Title PRE-INTENSIVE - NP4 - SC ✅

C. Elevated serum lipase D. Increased Creatinine 33. Which of the following tests would confirm Upper GIT bleeding? A. Endoscopy B. Upper GI series C. Low hgb and hct levels D. Barium Swallow 34. Patient Sansa is suffering from dysphagia and is being prepared for discharge. Which should be advised to the client? A. Patient should eat upright B. Patient would start soft, thin diet C. Patient can watch TV while eating D. Patient can overeat 35. While palpating Patient Margaery’s right upper quadrant (RUQ), the nurse would expect to find which of the following structures? A. Liver B. Appendix C. Spleen D. Sigmoid colon 36. The nurse is caring for Patient Brienne with active upper GI bleeding. What is the appropriate diet for this client during the first 24 hours after admission? A. Regular diet B. Soft diet C. NPO D. CL Situation: A 55-year-old female patient is admitted due to profuse vaginal bleeding. She underwent ultrasound and laparoscopic examination. She was diagnosed with leiomyoma. 37. Which among the following is not true regarding leiomyoma? A. It is a tumor of the uterine endometrium. B. It is a slow-growing tumor. C. Leimyomas grow with estrogen stimulation. D. The tumor usually shrinks during the menopausal stage. 38. What is the cell origin of the tumor? A. Endometrial glands B. Skeletal muscle cell C. Smooth muscle cell D. Neuronal cell 39. Goserelin, a gonadotropin-releasing hormone agonist, is prescribed to the patient. Which among the following is a common side effect of the drug during the first days of administration A. Flaring B. Bone pain C. Hirsutism D. Depression 40. After the GnRH agonist therapy, the patient is about to undergo uterine artery embolization. What is the mechanism of this therapy? A. A laser is used to conservatively remove the leiomyoma from the uterus. B. Radioablation is used to destroy the uterine endometrium guided by a hysteroscope. C. Removal of the uterus and cervix through the vagina without external incision. D. ellets are inserted into the uterine artery to cause blockage 41. To be able to distinguish it from a cancerous lesion, what is the standard diagnostic test that should be performed? A. Intravaginal examination B. Biopsy C. Pap smear D. Ultrasound Situation: In the United States, around 40,000 cases of endometrial cancer are documented annually. Gina is a 56-year-old female diagnosed with Stage II endometrial carcinoma, grade I. 42. Endometrial carcinoma is commonly preceded by which of the following conditions? A. HPV infection B. Chronic malnutrition C. Endometrial hyperplasia D. Early menopause 43. What is the most common type of endometrial carcinoma? A. Squamous cell carcinoma B. Adenocarcinoma C. Clear cell carcinoma D. Serous papillary carcinoma 44. Which among the following does not contribute to the development of endometrial CA? A. Use of oral combination contraceptives (estrogen + progestin) B. Nulliparity C. Diabetes mellitus D. Late onset of menopause 45. The patient underwent radical hysterectomy with bilateral lymph node dissection and removal of the upper third of the vagina. She asks you when she can have intercourse with her husband, fearing that she might have complications. Your best response would be: A. “Because of what was removed from you, I am afraid you can no longer have intercourse with your spouse again.” B. “You should avoid sexual intercourse for at least 6 weeks.” C. “Having intercourse as early as one week will no longer pose dangers.” D. “You may go ask your gynecologist about it.” 46. Which among the following signs and symptoms should the patient report after discharge? A. Occasional vaginal discharges B. Mild dyspareunia at the first intercourse C. Calf pain and tenderness D. All of the above Situation: Nurse Nina knows that proper knowledge on the different causative agents and manifestations of the reproductive disorders will help in the proper management of patients. 47. What is the most common cause of vaginitis in women? A. Bacterial vaginosis B. Candidiasis C. Trichomoniasis D. Lichen planus 48. A 29-year-old patient with history of multiple sexual partners is admitted due to foul-smelling, gray vaginal discharge. Upon microscopic examination, clue cells are seen and there are no lactobacilli present. What is the causative agent of this condition? A. Treponema pallidum B. Human simplex virus C. Human papilloma virus D. Gardnerella vaginalis 49. Which among the following strains of human papilloma virus is implicated in the development of condyloma tauminatum? A. HPV 16 B. HPV 11 C. HPV 31 D. HPV 33 50. Herpes simplex virus has the propensity to become latent in patients. They usually ascend the peripheral sensory nerves and become dormant in which of the following structures? A. Trigeminal nerve B. Dorsal root ganglion C. Brachial plexus D. Spinal cord 51. A 35-year-old patient complains of thin, frothy discharge accompanied with vulvovaginal pruritus. Upon colposcopy, the cervix was seen to be erythematous with multiple small petechiae appearing like a strawberry. Knowing what usually causes “strawberry cervix”, which among the following medications do you expect to be prescribed to the patient? A. Metronidazole B. Ketoconazole C. Clindamycin D. Piperacillin-tazobactam 3 | Page
