MDC3-2

MAKE SURE TO ANSWER THE FOLLOWING CAREFULL AND CORRECTLY.
 

1. The nurse is assessing a client who reports being struck in the face and head several times. During the assessment, the nurse observes pink-tinged drainage from the client’s nares.

What nursing action provides relevant assessment data?

1. Have the client gently blow their nose and observe for bloody mucus
2. Test the drainage with reagent to check the ph.
3. Ask the client to describe the appearance of the face before the injury
4. Place a drop of the drainage on filter paper and look for a yellow ring

 

2. A nurse is providing discharge instruction to a client recently diagnosed with tuberculosis (TB). Which statements by the client indicates correct understanding of the teaching (select all that apply)
3. I will visit the clinic every week for injection of medication.
4. I will avoid alcoholic beverage while on this treatment plan
5. My family does not require testing.
6. Will follow up with my healthcare provider regularly
7. I need to strictly adhere to my medication schedule

 

3. A nurse is caring for a client who recently underwent a laryngectomy for neck cancer. Which of the following multidimensional nursing strategies would be appropriate for the postoperative care of this client? (select all that apply)
4. Alternative means of communication
5. Diet modification
6. stress reduction
7. pain management
8. Aerobic exercise

 

4. A nurse is assessing a client admitted with status asthmatics. Initially the nurse heard wheezes in the lungs, but now the lungs sounds are inaudible. What is the priority intervention?
5. Education to prevent future exacerbations
6. Administration of a long- acting bronchodilator
7. Measures to reduce anxiety
8. Activation of the rapid response term to secure an airway

 

5. Which of the following is a major diagnostic test for cystic fibrosis?
6. Sweat chloride test
7. Arterial blood gas
8. Chest x-ray
9. CT scan of the chest
10. A client has a positive Mantoux skin test result. What explanation does the nurse give to the client?
11. There is active disease, but you are not infectious to others.
12. There is active disease, and you need immediate treatment.
13. You have been infected. But this does not mean active disease is present
14. A repeat skin test is necessary because the test could give a false- positive result.

 

7. A client with suspected tuberculosis (TB) is admitted to the hospital. Along with a private room, which of the following is appropriate related to isolation percussion?
8. Respiratory isolation and contact isolation sputum only
9. Negative airflow room with a specially fitted respirator
10. Respiratory isolation with surgical masks until diagnosis is confirmed
11. No respiratory isolation necessary until diagnosis is confirmed

 

8. The nurse knows which of the following is the purpose of a fluticasone inhaler for a client with asthma?
9. Relaxes smooth muscles of the airway
10. Act as a bronchodilator in severe episodes
11. Reduces obstruction of the airways by decreasing agent
12. Reduces histamine effect of the triggering agent.

 

9. A nurse is teaching a 78-year-old client about the importance of the pneumonia vaccination. Which statement by the client indicates an understanding of the teaching?
10. Only the flu vaccination is recommended at my age.
11. I only need pneumonia vaccination upon admission to a nursing home.
12. I need two different vaccination to prevent pneumonia
13. I’ve already had pneumonia, so I only need one vaccination.

 

10. In plaining care for client with chronic obstructive pulmonary disease (COPD) and chronic difficulty breathing, the nurse acknowledges what condition is present in the client?
11. Decreased level of calories and protein since dyspnea cause activity intolerance
12. COPD has no effect on calories and protein needs, meal tolerance appetite and weight.
13. Increase metabolism and the need for additional calories and protein supplements
14. Anabolic state, which creates conditions for building body strength and muscle mass.

 

11. A nurse admitted a client from the emergency department with new onset of dyspnea and productive cough with suspected pneumonia, the client has an oxygen saturation of 96% on and 2 L of O2 via nasal cannula and crackles in bilateral bases. Oral temperature 98.9 degrees F, heart rate 103 beats per minute and respiration rate 18 breaths per minute. The provider enters the following orders, which the nurse perform first?
12. Administer broad spectrum antibiotic through Iv
13. Collect sputum sample for culture
14. Administer PO antipyretic for temperature
15. Collect blood sample for complete blood count

 

12. A client with recent diagnosis of sinus cancer states that he wants another course of antibiotic because he believes he has another sinus infection. What is the nurse’s best response?
13. I will call the physician to request an order for the antibiotic
14. Why are you doubting your doctor’s diagnosis?
15. Let met bring you a brochure about sinus cancer.
16. Tell me your understanding about your diagnosis of sinus cancer?

