310 Adult Health Final Review (UMB)

56. The healthcare provider is teaching a group of senior citizens about risk factors for heart failure. Which of these factors will the healthcare provider include in the teaching? Select all that apply. a. Hypertension b. High sodium intake c. Increased High Density Lipoproteins (HDL) d. History of preeclampsia

a. Hypertension b. High sodium intake d. History of preeclampsia

8. What are the usual signs and symptoms a male would present with for prostate cancer? (Select all) a. Increased prostate size b. Decreased PSA c. Increased urinary frequency d. Sexual dysfunction e. Constipation

a. Increased prostate size c. Increased urinary frequency d. Sexual dysfunction

85. A client with hyperthyroidism is about to receive radioactive iodine as an outpatient. What safety measures should the nurse teach the client to protect his family while he undergoes treatment? a) Good hand washing b) How to isolate himself in one room of the house c) Use of disposable eating utensils d) Not worrying about precautions

c) Use of disposable eating utensils

83. A nurse is caring for a client with syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which finding would indicate that the client has developed fluid overload? a) Confusion and diarrhea b) Pulmonary congestion and muscle cramps c) Hypertension and weight gain without edema d) Dyspnea and hypertension

d) Dyspnea and hypertension

92. A nurse practitioner prescribes drug therapy for a patient with peptic ulcer disease. Choose the drug that can be used for 4 weeks and has a 90% chance of healing the ulcer a) Ranitidine (Zantac b) Cimetidine (Tagamet) c) Famotidine (pepcid) d) Omeprazole (Prilosec)

d) Omeprazole (Prilosec)

39. A client is scheduled for computed tomography (CT) of the kidneys to rule out renal disease. As an essential preprocedural component of the nursing assessment, the nurse plans to ask the client about a history of: a) familial renal disease b) frequent antibiotic use c) long-term diuretic therapy d) allergy to shellfish or iodine

d) allergy to shellfish or iodine

54. The nurse enters the room of the client diagnosed with congestive heart failure. The client is lying in bed gasping for breath, is cool and clammy, and has buccal cyanosis. Which intervention would the nurse implement first? A. Sponge the client's forehead B. Obtain a pulse oximetry reading C. Take the client's vital signs D. Assist the client into a sitting position

D. Assist the client into a sitting position

46. A patient presents to the ED in distress and complaining of "crushing" chest pain. What is the nurse's priority for assessment? A) Prompt initiation of an ECG B) Auscultation of the patient's point of maximal impulse (PMI) C) Rapid assessment of the patient's peripheral pulses D) Palpation of the patient's cardiac apex

A) Prompt initiation of an ECG

41. A nurse is assigned to care for a client with nephrotic syndrome. The nurse assesses which important parameter on a daily basis? a) weight b) albumin levels c) activity tolerance d) blood urea nitrogen (BUN) level

a) weight

90. A client has a history of gastroesophageal reflux disease (GERD). Why should the nurse also monitor the client for clinical manifestations of heart disease? A. Esophageal pain may imitate the symptoms of a heart attack. B. GERD may predispose to heart disease. C. Strenuous exercise may exacerbate reflux problems. D. Similar changes in laboratory studies may occur in both cardiac and reflux problems.

A. Esophageal pain may imitate the symptoms of a heart attack.

13. Which client is at most risk for cancer? A) 25-year old client who works in construction B) 35- year old client who smokes ½ a pack of cigarettes a day C) 45- year old client who is overweight and unemployed D) 65-year old client who has had multiple UTIs

B) 35- year old client who smokes ½ a pack of cigarettes a day

10. The client diagnosed with leukemia is being admitted for an induction course of chemotherapy. Which laboratory values indicate a diagnosis of leukemia? a. A left shift in the WBC count differential b. A large number of WBCs that decreases after the administration of antibiotics c. An abnormally low Hb and Hct levels d. RBC that are larger than normal

a. A left shift in the WBC count differential

100. Which signs and symptoms should the nurse report to the healthcare provider for the client recovering from an open cholecystectomy? Select all that apply. A) Clay-colored stools B) Yellow-tinted sclera C) Amber- Colored urine D) Wound Approximated E) Abdominal Pain

A) Clay-colored stools B) Yellow-tinted sclera E) Abdominal Pain

50. The nurse is assessing a patient with acute coronary syndrome (ACS). The nurse includes a careful history in the assessment, especially with regard to signs and symptoms. What signs and symptoms are suggestive of ACS? Select all that apply. A) Dyspnea B) Unusual fatigue C) Hypotension D) Syncope E) Peripheral cyanosis

