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 41-55

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.

41. Hypoxia may occur in the older patients because of which of the following

physiologic changes associated with aging.

A. Ineffective airway clearance

B. Decreased alveolar surfaced area

C. Decreased anterior-posterior chest diameter

D. Hyperventilation

42. The older patient is at higher risk for incontinence because of:

A. dilated urethra

B. increased glomerular filtration rate

C. diuretic use

D. decreased bladder capacity

43. Merle, age 86, is complaining of dizziness when she stands up. This may

indicate:

A. dementia

B. a visual problem

C. functional decline

D. drug toxicity

44. Cardiac ischemia in an older patient usually produces:

A. ST-T wave changes

B. Very high creatinine kinase level

C. Chest pain radiating to the left arm

D. Acute confusion

45. The most dependable sign of infection in the older patient is:

A. change in mental status

B. fever

C. pain

D. decreased breath sounds with crackles

Situation – A “disaster” is a large-scale emergency—even a small emergency left unmanaged may turn into a disaster. Disaster preparedness is crucial and is everybody’s business. There are agencies that are in charge of ensuring prompt response. Comprehensive Emergency Management (CEM) is an integrated approach to the management of emergency programs and activities for all four emergency

phases (mitigation, preparedness, response, and recovery), for all types of emergencies and disasters (natural, man-made, and attack) and for all levels of government and the private sector.

46. Which of the four phases of emergency management is defined as “sustained action that reduces or eliminates long-term risk to people and property from natural hazards and their effects.”?

A. Recovery

B. Mitigation

C. Response

D. Preparedness

47. You are a community health nurse collaborating with the Red Cross and working with disaster relief following a typhoon which flooded and devastated the whole province. Finding safe housing for survivors, organizing support for the family, organizing counseling debriefing sessions and securing physical care are the services you are involved with. To which type of prevention are these activities included:

A. Tertiary prevention

B. Primary prevention

C. Aggregate care prevention

D. Secondary prevention

48. During the disaster you see a victim with a green tag, you know that the person:

A. has injuries that are significant and require medical care but can wait hours with

threat to life or limb

B. has injuries that are life threatening but survival is good with minimal

intervention

C. indicates injuries that are extensive and chances of survival are unlikely even

with definitive care

D. has injuries that are minor and treatment can be delayed from hours to

Days

49. The term given to a category of triage that refers to life threatening or potentially life threatening injury or illness requiring immediate treatment:

A. Immediate

B. Emergent

C. Non-acute

D. Urgent

50. Which of the following terms refer to a process by which the individual receives education about recognition of stress reaction and management strategies for handling stress which may be instituted after a disaster?

A. Clinical incident stress management

B. Follow-up

C. Debfriefing

D. Defusion

Situation – As a member of the health and nursing team you have a crucial role to play in ensuring that all the members participate actively is the various tasks agreed upon.

51. While eating his meal, Matthew accidentally dislodges his IV lines and bleeds. Blood oozes on the surface of the over-bed table. It is most appropriate that you instruct the housekeeper to clean the table with:

A. Acetone

B. Alcohol

C. Ammonia

D. Bleach

52. You are a member of the infection control team of the hospital. Based on a feedback during the meeting of the committee there is an increased incidence of pseudomonas infection in the Burn Unit (3 out of 10 patients had positive blood and wound culture). What is your priority activity?

A. Establish policies for surveillance and monitoring

B. Do data gathering about the possible sources of infection (observation,

chart review, interview).

C. Assign point persons who can implement policies.

D. Meet with the nursing group working in the burn unit and discuss problem with

them.

53. Part of your responsibility as a member of the diabetes core group is to getreferrals from the various wards regarding diabetic patients needing diabetes education. Prior to discharge today, 4 patients are referred to you. How would you start prioritizing your activities?

A. Bring your diabetes teaching kit and start your session taking into consideration

their distance from your office

B. Contact the nurse in-charge and find out from her the reason for the referral

C. Determine their learning needs then prioritize

D. Involve the whole family in the teaching class

54. You have been designated as a member of the task force to plan activities for the Cancer Consciousness Week. Your committee has 4 months to plan and implement the plan. You are assigned to contact the various cancer support groups in your hospital. What will be your priority activity?

A. Find out if there is a budget for this activity

B. Clarify objectives of the activity with the task force before contacting the

support groups

C. Determine the VIPs and Celebrities who will be invited

D. Find out how many support groups there are in the hospital and get the contact

number of their president

55. You are invited to participate in the medical mission activity of your alumni association. In the planning stage everybody is expected to identify what they can do during the medical mission and what resources are needed. You thought it is also your chance to share what you can do for others. What will be your most important role where you can demonstrate the impact of nursing in health?

A. Conduct health education on healthy life style

B. Be a triage nurse

C. Take the initial history and document findings

D. Act as a coordinator