Exam 4 Topics

Which instruction by the nurse is most important when educating a patient about using viscous lidocaine (Xylocaine) for mucositis? "Your sense of taste will be diminished." "This medication can be used as a gargle." "After using, wait for 30 minutes before eating." "Cleanse the oral cavity after using."

"After using, wait for 30 minutes before eating."

A postoperative appendectomy patient has a nasogastric tube and wonders why the previous nurse told him that he was receiving an IV "ulcer-preventing" medication called ranitidine. The patient states that he has never had any stomach problems in his life. Which is the best response by the nurse? "This medication helps coat your stomach while the nasogastric tube is in place." "Because you are not eating after surgery, this medication will help reduce the hydrochloric acid your stomach is still secreting." "The nasogastric tube will cause peptic ulcer disease. This medication will help prevent that." "This medication will cause the pH in your stomach to drop."

"Because you are not eating after surgery, this medication will help reduce the hydrochloric acid your stomach is still secreting."

Which question is likely to elicit the most valid response from the patient who is being interviewed about a neurologic problem? "Can you describe the sensations you are having?" "Do you ever have any nausea or dizziness?" "Do you have any sensations of pins and needles in your feet?" "Does the pain radiate from your back into your legs?"

"Can you describe the sensations you are having?"

A young gay patient being treated for his third sexually transmitted disease does not see why he should use condoms, because "they don't work." Which is the most appropriate response? "Condoms do not provide 100% protection, but when used with a spermicide you can be assured of complete protection against HIV and other STDs." "Condoms may not provide 100% protection, but when used correctly and consistently with every act of sexual intercourse they reduce your risk of getting infected with HIV or other sexually transmitted diseases." "You are correct. Condoms don't always work, so your best protection is to limit your number of partners." "Condoms do not provide 100% protection, so you should always discuss with your sexual partners their HIV status or ask if they have any STD."

"Condoms may not provide 100% protection, but when used correctly and consistently with every act of sexual intercourse they reduce your risk of getting infected with HIV or other sexually transmitted diseases."

The home health nurse evaluates a patient being treated for a peptic ulcer with Riopan (antacid) and famotidine (histamine receptor blocker). Which statement made by the patient indicates a need for further instruction? "Boy! That Riopan keeps my stomach happy!" "I know famotidine will not interfere with my Coumadin." "I take the Riopan at least 2 hours after any of my other drugs." "I take both those meds at the same time every morning."

"I take both those meds at the same time every morning."

The home health nurse evaluates a patient being treated for a peptic ulcer with Riopan (antacid) and famotidine (histamine receptor blocker). Which statement made by the patient indicates a need for further instruction? "I take the Riopan at least 2 hours after any of my other drugs." "I know famotidine will not interfere with my Coumadin." "I take both those meds at the same time every morning." "Boy! That Riopan keeps my stomach happy!"

"I take both those meds at the same time every morning."

The nurse is instructing a patient recently diagnosed with GERD. Which statement by the patient indicates a need for further teaching? "I will eat small frequent meals and have a snack at bedtime." "Orange juice may aggravate my symptoms." "I will avoid foods high in fat." "I will wait 2 hours after eating lunch before lying down for a nap."

"I will eat small frequent meals and have a snack at bedtime."

A patient who works in a plant nursery and has suffered an allergic reaction to a bee sting is stabilized and prepared for discharge from the clinic. During discussion of prevention and management of further allergic reactions, the nurse identifies a need for additional teaching based on which comment? "I should wear a Medic-Alert bracelet indicating my allergy to insect stings." "I will learn to administer epinephrine so that I will be prepared if I am stung again." "I will need to take maintenance doses of corticosteroids to prevent reactions to further stings." "I need to think about a change in my occupation."

"I will need to take maintenance doses of corticosteroids to prevent reactions to further stings."

The nurse is providing education to a patient recently placed on selegiline disintegrating tablets. Which statement by the patient indicates a need for further teaching? "I may need to use a stool softener for constipation." "This medication will help slow the development of symptoms." "I will place the tablet on my tongue before breakfast." "I should not push the tablet through the foil."

"I will place the tablet on my tongue before breakfast."

The nurse is instructing a patient about insulin administration. Which statement by the patient indicates a need for further teaching? "I may need more insulin if I have surgery." "Once I open my insulin, I will store it in the refrigerator." "I will keep a spare bottle of insulin on hand." "I will date the insulin bottle when I open it."

"Once I open my insulin, I will store it in the refrigerator."

Which explanation by the nurse is accurate to include when teaching a patient who is beginning therapy for gastroesophageal reflux disease (GERD) with metoclopramide? "Peristalsis is increased, so food is digested more quickly." "This medication is an antikinetic agent, so you may have difficulty with motor skills." "Gastric emptying is delayed, so you may feel full for longer intervals." "This medication decreases esophageal muscle tone to reduce reflux."

"Peristalsis is increased, so food is digested more quickly."

Which instruction(s) given by the nurse will assist a patient to cope with the common adverse effects of anticholinergic medications? (Select all that apply.) "Suck on candy or ice chips." "Take the medication with meals." "Monitor blood glucose." "Increase fluids daily." "Decrease fiber in the diet."

"Suck on candy or ice chips." "Increase fluids daily."

The nurse is teaching a patient with Parkinson's disease about levodopa. Which statement by the nurse is accurate regarding drug administration? "Take this medication when your tremors get worse." "Take this medication at bedtime to prevent dizziness." "Take this medication with food or antacids to reduce GI upset." "Take this medication in between meals."

"Take this medication with food or antacids to reduce GI upset."

A family member of a patient asks the nurse about the protein-restricted diet ordered because of advanced liver disease with hepatic encephalopathy. What statement by the nurse would best explain the purpose of the diet? "Because of portal hypertension, the blood flows around the liver, and ammonia made from protein collects in the brain, causing hallucinations." "The liver heals better with a high-carbohydrate diet rather than with a diet high in protein." "The liver cannot rid the body of ammonia that is made by the breakdown of protein in the digestive system." "Most people have too much protein in their diets. The amount in this diet is better for liver healing."

"The liver cannot rid the body of ammonia that is made by the breakdown of protein in the digestive system."

A patient with pancreatitis is NPO. The patient asks the nurse why he is unable to have anything by mouth. Which of the following is the best response? "Eating causes the need for a bowel movement, which excretes your medication too rapidly." "Diagnostic tests depend on you not eating anything." "The pancreas is stimulated whenever you eat or drink and causes pain." "Resting your GI tract will cure your pancreatitis."

"The pancreas is stimulated whenever you eat or drink and causes pain."

A patient with chronic obstructive pulmonary disease (COPD) reports having insomnia and a racing heart after starting terbutaline therapy. Which explanation by the nurse is most accurate? "The symptoms will tend to resolve with continued therapy." "The symptoms are typical and indicate that the medication is at a therapeutic level." "The symptoms are unusual and need to be reported to the health care provider immediately." "The symptoms are indicative of toxicity."

"The symptoms will tend to resolve with continued therapy."

A patient with Parkinson's disease asks the nurse why anticholinergics are used in the treatment. Which response by the nurse is most accurate? "These drugs inhibit the action of acetylcholine." "These drugs will decrease your eye pressure." "These drugs will assist in lowering your heart rate." "These drugs help you urinate."

"These drugs inhibit the action of acetylcholine."

A patient with a ruptured diverticulum in the descending colon has undergone a transverse loop colostomy. The patient is upset and says, "I didn't know it was going to be this awful. I hate this!" Which response made by the nurse would be most helpful? "This seems awful now, but you won't have the problems you had before." "If everything goes well the surgeon can close this colostomy in about a year." "This is a temporary solution. It will be closed in 6 weeks." "With the appropriate pouch and loose clothing, no one will notice a thing."

"This is a temporary solution. It will be closed in 6 weeks."

A patient with a history of type 1 diabetes after myocardial infarction has been placed on a beta-adrenergic blocking agent. Which statement by the patient indicates a need for further teaching? "This medication lowers my blood pressure by helping me get rid of fluid." "This medication may take a few weeks to work." "This medication should not be discontinued suddenly." "I may not have my usual symptoms of a hypoglycemic reaction while on this drug."

"This medication lowers my blood pressure by helping me get rid of fluid."

When assigned to a newly admitted patient with AIDS, the nurse says, "I'm pregnant. It is not safe for me or my baby if I am assigned to his case." Which is the most appropriate response by the charge nurse? "This patient would not be a risk for your baby if you use standard precautions and avoid direct contact with blood or body fluids." "Wear a mask, gown, and gloves every time you go into his room and use disposable trays, plates, and utensils to serve his meals." "You should ask for a transfer to another unit because contact with this patient would put you and your baby at risk for AIDS." "We should recommend that this patient be transferred to an isolation unit."

"This patient would not be a risk for your baby if you use standard precautions and avoid direct contact with blood or body fluids."

