1、美国护士资格认证(CGFNS)-12 及答案解析(总分：53.00，做题时间：90 分钟)一、Part One(总题数：30，分数：30.00)1.Which of the following nursing interventions would be included in the care of a client with anorexia nervosa as therapy progresses?A. Let the client eat alone to avoid embarrassment.B. Weigh the client once a week in the same
2、clothing.C. Monitor the client for self-destructive tendencies.D. Praise the client for “looking better“ and remind the client that she isnt “too fat. /（分数：1.00）A.B.C.D.2.Which one of the following clients is at the greatest risk for aspiration?A. A stroke client with dysarthria.B. An ambulatory cli
3、ent with Alzheimers disease.C. A 92-year-old client who needs help with activities of daily living (ADLs).D. A client with severe, deforming rheumatoid arthritis.（分数：1.00）A.B.C.D.3.The nurse is performing wound care. Which of the following practices violates surgical asepsis?A. Holding sterile objec
4、ts above the waist.B. Considering a 1“ (2.5 cm) edge around the sterile field as being contaminated.C. Pouring solution onto a sterile field cloth.D. Opening the outermost flap of a sterile package away from the body.（分数：1.00）A.B.C.D.4.A 34-year-old client at 32 weeks gestation tells the nurse that
5、her baby will be sick because she saw a dead dog on the road yesterday. Whats the best response by the nurse?A. “Your baby will be fine. Thats just superstition. “B. “Dont worry. Well make sure your baby is okay. “C. “I can see that you are concerned. Lets talk about whats bothering you. “D. “Perhap
6、s so. Your baby should be seen by a physician as soon as its born. /（分数：1.00）A.B.C.D.5.The nurse is providing care for a pregnant 16-year-old client. The client says that shes concerned she may gain too much weight and wants to start dieting. The nurse should respond by saying.A. “Now isnt a good ti
7、me to begin dieting because you are eating for two. “B. “Lets explore your feelings further. “C. “ Nutrition is important because depriving your baby of nutrients can cause developmental and growth problems. “D. “The prenatal vitamins should ensure the baby gets all the necessary nutrients. /（分数：1.0
8、0）A.B.C.D.6.The nurse is preparing to give a 9-year-old client a preoperative IM injection. Which size needle should the nurse use?A. 22G, .B. 22G, 1“.C. 20G, （分数：1.00）A.B.C.D.7.During the assessment of a geriatric client, a nurse would expect which findings?A. Eye structure and visual acuity change
9、s.B. Facial hair decreasing in a female client.C. Facial hair increasing in a male client.D. Wounds healing more quickly.（分数：1.00）A.B.C.D.8.The nurse is assessing a 71-year-old female client with ulcerative colitis. Which assessment finding related to the family will have the greatest impact on the
10、clients rehabilitation after discharge?A. The familys ability to take care of the clients special diet needs.B. The familys expectation that the client will resume responsibilities and role-related activities.C. Emotional support from the family.D. The familys ability to understand the ups and downs
11、 of the illness.（分数：1.00）A.B.C.D.9.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 clients need to achieve what developmental milestone?A. Autonomy.B. Init
12、iative.C. Industry.D. Identity.（分数：1.00）A.B.C.D.10.The nurse is developing a care plan for a client whos at risk for ineffective coping due to the effects of chronic illness. Which factor provides the best evidence that the client is at risk for difficulty in coping with his illness?A. Poor sleeping
13、 habits.B. Lack of social support.C. Adverse drug effects.D. Presence of panic disorder.（分数：1.00）A.B.C.D.11.The physician orders IV fluid volume replacement with lactated Ringers solution at a rate of 75 mL/hour. Using an infusion set that provides 15 gtt/mL, the nurse should calculate the flow rate
14、 to beA. 10 gtt/min.B. 12 gtt/min.C. 19 gtt/min.D. 75 gtt/min.（分数：1.00）A.B.C.D.12.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 mater
15、nal 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.（分数：1.00）A.B.C.D.13.The nurse is preparing to discharge a child who ha
16、s rheumatic fever. Which of the following medications is prescribed to prevent recurrence of rheumatic fever?A. Glucocorticoids.B. Digoxin.C. Antibiotics.D. Anti-inflammatory medications.（分数：1.00）A.B.C.D.14.While auscultating heart sounds of a client with heart failure, the nurse hears an extra hear
17、t sound immediately after the second heart sound (S2). The nurse should document this asA. a first heart sound (S1).B. a third heart sound (S3).C. a fourth heart sound (S4).D. a murmur.（分数：1.00）A.B.C.D.15.A 7-year-old boy is hospitalized with cystic fibrosis. To help him manage secretions and avoid
