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NUR 206 FINAL EXAM NEWEST 2024 -2025
COMPLETE 300 QUESTIONS WITH CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS)
GRADED A+
A patient who has been diagnosed with inoperable lung cancer and has a poor prognosis plans a trip across the country "to settle some issues with family members." The nurse recognizes that the patient is manifesting which psychosocial response to death?
- Protesting the unfairness of death
- Anxiety about unfinished business
- Fear of having lived a meaningless life
d. Restlessness about the uncertainty of prognosis - Correct Answer - ANS: B
The patient's statement indicates that there is some unfinished family business that the patient would like to address before dying. There is no indication that the patient is protesting the prognosis, feels uncertain about the prognosis, or fears that life has been meaningless.
A patient with a tracheostomy has a new order for a fenestrated tracheostomy tube.Which action should the nurse include in the plan of care in collaboration with the speech therapist?
- Assess the ability to swallow before using the fenestrated tube.
- Inflate the tracheostomy cuff during use of the fenestrated tube.
- Leave the tracheostomy inner cannula inserted at all times.
- Place the decannulation cap in the tube before cuff deflation. - Correct Answer –
A
Assess the ability to swallow before using the fenestrated tube. Because the cuff is deflated when using a fenestrated tube, the patient's risk for aspiration should be assessed before changing to a fenestrated tracheostomy tube. 1 / 4
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An alcoholic and homeless patient is diagnosed with active tuberculosis (TB). Which intervention by the nurse will be most effective in ensuring adherence with the treatment regimen?
- Teach the patient about the high risk for infecting others unless treatment is
- Arrange for a daily noon meal at a community center where the drug will be
- Arrange for a friend to administer the medication on schedule.
- Give the patient written instructions about how to take the medications. - Correct
followed.
administered.
Answer – B
Directly observed therapy is the most effective means for ensuring compliance with the treatment regimen, and arranging a daily meal will help ensure that the patient is available to receive the medication. The other nursing interventions may be appropriate for some patients but are not likely to be as helpful for this patient.
A lobectomy is scheduled for a patient with stage I non-small cell lung cancer. The patient tells the nurse, "I would rather have chemotherapy than surgery." Which response by the nurse is most appropriate?
- "Surgery is the treatment of choice for stage I lung cancer."
- "Tell me what you know about the various treatments available."
- "Are you afraid that the surgery will be very painful?"
- "Did you have bad experiences with previous surgeries?" - Correct Answer – B
More assessment of the patient's concerns about surgery is indicated. An open-ended response will elicit the most information from the patient. The answer beginning, "Surgery is the treatment of choice" is accurate, but it discourages the patient from sharing concerns about surgery. The remaining two answers indicate that the nurse has jumped to conclusions about the patient's reasons for not wanting surgery.Chemotherapy is the primary treatment for small cell lung cancer. In non-small cell lung cancer, chemotherapy may be used in the treatment of nonresectable tumors or as adjuvant therapy to surgery
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pg. 3 A nurse assesses a client who has a chest tube. For which manifestations should the nurse immediately intervene? (Select all that apply.)
- Drainage of 75 mL/hr
- Tracheal deviation
- Production of pink sputum
- Pain at insertion site
- Sudden onset of shortness of breath - Correct Answer - B,E
Tracheal deviation and sudden onset of shortness of breath are manifestations of a tension pneumothorax. The nurse must intervene immediately for this emergency situation. Pink sputum is associated with pulmonary edema and is not a complication of a chest tube. Pain at the insertion site and drainage of 75 mL/hr are normal findings with a chest tube.
A patient who is lethargic and exhibits deep, rapid respirations has the following arterial
blood gas (ABG) results: pH 7.32, PaO2 88 mm Hg, PaCO2 37 mm Hg, and HCO3 16
mEq/L. How should the nurse interpret these results?
- Respiratory acidosis
- Respiratory alkalosis
- Metabolic acidosis
- Metabolic alkalosis - Correct Answer – C
Normal pH is 7.35-7.45. Values less than 7.35 indicate acidosis. Normal value for HCO3¯ is 22--26 mEq/L. Because the PaCO2 is normal and the HCO3¯ is low, below the normal, the source of the acidosis is metabolic. The patient is in metabolic acidosis.
https://www.youtube.com/watch?v=URCS4t9aM5o
After 2 months of tuberculosis (TB) treatment with isoniazid (INH), rifampin (Rifadin), pyrazinamide (PZA), and ethambutol, a patient continues to have positive sputum smears for acid-fast bacilli (AFB). Which action should the nurse take next?
- Schedule the patient for directly observed therapy three times weekly.
- Discuss with the health care provider the need for the patient to use an injectable
- Teach about treatment for drug-resistant TB treatment. 3 / 4
antibiotic.
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- Ask the patient whether medications have been taken as directed. - Correct
Answer – D
The first action should be to determine whether the patient has been compliant with drug therapy because negative sputum smears would be expected if the TB bacillus is susceptible to the medications and if the medications have been taken correctly.Assessment is the first step in the nursing process. Depending on whether the patient has been compliant or not, different medications or directly observed therapy may be indicated. The other options are interventions based on assumptions until an assessment has been completed.
A patient with terminal cancer is being admitted to a family-centered inpatient hospice.The patient's spouse visits daily and cheerfully talks with the patient about wedding anniversary plans for the next year. When the nurse asks about any concerns, the spouse says, "I'm busy at work, but otherwise things are fine." Which provisional nursing diagnosis is appropriate for the patient's spouse?
- Ineffective coping related to lack of grieving
- Anxiety related to complicated grieving process
- Hopelessness related to knowledge deficit about cancer
- Caregiver role strain related to spouse's complex care needs - Correct Answer -
ANS: A
The spouse's behavior and statements indicate the absence of anticipatory grieving, which may lead to impaired adjustment as the patient progresses toward death. The spouse does not appear to feel overwhelmed, hopeless, or anxious.
As the nurse admits a patient in end-stage renal disease to the hospital, the patient tells the nurse, "If my heart or breathing stop, I do not want to be resuscitated." Which action should the nurse take first?
- Place a "Do Not Resuscitate" (DNR) notation in the patient's care plan.
- Invite the patient to add a notarized advance directive in the health record.
- Advise the patient to designate a person to make future health care decisions.
- Ask if the decision has been discussed with the patient's health care provider. -
Correct Answer - ANS: D
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