A patient with type 2 diabetes mellitus, which was previously controlled with an oral antidiabetic agent, is hospitalized for treatment of a leg ulcer. The health care provider has ordered sliding scale insulin coverage with regular insulin for hyperglycemia. The nurse brings the injection into the room, and the patient becomes upset, stating "I don't want to start taking that drug! I'll need it the rest of my life." What is the nurse's best response? "Don't worry. You shouldn't need this too often. As you feel better, your blood glucose level will drop." "This is the same drug as the oral medication you were taking. It's a stronger dose while you are in the hospital." "Your disease is progressing and your pancreas is producing less insulin. I know this is a hard time for you. Do you want to talk about it?" "Your body is under stress right now, which raises your blood glucose level. This does not mean you will be on this drug permanently. Once you're feeling better, your provider will determine if your oral medication is all you will need."

"Your body is under stress right now, which raises your blood glucose level. This does not mean you will be on this drug permanently. Once you're feeling better, your provider will determine if your oral medication is all you will need."

The 100 lb patient who has been exposed to hepatitis A is to receive an injection of immune serum globulin. What should the dose (0.02 mL/kg) be? 1.8 mL 1.6 mL 1.4 mL 0.9 mL

0.9 mL

The nurse is preparing to administer medications and notes that a patient has sucralfate ordered qid. When is the best time to administer this medication? 1 hour after meals 1 hour before meals With a bedtime snack With meals

1 hour before meals

After inserting a nasogastric tube, how much suction, in mmHg would you apply?

100 to 125 mm Hg

What Glasgow Coma Scale rating would a patient receive who opens the eyes spontaneously, but has incomprehensible speech and obeys commands for movement? 11 10 12 8

12

The human insulin whose onset of action occurs within ____ minutes is lispro (Humalog). 30 15 45 60

15

A patient received the evening dose of Lispro subcutaneously at 16:30. What time will symptoms of hypoglycemia likely occur? 01:30 06:00 18:30 19:00

18:30

The nurse is planning to administer an antacid to a patient diagnosed with PUD who will receive an H2 antagonist at 8:00 AM. When is the most appropriate time for the nurse to provide the antacid to this patient? With the H2 antagonist 30 minutes prior to the H2 antagonist Within an hour after the H2 antagonist 2 hours after the H2 antagonist

2 hours after the H2 antagonist

The nurse cautions the patient who is being instructed on self-medication with insulin to be aware that there are 25-, 30-, 50-, and 100-unit syringes. How is the 100-unit syringe marked? 5-unit increments 4-unit increments 1-unit increments 2-unit increments

2-unit increments

The nurse is aware that the drug t-PA (Activase), a tissue plasminogen activator, must be given in _______ hours of the onset of symptoms to have maximum benefit. 8 hours 3 hours 4 hours 6 hours

3 hours

What time frame must blood be transfused within once it has been removed from refrigeration? 4 hours 6 hours 3 hours 2 hours

4 hours

What is the normal range for serum glucose? According to AHN book.

70 - 115 mg/dL

The nurse points out which of the following as an example of a nonmechanical bowel obstruction? Narrowed bowel lumen from an inflammatory process Fecal impaction Tumor of the bowel A paralytic ileus

A paralytic ileus

The HIV-infected patient who has just seroconverted says he just cannot take all those confusing, expensive antiretroviral (ART) medications. He says he still feels fine, anyway. What should the nurse keep in mind when counseling this patient? Cessation of the ART may prevent the emergence of a resistant strain of HIV. Once ART is initiated, it cannot be restarted in the same patient. Adherence to the ART protocol is essential to the success of the treatment. Resumption of the ART later in the disease is just as effective.

Adherence to the ART protocol is essential to the success of the treatment.

It is 2:00 PM and a patient who has been NPO since 12:00 AM for a bronchoscopy is complaining of a headache and shakiness and is extremely irritable. Vital signs are within normal limits, and a one touch glucose reads 50 mg/dL. Which action is most important for the nurse to take? Administer glucagon subcutaneously. Have the patient eat a snack and drink milk. Obtain an A1c test. Call the bronchoscopy room to follow up with the delay.

Administer glucagon subcutaneously.

Immediately after the nurse administers an intradermal injection of a suspected antigen during allergy testing, the patient complains of itching at the site, weakness, and dizziness. Which action by the nurse is most appropriate initially? Administer subcutaneous epinephrine. Apply a local antiinflammatory cream to the site. Elevate the arm above the shoulder. Apply a warm compress to area.

Administer subcutaneous epinephrine.

What is the term for transplantation of tissue between members of the same species? Allograft Isograft Homograft Autograft

Allograft

The autonomic nervous system can be subdivided into which types of adrenergic receptors? Agonists and antagonists Nicotinic and muscarinic Alpha and beta Afferent and efferent

Alpha and beta

Which category of medications is used for peripheral vascular diseases characterized by excessive vasoconstriction, such as Raynaud's disease? Beta-adrenergic blocking agents Alpha-adrenergic blocking agents Adrenergic agents Cholinergic agents

Alpha-adrenergic blocking agents

Which information will the nurse include when teaching a patient with renal failure about antacid therapy for treatment of heartburn? (Select all that apply.) Taking magnesium-based antacids prevents diarrhea. Aluminum hydroxide antacids exacerbate constipation. Antacids neutralize gastric acid. If the patient has coffee-ground emesis or bloody stools, the frequency of antacids should be doubled. Magnesium-based antacids are preferred for patients with renal failure.

Aluminum hydroxide antacids exacerbate constipation Antacids neutralize gastric acid.

Which assessment information is pertinent to oral health? (Select all that apply.) Amount of saliva present Presence of halitosis Medication history Dental history, visit frequency Bowel sounds

Amount of saliva present Presence of halitosis Medication history Dental history, visit frequency

The nurse is administering sulfonylurea drugs to four different patients diagnosed with type 2 diabetes. Which patient should not receive the medication as ordered? An 80-year-old woman with an allergy to sulfa A 37-year-old man with a blood glucose level of 140 A 50-year-old woman with shingles A 42-year-old man with hypertension

An 80-year-old woman with an allergy to sulfa

In diabetes insipidus, a deficiency of which hormone causes clinical manifestations? Thyroid-stimulating hormone (TSH) Adrenocorticotropic hormone (ACTH) Follicle-stimulating hormone (FSH) Antidiuretic hormone (ADH)

Antidiuretic hormone (ADH)

What is the primary pharmacologic therapy for Candida albicans? Steroids Topical anti-inflammatory agents Antifungal agents Topical anesthetics

Antifungal agents

What is B-cell proliferation dependent on? Antigen stimulation Complement system Presence of NK (natural killer) cells Lymphokines

Antigen stimulation

Which of the following would be the most helpful nursing intervention to increase the comfort of a patient with appendicitis? Warm compress over entire abdomen Ambulate for short periods in the room Application of ice bag Administration of small tap water enema

Application of ice bag

The patient with cirrhosis has a rising ammonia level and is becoming disoriented. The patient waves to the nurse as she enters the room. How should the nurse interpret this? As an indication of respiratory obstruction from varices As asterixis As an attempt to get the nurse's attention As spasticity

As asterixis

How should the nurse administer insulin to prevent lipohypertrophy? At room temperature After rolling bottle between hands to warm At body temperature Straight from the refrigerator

At room temperature

The patient has come to the PACU following an ileostomy for the treatment of ulcerative colitis. The patient is conscious and has a nasogastric tube in place and a pouch over the stoma. What should be the nurse's initial action? Give patient ice chips to moisten mouth. Attach NG tube to suction. Irrigate NG tube. Turn patient to right side.

Attach NG tube to suction

What instructions should a nurse give to a diabetic patient to prevent injury to the feet? Use of commercial keratolytic agents to remove corns and calluses are preferred to cutting off corns and calluses. Soak feet in warm water every day. Avoid going barefoot and always wear shoes with soles. Use a heating pad to warm feet when they feel cool to the touch.

Avoid going barefoot and always wear shoes with soles.

The nurse is caring for a patient with a history of numerous allergies. What is the most important teaching concept? Avoidance of the allergen Immunotherapy regimen Antihistamine administration Adrenaline administration

Avoidance of the allergen

What is the etiology of autoimmune diseases based on? T cells destroying B cells Reaction to a "superantigen" Immune system producing no antibodies at all B and T cells producing autoantibodies

B and T cells producing autoantibodies

How does normal aging change the immune system? T cells become hyperactive. Increase in the size of the thymus. B cells show deficiencies in activity. Depresses bone marrow.

B cells show deficiencies in activity.

Why are peptic ulcers a common problem of aging? Because of overuse of laxatives Because of overuse of antacids Because of overuse of NSAIDs Because of overuse of antibiotics

Because of overuse of NSAIDs

Which instruction by the nurse is accurate to include when providing teaching to a patient recently diagnosed with diabetes who has been prescribed insulin? Lipodystrophy increases the absorption of insulin. Beta blockers can mask symptoms of hypoglycemia. Infection will decrease the need for insulin. Excessive exercise will increase the need for insulin.

