Pre test - Musculoskeletal disorders

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Which of the following conditions is the primary complication of osteoporosis?
1 point
a. Pain
b. Fracture
c. Hardening of the bones
d. Increased bone matrix and remineralization
A client with hip fracture asks the nurse why Buck’s (extension) traction is being
applied before the surgery. The nurse’s response is based on the understanding that
Buck’s (extension) traction primarily:
1 point
a. Allows bony healing to begin before surgery
b. Provides rigid immobilization of the fractured site
c. Lengthens the fractured leg to prevent severing of blood vessels
d. Provides comfort by reducing muscle spasms and provides fracture immobilization
A nurse is lecturing to a group of women who are at high risk for osteoporosis.
What is the most important intervention that the nurse can inform the women about?
1 point
a. Limit protein in the diet because it contributes to the incidence of bone
demineralization
b. Limit participation in activities such as walking and swimming
c. Limit caffeine intake
d. Limit intake of vitamin D
Which of the following would be most comfortable for a client with a ruptured disc
at right L5-S1, that the nurse would position the client?
1 point
a. Prone
b. Supine with the legs flexed
c. High Fowler’s
d. Right Sims
A client is complaining of low back pain that radiates down the left posterior
thigh. The nurse further assesses the client to see if the pain is worsened or
aggravated by:
1 point
a. Letting the patient rest in bed
b. Letting the patient bend or lift something
c. Giving Ibuprofen
d. Applying heat to the affected site
Which of the following activities would the nurse instruct the client with low back
pain to avoid?
1 point
a. Keeping light objects below the level of the elbows when lifting
b. Leaning forward while bending the knees
c. Exceeding prescribed exercise program
d. Sleeping on the side with legs flexed
Which of the following mechanism is believed to cause gout?
1 point
a. Overproduction of calcium
b. Underproduction of calcium
c. Overproduction of uric acid
d. Underproduction of uric acid
A hospitalized client has been diagnosed with osteomyelitis of the left tibia. The
nurse understands that this condition is most likely to be a result of which of the
following events in the client’s recent history?
1 point
a. Open trauma to the leg
b. Sprained left ankle
c. Decreased calcium intake
d. Starting to smoke cigarette
The client diagnosed with osteoarthritis states, “My friend takes steroid pills for
her rheumatoid arthritis. Why don’t take steroids for my osteoarthritis?” what is
the nurse’s response to the client based on an understanding of the difference
between osteoarthritis and rheumatoid arthritis?
1 point
a. Non-opioid analgesics can be used for osteoarthritis
b. Oral corticosteroids can be used only in osteoarthritis
c. A systemic effect is needed in osteoarthritis not in Rheumatoid arthritis
d. Rheumatoid arthritis and osteoarthritis are two similar disease
At which of the following times would the nurse instruct the client to take
ibuprofen (Motrin) prescribed for left hip pain secondary to osteoarthritis, to
minimize gastric mucosal irritation?
1 point
a. At bedtime
b. On arising
c. Immediately after a meal
d. On an empty stomach
A home health nurse visits a client who is having an acute attack of gout. The
nurse determines that the client does not understand the treatment if the client
states that he is:
1 point
a. restricting fluids
b. eating a low-purine diet
c. maintaining bedrest
d. taking nonsteroidal anti-inflammatory drugs (NSAIDs)
A client with diabetes mellitus has had a right below-knee amputation. The nurse
would assess specifically for which of the following signs because of the history
of diabetes?
1 point
a. Hemorrhage
b. Edema of the stump
c. Slight redness of the incision
d. Separation of the wound edges
While assessing the home environment of an elderly client who is using crutches
during postoperative recovery phase after hip pinning. The nurse understands that
the following would pose the greatest hazard to the client as a risk for falling at
home, which will prompt her to do further health teaching before the client goes
home?
1 point
a. A 4-year-old cookware
b. Scatter rugs
c. Snack table
d. Rocking chair
A nurse is caring for a client who had an above-knee amputation 2 days ago. The
residual limb was wrapped with an elastic compression bandage, which has come off.
The nurse immediately:
1 point
a. Calls the physician
b. Applies ice to the site
c. Rewraps the stump with an elastic compression bandage
d. Applies a dry sterile dressing and elevates it with one pillow
In planning the postoperative care for a client with a cast, the nurse would select
which of the following as an appropriate nursing diagnosis?
