Comprehensive Exam

Comprehensive Quiz SITUATION: the client 65 y/o has been experiencing cramping pain in her lower abdomen and has noticed a gradual change in her elimination pattern. She is admitted to the hospital for a diagnostic workup and probable surgery 1.) The client is scheduled for barium enema. Preparation includes administration of 60ml of castor oil orally. Castor oil facilitates cleansing of the bowel primarily by: A.) softening of feces B.) Lubricating the stool C.) Increasing the volume of intestinal content D.) Irritating the nerve endings in the intestinal mucosa Ans: D 2.) Following barium enema, the nurse should be prepared to administer which type of medication? A.) Laxative B.) Antiemetic C.) Antacid D.) antibiotic Ans: A 3.) The diagnosis of cancer is confirmed. The client is scheduled for permanent colostomy. The preferred site would be: A.) Ascending colon B.) Lower portion of the descending colon C.) Middle portion of the transverse colon D.) Ileum Ans: B 4.) The patient had NGT inserted at the time of surgery. The tube will most likely be removed when the client demonstrates A.) Absence of bowel sounds B.) Passage of mucus from the rectum C.) Passage of flatus and feces from the colostomy D.) Absence of gastric drainage for about 24hours Ans: C 5.) A colostomy irrigation is ordered on the 5th postop day. The primary purpose of this first

irrigation is to: A.) Cleanse the colon B.) Regulate the bowel C.) Dilate the sphincter D.) Stimulate peristalsis Ans: D 6.) Which of the following preparations would be best to apply around the colostomy? A.) Karaya B.) Petroleum C.) Cornstarch D.) Antiseptic cream Ans: A SITUATION: Mr. H. Sy, 51 y/o is admitted with a diagnosis of end-stage, irreversible chronic renal failure. He has been scheduled for hemodialysis. He has an A-V fistula created in his left forearm. 7.) Mr. Sy, is being given aluminum hydroxide gel (Amphogel) 40 ml. after meals and at bedtime. The primary purpose of prescribing this medication is to: A.) Relieve gastric irritation B.) Prevent metabolic acidosis C.) Prevent peptic ulcer formation D.) Phosphate levels lower serum Ans: D 8.) The nursing care plan states to observe for hyperkalemia. The nurse should recognize that the greatest risk of hyperkalemia is: A.) Tetany B.) Cardiac arrest C.) Fluid overload D.) Internal bleeding Ans: B 9.) The physician orders sodium polysterene sulfonate 15g (exchange resin kayexalate) four times a day. The expected outcome of this medication is to: A.) Lower serum potassium B.) Lower BP C.) Increase urinary output D.) Prevent hemorrhage Ans: A 10.) The physician orders regular insulin, 10 U added to 50 ml of 50% dextrose to be given

intravenously. The expected outcome is to: A.) Lower the blood sugar B.) Decrease the serum potassium C.) Reduce cerebral edema D.) Prevent tetany Ans: B 11.) While caring for Mr. Sy who is now having hemodialysis via A-V shunt, the nurse should recognize that: A.) The use of stethoscope to auscultate the fistula is contraindicated B.) The client feels best immediately after the hemodialysis C.) Taking BP on the affected arm can cause clotting D.) No pain should be experienced during initiation of the dialysis Ans: C 12.) Following hemodialysis, the nurse should anticipate A.) weight loss B.) Polyuria C.) Increased BP D.) Glycosuria Ans: A 13.) After hemodialysis, the expected outcome is decreased serum A.) Bicarbonate B.) Creatinine C.) Proteins D.) Glucose Ans: B 14.) The nurse observe symptoms of disequilibrium syndrome which includes A.) Headache, confusion, and seizure B.) Ankle edema, rales, weight gain C.) Fever, joint pain and chills D.) Decreased BP, tachycardia and chest pain