Beta blockers can mask symptoms of hypoglycemia.

Prior to the administration of metoprolol, a beta-adrenergic blocking agent, which is most important for the nurse to assess? Blood pressure Lung sounds Mental status Urine output

Blood pressure

Which body function(s) is/are controlled by the autonomic nervous system? (Select all that apply.) Body temperature Blood pressure Skeletal muscle contraction GI secretion Urination

Body temperature Blood pressure GI secretion Urination

The nurse outlines for a patient who has asthma attacks from pollen that the process from exposure to symptoms follows a systematic sequence. What is the last physiologic responses of an allergic asthma attack? Vasodilation Activation of mast cells Exposure to pollen Bronchospasm Release of histamine Edema

Bronchospasm

To be diagnosed as having AIDS, the patient must be HIV-positive, have a compromised immune system without known immune system disease or recent organ transplant, and present with which of the following? A positive ELISA or Western blot test Opportunistic infection CD4+ lymphocyte count less than 200 mm3 Weight loss, fever, and generalized lymphedema

CD4+ lymphocyte count less than 200 mm3

A 27-year-old patient with hypothyroidism is referred to the dietitian for dietary consultation. What should nutritional interventions include? Frequent small meals high in carbohydrates Fluid restrictions Calorie-restricted meals Caffeine-rich beverages

Calorie-restricted meals

What does the nurse know about the stroke patient who has expressive aphasia? Has difficulty comprehending spoken and written communication. Cannot make any vocal sounds. Can understand the spoken word, but cannot speak. Has total loss and comprehension of language.

Can understand the spoken word, but cannot speak.

A patient with chronic obstructive pulmonary disease (COPD) uses a corticosteroid inhaler bid. Which adverse effect is associated with this medication? Candidiasis Xerostomia Plaque Mucositis

Candidiasis

Which infection is often called the "disease of the diseased" because it appears in debilitated patients? Candidiasis Brucellosis Trichomoniasis Aspergillosis

Candidiasis

A male patient is concerned about telling others he has HIV infection. What should the nurse stress when discussing his concerns? Care providers and sexual partners should be told about his diagnosis. His diagnosis will be obvious to most people with whom he will come into contact. Secrecy is a poor idea because it will lower his self-esteem. There is no reason to hide his disease.

Care providers and sexual partners should be told about his diagnosis.

What are the two divisions of the nervous system? Somatic and the autonomic Central and the peripheral Medulla oblongata and the diencephalon Cerebellum and the brainstem

Central and the peripheral

Which assessment would indicate possible gallbladder disease in an older adult? Changes in color of urine or stool Distention of veins in upper part of body Aching muscles and tenderness in the liver Dull pain in the right upper quadrant region

Changes in color of urine or stool

The LPN/LVN has arrived at the patient's bedside with a unit of packed cells to be connected to an IV that is infusing. When the RN arrives, what is the first thing the nurses must do? Check the patient's ID bracelet and then administer the packed cells. Request the patient to sign the card on the packed cells. Check to ensure that the donor and recipient numbers match according to policy. Immediately administer the packed cells.

Check to ensure that the donor and recipient numbers match according to policy.

Which of the following techniques are necessary for safely feeding a hemiplegic patient? (Select all that apply.) Taking the patient's dentures out to prevent choking Checking the affected side of mouth for food accumulation Adding a thickening agent to liquids Elevating the patient to no more than 30 degrees Offering small bites of food Mixing liquids and solid foods together

Checking the affected side of mouth for food accumulation Adding a thickening agent to liquids Offering small bites of food

Before the initiation of anticholinergic medications, it is important for the nurse to screen patients for which condition? Hypertension Diabetes Infectious diseases Closed-angle glaucoma

Closed-angle glaucoma

Viral hepatitis may be treated at home. What should be taught to the patient's family? (Select all that apply.) Clothes should be laundered separately with hot water. Hands need to be thoroughly washed after toileting. Articles soiled with feces do not require extra care. Personal items and drinking glasses should not be shared. Contaminated items may be disposed of with regular trash.

Clothes should be laundered separately with hot water. Hands need to be thoroughly washed after toileting Personal items and drinking glasses should not be shared.

Which of the following cranial nerves control the eye Cranial nerve IX Cranial nerve VI Cranial nerve III Cranial nerve VII Cranial nerve IV Cranial nerve II

Cranial nerve VI Cranial nerve III Cranial nerve IV Cranial nerve II

Which of the following are signs and symptoms of hypoglycemia? (Select all that apply.) Dry mouth Deep respirations Diaphoresis Tremors Irritability Fruity breath

Diaphoresis Tremors Irritability

Which is a common adverse effect of magnesium-based antacid preparations? Diarrhea Heartburn Constipation Rebound indigestion

Diarrhea

What is the rationale for administering levodopa instead of dopamine for treatment of Parkinson's disease? The half-life of dopamine is too short. Dopamine does not cross the blood-brain barrier when administered orally. Dopamine has too many reactions with other medications. Levodopa is much less expensive.

Dopamine does not cross the blood-brain barrier when administered orally.

After a blood glucose reading, it is determined that the patient should receive 4 units of Lispro and 8 units of NPH. Which action will the nurse take to administer these medications? Administer the Lispro before the meal and the NPH after the meal. Draw up the Lispro first and then the NPH using the same syringe. Draw up each insulin in separate syringes and administer two injections. Draw up the NPH first and then the Lispro using the same syringe.

Draw up the Lispro first and then the NPH using the same syringe.

Which recommendation is most appropriate for a patient who has had an esophageal dilation related to achalasia? - Lie down for 30 minutes after each meal. - Avoid fruit juices. - Drink 10 oz of fluid with each meal. - Consume only liquid.

Drink 10 oz of fluid with each meal.

The home health nurse is caring for a patient who has frequent bouts of diverticulitis accompanied by increased flatulence, diarrhea, and nausea. Which of the following is the most appropriate suggestion to lessen these symptoms? Increase dietary fat intake. Exercise to increase intraabdominal pressure. Take daily laxatives. Eat a diet high in fiber content.

Eat a diet high in fiber content.

Which of the following should be included in the patient teaching of a patient with a peptic ulcer? Eating 6 small meals a day Restricting fluid to 1000 mL per day Introducing irritating foods in minute amounts to desensitize the stomach Drinking alcohol and caffeine in moderation

Eating 6 small meals a day

Which of the following should be included in the patient teaching of a patient with a peptic ulcer? Restricting fluid to 1000 mL per day Eating 6 small meals a day Drinking alcohol and caffeine in moderation Introducing irritating foods in minute amounts to desensitize the stomach

Eating 6 small meals a day

Dumping syndrome after a Billroth II procedure occurs when high-carbohydrate foods are ingested over a period of less than 20 minutes. What would the nurse suggest to reduce the risk of dumping syndrome? Eating six small daily meals high in protein and fat Remaining upright for 2 hours after meals Drinking 10 oz of fluids with meals Eating a high-carbohydrate diet

Eating six small daily meals high in protein and fat

What should the nurse include in a teaching plan for a patient with a hiatal hernia to reduce the frequency of heartburn? Panting through mouth when symptoms begin Drinking 10 oz of milk with every meal Lie down after eating Eating small meals

Eating small meals

The patient with cirrhosis has an albumin of 2.8 g/dL. Based on these findings, what would the nurse expect the patient to exhibit? Copious urine output Pallor Edema Jaundice

Edema

Which condition would alert the nurse of the need to use beta-adrenergic blockers cautiously? Cardiac dysrhythmias Hypertension Raynaud's phenomenon Emphysema

Emphysema

A male patient complains that he will never adjust to his colostomy. Which is the best action for the nurse in this situation? Assure him that his concerns will diminish when he is able to care for his colostomy. Suggest that he discuss his concerns with his physician. Counsel him that everything will be all right. Encourage him to express his concern.

Encourage him to express his concern.

Name the 3 medications that would be given to a patient experiencing an anaphylactic reaction.

