NR606 Midterm Exam Questions and Answers

NR606 Midterm Exam Questions and Answers Before modifying a care plan to meet a patient's changing needs, the nurse's first action should be to: A. re-do the entire care plan B. focus only on the nursing diagnoses with moderate priority C. assess/reassess the patient's responses to interventions D. add more nursing interventions from a standardized plan of care C. assess/reassess the patient's responses to interventions True or False: Actual or potential health problems that can be prevented or resolved by dependent nursing intervention are termed nursing diagnoses. True Objective data is usually recorded: A. by body systems. B. after the assessment and plan. C. before the health history. D. in the problem list. A. by body systems The examiner's evaluation of a patient's mental status belongs in the: A. history of present illness. B. review of systems. C. physical examination. D. patient education. C. physical examination. Which following component is not related to the format of nursing diagnosis? A. Problem B. Etiology C. Sign and Symptom D. Pain D. Pain Differential diagnoses belong in the: history. assessment. plan. laboratory data. Assessment Which of the following outcome statements contains the best example of performance criteria? The patient will Turn herself in bed frequently while awake Understand how to use crutches by Day 2 State that pain is decreased after being medicated Eat 75% of each meal without complaint of nausea Eat 75% of each meal without complaint of nausea True or False: Nursing assessments have the same components as medical assessment, but with less detail. False A patient tells the nurses that he is nervous, he is nauseated and he "feels hot". This type of data would be: objective reflective subjective introspective Subjective A 42-year-old Asian patient is being seen at the clinic for an initial examination. The nurse knows that it is important to include cultural information in his health assessment to: Identify the cause of his illness Make accurate disease diagnoses Provide cultural health rights for the individual Provide culturally sensitive and appropriate care Provide culturally sensitive and appropriate care When questioning a patient regarding alcohol intake, she tells you that she is "only a social drinker." Which initial response is appropriate? I am glad that you are a responsible drinker Many people who are really alcoholic say they are social drinkers What amount and what kind of alcohol do you drink in a week? If you only drink socially, you won't need a designated driver What amount and what kind of alcohol do you drink in a week? True or False: Carrying out a physician-initiated order is an example of an independent nursing action. False Where would you document that a patient had a flu vaccination last month? HPI (History of Present Illness) section of the SOAP note Past Medical History section of the SOAP note Reveiw of systems section of the SOAP note Objective data section of the SOAP note Past Medical History section of the SOAP note Which of the following questions may lead to an inaccurate patient response? "Where do you feel the pain?" "How does this situation make you feel?" "What happened after you noticed the injury?" "That was a horrible experience, wasn't it?" "That was a horrible experience, wasn't it?" The nurse is performing a physical assessment on a newly admitted patient. An example of objective information obtained during the physical assessment includes the: Patient's history of allergies Patient's use of medications at home Last menstrual period 2x5 cm scar present on the right lower forearm 2x5 cm scar present on the right lower forearm The review of systems is a component of the: Physical examination. Health history. Past medical/surgical history. Personal/social history. Health history True or False: Clearly identifying patient strengths and actual and potential problems is a part of the nursing process known as assessing. False A detailed description of the symptoms related to the chief concern is presented in the: History of present illness. Differential diagnosis. General patient information section. Past medical history. History of present illness. A patient presents with abdominal cramping. From the options below, which would be the most appropriate section document that the patient denies any diarrhea? Subjective: Review of systems section Objective section Assessment section Plan section Subjective: Review of systems section True or False: A focused assessment is conduced to gather data abut a specific problem that has already been identify True New drug development is good at determining: efficacy safety side effects toxicity