Chronicity Practice Exam

Front 1

Which Nursing action best relieves stress for a newly admitted dying patient and his family?

Back 1

Stay At the bed-side as much as possible.

Rationale: Nurse needs to be available to demonstrate presence and Caring.

Front 2

What statement shows that a family member correctly understands the transplant coordinators exlination on organ donation.

Back 2

" Im glad the casket can remain open"

Rationale: Body is not mutilated in any way if it undergoes organ harvesting/transplant, therefore casket can be open.

Front 3

When assessing the signifigance of a loss, who provides the most information?

Back 3

The patient

Rationale: As with other symptoms such as pain, fatigue it is importation to obtain the patients own perception of loss.

Front 4

what description best describes a substantial resolution of grieving?

Back 4

Brief periods of intense feelings may occur at signifigant times.

Rationale: A person who has reached resolution of a particular loss/grief can still expect to have brief but strong feelings, ie @ anniversaries.

Front 5

Which psychosocial nursing intervention best supports a dying patients prefernces?

Back 5

Explore meanings, relationships, and hope with the patient.

Rationale: Fisher and mitchell reported that exploring " meaning, realtionships, and hope with clients creates new self-perceptions for clients.

Front 6

Which is a belief in the hispanic culture related to the care of a dying patient?

Back 6

The patient does not need to know the prognosis

Rationale: Reaserch has found that in hispanice culture the patient is protected from the prognosis

Front 7

The nurse is developing a care plan for a family with a nursing diagnosis of anticipiatory grieving related to a dx of advanced ovarian cancer in the mother. The nurse should consider which intervention to be of primary importance?

Back 7

Establish a trusting relationship

Rationale: this is the first step in developing the care plan.

Front 8

What is the first step the community based nurse would take when preparing a middle school eduational program on sexually transmitted disease?

Back 8

Inform school officials

Rationale: the nurse needs to consult school officals first and receive support for the program.

Front 9

When is the most appropriate time to discuss termination of home care with the patient and family?

Back 9

During the initial visit.

Discussion of termination of care begins in the introductory phase of a helping relationship. This is the time to establish a contract indicicating obligations of the patient and nurse.

Front 10

Which instruction for the care-giver of a child with asthma would the community health nurse include during a home visit?

Back 10

Clean bare floors with wet mop once a week.

Rationale: wet mop bare floors weekly. This decreases the presence of allergens

Front 11

Which patient statment about vision is of greatest conern to the nurse?

Back 11

" I now have a shadow spreading over oone eyes vision."

Rationale: This would indicate retinal detachment, which is an emergency.

Front 12

Following a trauma to the eye, a patient experinces a mild hyphema. The nurse instructs the patient to maintain an upright position and rest in bed for a few days. Which rationale supports this invervention?

Back 12

This postion enhances the pooling of blood in the anterior chamber.

Rationle: Bed rest in fowlers postion is recommended so that gravity can aid in keeping hyphema awary from the optical center of the cornea.

Front 13

Explain what hyphema is, how it is reconized and poteintial causes.

Back 13

Hyphema is a pooling or collection of blood inside the anterior chamber of the eye. This is the space between the cornea and the iris. The blood may cover most or all of the iris and the pupil, blocking vision partially or completely.

Hyphema is usually painful. If left untreated, it can cause permanent vision problems.

Hyphema is usually caused by trauma to the eye and is accompanied by an increase in intraocular pressure. It is possible for it to appear without warning in children with sickle cell anemia or hemophilia.

Front 14

A patient who has moderate hearing loss is recieving insturctions from the nurse on the correct use of a new in the ear hearing aid. Which response made by the pateint indicates a need for further instructions?

Back 14

" a whistling sound means that my hearing aid needs to be cleaned."

Rationale: A constant whistling sound means that the battery is functioing. The sound may be associated with improperly fitted or worn ear mold.

Front 15

Mydriatics are used during eye surgery for which purpose?

Back 15

Mydriatics are used to induce relaxation of the ciliary muscle.

Rationale: this is the action of mydriatics.

Front 16

Which disorder is associated with a conductive hearing loss of the middle ear?

Back 16

Eustachian tube dysfuction.

Rationale: Eustachian tube ostruction leads to otitis media, which in turn can cause conductive hearing loss of the middle ear.

Front 17

Which is an appropriate nursing diagnosis for a patient with vertigo?

Back 17

Risk for fluid volsume decicit related to increased fluid out-put, alterted intake, and mediations.

Rationale: Ninety five percent of patients with vertigo experince nausea and vomiting and are at risk for fluid volume decicit. In the patients whose vertigo is due to mineres disease, tx is likley to involve the use of diuretics and vasodilators and changes in dietary habits including redistribution of intake throughout the day.

Front 18

What are the symptoms of acute angle closure glaucoma?

Back 18

Symptoms of acute-angle closure glaucoma are pain and halo vison.

Rationale: Obstruction to the aqueous humor outflow causes an increase in intraocular pressure which is manifested by pain and conjunctival hyperemia. Peripehral vison may be better than central vision.

Front 19

Sustained noise at what level can lead to progressive hearing loss?

Back 19

90 decibles.

Rationale: Sustained noise levels between 85 & 95 decibles begin to pose a danger to hearing.

Front 20

The nurse teaches the patient with glaucoma to take the prescribed medicationin order to prevent which adverse effect?

