ADH 2 Exam 1 Practice Questions

A client who plays tennis is experiencing elbow discomfort. Following assessment, the client receives a diagnosis of tendinitis, epicondylitis, or tennis elbow. What symptoms and signs did the client have? Select all that apply. pain more prominent at night pain or burning in one or both hands pain radiating down the dorsal surface of the forearm weak grasp

pain radiating down the dorsal surface of the forearm weak grasp

The nurse teaches the client who demonstrates herpes zoster (shingles) that the infection results from reactivation of the chickenpox virus. once the client has had shingles, they will not have it a second time. no known medications affect the course of shingles. a person who has had chickenpox can contract it again upon exposure to a person with shingles.

the infection results from reactivation of the chickenpox virus.

A nurse is caring for a client with a chronic disease. What statement made by the client indicates that additional teaching is necessary? "Certain chronic diseases only affect men." "Most chronic disease can be traced to modifiable risk factors." "The majority of chronic diseases are known." "Chronic disease does not typically cause sudden death."

"Certain chronic diseases only affect men." Chronic disease almost always impacts women at the same rate as men.

When using the Palmer method to estimate the extent of a small or scattered burn injury, the nurse recognizes the palm is equal to which percentage of total body surface area? 4 1 3 2

1

A client with a severe electrical burn injury is treated in the burn unit. Which laboratory result would cause the nurse the most concern? BUN: 28 mg/dL K+: 5.0 mEq/L Na+: 145 mEq/L Ca: 9 mg/dL

BUN: 28 mg/dL

In a client with a dislocation, the nurse should initially perform neurovascular assessments a minimum of every 15 minutes until stable. Which complication does the assessments help the nurse to monitor in the client? Carpal tunnel syndrome Compartment syndrome Fat embolism syndrome Disseminated intravascular coagulation

Compartment syndrome

Which type of fracture is one in which the skin or mucous membrane extends to the fractured bone? Compound Incomplete Simple Complete

Compound

A client receives hydromorphone 2 mg intravenously for report of postoperative pain. Fifteen minutes later, the nurse notes respirations are 6 breaths/minute and the client is nonresponsive. The nurse administers prescribed naloxone. The next time the client reports pain, the best nursing action is: Administer one-half of the prescribed opioid dose. Consult with the healthcare provider to reduce the dose. Withhold the hydromorphone. Ensure naloxone is available.

Consult with the healthcare provider to reduce the dose.

After a car accident, a client is admitted to an acute care facility with multiple traumatic injuries, including a fractured pelvis. For 24 to 48 hours after the accident, the nurse must monitor the client closely for which potential complication of a fractured pelvis? Infection Compartment syndrome Fat embolism Volkmann's ischemic contracture

Fat embolism

Which is a cause related to the increasing number of people with chronic conditions? Shorter lifespans A tendency for these conditions to develop in younger people An increase in mortality from infectious disease Improved screening and diagnostic procedures

Improved screening and diagnostic procedures

To reduce the incidence of complications in a client in traction, which intervention should be included in the care plan? Reduce fluid intake. Increase fiber intake. Remove the weights during linen changes. Increase calorie intake.

Increase fiber intake.

Which disability model is most appropriate for the nurse to use as a guide for planning care? Medical and Rehabilitation Model Biopsychosocial Model Interface Model Social Model

Interface Model

Which of the following is a true statement regarding psoriasis? A cure is possible with prompt treatment. The onset typically occurs in young children. It is a chronic, infectious inflammatory disease. It is characterized by patches of redness covered with silvery scales.

It is characterized by patches of redness covered with silvery scales.

A client has partial-thickness burns on both lower extremities and portions of the trunk. Which IV fluid does the nurse plan to administer first? Albumin Normal saline solution with 20 mEq of potassium per 1,000 ml Dextrose 5% in water (D5W) Lactated Ringer's solution

Lactated Ringer's solution

Which of the following is an appropriate teaching component for the client diagnosed with lice to prevent reinfestation? Infestation is a reflection of hygiene practices. Pediculicides may be used on pets. There is no risk when used in pregnant women. Perform hair inspection whenever there is an outbreak, even if asymptomatic.

Perform hair inspection whenever there is an outbreak, even if asymptomatic.

A nurse is caring for a client who underwent a total hip replacement. What should the nurse and other caregivers do to prevent dislocation of the new prosthesis? Keep the affected leg in a position of adduction. Use measures other than turning to prevent pressure ulcers. Prevent internal rotation of the affected leg. Keep the hip flexed by placing pillows under the client's knee.

Prevent internal rotation of the affected leg.