efficacy The student nurse asks the nursing instructor why he needs to take anatomy and physiology, as well as microbiology, when he only wants to learn about pharmacology. What is the best response by the instructor? "Because pharmacology is an outgrowth of those subjects" "You must learn all, since those subjects, as well as pharmacology, are part of the curriculum." "Knowledge of all those subjects will prepare you to provide the best patient care, including the administration of medications." "Because an understanding of those subjects is essential to understanding pharmacology." "Because an understanding of those subjects is essential to understanding pharmacology." When giving drugs by the intramuscular route, absorption depends upon: Amount of subcutaneous fat Blood flow to the site of injection Lipid solubility of the drug blood flow to the site of injection The first pass effect can cause a drug to be Eliminated from the body completely Inactivated before reaching the bloodstream Made more potent before being absorbed into the bloodstream Inactivated before reaching the bloodstream Drugs that produce effects by preventing receptor activation but have no effects of their own on receptor function are called Agonists Antagonists Mimetics Antagonists Half life is used to predict and interpret Absorption Change in plasma concentration Saturation time for receptors Change in plasma concentration The cytochrome P450 system is found in the Kidney Liver Thymus Brain Liver Drugs that cross the blood-brain barrier are Bound to albumin Lipid soluble Water soluble Lipid soluble Passage of a drug from the site of administration into the circulation is Absorption Bioavailability Distribution Absorption The half life of a drug is two hours. At four hours, the expected concentration of the drug is 0% 25% 50% 25% Drugs are available to exert their effect on the cell when they are Bound to albumin Dissolved in lipids Unbound to albumin (free) Unbound to albumin (free) Maximum efficacy refers to the: Minimal level needed to have an effect on most people Maximum effect a drug can produce Toxic level of a drug Maximum effect a drug can produce Elimination of drugs happens primarily via the GI tract Kidney Liver Kidney Oral distribution of drugs may vary in the neonate because of Decreased GI transit time Decreased GI surface area in relation to body weight Increased GI blood flow Decreased GI transit time Measuring a trough level of a drug may determine a change in the Dose Interval Route Interval Drugs that activate receptors and mimic the actions of the body's own regulatory molecules are called: Agonists Antagonists Regulators Agonists The therapeutic index refers to the: Amount of drug that it takes to have an effect on the patient Level at which a drug will be toxic to most patients Ratio of the drug's lethal dose to it's effective dose Ratio of the drug's lethal dose to it's effective dose True or false: Clinical trials will determine any adverse effects of a drug before the drug is marketed to health care providers. False True or false: The more potent a drug is, the greater its maximum efficacy False True or false: Infants have the highest overall percentage of body water. True True or false: The two main intracellular fluid (ICF) compartments are the interstitial fluid contained in the nucleus and the intravascular fluid contained in the cell body. False What is the mechanism by which the energy produced from carbohydrates, proteins and lipids is transferred to adenosine triphosphate (ATP)? Anaerobic glycolysis Oxidative cellular metabolism Oxidative phosphorylation Tricarboxylic acid phosphorylation Oxidative phosphorylation True or false: Loss of sodium and gain of water can cause hyponatremia True In hypoxic injury, why does sodium enter the cell and cause swelling? Because the cell membrane permeability increases for sodium during periods of hypoxia Because there is insufficient ATP to maintain the pump that keeps sodium out of the cell Because the lactic acid produced by the hypoxia binds with sodium within the cell Because sodium cannot be transported in the cytosol to the cell membrane during hypoxia Because there is insufficient ATP to maintain the pump that keeps sodium out of the cell What organic compound facilitates transportation across cell membranes by acting as receptors, transport channels for electrolytes, and enzymes to drive active pumps? Lipids Proteolytic cascade Proteins Carbohydrates Proteins The patient has the following arterial blood gas (ABG's) results; pH 7.32, PaCO2 88 mmHg and HCO3 24 mEQ/L. The nurse interprets these results as: Metabolic acidosis Respiratory alkalosis Metabolic alkalosis Respiratory acidosis Respiratory