NURS2120- Final Exam Study Guide - Even Chapters

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symptoms of metabolic acidosis

-Headache, lethargy -Nausea, vomiting, diarrhea -Coma -Death

A patient presented to a clinic with a cough suggestive of pneumonia. Which of the following describes the expected characteristic of the cough? 1- Dry and slightly irritating 2- High-pitched and irritating 3- Brassy and dry 4- Hacking with sputum production

Hyperglycemia symptoms

- dizziness - Headache - Anxiety- Shakiness - Diaphoresis - Excessive hunger- Confusion - clumsy or jerky movement - Tremors- Palpitations or fast heart rate - blurred vision

Which nursing assessment finding indicates the client with renal dysfunction has not met expected outcomes? 1- Client reports increasing fatigue. 2- Client rates pain at a 3 on a scale of 0 to 10. 3- Client denies frequency and urgency. 4- Urine output is 100 ml/hr.

Which nursing intervention is appropriate for a client with a closed-reduction extremity fracture? 1- Encourage participation in ADLs 2- Promote intake of omega-3 fatty acids 3- Use frequent dependent positioning to prevent edema 4- Administer prescribed enema to prevent constipation

Which nursing intervention should a nurse perform to reduce cardiac workload in a client diagnosed with myocarditis? 1- Maintain the client on bed rest. 2- Administer a prescribed antipyretic. 3- Elevate the client's head. 4- Administer supplemental oxygen.

Which nursing intervention would reduce cardiac workload in a client with myocarditis? 1- Maintain the client on bed rest. 2- Administer a prescribed antipyretic. 3-Lower the client's head. 4- Eliminate all phone calls and visitors.

Which of the following cell types are involved in humoral immunity? 1- B lymphocytes 2- Helper T lymphocyte 3- Suppressor T lymphocyte 4- Memory T lymphocyte

Which of the following insulins are used for basal dosage? 1- Glarginet (Lantus) 2- NPH (Humulin N) 3- Lispro (Humalog) 4- Aspart (Novolog)

Which of the following is a leading health indicator to be used to measure the health of the nation? 1- Overweight and obesity 2- Intelligence 3- Cultural awareness 4- Religion

Which of the following is an example of a gliding joint? 1- Carpal bones in the wrist 2- Knee 3- Hip 4- Joint at base of thumb

Which of the following is the final stage of fracture repair? 1- Remodeling 2- Cartilage calcification 3- Cartilage removal 4- Angiogenesis

Which of the following is the most common complication of prosthetic valves? 1- Thromboembolism 2- Hemolysis 3- Infection 4- Arrhythmias

Which of the following is the most common site for a dissecting aneurysm? 1- Thoracic area 2- Lumbar area 3- Sacral area 4- Cervical area

Which of the following is the most common site of joint effusion? 1- Knee 2- Elbow 3- Hip 4- Shoulder

Which of the following is the priority nursing diagnosis for the client preparing for a bone marrow biopsy? 1- Deficient knowledge: procedure 2- Acute pain 3- Risk for infection 4- Risk for ineffective peripheral tissue perfusion

Which of the following may result if prostate cancer invades the urethra or bladder? 1- Hematuria 2- Backache 3- Hip pain 4- Rectal discomfort

Which of the following medications is considered a thrombolytic? 1- Alteplase 2- Heparin 3- Coumadin 4- Lovenox

Which of the following musculoskeletal injuries is manifested by acromioclavicular joint pain? 1- Rotator cuff tears 2- Epicondylitis 3- Heterotopic ossification 4- Acute compartment syndrome

Which of the following type of fracture is associated with osteoporosis? 1- Compression 2- Stress 3- Oblique 4- Simple

Which program focuses on processes used to provide care? 1- Continuous quality improvement (CQI) 2- Quality assurance (QA) 3- Health maintenance organization (HMO) 4- Preferred provider organization (PPO)

Which sign or symptom suggests that a client's abdominal aortic aneurysm is extending? 1- Increased abdominal and back pain 2- Decreased pulse rate and blood pressure 3- Retrosternal back pain radiating to the left arm 4- Elevated blood pressure and rapid respirations

Which step of the nursing process determines whether the client understands the health teaching that is provided? 1- Evaluation 2- Assessment 3- Planning 4- Implementation

Which of the following are immunosuppressants that prevent the patient's lymphocytes from destroying the stem cells in a patient diagnosed with aplastic anemia? Select all that apply. 1- Cyclosporine 2- Corticosteroids 3- ATG 4- Cyclophosphamide 5- Filgrastim

1,2,3,4

s/s of cancer of prostate

Hard nodule felt on periphery of glandHesitancy in urinationDecreased urine streamFrequent urinationRecurrent UTI

Troponin levels

After myocardial injury, these biomarkers rise early (within 3 to 4 hours), peak in 4 to 24 hours, and remain elevated for 1 to 3 weeks

Occupational Safety and Health Administration

promote the safety and health of working people by setting and enforcing standards; providing training, outreach, and education; establishing partnerships; and encouraging continual process improvement in workplace safety and health

all nursing care is directed toward

promoting, maintaining, and restoring health; preventing illness; and helping people adapt to the residual effects of illness

cystocele

protrusion of the bladder

right ventricle

pumps deoxygenated blood to the lungs

left ventricle

pumps oxygenated blood to the body

What to do when someone is anxious and breathing fast and vitals are out of control (hyperventilation or panic attack)

pursed lip breathing breath into paper bag belly breathing hold breath 10-15 seconds at a time

crackles

rales Soft, high-pitched, discontinuous popping sounds that occur during inspiration; sounds like several hairs rubbing together between the thumb and index finger

symptoms of respiratory acidosis

rapid, shallow respirations dyspnea disorientation muscle weakness

left atrium

receives oxygenated blood from the lungs

Which of the following arterial blood gas results would be consistent with metabolic alkalosis? 1- Serum bicarbonate of 28 mEq/L 2- PaCO2 less than 35 mm Hg 3- Serum bicarbonate of 21 mEq/L 4- pH 7.26

normal specific gravity

1.005-1.030

magnesium levels

1.5-2.5 mEq/L

BUN/Creatinine Ratio

10:1 to 20:1

The nurse is to provide discharge teaching to a patient with newly diagnosed coronary artery disease. In what order should the following steps be prioritized and completed? 1- Implement teaching plan. 2- Collect and analyze data regarding the patient's knowledge of coronary artery disease. 3- Form nursing diagnoses related to patient teaching. 4- Reassess patient's knowledge as needed. 5- Develop teaching plan. 6- Identify learning needs. 7- Update and change plan.