A nurse is aware that after a burn injury and respiratory difficulties have been managed, the next most urgent need is to: Replace lost fluids and electrolytes. Measure hourly urinary output. Monitor cardiac status. Prevent renal shutdown.

Replace lost fluids and electrolytes.

A nurse is required to monitor the effectiveness of fluid resuscitation in a client who is being treated for burns. Which of the following assessments would indicate the success of the fluid resuscitation? The client is alert and conscious. The client's heart rate is rapid and regular. The client's breathing is unlabored, and skin is clammy. The client's urinary output is 0.3 to 0.5 mL/kg/hour.

The client's urinary output is 0.3 to 0.5 mL/kg/hour.

A client has severe osteoarthritis in the left hip and is having surgery to replace both articular surfaces of the hip. What type of surgical procedure will the nurse prepare the client for? Arthrodesis Hemiarthroplasty Total arthroplasty Osteotomy

Total arthroplasty

A client who has been burned significantly is taken by air ambulance to the burn unit. What physiologic process furthers a burn injury? intravascular fluid excess inflammatory neuroendocrine hypertension

inflammatory

The nurse is educating a client with low back pain on proper lifting techniques. The nurse recognizes that the education was effective when the client Reaches over the head with the arms fully extended. bends at the hips and tightens the abdominal muscles. uses a narrow base of support. places the load close to the body.

places the load close to the body.

A client is being discharged from the Emergency Department after being diagnosed with a sprained ankle. Which client statement indicates the client understands the discharge teaching? "I'll make sure to keep my ankle elevated as much as possible." "I'll start with ice for the first couple of hours and then apply heat." "I'll get the prescription filled for the narcotic pain reliever." "I need to stay off my ankle for at least the next 3 to 4 weeks."

"I'll make sure to keep my ankle elevated as much as possible."

A client is brought to the emergency department with partial-thickness and full-thickness burns on the left arm, left anterior leg, and anterior trunk. Using the Rule of Nines, what is the total body surface area that has been burned? 27% 18% 30% 36%

36%

A group of students is studying for a test on traction. The students demonstrate understanding of the types of traction when they identify which of the following as an example of skin traction? Buck's Crutchfield tongs Balanced suspension Thomas splint

Buck's

The client is admitted to the hospital with a diagnosis of left femoral neck fracture. Which treatment modality would the nurse expect the physician to order? Casting Buck's traction Skeletal traction External fixator

Buck's traction

The nurse recognizes which disorder as a developmental disability in a patient? Stroke Cerebral palsy Spinal cord injury Osteoarthritis

Cerebral palsy

The nurse is caring for a client with diabetes. Which of the following is a characteristic of chronic illness? Managing chronic conditions must be an individual process. Chronic illness affects the entire family. One chronic disease never develops into another chronic condition. Chronic conditions only involve one aspect of a person's life.

Chronic illness affects the entire family.

Clients must contend with chronic illness daily. Nurses relate more effectively to clients when they understand the following as characteristics of chronic illness. Choose all that apply. Chronic conditions only involve one phase of a person's life. Chronic illness affects the entire family. Managing chronic conditions must be a collaborative process. Chronic illness involves treating only the medical problems. The management of chronic conditions is a process of discovery.

Chronic illness affects the entire family. Managing chronic conditions must be a collaborative process. The management of chronic conditions is a process of discovery.

Which chronic illness directly related to an unhealthy lifestyle does the nurse understand is increasing rapidly? Diabetes mellitus Colorectal cancer Breast cancer Emphysema

Diabetes mellitus

Which is a benefit of a continuous passive motion (CPM) device when applied after knee surgery? It promotes healing by immobilizing the knee joint. It promotes healing by increasing circulation and movement of the knee joint. It provides active range of motion. It prevents infection and controls edema and bleeding.

It promotes healing by increasing circulation and movement of the knee joint.

Which assessment findings would the nurse expect in a client diagnosed with osteomyelitis? Leukocytosis and localized bone pain Petechiae over the chest and abnormal ABGs Pruritus and uremic frost Thrombocytopenia and ecchymosis

Leukocytosis and localized bone pain

A client has undergone an external fixation. Which actions would be the priority for this client? Monitoring the client's blood pressure. Maintaining pin care. Planning the client's diet. Monitoring the client's urine output.

Maintaining pin care.

