P2W3 MS LEC CFU 9/2/22

Total points57/60
 
SESSIONS 30-35
The respondent's email (anpa.florentino.coc@phinmaed.com) was recorded on submission of
this form.

0 of 0 points
CLINICAL INSTRUCTOR*
April Den Canonigo

LAST NAME, FIRST NAME, MI.*

Florentino Angelyn P

SECTION*
C-03

SESSION 30
9 of 10 points
MULTIPLE CHOICE

While caring for a patient who is being treated for severe pelvic inflammatory disease
(PID), which of the following nursing actions minimizes transmission of infection?
*
1/1
Keeping the patient in a sitting position
Performing hand hygiene when entering the room
Strictly adhering to the no visitation policy
Implementing reverse isolation precautions

The nurse is assessing a client who is suspected of experiencing an enlarging prostate

gland (BPH). The nurse expects the enlarging prostate in BPH to be manifested by
which of the following symptoms?
*
1/1
Bowel elimination
Skin integrity
Peripheral vascular function
Urinary elimination
Which statement by the nurse demonstrates effective communication techniques when
initiating a discussion about sex with a 25-year-old female client?
*
1/1
"Do you know how to properly apply a male condom?"
"What questions do you have related to your sexual health?"
"Have you had sex with more than one partner?"
"Why didn't you start receiving annual Pap tests at an earlier age?"

The nurse is obtaining the history from a client who is suspected of having pelvic
inflammatory disease (PID). Which client statement would help support the suspicion of
PID?
*
1/1
"I haven't had sex with anyone else except my current partner."
"My partner and I use condoms during sexual intercourse."
"I was 15 years old when I first had sex."
"I've never had any sexually transmitted infection."

While caring for a client who is being treated for severe pelvic inflammatory disease
(PID), the nurse insists on keeping her in a semi sitting position. What would be the best
possible reason for the nurse's advice?
*
1/1
To prevent nosocomial infections to other clients
To facilitate easy distraction of the client
To prevent movement as it increases pain
To facilitate pelvic drainage and to minimize the upward extension of infection

The nurse is taking the history of a client who has had benign prostatic hyperplasia in
the past. To determine whether the client currently is experiencing difficulty, the nurse
asks the client about the presence of which of the following early symptoms?
*
1/1
Urge incontinence
Nocturia
Decreased force in the stream of urine
Urinary retention
A 16-year-old sexually active female patient with a history of pelvic inflammatory
disease (PID) presents to the emergency room with complaints of sudden right-sided
lower abdominal pain and gastrointestinal distress. She cannot recall the date of her last
menstrual period, but states she knows that she’s “late.” Her exam demonstrates a
unilateral, right adnexal mass. The nurse knows that this patient likely has which of
these prenatal complications?
*
0/1
gestational trophoblastic disease (GTD)
spontaneous abortion
ectopic pregnancy
premature rupture of membranes (PROM)

Correct answer
spontaneous abortion

The client asks, "What does an elevated PSA test mean?" On which scientific rationale
should the nurse base the response?
*
1/1
An elevated PSA can result from several different causes.
An elevated PSA can be only from prostate cancer.
An elevated PSA can be diagnostic for testicular cancer.
An elevated PSA is the only test used to diagnose BPH.

A man whose BPH has been successfully managed through medical treatment visits the
provider's office and reports he has suddenly had a return of symptoms including
frequency, urgency, and a sensation of incomplete emptying after voiding. The nurse
collects a thorough history and suspects the possible cause of the sudden exacerbation
of the client's symptoms may be:
*
1/1
increased sexual activity since his wife has retired.
antihypertensive medications he was recently prescribed.
increased levels of exercise as he trains for a marathon.
over-the-counter medications he's been taking to treat cold symptoms.

The nurse recognizes that urinary elimination changes may occur even in healthy elders
because:
*
1/1
the bladder distends, and its capacity increases.
elders ignore the need to void.
the amount of urine retained after voiding increases.
urine becomes more concentrated.

SESSION 31
10 of 10 points
MULTIPLE CHOICE

The nurse is providing care for a newly married woman with systemic lupus
erythematosus (SLE). Which client
statement indicates plan of care understanding?
*
1/1
"I will take birth control pills while I am taking cytotoxic medications."
"I do not need to contact the doctor if I develop a fever or rash."
"I plan to go to the movies this weekend so that I get out of the house."
"I can take ibuprofen as indicated for pain."

