Nursing Board Exam Reviewer Part 1 of 5

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81. Which of the following “awareness contexts” is characterized by the patient, the family, and the health care professionals being aware that the patient is dying but all pretend otherwise?

a)      Mutual pretense awareness
In mutual pretense awareness, the patient, the family and the health care professionals are aware that the patient is dying but all pretend otherwise.

b)      Closed awareness
In closed awareness, the patient is unaware of his terminality in a context where others are aware.

c)      Suspected awareness
In suspected awareness, the patient suspects what others know and attempts to find it out.

d)      Open awareness
In open awareness, all are aware that the patient is dying and are able to openly acknowledge that reality.

82. For individuals known to be dying by virtue of age and/or diagnoses, which of the following signs indicate approaching death:

a)      Increased restlessness
As the oxygen supply to the brain decreases, the patient may become restless.

b)      Increased wakefulness
As the body weakens, the patient will sleep more and begin to detach from the environment.

c)      Increased eating
For many patients, refusal of food is an indication that they are ready to die.

d)      Increased urinary output
Based upon decreased intake, urinary output generally decreases in amount and frequency.

83. Which of the following terms best describes a living will?

a)      Medical directive
The living will is a type of advance medical directive in which the individual of sound mind documents treatment preferences.

b)      Proxy directive
A proxy directive is the appointment and authorization of another individual to make medical decisions on behalf of the person who created an advance directive when he/she is no loner able to speak for him/herself.

c)      Health care power of attorney
Health care power of attorney is a legal document that enables the signer to designate another individual to make health care decisions on his/her behalf when he/she is unable to do so.

d)      Durable power of attorney for health
A durable power of attorney for health care is a legal document that enables the signer to designate another individual to make health care decisions on his/her behalf when he/she is unable to do so.

84. A malignant tumor

a)      gains access to the blood and lymphatic channels.
By this mechanism, the tumor metastasizes to other areas of the body.

b)      demonstrates cells that are well-differentiated.
Cells of malignant tumors are undifferentiated.

c)      is usually slow growing.
Malignant tumors demonstrate variable rate of growth; however, the more anaplastic the tumor, the faster its growth.

d)      grows by expansion.
A malignant tumor grows at the periphery and sends out processes that infiltrate and destroy surrounding tissues.

85. Which of the following classes of antineoplastic agents is cell–cycle-specific?

a)      Antimetabolites (5-FU)
Antimetabolites are cell–cycle-specific (S phase).

b)      Antitumor antibiotics (bleomycin)
Antitumor antibiotics are cell-cycle nonspecific.

c)      Alkylating agents (cisplatin)
Alkylating agents are cell-cycle nonspecific.

d)      Nitrosureas (carmustine)
Nitrosureas are cell-cycle nonspecific.

86. Regarding the surgical patient, which of the following terms refers to the period of time that constitutes the surgical experience?

a)      Perioperative phase
Perioperative period includes the preoperative, intraoperative, and postoperative phases.

b)      Preoperative phase
Preoperative phase is the period of time from when the decision for surgical intervention is made to when the patient is transferred to the operating room table.

c)      Intraoperative phase
Intraoperataive phase is the period of time from when the patient is transferred to the operating room table to when he or she is admitted to the postanesthesia care unit.

d)      Postoperative phase
Postoperative phase is the period of time that begins with the admission of the patient to the postanesthesia care unit and ends after a follow-up evaluation in the clinical setting or home.

87. When the indication for surgery is without delay, the nurse recognizes that the surgery will be classified as

a)      emergency.
Emergency surgery means that the patient requires immediate attention and the disorder may be life-threatening.

b)      urgent.
Urgent surgery means that the patient requires prompt attention within 24-30 hours.

c)      required.
Required surgery means that the patient needs to have surgery, and it should be planned within a few weeks or months.

d)      elective.
Elective surgery means that there is an indication for surgery, but failure to have surgery will not be catastrophic.

88. When a person with a history of chronic alcoholism is admitted to the hospital for surgery, the nurse anticipates that the patient may show signs of alcohol withdrawal delirium during which time period?

a)      Up to 72 hours after alcohol withdrawal
Alcohol withdrawal delirium is associated with a significant mortality rate when it occurs postoperatively.

b)      Immediately upon admission
Onset of symptoms depends upon time of last consumption of alcohol.

c)      Upon awakening in the post-anesthesia care unit
Onset of symptoms depends upon time of last consumption of alcohol.

d)      Up to 24 hours after alcohol withdrawal
Twenty-four hours is too short a time frame to consider alcohol withdrawal delirium no longer a threat to a chronic alcoholic.

89. Which of the following categories of medications may result in seizure activity if withdrawn suddenly?

a)      Tranquilizers
Abrupt withdrawal of tranquilizers may result in anxiety, tension, and even seizures if withdrawn suddenly.

b)      Adrenal corticosteroids
Abrupt withdrawal of steroids may precipitate cardiovascular collapse.

c)      Antidepressants
Monoamine oxidase inhibitors increase the hypotensive effects of anesthetics.

d)      Diuretics
Thiazide diuretics may cause excessive respiratory depression during anesthesia due to an associated electrolyte imbalance.

90. When the patient is encouraged to concentrate on a pleasant experience or restful scene, the cognitive coping strategy being employed by the nurse is

a)      imagery.
Imagery has proven effective for oncology patients.

b)      optimistic self-recitation.
Optimistic self-recitation is practiced when the patient is encouraged to recite optimistic thoughts such as “I know all will go well.”

c)      distraction.
Distraction is employed when the patient is encouraged to think of an enjoyable story or recite a favorite poem.

d)      progressive muscular relaxation.
Progressive muscular relaxation requires contracting and relaxing muscle groups and is a physical coping strategy as opposed to cognitive.

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