Epinephrine Benadryl Prednisone

Which hormones are responsible for "fight or flight"? Estrogen and testosterone Calcitonin and parathyroid hormone Epinephrine and norepinephrine FSH and LH

Epinephrine and norepinephrine

Because bowel contents from an ileostomy are virtually liquid, what should the nurse include in the plan of care? Evaluation and assessment of the adequacy of the collection device Evaluation and assessment of dietary intake of fiber Evaluation and assessment of patient cleanliness Evaluation and assessment of peristomal skin integrity

Evaluation and assessment of peristomal skin integrity

The nurse explains that the two divisions of the autonomic nervous system work to maintain homeostasis. Which is the first autonomic event? Parasympathetic nervous system dominates Sympathetic nervous system dominates Extremely stressful or frightening event Blood pressure, heart rate, and adrenaline output decrease Heart rate and blood pressure rise, secretion of adrenaline

Extremely stressful or frightening event

Which test will furnish immediate feedback for a newly diagnosed diabetic who is not yet under control? Oral glucose tolerance test (OGTT) Glycosylated hemoglobin (HbA1c) Fasting blood sugar (FBS) Clinitest

Fasting blood sugar (FBS)

What should the nurse monitor in caring for the patient undergoing a paracentesis? Fluid removal over at least 30 minutes The urinary output Hypervolemia Seizure

Fluid removal over at least 30 minutes

What should the nurse avoid contamination from to prevent the transmission of hepatitis A? Food or water Sexual contact Blood transfusion Needles

Food or water

What is the nurse assessing when asking the patient, "Who is the president of the United States?" during a level of consciousness assessment? Calculation Fund of knowledge Memory Orientation

Fund of knowledge

Which factor(s) contribute(s) to the development of PUD? (Select all that apply.) Genetics Cigarette smoking Excessive ingestion of milk products Stress H. pylori

Genetics Cigarette smoking H. pylori

The newly admitted patient to the emergency room after a motorcycle accident has serosanguineous drainage coming from the nose. What is the most appropriate nursing response to this assessment? Gently suction the nasal cavity. Cleanse nose with a soft cotton-tipped swab. Ask patient to blow his nose. Gently wipe nose with absorbent gauze.

Gently wipe nose with absorbent gauze.

What would the nurse recommend for a 94-year-old home health patient with deteriorated cell-mediated immunity? Getting pneumonia vaccine Avoiding the influenza vaccine Having skin tests for all antigens Taking large doses of b-carotene

Getting pneumonia vaccine

Pathologic conditions in Broca's and Wernicke's areas of the brain will result in

Global aphasia

Which diagnostic test for diabetes mellitus provides a measure of glucose levels for the previous 8 to 12 weeks? Glycosylated hemoglobin (HbA1c) Postprandial glucose test (PPBG) Oral glucose tolerance test (OGT) Fasting blood sugar (FBS)

Glycosylated hemoglobin (HbA1c)

The patient with a peptic ulcer has been placed on regular doses of bismuth salicylate (Pepto-Bismol) to combat Helicobacter pylori. What color will this drug turn the stool? Gray-black Dark green Red-orange Yellow

Gray-black

The patient with a peptic ulcer has been placed on regular doses of bismuth salicylate (Pepto-Bismol) to combat Helicobacter pylori. What color will this drug turn the stool? Yellow Gray-black Dark green Red-orange

Gray-black

Which organism or disorder is responsible for many cases of PUD? H. pylori Escherichia coli Candida albicans Herpes zoster

H. pylori

Which drug therapy is aimed at reducing gastric acid secretions? (Select all that apply.) H2 antagonists Coating agents Prokinetic agents Antacids Proton pump inhibitors

H2 antagonists Proton pump inhibitors

What should the nurse look for when reviewing a patient's chart to determine whether she has progressed from HIV disease to AIDS? HIV-positive test result, CD4+ count below 200, history of opportunistic disease Weight loss, persistent generalized lymphadenopathy, chronic diarrhea Fever, chills, CD4+ count below 200 CD4+ count below 500, chronic fatigue, night sweats

HIV-positive test result, CD4+ count below 200, history of opportunistic disease

What does the nurse know about the stroke patient who has receptive aphasia? Cannot make any vocal sounds. Has difficulty comprehending spoken and written communication. Can understand the spoken word, but cannot speak. Has total loss and comprehension of language.

Has difficulty comprehending spoken and written communication.

What is an essential nursing measure to prevent injury to the patient who is to receive a paracentesis? Have patient void immediately before procedure. Check for allergy to contrast media or to shellfish. Pad side rails. Have patient sign a permit.

Have patient void immediately before procedure.

A patient states that he feels terrific, but a blood test shows that he is HIV-positive. It is important for the nurse to discuss with him that HIV may remain dormant for several years. What is true of the patient during this time? He experiences decreased immunity. He experiences minor symptoms only. He is contagious. He is not dangerous to anyone.

He is contagious.

What is the most appropriate method used by high-risk health workers to prevent hepatitis B? Hepatitis B vaccine Hb immune globulin injections Diligent hand washing Wearing protective gear

Hepatitis B vaccine

What is the challenge in encouraging coughing and deep breathing for a postoperative patient who had an open cholecystectomy? Excessive nausea Poor oxygenation High placement of incision Weakened abdominal muscles

High placement of incision

Cimetidine (Tagamet) is an example of which class of drug? Histamine (H2) receptor antagonist Proton pump inhibitor Protokinetic agent Coating agent

Histamine (H2) receptor antagonist

The nurse assures an anxious family member of a 92-year-old patient who is demonstrating signs of dementia, that many causes of dementia are reversible and preventable. What is one example? Hypotension Alzheimer's disease Parkinson disease Diabetes

Hypotension

What should the nurse include to assess for in the plan of care for a patient undergoing plasmapheresis? Hypotension Flank pain Hypersensitivity Urticaria

Hypotension

What is the first sign of Bell's palsy? Inability to wrinkle forehead and pucker lips on affected side Excessive salivation on the affected side Excessive mucus running from nostril on affected side Sudden pain in nostril on affected side

Inability to wrinkle forehead and pucker lips on affected side

In addition to discomfort, which are adverse effects of xerostomia? (Select all that apply.) Improved taste and enjoyment of food Increase in dental caries Excessive salivation Difficulty chewing and swallowing food Difficulty with speech Reduced taste and appetite

Increase in dental caries Difficulty chewing and swallowing food Difficulty with speech Reduced taste and appetite

Which of the following is a CDC criterion for the progression of HIV infection to AIDS? Decreased ratio of CD8 to CD4 Increase in white blood cells Increase in viral load Increased reactivity to skin tests

Increase in viral load

What should the nurse expect of a patient with a malabsorption of vitamin K? Elevated hematocrit Increased prothrombin time Diminished white blood cell count Lowered hemoglobin

Increased prothrombin time

A 65-year-old man is diagnosed with type 2 diabetes mellitus. Which patient symptom(s) would indicate type 1 diabetes mellitus and not type 2? (Select all that apply.) Increased thirst over the past week Polyphagia Impotence Ketoacidosis A 10-pound weight loss within the past month

Increased thirst over the past week Polyphagia Ketoacidosis A 10-pound weight loss within the past month

What should the nurse caution a type I diabetic about excessive exercise? It can increase muscle bulk and may result in malabsorption of insulin. It can decrease the need for insulin and may result in hypoglycemia. It can decrease metabolic demand and may result in metabolic acidosis. It can increase the need for insulin and may result in hyperglycemia.

It can decrease the need for insulin and may result in hypoglycemia.

Which of the following is the purpose of antibiotic therapy in treating peptic ulcers? It eradicates H. pylori. It neutralizes or reduces the acidity of stomach contents. It protects the gastric mucosa. It inhibits gastric acid secretion.

It eradicates H. pylori.

Which of the following is the purpose of antibiotic therapy in treating peptic ulcers? It inhibits gastric acid secretion. It eradicates H. pylori. It protects the gastric mucosa. It neutralizes or reduces the acidity of stomach contents.

It eradicates H. pylori.

A patient with PUD asks the nurse about the action of prokinetic medications. Which explanation by the nurse is accurate? It increases the lower esophageal sphincter muscle pressure and peristalsis. It decreases the volume of hydrochloric acid produced, increasing the gastric pH. It blocks the formation of hydrochloric acid, reducing irritation of the gastric mucosa. It reduces the secretion of saliva, hydrochloric acid, pepsin, bile, and other enzymatic fluids.

It increases the lower esophageal sphincter muscle pressure and peristalsis.

A frantic family member is distressed about the flaccid paralysis of her son following a spinal cord injury several hours ago. What does the nurse know about this condition? It degenerates into a spastic paralysis. It is an ominous indicator of permanent paralysis. It is possibly a temporary condition and will clear. It will progress up the cord to cause seizures.

It is possibly a temporary condition and will clear.

The health care provider prescribes glyburide (Micronase, DiaBeta, Glynase) for a patient, age 57, when diet and exercise have not been able to control type 2 diabetes. What should the nurse include in the teaching plan about this medication? It is a substitute for insulin and acts by directly stimulating glucose uptake into the cell. It does not cause the hypoglycemic reactions that may occur with insulin use. It is thought to stimulate insulin production and increase sensitivity to insulin at receptor sites. It lowers blood sugar by inhibiting glucagon release from the liver, preventing gluconeogenesis.

It is thought to stimulate insulin production and increase sensitivity to insulin at receptor sites.