The nurse is planning care for an adolescent client who has systemic lupus
erythematosus (SLE). The nurse knows that the treatment plan implemented by the
healthcare team is appropriate for the situation when the client:
*
1/1
Refuses to attend school.
Does not want to attend any social functions.
Discusses skin changes with the healthcare personnel.
Discusses skin changes with a good friend.

The nurse is caring for a client who has been diagnosed with discoid lupus
erythematosus. The nurse is collaborating with the client to set goals for the nursing
plan of care. What is an appropriate goal for this client?
*
1/1
Work through the stages of death and dying.
Comply 100% of the time with a sun protection plan.
Gain weight to within 10 pounds of normal for height.
Report pain no higher than four on a scale of 1-10.
A client with SLE is being treated with immunosuppressant drugs and corticosteroids.
Which precautions should the nurse provide this client? Select all that apply.
*
1/1
Avoid large crowds.
Don't get a flu shot.
Use contraception to prevent pregnancy
Refrain from taking aspirin or ibuprofen.
Report signs of infection to the physician.

The client enters the outpatient clinic and states to the triage nurse, "I think I have the
flu. I'm so tired, I have no
appetite, and everything hurts." The triage nurse assesses the client and finds a
butterfly rash over the bridge of nose and on the cheeks. Which diagnosis does the
nurse expect?
*
1/1
Systemic lupus erythematosus
Fibromyalgia
Lyme disease
Gout

A nurse is caring for a client with systemic lupus erythematous (SLE) who is taking
hydroxychloroquine (Plaquenil). The nurse understands that the primary concern with
this drug is:
*
1/1
Pulmonary fibrosis.
Cushingoid effects.
Retinal toxicity.
Renal toxicity.

A nurse is caring for a client with systemic lupus erythematosus (SLE). The client
begins to cry and tells the nurse that
she is afraid that her skin will be disfigured with lesions. Which intervention does the
nurse plan to teach this client to minimize skin infections associated with SLE?
Select all that apply.
*
1/1
Use sunscreen with an SPF of 15 or greater.
Remain indoors on sunny days.
Avoid swimming in a pool or the ocean.
Avoid sun exposure between 10:00 a.m. and 3:00 p.m.
Decrease sun exposure between 3:00 p.m. and 5:00 p.m.

The nurse is caring for a client who is hospitalized due to an exacerbation of systemic
lupus erythematosus (SLE). The nurse is reviewing the client's lab work and finds the
white blood cell count (WBC) is shifted to the left. Based on this information, which is a
priority nursing diagnosis for this client?
*
1/1
Ineffective Protection
Ineffective Health Maintenance
Ineffective Individual Coping
Risk for Impaired Skin Integrity

The nurse is providing health education to a diverse group at a neighborhood

community center. Why does the nurse plan to include signs and symptoms of systemic
lupus erythematosus (SLE)?
*
1/1
The neighborhood is composed of many young female children.
The audience has asked the nurse to include the information.
The audience is mainly composed of Caucasian women.
The audience is mainly females of Asian-American descent.

A female client asks the nurse if there are any conditions that can exacerbate systemic
lupus erythematosus (SLE). Which is the best nurse response?
*
1/1
"Conditions that cause hypotension can often exacerbate SLE."
"GI upset is often associated with SLE exacerbation."
"Pregnancy is often associated with an SLE exacerbation."
"Fever is a known trigger for an SLE exacerbation."

SESSION 32
10 of 10 points
MULTIPLE CHOICE

A patient's low hemoglobin and hematocrit have necessitated a transfusion of packed

red blood cells (RBCs). Shortly after the first unit of RBCs starts to infuse, the patient
develops signs and symptoms of a transfusion reaction. Which type of hypersensitivity
reaction has the patient experienced?
*
1/1
Type I
Type II
Type III
Type IV

A nurse practicing in a nurse-managed clinic suspects that an 8-year-old child's chronic

sinusitis and upper respiratory tract infections may result from allergies. She orders an
immunoglobulin assay. Which immunoglobulin would the nurse expect to find elevated?
*
1/1
Immunoglobulin M
Immunoglobulin E
Immunoglobulin D
Immunoglobulin G

