Tiêu đề CDC - PART B (NP2).pdf ✅

CLOSED DOOR COACHING PART 2 Nursing Practice 2 Situation: For almost two years, Nurse Dwayne has been assigned to the Pediatric Ward. He plans to join the team of nurses who will be conducting a study about sleeping patterns. To assess whether he is equipped with the basic foundation of nursing research, the team leader evaluates Nurse Dwayne. 1. Nurse Dwayne was asked to discuss informed consent by definition. After defining the term, he was further asked about its use. Which of the following should be Nurse Dwayne’s answer? To fully understand what the research is all about and what will happen should the participants opt to involve themselves in the research study To get assurance that participants have the right to withdraw from participating in the research at any given time. To get a complete and full information as to the objective of the study, procedures to be implemented, data collection, benefits and harm and options in the method of treatment. To get assurance how anonymity and confidentiality will be maintained. A. 1, 2 & 3 B. 2 only C. 1, 2, 3 & 4 D. 3 only 2. To strictly adhere to respecting the privacy of individuals or subjects, Nurse Dwayne should focus on: A. Breach of contract. B. Anonymity C. Ethical dilemma D. Confidentiality 3. Nurse Dwayne further explained that the ultimate goal of conducting research in nursing is to ___________________________________. A. Justify the role of nurses as health care provider. B. Establish a credible body of evidence to support and improve the delivery of care. C. Identify research priorities that will justify the oversupply of nurses. D. Develop a body of knowledge to address non-nursing problems. 4. In conducting a study on sleep, Nurse Dwayne determines which of the types of research will be utilized that involves collecting numerical data which is most often under considerable control. Nurse Dwayne should conduct which research? A. Ethnographic B. Phenomenological C. Qualitative D. Quantitative 5. Should a 24-hour period clinical observations and activities be considered in conducting the research on sleep, the type of study that Nurse Dwayne will be conducting is ____________________. A. Quantitative B. Descriptive C. Ethnological D. Exploratory Situation: At 36 weeks AOG, Rosmar enters the labor and delivery unit in probable preterm labor. She was then evaluated for fetal presentation which showed breech presentation. An order of catheterized urine specimen was deemed necessary which prompted Nurse Cassidy to prepare for the procedure. 6. Rosmar asks Nurse Cassidy why such a diagnostic procedure is needed. The nurse explains to Rosmar the rationale behind the placement of the catheter. Which of the following is the most appropriate response from Nurse Cassidy? A. Urinary tract infections are strongly associated with the occurrence of preterm labor B. Reduced sensation to urinate usually occur during preterm labor C. Preterm labor treatment usually causes women a bladder infection because of restricted fluid intake D. Catheterized urine is usually ordered for any woman admitted to the labor and delivery unit 7. The physician has ordered Betamethasone (Celestone). Rosmar asks Nurse Cassidy about the purpose of this medication. The most accurate answer is that the medication ______________________. A. Promote fetal lung maturity. B. Prevent the premature closure of the ductus arteriosus. C. Delay delivery for at least 48 hours. D. Stop the premature uterine contractions. 8. A diagnostic pelvic ultrasound was requester for Rosmar. Nurse Cassidy must instruct the client on which of the following preparation? A. Explanation of the procedure B. NPO 6 hours before C. Informed consent D. Voiding 9. Nurse Cassidy is aware that pelvic ultrasound can detect which of the following? A. Congenital defects in the structure, fetal gender, H-mole B. Fetal DM, multiple pregnancies, fetal age of gestation C. Fetal sex, number and lung maturity D. Fetal congenital defects, placenta previa, fetal lung maturity 10. As the labor was imminently progressing, the physician thought it necessary to perform amniotomy. Initially, Nurse Cassidy should assess for which of the following parameters? A. Bladder distention B. Maternal blood pressure C. Cervical dilatation D. Fetal heart rate (FHR) pattern Situation: Lovely is admitted to the hospital with severe preeclampsia. On assessment, her blood pressure is 160/110 mmHg with marked proteinuria and visible swelling on her cheekbones and anterior leg. As a college student from one of the local universities, she insists on continuing her studies while in the hospital despite being instructed to rest. Lovely studies approximately 10 hours a day and has numerous visits from fellow students, family and friends. The following questions apply. 