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Pre Final Exam NCM 118
Pre Final Exam NCM 118
A. Patients in the emergency room have a variety of actual and potential problems, and their conditions
may change constantly.
2. As a nurse, you know that when assessing Glasgow Coma Scale, the lowest possible score is _____? *
D. 0
B. 16
C. 3
A. 1
3. As a nurse, you know that when assessing Glasgow Coma Scale, the highest possible score is _____?
B. 4
A. 5
D. 15
C. 16
A. Fatigue
D. Unexplained anemia
B. Weight gain
A. Bloody stool
C. Proctosigmoidoscopy
7. The most important diagnostic procedures for cancer of the colon are the following EXCEPT?
B. Proctosigmoidoscopy
D. Colonoscopy
A. Urinalysis
8. Adjuvant therapy is an additional cancer treatment given after the primary treatment to lower the risk
that the cancer will come back. Which of the following is not an adjuvant therapy?
A. Chemotherapy
C. Radiation therapy
B. Immunotherapy
C. A patient with abdominal and chest pain, following a large, spicy meal.
A. A patient with low-grade fever, headache, and myalgias for the past 72 hours.
B. A patient who is unable to bear weight of the left foot, with swelling and bruising following a running
accident.
D. A child with a one-inch bleeding laceration on the chin but otherwise well after falling while jumping
on his bed.
10. A patient arrives in the emergency department and reports splashing concentrated household cleaner
in his eye. Which of the following nursing actions is a priority?
11. The nurse, caring for a patient recovering from an acute myocardial infarction, is planning
interventions to reduce the risk of which type of shock?
A. Cardiogenic
D. Neurogenic
C. Anaphylactic
B. Hypovolemic
12. In conducting a primary survey on a trauma patient, which of the following is considered one of the
priority elements of the primary survey?
13. All but one, are the Elements of Emergency Action Principles:
A. Scene Safety
B. Scene Size Up
14. When assessing the eyes of a patient who was involved in a car accident, the nurse notices an unequal
pupil. The nurse is aware that this is called:
D. Anisocoria
A. Ataxia
B. Doll’s Eye
C. Anorexia
15. It is the duty of a community nurse to educate and train the community for unexpected events such as
disaster. Disaster is defined as:
A. Sudden catastrophic event leading to disruption of life patterns in a certain locality that will lead
to the loss of life and property in addition to multiple injuries.
B. Phenomenon or human activity that poses threat to people, structure, and economic assets.
D. A perilous situation that arises suddenly and threatens the life or welfare of a person or a group of
people.
16. The following are the stages of Critical Incident Stress Debriefing EXCEPT:
D. Debriefing
A. Follow- up
C. Defusing
B. Follow-down
17. When taking a health history, the nurse screens for manifestations suggestive of diabetes type 1.
Which of the following manifestations are considered the primary manifestations of diabetes type 1 and
would be most suggestive of diabetes type 1 and require follow up investigation?
A. Excessive intake of calories, rapid weight gain, and difficulty losing weight.
18. Which of the following informations or facts about colorectal cancer and colon polyps is not true?
C. When chromosomal damage increases further within the polyp, cell growth becomes uncontrolled, and
the cells begin to spread, that is, they become cancer.
D. Decreasing age is the main risk factor for colorectal cancer. Around 90% of colorectal cancers
are diagnosed after age 20.
19. Which of the following informations or facts about colorectal cancer and ulcerative colitis is not true?
A. Chronic ulcerative colitis causes inflammation of the inner lining of the colon.
C. The risk for cancer begins to increase after birth, eight to 10 weeks.
B. Colon cancer is a recognized complication of chronic ulcerative colitis.
D. The risk of developing colon cancer in a patient with ulcerative colitis also is related to the location
and the extent of his or her disease.
20. The following are the nursing interventions for colorectal cancer patients EXCEPT:
B. Help make referrals to other services, such as to a psychologist if there is a concern about distress.
C. Act in the best interest of the patient and their family to help coordinate the diagnosis, treatment and
after-care of a person
21. A client newly diagnosed with diabetes mellitus has been stabilized with insulin injections daily. A
nurse prepares a discharge teaching plan regarding the insulin. The teaching plan should reinforce which
of the following concepts?
