Exam 1 study guide

B, D, C, A

A 10-year-old girl was playing on a slide at a playground during a summer camp. She fell and broke her arm. The camp notified the parents and took the child to the emergency department according to the camp protocol for injuries. The parents arrive at the emergency department and are stressed and frantic. The 10-year-old is happy in the treatment room, eating a Popsicle and picking out the color of her cast. List in order of priority what the nurse should say to the parents. A. "Can I contact someone to help you?" B. "Your daughter is happy in the treatment room, eating a Popsicle and picking out the color of her cast." C. "I'll have the doctor come out and talk to you as soon as possible." D. "I want to be sure you are ok. Let's talk about what your concerns are about your daughter before we go see her."

D. "Tell me what you mean when you say you can't go on any longer."

A 34-year-old single father who is anxious, tearful, and tired from caring for his three young children tells the nurse that he feels depressed and doesn't see how he can go on much longer. Which statement would be the nurse's best response? A. "Are you thinking of suicide?" B. "You've been doing a good job raising your children. You can do it!" C. "Is there someone who can help you during the evenings and weekends?" D. "Tell me what you mean when you say you can't go on any longer."

C. roux-en-Y gastric bypass

A 40-year-old female patient has extreme obesity and type 2 diabetes. She wants to lose weight. After learning about the surgical procedures, she thinks a combination of restrictive and malabsorptive surgery would be the best. Which procedure should the nurse teach her about? A. Lipectomy B. Sleeve gastrectomy C. roux-en-Y gastric bypass D. Adjustable gastric banding

A. "It was very frightening for you."

A client brought to the emergency department is perspiring profusely, breathing rapidly, and having dizziness and palpitations. Problems of a cardiovascular nature are ruled out, and the client's diagnosis is tentatively listed as a panic attack. After the symptoms pass, the client states, "I thought I was going to die." Which of the following responses by the nurses is best? A. "It was very frightening for you." B. "We would not have let you die.' C. "I would have felt the same way." D. "But you're okay now."

A. Referral to social service process reestablishing the child's disability payment C. Coordinating hospital-based and home-based schooling with the child's teacher D. Teaching the mother signs and symptoms of a respiratory tract infection

A crisis intervention nurse is working with a mother whose child with Down syndrome has been hospitalized with pneumonia and who has lost her child's disability payment while the child is hospitalized. The mother worries that her daughter will fall behind in her classes during hospitalization. Which strategies are effective in helping this mother cope with these stressors? (Select all that apply.) A. Referral to social service process reestablishing the child's disability payment B. Sending the child home in 72 hours and having the child return to school C. Coordinating hospital-based and home-based schooling with the child's teacher D. Teaching the mother signs and symptoms of a respiratory tract infection E. Telling the mother that the stress will decrease in 6 weeks when everything is back to normal

C, D, B, A, E

A new nurse is going to help a patient walk down the corridor and sit in a chair. The patient has an eye patch over the left eye and poor vision in the right eye. What is the correct order of steps to help the patient safely walk down the hall and sit in the chair? A. Tell patient when you are approaching the chair. B. Walk at a relaxed pace. C. Guide patient's hand to nurse's arm, resting just above the elbow. D. Position yourself one-half step in front of patient. E. Position patient's hand on back of chair.

A. Demonstrate hearing aid battery replacement. B. Review method to check volume on hearing aid. D. Discuss the importance of having wax buildup in the ear canal removed.

A nurse is performing a home care assessment on a patient with a hearing impairment. The patient reports, "I think my hearing aid is broken. I can't hear anything." After determining that the patient's hearing aid works and that the patient is having trouble managing the hearing aid at home, which of the following teaching strategies does the nurse implement? (Select all that apply.) A. Demonstrate hearing aid battery replacement. B. Review method to check volume on hearing aid. C. Demonstrate how to wash the earmold and microphone with hot water. D. Discuss the importance of having wax buildup in the ear canal removed. E. Recommend a chemical cleaner to remove difficult buildup.

