Get Answer: Multiple Nurse Planning Question Guide

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Use appropriate theories and support your answer with clear reasoning.

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This topic involves multiple nurse planning. A strong answer should include explanation, application, and examples.

Original Question

Multiple A. The nurse is planning care for a newborn who has Myelomeningocele. B. What actions should the nurse include in the plan of care? C. Include nursing actions before and after surgery for a newborn who has Myelomeningocele. ____ 1. A 22-year-old patient is being seen in the clinic with increased secretion of the anterior pituitary hormones. The nurse would expect the laboratory results to show a. increased urinary cortisol. b. decreased serum thyroxine. c. elevated serum aldosterone levels. d. low urinary catecholamines excretion. ____ 2. Which statement by a 50-year-old female patient indicates to the nurse that further assessment of thyroid function may be necessary? a. “I notice my breasts are tender lately.” b. “I am so thirsty that I drink all day long.” c. “I get up several times at night to urinate.” d. “I feel a lump in my throat when I swallow.” ____ 3. A 30-year-old patient seen in the emergency department for severe headache and acute confusion is found to have a serum sodium level of 118 mEq/L. The nurse will anticipate the need for which diagnostic test? a. Urinary 17-ketosteroids b. Antidiuretic hormone level c. Growth hormone stimulation test d. Adrenocorticotropic hormone level ____ 4. Which question will provide the most useful information to a nurse who is interviewing a patient about a possible thyroid disorder? a. “What methods do you use to help cope with stress?” b. “Have you experienced any blurring or double vision?” c. “Have you had a recent unplanned weight gain or loss?” d. “Do you have to get up at night to empty your bladder?” ____ 5. A 29-year-old patient in the outpatient clinic will be scheduled for blood cortisol testing. Which instruction will the nurse provide? a. “Avoid adding any salt to your foods for 24 hours before the test.” b. “You will need to lie down for 30 minutes before the blood is drawn.” c. “Come to the laboratory to have the blood drawn early in the morning.” d. “Do not have anything to eat or drink before the blood test is obtained.” ____ 6. A 61-year-old female patient admitted with pneumonia has a total serum calcium level of 13.3 mg/dL (3.3 mmol/L). The nurse will anticipate the need to teach the patient about testing for _____ levels. a. calcitonin b. catecholamine c. thyroid hormone d. parathyroid hormone ____ 7. During the physical examination of a 36-year-old female, the nurse finds that the patient’s thyroid gland cannot be palpated. The most appropriate action by the nurse is to a. palpate the patient’s neck more deeply. b. document that the thyroid was nonpalpable. c. notify the health care provider immediately. d. teach the patient about thyroid hormone testing. ____ 8. Which laboratory value should the nurse review to determine whether a patient’s hypothyroidism is caused by a problem with the anterior pituitary gland or with the thyroid gland? a. Thyroxine (T4) level b. Triiodothyronine (T3) level c. Thyroid-stimulating hormone (TSH) level d. Thyrotropin-releasing hormone (TRH) level ____ 9. The nurse reviews a patient’s glycosylated hemoglobin (Hb A1C) results to evaluate a. fasting preprandial glucose levels. b. glucose levels 2 hours after a meal. c. glucose control over the past 90 days. d. hypoglycemic episodes in the past 3 months. ____ 10. A 60-year-old patient is taking spironolactone (Aldactone), a drug that blocks the action of aldosterone on the kidney, for hypertension. The nurse will monitor for a. increased serum sodium. b. decreased urinary output. c. elevated serum potassium. d. evidence of fluid overload. ____ 11. A 40-year-old male patient has been newly diagnosed with type 2 diabetes mellitus. Which information about the patient will be most useful to the nurse who is helping the patient develop strategies for successful adaptation to this disease? a. Ideal weight b. Value system c. Activity level d. Visual changes ____ 12. An 18-year-old male patient with a small stature is scheduled for a growth hormone stimulation test. In preparation for the test, the nurse will obtain a. ice in a basin. b. glargine insulin. c. a cardiac monitor. d. 50% dextrose solution. ____ 13. The nurse will teach a patient to plan to minimize