NURSING BOARD EXAM PRACTICE III – 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 81-100

Situation – Many hospitals from bioethical review committees to ensure quality of life of patients. You are invited by the nursing service departments to participate in their bioethical review committee. You are expected to know the purpose and apply bioethical principles.

81. Which of the following is the purpose of the ethical review committee?

A. Promote implementation of general standards

B. Enhance health care providers liability

C. Increase individuals responsibility

D. Decrease Public security of health care provider’s action

82. Daria who is admitted to the hospital with autoimmune thrombocytopenia and a platelet count of 20,000/ml develops epistaxis and melena. Treatment with corticosteroid and immunoglobulin has not been successful. Her physician recommend splenectomy. Daria states “I don’t need surgery. This will go away on its own”.

A. Beneficence

B. Justice

C. Autonomy

D. Advocacy

83. Zorayda is terminally ill and is experiencing sever pain. She has bone and liver metastasis. She has been on morphine for several months now. Zorayda is aware that they are having financial problems. She decides to sign DNR form,. What ethical principle did Zorayda and her family utilize as basis for their decision to sign a DNR.

A. Justice

B. Autonomy

C. Advocacy

D. Beneficence

84. Tricia, a staff nurse working in a cancer unit, is considered a role model not only by her colleagues but also by her patients. She goes out of her way to help other. She is very active in their professional organization and he practices what she teaches. What ethical principles is she practicing?

A. Beneficence

B. Justice

C. Autonomy

D. Advocacy

85. You are commuting to work riding the LRT. An older person collapsed and nobody seems to notice her. The security guard tried to make ker sit down but she remained unconscious. You saw what happened and you decided to help. With help, you brought the patient to the nearest hospital. You learned later that woman was diabetic. She was on her way To the diabetes clinic to have fasting blood sugar tested. She developed hypoglycemia. You were able to save a life. You felt good. What principle was applied?

A. Advocacy

B. Beneficence

C. Justice

D. Autonomy

Situation – Ensuring safety before, during, and after a diagnostic procedure is an important responsibility of the nurse

86. To help Fernan better tolerate the bronchoscopy, you should instruct him to practice which of the following prior to the procedure?

A. Clenching his fist every 2 minutes

B. Breathing in and out through the nose with his mouth open

C. Tensing the shoulder muscles while lying on his back

D. Holding his breath periodically for 30 seconds

87. Following bronchoscopy, which of the following complains to Fernan should be noted as possible complication:

A. Nausea and vomiting

B. Shortness of breath and laryngeal stridor

C. Blood tinged sputum and coughing

D. Sore throat and hoarseness

88. Immediately after bronchoscopy, you instructed Fernan to:

A. Exercise the neck muscles

B. Breathe deeply

C. Retrain from coughing and talking

D. Clear his throat

89. Thoracentesis may be performed for cytologic study of pleural fluid. As a nurse your most important function during procedure is to:

A. Keep the sterile equipment from contamination

B. Assist the physician

C. open and close the three-way stopcock

D. Observe the patient’s vital signs

90. Right after thoracentesis, which of the following is most appropriate intervention?

A. Instruct the patient not to cough or deep breathe for two hours

B. Observe for symptoms of tightness of chest or bleeding

C. Place an ice pack to the puncture site

D. Remove the dressing to check for bleeding

Situation – Brain tumor, whether malignant or benign, has serious

management implications. As a nurse, you should be able to understand the consequences of the disease and the treatment.

91. You are caring for Conrad who has a brained tumor and increased Intracranial Pressure (ICP). Which intervention should you include in your plan to reduce ICP?

A. Administer bowel softener

B. Position Conrad with his head turned toward the side of the tumor

C. Provide sensory stimulation

D. Encourage coughing and deep breathing

92. Keeping Conrad’s head and neck alignment results in:

A. increased inthrathoracic pressure

B. increased venous outflow

C. decreased venous outflow

D. increased intrabdominal pressure

93. Which of the following activities may increase intracranial pressure (ICP)?

A. Raising the head of the bed

B. Manual hyperventilation

C. Use of osmotic diuretics

D. Valsalva’s maneuver

94. After you asses Conrad, you suspected increased ICP. Your most appropriate respiratory goal is to:

A. maintain partial pressure of arterial O2 (PaO2) above 80 mmHg

B. lower arterial pH

C. prevent respiratory alkalosis

D. promote CO2 elimination

95. Conrad underwent craniotomy. As his nurse, you know that drainage on a craniotomy dressing must be measured and marked. Which findings should you report immediately to the surgeon?

A. Foul-smelling drainage

B. Yellowish drainage

C. Greenish drainage

D. Bloody drainage

Situation – As a nurse you are expected to be competent in utilizing the nursing process in the care of your clients.

96. Getty is receiving chemotherapy for cancer. You review Getty’s laboratory report and note that he has anemia. To which nursing diagnosis should you give the highest priority?

A. Activity intolerance

B. Impaired oral mucous membrane

C. Impaired tissue perfusion, cerebral, cardiovascular, gastrointestinal

D. Impaired tissue integrity

97. An immediate objective for nursing care of an overweight mildly hypertensive client with ureteral colic and hematuria is to decrease:

A. Hypertension

B. Pain

C. Hematuria

D. Weight

98. A difficult problem to deal with when caring for a patient with a partial thickness burns sustained 3 days ago is:

A. Alteration in body image

B. Maintenance of sterility

C. Frequent dressing change

D. Severe pain

99. Which outcome criterion would be appropriate for a client with a nursing diagnosis of effective airway clearance?

A. Continued use of oxygen when necessary

B. Breath sound clear on auscultation

C. Respiratory rate of 24/min

D. Presence of congestion

100. Which assessment would be most supportive of the nursing diagnosis, impaired skin integrity related to purulent drainage?

A. Heart rate of 88 beats/min

B. Dry and intact wound dressing

C. Oral temperature

D. Wound healing by first intention