Question 1

What is the relationship between a full opioid agonist and the ceiling effect?

Accepted Answer

A) A full opioid agonist produces few withdrawal symptoms when the drug's effects plateau and the client begins easing off the drug. 
B) A client may use a full opioid agonist as much or as little as necessary to control chronic pain with no ill effects. 
C) Side effects may limit a full opioid agonist's use but not a plateau in the beneficial effects it produces. 
D) At some point,a full opioid agonist's side effects cease to increase in potency,but the pain-relieving effect continues to increase. 
A) A full opioid agonist produces few withdrawal symptoms when the drug's effects plateau and the client begins easing off the drug. 
B) A client may use a full opioid agonist as much or as little as necessary to control chronic pain with no ill effects. 
C) Side effects may limit a full opioid agonist's use but not a plateau in the beneficial effects it produces. 
D) At some point,a full opioid agonist's side effects cease to increase in potency,but the pain-relieving effect continues to increase.

Question 2

A client with a history of insomnia is scheduled for a polysomnogram that requires an overnight stay in a sleep laboratory.The test will not include audio and video equipment.It will monitor the client's blood oxygen levels,heart rate,breathing,and eye and leg movements,and it will use an electroencephalogram to monitor brain waves.What disorder is least likely to be identified in this test?

Accepted Answer

A) Periodic limb movement disorder 
B) Sleep apnea 
C) Sleep talking 
D) Restless leg syndrome 
A) Periodic limb movement disorder 
B) Sleep apnea 
C) Sleep talking 
D) Restless leg syndrome

Question 3

Which client is exhibiting hypersomnia?

Accepted Answer

A) The client only gets about 5 or 6 hours of sleep each night. 
B) The client gets roughly 8 hours of sleep each night but can't stay awake during the day. 
C) The client consistently has trouble getting to sleep and often lies awake for hours after bedtime. 
D) The client experiences repetitive involuntary leg movements that interfere with sleep. 
A) The client only gets about 5 or 6 hours of sleep each night. 
B) The client gets roughly 8 hours of sleep each night but can't stay awake during the day. 
C) The client consistently has trouble getting to sleep and often lies awake for hours after bedtime. 
D) The client experiences repetitive involuntary leg movements that interfere with sleep.

Question 4

The nurse is caring for a client who is diagnosed with fibromyalgia.Based on this diagnosis,which clinical manifestations might the nurse anticipate for this client? Select all that apply.

Accepted Answer

A) Weakness 
B) Exhaustion 
C) Pain in the calves of the leg 
D) Nausea and vomiting 
E) Anxiety 
A) Weakness 
B) Exhaustion 
C) Pain in the calves of the leg 
D) Nausea and vomiting 
E) Anxiety

Question 5

An older adult client with terminal lung cancer is not breathing well and has cold and mottled skin.The client has a living will and requests comfort measures only.What should the nurse do to help this client?

Accepted Answer

A) Ask the family what they want to be done for the client. 
B) Withhold all care until the client dies. 
C) Contact the provider for orders to control the client's breathing. 
D) Provide the client with pain medication as ordered. 
A) Ask the family what they want to be done for the client. 
B) Withhold all care until the client dies. 
C) Contact the provider for orders to control the client's breathing. 
D) Provide the client with pain medication as ordered.

Question 6

What best explains the reason that a nurse should be responsible for communicating any changes in the condition of a client at the end of life that would warrant a change in the care plan?

Accepted Answer

A) Nurses typically are responsible for definitively diagnosing patient conditions. 
B) Nurses are the healthcare providers who tend to have the greatest amount of contact with clients at the end of life. 
C) Clients typically do not prefer to talk to physicians about problems. 
D) It is legally mandated that nurses are solely responsible for communicating this information. 
A) Nurses typically are responsible for definitively diagnosing patient conditions. 
B) Nurses are the healthcare providers who tend to have the greatest amount of contact with clients at the end of life. 
C) Clients typically do not prefer to talk to physicians about problems. 
D) It is legally mandated that nurses are solely responsible for communicating this information.