1 point
a. Risk for deficient fluid volume related to excess fluid loss
b. Total urinary incontinence: related to aging process
c. Constipation related to decreased mobility
d. Imbalance nutrition: less than body requirements related to lack of knowledge of
appropriate food
The nurse is discharging a client with rheumatoid arthritis who complains of
morning stiffness. Which of the following measures should the nurse include in the
discharge instruction?
1 point
a. Encourage the client to sleep with pillows under the knees
b. Instruct the client to apply ice packs to the joints before getting out of bed
c. Instruct the client to take a warm shower in the morning when getting up
d. Teach the client to perform all of the household chores at one time
A client’s x-ray reveals a fracture in which one bone fragment is forced into or
onto another fragment. What type of fracture is this?
1 point
a. Compression
b. Impacted
c. Spiral
d. Transverse
The client with a herniated intervertebral disc schedule for a myelogram asks the
nurse about the procedure. The nurse understands that radiographs will be taken of
the client’s spine after an injection of which of the following?
1 point
a. Sterile water
b. Normal saline solution
c. Liquid nitrogen
d. Radiopaque dye
Skeletal muscle relaxants may be used in acute treatment of a herniated nucleus
pulposus. Which of the following instructions should be included in client a
teaching?
1 point
a. Change position quickly to avoid dizziness
b. Double a missed dose to ensure proper muscle relaxation
c. Cough and cold medications are appropriate to take, if needed
d. Avoid activities that requires alertness; muscle relaxants can cause drowsiness
On a visit to the clinic, a client reports the onset of early symptoms of
rheumatoid arthritis. which of the following would the nurse most likely assess?
1 point
a. limited range of motion
b. deformed form of the hands
c. early morning stiffness
d. rheumatoid arthritis
Allopurinol (Zyloprim) is prescribed for a client and the nurse provides medication
instructions to the client. The nurse instructs the client:
1 point
a. To drink 3000 mL of fluid a day
b. To take the medication on an empty stomach
c. That the effect of the medication will occur immediately
d. That if swelling of the lips occurs, this is a normal expected response
A nurse is providing instruction to a client on how to protect his back. Which of
the following statements indicates that the client understood the instruction?
1 point
a. “I should sleep on my side, and carry object at arm’s length.”
b. “I should sleep on my back, and carry objects at arm’s length.”
c. “I should sleep on my side, and carry object close to my body.”
d. “I should sleep on my back, and carry objects at arm’s close to my body.”
A client who had a plaster cast applied to his right forearm is for discharge.
Which of the following will you include on the nurse’s health teaching? Select all
that applies.
1 point
a. Keep the cast and extremity elevated
b. The cast needs to be kept clean and dry
c. Allow the wet cast 24 to 72 hours to dry
d. Tingling and numbness in the extremity are expected
e. Use a hair dryer set on a warm to hot setting to dry the cast
f. Use a soft padded object that will fit under the cast to scratch the skin under
the cast
The nurse is admitting a client with rheumatoid arthritis. Which of the following
laboratory test results would the nurse determine as being elevated and used to
monitor disease activity?
1 point
a. Serum uric acid
b. Erythrocyte sedimentation rate
c. Bence Jones protein
d. White blood cell count
Osteoblast activity is needed for which of the following functions?
1 point
a. Bone formation
b. Estrogen production
c. Hematopoiesis
d. Muscle formation
Which of the following conditions is the cause of primary osteoporosis?
1 point
a. Alcoholism
b. Hormonal imbalance
c. Malnutrition
d. Osteogenesis imperfect
A nurse is caring for a client being treated for fat embolus after multiple
fractures. Which of the following data would the nurse evaluate as the most
favorable indication of resolution of fat embolism?
1 point
a. Minimal dyspnea
b. Clear mentation
c. Oxygen saturation of 85%
d. Arterial oxygen level of 78 mm Hg
A client was brought to the hospital because he could not get out of bed because of
low back pain radiating down to his right heel and lateral foot. When developing
the client’s plan of care, which of the following categories of medication would
the nurse anticipate the physician to order?
1 point
a. Angiotensin-converting enzyme (ACE) inhibitors
b. β – adrenergic blocking agents
c. nonsteroidal anti-inflammatory drugs (NSAIDs)
d. barbiturates
Which of the following symptoms indicates that the patient has a herniated nucleus
pulposus?