C. Placing necessary objects such as the nurse call system and water in front of the patient to prevent falls caused by reaching D. Orienting the patient to the environment to reduce anxiety and prevent further injury to the eye E. Alerting other nurses and health care providers about patient's visual status during hand-off reports

A nurse is performing an assessment on a patient admitted to the unit following treatment in the emergency department for severe bilateral eye trauma. During patient admission the nurse's priority interventions include which of the following? (Select all that apply.) A. Conducting a home-safety assessment and identifying hazards in the patient's living environment B. Reinforcing eye safety at work and in activities that place the patient at risk for eye injury C. Placing necessary objects such as the nurse call system and water in front of the patient to prevent falls caused by reaching D. Orienting the patient to the environment to reduce anxiety and prevent further injury to the eye E. Alerting other nurses and health care providers about patient's visual status during hand-off reports

A. Teaching how activities such as reading and using crossword puzzles provide stimulation C. Turning on the lights and opening the room blinds D. Sitting down, speaking, touching, and listening to his feelings and perceptions

A patient has been on contact isolation for 4 days because of a hospital-acquired infection. He has had few visitors and few opportunities to leave his room. His ambulation is also still limited. Which are the correct nursing interventions to reduce sensory deprivation? (Select all that apply.) A. Teaching how activities such as reading and using crossword puzzles provide stimulation B. Moving him to a room away from the nurses' station C. Turning on the lights and opening the room blinds D. Sitting down, speaking, touching, and listening to his feelings and perceptions E. Providing auditory stimulation for the patient by keeping the television on continuously

A. Use meditation D. Do favorite escape activity (e.g. playing cards) E. Share feelings with spouse or other family members

A patient has recently had a myocardial infarction. What emotion-focused coping strategies should the nurse encourage him to use to adapt to the physical and emotional stress of his illness (select all that apply). A. Use meditation B. Plan dietary changes C. Start an exercise program D. Do favorite escape activities (e.g. playing cards) E. Share feelings with spouse or other family members.

B. Have her grasp your arm just above the elbow and walk at a comfortable pace. C. Stand next to your mom at the top and bottom of stairs.

A patient is returning to an assisted-living apartment following a diagnosis of declining, progressive visual loss. Although she is familiar with her apartment and residence, she reports feeling a little uncertain about walking alone. There is one step into her apartment. Her children are scheduling themselves to be available to their mom for the next 2 weeks. Which of the following approaches will you teach the children to assist ambulation? (Select all that apply.) A. Walk one-half step behind and slightly to her side. B. Have her grasp your arm just above the elbow and walk at a comfortable pace. C. Stand next to your mom at the top and bottom of stairs. D. Stand one step ahead of mom at the top of the stairs. E>. Place yourself alongside your mom and hold onto her waist.

A. Denial

A patient who is having difficulty managing his diabetes mellitus responds to the news that his hemoglobin A1c, a measure of blood sugar control over the past 90 days, has increased by saying, "The hemoglobin A1c is wrong. My blood sugar levels have been excellent for the last 6 months." Which defense mechanism is the patient using? A. Denial B. Conversion C. Dissociation D. Displacement

A. Sharing information about senior transportation services D. Providing information about local social groups in the patient's neighborhood E. Recommending that the patient consider making living arrangements that will put him closer to family or friends

A patient with progressive vision impairments had to surrender his driver's license 6 months ago. He comes to the medical clinic for a routine checkup. He is accompanied by his son. His wife died 2 years ago, and he admits to feeling lonely much of the time. Which of the following interventions reduce loneliness? (Select all that apply.) A. Sharing information about senior transportation services B. Reassuring the patient that loneliness is a normal part of aging C. Maintaining distance while talking to avoid overstimulating the patient D. Providing information about local social groups in the patient's neighborhood E. Recommending that the patient consider making living arrangements that will put him closer to family or friends

A. The man with peptic ulcer disease.

After receiving the assigned patients for the day, the nurse determines that stress-relieving interventions are a priority for which patient? A. The man with peptic ulcer disease. B. The newly admitted woman with cholecystitis. C. The man with a bacterial exacerbation of chronic bronchitis. D. The woman who is 1 day postoperative for knee replacement.

B. Inattention and neglect, especially to the left side D. Visual spatial alterations such as loss of half of a visual field

An older adult is admitted from a skilled nursing home to a medical unit with pneumonia. A review of the medical record reveals that he had a stroke affecting the right hemisphere of the brain 6 months ago and was placed in the skilled nursing home because he was unable to care for himself. Which of these assessment findings does the nurse expect to find? (Select all that apply.) A. Slow, cautious behavioral style B. Inattention and neglect, especially to the left side C. Cloudy or opaque areas in part of the lens or the entire lens D. Visual spatial alterations such as loss of half of a visual field E. Loss of sensation and motor function on the right side of the body

C. Face the patient when speaking; demonstrate ideas you wish to convey. E. Verify that the information that has been given has been clearly understood.