A) Dyspnea B) Unusual fatigue D) Syncope

97. A patient has developed hepatic encephalopathy secondary to cirrhosis and is receiving care on the medical unit. The patient's current medication regimen includes lactulose (Cephulac) four times daily. What desired outcome should the nurse relate to this pharmacologic intervention? A) Two to three soft bowel movements daily B) Significant increase in appetite and food intake C) Absence of nausea and vomiting D) Absence of blood or mucus in stool

A) Two to three soft bowel movements daily

52. A 70-year-old woman with chronic heart failure and atrial fibrillation asks the nurse why warfarin (Coumadin) has been prescribed for her to continue at home. Which response by the nurse is accurate? A. "The medication prevents blood clots from forming in your heart." B. "The medication dissolves clots that develop in your coronary arteries." C. "The medication reduces clotting by decreasing serum potassium levels." D. "The medication increases your heart rate so that clots do not form in your heart."

A. "The medication prevents blood clots from forming in your heart."

31. A client comes to the emergency department complaining of severe pain in the right flank, nausea, and vomiting. The physician tentatively diagnoses right ureterolithiasis (renal calculi). When planning this client's care, the nurse should assign the highest priority to which nursing diagnosis? A. Acute pain B. Impaired urinary elimination C. Risk for infection D. Imbalanced nutrition: Less than body requirements

A. Acute pain

91. A nurse is teaching a patient who just underwent a gastric bypass, due to peptic ulcers, how to prevent dumping syndrome. What are ways the patient can prevent dumping syndrome? Select all that apply. A. Avoid gassy foods, such as beans, broccoli, corn etc. B. Eat slowly, small bites, chew well C. Lie down after meals D. Drink a glass of water with meals E. Avoid carbonated drinks

A. Avoid gassy foods, such as beans, broccoli, corn etc. B. Eat slowly, small bites, chew well E. Avoid carbonated drinks

82. The nurse in an outpatient clinic receives a blood test report of moderately elevated thyroid-stimulating hormone (TSH) and markedly decreased T3 and T4 levels. Which signs and/or symptoms should be expected in the client's evaluation? Select all that apply A. Cold intolerance B. Constipation C. Forgetfulness D. Hair loss E. Warm, moist skin F. Weight loss

A. Cold intolerance B. Constipation C. Forgetfulness D. Hair loss

89. A male client with a history of cirrhosis is admitted to the Intensive Care Unit (ICU) with esophageal varices. Which signs and symptoms alert the nurse to suspect rupturing of the esophageal varices? Select all that apply. A. Hemoglobin of 9.1 g/dL and Hematocrit of 32% B. Pain and localized tenderness in the calf C. Heart Rate of 124 beats per minute D. Cool, clammy skin E. Calcium level of 8.3mg/dL

A. Hemoglobin of 9.1 g/dL and Hematocrit of 32% C. Heart Rate of 124 beats per minute D. Cool, clammy skin

24. When assessing the chest drainage system, what indicates to the nurse that the water seal chamber is functioning properly? SELECT ALL THAT APPLY A. It contains 2 cm of water B. There is tidaling in the chamber. C. There is vigorous bubbling in the chamber. D. There is gentle bubbling sometimes in the chamber.

A. It contains 2 cm of water B. There is tidaling in the chamber. D. There is gentle bubbling sometimes in the chamber.

30. Examination of a client's bladder stones reveals that they are primarily composed of uric acid. The nurse would expect to provide the client with which type of diet? A. Low Purine B. Low Calcium C. High Calorie D. High Carbohydrate

A. Low Purine

80. Based on the clinical manifestations of Cushing syndrome, which nursing intervention would be appropriate for a client who is newly diagnosed with Cushing syndrome? A. Monitor blood glucose levels daily. B. Increase intake of fluids high in potassium. C. Encourage adequate rest between activities. D. Offer the client a sodium-enriched menu.