1 point
a. Pain, numbness, weakness, leg or foot pain
b. Shortness of breath, weakness, leg or foot pain
c. Inability to walk, shortness of breath, weakness, leg or foot pain
d. Unstable gait, disorientation, numbness, weakness, leg or foot pain
Which of the following would be inappropriate to include when preparing a client
for magnetic resonance imaging (MRI) to evaluate a ruptured disc?
1 point
a. Inform the client that the procedure is painless
b. Taking a thorough history of past surgeries
c. Checking for previous complains of claustrophobia
d. Starting an intravenous line at keep-open rate
A nurse is conducting health screening for osteoporosis. Which of the following
clients is at greatest risk of developing this disorder?
1 point
a. A 25-yewr-old woman who jogs
b. A 36-year-old man who has asthma
c. A 70-year-old- man who consumes excess alcohol
d. A sedentary 65-year-old woman who smokes cigarettes
A nurse is one of several persons who witness a vehicle hit a pedestrian at fairly
low speed on a small street. The victim is dazed and tries to get up. The leg
appears fractured. The nurse would plan to:
1 point
a. Try to reduce the fracture manually.
b. Assist the victim to get up and walk to the sidewalk
c. Leave the victim for a few moments to call an ambulance
d. Stay with the victim and encourage the person to remain still
A community health nurse is providing an educational session for community members
regarding dietary measures that will assist in reducing the risk of osteoporosis.
The nurse instructs the community members to increase dietary intake of which food
known to be helpful in minimizing this risk?
1 point
a. Yogurt
b. Turkey
c. Spaghetti
d. Shellfish
The nurse is evaluating a nursing student about his/her understanding about a 40-
year old female client who had a total hysterectomy, if she is at risk of
osteoporosis. Which of the following indicates that the student nurse understand
about osteoporosis?
1 point
a. No, because she is still has her thyroid gland
b. Yes, because she’s still producing hormones
c. No, because she isn’t at risk until she’s older
d. Yes, because she’s just had surgically induced menopause
A client has been diagnosed with gout. In developing a dietary plan for the client,
a nurse plans to include which item on a list of foods to be avoided?
1 point
a. Liver
b. Carrots
c. Broccoli
d. Chocolate
A client is treated in a physician’s office for a sprained ankle after a fall.
Radiographic examination has ruled out a fracture. Before sending the client home,
the nurse plans to teach the client to avoid which of the following in the next 24
hours?
1 point
a. Resting the foot
b. Applying a heating pad
c. Applying an elastic compression bandage
d. Elevating the ankle on a pillow while sitting or lying down
In preparation for total knee surgery, a 200-pound client with osteoarthritis is
being discharged from the hospital to lose weight to reduce the risk of anesthesia.
In conjunction with a weight loss program, which of the following exercises would
the nurse recommend as best if the client has no contraindications based on her
understanding of osteoarthritis?
1 point
a. Weight lifting
b. Walking
c. Aquatic exercise
d. Tai chi exercise
Which of the following types of traction is used for leg traction?
1 point
a. Bryant’s traction
b. Russel traction
c. Pelvic belt
d. Buck’s traction
A nurse is caring for a client with a diagnosis of gout. Which of the following
laboratory values would the nurse expect to note in the client?
1 point
a. Calcium level of 9.0 mg/dl
b. Uric acid level of 8.6 mg/dl
c. potassium level of 4.1 mEq/L
d. phosphorus level 3.1 mg/dl
A nurse is admitting a client with multiple traumas to the nursing unit. The client
has a leg fracture and had a plaster cast applied. In positioning the casted leg,
the nurse should:
1 point
a. Keep the leg in a level position
b. Elevate the leg for 3 hours and put it flat for 1 hour
c. Keep the leg level for 3 hours and elevate it for 1 hour
d. Elevate the leg on pillows continuously for 24 to 48 hours
A nurse is lecturing to a group of women who are at high risk for osteoporosis.
What is the most important intervention that the nurse can inform the women about?
1 point
a. Limit protein in the diet because it contributes to the incidence of bone
demineralization
b. Limit participation in activities such as walking and swimming
c. Limit caffeine intake
d. Limit intake of vitamin D
Ruptured disc pain usually occurs in which of the following locations?
1 point
a. Joints
b. Tendons
c. Long bones
d. Lower back
A nurse has given a client instruction about crutch safety. The nurse determines
that the client needs reinforcement of information if the clients states:
1 point
a. That he or she will not use someone else’s crutches
b. That crutch tips will not slip even when wet
c. The need to have spare crutches and tips available
d. The crutch tips should be inspected periodically for wear
A nurse in the hospital emergency department is caring for a client with a
fractured arm and is preparing the client for a reduction of the fracture that will
be done in the casting room. Which of the following is unnecessary?
