PNR 309 MIDTERM EXAM 2024 ACTUAL EXAM
COMPLETE ACCURATE EXAM QUESTIONS WITH
DETAILED VERIFIED ANSWERS (100% CORRECT
ANSWERS) /ALREADY GRADED A+
The nurse is preparing to interview an older-adult client. Which of the
following actions is most appropriate?
a)Ensure all assistive devices are in place.
b)Interview the client and caregiver together.
c)Perform the interview before administering analgesics.
d)Move on to the next question if the client does not respond quickly. -
ANSWER a)Ensure all assistive devices are in place.
All assistive devices, such as glasses and hearing aids, should be in place
when interviewing an older-adult client. It is best to interview the client and
caregiver separately to ensure a reliable assessment related to elder
mistreatment. The client should be free from pain during the assessment and
may need extra time to respond to questions.
A 70-year-old man has just been diagnosed with chronic obstructive
pulmonary disease (COPD). At what point should the nurse begin to include
the client's wife in the teaching around the management of the disease?
a)As soon as possible
b)When the client requests assistance from his spouse and family
c)When the client becomes unable to manage his symptoms independently
d)After the client has had the opportunity to adjust to his treatment regimen -
ANSWER a)As soon as possible
In the management of chronic illness, it is desirable to include family
caregivers in client education and symptom-management efforts as early in
the diagnosis as possible.
,A nurse who is providing care for an 81-year-old female client recognizes the
need to maximize the client's mobility during her recovery from surgery. Which
of the following statements provides the best rationale for the nurse's actions?
a)Lack of stimulation contributes to the development of cognitive deficits in
older adults.
b)Pharmacokinetics are improved by client mobility.
c)Continued activity prevents deconditioning.
d)Regularly scheduled physical rehabilitation provides an important sense of
purpose for older clients. - ANSWER c)Continued activity prevents
deconditioning.
Older adults are highly susceptible to deconditioning, a process that can be
slowed or prevented by regular physical activity. This consideration
supersedes any possible effect on pharmacokinetics, prevention of cognitive
deficits, or the client's sense of purpose.
The nurse is assessing an elderly client who has arrived to the emergency
department via ambulance from home where she lives with her adult daughter.
The client has a large pressure ulcer on the sacrum, three large bruises on the
upper back, appears depressed and withdrawn. Which of the following would
the nurse suscept related to this client?
a)Elder mistreatment
b)Social isolation
c)A stroke
d)Hypoglycemia - ANSWER a)Elder mistreatment
There are several types of elder mistreatment. In this scenario, the nurse
would suspect elder mistreatment related to physical neglect (pressure
ulcers), physical abuse (bruises), or psychological or emotional abuse
(withdrawn and depressed).
Which of the following are symptoms of an overwhelmed caregiver? (Select all
that apply.)
a)Powerlessness
,b)Depression
c)Resentment
d)Inadequacy
e)Fatigue - ANSWER ALL ANSWERS ARE CORRECT
Caregivers may develop a sense of being overwhelmed and have feelings of
inadequacy, powerlessness, and depression. The stress of caregiving may
result in emotional problems such as depression, anger, and resentment. The
burden of caregiving may lead to social isolation, which can be characterized
by increased time commitments and fatigue.
The nurse is caring for a client admitted to the hospital with pneumonia. Upon
assessment, the nurse notes a temperature of 38.6°C (101.5°F), a productive
cough with yellow sputum, and a respiratory rate of 20 breaths/minute. Which
of the following nursing diagnoses is most appropriate based upon this
assessment?
a)Hyperthermia related to infectious illness
b)Ineffective thermoregulation related to chilling
c)Ineffective breathing pattern related to pneumonia
d)Ineffective airway clearance related to thick secretions - ANSWER
a)Hyperthermia related to infectious illness
Because the client has spiked a temperature and has a diagnosis of
pneumonia, the logical nursing diagnosis is hyperthermia related to infectious
illness. There is no evidence of a chill, and the client's breathing pattern is
within normal limits at 20 breaths/minute. There is no evidence of ineffective
airway clearance from the information given because the client is
expectorating sputum.
Which of the following physical assessment findings in a client with a lower
respiratory problem best supports the nursing diagnosis of ineffective airway
clearance?
a)Basilar crackles
b)Respiratory rate of 28
, c)Oxygen saturation of 85%
d)Presence of greenish sputum - ANSWER a)Basilar crackles
The presence of adventitious breath sounds indicates that there is
accumulation of secretions in the lower airways. This would be consistent with
a nursing diagnosis of ineffective airway clearance because the client is
retaining secretions.
Which of the following clinical manifestations should the nurse expect to find
during assessment of a client admitted with pneumococcal pneumonia?
a)Hyper-resonance on percussion
b)Vesicular breath sounds in all lobes
c)Increased tactile fremitus on palpation
d)Fine crackles in all lobes on auscultation - ANSWER c)Increased tactile
fremitus on palpation
A typical physical examination finding for a client with pneumonia is increased
tactile fremitus on palpation. Other signs of pulmonary consolidation include
dullness to percussion, bronchial breath sounds, and crackles in the affected
area.
Which of the following is the priority nursing intervention in helping a client
expectorate thick lung secretions?
a)Humidify the oxygen as able
b)Administer cough suppressant q4hr
c)Teach client to splint the affected area
d)Increase fluid intake to 3 L/day if tolerated - ANSWER d)Increase fluid
intake to 3 L/day if tolerated
Although several interventions may help the client expectorate mucus, the
highest priority should be on increasing fluid intake, which will liquefy the
secretions so that the client can expectorate them more easily. Humidifying
the oxygen is also helpful, but is not the primary intervention. Teaching the
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