A. Monitor blood glucose levels daily.

34. A 27-year-old male patient was admitted with severe left flank pain. After a confirmation of a renal calculi, what would be the most appropriate nursing interventions. Select all that apply. A. Strain all urine output B. Administer a low-fat diet. C. Promote increased fluid intake D. Position patient in Trendelenburg position. E. Administer prescribed analgesics

A. Strain all urine output C. Promote increased fluid intake E. Administer prescribed analgesics

21. A client is admitted with an exacerbation of asthma following a respiratory viral illness. Which clinical manifestations characteristic of a severe asthma attack does the nurse expect to assess? Select all that apply. A. accessory muscle use B. chest tightness C. high pitched expiratory wheeze D. prolonged inspiratory phase E. tachypnea

A. accessory muscle use B. chest tightness C. high pitched expiratory wheeze E. tachypnea

88. The nurse is assessing a client with an ulcer for signs and symptoms of hemorrhage. The nurse interprets which condition as a sign/symptom of possible hemorrhage? A) Hypertension B) Hematemesis C) Bradycardia D) Clay-colored stool

B) Hematemesis

45. An adult patient is admitted to the ED with chest pain. The patient states that he had developed unrelieved chest pain that was present for approximately 20 minutes before coming to the hospital. To minimize cardiac damage, the nurse should expect to administer which of the following interventions? A) Thrombolytics, oxygen administration, and nonsteroidal anti-inflammatories B) Morphine sulphate, oxygen, and bed rest C) Oxygen and beta-adrenergic blockers D) Bed rest, albuterol nebulizer treatments, and oxygen

B) Morphine sulphate, oxygen, and bed rest

48. A patient with angina has been prescribed nitroglycerin. Before administering the drug, the nurse should inform the patient about what potential adverse effects? A) Nervousness or paresthesia B) Throbbing headache or dizziness C) Drowsiness or blurred vision D) Tinnitus or diplopia

B) Throbbing headache or dizziness

12. A client is asking about possible ways of prevention against skin cancer, which is a potential way of prevention? A) Drinking more fluids B) Wearing and reapplying the appropriate sunscreen C) Attending regular prostate screenings D) Attending regular breast exams

B) Wearing and reapplying the appropriate sunscreen

28. An 82-year-old male patient is receiving continuous bladder irrigation with 0.45% NaCl. 1200ml have been instilled, a total output of 1500ml is collected in the Foley catheter collection bag. What would be the true urine output? A. 2700 ml B. 300 ml C. 1500 ml D. 1200 ml

B. 300ml

101. For Rico who has chronic pancreatitis, which nursing intervention would be most helpful? A. Allowing liberalized fluid intake B. Counseling to stop alcohol consumption C. Encouraging daily exercise D. Modifying dietary protein

B. Counseling to stop alcohol consumption

5. A 45 y/o male is 3 days post-op for an appendectomy. This patient is 5'8 and weighs 310 pounds. The patient complains of feeling like "something gave out" as he was coughing. What would the nurse expect? A. Evisceration B. Dehiscence C. Abdominal distension D. Rupture of abdominal aortic aneurysm

B. Dehiscence

32. After undergoing retropubic prostatectomy, a client returns to his room. The client is on nothing-by-mouth status and has an IV infusing in his right forearm at a rate of 100 ml/hour. The client also has an indwelling urinary catheter that's draining light pink urine. While assessing the client, the nurse notes that his urine output is red and has dropped to 15 ml and 10 ml for the last 2 consecutive hours. How can the nurse best explain this drop in urine output? A. It's a normal finding associated with the client's nothing-by-mouth status. B. It's an abnormal finding that requires further assessment. C. It's an abnormal finding that will correct itself when the client ambulates. D. It's a normal finding caused by blood loss during surgery.

B. It's an abnormal finding that requires further assessment.

4. What is the primary consideration of a PACU nurse caring for a post op patient? A. Checking vitals q 15 mins B. Maintaining a patent airway C. Administering prescribed meds D. Removing the dressing and checking the surgical site

B. Maintaining a patent airway

6. The nurse would be alerted to malignant hyperthermia when the patient demonstrates which of the following? A. Hypocapnia B. Muscle rigidity C. Decrease body temperature D. Confusion upon arrival from anesthesia

B. Muscle rigidity

53. Which of the following are NOT typical signs and symptoms of right-sided heart failure? Select-all-that-apply: A. Jugular venous distention B. Persistent cough C. Weight gain D. Crackles E. Nocturia F. Orthopnea

B. Persistent cough D. Crackles F. Orthopnea

25. While helping a patient with a chest tube reposition in the bed, the chest tube becomes dislodged. What is your immediate nursing intervention? A. Stay and monitor patient the patient's vitals. Tell another nurse notifies the physician. B. Place a sterile dressing over the site and tape it on three sides and notify the physician. C. Attempt to re-insert the tube. D. Keep the site open to air and notify the physician.

