Nursing Process Test Questions

Nursing Process Test Questions Related

Review Nursing Process Test Questions related questions and content

A client is diagnosed with rheumatoid arthritis, an autoimmune disorder. When teaching the client and family about autoimmune disorders, the nurse should provide which information?

  • A. Clients with autoimmune disorders may have false-negative but not false-positive serologic tests
  • B. Advanced medical interventions can cure most autoimmune disorders
  • C. Autoimmune disorders include connective tissue (collagen) disorders
  • D. Autoimmune disorders are distinctive, adding differential diagnosis
Correct Answer: C

Rationale: Correct Answer: C - Autoimmune disorders include connective tissue (collagen) disorders.

Rationale: Autoimmune disorders involve the immune system mistakenly attacking healthy cells and tissues in the body, which can lead to various conditions, including connective tissue disorders like rheumatoid arthritis. Providing this information to the client and family is crucial for understanding the nature of autoimmune disorders and the potential impact on the body.

Summary of other choices:
A: False-negative or false-positive serologic tests can occur in autoimmune disorders, so this statement is not specific enough to be the most appropriate information to provide.
B: Advanced medical interventions can manage symptoms but not cure autoimmune disorders, making this statement inaccurate and misleading.
D: Autoimmune disorders can present with a wide range of symptoms and can be challenging to diagnose, but this statement does not address the specific link between autoimmune disorders and connective tissue disorders.

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Why are older adults with heart and blood vessel diseases susceptible to thrombophlebitis?

  • A. Choose all that apply
  • B. IV drugs and chemicals
  • C. Impaired mobility
  • D. Compromised circulation
Correct Answer: B

Rationale: The correct answer is B: IV drugs and chemicals. Thrombophlebitis is inflammation of a vein with blood clot formation, commonly caused by irritants like IV drugs. Impaired mobility (C) and compromised circulation (D) are risk factors for thrombophlebitis, but not specific to older adults with heart and blood vessel diseases. A is incorrect as not all choices apply in this scenario.

When assessing a client with autoimmune disorder, what signs should the nurse look for in the client?

  • A. Hypotension
  • B. Hives or rashes
  • C. Localized inflammation
  • D. Cramping and vomiting
Correct Answer: B

Rationale: The correct answer is B: Hives or rashes. In autoimmune disorders, the immune system mistakenly attacks the body's own tissues, leading to various symptoms. Hives or rashes are common manifestations of autoimmune disorders due to the immune response affecting the skin. Other choices are incorrect because hypotension is not typically associated with autoimmune disorders, localized inflammation may be present but is not specific to autoimmune disorders, and cramping and vomiting are not primary signs of autoimmune disorders.

What equipment should the nurse prepare for the primary care provider when a woman says she is concerned about possible Chlamydia infection?

  • A. Chlamydia slide
  • B. Chlamydia collection kit
  • C. Chlamydia swab
  • D. Chlamydia wet mount
Correct Answer: B

Rationale: The correct answer is B: Chlamydia collection kit. The primary care provider will need the collection kit to gather a sample for testing. A Chlamydia slide (A) is not necessary as the provider needs to collect a sample first. A Chlamydia swab (C) is used to collect the sample, not to provide to the provider. A Chlamydia wet mount (D) is not appropriate for Chlamydia testing, as it is typically used for other types of infections.

Which action by the nurse is appropriate?

  • A. Observe the patient for abnormal bleeding.
  • B. Notify the physician and expect an order to increase the warfarin dose.
  • C. Advise the patient to double today’s dose of warfarin.
  • D. Administer Vit. K per protocol.
Correct Answer: A

Rationale: The correct answer is A because observing the patient for abnormal bleeding is an appropriate action to monitor for potential complications of warfarin therapy. This aligns with the nursing role in assessing and monitoring patient responses to treatment.

B is incorrect as increasing warfarin dose without physician order can lead to adverse effects. C is incorrect as altering the dose without medical advice can be dangerous. D is incorrect as administering Vitamin K would counteract the effects of warfarin, which is used to prevent blood clotting.

Aling Loida, who was admitted for acute pancreatitis, starts complaining of acute abdominal pain, which of the following would be an appropriate nursing interventions by Nurse Norma?

  • A. administer morphine sulfate as ordered
  • B. obtain daily weights
  • C. maintain Aling Loida on high calorie, high protein diet
  • D. place her on supine position
Correct Answer: A

Rationale: The correct answer is A: administer morphine sulfate as ordered. This is the appropriate nursing intervention because acute abdominal pain is a common symptom of acute pancreatitis, and morphine sulfate is a commonly used medication to relieve severe abdominal pain. Administering morphine sulfate will help alleviate Aling Loida's discomfort and improve her overall well-being.

Choice B is incorrect because obtaining daily weights is not directly related to managing acute abdominal pain in this scenario. Choice C is incorrect as maintaining Aling Loida on a high calorie, high protein diet may exacerbate her symptoms due to the acute pancreatitis. Choice D is incorrect as placing her on a supine position may not address the underlying cause of the abdominal pain and could potentially worsen her condition.

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