Back 20

An increased loss of peripheral vision.

Rationale: Taking prescribed medications will lower the intraocular pressure and prevent further loss of peripheral vision which will impair mobility.

Front 21

Based on the goals of HEALTY PEOPLE 2010, a nurse focuses health screening for which group?

Back 21

Young african americans are screened for HTN

Rationale: Health disparities in minorities should be addressed. Young minority adults are @ risk for HTN.

Front 22

Which activity should a nurse suggest to a mother of a normal two and a half year old child?

Back 22

Jumping and using both feet.

Rationale: This is an appropriate expectation of a toddler.

Front 23

Which statment best teaches an older adult about saftey issues related to driving?

Back 23

Turn the head side to side before changing lanes to compensate for peripheral vision.

Rationale: Periperal vision is diminished in elders.

Front 24

Which is the most important reason for the nurse to include a cultural assesment as part of the patients health hx?

Back 24

Information about the patients cultural practices facilitates planning and treatment for the patient.

Rationale: A tx regimen that takes a patients cultural beliefs and practices into consideration is more likley to be successful.

Front 25

The wife of a native american patient tells the nurse that her husband is very depressed about his illness. Which nursing diagnosis would be most appropriate in this situation?

Back 25

Spiritual distress related to perception of disharmoney with nature

Rationale: Native Americans often define illness as a state of disharmoney with nature and the universe and a disturbance in the belief system what typicall provides strength, hope and meaning to life.

Front 26

A hispanice American patient requests that a curandero be involved in the tx. What fact should the nurse know about the traditional role of the curandero before formulating a plan of care for the patient?

Back 26

Involves the patients entire family in the tx plan of the patient.

Rationale: the curandero is a healer in the community who involves the family and who provides care in the patients home.

Front 27

The nurse ***** a patient who reports experinceing intermitent pain for the past two months. Which clinical manifestation will be present?

Back 27

Decreased appetite.

Rationale: Decreased appetite is a behavioral response often reported by patients with chronic pain

Front 28

Using a backrup to reduce pain intensity is based on which theory?

Back 28

gate control theory.

Rationale: In gate control theory, the transmission of the pain impulses to the brain can be interuppted by interventions such as heat, cold and pressure.

Front 29

Which statment reflects an un-biases understanding of pain?

Back 29

Euphoria is an expected side effect of proper analgesic control.

Rationale: Euphoria is experinced when adequate doses of narcotic analgesics are used.

Front 30

The nurse is planning home care for a patient with chronic pain related to degeneration of the vertebrae. Which assesment is a priority?

Back 30

How the pain affects self care abilities.

Rationale: it is a priority to ***** how the pain affets the patients self care abilities b/c of the pain interfers with the patients ability for self care, the patient may not be able to continue living in the home.

Front 31

The nurse provides care for a patient who has just been placed in an extended care facility. The patient is alert, oriented, and able to do limited self care. Which patient attribute would most likley contirbute postiviley to the patients adapation to the loss of independence?

Back 31

An active and strong spirituality

Rationale: A patient who has secure spiritual reserves is better able to cope with physical and mental challenges, including the loss of independence.

Front 32

Which clinical manifestation in an adolescent with systic fibrosis causes the greatest disruption in the adolescents ability to successfully attain Ericksons stage of idenity vs. role confusion?

Back 32

Chronic cough.

Rationale: An adolescent with a chronic cough will have an especially hard time being accepted and valued by peers.

Front 33

A patient with chronic illness has delveloped complications. Which factor is important for the nurse to *****?

Back 33

The patients efforts to manage the chronic illness.

Rationale: Knowing what measures the pt has already taken to manage the illness will best enable the nurse to plan effectively with the patient and health care team for dealing with the complications.

Front 34

A patient with a chronic illness says to the nurse, " You know im not sick now. I feel better each day." How should the nurse interpert the patients statment?

Back 34

See themselves as sick when disease interferes with their daily functioing.

Rationale: Patients who have adapted to their chronic illness view themselves as sick only when the symptoms interfere with their ability to functiong on a daily basis.

Front 35

Which nursing action would create a healing environment that would best facilitate feelings of self-worth in patients in a long term care facility?

Back 35

Teaching patients about health care decisions.

Rationale: Providing patients with knowledge and skills to empower them to make their health care decisions enhances their self worth.

Front 36

An adult patient reports not sleeping well at night. Which instructions shourld the nurse give the patient to promote restful sleep?

Back 36

Limit alchol intake in the evening.

Rationale: Excessive alcohol distrupts REM sleep, although it may hasten the onset of sleep.

Front 37

Which self healing method should nurses use to foster their own well being?

Back 37

Challenge the belief that others always come first.

Challenging the belief that others always come first is a healing strategy when the nurse feels over-involved with patients. Nurses need to replinish their own energy through creating a healing environent for themselves.

Front 38

Which instructions would the nurse provide to a mother asking about how to do a cooling sponge bath for her five year old daughter who has a fever of 102 degrees.

Back 38

Discontinue the bath if the child shivers during the sponge bath.

Rationale: If the child shivers this may indicate that the temperature if falling too quickley and the childs body may not be able to handle the change so rapidly. The bath shoud be discontinued if the child becomes pale or cyonotic or the pulse becomes rapid or irregular.