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卷

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50题)1.Positivesymptomsofschizophreniaincludewhichofthefollowing?A.Waxyflexibility,alogia,andapathy.B.Flataffect,avolition,andanhedonia.C.Hallucinations,delusions,anddisorganizedthinking.D.Somaticdelusions,echolalia,andaflataffect.2.Aclientisrecoveringfromagastricresectionforpepticulcerdisease.Whichofthefollowingoutcomesindicatesthatthegoalofadequatenutritionalintakeisbeingachieved3weeksfollowingsurgery?A.Increasesfoodintakeandtolerancegradually.B.Experiencesoccasionalepisodesofnauseaandvomiting.C.Experiencesarapidweightgainwithin1week.D.Drinks2000mL/dayofwater.3.Aclientwithaknownhistoryofopiateaddictionistreatedformultiplestabwoundstotheabdomen.Aftersurgicalrepairthenursenotesthattheclient'spainisnotrelievedbytheprescribedIMmeperidinehvdrochloride(Demerol)injections.ThenurserecognizesthatthefailuretoachievepainrelieffromtheDemeroiinjectionsindicatesthattheclientisprobablyexperiencingthephenomenonofA.ToleranceB.HabituationC.PhysicaladdictionD.Psychologicaladdiction4.ThecommunityhealthnursedevelopsahealtheducationprogramaboutpreventingthetransmissionofhepatitisB.ThenurseevaluatesthattheteachinghasbeeneffectivewhenthecommunityresidentsidentifywhichofthefollowingactivitiestobehighriskforacquiringhepatitisB?A.Sharingneedlesfordruguse.B.Ingestionofcontaminatedseafood.C.Frequentuseofmarijuana.D.Ingestionoflargeamountsofacetaminophen(Tylenol).5.Whichtoywouldbemostappropriatefora3-year-old?A.Abicycle.B.Apuzzlewithlargepieces.C.Apulltoy.D.Acomputergame.6.Anagitatedclientdemandstoseehischartsothathecanreadwhathasbeenwrittenabouthim.Whichofthefollowingstatementsisthenurse'sbestresponseinthissituation?A."I'msorrythechartisthepropertyofthefacility.Wedon'tpermitclientstoreadthem."B."Youhavetherighttoseeyourchart.Pleasediscussthiswithyourprimarycareprovider."C."Youmayseeyourchartafteryou'redischarged."D."Pleasediscussthismatterwithyourattorney."7.Whichofthefollowingshouldthenurseincludeinapostoperativeteachingplanforaclientwithalaryngectomy?A.Tellingtheclienttospeakbycoveringthestomawithasterilegauzepad.B.Reassuringtheclientthatnormaleatingwillbepossibleafterhealinghasoccurred.C.Instructingtheclienttoavoidcoughinguntilthesuturesareremoved.D.Instructingtheclienttocontroloralsecretionsbyswabbingthemwithtissuesorbyexpectoratingintoanemesisbasin.8.AclienthasseverepruritusfromhepatitisB.Whichofthefollowingnursingmeasureswouldbestenhancetheclient'scomfort?A.Usehotwatertoincreasevasodilation.B.Usecoldwatertodecreaseitchingsensation.C.Givetepidwaterbaths.D.Avoidlotionsandcreams.9.Thenurseisassessinga15-year-oldfemalewhoisbeingadmittedfortreatmentofanorexianervosa.Whichofthefollowingclinicalmanifestationisthenursemostlikelytofindfromtheclient?A.Tachycardia.B.Coarsehairgrowth.C.Parotidglandtenderness.D.Warm,flushedextremities.10.Thenursediscussesdischargeplanwiththeparentsofachildfollowingasicklecellcrisis.Whichofthefollowingwouldthenurseemphasizetheneedtoseekprompthealthcare?A.Headachesandnausea.B.Fatigueandlassitude.C.Skinrashanditching.D.Sorethroatandfever.11.Mr.Lambersrefusestopayincometaxesbecausehisconsciencewillnotallowhimtosupportagovernmentthatspendsbillionsofdollarsonmilitaryweapons.Mr.

