RPN Integrated Test VIII (GRADED A) Questions and Answer solutions | TOP SCORE | 100% Guaranteed pass
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Nursing
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Chamberlain School Of Nursing
RPN Integrated Test VIII (A): 1. Peter is young athlete, preparing for the Olympic competition, injures his knee on practice. The doctor prescribes Ibuprofen (Advil) for pain and to reduce infl ammation. Peter went for a 3-week therapy. On his 3rd week, he notices petechiae all over his skin, and h...
demanding pain medication the patient refuses to calm down so the nurse obtains leather restraints and threatens to
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RPN Integrated Test VIII
(A):
1.Peter is young athlete, preparing for the Olympic competition, injures his knee on practice. The doctor prescribes
Ibuprofen (Advil) for pain and to reduce inflammation. Peter went for a 3-week therapy. On his 3rd week, he
notices petechiae all over his skin, and his blood test showed a platelet count of 9,000mm³. The PN can expect that
a. the patient will be able to continue therapy with this medication – due to the side effect (bleeding – platelet
deceased) of the drug, it should be discontinued
b. the dosage will be reduced from 3 to 2 tablets a day
c. the medication will be discontinued and an alternative agent will be prescribed
d. the lab studies will be repeated, as they are likely an error
Answer: C – petechiae are signs of bleeding, a complication of Motrin (Ibuprofen); the medication must be
discontinued
2. In the 12th week of gestation, the patient completely expels the products of conception. Because the patient is Rh
(-), the PN must:
a. Administer RhoGam within 72 hours after delivery
b. Make certain she receives RhoGam on her first clinic visit – this is too late
c. Not give RhoGam since it is not used with the birth of a stillborn
d. Make certain the patient does not receive RhoGam since the gestation was only 12 weeks
Answer: A –this is to protect the succeeding pregnancy; – RhoGam must be given within 72 hours of
abortion or delivery to kill the Rh positive RBC from the fetus and thus prevent antibody formation
3. The PN who works on the night shift enters the medication room and finds a co-worker with tourniquet wrapped
around the upper arm. The co-worker was about to insert a needle, attached to a syringe containing a clear liquid,
into the antecubital area. The most appropriate initial action by the PN is which of the following?
a. call one of the staff to witness
b. confront your co-worker
c. obtain immediate help
d. call the nursing supervisor
Answer: D - the nurse should report the situation to the nursing supervisor. Proper channel of communication
should be used to deal with legal matters.
4. Three days after admission for CVA, a patient has a nasogastric tube inserted and is receiving intermittent
feedings. To best evaluate if a prior feeding has been absorbed, the PN should:
a. Evaluate the intake in relation to the output.
b. Aspirate for a residual volume and reinstill it.
c. Instill air into the stomach while auscultating.
d. Compare the patient’s body weight to the baseline data.
Answer: B – the presence of 50 ml or more of undigested formula may indicate impaired absorption; the volume of
the next feeding may need to be reduced or the feeding postponed to reducing the risk of aspiration.
5. The most therapeutic diet for a patient with hepatic cirrhosis would be:
a. High protein, low carbohydrate, low fat.
b. Low protein, low carbohydrate, high fat, soft.
c. High carbohydrate, low saturated fat, 1200 calories.
d. Low sodium, protein to tolerance, moderate fat, high calorie, soft.
Answer: D – low sodium controls fluid retention, blood pressure, and consequently edema; low protein controls
ammonia formation in proportion to the liver’s ability to detoxify ammonia in forming urea; moderate fat and high
calories and vitamins help repair a long standing nutritional deficit.
6. To prevent toxoplamosis, the PN should instruct to avoid:
, a. Contact with cat feces
b. Working with heavy metals
c. Ingestion of fresh water fish
d. Excessive radiation exposure
Answer: A - Toxoplasma gondii, a protozoan, can be transmitted by exposure to infected cat feces or ingestion of
undercooked contaminated meat.
7. John Sherman’s medical history includes R CVA. He has difficulty swallowing. The PN taking care of the patient
will appropriately do the following:
a. Offer pureed diet and spoon feed the patient
b. Use straw and instruct the patient to drink one glass of water
c. Encourage Mrs. Sherman to bring home-cooked food so the patient can eat his favorite foods
d. Encourage the patient to feed himself with his good hand
d. Important, pertinent and relevant data from another hospice in the community.
8. In assessing an infant for congenital hip dysplasia the PN would observe for:
a. Uneven gluteal folds
b. Positive Babinski reflex
c. Pain when moving the lower extremities
d. Weakness on the affected side
Answer: A – Uneven gluteal folds are an indication that one hip is dislocated
.