22. A client with diagnosis of diabetic ketoacidosis(DKA) is being treated in the emergency room. Which
finding would a nurse expect to note as confirming this diagnosis?
D. Comatose state
23. A nurse teaches a client with diabetes mellitus about differentiating between hypoglycaemia and
ketoacidosis. The client demonstrate an understanding of the teaching by stating that glucose will be
taken if which of the following symptoms develop?
A. Fruity breath odor
C. Blurred vision
B. Shakiness
D. Polyuria
24. A client with diabetes mellitus demonstrates acute anxiety when first admitted for the treatment of
hyperglycemia. The most appropriate intervention to decrease the client’s anxiety would be to
A. Administer a sedative
C. Ignore the signs and symptoms of anxiety so that they will soon disappear
B. Make sure the clients knows all the correct medical terms to understand what is happening
B. Almost all vitamin K sufficient for metabolic needs is produced by intestinal bacteria
C. Vitamin K is rarely found in dietary food sources, so a natural deficiency can easily occur
D. Usually vitamin K can easily be absorbed without assistance, so all that is consumed is absorbed.
102. The main function of adipose tissue in fat metabolism is synthesizing and:
103. When fat compounds accumulate to abnormal levels in the blood, the diet maybe modified as an
effort to control them. The foods most affected by such diet therapy would be:
D. Grains
B. Animal fats
A. Fuits
C. Vegetable oils
104. Amino acids are involved in total body metabolism building and rebuilding various tissues. Of these,
a number are essential amino acids. This means that:
A. These amino acids can be made by the body because they are essential to life
B. The body cannot synthesize these amino acids and thus they must be obtained from the diet
D. After synthesizing these amino acids, the body uses them in key processes essential for growth
C. These amino acids are are essential in body processes and the remaining amino acids are not
D. Meat
A. Milk
B. Vegetables
C. Fruits
106. Most of the work of changing raw fuel forms of carbohydrates to the refined usable fuel glucose is
accomplished by enzymes located in the:
A. Mouth
C. Small intestines
D. Stomach mucosa
B. Large intestines
107. Specific nursing responsibility in preparing a client for a sigmoidoscopy and barium enema includes:
110. A client with a peptic ulcer in the duodenum would probably describe the associated pain as:
111. A client is scheduled for pyloroplasty and vagotomy because of strictures caused by ulcers
unresponsive to medical therapy. The nurse reinforces the client's understanding by stating that the
vagotomy serves to:
C. Posterior pituitary
D. Anterior pituitary
B. Adrenal medulla
A. Adrenal cortex
113. In an emergency the rapid adjustments made by the body are associated with increased activity of
the:
A. Thyroid gland
D. Pancreatic gland
C. Adrenal gland
B. Pituitary gland
114. Following a head injury a client develops a deficiency of antidiuretic hormone. Normally secretion
of ADH causes:
115.When a client is first admitted hyperglycemic hyperosmolar nonketotic syndrome (HHNKs), the
nurse's priority is to provide:
C. Fluid replacement
D. Dietary instruction
A. Oxygen
B. Carbohydrates
116. Ketone bodies appear in the blood and urine when fats are being oxodized in great amounts. This
condition is associated with:
