CBQ no. 14 what life style changes can the client who is ...
Common Board Questions (CBQ)in Nurse Licensure Examination(CARDIOVASCULAR SYSTEM)CBQ no. 1 How do clients experiencing angina? Describe that pain.Answers: Described as squeezing, heavy, burning, radiates to left arm or shoulder, transient or prolonged.CBQ no. 2 Develop a teaching plan for the client taking nitroglycerin.Answers: Take at first sign of anginal pain.? Take no more than 3, five minutes apart.? Call for emergency attention if no relief in 10 minutes.CBQ no. 3 List the parameters of blood pressure for diagnosing hypertension.Answers: >140/90CBQ no. 4 Differentiate between essential and secondary hypertension.Answers: Essential has no known cause while secondary hypertension develops in response to an identifiable mechanism.CBQ no. 5 Develop a teaching plan for the client taking antihypertensive medications.Answers: Explain how and when to take med, reason for med, necessary of compliance, need for follow-up visits while on med, need for certain lab tests, vital sign parameters while initiating therapy.CBQ no. 6 Describe intermittent claudication.Answers: Pain related to peripheral vascular disease occurring with exercise and disappearing with rest.CBQ no. 7 Describe the nurse’s discharge instructions to a client with venous peripheral vascular disease.Answers: Keep extremities elevated when sitting, rest at first sign of pain, keep extremities warm (but do NOT use heating pad), change position often, avoid crossing legs, wear unrestrictive clothing.CBQ no. 8 What is often the underlying cause of abdominal aortic aneurysm?Answers: Atherosclerosis. CBQ no. 9 What lab values should be monitored daily for the client with thrombophlebitis who is undergoing anticoagulant therapy?Answers: PTT, PT, Hgb, and Hct, platelets.CBQ no. 10 When do PVCs (premature ventricular contractions) present a grave danger?Answers: When they begin to occur more often than once in 10 beats, occur in 2s or 3s, land near the T wave, or take on multiple configurations.CBQ no. 11 Differentiate between the symptoms of left-sided cardiac failure and right-sided cardiac failure.Answers: Left-sided failure results in pulmonary congestion due to back-up of circulation in the left ventricle.? Right-sided failure results in peripheral congestion due to back-up of circulation in the right ventricle.CBQ no. 12 List 3 symptoms of digitalis toxicity.Answers: Dysrhythmias, headache, nausea and vomitingCBQ no. 13 What condition increases the likelihood of digitalis toxicity occurring?Answers: When the client is hypokalemic (which is more common when diuretics and digitalis preparations are given together).CBQ no. 14 what life style changes can the client who is at risk for hypertension initiate to reduce the likelihood of becoming hypertensive?Answers: Cease cigarette smoking if applicable, control weight, exercise regularly, and maintain a low-fat/low-cholesterol diet.CBQ no. 15 What immediate actions should the nurse implement when a client is having a myocardial infarction?Answers: Place the client on immediate strict bedrest to lower oxygen demands of heart, administer oxygen by nasal cannula at 2-5 L/min., take measures to alleviate pain and anxiety (administer prn pain medications and anti-anxiety medications).CBQ no. 16 What symptoms should the nurse expect to find in the client with hypokalemia?Answers: Dry mouth and thirst, drowsiness and lethargy, muscle weakness and aches, and tachycardia.CBQ no. 17 Bradycardia is defined as a heart rate below ___ BPM.? Tachycardia is defined as a heart rate above ___ BPM.Answers: bradycardia 60 bpm; tachycardia 100 bpmCBQ no. 18 What precautions should clients with valve disease take prior to invasive procedures or dental work?Answers: Take prophylactic mon Board Questions (CBQ)in Nurse Licensure Examination(RENAL SYSTEM)CBQ no. 1 Differentiate between acute renal failure and chronic renal failure.Answers: Acute renal failure: often reversible, abrupt deterioration of kidney function.? – Chronic renal failure: irreversible, slow deterioration of kidney function characterized by increasing BUN and creatinine.? Eventually dialysis is required.CBQ no. 2 During the oliguric phase of renal failure, protein should be severely restricted.? What is the rationale for this restriction?Answer: Toxic metabolites