2023年CGNS美国海外护士资格认证历年高频考题带答案难题附详解

2023年CGNS美国海外护士资格认证历年高频考题带答案难题附详解（图片大小可自由调整）第1卷一.Comprehensivetestcenter(共25题)1.Theclientwasadmittedwithsevereheadinjuryresultingfromamotorvehicleaccident.Theclientispresentlyunconscious.Tofacilitaterehabilitationwhentheclient'sconditionallows,thenurseshouldA.maintainlimbsinthepositionoffunction.B.applyrestraintstoarmsandlegstocontrolspasms.C.exercisejustthearmsasthelegsmaintaintheirtonelonger.D.notifyphysicaltherapyassoonasthephysicianorderspassiverangeofmotion.2.Apreschool-agedchildwhoishospitalizedwithgastroenteritishasbeenNPO.Thephysicianhaswrittenanordertoadvancethedietastolerated.Whichofthefollowingfoodisthemostappropriateforthefirstfeedingthenurseshouldofferthechild?A.Clearlemoncarbonatedbeverage.B.Toast.C.Cookedcereal.D.Icecreamshake.3.Thenursediscusseswiththe4-year-oldchildandparentstheplanofcarethatwillbeimplementedwhenthechildreturnsfromthethroatsurgery.Whichofthefollowinginterventionsshouldthenurseemphasize?A.Needforfrequentcoughing.B.Useofacetylsalicylicacidforpain,asneeded.C.Abilitytohaveicecreamrightaftersurgery.D.Useofsipsofclearliquidswhenawakeandalert.4.Aparentreportsthathis2-year-oldchildoftenfailswhenrunning.Thenurseinterpretsthisasindicatingwhichofthefollowingasanormalaspectofatoddler'svision?A.Near-sightedness.B.Far-sightedness.C.Binocularvision.D.Strabismus.5.Thenurseisteachingtheclienthowtouseacane.Whichofthefollowingstatementsismostinaccurate?A.Theclientshouldholdthecaneontheinvolvedside.B.Theclientshouldholdthecaneclosetohisbody.C.Thestridelengthandthetimingofeachstepshouldbeequal.D.Thenurseshouldstandbehindtheclienttopreventfalls.6.A6-week-oldfemaleinfantexhibitsdryscalyskinandaprotrudingtongueafterhavingtroublebreast-feeding.Adiagnosisofcongenitalhypothyroidismismade.Themotherasksthenursewhythechildwasnotdiagnosedwiththisconditionatbirth.Whichofthefollowingwouldbethenurse'sbestresponse?A."Wehadtheresultsofthenewbornscreen,butyoudidnotbringthebabyinforthe2-weekcheckup."B."Wecouldnotreachyouathometogiveyoutheresultsofteststakenatbirth."C."Yourbabyhadlittleneedforthyroidhormoneuntilshewas1monthold."D."Newbornsgenerallyreceiveenoughthyroidhormonefromthemothertogetbythefirstfewweeks."7.Thenurseisprovidingcareforapregnant16-year-oldclient.Theclientsaysthatshe'sconcernedshemaygaintoomuchweightandwantstostartdieting.Thenurseshouldrespondbysaying.A."Nowisn'tagoodtimetobegindietingbecauseyouareeatingfortwo."B."Let'sexploreyourfeelingsfurther."C."Nutritionisimportantbecausedeprivingyourbabyofnutrientscancausedevelopmentalandgrowthproblems."D."Theprenatalvitaminsshouldensurethebabygetsallthenecessarynutrients."8.Afterdeliveringhersecondchild,theclienttellsthenursethatshewantstobreast-feed.Sheindicatesthatshewasunsuccessfulatbreast-feedingherfirstchildandthatshebottle-fedafter3daysoftryingtonurse.Whichofthefollowingresponseswouldbestsupportthisclient'sbreast-feedingefforts?A."I'llmakesurethatyou'reseenbythelactationconsultantbeforeyou'redischarged."B."It'simportanttoroom-inwithyourneonatesothatyoucanrespondtohernursing:cues,"C."Don'tworry,everybabyisdifferent,andI'msurethatyou'llbesuccessfulthistime."D."Breast-feedingispossiblebutyoumustbecommittedtoit."9.Thenurseisteachinganewgroupofmentalhealthaides.ThenurseshouldteachtheaidesthatsettinglimitsismostimportantforA.adepressedclient.B.amanicclient.C.asuicidalclient.D.ananxiousclient.10.Ahighschoolstudentisreferredtotheschoolnurseforsuspectedsubstanceabuse.Followingthenurse'sassessmentandinterventions,whatwouldbethemostdesirableoutcome?A.Thestudentdiscussesconflictsoverdruguse.B.Thestudentacceptsareferraltoasubstanceabusecounselor.C.Thestudentagreestoinformhisparentsoftheproblem.D.Thestudentreportsincreasedcomfortwithmakingchoices.11.Whileinspectingtheclient'schest,thenursenotesthatthechestwallcontractsoninspirationandbulgesonexpiration.Thenursesuspectswhichofthefollowingproblemfromthisassessment?A.Hemothorax.B.Flailchest.C.Pneumothorax.D.Tensionpneumothorax.12.Arecentlymarried22-year-oldisbroughttothetraumacenterbythepolice.Shehadbeenrobbed,beaten,raped,andsodomized.Theclient,althoughveryanxiousandtearful,appearsincontrol.Thephysicianordersdiazepam(Valium)5mgpoprnforagitation.ThenurseshouldadministerthismedicationwhentheA.ClientrequestssomethingtocalmherB.Client'scryingandtremblingseemtoincreaseC.PhysicianisreadytodoavaginalexaminationabusehistoryD.Nursedeterminestheclient'sanxietyisincreasing13.Aclientwhohassustainedaheadinjuryistoreceivemannitol(Osmitrol)byIVpush.Inevaluatingtheeffectivenessofthedrug,thenurseshouldexpecttofindA.increasedlungexpansion.B.decreasedcerebraledema.C.decreasedcardiacworkload.D.increasedcerebralcirculation.14.Thenurseiscaringforaclientwithdiabetesmellitus.Whenteachingtheclientaboutfootcare,whichinstructionshouldthenurseprovide?A.Examinefeetonceperweekforredness,blisters,andabrasions.B.Applylotiontodryfeet,especiallybetweenthetoes.C.Avoidhot-waterbottlesandheatingpads.D.Dryfeetvigorouslyaftereachbath.15.Aclientis22weekspregnantwithherfirstchild.Herweightgainisnormal,butshecomplainsofconstipation.What'sthemosteffectiverecommendationthenursecanmake?A."Takeamildlaxativedaily."B."Increaseintakeoffluidsandhigh-fiberfoods."C."Relaxwhentryingtomovethebowels."D."Startastrenuousexerciseprogram."16.Thenurseisdevelopingaplanofcareforaclientwithanorexianervosa.Whichactionshouldthenurseincludeintheplan?A.Setupastricteatingplanfortheclient.B.Encouragetheclienttoexercise,whichwillreduceheranxiety.C.Restrictvisitswiththefamilyuntiltheclientbeginstoeat.D.Provideprivacyduringmeals.17.JamesT.isadmittedtotheunitinanacutemanicepisode.Hehashadthreemajordepressiveepisodesinthepast10yearsandtwootherhospitalizationsformania.WhichofthefollowingdisorderswouldreflectJames'symptomprofile?A.BipolarⅠB.BipolarⅡC.CyclothymicdisorderD.Dysthymicdisorder18.Whichofthefollowingactivitiesshoulda2-year-oldchildtobeabletodo?A.Buildatowerofeightcubes.B.Pointoutapicture.C.Washanddryhishands.D.Removeagarment.19.A38-year-oldclientishospitalizedwithobsessive-compulsivedisorder.Onadmission,shebecomesnervousandaskstogotothebathroomtobrushherteeth.Herhusbandsaysthatshebrushesherteethatleast25timesperday.Thenursenotesthattheclient'sgumsareinflamedandbleeding.What'sthebestnursingintervention?A.Haveherstopbrushingherteethuntilthegumsheal.B.Allowhertocontinueherroutineofdailybrushing.C.Monitorherdentalcareandsetlimitsontheamountofdailybrushing.D.Brushherteethforher.20.Aclientisadmittedtothehospitalinthemanicphaseofbipolardisorder.Whenplacingadietorderfortheclient,whichfoodswouldbemostappropriate?A.Abowlofsoup,crackers,andadishofpeaches.B.Acheesesandwich,carrotsticks,freshgrapes,andcookies.C.Roastchicken,mashedpotatoes,andpeas.D.Atunasandwich,anapple,andadishoficecream.21.Thenurseiscaringforaclientinthemanicphaseofbipolardisorderwhoisreadyfordischargefromthepsychiatricunit.Asthenursebeginstoterminatethenurse-clientrelationship,whichclientresponseismostappropriate?A.Expressingfeelingsofanxiety.B.Displayinganger,shouting,andbangingthetable.C.Withdrawingfromthenurseinsilence.D.Rationalizingthetermination,sayingthateverythingcomestoanend.22.Whileevaluatingtheneedsofaclientduringthesecondtrimester,thenursecananticipatewhichofthefollowing?A.Feelingsofdisbeliefandambivalence.B.Feelingsofclumsinessand"ugliness".C.Increasingintrospectionbutageneralsenseofwell-being.D.Anxietyaboutthelaboranddeliveryexperience.23.Whichofthefollowingfluidandelectrolyteimbalanceswouldthenurseanticipatethattheclientwouldbeparticularlysusceptibletointheemergentphaseofburncare?A.Metabolicalkalosis.B.Hemodilution.C.Hypernatremia.D.Hyperkalemia.24.WhichofthefollowingisNOTacontributoryfactortothermoregulationinthepretermneonate?A.Immaturecentralnervoussystem(CNS).B.Largeskinsurfacearea.C.Lackofsubcutaneous(SC)andbrownfat.D.Tendencytowardcapillaryfragility.25.Whichofthefollowingdrugsmaybeabusedbecauseoftoleranceandphysiologicdependence?A.Lithium(Lithobid)anddivalproex(Depakote).B.Verapamil(Calan)andchlorpromazine(Thorazine).C.Alprazolam(Xanax)andphenobarbital(Luminal).D.Clozapine(Clozaril)andamitriptyline(Elavil).第1卷参考答案一.Comprehensivetestcenter1.参考答案：AMaintainingtheclient'slimbsinthepositionoffunctiondecreasesthelikelihoodofcontractures.There'snoevidencethattheclientisexperiencingspasms,andthenursewouldexercisethearmsandlegsaslongasinjuriespermit.Thelongerrehabilitationisdelayed,themoredifficultitis.2.参考答案：CAchildwithgastroenteritisshouldstarttoreceivesoftfoodsfirstafterrestingthebowelandrehydration.Cookedcereals,vegetables,andmeatsarerecommended.3.参考答案：DOncethechildisalert,hemayhavesipsofclearliquids.Eatingenhancesthebloodsupplytothethroat,whichpromotesrapidhealing.However,thechildshouldstartwithclearfluids.4.参考答案：AUntilage7years,childrenarenormallymyopicandnearsighted.Additionallytoddlerslackmotorcoordinationandtheirdepthperceptionisnotwelldeveloped,placingthematriskforfalling.5.参考答案：ATheclientisinstructedtoholdthecaneontheuninvolvedside,94"to26"(61to66era)fromthebaseofthelittletoe.Thisisdonetopromoteareciprocalgaitpattern.Thenurseshouldinstructtheclienttoholdthecaneclosetohisbodytopreventleaning.Thestridelengthandtimingofeachstepshouldbeequal.Topreventfails,thenursestandsbehindtheclientashe'slearningtousethecane.6.参考答案：DWithcongenitalhypothyroidism,failureofnormaldevelopmentoccursduringtheembryonicperiodorwhenaninbornerrorofmetabolismpreventsthenormalsynthesisofthyroxine.Althoughtheconditionispresentatbirth,maternalthyroxinecanpassthroughtheplacentatothefetus,supplyingthefetusandneonatesufficiently.Thus,inmostneonates,thesignsofhypothyroidismarecommonlymaskedatbirth.7.参考答案：CDeprivingthedevelopingfetusofnutrientscancauseseriousproblems,andthenurseshoulddiscussthiswiththeclient.Theclientisn'teatingfortwo;thisisamisconception.Exploringfeelingshelpstheclientunderstandherconcerns,butsheneedstobeawareoftherisksatthistime.Thevitaminsaresupplementsanddon'tcontaineverythingamotherorneonateneeds;theyworkincongruencewithabalanceddiet.8.