 

13. A nurse is providing education to a client recently diagnosed with pulmonary hypertension. What is the goal of drug therapy for this client?
14. Dilate pulmonary vessels and prevent clot formation
15. Decrease pain and make the client comfortable
16. Improve or maintain gas exchange
17. Maintain and manage pulmonary exacerbation

 

14. The nurse is providing education to a client who is prescribed a long- acting beta- agonist. Which statement by the client indicates the client understands the teaching?
15. I will carry this medication with me at all times in case I need it.
16. I will take this medication when I start to experience an asthma attack.
17. I will take this medication every morning to prevent asthma attack.
18. I will only take this medication when I am admitted to the hospital.

 

15. The nurse is preforming medication teaching to a client with chronic airflow limitation. What is the correct sequence for administering inhaled medications?
16. Bronchodilator should be taken 5 to 10 minutes after the steroid
17. Bronchodilator should be taken at least 5 minutes before other inhaled drugs
18. Bronchodilator should be taken immediately after the steroid
19. Bronchodilator and steroid are two different classes of drugs, so the sequence is irrelevant.

 

16. The nurse is caring for a client who was recently diagnosed with asthma and is providing education on causes and trigger of asthma. What risk factor is not related to potential causing or triggering the disease process?
17. Dust or air pollutants
18. Obesity
19. Cigarette smoking
20. History of environmental allergies

 

17. Which statement is true regarding asthma and chronic obstructive disease (COPD)as chronic disease of the lower respiratory system?
18. COPD cause episodes of respiratory distress with no permanent alveoli damage
19. In asthma, the lungs lose elasticity and become hyperinflated.
20. Asthma manifests as acute episodes of reversible airway distress
21. In COPD, a twitchy airway’ can cause airway obstruction.

 

18. The nurse is caring for a 50-year-old female client who presented to the emergency room status post motor vehicle accident. The client was an unrestrained passenger who hit the windshield, and she has multiple facial lacerations. Which of the following is a priority nursing priority nursing intervention for this client?
19. Maintain a patent airway
20. Pain management
21. Prepare the client for testing
22. Draw labs

 

19. A client presented to the emergency room with difficulty breathing. Upon examination, the client has pus behind the tonsils and swelling on the right side of his nick. She is diagnosed with peritonsillar abscess. Which of the following is a treatment priority for this client?
20. Maintain a patent airway
21. Oxygen therapy
22. Analgesics
23. Antibiotics

 

20. A client arrives in the emergency department with epistaxis. What is the nurse’s priority intervention?
21. Position the client upright with the head forward.
22. Apply an ice pack to the nose.
23. Monitor the color and amount of blood.
24. Place nasal packing.

 

21. Anxiety is common among client who are diagnosed with chronic obstructive pulmonary disease. Which of the following intervention can assist in reducing a client anxiety? (Select all that apply)
22. Written plan for dealing with anxiety
23. Professional counselling
24. Relaxation techniques
25. Starting a vigorous exercise routine
26. Plan out periods of rest throughout the day.

 

22. A nurse is caring for a client who has been diagnosed with chronic obstructive pulmonary disease. Which of the following will be a treatment priority for this client?
23. Improve gas exchange
24. Increase activity level
25. Blood pressure control
26. Prevention of infection

 

23. A nurse student is teaching a client about their new diagnosis of pulmonary fibrosis. The student would include which of the following in their teaching?
24. This is an incurable, autosomal recessive genetic disease that affects many organs
25. Most clients have progressive disease with a life expectancy of lets than 5 years
26. The use of a flutter- valve device can assist clients to remove thick airway secretions
27. Inflammation of the mucous membranes in the airways can trigger an attack.