Which nursing intervention should be completed immediately after the physician has performed a needle liver biopsy? Keeping the patient on the right side for a minimum of 2 hours Taking vital signs every 4 hours Assisting to ambulate for the bathroom Keeping the patient on the left side for a minimum of 4 hours

Keeping the patient on the right side for a minimum of 2 hours

Another term for hyperglycemic reaction is diabetic ______________.

Ketoacidosis

The nurse is administering long-acting insulin once a day, which provides insulin coverage for 24 hours. This insulin is _________________.

Lantus

Which of the following are diseases which result from one's own immune system attacking the body? (Select all that apply.) Lupus erythematosus Polio Rheumatoid arthritis Thrombocytopenic purpura Osteoarthritis Glomerulonephritis

Lupus erythematosus Rheumatoid arthritis Thrombocytopenic purpura Glomerulonephritis

What is the basic problem that prompts most of the early signs of Alzheimer's disease? Changes in mood Misplacing things Problems with words in speaking Memory loss that disrupts daily life

Memory loss that disrupts daily life

Which medication is used in the treatment of gastric reflux esophagitis and diabetic gastroparesis? Metoclopramide Misoprostol Pantoprazole Ranitidine

Metoclopramide

The patient is a 20-year-old college student who has type 1 diabetes and normally walks each evening as part of an exercise regimen. The patient plans to enroll in a swimming class. Which adjustment should be made based on this information? Time the morning insulin injection so that the peak action will occur during swimming class. Delay the meal before the swimming class until the session is over. Monitor glucose level before, during, and after swimming to determine the need for alterations in food or insulin. Delete normal walks on swimming class days.

Monitor glucose level before, during, and after swimming to determine the need for alterations in food or insulin.

Trace a bite of food from the mouth to the anus. Include sphincters and valves.

Mouth Pharynx Esophagus Esophageal (Cardiac) Sphincter Stomach Pyloric Sphincter Duodenum Jejunum Ileum Ileocecal Valve Cecum Ascending Colon Transverse Colon Descending Colon Sigmoid Colon Rectum Anus

Which factor(s) prevent(s) breakdown of the body's normal defense barriers that protect against ulcer formation? (Select all that apply.) Hydrochloric acid Mucous cells Stomach pH Intrinsic factor Prostaglandins

Mucous cells Prostaglandins

A patient who is taking NSAIDs to treat arthritis asks the nurse why misoprostol has also been prescribed. Which explanation by the nurse is accurate? Antiulcer medications eradicate the presence of bacteria in the stomach that cause ulcers. NSAIDs promote the production of prostaglandins and reduce the incidence of gastric irritation. Drug interactions are prevented when antiulcer medications are used in combination with NSAIDs. NSAIDs often cause GI irritation that can result in peptic ulcers.

NSAIDs often cause GI irritation that can result in peptic ulcers.

The newly admitted patient to the emergency room 30 minutes ago after a fall off a ladder has gradually decreased in consciousness and has slowly reacting pupils, a widening pulse pressure, and verbal responses that are slow and unintelligible. What is the most appropriate position for the patient? Head raised slightly with hips flexed. Supine in gravity neutral position. Neck placed in a neutral position. Turn on right side with head elevated.

Neck placed in a neutral position.

What should the nurse do because of the increasing strength of the dose in the injections for immunotherapy? Have the patient lie down quietly for an hour. Place a warm compress on the area to speed its absorption. Take the vital signs every 10 minutes for an hour. Observe the patient for at least 20 minutes after administration.

Observe the patient for at least 20 minutes after administration.

A patient, age 45, is to have a myelogram to confirm the presence of a herniated intervertebral disk. Which nursing action should be planned with respect to this diagnostic test? Keep NPO for 6 to 8 hours after the test. Obtain an allergy history before the test. Use heated blanket to keep patient warm after procedure. Ambulate the patient when returned to the room after the test.

Obtain an allergy history before the test.

What is an appropriate nursing intervention for a patient admitted into the hospital with signs and symptoms of diabetic ketoacidosis? Obtain blood glucose immediately. Administer NPH insulin intravenously. Give intravenous glucagon. Take vital signs every 4 hours.

Obtain blood glucose immediately.

What should a nurse do when obtaining a stool specimen to be examined for ova and parasites? Use an oil retention enema to facilitate collection. Check the specimen for the presence of occult blood. Obtain three different stool specimens on subsequent days. Refrigerate the specimen immediately.

Obtain three different stool specimens on subsequent days.

The home health nurse is caring for a patient who has frequent abdominal pain and diarrhea. The nurse uses the Rome Criteria to direct assessment for irritable bowel syndrome. What is included in the Rome Criteria? (Select all that apply.) Onset associated with change in stool consistency or frequency Pain relieved by defecation Excessive flatulence Discomfort at least 3 days a month Nausea and vomiting associated with onset Blood in stool

Onset associated with change in stool consistency or frequency Pain relieved by defecation Discomfort at least 3 days a month

Which symptom would be classified as a mild transfusion reaction? Wheezing Hypotension Tachycardia Orthopnea

Orthopnea

Which adverse effects associated with levodopa therapy would support the nursing diagnosis risk for injury? Orthostatic hypotension Tachycardia and palpitations Nausea and vomiting Anorexia and depression

Orthostatic hypotension

Which disorder(s) would indicate the use of anticholinergic agents? (Select all that apply.) Benign prostatic hypertrophy Parkinson's disease Preparation for surgery Stimulation of the vagus nerve Bradycardia Glaucoma

Parkinson's disease Preparation for surgery Bradycardia

A patient who is being evaluated for episodes of hematemesis and dyspepsia tells the nurse that pain occurs when he eats, but pain does not waken him. The nurse recognizes a diagnostic sign of which condition? Gastritis Peptic ulcer Achalasia Duodenal ulcer

Peptic ulcer

A patient who is being evaluated for episodes of hematemesis and dyspepsia tells the nurse that pain occurs when he eats, but pain does not waken him. The nurse recognizes a diagnostic sign of which condition? Gastritis Peptic ulcer Duodenal ulcer Achalasia

Peptic ulcer

The nurse caring for a patient with a peptic ulcer who has had a nasogastric tube inserted notes bright blood in the tube; the patient complains of pain and has become hypotensive. Which condition should the nurse recognize these as signs of? Bowel obstruction Perforation Hiatal hernia Gastritis

Perforation

The nurse caring for a patient with a peptic ulcer who has had a nasogastric tube inserted notes bright blood in the tube; the patient complains of pain and has become hypotensive. Which condition should the nurse recognize these as signs of? Gastritis Hiatal hernia Bowel obstruction Perforation

Perforation

What is the most lethal complication of a peptic ulcer? Bleeding Gastric outlet obstruction Perforation Severe pain

Perforation

What is the master gland of the endocrine system? Pancreas Pituitary Thyroid Parathyroid

Pituitary

What should the nurse do when the child arrives on the floor with the diagnosis of bacterial meningitis? Hold NPO until orders arrive. Place the child in respiratory isolation. Inquire about drug allergy. Arrange for humidified oxygen per mask.

Place the child in respiratory isolation.

Immediately following a liver biopsy, the patient becomes dyspneic, the pulse increases to 100, and no breath sounds can be heard on the affected side. What should the nurse suspect? Pneumothorax Hemorrhage of the liver Pleural effusion Peritonitis

Pneumothorax

What are the 3 cardinal signs of hyperglycemia? Please use medical terminology.

Polyphagia Polydipsia Polyuria

A family member of a patient who has just suffered a tonic-clonic seizure is concerned about the patient's deep sleep. What is this behavior called? Neural recovery period Postictal period Sombulant period Convalescent period

Postictal period

A family member of a patient who has just suffered a tonic-clonic seizure is concerned about the patient's deep sleep. What is this behavior called? Sombulant period Neural recovery period Convalescent period Postictal period

Postictal period

The patient who had an asthma-like reaction to a desensitization shot was medicated with a subcutaneous injection of epinephrine. What effect should the nurse assure the anxious patient this will have? Produce bronchodilation. Reduction of pulse rate. Cause productive coughing. Cause vasodilation.

Produce bronchodilation.

Why are the drugs neostigmine (Prostigmin) and pyridostigmine (Mestinon) helpful to the person with myasthenia gravis? Reduces pain. Improves visual disturbances. Promotes nerve impulse transmission. Improves speech.

Promotes nerve impulse transmission.

As the result of a stroke, a patient has difficulty discerning the position of his body without looking at it. In the nurse's documentation, which would best describe the patient's inability to assess spatial position of his body? Agnosia Proprioception Apraxia Sensation

Proprioception

An anxious patient enters the emergency room with angioedema of the lips and tongue, dyspnea, urticaria, and wheezing after having eaten a peanut butter sandwich. What should be the nurse's first intervention? Cover patient with a warm blanket. Provide oxygen per nonrebreathing mask. Apply cool compresses to urticaria. Prepare for venipuncture for the delivery of IV medication.

Provide oxygen per nonrebreathing mask.

