NUR 325 Final Exam With
Complete Question & Answers
2. A patient is receiving a PCA infusion after surgery to repair a hip fracture. She is sleeping
soundly but awakens when the nurse speaks to her in a normal tone of voice. Her respirations
are 8 breaths/minute. The most appropriate nursing action in this situation is to
a. stop the PCA infusion.
b. obtain an oxygen saturation level.
c. continue to closely monitor the patient.
d. administer naloxone and contact the physician.-C (8 breaths a minute is not alarming
because the patient was sleeping. It is most appropriate to monitor the patient closely.)
6. An example of distraction to provide pain relief is
a. TENS.
b. music.
c. exercise.
d. biofeedback.-B
A 34-year-old single father who is anxious, tearful, and tired from caring for his three young
children tells the nurse that he feels depressed and doesn't see how he can go on much longer.
Which of the following would be the nurse's best response?
a. "Are you thinking of suicide?"
b. "You've been doing a good job raising your children. You can do it!"
c. "Is there someone who can help you during the evenings and weekends?"
d. "What do you mean when you say you can't go on any longer?"-D (You need to get
information about what the gentleman means when he says he can't go on any longer. He might
be thinking of turning his children over to a grandparent or seeking other child-care
arrangements. Asking about suicide initially might be premature. Asking, "Are you thinking of
suicide?" prematurely might shut the patient down entirely. If the patient talks about suicide, for
safety reasons it is very important to further discuss his suicidal thoughts and refer to the
appropriate health care professional. Asking the open-ended question provides an opportunity
to understand what the person is thinking and open lines of communication.)
,A 59-yr-old female patient with a frontotemporal lobar dementia has difficulty with verbal
expression. While her husband was at work, she walked to the gas station for a soda but did not
understand the request for payment. What can the nurse suggest to keep the patient safe?
a. Assisted living
b. Adult day care
c. Advance directives
d. Monitor for behavioral changes-B (To keep the patient safe during the day while the husband
is at work, an adult day care facility would be the best choice. This patient would not need
assisted living. Advance directives are important but are not related to her safety. Monitoring for
behavioral changes will not keep her safe during the day.)
A 65-year-old woman has fallen while sweeping her driveway, sustaining a tissue injury. She
describes her condition as an aching, throbbing back. Which type of pain are these complaints
most indicative of?
a. Neuropathic pain
b. Nociceptive pain
c. Chronic pain
d. Mixed pain syndrome-B (Nociceptive pain refers to the normal functioning of physiologic
systems that leads to the perception of noxious stimuli (tissue injury) as being painful. Patients
describe this type of pain as dull or aching, and it is poorly localized. Neuropathic pain is
described as shooting, tingling, burning, or numbness that is constant in the extremities, as in
diabetic neuropathy. Chronic pain lasts longer than 30 days and is characterized by a disease
affecting brain structure and function, such as chronic headaches or open wounds. Mixed pain
syndromes are caused by different pathophysiologic mechanisms such as a combination of
neuropathic and nociceptive pain; this occurs in syndromes such as sciatica, spinal cord
injuries, and cervical or lumbar spinal stenosis.)
A 75-year-old female patient has just been admitted to the clinic you work at. You review their
health history and see that they were diagnosed with dementia two years ago. You ask their
caregiver some questions about behavioral changes that have occurred with the patient, which
they then reveal that she has been hoarding bottle caps in one of the kitchen cabinets for about
6 months and can't seem to convince her to stop doing it. The caregiver also states that the
patient tend to wander and is unable to perform ADLs. Which of the following diseases do these
symptoms indicate?
a. Alzheimer's
b. Delirium
c. Lewy Body
d. Depression-A
A 78-year-old male patient has just been admitted to the your ER with symptoms of confusion,
anxiety, and a decrease in memory. The patient's wife tells you that she thinks he has dementia,
but you suspect otherwise. To rule out delirium, which of the following tests would you perform
on your patient? (Select all that apply).
a. WBC count
b. Fluid and electrolytes
c. ALT, AST, and total bilirubin
d. Chest x-ray
,e. MRI
f. BUN, creatinine-A B C F
A 78-yr-old woman was transferred to the intensive care unit after emergency abdominal
surgery. The nurse notes the patient is disoriented and confused, has incoherent speech, is
restless, and agitated. Which action by the nurse is most appropriate?
a. Reorient the patient.
b. Notify the physician.
c. Document the findings.
d. Administer lorazepam (Ativan).-A (The patient is exhibiting clinical manifestations of delirium.