Ans: C 16.) Signs and symptoms of ECF volume excess include the following EXCEPT: A.) Weight gain B.) Tight, smooth shiny skin C.) Puffy eyelids D.) Flushed, dry skin Ans: D 17.) The following are manifestations of dehydration EXCEPT: A.) Thirst B.) Diluted urine and polyuria C.) Weight loss D.) Poor skin turgor Ans: B Situation: Mike’s history was taken upon admission. Impression is peptic ulcer disease (P.U.D.) 18.) Mike was prescribed antacids. The rationale for prescribing antacids to Mike is to: A.) Decrease gastric motility B.) Neutralize gastric acid C.) Aid in the digestion process D.) Prevent constipation Ans: B 19.) The nurse recognizes that the diet best indicated and must be prescribed for Mike is: A.) Bland diet B.) Full Diet C.) Sippy diet D.) Karrel’s diet Ans: A SITUATION: Mr. M is a 35 y/o bus driver. Accidentally, he sustained second and third degree burns of the chest, anterior portion of both arms and anterior and posterior portions of his right leg.

Ans: A 15.) Which of the following blood values will not be improved by hemodialysis? A.) Elevated serum creatinine B.) Hyperkalemia C.) Low hemoglobin D.) Hypernatremia

20.) At the scene of the accident, the burning process may be stopped by: A.) Immersing the burned parts in cold water B.) Applying oil to the burned parts C.) Flushing the burned areas with a weak solution of vinegar D.) Covering the burned areas with dry, sterile dressings

Ans: C Ans: A 21.) Based on the rule of 9’s, which percentage is the best estimate of the extent of the client’s burns? A.) 36 B.) 27 C.) 26 D.) 46

26.) The M.D. orders hourly CVP readings. The serial CVP readings are as follows: 3, 4, 6, 7, 8, cm of water. The nurse recognizes this as: A.) As indication to increase the flow rate of the IV fluid B.) A sign of fluid overload C.) The desired response to the fluid therapy D.) An indication of the need to decrease the flow rate of the IV therapy

Ans: A Ans: C 22.) Deep partial thickness burns (2nd degree) involves the: A.) Epidermis only B.) Entire epidermis and the dermis C.) Epidermis, dermis and the muscle D.) Epidermis, dermis, muscle and the bones Ans: B 23.) Visual inspection of full-thickness burns would reveal A.) Dry skin surface with a pearly white or charred appearance B.) Blisters of varying sizes, with a cherry red base C.) Moist skin surface with a mottled, reddened area D.) A swollen, reddened area that blanches when pressure is applied Ans: A

27.) The physicians prescribes Cimetidine (Tagamet) 400 mg every 6 hours per IV. The primary action of this drug is to prevent: A.) Vomiting B.) Esophageal Varices C.) Paralytic Ileus D.) Duodenal ulcers Ans: D 28.) The physician has ordered reverse isolation for Mr. M the nurse should understand that: A.) It is necessary to use sterile linens if the linens are properly washed B.) Sterile gowns, masks and gloves must be worn while caring for the client C.) Only some persons coming in contact with the patients need to wear marks and gloves D.) It is not necessarily to wear mask while administering medication Ans: B

24.) What is the priority of care in the emergency room during the initial management of the burn client? A.) Obtaining a medical history B.) Caring for the burn wound C.) Providing for fluid resuscitation D.) Administration of tetanus antitoxin as ordered

29.) Mr. M becomes confused and restless. His CVP reading is 17 cm water, weight gain of 5 lbs and urine output of 100ml/hr. The nurse should recognize this as a signs of: A.) Hypovolemia B.) Circulatory overload C.) The diuretic stage D.) Septic Shock

Ans: C Ans: B 25.) During the first 24 hours post-burn, there is a fluid shift from the intravascular compartment to the site of burns. The nurse anticipates the following observations EXCEPT: A.) Decreased urine output B.) Increased serum potassium C.) Decreased hematocrit D.) Decreased serum sodium

30.) During the diuretic phase of burns, fluid shifts from the interstitial compartment to the intravascular. There is increase urinary output. The ff changes occur during this stage: A.) Hypernatremia, hypokalemia, bicarbonate excess B.) Hyponatremia, hyperkalemia, carbonic acid deficits

C.) Hyponatremia, hyperkalemia, carbonic acid excess D.) Hyponatremia, hypokalemia, bicarbonate deficit Ans: D 31.) The physician has ordered Mefenide Acetate (Sulfamylon) for the burn site every 12 hours. The nurse should recognize that: A.) There is a great deal of pain associated with the application B.) A thick layer of the preparation should e applied for maximum effect C.) Cover the application with pressure dressing for better effect D.) It is not necessary to use sterile technique during application of the preparation because it is antimicrobial Ans: A Situation: A female client, 60 y/o, is admitted through the emergency department with crushing substernal chest pain that radiates to her shoulder, jaw and left arm. The admission diagnosis is acute MI. The client is extremely restless and frightened 32.) The pain associated with MI is due to: A.) An overload left ventricle B.) Impending circulatory collapse C.) Imbalances in extracellular electrolytes D.) Insufficient oxygen reaching the heart muscle

Ans: B 35.) One change in the ECG that indicates MI is: A.) Inverted T wave B.) Prolonged PR interval C.) Narrowing of the QRS complex D.) Absence of P wave Ans: A 36.) If the client develops cardiogenic shock, which characteristic sign of the condition should the nurse expect to observe? A.) Pulmonary rales B.) A slow pulse rate C.) Sudden onset of fever D.) A low blood pressure Ans: D 37.) After one attack of pain, the client says to the nurse “husband died of heart attack and I suppose I will too” Which of the ff would be the most response for the nurse to make. A.) “Are you thinking that you won’t recover from this illness?” B.) “You have a fine doctor. Everything will be alright” C.) “Tell me more about what you are feeling” D.) “Would you agree that this would be very unlikely?” Ans: C

33.) Which of the following hematological studies is typical finding of MI? A.) Elevated CPK value B.) Elevated cholesterol level C.) A below normal WBC count D.) A below normal ESR

38.) Which of the following orders should appear on the client’s NCP to help prevent Valsalva maneuver? A.) Have the client take fewer but deep breathes B.) Have the client clench her teeth while moving in C.) Have the client avoid holding her breath during activities D.) Have the client take oral fluids through a straw

Ans: A

Ans: C

34.) If the client has 8 PVC’s per minute, the nurse’s first course of action should be to: A.) Increase the rate of IV infusion B.) Notify the physician promptly C.) Increase the concentration of oxygen therapy D.) Administer an analgesic prescribed for the client

39.) Oral furosemide (Lasix) is prescribed for the client. Which of the ff signs and symptoms indicates the need for this medication? A.) The client is anxious B.) The client is restless C.) The client has anterior chest pain D.) The client has rales in the lower lobes of the lungs

Ans: D

Ans: D Ans: D Situation: Miss L, an acutely ill 17 y/o is admitted to the hospital with the chief complaint of upper respiratory infection. She is pale and weak. She has been diagnosed to have leukemia when she was 15. 40.) Which of the following statements best describes leukemia? A.) A disease is infectious in nature and characterized by increased WBC production B.) The disease is neoplastic in nature and characterized by a proliferation of immature white blood cells C.) The disease is inflammatory in nature and characterized by solid tumor formation in the lymph nodes D.) The disease is allergic in nature and characterized by an increased number of circulating antibodies in the bloodstream Ans: B 41.) Laboratory findings of the client shows that she is anemic, which has most probably resulted from blood loss and A.) An inadequate intake of iron in the diet B.) An increase in destruction of RBC by lymphocytes C.) A progressive replacement of the bone marrow with scar tissue D.) A decrease in the production of RBC

44.) Which of the following measure would be contraindicated when the nurse gives the client oral hygiene? A.) Applying petroleum jelly to the lips B.) Cleaning the teeth with hard-bristled toothbrush C.) Swabbing the mouth with moistened cotton swabs D.) Rinsing the mouth with a non-irritating mouth wash Ans: B 45.) The nurse should question the order if the drug prescribed for Miss L. T o help control discomfort is: A. Acetaminophen (Tylenol) B.) Acetylsalicylic (Aspirin) C.) Paracetamol (Biogesic) D.) Acetophenetidin (Phenacetin) Ans: B 46.) Miss L is scheduled for bone marrow aspiration. Over which of the following bone sites should the nurse prepare the client’s skin for entry of the needle? A.) The radius B.) A sternum C.) A cervical vertebra D.) The posterior iliac crest

