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NURS 498 Latest 2025 Final Exam with Well
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A client with a gunshot wound to the abdomen undergoes surgery, and a colostomy is formed as illustrated. Which of the following information should the nurse include in client teaching? a. Soft, formed stool can be expected as drainage. b. Stool will be expelled from both ostomy stomas. c. This type of colostomy is usually temporary. d. Irrigations can regulate drainage from the stomas. c. This type of colostomy is usually temporary. A client with cirrhosis is receiving lactulose. The nurse notes the client is more confused and has asterixis. The nurse should: a. assess for gastrointestinal bleeding b. increase protein in the diet c. monitor serum bilirubin levels d. withhold the lactulose a. assess for gastrointestinal bleeding
A few months after bariatric surgery, an older-adult client tells the nurse, "My skin is hanging in folds. I think I need cosmetic surgery." Which of the following responses by the nurse is best? a. "The important thing is that your weight loss is improving your health." b. "The skin folds will gradually disappear once most of the weight is lost." c. "Perhaps you would like to talk to a counsellor about your body image." d. "Cosmetic surgery is certainly a possibility once your weight has stabilized." d. "Cosmetic surgery is certainly a possibility once your weight has stabilized." The nurse is assessing a patient who has experienced severe neutropenia after chemotherapy and will monitor for which possible signs of infection? (Select all that apply.) a. elevated WBC count b. chills c. nausea d. fever e. sore throat b. chills d. fever e. sore throat Why does stomatitis, a common adverse effect of chemotherapeutic agents, occur?
b. "Has your surgeon discussed cryopreservation of your sperm?" Which points would be part of nursing teaching for a client undergoing brachytherapy of the cervix? a. The client will be taught about the treatment and need for staff time limitations in relation to her care. b. The client will be taught that she may experience desquamation of the skin on the abdomen and upper legs. c. The client will learn that she must undergo simulation to locate the treatment area. d. The client will require shielding of the ovaries during treatment to prevent ovarian damage. a. The client will be taught about the treatment and need for staff time limitations in relation to her care. Which information will the nurse provide to a client receiving radiation therapy or chemotherapy? a. Effective birth control methods should be used for the rest of the client's life. b. Notify the health care team if nausea and vomiting are experienced during treatment so that these can be managed. c. After successful treatment, the client returns to previous functional level. d. The cycle of fatigue-depression-fatigue that may occur during treatment can be reduced by restricting activity. b. Notify the health care team if nausea and vomiting are experienced during treatment so that these can be managed.
Which nursing roles are important for the prevention and detection of cancer? a. Using people's natural fear of cancer to motivate changes in unhealthy lifestyles b. Encouraging the public to participate in regular screening tests for all detectable cancer sites c. Health promotion in relation to eating low-fibre, refined-carbohydrate diets d. Teaching about cancer risk factors d. Teaching about cancer risk factors A patient diagnosed with acute myeloid leukemia receives a bone marrow transplant. Which medication to prevent graft-versus-host disease should a nurse anticipate receiving an order to administer? a. An immunosuppressant such as cyclosporin b. Peginterferon-alpha-2a for prevention and treatment of hepatitis c. A cyclosporine antibiotic such as ceftazidime d. Chemotherapeutic agents such as cisplatin a. An immunosuppressant such as cyclosporin Which is an inappropriate nursing intervention to promote nutrition in the client with cancer? a. Providing bland, pureed food because the person's taste sensation is altered b. Providing increased protein for normal cell recovery and immune system function c. Encouraging the client to eat a high-calorie, high-protein snack every few hours to prevent weight loss
a. Hypoglycemic event b. Hemorrhage c. Addisonian Crisis d. Cushing's syndrome c. Addisonian Crisis What is a priority nursing assessment for an individual presenting with adrenal insufficiency? a. CSM assessment b. COWS c. CIWA d. EKG/ECG d. EKG/ECG A patient is admitted to the unit with low cortisol (Hypocortisolism) and low aldosterone (hypoaldosteronism). What clinical manifestations could be expected from the deficiency of the hormones? a. Hypotension b. Hyponatremia c. Hypokalemia d. Acidosis e. Irritability or depression
f. Hyperglycemia a. Hypotension b. Hyponatremia d. Acidosis e. Irritability or depression What is the primary cause of adrenal insufficiency? a. Tuberculosis b. Motor vehicle accident c. Autoimmune response d. Hypertension c. Autoimmune response What type of meal would you recommend to a patient who has adrenal insufficiency? a. High potassium and high carbohydrates b. High protein and low carbohydrates c. High protein and high carbohydrates d. High potassium and high carbohydrates c. High protein and high carbohydrates What assessments do you not expect for a patient with suspected pheochromocytoma?