11. Nurse Kitty should perform which intervention to promote rest? A. Develop a routine with the patient to balance her studies and her rest needs. B. Include a significant other in helping the patient understand the need for rest. C. Instruct the patient that the baby's health is more important than her studies at this time. D. Ask her why she is not complying with the prescription of bed rest. 12. Lovely appears to be irritated with Nurse Kitty. She blatantly said to the nurse "I don't want to talk with you because you're only a nurse. I will wait for my doctor." Which of the following should Nurse Kitty say in response to the patient? A. Your doctor prescribed this for us to do nursing care. B. I understand. I should call your doctor. C. I'm angry with the way you dismiss me. D. So then you would prefer to speak with your doctor? 13. Nurse Kitty is experiencing an ethical dilemma. Ethical dilemma occurs when ______________. A. A decision had to be made quickly under stressful situation B. Choices are unclear C. There is a conflict between the nurse's decision and that of his/her superior
D. There is a conflict of two or more ethical principles 14. Irregardless of the patient’s response, which ethical principle must be upheld by Nurse Kitty when providing all patients with caring attention and information? A. Beneficence B. Nonmaleficence C. Veracity D. Advocacy 15. To promote safety for a patient with severe preeclampsia, Nurse Kitty should initiate which action to provide a safe environment? A. Take the patient's vital signs every 4 hours. B. Encourage visits from family and friends for psychosocial support. C. Maintain fluid and sodium restrictions. D. Take off the room lights and draw the window shades. Situation: Nurse Marilou is assigned to take care of Georgina, a 5-year-old patient who came in due to cough, respiratory distress, anxiety, and signs of dehydration. After initial assessment, the working diagnosis is pneumonia. 16. Nurse Marilou takes into account history taking and physical exam which are critical to the diagnostic process and often provide more information than can gained by broad testing strategies. She is aware that history taking includes all of the following, EXCEPT? A. History of present illness. B. Religious Affiliation C. Social & Family history D. Past medical history 17. The aim of taking the history of present illness is to elicit chronologic description and duration of the chief complaint. Which of the following questions would try to answer what Nurse Marilou wishes to elicit? History of immunizations. Aggravating and alleviating factors Duration of disease onset Any treatment and response to treatment A. 1, 2 & 3 B. 2,3 & 4 C. 1, 2, 3 & 4 D. 1, 2 & 3 18. The past medical history section of the client contains the following excluding ___________. A. Prenatal history. B. Childhood illness C. Current history D. Birth history 19. As Nurse Marilou is performing history taking, which of the following statements is TRUE? A. History taking must be long regardless if the child appears to be well. B. No proper history can be obtained without observation of child and the mother. C. Nurse Marilou should refrain from asking about the illness of other members of the family. D. An example of what can be elicited from a social history is how the disease started. 20. In order not to frighten the child during assessment, it is best to examine things that are uncomfortable or frightening to them last so as not to lose their cooperation. Which of the following is the least priority? Inspection of the throat with a throat stick. Inspection of the ears with an otoscope Auscultation of the heart Undressing the child Situation: Melody was admitted to the hospital with a complaint of moderate hypogastric pain. She intends to visit the clinic for her first prenatal check-up and informs Nurse Mark that she did not realize she is pregnant until a week ago. As a result, she has been on a diet and weightlifting at the gym. 21. After being seen by the physician, Melody was ordered with a medication that is larger than the standard dose. The most appropriate action for Nurse Mark would be to _________________. A. Give the drug as prescribed. B. Inform the supervisor. C. Give the average dose of the medication. D. Discuss the prescription with the physician. 