B. Place a sterile dressing over the site and tape it on three sides and notify the physician.

1. A patient scheduled for a cholecystectomy is undergoing routine pre-admission testing. Which lab values would warrant concern from the nurse? A. Calcium 10.5 mg/dL B. WBC 14,000 C. PTT 35 seconds D. HCT 35%

B. WBC 14000

51. The nurse is participating in the care conference for a patient with ACS. What goal should guide the care team's selection of assessments, interventions, and treatments? A) Maximizing cardiac output while minimizing heart rate B) Decreasing energy expenditure of the myocardium C) Balancing myocardial oxygen supply with demand D) Increasing the size of the myocardial muscle

C) Balancing myocardial oxygen supply with demand

98. Which of the following would be the most important nursing assessment in a patient diagnosed with ascites? a) Auscultation of abdomen b) Abdominal assessment for rebound tenderness C) Daily weight and measurement of abdominal girth d) Yellowing of the skin and eyes

C) Daily weight and measurement of abdominal girth

27. The nurse is caring for a client with a chest tube that was placed 2 hours ago for a pneumothorax. Where would the nurse expect gentle, continuous bubbling? A) Air leak monitor B) Collection chamber C) Suction control chamber D) Water seal chamber

C) Suction control chamber

49. Family members bring a patient to the ED with pale cool skin, sudden midsternal chest pain unrelieved with rest, and a history of CAD. How should the nurse best interpret these initial data? A) The symptoms indicate angina and should be treated as such. B) The symptoms indicate a pulmonary etiology rather than a cardiac etiology. C) The symptoms indicate an acute coronary episode and should be treated as such. D) Treatment should be determined pending the results of an exercise stress test.

C) The symptoms indicate an acute coronary episode and should be treated as such.

2. A nurse assesses her patient postop and obtains vital signs. The patient's blood pressure is 90/50, heart rate is 120, the patient is in visible distress and his skin is clammy. What action should the nurse do immediately? A. Continue to monitor the patient and document vital signs B. Check the patient's blood sugar for hypoglycemia C. Notify the physician D. Ask the patient if he is in pain and administer pain medications

C. Notify the physician

29. To determine the severity of the symptoms for a patient with benign prostatic hyperplasia (BPH), the nurse will ask the patient about A. the presence of blood in the urine. B. any erectile dysfunction (ED). C. Occurrence of a weak urinary stream. D. lower back and hip pain

C. Occurrence of a weak urinary stream.

47. A patient presents to the walk-in clinic complaining of intermittent chest pain on exertion, which is eventually attributed to angina. The nurse should inform the patient that angina is most often attributable to what cause? A) Decreased cardiac output B) Decreased cardiac contractility C) Infarction of the myocardium D) Coronary arteriosclerosis

D) Coronary arteriosclerosis

96. 3. A nurse is participating in the emergency care of a patient who has just developed variceal bleeding. What intervention should the nurse anticipate? A) Infusion of intravenous heparin B) IV administration of albumin C) STAT administration of vitamin K by the intramuscular route D) IV Administration of octreotide (Sandostatin)

D) IV Administration of octreotide (Sandostatin)

26. The patient in room 2569 calls on the call light to tell you something is wrong with his chest tube. When you arrive to the room you note that the drainage system has fallen on its side and is leaking drainage onto the floor from a crack in the system. What is your next PRIORITY? A. Place the patient in supine position and clamp the tubing. B. Notify the physician immediately. C. Disconnect the drainage system and get a new one D. Disconnect the tubing from the drainage system and insert the tubing 1 inch into a bottle of sterile water and obtain a new system.

D. Disconnect the tubing from the drainage system and insert the tubing 1 inch into a bottle of sterile water and obtain a new system.

81. The nurse assesses a client who had a thyroidectomy 8 hours ago. The nurse finds the client anxious, with tingling around the mouth and muscle twitching in the right arm. Which action is most important for the nurse to implement first? A. Change the surgical dressing to assess for bleeding B. Document the findings in the electronic medical record C. Draw arterial blood gases D. Obtain a serum calcium level

D. Obtain a serum calcium level

3. A patient has undergone a hysterectomy and is on a medical surgical floor for recovery. He is 12 hours post op and physical therapy comes to ambulate him. Which situation would the nurse continue to ambulate the patient? A. Patient's chart shows H&H low & stable vitals B. Blood pressure shows a significant decrease from laying to sitting C. Order states bed rest for 48 hours due to increased bleeding risk D. Patient is hesitant to start walking & has 3/10 pain in surgical area

D. Patient is hesitant to start walking & has 3/10 pain in surgical area

33. Which of the following nursing actions is most important in caring for the client following lithotripsy? A. Administer allopurinol (Zyloprim). B. Monitor the continuous bladder irrigation. C. Notify the physician of hematuria. D. Strain the urine carefully for stone fragments.