2, 6, 3, 5, 1, 4, 7

A client is found to have a low hemoglobin and hematocrit when laboratory work was performed. What does the nurse understand the anemia may have resulted from? Select all that apply. 1- Infection 2- Blood loss 3- Abnormal erythrocyte production 4- Destruction of normally formed red blood cells 5- Inadequate formed white blood cells

2,3,4

phosphate levels

2.5-4.5 mg/dL

normal trial natriuretic peptide levels

20 to 77 pg/mL

Bicarbonate levels

22-26 mEq/L

What treats DKA

regular insulin IV

Serum Osmolality (normal range)

275-295 mOsm/kg

potassium levels

3.5-5.0 mEq/L

Normal PTT/aPTT

30-45 seconds

A client hospitalized for treatment of a pulmonary embolism develops respiratory alkalosis. Which clinical findings commonly accompany respiratory alkalosis? 1- Nausea or vomiting 2- Abdominal pain or diarrhea 3- Hallucinations or tinnitus 4- Light-headedness or paresthesia

Colles fracture occurs in which area? 1- Elbow 2- Humeral shaft 3- Clavicle 4- Distal radius

The nurse is providing discharge instructions for a slightly overweight client seen in the Emergency Department with gastroesophageal reflux disease (GERD). The nurse notes in the client's record that the client is taking carbidopa/levodopa. Which order for the client by the health care provider should the nurse question? 1- a low-fat diet 2- elevation of upper body on pillows 3- pantaprazole 4- metoclopramide

When applying Maslow's hierarchy of needs to patient care, the nurse determines that the patient has reached the ultimate goal indicating integrated human functioning and health when which level is met? 1- Safety and security 2- Belongingness and affection 3- Esteem and self-respect 4- Self-actualization

normal urine pH

4.5-8

Normal HDL levels

40-60

calcium levels

8.5-10.5 mg/dL

non-pharmacologic Pharmacologic treatment fo nausea during chemo

relaxation guided imagery acupressure acupuncture deep breathing eliminating odors avoid reclining for 30 minutes after eating eat small frequent bland, chilled meals

Which of the following is accurate regarding the effects of nicotine and tobacco smoke on the body? Select all that apply. 1- Causes vasospasm 2- Reduces circulation to the extremities 3- Impairs transport and cellular use of oxygen 4- Increases blood viscosity 5- Decreases blood viscosity

1,2,3,4

vericocele

enlargement of the veins of the spermatic cordcan reduce sterility - ligationice or scrotal supporter

palliative surgery in cancer is used to

relieve complications of cancer, such as ulcerations, obstructions, hemorrhage, pain, and malignant effusions

Annuloplasty

repair of a cardiac valve's outer ring

chordoplasty

repair of the tendinous fibers that connect the edges of the atrioventricular valve leaflets to the papillary muscles)

dissecting aneurysm

A condition in which the inner layers of an artery, such as the aorta, become separated, allowing blood (at high pressures) to flow between the layers.

natural killer cells

A type of white blood cell that can kill tumor cells and virus-infected cells; an important component of innate immunity.

A patient with a recent diagnosis of HIV infection has expressed to the nurse that he is motivated to learn as much about his disease as possible. The patient has heard and read about the role of the different T cells, but is unclear of their roles in the immune response. Which of the following roles of T cells should the nurse identify? Select all that apply. A) Stimulating the immune system B) Secreting cytokines C) Directly attacking antigens D) Activating other T cells E) Producing antibodies

A,B,C,D

An obese patient with a history of smoking and hypertension underwent a coronary artery bypass graft for the treatment of coronary artery disease. During the patient's postoperative recovery, he developed a DVT. The development of this event was a result of the interaction between which of the following pathophysiological phenomena? Select all that apply. A) Stasis of blood resulting from immobility and surgery B) Injury to one or more of the patient's vessel walls C) Cardiac stress resulting from surgery D) Alterations in the normal process of coagulation E) The presence of an inflammatory process

A,B,D

What is the most common arrhythmia after CABG

A-fib - give beta blockers to prevent embolus

Anion gap equation

AG = Na - (Cl + HCO3)

Code of eithics is established by

ANA

Veins used for CABG

greater saphenous vein lesser saphenous vein internal thoracic arteries Less common: mammary arteries radial arteries

T-cells

Cells created in the thymus that produce substances that attack infected cells in the body.

Hypocalcemia symptoms

Chvostek's sign, Trousseau's Sign Numbness and tingling of fingers and circumoral (around mouth) region, hyperactive reflexes, positive Trousseau's sign (carpopedal spasm with hypoxia), positive Chvostek's sign (contraction of facial muscles when facial nerve is tapped), tetany, muscle cramps, and pathological fractures (chronic hypocalcemia)

Na+ 142 mEq/L K+. 5 mEq/L Ca++ 5 mEq/L Mg++ 2 mEq/L total 154 mEq/L

Cl- 103 mEq/L HCO3- 26 mEq/L PO4--- 2 mEq/L SO4-- 1 mEq/L Organic acids 5 mEq/L Proteinate. 17 mEq/L total 154 mEq/L

Stages of bone healing

hematoma formation inflammatory phasereparative phaseremodeling phase

symptoms of respiratory alkalosis

Dizzy, confused Tetany Hyperventilation Neuromuscular irritability

coarse crackles

Discontinuous popping sounds heard in early inspiration; harsh, louder, lower-pitched moist sound originating in the large bronchi

fine crackles

Discontinuous popping sounds heard in late inspiration; originates in the alveoli