Care of the patient with delirium is focused on eliminating precipitating factors and protecting the
patient from harm. Give priority to creating a calm and safe environment. The nurse should stay
at the bedside and provide reassurance and reorienting information as to place, time, and
procedures. The nurse should reduce environmental stimuli, including noise and light levels.
Avoid the use of chemical and physical restraints if possible.)
A 90-year-old patient is admitted to the hospital. Shortly after admission, the family notices that
the patient is exhibiting disorientation and agitation. When questioned about the behavior by the
family, the nurse states that the patient is at risk for developing which common complication of
hospitalization in older adults?
a. Delirium
b. Dementia
c. Alzheimer's disease
d. Sundowner syndrome-A (Delirium, which occurs over hours to a few days, is the most
frequent complication of hospitalization in the elderly population. Dementia occurs over a period
of months. Alzheimer's disease develops over months to years. Sundowner syndrome is most
prominent in dementia and becomes worse in the evenings.)
A broken bone would be an example of which source of stress?
a. Psychological
b. Physiological
c. Emotional
d. Episodic-B
A cancer patient who reports ongoing, constant moderate pain with short periods of severe pain
during dressing changes is
a. probably exaggerating his pain.
b. best treated by referral for surgical treatment of his pain.
c. best treated by receiving a long-acting and a short-acting opioid.
d. best treated by regularly scheduled short-acting opioids plus acetaminophen.-C
A college student is stressed out about a big test they have tomorrow. They sleep with their
favorite childhood teddy bear the night before the test. This behavior describes which of the
following defense mechanisms?
a. Conversion
b. Projection
, c. Undoing
d. Regression-D (The nurse should identify regression as a defense mechanism in which the
client adopts a more primitive, immature behavior in response to an unwanted situation.)
A community health nurse is preparing a course on protecting cognitive function. Which
population group should the nurse target for teaching?
a. Older male adults with diabetes
b. Older female adults who are overweight
c. Young adults living in school dormitories
d. Adolescents attending summer camps-A (The primary risk factor for cognitive impairment is
advancing age; males with a history of stroke or diabetes are at significant risk. Older females
with a history of poor health, insomnia, and lack of social support are at risk for cognitive
impairment, not those who are overweight. Risk factors for young adults include substance
abuse and high-risk behaviors, not crowded living conditions. Adolescents who attend summer
camp are not necessarily at risk for cognitive problems; adolescents who participate in high-risk
behaviors would be at risk.)
A crisis intervention nurse is working with a mother whose Down syndrome child has been
hospitalized with pneumonia and who has lost her child's disability payment while the child is
hospitalized. The mother worries that her daughter will fall behind in special-school classes
during hospitalization. Which strategies are effective in helping this mother cope with these
stressors? (Select all that apply.)
a. Referral to social service process reestablishing the child's disability payment
b. Sending the child home in 72 hours and having the child return to school
c. Coordinating hospital-based and home-based schooling with the child's teacher
d. Teaching the mother signs and symptoms of a respiratory tract infection
e. Telling the mother that the stress will decrease in 6 weeks when everything is back to normal-
A C D (The stressors for this parent are her child's illness, missing school, and loss of disability
payments. Obtaining resources to resolve these stressors will reduce the mother's stress load
and allow her to focus on helping her child improve and preventing another respiratory tract
infection. Discharging the child in 72 hours with a return to school may not be best for the child's
physical condition and may make the situation worse. Giving the mom a 6-week time frame is
unrealistic because everyone's time frame is different. The mom may also need to adjust to a
"new normal.")
A diabetic patient who is hospitalized asks the nurse what factors are associated with increased
blood glucose while in the hospital? Which response(s) by the nurse are appropriate? (Select all
that apply.)
a. Blood sugar may be higher in the hospital due to the increased bed rest.
b. Stressors such as illness cause the release of hormones that increase blood sugar.
c. Increased blood sugar occurs because the kidneys are not able to metabolize glucose as well
during stressful times.
d. A patient's diet is different here in the hospital than at home, and that is the most likely
because of the increased glucose level.
e. Medications such as steroids may increase glucose levels.-A B E (The release of cortisol,
epinephrine, and norepinephrine increases blood glucose levels. Activity decreases blood
glucose; therefore, increase in blood glucose while in the hospital could be related to inactivity.
