Mar 14, 2010

NURSING BOARD EXAM PRACTICE IV– Care of Clients with Physiologic and Psychosocial Alterations

NURSING BOARD EXAM PRACTICE IV – Care of Clients with Physiologic and Psychosocial Alterations

June 2008 Nursing Licensure Examination (NLE)
June 2008 NP4 Nursing Board Exam Answer Key
Nursing Board Exams Questions 1-15

June 2008

NURSING PRACTICE IV SET B

NURSING PRACTICE IV – Care of Clients with Physiologic and Psychosocial Alterations (Part B)

GENERAL INSTRUCTIONS:

1. This test booklet contains 100 test questions.

2. Read INSTRUCTIONS TO EXAMINEES printed on your answer sheet.

3. Shade only one (1) box for each question on your answer sheets. Two or more boxes shaded will invalidate your answer.

4. AVOID ERASURES.

INSTRUCTIONS:

1. Detach one (1) answer sheet from the bottom of your Examinee ID/Answer Sheet Set .

2. Write the subject title “Nursing Practice IV” on the box provided.

3. Shade Set Box “A” on your answer sheet if your test booklet is Set A; Set Box “B” if your test booklet is Set B.

Situation – Ensuring safety is one of your most important responsibilities. You will need to provide instructions and information to your clients to prevent complications.

1. Randy has chest tubes attached to a pleural drainage system. When caring for him you should:

A. empty the drainage system at the end of the shift

B. clamp the chest tube when suctioning

C. palpate the surrounding areas for crepitus

D. change the dressing daily using aseptic techniques

2. Fanny, came in from PACU after pelvic surgery. As Fanny’s nurse you know that the sign that would be indicative of a developing thrombophlebitis would be:

A. a tender, painful area on the leg

B. a pitting edema of the ankle

C. a reddened area at the ankle

D. pruritus on the calf and ankle

3. To prevent recurrent attacks on Terry who has acute glumerulonephritis, you should instruct her to:

A. seek early treatment for respiratory infections

B. take showers instead of tub bath

C. continue to take the same restrictions on fluid intake

D. avoid situations that involve physical activity

4. Herbert had a laryngectomy and he is now for discharge. He verbalized his concern regarding his laryngectomy tube being dislodged. What should you teach him first?

A. Recognize that prompt closure of the tracheal opening may occur

B. Keep calm because there is no immediate emergency

C. Reinsert another tubing immediately

D. Notify the physician at once

5. When caring for Larry after an exploratory chest surgery and pneumonectomy, your priority would be to maintain:

A. supplementary oxygen

B. ventilation exchange

C. chest tube drainage

D. blood replacement

Situation – As a nurse you need to anticipate the occurrence of complications of stroke so that life threatening situations can be prevented.

6. Wendy is admitted to the hospital with signs and symptoms of stroke. Her Glasgow Coma Scale is 6 on admission. A central venous catheter was inserted an I.V. infusion was started. As a nurse assigned to Wendy what will be your priority goal?

A. Prevent skin breakdown

B. Preserve muscle function

C. Promote urinary elimination

D. Maintain a patent airway

7. Knowing that for a comatose patient hearing is the last sense to be lost, as Judy’s nurse, what should you do?

A. Tell her family that probably she can’t hear them

B. Talk loudly so that Wendy can hear you

C. Tell her family who are in the room not to talk

D. Speak softly then hold her hands gently

8. Which among the following interventions should you consider as the highest priority when caring for June who has hemiparesis secondary to stroke?

A. Place June on an upright lateral position

B. Perform range of motion exercises

C. Apply antiembolic stockings

D. Use hand rolls or pillows for support

9. Ivy, age 40, was admitted to the hospital with a severe headache, stiff neck and photophobia. She was diagnosed with a subarachnoid hemorrhage secondary to ruptured aneurysm. While waiting for surgery, you can provide a therapeutic environment by doing which of the following?

A. honoring her request for a television

B. placing her bed near the window

C. dimming the light in her room

D. allowing the family unrestricted visiting privileges

10. When performing a neurologic assessment on Walter, you find that his pupils are fixed and dilated. This indicated that he:

A. probably has meningitis

B. is going to be blind because of trauma

C. is permanently paralyzed

D. has received a significant brain injury

Situation – With the improvement in life expectancies and the emphasis in the quality of life it is important to provide quality care to our older patients. There are frequently encountered situations and issues relevant to the older patients.

11. During a meal a client with hepatitis B dislodge her IV line and bleeds on the surface of the over-the-bed table. It would be most appropriate for the nurse to instruct a housekeeper to clean the table with:

A. Alcohol

B. Acetone

C. Ammonia

D. Bleach

12. Nino is being treated with radiation therapy. What would be included in the plan of care to minimize skin damage from the radiation therapy?

A. Cover the areas with thick clothing materials

B. Apply a heating pad to the site

C. Wash skin with water after the therapy

D. Avoid applying creams and powders to the area

13. You are assigned to the following patients. Which of the following patients is most at risk for metabolic alkalosis?

A. Grace, 30 years old post surgical patient who has continuous nasogastric suction

B. Rachel, 55 year old who has just experienced a stroke

C. Helen, 70 year old with altered level of consciousness who is unable to access water freely.

D. Mary Jane a 2 year old infant receiving isotonic sodium chloride IV solution

14. Studies have shown that the highest incidence of Hodgkin’s disease is common among young adults. Juana, 20 years old approaches you and tells you “I am worried about the mass on my neck. What should you do as a nurse?

A. Tell her there is nothing to worry if it does not bother her

B. Palpate Juana’s neck and explain the possible cause

C. Tell her Hodgkin’s disease is common among young adults like her

D. Tell her to see a doctor

15. As a nurse, you accidentally administer 40mg of Propanolol (Inderal) to a client instead of 10mg although the client exhibits no adverse reactions to the larger dose, you should: