Cindys CPNRE Practice Questions & Answers, 100% Accurate, graded A+.Verified.

Cindys CPNRE Practice Questions & Answers, 100% Accurate, graded A+.Verified. It is taught that when parents are informed that their child has been born with a abnormality they respond with a grief reaction. The f ...

Cindys CPNRE Practice Questions & Answers, 100% Accurate, graded A+.Verified. It is taught that when parents are informed that their child has been born with a abnormality they respond with a grief reaction. The first step in the normal grief reaction is: A) Acceptance B) shock-denial C) withdrawal D) planning B) Shock-denial On entering a client's room during change-of-shift rounds, you notice that the client and spouse have their backs turned to each other, and both have their arms folded across their chests. Which of the following is the best action for you to take at this time? A) Introduce yourself and begin discharge teaching. B) Proceed with the tasks you were intending to perform. C) Say nothing and leave quickly, closing the door behind you. D) Ask the client and spouse if they need some time alone right now. D) Ask the client and spouse if they need some time alone right now. Response Feedback: The situation suggests that you entered during a stressful time. Offering privacy would be appropriate. Because the situation indicates tension between the couple, this is not the time to initiate teaching. Before performing a procedure for the first time at a new agency, what does the travel nurse do? A) Refuses to perform the procedure B) Asks the charge nurse how to perform the procedure C) Reads about the procedure in the policy and procedure manual D) Performs the procedure as at the agency where the nurse previously worked C) Reads about the procedure in the policy and procedure manual Response Feedback: Every agency has its own policies and way of performing procedures. The charge nurse may not know how the procedure should be performed or may explain it incorrectly. The procedure may be performed differently than in the previous agency. If the nurse refuses to perform procedures that are covered by the nursing practice act, the nurse could be fired. The surgical unit has initiated the use of a pain rating scale to assess the severity of clients' pain during their postoperative recovery. The nurse assigned to a client can look at the pain flow sheet to see the client's pain scores over the last 24 hours. Use of the pain scale is an example of adherence to which intellectual standard? A) Depth B) Specificity C) Relevance D) Consistency D) Consistency Response Feedback: Using the same pain scale for all clients and ratings promotes consistency—each nurse has the same measurement scale to compare assessments. Relevance refers to how applicable the assessment is. An assessment has depth when it deals with less obvious issues. Specificity refers to the ability of the assessment to provide information about the particular problem of interest. Which of the following is the most accurate information to give a nurse during change-of-shift reporting? A) Client refuses to take medications. B) Client reports sharp pain in left anterior knee. C) Client encouraged to consume more fluids D) Client expressed concern about pending surgery. B) Client reports sharp pain in left anterior knee. Response Feedback: The information in option B represents objective data that the nurse can use as part of baseline information. "Encouraged" and "more" are vague terms. "Concern" is also vague; relating the exact concern would be more accurate. Option A may be true, but accurate data would also report why the client refused medication. The nurse refers to a client's postsurgical written plan of care, noting that the client has a drainage device collecting wound drainage. The surgeon is to be notified when drainage in the device exceeds 100 mL for the day. The nurse carefully notes the amount of drainage currently in the device. This is an example of which of the following? A) Planning B) Evaluation C) Assessment D) Intervention C) Assessment Response Feedback: Assessment is the process of observing and collecting data. Planning is the step in which the diagnosis is analyzed for problem resolution. Intervention consists of the steps actually taken after planning. Evaluation measures the effectiveness of the plan. The base level of Maslow's Hierarchy of Needs is... A) Psychological B) Belongingness C) Safety D) Physiological A) Psychosocial Response Feedback: Physiologic needs must be met first A client with diabetes mellitus who takes daily insulin injections is scheduled for surgery the next day. The client is to take nothing by mouth (NPO status) after midnight. The nurse questions whether insulin should be given the morning of surgery. This is an example of which of the following? A) Problem solving B) Previous experience C) Clinical practice guideline D) Scientifically based clinical judgement D) Scientifically based clinical judgement Response Feedback: The nurse is demonstrating awareness of the effect of insulin, which is to lower blood glucose level. Because the client will be NPO status for a long period of time, no calories will be consumed. Giving the usual injection of insulin could cause the client to experience hypoglycemia. The nurse asks a client how she feels about impending surgery for breast cancer. Before initiating the discussion, the nurse reviewed information about loss and grief in addition to therapeutic communication principles. Which critical thinking component is involved in your review of the literature? A) Experience B) Problem solving C) Knowledge application D) Clinical decision making C) Knowledge Application Response Feedback: The nurse sought appropriate information to be able to communicate more knowledgeably with the client. Experience is acquired through clinical learning situations. Problem solving is a series of steps to resolve a problem. Clinical decision making is a process in which critical thinking steps are followed for problem resolution. The nurse is assessing the urinary history of a middle-aged married woman. The nurse asks her if she gets up to go to the bathroom at night. She replies, "Yes." What other question should the nurse ask? A) "Why do you get up at night?" B) "How long have you been getting up at night?" C) "How many times do you get up at night?" D) "How easily do you go back to sleep after you get up?" A) "Why do you get up at night?" Response Feedback: Perhaps the client's husband is getting up in the middle of the night because of a prostate problem, and this is why she is awakened. The nurse should not assume nocturia without further assessment questions. The nurse is providing teaching regarding drug therapy to the husband of a woman with Alzheimer disease. The patient was diagnosed 3 months ago and has mild memory loss. She will be receiving donepezil (Aricept). Which of the following statements accurately describes the drug's actions? A) It prevents memory loss in later stages B) It will reverse the course of Alzheimer disease C) It provides sedation to prevent agitation and restlessness D) It may help to improve the symptoms of Alzheimer disease by improving the functioning of the person. D) It may help to improve the symptoms of Alzheimer disease by improving the functioning of the person. The client has an order for an anxiolytic agent, lorazepam (Ativan). Which of the following statements by the client indicates that client education about this medication has been effective? A) "My anxiety will be eliminated if I take this medication as prescribed." B) "This medication presents no risk of addiction or dependence." C) "I will probably always need to take this medication for my anxiety." D) "This medication will relax me so I can focus on problem solving." D) "This medication will relax me so I can focus on problem solving." A female client tells the nurse that she takes one "coated baby aspirin" every day. Which of the following effects would be of greatest concern to the nurse? A) Urinary calculi B) Atrophy of the liver C) Prolonged bleeding time D) Premature erythrocyte destruction C) Prolonged bleeding time The most common side effects of SSRI's are: A) Insomnia, weight gain, dry mouth B) Convulsions, respiratory difficulties C) Diarrhea, weight gain D) Jaundice, agranulocytosis A) Insomnia, weight gain, dry mouth A medication that is harmful to the developing fetus is termed: A) Teratogenic B) Mutagenic C) Pyrogenic D) Anaphylactic A) Teratogenic A patient taking an inhaled steroid should be instructed to rinse her mouth after administration of the drug to avoid development of which of the following conditions? A) Infection B) Anorexia C) Gingival hyperplasia D) Thrush D) Thrush A patient with cancer has been on high doses of morphine for several days. During an assessment, the side effect that the nurse would be likely to see is: A) Constipation B) Respiratory depression C) Pain relief D) Diarrhea A) Constipation A 2-year old patient must receive an injection. The nurse knows that the IM site of choice for this patient would be: A) Dorsogluteal B) Ventrogluteal C) Vastus lateralis D) Deltoid C) Vastus