Chronic Exam 1

An initiative has been launched in a large hospital to promote the use of "people-first" language in formal and informal communication. What is the significance to the client when the nurse uses "people-first" language?

The person is of more importance to the nurse than the disability.

a nurse is caring for a client following insertion of a permanent pacemaker. which of the following client statements indicates a potential complication of the insertion procedure?

" I cant get rid of these hiccups"

A young female client smokes two packs of cigarettes and drinks a six-pack of beer each day. The nurse is attempting to teach the client about smoking cessation and decreasing alcohol intake. The client states, "My grandmother lived to be in her 90s, and she smoked and drank. I come from good genes." The most apropriate statement by the nurse is

"Certain illnesses can be traced to common risk factors and can be prevented."

A client tells the nurse that her doctor just told her that her new diagnosis of rheumatoid arthritis is considered to be a "chronic condition." She asks the nurse what "chronic condition" means. What would be the nurse's best response?

"Chronic conditions are defined as health problems that require management of several months or longer."

When caring for clients with disabilities, nurses need to understand not only pathophysiological issues but also the concept of disability. Which of the following statements to the client demonstrates that the nurse understands the concept of disability?

"I have collaborated with a social worker to assess your needs for after discharge."

A 19-year-old client with a diagnosis of Down syndrome is being admitted to the unit for the treatment of community-acquired pneumonia. When planning this client's care, the nurse recognizes that this client's disability is categorized as what?

A developmental disability

A client who has recently been diagnosed with chronic heart failure is being taught by the nurse how to live successfully with her chronic condition. Her ability to meet this goal will primarily depend on her ability to do which of the following?

Adapt her lifestyle to accommodate her symptoms.

A client has a tentative diagnosis of lung cancer following computed tomography (CT) scanning. He is scheduled for a fiberoptic bronchoscopy with biopsy. In the trajectory phase of the Trajectory Model of Chronic Illness, the nurse

Answers the client's questions about the bronchoscopy procedure

A nurse is performing a cardiac assessment on a client. Identify the area the nurse should inspect when evaluating the point of maximal impulse.

Apex

A nurse is admitting a client who has a leg ulcer and history of DM. The nurse should use which of the following focused assessment to help differentiate b/t an arterial ulcer and a venous stasis ulcer?

Inquire about the presence or absence of claudication

A nurse is planning a presentation about hypertension for a community women's group. Which of the following lifestyle modifications should the nurse include?

Limited alcohol intake, regular exercise program, and smoking cessation.

Chronic conditions are most acutely experienced by clients and their immediate familiies. Nurses provide direct care especially during actue episodes. Which of the following is an example of what the nurse can do for a client with a chronic illness?

Provide teaching and secure resources and other support systems needed.

In which phase of the trajectory model of chronic illness are symptoms under control and managed?

Stable

A client is hospitalized with a traumatic brain injury following an automobile accident. The client has difficulty processing information and needs information to be repeated. A consulting physician enters the room. The nurse

Turns off the television

A nurse is caring for a client following an abdominal aortic aneurysm resection. Which of the following is the priority assessment for this client?

Urine output

A client experiencing a manic phase of bipolar disorder sustained cuts on the body from falling through a store window. The nurse is preparing to start an intravenous needle insertion and explains the procedure to the client

Using clear and simple terms

a nurse is caring for a client who is being treated for heart failure and has prescriptions for digoxin and furosemide. the nurse should plan to monitor for which of the folling as an adverse effect of these medications?

lightheadness

a client who has a new diagnosis of hypertension has a prescription for an ACE inhibitor. the nurse instructs the client about adverse effects of the medication. the client demonstrates an understanding of the teaching by stating that he will notify his provider if he experiences which of the following?

persistent cough

a nurse is caring for a client in the first hour following an aortic aneurysm repair. which of the following findings can indicate shock and should be reported to the provider?

urine output of 20 mL/hr

a nurse is caring for a client who has a history of angina and is scheduled for a stress test at 1100. which of the following statements by the client requires the nurse to contact the provider for possible rescheduling?

"I smoked a cigarette this morning to calm my nerves about having this procedure."

A client from a low socioeonomic background was diagnosed with a chronic health problem. The client states, "Everyone has to die of something." The most appropriate response by this nurse is

"There are things you can do to minimize the effects of this disease on your health."

The nurse is presenting health education to a 48-year-old man who was just diagnosed with type 2 diabetes. The client has a BMI of 35 and leads a sedentary lifestyle. The nurse gives the client information on the risk factors for his diagnosis and begins talking with him about changing behaviors around diet and exercise. The nurse knows that further client teaching is necessary when the client tells you what?

"There is nothing that can be done anyway, because chronic diseases like diabetes cannot be prevented."

A nurse providing teaching for a client who is 2 days post-op following a heart transplant. Which of the following statements should the nurse include in the teaching?

"You may no longer be able to feel chest pain."

a nurse is caring for a client who is scheduled for a coronary artery bypass graft (CABG) in 2 hr. which of the following client statements indicates a need for further clarification by the nurse?