Question 7

An adult client diagnosed with sleep apnea has been prescribed a continuous positive airway pressure (CPAP)machine as treatment.The nurse is instructing the client on how to use the machine.Which instruction least relates to ensuring the patient's comfort with the device?

Accepted Answer

A) Use a properly sized mask with the straps tight. 
B) Instruct the client to wear the mask with air pressure while sleeping. 
C) Show how to adjust the pressure to reduce difficulty exhaling. 
D) Demonstrate relaxation techniques to reduce a claustrophobic feeling when wearing the mask. 
A) Use a properly sized mask with the straps tight. 
B) Instruct the client to wear the mask with air pressure while sleeping. 
C) Show how to adjust the pressure to reduce difficulty exhaling. 
D) Demonstrate relaxation techniques to reduce a claustrophobic feeling when wearing the mask.

Question 8

A toddler being prepared for a lumbar puncture begins to cry when carried into the treatment room by the mother.Which nursing diagnosis is most appropriate for the client at this time?

Accepted Answer

A) Knowledge Deficient of the procedure 
B) Anxiety related to anticipated painful procedure 
C) Fear related to the unfamiliar environment 
D) Ineffective Coping related to an invasive procedure 
A) Knowledge Deficient of the procedure 
B) Anxiety related to anticipated painful procedure 
C) Fear related to the unfamiliar environment 
D) Ineffective Coping related to an invasive procedure

Question 9

A client has been prescribed iron supplements to treat fatigue and a hemoglobin level of 9.What additional information should the nurse suggest to the client to help reduce feelings of fatigue associated with a low red blood cell count? Select all that apply.

Accepted Answer

A) Increasing intake of ice cream 
B) Drinking a glass of orange juice each day 
C) Increasing intake of red meat 
D) Increasing intake of wax beans 
E) Increasing intake of green,leafy vegetables 
A) Increasing intake of ice cream 
B) Drinking a glass of orange juice each day 
C) Increasing intake of red meat 
D) Increasing intake of wax beans 
E) Increasing intake of green,leafy vegetables

Question 10

The nurse is caring for a dying child.Which nursing action supports the primary goal for a dying child?

Accepted Answer

A) Keep the child entertained so she does not think about dying. 
B) Ensure that a good relationship is maintained with the family. 
C) Administer pain medication as ordered. 
D) Maintain a busy schedule for child and family members. 
A) Keep the child entertained so she does not think about dying. 
B) Ensure that a good relationship is maintained with the family. 
C) Administer pain medication as ordered. 
D) Maintain a busy schedule for child and family members.

Question 11

Which of the following statements best characterizes risk for injury as it relates to pain?

Accepted Answer

A) Risk for injury is an external risk factor for pain. 
B) It is difficult to predict what might pose a risk for injury. 
C) Risk for injury can be decreased by living a healthy lifestyle. 
D) Precautions against risk for injury are rarely successful in preventing injury. 
A) Risk for injury is an external risk factor for pain. 
B) It is difficult to predict what might pose a risk for injury. 
C) Risk for injury can be decreased by living a healthy lifestyle. 
D) Precautions against risk for injury are rarely successful in preventing injury.

Question 12

An older school-age child is brought to the emergency department after a car accident.The parents witness and stare at the resuscitation scene unfolding before them.The child is not responding to the resuscitative efforts after 30 minutes.Which is the best communication strategy for the nurse to use in this situation?

Accepted Answer

A) Ask the parents whether they would like resuscitative efforts to be continued at this point. 
B) Ask the parents to stand at the foot of the cart to watch. 
C) Inform the parents that resuscitative efforts have not been effective and are not beneficial to the child. 
D) Ask the parents to leave until the child has stabilized. 
A) Ask the parents whether they would like resuscitative efforts to be continued at this point. 
B) Ask the parents to stand at the foot of the cart to watch. 
C) Inform the parents that resuscitative efforts have not been effective and are not beneficial to the child. 
D) Ask the parents to leave until the child has stabilized.