Hypomagnesium symptoms

Hyperactive deep tendon reflexes**, neuromuscular excitability**, confusion, disorientation

Hypernatremia S/S

Elevated temp Weakness Disorientation Irritability and restlessness Thirst Dry, swollen tongue Sticky mucous membranes Hypotension Tachycardia

A 20-year-old client cut a hand while replacing a window. While reviewing the complete blood count (CBC) with differential, the nurse would expect which cell type to be elevated first in an attempt to prevent infection in the client's hand? 1- Eosinophils 2- Neutrophils 3- B cells 4- Monocytes

Hyperphosphatemia symptoms

Fatigue Shortness of breath Anorexia Nausea Vomiting Sleep disturbances

WHO defines health as

Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

Splinter hemorrhages

Hemorrhages caused by trauma or injury to the nail bed that damage the capillaries and allow small amounts of blood flow.

transillumination can help identify what

hydrocele

linings of the heart

INNERMOST(ENDOCARDIUM), MIDDLE(MYOCARDIUM), OUTER(PERICARDIUM)

Normal Partial Pressures

In pulmonary vein plasma after gas exchange at alveoli PCO2 = 40 mm Hg PO2 = 100 mm Hg PN2 = 573 mm Hg

Hypermagnesemia symptoms

Inhibits acetylcholine release and can cause diminished neuromuscular function Hyporeflexia Muscle weakness Cardiovascular effects (eg, hypotension and arrhythmias) Severely high Mg++ levels (greater than 10 mEq/L) can cause cardiac arrest.

What are the intercellular cations?

K+. 150 mEq/L Mg++ 40 mEq/L Na+ 10 mEq/L total 200 mEq/L

Rapid acting insulin

Lispro (Humalog) Aspart (Novolog) Glulisine (Apidra) onset 5-15 min peak 30-90 minutes duration 3-5 hours

sonorous wheezes.

Low-pitched, loud, coarse, snoring sounds. (Often heard on expiration.)

Saccular (berry) aneurysm

Most common cause of subarachnoid hemorrhage

Intermediate acting insulin

NPH (Humulin N, Novolin N) onset - 2-4 hours peak - 6-8 hours duration 12-16

serum osmolality equation

Na × 2 = glucose/18 + BUN/3

What are the extracellular cations?

Na+ 142 mEq/L K+. 5 mEq/L Ca++ 5 mEq/L Mg++ 2 mEq/L total 154 mEq/L

Hyponatremia symptoms

Na+ loss: poor skin turgor dry mucosa headache decreased saliva production orthostatic blood pressure nausea abdominal cramping Water gain: edam, crackers, ascites, and JVD Neurologic: altered mental status headache lethargy seizures and a progressively decreased LOC eventuating in coma

nursing care for ARDS

O2 therapy, fluid restriction, HOB elevated, frequent O2 sats, repositioning

Treatment of testicular cancer

Orchiectomy lymph node removal.Chemo. Radiation.effects:sexualityinfertilitypoor self imageeducate they can donate sperm

cellular immune response

T cells attach directly to antigens and destroy them

Helper T cells

T cells that help the immune system by increasing the activity of killer cells and stimulating the suppressor T cells

Hypophosphatemia symptoms

Weakness, bone pain, rhabdomyolysis, and altered mental status

During auscultation of a client, the nurse suspects a diagnosis of mitral valve regurgitation when hearing which of the following? 1- Mitral click 2- High-pitched blowing sound at the apex 3- Low-pitched diastolic murmur at the apex 4- Diastolic murmur at the left sternal border

During which stage of the immune response does the circulating lymphocytes containing the antigenic message return to the nearest lymph node? 1- Recognition 2- Proliferation 3- Response 4- Effector

A 58-year-old patient's electrocardiogram (ECG) and presentation are suggestive of a myocardial infarction (MI), and treatment has been promptly initiated. The nurse who is part of the patient's care team should anticipate and facilitate which of the following interventions? Select all that apply. A) Providing the patient with supplementary oxygen B) Administering morphine by IV C) Administering oral warfarin (Coumadin) D) Administering a bolus of 0.9% NaCl E) Teaching the patient deep breathing and coughing techniques

a,b

Centers for Medicare and Medicaid Services (CMS)

a federal agency within the U.S. Department of Health and Human Services that is responsible for Medicare and Medicaid, among many other responsibilities.

Suppressor T cells

a lymphocyte that can suppress antibody production by other lymphoid cells.

While interviewing a client with an allergic disorder, the client tells the nurse about an allergy to animal dander. The nurse knows that animal dander is what type of substance? 1- Immunoglobulin 2- Complete protein antigen 3- Chemical mediator 4- T-lymphocyte

With fractures of the femoral neck, the leg is 1- shortened, adducted, and externally rotated. 2- shortened, abducted, and internally rotated. 3- adducted and internally rotated. 4- abducted and externally rotated.

Which is a true statement regarding regional enteritis (Crohn's disease)? 1- It has a progressive disease pattern. 2- It is characterized by pain in the lower left abdominal quadrant. 3- The clusters of ulcers take on a cobblestone appearance. 4- The lesions are in continuous contact with one another.