D. Strain the urine carefully for stone fragments.

59. During an assessment of a patient's abdomen, a pulsating abdominal mass is noted by the healthcare provider. Which of the following should be the healthcare provider's next action? a. Assess femoral pulses b. Measure the abdominal circumference c. Obtain a bladder scan d. Ask the patient to perform Valsalva maneuvers

a. Assess femoral pulses

95. The nurse understands that which of these body substances are modes of transmission for hepatitis B? Select all that apply. a. Blood b. Feces c. Semen d. Urine e. Vaginal secretions

a. Blood c. Semen e. Vaginal secretions

79. The nurse assesses a female client with a diagnosis of primary adrenal insufficiency (Addison's disease). The nurse recognizes which finding associated with the disease? a. Bronze pigmentation of skin b. Increased body or facial hair c. Purple or red striae on the abdomen d. Supraclavicular fat pad

a. Bronze pigmentation of skin

77. A nurse is caring for a client who has Cushing syndrome due to an adrenal tumor. Which assessment finding(s) should the nurse anticipate in this client? Select all that apply. a. Hirsutism b. Hypotension c. Serum potassium is 5.8 mEq/L d. Serum sodium is 154 mEq/L e. Truncal Obesity

a. Hirsutism d. Serum sodium is 154 mEq/L e. Truncal Obesity

55. The client is admitted to the telemetry unit diagnosed with acute exacerbation of congestive heart failure (CHF). Which signs/symptoms would the nurse expect to find when assessing this client? a) Apical pulse rate of 110 and 4+ pitting edema of feet b) Thick white sputum and crackles that clear with cough. c) The client sleeping with no pillow and eupnea. d) Radial pulse rate of 9- and capillary refill time <3 seconds.

a) Apical pulse rate of 110 and 4+ pitting edema of feet

16. While a nurse is conducting an initial assessment on a client, which classic sign would alert the nurse that the client has chronic obstructive pulmonary disease (COPD)? a) Barrel Chest b) Cyanosis c) Hyperventilation d) Lordosis

a) Barrel Chest

18. The nurse cares for a client with a pulmonary embolism. Which of the following clinical manifestations would the nurse anticipate? Select all that apply. a) Chest pain b) Dyspnea c) Bradycardia d) Hypoxemia e) Tachypnea

a) Chest pain b) Dyspnea d) Hypoxemia e) Tachypnea

19. A client with left-sided pneumonia is admitted to the medical unit. The nurse assesses intermittent cough production of copious amounts of thick yellow sputum and identifies ineffective airway clearance as the priority nursing diagnosis. Which interventions are appropriate to facilitate secretion removal? Select all that apply. a) Chest physiology b) Cough suppressant c) Huff coughing technique d) Left-side lying position e) Pursed lip breathing

a) Chest physiology c) Huff coughing technique

93. A client with peptic ulcer disease wants to know non-pharmacologic ways that he can prevent recurrence. Which of the following measures would the nurse recommend? Select all that apply. a) Smoking cessation b) Following a regular schedule for rest, relaxation, and meals c) Substitution of coffee with decaffeinated products d) Avoidance of alcohol

a) Smoking cessation b) Following a regular schedule for rest, relaxation, and meals d) Avoidance of alcohol

43. The nurse is providing care to a client who has had a kidney biopsy. The nurse would need to be alert for signs and symptoms of which of the following? a) bleeding b) GERD c) micturition d) dizziness

a) bleeding

66. A client is admitted to the hospital with a recurrence of chronic arterial insufficiency of the legs. Which clinical manifestations does the nurse expect to identify when performing an admission history and physical? a. Pain when exercising and thickening of the toenails b. Edema of the feet and ankles c. Reddened and painful areas on the calves d. Ulcers around the ankles and reports of a dull ache in the legs

a. Pain when exercising and thickening of the toenails

9. The nurse recognizes which of the following conditions as an oncologic emergency. (Select all that apply) a. Cardiac Tamponade b. Leukopenia c. Syndrome of Inappropriate Antidiuretic Hormone (SIADH) d. Hypercalcemia e. Hypophosphatemia f. Tumor Lysis Syndrome (TLS)

a. cardiac tamponade c. Syndrome of Inappropriate Antidiuretic Hormone (SIADH) d. Hypercalcemia f. Tumor Lysis Syndrome (TLS)

