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NURS 355 EXAM 2 QUESTIONS WITH CORRECT ANSWERS.
NURS 355 EXAM 2 QUESTIONS WITH CORRECT ANSWERS.
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NURS 355 EXAM 2 QUESTIONS WITH
CORRECT ANSWERS
Which ppinformation ppobtained ppby ppthe ppnurse ppin ppthe ppendocrine ppclinic ppabout ppa
pppatient ppwho pphas ppbeen pptaking ppprednisone pp40 ppmg ppdaily ppfor pp3 ppweeks ppis
ppmost ppimportant ppto ppreport ppto ppthe pphealth ppcare ppprovider?
a. ppPatient's ppblood pppressure ppis pp148/94 ppmm ppHg.
b. ppPatient pphas ppbilateral pp2+ pppitting ppankle ppedema.
c. ppPatient ppstopped pptaking ppthe ppmedication pp2 ppdays ppago.
d. ppPatient pphas ppnot ppbeen pptaking ppthe ppprescribed ppvitamin ppD. pp- ppAnswer
ppAnswer: ppPatient ppstopped pptaking ppthe ppmedication pp2 ppdays ppago.
Rationale: ppSudden ppcessation ppof ppcorticosteroids ppafter pptaking ppthe ppmedication
ppfor ppa ppweek ppor ppmore ppcan pplead ppto ppadrenal ppinsufficiency, ppwith ppproblems
ppsuch ppas ppsevere pphypotension ppand pphypoglycemia. ppThe pppatient ppwill ppneed
ppimmediate ppevaluation ppby ppthe pphealth ppcare ppprovider ppto ppprevent ppor pptreat
ppadrenal ppinsufficiency. ppThe ppother ppinformation ppwill ppalso ppbe ppreported ppbut
ppdoes ppnot pprequire pprapid pptreatment.
Which ppfinding ppfor ppa pppatient ppwho pphas pphypothyroidism ppand pphypertension
ppindicates ppthat ppthe ppnurse ppshould ppcontact ppthe pphealth ppcare ppprovider ppbefore
ppadministering pplevothyroxine pp(Synthroid)?
a. ppIncreased ppthyroxine pp(T4) pplevel
b. ppBlood pppressure pp112/62 ppmm ppHg
c. ppDistant ppand ppdifficult ppto pphear ppheart ppsounds
d. ppElevated ppthyroid ppstimulating pphormone pplevel pp- ppAnswer ppAnswer: ppIncreased
ppthyroxine pp(T4) pplevel
Rationale: ppAn ppincreased ppthyroxine pplevel ppindicates ppthe pplevothyroxine ppdose
ppneeds ppto ppbe ppdecreased. ppThe ppother ppdata ppare ppconsistent ppwith
pphypothyroidism ppand ppthe ppnurse ppshould ppadminister ppthe pplevothyroxine.
The ppnurse ppteaches ppa pppatient ppabout pppulmonary ppspirometry pptesting. ppWhich
ppstatement ppby ppthe pppatient ppindicates ppteaching ppwas ppeffective?
,a. pp"I ppshould ppuse ppmy ppinhaler ppright ppbefore ppthe pptest."
b. pp"I ppwon't ppeat ppor ppdrink ppanything pp8 pphours ppbefore ppthe pptest."
c. pp"I ppwill ppinhale ppdeeply ppand ppblow ppout pphard ppduring ppthe pptest."
d. pp"My ppblood pppressure ppand pppulse ppwill ppbe ppchecked ppevery pp15 ppminutes." pp-
ppAnswer ppAnswer: pp"I ppwill ppinhale ppdeeply ppand ppblow ppout pphard ppduring ppthe
pptest."
Rationale: ppFor ppspirometry, ppthe pppatient ppshould ppinhale ppdeeply ppand ppexhale ppas
pplong, pphard, ppand ppfast ppas pppossible. ppThe ppother ppactions ppare ppnot ppneeded.
ppThe ppadministration ppof ppinhaled ppbronchodilators ppshould ppbe ppavoided pp6 pphours
ppbefore ppthe ppprocedure.