ARDS occurs as a result of an inflammatory trigger that

initiates the release of cellular and chemical mediators, causing diffuse epithelial cell injury to the alveolar capillary membrane leading to leakage of protein-rich fluid and blood cells into the alveolar interstitial spaces and alterations in the capillary bed

sibilant wheeze

abnormal breath sound that is high pitched and musical in nature and is heard on inhalation and exhalation

myeloid leukemia

abnormal granulocytes or other cells of marrow

Type I Diabetes Mellitus

insulin dependent, occurs when pancreatic cells fail to function properly and insulin is not secreted normally - does not have enough insulin in system to transfer glucose into cells - prescribed synthetic insulin

The nurse suspects a patient has a pleural effusion. Which of the following respiratory findings would the nurse expect to find upon assessment of the patient? A) Increased tactile fremitus, egophony, and a dull sound upon percussion of the chest wall B) Decreased tactile fremitus, wheezes, and a hyperresonant sound upon percussion of the chest wall C) Lung fields dull to percussion, tactile fremitus absent, and breath sounds absent D) Normal tactile fremitus, decreased breath sounds, and a resonant sound upon percussion of the chest wall

Calcium Channel Blockers (amlodipine-Norvasc, diltiazem-Cardizem)

calcium ion antagonists decrease sinoatrial node decrease HR and decrease contractility decrease workload relax blood vessels dilate smooth muscle treat and prevent vasospasm (angina)

testicular cancer

cancer of the testicle, usually occurring in men 15 to 40 years of agegerminalnon-germinal s

What is CABG

coronary artery bypass graft

causes of dysphagia

neurologic deficit muscular disorder mechanical obstruction

Nitroglycerin

nitrate drug used in the treatment of angina do not give if there is hypotension

complications of CABG

hypoveolemia persistent bleeding cardiac tamponade fluid overlaod hypothermia hypertension tachyarrhythmias bradycardias cardia failure MI impair gas exchange hemorrhage neurological changes stroke kidney failure acute kidney injury electrolyte imbalance hepatic failure infection

primary management of ARDS

identify cause mechanical ventilation

mitral valve prolapse

improper closure of the mitral valve

the goal of patient and family education is to:

improve patient outcomes

hypernatremia results from

increased insensible losses and diabetes insipidus

precordial pain

pain in the anterior chest overlying the heart

stridor

strained, high-pitched sound heard on inspiration caused by obstruction in the pharynx or larynx

Coronary artery bypass graft

surgical technique to bring a new blood supply to heart muscle by detouring around blocked arteries

joint effusion

swelling from excess fluid in the joint capsule

Renin is release when the ___________ system is stimulated?

sympathetic

Nitrates (Nitroglycerin, Nitrostat, Nitrol, Nitro-Bid, Nitro-paste)

treatment of coronary ishemia vasoactive reduces O2 consumption of heart reduces ischemia relaxes alveolar bed and increase O2 supply dilates veins, and arteries in high doses reduces filling pressure do not give in hypovolemia

Types of aortic aneurysms

• Thoracic Aortic Aneurysms • Abdominal Aortic Aneurysms (AAA) • Aortic Dissection

What is the focus of health education

invovlvement accountabiliy communication

acromioclavicular joint

irregular joint between the acromion process of the scapula and the distal clavicle

The nurse is conducting an assessment of a patient's nutritional status prior to postpyloric intubation. When assessing the patient's most recent laboratory values the nurse should pay particular attention to the patient's level of: A) Prealbumin B) Potassium C) Blood glucose D) Alkaline phosphatase

What is one of the biggest barriers to patient education

lack of communication skills (includes reading and computer)

Normal LDL levels

less than 100 mg/dL

rhonchi

loud rumbling sounds heard on auscultation of bronchi obstructed by sputum, primarily during expiration

wheezes

continuous high-pitched whistling sounds produced during breathing, usually heard on expiration

pleural friction rub

continuous, dry grating sound caused by inflammation of pleural surfaces and loss of lubricating pleural fluid sound of snow

Troponin I levels of greater than 1.5 ng/mL or greater than 1.5 mg/L are

critical

Pathologic fracture

occurs when a weakened bone breaks under normal strain

compression fracture

occurs when the bone is pressed together (compressed) on itself

comminuted fracture

fracture in which the bone is splintered or crushed

Department of public health

generally charged with the protection of the health and well-being of the state's population and environment nursing board falls under this

long acting insulin

glargine (Lantus) detemir (Levemir) onset - 2 hours peak - none duration - 24-48 hours

Treatment for mucositis and sotmatis during chemo

good oral hygiene soft toothbrush & non-abrasive toothpaste soft mild foods topical anti-inflammatory or anti-inflammatory drugs products to coat or protect oral mucosa cryotherapy low-level laser therapy

promoting nutrition in cancer patients

high calorie/high protein small frequent meals avoid drinking while eating oral hygiene before meals manage pain, nausea before meals

Educational environment

homes, hospitals, community health centers, schools, places of business, service agencies, shelters, and consumer action or support groups.

hypochloremia symptoms

hyperexcitability of muscles, tetany, hyperactive DTRs, weakness, and muscle cramps

leaflet repair

includes removal of excess leaflet tissue and the repair of leaflet damage from stretching or tearing by using pericardial or synthetic patches

hyponatremia occurs with

increased thirst and ADH release

thrombocythemia

overproduction of platelets, leading to thrombosis or bleeding disorders due to platelet malformations

What should be assess before initiating education?

person's physical and emotional readiness to learn, as well as his or her ability to learn what is being taught

Autoimmunity

pertaining to one's immune system attacking its own tissues or cells

Combats bone marrow suppression during chemo

platelet transfusions

What do 63% to 89% of patients develop after CABG

pleural effusions

common electrolyte imbalances after CABG

potassium, magnesium, sodium, calcium, glucose

Pharmacologic treatment fo nausea during chemo

prevention is priority - give around the clock and breakthrough serotonin receptor antagonists - ondansetron dopamine receptor antagonists - metoclopramide phenothiazines - prochlorperazine corticosteroids - dexamethasone cannabinoids - dronabinol

Alluprinol

prevents nucleic acids from converting to uric acid during chemo

sinoatrial node (SA node)

primary pacemaker of the heart, initiates electrical impulses at an inherent rate of 60 to 100 beats per minute

type 2 diabetes

progressive disorder in which body cells become less responsive to insulin

Sodium levels

135-145 mEq/L

normal MCV

80-100 fL

chloride levels

98-106 mEq/L

critically high BUN

>100

What percentage of people older than 65 years have one or more chronic disease(s)? 1- 80 2- 50 3- 60 4- 70

aortic regurgitation

(aortic insufficiency) incompetent aortic valve that allows backward flow of blood into left ventricle during diastole

Maslow's Hierarchy of Needs

(level 1) Physiological Needs, (level 2) Safety and Security, (level 3) Relationships, Love and Affection, (level 4) Self Esteem, (level 5) Self Actualization

