Tiêu đề PB3 - NP 3 - STUDENT COPY.docx ✅

1 | Page PREBOARDS EXAMINATION 3 NURSING PRACTICE III CARE OF CLIENTS WITH PHYSIOLOGIC AND PSYCHOLOGICAL ALTERATIONS (PART A) 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 Emery is caring for patients with cardiac conduction abnormalities and arrhythmias. Understanding their characteristics and appropriate nursing actions is essential. 1. Which of the following best describes Second Degree AV Block Type 2? A. Irregular atrioventricular rhythm with dropped beats B. Regular atrioventricular rhythm with dropped beat C. ECG changes without any dropped beats D. Intermittent conduction block where all impulses reach the ventricles 2. The patient’s ECG strip now shows random, chaotic electrical activity with no identifiable P waves, and a ventricular rate exceeding 300 beats per minute. What is the priority nursing action to correct rhythm? A. Deliver Immediate defibrillation at 200-300 joules B. Administer intravenous diltiazem C. Initiate oxygen therapy D. Perform synchronized cardioversion 3. Which arrhythmia pattern is commonly seen with Premature Ventricular Contractions (PVCs)? A. Ventricular tachycardia B. Bigeminy C. Unifocal D. Ventricular fibrillation 4. For a patient experiencing PVCs, which class II antiarrhythmic drug is most appropriate? A. Metoprolol (Lopressor) B. Amiodarone (Cardaron) C. Diltiazem (Cardizem) D. Adenosine (Adenocard) 5. Which of the following substances is least likely to cause premature ventricular contractions? A. Nicotine B. Methamphetamine C. Benzodiazepine D. Caffeine Situation: Nurse Ferb is monitoring patients with myocardial infarction to identify unusual signs and manage their condition effectively. 6. Which of the following is an atypical ECG finding of Myocardial Infarction? A. T wave inversion B. Pathological Q waves C. ST Segment Elevation D. Sinus bradycardia 7. In managing myocardial infarction, which medication functions primarily by reducing myocardial contractility and oxygen demand? A. Atenolol B. Amlodipine C. Nitroglycerine D. Nifedipine 8. Beta blockers are used during acute MI for all of the following reasons, except: A. To reduce myocardial oxygen demand B. To prevent ventricular arrythmias C. To increase heart rate and contractility D. To limit infarct size Situation: Nurse Pam is conducting a health screening focused on hypertension. She encounters several patients with varying blood pressure readings and educates them about their conditions and necessary lifestyle modifications. 9. A patient’s blood pressure is recorded as 139/89 mmHg during the screening. According to JNC 8 classification, this blood pressure level is categorized as: A. Prehypertensive B. Stage 1 Hypertension C. Stage 2 Hypertension D. Hypertensive Crisis 10. Nurse Pam explains to a patient with malignant hypertension about possible complications. Which of the following target organ damages is least likely to be caused by malignant hypertension? A. Left ventricular hypertrophy and heart failure B. Hypertensive encephalopathy and cerebral hemorrhage C. Hepatic ischemia and fibrosis D. Retinopathy 11. During discharge teaching, Nurse Pam advises the patient on dietary restrictions for malignant hypertension. Which of the following food choices should the patient limit to help control blood pressure? A. Saba banana B. Pickled cucumber C. Baked tuna D. Sweet potato Situation: Nurse Mav is assessing a 28-year-old female patient who complains of intermittent chest pain, palpitations, and dizziness. During auscultation, Nurse Mav hears an unusual heart sound. The patient has a history of mitral valve prolapse and is scheduled for a balloon valvuloplasty to address moderate valve stenosis. 12. What auscultatory assessment finding is typical of mitral valve prolapse? A. Diastolic Rumble B. Mid systolic Click C. Pericardial Friction Rub D. Opening Snap 13. Which symptom is not commonly associated with mitral valve prolapse? A. Palpitations B. Shortness of breath C. Dizziness * NLE * NCLEX * CGFNS * HAAD * PROMETRICS * DHA * MIDWIFERY * LET * RAD TECH * CRIMINOLOGY * DENTISTRY * PHARMACY *

3 | Page 32. Nurse Heme percusses the patient’s posterior lung fields. Which sound is expected in normal lung tissue? A. Tympany B. Resonant C. Hyperresonant D. Dullness 33. While auscultating lung sounds in a healthy adult, Nurse Heme hears soft, low-pitched sounds over most lung fields. What breath sound is the nurse most likely hearing? A. Stridor B. Wheezes C. Rhonchi D. Vesicular 34. Nurse Heme places her hands on the patient’s posterior chest wall and asks them to say “eee eee eee”. This is an assessment of: A. Tactile Fremitus B. Bronchophony C. Egophony D. Whispered Pectoriloquy 35. Nurse Heme assesses a COPD patient presenting with a prolonged expiratory phase and uses accessory muscles during breathing. Which breathing pattern is expected in this patient? A. Kussmaul’s Respiration B. Diaphragmatic Breathing C. Cheyne-Stokes Respiration D. Biot’s Respiration Situation: Nurse Reed is an ER nurse assessing several patient with respiratory problems. 