1 point
a. Explanation of the procedure to the client
b. Administration of an analgesic
c. Anesthesia consent
d. Consent for the procedure
Which of the following dietary guidelines should the nurse provide to a client with
a fracture?
1 point
a. Three large high-calorie meals
b. High-fiber foods and 2000 to 3000 mL of fluids daily
c. Low-protein and low-fat foods
d. Limit milk and milk products to two servings daily
Client education for the individual with gout includes:
1 point
a. Dietary instructions to limit meat, poultry, organ meats and alcohol
b. Dietary instructions to limit complex carbohydrates such as flat bread, rice and
pasta
c. Instructions for cast care
d. Signs and symptoms of compartment syndrome, a major complication
A community health nurse is providing a teaching session on osteoporosis to women
living in the community. The nurse informs these community residents that which of
the following is a risk factor for this disorder?
1 point
a. A large skeletal frame
b. A high dietary intake of calcium
c. Low thyroid hormone levels
d. A diet low in vitamin D
A client has sustained a closed fracture and has just had a cast applied to the
affected arm. The client is complaining of intense pain. The nurse elevates the
limb, applies an ice bag, and administers an analgesic, with little relief. The
nurse interprets that this pain may be caused by:
1 point
a. Infection under the cast
b. The anxiety of the client
c. Impaired tissue perfusion
d. The recent occurrence of the fracture
A client being measured for crutches asks the nurse why the crutches cannot rest up
underneath the arm for extra support. The nurse’s response is based on the
understanding that this could most likely result in:
1 point
a. A fall and further injury
b. Injury to the brachial plexus nerves
c. Skin breakdown in the area of the axilla
d. Impaired range of motion while the client ambulates
The physician recommends a total hip replacement for a client with osteoporosis who
reports increasingly severe pain in the left hip. The nurse would initiate the
preoperative teaching plan for the client, beginning with which of the following?
1 point
a. Teaching how to prevent hip flexion
b. Demonstrating coughing and deep breathing techniques
c. Showing the client what an actual hip prosthesis looks like
d. Assessing the client’s fears about the procedure
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Which of the following behaviors demonstrated by an individual may be indicative of
hearing loss?
1 point
Not looking at the examiner when being questioned
Frequently asking for the question to be repeated
Talking in a high-pitched voice
Speaking slowly with well-articulated consonants
A patient is scheduled to take Brimonidine and Latanoprost eye drops for management
of glaucoma at 1000. What correct action below will the nurse take when
administering these eye drops?
1 point
The nurse assists the patient with using the index finger to gently place pressure
at the side of the nose bridge for about 30 seconds after administering each eye
drop medication.
The nurse waits at least 3-5 minutes before administering the second eye drop
medication.
The nurse administers each eye drop directly on the eye via the cornea.
The nurse encourages the patient to blink after each eye drop administration.
Your patient is being treated for open-angle glaucoma. What assessment finding is
NOT typically present with this type of glaucoma?
1 point
Tunnel vision
Cloudy vision
Optic disc cupping
High intraocular pressure
A patient asks you to explain how the intraocular pressure is measured to help
detect glaucoma. You state that IOP (intraocular pressure) is measured by what
instrument below?
1 point
Goniscope
Tonometry
Ophthalmoscope
Phoroptor
The following medications are indicated in a client with glaucoma. Select all that
apply.
1 point
Pilocarpine
Carbachol
Cogentin
Humorsol
Atropine
Timolol maleate
You're providing care to a patient who just had glaucoma surgery. The patient is
alert and oriented. Vital signs are: heart rate 82 bpm, blood pressure 110/80,
oxygen saturation 97% on room air, respiratory rate 18, and pain rating of 2 on 1-
10 scale. Which patient finding below requires you to notify the physician?
1 point
The patient reports blurred vision.
The patient is having difficulty passing stool and reports constipation.
The patient reports that the eyes feel itchy.
The patient's eyes are frequently tearing up.
Your patient is having a phacoemulsification for treatment of a cataract. You're
providing education to the patient about the procedure. Which statement by the
patient demonstrates he understood the educational material provided about this
procedure?
1 point
"The cloudy lens in my eye will be broken up with sound waves and removed. Then a
new permanent lens, called an intraocular lens, will be placed in my eye."