9. Before eating a meal, a client with obsessive-compulsive behavior must wash his hands for 18 times, combs his
hair 444 times strokes, and switch the bathroom light on and off 44 times. What is the most appropriate long
term treatment goal for this client?
a. omit one unacceptable behavior each day
b. increase client’s acceptance of therapeutic drug use
c. allow ample time for the client to complete all rituals before each meal
d. systematically decrease the amount of time spent in and the number of repetitions of rituals --
10. A 16-year-old patient who sustained partial thickness burn on both hands and left lower abdomen with total of
36% burn. The patient underwent skin grafting. Vital signs are BP 124/68; HR 100 bpm; RR 24; T 37.7ºC,
potential complication that can be possibly develop will be:
a. Sepsis - skin grafting may predispose the patient to septicemia
b. Hypovolemic – this will not happen from skin grafting
c. Pain – this is expected and not a complication
d. Electrolyte imbalance – this will not occur in skin grafting
11. A client admitted completely immobilized by an acute exacerbation of multiple sclerosis. Two days after
admission, the client cries frequently and refuses to see family members. For this client, the PN identifies a
nursing diagnosis of hopelessness. To address this diagnosis, which intervention should the PN include in the
client’s care plan?
a. Obtain an order for a tranquilizer – this is not an appropriate treatment to a depressed patient
b. Limit visitors to 15 minutes per day – socialization is encouraged in depression
c. Encourage the client to verbalize his feelings – this decreases anxiety level
d. Reinforce the client’s responsibility to the family
12.A 29-year-old-first-time mother came for her 6-week postpartum check up. Her, husband, who accompanies her
to the visit, reports that his wife is tearful much of the time. She has not been sleeping well, has little energy, and
a reduced appetite. She denies any suicidal thought, hallucinations or feelings that she wants to harm her baby.
Which of the following is the most likely diagnosis?
a. Maternal post partum blues
b. Post partum psychosis
, c. Post partum depression
d. Normal response to the overwhelming responsibilities of motherhood
Answer: C – this is post partum depression. The symptoms are identical to those of a major depressive episode. The
maternal blues is self limited that starts in the post partum week and resolved in the second. The patient does not
have any symptoms of post partum psychosis – mania, hallucination, and delusion. Management include medication,
counselling and close follow up.
13. Which nursing intervention is most important when caring for a client with acute pyelonephritis?
a. Administer sitz bath twice daily
b. Increase the fluid intake to 3 Quarts per day
c. Use an indwelling catheter to measure output accurately
d. Encourage the client to drink cranberry juice to acidify the urine – this acidify urine; alkaline urine
is one cause of UTI (pyelonephritis)
14. A client admitted with increased ascites associated with cirrhosis. Which nursing diagnosis should receive top
priority?
a. Fatigue - this may not be due to ascites
b. Excess fluid volume
c. Ineffective breathing pattern – the distended abdomen (ascites) pushes the diaphragm up causing
SOB
d. Imbalanced nutrition less than body requirements
15. Oral hypoglycemic agents may be used for patients with:
a. Ketosis – this is due to hyperglycemia
b. Obesity – not related
c. Type I DM – uses insulin
d. Some insulin production
Answer: D – oral hypoglycemics may be helpful when some functioning of the beta cells exists, as in type II DM.
16. A diabetic young diabetic came to the clinic for oral contraceptive. Which of the following responses made by
the PN is appropriate?
a. “Let’s discuss the various methods of contraceptive”
b. “Oral contraceptives are not appropriate for your medical condition” – oral contraceptives are
family of steroids and increases blood sugar
c. “You can probably use condom”
d. “You need to consult the physician”
17. Diana brought her mother to the long term facility. The PN wanted to interview the daughter but the patient
started crying. What should the PN do?
a. Leave them alone for sometime then come back when the patient is feeling better – the patient may not
feel better right away
b. Leave them alone for sometime and allow the patient to regain her self-esteem and come back later – this
may take sometime to happen
c. Leave them alone for sometime and let the patient compose herself and come back later to do the
interview - this is an appropriate – once composure is regain, the patient may be able to cooperate
with the interview
d. Explain to the daughter that the RN needs to do the interview right now
18. Marion is a 43-year-old female patient who was admitted with a diagnosis of depression. When working
with the patient who is depressed, the PN should initially:
a. Accept the patient for what she is. – unconditional acceptance of the patient is most important in
establishing the nurse-client relationship
b. Attempt to divert the patient’s attention.
c. Admit the patient in a private room.
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