70. A nurse expects to note an elevated serum glucose level in a client with hyperosmolar hyperglycemic nonketotic syndrome (HHNS). Which other laboratory finding should the nurse anticipate? a.) below-normal serum potassium level b.) serum alkalosis c.) serum ketone bodies d.) elevated serum acetone level

a.) below-normal serum potassium level

73. Which combination of adverse effects should a nurse monitor for when administering IV insulin to a client with diabetic ketoacidosis? a.) hypokalemia and hypoglycemia b.) hypocalcemia and hyperkalemia c.) hyperkalemia and hyperglycemia d.) hypernatremia and hypercalcemia

a.) hypokalemia and hypoglycemia

99. The nurse is teaching a client recovering from a laparoscopic cholecystectomy. Which statement indicates the discharge teaching is effective? a) "I will take my lipid-lowering medicine at the same time every night" b) "I may experience some discomfort when I eat a high-fat meal" c) "I need someone to stay with me for about a week after surgery" d) "I should not splint my incision when I deep breathe and cough.

b) "I may experience some discomfort when I eat a high-fat meal"

38. A patient has stage 3 chronic kidney failure. What would the nurse expect the patient's glomerular filtration rate (GFR) to be? a) A GFR of 90 mL/min b) A GFR of 30-59 mL/min c) A GFR of 120 mL/min d) A GFR of 85 mL/min

b) A GFR of 30-59 mL/min

94. The nurse is caring for a client with cirrhosis of the liver. Which blood test values would the nurse typically anticipate to be elevated when reviewing the client's morning laboratory results? Select all that apply. a) Albumin b) Ammonia c) Bilirubin d) Prothrombin time e) Sodium

b) Ammonia c) Bilirubin d) Prothrombin time

17. A patient has been diagnosed with right lower lobe pneumonia. Upon auscultation of the lung what sound does the nurse expect to hear? a) Wheezes b) Crackles c) C-Stridor d) D-Rhonchi

b) Crackles

15. Which nursing assessment data support that the client has experienced a pulmonary embolism? a) Calf pain with dorsiflexion of the foot. b) Sudden onset of chest pain and dyspnea. c) Left-sided chest pain and diaphoresis. d) Bilateral crackles and low-grade fever.

b) Sudden onset of chest pain and dyspnea.

64. A client reports foot pain and is diagnosed with arterial insufficiency. The nurse provides teaching about what the client can do to increase arterial dilation and to decrease foot pain. Which client statement indicates to the nurse that further teaching is needed? a. "I will wear socks." b. "I will elevate my foot." c. "I will increase fluid intake." d. "I will drink a moderate amount of alcohol."

b. "I will elevate my foot."

14. Four clients with different skin alterations come to the ED. Which clients would the nurse advise the health care provider (HCP) see first? a. 8-year-old client who uses corticosteroid inhaler and has white patches on the tongue b. 50-year-old client who developed a smooth, red, pinpoint rash after taking sulfa c. 60-year-old client with pain and crusted blisters along the back d. 70-year-old client who has erythema with a small pustule at the hair follicle

b. 50-year-old client who developed a smooth, red, pinpoint rash after taking sulfa

67. A nurse is teaching a group of clients with peripheral vascular disease about a smoking cessation program. Which physiologic effect of nicotine should the nurse explain to the group? a. Constriction of the superficial vessels dilates the deep vessels b. Constriction of the peripheral vessels increases the force of flow c. Dilation of the superficial vessels causes constriction of collateral circulation d. Dilation of the peripheral vessels causes reflex constriction of visceral vessels

b. Constriction of the peripheral vessels increases the force of flow

58. Which of the following are signs of a rupturing AAA? Select all that apply: a. Increased BP b. Decreased Hct c. Low Back Pain d. Decreased BP e. Intermittent abdominal pain

b. Decreased Hct c. Low Back Pain d. Decreased BP

63. A client who had injection sclerotherapy for varicose veins is advised to wear compression (support) stockings. What is most important for the nurse to explain to the client about compression stockings? a. Put the stockings on at the first sign of discomfort b. Don the stockings before getting out of bed in the morning c. Ensure that the cuff of the stockings reaches the middle of the knees d. Substitute elastic bandages for compression stockings if they are more comfortable

b. Don the stockings before getting out of bed in the morning

37. A client admitted with a gunshot wound to the abdomen is transferred to the intensive care unit after an exploratory laparotomy. IV fluid is being infused at 150 mL/hour. Which assessment finding suggests that the client is experiencing acute renal failure (ARF)? a. Blood urea nitrogen (BUN) level of 22 mg/dl b. Urine output of 250 ml/24 hours c. Temperature of 100.2° F (37.8° C) d. Serum creatinine level of 1.2 mg/dl