physical and emotional stress while the patient is undergoing a. a water deprivation test. b. testing for serum T3 and T4 levels. c. a 24-hour urine test for free cortisol. d. a radioactive iodine (I-131) uptake test. ____ 14. A nurse will teach a patient who is scheduled to complete a 24-hour urine collection for 17-ketosteroids to a. insert and maintain a retention catheter. b. keep the specimen refrigerated or on ice. c. drink at least 3 L of fluid during the 24 hours. d. void and save that specimen to start the collection. ____ 15. Which additional information will the nurse need to consider when reviewing the laboratory results for a patient’s total calcium level? a. The blood glucose is elevated. b. The phosphate level is normal. c. The serum albumin level is low. d. The magnesium level is normal. ____ 16. A 44-year-old patient is admitted with tetany. Which laboratory value should the nurse monitor? a. Total protein b. Blood glucose c. Ionized calcium d. Serum phosphate ____ 17. Which information about a 30-year-old patient who is scheduled for an oral glucose tolerance test should be reported to the health care provider before starting the test? a. The patient reports having occasional orthostatic dizziness. b. The patient takes oral corticosteroids for rheumatoid arthritis. c. The patient has had a 10-pound weight gain in the last month. d. The patient drank several glasses of water an hour previously. ____ 18. Which action by a new registered nurse (RN) caring for a patient with a goiter and possible hyperthyroidism indicates that the charge nurse needs to do more teaching? a. The RN checks the blood pressure on both arms. b. The RN palpates the neck thoroughly to check thyroid size. c. The RN lowers the thermostat to decrease the temperature in the room. d. The RN orders nonmedicated eye drops to lubricate the patient’s bulging eyes. ____ 19. The nurse is caring for a 45-year-old male patient during a water deprivation test. Which finding is most important for the nurse to communicate to the health care provider? a. The patient complains of intense thirst. b. The patient has a 5-lb (2.3 kg) weight loss. c. The patient’s urine osmolality does not increase. d. The patient feels dizzy when sitting on the edge of the bed. ____ 20. A 35-year-old female patient with a possible pituitary adenoma is scheduled for a computed tomography (CT) scan with contrast media. Which patient information is most important for the nurse to communicate to the health care provider before the test? a. Bilateral poor peripheral vision b. Allergies to iodine and shellfish c. Recent weight loss of 20 pounds d. Complaint of ongoing headaches ____ 21. The nurse is caring for a 63-year-old with a possible pituitary tumor who is scheduled for a computed tomography (CT) scan with contrast. Which information about the patient is most important to discuss with the health care provider before the test? a. History of renal insufficiency b. Complains of chronic headache c. Recent bilateral visual field loss d. Blood glucose level of 134 mg/dL 1. A patient who is on an anticoagulant (Coumadin) asks, “What did the primary care provider mean when he said I was to have my blood tested every 2 weeks?” The nurse explains, “It is important to monitor the effects of the drug to see how long it takes your blood to clot. The blood test the primary care provider was talking about is the: a. complete blood count (CBC).” b. activated partial thromboplastin time (APTT).” c. international normalized ratio (INR).” d. erythrocyte sedimentation rate (ESR).” ____ 2. A patient is scheduled to have a blood chemistry profile drawn at 8 AM tomorrow. The note should be added on the care plan and report provided to the oncoming shift to withhold food and drink after: a. 6 AM. b. 12 midnight tonight. c. 4 AM today. d. noon today. ____ 3. A patient wants to know what was meant when the doctor said that his white blood cell (WBC) count had a shift to the left. The nurse explains that a shift to the left indicates: a. an improvement in an infectious process. b. the relative effectiveness of the antibiotic therapy. c. an increase in the number of immature WBCs. d. that the infection is viral in nature. ____ 4. The nurse instructing in the collection of a midstream urine catch would tell the patient to first cleanse the external genitalia and then to: a. begin voiding into the specimen cup. b. let a few drops of urine dribble into the specimen cup. c. void until the bladder is almost empty and then collect the end portion of the