Tiêu đề DIAGNOSTIC EXAMINATION - NP1 - ANSWER KEY ✅

D. Measures the length of the tube from where it protrudes from the nose to the end and compares it to previously documented measurements 44. If the patient is on continuous feeding via NGT, how often should the nurse check the tube’s placement? A. Every 6-8 hours B. Every 1-3 hours C. Every 4-6 hours D. Every 8-10 hours 45. The client’s prognosis went well and the doctor ordered the patient for possible discharge within 24 hours. As the nurse prepares the client for the removal of a nasogastric tube, she instructs the client to: A. Inhale deeply. B. Exhale slowly. C. Hold in a deep breath. D. Pause between breaths. SITUATION: Ensuring safety before, during and after a respiratory diagnostic procedure is an important responsibility of the nurse. The following questions apply. 46. A client named Daryl is suspected of having a pleural effusion. The nurse assesses him for which typical manifestations of this respiratory problem? A. Dyspnea at rest and moist, productive cough B. Dyspnea on exertion and dry, non-productive cough C. Dyspnea at rest and dry, non-productive cough D. Dyspnea on exertion and moist, productive cough 47. The nurse plans to have which of the following items available for immediate use for Daryl’s untreated condition? A. Intubation tray B. Paracentesis tray C. Thoracentesis tray D. Central venous line insertion tray 48. The nurse recalls the nursing interventions before, during, and after aspiration of fluid in the pleural cavity. She was not able to recollect accurately if she anticipates that the doctor will not insert the trocar: A. Below the seventh rib laterally and above the ninth rib posteriorly B. Below the 2nd intercostal space (ICS) anteriorly and above 4th ICS posteriorly C. Below the seventh rib laterally and below the ninth rib posteriorly D. Above the 2nd intercostal space (ICS) anteriorly and below 4th ICS posteriorly 49. The nurse is assessing Daryl’s respiratory status after thoracentesis. The nurse would become most concerned with which of the following assessment findings? A. Equal bilateral chest expansion B. Respiratory rate of 22 breaths per minute C. Diminished breath sounds on the affected side D. Few scattered wheezes, unchanged from baseline 50. Daryl has become progressively dyspneic and now has been co-diagnosed with left tension pneumothorax. Which of the following observed by the nurse indicates that his pneumothorax is rapidly worsening? A. Tracheal deviation to the left B. Tracheal deviation to the center of carina C. Pain on respiration with flat neck veins D. Tracheal deviation to the right Situation: Verbal communication is extremely important especially when the Nurse is exploring problems and disorders with the clients in any age group. Nurse Dante is assigned to different clients in the ward. 51. A client is hospitalized with a diagnosis of possible Cancer of the pancreas. On admission the client asks the nurse, “Do you think I have anything serious like cancer?” What is the nurse’s best reply? A. “What makes you think you have cancer? B. “I don’t know if you do, but let’s talk about it.” C. “Why don’t you discuss this with your doctor?” D. “Don’t worry, we won’t know until all the test result are back.” 52. Nurse Dante approaches a male client and asks how he is feeling. The client states “I’m feeling a bit nervous today.” Which of the following is the Nurse’s best reply? A. Please explain what you mean by the word nervous B. What is making you feel nervous? C. Would a backrub ease your nervousness? D. You do look like you’re nervous 53. When assessing a client what statement would indicate negative self-talk? A. Everyone has to learn something new sometime B. I am looking forward to making home visits , but I am also nervous C. This is going to be difficult, but I know I can do it D. Who can ever have enough experience to prepare for that job? 54. While receiving a preoperative enema a client starts to cry and says. “I’m sorry you have to do this messy thing me,” what is the best response by the nurse? A. “I don’t mind it.” B. “You seem to be upset.” C. “This is part of my job.” D. “Nurses get used to this.” 55. “But you don’t understand” is a common statement associated with adolescent. The best response by the nurse when communicating with an adolescent is to say: A. “I don’t understand.” B. “I would like to understand, let’s talk.” C. “I don’t understand. I was a teenager once too.” D. “I’m not sure have to I believe it’s you who has to understand.” Situation: One of the important roles of the Nurses is being a Health Educator. Clients would always seek information on Health maintenance to prevent illness. 56. Nurse Diana, daughter of Hippolita and the princess of Themycera, is teaching a client about prescribe restricted diet. What is the Nurse’s best initial comment? A. “You can eat only the on this list.” B. “What types of food do you usually eat?” C. “You need to limit the intake of food on this list.” D. “Do you understand why you have these food restrictions?” 57. Nurse Diana is preparing a nursing care plan to a client with Diabetes Mellitus (D.M.) that includes before discharge to know how to self-administer insulin, adjust the insulin dosage, understand the diet, and test the serum for glucose level. The client progresses well and is discharge 5 days following admission. Legally the: A. Nurse was properly functioning as a health teacher B. Visiting nurse should do health teaching in the client’s home C. Family members also should have been taught to administer the insulin D. Physician was responsible and the nurse should have cleared the care with the physician 58. Which teaching method has been evaluated as most effective in a new diabetic client? A. Utilizing breaks after each unit of the teaching session B. Having the client repeat the steps of insulin administration C. Encouraging the client to ask many questions D. Confirming that the client is able to give his own insulin 59. Which of the following statements by a client would alert the Nurse that further teaching on the idea of a restful sleep is indicated? A. I don’t take naps throughout the day B. I go to bed and get up routinely at the same time each day C. I have a small snack and take a bath before going to bed each day D. I went to bed earlier than usual and I rested and watched television until I fall asleep 60. What can the Nurse do to support the client’s ability to sleep in the hospital setting? A. Assess the client’s towards the end of the shift , closer to the normal awakening time TOP RANK REVIEW ACADEMY, INC. Page 4 | 7