b. Urine output of 250 ml/24 hours

61. The nurse is watching the cardiac monitor and notices that the rhythm suddenly changes. No P waves or QRS complexes are seen instead, the monitor screen shows an irregular wavy line. The nurse interprets that the client is experiencing which rhythm? a. Sinus tachycardia b. Ventricular fibrillation c. Ventricular tachycardia d. Premature ventricular contractions (PVC)

b. Ventricular fibrillation

71. A nurse is assessing a client who is receiving total parenteral nutrition (TPN). Which finding suggests that the client has developed hyperglycemia? a.) Cheyne-Stokes respirations b.) Increased urine output c.) Decreased appetite d.) Diaphoresis

b.) Increased urine output

72. A client who was diagnosed with type 1 diabetes 14 years ago is admitted to the medical-surgical unit with abdominal pain. On admission, the client's blood glucose level is 470 mg/dl. Which finding is most likely to accompany this blood glucose level? a.) cool, moist skin b.) rapid, thready pulse c.) arm and leg trembling d.) slow, shallow respirations

b.) rapid, thready pulse

65. A client with varicose veins is scheduled for surgery. Which clinical finding does the nurse expect to identify when assessing the lower extremities of this client? a) Pallor b) Yellowed toenails c) Ankle edema d) Diminished pedal pulses

c) Ankle edema

84. Which of the following instructions should be included in the discharge teaching plan for a client after thyroidectomy for Graves' disease? a) Keep an accurate record of intake and output. b) Use nasal desmopressin acetate (DDAVP). c) Be sure to get regular follow-up care. d) Be sure to exercise to improve cardiovascular fitness

c) Be sure to get regular follow-up care.

20. A nurse is developing a teaching plan for a client with asthma. Which teaching point has the highest priority? a) Change filters on heating and air conditioning units frequently. b) Avoid contact with fur-bearing animals. c) Take ordered medications as scheduled. d) Avoid goose down pillows.

c) Take ordered medications as scheduled.

42. Diagnosis of acute pyelonephritis has been established your nursing intervention includes the following except: a) provide health teaching and discharge planning b) administer antibiotic c) measure I and O d) provide adequate comfort and rest

c) measure I and O

68. The nurse is caring for a client who has an occlusion of the left femoral artery and is scheduled for an arteriogram. Which clinical finding is most significant when assessing the left extremity before the arteriogram? a. Mottling of the leg b. Coolness of the foot c. Absence of the pedal pulses d. Thickening of the toenails on the foot

c. Absence of the pedal pulses

76. Following an addisonian crisis, a patients adrenal function has been gradually regained. The nurse should ensure that the patient knows about the need for supplementary glucocorticoid therapy in which of the following circumstances? a. Episodes of physical exertion b. Periods of dehydration c. Episodes of high psychosocial stress d. Administration of a vaccine

c. Episodes of high psychosocial stress

87. A nurse is performing discharge teaching with a client who had a total gastrectomy. Which statement indicates the need for further teaching? a. I will call my physician if I begin to have abdominal pain. b. I will weigh myself each day and record the weight. c. I will have to take vitamin B12 shots up to 1 year after surgery. d. I'm going to visit my pastor weekly for a while.

c. I will have to take vitamin B12 shots up to 1 year after surgery.

86. The nurse practicing in an out-patient clinic cares for a client recently diagnosed with hyperthyroidism. Which diet-related teaching should the nurse add to the client's plan of care? Select all that apply. a. Emphasize the importance of a low-carbohydrate diet b. Encourage the client to increase high-fiber foods in the diet c. Include meals and snacks high in protein content d. Teach avoidance of caffeine-containing liquids e. Teach the client about consumption of a high-calorie diet of 4000-5000 calories/day

c. Include meals and snacks high in protein content d. Teach avoidance of caffeine-containing liquids e. Teach the client about consumption of a high-calorie diet of 4000-5000 calories/day

22. A student nurse is talking to her nursing instructor about taking care of patients with chest tubes. What statement by the student nurse requires further teaching by her instructor? a. Chest Tubes can be inserted in the 5th or 6th intercostal space to drain fluid but not to drain air. b. Tidaling in the water seal chamber is normal. c. Keep the drainage system next to the patient on a table, so it doesn't get caught on anything. d. Chest Tube Assessment STOP stands for, Site, Tubing, Output and Patency.

c. Keep the drainage system next to the patient on a table, so it doesn't get caught on anything.

