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NUR 240 EXAM 2 Practice Questions.
NUR 240 EXAM 2 Practice Questions.
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NUR 240 EXAM 2 Practice QuestionsA 16-year-old adolescent informs her nurse that she became a vegetarian 1 year ago.
Lately she is reporting fatigue and has trouble concentrating. A quick blood test ordered
by her licensed provider informs the nurse that she has pernicious anemia. This is a
deficiency of what vitamin?
folic acid
vitamin C
vitamin B12
vitamin A - ANS-vitamin B12
Explanation:
Vitamin B12 deficiency is most commonly found in vegetarians, particularly in strict
vegans. Individuals who have such rigid dietary restrictions must take care to
supplement this vitamin.
A 57-year-old man is suffering from polyuria. What can cause polyuria?
renal disease
diabetes insipidus
urinary tract infection
renal calculi - ANS-diabetes insipidus
Explanation:
Untreated diabetes insipidus can cause an increase in the formation and excretion of
urine without a concurrent increase in fluid intake. Renal disease often leads to oliguria
and even anuria, a decrease in urine outputs. Urinary tract infections cause an increase
in frequency but not necessarily an increase in the amount of urine that is produced.
Renal calculi can cause hematuria.
A 70-year-old client who has four children and six grandchildren states that she "wets"
herself when she sneezes or laughs. She reports that sometimes this also occurs when
rising from a sitting to standing position. Which type of incontinence does the nurse
anticipate?
urge
stress
total
reflect - ANS-stress
Explanation:
,Stress incontinence is associated with a raise in intra-abdominal pressure related to
activities such as sneezing, coughing, or laughing. Other types of incontinence have
different causative factors.
A 74-year-old client has kyphosis and is reporting discomfort of the cervical vertebrate.
Which nursing intervention is most appropriate?
administering a muscle relaxer
placing a small towel under the neck
contacting the primary care physician
positioning the client on the stomach - ANS-placing a small towel under the neck
Explanation:
Kyphotic changes can cause pressure on cervical vertebrae when someone is in a
supine position. Effects of this can be minimized by placing a small towel or cervical
pillow under the neck. Placing the client on the stomach is incorrect, and a muscle
relaxer will not help reduce the pressure caused by the kyphosis. Contacting the
physician is unnecessary.
A 90-year-old widower lives alone in her home. The nurse knows that older clients are
at increased risk for falls. What other factors contribute to increased risk for falls in
clients? Select all that apply.
diuretics
installed carpeting
history of a fall 5 years ago
ataxic gait - ANS-ataxic gait
history of a fall 5 years ago
diuretics
Explanation:
Gait disturbances, history of falls, certain medications, and weakness are highly
predictive of a fall. Well-tacked carpeting can help prevent a fall in a home, while
hardwood floors or loose rugs present a fall risk.
A client at a health care facility is being treated for cancer of the bladder. The physician
uses a urinary diversion to help the client with urinary elimination. What describes a
urinary diversion?
inability to control either urinary or bowel elimination
use of a catheter to collect urine in a sterile environment
hygiene measures used to keep meatus and adjacent area of the catheter clean
one or both of the ureters are surgically implanted elsewhere - ANS-one or both of the
ureters are surgically implanted elsewhere
Explanation:
,The nurse should understand that in a urinary diversion, one or both of the ureters are
surgically implanted elsewhere. This procedure is done for various life-threatening
conditions. Incontinence is the inability to control either urinary or bowel elimination.
Catheter care means the hygiene measures used to keep meatus and adjacent area of
the catheter clean. In order to collect a catheter specimen, the nurse uses a catheter to
collect a sample of urine in a sterile environment.
A client has been given fecal occult blood test (FOBT) testing supplies. What teaching
will the nurse provide about the purpose for this test?
"This test detects heme, an iron compound in blood within the stool."
"This test gives the healthcare provider a very accurate indication about whether you
may have colorectal cancer."
"This will determine what foods you are allergic to that affect digestion and elimination."
"This test will help determine whether you have an infectious process in the intestines."
- ANS-"This test detects heme, an iron compound in blood within the stool."
Explanation:
The nurse will teach that the FOBT detects heme. It does not test for allergic foods, nor
does it test for infection. The fecal immunochemical test (FIT) test results have a high
rate of specificity for colorectal cancer.
A client has been put on oxygen therapy because of low oxygen saturation levels in the
blood. What should the nurse use to regulate the amount of oxygen delivered to the
client?
nasal cannula
flow meter
oxygen analyzer
nasal strip - ANS-flow meter
Explanation:
The nurse should use a flow meter to regulate the amount of oxygen delivered to the
client. A flow meter is a gauge used to regulate the amount of oxygen delivered to the
client and is attached to the source of oxygen. An oxygen analyzer is a device that
measures the percentage of delivered oxygen to determine if the client is receiving the
amount prescribed by the physician. An adhesive nasal strip increases the nasal
diameter and promotes easier breathing. A nasal cannula is a hollow tube used for
delivering a small concentration of oxygen. However, these devices are not used to
regulate the amount of oxygen delivered to the client.
A client has edema of the feet and ankles, along with crackles in the lower lobes and a
frothy, productive cough. The client is suffering from:
, congestive heart failure.
myocardial infarction.
pulmonary embolism.
lung cancer. - ANS-congestive heart failure.
Explanation:
A client who has edema and a cough that is productive with frothy sputum is
manifesting heart failure.
A client has received nursing teaching about proper skin care at a stomal site. The
nurse's teaching has been effective when the client identifies which solution is used to
clean the stoma?
saline
water and mild soap
alcohol-based sanitizer
mineral oil - ANS-water and mild soap
Explanation:
The nurse will teach the client to use water and mild soap to cleanse the stoma. Saline
only will not provide cleansing; an alcohol-based sanitizer will dry the stoma; mineral oil
is not appropriate for cleansing.
A client has undergone foot surgery and will use crutches in the short term. Which
teaching point should the nurse provide to the client?
"Your elbows will be slightly bent when you are using your crutches."
"We'll have the nursing assistant watch you while you walk around the unit the first
time."
"When your crutches fit right, most of your body weight will be supported by your
armpits."
"If you feel tired while walking with your crutches, rest your weight on your armpits for a
moment and then continue slowly." - ANS-"Your elbows will be slightly bent when you
are using your crutches."
Explanation:
When using crutches, the elbow should be slightly bent at about 30 degrees and the
hands, not the armpits, should support the client's weight. Supervision of the client
learning to use crutches should not be performed by unlicensed assistive personnel
(UAP). The client should stop ambulating and sit down, if fatigued.
A client is admitted to the hospital with shortness of breath, cyanosis and an oxygen
saturation of 82% (0.82) on room air. Which action should the nurse implement first?
Raise the head of the bed
Apply oxygen
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