NUR 280 EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS 2023/2024 REVISION
GUIDE
The nurse is reviewing medical prescriptions for newly admitted clients. It
would be a priority for the nurse to follow up with the physician if a client
with
(a) a potassium level of 4.5mEq/L has Kayexalate (sodium polystyrene)
prescribed
(b) a Dilantin (phenytoin) level of 8 mcg/ml is placed on seizure precautions
(c) sensitivity to Aspirin (acetylsalicylic acid) is prescribed Tylenol
(acetaminophen)
(d) sensitivity to Penicillin is prescribed Zithromax (azithromycin) -
ANSWER--1. A. The normal potassium level is 3.5 - 5.0 mEq/L. Giving
Kayexalate in this situation may cause the client to lose potassium, causing
hypokalemia, therefore the drug is not indicated; the therapeutic level for
Dilantin is 10 - 20 mcg/ml, a level of 8 is sub therapeutic thereby increasing
the risk of seizure activity. Acetaminophen can be safely prescribed to
clients with ASA sensitivity. Azithromycin (Zithromax) can be safely
prescribed for clients with sensitivity to Penicillin.
The nurse should intervene if the nurse notes a staff member
(a) obtaining a clients consent prior to their operative procedure after
receiving
Ativan (lorazepam)
(b) placing a client on the affected side following surgical repair of a retinal
detachment
(c) handling a wet cast with the palms of the hands
(d) using a broad base of support while transferring a client - ANSWER--2.
A. Informed consent, explanation and decision making must occur before
sedation is given; therapeutic interventions for retinal detachment include
bedrest with the area of detachment in a dependent position to promote
, NUR 280 EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS 2023/2024 REVISION
GUIDE
healing; the cast should be handled with the palms of the hands while wet
to prevent denting; a broad base of support is used during transfers to
prevent muscle injury.
The community health nurse is caring for the following clients. It would be a
priority for the nurse to initiate a multidisciplinary conference for the client
who
is
(a) 12 years old with Autism who is starting a new school and recently had
a
URI (upper respiratory tract infection)
(b) 16 years old, has type 1 Diabetes Mellitus, is unemployed and had a
recent
Hemoglobin A1c of 13%
(c) 52 years old, with Myasthenia Gravis, recently prescribed Mestinon
(pyridostigmine) and employed as a mail carrier
(d) 70 years old, has schizophrenia, lives alone and reports hearing
non threatening voices. - ANSWER--3. B. An adolescent with uncontrolled
Diabetes Mellitus would require the greatest number of disciplines
(multidisciplinary) to manage their care i.e. Medicine, Nursing, Social Work,
Nutritionist; the other choices do not require as many providers of care to
meet their needs.
The nurse from the postpartum unit has been temporarily assigned to the
medical surgical unit. It would be most appropriate to assign this nurse to
the
client who
, NUR 280 EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS 2023/2024 REVISION
GUIDE
(a) has returned from right total hip replacement surgery four hours ago
(b) is being observed for increased intracranial pressure
(c) had surgery two hours ago to remove the appendix
(d) is two weeks post partum being maintained on a mechanical ventilator
for respiratory failure - ANSWER--4. C. The management of a client
following abdominal surgery is standard. The postpartum nurse routinely
cares for mothers following caesarean section; therefore it is appropriate to
assign this client; The other choices are not appropriate to assign to this
nurse.
The nurse in a well baby clinic has assessed several children today. It
would
be a priority for the nurse to suggest follow up for the child who is
(a) 2 months old with a positive babinski reflex
(b) 5 months old and does not hold their own bottle
(c) 10 months old who cries around strangers
(d) 18 months old who needs support while ambulating - ANSWER--5. D. A
child experiencing normal growth and development should be ambulating
independently by 12 months; the Babinski reflex disappears after 2 years of
age; an infant typically holds their own bottle by 6 months; stranger anxiety
usually develops at approximately 7 months
The nurse is caring for a mechanically ventilated client who was declared
brain
dead. An Advance Directive is not documented on the medical record. It
would be most appropriate to obtain consent for organ donation from the
(a) client's primary care provider
, NUR 280 EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS 2023/2024 REVISION
GUIDE
(b) client's nurse manager
(c) closest living family member
(d) hospital's ethics committee - ANSWER--6. C. Consent for organ
donation is given by a client's next of kin in the absence of an Advance
Directive
The nurse has received report on four clients. The nurse should first
assess the client who has:
(a) Chronic Obstructive Pulmonary Disease (COPD) with a pulse oximetry
reading of 90%
(b) Parkinson's Disease and is demanding to leave the hospital against
medical advice (AMA)
(c) been admitted with suspected Guillian Barre Syndrome and has begun
plasmapheresis therapy
(d) Congestive Heart Failure (CHF) whose pitting edema has increased to
2(+) - ANSWER--7. C. The client admitted with Guillain-Barre' Syndrome
should be assessed first because of the possibility of rapid progression of
this illness and neuromuscular respiratory failure; clients with COPD are
likely to have pulse oximetry readings of 90% related to chronic hypoxia;
this client along with the other two choices are important, but not the
priority.
It would be appropriate to assign which of these tasks to the CNA?
