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NURS 315 Exam 3: Questions And Complete Solutions
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NURS 315 Exam 3: Questions And Complete Solutions
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NURS 315 Exam 3: Questions And Complete SolutionsA client is diagnosed with Bell's palsy. What information should the nurse
teach the client about Bell's palsy (select all that apply)?
a. Bell's palsy affects the motor branches of the facial nerve.
b. Antiseizure drugs are the drugs of choice for treatment of Bell's palsy.
c. Nutrition and avoidance of hot foods or beverages are special needs for this
client.
d. Herpes simplex virus I is strongly associated as a precipitating factor in the
development of Bell's palsy. Right Ans - a, d
When planning care for a client who is experiencing acute attack of trigeminal
neuralgia, the nurse sets the highest priority on the client outcome of
a. Relief of pain
b. Relief of anxiety
c. Maintenance of oral hygiene
d. Maintenance of positive body image Right Ans - a
When caring for a client who has Guillain-Barré syndrome, which assessment
data obtained by the nurse will require the most immediate action?
a. The client is incontinent.
b. The client has continuous drooling saliva.
c. The client's blood pressure is 152/82 mm Hg.
d. The client complains of severe pain in the feet. Right Ans - b
Which manifestations is the nurse likely to document when performing a
physical assessment on a patient with dementia with Lewy bodies? Select all
that apply.
a. Rigidity
b. Dementia
c. Physical growth delays
d. Bradykinesia
e. Postural instability
f. Mild to moderate intellectual disability Right Ans - a, b, d, f
A 62-year-old client is brought to the clinic by a family member who is
concerned about the client's inability to solve common problems. To identify
whether the client's current mental status indicates an early stage in
dementia, which question should the nurse ask the client?
,a. "Where were you were born?"
b. "How positive is your self-image?"
c. "What did you have for breakfast?"
d. "Do you have any feelings of sadness?" Right Ans - c
The nurse in the long-term care facility cares for a 70-yr-old man with late-
stage dementia who is undernourished and has problems chewing and
swallowing. What should the nurse include in the plan of care for this patient?
a. Limit fluid intake during mealtimes to prevent aspiration.
b. Turn on the television to provide a distraction during meals.
c. Provide thickened fluids and moist foods in bite-size pieces.
d. Allow the patient to select favorite foods from the menu choices. Right
Ans - c
The home care nurse is visiting patients in the community. Which patient is
exhibiting an early warning sign of Alzheimer's disease (AD)?
a. A 65-yr-old male patient does not recognize his family members and close
friends
b. A 59-yr-old female patient misplaces her purse and jokes about having
memory loss
c. .A 79-yr-old male patient is incontinent and not able to perform hygiene
independently.
d. A 72-yr-old female patient is unable to locate the address where she has
lived for 10 years. Right Ans - d
Which intervention will the nurse include in the plan of care for a client who
has late stage Alzheimer's disease?
a. Encourage the client to discuss events from the past
b. Maintain a consistent daily routine for the client's care
c. Reorient the client to the date and time every 2 to 3 hours
d. Provide the client with current newspapers and magazines Right Ans - b
A client with Alzheimer's disease is wandering the halls very agitated, asking
for her "mommy" and crying. What is the best response by the nurse?
a. Ask the client, "Why are you behaving this way?"
b. Tell the client, "Let's go get a snack in the kitchen."
c. Ask the client, "Wouldn't you like to lie down now?"
d. Tell the client, "Just take some deep breaths and calm down." Right Ans -
b
, You administer the Confusion Assessment Method (CAM) tool to K.P. to
differentiate among various cognitive disorders, primarily because:
a. delirium can be reversed by treating the underlying causes.
b. depression is a common cause of dementia in older adults.
c. nursing care should be based on the cause of the cognitive impairment.
d. drug therapy with antipsychotic agents is indicated in the treatment of
dementia. Right Ans - a
The nurse is performing preoperative teaching for the older adult client who
will be having a cataract removed. Which instructions does the nurse include?
Select all that apply.
a. "Cataracts are an opacity of the lens that can be caused by aging, sunlight, or
trauma."
b. "You will need to wear a patch on your eye for several weeks after the
surgery."
c. "Several different types of eyedrops are requested after surgery, and they
have to be taken several times a day for up to 4 weeks."
d. "You will receive a medication to help you relax. Then you will receive some
different eyedrops to dilate your pupils and paralyze the lens."
e. "Bring sunglasses with you on the day of your procedure."
f. "Can you show me how to put tear drops in your eyes?"
g. "You might experience bruising and swelling around the eye." Right Ans -
a, c, d, e, f
To determine whether treatment is effective for a client with primary open-
angle glaucoma, the nurse will evaluate the client for improvement in
a. Eye pain
b. Visual field
c. Blurred vision
d. Depth perception Right Ans - b
The nurse is reviewing postoperative instructions with the client undergoing
stapedectomy. Which statement by the client indicates a need for further
teaching?
a. "I may have problems with vertigo after the surgery."
b. "I should not drink from a straw for several weeks."
c. "I will have to take antibiotics after the surgery."
d. "I will be able to hear as soon as my dressing is removed." Right Ans - d
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