Which type of debridement occurs when nonliving tissue sloughs away from uninjured tissues? Natural Mechanical Enzymatic Surgical

Natural

The number of people with disabilities is expected to increase over time. What is a major contributor to this prediction? The ability to cure chronic disorders that are acquired The survival of people with severe trauma, chronic disorders, and early-onset disabilities The decrease in the number of people with early-onset disabilities The decrease in risk factors for early-onset disabilities that are genetic in cause

The survival of people with severe trauma, chronic disorders, and early-onset disabilities

Which sign may be helpful in identifying carpal tunnel syndrome? Babinski's Tinel's Kernig's Brudzinski's

Tinel's

The nurse is instructing the parents of a child with head lice. Which statement should the nurse include? Wash clothes in cold water. Disinfect brushes and combs with bleach. Use shampoo with Kwell. Use shampoo with piperonyl butoxide.

Use shampoo with piperonyl butoxide.

As the first priority of care, a patient with a burn injury will initially need: fluids replaced. a patent airway established. an indwelling catheter inserted. pain medication administered.

a patent airway established.

A client is seen in the emergency department for an injury acquired from falling off of a bicycle and fracturing the arm. The client also has a long laceration that has been sutured in the same area. The client asks the nurse why a splint is applied and not a cast. What is the best explanation by the nurse? "The arm does not require the same immobilization that a leg fracture would." "We will need to monitor the status of the laceration to be sure it does not get infected." "The splint is less expensive than the cast." "You will be able to wear the splint longer than you would a cast."

"We will need to monitor the status of the laceration to be sure it does not get infected."

The nurse is planning discharge instructions for the client with osteomyelitis. What instructions should the nurse include in the discharge teaching? "You will receive IV antibiotics for 3 to 6 weeks." "You need to limit the amount of protein and calcium in your diet." "You need to perform weight-bearing exercises twice a week." "Use your continuous passive motion machine (CPM) 2 hours each day."

"You will receive IV antibiotics for 3 to 6 weeks."

When providing discharge teaching to a client with a fractured toe, the nurse should include which instruction? Use crutches for 1 week. Apply ice to the fracture site. Apply heat to the fracture site. Perform ankle dorsiflexion three times per day.

Apply ice to the fracture site.

A nurse is assigned to work with a client who has a disability. The nurse believes that all people with disabilities have a poor quality of life and are dependent and nonproductive. What type of barrier will this client experience? Barrier to health care Structural barrier Attitudinal barrier Transportation barrier

Attitudinal barrier Attitudinal barriers are barriers in which bias, mistaken beliefs, and prejudices impose limitations for people with disabilities.

A client who has sustained a fracture reports an increase in pain and decreased function of the affected extremity. The nurse would suspect which of the following? Pulmonary embolism Infection Avascular necrosis Hypovolemic shock

Avascular necrosis

The nurse is working with a client who has difficulty controlling her blood sugar. The overweight client does not adhere to a low-calorie diet and forgets to take medications and check her blood glucose level. The client's glycohemoglobin is 8.5%. When establishing a goal for the client, the nurse first? Sets the long-term goal as "the client's glycohemoglobin will be 6.9% in 3 months" Informs the client about what goal the nurse wants the client to achieve Plans the short-term goal as "the client's blood sugar each AM will be less than 110 mg/dL" Collaborates with the client to establish an agreed-upon goal

Collaborates with the client to establish an agreed-upon goal

Which of the following would lead a nurse to suspect that a client has a rotator cuff tear? Pain worse in the morning Minimal pain with movement Ability to stretch arm over the head Difficulty lying on affected side

Difficulty lying on affected side

After undergoing surgery the previous day for a total knee replacement, a client states that he doesn't feel ready to ambulate yet. What should the nurse do? Do nothing because the client has the ultimate right to determine his degree of participation. Tell the client that she'll contact the physician and report his noncompliance. Discuss the complications that the client's may experience if he doesn't cooperate with the care plan. Document the client's refusal to ambulate.

Discuss the complications that the client's may experience if he doesn't cooperate with the care plan.

The nurse is caring for a client who had a total knee replacement 3 days ago. Which nursing assessment finding requires immediate attention by the nurse? Previous shift urine output = 500 ml Hypoactive bowel sounds Drainage from wound suction device = 100 ml Crackles that clear with coughing

Drainage from wound suction device = 100 ml Drainage from a wound suction device should be less than 25 ml 48 hours after surgery; 100 ml is an excessive amount and may necessitate opening of the wound to remove the blood.

A nursing instructor is discussing the causes of the increasing number of people with chronic conditions. Which of the following would the nurse correctly identify as a cause? Shorter lifespans An increased mortality rate from infectious diseases Lowered stress and increased physical activity lifestyles Early detection and treatment of diseases

Early detection and treatment of diseases

Which general nursing measure is used for a client with a fracture reduction? Promote intake of omega-3 fatty acids Assist with intake of immune-enhancing tube feeding formulas Encourage participation in ADLs Examine the abdomen for enlarged liver or spleen

Encourage participation in ADLs

A nurse notices a client lying on the floor at the bottom of the stairs. He's alert and oriented and states that he fell down several stairs. He denies pain other than in his arm, which is swollen and appears deformed. After calling for help, what should the nurse do? Raise the client's arm above his heart. Help the client walk to the nearest nurses' station. Place the client in a sitting position. Immobilize the client's arm.