18、respiratory distress, the nurse shouldA. perform chest physiotherapy every 4 hours.B. give pancreatic enzymes as ordered.C. place the child in an oxygen tent and have oxygen administered continuously.D. serve a high-calorie diet.（分数：1.00）A.B.C.D.16.The nurse is assessing a client who gave birth yest
19、erday. Where should the nurse expect to find the top of the clients 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.（分数：1.00）A.B.C.D.17.The nurse is teaching parents how to reduce the spread of imp
20、etigo. The nurse should encourage parents toA. 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.（分数：1.00）A.B.C.D.18.T
21、he nurse is developing a plan to teach a mother how to reduce her babys risk of developing otitis media. Which of the following directions should the nurse include in the teaching plan?A. Administer antibiotics whenever the baby has a cold.B. Place the baby in an upright position when giving a bottl
22、e.C. Avoid getting the ears wet while bathing or swimming.D. Clean the external ear canal daily.（分数：1.00）A.B.C.D.19.37-year-old teacher is hospitalized with complaints of weakness, incoordination, dizziness, and loss of balance. The diagnosis is multiple sclerosis (MS). Which of the following signs
23、and symptoms, discovered during the history and physical assessment, is typical of MS?A. Diplopia, history of increased fatigue, and decreased or absent deep tendon reflexes.B. Flexor spasm, clonus, and negative Babinskis reflex.C. Blurred vision, intention tremor, and urinary hesitancy.D. Hyperacti
24、ve abdominal reflexes and history of unsteady gait and episodic paresthesia in both legs.（分数：1.00）A.B.C.D.20.A client with a neurogenic bladder is beginning bladder training. Which of the following nursing actions is most important?A. Set up specific times to empty the bladder.B. Force fluids.C. Pro
25、vide adequate roughage.D. Encourage the use of an indwelling urinary catheter.（分数：1.00）A.B.C.D.21.The client is to receive an IV infusion of 3000 mL of dextrose and normal saline solution over 24 hours. The nurse observes that the rate is 150mL/hour. If the solution runs continuously at this rate, t
26、he infusion will be completed inA. 12 hours.B. 20 hours.C. 24 hours.D. 50 hours.（分数：1.00）A.B.C.D.22.A 3288. 5g baby boy is born by spontaneous vaginal delivery. During the initial assessment at 1 hour postpartum, the nurse notices lanugo, acrocyanosis, mongolian spots, and hemangiomas. Which of thes
27、e is an abnormal finding in a neonate?A. Lanugo.B. Acroeyanosis.C. Mongolian spots.D. Hemangiomas.（分数：1.00）A.B.C.D.23.A client is in the first postoperative day after a total laryngectomy and radical neck dissection. Which of the following is a priority goal?A. Communicate by use of esophageal speec
28、h.B. Improve body image and self-esteem.C. Attain optimal levels of nutrition.D. Maintain a patent airway.（分数：1.00）A.B.C.D.24.The nurse-manager of a hospital unit holds monthly staff meetings. During these meetings, she maintains control over the meeting and agenda, resists consensus decision making
29、, and uses discipline and coercion to elicit desired behavior from staff. This manager uses what type of leadership style?A. Autocratic.B. Democratic.C. Participative.D. Laissez-faire.（分数：1.00）A.B.C.D.25.The nurse is teaching family members of a client with hepatitis A virus (HAV). Family members we
30、re exposed to the client and, therefore, should receive immunoglobulin. The nurse should tell the family members that immunoglobulinA. prevents hepatitis infection in all people.B. provides immunity for life.C. must be administered within 2 weeks of exposure.D. should be administered even if the per
31、son has anti-HAV antibodies.（分数：1.00）A.B.C.D.26.A recent immigrant from Vietnam is diagnosed with pulmonary tuberculosis (TB). Which intervention is most important for the nurse to implement with this client?A. Client teaching about the cause of T.B. Reviewing the risk factors for T.C. Developing a
32、list of people with whom the client has had contact.D. Client teaching about the importance of T testing.（分数：1.00）A.B.C.D.27.Which nursing action takes priority when admitting a elient with right lower lobe pneumonia?A. Elevating the head of the bed 45 to 90 degrees.B. Auscultating the chest for adv
33、entitious sounds.C. Obtaining a sputum specimen for culture.D. Notifying the physician of the clients admission.（分数：1.00）A.B.C.D.28.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. Ke
34、ep 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 clients knee.（分数：1.00）A.B.C.D.29.A woman in her 8th month of pregnancy is having dinner wi