Complete Question & Answers
2. A patient is receiving a PCA infusion after surgery to repair a hip fracture. She is sleeping
soundly but awakens when the nurse speaks to her in a normal tone of voice. Her respirations
are 8 breaths/minute. The most appropriate nursing action in this situation is to
a. stop the PCA infusion.
b. obtain an oxygen saturation level.
c. continue to closely monitor the patient.
d. administer naloxone and contact the physician.-C (8 breaths a minute is not alarming
because the patient was sleeping. It is most appropriate to monitor the patient closely.)
6. An example of distraction to provide pain relief is
a. TENS.
b. music.
c. exercise.
d. biofeedback.-B
A 34-year-old single father who is anxious, tearful, and tired from caring for his three young
children tells the nurse that he feels depressed and doesn't see how he can go on much longer.
Which of the following would be the nurse's best response?
a. "Are you thinking of suicide?"
b. "You've been doing a good job raising your children. You can do it!"
c. "Is there someone who can help you during the evenings and weekends?"
d. "What do you mean when you say you can't go on any longer?"-D (You need to get
information about what the gentleman means when he says he can't go on any longer. He might
be thinking of turning his children over to a grandparent or seeking other child-care
arrangements. Asking about suicide initially might be premature. Asking, "Are you thinking of
suicide?" prematurely might shut the patient down entirely. If the patient talks about suicide, for
safety reasons it is very important to further discuss his suicidal thoughts and refer to the
appropriate health care professional. Asking the open-ended question provides an opportunity
to understand what the person is thinking and open lines of communication.)
,A 59-yr-old female patient with a frontotemporal lobar dementia has difficulty with verbal
expression. While her husband was at work, she walked to the gas station for a soda but did not
understand the request for payment. What can the nurse suggest to keep the patient safe?
a. Assisted living
b. Adult day care
c. Advance directives
d. Monitor for behavioral changes-B (To keep the patient safe during the day while the husband
is at work, an adult day care facility would be the best choice. This patient would not need
assisted living. Advance directives are important but are not related to her safety. Monitoring for
behavioral changes will not keep her safe during the day.)
A 65-year-old woman has fallen while sweeping her driveway, sustaining a tissue injury. She
describes her condition as an aching, throbbing back. Which type of pain are these complaints
most indicative of?
a. Neuropathic pain
b. Nociceptive pain
c. Chronic pain
d. Mixed pain syndrome-B (Nociceptive pain refers to the normal functioning of physiologic
systems that leads to the perception of noxious stimuli (tissue injury) as being painful. Patients
describe this type of pain as dull or aching, and it is poorly localized. Neuropathic pain is
described as shooting, tingling, burning, or numbness that is constant in the extremities, as in
diabetic neuropathy. Chronic pain lasts longer than 30 days and is characterized by a disease
affecting brain structure and function, such as chronic headaches or open wounds. Mixed pain
syndromes are caused by different pathophysiologic mechanisms such as a combination of
neuropathic and nociceptive pain; this occurs in syndromes such as sciatica, spinal cord
injuries, and cervical or lumbar spinal stenosis.)
A 75-year-old female patient has just been admitted to the clinic you work at. You review their
health history and see that they were diagnosed with dementia two years ago. You ask their
caregiver some questions about behavioral changes that have occurred with the patient, which
they then reveal that she has been hoarding bottle caps in one of the kitchen cabinets for about
6 months and can't seem to convince her to stop doing it. The caregiver also states that the
patient tend to wander and is unable to perform ADLs. Which of the following diseases do these
symptoms indicate?
a. Alzheimer's
b. Delirium
c. Lewy Body
d. Depression-A
A 78-year-old male patient has just been admitted to the your ER with symptoms of confusion,
anxiety, and a decrease in memory. The patient's wife tells you that she thinks he has dementia,
but you suspect otherwise. To rule out delirium, which of the following tests would you perform
on your patient? (Select all that apply).
a. WBC count
b. Fluid and electrolytes
c. ALT, AST, and total bilirubin
d. Chest x-ray
,e. MRI
f. BUN, creatinine-A B C F
A 78-yr-old woman was transferred to the intensive care unit after emergency abdominal
surgery. The nurse notes the patient is disoriented and confused, has incoherent speech, is
restless, and agitated. Which action by the nurse is most appropriate?
a. Reorient the patient.
b. Notify the physician.
c. Document the findings.
d. Administer lorazepam (Ativan).-A (The patient is exhibiting clinical manifestations of delirium.