voiding in the cup. d. pass a small amount of urine into the toilet and then collect the specimen. ____ 5. The nurse instructs an outpatient female patient preparing for an abdominal ultrasonography that prior to the procedure, she should: a. eat or drink nothing after midnight. b. drink a liter of water. c. empty the bladder fully. d. use enemas at home to clear the bowel fully. ____ 6. The nurse preparing a patient for a magnetic resonance imaging (MRI) should determine if the patient has: a. respiratory allergies. b. claustrophobia. c. fear of the dark. d. dizziness. ____ 7. Prior to the nurse transporting the patient to have a magnetic resonance imaging (MRI), it is essential that the nurse confirms that the patient: a. has eaten a meal. b. has drunk a liter of fluid. c. is not wearing anything with metal. d. has a Foley catheter in place. ____ 8. A patient who is scheduled for a cardiac catheterization asks what the catheterization will reveal that an electrocardiogram would not. The nurse explains that the catheterization shows: a. the entire heart to find evidence of cancer. b. heart rhythm. c. electrical activity of the heart action. d. oxygen concentration at various sites. ____ 9. A patient who is to have a treadmill stress test at 11:00 AM today should not consume: a. toast and jam. b. coffee and cream. c. oatmeal and sugar. d. pancakes and syrup. ____ 10. A patient who has undergone endoscopy is fully awake and asks the nurse for something to drink. After confirming that liquids are allowed on the primary care provider order sheet, the nurse should: a. assist the patient to the bathroom to void. b. listen to lung sounds. c. take a blood pressure and pulse. d. check for the return of gag and swallow reflexes. ____ 11. The patient in the skilled nursing facility who is to have a colonoscopy tomorrow complains about his limited diet prior to the examination. The nurse may offer the patient: a. lime Jell O. b. strawberry soda. c. oatmeal thinned with milk. d. vanilla ice cream. ____ 12. A patient has undergone cystoscopy and has a Foley catheter in place on return to the nursing unit. Immediately after the procedure, the nurse expects the urine color to be: a. clear as water. b. bright red with clots. c. pink tinged. d. cherry colored. ____ 13. A patient will undergo endoscopic retrograde cholangiopancreatography (ERCP) to determine the cause of jaundice. Before the test, the nurse would assess this patient for an allergy to: a. eggs. b. pork. c. aspirin. d. shellfish. ____ 14. For the patient who just had a liver biopsy performed, the nurse should position him: a. prone for 1 hour. b. on his right side lying for 2 hours. c. supine for 3 hours. d. on his left side lying for 4 hours. ____ 15. Following a colonoscopy with polyp removal, the wife of the patient is distressed that there is slight bleeding from her husband’s rectum. The nurse’s most helpful response would be: a. “This small amount of bleeding is expected after the removal of polyps.” b. “I will notify the primary care provider about this hemorrhage.” c. “I will watch your husband very carefully to assess any further hemorrhage.” d. “Don’t worry. This small amount of blood happens with these procedures.” ____ 16. To improve the comfort of an older adult patient who is to be in the radiology department for several hours, the nurse should send a(n): a. family member with the patient. b. extra pillow. c. blanket. d. newspaper to read. ____ 17. An older adult patient has had a series of enemas in preparation for a gastrointestinal diagnostic procedure. Which electrolytes should be monitored following the enemas? a. Calcium and chloride b. Sodium and potassium c. Magnesium and phosphorus d. Selenium and zinc ____ 18. The nurse explains to the patient that the significance of the hematocrit is that it: a. indicates the number of circulating white blood cells. b. indicates the value of the hemoglobin. c. refers to the separation of blood cells from plasma. d. will decrease when the patient is in shock. ____ 19. When obtaining a capillary blood sample for blood glucose, the nurse will select the puncture site to cause the least amount of discomfort, which is: a. the end of the index finger. b. the ball of the third finger. c. at right angles to the fingerprint lines. d. the ball of the thumb. ____ 20. A patient asks why the blood glucose meter directions state to wipe away the first drop of blood. The most informative response by the nurse would be: a. “This eliminates microorganisms from the sample.” b. “The first