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17. The Emergency Department wil.be sending the nurse to a patient with amyotrophic lateral sclerosis (ALS, Lou Gehrig’s Disease) who is on a ventilator. Which of the following is MOST appropriate to complete prior to this patient’s arrival on the unit?

1 Pace a pulse oximeter in the room for continuous oxygen saturation monitoring -me.

2 Obtain isolation gorms, gloves, and masks to place the patient in protective isolation

3 Pad the bed rails to protect him during a seizure

4 Place wrist restraints in the patient’s room to prevent him from pulling out his tracheostomy tube

 

19. A patient with amyotrophic lateral sclerosis (ALS, Lou Gehrig’s Disease) is hospitalized for pneumonia. The patient has been on a ventilator for the past 6 months. Once respiratory status has been stabilized, which nursing action will the nurse include in the plan of care?

1 Turn and reposition the patient at least every 2 hours to prevent pressure injury

2 SBAR the provider lo have a physical therapist help the patient walk with a portable ventilator

3 Asses for impulsiveness to decrease the risk of falls

4 Instruct unlicensed assistive personnel that the patient will no understand anything they say due to impaired cognition

 

27. During the RECOVERY phase of Guillain-Barré syndrome (GBS) the visiting nurse notices that the spouse is performing ALL ADLs for her husband. Which action by the nurse is MOST appropriate at this time?

1 Assess the patient’s ability to perform his own ADLS.

2 Tell the wife to stop performing her husband’s ADLs.

3  Support the wife’s decision to perform all of his ADLs.

4 Help the wile hire an aide to perform all of his ADLs.

 

30. A patient with Guillain-Barré syndrome (GBS) is NPO and receiving total parenteral nutrition (TPN) through a peripherally inserted central catheter (PICC line). Which of the following is the PRIORITY nursing diagnosis?

1 Diarrhea r/t infusion of total parenteral nutrition

2 Ineffective family coping tit the possibility of children inheriting this autosomal dominant disorder

3 Risk for injury r/t impaired cognition

4 Risk for infection r/t presence of a peripherally inserted central catheter

 

40. After receiving the report ,which patient will the nurse see FIRST? The patient with:

1 Hurtington’s disease who is experiencing choreiform movements

2 Myasthenia gravis who is scheduled for discharge laler in the day

3 Multiple sclerosis who has limited movement of her legs

4 Descending Guillain-Barré syndrome who was admitted during the night

 

42. A patient whose work involves loading boxes has a history of chronic low back pain. After teaching the patient about correct body mechanics, which statement by the patient indicates that TEACHING has been EFFECTIVE?

1 “I will bend from the waist whenever I need to pick up something heavy.”

2 “I will keep my knees straight when / lit something up from the floor.”

3 “I will sleep on my stomach to prevent back strain*

4  “I will avoid twisting my spine when lifting light objects”

 

43. A patient with carpal tunnel syndrome has paresthesias and pain that is NOT relieved by ibuprofen. The nurse will:

1 Explain that there is nothing that can relieve the pain and paresthesias

2 Assess range of motion in both elbows

3 Ask the patient if he/she uses a wrist splint to prevent wrist flexion

4 Encourage the patient to strengthen the tendons in the wrist by lifting weights

 

45. A patient has returned from surgery after a lumbar laminectomy. After surgery, the nurses will position the patient on the SIDE by:

1 Turing the patient’s head and shoulders to the side. Then, tum the hips.

2 Asking the patient to grasp the side rail and pull himself over.

3 Elevating the head of the bed 60 degrees before turning the patient.

4 Placing a pillow between the legs and turning the body as a unit.

 

51. Which of the following will the nurse teach the patient with CHRONIC hepatitis C?

1 “You should get the hepatitis C vaccine because it will help your immune system fight off the infection.”

2 “You should limit alcohol intake to 2 drinks daily to protect your liver.”

3 “Acetaminophen is completely safe for someone with liver disease to take.”

4 “The ultrasound elastography (fibro scan) test has been ordered to see if you have scar tissue in your liver.”

 

53. When assessing a patient with cirrhosis, which assessment finding will the nurse anticipate?

1 Edema related to increased ammonia level.

2 Jaundice related to an elevated bilirubin level.

3 Ascites related to prolonged prothrombin time.

4 Ecchymoses related to the low albumin level.

 

58. If a patient’s chest drainage unit accidentally tips over during ambulation, the nurse’s FIRST intervention will be to upright the unit and:

1 Assess the drainage collection chamber

2 Assess the water-seal chamber

3 Double clamp the chest tube

4 Add sterile water to the suction control chamber until it reaches the 20 cm mark

 

 

61. A patient with gastroesophageal reflux disease (GERD) returned from a laparoscopic nissen fundoplication 4 HOURS ago. Which assessment finding is MOST important for the nurse to address immediately ?

1 The patient feels like he is going to vomit.

2 The patient’s respiratory rate is 14 per minute.

3 The patient’s pain rating is 3 on a 0-10 scale.

4 The patient has decreased bowel sounds.

 

66. A patient with bladder cancer has undergone a radical cystectomy and creation of an ILEAL CONDUIT. Which of the following will the nurse expect to see on the FIRST postoperative day?

1 Urine and stool will drain from the ileal conduit

2 Stents that maintain patency of the urelers will protrude from the ileal conduit stoma

3 A healthy ileal conduit stoma will appear bluish in color

4 The soma will need to be catheterized once every hour around the clock

 

83. The cuff of a tracheostomy tube is inflated to:

1.Prevent air from escaping around the tube when a patient is on a ventilator

2. To enable the patient on a ventilator to speak

3. Prevent infection with drug resistant organisms

4. Keep the inner cannula from falling out of the outer cannula of the tracheostomy tube

 

84. A patient has systemic lupus erythematosus (SLE) and will be started on 20 mg of Prednisone daily to help control the disease. Which of the following is appropriate for the nurse to teach this patient?

1. The patient should not receive an annual flu shot.

2. The patient should have a TB test before beginning long-term prednisone therapy.

3. Prednisone should not be taken if the patient is scheduled for surgery.

4. Prednisone should be discontinued if the patient develops a fever.

SCIENCE
HEALTH SCIENCE
NURSING
NRS 315

 

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