Question 13

Fibromyalgia is a disorder that involves which of the following?

Accepted Answer

A) Muscle strength 
B) Respiratory control 
C) Heat regulation 
D) Pain Processing 
A) Muscle strength 
B) Respiratory control 
C) Heat regulation 
D) Pain Processing

Question 14

If nutrients and hydration are provided artificially for a client at the end of life because of the client's diminished muscle control,then what is another therapy that is likely to accompany this therapy?

Accepted Answer

A) Provide oral care regularly. 
B) Provide mechanical ventilation. 
C) Gently massage extremities. 
D) Maintain client safety. 
A) Provide oral care regularly. 
B) Provide mechanical ventilation. 
C) Gently massage extremities. 
D) Maintain client safety.

Question 15

The nurse is creating a pain management plan using the three-step approach for a client with intractable pain.Which interventions should the nurse include in this plan? Select all that apply.

Accepted Answer

A) Administer a nonopioid analgesic first. 
B) Administer an opioid analgesic first. 
C) Administer a nonopioid with an opioid second. 
D) Administer an opioid analgesic last. 
E) Administer analgesics upon client request. 
A) Administer a nonopioid analgesic first. 
B) Administer an opioid analgesic first. 
C) Administer a nonopioid with an opioid second. 
D) Administer an opioid analgesic last. 
E) Administer analgesics upon client request.

Question 16

The nurse is caring for a client who has suffered a massive cerebral hemorrhage and is not expected to survive.The client's mother indicates the client is Catholic.Which intervention is most appropriate?

Accepted Answer

A) If the nurse is not Catholic,then finding a Catholic nurse to continue care for the client is necessary. 
B) The nurse should contact a priest and ask him what must be done for the client. 
C) The nurse should assume the client's desires based on the nurse's existing understanding of the Catholic faith. 
D) The nurse should ask the client or the client's family what they want in terms of religious rituals. 
A) If the nurse is not Catholic,then finding a Catholic nurse to continue care for the client is necessary. 
B) The nurse should contact a priest and ask him what must be done for the client. 
C) The nurse should assume the client's desires based on the nurse's existing understanding of the Catholic faith. 
D) The nurse should ask the client or the client's family what they want in terms of religious rituals.

Exam 3: Comfort

What is the relationship between a full opioid agonist and the ceiling effect?

Which client is exhibiting hypersomnia?

The nurse is caring for a client who is diagnosed with fibromyalgia.Based on this diagnosis,which clinical manifestations might the nurse anticipate for this client? Select all that apply.

An older adult client with terminal lung cancer is not breathing well and has cold and mottled skin.The client has a living will and requests comfort measures only.What should the nurse do to help this client?

What best explains the reason that a nurse should be responsible for communicating any changes in the condition of a client at the end of life that would warrant a change in the care plan?

An adult client diagnosed with sleep apnea has been prescribed a continuous positive airway pressure (CPAP)machine as treatment.The nurse is instructing the client on how to use the machine.Which instruction least relates to ensuring the patient's comfort with the device?

A toddler being prepared for a lumbar puncture begins to cry when carried into the treatment room by the mother.Which nursing diagnosis is most appropriate for the client at this time?

A client has been prescribed iron supplements to treat fatigue and a hemoglobin level of 9.What additional information should the nurse suggest to the client to help reduce feelings of fatigue associated with a low red blood cell count? Select all that apply.

The nurse is caring for a dying child.Which nursing action supports the primary goal for a dying child?

Which of the following statements best characterizes risk for injury as it relates to pain?

Fibromyalgia is a disorder that involves which of the following?

If nutrients and hydration are provided artificially for a client at the end of life because of the client's diminished muscle control,then what is another therapy that is likely to accompany this therapy?

The nurse is creating a pain management plan using the three-step approach for a client with intractable pain.Which interventions should the nurse include in this plan? Select all that apply.

The nurse is caring for a client who has suffered a massive cerebral hemorrhage and is not expected to survive.The client's mother indicates the client is Catholic.Which intervention is most appropriate?

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