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NURS 498 ACTUAL FINAL EXAM 2025 SPRING-SUMMER
VERIFIED QUESTIONS AND ANSWERS GRADED A+
The nurse is caring for a client who returns to the surgical nursing unit following a vertical banded gastroplasty with a nasogastric tube to low, intermittent suction and a patient-controlled analgesia (PCA) machine for pain control. Which of the following nursing actions should be included in the postoperative plan of care?
a. Support the surgical incision during client coughing and turning in bed.
b. Irrigate the nasogastric (NG) tube frequently with normal saline.
c. Offer sips of sweetened liquids at frequent intervals.
d. Remind the client that PCA use may slow the return of bowel function.
a. Support the surgical incision during client coughing and turning in bed.
A client with a gunshot wound to the abdomen undergoes surgery, and a colostomy is formed as illustrated. Which of the following information should the nurse include in client teaching?
a. Soft, formed stool can be expected as drainage.
b. Stool will be expelled from both ostomy stomas.
c. This type of colostomy is usually temporary.
d. Irrigations can regulate drainage from the stomas.
c. This type of colostomy is usually temporary.
A client with cirrhosis is receiving lactulose. The nurse notes the client is more confused and has asterixis. The nurse should:
a. assess for gastrointestinal bleeding
b. increase protein in the diet
c. monitor serum bilirubin levels
d. withhold the lactulose
a. assess for gastrointestinal bleeding
After the nurse has completed teaching a client with newly diagnosed celiac disease, which of the following breakfast choices by the client indicates good understanding of the information?
a. Corn tortilla with eggs
b. Bagel with cream cheese
c. Oatmeal with non-fat milk
d. Whole wheat toast with butter
a. corn tortilla with eggs
A client with ulcerative colitis who is taking azathioprine calls the nurse in the outpatient clinic about all of these symptoms. Which of the following symptoms is most important to communicate to the health care provider?
a. Elevated temperature
b. Joint pain
c. Frequent headaches
d. Nausea
a. elevated temperature
A nurse is developing a care plan for a client with hepatic encephalopathy. Which are the goals for the care for this client? Select all that apply.
a. provide food and fluids high in carbohydrates
a. limit the fluid taken with meals
The nurse is caring for a client following a gastrojejunostomy (Billroth II procedure). Which post-operative prescription should the nurse question and verify?
a. leg exercises
b. early ambulation
c. irrigating the nasogastric tube
d. deep breathing and coughing exercises
c. irrigating the nasogastric tube
A few months after bariatric surgery, an older-adult client tells the nurse, "My skin is hanging in folds. I think I need cosmetic surgery." Which of the following responses by the nurse is best?
a. "The important thing is that your weight loss is improving your health."
b. "The skin folds will gradually disappear once most of the weight is lost."
c. "Perhaps you would like to talk to a counsellor about your body image."
d. "Cosmetic surgery is certainly a possibility once your weight has stabilized."
d. "Cosmetic surgery is certainly a possibility once your weight has stabilized."
The nurse is assessing a patient who has experienced severe neutropenia after chemotherapy and will monitor for which possible signs of infection? (Select all that apply.)
a. elevated WBC count
b. chills
c. nausea
d. fever
e. sore throat
b. chills
d. fever
e. sore throat
Why does stomatitis, a common adverse effect of chemotherapeutic agents, occur?
a. The general health of the client with cancer is poor.
b. Chemotherapeutic drugs have a local and irritating effect on epithelial cells.
c. Rapidly dividing cells of the mucous membranes of the mouth are being destroyed.
d. The site of the malignancy is near the oral cavity.
c. Rapidly dividing cells of the mucous membranes of the mouth are being destroyed.
The nurse monitors a patient who is experiencing thrombocytopenia from severe bone marrow suppression by looking for which symptom(s):
a. Excessive bleeding and bruising
b. Decreased skin turgor
c. Elevated body temperature
d. Severe weakness and fatigue
a. Excessive bleeding and bruising
A client is told that he will require a right orchiectomy and chemotherapy for testicular cancer. The client asks the nurse if he will be infertile after the procedure. Which response should be made by the nurse?
Which nursing roles are important for the prevention and detection of cancer?
a. Using people's natural fear of cancer to motivate changes in unhealthy lifestyles
b. Encouraging the public to participate in regular screening tests for all detectable cancer sites
c. Health promotion in relation to eating low-fibre, refined-carbohydrate diets
d. Teaching about cancer risk factors
d. Teaching about cancer risk factors
A patient diagnosed with acute myeloid leukemia receives a bone marrow transplant. Which medication to prevent graft-versus-host disease should a nurse anticipate receiving an order to administer?
a. An immunosuppressant such as cyclosporin
b. Peginterferon-alpha-2a for prevention and treatment of hepatitis
c. A cyclosporine antibiotic such as ceftazidime
d. Chemotherapeutic agents such as cisplatin
a. An immunosuppressant such as cyclosporin
Which is an inappropriate nursing intervention to promote nutrition in the client with cancer?
