Medical Tests Medical Tests Certifications CEN Questions & Answers

• Question 21:

  When developing a plan of care for a patient with stage I Lyme disease, which of the following would you want to include?

  A. No treatment without symptoms

  B. Three-week course of antibiotics

  C. Intravenous antibiotics

  D. Oatmeal baths for two weeks

  Correct Answer: B

  In stage I Lyme disease a three-week course of oral antibiotics is begun. In later stages the patient may require intravenous antibiotics. Both A and D are inappropriate responses for patients with Lyme disease. Prevention, education and early diagnoses are important in controlling Lyme disease.

• Question 22:

  What signs and symptoms would a a patient with stage I Lyme disease have?

  A. Signs of neurological disorders

  B. Enlarged and inflamed joints

  C. Arthralgias

  D. Flu-like symptoms

  Correct Answer: D

  Stage I Lyme disease begins with a rash at the bite within 2 to 30 days. Then the patient develops Flu-like symptoms that last 7 to 10 days and may reoccur at a later date. Neurological symptoms occur in stage II, and arthralgias and inflamed joints occur in stage III.

• Question 23:

  You are caring for a patient with Lyme disease. Which of the following would be the method that the patient contracted Lyme disease?

  A. Skin contact with an infected person.

  B. Inhalation of spores in bird droppings.

  C. Contamination from cat feces.

  D. Tick carried by deer.

  Correct Answer: D

  Lyme disease is caused by ticks carried by deer. When bitten by the tick, the patient becomes infected with Borrelia burgdorferi. Histoplasmosis is contracted from inhalation of spores from bird droppings. Toxoplasmosis is contracted from contaminated cat feces.

• Question 24:

  You are caring for a child in burn shock. Which of the following assessments indicates the child is getting adequate fluid resuscitation?

  A. Skin turgor

  B. Edema at burn sites

  C. Peripheral pulses

  D. Neurological assessment

  Correct Answer: D

  The neurological assessment would be the most accurate indication of adequate fluid resuscitation. Burns do not affect neurological status, and the child should be alert and oriented. If for any reason the child is not, then further investigation would be necessary.

• Question 25:

  You are admitting a child with partial and full thickness burns over 35% of the body. The priority intervention for this child would be:

  A. Morphine

  B. Restricting fluids

  C. Nasogastric tube

  D. Foley catheter

  Correct Answer: D

  This child will need a foley catheter. This is to insure that accurate output can be tracked each hour. All other options are inappropriate for the child at this time.

• Question 26:

  You are caring for a patient with a severe burn. The patient is scheduled to go to surgery for an autograft of the lower extremity. What should you include in the postoperative plan of care for this patient?

  A. Keep the surgical extremity flat.

  B. Keep a blanket over the extremity.

  C. Place the patient in prone position.

  D. Immobilize and elevate the extremity.

  Correct Answer: D

  The grafted extremity should be immobilized and elevated for three to seven days. This allows the graft time to adhere to the wound bed and decreases edema. All other options can disrupt the graft site.

• Question 27:

  You are working in the Emergency department when you receive a call from a mother who says her threeyear-old has ingested furniture polish. What should you tell the mother to do first?

  A. Induce vomiting.

  B. Bring the child to the emergency department.

  C. Call an ambulance.

  D. Call the poison control center.

  Correct Answer: D

  The mother needs to call the poison control center first. The poison control center will advise the mother what to do from there. Do not induce vomiting unless poison control says to do so. Poison control may advise that the mother bring the child to the emergency department; if so then the mother should call the ambulance.

• Question 28:

  You are caring for a patient in iron overload. Which medication do you suspect the physician will order?

  A. Granisetron (Kytril)

  B. Deferoxamine (Desferal)

  C. Ketoconazole (Nizoral)

  D. Terbinafine (Lamisil)

  Correct Answer: B

  Deferoxamine (Desferal) is what the physician will order for a patient who is in iron overload. Granisetron (Kytril) is an antiemetic. Ketoconazole (Nizoral) and terbinafine (Lamisil) are antifungal medications.

• Question 29:

  You are caring for a patient with a phosphorus level of 2.0 mg/dL. What condition do you know would cause the phosphorus level to be so low?

  A. Alcoholism

  B. Hypoparathyroidism

  C. Tumor lysis syndrome

  D. Renal insufficiency

  Correct Answer: A

  Of the above listed conditions, the patient with alcoholism would be most likely to have a phosphorus level of 2.0 mg/dL. A normal phosphorus level is 2.7 to 4.5 mg/dL. Malnutrition or starvation and the use of aluminum hydroxide-based antacids can also be causes of low phosphorus levels. The other three conditions are more likely to cause hyperphosphatemia.

• Question 30:

  Your patient is in cardiogenic shock and has had an intraaortic balloon pump placed through the left femoral artery. On assessment you note that the left foot is cool and mottled and the pedal pulse weak. What is the priority for this patient?

  A. Document the data because it is expected.

  B. Reevaluate in an hour.

  C. Increase the rate on the nitroglycerin drip.

  D. Notify the physician.

  Correct Answer: D

  The nurse would want to notify the physician of the change. This is a sign of decreased circulation to the extremity. The physician will need to intervene to prevent the patient from having further adverse affects.