"A small air bubble is injected into the eye to help push the retina back into
position to help the lens refract light."
"An incision is made to remove the trabecular meshwork and this will help drain
fluid out of the cloudy lens."
"The surgeon will remove parts of the iris and lens."
A patient has a cataract in the left eye and has decided to prolong having surgery
as long as possible until her activities of daily living are affected. The
following are some measures the patient can take to help manage the cataract at
this time, except:
1 point
Wearing sunglasses with UVA protection.
Enlarging text or visual images with a magnifier.
Adding more light when reading.
Wearing anti-glare glasses.
In the development of cataracts, light is scattered and cannot travel properly to
the retina's _____________________, and this leads to visual impairment.
1 point
crystalline proteins
amacrine cells
ganglion cells
cones and rods
A nurse is assessing an infant. Which of the following findings are clinical
manifestations of acute otitis media? (Select all that apply.)
1 point
Decreased pain in the supine position
Rolling head side to side
Loss of appetite
Increased sensitivity to sound
Crying
The following statements are true about Snellen's test. Select all that apply.
1 point
visual acuity is tested
Right eye is tested first, then the left eye, then both eyes
The client should be 30 feet away from the chart
It can assess nearsightedness and farsightedness
A result of 20/20 indicates legal blindness
It can assess color blindness
The client is experiencing vertigo due to Meniere's disease. Which of the following
is the priority nursing diagnosis?
1 point
high risk for injury related to vertigo
alteration in comfort related to tinnitus
altered body image related to hearing loss
altered nutrition related to nausea and vomiting
the most common complaint of a client with ear disorder is?
1 point
earache
discharge from the ear
hearing loss
tinnitus
Your patient has several risk factors that increase his risk for developing
cataracts. What preventive measures can you educate the patient about? Select all
that apply:
1 point
Wearing large brim hats while in the sun
Eating a diet rich in vegetables and fruits
Quit smoking
Reducing alcohol consumption
Managing blood glucose levels
Scheduling regular eye exams
TRUE OR FALSE: If a patient has bilateral cataracts and needs surgery, both eyes
can be surgically treated at the same time.
1 point
True
False
In your patient's health history you read that the patient has a cataract in the
right eye. You know that this eye disorder can be best described by which statement
below?
1 point
This eye disorder is caused by increased intraocular pressure that results in
damage to the optic nerve.
Cataracts occur in the eye when the macula of the retina become damaged and impair
the central vision.
The development of a cataract occurs when the lens of the eye loses its
transparency.
This eye disorder occurs from uncontrolled high blood glucose levels which lead to
retinal damage.
Which activity below is allowed after cataract surgery?
0 points
Bending
Running
Watching TV
Swimming
A patient is 2 hours post-op from cataract surgery in the right eye. You're
collecting vital signs and assessing the patient. Which finding in your patient
after cataract surgery requires to you re-educate the patient?
1 point
The patient is asleep on their right side.
The patient is wearing the eye shield while asleep.
The patient fell asleep watching TV.
The patient is not wearing his glasses.
A patient with glaucoma is ordered eye medication for the right eye in the form of
an ointment and eye drop. The nurse will administer which type of medication first?
1 point
Ointment and then the eye drops
Eye drops and then the ointment
A patient has arrived for a post-op visit to the clinic after cataract surgery in
the left eye. Which statement by the patient causes concern and requires further
investigation?
1 point
"My left eye has experienced some itchiness."
"The vision in my left eye was blurry for a few days."
"I have been experiencing flashes of light in my left eye."
"I had pain in my left eye after surgery and took Acetaminophen."
Absence of red reflex indicates which of the following eye disorders?
1 point
Presbyopia
Cataract
Glaucoma
Ptyregium
Which statement below is CORRECT about glaucoma?
1 point
“The vision loss that occurs with glaucoma is reversible with eye drop
medications.”
“Glaucoma occurs due to decreased intraocular pressure, which damages the optic
nerve.”
“Surgery can cure glaucoma.”
“A normal intraocular pressure is about 10-21 mmHg and is elevated in most patients
with glaucoma.”
The client had undergone cataract extraction. Iridectomy is done for which of the
following reasons?
1 point
To prevent secondary glaucoma
To prevent color blindness
To prevent retinal detatchment
To prevent presbyopia
A patient will be having outpatient cataract surgery in 3 days. The surgeon ordered
the patient to begin instilling two types of eye drop medications 3 days prior to
the surgery. You have demonstrated and educated the patient on how to do this
properly. Which action by the patient is incorrect and requires re-education about
how to instill the eye drops?