22. Melody refuses to take the medication because it causes diarrhea. Nurse Mark explains the action of the drug, but the patient vehemently refuses the medication. What should be the initial action of the nurse? A. Discuss with a family member the need for the patient to take the medication. B. Document the patient's refusal to take the medication. C. Notify the physician of the patient's refusal to take the medication. D. Explain again to the patient the consequences of refusing to take the medication. 23. As a strong believer of her faith and the need for spiritual guidance, Melody requests that she wants that clergy to visit her. Which function did Nurse Mark applied when he initiated the visit? A. Dependently B. Collegially C. Interdependently D. Independently 24. Melody sought referral to an abortion clinic from the nurse. She states that her pregnancy a burden to her work and daily routines. Which of the following would you consider as the best response from Nurse Mark? It will cause discrimination from friends and relatives. Inform her that abortion is morally and legally wrong by virtue of the law. It will cause infection. It is against any religion. 25. Nurse Aliza, the incoming nurse-on-duty, was about to administer a medication when the patient says, "This pill looks different from the one I had taken before." Which of the following is the appropriate action of the nurse? A. Explain the purpose of the medication. B. Encourage the patient to take the medication. C. Check the original medication prescription. D. Ask what the other pill looked like. Situation: Nurse Yladia, a newly hired nurse is assigned in the OB ward. She was supervised by Nurse Greta, a senior nurse in the ward. The following questions apply. 26. Nurse Yladia was asked by the nurse supervisor about her concern and what are the considered ideal fetal positions for a healthy delivery? A. Right occipitoposterior with no flexion. B. Right occipitoanterior with full flexion. C. Left transverse anterior in moderate flexion D. Left sacroanterior with full flexion 27. Nurse Yladia prepares a client for an ultrasonography. She informs the ultrasound unit-in-charge and prepares the client for the procedure. The client inquires the importance of the procedure, the correct response from Nurse Yladia would be ________________. A. To determine diameters of the fetal skull B. Increase sensitivity for common bile duct of the fetus C. Useful to a visualized cystic duct of the fetus D. To assess fetus’ well-being 28. Nurse Yladia asks for advice from the supervisor. The supervisor notices that Nurse Yladia felt uneasy upon learning that the fetus is on breech presentation. To lessen the tension that she feels, which of the following is the best response by the supervisor?
A. "I understand how you feel. Tell me more." B. "Is this your first time to witness a breech presentation" C. "Are you afraid to assist the case" D. "Don't worry. There is always a first time" 29. After the successful vaginal delivery, Oxytocin (Pitocin) was ordered to be given immediately. The supervisor reassured the Nurse Yladia that everything will be fine because the medication is expected to __________________. A. Promote vasoconstriction of uterine muscles B. Hasten uterine contractility and control bleeding C. Facilitate the return of pregnancy vital signs D. Promote vasodilation of uterine muscles 30. Nurse Yladia oriented the caregiver hired by the couple who just delivered their twins. Which of the following should she encourage the parents to do? A. Relate to each twin individually to enhance the attachment process. B. Avoid assistance from other family members and support groups. C. Bottle-feed the twins to prevent maternal exhaustion. D. Plan for each parent to spend equal amounts of time with each twin. Situation: Queenie is a 2-week postpartum mother coming in for her check-up at the health center. On further assessment, Nurse Mylene noted a localized area of redness on the left breast. She was then diagnosed with mastitis. 