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fourth semester final[1]

fourth semester final[1]

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Published by: mara5140 on Dec 23, 2008
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Department of NursingFinals Frenzy Practice Test
For students taking the final exam for NUR2744Directions: Print the exam and allow one hour to complete it. Use paper and pencil to record your answers. Please read each question carefully. Select theBEST possible answer. There is only one correct answer per question. Whenyou are done, click on the answers icon to check results.1. A patient presents with complaints of anorexia, muscle cramping,decreased urination and weight gain. In addition, the patient states she has been more tired than usual and more forgetful experiencing frequentheadaches. What should the nurse do first?a. Assess the Patient’s Medical History b. Obtain Serum Electrolytesc. Assess for Evidence of Peripheral Edemad. Observe for Abdominal Distention2. A patient with a pituitary tumor has a urine output of more than 300ml per hour for the past two hours. The nurse knows that this indicates DiabetesInsipidus. Which action should the nurse take first.a. Monitor urine output over the next two hours b. Assess the urine for osmolality, glucose, and acetonec. Obtain Serum Electrolytes and Osmolalityd. Notify the physician and anticipate an increase in IV fluid rate3. After sustaining a right ventricular MI, your patient develops cardiogenicshock. Initally, you should expect to administer:a. Nitroglycerine (Tridyl) b. Lopressor (Metoprolol)c. Morphine Sulfate (Morphine)d. Plasmanex (Normal serum albumin)
4. Which of the following statements would be most effective whenspeaking with a staff member who refused to float to another area as theteam leader assigned?a. “You never float when I ask you to, you are causing other staff complaints” b. “I would appreciate your floating in rotation with others, you have work standards that would benefit other units as well as ours”c. “I know you hate to float but you have to take your turn and be flexible”d. “Please just go this time and I promise I won’t ask again”5. A 82 year old patient sustained an accident resulting in a cervical fracture.After application of a halo traction device, it will be most important for thenurse to apply which safety measure?a. Logrolling to position patient b. Keeping the head of bed at 30-45 degrees.c. Ensuring visibility of the wrench and tool kit at the bedsided. Inserting a nasogastric tube to prevent aspiration6. A patient admitted with an anterior wall MI 12 hours ago complains of recurring chest pain. What would be the most appropriate nursing action?a. No action is necessary, the patient is experiencing normal reperfusion. b. Obtain a 12 lead EKG and notify the physicianc. Administer a thrombolytic and begin heparin therapyd. Adminiser morphine sulfate and lidocaine7. Which nursing intervention can prevent a patient from experiencingautonomic dysreflexia?a. Administering chloral hydrate (Noctec) b. Assessing laboratory results as orderedc. Placing the patient in a Trendelenberg Positiond. Monitoring patency of the patient’s foley catheter 
8. A patient with pulmonary edema is monitored with a thermodilution(Swan-Ganz) catheter. The patient exhibits SOB, SaO2 92%, CVP 14, PAP32/21, SVR 900, HR 100, RR 26. Which would be the highest prioritynursing diagnosis?a. Ineffective Breathing Pattern b. Anxietyc. Impaired Gas Exchanged. Decreased Cardiac Output9. A patient with respiratory acidosis receives an order for endotrachealintubation for an ABG result of pH 7.29, PaO2 68, PCO2 56, NaHCO3 26,on a 100% Non-rebreather mask. Which nursing action is most appropriate post intubation?a. Auscultation of lungs for bilateral breath sounds b. Turning the patient from side to side every two hoursc. Monitoring serial arterial blood gassesd. Providing frequent oral hygiene10. A patient is status post exploratory laparotomy and repair of an intestinal perforation. Twentyfour hours post op, the patient’s blood pressure hasdropped to 90/58, is oozing red colored drainage from the central line siteand incision, and has developed 3mm petechiae over the armsand legs. The nurse suspects Disseminated Intervascular Coagulation (DIC).To confirm this diagnosis, the nurse should assess for which laboratoryfinding?a. Patelet count of 90,000mcg/L and HGB 9.1mg/dL b. PT 15 seconds and APTT 80 secondsc. FDP 50mcg/mL and D-Dimer 1:6 dilutiond. Creatinine 1.4 mg/dL and Fibrinogen Level 160mg/dL11. The nurse is caring for an intubated patient receiving TPN at 100cc/hour a 10% Lipid solution at 21cc/hour, dopamine at 10cc/hour (5mcg/kg/min),and propofol (Diprivan) at 50cc/hour (15 mcg/ kg/min). The most prioritynursing diagnosis for this patient would be:a. Anxiety: level 4 b. Alteration in nutrition: more than body requirementsc. Fluid volume overloadd. Risk for infection

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