When administering a blood transfusion to a client with multiple traumatic injuries, the
nurse monitors closely for evidence of a transfusion reaction. Shortly after the
transfusion begins, the client complains of chest pain, nausea, and itching and there is a
rise in the client's temperature. The nurse stops the transfusion and notifies the
physician. The nurse suspects which type of hypersensitivity reaction with a blood
transfusion?
*
1/1
Type II (cytolytic, cytotoxic) hypersensitivity reaction
Type IV (cell-mediated, delayed) hypersensitivity reaction
Type I (immediate, anaphylactic) hypersensitivity reaction
Type III (immune complex) hypersensitivity reaction

A nurse encourages a client with an immunologic disorder to eat a nutritionally balanced

diet to promote optimal immunologic function. Which snacks have the greatest
probability of stimulating autoimmunity?
*
1/1
Applesauce and dried apricots
Potato chips and chocolate milk shakes
Raisins and carrot sticks
Fruit salad and mineral water

A nurse practicing in a nurse-managed clinic suspects that an 8-year-old child's chronic

sinusitis and upper respiratory tract infections may result from allergies. Which
laboratory test would the nurse most likely order? Select all that apply.
*
1/1
Metabolic panel
Rheumatoid factor
Immunoglobulin assay (IgE)
Liver function studies
Complete blood count

A 19-year-old male being tested for multiple allergies develops localized redness and
swelling in reaction to a patch skin test. Which intervention by the nurse would have the
highest priority?
*
1/1
Notify the primary care provider
Apply a topical anti-inflammatory cream
Remove the patch and extract from the skin
Administer oral diphenhydramine (Benadryl)

During a school party a child with a known food allergy has an itchy throat, is wheezing,
and reports not feeling "quite right." The nurse should do the following in what order
from first to last? All options must be used. 
a) Assess vital signs.
b) Position to facilitate breathing.
c) Send someone to activate the Emergency Management Systems (EMS).
d) Administer the child's epinephrine.
e) Notify the parents.
*
1/1
B, D, A, E, C
C, D, B, A, E
A, B, C, D, E
E, C, B, A, D
A client develops a facial rash and urticaria after receiving penicillin. Which laboratory
value does the nurse expect to be elevated?
*
1/1
IgE
IgG
IgA
IgB

A client is experiencing an allergic response. The nurse should perform the actions in
which order from first to last? All options must be used.
a) Activate the rapid response team.
b) Assess the airway and breathing pattern.
c) Notify the health care provider (HCP).
d) Assess for urticaria.
*
1/1
B, D, A, C
A, B, C, D
D, C, A, B
C, B, D, A

A nurse is caring for a client with the following laboratory values: white blood cell count
(WBC) 4,500/mm3, neutrophils 15%, and bands 1%. Based on the client's absolute
neutrophil count (ANC), the nurse knows that the clients risk for infection is:
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1/1
No increased risk
Significant risk
low risk
intermediate risk

SESSION 33
10 of 10 points
MULTIPLE CHOICE

Which of the following statements should the nurse include in the teaching session
when preparing a client for arthrocentesis? Select all that apply.
*
1/1
"A local anesthetic agent may be injected into the joint site for your comfort."
"A syringe and needle will be used to withdraw fluid from your joint."
"The procedure, although not painful, will provide immediate relief."
"We'll want you to keep your joint active after the procedure to increase blood flow."
"You will need to wear a compression bandage for several days after the procedure."

Which of the following should the nurse assess when completing the history and
physical examination of a client diagnosed with osteoarthritis?
*
1/1
Anemia.
Osteoporosis.
Weight loss.
Local joint pain.

A client with rheumatoid arthritis states, "I can't do my household chores without
becoming tired. My knees hurt whenever I walk." Which nursing diagnosis would be
most appropriate?
*
1/1
Activity intolerance related to fatigue and pain.
Self-care deficit related to increasing joint pain.
Ineffective coping related to chronic pain.
Disturbed body image related to fatigue and joint pain.

A physician orders a lengthy X-ray examination for a client with osteoarthritis. Which of
the following actions by the nurse would demonstrate client advocacy?
*
1/1
Contact the X-ray department and ask the technician if the lengthy session can be divided into
shorter sessions.
Contact the physician to determine if an alternative examination could be scheduled.
Provide a dose of acetaminophen (Tylenol).
Cancel the examination because of the hard X-ray table.

