1、美国护士资格认证(CGFNS)-1 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.After delivering her second child, the client tells the nurse that she wants to breast-feed. She indicates that she was unsuccessful at breast-feeding her first child and that she bottle-fed after 3 days of trying to nurse. Whi
2、ch of the following responses would best support this clients breast-feeding efforts?A. “Ill make sure that youre seen by the lactation consultant before youre discharged. “B. “Its important to room-in with your neonate so that you can respond to her nursing: cues, “C. “Dont worry, every baby is dif
3、ferent, and Im sure that youll be successful this time. “D. “Breast-feeding is possible but you must be committed to it. /（分数：1.00）A.B.C.D.2.A hospitalized client who has a living will is being fed through a nasogastric (NG) tube. During a bolus feeding, the client vomits and begins choking. Which o
4、f the following actions is most appropriate for the nurse to take?A. Clear the clients airway.B. Make the client comfortable.C. Start eardiopulmonary resuscitation.D. Stop the feeding and remove the NG tube.（分数：1.00）A.B.C.D.3.A client admitted for a hysterectomy has a secondary diagnosis of Mnire s
5、disease. Which of the following nursing interventions should the nurse include in the clients plan of care to decrease the effects of tinnitus?A. Reduce the amount of glucose and cholesterol in the diet.B. Encourage the client to listen to the radio with earphones.C. Encourage a weight-reduction die
6、t.D. Administer antihypertensive medications as ordered.（分数：1.00）A.B.C.D.4.A 45-year-old auto mechanic comes to the physicians office because an exacerbation of his psoriasis is making it difficult to work. He tells the nurse that his finger joints are stiff and sore in the morning. The nurse should
7、 respond byA. inquiring further about this problem because psoriatic arthritis can accompany psoriasis vulgaris.B. suggesting he take aspirin for relief because its probably early rheumatoid arthritis.C. validating his complaint but assuming its an adverse effect of his vocation.D. asking him if he
8、has been diagnosed or treated for carpal tunnel syndrome.（分数：1.00）A.B.C.D.5.A client is admitted to the hospital with an exacerbation of his chronic gastritis. When assessing his nutritional status, the nurse should expect a deficiency inA. vitamin .B. vitamin 6.C. vitamin 12.D. vitamin .（分数：1.00）A.
9、B.C.D.6.Which vaginal infection doesnt require treatment for sexual partners?A. Neisseria gonorrhoeae.B. Candida albicans.C. Trichomonas vaginalis.D. Chlamydia trachomatis.（分数：1.00）A.B.C.D.7.The nurse is assisting with a subclavian vein central line insertion when the clients oxygen saturation rapid
10、ly drops. He complains of shortness of breath and becomes tachypneic. The nurse suspects a pneumothorax has developed. Further assessment findings supporting the presence of a pneumothorax includeA. diminished or absent breath sounds on the affected side.B. paradoxical chest wall movement with respi
11、rations.C. tracheal deviation to the unaffected side.D. muffled or distant heart sounds.（分数：1.00）A.B.C.D.8.Which of the following functions would the nurse expect to be unrelated to the placenta?A. Production of estrogen and progesterone.B. Detoxification of some drugs and chemicals.C. Exchange site
12、 for food, gases, and waste.D. Production of maternal antibodies.（分数：1.00）A.B.C.D.9.While performing rounds, a nurse finds that a client is receiving the wrong IV solution. The nurses initial response should be toA. remove the IV catheter and call the physician.B. write up an incident report describ
13、ing the mistake.C. slow the IV flow rate and hang the appropriate solution.D. wait until the next bottle is due and then change to the proper solution.（分数：1.00）A.B.C.D.10.A client with a history of heart failure is examined in the outpatient department to investigate the recent onset of peripheral e
14、dema and increased shortness of breath. Physical findings include bilateral crackles, a third heart sound (S3), distended neck veins, elevated blood pressure, and pitting edema of the ankles. The nurse documents the severity of pitting edema as +1. What is the best description of this type of edema?