Immobilize the client's arm.

Radiographic evaluation of a client's fracture reveals that a bone fragment has been driven into another bone fragment. The nurse identifies this as which type of fracture? Greenstick Compression Comminuted Impacted

Impacted

While examining a client's leg, a nurse notes an open ulceration with visible granulation tissue in the wound. Until a wound specialist can be contacted, which type of dressing should the nurse apply? Moist sterile saline gauze Sterile petroleum gauze Dry sterile dressing Povidone-iodine-soaked gauze

Moist sterile saline gauze Moist sterile saline dressings support wound healing and are cost-effective. Dry sterile dressings adhere to the wound and debride the tissue when removed.

The nurse teaches the client which intervention to avoid hip dislocation after replacement surgery? Avoid placing a pillow between the legs when sleeping Bend forward only when seated in a chair Never cross the affected leg when seated Keep the knees together at all times

Never cross the affected leg when seated

The nurse is caring for a client with an external fixator that requires pin care twice a day. The nurse observes that there is a new purulent drainage around one of the pins. What intervention should the nurse anticipate doing? Applying iodine-based solution Apply ointment to the pin site. Obtaining a culture Scrubbing the drainage from around the pin site

Obtaining a culture

A patient is diagnosed with psoriasis after developing scales on the scalp, elbows, and behind the knees. The patient asks the nurse where this was "caught." What is the best response by the nurse? Psoriasis comes from dermal abrasion. Psoriasis is an inflammatory dermatosis that results from a superficial infection with Staphylococcus aureus. Psoriasis is an inflammatory dermatosis that results from an overproduction of keratin. Psoriasis results from excess deposition of subcutaneous fat.

Psoriasis is an inflammatory dermatosis that results from an overproduction of keratin.

A patient has a burn injury that has damaged the epidermis. There are no blisters, and the skin is pink in color. This type of burn injury would be documented as which of the following? Full-thickness Superficial Superficial partial-thickness Deep partial-thickness

Superficial

The nurse notes that the client's lower extremities are covered with very dry skin and that the horny layer of the skin has become thickened. The nurse notes the finding as lichenification. dermatitis. pyodermas. acantholysis.

lichenification. The nurse should note this as being lichenification, also called scaling. Dermatitis is an inflammation of the skin. Acantholysis is a separation of the epidermal cells from each other, and pyodermas is a bacterial skin infection.

A nurse is caring for a client who recently underwent a total hip replacement. The nurse should: allow the client's legs to be crossed at the knees when out of bed. limit hip flexion of the client's hip when he sits. use soft chairs when the client is sitting out of bed. ease the client onto a low toilet seat.

limit hip flexion of the client's hip when he sits.

A client with a superficial partial-thickness solar burn (sunburn) of the chest, back, face, and arms is seen in urgent care. The nurse's primary concern should be: body image. pain management. fluid resuscitation. infection.

pain management.

The nurse is caring for a client with questionable lice infestation. The nurse is using a bright light focused on an area of the head to confirm the presence of lice. In which manner is it easiest to differentiate nits from dandruff? Dandruff looks white and flakey. Nits are difficult to move from hair shafts. Nits are located near the scalp. Dandruff is throughout the hair.

Nits are difficult to move from hair shafts.

A client has lost mobility following a stroke. The nurse has established interventions that include providing direct care to the client, teaching, making referrals, and managing the case, to meet the goal. The next step is to Instruct the client what he or she must do. Assist the familly in obtaining equipment that would help the client to walk. Refer the client to physical therapy for ambulation exercise two times a week. Plan with the client how to incorporate the regimen into the client's activities of daily living.

Plan with the client how to incorporate the regimen into the client's activities of daily living.

The nurse recognizes that goal of treatment for metastatic bone cancer is to: Diagnose the extent of bone damage Reconstruct the bone with a prosthesis Promote pain relief and quality of life Cure the diseased bone and cartilage

Promote pain relief and quality of life

The nurse is assessing a patient with toxic epidermal necrolysis (TEN). What assessment data would indicate that the patient may be progressing to keratoconjunctivitis? Select all that apply. Burning of the eyes Pruritus of the eyes Blurred optic discs Skin peeling on eyelids Dryness of the eyes

Pruritus of the eyes Burning of the eyes Dryness of the eyes