that accumulate in the blood (urea, creatinine) are derived mainly from protein catabolism.CBQ no. 3 Identify 2 nursing interventions for the client on hemodialysis.Answer: Do NOT take BP or perform venipunctures on the arm with the A-V shunt, fistula, or graft.? Assess access site for thrill or bruit.CBQ no. 4 What is the highest priority nursing diagnosis for clients in any type of renal failure?Answer: Alteration in fluid and electrolyte balance.CBQ no. 5 A client in renal failure asks why he is being given antacids.? How should the nurse reply?Answer: Calcium and aluminum antacids bind phosphates and help to keep phosphates from being absorbed into blood stream thereby preventing rising phosphate levels, and must be taken with meals.CBQ no. 6 List 4 essential elements of a teaching plan for clients with frequent urinary tract infections.Answer: Fluid intake 3 liters/day; good handwashing; void every 2-3 hours during waking hours; take all prescribed medications; wear cotton undergarments.CBQ no. 7 What are the most important nursing interventions for clients with possible renal calculi?Answer: Strain all urine is the MOST IMPORTANT intervention.? Other interventions include accurate intake and output documentation and administer analgesics as needed.CBQ no. 8 What discharge instructions should be given to a client who has had urinary calculi?Answer: Maintain high fluid intake 3-4 liters per day.? Follow-up care (stones tend to recur).? Follow prescribed diet based in calculi content.? Avoid supine position.CBQ no. 9 Following transurethral resection of the prostate gland (TURP), hematuria should subside by what post-op day?Answer: Fourth dayCBQ no. 10 After the urinary catheter is removed in the TURP client, what are 3 priority nursing actions?Answer: Continued strict I&O; continued observations for hematuria; inform client burning and frequency may last for a week.CBQ no. 11 After kidney surgery, what are the primary assessments the nurse should make?Answer: Respiratory status (breathing is guarded because of pain); circulatory status (the kidney is very vascular and excess bleeding can occur); pain assessment; urinary assessment most importantly, assessment of urinary mon Board Questions (CBQ)in Nurse Licensure Examination(RESPIRATORY SYSTEM)CBQ n0. 1 List 4 common symptoms of pneumonia the nurse might note on a physical exam.Answer: Tachypnea, fever with chills, productive cough, bronchial breath sounds.CBQ no. 2 State 4 nursing interventions for assisting the client to cough productively.Answer: Deep breathing, fluid intake increased to 3 liters/day, use humidity to loosen secretions, suction airway to stimulate coughing.CBQ no. 3 What symptoms of pneumonia might the nurse expect to see in an older client?Answer: Confusion, lethargy, anorexia, rapid respiratory rate.CBQ no. 4 What should the O2 flow rate be for the client with COPD?Answer: 1-2 liters per nasal cannula, too much O2 may eliminate the COPD client’s stimulus to breathe, a COPD client has hypoxic drive to breathe.CBQ no. 4 How does the nurse prevent hypoxia during suctioning?Answer: Deliver 100% oxygen (hyperinflating) before and after each endotracheal suctioning.CBQ no. 5 During mechanical ventilation, what are three major nursing intervention?Answer: Monitor client’s respiratory status and secure connections, establish a communication mechanism with the client, keep airway clear by coughing/suctioning.CBQ no. 6 When examining a client with emphysema, what physical findings is the nurse likely to see?Answer: Barrel chest, dry or productive cough, decreased breath sounds, dyspnea, crackles in lung fields.CBQ no. 7 What is the most common risk factor associated with lung cancer?Answeer: SmokingCBQ no. 8 Describe the pre-op nursing care for a client undergoing a laryngectomy.Answer: Involve family/client in manipulation of tracheostomy equipment before surgery, plan acceptable communication method, refer to speech pathologist, discuss rehabilitation program.CBQ no. 9 List 5 nursing interventions after chest tube insertion.Answer: Maintain a dry occlusive dressing to chest tube site at all times.? Check all connections every 4 hours.? Make sure bottle III or end of chamber is bubbling.? Measure chest tube drainage by marking level on outside of drainage unit.? Encourage use of incentive spirometry every 