Which information will the nurse include when teaching a patient about cold sores? Use of drying agents prevents the spread of secretions. Eruptions are related to breaks in personal hygiene. Erupted lesions are not contagious. Pus-filled lesions indicate a secondary bacterial infection.

Pus-filled lesions indicate a secondary bacterial infection.

A male patient states that he returned from a 2-week camping trip a few days ago. He complains of nausea and anorexia, and dark urine. What additional information would assist in diagnosing hepatitis A? History of intravenous drug use Exposure to blood Multiple sex partners Recent ingestion of raw fish

Recent ingestion of raw fish

A 72-year-old patient is admitted to the hospital with a diagnosis of immunodeficiency disease. What is the primary nursing goal? Reduce the risk of the patient developing an infection. Plan nutritious meals to provide adequate intake. Encourage the patient to provide self-care Encourage the patient to interact with other patients.

Reduce the risk of the patient developing an infection.

What are the effects of normal aging on the nervous system? (Select all that apply.) Calcification of cerebrum Reduction of cerebral blood flow Loss of neurons Small vessel occlusion Decrease in oxygen use

Reduction of cerebral blood flow Loss of neurons Decrease in oxygen use

Only ________insulin can be administered intravenously.

Regular

What is the major negative effect of cell-mediated immunity? Depression of bone marrow Rejection of transplanted tissue Activation of the T cells Stimulation of the B cells

Rejection of transplanted tissue

What is a long-term complication of diabetes mellitus? Hyperglycemia Diverticulitis Hypothyroidism Renal failure

Renal failure

What is the purpose of a "drug holiday" in the treatment of Parkinson disease? Change all drugs. Allow the natural dopamine levels to rise. Restart drugs at a lower dosage with favorable results. Reduce the extrapyramidal symptoms.

Restart drugs at a lower dosage with favorable results.

What type of isolation would be required for an immunocompromized patient?

Reverse or neutropneic isolation

Which of the following is a classic symptom of cholecystitis? Epigastric, radiating to the back Left upper abdomen, radiating to the jaw and neck Right upper abdomen, radiating to the back or right scapula Substernal, radiating to the left shoulder and arm

Right upper abdomen, radiating to the back or right scapula

What is an appropriate patient problem for a patient who has recently been diagnosed with acromegaly? Activity intolerance Chronic low self-esteem Ineffective coping Risk for trauma

Risk for trauma

Which activities should the home health nurse suggest to an elderly patient to avoid constipation? (Select all that apply.) Schedule toileting after meals Drinking at least 1000 mL fluid Using tap water enemas for persons with altered mobility Increasing fiber intake Taking a daily stool softener Taking bulk-forming laxatives

Schedule toileting after meals Drinking at least 1000 mL fluid Increase fiber intake Taking bulk-forming laxatives

A patient is in which stage of Alzheimer's disease when she demonstrates "sundowning"? Second stage Early stage Final stage Third stage

Second stage

For most people who are HIV-positive, marker antibodies are usually present 10 to 12 weeks after exposure. What is the development of these antibodies called? Immunocompetence Seroconversion Immunodeficiency Opportunistic infection

Seroconversion

While teaching community groups about AIDS, what should the nurse indicate as the most common method of transmission of the HIV? Sexual contact with an HIV-infected partner Nonsexual exposure to saliva and tears Perinatal transmission Exposure to contaminated blood

Sexual contact with an HIV-infected partner

The client is having a lumbar puncture performed. The nurse should place the client in which position for the procedure? Prone, in slight Trendelenburg's Prone, with a pillow under the abdomen Side-lying, with legs pulled up and chin to the chest Supine, in semi-Fowler's

Side-lying, with legs pulled up and chin to the chest

What is the nurse aware of when assessing a person with a craniocerebral injury? Most injuries of this type are irreversible. Signs and symptoms may not occur until several days after the trauma. Open injuries are always more serious than closed injuries. Trauma to the frontal lobe is more significant than to any other area.

Signs and symptoms may not occur until several days after the trauma.

A patient with a spinal cord injury at T1 complains of stuffiness of the nose and a headache. The nurse notes a flushing of the neck and "goose flesh." What should be the primary nursing intervention based on these assessments? Place on side and check for leg swelling. Place patient in flat position and check temperature. Sit upright and check blood pressure. Administer oxygen and check oxygen saturation.

Sit upright and check blood pressure.

A patient with a spinal cord injury at T1 complains of stuffiness of the nose and a headache. The nurse notes a flushing of the neck and "goose flesh." What should be the primary nursing intervention based on these assessments? Sit upright and check blood pressure. Administer oxygen and check oxygen saturation. Place on side and check for leg swelling. Place patient in flat position and check temperature.

Sit upright and check blood pressure.

When caring for an extremely jaundiced patient with cirrhosis, what should the nurse include provisions for in the plan of care? Meticulous foot care Skin care to relieve pruritus Offering foods rich in fat-soluble vitamins Encouraging consumption of a high-fat diet

Skin care to relieve pruritus

Which instruction is most important for the nurse to teach a patient with diabetes who is receiving metformin? This medication will cause the pancreas to secrete more insulin. Take the medication before meals. There may be an increase in the triglyceride level. Stop taking the drug 24 to 48 hours prior to radiopaque dye procedures.

Stop taking the drug 24 to 48 hours prior to radiopaque dye procedures.

The nurse arrives at the bedside of a patient who has had a unit of packed cells infusing in his right arm for 35 minutes. He is complaining of chills, itching, and shortness of breath. What should be the nurse's initial action? Elevate the head of the bed. Take the patient's temperature. Cover with a warm blanket. Stop the transfusion and continue with saline.

Stop the transfusion and continue with saline.

A patient with a large inguinal hernia has abdominal distention and inguinal pain. The nurse recognizes these as indicators of which type of hernia? Strangulated Ventral Umbilical Hiatal

Strangulated

A 56 -year-old man is admitted to the emergency room with an acute attack of diverticulitis. The patient has a temperature of 102°F, and has an elevated white count. Which assessment would alert the nurse to impending septic shock? Chest pain Massive diarrhea Tachycardia Seizure

Tachycardia

Which of the following provide the body with innate immunity? (Select all that apply.) Tears and saliva Heart Natural intestinal and vaginal flora Skin and mucous membranes Lungs Stomach acid

Tears and saliva Natural intestinal and vaginal flora Skin and mucous membranes Stomach acid

Which person is most at risk for a hypersensitivity reaction? 26 year old receiving his second desensitization injection The 52 year old started on a new series of Pyridium for cystitis The 84 year old receiving penicillin for an annually recurring respiratory infection 35 year old starting back on birth control tablets

The 84 year old receiving penicillin for an annually recurring respiratory infection

A male patient is advised to receive HIV antibody testing because of his multiple sexual partners and injectable drug use. What should the nurse inform the patient to ensure understanding? If the HIV tests are seronegative, the patient can be assured that he is not infected. The blood is tested with an ELISA; if positive, it is tested again with an ELISA, followed by a Western blot if the second ELISA is positive. The blood is tested with the highly sensitive test called the Western blot. A series of HIV tests is performed to confirm if the patient has AIDS.

The blood is tested with an ELISA; if positive, it is tested again with an ELISA, followed by a Western blot if the second ELISA is positive.

What is humoral immunity based on? (Select all that apply.) T cells are activated by an antigen Sensitized T cells destroy the antigen The body's response to an antigen Production of antibodies by B cells Helper T cells activate phagocytosis

The body's response to an antigen Production of antibodies by B cells Helper T cells activate phagocytosis

Why is the patient with suspected Guillain-Barre Syndrome (GBS) hospitalized immediately? IV hydration is needed to prevent possible fatal hypotension. The brain may swell quickly causing seizures. The disease can rapidly progress into respiratory failure. The infection needs to be treated with IV antibiotics to prevent paralysis.

The disease can rapidly progress into respiratory failure.

Which is most important for the successful management of diabetes mellitus? Preventative education A network of community resources The level of self-management Frequent follow-up with the health care provider

The level of self-management

In which patient should the nurse be most concerned about immunodeficiency disorder? The patient recently diagnosed with lupus erythematosus The patient taking desensitization injections (immunotherapy) The patient on long-term radiation therapy for cancer The overweight patient

The patient on long-term radiation therapy for cancer

Which symptom is specific to migraine headaches? They involve the entire head They are preceded by an aura Tachycardia They become worse in the evening

They are preceded by an aura

Which are important nursing considerations when administering prokinetic agents? (Select all that apply.) Administer the medication to diabetic patients after meals. They may be administered intravenously. They may be useful in treating nausea associated with chemotherapy treatment. These agents are used to treat esophagitis associated with gastric reflux. They are used to treat GERD when lifestyle changes and diet are ineffective.

They may be administered intravenously. They may be useful in treating nausea associated with chemotherapy treatment. These agents are used to treat esophagitis associated with gastric reflux. They are used to treat GERD when lifestyle changes and diet are ineffective.