lateralis To instill eardrops in the adult patient, the ear canal is opened by pulling the ear: A) Up and back B) Down and back C) Up and forward D) Back and forward A) Up and back A patient is being started on warfarin (Coumadin) in preparing for cardiac tests. Which of the following medications should the patient be instructed to omit while he is on this medication? A) Enalapril (Vasotec) B) Metformin (Glucophage) C) Ibuprophen (Motrin) D) Digoxin (Lanoxin) C) Ibuprophen (Motrin) The antidote for heparin (Heparin) is: A) Protamine sulphate B) Potassium C) Vitamin K D) Zinc A) Protamine sulphate What trimester of pregnancy is the period of greatest danger for drug-induced developmental defects in the fetus? A) First B) Second C) Third D) Fourth A) First Ototoxicity is a major side effect involving which of the following? A) Hearing B) Liver C) Fetus D) Kidney A) Hearing A medication used to treat Parkinson's disease is: A) Methylphenidate (Ritaline) B) Carbamazepine (Tegretol) C) Benztropine mesylate (Cogentin) D) Theophylline (Accurbron) C) Benztropine mesylate (Cogentin) Which type of insulin is the only one that may be given intravenously? A) Regular B) Lente C) NPH D) Ultralente A) Regular A nurse has made an entry in the hard copy of the wrong client's health record. What should be the corrective action? A) Remove the entry from the wrong chart B) Draw a line through the entry, write "error," and initial it C) Use whiteout to eliminate the entry D) Complete an incident report and place a copy in both client charts B) Draw a line through the entry, write "error," and initial it A physician writing orders for a new patient, states to the nurse, "I would like this medicine to work as quickly as possible." To obtain fastest absorption and action from a medication, the nurse knows that it should be administered: A) By mouth B) Intramuscularly C) Subcutaneously D) Intravenously D) Intravenously Combining white wine with an analgesic is dangerous. The effect on the CNS when given is called: A) Antagonist B) Synergistic C) Cumulative D) Tolerance B) Synergistic Patients who are placed on spironolactone (Aldactone) should be assessed continuously for which of the following? A) Hypokalemia B) Hyperkalemia C) Hyponatremia D) Hypercalcemia B) Hyperkalemia A patient asks the nurse how amlodipine (Norvasc) works to reduce the blood pressure. Which response will the nurse provide? A) "It causes blood vessel dilation." B) "It helps you get rid of fluid." C) "It helps your heart beat stronger." D) "It slows your heart rate." A) "It causes blood vessel dilation." When administering a buccal tablet, the nurse will tell the patient to: A) Chew the tablet B) Swallow the tablet with water C) Let the tablet dissolve under the tongue D) Let the tablet dissolve between the cheek and the gum D) Let the tablet dissolve between the cheek and the gum A 19-year-old college student has been diagnosed with hypothyroidism and has started thyroid replacement therapy with levothyroxine (Synthroid). After 1 week, she calls you to complain that she feels no better. Your response is based on the fact that: A) She will probably require surgery for a cure. B) Synthroid does not reach peak effect for several months. C) She probably did not take her medication as instructed. D) Her diet may be causing absorption problems. B) Synthroid does not reach peak effect for several months. The angle for an intramuscular injection is: A) 45 degrees B) 60 degrees C) 90 degrees D) 10 degrees C) 90 degrees A patient is admitted with a fever of 39°C. It is of unknown origin. The assessment reveals bilateral crackles and a productive cough. The physician has ordered sputum and blood cultures and the administration of ampicillin 500 mg intravenous (IV) stat and then every 6 hours. Which is the correct sequence for the nurse to follow to complete these orders? A) Blood culture, ampicillin dose, then sputum culture B) Sputum culture, ampicillin dose, then blood culture C) Ampicillin dose, then blood and sputum cultures D) Blood and sputum cultures, then ampicillin dose D) Blood and sputum cultures, then ampicillin dose A patient on iron treatment for anemia would benefit from which of these medications to prevent constipation? A) Loperamide (Immodium) B) Docosate sodium (Colace) C) Hydralazine (Apresoline) D) Hydroxyzine (Vistaril) B) Docosate sodium (Colace) Too much salt in the diet of a client taking Lithium will result in increased secretion and therefore low levels. Drinking too little water or losing fluid through excess sweating, vomiting or diarrhea will result in: A) Lower levels resulting in a deficit B) Maintenance level C) Increased lithium level causing toxicity D) All of the above -------?