NUR 417 FINAL EXAM QUESTIONS WITH COMPLETE
SOLUTIONS
A cattle rancher with a new onset of fever, chills, and headache
is suspected of being exposed to tularemia. Which medication
will the nurse anticipate being prescribed for this client? Correct
Answers Tularemia post-exposure prophylaxis is recommended
in cases of occupational exposure to infectious materials.
Doxycycline (100 mg orally BID X 10-14 days) is
recommended for prophylaxis in adults, as well as ciprofloxacin
(500 mg orally BID X 7 days) and levofloxacin (500 mg orally
daily X 7 days).
A nurse is providing care for an unconscious patient with a head
injury prescribed IV
mannitol. Which of the following parameters is best for the
nurse to monitor to determine if
the mannitol has been effective?
a. Hematocrit
b. Blood pressure
c. Oxygen saturation
d. Intracranial pressure Correct Answers ANS: D
Mannitol is an osmotic diuretic and will reduce cerebral edema
and intracranial pressure. It
may initially reduce hematocrit and increase blood pressure, but
these are not the best
parameters for evaluation of the effectiveness of the drug.
Oxygen saturation will not directly
improve as a result of mannitol administration.
,A patient contracts hepatitis from contaminated food. During the
acute (icteric) phase of the
patient's illness, which of the following serological findings
should the nurse expect?
a. Antibody to hepatitis D virus (anti-HDV)
b. Hepatitis B surface antigen (HBsAg)
c. Anti-hepatitis A virus immunoglobulin G (anti-HAV IgG)
d. Anti-hepatitis A virus immunoglobulin M (anti-HAV IgM)
Correct Answers ANS: D
Hepatitis A is transmitted through the oral-fecal route, and
antibody to HAV IgM appears
during the acute phase of hepatitis A. The patient would not
have antigen for hepatitis B or
antibody for hepatitis D. Anti-HAV IgG would indicate past
infection and lifelong immunity.
A patient is being treated with a medication to block the effect
of antidiuretic hormone to control the symptoms of syndrome of
inappropriate antidiuretic hormone (SIADH). Which of
the following findings indicates that the medication is effective?
a. Decreased peripheral edema
b. Increased weight
c. Increased urine specific gravity
d. Increased urinary output Correct Answers ANS: D
Agents that block the effect of ADH on the renal tubules may be
prescribed, thereby allowing
more dilution of urine leading to an increased urine output. An
increase in weight or an
increase in urine specific gravity indicates that the SIADH is not
corrected. Peripheral edema
,does not occur with SIADH. A sudden weight gain without
edema is a common clinical
manifestation of this disorder
A patient is brought to the emergency department (ED) by
ambulance after being found
unconscious on the bathroom floor by the partner. Which of the
following actions should the
nurse take first?
a. Obtain oxygen saturation.
b. Check pupil reaction to light.
c. Palpate the head for hematoma.
d. Assess Glasgow Coma Scale (GCS). Correct Answers ANS:
A
Airway patency and breathing are the most vital functions and
should be assessed first. The
neurological assessments should be accomplished next and the
health and medication history
last.
A patient is brought to the emergency department with a knife
impaled in the abdomen
following a domestic fight. During the initial assessment of the
patient, which of the following
actions should the nurse implement?
a. Assess the BP and pulse.
b. Remove the knife to assess the wound.
c. Determine the presence of Rovsing sign.
d. Insert a urinary catheter and assess for hematuria Correct
Answers ANS: A
, The initial assessment is focused on determining whether the
patient has hypovolemic shock.
The knife should not be removed until the patient is in surgery,
where bleeding can be
controlled. Rovsing sign is assessed in the patient with suspected
appendicitis. A patient with
a knife in place will be taken to surgery and assessed for bladder
trauma there.
A patient who is suspected of having an epidural hematoma is
admitted to the emergency
department. Which of the following actions should the nurse
plan to take?
a. Administer IV furosemide.
b. Initiate high-dose barbiturate therapy.
c. Type and crossmatch for blood transfusion.
d. Prepare the patient for immediate craniotomy. Correct
Answers ANS: D
The principal treatment for epidural hematoma is rapid surgery
to remove the hematoma and
prevent herniation. If intracranial pressure (ICP) is elevated after
surgery, furosemide or highdose barbiturate therapy may be
needed, but these will not be of benefit unless the hematoma
is removed. Minimal blood loss occurs with head injuries, and
transfusion is usually not
necessary
A patient who is unconscious after a fall from a ladder is
transported to the emergency
department by family members. During the primary survey of
the patient, which of the
SOLUTIONS
A cattle rancher with a new onset of fever, chills, and headache
is suspected of being exposed to tularemia. Which medication
will the nurse anticipate being prescribed for this client? Correct
Answers Tularemia post-exposure prophylaxis is recommended
in cases of occupational exposure to infectious materials.
