Expiration Date: December 31, 2010. No CE contact hours (CH) will be given after this date.
This continuing education module should be taken ONLY by those who have purchased the Medical-Surgical Nursing Review & Resource Manual. During the process of purchasing this CE module, you will be asked to input the proof of purchase code which can be obtained by sending an e-mail to revmanuals@ana.org.
The actual questions that will be on the test have been posted below. The link to the test is at the bottom of the page.
When you purchase the CE module, you will be issued a password which will allow you to access all CE modules purchased on the NursingWorld Web site. This password is NOT to be confused with the proof of purchase code you received when you purchased the manual. It is important that you remember this password, as you MUST use it if you wish to log out of the system and return at a later time to take the test or to print duplicates of your certificate of completion.
IMPORTANT NOTE: The test for Contact Hours for the Medical-Surgical Nursing Review & Resource Manual contains 25 questions. You may find that you are not able to complete the entire test in one sitting. If this is the case, simply click on "Grade My Test" at the bottom of the test page even though you have not yet completed the test. This will allow the system to store your test for your return visit.
When you wish to return, click on "Log Back In" from the CE home page menu and input the CE password you were issued when you first registered for ANA's online CE. Again, do not input the purchse code you were issued as proof of purchase of the manual. Once you are logged back into the system, you will see a list of the ISMs you have completed and ones that are incomplete. Click on "Take Test" next to any incomplete ISM and you will be told how many questions you have completed and how many are left to complete.
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Test Questions
1. Outcomes that are focused on the cost of care, resource utilization, and length of service are:
a. Health care provider outcomes
b. Patient outcomes
c. System outcomes
d. Functional outcomes
2. Hospitalized patients have all of the following rights except the right to :
a. Information about diagnosis, treatment and prognosis
b. Review information in the clinical record
c. Move freely in all areas of the hospital
d. Courteous and respectful care
3. Mrs. Deluth is a 68-year-old Caucasian female with a history of bilateral oophorectomy at age 34 with estrogen replacement therapy. She recently has been diagnosed with metabolic syndrome and hypertension. When teaching her about ways to reduce her risk for coronary heart disease, which of the following statements would be most beneficial?
a. Metabolic syndrome and hypertension are two modifiable risk factors that if reduced or eliminated can lessen the risk for coronary heart disease.
b. Since you are a Caucasian female, your risk is much higher for heart attack and stroke than for African-American females.
c. Since you had both of your ovaries remove before age 35, you are at a very high risk for coronary heart disease.
d. Your age and the fact that you are female places you in the highest risk category for coronary heart disease, even more so than men and both men and women of African American or Hispanic origins.
4. When administering your patient sublingual nitroglycerin, he tells you that he thinks that something is wrong with the medication because he has a burning or tingling sensation under his tongue, which does not happen with his nitroglycerin at home. Your response is:
a. You are probably right. If your blood pressure is stable, I will give you another nitroglycerin and report this finding to pharmacy administration immediately.
b. That is just a local reaction to the medication. Nothing to worry about.
c. This is supposed to happen with sublingual nitroglycerin administration. You should probably check to make sure your pills at home are not expired.
d. Thank you for reporting this. Sometimes nitroglycerin has this effect when it is ready to expire. We will get you another one right away.
5. Your patient has a history of mitral regurgitation with a mechanical prosthetic valve replacement. Which history question is most important to ask during the initial interview?
a. Do you have any past medical history of bacterial endocarditis or rheumatic heart disease?
b. Does anyone else in your family have mitral stenosis or other valve disorders?
c. Do you understand that you will have to be on lifelong medication(s) to prevent blood clots?
d. Did you know that you will need prophylactic antibiotic treatment prior to any and all dental procedures for the rest of your life?
6. Increased tactile fremitus may be noted with which of the following conditions?
a. Atelectasis
b. Emphysema
c. Pneumothorax
d. Lobar pneumonia
7. The depth of patients' inspiration is necessary to assess. It is important for the nurse to understand the concept of anatomical dead space. This refers to
a. the amount of air that can be inhaled over the tidal volume.
b. the amount of air that is forced out over the tidal volume.
c. the amount of air that is in the passageway that never reaches the alveoli.
d. the amount of air that remains in the lungs after a forced expiration.