A pppatient ppwith ppacute ppshortness ppof ppbreath ppis ppadmitted ppto ppthe pphospital.
ppWhich ppaction ppshould ppthe ppnurse pptake ppduring ppthe ppinitial ppassessment ppof
ppthe pppatient?
a. ppAsk ppthe pppatient ppto pplie ppdown ppfor ppcomplete ppa ppfull ppphysical ppassessment.
b. ppComplete ppthe pphealth pphistory ppand ppcheck ppfor ppallergies ppbefore pptreatment.
c. ppBriefly ppask ppspecific ppquestions ppabout ppthis ppepisode ppof pprespiratory ppdistress.
d. ppDelay ppthe ppphysical ppassessment ppto ppfirst ppcomplete pppulmonary ppfunction
pptests. pp- ppAnswer ppAnswer: ppBriefly ppask ppspecific ppquestions ppabout ppthis
ppepisode ppof pprespiratory ppdistress pp
Rationale: ppWhen ppa pppatient pphas ppsevere pprespiratory ppdistress, pponly ppinformation
pppertinent ppto ppthe ppcurrent ppepisode ppis ppobtained, ppand ppa ppmore ppthorough
ppassessment ppis ppdeferred ppuntil pplater. ppObtaining ppa ppcomprehensive pphealth
pphistory ppor ppfull ppphysical ppexamination ppis ppunnecessary ppuntil ppthe ppacute
ppdistress pphas ppresolved. ppBrief ppquestioning ppand ppa ppfocused ppphysical
ppassessment ppshould ppbe ppdone pprapidly ppto pphelp ppdetermine ppthe ppcause ppof ppthe
ppdistress ppand ppsuggest pptreatment. ppChecking ppfor ppallergies ppis ppimportant, ppbut
ppit ppis ppnot ppappropriate ppto ppcomplete ppthe ppentire ppadmission ppdatabase ppat ppthis
pptime. ppThe ppinitial pprespiratory ppassessment ppmust ppbe ppcompleted ppbefore ppany
ppdiagnostic pptests ppor ppinterventions ppcan ppbe ppordered.
The ppnurse ppprepares ppa pppatient ppwho pphas ppa ppleft-sided pppleural ppeffusion ppfor
ppa ppthoracentesis. ppHow ppshould ppthe ppnurse ppposition ppthe pppatient?
a. ppHigh-Fowler's ppposition ppwith ppthe ppleft pparm ppextended
b. ppSupine ppwith ppthe pphead ppof ppthe ppbed ppelevated pp30 ppdegrees
c. ppOn ppthe ppright ppside ppwith ppthe ppleft pparm ppextended ppabove ppthe pphead
d. ppSitting ppupright ppwith ppthe pparms ppsupported ppon ppan ppover ppbed pptable pp-
ppAnswer ppAnswer: ppSitting ppupright ppwith ppthe pparms ppsupported ppon ppan ppover
ppbed pptable pp
,Rationale: ppThe ppupright ppposition ppwith ppthe pparms ppsupported ppincreases pplung
ppexpansion, ppallows ppfluid ppto ppcollect ppat ppthe pplung ppbases, ppand ppexpands ppthe
ppintercostal ppspace ppso ppthat ppaccess ppto ppthe pppleural ppspace ppis ppeasier. ppThe
ppother pppositions ppwould ppincrease ppthe ppwork ppof ppbreathing ppfor ppthe pppatient
ppand ppmake ppit ppmore ppdifficult ppfor ppthe pphealth ppcare ppprovider ppperforming ppthe
ppthoracentesis.
A pppatient ppwith ppdiabetes pphas pparterial ppblood ppgas pp(ABG) ppresults pppH pp7.28;
ppPaCO2 pp34 ppmm ppHg; ppPaO2 pp85 ppmm ppHg; ppHCO3?2- pp18 ppmEq/L. ppThe
ppnurse ppwould ppexpect ppwhich ppfinding?
a. ppIntercostal ppretractions
b. ppKussmaul pprespirations
c. ppLow ppoxygen ppsaturation pp(SpO2)
d. ppDecreased ppvenous ppO2 pppressure pp- ppAnswer ppAnswer: ppKussmaul
pprespirations
Rationale: ppKussmaul pp(deep ppand pprapid) pprespirations ppare ppa ppcompensatory
ppmechanism ppfor ppmetabolic ppacidosis. ppThe pplow pppH ppand pplow ppbicarbonate
ppresult ppindicate ppmetabolic ppacidosis. ppAcidosis ppdoes ppnot ppcause ppintercostal
ppretractions, ppa pplow ppoxygen ppsaturation pprate, ppand ppa ppdecrease ppin ppvenous
ppO2 pppressure.