drop is usually too small.” c. “The first drop is usually contaminated.” d. “The first drop has serous fluid that can dilute the specimen.” ____ 21. A patient in the outpatient clinic has provided a urine sample. To perform a urine dipstick test accurately, the nurse wets the dipstick and starts timing: a. immediately. b. after 5 seconds. c. after 10 seconds. d. after 30 seconds. ____ 22. The nurse obtaining a wound culture would: a. use clean gloves. b. rotate the swab vigorously in the wound bed. c. rinse the exudate on the swab with normal saline. d. place the swab in the culture tube without touching the sides. ____ 23. The patient who has just returned to the unit after an angiography test should be assessed immediately for: a. swelling of tongue. b. pulmonary congestion. c. bleeding at insertion site. d. hypotension. ____ 24. The nurse instructing a patient who is to have a Papanicolaou smear (Pap smear) in 2 days would tell the patient to avoid: a. sexual intercourse. b. douching. c. eating shellfish. d. taking a bubble bath. ____ 25. The statement made by a patient that would delay a scheduled CT scan would be: a. “I have terrible claustrophobia.” b. “I have just been started on metformin.” c. “I am allergic to penicillin.” d. “I have an implanted pacemaker.” ____ 26. The nurse evaluates a prothrombin time (PT/INR) for a patient who is taking heparin. The nurse’s initial action should be to: a. document the findings in the medical record. b. notify the laboratory that they have made an error. c. check the primary care provider’s order. d. notify the primary care provider of the laboratory finding. ____ 27. A major concern for an 86-year-old patient who has been NPO for 8 hours prior to a diagnostic test would be: a. fatigue. b. circulatory status. c. hydration status. d. nutritional status. ____ 28. A patient is having an MRI for a knee injury. During the test, he complains of burning in his upper thigh and swelling. Which of the following is the most probable cause of this complaint? a. Fluid is trapped in the leg due to the dependent positioning. b. Discomfort most likely related to injury in the knee. c. Trace metals in ink from a tattoo on the thigh. d. Discomfort indicates an emergency and requires discontinuation of the MRI. Multiple Response ____ 1. The nurse is aware that the medical record of a patient going for a cardiac catheterization should have: (Select all that apply.) a. a signed consent form. b. a complete history and physical examination. c. evidence of the initiation of NPO status at least 2 hours prior. d. evidence of patient education done before the consent form is signed. e. report of kidney function tests. f. administration of ordered preoperative medications. ____ 2. The primary care provider has ordered the collection of a 24-hour urine specimen. The nurse’s instructions to the patient for proper collection of the urine specimen include: (Select all that apply.) a. keep the container refrigerated as needed. b. empty the bladder into the toilet and begin timing the collection. c. void a small amount of urine after external genitalia are cleansed. d. keep the container on ice if instructed to do so. e. save only the first voiding in the morning. ____ 3. The nurse is aware that patients who are not candidates for magnetic resonance imaging (MRI) include patients with: (Select all that apply.) a. a hip prosthesis. b. bleeding tendencies. c. allergy to iodine. d. cardiac pacemakers. e. previous radiological treatment. ____ 4. The nurse informs the patient who is to have an electroencephalogram (EEG) that the technician will try to stimulate seizure activity by asking the patient to: (Select all that apply.) a. close his eyes. b. hyperventilate. c. breathe in a rapid shallow fashion. d. hold a flashing light over his face. e. submerge his hands in cold water. Completion Complete each statement. 1. The nurse is aware that a patient who is to have a colonoscopy is requested to stop taking drugs that contain iron for ______ days prior to the test. Ordering 1. The nurse is to collect a sample of blood for a laboratory test. Arrange the sequence of a phlebotomy. (Separate letters by a comma and space as follows: A, B, C, D, E, F, G, H.) a. Place vacutainer tube inside holder. b. Press tube stopper onto needle. c. Puncture site. d. Apply tourniquet and cleanse site. e. Label tube. f. Fill tube completely. g. Loosen tourniquet and apply pressure to site. h. Perform hand hygiene and apply gloves.

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