1. The initial, psychosocial assessment of a patient with metastatic cancer, refractory to treatment, includes: a discussion of hospice care. a review of critical life incidents. the family's readiness to learn about the dying process. the patient's preference for quality versus quantity of life. - Answer- the patient's preference for quality versus quantity of life. 2. An adult-gerontology clinical nurse specialist evaluates a patient who has chronic obstructive pulmonary disease and is on home oxygen therapy. The efficacy of the oxygen therapy is demonstrated by the patient's: awareness of the disease complications. energy conservation strategies. improved gas exchange. knowledge of the hazards of smoking. - Answer- improved gas exchange. 3. What clinical tool is used to aid in the diagnosis of Guillain-Barré syndrome? Cerebrospinal fluid analysis Computed tomography angiography Magnetic resonance angiography Magnetic resonance imaging - Answer- Cerebrospinal fluid analysis 4. Several days after gastrointestinal surgery, a patient begins to receive total, parenteral hyperalimentation. In addition to the blood glucose, which laboratory values are most important for the adult-gerontology clinical nurse specialist to monitor? Creatinine clearance and magnesium Potassium and hemoglobin Serum electrolytes and blood urea nitrogen Total protein level and serum calcium - Answer- Serum electrolytes and blood urea nitrogen 5. A staff nurse admits a patient, who has overdosed on cocaine, to a busy medical unit. The nurse asks the adult-gerontology clinical nurse specialist, "Why are we bothering with this patient? He will only wind up being readmitted." The clinical nurse specialist's response is: "As nurses, we are responsible for learning to recognize our own feelings when caring for patients whose diagnoses we may find difficult to accept." "As nurses, we need to put the patient first. Our feelings are not supposed to be considered when we care for challenging patients." "I hear what you are saying, but nurses cannot be judgmental of their patients." "I'm going to refer you to the employee health nurse, so that you can receive some help for your burnout." - Answer- "As nurses, we are responsible for learning to recognize our own feelings when caring for patients whose diagnoses we may find difficult to accept." 6.The colleague of a researcher requests the mailing list of subjects who have participated in a researcher's study. The researcher tells the colleague that: a formal, written request will be needed before any information may be released. authorization from all study investigators will be needed before sharing the information. the information may not be shared without institutional review board approval. the information will be shared, provided the colleague uses it only as approved by the researcher. - Answer- the information may not be shared without institutional review board approval. 7. A 68-year-old patient has a history of dyspnea on exertion, paroxysmal nocturnal dyspnea, weakness, and palpitations. The patient's electrocardiogram reveals atrial fibrillation, right ventricular hypertrophy, and right axis deviation. The adultgerontology clinical nurse specialist anticipates a differential diagnosis of: aortic insufficiency. aortic stenosis. mitral regurgitation. mitral stenosis. - Answer- mitral stenosis. 8. An exploratory study is conducted to examine the emotional responses of family members of patients in the intensive care unit. Of the 52 subjects, 94.2% were white, 86.5% were married, 44.2% had completed high school, and 40.4% had finished college. The subjects kept daily logs of their feelings and supportive behaviors. The researchers concluded that the subjects experienced a broad range of powerful emotions throughout the patients' stay. A major limitation of the study is that: exploratory studies have demonstrated an effective research approach. families are not capable of properly identifying the supportive behavior of others. the documented feelings are too subjective to be valid for study. the subjects do not represent a diverse population sample. - Answer- the subjects do not represent a diverse population sample. 9. An adult-gerontology clinical nurse specialist examines a patient who is on medication for chronic low back pain, hypercholesterolemia, hypertension, and hypothyroidism. Which medication, when used over a long period of time, may contribute to a diagnosis of osteoporosis? Antihypertensive medication Cholesterol lowering medication Nonsteroidal antiinflammatory medication Thyroid replacement medication - Answer- Thyroid replacement medication