NURSING

Question 12

A patient experiencing immotile cilia syndrome should be frequently assessed by the nurse for which priority complication?

Answers:

A. Epistaxis resulting from loss of cilia in the nasal passageway

B. Sterility caused by inability of the sperm to swim downstream

C. Bronchiectasis due to interferences with clearance of inhaled bacteria along the respiratory tract

D. Inability to hear soft sounds related to kinocilium on the hair cells in the inner ear

Question 13

The unique clinical presentation of a 3-month-old infant in the emergency department leads the care team to suspect botulism. Which of the following assessment questions posed to the parents is likely to be most useful in the differential diagnosis?

Answers:

A. “Is there any mold in your home that you know of?”

B. “Is there any family history of neuromuscular diseases?”

C. “Has your baby ever been directly exposed to any chemical cleaning products?”

D. “Have you ever given your child any honey or honey-containing products?”

Question 14

In the context of a workshop on rheumatoid arthritis, a clinical educator is teaching a group of nurses about autoimmune diseases. Which of the following statements by an attendee would the educator most likely want to follow up with further teaching?

Answers:

A. “Often the problem can be traced to antigens that sensitize T cells without the need for presentation.”

B. “In some cases, the body attacks its own cells that are chemically similar to those of infectious organisms.”

C. “Introduction of a foreign antigen can sometimes induce a cascade of immune response that is not self-limiting”

D. “Sometimes when the body’s own cells are released after a long time, they are interpreted as being foreign.”

Question 15

Which of the following pregnant women has most likely encountered the greatest increase in the risk that her child will have a fetal anomaly?

Answers:

A. A woman with diagnoses of syphilis and cirrhosis of the liver

B. A woman who has herpes simplex and who has recently recovered from endocarditis

C. A woman with chronic obstructive pulmonary syndrome and tuberculosis

D. A woman with diagnoses of insulin-dependent diabetes mellitus and peripheral neuropathy

Question 16

In which of the following individuals would a clinician most suspect multiple myeloma as a diagnosis?

Answers:

A. A 70-year-old woman whose blood work reveals large numbers of immature granulocytes

B. A 68-year-old former coal miner who has white cell levels exponentially higher than normal ranges

C. A 40-year-old man who has had three broken bones over the past 6 months and whose serum calcium and creatinine levels are elevated

D. An 81-year-old male resident of a long-term care home who has an uncommon bacterial pneumonia and who is unable to produce a fever

Question 17

A group of novice nursing students are learning how to manually measure a client’s blood pressure using a stethoscope and sphygmomanometer. Which of the following statements by students would the instructor most likely need to correct?

Answers:

A. “If my client’s arm is too big for the cuff, I’m going to get a BP reading that’s artificially low.”

B. “I’ll inflate the cuff around 30 mm Hg above the point at which I can’t palpate the client’s pulse.”

C. “The accuracy of the whole process depends on my ability to clearly hear the Korotkoff sounds with the bell of my stethoscope.”

D. “With practice, my measurement of clients’ blood pressures with this method will be more accurate than with automated machines.”

Question 18

A physician is explaining to a 40-year-old male patient the importance of completing his course of antibiotics for the treatment of tuberculosis. The physician explains the damage that could occur to lung tissue by Mycobacterium tuberculosis. Which of the following phenomena would underlie the physician’s explanation?

Answers:

A. Tissue destruction results from neutrophil deactivation.

B. Macrophages form a capsule around the Mycobacterium tuberculosis bacteria, resulting in immune granulomas.

C. Neutrophils are ineffective against the Mycobacterium tuberculosis antigens.

D. Nonspecific macrophage activity leads to pulmonary tissue destruction and resulting hemoptysis.

Question 19

0 out of 1 points

A student makes the statement to a colleague, “Blood plasma is essentially just a carrier for the formed elements like red blood cells and white blood cells.”What would be the most accurate response to this statement?

Answers:

A. “Not really. Plasma also contributes to the processes of protein synthesis and hematopoiesis.”

B. “Actually, plasma is integral to the proper function of the liver and maintenance of acid–base balance.”

C. “Actually, plasma plays a significant role in nutrient and waste transport.”

D. “That’s not really true. Plasma is crucial in the immune and inflammatory responses.”

Question 20

A number of clients have presented to the emergency department in the last 32 hours with complaints that are preliminarily indicative of myocardial infarction. Which of the following clients is least likely to have an ST-segment myocardial infarction (STEMI)?

Answers:

A. A 70-year-old woman who is complaining of shortness of breath and vague chest discomfort

B. A 66-year-old man who has presented with fatigue, nausea and vomiting, and cool, moist skin

C. A 71-year-old man who has moist skin, fever, and chest pain that is excruciating when he moves but relieved when at rest

D. A 43-year-old man who woke up with substernal pain that is radiating to his neck and jaw

Question 21

In which of the following situations would blood most likely rapidly relocate from central circulation to the lower extremities?

Answers:

A. A client does isotonic exercises in a wheelchair.

B. A client reclines from a sitting to supine position.

C. A client is helped out of bed and stands up.

D. A client undergoes a stress test on a treadmill.

Question 22

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