Practice Exam Flashcards

A high school student returns to school following a 3-week absence due to mononucleosis. The school nurse knows it will be important for the client:

Answer: To avoid contact sports for 1–2 months

Mononucleosis can cause splenomegaly (enlarged spleen), making it vulnerable to rupture with trauma. To prevent this serious and potentially life-threatening complication, clients are advised to avoid contact sports and strenuous activities for at least 1-2 months, or until the spleen returns to normal size as confirmed by a physician.

A 6-year-old with cystic fibrosis has an order for Creon (pancrelipase). The nurse knows that the medication will be given:

Answer: With meals and snacks

Creon (pancrelipase) is a pancreatic enzyme replacement therapy used in cystic fibrosis to aid in the digestion and absorption of fats, proteins, and carbohydrates. To be effective, it must be taken immediately before or with all meals and snacks. This ensures the enzymes are present in the digestive tract when food arrives, optimizing nutrient absorption.

The doctor has prescribed a diet high in vitamin B12 for a client with pernicious anemia. Which foods are highest in B12?

Answer: Meat, eggs, dairy products

Vitamin B12 is primarily found in animal products. Meat (especially liver), eggs, and dairy products are excellent natural sources of B12. While clients with pernicious anemia require B12 injections due to absorption issues, dietary intake of these foods is still important for overall nutrition and to ensure adequate intake for any remaining absorption capacity.

A client with hypertension has begun an aerobic exercise program. The nurse should tell the client that the recommended exercise regimen should begin slowly and build up to:

Answer: 20–30 minutes three times a week

For cardiovascular health and blood pressure management, current guidelines recommend engaging in moderate-intensity aerobic exercise for at least 30 minutes on most days of the week. For beginners, building up to 20-30 minutes three times a week is a safe and effective starting point. This regimen helps improve cardiovascular fitness and can contribute to lowering blood pressure.

A client with breast cancer is returned to the room following a right total mastectomy. The nurse should:

Answer: Elevate the client’s right arm on pillows

After a mastectomy, elevating the affected arm on pillows helps to promote lymphatic drainage and reduce swelling (lymphedema) in the arm and hand. This position also helps to prevent fluid accumulation in the surgical area and improves client comfort. Keeping the arm elevated is a crucial post-operative intervention.

A neurological consult has been ordered for a pediatric client with suspected petit mal seizures. The client with petit mal seizures can be expected to have:

Answer: A brief lapse in consciousness

Petit mal seizures, now known as absence seizures, are characterized by brief, sudden lapses of consciousness that typically last only a few seconds. During these episodes, the child may stare blankly, have subtle eye fluttering, or make slight mouth movements, but there is no loss of muscle tone or severe jerking movements. They often go unnoticed or are mistaken for daydreaming.

A client with schizoaffective disorder is exhibiting Parkinsonian symptoms. Which medication is responsible for the development of Parkinsonian symptoms?

Answer: Zyprexa (olanzapine)

Zyprexa (olanzapine) is an atypical antipsychotic medication that, while generally having a lower risk than first-generation antipsychotics, can still cause extrapyramidal symptoms (EPS), including Parkinsonian symptoms. These symptoms, such as tremors, rigidity, and bradykinesia, are a known side effect of antipsychotic medications, especially at higher doses or in sensitive individuals. The other medications listed are either used to treat EPS or are mood stabilizers.

Which activity is best suited to the 12-year-old with juvenile rheumatoid arthritis?

Answer: Swimming

Swimming is an excellent activity for individuals with juvenile rheumatoid arthritis because the buoyancy of water reduces stress on inflamed joints while allowing for a full range of motion. This helps strengthen muscles, improve flexibility, and maintain joint function without exacerbating pain or damage. Other options like video games are sedentary, and playing softball could put undue stress on joints.

The glycosylated hemoglobin of a 40-year-old client with diabetes mellitus is 2.5%. The nurse understands that:

Answer: The client has good control of her diabetes.

Glycosylated hemoglobin (HbA1c) reflects the average blood glucose levels over the past 2-3 months. A normal HbA1c is typically below 5.7%, and for individuals with diabetes, a target is often below 7%. A reading of 2.5% is significantly below the normal range, indicating exceptionally good, and potentially even too tight, control of blood glucose levels.