a. Providing bland, pureed food because the person's taste sensation is altered
b. Providing increased protein for normal cell recovery and immune system function
c. Encouraging the client to eat a high-calorie, high-protein snack every few hours to prevent weight loss
d. Alerting the physician that nutritional supplements may be needed when the client has a 4-kg weight loss
a. Providing bland, pureed food because the person's taste sensation is altered
A nurse obtains the following assessment data for a client diagnosed with acute myeloid leukemia. For which finding should a nurse plan interventions first?
a. Ecchymosis and petechiae noted on arms
b. Weakness and fever
c. T-37.2º
d. Pain from mucositis
a. Ecchymosis and petechiae noted on arms
If extravasation of an antineoplastic medication occurs, which intervention will the nurse perform first?
a. Stop the infusion immediately, while leaving the catheter in place.
b. Inject the appropriate antidote through the IV catheter.
c. Inject subcutaneous doses of epinephrine around the IV site every 2 hours.
d. Apply cold compresses to the site while elevating the arm.
a. Stop the infusion immediately, while leaving the catheter in place.
A patient with a history of adrenal insufficiency presents with fatigue, dehydration, and a blood pressure of 70-42. The patient's blood work shows hyponatremia and hyperkalemia. What is the patient most likely experiencing?
a. Hypoglycemic event
b. Hemorrhage
c. Addisonian Crisis
d. Cushing's syndrome
c. Addisonian Crisis
d. Hypertension
c. Autoimmune response
What type of meal would you recommend to a patient who has adrenal insufficiency?
a. High potassium and high carbohydrates
b. High protein and low carbohydrates
c. High protein and high carbohydrates
d. High potassium and high carbohydrates
c. High protein and high carbohydrates
What assessments do you not expect for a patient with suspected pheochromocytoma?
a. COWs assessment
b. Cardiovascular assessment
c. Monitor blood glucose levels
d. Respiratory assessment
a. COWs assessment
For a diagnosis of pheochromocytoma, what labs and tests are required?
a. Creatinine and CT scan
b. Colonoscopy
c. CBC
d. Urinary ultrasound
a. Creatinine and CT scan
In a patient with pheochromocytoma what is the most prevalent symptom?
a. Pallor
b. Hypotension
c. Hypertension
d. Headache
c. Hypertension
What are foods to avoid with pheochromocytoma?
a. Organ meats
b. Grapefruits
c. Jello
d. Tyrosine containing foods
d. Tyrosine containing foods
What is the best treatment option for pheochromocytoma?
a. Diet and lifestyle changes
b. Radiation
c. Nephrectomy
d. Adrenalectomy
d. Adrenalectomy
A 67-year-old man (E.J.) presents in the E.D. with drooping of the right eye, difficulty swallowing and weakness, affecting his gait. He has a history of diabetes and hypertension. The physician suspects it could be Myasthenia Gravis. What would be the most appropriate diagnostic test to conclude this diagnosis?
a. Endophonium test
b. Beta-blockers
c. Acetylcholinesterase Inhibitors
d. Glucocorticosteroids
b. Beta-blockers
E.J. has blood work done to help confirm the diagnosis of Myasthenia Gravis. When analyzing the blood test for someone diagnosed with Myasthenia Gravis, the lab work would show:
a. A positive result for acetylcholine receptor antibodies, which causes some of the first symptoms experienced, such as muscle weakness and drooping of the eyelids.
b. A negative result for acetylcholine receptor antibodies, which causes some of the first symptoms experienced, such as muscle weakness and drooping of the eyelids.
c. A positive result for acetylcholine receptor antibodies, which causes some of the first symptoms experienced, such as lethargy and nausea, as muscles breakdown.
d. A negative result for acetylcholine receptor antibodies, which causes some of the first symptoms experienced, such as lethargy and nausea, as muscles breakdown.
a. A positive result for acetylcholine receptor antibodies, which causes some of the first symptoms experienced, such as muscle weakness and drooping of the eyelids.
Which pathogen is most associated with GBS?
a. Campylobacter jejuni
b. Mycoplasma pneumoniae
c. Cytomegalovirus
d. Epstein-Barr virus
a. Campylobacter jejuni
A patient has been diagnosed with Guillain-Barre Syndrome, what assessment findings would you expect to find?
a. Edema with warm extremities and is diaphoretic
b. Bilateral , descending paralysis of the lower limbs
c. Bilateral numbness and weakness on the lower limbs that progressively ascends
d. None of the above
c. Bilateral numbness and weakness on the lower limbs that progressively ascends
During the acute phase of GBS, what are the important nursing assessments to make? Select all that apply. (for ascending paralysis)
a. Gag and swallowing reflexes
b. Headache
c. Respiratory function
d. Corneal reflex
a. Gag and swallowing reflexes
c. Respiratory function
d. Corneal reflex
What are the tests ordered to diagnose Guillain-Barre Syndrome? Select all that apply.