Influences on health care

* Immigration and diversity * aging population * regulatory bodies * professional societies and associations * hospitals and institutions * individual employees

Models of Nursing Care

* Patient and family centered care * Collaborative Practice * Care across the continuum

antiplatelets and anticoagulants

* monitor for signs and symptoms of bleeding (lo BP, hi HR, lo hemo and hematocrit) * aspirin, clopidogrel, heparin, glycoprotein, IIb/IIIa inhibitors)

indications for CABG

* persistent angina * multivesslel CAD (70% occlusion) * MI, arrhythmia, HF (left ventricle) * complications and unsuccessful PCI

Where do you draw ABGS from

* radial artery (perform Allen test to determine latency of ulnar artery) * brachial or femoral artery * indwelling arterial catheter

assessment after cardiac Cath/PCI via radial approach

* vital signs - including near checks (Q15 minutes x4, Q30 minutes x4, Q1 hour x4, and then Q4 hours or routine) * bleeding hematoma * don't use affected arm for 24 hours * leave TR band in place for 1-2 hours * Pulse Oximeter on the affected hand

Eosinophils

*What IgE-mediated cell secretes major basic protein and has elevated levels in the blood during asthma and parasitic infections? *What type of WBC is present in increased numbers during an allergic reaction?

Fatigue - Cancer/Treatment Side effect

-Plan client care -Provide time for adequate rest periods (ex: naps, limiting visitors, clustering care) - stay active when possible

symptoms of metabolic alkalosis

-Respiration slow and shallow -Hyperactive reflexes ; tetany -Often related to depletion of electrolytes -Atrial tachycardia -Dysrhythmias

Which of the following are alterations noted in Virchow's triad? Select all that apply. 1- Stasis of blood 2- Vessel wall injury 3- Altered coagulation 4- Edema 5- Tenderness

1,2,3

Which statement is correct regarding glargine insulin? 1- Its peak action occurs in 2 to 3 hours. 2- It cannot be mixed with any other type of insulin. 3- It is absorbed rapidly. 4- It is given twice daily.

Normal troponin level

0.0 - 0.10 ng/mL

A 16-year-old female patient experiences alopecia resulting from chemotherapy, prompting the nursing diagnoses of disturbed body image and situational low self-esteem. What action by the patient would best indicate that she is meeting the goal of improved body image and self-esteem? 1- The patient requests that her family bring her makeup and wig. 2- The patient begins to discuss the future with her family. 3- The patient reports less disruption from pain and discomfort. 4- The patient cries openly when discussing her disease.

A 29-year-old patient has just been told that he has testicular cancer and needs to have surgery. The surgery is scheduled for the following week. That afternoon, the patient calls the nurse and tells her he wants to cancel the surgery because he thinks he might be better off dead. The nurse asks him why he feels that way. The patient states "My wife won't want to have sex with me anymore. He says he feels like he's spoiled a happy, satisfying sex life with his wife and he starts to cry. Based on these statements, which nursing diagnosis would be most appropriate for creating a plan of care for this patient? 1- Situational low self-esteem 2- Inability to function 3- Social isolation 4- Risk for loneliness

A 48-year-old patient has had multiple sclerosis for 15 years, and she is receiving interferon injections. What is the purpose of interferon injections? 1- To modify the immune response by suppressing antibody production and cellular immunity 2- To give rise to numerous cell types able to form tissues in three germ layers 3- To complement receptors and, as a result, play an important role in the clearance of antigens 4- To complement components, prostaglandins, leukotrienes, and other inflammatory mediators

A 61-year-old man has a longstanding history of peripheral artery disease that has progressed in recent months to acute limb ischemia (ALI). As a result, he has just undergone bilateral arterial bypass grafts and is postoperative day 1. The nurse's most recent assessment reveals that the patient's left foot is cold to touch and dusky in appearance with nonpalpable peripheral pulses. How should the nurse respond to this assessment finding? 1- Report the finding to the surgeon immediately. 2- Encourage the patient to perform light activity and assist with range of motion exercises. 3- Place a warm compress on the patient's foot to stimulate circulation. 4- Administer a dose of the patient's prescribed anticoagulant.

A 61-year-old man's elevated prostate screening antigen (PSA) levels and abnormal digital rectal examination (DRE) results prompted his care provider to refer him for treatment. The patient has subsequently been diagnosed with prostate cancer and is scheduled for surgery. The nurse should recognize that this patient's plan of nursing care should include interventions to address what potential long-term complication of prostate surgery? 1- Erectile dysfunction 2- Stress incontinence 3- Urge incontinence 4- Abdominal distention

A 68-year-old woman has experienced multiple urinary tract infections over the past several months, and her care provider suspects a structural problem with her bladder or urethra. To directly visualize these structures, what diagnostic test may be ordered? 1- Cystoscopy 2- Ureteral brush biopsy 3- Urinalysis 4- Renal biopsy

A 73-year-old client is admitted to the pulmonology unit of the hospital. She was admitted with a pleural effusion and was "tapped" to drain the fluid to reduce her mediastinal pressure. How much fluid is typically present between the pleurae, which surround the lungs, to prevent friction rub? 1- 5 - 15 ml 2- 15 - 25 ml 3- 20 - 30 ml 4- No fluid normally is present

A 77-year-old man is recovering in the hospital after a recent femoral fracture and has rung his call light. The nurse has entered the room to find the patient in distress, clutching his chest while struggling to say, "I can't breathe." The nurse should take prompt action based on the knowledge that this patient may be experiencing what complication of lower extremity fractures? 1- Thromboembolism 2- Unstable angina 3- Acute respiratory distress syndrome (ARDS) 4- Ischemic stroke

A client admitted to the coronary care unit (CCU) diagnosed with a STEMI is anxious and fearful. Which medication will the nurse administer to relieve the client's anxiety and decrease cardiac workload? 1- IV morphine 2- IV nitroglycerin 3- Atenolol 4- Amlodipine

A client arrives at the physician's office stating 2 days of febrile illness, dyspnea, and cough. Upon assisting the client into a gown, the nurse notes that the client's sternum is depressed, especially on inspiration. Crackles are noted in the bases of the lung fields. Based on inspection, which will the nurse document? 1- The client has a funnel chest. 2- The client has chronic respiratory disease. 3- The client has pneumonia in the bases. 4- The client needs a cough suppressant.