35、th 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. Repositio
36、n the client on her side.（分数：1.00）A.B.C.D.30.A 10-year-old girl visits the clinic for a checkup before entering school. The childs mother questions the nurse about what to expect of her daughters growth and development at this stage. Which response is most appropriate?A. “Her physical development wi
37、ll be rapid at this stage, and rapid development will continue from now on. “B. “Shell become more independent and wont require parental supervision. “C. “Dont anticipate any changes at this stage in her growth and development. “D. “Friends will be very important to her, and shell develop an interes
38、t in the opposite sex. /（分数：1.00）A.B.C.D.二、Part Two(总题数：18，分数：23.00)31.The nurse is giving home care instructions to a client who just had a cataract removed and an intraocular lens implanted. What should the nurse tell the client?A. Dont sleep on the operated side.B. Wear the eye shield continuousl
39、y for 2 weeks.C. Aspirin may be taken for mild pain.D. Straining during bowel movements is allowed.（分数：1.00）A.B.C.D.Directions: The question below is followed by six choices numbered 260-265. If a choice is correct, mark A in the space provided. If a choice is not correct, mark B. Blacken one circle
40、 on your answer sheet for each number.A client is diagnosed with gout. Which foods should the nurse instruct the client to avoid?（分数：6.00）(1).Green leafy vegetables.（分数：1.00）A.正确B.错误(2).Liver.（分数：1.00）A.正确B.错误(3).Chocolate.（分数：1.00）A.正确B.错误(4).Sardines.（分数：1.00）A.正确B.错误(5).Cod.（分数：1.00）A.正确B.错误(6).E
41、ggs.（分数：1.00）A.正确B.错误32.The child with rheumatic fever must have his heart rate measured while awake and while sleeping. Why are two readings necessary?A. To obtain a heart rate that isnt affected by medication.B. To eliminate interference from the jerky movements of chorea.C. To ensure that the chi
42、ld cant consciously raise or lower the heart rate.D. To compensate for the effects of activity on the heart rate.（分数：1.00）A.B.C.D.33.The nurse is teaching a group of patient-care attendants about infection-control measures. The nurse tells the group that the first line of intervention for preventing
43、 the spread of infection isA. wearing gloves.B. administering antibiotics.C. washing hands.D. assigning private rooms for clients.（分数：1.00）A.B.C.D.34.The physician inserts a chest tube into a client to treat a pneumothorax. The tube is connected to water-seal drainage. The nurse can prevent chest tu
44、be air leaks byA. keeping the chest drainage system below the level of the chest.B. keeping the head of the bed slightly elevated.C. checking and taping all connections.D. checking patency of the chest tube.（分数：1.00）A.B.C.D.35.A gravida 2, para 1 with pregnancy-induced hypertension is receiving magn
45、esium sulfate IV, 2g/hour via infusion pump. In assessing the client, the nurse notes a decrease in respirations from 16 to 12 breaths/minute and slightly pink-tinged urine (output is 25mL/hour). The client still complains of feeling sleepy. The nurses action should includeA. checking the most recen
46、t serum level of magnesium sulfate and notifying the physician of the results.B. turning the client on her left side and taking vital signs again.C. flushing the clients indwelling urinary catheter with sterile normal saline solution to see if its draining properly.D. instructing the client to turn,
47、 cough, and deep breathe every 30 minutes.（分数：1.00）A.B.C.D.36.A 2-week postpartum client inquires about alcohol use during lactation. She tells the nurse she has heard that a small glass of wine or beer before nursing will increase her milk supply and be good for the baby. Whats the nurses best resp
48、onse?A. “Its true that a little alcohol before breast-feeding will help your milk supply because it will help you relax. “B. “Research has shown that it actually decreases the amount of milk the baby will get, perhaps because it affects the taste of your milk. “C. “A little alcohol will help you to
49、relax and the small amount that will pass through the milk may just help the baby relax. “D. “You shouldnt even consider drinking alcohol while you are nursing a baby. /（分数：1.00）A.B.C.D.37.For a client with bulimia, which assessment is least important in the care plan?A. Observe the client after eating for 1 hour.B. Note the clients intake.C. Note changes in appetite.D. Note changes in respiratory rate.（分数：1.00）A.B.C.D.38.A 28-year-old accountant is admitted to the neurologic unit after a sudden onset of blindness the day before an important projec
