国际护士模拟试题16
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76. The nurse is caring for a postoperative patient receiving morphine via patient-controlled analgesia(PCA).The patient complains that he wakes up in severe pain after sleeping. Which of the following actions by the nurse would be most appropriate?
A. Administer the medication for the patient every hour.
B. Request that the physician order a bolus dose of pain medication.
C. Notify the physician to increase the patient’s dosage.
D. Instruct the patient to use the PCA pump every 10 minutes during the hour prior to sleep.
77. The nurse provides discharge instructions to a patient with hepatitis B. Which of the following statements. if made by the patient, would indcate the need for further instruction?
A I can never donate blood.”.
B. "I can never have unprotected sex”.
C. "I cannot share needles.”.
D. "I should avoid drugs and alcohol,”.
78. In a prlmigravida, the nurse would suspect cephalopelvic disproportion when
A. an unopened cervix fails to dilate after 20 hours of contractions.
B. the cervix remains unchanged for three hours with regular contractions and prior cervical dilatation.
C. the fetus descends in active labor at a rate of 1 .0 cm per hour.
D. the woman complains of an urge to push at 7-cm dilatation.
79. An elderly patient who is being assessed for postoperative pain, tells the nurse "1 don't want to bother you. I'll be okay.”Which of the following indicators should the nurse initially use to assess this patient for pain?
A. Statement of discomfort.
B. Nonverbal indicators of pain.
C. Changes in vital sign parameters.
D. Frequency of pain medication requests.
80. A patient is admitted for treatment with a thrombolytic medication. Which of the following patient statements should be reported to the physician?
A. "I am allergic to ibuprofen.”
B. "I have glaucoma.”
C. "I take aspirin (acetylsalicylic acid) every day.”
D I have had my gall bladder removed five years ago.”
71. Key: D
Client Teed: Growth and Development
D. The patient should check ber basal temperature to determine the effectiveness of this method because basal temperature changes signal ovulation. The patient will notice a drop in temperature when ovulation occurs. This is followed by a rise that lasts for two to four days prior to menstruation unless pregnancy occurs. If pregnancy occurs. the temperature remains elevated.
A. This method should not be advised after the sixth month postpartally. A more reliable method should be considered.
B. Breast-feeding does provide a period of infertility but is not considered effective.
C. This supplementation with formula feedings will disrupt breastfeeding and increase the likelihood of the menses returning as well as ovulation.
72. Key: B
Client Need: Management of Care
B. The most important management issue in DIC is treating the underlying cause. The primary prognostic factor is the ability to treat the underlying disease that precipitated the DIC.
A. Intravenous (IV) fluids, blood, platelets and fresh, frozen plasma are given to replace volume lost through severe bleeding. However. the primary management of DIC involves correction of the underlying cause.
C.The primary management is of DIC involves correction of the underlying cause,which may be removal of a dead fetus, treatment of existing infection, preeclampsia. eclampsia or removal of a placental abruption.
D. Renal failure is one consequence of DIC. The output is carefully monitored: however, treating the underlying cause is the priority.
73. Key: D
Client Need: Pharmacological and Parenteral Therapies
D. Fosamax is used to treat osteoporosis in post-menopausal women. The patient should be instructed to remain upright for 30 minutes after taking the dose of Fosamax to prevent esophageal irritation. Gastrointestinal side effects of Fosamax include anorexia, abdominal pain, nausea. vomiting. constipalion and esophageal ulceration.
A. Fosamax should be taken in the morning before food is consumed. It should not be crushed and mixed with food.
B. Fosamax should be taken with six to eight ounces of water.
C. Fosamax should not be taken sublingually. It should be taken orally with six to eight ounces of water in the morning before food and other medications.。
74. Key: B
Client Need: Management of Care
B. Blindness may occur when glaucoma is ignored or patients are not compliant with medication instructions. Having a second bottle of eye drops available will decrease the likelihood of not having sufficient medication on hand.
A. Patients with glaucoma should be instructed to refrain from driving for one to two hours after using eye drops.
C. Treatment of glaucoma is usually life-long.
D. Medications that dilate the pupil will prevent aqueous humor from draining through the canal of Schlemm, increasing the intraocular pressure. Patients with glaucoma are treated with eye drops that constrict the pupil.
75. Key: C
Client Need: Management of Care
C. Request that the physician stop the procedure until a local anesthetic can be administered.The nurse needs to be a protector and patient advocate. The nurse helps to maintain a safe environment for the client and takes steps to prevent injury and protect the client from possible adverse effects of diagnostic or treatment measures.
A. The patient is in pain now and relief should be immediate.
B. The procedure should not be allowed to continue until a local anesthetic is given.
D. The procedure should be stopped and the patient medicated rather than distracted.
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