Ans: D Ans: D 42.) The nurse notes that the client has petechiae, her gums, lips and nose bleed easily, and that there are bruises on various parts of his body. Which of the following laboratory findings would be typical when theses symptoms appear? A.) Low platelet count B.) Low serum calcium level C.) Faulty thrombin production D.) Insufficient fibrinogen concentration

47.) The following are nursing consideration when administering oral iron preparation EXCEPT: A.) Use straw when taking liquid iron preparation B.) Take the medication with orange juice C.) Inform that stool may become black and tarry D.) Take the medication before meals for better absorption

Ans: A

Ans: D

43.) Which of the following measures should be kept at a minimum, when possible because the client is prone to bruises and bleed easily? A.) Giving her stool softener B.) Changing her position in bed C.) Offering her food at frequent intervals D.) Administering drugs to her intramuscularly

Situation: Mr. G, is a 45 y/o man, who has been diagnosed to have acute renal failure 48.) Mr. G has been prescribed low protein, potassium, and sodium diet. A touching program should include:

A.) Encourage to include raw fruits and vegetables in the diet B.) Inform that eggs, poultry and lean meat may be included in the diet C.) Point out that raw fruits such as bananas, watermelon and oranges have low potassium content D.) Dried fish may be allowed in the diet Ans: B 49.) During the first peritoneal dialysis exchange, the fluid that drains from the outflow tubing is tinged with blood. The nurse should: A.) Check the urine output for hematuria B.) Apply a pressure dressing to the insertion site C.) Recognize that the abdominal blood vessels have been inadvertently punctured D.) Realize that this is an expected occurrence for the first few exchange

C.) Decrease chest pain D.) Maintain adequate circulating volume Ans: B 53.) Which of the following findings would confirm the presence of pneumothorax? A.) Pronounced rales B.) Inspiratory wheezes C.) Dullness to percussion D.) Absence of breath sounds Ans: D 54.) The nurse administers oxygen to the client by nasal cannula at 3L/min. What percentage of oxygen is the patient receiving? A.) %% to 10% B.) 15% to 20% C.) 30% to 35% D.) 50% to 60%

Ans: D

Ans: C

50.) To prevent abdominal cramps during peritoneal dialysis, the nurse should: A.) Instruct the client to lie flat during the entire exchange cycle B.) Infuse the dialyzing solution at a slow rate C.) Warm the dialysate solution to body temperature D.) Drain the solution as soon as the inflow period is completed

55.) A chest tube has been inserted, and has been removed on the 6th post op day. The chest tube is best removed A.) at the end of inhalation or during exhalation and do valsalva maneuver B.) During inhalation C.) As the patient do keep breathing exercises D.) Anytime Ans: A

Ans: C 51.) To promote drainage of fluid during the outflow period, the nurse should A.) Keep the head of the bed flat B.) Attach the outflow tubing to low suction C.) Move the outflow tubing an inch in or out D.) Turn the client from side to side

56.) Which of the following items should the nurse have ready to be placed directly over the wound when the chest tube is removed? A.) A butterfly dressing B.) A petrolatum gauze dressing C.) A scultetus binder D.) A 4x4 sterile gauze moistened with NSS

Ans: D

Ans: B

Situation: After a serious automobile accident, a male client age 36 is transported by ambulance to the emergency room. He complains of severe pain in his right chest where he struck the steering wheel. He also experienced multiple lacerations and contusions

57.) The best position for the client undergoing thoracentesis is to maintain very still in A.) Lateral Position B.) Supine position C.) Sitting position and bending over an overbed table D.) Prone position