 

24. The nurse teaches a client with asthma to monitor for which problem while exercising?
25. Increased peak expiration flow rate.
26. Wheeze from bronchospasm
27. Swelling in the feet and ankles
28. Respiratory muscle fatigue

 

25. A client has been taking isoniazid for tuberculosis for 3 weeks. What information gathered by the public health nurse need to be reported to the healthcare provider immediately?
26. Client has been taking isoniazid daily as prescribed
27. Client is drinking 4-6 alcoholic beverages per day
28. Client smokes 1,5 pack of cigarettes per day
29. Client was recently started on varenicline to quit smoking

 

26. A nurse is caring for a client who has emphysema. Which of the following findings should the nurse expect to assess in this client? (select all that apply)
27. Dyspnea
28. Bradycardia
29. Barrel chest
30. clubbing of the finger
31. deep respirations
32. a 47-year-old male client presented to the emergency room with complaints of nasal and facial pain and bloody discharge. He states the symptom ————— age and have gotten progressively worse. He states that it feels like his nose is blocked up all the time. Based on these symptoms. What of the following order will the nurse expect the provider to order?
33. CT scan of the face
34. Liver function test
35. Complete blood count
36. Tumor mapping
37. The nurse knows that which of the following test is needed to confirm a tuberculosis diagnosis?
38. Complete blood count
39. Chest x-ray
40. Mantoux skill test
41. Sputum culture

 

29. The nurse is caring for the client with cystic fibrosis. Which of the following are common assessment findings for a client with this disorder? (select all that apply)
30. Distended abdomen
31. Foul-smelling, pale stool with high-fat content
32. Gastroesophageal reflux
33. Weight gain
34. Cough with sputum production

 

30. A nurse is preparing to administer 750 mg of ceftriaxone IM stat. available is ceftriaxone 1 gram/ 5mL. how many mL should the nurse administer pr dose? Round the answer to the nearest hundredth (two decimal places). Use a leading zero if it applies. Do not use a trailing zero

 

31. A nurse was recently diagnosed with laryngeal cancer. When the nurse begins taking the clients history. The client asks.’’ Did you know that I have throat cancer and may not survive?

What is the appropriate nursing response?

1. Are you having difficulty swallowing?
2. Have you told your family yet?
3. I know you have been diagnosis with cancer. Are you concerned about what the future may hold?
4. I am sure that we can cure you as long as you follow doctor’s directions

 

32. A client with chronic bronchitis often shows signs of hypoxia. Which of the following is the priority to monitor for in this client?
33. Large amounts of thick mucus
34. Barrel chest
35. Nutritional status
36. Clubbing of fingers

 

33. Which statement by the client indicates an understanding of radiation therapy for neck cancer?
34. My voice may initially be hoarse but should improve over time
35. There are no side effect other than a hoarse voice
36. Radiation causes excessive saliva production
37. My throat is not directly affected by radiation

 

34. Which of the following is a common problem associated with cystic fibrosis in adults?
35. Obesity
36. Osteoporosis
37. Hypertension
38. Asthma

 

35. A nurse is preparing to administer hydromorphone 2.5 mg po now. Available is hydromorphone 5 mg/5 mL elixir. How many mL should the nurse administer per dose? Round the answer to the nearest tenth (one decimal places). Use a leading zero if it applies. Do not use a trailing zero

 

36. The change of shift report has just been completed on the medical-surgical unit. Which client will the oncoming nurse plan to assess first?
37. Client with COPD who is ready for discharge but is unable to afford prescribed medication
38. Client with cystic fibrosis (CF) who has an elevated temperature and a respiratory rate of 38 breaths/min.
39. Hospice client with end state pulmonary fibrosis and an oxygen saturation level of 89%
40. Client with lung cancer who needs an IV antibiotic administered before going to surgery.