An older adult patient with bilateral hearing loss wears a hearing aid in her left ear. Which of the following approaches best facilitates communication with her? (Select all that apply.) A. Talk to the patient at a distance so he or she may read your lips. B. Keep your arms at your side; speak directly into the patient's left ear. C. Face the patient when speaking; demonstrate ideas you wish to convey. D. Position the patient so that the light is on his or her face when speaking. E. Verify that the information that has been given has been clearly understood.

A. The patient's motivation to lose weight

Before selecting a weight reduction plan with an obese patient, what is most important for the nurse to first assess? A. The patient's motivation to lose weight. B. The length of time the patient has been obese. C. Whether financial considerations will affect the patient's choices. D. The patient's height, weight, BMI, waist-to-hip ratio, and skinfold thickness

A. Frequent cold symptoms B. Decreased bowel sounds C. Cool, rough, dry, scaly skin E. Prominent bony structures F. Decreased reflexes and lack of attention

During assessment of the patient with protein-calorie malnutrition, what should the nurse expect to find (select all that apply)? A. Frequent cold symptoms B. Decreased bowel sounds C. Cool, rough, dry, scaly skin D. A flat or concave abdomen E. Prominent bony structures F. Decreased reflexes and lack of attention

A. N B. N C. P D. P E. P

Identify the behaviors listed as either positive or negative coping strategies: A. Smoking cigarettes _______ B. Ignoring the situation _______ C. Joining a support group _______ D. Starting an exercise program _______ E. Increasing time spent with friends _______

C. "Mild anxiety is okay because it helps me to focus."

Isabel is a straight A student, yet she suffers from severe anxiety and seeks medical attention. The nurse interviews Isabel and develops a plan of care. The nurse recognizes effective teaching about mild anxiety when Isabel states the following: A. "I would like to try benzodiazepines for my anxiety." B. "If I study harder, my anxiety level will go down." C. "Mild anxiety is okay because it helps me to focus." D. " I have a fear that I will fail at college."

B. Use of warm incandescent lighting C. Use of yellow or amber lenses to decrease glare D. Use of adjustable blinds, sheer curtains, or draperies

The home care nurse is instructing an assistive personnel about interventions to facilitate location of items for patients with vision impairment. Which are effective strategies for enhancing a patient's impaired vision? (Select all that apply.) A. Use of fluorescent lighting B. Use of warm incandescent lighting C. Use of yellow or amber lenses to decrease glare D. Use of adjustable blinds, sheer curtains, or draperies E. Indirect lighting to reduce glare

D. A decrease in the ability to hear high-pitched sounds

The nurse expects a patient has presbycusis when she says she has A. Ringing ears B. A sensation of fullness in the ears C. Difficulty understanding the meaning of the words D. A decrease in the ability to hear high-pitched sounds

C. "I'm going to let the occupational therapist assess my home to improve efficiency." E. "I'm going to attend a support group to learn more about multiple sclerosis."

The nurse is evaluating how well a patient newly diagnosed with multiple sclerosis and psychomotor impairment is coping. Which statements indicate that the patient is beginning to cope with the diagnosis? (Select all that apply.) A. "I'm going to learn to drive a car, so I can be more independent." B. "My sister says she feels better when she goes shopping, so I'll go shopping." C. "I'm going to let the occupational therapist assess my home to improve efficiency." D. "I've always felt better when I go for a long walk. I'll do that when I get home." E. "I'm going to attend a support group to learn more about multiple sclerosis."

C. Chronic illness D. Insomnia E. Depression

The nurse is interviewing a patient in the community clinic and gathers the following information about her: she is intermittently homeless, a single parent with two children who have developmental delays. She has had asthma since she was a teenager. She does not laugh or smile, does not volunteer any information, and at times appears close to tears. She has no support system and does not work. She is experiencing an allostatic load. As a result, which of the following would be present during complete patient assessment? (Select all that apply.) A. Post-traumatic stress disorder B. Rising hormone levels C. Chronic illness D. Insomnia E. Depression

B. Physical appearance and body image C. Accepting one's personal identity D. Separation from family E. Taking tests in school

The nurse plans care for a 16-year-old male, taking into consideration that stressors experienced most commonly by adolescents include which of the following? (Select all that apply.) A. Loss of autonomy caused by health problems B. Physical appearance and body image C. Accepting one's personal identity D. Separation from family E. Taking tests in school

D. Loss of accommodation associated with age

The patient is diagnosed with presbyopia. When he asks the nurse what that is, what is the best explanation the nurse can give to the patient? A. Absence of the lens B. Abnormally long eyeballs C. Correctable with cylinder lenses D. Loss of accommodation associated with age

B. The student's stress will contribute to physical illness.

The student nurse is depressed. He is trying to study for an important examination but cannot focus. Yesterday he received news that his mother was diagnosed with metastatic breast cancer. What effect could the stress on the student's mind and spirit most likely have on the student's body? A. The student's stress will cause failure of the examination. B. The student's stress will contribute to physical illness. C. The student's worry will affect his driving to see his mother. D. The student's emotional stress will cause bad feelings about the examination.