Situation: A 54-year-old man is brought to the emergency room unconscious. HR 100bpm, BP 100/60, Temp 37.2C, RR 22cpm. Hemorrhagic stroke is the primary impression. 52. The most common cause of subarachnoid hemorrhage is a rupture of a saccular aneurysm located in the circle of Willis. Which among the following vessels is not a part of the Circle of Willis? A. Anterior communicating artery B. Basilar artery C. Posterior communicating artery D. Posterior cerebral artery 53. What is the most common symptom that precedes hemorrhagic strokes? A. Projectile vomiting B. Sudden, severe headache C. Nuchal rigidity D. Ptosis 54. Which among the following drug orders for the patient will alert the nurse to ask the physician? A. Nicardipine B. Labetalol C. Coumadin D. Nitroprusside 55. Which acid-base balance is usually seen after subarachnoid hemorrhage? A. Hyponatremia B. Hypocalcemia C. Hyperphosphatemia D. Hypernatremia 56. In the presence of aneurysm, you institute the following interventions except: A. Raising the head of bed to 15 to 30-degree elevation B. Administering enema for constipation C. Providing dim lights in the patient’s room D. Instructing the patient to avoid straining or doing Valsalva Situation: In the United States, around 40,000 cases of endometrial cancer are documented annually. Gina is a 56-year-old female diagnosed with Stage II endometrial carcinoma, grade I. 57. Endometrial carcinoma is commonly preceded by which of the following conditions? A. HPV infection B. Chronic malnutrition C. Endometrial hyperplasia D. Early menopause 58. What is the most common type of endometrial carcinoma? A. Squamous cell carcinoma B. Adenocarcinoma C. Clear cell carcinoma D. Serous papillary carcinoma 59. Which among the following does not contribute to the development of endometrial CA? A. Use of oral combination contraceptives (estrogen + progestin) B. Nulliparity C. Diabetes mellitus D. Late onset of menopause 60. The patient underwent radical hysterectomy with bilateral lymph node dissection and removal of the upper third of the vagina. She asks you when she can have intercourse with her husband, fearing that she might have complications. Your best response would be: A. “Because of what was removed from you, I am afraid you can no longer have intercourse with your spouse again.” B. “You should avoid sexual intercourse for at least 6 weeks.” C. “Having intercourse as early as one week will no longer pose dangers.” D. “You may go ask your gynecologist about it.” 61. Which among the following signs and symptoms should the patient report after discharge? A. Occasional vaginal discharges B. Mild dyspareunia at the first intercourse C. Calf pain and tenderness D. All of the above SITUATION: Since 2012, there has been a shift of nursing core competency standards from eleven, it has been compressed into three. These are: Beginning role of nurses in client care (as a nurse generalist), in leadership & management, and in research. To be successful in the local boards, student-nurses must master PALMER concepts. The following questions apply. 62. During orientation, student-nurse Maxine learns that the nursing model of practice implemented in the facility is a primary nursing approach. When she attends a report on the medical unit, she will verify with the staff which of the following characteristics of primary nursing? A. critical paths are used when providing client care B. the nurse manager assigns tasks to the staff members C. a registered nurse leads nursing staff in providing care to a group of clients D. a single RN is responsible for planning and providing individualized nursing care to 4-6 clients 63. Maxine attends an in-service educational session for staff and student nurses about case management conducted by the unit’s nurse manager. The clinical nurse manager determines that a review of the material needs to be done if one of the staff nurse stated that case management: A. manages a client care by managing the client care environment B. maximizes hospital revenues while providing for optimal client care C. is designed to promote appropriate use of hospital personnel and material resources D. represents a primary health prevention focus managed by a single case manager 64. Now the nurse manager in the said nursing unit is reviewing the critical paths of the clients. She collaborates with each nurse assigned to the clients and performs a variance analysis. Which of the following indicate the need for further action and analysis? A. A client is performing his own colostomy care B. Purulent drainage is noted from a postoperative wound incision C. 1-day postoperative client has a temperature of 98.80F D. A client newly diagnosed with diabetes mellitus is preparing his own insulin for injection 65. The nurse manager is planning to implement a change in the nursing unit from team nursing to primary nursing. She anticipates that there will be resistance to the change during the change process. The primary technique that she should use in implementing this change is? A. Introduce the change gradually B. Confront the individuals involved in the change process C. Use coercion to implement that change D. Manipulate the participant in the change process. 66. A nursing assistant in the unit is resistant to the change and is not taking an active part in facilitating the process of change. Which of the following is the best approach of the nurse manager in dealing with the nursing assistant? A. Ignore the resistance B. Exert coercion with the nursing assistant C. Provide a positive reward system for the nursing assistant D. Confront the nursing assistant to encourage verbalization of feeling regarding the change Situation: A 55-year-old female patient is admitted due to profuse vaginal bleeding. She underwent ultrasound and laparoscopic examination. She was diagnosed with leiomyoma. 67. Which among the following is not true regarding leiomyoma? A. It is a tumor of the uterine endometrium. B. It is a slow-growing tumor. C. Leimyomas grow with estrogen stimulation. D. The tumor usually shrinks during the menopausal stage. 4 | Page