Acidosis Which is a description of the characteristics of apoptosis? A programmed cell death of scattered, single cells Characterized by swelling of the nucleus and cytoplasm Has unpredictable patterns of cell death Results in benign malignancies A programmed cell death of scattered, single cells Under anaerobic conditions, the process of ______________ provides energy for the cell. Oxidative phosphorylation Glycolysis Lactolysis Passive transport Glycolysis Low plasma albumin causes edema as a result of a reduction in which pressure? Capillary hydrostatic pressure Interstitial hydrostatic pressure Capillary oncotic pressure Interstitial oncotic pressure Capillary oncotic pressure True or false: Nondividing cells, such as myocardial fibers, are capable of hypertrophy, but not hyperplasia. True What is the single most common cause of cellular injury? Hypoxic injury Chemical injury Infectious injury Genetic injury Hypoxic injury True or false: Movement of water from the ICF to the ECF is primarily accomplished by active transport. False During cell injury caused by hypoxia, why is there an increase in the osmotic pressure within the cell? Because plasma proteins enter the cell Because the ATPase-driven pump is stronger during hypoxia Because sodium chloride enters the cell Because there is an influx of glucose through the injured cell membranes Because sodium chloride enters the cell True or false: The function of adenosine triphosphate (ATP) is to store energy in molecules of carbohydrates, proteins and lipids, but not to transfer energy from one molecule to another. False Which cells, if any, lose their ability to replicate and divide? None; all cells have the ability to replicate and divide. Cells of the lung and intestinal tract Cells of the skin Cells of the lens of the eye and skeletal muscle Cells of the lens of the eye and skeletal muscle How is insulin used to treat hyperkalemia? Insulin stimulates sodium to be removed from the cell in exchange for potassium. Insulin binds to potassium to remove it through the kidneys. Insulin transports potassium from the blood to the cell along with glucose. Insulin breaks down the chemical components of potassium so that it is no longer effective. Insulin transports potassium from the blood to the cell along with glucose. The movement of fluid across the arterial end of capillary membranes into the interstitial fluid surrounding the capillary is an example of which process of fluid movement? Hydrostatic pressure Osmosis Diffusion Active transport Hydrostatic pressure During acidosis, the body compensates for the increase in hydrogen ions in the blood by shifting hydrogen ions into the cell in exchange for which electrolyte? Oxygen Sodium Potassium Magnesium Potassium During ischemia, what effect does the loss of the adenosine triphosphate (ATP) level have on cells? Cells shrink because of the influx of Ca. Cells shrink because of the influx of KCl. Cells swell because of the influx of NaCl. Cells swell because of the influx of NO. Cells swell because of the influx of NaCl. True or false: DNA directs the synthesis of all of the body's proteins. True True or false: The primary functions of the cell nucleus are cell division and control of genetic information. True True or false: Eukaryotic cells are characterized by a lack of a distinct nucleus, whereas prokaryotic cells have intracellular compartments bordered by membranes and a well-defined nucleus. False Most of a cells genetic information, including RNA and DNA, is contained in the: mitochondria. ribosome. nucleolus. lysosome Nucleolus True or false: The cells of a normal female contain two X chromosomes True True or false: The human genome project has mapped the majority of human genes True True or false: Single-gene disorders are the result of a mutant allele at one gen locus. True True or false: The most common form of inherited mental retardation is fragile Y syndrome. False True or false: Prenatal Screening can be used to rule out fetal abnormalities. False True or false: Th number of chromosomes divides in half during the process of meiosis. True A mother calls the clinic and tells the nurse that her 4-month-old baby has a fever. The mother asks if she can use the liquid acetaminophen (Tylenol) that is used for her 10-year-old child. What is the best response by the nurse? "Infants should not have acetaminophen (Tylenol) because it damages the liver." "It is best if the pediatrician is called; he can be asked this question." "It is fine to use the same medicine for both children." "Infant drops should be used for the baby; they are different from liquid medicine." "Infant drops should be used for the baby; they are different from liquid medicine."