Lambers'sreasoningbestillustratesKohlberg's______stage.A.EgocentricB.PreconventionalC.PostconventionalD.Conventional12."Earliertodayyousaidyouwereconcernedthatyoursonwasstillupsetwithyou.WhenIstoppedbyyourroomaboutanhourago,youandyoursonseemedrelaxedandsmilingasyouspoketoeachother.Howdidthingsgobetweenthetwoofyou?"

Thisisanexampleofwhichtherapeuticcommunicationtechnique?A.ConsensualvalidationB.EncouragingcomparisonC.AcceptingD.Generallead13.Whichnursinginterventionwouldmostlikelyleadtoahyposmolarstate?A.Performingnasogastric(NG)tubeirrigationwithnormalsalinesolution.B.Weighingtheclientdaily.C.Administeringtapwaterenemauntilthereturnisclear.D.Encouragingtheclientwithexcessiveperspirationtodrinkbroth.14.A45-year-oldautomechaniccomestothephysician'sofficebecauseanexacerbationofhispsoriasisismakingitdifficulttowork.Hetellsthenursethathisfingerjointsarestiffandsoreinthemorning.ThenurseshouldrespondbyA.inquiringfurtheraboutthisproblembecausepsoriaticarthritiscanaccompanypsoriasisvulgaris.B.suggestinghetakeaspirinforreliefbecauseit'sprobablyearlyrheumatoidarthritis.C.validatinghiscomplaintbutassumingit'sanadverseeffectofhisvocation.D.askinghimifhehasbeendiagnosedortreatedforcarpaltunnelsyndrome.15.Aschool-agechildisadmittedtothehospitalwithadiagnosisofacutelymphoblasticleukemia.ThenurseformulatesanursingdiagnosisofRiskforinfection.Whichofthefollowingisthemosteffectivewayforthenursetoreducethechild'sriskofinfection?A.Implementingreverseisolation.B.Maintainingstandardprecautions.C.Requiringstaffandvisitorstowearmasks.D.Practicingthoroughhandwashing.16.Whenselectingaroomforaclientwiththediagnosisofbipolardisorder,manicphase,whoishyperactiveandtalkingnonstopinalouddemandingvoice,thenurserecognizesthatamostimportantfactorwouldbethattheA.RoomhaveapleasantviewB.AtmospherebequietandrestfulC.Locationbeclosetothenurses'stationD.Roommateshavesimilarbehavioralresponses17.ThenurseisteachingaclientandhisfamilyaboutdietarypracticesrelatedtoParkinson'sdisease.ApriorityforthenursetoaddressisriskofA.fluidoverloadanddrooling.B.aspirationandanorexia.C.chokinganddiarrhea.D.dysphagiaandconstipation.18.Ifyouareinvolvedintheterminalweaningofapatient,youwillwanttodoallofthefollowingexceptA.Participateinthedecision-makingprocessbyofferingthefamilyinformationabouttheadvantagesanddisadvantagesofcontinuedventilatorysupportB.ExplaintothefamilywhatwillhappenateachphaseoftheweaningandoffersupportC.ChecktheordersforsedationandanalgesiaandmakesurethattheanticipateddeathiscomfortableanddignifiedD.Tellthefamilythatdeathwilloccuralmostimmediatelyafterthepatientisremovedfromtheventilator19.Aclienthospitalizedwithpneumoniahasthick,tenacioussecretions.Tohelpliquefythesesecretions,thenurseshouldA.turntheclientevery2hours.B.elevatetheheadofthebed30degrees.C.encourageincreasedfluidintake.D.maintainacoolroomtemperature.20.Ifnoneofthefollowingbedpositionsiscontraindicated,whichpositionwouldbepreferredfortheclientwithhypovolemicshock?A.Supine.B.Semi-Fowler's.C.Trendelenburg's.D.Supinewiththelegselevated15degrees.21.Ahighschoolstudentisreferredtotheschoolnurseforsuspectedsubstanceabuse.Followingthenurse'sassessmentandinterventions,whatwouldbethemostdesirableoutcome?A.Thestudentdiscussesconflictsoverdruguse.B.Thestudentacceptsareferraltoasubstanceabusecounselor.C.Thestudentagreestoinformhisparentsoftheproblem.D.Thestudentreportsincreasedcomfortwithmakingchoices.22.AclientwithHashimoto'sthyroiditisandahistoryoftwomyocardialinfarctionsandcoronaryarterydiseaseistoreceivelevothyroxine(Synthroid).Becauseoftheclient'scardiachistory,thenursewouldexpectthattheclient'sinitialdoseforthethyroidreplacementwouldbewhichofthefollowing?A.25g/day,initially.B.100g/day,initially.C.Delayeduntilafterthyroidsurgery.D.Initiatedbeforethyroidsurgery.23.Incaringforaclientwithvasovagalsyncope,thenurseshouldknowthattheassociatedtemporarylossofconsciousnessismostcommonlyrelatedtoA.vestibulardysfunction.B.suddenvascularfluidshifting.C.posturalhypotension.D.bradyrhythmia.24.Thenurseisassessingapostcraniotomyclientandfindstheurineoutputfromacatheteris1,500mLforthe1sthourandthesameforthe2ndhour.ThenurseshouldsuspectA.Cushing'ssyndrome.B.diabetesmellitus.C.adrenalcrisis.D.diabetesinsipidus.25.Aclientwithiron-deficiencyanemiaisprescribedliquidironsupplements.Thenurseteachestheclient'sabouthowtotakethisdrug.Whichofthefollowingstatementsbytheclientindicatesthattheeducationiseffective?A."Iwillreportanyblackstoolstothephysician."B."Iwilldilutethemedicationanddrinkitwithastraw."C."Iwillcheckmygumsforanybleeding."D."IcanuseantidiarrhealdrugsifIdevelopdiarrhea."26.Thenurseisgivinginstructionstoaclientwhoisgoinghomewithacastonhisleg.Whichpointismostcritical?A.Usingcrutchesproperly.B.Exercisingjointsaboveandbelowthecast,asordered.C.Avoidingwalkingonalegcastwithoutthephysician'spermission.D.Reportingsignsofimpairedcirculation.27.Aclienthasatotalserumcholesterollevelof326mg/dL.ThenurseexplainstotheclientthatthislevelA.isnormalandrequiresnofurthertreatment.B.ishighandwillrequiredietarymodification.C.islowandrequiresnofurthertreatment.D.isborderlinenormalandmayrequiredietarymodification.28.Thenurseiscaringforaclientwithlate-stageAlzheimer'sdisease.Theclient'swifetellsthenursethattheclienthasbecomeverydependent.Theclient'swifefeelsguiltyifshetakesanytimeforherselfbecausetheclientcriesoutforher.Thenurseshoulddevelopwhichoutcometoassisttheclient'swife?A.Thecaregiverlearnstoexplaintotheclientwhysheneedstimeforherself.B.Thecaregiverdistinguishesobligationsshemustfulfillfromthosethatcanbecontrolledorlimited.C.Thecaregiverleavestheclientathomealoneforshortperiodsoftimetoencourageindependence.D.Thecaregiveravoidsaskingotherfamilymemberstohelpforfearofimposingonthem.29.Thenursemustassessjudgmenttodetermineaclient'smentalstatus.Whichtestbestaccomplishesthis?A.Interpretingproverbs.B.Spellingwordsbackward.C.Countingbyserialsevens.D.Discussinghypotheticalethicalsituations.30.Aclientreportslosinghisjob,notbeingabletosleepatnight,andfeelingupsetwithhiswife.Thenurserespondstotheclient,"Youmaywanttotalkaboutyouremploymentsituationingrouptoday."Thenurseisusingwhichtherapeutictechnique?A.Restating.B.Makingobservations.C.Exploring.D.Focusing.31.Anadolescentclientimmobilizedinaspicacastcomplainsofhavingtroublebreathingaftermeals.Whichofthefollowingactionswouldbebest?A.Encouragetheclienttodrinkmorebetweenmeals.B.Teachtheadolescentpurse&lipbreathing.C.Givetheclientalaxativeaftermeals.D.Offertheclientsmallfeedingsseveraltimesaday.32.Ahospitalizedclientcravesadrinkwhilewithdrawingfromalcohol.Whichofthefollowingmeasuresisthebestwaytohelptheclientresisttheurgetodrink?A.Aroutinesearchofvisitors.B.Alocked-doorpolicy.C.One-to-onesupervisionbythestaff.D.Supportfromotheralcoholicclients.33.Whenworkingwithaclientwhoisdepressed,thenurseshouldinitially:A.AcceptwhattheclientsaysB.AttempttokeeptheclientoccupiedC.TrytokeeptheclientfromtalkingtoomuchD.Keeptheclient'ssurroundingsbrightandgay34.Thenurseisplanningcareforaclientadmittedtothepsychiatricunitwithadiagnosisofparanoidschizophrenia.Whichnursingdiagnosisshouldreceivethehighestpriority?A.Riskforself-orother-directedviolence.B.Imbalancednutrition.C.Ineffectivecoping.D.Impairedverbalcommunication.35.Aclientwithleft-sidedheartfailurecomplainsofincreasingshortnessofbreathandisagitatedandcoughinguppink-tinged,foamysputum.ThenurseshouldrecognizetheseassignsandsymptomsofA.right-sidedheartfailure.B.acutepulmonaryedema.C.pneumonia.D.cardiogenicshock.36.Thenurseispreparingtocareforaclientdiagnosedwithcatatonicschizophrenia.Inanticipationofthisclient'sarrival,whatshouldthenursedo?A.Notifysecurity.B.Prepareamagnesiumsulfatedrip.C.Placeaspecialtymattressoverlayonthebed.D.Communicatetheclient'snothing-by-mouthstatustothedietarydepartment.37.Whenexaminingschool-ageandadolescentchildren,thenurseroutinelyscreensforscoliosis.Whichstatementaccuratelysummarizeshowtoperformthisscreening?A.Havethechildstandfirmlyonbothfeetandbendforwardatthehips,withthetrunkexposed.B.Listenforaclickingsoundasthechildabductsthehips.C.Havethechildruntheheelofonefootdowntheshinoftheotherlegwhilestanding.D.Havethechildshrugtheshouldersasthenurseappliesmildpressuretotheshoulders.38.Oninitialassessmentofa7-year-oldwithrheumaticfever,whichofthefollowingwouldrequirethenursetocontactthephysicianimmediately?A.Heartrateof150bpm.B.Twitchingintheextremities.C.Redrashonthetrunk.D.Swollenandpainfulkneejoints.39.Thenurseisinstructingaclientwithanginaaboutsublingualnitroglycerin.Whichofthefollowingpointsshouldbeincluded?A.Theshelflifeofnitroglycerinislong,itkeepsforupto2years.B.Storethetabletsinatight,light-resistantcontainer.C.Usethetabletsonlywhenthepainissevere.D.Thedrugwillcauseincreasedurineoutput.40.ThemostsignificantsignofacuterenalfailureisA.elevatedbodytemperature.B.increasedbloodpressure.C.decreasedurineoutput.D.increasedurinespecificgravity.41.A22-year-oldclientisdiagnosedwithdependentpersonalitydisorder.Whichbehaviorismostlikelytoindicateherineffectivecoping?A.Inabilitytomakechoicesanddecisionswithoutadvice.B.Showinginterestonlyinsolitaryactivities.C.Avoidingdevelopingrelationships.D.Recurrentself-destructivebehaviorwithhistoryofdepression.42.Duringtheassessmentstage,aclientwithschizophrenialeaveshisarmintheairafterthenursehastakenhisbloodpressure.Whichofthefollowingexplainshisaction?A.Somaticdelusions.B.Waxyflexibility.C.Neologisms.D.Nihilisticdelusions.43.ThephysicianhasorderedOxtriphyllin(CholedylSA)0.2g.Availabletabletsofthemedicineare100mg.Howmanytabletsshouldbegiven?A.0.5tablets.B.2.0tablets.C.2.5tablets.D.5.0tablets.44.Aclienthasjustfinishedhisglucosetolerancetest.Howmanyhoursshouldittakeforhisbloodglucoseleveltoreturntonormal?A.2hours.B.3hours.C.5hours.D.6hours.45.Thenurseisawarethatasidefromfeelingsadandhavingdifficultyconcentratingandsleeping,othercommonsignsofdepressioninclude:A.RigidandnarrowingofperceptionB.AlternatingepisodesoffatigueandhighenergylevelsC.DiminishedpleasureinactivitiesandalterationinappetiteD.Fleetingparticipationandinterestinactivitiesofdailyliving46.Theskinlesionsevidentinherpeszosteraresimilartothoseseeninwhichdisease?A.Impetigo.B.Syphilis.C.Varicella.D.Rubella.47.A10-year-olddiagnosedwithacuteglomerulonephritisisadmittedtothepediatricunit.Thenurseshouldensurethatwhichofthefollowingisapartofthechild'scare?A.Takingvitalsignsevery4hoursandobtainingdailyweight.B.Obtainingabloodsampleforelectrolyteanalysiseverymorning.C.Checkingeveryurinespecimenforproteinandspecificgravity.D.Ensuringthatthechildhasaccurateintakeandoutputandeatsahigh-proteindiet.48.Thenurseisprovidingcaretoa5-year-oldclientwithafracturedfemurwhosenursingdiagnosisisImbalancednutrition:lessthanbodyrequirementsrelatedtoimpairedphysicalmobility.Whichofthefollowingismostlikelytooccurwiththiscondition?A.Decreasedproteincatabolism.B.Increasedcalorieintake.C.Increaseddigestiveenzymes.D.Increasedcarbohydrateneed.49.Aclienthasanasogastrictubeinsertedatthetimeofabdominalperinealresectionwithpermanentcolostomy.Thistubewillmostlikelyberemovedwhentheclientdemonstrateswhichofthefollowing?A.Absenceofnauseaandvomiting.B.Absenceofstomachdrainagefor24hours.C.Passageofmucusfromtherectum.D.Passageofflatusandfecesfromthecolostomy.50.Whenspeakingwithamotheraccusedofchildabuse,thenurseshouldexpecthertoA.AttempttorationalizeandexplainherbehaviorB.OfferadetailedexplanationofhowhersonwasinjuredC.RevealanoverwhelmingfeelingthatherchildrenareworthlessD.Askhowshemaygetpermissiontovisithersononthepediatricunit第1卷参考答案一.Comprehensivetestcenter1.参考答案：CThepositivesymptomsofschizophreniaaredistortionsofnormalfunctioning,includinghallucinations,delusions,disorganizedthinking,somaticdelusions,echolalia,andwaxyflexibility.Aflataffect,alogia,apathy,avolition,andanhedoniarefertothenegativesymptoms.Negativesymptomslistthediminutionorlossofnormalfunction.2.参考答案：AWeightgainwillbeslowandgradualbecauselessfoodcanbeeatenatonetimeduetothedecreasedstomachsize.Morefoodandfluidwillbetoleratedasedemaatthesuturelinedecreasesandhealingprogresses.Theremainingstomachmaystretchovertimetoaccommodatemorefood.3.参考答案：A4.参考答案：ASharingneedlesisassociatedwithincreasedincidenceofblood-bornediseasessuchashepatitis.5.参考答案：BAtage3,childrenliketocolor,draw,andputtogetherpuzzles.Abicycleisappropriatefora5-or6-year-oldchild;apulltoy,foratoddler;andacomputergame,foraschool-agechild.6.参考答案：BTheBillofRightsforPsychiatricClientsincludestherightforclientstoaccesstheirmedicalrecordsunlessdoingsowouldbedetrimentaltotheirhealth.Todetermineifinformationmightbedetrimentaltotheclient,theprimarycareprovidershouldbeinformedoftheclient'srequest.Theclientdoesn'tneedanattorneytoviewhischart.Healsodoesn'tneedtowaituntilafterdischargetoviewit.7.参考答案：BNormaleatingispossibleoncethesuturelinehashealed.8.参考答案：CMeasurestotreatpruritusincludetepidspongebathsandtheuseofemollientcreamsandlotions.Hotwatershouldbeavoidedbecausecapillarydilationmayincreasepruritus.Warmwaterispreferredtocold.Theuseofemollientcreamsandlotionsondryskinisrecommended.9.参考答案：CFrequentvomitingcausestendernessandswellingoftheparotidglands.Thereducedmetabolismthatoccurswithsevereweightlossproducesbradycardiaandcoldextremities.Soft,downlikehair(calledlanugo)maycovertheextremities,shoulders,andfaceofananorexicclient.10.参考答案：DChildrenwithsicklecelldiseasearepronetodevelopinfectionsasaresultofthenecrosisofareaswithinthebodyandageneralizedless-than-optimalhealthstatus.Ifthechildwithsicklecellanemiadevelopssignsofinfection,suchassorethroatandfever,promptevaluationisnecessarybecauseaninfectioncanprecipitateacrisis.11.