Practice Exam Flashcards

The nurse is planning room assignments for the day. Which client should be assigned to a private room if only one is available?

Answer: The client with Cushing’s disease

Clients with Cushing's disease have elevated cortisol levels, which leads to immunosuppression and increased susceptibility to infections. Placing them in a private room minimizes their exposure to pathogens from other clients, thereby reducing their risk of developing hospital-acquired infections. This isolation helps protect their compromised immune system.

A gravida 3 para 0 is admitted to the labor and delivery unit. The doctor performs an amniotomy. Which observation would the nurse be expected to make after the amniotomy?

Answer: A moderate amount of straw-colored fluid

After an amniotomy (artificial rupture of membranes), the expected finding is the release of amniotic fluid that is clear or straw-colored and without a foul odor. A moderate amount indicates a normal volume and healthy fetal environment. Greenish fluid suggests meconium staining, and a small segment of the umbilical cord indicates a prolapsed cord, both of which are complications requiring immediate intervention.

The nurse is caring for an 80-year-old with chronic bronchitis. Upon the morning rounds, the nurse finds an O2 sat of 76%. Which of the following actions should the nurse take first?

Answer: Apply oxygen by mask

An O2 saturation of 76% is critically low and indicates severe hypoxemia, which is a life-threatening emergency. The nurse's first priority is to address the immediate physiological need for oxygen to prevent further deterioration and organ damage. Applying oxygen by mask directly intervenes to improve oxygenation, while other actions like notifying the physician or rechecking the O2 sat would delay crucial intervention.

The registered nurse is making assignments for the day. Which client should be assigned to the pregnant nurse?

Answer: The client receiving linear accelerator radiation therapy for lung cancer

A pregnant nurse must avoid exposure to ionizing radiation to protect the fetus. Clients receiving linear accelerator radiation therapy are not radioactive themselves; the radiation source is external and contained within the machine, meaning there is no residual radiation risk to the nurse. In contrast, clients with radium implants, soluble brachytherapy, or iridium seeds are sources of internal radiation, posing a direct risk to the pregnant nurse.

The 5-year-old is being tested for enterobiasis (pinworms). To collect a specimen for assessment of pinworms, the nurse should teach the mother to:

Answer: Examine the perianal area with a flashlight 2 or 3 hours after the child is asleep

Pinworms (Enterobius vermicularis) migrate to the perianal region to lay eggs, typically at night when the host is asleep. The most effective method for collecting a specimen is to examine the perianal area with a flashlight 2 or 3 hours after the child is asleep, or to use the 'tape test' in the early morning before bathing. This allows for the collection of eggs or observation of adult worms, which are most active at night.

The client is having an arteriogram. During the procedure, the client tells the nurse, “I’m feeling really hot.” Which response would be best?

Answer: “That feeling of warmth is normal when the dye is injected.”

During an arteriogram, a contrast dye is injected into the arteries to visualize blood vessels. A common and expected side effect of this dye is a transient feeling of warmth or flushing throughout the body, especially in the area of injection. Reassuring the client that this sensation is normal helps alleviate anxiety and demonstrates the nurse's knowledge of the procedure, preventing unnecessary alarm.

A vaginal exam reveals a footling breech presentation. The nurse should take which of the following actions at this time?

Answer: Apply the fetal heart monitor

A footling breech presentation, where one or both feet are presenting first, is an abnormal and high-risk fetal presentation. The immediate priority is to assess fetal well-being by applying a fetal heart monitor to continuously track the fetal heart rate. This helps detect any signs of fetal distress, which is crucial given the increased risks associated with breech presentations, and guides further medical decisions.

Which of the following instructions should be included in the nurse’s teaching regarding oral contraceptives?

Answer: An alternate method of birth control is needed when taking antibiotics.

Certain antibiotics, particularly broad-spectrum ones like rifampin, can decrease the effectiveness of oral contraceptives by altering gut flora and interfering with hormone reabsorption. This can lead to unintended pregnancy. Therefore, clients taking oral contraceptives should be advised to use an alternative or backup method of birth control while on antibiotics and for a short period afterward to ensure contraceptive efficacy.

The rationale for inserting a French catheter every hour for the client with epidural anesthesia is:

Answer: The sensation of the bladder filling is diminished or lost.

Epidural anesthesia blocks nerve impulses, including those that transmit the sensation of bladder fullness. This can lead to urinary retention, as the client may not feel the urge to void even when their bladder is full. Regular catheterization, such as every hour with a French catheter, is necessary to prevent bladder distension, potential bladder damage, and urinary tract infections.

What are scientific criteria appropriate for qualitative research? Select all that apply.

Answer: Auditability

Auditability in qualitative research refers to the ability for an external reviewer to follow the researcher's decision trail and arrive at similar conclusions. It ensures that the research process, from data collection to analysis and interpretation, is transparent and well-documented. This criterion enhances the trustworthiness and confirmability of the study's findings by allowing for verification of the research process.

What are ethical concerns for qualitative researchers? Select all that apply.

Answer: Because the study emerges over time, the researcher may not anticipate and inform the participants of a potential threat.

Qualitative research often involves an emergent design, meaning the study's direction and specific questions can evolve as data are collected and analyzed. This iterative process can make it challenging for researchers to fully anticipate all potential risks or threats to participants at the outset, making comprehensive informed consent more complex. Researchers must continuously assess and address ethical considerations as the study unfolds.

Which of the following is most accurate regarding the grounded-theory method?

Answer: It is an inductive approach.

Grounded theory is an inductive research method where theories are developed directly from the data collected, rather than starting with a pre-existing hypothesis. Researchers systematically collect and analyze data, identifying patterns and themes that emerge to construct a theory that is 'grounded' in the empirical observations. This approach allows for the discovery of new theoretical insights from the data itself.

What is the term used for the coding and clustering of data to form categories in the grounded-theory method?

Answer: Constant-comparative method

The constant-comparative method is a core analytical technique used in grounded theory. It involves continuously comparing new data with existing data, codes, and categories to refine and develop theoretical concepts. This iterative process helps researchers identify similarities, differences, and patterns, leading to the emergence of a well-developed and robust theory that is deeply rooted in the data.

What is a characteristic of an intrinsic case study?

Answer: It yields a better understanding of each case.

An intrinsic case study is undertaken when a researcher has a particular interest in understanding a specific, unique case in depth, rather than using it to generalize to other cases or build theory. The primary goal is to gain a profound and comprehensive understanding of that individual case itself. It focuses on the unique characteristics and complexities of the single case being studied.

What is a characteristic of metasynthesis?

Answer: It synthesizes critical masses of qualitative findings.

Metasynthesis is a systematic and rigorous approach to integrating and interpreting findings from multiple qualitative studies on a particular phenomenon. Its purpose is to create new, broader understandings and interpretations that go beyond the individual findings of each study. This process provides a more comprehensive and nuanced perspective on the topic by synthesizing a critical mass of qualitative evidence.

What is meant by the “fittingness” of a research study?

Answer: Faithfulness to everyday reality of the participants

'Fittingness' in qualitative research, also known as transferability, refers to the extent to which the study's findings are meaningful and applicable to other contexts or populations. It assesses whether the research accurately reflects the experiences and realities of the participants. This allows others to judge if the findings resonate with their own experiences or situations, making the research relevant beyond its original context.