52.) The primary nursing goal at this point should be to: A.) Reduce anxiety B.) Maintain effective respirations

Ans: C 58.) Nursing care during thoracentesis include

the ff. EXCEPT: A.) Observe for the rate, character of pulse and respiration, color and general appearance during the procedure B.) Encourage the patient to cough and deep breathe after the needle is inserted C.) Place the patient on the unaffected side for one hour after the procedure D.) Monitor VS after the procedure to detect hemorrhage and impending shock

Ans: A 64.) Risk factors that may produce pulmonary emboli and deep vein thrombosis include the ff EXCEPT: A.) Immobility B.) Obesity C.) Pelvic surgeries, orthopedic surgeries of lower D.) Early ambulation post op

Ans: B Ans: D 59.) Health teachings to a client with bronchial asthma include the following EXCEPT: A.) Avoid emotional stress, extremes of temperature B.) Avoid personal pollution such as smoking C.) Avoid dust, pollens, and animal danders D.) Practice respiratory isolation Ans: D 60.) A patient as diagnosed to have laryngeal CA. which of the following is viewed as the primary predisposing factors? A.) Cigarette smoking B.) Excessive alcohol C.) Voice strain D.) Environmental pollutants Ans: A 61.) An early manifestation of laryngeal CA is A.) Weight loss B.) Dysphagia C.) Hoarseness of voice D.) Lump in the neck Ans: C 62.) The patient had laryngectomy. The following are expected after the surgery EXCEPT: A.) A tracheostomy in place B.) Constipation C.) Loss of sense of smell D.) An Endotracheal tube in place

65.) In chest injury, cautious and judicious administration of analgesic is indicated to prevent respiratory depression. Which of the ff drug may be given in small doses? A.) Pancuronium Hydrobromide (Pavulcon) B.) Morphine Sulfate C.) Succinylcholine (Anectine) D.) Meperidine HCL ( Demerol) Ans: D 66.) Nursing interventions to a client with bronchogenic CA include the ff EXCEPT: A.) Administration of oxygen inhalation therapy as ordered B.) performing chest percussion and vibration C.) Administration of medimist inhalation therapy as ordered D.) Promotion of physical comfort and physiological support Ans: B 67.) The following are nursing responsibilities when caring for a patient with tracheostomy tube: A.) Apply suction for no longer than 10-15 seconds B.) Instill 5 mls of sterile NSS to the tracheostomy tube to liquefy mucous secretions as needed C.) use clean technique when suctioning tracheostomy tube D.) Insert 3-5 inches length of suction catheter

Ans: D Ans: C 63.) A client has pleural effusion. Percussion sound would most likely be: A.) Dull B.) Flat C.) Tympanic D.) Resonant

68.) The following are nursing responsibilities to a patient who had undergone tonsillectomy EXCEPT: A.) Place in lateral position with the head down until fully awake

B.) Observe for frequent swallowing C.) Instruct to avoid clearing the throat, coughing D.) Allow to drink fluids through a straw Ans: D 69.) The first aid treatment of epistaxis includes which of the following? A.) Exerting pressure at the soft tissues of the nose B.) Tilting the head back C.) Inserting cotton swabs into nares D.) Applying hot compress over the nose Ans: A 70.) A client is scheduled for a transurethral resection of the prostate (TURP) tomorrow. During outpatient preop teaching, he asks where his incision will be. What is the most appropriate response? A.) “The incision is made in the abdomen” B.) “The incision is made in the lower abdomen” C.) “The incision is made in the perineum between the scrotum and the rectum” D.) “There is no incision. The Doctor inserts an instrument through the urethra, the opening in the penis Ans: D 71.) When a client after prostectomy returns from the recovery room he has an IV infusing at 100ml/hr., a three Foley catheter in place, and continuous bladder irrigation. What would the nurse do first when increase blood in the urine is detected? A.) Increase the speed of the irrigation B.) Release the traction on the Foley C.) Irrigate the catheter manually D.) Notify the physician

