美国护士资格认证(CGFNS)冲刺试卷一2017年
1.The nurse has a client at 30 weeks' gestation who has tested positive for the human immunodeficiency virus (HIV). What should the nurse tell the client when she says that she wants to breast-feed her neonate ？（）
A Encourage breas-feeding so that she can get her rest and get healthier.
B Encourage breast-feeding because it's healthier for the neonate.
C Encourage breast-feeding to facilitate bonding.
D Discourage breast-feeding because HIV can be transmitted through breast milk.
2.Which client has the highest risk of ovarian cancer ？（）
A 30-year-old woman taking oral contraceptive pills.
B 45-year-old woman who has never been pregnant.
C 40-year-old woman with three children.
D 36-year-old woman who had her first child at age 22.
3.The nurse is providing postoperative care for a client recovering from abdominal surgery. The client is receiving morphine through a client-controlled analgesia pump. Which finding would indicate that the client is obtaining adequate pain relief ？（）
A Awakening several times during the night to redose.
B Respiratory rate of 10 breaths/minute.
C Pain rating of 2 or 3 on a scale of 0 to 10.
D Complaint of itching as an adverse effect of the analgesia.
4.The nurse is caring for a client who underwent a total hip replacement. What should the nurse and other caregivers do to prevent dislocation of the new prosthesis ？（）
A Keep the affected leg in a position of adduction.
B Use measures other than turning to prevent pressure ulcers.
C Prevent internal rotation of the affected leg.
D Keep the hip flexed by placing pillows under the client's knee.
5.The nurse is assessing a client who gave birth yesterday. Where should the nurse expect to find the top of the client's fundus ？（）
A One fingerbreadth above the umbilicus.
B One fingerbreadth below the umbilicus.
C At the level of the umbilicus.
D Below the symphysis pubis.
6.The nurse is giving instructions to a client who is going home with a cast on his leg. Which point is most critical ？（）
A Using crutches properly.
B Exercising joints above and below the cast, as ordered.
C Avoiding walking on a leg cast without the physician's permission.
D Reporting signs of impaired circulation.
7.A male client with a total hip replacement is progressing well and expects to be discharged tomorrow. On returning to bed after ambulating, he complains of severe pain in the surgical wound. Which action should the nurse take ？（）
A Assume he's anxious about discharge, and administer pain medication.
B Assess the surgical site and affected extremity.
C Reassure the client that pain is a direct result of increased activity.
D Suspect a wound infection, and monitor the client's temperature and vital signs.
8.In planning a presentation that advocates a decrease in the client-to-nurse ratio from 8:1 to 6:1, a nurse should emphasize its effect on （）.
A institutional resources.
B standards of practice.
C client-care quality.
D nursing recruitment.
9.The nurse is interviewing a 19-year-old female at a clinic. It's her first visit, and she says that she has been exposed to herpes by her boyfriend. Initially, with primary genital or type 2 herpes simplex, the nurse would expect the client to have （）.
A burning or tingling on the vulva, perineum, or vagina.
B dysuria and urine retention.
C perineal ulcers and erosions.
D bilateral inguinal lymphadenopathy.
10.The nurse is caring for a client infected with methicillin-resistant Staphylococcus aureus (MRSA). What's the major infection control measure to reduce MRSA and other nosocomial pathogens in a health care setting ？（）
A Using antibacterial soap when bathing clients with MRSＡ.
B Conducting culture surveys periodically.
C Ensuring that personnel wash their hands before and after contact with every client.
D Using specific housekeeping practices for environmental cleaning.
11.The nurse is providing care for a postoperative client who has undergone a small bowel resection. The nurse may use an epidural catheter for which of the following ？（）
A Antibiotic therapy.
B Pain management.
C Blood transfusion.
D Anticoagulation.
12.A client has just finished his glucose tolerance test. How many hours should it take for his blood glucose level to return to normal ？（）
A 2 hours.
