Practice Test Flashcards

A nurse in the emergency department assesses a patient who has been taking long-term corticosteroids to treat renal disease. Which of the following is a typical side effect of corticosteroid treatment? Note: More than one answer may be correct.

Answer: Hypertension.

Long-term corticosteroid use is associated with several side effects due to their broad physiological effects. Hypertension is common because corticosteroids can cause sodium and water retention, increasing blood volume and pressure. Cushingoid features, such as moon face and buffalo hump, result from the redistribution of fat and protein catabolism, while low serum albumin can occur due to protein catabolism and decreased synthesis.

A client had a total thyroidectomy yesterday. The client is complaining of tingling around the mouth and in the fingers and toes. What would the nurses’ next action be?

Answer: Check the calcium level

A total thyroidectomy removes the thyroid gland, which is anatomically close to the parathyroid glands. Damage to or accidental removal of the parathyroid glands during surgery can lead to hypoparathyroidism, resulting in decreased parathyroid hormone (PTH) production. PTH regulates calcium levels, so a decrease leads to hypocalcemia. Tingling around the mouth and in the fingers and toes (paresthesias) are classic early symptoms of hypocalcemia, making checking the calcium level the priority.

A client has had a unilateral adrenalectomy to remove a tumor. To prevent complications, the most important measurement in the immediate postoperative period for the nurse to take is:

Answer: Blood pressure

A unilateral adrenalectomy involves removing one adrenal gland, which produces hormones like cortisol and aldosterone. In the immediate postoperative period, there's a risk of adrenal insufficiency if the remaining adrenal gland doesn't adequately compensate, or if the tumor was hypersecreting and its sudden removal causes a drop in hormone levels. Adrenal insufficiency can lead to severe hypotension and shock, making frequent monitoring of blood pressure the most critical assessment to detect this life-threatening complication.

The nurse is instructing a client with iron-deficiency anemia. Which of the following meal plans would the nurse expect the client to select?

Answer: Egg salad on wheat bread, carrot sticks, lettuce salad, raisin pie

Iron-deficiency anemia requires increased dietary intake of iron. The meal plan with egg salad (eggs contain iron), wheat bread (often fortified with iron), and especially raisin pie (raisins are a good source of non-heme iron) provides the most iron-rich options compared to the other choices. This combination helps to boost the client's iron intake effectively.

A 30-year-old male from Haiti is brought to the emergency department in sickle cell crisis. What is the best position for this client?

Answer: Semi-Fowler’s with legs extended on the bed

In a sickle cell crisis, pain is a primary concern, often due to vaso-occlusion and impaired circulation. Positioning the patient in Semi-Fowler's with legs extended promotes comfort and helps improve circulation by avoiding sharp angles that could impede blood flow in the extremities. Flexing the knees or adopting a knee-chest position could potentially worsen venous pooling and increase pain.

A patient arrives in the emergency department with symptoms of myocardial infarction, progressing to cardiogenic shock. Which of the following symptoms should the nurse expect the patient to exhibit with cardiogenic shock?

Answer: Confusion

Cardiogenic shock is a severe condition where the heart cannot pump enough blood to meet the body's needs, leading to inadequate tissue perfusion. Reduced blood flow to the brain (cerebral hypoperfusion) results in altered mental status, including confusion, disorientation, and decreased level of consciousness. This is a key indicator of organ hypoperfusion and a critical symptom of cardiogenic shock.

A patient is about to undergo bone marrow aspiration and biopsy and expresses fear and anxiety about the procedure. Which of the following is the most effective nursing response?

Answer: Stay with the patient and focus on slow, deep breathing for relaxation.

Bone marrow aspiration and biopsy can be a painful and anxiety-provoking procedure. The most effective nursing response is to provide direct support and comfort measures. Staying with the patient and guiding them through slow, deep breathing helps distract from the pain, promotes relaxation, and provides a sense of control, thereby reducing fear and anxiety during the procedure.