2 hours.CBQ no. 10 What immediate action should the nurse take when a chest tube becomes disconnected from a bottle or a suction apparatus?? What should the nurse do if a chest tube is accidentally removed from the client?Answer: Place end in container of sterile water.? Apply an occlusive dressing and notify physician STAT.CBQ no. 11 What instructions should be given to a client following radiation therapy?Answer: Do NOT wash off lines; wear soft cotton garments, avoid use of powders/creams on radiation site.CBQ no. 12 What precautions are required for clients with TB when placed on respiratory isolation?Answer: Mask for anyone entering room; private room; client must wear mask if leaving room.CBQ no. 13 List 4 components of teaching for the client with tuberculosis.Answer: Cough into tissues and dispose immediately into special bags.? Long-term need for daily medication.? Good handwashing technique.? Report symptoms of deterioration, i.e., blood in mon Board Questions (CBQ)in Nurse Licensure Examination(ENDOCRINE SYSTEM)CBQ. no 1. What diagnostic test is used to determine thyroid activity?Answers: T3 and T4CBQ. no 2. What condition results from all treatments for hyperthyroidism?Answers: Hypothyroidism, requiring thyroid replacementCBQ. no 3. State 3 symptoms of hyperthyroidism and 3 symptoms of hypothyroidism.Answers: Hyperthyroidism: weight loss, heat intolerance, diarrhea. Hypothyroidism: fatigue, cold intolerance, weight gain.CBQ. no 4. List 5 important teaching aspects for clients who are beginning corticosteroid therapy.Answers: Continue medication until weaning plan is begun by physician, monitor serum potassium, glucose, and sodium frequently; weigh daily, and report gain of >5lbs./wk; ? ? ?? monitor BP and pulse closely; teach symptoms of Cushing’s syndromeCBQ. no 5. Describe the physical appearance of clients who are Cushinoid.Answers: Moon face, obesity in trunk, buffalo hump in back, muscle atrophy, and thin skin.CBQ. no 6. Which type of diabetic always requires insulin replacement?Answers: Type I, Insulin-dependent diabetes mellitus (IDDM)CBQ. no 7. What type of diabetic sometimes requires no medication?Answers: Type II, Non-insulin dependent diabetes mellitus (NIDDM)CBQ. no 8. List 5 symptoms of hyperglycemia.Answers:Polydipsia, polyuria, polyphagia, weakness, weight lossCBQ. no 9. List 5 symptoms of hypoglycemia.Answers: Hunger, lethargy, confusion, tremors or shakes, sweatingCBQ. no 10. Name the necessary elements to include in teaching the new diabetic.Answers: Teach the underlying pathophysiology of the disease, its management/ treatment regime, meal planning, exercise program, insulin administration, sick-day management, symptoms of hyperglycemia (not enough insulin)CBQ. no 11. In less than ten steps, describe the method for drawing up a mixed dose of insulin (regular with NPH).Answers: Identify the prescribed dose/type of insulin per physician order; store unopened insulin in refrigerator. If opened, may be kept at room temperature for up to 3 months. Draw up regular insulin FIRST. Rotate injection sites. May reuse syringe by recapping and storing in refrigerator.CBQ. no 12. Identify the peak action time of the following types of insulin: rapid-acting regular insulin, intermediate-acting, long-acting.Answers: Rapid-acting regular insulin: 2-4 hrs. Immediate-acting: 6-12 hrs. Long-acting: 14-20 hrs.CBQ. no 13. When preparing the diabetic for discharge, the nurse teaches the client the relationship between stress, exercise, bedtime snacking, and glucose balance. State the relationship between each of these.Answers: Stress and stress hormones usually increase glucose production and increase insulin need; exercise can increase the chance for an insulin reaction, therefore, the client should always have a sugar snack available when exercising (to treat hypoglycemia); bedtime snacking can prevent insulin reactions while waiting for long-acting insulin to peak.CBQ. no 14. When making rounds at night, the nurse notes that an insulin-dependent client is complaining of a headache, slight nausea, and minimal trembling. The client’s hand is cool and moist. What is the client most likely experiencing?Answers: Hypoglycemia/insulin reaction.CBQ. no 1. Identify 5 foot-care interventions that should be taught to the diabetic client.Answers: Check feet daily & report any breaks, sores, or blisters to health care provider, wear well-fitting shoes; never go barefoot or wear sandals, never personally remove corns or calluses, cut or file nails straight across; wash daily with mild soap & warm mon Board Questions (CBQ)in Nurse Licensure Examination(NEUROLOGICAL SYSTEM)CBQ. no 1. What are the classifications of the commonly prescribed eye drops for glaucoma?Answers: Parasympathominetics for pupillary constriction.? Beta-adrenergic receptor-blocking agents to inhibit formation of aqueous humor. Carbonic anhydrase inhibitors to reduce aqueous humor production, and prostaglandin agonists to increase aqueous humor outflow.CBQ. no 2. Identify 2 types of hearing loss.Answers: Conductive (transmission of sound to inner ear is blocked) and sensorineural (damage to 8th cranial nerve)CBQ. no 3. Write 4 nursing interventions for the care of the blind person and 4 nursing interventions for the care of the deaf person.Answers: Care of the blind: announce presence clearly, call by name, orient carefully to surroundings, guide by walking in front of client with his/her hand in your elbow.? Care of deaf: reduce distraction before beginning conversation, look and listen to client, give client full attention if they are a lip reader, face client directly.CBQ. no 4. In your own words describe the Glasgow Coma Scale.Answers: An objective assessment of the level of consciousness based on a score of 3 to 15, with scores of 7 or less indicative of coma.CBQ. no 5. List 4 nursing diagnoses for the comatose client in order of priority.Answers: Ineffective breathing pattern, ineffective airway clearance, impaired gas exchange, and decreased cardiac output.CBQ. no 6. State 4 independent nursing interventions to maintain adequate respirations, airway, and oxygenation in the unconscious client.Answers: Position for maximum ventilation (prone or semi-prone and slightly to one side), insert airway if tongue obstructing; suction airway efficiently, monitor arterial pO2 and pCO2 and hyperventilate with 100% oxygen before suctioning.CBQ. no 7. Who is at risk for cerebral vascular accidents?Answers: Persons with history of hypertension, previous TIAs, cardiac disease (atrial flutter/fibrillation), diabetes, oral contraceptive use, and the elderly.CBQ. no 8. Complications of immobility include the potential for thrombus development.? State 3 nursing interventions to prevent thrombi.Answers: Frequent range of motion exercises, frequent (q2h) position changes, and avoidance of positions which decrease venous return.CBQ. no 9. List 4 rationales for the appearance of restlessness in the unconscious client.Answers: Anoxia, distended bladder, covert bleeding, or a return to consciousnessCBQ. no 10. What nursing interventions prevent corneal drying in a comatose client?Answers: Irrigation of eyes PRN with sterile prescribed solution, application of opthalmic ointment q8h, close assessment for corneal ulceration/drying.CBQ. no 11. When a comatose client on IV hyperalimentation begin to receive tube feedings instead?Answers: When peristalsis resumes as evidenced by active bowel sounds, passage of flatus or bowel movement.CBQ. no 12. What is the most important principle in a bowel management program for a neurologic client?Answers: Establishment of REGULARITYCBQ. no 13. Define cerebral vascular accident.Answers: A disruption of blood supply to a part of the brain, which results in sudden loss of brain function.CBQ. no 14. A client with a diagnosis of CVA presents with symptoms of aphasia, right hemiparesis, but no memory or hearing deficit.? In what hemisphere has the client suffered a lesion?Answer: LeftCBQ. no 15. What are the symptoms of spinal shock?Answers: Hypotension, bladder and bowel distention, total paralysis, lack of sensation below lesion.CBQ. no 16. What are the symptoms of autonomic dysreflexia?Answers: Hypertension, bladder and bowel distention, exaggerated autonomic responses, headache, sweating, goose bumps, and bradycardiaCBQ. no 17. What is the most important indicator of increased ICP?Answers: A change in the level of responsivenessCBQ. no 18. What vital sign changes are indicative of increased ICP?Answers: Increased BP, widening pulse pressure, increased or decreased pulse, respiratory irregularities and temperature increase.CBQ. no 19. A neighbor calls the neighborhood