Why are beta blockers used cautiously in patients with respiratory conditions? They increase hypertensive episodes. They cause extensive vasodilation and cardiac overload. They mask the signs and symptoms of acute hypoglycemia. They may produce severe bronchoconstriction.

They may produce severe bronchoconstriction.

Why should interventions such as promotion of nutrition, exercise, and stress reduction be undertaken by the nurse for patients who have HIV infection? They will prevent transmission of the virus to others. They will promote a feeling of well-being in the patient. They will improve immune function. They will increase the patient's strength and ability to care for himself or herself.

They will improve immune function.

The nurse is assessing a patient's mouth and notes white, milk curd-appearing plaques attached to the oral mucosa. Which condition is present? Mucositis Cold sores Thrush Canker sores

Thrush

A patient was scheduled for a laparoscopic cholecystectomy, but complications developed and he underwent an open cholecystectomy with a T tube inserted into the common bile duct. What is the purpose of the T tube? To keep the duct open and allow drainage of the bile until edema resolves. To shorten postoperative recovery and hasten the healing process. To decompress the duct and relieve pain caused by stimulation of the sphincter of Oddi. To improve diaphragmatic expansion and prevention of atelectasis.

To keep the duct open and allow drainage of the bile until edema resolves.

The health care provider orders an 1800-calorie diabetic diet and 40 units of (Humulin N) insulin U-100 subcutaneously daily for a patient with diabetes mellitus. Why would a mid-afternoon snack of milk and crackers be given? To improve carbohydrate metabolism. To prevent an insulin reaction. To improve nutrition. To prevent diabetic coma.

To prevent an insulin reaction.

What is the purpose of plasmapheresis in the treatment of rheumatoid arthritis? To add antinuclear antibodies. To remove pathologic substances present in the plasma. To add corticosteroids to relieve pain. To remove waste products such as urea and albumin.

To remove pathologic substances present in the plasma.

How would the nurse instruct a patient with Parkinson disease to improve activity level? To use a soft mattress to relax the spine. To walk with a shuffling gait to avoid tripping. To sit in hard chair with arms for posture control. To walk with hands clasped behind back to help balance.

To walk with hands clasped behind back to help balance.

If a nurse is sensitive to latex gloves, what potential food sensitivities might the nurse develop? (Select all that apply.) Tomatoes Peanuts Potatoes Milk Avocados Bananas

Tomatoes Potatoes Avocados Bananas

A patient is being discharged on an adrenergic bronchodilator. Which common adverse effect(s) will the nurse include in discharge teaching? (Select all that apply.) Bradycardia Hypoglycemia Tremors Dizziness Palpitations Orthostatic hypotension

Tremors Dizziness Palpitations Orthostatic hypotension

Which cholinergic symptoms of Parkinson's disease are reduced with anticholinergic drugs? Tremors and drooling Postural abnormalities Cognitive impairments Rigidity

Tremors and drooling

Gray matter is gray because it does not have myelin. True False

True

A patient has recently suffered a stroke with left-sided weakness and has problems with choking, especially when drinking thin liquids. What nursing interventions would be most helpful in assisting this patient to swallow safely? Take a sip of liquid with each bite. Tuck chin when swallowing. Turn head to the left. Use a straw.

Tuck chin when swallowing.

Which statement(s) regarding type 2 diabetes mellitus would be correct? (Select all that apply.) Type 2 diabetes is often diagnosed after complications have resulted. Type 2 diabetes is more prevalent in overweight people older than 45 years. A genetic predisposition exists for the development of type 2 diabetes mellitus. Women have a higher incidence of type 2 diabetes. Type 2 diabetes requires lifelong insulin replacement.

Type 2 diabetes is often diagnosed after complications have resulted. Type 2 diabetes is more prevalent in overweight people older than 45 years. A genetic predisposition exists for the development of type 2 diabetes mellitus. Women have a higher incidence of type 2 diabetes.

A patient with a T tube for an open cholecystectomy has resumed oral intake. The T tube is clamped 2 hours before meals and unclamped 2 hours after meals to aid in the digestion of fat. During the time the tube is clamped the patient complains of abdominal pain and nausea. Which intervention is most appropriate? Increase the IV fluids. Change the T-tube dressing. Unclamp the tube immediately. Notify the physician.

Unclamp the tube immediately.

What is the cranial nerve that supplies most of the organs in the thoracic and abdominal cavities and carries motor fibers to glands that produce digestive juices and other secretions? Vagus nerve Visceral sensory nerve Somatic motor nerve Abducens nerve

Vagus nerve

What is the cranial nerve that supplies most of the organs in the thoracic and abdominal cavities and carries motor fibers to glands that produce digestive juices and other secretions? Visceral sensory nerve Vagus nerve Abducens nerve Somatic motor nerve

Vagus nerve

Which is considered an acceptable time frame for a patient with gastric distress to self-medicate with over-the-counter antacids? Hours Months Days Weeks

Weeks

The nurse gave an intramuscular penicillin injection to a patient. What assessment finding would be most indicative of a systemic anaphylactic response? Uticaria Bradycardia Wheezing Increased blood pressure

Wheezing

Which of the following is an example of immunocompetence? A child that is immune to measles because of an inoculation When the symptoms of a common cold disappear in 1 day A person who has seasonal allergies every fall A neonate having a natural immunity from maternal antibodies

When the symptoms of a common cold disappear in 1 day

What are the three signs of Cushing response? (Select all that apply.) Widened pulse pressure Increased pulse rate Increased systolic blood pressure Bradycardia Increased blood pressure Uncontrolled thermoregulation

Widened pulse pressure Increased systolic blood pressure Bradycardia

An older adult patient is to receive atenolol, a beta-adrenergic blocking agent. Prior to administration of the drug, the nurse assesses an apical pulse rate of 58 and notes ankle edema. Which action will the nurse take first? Determine the therapeutic blood level. Withhold the medication. Elevate the patient's legs. Encourage the patient to decrease water intake.

Withhold the medication.

When is the best time for the nurse to administer Lispro? You Answered 30 minutes before a meal After the patient has started eating Within 10 to 15 minutes of eating 45 to 60 minutes before a meal

Within 10 to 15 minutes of eating

Which condition is treated by saliva substitutes? Xerostomia Mucositis Halitosis Caries

Xerostomia

Which foods should the person who suffers from migraine headaches avoid? (Select all that apply.) Milk Yogurt Beef Marinated foods Caffeine Pears

Yogurt Marinated foods Caffeine

The home health nurse caring for a patient who has dysphagia related to radiation therapy for oral cancer would recommend that the family provide: - a bell to summon help. - a walkie-talkie. - a tablet and pencil as a communication aid. - a TV for diversion.

a tablet and pencil as a communication aid

To provide examples of an active acquired immunity, the nurse uses the example of a person who has acquired immunity from measles because that person has had: (Select all that apply.) maternal antibodies against measles. an extremely healthy immune system. an inoculation against measles. measles. chickenpox and mumps.

an inoculation against measles. measles.

Cerebrospinal fluid is found between the dura mater and the arachnoid mater. skull and the dura mater. pia mater and the brain. arachnoid mater and the pia mater.

arachnoid mater and the pia mater.

The nurse is discussing dietary and lifestyle changes with a patient diagnosed with GERD. When reviewing necessary modifications, the nurse will include information regarding (Select all that apply.) limiting coffee intake to 2 cups/day. avoiding NSAIDs. using nonfat milk. smoking cessation. decreasing protein foods.

avoiding NSAIDs. using nonfat milk. smoking cessation.

When a patient taking a monoamine oxidase B inhibitor receives his dietary tray, the nurse knows to remove the coffee. cheese. eggs. bread.

cheese

The nurse recommends to the busy mother of three that the antihistamine fexofenadine (Allegra) would be more beneficial than diphenhydramine (Benadryl) because Allegra: does not dry out the mucous membranes. contains a stimulant for an energy boost. does not induce drowsiness. is inexpensive.

does not induce drowsiness.

The outermost layer of the meninges is the choroid plexus. pia mater. dura mater. arachnoid mater.

dura mater

The patient's cirrhosis of the liver has also caused a dilation of the veins of the lower esophagus secondary to portal hypertension, resulting in the development of the complication of: esophageal varices. esophageal reflux (GERD). Crohn disease. diverticulosis.

esophageal varices.

The nurse assisting in the treatment of a patient with ruptured esophageal varices who has received vasopressin IV will carefully assess for: muscular twitching/spasm. hematuria. evidence of cardiac ischemia. macular rash on trunk and arms.

evidence of cardiac ischemia.

The nurse is caring for a home health patient who had a spinal cord injury at C5 3 years ago. The nurse bases the plan of care on the knowledge that the patient will be able to: stand erect with full leg braces. transfer self to wheelchair. feed self with setup and adaptive equipment. sit with good balance.

feed self with setup and adaptive equipment.