参考答案：BOnewaytohelpsupportthisclient'swishestobreast-feedistoinstructhertoroom-inwithherneonatesoshecanrespondtotheneonate'scues.Sendingtheneonatetothenurserylessensthemother'sabilitytolearnherneonate'sbreast-feedingcues.Theotheroptionsdon'tsupporttheclient'sneedforguidance.9.参考答案：BSettinglimitsforunacceptablebehaviorismostimportantinamanicclient.Typically,depressed,anxious,orsuicidalclientsdon'tphysicallyormentallytestthelimitsofthecaregiver.10.参考答案：BAlloftheoutcomesstatedaredesirable;however,thebestoutcomeisthatthestudentwouldagreetoseektheassistanceofaprofessionalsubstanceabusecounselor.11.参考答案：BFlailchestoccurswhentwoormoreadjacentribsarefracturedattwoormoresites,resultinginafree-floatingsegment.Thislossofchestwallstabilitycausesrespiratoryimpairmentandnotableparadoxicalchestwallmovement.Hemothoraxorpneumothoraxbothdecreasechestwallexcursionontheaffectedside.Atensionpneumothoraxcausesamediastinalshiftandtrachealdeviationtowardtheunaffectedside.12.参考答案：A13.参考答案：BMannitol,anosmoticdiuretic,isusedtodecreasecerebraledemainclientswithheadinjuries.Increasedlungexpansion,decreasedcardiacworkload,andincreasedcerebralcirculationaren'teffectsofmannitol.14.参考答案：CHot-waterbottlesandheatingpadsshouldneverbeusedtowarmcoldfeet.Becausemanyclientswithdiabetesmellitushaveneuropathyandcan'tfeeltemperaturechanges,seriousinjuriesorburnsmayoccur.Socksshouldbewornforwarmth.Feetshouldbeexaminedeachdayforcuts,blisters,swelling,redness,tenderness,andabrasions.Lotionshouldbeappliedtodryfeetbutneverbetweenthetoes.Afterabath,theclientshouldgently--notvigorously--patfeetdrytoavoidinjury.15.参考答案：BIncreasedfluidsandfiberwillsoftenthestool,makingiteasiertopasswithoutmedicationuse.Takingalaxativemakestheclientrelyonmedication.Relaxingduringbowelmovementsisimportantbutdoesn'taddresstheproblemaseffectivelyasincreasingfluidsandfiber.Startingastrenuousexerciseprogramisdiscouragedduringpregnancyunlesstheclientisalreadyaccustomedtoit.Mildexerciseissafe,however,andmayincreaseperistalsisandenhancestoolpassage.16.参考答案：AEstablishingaconsistenteatingplanandmonitoringtheclient'sweightareimportantforthisdisorder.Thefamilyshouldbeincludedintheclient'scare.Theclientshouldbemonitoredduringmeals--notgivenprivacy.Exercisemustbelimitedandsupervised.17.参考答案：A18.参考答案：DAccordingtotheDenverⅡDevelopmentalScreeningtest,most2-year-oldsareabletoremoveonegarment.A-year-oldcanbuildatowerofeightcubesandpointoutapicture.A3-year-oldcanwashanddryhishands.19.参考答案：CThisallowsthebehaviorthatreducesanxietyfortheclient,butitsetslimitsasafirststepinmodifyingthebehavior.Havingherstopbrushingherteethuntilhergumshealmayleavetheclientunabletomanageanxiety.Allowinghertocontinueherroutineofdailybrushingdoesnothingtochangethebehavior.Brushingherteethforhertreatstheclientlikeatoddler.20.参考答案：BTheclientmayhaveadifficulttimesittinglongenoughtoeathismeal;therefore,fingerfoodsthatcanbeeateneasilyaremostappropriate.Theotherfoodsrequiretheclienttositandeat,atasktheclientwillbeunabletoachieveatthistime.21.参考答案：AAnxietyisanormalreactiontotheterminationofthenurse-clientrelationship.Thenurseshouldhelptheclientexplorehisfeelingsabou