15、A. Barely detectable depression when the thumb is released from the swollen area; normal foot and leg contours.B. Detectable depression of less than 5 mm when the thumb is released from the swollen area; normal foot and leg contours.C. A 5-to 10-mm depression when the thumb is released from the swol
16、len area; foot and leg swelling.D. A depression of more than 1 cm when the thumb is released from the swollen area; severe foot and leg swelling.（分数：1.00）A.B.C.D.11.A client who has a potassium level of 6 mEq/L should be treated withA. antacids.B. IV fluids.C. fluid restriction.D. sodium polystyrene
17、 sulfonate (Kayexalate).（分数：1.00）A.B.C.D.12.The nurse is providing home care instructions to a client who has recently had a skin graft. Which instruction is most important for the client to remember?A. Use cosmetic camouflage techniques.B. Protect the graft from direct sunlight.C. Continue physical
18、 therapy.D. Apply lubricating lotion to the graft site.（分数：1.00）A.B.C.D.13.A 38-year-old client is admitted for alcohol withdrawal. The most common early sign or symptom that this client is likely to experience isA. impending coma.B. manipulating behavior.C. suppression.D. perceptual disorders.（分数：1
19、.00）A.B.C.D.14.The nurse is caring for a client with left-sided heart failure. To reduce fluid volume excess, the nurse can anticipate usingA. antiembolism stockings.B. oxygen.C. diuretics.D. anticoagulants.（分数：1.00）A.B.C.D.15.A client with no known history of peripheral vascular disease comes to th
20、e emergency department complaining of sudden onset of lower leg pain. Inspection and palpation reveal absent pulses, paresthesia, and a mottled, cyanotic, cold, and cadaverous left calf. While the physician determines the appropriate therapy, the nurse shouldA. place a heating pad around the affecte
21、d calf.B. elevate the affected leg as high as possible.C. keep the affected leg level or slightly dependent.D. shave the affected leg in anticipation of surgery.（分数：1.00）A.B.C.D.16.After insertion of a chest tube for a pneumothorax, a client becomes hypotensive with neck vein distention, tracheal sh
22、ift, absent breath sounds, and diaphoresis. The nurse suspects a tension pneumothorax has occurred. What cause of tension pneumothorax should the nurse check for?A. Infection of the lung.B. Kinked or obstructed chest tube.C. Excessive water in the water-seal chamber.D. Excessive chest tube drainage.
23、（分数：1.00）A.B.C.D.17.A client with an indwelling urinary catheter is suspected of having a urinary tract infection. The nurse should collect a urine specimen for culture and sensitivity byA. disconnecting the tubing from the urinary catheter and letting the urine flow into a sterile container.B. wipi
24、ng the self-sealing aspiration port with antiseptic solution and aspirating urine with a sterile needle.C. draining urine from the drainage bag into a sterile container.D. clamping the tubing for 60 minutes and inserting a sterile needle into the tubing above the clamp to aspirate urine.（分数：1.00）A.B
25、.C.D.18.Touching other people without their permission, reading someone elses mail, and using personal possessions without asking permission are all examples ofA. antisocial behavior.B. manipulation.C. poor boundaries.D. passive-aggressive behavior.（分数：1.00）A.B.C.D.19.Which laboratory test results w
26、ould the nurse expect to find in a client diagnosed with Hashimotos thyroiditis?A. Thyroxine (T4), 22g/dL; triiodothyronine (T 3), 320ng/dL; thyroid-stimulating hormone (TSH) undetectable.B. T4, 22g/dL; T 3, 200ng/dL; TSH,0.1IU/mL.C. T4, 2g/dL; T 3, 200ng/dL; TSH,5.9IU/mL.D. T4, 2g/dL; T 3, 35ng/dL;
27、 TSH,45IU/mL.（分数：1.00）A.B.C.D.20.Whats the most appropriate nursing diagnosis for a client exhibiting obsessive-compulsive behavior?A. Ineffective coping.B. Imbalanced nutrition: Less than body requirements.C. Imbalaneed nutrition: More than body requirements.D. Interrupted family processes.（分数：1.00
28、）A.B.C.D.21.A client reports losing his job, not being able to sleep at night, and feeling upset with his wife. The nurse responds to the client, “You may want to talk about your employment situation in group today. “ The nurse is using which therapeutic technique?A. Restating.B. Making observations
29、.C. Exploring.D. Focusing.（分数：1.00）A.B.C.D.22.The nurse is caring for a client who recently underwent a total hip replacement. The nurse shouldA. ease the client onto a low toilet seat.B. allow the clients legs to be crossed at the knees when out of bed.C. use soft chairs when the client is sitting
30、out of bed.D. limit client hip flexion when sitting.（分数：1.00）A.B.C.D.23.Which of the following observations signals the onset of puberty in male adolescents?A. Appearance of pubic hair.B. Appearance of axillary hair.C. Testicular enlargement.D. Nocturnal emissions.（分数：1.00）A.B.C.D.24.A nurse is cari
31、ng for a client with a history of GI bleeding, sickle cell disease, and a platelet count of 22,000/L. The client is dehydrated and receiving dextrose 5% in half-normal saline solution at 150mL/hr. He reports severe bone pain and is scheduled to receive a dose of morphine sulfate. In administering th
32、e medication, the nurse should avoid which route?A. Oral.B. IV.C. IM.D. Subcutaneous (SC).（分数：1.00）A.B.C.D.25.The nurse is teaching the parents of a school-age child. Which teaching topic should take priority?A. Preventing accidents.B. Keeping a night light on to allay fears.C. Explaining normalcy o
33、f fears about body integrity.D. Encouraging the child to dress without help.（分数：1.00）A.B.C.D.26.A client with three children who is still in her childbearing years is admitted for surgical repair of a prolapsed bladder. The nurse would find that the client understood the surgeons preoperative teachi
34、ng when the client states,A. “If I should become pregnant again, the child would be delivered by cesarean delivery. “B. “If I have another child, the procedure may need to be repeated. “C. “This surgery may render me incapable of conceiving another child. “D. “This procedure is accomplished in two s
35、eparate surgeries. /（分数：1.00）A.B.C.D.27.The nurse is caring for a client who complains of lower back pain. Which instructions should the nurse give to this client to prevent back injury?A. Bend over the object youre lifting.B. Narrow the stance when lifting.C. Push or puI1 an object using your arms.
