2310 Final Exam Questions With Correct
•The cnurse cis ccaring cfor ca cpatient cwith cpneumonia cunresponsive cto ctwo cdifferent cantibiotics. cW
cfor cthe cnurse cto ccomplete cbefore cadministering ca cnewly cprescribed cantibiotic?
a. cTeach cthe cpatient cto ccough cand cdeep cbreathe.
b. cTake cthe ctemperature, cpulse, cand crespiratory crate.
c. cObtain ca csputum cspecimen cfor cculture cand cGram cstain.
d. cCheck cthe cpatient's coxygen csaturation cby cpulse coximetry. c- cCORRECT cANS✔✔Answer: cC
•The cnurse cis ccaring cfor ca cpatient cwith can calteration cin cairway cclearance. cWhat cnursing caction
cpromote cairway cclearance c(select call cthat capply.)?
a. cMaintain cadequate cfluid cintake.
b. cMaintain ca c30-degree celevation.
c. cSplint cthe cchest cwhen ccoughing.
d. cMaintain ca csemi-Fowler's cposition.
e. cInstructpatient cto ccough cat cend cof cexhalation c- cCORRECT cANS✔✔Answer: cACE
Rationale: cMaintaining cadequate cfluid cintake cliquefies csecretions, callowing ceasier cexpectoration
cthe cpatient cto csplint cthe cchest cwhile ccoughing. cThis cwill creduce cdiscomfort cand callow cfor ca cm
cat cthe cend cof cexhalation cpromotes ca cmore ceffective ccough. cThe cpatient cshould cbe cpositioned
c(high cFowler's) cwith chead cslightly cflexed.
•The cnurse cevaluates cthat cdischarge cteaching cfor ca cpatient chospitalized cwith cpneumonia chas c
cpatient cmakes cwhich cstatement cabout cmeasures cto cprevent ca crelapse?
a. c"I cwill cseek cimmediate cmedical ctreatment cfor cany cupper crespiratory cinfections."
b. c"I cshould ccontinue cto cdo cdeep cbreathing cand ccoughing cexercises cfor cat cleast c12 cweeks."
c. c"I cwill cincrease cmy cfood cintake cto c2400 ccalories ca cday cto ckeep cmy cimmune csystem cwell."
d. c"I cmust chave ca cfollow-up cchest cx-ray cin c6 cto c8 cweeks cto cevaluate cthe cpneumonia's cresolu
cANS✔✔Answer: cD
Rationale: cThe cfollow-up cchest cx-ray cexamination cwill cbe cdone cin c6 cto c8 cweeks cto cevaluate cp
cpatient cshould cseek cmedical ctreatment cfor cupper crespiratory cinfections cthat cpersist cfor cmore ct
cimportant cfor cthe cpatient cto ccontinue cwith ccoughing cand cdeep cbreathing cexercises cfor c6 cto c8
call cof cthe cinfection chas ccleared cfrom cthe clungs. cIncreased cfluid cintake, cnot ccaloric cintake, cis c
•The cnurse cis ccaring cfor ca cpatient cwith cineffective cairway cclearance. cWhat cis cthe cpriority cnurs
, •The cnurse cis ccaring cfor ca cpatient cwith ca cnursing cdiagnosis cof chyperthermia crelated cto cpneum
cdoes cthe cnurse cobtain cthat ccorrelates cwith cthis cnursing cdiagnosis c(select call cthat capply.)?
a. cA ctemperature cof c101.4°F
b. cHeart crate cof c120 cbeats/min
c. cRespiratory crate cof c20 cbreaths/min
d. cA cproductive ccough cwith cyellow csputum
e. cReports cof cunable cto chave ca cbowel cmovement cfor c2 cdays c- cCORRECT cANS✔✔Answer: cA
Rationale: cA cfever cis can cinflammatory cresponse crelated cto cthe cinfectious cprocess. cA cproductiv
csputum c(which cshould cbe cclear) cis can cindication cthat cthe cpatient chas cpneumonia. cA crespirato
cwithin cnormal crange. cInability cto chave ca cbowel cmovement cis cnot crelated cto ca cdiagnosis cof cpn
cbeats/min cindicates cthat cthere cis cincreased cmetabolism cdue cto cthe cfever cand cis crelated cto cth
•The cnurse cinstructs ca cpatient cwith ca cpulmonary cembolism cabout cadministering cenoxaparin caf
cby cthe cpatient cindicates cunderstanding cabout cthe cinstructions?
