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Medical Surgical Nursing Critical Thinking in Client Care Single Volume 4th Edition By Priscilla T LeMone -Test Bank
- MC A client tells the nurse, “I seem to need one more drink each night after work, just to unwind.” The nurse realizes this client is describing:
- Withdrawal symptoms.
- Substance abuse.
- MC A nurse calls off from work periodically and has a known history of using alcohol. This nurse is most likely demonstrating:
C.* Substance abuse.
- Substance dependence.
- MC A client who was sexually abused as a child tells the nurse, “I just like to try different drugs recreationally.” The nurse realizes this client:
A.* Has low self-esteem and difficulty expressing emotions.
- Has an addictive personality.
- Wants to fit into his peer group.
- Has a mental illness.
- MC The nurse manager has been alerted to an unusually high number of “wasted” narcotics in the care area. Which of the following should the nurse do about this finding?
- Have an educational program provided to all staff about narcotic use.
- Nothing. This could be a normal occurrence.
C.* Realize that a substance abuse problem may be occurring with a staff member and begin closer observation.
- Review the records to see which clients were prescribed the wasted narcotics and interview them.
- MC A client has been diagnosed with alcoholism which is causing him to be depressed. The nurse realizes these diagnoses are indicative of:
- Sexual abuse as a child.
D.* A dual disorder.
- MC A pregnant client continues to smoke so that she “doesn’t gain a lot of weight.” Which of the following can the nurse instruct this client about smoking while pregnant?
- “It will not harm the infant.”
- “It will prevent some weight gain.”
C.* “It can cause low birth weight in the infant.”
- “It doesn’t prevent weight gain.”
- MC A 76-year-old male who used to run a bar and restaurant comes into the clinic with progressive numbness and tingling of all four extremities. For which of the following should this client be evaluated?
- Psychological dependence.
D.* Korsakoff’s psychosis.
- MC A 48-year-old male with a history of chronic marijuana use tells the nurse that his wife cannot get pregnant and wants to have fertility testing done. Which of the following would be an appropriate response for the nurse to make to this client?
A.* “Marijuana adversely affects the sperm and testosterone levels in men.”
- “Children would cost money and maybe he would have to reduce his marijuana use.”
- “It wouldn’t hurt to see which partner has the fertility issues.”
- “Having a baby at his age might not be a good idea.”
- MC A 35-year-old client with a history of barbiturate abuse tells the nurse that she “likes to have a few drinks with friends”. The nurse realizes this client is at risk for:
- Dual disorders.
- Withdrawal symptoms.
- Psychotic illness.
- MC A client with a crystal methamphetamine addiction is withdrawing from the drug. The family phones the clinic concerned about the client’s symptoms, which include excessive fatigue, sleeping, and a voracious appetite. Which of the following can the nurse instruct this family about the client’s symptoms?
- Prevent the client from eating.
B.* This is completely normal while withdrawing from this drug.
- Give the client hot black coffee to keep them awake.
- Try to keep the client awake and take to an emergency room if sleeping continues.
- MC The nurse sees a client with excessive lacrimation, rhinorrhea, yawning, and diaphoresis despite the cool temperature in the waiting room. Which of the following do these assessment findings suggest to the nurse?
- Amphetamine withdrawal.
B.* Heroin withdrawal.
- Marijuana withdrawal.
- Nicotine withdrawal.
- MC A client tells the nurse that she recalls “feeling funny” after taking a few sips of her drink at a night club and later remembers that she was raped. The nurse suspects that this client had been given:
- MC The nurse learns that there are multiple ways for organic inhalants to gain entry into the body. What are they? (Select all that apply.)
- MC A client tells the nurse that the new medication he is taking will cause him to be physically ill if he drinks with it. The nurse realizes this client has been prescribed:
- Fluoxetine (Prozac).
- Magnesium sulfate.
C.* Disulfiram (Antabuse).
- Naltrexone (ReVia).
- MC The nurse is interviewing a client who denies having a longstanding history of alcohol and drug use. Which of the following should the nurse do to gain information and direct care?
- Confront the client.
B.* Utilize the CAGE questionnaire.
- Refer to a psychologist.
- Request an inpatient evaluation.
- MC A client withdrawing from a drug is experiencing hallucinations. Which of the following nursing diagnoses would be appropriate for this client?
A.* Disturbed thought processes
- Imbalanced nutrition
- Low self-esteem
- Deficient knowledge
- MC The nurse in the emergency department is providing care to a client with a cocaine addiction. Which of the following terms are often used for cocaine? (Select all that apply.)
