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 71 - 85

Situation - Specific surgical interventions may be done when lung cancer is detected early. You have important peri-operative responsibilities in caring for patients with lung cancer.

71. Horace underwent lobectomy. Which of following is the purpose of Horace’s closed chest drainage post lobectomy:

a. expansion of the remaining lung

b. facilitation of coughing

c. prevention of mediastinal shift

d. promotion of wound healing

72. Which of the following observations indicates that the closed chest drainage system is functioning properly?

A. absence of bubbling in the suction-control bottle

B. the fluctuating movement of fluid in the long tube of the water-seal bottle during inspiration

C. intermittent bubbling through the long tube of the suction control bottle.

D. less than 25 ml drainage in the drainage bottle

73. Following lobectomy, you can BEST help Horace to reduce pain during the deep breathing and coughing exercises by:

A. placing the patient on his/her operative side during exercises

B. splinting the patient’s chest with both hands during the exercises

C. administering the prescribed analgesic immediately prior to exercises

D. providing rest for 6 hours before exercises

74. Peter underwent pneumonectomy. During the immediate post operative period, deep tracheal suction should be done with extreme caution because:

A. Peter will not be able to tolerate coughing

B. the tracheobronchial trees are dry

C. the remaining normal lung needs minimal stimulation

D. the bronchial suture line maybe traumatized

75. On which of the following positions should you place Peter who just underwent pneumonectomy?

A. Prone position

B. On his abdomen or on the side opposite the surgery

C. On his back or on the side of surgery

D. Any position is acceptable

Situation – Mang Felix, a 79 year old man who is brought to the Surgical Unit from PACU after a transurethral resection. You are assigned to receive him. You noted that he has a 3-way indwelling catheter for continuous fast dip bladder irrigation which is connected to a straight drainage.

76. Immediately after surgery, what would you expect his urine to be?

A. Light yellow

B. Amber

C. Bright red

D. Pinkish to red

77. The purpose of the continuous bladders irrigation is to:

A. Allow continuous monitoring of the fluid output status

B. Provide continuous flushing of clots and debris from the bladder

C. Allow for proper exchange of electrolytes

D. Ensure accurate monitoring of intake and output

78. Mang Felix informs you that he feels some discomfort on the hypogastric area and he has to void. What will be your most appropriate action?

A. Remove his catheter then allow him to void his own

B. Irrigate his catheter

C. Tell him “Go ahead and void. You have an indwelling catheter”

D. Assess color and rate of outflow, if there is a change refer to urologist for possible irrigation

79. You decided to check on Mang Felix’s IV fluid infusion. You noted in flow rate, pallor and coldness around the insertion site. What is your assessment finding?

A. Phlebitis

B. Infiltration to subcutaneous tissue

C. Pyrogenic reaction

D. Air embolism

80. Knowing that proper documentation of assessment findings and interventions share important responsibilities of the nurse during first post operative days, which of the following is the LEAST relevant to document in the case of Mang Felix?

A. Chest pain and vital signs

B. Intravenous infusion rate

C. Amount, color and consistency of bladder irrigation drainage

D. Activities of daily living started

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