A client asks the nurse how long to wait after taking nitroglycerin before experiencing pain relief. What is the best answer by the nurse? 1- 3 minutes 2- 15 minutes 3- 30 minutes 4- 60 minutes

A client comes to the clinic and informs the nurse that he feels as though he has allergies. What laboratory test results will be a positive indicator for an allergic disorder? 1- Radioallergosorbent blood test (RAST) of 3 2- WBC of 7000/mm3 3- Neutrophils 60% 4- Eosinophils 6%

A client diagnosed with a myocardial infarction (MI) is being moved to the rehabilitation unit for further therapy. Which statement reflects a goal of rehabilitation for the client with an MI? 1- Improvement in quality of life 2- Limitation of the effects and progression of atherosclerosis 3- Ability to return to work and a preillness functional capacity 4- Prevention of another cardiac event

A client experiencing a severe anxiety attack and hyperventilating presents to the emergency department. The nurse would expect the client's pH value to be 1- 7.50 2- 7.45 3- 7.35 4- 7.30

A client had a percutaneous transluminal coronary angioplasty (PTCA). What medication will the nurse administer to prevent thrombus formation in the stent? 1- Clopidogrel 2- Isosorbide mononitrate 3- Metoprolol 4- Diltiazem

A client has a new order for metoclorpramide. What potential side effects should the nurse educate the client about? 1- Extrapyramidal 2- Peptic ulcer disease 3- Gastric slowing 4- Nausea

A nurse is examining a client's chest. During the exam, the nurse palpates what feels like bubbles under the clent's chest muscles. Which term would the nurse use when documenting this finding? 1- crepitus 2- crackles 3- rhonchi 4- wheeze

A client has been admitted in the emergency care unit with conditions of respiratory distress and pneumonia. The client's condition worsens and requires mechanical ventilation. While visiting this client in the hospital, the family observes members of the health care team washing their hands upon entering and leaving the room. By implementing recommended hand hygiene measures, which organization's goals is the health care team supporting? 1- The Joint Commission 2- The National Council of State Boards of Nursing (NCSBN) 3- Institute of Medicine (IOM) 4- Agency for Healthcare Research and Quality (AHRQ)

A client has been experiencing severe pain and hematuria and is hardly able to ambulate into the physician's office. The physician suspects kidney stones and orders diagnostic tests to confirm. What test would physician order? 1- KUB 2- ultrasound 3- CT 4- MRI

A client has had oral anticoagulation ordered. What should the nurse monitor for when the client is taking oral anticoagulation? 1- Prothrombin time (PT) or international normalized ratio (INR) 2- Hourly IV infusion 3- Vascular sites for bleeding 4- Urine output

A client has hypoxemia of pulmonary origin. What portion of arterial blood gas results is most useful in distinguishing between acute respiratory distress syndrome and acute respiratory failure? 1- Partial pressure of arterial oxygen (PaO2) 2- Partial pressure of arterial carbon dioxide (PaCO2) 3- pH 4- Bicarbonate (HCO3-)

A client has recently undergone a coronary artery bypass graft (CABG). The nurse should be alert to which respiratory complication? 1- Atelectasis 2- Elevated blood glucose level 3- Hyperkalemia 4- Urinary tract infection (UTI)

A client in end-stage renal disease is prescribed epoetin alfa and oral iron supplements. Before administering the next dose of epoetin alfa and oral iron supplement, what is the priority action taken by the nurse? 1- Assesses the hemoglobin level 2- Questions the administration of both medications 3- Ensures the client has completed dialysis treatment 4- Holds the epoetin alfa if the BUN is elevated

A client is admitted to the emergency room after being hit by a car while riding a bicycle. The client sustained a fracture of the left femur, and the bone is protruding through the skin. What type of fracture does the nurse recognize requires emergency intervention? 1- Compound 2- Greenstick 3- Oblique 4- Spiral

A client is admitted to the hospital with aortic stenosis. What assessment findings would indicate the development of left ventricular failure? 1- Dyspnea, orthopnea, pulmonary edema 2- Distended jugular veins, pedal edema, nausea 3- Dyspnea, distended jugular veins, orthopnea 4- Orthopnea, nausea, pedal edema

A client is experiencing pain, joint instability, and difficulty walking due to an injury to the knee ligaments. The injury was judged not to require surgery. Which intervention would not be included in this client's care? 1- traction 2- joint immobilization 3- limited weight bearing 4- ice and NSAIDs

A client is having a diagnostic workup for reports of frequent diarrhea, right lower abdominal pain, and weight loss. The nurse is reviewing the results of the barium study and notes the presence of "string sign." What does the nurse understand that this is significant of? 1- Crohn's disease 2- Ulcerative colitis 3- Irritable bowel syndrome 4- Diverticulitis

A client is hospitalized for repair of an abdominal aortic aneurysm. The nurse must be alert for signs and symptoms of aneurysm rupture and thus looks for which of the following? 1- Constant, intense back pain and falling blood pressure 2- Constant, intense headache and falling blood pressure 3- Higher than normal blood pressure and falling hematocrit 4- Slow heart rate and high blood pressure

A client is prescribed an oral corticosteroid for 2 weeks to relieve asthma symptoms. The nurse educates the client about side effects, which include 1- adrenal suppression. 2- diuresis. 3- hypoglycemia. 4- hypotension.

A client is receiving insulin lispro at 7:30 AM. The nurse ensures that the client has breakfast by which time? 1- 7:45 AM 2- 8:00 AM 3- 8:15 AM 4- 8:30 AM

A client is recovering from a craniotomy with tumor debulking. Which comment by the client indicates to the nurse a correct understanding of what the surgery entailed? 1- "I guess the doctor could not remove the entire tumor." 2- "I am so glad the doctor was able to remove the entire tumor." 3- "I will be glad to finally be done with treatments for this thing." 4- "Thank goodness the tumor is contained and curable."

