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ISPN

旗下栏目: ISPN RN CGFNS OET

ISPN考试模拟题(12道)

来源:中国护士网 作者:www.hushi512.com 人气: 发布时间:2015-09-08
摘要:ISPN考试模拟题(12道)
1、The nurse in the medical unit is assigned to provide discharge teaching to a client with a diagnosis of angina pectoris. The nurse is discussing lifestyle changes that are needed to minimize the effects of the disease process. The client continually changes the subject during the teaching session. The nurse interprets that this client's behavior is most likelyrelated to which problem?
 
    1. Anxiety related to the need to make lifestyle changes
    2. Boredom resulting from having already learned the material
    3. An attempt to ignore or deny the need to make lifestyle changes
    4.Lack of understanding of the material provided at the teaching session and embarrassment about asking question
 
Correct Answer: 3
 
Denial is a defense mechanism that allows the client to minimize a threat that may be manifested by refusal to discuss what has happened. Denial is a common early reaction associated with chest discomfort, angina, or myocardial infarction (MI). Anxiety usually is manifested by symptoms of sympathetic nervous system arousal. No data are provided in the question that would lead the nurse to interpret the client's behavior as boredom or as either understanding or not understanding the material provided at the teaching session.
 
2、Nursing staff members are sitting in the lounge taking their morning break. An unlicensed assistive personnel (UAP) tells the group that she thinks that the unit secretary has acquired immunodeficiency syndrome (AIDS) and proceeds to tell the nursing staff that the secretary probably contracted the disease from her husband, who is supposedly a drug addict. Which legal tort has the UAP violated?
 
    1. Libel
    2. Slander
    3. Assault
    4. Negligence
 
Correct Answer: 2
 
Defamation is a false communication or a careless disregard for the truth that causes damage to someone's reputation, either in writing (libel) or verbally (slander). An assault occurs when a person puts another person in fear of a harmful or an offensive contact. Negligence involves the actions of professionals that fall below the standard of care for a specific professional group.
 
3、The nurse is preparing a plan of care for a client with a diagnosis of brain attack (stroke). On reviewing the client's record, the nurse notes an assessment finding of anosognosia. The nursing care plan should address which manifestation related to this finding?
 
    1. The client will be easily fatigued.
    2. The client will have difficulty speaking.
    3. The client will have difficulty swallowing.
    4. The client will exhibit neglect of the affected side.
 
 Correct Answer: 4
 
In anosognosia, the client neglects the affected side of the body. The client either may ignore the presence of the affected side (often creating a safety hazard as a result of potential injuries) or may state that the involved arm or leg belongs to someone else. Options 1, 2, and 3 are not associated with anosognosia.

4、Epoetin alfa (Epogen, Procrit) by the subcutaneous route is prescribed for a client. Which is the correct action for the nurse to implement?
 
    1. Shake the vial before use.
    2. Freeze the medication before use.
    3. Refrigerate the medication until used.
    4. Obtain syringes with 1½-inch needles from the pharmacy.
 
Correct Answer: 3
 
Epoetin alfa (Epogen, Procrit) should be refrigerated at all times. The bottle should not be shaken and the medication should not be frozen because this will affect the chemical composition. Syringes with a 5/6-inch needle are used for subcutaneous injection. A 1½-inch needle may be used for intramuscular injection.
 
5、A client with a history of angina pectoris tells the nurse that chest pain usually occurs after going up two flights of stairs or after walking four blocks. What type of angina should the nurse determine that the client is experiencing?
 
    1. Stable
    2. Variant
    3. Unstable
    4. Intractable
 
Correct Answer: 1
 
Stable angina is triggered by a predictable amount of effort or emotion. Variant angina is triggered by coronary artery spasm; the attacks are of longer duration than in classic angina and tend to occur early in the day and at rest. Unstable angina is triggered by an unpredictable amount of exertion or emotion and may occur at night; the attacks increase in number, duration, and severity over time. Intractable angina is chronic and incapacitating and is refractory to medical therapy.
 
6、A kosher meal is delivered to a Jewish-American client . Which action by the nurse is most appropriate in assisting the client with the meal?
 
    1. Ask the client to prepare the meal for eating.
    2. Ensure that the client has metal eating utensils.
    3. Prepare the eating utensils and food for the client.
    4. Transfer the food from the paper plates to glass plates.
 