1 point
The patient instills the eye drops onto the conjunctival sac.
The patient instilled the anti-inflammatory eye drops before the antibiotic eye
drops.
The patient waited 30 seconds before instilling the second eye drop medication into
the eye.
After instilling each type of eye drop medication, the patient kept the eye closed
and took her index finger and placed it at the side of the bridge of the nose for 2
minutes.
What signs and symptoms are present with angle-closure glaucoma? Select all that
apply:
1 point
Patients are mainly asymptomatic
Gradual loss of peripheral vision
Sudden vision changes (halos around lights or blurred vision)
Severe eye pain
Corneal edema
Nausea and vomiting
Red eyes
No pain
IOP <10 mmHg
The client had undergone retinal detachment repair. which of the following should
concern the nurse most?
1 point
The client complains of thirst
The client complains of nausea
The client complains of severe pain in the eye
The client complains of fatigue
A patient is experiencing a severe case of acute angle-closure glaucoma. The
patient is not a candidate for laser intervention. The nurse would anticipate the
physician would order the nurse to prep the patient for what procedure?
1 point
Trabeculoplasty
Trabeculectomy
Iridectomy
Blepharoplasty
A 68-year-old male patient is considering cataract surgery. You're collecting the
patient's health and medication history. Which medication below on the patient's
home medication list should the nurse notify the doctor about?
1 point
Tamsulosin
Levothyroxine
Atorvastatin
Omeprazole
Your patient has a history of angle-closure glaucoma. What type of medications
should this patient avoid?
1 point
Anticholinergics
Cholinergics
Beta blockers
Alpha-agonists
You're observing a patient self-administer eye drops for the treatment of glaucoma.
Which finding below requires you to re-educate the patient on how to administer eye
drops correctly?
1 point
The patient refrains from blinking after instilling the eye drops.
The patient washes hands before and after administering the eye drops.
The patient uses a tissue to catch any medication that drips out of the eye after
administration of the drops.
The patient places the drops of medication directly on the eye via the cornea.
The nurse is preparing to instill eye dilation drops to a patient prior to cataract
surgery. The nurse confirms that the operative eye is the right eye. On assessment,
the nurse notes the patient has dark brown eyes and that a cataract is present in
the right eye. Which of the following nursing actions is incorrect prior to
instillation of the eye drops?
1 point
The nurse will lower the lights in the room prior to administration.
The nurse prepares the patient for blurry vision.
The nurse is aware that pupil dilation effects will occur quickly in this patient
and should be administered at a time that correlates with the actual time of the
surgery.
The nurse places the call light within reach of the patient.
Which patient finding below is associated with the development of cataracts?
1 point
Loss of central vision
Loss of peripheral vision
Cloudy, hazy vision
Black spots in vision
Which of the following cranial nerves is most frequently affected by acoustic
neuroma?
1 point
olfactory berve
facial nerve
oculomotor nerve
trochlear nerve
Your patient is ordered to take Acetazolamide for treatment of glaucoma. What in
the patient's history would require you to hold the medication and obtain an order
clarification from the physician?
1 point
The patient has open-angle glaucoma.
The patient is allergic to sulfonamides.
The patient reports tunnel vision.
The patient's IOP is 25 mmHg.
Your patient, who has open-angle glaucoma, is scheduled for a procedure that will
remove some of the trabecular meshwork and create an opening to allow aqueous humor
to collect in an area of the conjunctiva. This procedure will allow aqueous humor
to be reabsorbed and help decrease IOP. As the nurse you know that you will need to
provide pre-op and post-op patient education about what procedure below?
1 point
Iridectomy
Selective Laser Trabeculoplasty (SLT)
C. Laser iridotomy
Trabeculectomy
A patient is being evaluated for cataracts. The doctor uses a slit-lamp to assess
the patient's eyes. As the nurse you know that this device will?
1 point
help test the patient's visual acuity.
test the strength of the ciliary muscles.
enlarge the front area of the eye (cornea, iris, lens etc.).
help for visualization of the fundus.
What is the most common cause of cataracts?
1 point
Congenital
Aging
Trauma
Uncontrolled blood glucose levels
Which of the following activities is contraindicated immediately after cataract
extraction?
