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Medical Examination CCNS この世界は毎日変わっています。

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CCNS PDF DEMO:

QUESTION NO: 1
When planning discharge teaching for an adolescent patient who had an ileostomy, the nurse should
place primary emphasis on:
A. Informing the patient about the ileostomy association
B. Telling the patient whom to contact if assistance is needed
C. Encouraging the patient to return to school or work as soon as possible
D. Teaching the patient the importance of irrigations to regulate bowel movements
Answer: B
Explanation: When planning discharge teaching for an adolescent patient who had an ileostomy, the nurse should place primary emphasis on telling the patient whom to contact if assistance is needed.
The
patient should know there is help available, even though direct supervision is no longer provided.

QUESTION NO: 2
A seventeen-year-old female patient is receiving furosemide, 40 mg P.O. twice daily. In the plan of care,
the nurse should emphasize teaching the patient about the importance of consuming:
A. Lean red meat
B. Bananas and oranges
C. Fresh, green vegetables
D. Creamed corn
Answer: B
Explanation: In the plan of care, the nurse should emphasize teaching the patient about the importance of
consuming bananas and oranges. Because furosemide is a potassium-wasting diuretic, the nurse should
plan to teach the patient to increase intake of potassium-rich foods, such as bananas and oranges.
Fresh,
green vegetables; lean red meat; and creamed corn are not good sources of potassium.

QUESTION NO: 3
A nurse is caring for patient who is scheduled for nephrectomy due to a renal cell carcinoma of the right
kidney. It appears that the left kidney is normal. The nurse observes that the patient is anxious and in doubt whether dialysis will ultimately be a necessity. The nurse should plan to use which information in
discussing this with the patient?
A. Dialysis could become likely, but it depends on how the patient complies with restrictions after the surgery
B. One kidney is adequate to meet the needs of the body, so long as it has a normal function
C. There is likelihood that the patient will need dialysis within the next 3-10 years
D. There is no need for dialysis because of the nature of the surgery
Answer: B
Explanation: When discussing this with the patient, the nurse should explain that one kidney is adequate
to meet the needs of the body, so long as it has a normal function. This patient needs emotional support
and reassurance that the remaining kidney should be able to fully meet the body's metabolic needs.

QUESTION NO: 4
A 20-year-old patient was diagnosed with neutropenia. When teaching the patient and his family, the
nurse should include the avoidance of:
A. Using suppositories or enemas
B. Using a filter mask
C. Performing oral hygiene after every meal
D. Performing perineal hygiene after each bowel movement
Answer: A
Explanation: When teaching the patient and his family, the nurse should include the avoidance of using
suppositories or enemas. A neutropenic patient is at high risk for infection, especially from bacterial infection of the gastrointestinal and respiratory tract.

QUESTION NO: 5
Which of the following findings, if identified in a patient who is being treated for hypovolemic shock, should
indicate to the nurse that the treatment is having the desired effect?
A. Pulse oximeter reading of 99%
B. Temperature of 98.4oF
C. Urine output of 30 mL/hr
D. CVP of 40 mmHg
Answer: C
Explanation: A finding, if identified in a patient who is being treated for hypovolemic shock, that should
indicate to the nurse that the treatment is having the desired effect, is a urine output of 30 mL/hr.
Management of hypovolemic shock includes monitoring of fluid balance. A diminished urinary output is
characteristic, thus fluid replacement therapy would adequately perfuse the kidneys and increase urine
output.

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Updated: May 25, 2022