31. Nurse Mylene would corroborate the diagnosis of mastitis through which additional finding commonly associated with mastitis? A. Enlarged glands in the axilla B. Normal temperature C. Engorged both breasts D. Hard mass and reddened area 32. Queenie was curious about the cause of this ailment. Nurse Mylene would include the following as predisposing factors of mastitis (Select all that applies). Milk stasis Nipple trauma Using alcohol in cleaning nipples Baby's sitting position A. II and IV B. I and IV C. I and II D. II and III 33. Queenie complains of unbearable pain on her left breast. Which of the following characteristics should Nurse Mylene emphasize in a culturally sensitive nursing care? (Select all that apply). I. The expression of pain is affected by learned behavior. II. Physiologically, all individuals experience pain in a similar manner. III. Some Asian people has high response to pain medications. IV. Patients should be assessed for pain regardless of overt symptomatology. A. III and IV B. I and II C. I and III D. II and III 34. Nurse Mylene provides instructions to Joanna about measures to prevent postpartum mastitis who is breastfeeding her newborn. Which statements indicates a need for further teaching "I should____.” A. Wash my hands well before breastfeeding B. Breastfeed every 2-3 hours C. Change the breast pads frequently D. Wash my nipples with soap and water prior to feeding 35. Queenie is starting to feel anxious and tense as soon as she found out she has mastitis. As a healthcare provider, Nurse Mylene aims to alleviate these feelings by providing her ways to relieve breast discomfort. Which statement is indicative that Queenie still needs further instructions? A. "I have to stop breastfeeding until this condition resolves." B. "I can take antibiotics and should begin to feel better in 24 to 48 hours." C. "I can use analgesics to assist in alleviating some of these discomforts." D. "I have to wear a supportive bra to relieve the discomfort." Situation: Nurse Camila is assigned in the nursery. She is tasked to perform newborn assessment on Baby Boy Raul born at 40 weeks AOG. The following questions apply. 36. Using the APGAR Score, Nurse Camila should bear in mind that this method of evaluating a newborn's condition is used at how many minutes after birth? A. 1 and 10 minutes after birth B. 1 and 3 minutes after birth C. 1 and 7 minutes after birth D. 1 and 5 minutes after birth 37. Nurse Camila is aware that testing of vision in infants and children has been treated separately from the testing of adult. Which of the statement is NOT true? A. Infants and children often cannot be tested with the same materials and techniques as adults. B. Special techniques often must be used, especially to test infants and preschoolers, that cannot be held to the same standards that apply to tests for adults C. Some infants who appear visually impaired early in life will not show normal visual responses several weeks or months later. D. Course of visual and cognitive development must be taken into account in evaluating infants and children's visual abilities 38. Nurse Camila assesses the skin characteristics of the baby. None of the following statements are incorrect about physiologic jaundice, EXCEPT? Caused by impairment in the removal of bilirubin deficiency in the production of glucoronide transferase. Begins to decrease by the 6th or 7th day. Is visible in skin and sclera. Begins after 48 hours of life. 39. Nurse Camila determines the progression of symptoms of the infant. She understands that neonatal jaundice FIRST becomes visible in which of the following parts? (Select all that apply.) Face Forehead Trunk Extremities A. 3 & 4 B. 1 & 2 C. 1 & 4 D. 2 & 3 40. Nurse Camila develops the plan of care for the infant with hyperbilirubinemia. The nursing care plan should focus on all the following, except? A. Informing appropriately the significant others B. Preventing injury C. Maintaining physiological homeostasis with bilirubin levels increasing D. Preventing complications
Situation: Farrah, a 23-year-old pregnant woman, 37th weeks AOG, is admitted in the intensive care unit due to paroxysmal ventricular tachycardia. She is conscious although her cervix appears to be open so the healthcare team decided to induce labor. 