B 3 hours.
C 5 hours.
D 6 hours.
13.The nurse is teaching a client who receives nitrates for the relief of chest pain. Which of the following instructions should the nurse emphasize ？（）
A Repeat the dose of sublingual nitroglycerin every 15 minutes for three doses.
B Store the drug in a cool, well-lit place.
C Lie down or sit in a chair for 5 to 10 minutes after taking the drug.
D Restrict alcohol intake to two drinks per day.
14.The nurse is teaching a new group of mental health aides. The nurse should teach the aides that setting limits is most important for （）.
A a depressed client.
B a manic client.
C a suicidal client.
D an anxious client.
15.The nurse is administering sublingual nitroglycerin to a client with chest pain. The nurse should place the medication （）.
A in the cheek.
B on the tip of the tongue.
C under the tongue.
D under the lower lid of the eye.
16.The physician orders IV fluid volume replacement with lactated Ringer's solution at a rate of 75 mL/hour. Using an infusion set that provides 15 gtt/mL, the nurse should calculate the flow rate to be （）.
A 10 gtt/min.
B 12 gtt/min.
C 19 gtt/min.
D 75 gtt/min.
17.A client is receiving chemotherapy for cancer. The nurse reviews his laboratory report and notes that he has thrombocytopenia. To which nursing diagnosis should the nurse give the highest priority ？（）
A Activity intolerance.
B Impaired tissue integrity.
C Impaired oral mucous membranes.
D Ineffective tissue perfusion (cerebral, cardiopulmonary, GI).
18.A client hospitalized with pneumonia has thick, tenacious secretions. To help liquefy these secretions, the nurse should （）.
A turn the client every 2 hours.
B elevate the head of the bed 30 degrees.
C encourage increased fluid intake.
D maintain a cool room temperature.
19.While auscultating heart sounds of a client with heart failure, the nurse hears an extra heart sound immediately after the second heart sound (S2). The nurse should document this as （）.
A a first heart sound (S1).
B a third heart sound (S3).
C a fourth heart sound (S4).
D a murmur.
20.The nurse is caring for an elderly female with osteoporosis. When teaching the client, the nurse should include information about which major complication ？（）
A Bone fracture.
B Loss of estrogen.
C Negative calcium balance.
D Dowager's hump.
21.A client in her 36th week of pregnancy is admitted to the hospital with vaginal bleeding. After undergoing an ultrasonic scan, she's diagnosed with placenta previa. Which assessment finding would best confirm this diagnosis ？（）
A A rigid abdomen.
B A soft, nontender uterus.
C Painful vaginal bleeding.
D Hypotension.
22.A female client has just been diagnosed with condylomata acuminata (genital warts). What information is appropriate to tell this client ？（）
A This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) test annually.
B The most common treatment is metronidazole (Flagyl), which should eradicate the problem within 7 to 10 days.
C The potential for transmission to her sexual partner will be eliminated if condoms are used every time they have sexual intercourse.
D The human papillomavirus (HPV), which causes condylomata aeuminata, can't be transmitted during oral sex.
23.The nurse is providing home care to a client with failing vision due to macular degeneration. The nurse is concerned about the client's safety. Which of the following activities would help to lessen the client's risk of falling ？（）
A Arranging pieces of furniture close together so the client can use them for guidance and support.
B Encouraging the client to wear a medical identification bracelet that describes the client's visual deficit.
C Installing a flashing light to indicate when the phone or doorbell is ringing.
D Installing handrails in hallways, in bathrooms, and on steps.
24.A 14-year-old female client in skeletal traction for treatment of a fractured femur is expected to be hospitalized for several weeks. When planning care, the nurse should take into account the client's need to achieve what developmental milestone ？（）
A Autonomy.
B Initiative.
C Industry.
D Identity.
25.When inserting a urinary catheter, the nurse can facilitate the insertion by asking the client to （）.