a. c"I cneed cto ctake cthis cmedicine cwith cmeals."
b. c"The cmedicine cwill cbe cprescribed cfor c10 cdays."
c. c"I cwill cinject cthis cmedicine cinto cmy cupper carm."
d. c"The cmedicine cwill cdissolve cthe cclot cin cmy clung." c- cCORRECT cANS✔✔Answer: cB
Rationale: cEnoxaparin cis ca clow-molecular-weight cheparin cthat cis cadministered cfor c10 cto c14 cda
cbut cdoes cnot cdissolve cexisting cclots. cFibrinolytic cagents c(e.g., ctissue cplasminogen cactivator cor
cexisting cclot. cEnoxaparin cis cadministered csubcutaneously cby cinjection cinto cthe cabdomen.
•The cnurse cis ccaring cfor can colder cadult cpatient cwho cunderwent ca cleft ctotal cknee carthroplasty.
cday, cthe cpatient creports cshortness cof cbreath, cslight cchest cpain, cand cthat c"something cis cwrong
cblood cpressure cis c130/88 cmm cHg, crespirations care c36 cbreaths/min, cand coxygen csaturation cis
cthe cpriority cnursing caction?
a. cNotify cthe chealth ccare cprovider.
b. cAdminister ca cnitroglycerin ctablet csublingually.
c. cConduct ca cthorough cassessment cof cthe cchest cpain.
d. cSit cthe cpatient cup cin cbed cas ctolerated cand capply coxygen. c- cCORRECT cANS✔✔Answer: cD
Rationale: cThe cpatient's cclinical cpicture cis cmost clikely cpulmonary cembolus, cand cthe cfirst caction
cto cassist cwith cthe cpatient's crespirations. cFor cthis creason, cthe cnurse cshould csit cthe cpatient cup
coxygen cbefore cnotifying cthe cphysician. cThe cnitroglycerin ctablet cwould cnot cbe chelpful, cand cthe
cbigger cproblem cthan cthe cslight cchest cpain cat cthis ctime.
•The cnurse cis cadmitting ca cpatient cwith ca cdiagnosis cof cpulmonary cembolism. cWhat crisk cfactors
cassess c(select call cthat capply.)?
a. cObesity
b. cPneumonia
c. cMalignancy
d. cCigarette csmoking
e. cProlonged cair ctravel c- cCORRECT cANS✔✔Answer: cACDE
Rationale: cAn cincreased crisk cof cpulmonary cembolism cis cassociated cwith cobesity, cmalignancy, c
cprolonged cair ctravel cwith creduced cmobility. cOther crisk cfactors cinclude cdeep cvein cthrombosis, c
cwithin cthe cprevious c3 cmonths, coral ccontraceptives cand chormone ctherapy, cheart cfailure, cpregn
•A cpatient cwith ca cgunshot cwound cto cthe cright cside cof cthe cchest carrives cin cthe cemergency cdep
cshortness cof cbreath cwith cdecreased cbreath csounds con cthe cright cside cof cthe cchest. cWhich cac
cimmediately?
a. cCover cthe cchest cwound cwith ca cnonporous cdressing ctaped con cthree csides.
b. cPack cthe cchest cwound cwith csterile csaline csoaked cgauze cand ctape csecurely.
c. cStabilize cthe cchest cwall cwith ctape cand cinitiate cpositive cpressure cventilation.