(a) Feeding a client who is experiencing dysphagia
(b) One-on-one client observation for safety
(c) Removal of an indwelling catheter
DETAILED ANSWERS 2023/2024 REVISION
GUIDE
The nurse is reviewing medical prescriptions for newly admitted clients. It
would be a priority for the nurse to follow up with the physician if a client
with
(a) a potassium level of 4.5mEq/L has Kayexalate (sodium polystyrene)
prescribed
(b) a Dilantin (phenytoin) level of 8 mcg/ml is placed on seizure precautions
(c) sensitivity to Aspirin (acetylsalicylic acid) is prescribed Tylenol
(acetaminophen)
(d) sensitivity to Penicillin is prescribed Zithromax (azithromycin) -
ANSWER--1. A. The normal potassium level is 3.5 - 5.0 mEq/L. Giving
Kayexalate in this situation may cause the client to lose potassium, causing
hypokalemia, therefore the drug is not indicated; the therapeutic level for
Dilantin is 10 - 20 mcg/ml, a level of 8 is sub therapeutic thereby increasing
the risk of seizure activity. Acetaminophen can be safely prescribed to
clients with ASA sensitivity. Azithromycin (Zithromax) can be safely
prescribed for clients with sensitivity to Penicillin.
The nurse should intervene if the nurse notes a staff member
(a) obtaining a clients consent prior to their operative procedure after
receiving
Ativan (lorazepam)
(b) placing a client on the affected side following surgical repair of a retinal
detachment
(c) handling a wet cast with the palms of the hands
(d) using a broad base of support while transferring a client - ANSWER--2.
A. Informed consent, explanation and decision making must occur before
sedation is given; therapeutic interventions for retinal detachment include
bedrest with the area of detachment in a dependent position to promote
, NUR 280 EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS 2023/2024 REVISION
GUIDE
healing; the cast should be handled with the palms of the hands while wet
to prevent denting; a broad base of support is used during transfers to
prevent muscle injury.
The community health nurse is caring for the following clients. It would be a
priority for the nurse to initiate a multidisciplinary conference for the client
who
is
(a) 12 years old with Autism who is starting a new school and recently had
a
URI (upper respiratory tract infection)
(b) 16 years old, has type 1 Diabetes Mellitus, is unemployed and had a
recent
Hemoglobin A1c of 13%
(c) 52 years old, with Myasthenia Gravis, recently prescribed Mestinon
(pyridostigmine) and employed as a mail carrier
(d) 70 years old, has schizophrenia, lives alone and reports hearing
non threatening voices. - ANSWER--3. B. An adolescent with uncontrolled
Diabetes Mellitus would require the greatest number of disciplines
(multidisciplinary) to manage their care i.e. Medicine, Nursing, Social Work,
Nutritionist; the other choices do not require as many providers of care to
meet their needs.
The nurse from the postpartum unit has been temporarily assigned to the
medical surgical unit. It would be most appropriate to assign this nurse to
the
client who
, NUR 280 EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS 2023/2024 REVISION
GUIDE
(a) has returned from right total hip replacement surgery four hours ago
(b) is being observed for increased intracranial pressure
(c) had surgery two hours ago to remove the appendix
(d) is two weeks post partum being maintained on a mechanical ventilator
for respiratory failure - ANSWER--4. C. The management of a client
following abdominal surgery is standard. The postpartum nurse routinely
cares for mothers following caesarean section; therefore it is appropriate to
assign this client; The other choices are not appropriate to assign to this
nurse.
The nurse in a well baby clinic has assessed several children today. It
would
be a priority for the nurse to suggest follow up for the child who is
(a) 2 months old with a positive babinski reflex
(b) 5 months old and does not hold their own bottle
(c) 10 months old who cries around strangers
(d) 18 months old who needs support while ambulating - ANSWER--5. D. A
child experiencing normal growth and development should be ambulating
independently by 12 months; the Babinski reflex disappears after 2 years of
age; an infant typically holds their own bottle by 6 months; stranger anxiety
usually develops at approximately 7 months
The nurse is caring for a mechanically ventilated client who was declared
brain
dead. An Advance Directive is not documented on the medical record. It
would be most appropriate to obtain consent for organ donation from the
(a) client's primary care provider
, NUR 280 EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS 2023/2024 REVISION
GUIDE
(b) client's nurse manager
(c) closest living family member
(d) hospital's ethics committee - ANSWER--6. C. Consent for organ
donation is given by a client's next of kin in the absence of an Advance
Directive
The nurse has received report on four clients. The nurse should first
assess the client who has:
(a) Chronic Obstructive Pulmonary Disease (COPD) with a pulse oximetry
reading of 90%
(b) Parkinson's Disease and is demanding to leave the hospital against
medical advice (AMA)
(c) been admitted with suspected Guillian Barre Syndrome and has begun
plasmapheresis therapy
(d) Congestive Heart Failure (CHF) whose pitting edema has increased to
2(+) - ANSWER--7. C. The client admitted with Guillain-Barre' Syndrome
should be assessed first because of the possibility of rapid progression of
this illness and neuromuscular respiratory failure; clients with COPD are
likely to have pulse oximetry readings of 90% related to chronic hypoxia;
this client along with the other two choices are important, but not the
priority.
It would be appropriate to assign which of these tasks to the CNA?
(a) Feeding a client who is experiencing dysphagia
(b) One-on-one client observation for safety
(c) Removal of an indwelling catheter