57. What is the only non-surgical treatment for patients with AAA? a. Increase calcium intake b. Increase sodium intake c. Maintain blood pressure d. Complete bed rest

c. Maintain blood pressure

11. The nurse receives report on the assigned team of clients on the oncology unit. All receiving chemotherapy. Which client should the nurse check on first? a. Alopecia and oral mucositis notes on assessment b. Morning hemoglobin result in 8 g/dL (80 g/L) c. New-onset back pain and weakness in legs d. Persistent vomiting and potassium result is 3.4 mEq/L (3.4 mmol/L)

c. New-onset back pain and weakness in legs

7. A client with polycythemia vera comes into the clinic for a monthly treatment. The nurse knows that treatment for this condition will consist of which of the following? a. Blood transfusion b. Fluid bolus c. Phlebotomy d. Steroid injections

c. Phlebotomy

78. A nurse is caring for a client with hyperaldosteronism (Conn's Syndrome). Which assessment(s) should the nurse anticipate in this client? Select all that apply. a. Acidosis b. Hypoglycemia c. Polyuria d. Hypertension e. Hypokalemia

c. Polyuria d. Hypertension e. Hypokalemia

75. The nurse writes a problem of "altered body image" for a 34-year-old client with Cushing's disease. Which intervention should be implemented? a. Monitor blood glucose levels prior to meals and at bedtime. b. Perform a head-to-toe assessment on the client every shift. c. Use therapeutic communication to allow the client to discuss feelings. d. Assess bowel sounds and temperature every four hours.

c. Use therapeutic communication to allow the client to discuss feelings.

60. What is the cause for an elevated T wave? a. Ischemia b. Hypokalemia c. hyperkalemia d. Pregnancy

c. hyperkalemia

35. A client has an arteriovenous (AV) fistula in place in the right upper extremity for hemodialysis treatments. When planning care for this client, which of the following measures should the nurse implement to promote client safely? a) take blood pressures only on the right arm to ensure accuracy b) use the fistula for all venipunctures and intravenous infusions c) ensure that small clamps are attached to the AV fistula dressing d) assess the fistula for the presence of a bruit and thrill every 4 hours

d) assess the fistula for the presence of a bruit and thrill every 4 hours

40. The client in end-stage of renal failure had undergone kidney transplant. Which of the following assessment findings indicate kidney transplant rejection? a) increased urinary output, BUN = 15 mg/dL b) HCT = 50%, Hgb = 17 g/dl c) decreased urinary output, sudden weight gain d) decreased urinary output, sudden weight loss

d) decreased urinary output, sudden weight loss

36. The client with chronic renal failure who is scheduled for hemodialysis this morning is due to receive a daily dose of enalapril (Vasotec). The nurse should plan to administer this medication: a) during dialysis b) just before dialysis c) the day after dialysis d) on return from dialysis

d) on return from dialysis

23. You are providing care to a patient with a chest tube. On assessment of the drainage system, you note continuous bubbling in the water seal chamber and oscillation. Which is the correct nursing intervention for this type of finding? a. Reposition the patient before the tubing is kinked. b. Continue to monitor the drainage system. c. Increase the suction to the drainage system until the bubbling stops. d. Check the drainage system for an air leak.

d. Check the drainage system for an air leak.

102. A 70-year-old client is admitted with acute pancreatitis. The nurse understands that the mortality rate associated with acute pancreatitis increases with advanced age and attributes this to which gerontologic consideration associated with the pancreas? a. Increases in the bicarbonate output by the kidneys b. Development of local complications c. Increases in the rate of pancreatic secretion d. Decreases in the physiologic function of major organs

d. Decreases in the physiologic function of major organs

74. A nurse teaches a client with type 2 diabetes how to provide self-care to prevent infections of the feet. Which statement made by the client shows that teaching was effective? a.) "I should massage my feet and legs with oil or lotion" b.) "I should apply heat intermittently to my feet and legs" c.) "I should eat foods high in protein and carbohydrates kilocalories" d.) "I should control my blood glucose with diet, exercise, and medication"

d.) "I should control my blood glucose with diet, exercise, and medication"

69. The nurse cares for a client diagnosed with type I diabetes mellitus who came to the emergency department with the acute complication of diabetic ketoacidosis (DKA). After checking the blood glucose, which prescription should the nurse implement first? a.) Insert an indwelling urinary catheter for accurate output calculation b.) Obtain serum potassium level results and report to the primary health care provider c.) Prepare an insulin drip for intravenous (IV) infusion as prescribed d.) Start an IV line and infuse normal saline as prescribed

d.) Start an IV line and infuse normal saline as prescribed