A initiate a stream of urine.
B breathe deeply.
C turn to the side.
D hold the labia or shaft of penis.
26.The nurse is assessing a client with possible osteoarthritis. The most significant risk factor for osteoarthritis is （）.
A congenital deformity.
B age.
C trauma.
D obesity.
27.The nurse is caring for a client admitted to the hospital with a bowel obstruction. The nurse should wear sterile gloves when （）.
A inserting an indwelling urinary catheter.
B giving a back rub on intact skin.
C changing an oxygen system.
D inserting an IV catheter.
28.A client is taking spironolactone (Aldactone) to control her hypertension. Her serum potassium level is 6 mEq/L. For this client, the nurse's priority would be to assess her （）.
A neuromuscular function.
B bowel sounds.
C respiratory rate.
D electrocardiogram (ECG) results.
29.A primigravida client with acquired immunodeficiency syndrome (AIDS) is in labor at term. In preparing her nursing care plan, the nurse should include which of the following nursing diagnoses ？（）
A Risk for fetal or maternal injury related to the crisis of childbearing.
B Risk for infection related to suppressed immune status.
C Risk for deficient fluid volume related to dehydration.
D Risk for fetal injury related to uteroplacental insufficiency.
30.A client has been prescribed 75 mg of amitriptyline (Elavil) at bedtime and 15 mg of phenelzine (Nardil) three times per day. Which nursing action takes priority ？（）
A Teaching the client about the adverse effects.
B Calling the physician and questioning the order.
C Instituting dietary restrictions.
D Taking baseline vital signs.
31.A client with coronary artery disease reports intermittent chest pain that occurs with exertion. The physician prescribes sublingual nitroglycerin. When teaching the client about nitroglycerin administration, the nurse should include which instruction ？（）
A "Be careful after taking nitroglycerin because it may cause dizziness. "
B "Make sure you replace your nitroglycerin tablets every 6 months to ensure potency. "
C "A burning sensation after taking nitroglycerin indicates medication potency. "
D "When you experience chest pain, take one tablet every 30 minutes until the pain is relieved. "
32.The nurse is admitting a client with a suspected fluid imbalance. The most sensitive indicator of body fluid balance is （）.
A daily weight.
B serum sodium levels.
C measured intake and output.
D blood pressure.
33.The nurse is caring for a client who has hemoconcentration after fluid loss. Which IV fluids would be the most appropriate fluid replacement therapy for this client ？（）
A Distilled water.
B Dextrose 5% in water (D5W) only.
C DSW with 40 mEq of potassium chloride.
D Dextrose 10% in saline.
34.A client's blood glucose level is 45 mg/dL. The nurse should be alert for which signs and symptoms ？（）
A Coma, anxiety, confusion, headache, and cool, moist skin.
B Kussmaul's respirations, dry skin, hypotension, and bradycardia.
C Polyuria, polydipsia, hypotension, and hypernatremia.
D Polyuria, polydipsia, polyphagia, and weight loss.
35.A client is admitted for a suspected eating disorder. Which of the following statements would indicate that the client may be suffering from anorexia nervosa ？（）
A "I've gained 3 pounds in the last month. "
B "I eat loads of spinach and yellow vegetables each day. "
C "I'm a perfectionist, and I work hard to get A's. "
D "I binge frequently in the morning and feel fat. "
36.An elderly client with Alzheimer's disease begins supplemental tube feedings through a gastrostomy tube to provide adequate calorie intake. The nurse should be concerned most with the potential for （）.
A hypoglycemia.
B fluid volume excess.
C aspiration.
D constipation.
37.The nurse is teaching parents how to reduce the spread of impetigo. The nurse should encourage parents to （）.
A teach children to cover mouths and noses when they sneeze.
B have their children immunized against impetigo.
C teach children the importance of proper hand washing.
D isolate the child with impetigo from other members of the family.
