【医学类职业资格】美国护士资格认证(CGFNS)冲刺试卷一2017年及答案解析.doc

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1、美国护士资格认证(CGFNS)冲刺试卷一 2017年及答案解析(总分：100.00，做题时间：180 分钟)一、单项选择题（共 50题，每题 2分(总题数：50，分数：100.00)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

2、？（）（分数：2.00）A.Encourage breas-feeding so that she can get her rest and get healthier.B.Encourage breast-feeding because its 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

3、 highest risk of ovarian cancer ？（）（分数：2.00）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 recov

4、ering 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 ？（）（分数：2.00）A.Awakening several times during the night to redose.B.Respiratory rate of 10 breaths/minute.C.Pain ra

5、ting 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 ？（）（分数：2.00）A.Keep the affected leg i

6、n 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.5.The nurse is assessing a client who gave birth yesterday. Where should the nurse expect to find the

7、 top of the clients fundus ？（）（分数：2.00）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 ？（）

8、（分数：2.00）A.Using crutches properly.B.Exercising joints above and below the cast, as ordered.C.Avoiding walking on a leg cast without the physicians permission.D.Reporting signs of impaired circulation.7.A male client with a total hip replacement is progressing well and expects to be discharged tomor

9、row. On returning to bed after ambulating, he complains of severe pain in the surgical wound. Which action should the nurse take ？（）（分数：2.00）A.Assume hes anxious about discharge, and administer pain medication.B.Assess the surgical site and affected extremity.C.Reassure the client that pain is a dir

10、ect result of increased activity.D.Suspect a wound infection, and monitor the clients 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 （）.（分数：2.00）A.institutional resources.B.standa

11、rds of practice.C.client-care quality.D.nursing recruitment.9.The nurse is interviewing a 19-year-old female at a clinic. Its 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 clien

12、t to have （）.（分数：2.00）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). Whats the major infect

13、ion control measure to reduce MRSA and other nosocomial pathogens in a health care setting ？（）（分数：2.00）A.Using antibacterial soap when bathing clients with MRS.B.Conducting culture surveys periodically.C.Ensuring that personnel wash their hands before and after contact with every client.D.Using spec

14、ific 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 ？（）（分数：2.00）A.Antibiotic therapy.B.Pain management.C.Blood transfusion.D.Antic

15、oagulation.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 ？（）（分数：2.00）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 fo

16、llowing instructions should the nurse emphasize ？（）（分数：2.00）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

17、.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 （）.（分数：2.00）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 c

18、hest pain. The nurse should place the medication （）.（分数：2.00）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 Ringers solution at a rate of 75 mL/hour. Using an infusion set that provides 1

19、5 gtt/mL, the nurse should calculate the flow rate to be （）.（分数：2.00）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

20、the highest priority ？（）（分数：2.00）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 sho

21、uld （）.（分数：2.00）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 so

22、und (S2). The nurse should document this as （）.（分数：2.00）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 compli

23、cation ？（）（分数：2.00）A.Bone fracture.B.Loss of estrogen.C.Negative calcium balance.D.Dowagers hump.21.A client in her 36th week of pregnancy is admitted to the hospital with vaginal bleeding. After undergoing an ultrasonic scan, shes diagnosed with placenta previa. Which assessment finding would best

24、confirm this diagnosis ？（）（分数：2.00）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 ？（）（分数：2.00）A.This condition puts her at

25、 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 use

26、d every time they have sexual intercourse.D.The human papillomavirus (HPV), which causes condylomata aeuminata, cant 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 clients safety. Which

27、of the following activities would help to lessen the clients risk of falling ？（）（分数：2.00）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 clients visual deficit.C.I

28、nstalling 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

29、 nurse should take into account the clients need to achieve what developmental milestone ？（）（分数：2.00）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 （）.（分数：2.00）A.initiate a stream of urine.B.breathe d

30、eeply.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 （）.（分数：2.00）A.congenital deformity.B.age.C.trauma.D.obesity.27.The nurse is caring for a client admitted to the hospital

31、 with a bowel obstruction. The nurse should wear sterile gloves when （）.（分数：2.00）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 seru

32、m potassium level is 6 mEq/L. For this client, the nurses priority would be to assess her （）. （分数：2.00）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 preparin

33、g her nursing care plan, the nurse should include which of the following nursing diagnoses ？（）（分数：2.00）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 fo

34、r 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 ？（）（分数：2.00）A.Teaching the client about the adverse effects.B.Calling the physic

35、ian 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 administr

36、ation, the nurse should include which instruction ？（）（分数：2.00）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 potenc

37、y. “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 （）.（分数：2.00）A.daily weight.B.serum sodium levels.C.measured intake and outpu

38、t.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 ？（）（分数：2.00）A.Distilled water.B.Dextrose 5% in water (D5W) only.C.DSW with 40 mEq of potassium chloride.D.Dextros

39、e 10% in saline.34.A clients blood glucose level is 45 mg/dL. The nurse should be alert for which signs and symptoms ？（）（分数：2.00）A.Coma, anxiety, confusion, headache, and cool, moist skin.B.Kussmauls respirations, dry skin, hypotension, and bradycardia.C.Polyuria, polydipsia, hypotension, and hypern

40、atremia.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 ？（）（分数：2.00）A.“Ive gained 3 pounds in the last month. “B.“I eat loads of spinac

41、h and yellow vegetables each day. “C.“Im a perfectionist, and I work hard to get As. “D.“I binge frequently in the morning and feel fat. “36.An elderly client with Alzheimers disease begins supplemental tube feedings through a gastrostomy tube to provide adequate calorie intake. The nurse should be

42、concerned most with the potential for （）.（分数：2.00）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 （）.（分数：2.00）A.teach children to cover mouths and noses when they sneeze.B.ha

43、ve 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

44、radiograph. The nurse should （）.（分数：2.00）A.inform the surgeon this isnt 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 ris

45、k for aspiration ？（）（分数：2.00）A.A stroke client with dysarthria.B.An ambulatory client 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.40.A client with heart failure develops pink frothy sputum

46、, coarse crackles, and restlessness. Which of the following actions should the nurse take first ？（）（分数：2.00）A.Check the clients blood pressure.B.Place the client in high Fowlers position.C.Calculate the clients fluid balance.D.Notify the physician.41.A woman in her 8th month of pregnancy is having d

47、inner 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 ？（）（分数：2.00）A.Apply abdominal thrust.B.Apply chest thrust.C.Begin cardiopulmonary resuscitation (

48、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 （）.（分数：2.00）A.has a respiratory infection.B.is intubated and on a ventilator.C.has pleural chest tube

49、s.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 ？（）（分数：2.00）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 nurses assessment and interventions, what would be the most desirable outcome ？（）（分数：2.00）A.