36、D. Stand close to the object youre lifting.（分数：1.00）A.B.C.D.28.The nurse is caring for a client diagnosed with bulimia. The most appropriate initial goal for a client diagnosed with bulimia is toA. avoid shopping for large amounts of food.B. control eating impulses.C. identify anxiety-causing situat
37、ions.D. eat only three meals per day.（分数：1.00）A.B.C.D.29.When examining school-age and adolescent children, the nurse routinely screens for scoliosis. Which statement accurately summarizes how to perform this screening?A. Have the child stand firmly on both feet and bend forward at the hips, with th
38、e trunk exposed.B. Listen for a clicking sound as the child abducts the hips.C. Have the child run the heel of one foot down the shin of the other leg while standing.D. Have the child shrug the shoulders as the nurse applies mild pressure to the shoulders.（分数：1.00）A.B.C.D.30.The nurse is administeri
39、ng neostigmine to a client with myasthenia gravis. Which nursing intervention should the nurse implement?A. Give the medication on an empty stomach.B. Warn the client that hell experience mouth dryness.C. Schedule the medication before meals.D. Administer the medication for complaints of muscle weak
40、ness or difficulty swallowing.（分数：1.00）A.B.C.D.二、Part Two(总题数：18，分数：23.00)31.Pericardiocentesis is performed on a client with cardiac tamponade. This procedure would be deemed effective ifA. aspirated blood clots rapidly.B. blood pressure decreases.C. blood pressure increases.D. heart sounds become
41、muffled.（分数：1.00）A.B.C.D.32.When administering gentamicin to a preschooler, which of the following monitoring schedules is best for determining the drugs effectiveness?A. A serum trough level every morning.B. A serum peak level after the second dose.C. A serum trough and peak level around the third
42、dose.D. Serial serum trough levels after three doses (24 hours).（分数：1.00）A.B.C.D.33.When assessing the fetal heart rate tracing, the nurse becomes concerned about the fetal heart rate pattern. In response to the loss of variability, the nurse repositions the client to her left side and administers o
43、xygen. These actions are likely to improve which of the following?A. Fetal hypoxia.B. The contraction pattern.C. The status of a trapped cord.D. Maternal comfort.（分数：1.00）A.B.C.D.34.The nurse is interviewing a client who is currently under the influence of a controlled substance and shows signs of b
44、ecoming agitated. What should the nurse do?A. Use confrontation.B. Express disgust with the clients behavior.C. Be aware of hospital security.D. Communicate a scolding attitude to intimidate the client.（分数：1.00）A.B.C.D.35.A client is admitted to the emergency department with complaints of chest pain
45、 and shortness of breath. The nurses assessment reveals jugular vein distention. The nurse knows that when a client has jugular vein distention, its typically due toA. a neck tumor.B. an electrolyte imbalance.C. dehydration.D. fluid overload.（分数：1.00）A.B.C.D.36.Before undergoing a subtotal thyroidec
46、tomy, a client receives potassium iodide (Lugols solution) and propylthiouracil (PTU). The nurse would expect the clients symptoms to subsideA. in a few days.B. in 3 to 4 months.C. immediately.D. in 1 to 2 weeks.（分数：1.00）A.B.C.D.37.Which signs and symptoms are associated with an acoustic neuroma?A.
47、Amenorrhea and obesity.B. Acromegaly.C. Ataxia and intention tremor.D. Unilateral hearing loss and tinnitus.（分数：1.00）A.B.C.D.38.The nurse notices that a client with obsessive-compulsive disorder washes his hands for long periods each day. How should the nurse respond to this compulsive behavior?A. B
48、y designating times during which the client can focus on the behavior.B. By urging the client to reduce the frequency of the behavior as rapidly as possible.C. By calling attention to or attempting to prevent the behavior.D. By discouraging the client from verbalizing anxieties.（分数：1.00）A.B.C.D.39.T
49、he nurse is providing care for a pregnant client. The client asks the nurse how she can best deal with her fatigue. The nurse should instruct her toA. take sleeping pills for a restful nights sleep.B. try to get more rest by going to bed earlier.C. take her prenatal vitamins.D. tell her not to worry because the fatigue will go away soon.（分数：1.00）A.B.C.D.40.The nurse is assessing a client suffering from stress and anxiety. A common physiological response to stress and anxiety isA. sedation.B. diarrhea.C. vertigo.D. urticaria.（分数：1.00）A.B.C.D.41.The
