fluids

Monitoring CBC count

Providing frequent oral care

22. A client diagnosed a having bowel tumor. Several diagnostic tests are prescribed. A nurse understands that which of the following tests will confirm the diagnosis of malignancy?

MRI

CT scan

Abdominal ultrasound

Biopsy of tumor

23. The client with cancer is receiving chemotherapy & develops thrombocytopenia. A nurse identifies which intervention as the highest priority in the nursing plan of care?

Ambulation 3 times daily

Monitoring temperature

Monitoring platelet count

Monitoring for pathological fractures

24. To help meet a patient's self-esteem needs, the nurse should:

Encourage the patient to perform self care when able

Suggest that the family visit the patient more often

Anticipate needs before the patient requests help

Assist the patient with bathing & grooming

25. To meet a patient's physical needs, the nurse should:

Pull the curtain when providing care

Answer the call bell immediately

Administer physical hygiene

Obtain vital signs