A. Alcoholosm
B. Bone healing
C. Starvation
C. Ketosis
D. Obesity
B. Type I diabetes
118. Diabetic coma results from an excess accumulation in the blood of:
119. Which of the following is the highest priority when planning care for a diabetic client?
B. Reducing activities
C. Adjustment of diet
A. Prevention of infection
D. Reducing stress
120. A patient with diabetes mellitus ask the nurse if he should exercise. The nurse's response should be
based on the theory that exercise will:
121. Mrs. Ayoto is admitted to the hospital for thyroidectomy. She first asks for help because of a goiter
of thyroid. Mrs. Ayoto's pre operative nursing care includes monitoring for signs and symptoms of
thyroid storm such as:
122. After thyroidectomy,a priority nursing implementation to Mrs. Ayoto's care is:
123. When evaluating the treatment of the client with pheochromocytoma,the nurse would expect to see
the improvement in the control of the following symptoms:
D. Hypertention,tachycardia,nervousness
C. Hypotention
B. Hypoglycemia
Mrs. Ayo is a 60 year old, newly diagnosed diabetic. She is 31 kg overweight.125. As a new diabetic, the
first topic to Ayo should be taught about is:
126. Oral hypoglycaemic medication was prescribed for Mrs. Ayo because she :
127. Mrs. Ayo understands your health teachings by accurately selecting the following signs and
symptoms of hypoglycemia:
D. Kussmaul's respirations
A. Sweating,nervousness,dizziness
C. Thirst,glycosuria
Mrs. Javier, a 54-year-old housewife, is diagnosed as having acromegaly. She is scheduled for
hypophysectomy.128. You observed Mrs. Javier and note that she is evidencing which of the following
signs and symptoms of acromegaly?
129. After hypophysectomy, Mrs. Javier returning to the unit. Priority nursing care to prevent increasing
intracranial pressure is by:
D. Encouraging ambulation
130. Mark Effron,26 year old is attending an endocrine clinic for the treatment of her hypothyroidism. As
a nurse you will teach him about her health regimen, which includes:
131. Marky,30 years old has undergone tests which indicates that he has a deficiency of a parathormone
secretion. Potential complications that Marky should be informed about include:
C.Laryngeal spasms
D.Kidney stones
A.Osteoporosis
B.Lethargy
132. Mrs. Santiago is depressed about the changes in her personal appearance that are related to Cushing's
disease. Some of these changes maybe reversed by surgery. Mrs. Santiago is particularly like to exhibit
which of the following changes?
D.Nervousness
C.Bulging eyeballs
133. When teaching Mrs. Santiago about her diet, you will describe a diet, which is:
C.Low CHO
A. Pancreas
D.Pituitary gland
C.Adrenal glands
B.Hypohysis
D.Blurring vision
C.Edema
B.Severe headache
A. Bleeding of gums
137. When caring an elderly people with DM, it is most important to the nurse to:
C.Teach them how to do urinalysis and give them their own insulin
A. Albumin in urine
139. The ketosis occurring in uncontrolled diabetes is caused by the excessive oxidation of:
C.CHO
A.CHON
B. Fats
D. Minerals
140. The assessment of a client that would be most indicative of diabetes insipidus is:
C.Thyroid hormone
A. Testosterone
D. Adrenocorticotropic hormone
B.Growth hormone
142. In Cushing's syndrome, excessive amounts of glucocorticoids and mineralocorticoids will increase
the client's:
A. Urine output
B. Glucose level
C.Serum potassium
D. Immune response
143. Hypotension associated with Addison's disease involves a disturbance in the production of:
B. Androgens
A. Estrogens
C. Glucocorticoids
D. Mineralocorticoids
144. The most common cause of DKA is:
A. Emotional stress
B. Presence of infection
145. Following hypophysectomy, the nurse specifically should observe the client for early signs of:
D. Increased ICP
B. Respiratory distress
A. Urinary retention
146. Which of the following is the highest priority when placing care for a diabetic patient?
C. Reducing activities
A. Adjustment of diet
B. Prevention of infection
D. Reducing activities
147. An acute episode resulting from any form of stress that makes the adrenal cortical function beyond
its capabilities is:
D. Cushing's disease
B. Cushing's syndrome
A. Addison's disease
C. Adrenal crisis
D. Tetany
C. Blindness
B. Diplopia
A. Headache
D. Muscle cramps
C. Non-functioning tumors
B. Pituitary infarction
A. Functioning tumors
150. Which of the following best explains why “endocrine diseases develop secondary to pituitary
disorders and as a consequence of non-endocrine disease”:
108. A client with gastric ulcer disease asks the nuse the reason for antibiotic therapy that includes
metronidazole( Flagyl). The nurse should explain that antibiotics are prescribed to:
D. Esophageal junction
B. Pyloric portion
1. Which of the following statements, if made by a client who is being administered Adriamycin
(doxorubicin hydrochloride), would indicate to a nurse that the client needs further instruction about the
use of the drug?