1 point
Eating
Shaving
Tooth brushing
Sleeping
The nurse is to administer ear irrigation as prescribed by the physician. which of
the following is appropriate nursing action?
1 point
direct the flow of solution to the ear drum
use cold water
warm solution at 98 F
position the client with the ear to be irrigated facing upward
Which of the following assessment findings indicate presbycussis?
1 point
The client has difficulty hearing in quiet environment
The client has difficulty understanding women's voice
The client's Weber test indicates that vibration of tuning fork is perceived better
in the poor ear
The client hears and understands telephone conversation well
The client has been diagnosed to have Meniere's disease. The client should avoid
which of the following to prevent acute attack of the disease. Select all that
apply.
1 point
alcohol
high sodium foods
caffeine
fruit juices
cigarette smoking
green salad
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After surgery for an ileal conduit, the nurse should closely evaluate the client
for the occurrence of which of the following complication related to pelvic
surgery?
1 point
peritonitis
thrombophlebitis
ascites
inguinal hernia
A client is admitted to the hospital with a diagnosis of renal calculi. She is
experiencing severe flank pain and complains of nausea. Her temperature is 38.1
degree C. Which of the following would be a priority outcome for this client?
1 point
prevention of urinary tract complications
alleviation of nausea
alleviation of pain
maintenance of fluid and electrolyte balance
Which of the following nursing interventions should be included in the client's
care plan during dialysis therapy?
1 point
limit the client's visitors
monitor client's blood pressure
pad the side rails of the bed
keep the client NPO
A client who has been diagnosed with bladder cancer is scheduled for an ileal
conduit. Preoperatively, the nurse reinforces the client's understanding of the
surgical procedure by explaining that an ileal conduit:
1 point
is a temporary procedure that can be reversed later
diverts urine into the sigmoid color, where it is expelled through the rectum
conveys urine from the ureters to a stoma opening on the abdomen
creates an opening in the bladder that allows urine to drain into an external pouch
The client has a clinic appointment scheduled for 10 days after discharge. Which
laboratory findings at that time would indicate that allopurinol (Zyloprim) has had
a therapeutic effect?
1 point
decreased urinary alkaline phosphatase level
increased urinary calcium excretion
increased serum calcium level
decreased serum uric acid level
During dialysis, the nurse observes that the flow of dialysate stops before al the
solution has drained out. the nurse should:
1 point
have the client sit in a chair
turn the client from side to side
reposition the peritoneal catheter
have the client walk
Which of the following statements by the client would indicate that she is at high
risk for the recurrence of cystitis?
1 point
"I can usually go 8 to 10 hours without needing to empty my bladder."
"I take a tub bath every evening."
"I wipe from front to back after voiding"
"I drink lots of water during the day"
A client is to have a cystoscopy to rule out cancer of the bladder. Which of the
following symptoms would indicate that the client has developed a complication
after cystoscopy?
1 point
dizziness
chills
pink-tinged urine
bladder spasm
A female client who has urinary diversion tells the nurse. "The urinary pouch is
embarrassing. Everyone will know that I'm not normal." The most appropriate nursing
diagnosis for this client is:
1 point
anxiety related to the urinary diversion
deficient knowledge about how to care for the urinary diversion
low-self esteem related to feelings of worhtlessness
disturbed body image related to creation of a urinary diversion
The client is scheduled to have a kidney, ureter and bladder (KUB) radiograph.
which of the following would be ordered to prepare the client for this radiograph?
1 point
fluid and food will be withheld the morning of the examination
a tranquilizer will be given before the examination
an enema will be given before the examination
no special preparation is required for the examnination
The nurse assesses the client who has chronic renal failure and notes the
following: crackles in the lung bases, elevated blood pressure, and weight gain of
2 lbs in 1 day. based on these data, which of the following nursing diagnosis is
appropriate?
1 point
excess fluid volume related to the kidney's inability to maintain fluid balance
increased cardiac output related to fluid overload
ineffective tissue perfusion related to interrupted arterial blood flow
ineffective therapeutic regimen management related to lack of knowledge about
therapy
The nurse finds a container with the client's urine specimen sitting on a corner in
the bathroom. The client states that the specimen has been sitting in the bathroom
for at least 2 hours. What would be the nurse's most appropriate action?
1 point
discard the urine and obtain a new specimen
send the urine to the laboratory as quickly as possible
add fresh urine to the collected specimen and send to the laboratory
refrigerate the specimen until it can be transported to the labratory
The dialysis solution is warmed before use in peritoneal dialysis primarily to?