During a home health visit you are helping a patient with gout identify foods in their
pantry they should avoid eating. Select all the foods below the patient should avoid:
*
1/1
Sardines
Whole wheat bread
Sweetbreads
Crackers
Craft beer
Bananas

A client with osteoarthritis will undergo an arthrocentesis on his painful edematous

knee. What should be included in the nursing plan of care? Select all that apply.
*
1/1
Explain the procedure.
Administer preoperative medication 1 hour before surgery.
Instruct the client to immobilize the knee for 2 days after the surgery.
Assess the site for bleeding.
Offer pain medication

Of the clients listed below, who is at risk for developing rheumatoid arthritis (RA)?
Select all that apply.
*
1/1
Adults between the ages of 20 and 50 years.
Adults who have had an infectious disease with the Epstein-Barr virus.
Adults that are of the male gender.
Adults who possess the genetic link, specifically HLA-DR4.
Adults who also have osteoarthritis.

Identify which patient below is at MOST risk for developing gout:

*
1/1
A 56-year-old male who reports consuming foods low in purines.
A 45-year-old male with a BMI of 40 who reports taking hydrochlorothiazide and aspirin.
A 39-year-old female hospitalized with bulimia that has a BMI of 24.
A 27-year-old female with ulcerative colitis.

A client is in the acute phase of rheumatoid arthritis. Which of the following should the
nurse identify as lowest priority in the plan of care?
*
1/1
Relieving pain.
Preserving joint function.
Maintaining usual ways of accomplishing tasks.
Preventing joint deformity.
On a visit to the clinic, a client reports the onset of early symptoms of rheumatoid
arthritis. The nurse should conduct a focused assessment for:
*
1/1
Limited motion of joints.
Deformed joints of the hands.
Early morning stiffness.
Rheumatoid nodules.

SESSION 34
9 of 10 points
MULTIPLE CHOICE

The nurse has taught a patient admitted with diabetes, cellulitis, and osteomyelitis about
the principles of foot care. The nurse evaluates that the patient understands the
principles of foot care if the patient makes what statement?
*
0/1
"I should only walk barefoot in nice dry weather."
"I should look at the condition of my feet every day."
"I am lucky my shoes fit so nice and tight because they give me firm support."
"When I am allowed up out of bed, I should check the shower water with my toes."

Correct answer
"I should only walk barefoot in nice dry weather."

Which patient with type 1 diabetes mellitus would be at the highest risk for developing
hypoglycemic unawareness?
*
1/1
A 58-year-old patient with diabetic retinopathy
A 73-year-old patient who takes propranolol (Inderal)
A 19-year-old patient who is on the school track team
A 24-year-old patient with a hemoglobin A1C of 8.9%

The nurse is assigned to the care of a 64-year-old patient diagnosed with type 2
diabetes. In formulating a teaching plan that encourages the patient to actively
participate in management of the diabetes, what should be the nurse's initial
intervention?
*
1/1
Assess patient's perception of what it means to have diabetes.
Ask the patient to write down current knowledge about diabetes.
Set goals for the patient to actively participate in managing his diabetes.
Assume responsibility for all of the patient's care to decrease stress level.

The nurse teaches a 38-year-old man who was recently diagnosed with type 1 diabetes
mellitus about insulin
administration. Which statement by the patient requires an intervention by the nurse?
*
1/1
"I will discard any insulin bottle that is cloudy in appearance."
"The best injection site for insulin administration is in my abdomen."
"I can wash the site with soap and water before insulin administration."
"I may keep my insulin at room temperature (75o F) for up to a month."

The nurse is teaching a 60-year-old woman with type 2 diabetes mellitus how to prevent
diabetic nephropathy. Which statement made by the patient indicates that teaching has
been successful?
*
1/1
"Smokeless tobacco products decrease the risk of kidney damage."
"I can help control my blood pressure by avoiding foods high in salt."
"I should have yearly dilated eye examinations by an ophthalmologist."
"I will avoid hypoglycemia by keeping my blood sugar above 180 mg/dL."

The nurse has been teaching a patient with diabetes mellitus how to perform self-
monitoring of blood glucose (SMBG). During evaluation of the patient's technique, the
nurse identifies a need for additional teaching when the patient does what?
*
1/1
Chooses a puncture site in the center of the finger pad.
Washes hands with soap and water to cleanse the site to be used.
Warms the finger before puncturing the finger to obtain a drop of blood.
Tells the nurse that the result of 110 mg/dL indicates good control of diabetes.