nurse stating that he was knocked hard to the floor by his very hyperactive dog.? He is wondering what symptoms would indicate the need to visit an emergency room.? What should the nurse tell him to do?Answers: Call his physician now and inform him/her of the fall.? Symptoms needing medical attention would include vertigo, confusion or any subtle behavioral change, headache, vomiting, ataxia (imbalance), or seizure.CBQ. no 20. What activities and situations should be avoided that increase ICP?Answers: Change in bed position, extreme hip flexion, endotracheal suctioning, compression of jugular veins, coughing, vomiting, or straining of any kind.CBQ. no 21. How do Hyperosmotic agents (osmotic diuretics) used to treat intracranial pressure act?Answers: Dehydrate the brain and reduce cerebral edema by holding water in the renal tubules to prevent reabsorption, and by drawing fluid from the extravascular spaces into the plasma.CBQ. no 22. Why should narcotics be avoided in clients with neurologic impairment?Answers: Narcotics mask the level of responsiveness as well as pupillary response.CBQ. no 23. Headache and vomiting are symptoms of many disorders.? What characteristics of these symptoms would alert the nurse to refer a client to a neurologist?Answers: Headache which is more severe upon awakening and vomiting not associated with nausea are symptoms of a brain tumor.CBQ. no 24. How should the head of the bed be positioned for post-craniotomy clients with infratentorial lesions?Answers: Infratentorial – FLAT; Supratentorial – elevatedCBQ. no 25. Is multiple sclerosis thought to occur because of an autoimmune process?Answer: YESCBQ. no 26. Is paralysis always a consequence of spinal cord injury?Answer: NOCBQ. no 27. What types of drugs are used in the treatment of myasthenia gravis?Answers: Anticholinesterase drugs, which inhibit the action of cholinesterase at the nerve endings to promote the accumulation of acetylcholine at receptor sires, which should improve neuronal transmission to mon Board Questions (CBQ)in Nurse Licensure Examination(GASTROINTESTINAL SYSTEM)CBQ n0. 1 List 4 nursing interventions for the client with a hiatal hernia.Answer: Sit up while eating and one hour after eating.? Eat small, frequent meals.? Eliminate foods that are problematic.CBQ n0. 2 List 3 categories of medications used in the treatment of peptic ulcer disease.Answer: Antacids, H2 receptor-blockers, mucosal healing agents, proton pump inhibitors.CBQ no. 3 List the symptoms of upper and lower gastrointestinal bleeding.Answer: Upper GI: melena, hematemesis, tarry stools.? Lower GI: bloddy stools, tarry stools.? Similar: tarry stools.CBQ n0. 4 What bowel sound disruptions occur with an intestinal obstruction?Answer: Early mechanical obstruction: high-pitched sounds; late mechanical obstruction: diminished or absent bowel sounds.CBQ n0. 5 List 4 nursing interventions for post-op care of the client with a colostomy.Answer: Irrigate daily at same time; use warm water for irrigations; wash around stoma with mild soap/water after each colostomy bag change; pouch opening should extend at least 1/8 inch around the stoma.CBQ n0. 6 List the common clinical manifestations of jaundice.Answer: Sclera-icteric (yellow sclera), dark urine, chalky or clay-colored stoolsCBQ n0. 7 What are the common food intolerances for clients with cholelithiasis?Answer: Fried/spicy or fatty foods.CBQ n0. 8 List 5 symptoms indicative of colon cancer.Answer: Rectal bleeding, change in bowel habits, sense of incomplete evacuation, abdominal pain with nausea, weight loss.CBQ n0. 9 In a client with cirrhosis, it is imperative to prevent further bleeding and observe for bleeding tendencies.? List 6 relevant nursing interventions.Answer: Avoid injectons, use small bore needles for IV insertion, maintain pressure for 5 minutes on all venipuncture sites, use electric razor, use soft-bristle toothbrush for mouth care, check stools and emesis for occult blood.CBQ n0. 10 What is the main side effect of lactulose, which is used to reduce ammonia levels in clients with cirrhosis?Answer: Diarrhea.CBQ n0. 11 List 4 groups who have a high risk of contracting hepatitis.Answer: Homosexual males, IV drug users, recent ear piercing or tattooing, and health care workers. ................
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