a. Electromyography (EMG)( recordings prove the presence of nerve damage and show whether the damage affects the nerve sheaths (made of myelin) or the nerve fibers inside the sheaths (called axons) or both)
b. MRI
c. Nerve conduction studies (small discs (electrodes) are stuck on your skin and minor electric shocks are used to activate the nerves and measure how quickly these signals travel along them
d. Lumbar puncture test (supports the diagnosis by showing a raised protein content and normal cell count)
a. Electromyography (EMG)( recordings prove the presence of nerve damage and show whether the damage affects the nerve sheaths (made of myelin) or the nerve fibers inside the sheaths (called axons) or both)
c. Nerve conduction studies (small discs (electrodes) are stuck on your skin and minor electric shocks are used to activate the nerves and measure how quickly these signals travel along them
b. The death of muscle fibres
c. The inability of nerves to produce glutamate
d. The death of upper and lower motor neurons
d. The death of upper and lower motor neurons
What diagnostic tool is used to help rule out other neurological diseases?
a. Positron Emission Tomography (PET) scan
b. Magnetic Resonance Imaging (MRI)
c. X-ray
d. Electroencephalogram (EEG)
b. Magnetic Resonance Imaging (MRI)
Which assessment data would make the nurse suspect that the patient has Amyotrophic Lateral Sclerosis (ALS)?
a. Contracted COVID-19 and was on a ventilator in the ICU for 6 weeks.
b. Complaints of double vision, insomnia, eye twitching, crow's feet on their eyes.
c. Progressive memory loss and paralysis below the umbilicus.
d. Fatigue, progressive muscle weakness, and twitching
d. Fatigue, progressive muscle weakness, and twitching
What is the leading cause of death in a person with Amyotrophic Lateral Sclerosis (ALS)?
a. Respiratory failure
b. Heart failure
c. Aspiration
d. Rhabdomyolysis
a. Respiratory failure
David, a 26-year-old, is being seen by the nurse at his primary care physicians office where you work. He has developed a painless ulcer on his penis and is concerned about his health. The nurse expressed this finding to the physician and a diagnosis of primary syphilis was made. What is the typical span of time between infection and developing symptoms with syphilis?
a. 3 months
b. 21 days
c. 5 days
d. 6 months
b. 21 days
A pregnant woman has tested positive for Treponema pallidum bacteria. What antibiotic would the nurse expect the physician to order?
a. Benzathine Penicillin G (Bicillin)
b. Vancomycin (Vancocin)
c. Ceftriaxone (Rocephin)
d. Metronidazole (Flagyl)
a. Benzathine Penicillin G (Bicillin)
A patient presents to the emergency department with primary syphilis. Which signs and symptoms would the nurse expect to find?
a. Genital lesions
b. Pubic lice
c. Cyanosis
d. Peripheral edema
a. Genital lesions
a. need to take a "drug holiday" to improve response to medications
b. variable response to levodopa, resulting in periods of good control and periods of poor control of PD symptoms
c. alternating schedule of medications needed to control PD
d. fluctuation of emotions that often occurs with PD
b. variable response to levodopa, resulting in periods of good control and periods of poor control of PD symptoms
When given intravenous cholinergic drugs, the nurse must wash for the symptoms of a cholinergic crisis, such as: (select all that apply)
a. peripheral tingling
b. hypotension
c. tinnitus
d. syncope
e. dyspnea
e. dry mouth
b. hypotension
d. syncope
e. dyspnea
What is a major goal of treatment for the client with dementia?
a. maintain safety
b. returns to a higher level of self-care
c. enhance functional ability over time
d. maintain or increase body weight
a. maintains safety
A patient with PD will start taking entacapone along with Levodopa-carbidopa he has been taking for years. The nurse recognizes that the advantage of taking entacapone is that?
a. the Levodopa may be stopped in a few days
b. there is less GI upset with entacapone
c. it does not cause the cheese effect
d. the entacapone can reduce on-off effects
d. the entacapone can reduce on-off effects
The family of a patient who has recently been diagnosed with Alzheimer's disease asks about the new drug prescribed to treat this disease. The patient's wife
says, I'm so excited that there are drugs that can cure this disease!
I can't wait for him to start treatment.* Which reply from the nurse is appropriate?
a. These drugs do not cure Alzheimer's disease. Let's talk about what the HCP said to expect with this drug therapy.
b. "These effects won't be seen for a few months."
c. His response to this drug therapy will depend on how far along he is in the disease process:
d. The sooner he starts on the medicine, the sooner it can have this effect."
a. These drugs do not cure Alzheimer's disease. Let's talk about what the HCP said to expect with this drug therapy.
The nurse is caring for a client with Alzheimer's disease. A family member asks the nurse which of the client's medication is to
treat the decreased memory and cognition. Which of the following medications is used to treat this problem associated with
Alzheimer's disease?
a. Rivastigmine