-------- The patient will be taught to take his iron preparation: A) At bedtime B) Before meals C) With meals D) Between meals D) Between meals When teaching self-administration of eye drops to a patient, the nurse will stress that the correct method for instilling eye drops is to drop the medication into the: A) Eyeball itself B) Inner canthus of the eye C) Lower conjunctival sac D) Outermost point of the eye C) Lower conjunctival sac Which of the following conditions would most interfere with the pharmacokinetics of medications? A) Diabetes B) Kidney disease C) Angina pectoris D) Brain tumor B) Kidney disease Why do corticosteroids increase a client's risk for infection? A) Corticosteroids increase the production of leukocytes B) Corticosteroids interfere with antibody production in the lymphatic tissues C) Corticosteroids promote the growth and spread of enteric viruses D) Corticosteroids suppress the inflammatory response of the body D) Corticosteroids suppress the inflammatory response of the body If a patient takes a drug on an empty stomach with a full glass of water, the nurse is aware that the drug will be: A) absorbed more slowly B) neutralized by the first-pass effect C) absorbed more rapidly D) excreted more rapidly C) absorbed more rapidly While the nurse administers the daily dose of furosemide (Lasix) to the patient, the opportunity arises for patient teaching. Which of the following should the nurse be sure to stress? A) "Take the medication at bedtime." B) "You may need sodium and potassium supplements." C) "Weight yourself twice a day." D) "Change positions slowly to prevent dizziness." D) "Change positions slowly to prevent dizziness." When teaching your patient how to prevent lipodystrophy when self-administering insulin, the nurse would stress the importance of: A) Immediately reporting any itching at the injection site B) Rotating injection sites and areas C) Massaging the injection site to enhance absorption D) Administering insulin only by the intravenous route B) Rotating injection sites and areas A patient is experiencing hives in an allergic reaction. Which of the following reports would indicate that diphenhydramine (Benadryl) is showing its desired therapeutic effects? A) Improved vision B) Decreased pruritus C) Decreased muscle cramps D) Decreased headache B) Decreased pruritus Levodopa-carbidopa is also known as: A) Sinemet B) Amantadine C) Selegiline D) Dopamine. A) Sinemet The nurse is going to give a subcutaneous injection to a 42-year old patient. The needle and gauge the nurse will use is: A) 19 gauge: 1 ½ inch B) 22 gauge: 1 inch C) 24 gauge: 1 inch D) 25 gauge: 5/8 inch D) 25 gauge: 5/8 inch Which explanation by the nurse is accurate to include when teaching a patient who is beginning therapy for gastroesophageal reflux disease (GERD) with Maxeran (Apo-Metoclop)? A) "This medication decreases esophageal muscle tone to reduce reflux." B) "Peristalsis is increased, so food is digested more quickly." C) "Gastric emptying is delayed, so you may feel full for longer intervals." D) "This medication is an antikinetic agent, so you may have difficulty with motor skills." B) "Peristalsis is increased, so food is digested more quickly." A client has been taking antidepressant medication for 1 week and tells the nurse that is not helping. The most accurate response by the nurse would be: A) The medication will have to be switched to another type of antidepressant B) Therapeutic effects usually begin after 2-6 weeks C) They client must not be taking their medication D) None of the above B) Therapeutic effects usually begin after 2-6 weeks A patient about to receive his morning dose of digoxin (Lanoxin) has an apical pulse of 70. What should the nurse do? A) Administer the dose B) Withhold the dose and notify the physician C) Notify the physician and monitor the patient's vital signs D) Recheck the pulse, making sure to count for 1 full minute A) Administer the dose Which of the following will give the patient a healthy supplement of potassium while taking a potassium losing (non K sparing) diuretic? A) a glass of milk B) a bottle of "Honey Brown" ale C) oranges and bananas D) a glass of cranberry juice C) oranges and bananas A male client is asking the nurse a question regarding the Mantoux test for tuberculosis. The nurse should base her response on the fact that the: A) Area of redness is measured in 3 days and determines whether tuberculosis is present. B) Skin test doesn't