The nurse is reviewing laboratory results for the clinic patients to be seen today. Which
patient meets the diagnostic criteria for diabetes mellitus?
*
1/1
A 48-year-old woman with a hemoglobin A1C of 8.4%
A 58-year-old man with a fasting blood glucose of 111 mg/dL
A 68-year-old woman with a random plasma glucose of 190 mg/dL
A 78-year-old man with a 2-hour glucose tolerance plasma glucose of 184 mg/dL

The nurse instructs a 22-year-old female patient with diabetes mellitus about a healthy
eating plan. Which statement made by the patient indicates that teaching was
successful?
*
1/1
"I plan to lose 25 pounds this year by following a high-protein diet."
"I may have a hypoglycemic reaction if I drink alcohol on an empty stomach."
"I should include more fiber in my diet than a person who does not have diabetes."
"If I use an insulin pump, I will not need to limit the amount of saturated fat in my diet."

The nurse caring for a patient hospitalized with diabetes mellitus would look for which
laboratory test result to obtain information on the patient's past glucose control?
*
1/1
Prealbumin level
Urine ketone level
Fasting glucose level
Glycosylated hemoglobin level

A 54-year-old patient admitted with type 2 diabetes asks the nurse what "type 2" means.
What is the most appropriate response by the nurse?
*
1/1
"With type 2 diabetes, the body of the pancreas becomes inflamed."
"With type 2 diabetes, insulin secretion is decreased, and insulin resistance is increased."
"With type 2 diabetes, the patient is totally dependent on an outside source of insulin."
"With type 2 diabetes, the body produces autoantibodies that destroy β-cells in the pancreas."

SESSION 35
9 of 10 points
MULTIPLE CHOICE

Which of the following causes the majority of UTI’s in hospitalized patients?

*
1/1
Lack of fluid intake
Inadequate perineal care
Invasive procedures
Immunosuppression
The nurse is planning to teach the client about the signs and symptoms of a urinary
tract infection. The nurse should include: 
*
0/1
dysuria.
foul smelling cloudy urine.
urgency.
back pain.

Correct answer
dysuria.

the most common early sign of kidney disease is:

*
1/1
Sodium retention
Elevated BUN level
Development of metabolic acidosis
Inability to dilute or concentrate urine

A client diagnosed with pyelonephritis asks the nurse "What is the disease?" The
nurse's best response "Pyelonephritis is an:
*
1/1
inflammation of the kidney and renal pelvis."
inflammation of the prostate gland."
inflammation of the urethra."
inflammation of the bladder."

When examining a female client’s genitourinary system, Nurse Sandy assesses for
tenderness at the costovertebral angle by placing the left hand over this area and
striking it with the right fist. Normally, this percussion technique produces which sound?
*
1/1
A flat sound
A dull sound
Hyperresonance
Tympany
Which of the following symptoms do you expect to see in a patient diagnosed with acute
pyelonephritis?
*
1/1
Jaundice and flank pain
Costovertebral angle tenderness and chills
Burning sensation on urination
Polyuria and nocturia

A client with pyelonephritis is being discharged from the hospital, and the nurse
provides instructions to the client to prevent recurrence. The nurse determines that the
client understands the information that was given if the client states an intention to:
*
1/1
increase fluids for 2 days if signs and symptoms of a urinary tract infection develop
take the prescribed antibiotics until all symptoms subside
return to the physician's office for scheduled follow-up urine cultures
decrease fluid intake if frequent urination occurs

Which patient is at greatest risk for developing a urinary tract infection (UTI)?
*
1/1
A 35 y.o. woman with a fractured wrist
A 20 y.o. woman with asthma
A 50 y.o. postmenopausal woman
A 28 y.o. with angina

A male client is complaining of urinary frequency, dysuria, pain, fever and chills for the
third time in 9 months. The nurse should expect which diagnostic test to be ordered
since this is the third infection in 9 months?
*
1/1
Urinalysis
X-ray of kidneys, ureter and bladder
Intravenous pyelography
Computed tomography of the abdomen

The nurse is aware that the following laboratory values supports a diagnosis of
pyelonephritis?
*
1/1
Myoglobinuria
Ketonuria
Pyuria
Low white blood cell (WBC) count
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