Title ENHANCEMENT- PB EXAM - NP 4- STUDENT COPY.docx.pdf ✅

PREBOARDS EXAMINATION NURSING PRACTICE IV CARE OF CLIENTS WITH PHYSIOLOGIC AND PSYCHOLOGICAL ALTERATIONS (PART B) ENHANCEMENT PHASE GENERAL INSTRUCTIONS: 1. This test questionnaire contains 100 test questions 2. Shade only one (1) box for each question on your answer sheets. Two or more boxes shaded will invalid your answer. 3. AVOID ERASURES. 4. Detach one (1) answer sheet from the bottom of your Examinee ID/Answer Sheet Set. 5. Write the subject title “NURSING PRACTICE I” on the box provided Situation: Nurse Chotola has recently embarked on his journey as a perioperative nurse at a bustling hospital. This position represents his first foray into a surgical setting, and he is filled with determination to make a positive impact. On his first day on the job, Nurse Chotola is inspired to handle his responsibilities with excellence and dedication. 1. Nurse Chotola is going over a surgeon's prescription for a preoperative patient, which indicates that the patient should not eat or drink anything after midnight. Nurse Chotola should contact the surgeon to confirm which medication should be administered to the patient rather than being withheld? A. Ferrous sulfate B. Prednisone C. Alprazolam D. Conjugated estrogen 2. Nurse Chotola is instructing a patient on coughing and deep-breathing methods to help avoid complications after surgery. What would be the most suitable statement for Nurse Chotola to convey to the patient regarding these techniques? A. "Careful observation of your oxygen levels will detect the presence of hypoxemia." B. "The utilization of an incentive spirometer can reduce the risk of pneumonia." C. "Giving intravenous fluids will help prevent or address fluid imbalance." D. "Practicing early ambulation and providing blood thinners will help prevent the development of pulmonary embolism." 3. When creating a plan of care for a client scheduled for surgery, Nurse Chotola should include which of the following activities on the day of surgery? A. Encouraging the client to void before going into surgery B. Avoiding oral hygiene and mouthwash use C. Ensuring the client has not eaten for the last 24 hours to prevent aspiration D. Close monitoring and reporting of slight changes in vital signs, such as the blood pressure or pulse 4. Nurse Chotola demonstrates correct understanding when he says that all but one of the postoperative nursing management tasks in the clinical unit are being performed. A. Reviewing the postoperative orders, admit patient to the unit, and performing an initial assessment are essential parts of the postoperative nursing management tasks B. In the hours immediately post-surgery, nursing interventions focus on aiding the patient's recovery from anesthesia, conducting regular assessments, watching for complications, managing pain, and implementing strategies to encourage self-care, successful adherence to the treatment plan, home discharge, and complete recovery. C. During the first few hours after being admitted to the clinical unit, primary concerns include ensuring adequate ventilation, maintaining hemodynamic stability, addressing incisional pain, preserving surgical site integrity, managing nausea and vomiting, evaluating neurological status, and ensuring spontaneous voiding. D. Unless otherwise specified, vital signs, including pulse, blood pressure, and respirations, should be recorded every 15 minutes during the first 2 hours, followed by every 30 minutes for the subsequent two hours. Thereafter, they are measured less frequently if they remain stable. Monitoring of the patient's temperature is done every 2 hours for the first 24 hours postoperatively. 5. Nurse Chotola is providing preoperative education to a patient regarding the use of an incentive spirometer. Which information should he include during his discussion with the patient? A. Inhale as rapidly as possible. B. Keep a loose seal between the lips and the mouthpiece. C. After maximum inspiration, hold the breath for 15 seconds and exhale. D. The best results are achieved when sitting up or with the head of the bed elevated 45 to 90 degrees 6. Jun Pooh is a newly hired nurse assigned to care for a patient who underwent posterior fossa decompression. Which of the following actions by Jun Pooh would require follow-up by the observing nurse preceptor? A. Monitor vital signs, and perform neurologic checks B. Spacing nursing interventions and assisting the patient with self-care C. Checking the patient’s motor function and sensory disturbances at intervals D. Encouraging the patient to perform deep breathing exercises and coughing frequently to facilitate respiratory function 7. Which of the following is not true about informed consent? A. The nurse reinforces information provided by the surgeon and provides information regarding the step by step surgical procedure to help alleviate the patient's anxiety. B. The nurse should notify the physician if the patient needs additional information to make his or her decision. C. The nurse should ensure that the consent form has been signed before giving the patient any psychoactive premedication. D. Ensures that the patient has received and comprehended the procedure, including its risks, benefits, and alternatives, and, most importantly, confirm that the patient was competent and consented voluntarily. 1 | Page