73.) Which of the following would be included in the discharge teaching for a prostectomy client? A.) “Avoid straining at stools” B.) “Avoid heavy lifting for approximately one week after surgery” C.) “Drive your care whenever you are ready to do so” D.) “Refrain from sexual intercourse for 12 weeks” Ans: A 74.) Which of the following statements indicates that a prostectomy client understand his discharge instruction? A.) “I know my urine maybe slightly pink-tinged” B.) “I know my urine should be clear all the time” C.) “I know my urine should be clear most of the time D.) “I’ll let my doctor knows if I have any urinary dribbling, retention or bleeding” Ans: D 75.) Which of the following is a common early symptom of prostate hypertrophy? A.) Difficulty urinating B.) Impotence C.) Urinary Infection D.) Hematuria Ans: A 76.) The physician wants to examine a client’s prostate gland. What equipment will be necessary for the exam? A.) A Foley catheter B.) Lubricant and gloves C.) Urethral dilators D.) A rectal tube Ans: B

Ans: A 72.) A client who had a TURP complains of pain and bladder spasms. Which of the following nursing actions is most appropriate after determining that the drainage system is patent? A.) Administer narcotics plus anticholinergic drugs, as ordered B.) Help him to sitz bath C.) Decrease the speed of the irrigation D.) Decrease the traction on the Foley

77.) A client undergoes TURP under spinal anesthesia. He returns to his room with continuous bladder irrigation (CBI). Which of these statements best explains the reason for the CBI? A.) To decrease bladder atony B.) To remove blood clots from the bladder C.) To maintain patency of the urethral catheter D.) To dilute the concentrated urine Ans: B

Ans; A 78.) Which of the following symptoms can be

expected temporarily when a client’s Foley catheter is removed? A.) Urgency B.) Dribbling C.) Urinary retention D.) Decreased urinary output Ans: B 79.) Which of the following is the most common complication following a prostectomy that has implications for nursing assessment and intervention? A.) Urinary tract infection B.) Cardiac Arrest C.) Pneumonia D.) Thrombophlebitis Ans: D 80.) Which of the following is the most appropriate when preparing a client for a proctosigmoidoscopy? A.) On the morning of the examination administer enemas until the returns are clear B.) Maintain the client NPO for 24 hours preceding the examination C.) Give a strong cathartic on both the evening before and the morning of the examination D.) Give sitz bath three times daily for 3 days preceding the examination Ans: A 81.) What position is best for a client during a proctoscopic examination? A.) Prone B.) Right Sims C.) Lithotomy D.) Knee chest Ans: D 82.) Which nursing response is the most appropriate when preparing a client for a proctosigmoidoscopy? A.) “You need have no anxiety concerning this procedure. You will exercise no pain or discomfort” B.) “You will experience a feeling of pressure and the desire to move your bowels during the brief time that the scope is in place” C.) “You can reduce your discomfort during the procedure to a minimum by bearing down as the prostoscope is introduced” D.) “You will experience no discomfort during the

procedure, because a topical anesthetic will be applied to the anus” Ans: B 83.) Which of the following is most characteristic of the stools in ulcerative colitis? A.) Diarrhea B.) Clay-colored with blood and mucus C.) Gray and foamy D.) Semisolid, green with blood and mucus Ans: A 84.) A colectomy and ileostomy are proposed for a client. This surgery involves which of the following? A.) Removal of the rectum with a portion of the colon brought through the abdominal wall B.) Removal of the colon with a portion of the ileum brought through the abdominal wall C.) Removal of the ileum with portion of the colon brought through the abdominal wall D.) A “pull-through” procedure Ans: B 85.) Which of the following is not anticipated after an ileostomy? A.) Weight gain B.) Liquid stool C.) Reestablishment of a regular bowel pattern D.) Irritation of the skin around the stoma Ans: A 86.) Skin care around a stoma is critical. In colostomy skin care, which of the following is contraindicated? A.) Observe for any excoriated areas B.) Use karaya paste and rings around the stoma C.) Apply mineral oil to the area for moisture D.) Clean the area daily with soap and water before applying the bag Ans: C 87.) Regulation of a colostomy will be most enhanced if the client A.) Eats balanced meals at regular intervals B.) Irrigates after lunch each day C.) Restricts exercise to walking only D.) Eats fruit all three meals Ans: A