A client is scheduled to undergo an electromyography. When performed, what will this test evaluate? 1- Muscle weakness 2- Muscle composition 3- Bone density 4- Metastatic bone lesions

A client is transported to the emergency department for a femur fracture following a motor vehicle crash. What action by the nurse is the highest priority? 1- Assess vital signs and level of consciousness. 2- Administer pain medication per orders. 3- Assess pedal pulses. 4- Assess the diameter of the thigh every 15 minutes.

A client is treated in the clinic for a sexually transmitted infection, and the nurse suspects that the client is at risk for HIV. The physician determines that the client should be tested for the virus. What responsibility does the nurse have? 1- The nurse ensures a written consent is obtained prior to testing. 2- The nurse should send the client to have the blood drawn without informing him about the specific screening test. 3- The nurse will call the client with the results of the test. 4- The nurse will inform the client that the results will have to be reported to the Centers for Disease Control and Prevention (CDC).

A client presents to the ED reporting anxiety and chest pain after shoveling heavy snow that morning. The client says that nitroglycerin has not been taken for months but upon experieincing this chest pain did take three nitroglycerin tablets. Although the pain has lessened, the client states, "They did not work all that well." The client shows the nurse the nitroglycerin bottle; the prescription was filled 12 months ago. The nurse anticipates which order by the physician? 1- Nitroglycerin SL 2- Chest x-ray 3- Serum electrolytes 4- Ativan 1 mg orally

Which treatment involves implantation of interstitial radioactive seeds under anesthesia to treat prostate cancer? 1- Hormone therapy 2- Brachytherapy 3- Teletherapy 4- Chemotherapy

A client presents to the ED reporting left flank pain and lower abdominal pain. The pain is severe, sharp, stabbing, and colicky in nature. The client has also experienced nausea and emesis. The nurse suspects the client is experiencing: 1- ureteral stones. 2- pyelonephritis. 3- cystitis. 4- Urethral infection.

A client receiving chemotherapy has a nursing diagnosis of Deficient diversional activity related to decreased energy. Which client statement indicates an accurate understanding of appropriate ways to deal with this deficit? 1- "I'll play card games with my friends." 2- "I'll take a long trip to visit my aunt." 3- "I'll bowl with my team after discharge." 4- "I'll eat lunch in a restaurant every day."

A client reports chest pain and heavy breathing when exercising or when stressed. Which is a priority nursing intervention for the client diagnosed with coronary artery disease? 1- Assess chest pain and administer prescribed drugs and oxygen 2- Assess blood pressure and administer aspirin 3- It is not important to assess the client or to notify the physician 4- Assess the client's physical history

A client reports headaches and "just not feeling right," which the client blames on ongoing sleep disturbances. Inspection reveals Janeway lesions on the bottoms of the client's feet. These symptoms may indicate: 1- infective endocarditis. 2- rheumatic fever. 3- myocarditis. 4- dilated cardiomyopathy.

A client reports muscle cramps in the calves and feeling "tired a lot." The client is taking ethacrynic acid (Edecrin) for hypotension. Based on these symptoms, the client will be evaluated for which electrolyte imbalance? 1- hypokalemia 2- hyperkalemia 3- hypocalcemia 4- hypercalcemia

A client who can't tolerate oral feedings begins receiving intermittent enteral feedings. When monitoring for evidence of intolerance to these feedings, what must the nurse remain alert for? 1- diaphoresis, vomiting, and diarrhea. 2- manifestations of electrolyte disturbances. 3- manifestations of hypoglycemia. 4- constipation, dehydration, and hypercapnia.

A client who has fallen and injured a hip cannot place weight on the leg and is in significant pain. After radiographs indicate intact but malpositioned bones, what would the physician diagnose? 1- dislocation 2- strain 3- sprain 4- fracture

A client who has no health insurance asks if there is any chance that they will benefit from healthcare reform. What should the nurse tell the client about the goal of the Patient Protection and Affordable Care Act? 1- The goal of the Patient Protection and Affordable Care Act is to provide affordable healthcare to U.S. citizens who previously had no access to health insurance. 2- The Patient Protection and Affordable Care Act applies only to people who are eligible for Medicaid, so it will not apply to the client's situation. 3- The Patient Protection and Affordable Care Act applies only to people who are eligible for Medicare, so it will not apply to the client's situation. 4- The goal of the Patient Protection and Affordable Care Act is to provide affordable healthcare to U.S. citizens who have at least three dependents.

A client who was in a motor vehicle crash is diagnosed with a stable T7 spinal fracture with no neurologic deficits. Which nursing intervention should the nurse implement? 1- Maintain bed rest with the head of the bed at 20 degrees. 2- Withhold opioid pain medication to prevent ileus. 3- Maintain NPO (nothing by mouth) status for surgical repair. 4- Sit the client upright in a padded chair for meals.

A client with a history of right-sided heart failure lives in a long-term care facility. In the daily assessment, the nurse is required to record the level of this client's peripheral edema. Which would be the main area for examination? 1- feet and ankles 2- over the sacrum 3- lips and earlobes 4- knees and elbows

A client with a suspected overdose of an unknown drug is admitted to the emergency department. Arterial blood gas values indicate respiratory acidosis. What should the nurse do first? 1- Prepare to assist with ventilation. 2- Monitor the client's heart rhythm. 3- Prepare for gastric lavage. 4- Obtain a urine specimen for drug screening.