An 83-year-old patient has had a stroke. He is right handed and has a history of hypertension and "little" strokes. He presents with right hemiplegia. To afford him the best visual field, the nurse should approach him: from the left side. from the right side. from the center. from either side.

from the left side.

Because the older adult has decreased production of saliva and gastric secretions, they are at risk for: mouth ulcers. gastrointestinal infections. bloating. fissures in corners of the mouth.

gastrointestinal infections.

Bowel sound assessment on a patient with an obstruction who has distention, nausea, and visible peristaltic waves would be: absent. high pitched. loud and clearly audible. hyperactive.

high pitched

The nurse teaching a patient with type 1 diabetes mellitus (IDDM) about early signs of insulin reaction would include information about: flushing of the skin and headache. hunger and a trembling sensation. abdominal pain and nausea. dyspnea and pallor.

hunger and a trembling sensation.

The nurse discovers the type 1 diabetic (IDDM) patient drowsy and tremulous, the skin is cool and moist, and the respirations are 32 and shallow. These are signs of: hyperglycemic hyperosmolar nonketotic reaction; squeeze glucagon gel in buccal cavity. hypoglycemic reaction; give 6 oz of orange juice. hypoglycemic reaction; give ordered insulin. hyperglycemic reaction; give ordered regular insulin.

hypoglycemic reaction; give 6 oz of orange juice.

The nurse would make provisions in the plan of care for a person who has had a liver transplant to prevent: infection. fatigue. urinary retention. fluid congestion.

infection

A patient is admitted with a secondary immunodeficiency from chemotherapy. The nursing plan of care should include provisions for: infection control. nutritional education. supporting self-care. maintaining high fluid intake.

infection control

In caring for a patient with gastric bleeding who has a nasogastric tube in place, the nurse should include in the plan of care to ensure that the NG tube is: changed every 72 hours. frequently repositioned to the opposite nostril. clamped for 10 minutes every hour. kept patent with irrigation.

kept patent with irrigation.

In caring for a patient with gastric bleeding who has a nasogastric tube in place, the nurse should include in the plan of care to ensure that the NG tube is: kept patent with irrigation. clamped for 10 minutes every hour. changed every 72 hours. frequently repositioned to the opposite nostril.

kept patent with irrigation.

In designing a teaching plan to present to a group of older adults regarding the prevention of esophageal cancer, the nurse would include information about the significance of: (Select all that apply.) reducing excessive weight. limiting alcohol consumption. good oral care. reduction of consumption of citrus fruits. regular checkups if dysphagia is present. cessation of smoking.

limiting alcohol consumption. good oral care. regular checkups if dysphagia is present. cessation of smoking.

The nurse outlines the functions of the immune system as those actions which: (Select all that apply.) prevent the hemorrhage. maintain the hemoglobin level. maintain the homeostasis by removing damaged cells. protect the body's internal environment. destruct the growth of abnormal cells.

maintain the homeostasis by removing damaged cells. protect the body's internal environment. destruct the growth of abnormal cells.

The vital centers are located in the medulla oblongata. pons. spinal cord. midbrain.

medulla oblongata. pons.

A patient hospitalized in an acute care setting reports to the nurse that since starting on an adrenergic medication, he has been feeling "dizzy and weak." The most appropriate action for the nurse is to discontinue the adrenergic blocker. monitor the blood pressure in both the supine and standing positions. teach the patient to move slowly from standing to sitting. immediately notify the physician.

monitor the blood pressure in both the supine and standing positions.

The indentations between Schwann cells are called neurilemmas. nodes of Ranvier. myelin. glias.

nodes of Ranvier.

Involuntary rhythmic movement of the eyes, with oscillations that may be horizontal, vertical, or mixed movements, is called ___________________.

nystagmus

The nurse is assisting with care of a patient on chemotherapy with severe mucositis. The patient reports mucous membrane pain level to be "8" on the pain scale. The priority nursing diagnosis for this patient is pain. risk for aspiration. fluid volume deficit. altered nutrition: less than body requirements.

pain

The nurse explains that when the patient received tetanus antitoxin with the antibodies in it, the patient received a ___________ type of immunity. passive natural active natural passive artificial active artificial

passive artificial

The autonomic nervous system is a subdivision of the _____ nervous system. central parasympathetic peripheral sympathetic

peripheral

A patient has come to the clinic because of enlarged hands and feet, amenorrhea, and increased hair growth. These symptoms most likely indicate problems with the: thyroid gland. pancreas. pituitary gland. adrenal glands.

pituitary gland.

The nurse caring for a patient who has had an open cholecystectomy with a T Tube will: place the collection bag so the tube is not kinked. irrigate the T tube with normal saline to ensure the free flow of bile. position and secure the drainage bag at the chest level. open the T tube to the air so that it will drain freely.

position and secure the drainage bag at the chest level.

The nurse caring for a 75-year-old man who has developed diabetes insipidus following a head injury will include in the plan of care provisions for: limiting fluids to 1500 mL a day. discouraging daytime naps. encouraging physical exercise. protecting patient from injury.

protecting patient from injury.

A long-term care resident is taking an anticholinergic agent. The nurse observes the resident to be disoriented and hallucinating. The priority nursing action is to report development of alterations to the charge nurse. assess blood glucose. medicate with antianxiety medication. provide for resident's safety.

provide for resident's safety.

The nurse explains to the patient with Crohn disease that the tube feedings allow for: rapid absorption in the upper GI tract. reduction of diarrheic episodes. a permanent nutritional support. decompression of the stomach.

rapid absorption in the upper GI tract.

The nurse should instruct the patient who is diagnosed with AIDS to report signs of Kaposi's sarcoma, which include: open, bleeding skin lesions. watery diarrhea. blood-tinged sputum. reddish-purple skin lesions.

reddish-purple skin lesions.

In designing a teaching plan to present to a group of older adults regarding the prevention of esophageal cancer, the nurse would include information about the significance of: (Select all that apply.) reducing excessive weight. regular checkups if dysphagia is present. cessation of smoking. reduction of consumption of citrus fruits. limiting alcohol consumption. good oral care.

regular checkups if dysphagia is present. cessation of smoking. limiting alcohol consumption. good oral care.

Following a myelogram the nurse should include in the postprocedure care assessment for: elevation of blood pressure. sensation in lower extremities. urine retention. slurred speech.

sensation in lower extremities.

Following a myelogram the nurse should include in the postprocedure care assessment for: elevation of blood pressure. urine retention. sensation in lower extremities. slurred speech.

sensation in lower extremities.

The nurse is aware that the characteristic gait of the person with Parkinson disease is a propulsive gait, which causes the patient to: shuffle with arms flexed. fall over to one wide when walking. stagger and need support of a walker. take small steps balanced on the toes.

shuffle with arms flexed.

The nurse is aware that the characteristic gait of the person with Parkinson disease is a propulsive gait, which causes the patient to: stagger and need support of a walker. shuffle with arms flexed. take small steps balanced on the toes. fall over to one wide when walking.

shuffle with arms flexed.

A patient taking misoprostol (Cytotec) to treat a gastric ulcer reports recurrent diarrhea. The nurse should encourage this patient to immediately discontinue misoprostol (Cytotec). omit fresh fruits from diet. take with a magnesium-containing antacid. take medication with meals.

take medication with meals.

The nurse explains that the negative feedback inhibition controls hormone release by communication between: the pituitary and the target organ. the thymus and the bloodstream. lymphatic system and the target organ. central nervous system and the bloodstream.

the pituitary and the target organ.

The nurse explains that the triad of signs of Parkinson disease is: _______, rigidity, and bradykinesia.

tremor

Health care facilities have reduced the incidence of serious latex reactions by: using only powder-free gloves. desensitizing staff who are allergic. having local and injectable corticosteroids on hand for employees. supplying extra hand washing stations in the halls.

using only powder-free gloves.

The nurse anticipates that the patient who has had a subtotal gastrectomy will need supplemental: protein due to the loss of some of the digestive processes. vitamin A due to the loss of the gastric lining. bulk to prevent constipation. vitamin B12 due to the loss of the intrinsic factor.

vitamin B12 due to the loss of the intrinsic factor.

The nurse clarifies that unconjugated bilirubin, which is made up of broken-down red cells, is: water-insoluble bilirubin that must be converted by the liver. necessary for digestion of fats. a by-product which is excreted directly into the bowel for excretion. stored in the gallbladder to make bile.

water-insoluble bilirubin that must be converted by the liver.

The nurse is caring for a patient taking a cholinergic agent. When auscultating lung sounds, the nurse notes inspiratory and expiratory wheezing bilaterally. The best action for the nurse to take would be to reposition the patient. provide the next dose of the cholinergic agent immediately. assess heart rate and blood pressure. withhold the next dose and notify the physician.

withhold the next dose and notify the physician.