88.) When helping a client to accept his colostomy, which of the following actions is inappropriate? A.) Encourage him to look at the stoma B.) Emphasize his positive attributes C.) Involve the family in his care D.) Have him do his own irrigation Ans: D 89.) A gastric suction tube was inserted before a client was sent to surgery, in order to: A.) Facilitate administration of high caloric, nutritious liquids immediately after completion of the procedure B.) Prevent accumulation of gas and fluid in the stomach both during and following surgical action C.) Provide a reliable means of detecting gastrointestinal hemorrhage during the operative procedure D.) Serve as s stimulus to restore normal peristaltic movement following recovery from anesthesia

A.)18% B.) 22% C.) 36% D.) 40% Ans: C 93.) Which of the following would be characteristic of a fresh, second degree burn? A.) Absence of pain and pressure sense B.) White or dark, dry, leathery appearance C.) Large, thick blisters D.) Visible, thrombosed small vessels Ans: C 94.)with the location of burns over the upper torso, what is the nurse’s primary concern? A.) Debride and dress the wounds B.) Initiate and administer antibiotics C.) Frequently observe for hoarseness, stridor and dyspnea D.) Obtain a thorough history of events leading to the accident Ans: C

Ans: B 90.) The symptoms of colon cancer vary depending on where in the colon lesion is located. Which would not be a classic symptom of colon cancer? A.) Change in bowel habits B.) Excessive flatus C.) pain on the right upper quadrant of the abdomen D.) Anorexia and nausea Ans: C 91.) Which of the following diagnostic tests will confirm the diagnosis of colon cancer most conclusively? A.) Carcinoembryonic antigen (CEA) B.) Barium Enema C.) Biopsy of the lesion D.) Stool examination Ans: C 92.) A 30 y/o homemaker fell asleep while smoking a cigarette. She sustained severe burns of the face, head and neck, anterior chest and both arms and hands. Using the “rule of nine” which of the following is the best estimate of total body surface area burned?

95.) A narcotic IV was ordered to control the pain of a client with burns. Why was the IV route selected? A.) Burns cause excruciating pain, requiring immediate relief B.) Circulatory blood volume is reduced, delaying absorption from subcutaneous and muscle tissue C.) Cardiac function is enhanced by immediate action of the drug D.) Metabolism of the drug would be delayed because of decreased insulin production Ans: B 96.) A major goal for the client during the first 28 hours after severe burns is to prevent hypovolemic shock. Which of the following would not be a useful monitor of fluid restitution during this period? A.) Elevated hematocrit B.) Urine output of 30 ml/hr C.) Change in sensorium D.) Estimate of fluid loss through the burn eschar Ans: D 97.) Mafenide acetate (Sulfamylon) is applied to

a burned client’s wound every 12 hours, the nurse’s assessment would include observation for which of the following side effects of this drug? A.) Metabolic acidosis B.) Discoloration of the skin C.) Laceration of the skin D.) Dehydration and electrolytes loss Ans: A 98.) Contractures are among the most serious of the long-term complications of a burn. Because of the burn location on the upper torso, which of the following measures would most likely cause a client to have contractures? A.) Change the location of the bed or the TV set, or both, daily B.) Encourage the client to chew gum and blow up balloons C.) Avoid using a pillow or place the head in a portion of hyperextension D.) Allow the client to assume a position of comfort Ans: D 99.) What is the primary aim of all burn-wound care? A.) To debride the wound of dead tissue and eschar B.) To limit fluid loss through the skin C.) To prevent growth of microorganisms D.) To decrease formation of disfiguring scars Ans: C 100.) Deep partial thickness burns (2nd degree) involves the: A.) Epidermis B.) Entire epidermis and the dermis C.) Epidermis, dermis and the muscles D.) Epidermis, dermis, muscle and the bones