38.When reporting to the surgeon that a chest tube is malfunctioning, the nurse is ordered to reposition the tube and obtain a chest radiograph. The nurse should （）.
A inform the surgeon this isn't within her scope of practice.
B report the surgeon to the Ethics Committee.
C report the surgeon to the nursing supervisor.
D follow the order as requested by the surgeon.
39.Which one of the following clients is at the greatest risk for aspiration ？（）
A A stroke client with dysarthria.
B An ambulatory client with Alzheimer's disease.
C A 92-year-old client who needs help with activities of daily living (ADLs).
D A client with severe, deforming rheumatoid arthritis.
40.A client with heart failure develops pink frothy sputum, coarse crackles, and restlessness. Which of the following actions should the nurse take first ？（）
A Check the client's blood pressure.
B Place the client in high Fowler's position.
C Calculate the client's fluid balance.
D Notify the physician.
41.A woman in her 8th month of pregnancy is having dinner with her husband at their favorite restaurant. The woman suddenly chokes on a piece of chicken and appears to lose consciousness. What would be the best action by a nurse sitting at the next table ？（）
A Apply abdominal thrust.
B Apply chest thrust.
C Begin cardiopulmonary resuscitation (CPR).
D Reposition the client on her side.
42.The nurse is caring for four clients on a step-down intensive care unit. The client at the highest risk for developing nosocomial pneumonia is the one who （）.
A has a respiratory infection.
B is intubated and on a ventilator.
C has pleural chest tubes.
D is receiving feedings through a jejunostomy tube.
43.While evaluating the needs of a client during the second trimester, the nurse can anticipate which of the following ？（）
A Feelings of disbelief and ambivalence.
B Feelings of clumsiness and "ugliness".
C Increasing introspection but a general sense of well-being.
D Anxiety about the labor and delivery experience.
44.A high school student is referred to the school nurse for suspected substance abuse. Following the nurse's assessment and interventions, what would be the most desirable outcome ？（）
A The student discusses conflicts over drug use.
B The student accepts a referral to a substance abuse counselor.
C The student agrees to inform his parents of the problem.
D The student reports increased comfort with making choices.
45.Which procedure or practice is associated with surgical asepsis ？（）
A Hand washing.
B Nasogastrie (NG) tube irrigation.
C Colostomy irrigation.
D IV catheter insertion.
46.A client is admitted for detoxification after a cocaine overdose. The client tells the nurse that he frequently uses cocaine but that he can control his use if he chooses. Which coping mechanism is he using ？（）
A Withdrawal.
B Logical thinking.
C Repression.
D Denial.
47.The nurse is developing a teaching plan for a client diagnosed with diabetes insipidus. The nurse should include information about which hormone, commonly lacking in clients with diabetes insipidus ？（）
A Antidiuretic hormone (ADH).
B Thyroid-stimulating hormone (TSH).
C Follicle-stimulating hormone (FSH).
D Luteinizing hormone (LH).
48.To assess a client's cranial nerve function, the nurse should （）.
A assess hand grip.
B assess orientation to person, time, and place.
C assess arm drifting.
D assess gag reflex.
49.A nurse performs cardiopulmonary resuscitation (CPR) for 1 minute on an infant without calling for assistance. In reassessing the infant after I minute of CPR, the nurse finds that he still isn't breathing and that he has no pulse. The nurse should then （）.
A resume CPR beginning with breaths.
B declare her efforts futile.
C resume CPR beginning with chest compressions.
D call for assistance.
50.A family member is caring for a client diagnosed with Alzheimer's disease. Which of the following is most likely to cause the caregiver depression and role strain ？（）
A The caregiver had a close relationship with the client before diagnosis of the illness.
B The caregiver has no formal support, such as a visiting nurse or day care worker.
C The caregiver understands the full reality of the disease and its inevitable progression.
D The caregiver feels unable to control the client and unable to cope with caregiving.