a. Organ meats b. Grapefruits c. Jello d. Tyrosine containing foods d. Tyrosine containing foods What is the best treatment option for pheochromocytoma? a. Diet and lifestyle changes b. Radiation c. Nephrectomy d. Adrenalectomy d. Adrenalectomy A 67-year-old man (E.J.) presents in the E.D. with drooping of the right eye, difficulty swallowing and weakness, affecting his gait. He has a history of diabetes and hypertension. The physician suspects it could be Myasthenia Gravis. What would be the most appropriate diagnostic test to conclude this diagnosis? a. Endophonium test b. CT of the spinal cord c. Ice pack test d. 12-lead ECG a. Endophonium test
The emergency department is educating E.J. about his new diagnosis of Myasthenia Gravis. The physician could best describe Myasthenia Gravis as a progressive disease, with maximum muscle weakness occurring in year "_______." Muscles usually atrophy after "_______" years. a. One, Fifteen b. One, Five c. Three, Fifteen d. Three, Five a. One, Fifteen E.J returns to a community health clinic expressing concerns related to decreased swallowing ability. What would be the most appropriate response by the community health nurse to aid in decreasing the risk for aspiration? a. "Make sure you remain upright for at least an hour after meals to reduce the risk of choking." b. "Eat several, small meals throughout the day." c. "Avoid regular liquids and only drink thickened fluids." d. "Do neck strengthening exercises to help strengthen the swallowing muscles." c. "Avoid regular liquids and only drink thickened fluids." Although there is no cure for Myasthenia Gravis, the goals of the treatment include symptom relief/management and prevention of complications. All the following pharmacological therapies would be expected in treatment for E. J's condition, except:
a. Campylobacter jejuni A patient has been diagnosed with Guillain-Barre Syndrome, what assessment findings would you expect to find? a. Edema with warm extremities and is diaphoretic b. Bilateral , descending paralysis of the lower limbs c. Bilateral numbness and weakness on the lower limbs that progressively ascends d. None of the above c. Bilateral numbness and weakness on the lower limbs that progressively ascends During the acute phase of GBS, what are the important nursing assessments to make? Select all that apply. (for ascending paralysis) a. Gag and swallowing reflexes b. Headache c. Respiratory function d. Corneal reflex a. Gag and swallowing reflexes c. Respiratory function d. Corneal reflex What are the tests ordered to diagnose Guillain-Barre Syndrome? Select all that apply.