"i took my warfarin last night according to my usual schedule."

A man and woman are in their early 80s and have provided constant care for their 44-year-old son who has Down syndrome. When planning this family's care, the nurse should be aware that the parents most likely have what concerns around what question?

"who will care for our son once were unable?"

A nurse is monitoring a client following coronary artery bypass graft surgery. Which of the following can indicate cardiac tamponade?

Blood pressure 140/82 on inspiration and 154/90 on expiration

A nurse is caring for a client who had an onset of chest pain 24 hours ago. The nurse should recognize that an increase in which of the following is a diagnostic of an MI?

Creatine kinase-MB

a nurse is caring for a client who has a history of deep vein thrombosis and is receiving warfarin. which of the following client findings provides the nurse with the best evidence regarding the effectiveness of the warfarin therapy?

INR 2.5

A nursing instructor is discussing characteristics of chronic illness with a class. The instructor asks the students to name one characteristic. Which of the following answers is correct?

Managing chronic conditions must be a collaborative process.

Which is a true statement regarding characteristics of chronic conditions?

Managing chronic conditions must be a collaborative process.

A client who is hearing impaired and communicates through sign language only is scheduled for an endoscopy. She does not read lips. It would be best for the nurse to

Obtain a sign interpreter

A client with end-stage lung cancer has been admitted to hospice care. The hospice team is meeting with the client and her family to establish goals for care. What is likely to be a first priority in goal setting for the client?

Pain control

A nurse is providing discharge teaching for a client who has a prescription for the transdermal NTG patch. Which of the following instruction should the nurse include in the teaching?

Place the patch on an area of skin away from skin folds and joints

A nurse is preparing a client for a coronary angiography. The nurse should report which of the following findings to the provider prior to the procedure?

Previous allergic reaction to shellfish

The nurse is caring for a client who communicates via sign language. What should the nurse should do to promote communication?

Provide a sign language interpreter.

A community health nurse has drafted a program that will address the health promotion needs of members of the community who live with one or more disabilities. Which of the following areas of health promotion education is known to be neglected among adults with disabilities?

Sexual health

a nurse is providing discharge teaching for a client who has heart failure. the nurse should instruct the client to report which of the followings immediately to the provider?

weight gain of 0.9 kg (2 lb) in 24 hr

A nurse us reviewing the ECG rhythm strip of a client who is receiving telemetry. Where should the nurse observe for atrial depolarization.

The P wave. Atrial depolarization

An elderly client has presented to the clinic with a new diagnosis of osteoarthritis. The client's daughter is accompanying him and the nurse has explained why the incidence of chronic diseases tends to increase with age. What rationale for this phenomenon should the nurse describe?

With age, biologic changes reduce the efficiency of body systems.

a nurse is providing health teaching for a group of clients. which of the following clients is at risk for developing peripheral arterial disease?

a client who has diabetes mellitus

a nurse in the emergency department is caring for a client who had an anterior myocardial infarction. the client's history reveals she is 1 week postoperative open cholecystectomy. the nurse should recognize that which of the following interventions is contraindicated?

assisting with thrombolytic therapy

a nurse is caring for a client in the first 8 hr following coronary artery bypass graft (CABG) surgery. which of the following client findings should the nurse report to the provider?

blood pressure 160/80 mm Hg

a nurse is reviewing the laboratory results of several clients who have peripheral arterial disease. the nurse should plan to provide dietary teaching for the client who has which of the following laboratory values?

cholesterol 190 mg/dL, HDL 25 mg/dL, LDL 160 mg/dL

a nurse is assessing a client in the emergency room who has a bradydysrhythmia. which of the following findings should the nurse expect?

confusion

a nurse is caring for a client who has dilated cardiomyopathy. the client reports increasing difficulty completing her daily 1-mile walks. the nurse should recognize that this is a finding of which of the following?

left ventricular failure

a nurse is caring for a client who presents to the emergency department with a blood pressure of 254/139 mm/Hg. the nurse recognizes that the client is in a hypertensive crisis. which of the following actions should the nurse take first?

place the head of the bed at 45 degrees

a nurse is caring for a client who has heart failure and is experiencing atrial fibrillation. the nurse should plan to monitor for and report which of the following findings to the provider immediately?

slurred speech

A nurse is reviewing the medical record of a client who is receiving heparin therapy for treatment of deep-vein thrombosis. Which of the following interventions should the nurse anticipate taking if the client's aPTT is 96 seconds?

stop the heparin infusion

a nurse is watching a client's ECG monitor and notes that the client's rhythm has changed from a normal sinus rhythm to a supraventricular tachycardia. the client is conscious with a heart rate of 200 to 210/min and has a faint radial pulse. the nurse should anticipate assisting with which of the following interventions?

vagal stimulation

a nurse is caring for a client who has endocarditis. which of the following findings should the nurse recognize as a potential complication?

valvular disease

a nurse is assessing a client who has a left-sided heart failure. which of the following manifestations should the nurse expect to find?

weak peripheral pulses