41. Farrah asks Nurse Nima about induction of labor and its indication given the circumstance. Nurse Nima’s appropriate statement should be: “Induction is a _______.” A. Local anesthesia used for blocking pain during episiotomy B. Deliberate initiation of uterine contractions that stimulates labor C. Medication injected into the subarachnoid space and has a rapid onset of action D. Procedure performed by artificial rupture of the membranes 42. Which of the following statement is NOT an indication for any uterine stimulants (Oxytocin)? A. Preinducting cervical ripening B. Controlling postpartum bleeding C. Inducing or augmenting labor D. Manages an incomplete abortion 43. An order for Oxytocin (Pitocin) drip was initiated to induce labor. Nurse Nima determines the assessment findings that would prompt her to IMMEDIATELY discontinue the infusion (Select all that applies). I. Fatigue and drowsiness II. Early decelerations of the fetal heart rate. III. Uterine hyperstimulation IV. Late decelerations of the fetal heart rate A. III and IV B. II and III C. I and III D. I and II 44. While Oxytocin (Pitocin) drip was running left arm. An order of intravenous (IV) lidocaine (Xylocaine) was given to Nurse Nima. She conferred with the pharmacist-on-duty regarding its preparation. She should be able to dilute the concentrated solution of lidocaine to infuse in the right arm with which solution? A. 5% Dextrose in Water B. Normal Saline 0.9% C. Normal Saline 0.45% D. Lactated Ringer's 45. Farrah was provided with home instructions regarding digitalis therapy when she was pregnant. Which of the following should be anticipated in accordance to the prescribed medication? A. Switching to a more potent drug. B. Continuation of the same dosage. C. Need for change in medication. D. Addition of diuretic to the regimen. Situation: Nurse Kieran begins his first day in the Pediatric Ward. He is assigned to take care of Paula, an 8-year-old child admitted due to pneumonia and she has a tracheostomy tube in place. 46. Nurse Kieran is set to perform tracheal suctioning. The initial step in the preparation for suctioning for the patient is to ______________. A. Perform hand hygiene B. Gather equipment C. Assess lung sounds, heart rate and rhythm D. Check physician's order and patient care plan 47. Prior to suctioning, Paula should be placed in which of the following position, if not contraindicated? (Select all that applies). 1. Fowler 2. Semi-Fowler 3. Supine 4. Sim A. 1, 2 & 3 B. 2 only C. 1 & 2 D. 1 only 48. Nurse Kieran understands that the common indications for the placement of a tracheostomy includes which of the following? (Select all that applies). 1. Prolonged intubation. 2. Sepsis 3. Hypoventilation associated with neurologic disorders. 4. Severe Sleep Obstructive Apnea Syndrome (SOAS) A. 2 only B. 1 & 2 C. 1, 2, 3 & 4 D. 1 only. 49. Nurse Kieran will give priority to which of the following nursing objective when caring a patient with a tracheostomy? A. To increase tissue oxygenation B. To provide patent airway C. To decrease tissue oxygenation D. To improve ventilation 50. Nurse Kieran would place an emphasis on which expected outcome when performing suctioning? A. Lessened amount of secretions leading to decreased frequency of suctioning. B. Secretions removed without complication. C. Tube-fed patient does not aspirate feeding. D. Prevention of occurrence of hypoxemia and bradycardia. Situation: Kael, an 18 years old boy went to the Emergency Room complaining of severe pain in his right lower abdomen. Nurse Jamil assessed Kael and has found out that he is positive for rebound tenderness and with history of nausea and vomiting, she suspect that Mikael might be diagnosed with Appendicitis 51. Which is true regarding Appendicitis? A. Pain starts from the umbilical area to the right lower quadrant B. Diarrhea may be a sign of appendicitis C. High grade fever D. Abdominal pain that is most intense at the right lower quadrant when left lower quadrant is pressed 52.The Complete Blood Count of someone with an appendicitis demonstrates: A. Elevated WBC, elevated neutrophils, decrease c-reactive protein B. Elevated WBC, elevated neutrophils, elevated ESR C. Elevated WBC, elevated neutrophils, elevated c-reactive protein D. Elevated WBC, elevated neutrophils, decreased ESR 53. The major complications of appendicitis are: i.Hemorrhage ii.Necrotitis iii.Gangrene iv.Perforation A. III and IV B. I and IV C. I and II D. II and III 54. Which is true among gerontologic considerations regarding appendicitis? A. Acute appendicitis is common in older adults B. Fever and leukocytosis is present in most cases C. Pain may be present or minimal D. Incidence of complications is higher to younger adults 55. After appendectomy, the nurse provides post-operative care. Which among the choices are included? A.After the surgery the patient is placed in a high fowler’s position