Excelsior Chronicity Practice Exam #1

Front 1

A nurse is teaching a group of older adults techniques to promote medication safety. Which statement made by the older adult indicates the teaching is ineffective?

Back 1

"My daughter knows the reason why I take each of my medications and I think that's okay."

Front 2

The family of a 78-year old patient complains to the nurse that the patient is up and wandering around the house all hours of the night and is disturbing everyone's sleep. Which response should the nurse use initially?

Back 2

"What does he do during the day?"

Front 3

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

Back 3

Young African Americans are screened for HTN.

Front 4

Which part of a functional assessment can be assigned to an unlicensed assistive personnel?

Back 4

vital signs

Front 5

Which statement best teaches an older adult about safety issues related to driving?

Back 5

Turn the head to side to side to compensate for peripheral vision.

Front 6

A nurse is screening healthy adolescents for health risks. Which factor should be included in this screening?

Back 6

suicide

Front 7

a 49-year old divorced female is in the clinic for a routine PE. Which statement indicates the need for further screening during the examination?

Back 7

"I do not use protection since I have gone through menopause."

Front 8

An 89-year old patient states, "I live alone and I have little money. On sunny days, I don't use my AC. I don't like to get a flu shot." What nursing Dx would be priority when using Maslow's hierarchy of needs?

Back 8

ineffective thermoregulation

Front 9

An 80-year old patient has a neuromuscular impairment with very little fine motor improvement. Which nursing Dx is priority for this patient?

Back 9

self-care deficit: dressing

Front 10

Which activity should a nurse suggest to a mother of a 2-1/2 year-old child?

Back 10

jumping using both feet

Front 11

Which instructions would a nurse provide to a mother to instruct how to do a cooling sponge bath for her 5-year daughter whom has a fever of 102?

Back 11

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

Front 12

A patient expresses interest in mind-body therapies to increase the release of insulin from the pancreas to improve his diabetes. Which therapy would the nurse recommend?

Back 12

yoga

Front 13

For which patient would a back massage as a comfort measure be most appropriate?

Back 13

patient who is experience sleeping difficulty

Front 14

An adult patient reports not sleeping well at night. Which instruction should the nurse provide the patient to promote restful sleep?

Back 14

Limit alcohol intake in the evening.

Front 15

A patient is experiencing a pulsating sensation in relation to a noxious stimulus. Which nursing Dx is appropriate for this patient?

Back 15

impaired comfort

Front 16

Which self-healing methods should nurses use to foster their own health and well-being?

Back 16

Challenge the belief that others always come first.

Front 17

Which instructions should the nurse include in the teaching plan of a patient with diabetes who asks about the application of an ice pack for chronic knee discomfort?

Back 17

"You are at risk for not being able to feel the temperature of a cold pack, which could cause tissue damage."

Front 18

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

Back 18

teachin patients about making health care decisions

Front 19

Which nursing action best promotes warmth and sleep for an older adult patient?

Back 19

Use flannel sheets on the bed.

Front 20

A CNA is giving hygiene care to an older African American who has impaired comfort related to itching skin, The CNA asks what can be done to help this patient. What is the nurse's most appropriate response?

Back 20

Apply a lanolin-based lotion.

Front 21

The nurse is caring for a patient who is receiving an NSAID. The nurse should give priority to which nursing Dx?

Back 21

risk for injury related to GI irritation

Front 22

A patient is receiving MSO4 via PCA pump. The patient states, "I've been pushing the button and I still have pain." The nurse should take which initial action?

Back 22

Check to ensure that the pump is properly programmed.

Front 23

The nurse assesses a patient who reports experiencing intermittent pain for the past two months. Which clinical Euphoria manifestation will be present?

Back 23

decreased appetite

Front 24

The nurse teaches the family of a patient who is being cared for at home how to manage the patient's pain. Which finding would best indicate that the nurse's teaching was sucessful?

Back 24

The patient indicates satisfaction with pain control options.

Front 25

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

Back 25

how the pain affects self-care abilities

Front 26

How does a TENS unit relieve pain?

Back 26

blocks small nerve fibers by stimulating large ones

Front 27

Which assessment of a 4-year old with severe abdominal pain will provide objective info as to the exact location of the pain?

Back 27

Have the patient point to where the pain is felt.

Front 28

A patient is receiving a narcotic analgesic via an epidural catheter. Which clinical manifestation indicates a possible side effect of this therapy?

Back 28

urinary retention

Front 29

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

Back 29

gate control

Front 30

Which statement reflects an unbiased understanding of pain?

Back 30

Euphoria is an expected side effect of proper analgesic control.

Front 31

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

Back 31

the patient's efforts to manage the chronic illness

Front 32

Which nursing action is a priority when caring for a patient with a chronic disease?

Back 32

provide supportive assistance for management of care

Front 33

Which data supports the nursing Dx of altered growth and development related to chronic illness?

Back 33

The parent plans the daily activity schedule of a 13-year old.

Front 34

A patient with chronic illness says to the nurse, "You know I'm not sick now, I feel better each day." How should the nurse interpret the patient's statement? Patients who respond this way

Back 34

see themselves as sick when the illness interferes with their daily functioning

Front 35

Which nursing action assures that a caregiver safely administers medications through a PEG tube?

Back 35

Flush tube with clear water between administrations of medications.

Front 36

Which clinical manifestation in a patient with CF causes the greatest disruption in the adolescent's ability to successfully attain Erikson's stage of identity vs. role confusion?

Back 36

chronic cough

Front 37

The nurse provides care for a patient who has just been placed in an extended care facility. The pt is A&O and able to do limited self-care. Which pt attribute would be most likely to contribute positively to the pt's adaption to loss of independence?

Back 37

an active and strong spirituality

Front 38

Which statement by a pt regarding advanced directives indicates that the pt understands their use?

Back 38

"If I have a stroke, I do not want CPR or a ventilator, so I signed an advanced directive."

Front 39

During a home visit, the nurse notices that the pt is lying in a urine-soaked bed and areas of inflammation appear on the pt's buttocks and elbows. The caregiver appears tired and states that they are doing their best for the pt, but they are just overwhelmed. What would be the appropriate intervention?

Back 39

Suggest respite care for the pt.

Front 40

Which statement made by the pt on long-term anti-coag therapy indicates that the nurse needs to provide the pt with extra info?

Back 40

"I use laxatives as needed to keep my stools soft."