36. A patient with a specific phobia is brought to the emergency department hyperventilating after an anxiety attack. The patient’s ABG result is most likely: A. Metabolic acidosis B. Respiratory acidosis C. Metabolic alkalosis D. Respiratory alkalosis 37. Which scenario may cause iatrogenic respiratory acidosis? A. Breathing into a brown paper bag B. Excessive oxygen administration in COPD C. Ongoing hemorrhage D. Hypoxemia Situation: Nurse Reed, an emergency department nurse, has been floated to the medical-surgical ward for the day. One of her assigned patients is a teenage male recently admitted with a diagnosis of allergic rhinitis. He reviews care plan and prepares to provide patient education. 38. Which of the following clinical manifestations would he expect to find in the patient with allergic rhinitis? A. Thick yellow nasal discharge, fever, and sinus tenderness B. Persistent cough, night sweats, and wheezing C. Sneezing, clear nasal discharge, rhinorrhea D. Productive cough, chest pain, and shortness of breath 39. The physician prescribes cromolyn sodium for the patient with allergic rhinitis. Nurse Reed instructs the client that the medication is most effective when used: A. At the onset of symptoms, 2-3 doses per day B. Every morning, once a day C. One week before the allergy season begins D. At night, once daily 40. Nurse Reed has returned to the emergency department and is assigned to care for a child who has been brought in with difficulty breathing. The child has a known history of asthma and is currently experiencing an acute episode. Which of the following breath sounds is most expected during assessment? A. Coarse rales B. Wheezing C. Ronchi D. Fine Crackles 41. Nurse Reed is reviewing medications used in the treatment of asthma. Which of the following drugs is typically indicated for immediate relief during an acute asthma attack? A. Theophylline B. Cromolyn Sodium C. Salbutamol D. Prednisone Situation: Nurse Sue is an ICU nurse caring for a patient with a tracheostomy who has thick secretions, audible gurgling, and oxygen saturation of 90%. 42. Based on this assessment, which nursing diagnosis is most appropriate? A. Impaired gas exchange B. Ineffective airway clearance C. Risk for aspiration D. Ineffective breathing pattern 43. What is the primary purpose of a tracheostomy procedure? A. To establish an airway B. To provide nutritional route C. To monitor hypoxia D. To prevent pulmonary embolism 44. Another patient with a tracheostomy appears frustrated and anxious when trying to speak. Nurse Sue recognizes this behavior is most likely related to which nursing diagnosis? A. Ineffective airway clearance related to thick secretions B. Disturbed thought process related to difficulty comprehending communication C. Impaired verbal communication related to physical barrier from tracheostomy D. Social isolation related to inability to speak Situation: Nurse Lorelai is assessing a Chronic Obstructive Pulmonary Disease (COPD) patient with a long history of smoking. She evaluates the patient’s physical condition, provides discharge instructions, and reinforces knowledge about disease management. 45. During physical assessment of a patient with COPD, which chest shape would Nurse Lorelai most likely observe? A. Flail Chest B. Funnel Chest C. Pigeon Chest D. Barrel Chest 46. Which thoracic measurement finding supports the above- mentioned condition? A. Anteroposterior diameter is less than transverse diameter B. Anteroposterior diameter equals than transverse diameter C. Transverse diameter is smaller than normal D. Anteroposterior diameter is absent 47. While teaching the patient with COPD about lifestyle modifications, which statement indicates a need for further teaching? A. “I should eat small, frequent meals that are high in fat and protein.” B. “I need to avoid foods that increase carbon dioxide production, like carbohydrates.” C. “I will increase my fluid intake to thin secretions.” D. “I should avoid all physical activity to conserve energy.” 48. During discharge teaching, Nurse Lorelai reviews breathing techniques to manage dyspnea at home. Which patient statement indicates effective understanding? A. “I will take short, shallow breaths through my nose to conserve energy.” B. “I will lie on my right side and breathe deeply when I feel short of breath” C. “I will hold my breath after inhaling to increase oxygen absorption” D. “I will practice pursed-lip breathing to help slow my breathing and reduce panic” 49. The patient requires oxygen therapy with a precise and low concentration of oxygen. Which oxygen delivery device is most appropriate? A. Nasal Cannula B. Simple Face Mask C. Venturi Mask D. Non-Rebreather Mask