参考答案：C12.参考答案：A13.参考答案：CAdministeringatapwaterenemauntilreturnisclearwouldmostlikelycontributetoahyposmolarstate.Becausetapwaterishypotonic,itwouldbeabsorbedbythebody,dilutingthebodyfluidconcentrationandloweringosmolality.NGtubeirrigationwithnormalsalinesolutionwouldn'tcauseashiftinfluidbalance.Weighingtheclientistheeasiest,mostaccuratemethodtodeterminefluidchanges.Therefore,ithelpsidentifyratherthancontributetofluidimbalance.Drinkingbrothwouldn'tcontributetoahyposmolarstatebecauseitdoesn'treplacesodiumandwaterlostthroughexcessiveperspiration.14.参考答案：AAnyonewithpsoriasisvulgariswhoreportsjointpainshouldbeevaIuatedforpsoriaticarthritis.Approximately15%to20%ofindividualswithpsoriasiswillalsodeveloppsoriaticarthritis,whichcanbepainfulandcausedeformity.Itwouldbeincorrecttoassumethathispainiscausedbyearlyrheumatoidarthritisorhisvocationwithoutaskingmorequestionsorperformingdiagnosticstudies.Carpaltunnelsyndromecausessensoryandmotorchangesinthefingersratherthanlocalizedpaininthejoints.15.参考答案：DAcutelymphoblasticleukemiaanditstreatmentcauseimmunosuppression.ThoroughhandwashingisthesinglemosteffectivewaytopreventinfectioninanimmunosuppressedcIient.Reverseisolationdoesn'tsignificantlyreducetheincidenceofinfectioninimmunosuppressedclients;furthermore,isolationmaycausepsychologicalstress.Standardprecautionsareintendedmainlytoprotectcaregiversfromcontactwithinfectiousmatter,nottoreducetheclient'sriskofinfection.Staffandothersneednotwearmaskswhenvisitingbecausemostinfectionsaretransmittedbydirectcontact.Insteadofrelyingonmasksandotherbarriermethods,thenurseshouldkeeppersonswithknowninfectionsoutoftheclient'sroom.16.参考答案：B17.参考答案：DTheeatingproblemsassociatedwithParkinson'sdiseaseincludedysphagia,aspiration,constipation,andriskofchoking.Fluidoverload,anorexia,anddiarrheaaren'tproblemsspecificallyrelatedtoParkinson'sdisease.DroolingoccurswithParkinson'sdiseasebutdoesn'ttakepriority.18.参考答案：D19.参考答案：CIncreasingtheclient'sintakeoforalorIVfluidshelpsliquefythick,tenacioussecretionsandensuresadequatehydration.Turningtheclientevery2hourswoulddecreasepoolingofsecretionsbutwouldn'tliquefythem.Elevatingtheheadofthebedwouldreducepressureonthediaphragmandeasebreathingbutwouldn'tliquefysecretions.Maintainingacoolroomtemperaturewouldincreasetheclient'scomfortbutwouldn'tliquefysecretions.20.参考答案：DAclientinhypovolemicshockisbestpositionedsupineinbedwiththefeetelevated15degreestobringperipheralbloodintothecentralcirculation.21.参考答案：BAlloftheoutcomesstatedaredesirable;however,thebestoutcomeisthatthestudentwouldagreetoseektheassistanceofaprofessionalsubstanceabusecounselor.22.参考答案：AElderlyclientsandclientswithcardiacdiseaseshouldbeginwithlow-doselevothyroxineincreasedat2-to4-weekintervalsuntil100g/disreached.Thisslowtitrationpreventsfurthercardiacstress.Youngerclientswouldbestartedontheusualmaintenancedoseof100g/d.ClientswithHashimoto'sthyroiditisdon'trequiresurgicalintervention.23.参考答案：DParasympathetichyperactivityleadingtosuddenhypotensionsecondarytobradyrhythmiacausesvasovagalsyncope.Thatis,bradyrhythmialeadstocerebralischemiawhich,inturn,leadstosyncope.Vasovagalsyncopeisn'tcausedbyvestibular(innerear)dysfunction,vascularfluidshifting,orposturalhypotension.24.