A. "My hair is going to fall out and my urine will turn red."
B. "I will need to limit my fluid intake to two glasses per day."
2. A child with Hodgkin's disease is receiving Cytoxan (cyclophosphamide) for treatment. The nurse
should include which of the following strategies in the care plan?
3. The nurse assesses a client for common symptoms of carcinoma of the bladder, which include?
B. Nocturia
A. Painless hematuria
4. The most common site of breast cancer is believed to be in the:
5. A nurse is educating a client prior to an intracavitary cesium insertion as therapy for cervical cancer.
which of the following statements, if made by the client, would indicate the need for further instruction?
6. Which of these findings should a nurse expect to identify when assessing a client who is receiving
radiation therapy for cancer of the esophagus?
A. Tingling sensation
D. Hypersalivation
D. Anorexia
A. Dysphagia
C. Hoarseness
B. Sore throat
8. Which of the following would most likely predispose the client to ovarian cancer?
D. Fatty foods
A. Trauma
B. Multiple pregnancy
D. Serum amylase
A. Levels of testosterone
10. The normal testes can be described by all of the following except:
D. Lump-free
B. Egg-shaped
A. Smooth
C. Spongy
11. Which of the following types of medication should be used in the treatment of breakthrough pain in
clients with chronic cancer?
C. Short-acting opioid
B. Long-acting analgesic
A. Non- opioid
12. Which of the following statements is not correct regarding testicular cancer?
C. A cancerous testes is spongy
88. Which of the following types of insulin should a nurse have available to administer intravenously to
client receiving total parenteral nutrition and with an elevated blood glucose level?
89. A client with hyperthyroidism is started with propylthiouracil (PTU). After 2-4 weeks improvement,
which of the following areas indicate a positive effect of the drug?
C. Sleep pattern
D. Exercise
A. Memory
B. Speech
90. Which initial etiological factor establishes a nursing diagnosis of fluid volume deficit in a client with
Addison's disease?
A. Glucocorticoid excess
B. Mineralocorticoid deficiency
92. In planning the care of a client with diabetes insipidus, priority must be the prevention of:
A. Foot ulcer
93. To which of the following nursing diagnoses would a nurse give priority when caring for a client who
has syndrome of inappropriate secretion of anti diuretic hormone(SIADH)?
B. Altered nutrition
C. Urinary incontinence
94. A client with hypoparathyroidism should be given which of the following foods:
C. Seaweeds
B. Grapes
A. Spinach
D. Orange juice
95. A 33-year old client with hypothyroidism has not been complying with the medical regimen for the
past several years. The nurse would expect the client to manifest which of the following?
C. Pheochromocytoma
D. Myxedema
A. Addisonian crisis
B. Thyroid storm
96. Which of the following manifestations is a priority for the nurse to assess in a client with
pheochromocytoma?
A. Dry skin
C. Hypoglycemia
D. Hypertension
B. Bradycardia
97. A 40-year old client who has a pituitary adenoma had transphenoidal hypophysectomy. A nurse is
providing the client discharge instructions. Which statement by the nurse is accurate?
98. The hallmark sign for the diagnosis of diabetes mellitus is the presence of:
A. Ketonuria
D. Hyperglycemia
C. Kussmaul's breathing
99. What is the highest priority, in terms of goal of care, by the nurse after a client's prostatectomy?
D. To prevent respiratory distress
A. To prevent infection
C. To prevent impotence
B. To prevent bleeding
100. When providing care to a dying client, the nurse should focus on all of the following, Except:
C. Preserving the rights of the client- his/her need for dignity, security and self worth and his/her family