A patient who has received chemotherapy for cancer treatment is given an injection of Epoetin. Which of the following should reflect the findings in a complete blood count (CBC) drawn several days later?

Answer: An increase in hematocrit.

Epoetin (erythropoietin) is a hormone that stimulates the bone marrow to produce red blood cells. It is administered to patients, often those undergoing chemotherapy, to treat anemia. Therefore, an effective response to Epoetin treatment would be an increase in the red blood cell count, which is reflected as an increase in hematocrit (the percentage of red blood cells in the blood).

The client with a history of diabetes insipidus is admitted with polyuria, polydipsia, and mental confusion. The priority intervention for this client is:

Answer: Check the vital signs

Diabetes insipidus (DI) is characterized by the inability to conserve water, leading to excessive urination (polyuria) and thirst (polydipsia). This can quickly lead to severe dehydration and electrolyte imbalances. Checking vital signs, especially blood pressure and heart rate, is the priority to assess for signs of hypovolemic shock or severe dehydration, which are life-threatening complications requiring immediate intervention.

He thinks of an appropriate theoretical framework. Whose theory addresses the four modes of adaptation?

Answer: Sr. Callista Roy

Sr. Callista Roy developed the Adaptation Model of Nursing, which focuses on the individual as an adaptive system. Her theory identifies four modes of adaptation: physiological-physical, self-concept-group identity, role function, and interdependence. Nursing interventions aim to promote adaptation in these modes when a person is faced with stressors.

He opts to use a self-report method. Which of the following is NOT TRUE about this method?

Answer: Most accurate and valid method of data gathering

Self-report methods, such as questionnaires or interviews, are valuable for gathering subjective information directly from participants. However, they are not always the most accurate or valid method because responses can be influenced by social desirability bias, recall bias, or a lack of self-awareness. While versatile and direct, their accuracy depends heavily on the participant's honesty and perception.

Which of the following articles would Kevin least consider for his review of literature?

Answer: “Turnaround Time in Emergency Rooms”

Kevin's study aims to determine the level of patient satisfaction on the care they received from the hospital. Articles related to 'Story-Telling and Anxiety Reduction,' 'Outcome Standards,' and 'Environmental Manipulation' are relevant to patient care and outcomes, which could influence satisfaction. 'Turnaround Time in Emergency Rooms,' while a hospital operational metric, is less directly related to patient satisfaction with overall care in a general hospital admission context.

Which of the following variables will he likely EXCLUDE in his study?

Answer: Salary of nurses

Kevin's study is about patient satisfaction with the care received. While nurse competence and responsiveness directly impact patient care and satisfaction, the salary of nurses is an internal organizational factor that does not directly or immediately influence a patient's perception of the care they receive. It is unlikely to be a variable that would explain variations in patient satisfaction.

He plans to use a Likert Scale to determine

Answer: degree of agreement and disagreement

A Likert scale is a psychometric scale commonly used in questionnaires to measure attitudes, opinions, or perceptions. It typically presents a statement, and respondents indicate their level of agreement or disagreement on a symmetric agree-disagree scale (e.g., Strongly Disagree, Disagree, Neutral, Agree, Strongly Agree). While it can be adapted for satisfaction, its primary and most direct application is for measuring agreement.

He checks if his instruments meet the criteria for evaluation. Which of the following criteria refers to the consistency or the ability to yield the same response upon its repeated administration?

Answer: Reliability

Reliability refers to the consistency and stability of a measurement instrument. An instrument is reliable if it yields the same or highly similar results when administered repeatedly under the same conditions to the same subjects. It indicates the extent to which a measurement is free from random error, ensuring dependable and reproducible results.

Which criteria refer to the ability of the instrument to detect fine differences among the subjects being studied?

Answer: Sensitivity

Sensitivity refers to an instrument's ability to detect small, true differences or changes among the subjects being studied. It ensures that the measurement tool is precise enough to capture subtle variations that actually exist. This characteristic is crucial for accurate assessment and monitoring in research and clinical settings, allowing for fine distinctions between individuals or over time.