NURS 280 Exam 2
A 33-year-old patient presents at the clinic with complaints of weakness, incoordination,
dizziness, and loss of balance. The patient is hospitalized and diagnosed with MS. What
sign or symptom, revealed during the initial assessment, is typical of MS?
A) Diplopia, history of increased fatigue, and decreased or absent deep tendon reflexes
B) Flexor spasm, clonus, and negative Babinskis reflex
C) Blurred vision, intention tremor, and urinary hesitancy
D) Hyperactive abdominal reflexes and history of unsteady gait and episodic
paresthesia in both legs - ANS-c
A 48-year-old patient has been diagnosed with trigeminal neuralgia following recent
episodes of unilateral face pain. The nurse should recognize what implication of this
diagnosis?
A) The patient will likely require lifelong treatment with anticholinergic medications.
B) The patient has a disproportionate risk of developing myasthenia gravis later in life.
c. the patient needs to be assessed for MS.
D) The disease is self-limiting and the patient will achieve pain relief over time. - ANS-c
A 52-year-old female patient is receiving care on the oncology unit for breast cancer
that has metastasized to her lungs and liver. When addressing the patients pain in her
plan of nursing care, the nurse should consider what characteristic of cancer pain?
A) Cancer pain is often related to the stress of the patient knowing she has cancer and
requires relatively low doses of pain medications along with a high dose of anti-anxiety
medications.
B) Cancer pain is always chronic and challenging to treat, so distraction is often the best
intervention.
C) Cancer pain can be acute or chronic and it typically requires comparatively high
doses of pain medications.
D) Cancer pain is often misreported by patients because of confusion related to their
disease process. - ANS-C
A 60-year-old patient who has diabetes had a below-knee amputation 1 week ago. The
patient asks why does it still feel like my leg is attached, and why does it still hurt? The
nurse explains neuropathic pain in
terms that are accessible to the patient. The nurse should describe what
pathophysiologic process?
A) The proliferation of nociceptors during times of stress
B) Age-related deterioration of the central nervous system
,C) Psychosocial dependence on pain medications
D) The abnormal reorganization of the nervous system - ANS-d
A 7-year-old child with ADHD is taking clonidine (Kapvay). Common side effects
include? Select all that apply.
a.appetite suppression.
b.dizziness.
c.dry mouth.
d.hypotension.
e.insomnia.
f.nausea. - ANS-b, c, d
A 74-year-old woman was diagnosed with rheumatoid arthritis 1 year ago, but has
achieved adequate symptom control through the regular use of celecoxib (Celebrex), a
COX-2 selective NSAID. The nurse should recognize that this drug, like other NSAIDs,
influences what aspect of the pathophysiology of nociceptive pain?
a. Distorting the action potential that is transmitted along the A-delta (d) and C fibers
b. Diverting noxious information from passing through the dorsal root ganglia and
synapses in the dorsal horn of the spinal cord
c. Blocking modulation by limiting the reuptake of serotonin and norepinephrine
d. Inhibiting transduction by blocking the formation of prostaglandins in the periphery -
ANS-d
A 79-year-old man is admitted to the medical unit with digital gangrene. The man states
that his problems first began when he stubbed his toe going to the bathroom in the dark.
In addition to this trauma, the nurse should suspect that the patient has a history of what
health problem?
A) Raynauds phenomenon
b. CAD
c. Arterial insufficiency
d. Varicose veins - ANS-c
A child is taking pemoline (Cylert) for ADHD. The nurse must be aware of which side
effect?
a.Decreased thyroid-stimulating hormone
b.Decreased red blood cell count
c.Elevated white blood cell count
d.Elevated liver function tests - ANS-d
,A client comes to day treatment intoxicated but says he is not. The nurse identifies that
the client is exhibiting symptoms of
a.denial.
b.reaction formation.
c.projection.
d.transference. - ANS-a
A client has a severe abdominal injury with damage to the liver and colon from a
motorcycle crash. What type of pain 7. will predominate?
A) Psychogenic pain
B) Neuropathic pain
C) Cutaneous pain
D) Visceral pain - ANS-d
A client has an order for a narcotic analgesic every three to four hours and he received
his last dose three hours earlier.
Which of the following actions is most appropriate for the nurse to take in response to
the client's request for pain 24. medication on his first postoperative day?
A) Provide the client with pain medication
B) Tell the client that the pain cannot be severe
C) Document and ask the client to wait one hour
D) Contact the physician for a change in medication - ANS-a
A client has been taught relaxation exercises before beginning a painful procedure.
What chemicals are believed to be 12. released in the body during relaxation to relieve
pain?
A) Narcotics
B) Sedatives
C) A-delta fibers
D) Endorphins - ANS-d
A client having acute pain tells the nurse that her pain has gradually reduced, but that
she fears it could recur and 21. become chronic. What is a characteristic of chronic
pain?
A) Chronic pain will lead to psychological imbalance.
B) Chronic pain has far-reaching effects on the client.
C) Chronic pain can be severe in its initial stages.
D) Chronic pain eases with healing and eventually disappears. - ANS-b
, A client in the emergency department is diagnosed with a myocardial infarction (heart
attack). The client describes pain 8. in his left arm and shoulder. What name is given to
this type of pain?
A) Cutaneous pain
B) Referred pain
C) Allodynia
D) Nociceptive - ANS-b
A client says to the nurse, "You are the best nurse I've ever met. I want you to
remember me." What is an appropriate response by the nurse?
a."Thank you. I think you are special too."
b."I suspect you want something from me. What is it?"
c."You probably say that to all your nurses."
d."Are you thinking of suicide?" - ANS-d
A client tells the nurse that she is experiencing stabbing pain in her mouth, gums, teeth,
and chin following brushing her 10. teeth. These are symptoms of which of the following
pain syndromes?
A) Complex regional pain syndrome
B) Postherpetic neuralgia
C) Trigeminal neuralgia
D) Diabetic neuropathy - ANS-c
A client who has breast cancer is said to be in remission. What does this term signify?
A) The client is experiencing symptoms of the disease.
B) The client has end-stage cancer.
C) The client is experiencing unremitting pain.
D) The disease is present but the client is not experiencing symptoms. - ANS-d
A client with bipolar disorder begins taking lithium carbonate (lithium) 300 mg four times
a day. After 3 days of therapy, the client says, "My hands are shaking." Which is the
best response by the nurse?
a."Fine motor tremors are an early effect of lithium therapy that usually subsides in a
few weeks."
b."It is nothing to worry about unless it continues for the next month."
c."Tremors can be an early sign of toxicity, but we'll keep monitoring your lithium level to
make sure you're OK."
d."You can expect tremors with lithium. You seem very concerned about such a small
tremor." - ANS-a
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