On ppauscultation ppof ppa pppatient's pplungs, ppthe ppnurse pphears pplow-pitched,
ppbubbling ppsounds ppduring ppinhalation ppin ppthe pplower ppthird ppbilaterally. ppHow
ppshould ppthe ppnurse ppdocument ppthis ppfinding? pp
a. ppInspiratory ppcrackles ppat ppthe ppbases
b. ppExpiratory ppwheezes ppin ppboth pplungs
c. ppAbnormal pplung ppsounds ppin ppthe ppapices ppof ppboth pplungs
d. ppPleural ppfriction pprub ppin ppthe ppright ppand ppleft pplower pplobes pp- ppAnswer
ppAnswer: ppInspiratory ppcrackles ppat ppthe ppbases pp
Rationale: ppCrackles ppare pplow-pitched, ppbubbling ppsounds ppusually ppheard ppon
ppinspiration. ppWheezes ppare pphigh-pitched ppsounds. ppThey ppcan ppbe ppheard ppduring
ppthe ppexpiratory ppor ppinspiratory ppphase ppof ppthe pprespiratory ppcycle. ppThe pplower
ppthird ppof ppboth pplungs ppare ppthe ppbases, ppnot ppapices. ppPleural ppfriction pprubs ppare
ppgrating ppsounds ppthat ppare ppusually ppheard ppduring ppboth ppinspiration ppand
ppexpiration.
, The ppnurse pppalpates ppthe ppposterior ppchest ppand ppnotes ppabsent ppfremitus ppwhile
ppthe pppatient ppsays pp"99". ppWhich ppaction ppshould ppthe ppnurse pptake ppnext?
a. ppPalpate ppthe ppanterior ppchest ppand ppobserve ppfor ppbarrel ppchest.
b. ppEncourage ppthe pppatient ppto ppturn, ppcough, ppand ppdeep ppbreathe.
c. ppReview ppthe ppchest ppx-ray ppreport ppfor ppevidence ppof pppneumonia.
d. ppAuscultate ppanterior ppand ppposterior ppbreath ppsounds ppbilaterally. pp- ppAnswer
ppAnswer: ppAuscultate ppanterior ppand ppposterior ppbreath ppsounds ppbilaterally
Rationale: ppTo ppassess ppfor pptactile ppfremitus, ppthe ppnurse ppuses ppthe pppalms ppof
ppthe pphands ppto pppalpate ppfor ppvibration ppwhile ppthe pppatient pprepeats ppa ppword ppor
ppphrase ppsuch ppas pp"99." ppAfter ppnoting ppabsent ppfremitus, ppthe ppnurse ppshould
ppthen ppauscultate ppthe pplungs ppto ppassess ppfor ppthe pppresence ppor ppabsence ppof
ppbreath ppsounds. ppAbsent ppfremitus ppmay ppbe ppnoted ppwith pppneumothorax ppor
ppatelectasis. ppThe ppvibration ppis ppincreased ppin ppconditions ppsuch ppas pppneumonia,
pplung pptumors, ppthick ppbronchial ppsecretions, ppand pppleural ppeffusion. ppTurning,
ppcoughing, ppand ppdeep ppbreathing ppare ppappropriate ppinterventions ppfor ppatelectasis,
ppbut ppthe ppnurse ppneeds ppto ppfirst ppassess ppbreath ppsounds. ppFremitus ppis
ppdecreased ppif ppthe pphand ppis ppfarther ppfrom ppthe pplung ppor ppthe pplung ppis
pphyperinflated pp(barrel ppchest). ppThe ppanterior ppof ppthe ppchest ppis ppmore ppdifficult
ppto pppalpate ppfor ppfremitus ppbecause ppof ppthe pppresence ppof pplarge ppmuscles ppand
ppbreast pptissue.
A pppatient ppwith ppa ppchronic ppcough ppis ppscheduled ppto pphave ppa ppbronchoscopy
ppwith ppbiopsy. ppWhich ppintervention ppwill ppthe ppnurse ppimplement ppdirectly ppafter
ppthe ppprocedure?
a. ppEncourage ppthe pppatient ppto ppdrink ppclear ppliquids.
b. ppPlace ppthe pppatient ppon ppbed pprest ppfor ppat ppleast pp4 pphours.
c. ppKeep ppthe pppatient ppNPO ppuntil ppthe ppgag ppreflex ppreturns.
d. ppMaintain ppthe pphead ppof ppthe ppbed ppelevated pp90 ppdegrees. pp- ppAnswer
ppAnswer: ppKeep ppthe pppatient ppNPO ppuntil ppthe ppgag ppreflex ppreturns pp
Rationale: ppRisk ppfor ppaspiration ppand ppmaintaining ppan ppopen ppairway ppis ppthe
pppriority. ppBecause ppa pplocal ppanesthetic ppis ppused ppto ppsuppress ppthe ppgag ppand
ppcough ppreflexes ppduring ppbronchoscopy, ppthe ppnurse ppshould ppmonitor ppfor ppthe
ppreturn ppof ppthese ppreflexes ppbefore ppallowing ppthe pppatient ppto pptake pporal ppfluids
ppor ppfood. ppThe pppatient ppdoes ppnot ppneed ppto ppbe ppon ppbed pprest, ppand ppthe
pphead ppof ppthe ppbed ppdoes ppnot ppneed ppto ppbe ppin ppthe pphigh-Fowler's ppposition.