- Purple hearts
C.* White cloud
- MC The nurse is planning to attend a program to learn how to respond to mass casualty incidents. There are core competencies within this program. The nurse knows that these competencies are: (Select all that apply.)
C.* Critical thinking
D.* Technical skills
- Nursing process
- MC The hospital has been notified of a subway derailment with approximately 250 passengers. Many of the passengers are reported to be injured. This situation would be classified as being:
- A multiple casualty incident.
- An accidental disaster.
- A natural disaster.
D.* A mass casualty incident.
- MC The care area has been alerted to a possible illness associated with the tainting of a popular over-the-counter pain reliever. The nurse realizes the tainting of this pain reliever could be classified as being:
- A natural disaster.
B.* A non-conventional terrorist attack.
- An accidental disaster.
- A conventional terrorist attack.
- MC The emergency room nurses are noting an usually high number of clients coming into the department with complaints of nausea, vomiting, and severe headache. What should be done with this information?
- No further action is needed at this time.
- Close the emergency room.
- Call for more staffing to handle all of the clients.
D.* Contact the Infection Control Department and Laboratory Medicine.
- MC A client comes into the clinic with the onset of itching after opening a letter received about a week ago that contained “quite a bit of white powder”. It is suspected that this client has had an anthrax exposure. Which medication can the nurse anticipate that this client will most likely be prescribed?
- Normal saline solution flush to the skin
- MC A client says to the nurse, “I’m scared about a terrorist attack since I live so close to the airport.” Which of the following would be an appropriate response for the nurse to make to this client?
- “I would be concerned too.”
B.* “What do you have in your home to help you in the event of a terrorist attack?”
- “Have you thought about moving?”
- “That’s silly to be so worried.”
- MC The nursing staff is planning to attend a disaster prevention presentation. The purpose of this education is:
- To have the nurses participate in the plan for handling a disaster.
- To learn the organization’s disaster plan.
- To educate the nurses about recognizing possible terrorists.
D.* To learn how the nurse will participate in mitigation.
- MC The community is holding a memorial service to honor those members whose lives were lost in the flood one year ago. In which stage of the disaster recovery process is this community?
- Disaster reflection
- MC During the disaster preparedness presentation, the nurse learns about the harmful effects of a dirty bomb. Which of the following treatments will preserve life in the event of this disaster?
- Support the client who will develop radiation sickness.
B.* Bone marrow transplant
- Heart-lung transplant
- Liver transplant
- MC A client who was exposed to a thermal nuclear blast is experiencing blindness. Which of the following can the nurse instruct this client about the eye injury?
- The blindness will last for several years.
- The blindness is permanent.
C.* The blindness will resolve in time. The intense light from the blast caused the temporary blindness.
- The blindness will resolve somewhat in time; however, the client will always have vision changes afterwards.
- MC A client is brought into the emergency room with chemical burns. Which of the following should the nurse do to help this client?
- Do not remove any jewelry.
- Keep the client’s contact lenses in place and flush only with warm water.
- Begin flushing the client’s clothes and skin with warm water.
D.* Check to see if all of the clothing has been removed and begin flushing the client’s skin with water.
- MC The National Weather Service has announced the likelihood of a large snow event in a major metropolitan area. Which of the following is most likely to occur with this weather event?
- Crushing injuries
B.* Myocardial infarctions
- Stress-related injuries
- MC The emergency response team is setting up an area to triage victims of a building blast in a major metropolitan area. Which of the following areas can be used to set up this triage location?
- Hot zone
- Clean zone
C.* Cold zone
- Warm zone
- MC The nurse is planning the coding for a triage disaster plan. What are the colors most associated with triage? (Select all that apply.)
- MC A community client arrives to the site of a disaster, hysterically crying because she was in the building that had collapsed just minutes before the disaster. Which of the following should be done with this client?
- Advise her to go home with her family.
- Have a nurse talk with the client.
- Triage this client and transport to the hospital.
D.* Ask psychiatric service personnel to talk with this client.
- MC An elderly client asks the nurse, “What can we do to be prepared if there’s a disaster in our community?” Which of the following can the nurse respond to this client?
- “There is not really much we can do to be prepared.”
B.* “Make sure all of your important papers, health information, medication information, and next-of-kin information is in one place.”
- “Make sure you can call your family to come and pick you up if this happens.”
- “Plan to evacuate your home at a moment’s notice.”
- MC A mass casualty accident has occurred. The nurse has received a list of terms to use for the Alternate Triage 5-Category System. The first client the nurse receives has a color code of red. The nurse knows that this client needs:
- To be evaluated in the next few hours.
- To be sent home.
- To be sent with their family for privacy during the dying process.
D.* To be evaluated for immediate intervention.