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发布时间:2024-02-02 05:40:47

[单项选择]After a cerebrovascular accident (CVA) a client develops aphasia. Which assessment finding is most typical in aphasia
A. Arm and leg weakness.
B. Absence of the gag reflex.
C. Difficulty swallowing.
D. Inability to speak clearly.

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[单项选择]A client has had a cerebrovascular accident (CVA). Because the CVA affected the left side of the client’s brain, the nurse should anticipate that the client would most likely experience()
A. dyslexia.
B. apraxia.
C. agnosia.
D. expressive aphasia.
[单项选择]Nursing care for a client after electroeonvulsive therapy (ECT) should include which of the following()
A. Nothing by mouth for 24 hours after the treatment because of the anesthetic agent.
B. Bed rest for the first 8 hours after a treatment.
C. Assessment of short-term memory loss.
D. No special care.
[单项选择]The nursing care plan for a client after gynecologic surgery includes nursing orders intended to help reduce the risk of thrombophlebitis. Which is not appropriate among the following nursing interventions( )
A. Ambulate the client.
B. Massage the client’s legs.
C. Have the client wear elasticized stockings.
D. Have the client perform range-of-motion exercises in bed.
[单项选择]The nurse is planning care for a client after a tracheostomy. One of the client’s goals is to overcome verbal communication impairment. Which of the following interventions should the nurse include in the care plan()
A. Make an effort to read the client’s lips to foster communication.
B. Encourage the client’s communication attempts by allowing him time to select or write words.
C. Answer questions for the client to reduce his frustration.
D. Avoid using a tracheostomy plug because it blocks the airway.
[单项选择]A few days after a colectomy, a client suddenly develops chest pain, shortness of breath, and air hunger. The nurse knows she must further assess the client’s chest pain to determine its origin. When determining whether the chest pain is cardiac or pleuritic in nature, the nurse knows that pleuritic chest pain typically()
A. is described as crushing and substernal.
B. worsens with deep inspiration.
C. is relieved with nitroglycerin.
D. is relieved when the client leans forward.
[单项选择]A client is admitted for detoxification after a cocaine overdose. The client tells the nurse that he frequently uses cocaine but that he can control his use if he chooses. Which coping mechanism is he using()
A. Withdrawal.
B. Logical thinking.
C. Repression.
D. Denial.
[单项选择]After cancer chemotherapy, a client develops nausea and vomiting. For this client, the nurse should give the highest priority to which action in the plan of care()
A. Serve small portions of bland food.
B. Encourage rhythmic breathing exercise.
C. Administer metoclopramide (Reglan) and dexamethasone (Decadron) as prescribed.
D. Withhold fluids for the first 4 to 6 hours after chemotherapy administration.
[单项选择]A client is brought to the hospital after vomiting bright red blood and is admitted through the emergency department with a diagnosis of bleeding duodenal ulcer. While the client is bleeding, it will be essential for the nurse to assess frequently for signs of early shock. Which one of the following is an important indicator of early shock()
A. Tachycardia.
B. Dry, flushed skin.
C. Increased urine output.
D. Loss of consciousness.
[单项选择]A client reports a severe headache shortly after a lumbar puncture for a myelogram. What would be the nurse’s best response()
A. Increase the client’s fluid intake.
B. Administer prescribed antihypertensives.
C. Offer roll lenses to the client.
D. Place cooling packs over the lumbar puncture site.
[单项选择]After delivering her second child, the client tells the nurse that she wants to breast-feed. She indicates that she was unsuccessful at breast-feeding her first child and that she bottle-fed after 3 days of trying to nurse. Which of the following responses would best support this client’s breast-feeding efforts()
A. "I’ll make sure that you’re seen by the lactation consultant before you’re discharged. "
B. "It’s important to room-in with your neonate so that you can respond to her nursing: cues, "
C. "Don’t worry, every baby is different, and I’m sure that you’ll be successful this time. "
D. "Breast-feeding is possible but you must be committed to it. "
[单项选择]During the first 24 hours after a client is diagnosed with addisonian crisis, which of the following should the nurse perform frequently()
A. Weigh the client.
B. Test urine for ketones.
C. Assess vital signs.
D. Administer oral hydrocortisone.
[单项选择]After a client receives an IM injection, he complains of burning pain in the injection site. Which nursing action would be the best to take at this time()
A. Apply a cold compress to decrease swelling.
B. Apply a warm compress to dilate the blood vessels.
C. Massage the area to promote absorption of the drug.
D. Instruct the client to tighten his gluteal muscles to promote better absorption.
[单项选择]After determining that a pregnant client is Rh-negative, the physician orders an indirect Coombs’test. What’s the purpose of performing this test on a pregnant client( )
A. To determine the fetal blood Rh factor.
B. To determine the maternal blood Rh factor.
C. To detect maternal antibodies against fetal Rh-positive factor.
D. To detect maternal antibodies against fetal Rh-negative factor.
[单项选择]After a gastrectomy, the client will have a nasogastric tube in place for several days postoperatively. The nurse explains to the client that the nasogastric tube is for which of the following reasons
A. Prevent excessive pressure on suture lines.
B. Prevent the development of ascites.
C. Provide enteral feedings in the immediate postoperative period.
D. Enable administration of antacids to promote healing of the anastomosis.
[单项选择]A 2-year-old client returns from surgery after a bowel resection as a result of Hirschsprung’s disease. A temporary colostomy is in place. Which immediate postoperative nursing intervention takes priority()
A. Changing the surgical dressing.
B. Suctioning the nasopharynx frequently to remove secretions.
C. Irrigating the colostomy with 100 ml of normal saline solution.
D. Auscultating lung sounds.
[单项选择]A client is in the first postoperative day after a total laryngectomy and radical neck dissection. Which of the following is a priority goal()
A. Communicate by use of esophageal speech.
B. Improve body image and self-esteem.
C. Attain optimal levels of nutrition.
D. Maintain a patent airway.
[单项选择]After 5 days of hospitalization, the client who is receiving morphine sulfate for pain control asks for more pain medication with increasing frequency and exhibits increased anxiety and restlessness. His physical condition is stable. What is the probable cause of his behavior()
A. His morphine dosage is too high.
B. His coping mechanisms are exhausted.
C. He is becoming addicted to the narcotic.
D. He has developed tolerance to his narcotic dosage.

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