Care of the patient with delirium is focused on eliminating precipitating factors and protecting the
patient from harm. Give priority to creating a calm and safe environment. The nurse should stay
at the bedside and provide reassurance and reorienting information as to place, time, and
procedures. The nurse should reduce environmental stimuli, including noise and light levels.
Avoid the use of chemical and physical restraints if possible.)
A 90-year-old patient is admitted to the hospital. Shortly after admission, the family notices that
the patient is exhibiting disorientation and agitation. When questioned about the behavior by the
family, the nurse states that the patient is at risk for developing which common complication of
hospitalization in older adults?
a. Delirium
b. Dementia
c. Alzheimer's disease
d. Sundowner syndrome-A (Delirium, which occurs over hours to a few days, is the most
frequent complication of hospitalization in the elderly population. Dementia occurs over a period
of months. Alzheimer's disease develops over months to years. Sundowner syndrome is most
prominent in dementia and becomes worse in the evenings.)
A broken bone would be an example of which source of stress?
a. Psychological
b. Physiological
c. Emotional
d. Episodic-B
A cancer patient who reports ongoing, constant moderate pain with short periods of severe pain
during dressing changes is
a. probably exaggerating his pain.
b. best treated by referral for surgical treatment of his pain.
c. best treated by receiving a long-acting and a short-acting opioid.
d. best treated by regularly scheduled short-acting opioids plus acetaminophen.-C
A college student is stressed out about a big test they have tomorrow. They sleep with their
favorite childhood teddy bear the night before the test. This behavior describes which of the
following defense mechanisms?
a. Conversion
b. Projection
, c. Undoing
d. Regression-D (The nurse should identify regression as a defense mechanism in which the
client adopts a more primitive, immature behavior in response to an unwanted situation.)
A community health nurse is preparing a course on protecting cognitive function. Which
population group should the nurse target for teaching?
a. Older male adults with diabetes
b. Older female adults who are overweight
c. Young adults living in school dormitories
d. Adolescents attending summer camps-A (The primary risk factor for cognitive impairment is
advancing age; males with a history of stroke or diabetes are at significant risk. Older females
with a history of poor health, insomnia, and lack of social support are at risk for cognitive
impairment, not those who are overweight. Risk factors for young adults include substance
abuse and high-risk behaviors, not crowded living conditions. Adolescents who attend summer
camp are not necessarily at risk for cognitive problems; adolescents who participate in high-risk
behaviors would be at risk.)
A crisis intervention nurse is working with a mother whose Down syndrome child has been
hospitalized with pneumonia and who has lost her child's disability payment while the child is
hospitalized. The mother worries that her daughter will fall behind in special-school classes
during hospitalization. Which strategies are effective in helping this mother cope with these
stressors? (Select all that apply.)
a. Referral to social service process reestablishing the child's disability payment
b. Sending the child home in 72 hours and having the child return to school
c. Coordinating hospital-based and home-based schooling with the child's teacher
d. Teaching the mother signs and symptoms of a respiratory tract infection
e. Telling the mother that the stress will decrease in 6 weeks when everything is back to normal-
A C D (The stressors for this parent are her child's illness, missing school, and loss of disability
payments. Obtaining resources to resolve these stressors will reduce the mother's stress load
and allow her to focus on helping her child improve and preventing another respiratory tract
infection. Discharging the child in 72 hours with a return to school may not be best for the child's
physical condition and may make the situation worse. Giving the mom a 6-week time frame is
unrealistic because everyone's time frame is different. The mom may also need to adjust to a
"new normal.")
A diabetic patient who is hospitalized asks the nurse what factors are associated with increased
blood glucose while in the hospital? Which response(s) by the nurse are appropriate? (Select all
that apply.)
a. Blood sugar may be higher in the hospital due to the increased bed rest.
b. Stressors such as illness cause the release of hormones that increase blood sugar.
c. Increased blood sugar occurs because the kidneys are not able to metabolize glucose as well
during stressful times.
d. A patient's diet is different here in the hospital than at home, and that is the most likely
because of the increased glucose level.
e. Medications such as steroids may increase glucose levels.-A B E (The release of cortisol,
epinephrine, and norepinephrine increases blood glucose levels. Activity decreases blood
glucose; therefore, increase in blood glucose while in the hospital could be related to inactivity.
