COVERING MOST TESTED QUESTIONS ALREADY

MSN 277 Final ACTUAL EXAM -

COVERING MOST TESTED QUESTIONS ALREADY

GRADED A+

A 24 year old female patient with SLE tells the nurse she wants to have a baby and is considering getting pregnant. Which response by the nurse is most appropriate?

• "Temporary remission of your signs and symptoms are common during pregnancy."
• "SLE symptoms usually peak during the first trimester."
• "Autoantibodies transferred to the baby during pregnancy will cause congenital heart defects."
• "The best time to plan pregnancy is during a remission when the symptoms are a minimum." -

CORRECT ANSWER-D. "The best time to plan pregnancy is during a remission when the symptoms are a minimum."

A patient being seen in the clinic has rheumatoid nodules on the elbows. Which action will the nurse take?

• Draw blood for rheumatoid factor analysis.
• Teach the patient about injections for the nodules.
• Assess the nodules for skin breakdown or infection.
• Discuss the need for surgical removal of the nodules. - CORRECT ANSWER-C. Assess the nodules

for skin breakdown or infection.

A patient with rheumatoid arthritis (RA) complains to the clinic nurse about having chronically dry eyes. Which action by the nurse is appropriate?

• Ask the HCP about discontinuing methotrexate.
• Remind the patient that RA is a chronic health condition.
• Suggest the patient use over-the-counter artificial tears.
• Teach the patient about adverse effects of the RA medications. - CORRECT ANSWER-C. Suggest

the patient use over-the-counter artificial tears.

Which laboratory result will the nurse monitor to determine if prednisone has been effective for a patient with an acute exacerbation of rheumatoid arthritis?

• Blood glucose
• C-reactive protein
• Serum electrolytes
• Liver function tests - CORRECT ANSWER-B. C-reactive protein 1 / 4

A patient, newly diagnosed with rheumatoid arthritis, arrives at the clinic for a follow-up visit. For which of the following extraarticular manifestations should the nurse assess? (Select all that apply.)

• Rheumatoid nodules
• Morning stiffness that lasts > 1 hour
• Weight loss
• Fatigue
• Sjogren's syndrome
• Discoid rash - CORRECT ANSWER-C. Weight loss
• Fatigue
• Sjogren's syndrome

Which of the following are risk factors for the development of gout? (Select all that apply.)

• Repetitive motion to the joints
• Hypertension
• Obesity
• Alcohol consumption
• Diuretic use
• Corticosteroid use - CORRECT ANSWER-B. Hypertension
• Obesity
• Alcohol consumption
• Diuretic use

A patient is admitted to the hospital with possible cholelithiasis. Which diagnostic test will the nurse anticipate will be ordered first to provide data for diagnosis?

• X-ray of the abdomen
• Ultrasound of the liver, gall bladder, and pancreas

C. ERCP

• CT scan of the abdomen - CORRECT ANSWER-B. Ultrasound of the liver, gall bladder, and

pancreas

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A patient is receiving pharmacologic therapy with ursodeoxycholic acid (Actigall) for treatment of small gallstones. The patient asks the nurse how long the therapy will take to dissolve the stones.What is the best response by the nurse?

• 1-2 weeks
• 3-5 months
• 6-8 weeks
• 6-12 months - CORRECT ANSWER-D. 6-12 months

Following a laparoscopic cholecystectomy, the nurse would expect the patient to:

• Return to work in 2-3 weeks.
• Be hospitalized for 3-5 days postoperatively.
• Have four small abdominal incisions covered with small dressings or bandaids.
• Have a T-tube placed in the common bile duct to provide bile drainage. - CORRECT ANSWER-C.

Have four small abdominal incisions covered with small dressings or bandaids.

A patient with chronic cholecystitis asks the nurse whether she will need to continue a low-fat diet

after she has a cholecystectomy. The best response by the nurse is:

• "A low-fat diet will prevent the development of further gallstones and should be continued."
• "Yes, because you will not have a gallbladder to store bile, you will not be able to digest fats

adequately."

• "A low-fat diet is recommended for a few weeks after surgery until the intestine adjusts to

receiving a continuous flow of bile."

• "Removal of the gallbladder will eliminate the source of your pain associated with fat intake, so

you may eat whatever you like." - CORRECT ANSWER-C. "A low-fat diet is recommended for a few weeks after surgery until the intestine adjusts to receiving a continuous flow of bile."

To care for a T-tube placed in a patient following an open cholecystectomy, the nurse:

• Keeps the tube supported and free of kinks.
• Attaches the tube to low continuous suction.
• Clamps the tube when ambulating the patient.
• Irrigates the tube with 10 ml sterile saline every 2-4 hours. - CORRECT ANSWER-A. Keeps the tube

supported and free of kinks.

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A nurse is caring for a client who has GERD and a new prescription for metoclopramide. The nurse should plan to monitor for which of the following adverse effects?

• thrombocytopenia
• hearing loss
• hypersalivation
• ataxia - CORRECT ANSWER-d. ataxia

the nurse should plan to monitor the client for extrapyramidal symptoms, such as ataxia, and should report any of these findings to the provider.

During discharge instructions for a pt following a laparoscopic cholecystectomy, what should the nurse include in the teaching?

• keep the incision area clean and dry for at least a week
• report the need to take pain medication for shoulder pain
• report any bile-colored or purulent drainage from the incisions.
• expect some postoperative nausea and vomiting for several days. - CORRECT ANSWER-c. report

any bile-colored or purulent drainage from the incisions.

What must the nurse do to care a T-tube in a pt following a cholecystectomy?

• keep the tube supported and free of kinks.
• attach the tube to low, continuous suctioning
• clamp the tube when ambulating the pt.
• irrigate the tube with 10-ml sterile saline every 2-4 hrs - CORRECT ANSWER-a. keep the tube

supported and free of kinks.

A pt with chronic cholecystitis asks the nurse whether she will need to continue a low-fat diet after she has a cholecystectomy. What is the best response by the nurse?

• A low-fat diet will prevent the development of further gallstones and should be continued.
• yes; because you will not have a gallbladder to store bile, you will not be able to digest fats

adequately.

• a low-fat diet is recommended for a few weeks after surgery until the intestine adjusts to receiving

a continuous flow of bile.

• / 4