B. Acute bacterial conjunctivitis

What best describes pink eye? A. Blindness B. Acute bacterial conjunctivitis C. Epidemic keratoconjunctivitis D. Chronic inflammation of sebaceous gland

B. Monitor patients at risk for drug induced ototoxicity for tinnitus and vertigo.

What is the role of the nurse in preservation of hearing? A. Advise patients to keep the ears clear of wax with cotton-tipped applicators. B. Monitor patients at risk for drug induced ototoxicity for tinnitus and vertigo. C. Promote the use of ear protection in work and recreational activity with noise levels above 75 bB. D. Advocate for MMR (measles, mumps, rubella) immunization in susceptible women as soon as pregnancy is confirmed.

D. Frequent and thorough hand washing to avoid spreading the infection

What should the nurse teach all patients with conjunctivitis to use? A. Artificial tears to moisten and soothe the eyes B. Dark glasses to prevent the discomfort of photophobia C. Iced moist compresses to the eyes to promote comfort and healing D. Frequent and thorough hand washing to avoid spreading the infection

Post-traumatic stress disorder (PTSD)

When assessing a young woman who was a victim of a home invasion 3 months earlier, the nurse learns that the woman has vivid images of the event whenever she hears loud yelling or a sudden noise. The nurse recognizes this as__________________.

C. A thorough physical assessment

When assessing an older adult who is showing symptoms of anxiety, insomnia, anorexia, and mild confusion, what is the first assessment the nurse conducts? A. The amount of family support B. A 3-day diet recall C. A thorough physical assessment D. Threats to safety in her home

A. Living alone on a fixed income

When planning nutritional interventions for a healthy, 83-year-old widowed man, the nurse recognizes what factor is most likely to affect his nutrition status? A. Living alone on a fixed income B. Changes in cardiovascular function C. An increase in GI motility and absorption D. Snacking between meals, resulting in obesity

B. Fewer calories, but the same or slightly increased amount of protein, are required as one ages.

When teaching the older adult about nutritional needs during aging, what does the nurse emphasize? A. The need for all nutrients decreases as a person ages. B. Fewer calories, but the same or slightly increased amount of protein, are required as one ages. C. Fats, carbohydrates, and protein should be decreased, but vitamin and mineral intake should be increased. D. High-calorie oral supplements should be taken between meals to ensure that recommended nutrient needs are met.

A. Gradual loss of peripheral vision D. May be caused by increased production of aqueous humor F. Resistance to aqueous outflow through trabecular meshwork

When teaching the patient about the new diagnosis of glaucoma, which characteristics relate only to primary open-angle glaucoma (PAOG) (select all that apply)? A. Gradual loss of peripheral vision B. Treated with iridotomy or iridectomy C. Causes loss of central vision with corneal edema D. May be caused by increased production of aqueous humor E. Treated with cholinergic agents, such as pilocarpine F. Resistance to aqueous outflow through trabecular meshwork

A. With whom do you talk on a routine basis? B. What do you do when you feel lonely? E. Have you experienced any changes in lifestyle habits, such as sleeping, eating, smoking, or drinking?

While assessing an older woman who is recently widowed, the nurse suspects that this woman is experiencing a developmental crisis. Which questions provide information about the impact of this crisis? (Select all that apply.) A. With whom do you talk on a routine basis? B. What do you do when you feel lonely? C. Tell me what your husband was like. D. I know this must be hard for you. Let me tell you what might help. E. Have you experienced any changes in lifestyle habits, such as sleeping, eating, smoking, or drinking?

B. Chronic and intense stress can cause exacerbation of immune-based diseases.

While caring for a female patient with Alzheimer's disease and her caregiver husband, the nurse finds that the patient's husband is experiencing increased asthma problems. What is a possible explanation for this finding? A. Progressive worsening of asthma occurs in people as they age. B. Chronic and intense stress can cause exacerbation of immune-based diseases. C. The husband is probably smoking more to help him cope with needing to care continually for his wife. D. The husband inadequately copes with his wife's condition by unconsciously forgetting to take his medication.