 

37. A client presents with sign and symptoms that are often associated with lung cancer. Which clinical manifestations does the nurse expect to observe in the client?
38. Hemoptysis, hoarseness, cough, and shortness of breath
39. Abdominal distension, steatorrhea, and dyspnea
40. Wheezing, clubbing of the nails, cyanosis, and dyspnea
41. Fever, fatigue, dyspnea, and peripheral edema

 

38. A nurse is caring for a client with end-stage-emphysema, which of the following would be a expected finding?
39. Increased CO2
40. Increased PO2
41. Increased PH
42. Decreased CO2

 

39. Which intervention promote comfort in dyspnea management for a client with lung cancer?
40. Administer morphine only when the client requests it
41. Place the client in a supine position with a pillow under the knees and legs
42. Encourage exercise and independent ambulation around the room
43. Provide supplemental oxygen via nasal cannula or mask.

 

40. A nurse is caring for a client who recently diagnosed with cystic fibrosis. Which of the following treatment option for this disorder?
41. Tracheostomy
42. Weight reduction
43. Chest physiotherapy
44. Pain management

 

41. The nurse is providing discharge instructions, for a client diagnosed with pneumonia. Which information is the nurse sure to include?
42. Complete antibiotic as prescribed, rest, drink fluid and minimize contact with crowds.
43. Take all antibiotic as order, resume diet and all activities as before hospitalization.
44. No restrictions regarding activities, diet, and rest because the client is fully recovered when discharged.
45. Continue antibiotic only no further signs of pneumonia are present avoid exposing immunosuppressed individuals.

 

42. A nurse is caring for several older clients in the hospital that the nurse identifies as being at high risk for healthcare-associated pneumonia. To reduce this risk, what activity should the nurse delegate to the unlicensed assistive personal (UAP)?
43. Encourage between-meal snacks
44. Monitor temperature every 4 hours.
45. Provide oral care every 4 hours
46. Report any new onset of cough.

 

43. A client is being discharged on long-term therapy for tuberculosis (TB). What referral by the nurse is most appropriate?
44. Community social worker for meals on wheels
45. Occupational therapy for job retraining
46. Physical therapy for homebound therapy services
47. Visiting public health nurses for directly observed therapy.
48. The nurse is teaching a client post rhinoplasty care. Which statement by the client indicates an understanding of the instructions?
49. I will be able to breathe only from my nose
50. I should try and avoid coughing, sneezing, and blowing my nose
51. I should take over the counter nonsteroidal anti-inflammatory drugs (NSAIDS) for pain
52. I should retain supine if possible

 

45. A nurse is caring for a 56- year-old male client recently diagnosed with neck cancer. Which of the following assessment findings is most consistent with this diagnosis?
46. Dizziness
47. Weight gain
48. Nasal congestion
49. Hoarseness

 

46. An 84-year-old client is diagnosed with rhinosinusitis. The nurse questions which medication that she sees on the client’s PRN medication list?
47. Analgesic
48. Antipyretic
49. Antihistamine
50. Nasal spray

 

47. During an admission assessment the client tells the nurse that she was recently prescribed a new medication called montelukast, but she forgot to pick it up at the pharmacy. What is the best response by the nurse to assess the client’s understanding of the montelukast?
48. Don’t you know that montelukast would have prevented you from coming to the hospital
49. Why didn’t you remember to get the prescription filled?
50. Have you been having more problems with your asthma recently?
51. Don’t worry about it, you probably have been busy?

 

48. Which statement from a client with seasonal influenza requires additional teaching?
49. I’m contagious only when symptoms are present
50. I should receive a new influenza vaccine every year.
51. I can reduce my risk by implementing good hand hygiene
52. I can be diagnosed on presentation of symptoms

 

49. A nurse is preparing to administer dextromethorphan 30 mg PO now. The amount available is dextromethorphan oral liquid 7.5 mg/5ml. How many ml should the nurse administer per dose? (Record the answer as a whole number. Do not use a training zero)
50. A nurse is providing education to a client recently diagnosed with sleep apnea. Which of the following statements by the client indicates an understanding of the teaching?
51. I should contact the provider for a prescription for sleep medication
52. I should begin treatment only if my snoring impacts my partner
53. Sleep apnea only has an impact on my mental concentration
54. I may be at risk for developing heart disease or stroke.