d. cApply ca cpressure cdressing cover cthe cwound cto cprevent cexcessive closs cof cblood. c- cCORREC
Rationale: cThe cpatient chas ca csucking cchest cwound c(open cpneumothorax). cAir centers cthe cpleu
•The cnurse cis ccaring cfor ca cpatient cwith cpneumonia cunresponsive cto ctwo cdifferent cantibiotics. cW
cfor cthe cnurse cto ccomplete cbefore cadministering ca cnewly cprescribed cantibiotic?
a. cTeach cthe cpatient cto ccough cand cdeep cbreathe.
b. cTake cthe ctemperature, cpulse, cand crespiratory crate.
c. cObtain ca csputum cspecimen cfor cculture cand cGram cstain.
d. cCheck cthe cpatient's coxygen csaturation cby cpulse coximetry. c- cCORRECT cANS✔✔Answer: cC
•The cnurse cis ccaring cfor ca cpatient cwith can calteration cin cairway cclearance. cWhat cnursing caction
cpromote cairway cclearance c(select call cthat capply.)?
a. cMaintain cadequate cfluid cintake.
b. cMaintain ca c30-degree celevation.
c. cSplint cthe cchest cwhen ccoughing.
d. cMaintain ca csemi-Fowler's cposition.
e. cInstructpatient cto ccough cat cend cof cexhalation c- cCORRECT cANS✔✔Answer: cACE
Rationale: cMaintaining cadequate cfluid cintake cliquefies csecretions, callowing ceasier cexpectoration
cthe cpatient cto csplint cthe cchest cwhile ccoughing. cThis cwill creduce cdiscomfort cand callow cfor ca cm
cat cthe cend cof cexhalation cpromotes ca cmore ceffective ccough. cThe cpatient cshould cbe cpositioned
c(high cFowler's) cwith chead cslightly cflexed.
•The cnurse cevaluates cthat cdischarge cteaching cfor ca cpatient chospitalized cwith cpneumonia chas c
cpatient cmakes cwhich cstatement cabout cmeasures cto cprevent ca crelapse?
a. c"I cwill cseek cimmediate cmedical ctreatment cfor cany cupper crespiratory cinfections."
b. c"I cshould ccontinue cto cdo cdeep cbreathing cand ccoughing cexercises cfor cat cleast c12 cweeks."
c. c"I cwill cincrease cmy cfood cintake cto c2400 ccalories ca cday cto ckeep cmy cimmune csystem cwell."
d. c"I cmust chave ca cfollow-up cchest cx-ray cin c6 cto c8 cweeks cto cevaluate cthe cpneumonia's cresolu
cANS✔✔Answer: cD
Rationale: cThe cfollow-up cchest cx-ray cexamination cwill cbe cdone cin c6 cto c8 cweeks cto cevaluate cp
cpatient cshould cseek cmedical ctreatment cfor cupper crespiratory cinfections cthat cpersist cfor cmore ct
cimportant cfor cthe cpatient cto ccontinue cwith ccoughing cand cdeep cbreathing cexercises cfor c6 cto c8
call cof cthe cinfection chas ccleared cfrom cthe clungs. cIncreased cfluid cintake, cnot ccaloric cintake, cis c
•The cnurse cis ccaring cfor ca cpatient cwith cineffective cairway cclearance. cWhat cis cthe cpriority cnurs
, •The cnurse cis ccaring cfor ca cpatient cwith ca cnursing cdiagnosis cof chyperthermia crelated cto cpneum
cdoes cthe cnurse cobtain cthat ccorrelates cwith cthis cnursing cdiagnosis c(select call cthat capply.)?
a. cA ctemperature cof c101.4°F
b. cHeart crate cof c120 cbeats/min
c. cRespiratory crate cof c20 cbreaths/min
d. cA cproductive ccough cwith cyellow csputum
e. cReports cof cunable cto chave ca cbowel cmovement cfor c2 cdays c- cCORRECT cANS✔✔Answer: cA
Rationale: cA cfever cis can cinflammatory cresponse crelated cto cthe cinfectious cprocess. cA cproductiv
csputum c(which cshould cbe cclear) cis can cindication cthat cthe cpatient chas cpneumonia. cA crespirato
cwithin cnormal crange. cInability cto chave ca cbowel cmovement cis cnot crelated cto ca cdiagnosis cof cpn
cbeats/min cindicates cthat cthere cis cincreased cmetabolism cdue cto cthe cfever cand cis crelated cto cth
•The cnurse cinstructs ca cpatient cwith ca cpulmonary cembolism cabout cadministering cenoxaparin caf
cby cthe cpatient cindicates cunderstanding cabout cthe cinstructions?