Doxycycline (100 mg orally BID X 10-14 days) is
recommended for prophylaxis in adults, as well as ciprofloxacin
(500 mg orally BID X 7 days) and levofloxacin (500 mg orally
daily X 7 days).
A nurse is providing care for an unconscious patient with a head
injury prescribed IV
mannitol. Which of the following parameters is best for the
nurse to monitor to determine if
the mannitol has been effective?
a. Hematocrit
b. Blood pressure
c. Oxygen saturation
d. Intracranial pressure Correct Answers ANS: D
Mannitol is an osmotic diuretic and will reduce cerebral edema
and intracranial pressure. It
may initially reduce hematocrit and increase blood pressure, but
these are not the best
parameters for evaluation of the effectiveness of the drug.
Oxygen saturation will not directly
improve as a result of mannitol administration.
,A patient contracts hepatitis from contaminated food. During the
acute (icteric) phase of the
patient's illness, which of the following serological findings
should the nurse expect?
a. Antibody to hepatitis D virus (anti-HDV)
b. Hepatitis B surface antigen (HBsAg)
c. Anti-hepatitis A virus immunoglobulin G (anti-HAV IgG)
d. Anti-hepatitis A virus immunoglobulin M (anti-HAV IgM)
Correct Answers ANS: D
Hepatitis A is transmitted through the oral-fecal route, and
antibody to HAV IgM appears
during the acute phase of hepatitis A. The patient would not
have antigen for hepatitis B or
antibody for hepatitis D. Anti-HAV IgG would indicate past
infection and lifelong immunity.
A patient is being treated with a medication to block the effect
of antidiuretic hormone to control the symptoms of syndrome of
inappropriate antidiuretic hormone (SIADH). Which of
the following findings indicates that the medication is effective?
a. Decreased peripheral edema
b. Increased weight
c. Increased urine specific gravity
d. Increased urinary output Correct Answers ANS: D
Agents that block the effect of ADH on the renal tubules may be
prescribed, thereby allowing
more dilution of urine leading to an increased urine output. An
increase in weight or an
increase in urine specific gravity indicates that the SIADH is not
corrected. Peripheral edema
,does not occur with SIADH. A sudden weight gain without
edema is a common clinical
manifestation of this disorder
A patient is brought to the emergency department (ED) by
ambulance after being found
unconscious on the bathroom floor by the partner. Which of the
following actions should the
nurse take first?
a. Obtain oxygen saturation.
b. Check pupil reaction to light.
c. Palpate the head for hematoma.
d. Assess Glasgow Coma Scale (GCS). Correct Answers ANS:
A
Airway patency and breathing are the most vital functions and
should be assessed first. The
neurological assessments should be accomplished next and the
health and medication history
last.
A patient is brought to the emergency department with a knife
impaled in the abdomen
following a domestic fight. During the initial assessment of the
patient, which of the following
actions should the nurse implement?
a. Assess the BP and pulse.
b. Remove the knife to assess the wound.
c. Determine the presence of Rovsing sign.
d. Insert a urinary catheter and assess for hematuria Correct
Answers ANS: A
, The initial assessment is focused on determining whether the
patient has hypovolemic shock.
The knife should not be removed until the patient is in surgery,
where bleeding can be
controlled. Rovsing sign is assessed in the patient with suspected
appendicitis. A patient with
a knife in place will be taken to surgery and assessed for bladder
trauma there.
A patient who is suspected of having an epidural hematoma is
admitted to the emergency
department. Which of the following actions should the nurse
plan to take?
a. Administer IV furosemide.
b. Initiate high-dose barbiturate therapy.
c. Type and crossmatch for blood transfusion.
d. Prepare the patient for immediate craniotomy. Correct
Answers ANS: D
The principal treatment for epidural hematoma is rapid surgery
to remove the hematoma and
prevent herniation. If intracranial pressure (ICP) is elevated after
surgery, furosemide or highdose barbiturate therapy may be
needed, but these will not be of benefit unless the hematoma
is removed. Minimal blood loss occurs with head injuries, and
transfusion is usually not
necessary
A patient who is unconscious after a fall from a ladder is
transported to the emergency
department by family members. During the primary survey of
the patient, which of the