malignant cells, which can lead to electrolyte imbalances and acute renal failure. The following conditions can be observed in TLS, except: A. Hyperkalemia B. Hypercalcemia C. Hyperuricemia D. Hyperphosphatemia 23. The following signs and symptoms can be observed in patients experiencing Tumor Lysis Syndrome (TLS), except: A. ECG changes B. Altered mental status C. Polyuria D. Flaccid paralysis 24. Which of the following interventions is not related to the management of patients experiencing Tumor Lysis Syndrome (TLS)? A. IV hydration B. Administration of allopurinol C. Administration of Na bicarbonate D. Potassium replacement 25. Nurse Lee Suh understands that which of the following medications is indicated for breast cancer among postmenopausal women who are estrogen receptor (ER) positive? A. Tamoxifen B. Leuprolide C. Ondansetron D. Doxorubicin 26. Nurse Nina is reinforcing teaching with a client who has cancer and is receiving external radiation therapy. Which of the following statements made by the client indicates a need for further teaching? A. “I’m glad that the procedure is painless and lasts only for a few minutes. B. “I will be alone in the treatment room.” C. “Activities of daily living may be resumed immediately after the treatment.” D. “I have to be isolated to protect others from radiation. 27. A nurse is providing care for a patient diagnosed with advanced breast cancer, who is experiencing anorexia and cachexia. To address the patient's loss of appetite and malnutrition, the nurse anticipates that which medication will be prescribed as part of the patient's treatment plan? A. Tamoxifen B. Megestrol C. Leuprolide D. Ondansetron 28. A 58-year-old male patient diagnosed with squamous cell carcinoma of the larynx is receiving intravenous bleomycin as part of his chemotherapy regimen. The nurse caring for the patient expects that which diagnostic test will be ordered? A. Echocardiography B. Pulmonary function studies C. Cervical radiography D. Electrocardiography 29. A female patient is undergoing treatment with methotrexate, administered intravenously at a dosage of 12 g/m2, for osteogenic carcinoma. During the course of methotrexate therapy, the nurse anticipates that the patient will receive which of the following additional agents to safeguard normal cells from the adverse effects of the treatment? A. Leucovorin Calcium B. Mesna C. Zofran D. Phentolamine 30. Pedro is a 57-year-old patient currently undergoing chemotherapy with Cytoxan (Cyclophosphamide). The nurse would tell the client to take which action? A. Take the medication with food. B. Increase fluid intake to 2000 to 3000 mL daily. C. Decrease sodium intake while taking the medication. D. Increase potassium intake while taking the medi- cation. 31. A nurse is preparing a care plan for a 38-year-old female client with metastatic breast cancer who is receiving tamoxifen. The nurse specifically monitors which laboratory value while the client is taking this medication? A. Glucose level B. Calcium level C. Potassium level D. Prothrombin time 32. A nurse is preparing a care plan for a 38-year-old female client who is scheduled to receive Cytoxan (Cyclophosphamide) as part of her chemotherapy regimen. The nurse is aware that which of the following medications is the antidote for cyclophosphamide toxicity? A. Mesna B. Leucovorin Calcium (folinic acid) C. Naloxone (Narcan) D. Neostigmine 33. A 47-year old client has a radiation implant located in the endocervical area. The nurse has observed that the radiation source has become dislodged and is lying on the bed. Which of the following nursing actions should the nurse undertake as the most appropriate initial response? A. Reassure the client that you will be back as soon as you can after notifying the physician B. Don sterile gloves and proceed to remove the radiation source from the room. C. Immediately put on lead-lined gloves and reinsert the implant. D. Utilize long-handled forceps to transfer the implant into a sealed lead-lined container situated within the room. 34. Mr. Berto, a 39-year old patient is scheduled to undergo external radiation therapy for thyroid cancer. The nurse will provide education regarding the procedure. Which of the following statements should not be included in the teaching? A. "You will be alone in the room; however, observation is ongoing, and communication is possible." B. "The procedure is painless." C. "The patient may immediately resume normal activities following the treatment." D. "The duration of the procedure is one hour, during which the patient must remain still." 35. The most common site of cancer of the breast is the: A. Upper outer quadrant of the breast B. Upper inner quadrant of the breast C. Lower outer quadrant of the breast D. Lower inner quadrant of the breast 36. Nurse Gu Rang has been assigned to provide care for a patient diagnosed with multiple myeloma. In preparation for this responsibility, Nurse Gu Rang is reviewing the laboratory results associated with this condition and would anticipate observing which specific significant findings typical of this disorder? A. Decreased blood urea nitrogen level B. Increased calcium level C. Increased white blood cells D. Decreased number of plasma cells in the bone marrow 37. Nurse Gu Rang is developing a care plan for a client diagnosed with multiple myeloma. The plan will prioritize which of the following interventions? A. Promoting fluid intake B. Facilitating coughing and deep breathing exercises C. Monitoring the red blood cell count. D. Ensuring regular oral hygiene 38. A patient has been admitted for evaluation with a suspected diagnosis of Hodgkin's lymphoma. What specific assessment findings should the nurse expect to observe in this individual? A. Fatigue B. Slapped cheek appearance C. Weight gain D. Enlarged lymph nodes 39. A nurse is reviewing the medical history of a patient diagnosed with bladder cancer in preparation for an upcoming assessment. As part of this process, the nurse carefully examines the patient's records for any relevant clinical findings. Given the nature of the diagnosis, the nurse anticipates finding documentation indicating which most prevalent sign or symptom associated with this type of cancer? A. Urgency during urination B. Increased frequency of urination. C. Dysuria 3 | Page