a. c"I cneed cto ctake cthis cmedicine cwith cmeals."
b. c"The cmedicine cwill cbe cprescribed cfor c10 cdays."
c. c"I cwill cinject cthis cmedicine cinto cmy cupper carm."
d. c"The cmedicine cwill cdissolve cthe cclot cin cmy clung." c- cCORRECT cANS✔✔Answer: cB
Rationale: cEnoxaparin cis ca clow-molecular-weight cheparin cthat cis cadministered cfor c10 cto c14 cda
cbut cdoes cnot cdissolve cexisting cclots. cFibrinolytic cagents c(e.g., ctissue cplasminogen cactivator cor
cexisting cclot. cEnoxaparin cis cadministered csubcutaneously cby cinjection cinto cthe cabdomen.
•The cnurse cis ccaring cfor can colder cadult cpatient cwho cunderwent ca cleft ctotal cknee carthroplasty.
cday, cthe cpatient creports cshortness cof cbreath, cslight cchest cpain, cand cthat c"something cis cwrong
cblood cpressure cis c130/88 cmm cHg, crespirations care c36 cbreaths/min, cand coxygen csaturation cis
cthe cpriority cnursing caction?
a. cNotify cthe chealth ccare cprovider.
b. cAdminister ca cnitroglycerin ctablet csublingually.
c. cConduct ca cthorough cassessment cof cthe cchest cpain.
d. cSit cthe cpatient cup cin cbed cas ctolerated cand capply coxygen. c- cCORRECT cANS✔✔Answer: cD
Rationale: cThe cpatient's cclinical cpicture cis cmost clikely cpulmonary cembolus, cand cthe cfirst caction
cto cassist cwith cthe cpatient's crespirations. cFor cthis creason, cthe cnurse cshould csit cthe cpatient cup
coxygen cbefore cnotifying cthe cphysician. cThe cnitroglycerin ctablet cwould cnot cbe chelpful, cand cthe
cbigger cproblem cthan cthe cslight cchest cpain cat cthis ctime.
•The cnurse cis cadmitting ca cpatient cwith ca cdiagnosis cof cpulmonary cembolism. cWhat crisk cfactors
cassess c(select call cthat capply.)?
a. cObesity
b. cPneumonia
c. cMalignancy
d. cCigarette csmoking
e. cProlonged cair ctravel c- cCORRECT cANS✔✔Answer: cACDE
Rationale: cAn cincreased crisk cof cpulmonary cembolism cis cassociated cwith cobesity, cmalignancy, c
cprolonged cair ctravel cwith creduced cmobility. cOther crisk cfactors cinclude cdeep cvein cthrombosis, c
cwithin cthe cprevious c3 cmonths, coral ccontraceptives cand chormone ctherapy, cheart cfailure, cpregn
•A cpatient cwith ca cgunshot cwound cto cthe cright cside cof cthe cchest carrives cin cthe cemergency cdep
cshortness cof cbreath cwith cdecreased cbreath csounds con cthe cright cside cof cthe cchest. cWhich cac
cimmediately?
a. cCover cthe cchest cwound cwith ca cnonporous cdressing ctaped con cthree csides.
b. cPack cthe cchest cwound cwith csterile csaline csoaked cgauze cand ctape csecurely.
c. cStabilize cthe cchest cwall cwith ctape cand cinitiate cpositive cpressure cventilation.
d. cApply ca cpressure cdressing cover cthe cwound cto cprevent cexcessive closs cof cblood. c- cCORREC
Rationale: cThe cpatient chas ca csucking cchest cwound c(open cpneumothorax). cAir centers cthe cpleu