8. Which patient is at the greatest risk for developing an aspergillus infection?
a. 55-year-old female with osteoporosis
b. 22-year-old male with gonorrhea
c. 67-year old male with benign prostatic hypertrophy
d. d. 35-year old female undergoing chemotherapy for breast cancer
9. Which of the following diagnostic tests is the most accurate way to determine body fat?
a. Body mass index
b. Anthropometry
c. Underwater weighing
d. Bioelectrical impedance
10. L.L. is a 70-year-old male with severe diarrhea. The most important nursing concern for him is
a. pain and discomfort.
b. dehydration.
c. embarrassment.
d. skin breakdown.
11. A patient with diabetes may suffer from what type of urinary incontinence?
a. Stress
b. Urge
c. Overflow
d. Functional
12. The anterior pituitary gland secretes which of the following hormones?
a. Thyroid-stimulating hormone (TSH), follicle-stimulating hormone (FSH)
b. Antidiuretic hormone (ADH), oxytocin
c. Thyroid hormone (TH), parathyroid hormone (PTH)
d. Aldosterone, cortisol
13. The nurse assesses a client and notes that the patient has an increased lumbar curve of the spine. This is documented as
a. scoliosis.
b. kyphosis.
c. Phalen's sign.
d. lordosis.
14. A patient with gout asks about foods that may make the gout worse. You realize that there are many items are high in purine, but which of the following items could precipitate an attack for him?
a. Alcohol
b. Eggs
c. Peaches
d. Green beans
15. Which of the following nursing diagnoses for a stroke victim would most affect the self-esteem of the patient?
a. Altered sensation
b. Risk for constipation
c. Impaired swallowing
d. Self-care deficit
16. On admitting a patient with Stage 2 Alzheimer's disease for treatment of a urinary tract infection (UTI), you note that the caregiver and patient have unkempt appearances. The caregiver keeps her eyes downcast during the initial interview and frequently avoids answering questions. These observations cause concern for
a. caregiver role strain.
b. physical abuse.
c. rapidly declining cognitive status.
d. excessive financial burden.
17. Which of the following nursing interventions is MOST important to prevent spread of infection when working with a patient who has methicillin-resistant Staphylococcus aureus (MRSA) cellulitis?
a. Limit the number of persons allowed to visit the patient
b. Practice good handwashing
c. Cover the wound with two layers of gauze
d. Monitor the patient for signs of systemic infection, such as fever, chills
18. You, the nurse, find a diabetic patient lying in bed mumbling incoherently. She is mildly diaphoretic. Your FIRST action is:
a. Document your observations
b. Check the patient's blood sugar
c. Give 50 gm of oral glucose solution
d. Call the physician
19. The nurse documents that the patient has pain with adduction of the left arm. This indicates the pain occurs
a. when the elbow is flexed to 90 degrees.
b. when the palm is facing downward.
c. when the arm is moved away from the body midline.
d. when the arm is moved toward the body midline.
20. Multiple rib fractures may result in a flail chest. Coughing and deep breathing are encouraged to prevent what common complication of this condition?
a. Liver laceration
b. Severe pain
c. Pneumothorax
c. Pneumonia
21. Which of the following theorists described the grieving process in terms of protest, despair, and detachment?
a. Bowlby
b. Kübler-Ross
c. Carter
d. Freud
22. The characteristic lesion seen in psoriasis is:
a. Firm red spots that join to form a circumscribed hot lesion
b. Well-demarcated erythematous plaque that sheds gray flakes
c. Open lesion that oozes a honey-colored liquid that hardens into a crust
d. Enlarged firm mass seen along the hair line
23. The medical-surgical nurse knows that pressure, friction, and shearing forces are the most common causes of pressure ulcers. Which of the following is not an example of a shearing force that could lead to a pressure ulcer?
a. A hospitalized patient in bed with the head of the bed raised 90 degrees
b. Pulling a patient up in the bed using the armpits as levers to slide them upward
c. Pulling the patient up in bed by lifting the entire body up toward the head of the bed
d. The hospitalized patient positioned in bed to watch television for 4 hours with the head of the bed elevated 60 degrees
24. In regard to normal skin remodeling after a burn, an overgrowth of dermal tissue that remains within the boundaries of the wound is called a
a. hypertrophic scar.
b. keloid.
c. normal scar.
d. proliferation scar.
25. Which of the following is a colloid solution that could be used in the treatment of shock?
a. D5W
b. RL
c. 0.9% NS
d. 5% albumin
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