16.    Why is it important to have the nurse check the temperature of water before Lolo Teryo takes a shower?*1 pointA. He may catch cold if the water temperature is too lowB. He may burn himself because of a lower pain sensitivityC. Has difficulty of discriminating between hot and coldD. He might have lower pain threshold17.    The nurse encouraged Lolo Teryo to attend early morning exercise. He becomes tired and short of breath. The nurse interprets this as*1 pointA. Changes in the cardiovascular systemB. Attributed to his sedentary lifestyleC. Effects of his depression on his staminaD. Medication the doctor might give him18.    According to studies and literature, which of the following is most important for Lolo Teryo to maintain a healthy, adaptive old age?*1 pointA. To remain socially interactiveB. To disengage slowly in preparation to last stage of lifeC. To move in with his son and familyD. To maintain total independence and accept helpSituation: Danny  a 46 year old patient admitted to the coronary care unit (CCU) with an MI and frequent premature ventricular contractions (PVCs) has doctor orders for continuous amiodarone infusion, IV nitroglycerin infusion, and morphine sulfate 2 mg IV every 10 minutes until there is relief of pain. She is taken care of by Leona, a newly graduate nurse.19.    Because of Danny’s premature ventricular contraction, the nurse should monitor its effects on which of the following parameters?*1 pointA. Electrolyte levelsB. Apical radial heart rateC. Oxygen saturationD. Medications20.    In analyzing a patient’s electrocardiographic (ECG) rhythm strip, Leona uses the knowledge that the time of the conduction of an impulse through the Purkinje fibers is represented by*1 pointA. PR intervalB. QT intervalC. QRS complexD. P wave21.    A considerable difference between the apical and radial pulse rate of Danny would indicate*1 pointA. Stronger left than right ventricular musclesB. Numerous weak ineffectual cardiac contractionsC. Thickened myocardium and large heart chambersD. Increased pressure in systemic arteries22.    As Danny is assessed he complains of being nauseated and very weak. The nurse should*1 pointA. Perform nutritional assessmentB. Alert staff for potential helpC. Explore and discuss possible effect of stressD. Provide reassurance while focusing on pleasant topics23.    The Physician scheduled for an exercise electrocardiogram (stress test). What information should the nurse include when explaining the value of this test? Exercise stress testing is a: *1 pointA. definitive method to diagnose the cause of chest painB. diagnostic modality of minimal value in planning treatment of anginaC. noninvasive means of assessing cardiovascular conduction and functionD. minimally invasive manner of assessing a body’s reaction to increase in exerciseSITUATION: You are caring for a married woman who underwent modified radical left mastectomy24.    On admission to Post-anesthesia Care Unit, you read the OR report which indicates that estimated blood loss during surgery was 1000mL. From the list below, select the MOST objective indicator for the nurse to monitor closely.*1 pointA. Changes in vital signsB. Altered level of consciousnessC. Soaked dressingD. Pupillary reaction to light25.    You assisted positioning the client. Her left arm should be placed in which of the following manner?*1 pointA. Placed above the level of the heartB. Hyperextended away from the chestC. Placed at the level of the heart and the hand below the heartD. Adducted and flexed26.    When the patient woke up from anesthesia, she refuses to see her husband. She remarks that she is “not the same person, no longer a woman; much, much less a wife.” Which psychosocial nursing diagnosis would best describe this situation?*1 pointA. Altered role performance r/t impaired physical functionB. Anxiety r/t surgical removal of the breastC. Altered body image r/t perception of disfigurement and incapacityD. Self-esteem disturbance r/t changing ability to perform basic wife function27.    The client was obviously withdrawn although her recovery from the surgery was uneventful. How can the nurse be of best help during this period of recovery?*1 pointA. Allowing the client to have more time to herselfB. Encouraging the client to have more time to verbalize concerns with her familyC. Allowing the client to talk with other clients in the ward who had the same kind of surgeryD. Allowing the patient more time to reflect about the effects of surgery28.    During the first 8 hours postoperative, the total drainage from the Jackson-Pratt drain attached to the wound totaled to 25 mL. What is your next best action?*1 pointA. Do nothing as the drainage is expectedB. Empty the Jackson-Pratt deviceC. Notify the surgeon statD. Inform the client that her wound is draining well.Situation: Gerard 56 years old underwent partial gastrectomy with gastrojejunostomy.29.    The nurse identified iron deficiency anemia as a potential problem. Which of the following specifically would predispose the patient to this problem?*1 pointA. Rapid gastric emptying due to gastrojejunostomyB. Inadequate intake of food rich in ironC. Excessive loss of blood during surgeryD. Inability to eat large meals30.    The nurse understands that iron deficiency anemia results in decreased RBC which are:*1 pointA. Abnormally crescent shapedB. Large and immatureC. Microcytic and hypochromicD. Fragile and megaloblastic