参考答案：DDiabetesinsipidusisanabruptonsetofextremepolyuriathatcommonlyoccursinclientsafterbrainsurgery.Cushing'ssyndromeisexcessiveglucocorticoidsecretionresultinginsodiumandwaterretention.Diabetesmellitusisahyperglycemicstatemarkedbypolyuria,polydipsia,andpolyphagia.Adrenalcrisisisundersecretionofglucocorticoidsresultinginprofoundhypoglycemia,hypovolemia,andhypotension.25.参考答案：BLiquidironsupplementsshouldbedilutedandtakenthroughastrawtohelpdecreasethelikelihoodofstainingtheteeth.26.参考答案：DAlthoughalloftheseinterventionsareimportant,reportingsignsofimpairedcirculationisthemostcritical.Signsofimpairedcirculationmustbereportedtothephysicianimmediatelytopreventpermanentdamage.Theotheroptionsreflectmorelong-termconcerns.Theclientshouldlearntousehiscrutchesproperlytoavoidnervedamage.Theclientmayexerciseaboveandbelowthecast,asthephysicianorders.Theclientshouldbetoldnottowalkonthecastwithoutthephysician'spermission.27.参考答案：BAtotalserumcholesterollevelof326mg/dLishigh.Aclientwithacholesterollevelof326willrequiredietarymodificationsandmaybeplacedonlipid-loweringmedication.28.参考答案：BThecaregivermustlearntodistinguishobligationsthatshemustfulfillandlimitthosethataren'tnecessary.Thecaregivercantelltheclientwhensheleavesbutsheshouldn'texpectthattheclientwillrememberorwon'tbecomeangrywithherforleaving.Thecaregivershouldn'tleavetheclienthomealoneforanylengthoftimebecauseitmaycompromisetheclient'ssafety.Thenursecanprovidesupporttotheprimarycaregiverifsheneedstoaskotherfamilymembersforassistance.29.参考答案：DHypotheticalethicalsituations--suchas"Whatwouldyoudoifyoufoundawalletcontainingcreditcardsandidentification?"--areusedtotestjudgment.Proverbinterpretationteststhinking.Spellingwordsbackwardandcountingbyserialsevenstestconcentration.30.参考答案：DThenurseisusingfocusingbysuggestingthattheclientdiscussaspecificissue.Shedidn'trestatethequestion,askfurtherquestions(exploring),anddidn'tmakeanobservation.31.参考答案：DAhipspicacastextendsupovertheabdomen.Becausetheabdomenisinafixedspace,abdominaldistentionsecondarytoeatingpushestheabdominalcontentsagainstthediaphragmresultingindecreasedchestexpansionandsubsequentpossiblerespiratorydistress.Becausetheclient'scomplaintsareassociatedwithmeals,offeringsmallfrequentmealsprovidesnutritionalsupportwhileminimizingdistention.32.参考答案：DGroupsupporthasprovedmoresuccessfulthanindividualattentionfromthestaffininfluencingpositivebehaviorinalcoholics.33.参考答案：A34.参考答案：ABecauseofsuchfactorsassuspiciousness,anxiety,andhallucinations,theclientwithparanoidschizophreniaisatriskforviolencetowardhimselforothers.Theotheroptionsarealsoappropriatenursingdiagnosesbutshouldbeaddressedafterthesafetyoftheclientandthosearoundhimisestablished.35.参考答案：BBecauseofdecreasedcontractilityandincreasedfluidvolumeandpressureinclientswithheartfailure,fluidmaybedrivenfromthepulmonarycapillarybedsintothealveoli,causingpulmonaryedema.Inright-sidedheartfailure,theclientexhibitshepatomegaly,jugularveindistention,andperipheraledema.Inpneumonia,theclientwouldhaveatemperaturespike,andsputumthatvariesincolor.Aclientincardiogenicshockwouldshowsignsofhypotensionandtachycardia.36.参考答案：CThenurseshouldfirstfocusonmeetingtheclient'simmediatephysicalneedsandpreventingcomplicationsrelatedtothecatatonicstate.Theneedforinterventionfromsecuritypersonnelisunlikely.Amagnesiumsulfatedripisn'tindicated.Nutritionalstatusshouldbeaddressedaftertheclientisfullyassessedandadmitted.37.参考答案：AToscreenforscoliosis,alat