a. Electromyography (EMG)( recordings prove the presence of nerve damage and show whether the damage affects the nerve sheaths (made of myelin) or the nerve fibers inside the sheaths (called axons) or both) b. MRI c. Nerve conduction studies (small discs (electrodes) are stuck on your skin and minor electric shocks are used to activate the nerves and measure how quickly these signals travel along them d. Lumbar puncture test (supports the diagnosis by showing a raised protein content and normal cell count) a. Electromyography (EMG)( recordings prove the presence of nerve damage and show whether the damage affects the nerve sheaths (made of myelin) or the nerve fibers inside the sheaths (called axons) or both) c. Nerve conduction studies (small discs (electrodes) are stuck on your skin and minor electric shocks are used to activate the nerves and measure how quickly these signals travel along them d. Lumbar puncture test (supports the diagnosis by showing a raised protein content and normal cell count) A patient expresses confusion on what causes Guillain-Barre Syndrome, what is an appropriate answer by the nurse? a. An acute infection destroys the myelin sheath of the peripheral nerves, which slows or stops transmission of nerve impulses. b. Antibodies attack ACh receptors at neuromuscular junction, preventing muscle contraction (myasthenia gravis etiology) c. An autoimmune condition that causes an inflammation of the peripheral nerves, destroying the myelin sheath of the axons. Transmission between the nerves are then slowed or stopped. d. None of the above
What diagnostic tool is used to help rule out other neurological diseases? a. Positron Emission Tomography (PET) scan b. Magnetic Resonance Imaging (MRI) c. X-ray d. Electroencephalogram (EEG) b. Magnetic Resonance Imaging (MRI) Which assessment data would make the nurse suspect that the patient has Amyotrophic Lateral Sclerosis (ALS)? a. Contracted COVID-19 and was on a ventilator in the ICU for 6 weeks. b. Complaints of double vision, insomnia, eye twitching, crow's feet on their eyes. c. Progressive memory loss and paralysis below the umbilicus. d. Fatigue, progressive muscle weakness, and twitching d. Fatigue, progressive muscle weakness, and twitching What is the leading cause of death in a person with Amyotrophic Lateral Sclerosis (ALS)? a. Respiratory failure b. Heart failure c. Aspiration d. Rhabdomyolysis a. Respiratory failure
David, a 26-year-old, is being seen by the nurse at his primary care physicians office where you work. He has developed a painless ulcer on his penis and is concerned about his health. The nurse expressed this finding to the physician and a diagnosis of primary syphilis was made. What is the typical span of time between infection and developing symptoms with syphilis? a. 3 months b. 21 days c. 5 days d. 6 months b. 21 days A pregnant woman has tested positive for Treponema pallidum bacteria. What antibiotic would the nurse expect the physician to order? a. Benzathine Penicillin G (Bicillin) b. Vancomycin (Vancocin) c. Ceftriaxone (Rocephin) d. Metronidazole (Flagyl) a. Benzathine Penicillin G (Bicillin) A patient presents to the emergency department with primary syphilis. Which signs and symptoms would the nurse expect to find? a. Genital lesions
When providing teaching to a patient receiving an anticholinergic for the treatment of PD, the nurse will include which instructions or information? a. take the medication first thing in the morning b. limit fluid intake when taking this drug c. the tremors you experience will be reduced within 24 hours of taking this drug d. do not take this medication at the same time as other medications d. do not take this medication at the same time as other medications The "off-on phenomenon" that some patients with PD experience is best explained as the... a. need to take a "drug holiday" to improve response to medications b. variable response to levodopa, resulting in periods of good control and periods of poor control of PD symptoms c. alternating schedule of medications needed to control PD d. fluctuation of emotions that often occurs with PD b. variable response to levodopa, resulting in periods of good control and periods of poor control of PD symptoms After the nurse has completed teaching a client with newly diagnosed celiac disease, which of the following breakfast choices by the client indicates good understanding of the information?
a. Corn tortilla with eggs b. Bagel with cream cheese c. Oatmeal with non-fat milk d. Whole wheat toast with butter a. corn tortilla with eggs A client with ulcerative colitis who is taking azathioprine calls the nurse in the outpatient clinic about all of these symptoms. Which of the following symptoms is most important to communicate to the health care provider? a. Elevated temperature b. Joint pain c. Frequent headaches d. Nausea a. elevated temperature A nurse is developing a care plan for a client with hepatic encephalopathy. Which are the goals for the care for this client? Select all that apply. a. provide food and fluids high in carbohydrates b. encourage physical activity c. prevent constipation d. administer lactulose to reduce blood ammonia levels f. check the pupil reaction
