MOH/ NCLEX EXAM QUESTIONS

1.  It is hospital policy to assess and record a patient's pulse before administering digoxin (Lanoxin). By auditing the nursing records to determine the frequency of compliance with this policy, the quality assessment and improvement committee is conducting:

•  a process analysis.
•  a quality analysis.
•  a system analysis.
•  an outcome analysis.

2. The most common, preventable complication of abdominal surgery is:

•  atelectasis.
•  fluid and electrolyte imbalance.
•  thrombophlebitis.
•  urinary retention.

3. A patient who received spinal anesthesia four hours ago during surgery is transferred to the surgical unit and, after one and a half hours, now reports severe incisional pain. The patient's blood pressure is 170/90 mm Hg, pulse is 108 beats/min, temperature is 99F (37.2C), and respirations are 30 breaths/min. The patient's skin is pale, and the surgical dressing is dry and intact. The most appropriate nursing intervention is to:

•  medicate the patient for pain.
•  place the patient in a high Fowler position and administer oxygen.
•  place the patient in a reverse Trendelenburg position and open the IV line.
•  report the findings to the provider.

4.  At high altitudes, the boiling point of water decreases because

• the atmospheric pressure is high
• the temperature is low
• the atmospheric pressure is low*
• the temperature is high

5. To prepare a patient on the unit for a bronchoscopic procedure, a medical-surgical nurse administers the IV sedative. The medical-surgical nurse then instructs the licensed practical nurse to:

•  educate the patient about the pending procedure.
•  give the patient small sips of water only.
•  measure the patient's blood pressure and pulse readings.
•  take the patient to the bathroom one more time.

6. A 78-year-old patient is scheduled for transition to home after treatment for heart disease. The patient's spouse, who has chronic obstructive pulmonary disease, plans to care for the patient at home. The spouse says that their grown children, who live nearby, will help. The best approach to discharge planning is to:

•  arrange nursing home placement for the couple.
•  consult the spouse's healthcare provider about the spouse's ability to care for the patient.
•  contact the children to ascertain their commitment to help.
•  discuss community resources with the spouse and offer to make referrals.

7. During an assessment of a patient who sustained a head injury 24 hours ago, the medical-surgical nurse notes the development of slurred speech and disorientation to time and place. The nurse's initial action is to:

•  continue the hourly neurologic assessments.
•  inform the neurosurgeon of the patient's status.
•  prepare the patient for emergency surgery.
•  recheck the patient's neurologic status in 15 minutes.

8. An 80-year-old patient is placed in isolation when infected with methicillin-resistant Staphylococcus aureus. The patient was alert and oriented on admission, but is now having visual hallucinations and can follow only simple directions. The medical-surgical nurse recognizes that the changes in the patient's mental status are related to:

•  a fluid and electrolyte imbalance.
•  a stimulating environment.
•  sensory deprivation.
•  sundowning.

9. Which action occurs primarily during the evaluation phase of the nursing process?

•  Data collection
•  Decision-making and judgment
• Priority-setting and expected outcomes
•  Reassessment and audit

10. For the evaluation feedback process to be effective, a manager:

•  conducts weekly meetings with staff members.
•  considers staff members' interests and abilities when delegating tasks.
•  informs staff members regularly of how well they are performing their jobs.
•  provides goals for staff members to meet.

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