1 point
encourage the removal of serum urea
force potassium back into the cells
add extra warmth to the body
promote abdominal muscle relaxation
In the oliguric phase of acute renal failure, the nurse should anticipate the
development of which of the following complications?
1 point
pulmonary edema
metabolic alkalosis
hypotension
hypokalemia
The client is scheduled for an intravenous pyelogram (IVP) to determine the
location of the renal calculi. Which of the following measures would be most
important for the nurse to include in pretest preparation?
1 point
ensuring adequate fluid intake on the day of the test
preparing the client for the possibility of bladder spasms during the test
checking the client's history for allergy to iodine
determining when the client last had a bowel movement
The nurse initiates the client's first hemodialysis treatment. The client develops
a headache, confusion, and nausea. These symptoms indicate which of the following
potential complications?
1 point
disequilibrium syndrome
myocardial infarction
air embolism
peritonitis
Because a client's renal stone was found to be composed of uric acid, a low purine,
alkaline-ash diet was ordered. incorporation of which of the following food items
into the home diet would indicate that the client understands the necessary diet
modifications?
1 point
Milk, apples, tomatoes, and corn
eggs, spinach, dried peas and gravy
salmon, chicken, caviar, and liver
grapes, corn, cereals, and liver
The client's serum potassium is elevated in acute renal failure, and the nurse
administers sodium polysterene sulfonate (KAyexalate). the drug acts to:
1 point
increase potassium excretion from the colon
release hydrogen ions for sodium ions
increase calcium absorption in the colon
exchange sodium for potassium ions in the colon
Which of the following urinary symptoms is the most common initial manifestation of
acute renal failure?
1 point
dysuria
anuria
hematuria
oliguria
The client with cystitis is also given a prescription of phenazopyridine
hydrochloride (Pyridium). The nurse should teach the client that this drug is used
to treat urinary tract infection by?
1 point
releasing formaldehyde and providing bacteriostatic action
potentiating the action of teh antibiotic
providing an analgesic effect on the bladder mucosa
preventing the crystallization that can occur with sulfa drugs
The client with chronic renal failure complains of feeling nauseated at least part
of every day. The nurse should explain that the nausea is the result of:
1 point
acidosis caused by the medications
accumulation of waste products in the blood
chronic anemia and fatigue
excess fluid load
Which of the following abnormal blood values would not be improved by dialysis
treatment?
1 point
elevated serum creatinine
hyperkalemia
decreased hemoglobin
hypernatremia
After an IVP, the nurse should anticipate to incorporate which of the following
measures into the client's plan of care?
1 point
mainataining bed rest
encouraging adequate fluid intake
assessing for hematuria
administering a laxative
If the client's serum potassium continues to rise in acute renal failure, the nurse
should be prepared for which of the following emergency situations?
1 point
cardiac arrest
pulmonary edema
circulatory collapse
hemorrhage
The nurse is conducting a postoperative assessment of a client on the first day
after renal surgery. Which of the following findings would be most important for
the nurse to report to the physician?
1 point
temperature 37.7 degree C
urine output, 20 mL/hour
absence of bowel sounds
a 2x2-inch area of serosanguinous drainage on the flank dressing
What is the most potentially dangerous complication of peritoneal dialysis?
1 point
abdominal pain
gastrointestinal bleeding
peritonitis
muscle cramps
The nurse is instructing the unlicensed assistant on the correct technique for
obtaining a clean-catch urine culture from a client. which of the following
statements indicates that the assistant has understood the instruction?
1 point
"I will have the client completely empty her bladder into the specimen cup."
"I will need to catheterize the client to get the urine specimen."
"I will ask the client to cleanse her labia, void the toilet, and then into the
specimen cup."
"I will obtain the specimen in the afternoon after the client has had plenty of
fluids."
Which of the following solutions will be useful to help control odor in the urine
collecting bag after it has been cleaned?
1 point
salt water
vinegar
ammonia
bleach
Which of the following symptoms is the most common clinical finding associated with
bladder cancer?
1 point
suprapubic pain
dysuria
painless hematuria
urinary retention
A 24-year old female client comes to an ambulatory care clinic in moderate distress
with a probable diagnosis of acute cystitis. Which of the following symptoms would
the nurse most likely expect the client to report during assessment?
1 point
fever and chills
frequency and burning on urination
flank pain and nausea
hematuria
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