Final Exam PASADO Nursing, Verified And Correct Answers
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Final Exam PASADO Nursing
Final Exam PASADO Nursing
FINAL EXAM PASADO 4. A patient who was admitted to the hospital with hyperglycemia and newly diagnosed diabetes mellitus is scheduled for discharge the second day after admission. When implementing patient teaching, what is the priority action forthe nurse? a. Instruct ab...
1. A patient who was admitted to the hospital with hyperglycemia and newly diagnosed diabetes
mellitus is scheduled for discharge the second day after admission. When implementing patient
teaching, what is the priority action forthe nurse?
a. Instruct about the increased risk for cardiovascular disease.
b. Provide detailed information about dietary control of glucose.
c. Teach glucose self-monitoring and medication administration.
d. Give information about the effects of exercise on glucose control.
ANS: C
When time is limited, the nurse should focus on the priorities of teaching. In this situation, the
patient should know how to test blood glucose and administer medications to control glucose
levels. The patient will need further teaching about the role of diet, exercise, various
medications, and the many potential complications of diabetes, but these topics can be addressed
through planning for appropriate referrals.
2. A 75-year-old patient is admitted for pancreatitis. Which tool would be the most appropriate
for the nurse to use during the admission assessment?
,a. Drug Abuse Screening Test (DAST-10)
b. Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-Ar)
c. Screening Test-Geriatric Version (SMAST-G)
d. Mini-Mental State Examination
ANS: C
Because the abuse of alcohol is a common factor associated with the development of
pancreatitis, the first assessment step is to screen for alcohol use using a validated screening
questionnaire. The SMAST-G is a short-form alcoholism screening instrument tailored
specifically to the needs of the older adult. If the patient scores positively on the SMAST-G, then
the CIWA-Ar would be a useful tool for determining treatment. The DAST-10 provides more
general information regarding substance use. The Mini-Mental State Examination is used to
screen for cognitive impairment.
3. The sister of a patient diagnosed with BRCA gene–related breast cancer asks the nurse, “Do
you think I should be tested for the gene?” Which response by the nurse is most appropriate?
a. “In most cases, breast cancer is not caused by the BRCA gene.”
b. “It depends on how you will feel if the test is positive for the BRCA gene.”
c. “There are many things to consider before deciding to have genetic testing.”
d. “You should decide first whether you are willing to have a bilateral mastectomy.”
ANS: C
,Although presymptomatic testing for genetic disorders allows patients to take action (such as
mastectomy) to prevent the development of some genetically caused disorders, patients also need
to consider that test results in their medical record may affect insurance, employability, etc.
Telling a patient that a decision about mastectomy should be made before testing implies that the
nurse has made a judgment about what the patient should do if the test is positive. Although the
patient may need to think about her reaction if the test is positive, other issues (e.g., insurance)
also should be considered. Although most breast cancers are not related to BRCA gene mutations,
the patient with a BRCA gene mutation has a markedly increased risk for breast cancer.
4. The nurse in the outpatient clinic has obtained health histories for these new patients. Which
patient may need referral for genetic testing?
a. 35-year-old patient whose maternal grandparents died after strokes at ages 90 and 96
b. 18-year-old patient with a positive pregnancy test whose first child has cerebral palsy
c. 34-year-old patient who has a sibling with newly diagnosed polycystic kidney disease
d. 50-year-old patient with a history of cigarette smoking who is complaining of dyspnea
ANS: C
The adult form of polycystic kidney disease is an autosomal dominant disorder and frequently it is
asymptomatic until the patient is older. Presymptomatic testing will give the patient information that
will be useful in guiding lifestyle and childbearing choices. The other patients do not have any
indication of genetic disorders or need for genetic testing.
, 5. An adolescent patient seeks care in the emergency department after sharing needles forheroin
injection with a friend who has hepatitis B. To provide immediate protection from infection, what
medication will the nurse administer?
a. Corticosteroids
b. Gamma globulin
c. Hepatitis B vaccine
d. Fresh frozen plasma
ANS: B
The patient should first receive antibodies for hepatitis B from injection of gamma globulin. The
hepatitis B vaccination series should be started to provide active immunity. Fresh frozen plasma
and corticosteroids will not be effective in preventing hepatitis B in the patient.
6. A patient who is diagnosed with cervical cancer that is classified as Tis, N0, M0 asks the nurse
what the letters and numbers mean. Which response by the nurse is most appropriate?
a. “The cancer involves only the cervix.”
b. “The cancer cells look almost like normal cells.”
c. “Further testing is needed to determine the spread of the cancer.”
d. “It is difficult to determine the original site of the cervical cancer.”
ANS: A
Cancer in situ indicates that the cancer is localized to the cervix and is not invasive at this time.
Cell differentiation is not indicated by clinical staging. Because the cancer is in situ, the origin is
the cervix. Further testing is not indicated given that the cancer has not spread.
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