 Correct Answer: 1
 
Kosher meals arrive on paper plates and with plastic utensils sealed. Health care providers should not unwrap the utensils or place the food on another serving dish. Although the nurse may want to be helpful in assisting the client with the meal, the only appropriate option for this client is option 1.

7、The nurse notes that a client's parenteral nutrition solution is 4 hours behind. Which action should the nurse take?
 
    1. Assess the infusion pump to be sure it is functioning properly and is set at the correct rate.
    2. Increase the infusion rate to a rate that allows the infusion volume to correct itself within a 2-hour period.
    3. Replace the parenteral nutrition solution with 10% dextrose, and restart the solution the following day.
    4. Administer the parenteral nutrition solution using gravity flow because the infusion pump is malfunctioning.
 
Correct Answer: 1
 
If an infusion falls behind schedule, the nurse should not increase the rate in an attempt to catch up, because a hyperosmotic reaction, among other reactions, could result. The solution should not be replaced by another or restarted the next day. An infusion pump should always be used to administer parenteral nutrition solution.
 
8、A child is admitted to the hospital after being seen in the emergency department with complaints of right lower quadrant abdominal pain, nausea and vomiting, fever, and chills. The health care provider suspects appendicitis. Which assessment finding should the nurse immediately report to the health care provider?
 
    1. Sudden relief of pain
    2. Decreasing oral temperature
    3. Increasing complaints of pain
    4. Refusal to take fluids by mouth
 
Correct Answer: 1
 
A sudden relief of pain from a suspected appendicitis is commonly indicative of a ruptured appendix. This places the individual at risk for peritonitis and shock. The health care provider should be notified immediately because of the need to begin intravenous antibiotics to prevent further complications. Although option 3 is a concern, the higher priority is option 1 because of the risk of peritonitis and shock. Options 2 and 3 are findings that should be monitored but are not of highest priority. The child will be placed NPO in anticipation of surgery; therefore option 4 is incorrect.
 
9、The home health nurse is reviewing medications with a client receiving colchicine for the treatment of gout. The nurse evaluates that the medication iseffective if the client reports a decrease in which measure?
 
    1. Headaches
    2. Blood glucose
    3. Blood pressure
    4. Joint inflammation
 
 Correct Answer: 4
 
Colchicine is classified as an antigout agent. It interferes with the ability of the white blood cells to initiate and maintain an inflammatory response to monosodium urate crystals. The client should report a decrease in pain and inflammation in the affected joints, as well as a decrease in the number of gout attacks. Headaches, blood glucose, and blood pressure are not associated with the use of this medication.

10、The nurse is developing a plan of care for a client with dysphagia following a stroke (brain attack). Which should the nurse include in the plan? Select all that apply.
 
    1. Thicken liquids.
    2. Assist the client with eating.
    3.Assess for the presence of a swallow reflex.
    4. Place the food on the affected side of the mouth.
    5. Provide ample time for the client to chew and swallow.
 
Correct Answer: 1,2,3,5
 
Liquids are thickened to prevent aspiration. The nurse should assist the client with eating and place food on the unaffected side of the mouth. The nurse should assess for gag and swallowing reflexes before the client with dysphagia is started on a diet. The client should be allowed ample time to chew and swallow to prevent choking. 
 
11、The emergency department nurse is assessing a client who has sustained a blunt injury to the chest wall. Which finding would indicate the presence of a pneumothorax in this client?
 
    1.  A low respiratory rate
    2. Diminished breath sounds
    3. The presence of a barrel chest
    4. A sucking sound at the site of injury
 
Correct Answer: 2
 
This client has sustained a blunt or closed-chest injury. Basic symptoms of a closed pneumothorax are shortness of breath and chest pain. A larger pneumothorax may cause tachypnea, cyanosis, diminished breath sounds, and subcutaneous emphysema. Hyperresonance also may occur on the affected side. A sucking sound at the site of injury would be noted with an open chest injury.
 
12、A client is experiencing blockage of the eustachian tubes. Which activity by the client may forcibly open the eustachian tube?
 
    1.  Performing the Valsalva maneuver
    2. Tapping the side of the head lightly
    3. Using cotton-tipped applicators in the ears
    4. Chewing food using exaggerated mouth movements
 
 Correct Answer: 1
 
Performing the Valsalva maneuver increases pressure in the nasopharynx and may help open a blocked eustachian tube. The actions described in the other options will not accomplish this.

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