differentiate between active and dormant tuberculosis infection. C) Presence of a wheal at the injection site in 2 days indicates active tuberculosis. D) Test stimulates a reddened response in some clients and requires a second test in 3 months. B) Skin test doesn't differentiate between active and dormant tuberculosis infection. The nurse is teaching a male client with chronic bronchitis about breathing exercises. Which of the following should the nurse include in the teaching? A) Make inhalation longer than exhalation. B) Exhale through an open mouth. C) Use diaphragmatic breathing. D) Use chest breathing. C) Use diaphragmatic breathing. Response Feedback: In chronic bronchitis the diaphragm is flat and weak. Diaphragmatic breathing helps to strengthen the diaphragm and maximizes ventilation. Exhalation should be longer than inhalation to prevent collapse of the bronchioles. The client with chronic bronchitis should exhale through pursed lips to prolong exhalation, keep the bronchioles from collapsing, and prevent air trapping. Diaphragmatic breathing — not chest breathing — increases lung expansion. A female client must take streptomycin for tuberculosis. Before therapy begins, the nurse should instruct the client to notify the physician if which health concern occurs? A) Impaired color discrimination B) Increased urinary frequency C) Decreased hearing acuity D) Increased appetite C) Decreased hearing acuity Response Feedback: Decreased hearing acuity indicates ototoxicity, a serious adverse effect of streptomycin therapy. The client should notify the physician immediately if it occurs so that streptomycin can be discontinued and an alternative drug can be prescribed. The other options aren't associated with streptomycin. Impaired color discrimination indicates color blindness; increased urinary frequency and increased appetite accompany diabetes mellitus. The nurse assesses a male client's respiratory status. Which observation indicates that the client is experiencing difficulty breathing? A) Diaphragmatic breathing B) Use of accessory muscles C) Pursed-lip breathing D) Controlled breathing B) Use of accessory muscles Response Feedback: The use of accessory muscles for respiration indicates the client is having difficulty breathing. Diaphragmatic and pursed-lip breathing are two controlled breathing techniques that help the client conserve energy. A male client who weighs 175 lb (79.4 kg) is receiving aminophylline (Aminophyllin) (400 mg in 500 ml) at 50 ml/hour. The theophylline level is reported as 6 mcg/ml. The nurse calls the physician who instructs the nurse to change the dosage to 0.45 mg/kg/hour. The nurse should: A) Question the order because it's too low. B) Question the order because it's too high. C) Set the pump at 45 ml/hour. D) Stop the infusion and have the laboratory repeat the theophylline measurement. A) Question the order because it's too low. Response Feedback: A therapeutic theophylline level is 10 to 20 mcg/ml. The client is currently receiving 0.5 mg/kg/hour of aminophylline. Because the client's theophylline level is sub-therapeutic, reducing the dose (which is what the physician's order would do) would be inappropriate. Therefore, the nurse should question the order. A male client admitted to an acute care facility with pneumonia is receiving supplemental oxygen, 2 L/minute via nasal cannula. The client's history includes chronic obstructive pulmonary disease (COPD) and coronary artery disease. Because of these history findings, the nurse closely monitors the oxygen flow and the client's respiratory status. Which complication may arise if the client receives a high oxygen concentration? A) Apnea B) Anginal pain C) Respiratory alkalosis D) Metabolic acidosis A) Apnea Response Feedback: Hypoxia is the main breathing stimulus for a client with COPD. Excessive oxygen administration may lead to apnea by removing that stimulus. Anginal pain results from a reduced myocardial oxygen supply. A client with COPD may have anginal pain from generalized vasoconstriction secondary to hypoxia; however, administering oxygen at any concentration dilates blood vessels, easing anginal pain. Respiratory alkalosis results from alveolar hyperventilation, not excessive oxygen administration. In a client with COPD, high oxygen concentrations decrease the ventilatory drive, leading to respiratory acidosis, not alkalosis. High oxygen concentrations don't cause metabolic acidosis. A black client with asthma seeks emergency care for acute respiratory distress. Because of this client's dark skin, the nurse should assess for cyanosis