A client with aortic regurgitation is admitted to the hospital. Which assessment findings would indicate left ventricular failure? 1- Dyspnea, orthopnea, paroxysmal nocturnal dyspnea (PND) 2- Distended jugular veins, pedal edema, nausea 3- Dyspnea, distended jugular veins, orthopnea 4- Orthopnea, nausea, pedal edema

A client with cancer is being treated on the oncology unit for bilateral breast cancer. The client is undergoing chemotherapy. The nurse notes the client's serum calcium concentration is 12.3 mg/dL (3.08 mmol/L). Given this laboratory finding, the nurse should suspect that the 1- malignancy is causing the electrolyte imbalance. 2- client's diet is lacking in calcium-rich food products. 3- client may be developing hyperaldosteronism. 4- client has a history of alcohol abuse.

A client with diabetes is receiving an oral anti diabetic agent that acts to help the tissues use available insulin more efficiently. Which of the following agents would the nurse expect to administer? 1- Metformin 2- Glyburide 3- Repaglinide 4- Glipizide

A client with emphysema is at a greater risk for developing which acid-base imbalance? 1- chronic respiratory acidosis 2- metabolic alkalosis 3- metabolic acidosis 4- respiratory alkalosis

A client with infective endocarditis (IE) and a fever is admitted to the intensive care unit. Which of these physician orders should the nurse implement first? 1- Order blood cultures drawn from two sites 2- Give acetaminophen pro re nata for fever higher than 100.3 F 3- Administer ceftriaxone 1 g IVPB q 12 hours 4- Obtain a transesophageal echocardiogram

A client with known coronary artery disease reports intermittent chest pain, usually on exertion. When teaching the client about nitroglycerin administration, which instruction should the nurse provide? 1- "Be sure to take safety precautions because nitroglycerin may cause dizziness when you stand up." 2- "Replace leftover sublingual nitroglycerin tablets every 9 months to make sure your pills are fresh." 3- "A burning sensation after administration indicates that the nitroglycerin tablets are potent." 4- "You may take a sublingual nitroglycerin tablet every 30 minutes, if needed. You may take as many as four doses."

A client with status asthmaticus requires endotracheal intubation and mechanical ventilation. Twenty-four hours after intubation, the client is started on the insulin infusion protocol. The nurse must monitor the client's blood glucose levels hourly and watch for which early signs and symptoms associated with hypoglycemia? 1- Sweating, tremors, and tachycardia 2- Dry skin, bradycardia, and somnolence 3- Bradycardia, thirst, and anxiety 4- Polyuria, polydipsia, and polyphagia

A client's blood glucose level is 45 mg/dl. The nurse should be alert for which signs and symptoms? 1- Coma, anxiety, confusion, headache, and cool, moist skin 2- Kussmaul's respirations, dry skin, hypotension, and bradycardia 3- Polyuria, polydipsia, hypotension, and hypernatremia 4- Polyuria, polydipsia, polyphagia, and weight loss

A client's chart indicates Virchow's triad. This client is at risk for which complication? 1- thrombophlebitis 2- venous stasis 3- altered blood coagulation 4- postphlebitic syndrome

A community health nurse is well aware that taking responsibility for oneself is the key to successful health promotion. Which of the following actions by the nurse's patients best demonstrates self-responsibility and health promotion? 1- A woman takes action to quit smoking cigarettes. 2- A man seeks care because of an apparent cognitive decline. 3- A man questions his pharmacist when having a prescription refilled. 4- A woman reluctantly agrees to have her infant immunized.

A current trend in health education that significantly influences nursing practice is: 1- Increased emphasis on patient involvement in their own care. 2- Improved distribution of health information materials. 3- Increased numbers of health care providers. 4- Increased emphasis on the diversity of patient needs.

A gardener sustained a deep laceration while working and requires sutures. The patient is asked about the date of his last tetanus shot, which he tells the nurse was more than 10 years ago. Based on this information, the patient will receive a tetanus immunization. The tetanus injection will allow for the release of what? 1- An antibody 2- An antigen 3- A bacteria 4- A virus

A group of students is reviewing the phenomena as the focus of nursing care and research identified by the American Nurses Association. The group demonstrates the need for additional review when they identify which of the following as a phenomenon? 1- Ethical actions 2- Self-care processes 3- Lifespan transitions 4- Environmental systems

A health care provider prescribes short-acting insulin for a patient, instructing the patient to take the insulin 20 to 30 minutes before a meal. The nurse explains to the patient that Humulin-R taken at 6:30 AM will reach peak effectiveness by: 1- 8:30 AM. 2- 10:30 AM. 3- 12:30 PM. 4- 2:30 PM.

A hospital patient has been ordered a sliding scale of Humulin R for the duration of her admission. The patient's medication administration record specifies the first administration time of the day at 08:00 and the nurse knows that breakfast trays typically arrive on the unit between 07:45 and 07:50. When should the nurse administer the patient's insulin? 1- 07:30 2- 07:45 3- 08:00 4- 08:15

A male client has been unable to return to work for 10 days following chemotherapy as the result of ongoing fatigue and inability to perform usual activities. Laboratory test results are WBCs 2000/mm³, RBCs 3.2 x 10¹²/L, and platelets 85,000/mm³. The nurse notes that the client is anxious. Which of the following is the priority nursing diagnosis? 1- Risk for infection related to inadequate defenses 2- Fatigue related to deficient blood cells 3- Activity intolerance related to side effects of chemotherapy 4- Anxiety related to change in role function

A new surgical patient who has undergone a coronary artery bypass graft (CABG) is receiving opioids for pain control. The nurse must be alert to adverse effects of opioids. Which of the following effects would be important for the nurse to document? 1- Hypotension 2- Urinary incontinence 3- Hyperactive bowel sounds 4- Hypertension

A nurse assesses arterial blood gas results for a patient in acute respiratory failure (ARF). Which results are consistent with this disorder? 1- pH 7.28, PaO2 50 mm Hg 2- pH 7.46, PaO2 80 mm Hg 3- pH 7.36, PaCO2 32 mm Hg 4- pH 7.35, PaCO2 48 mm Hg

A nurse is caring for a client after cardiac surgery. Upon assessment, the client appears restless and reports nausea and weakness. The client's ECG reveals peaked T waves. The nurse reviews the client's serum electrolytes, anticipating which abnormality? 1- Hyperkalemia 2- Hypercalcemia 3- Hypomagnesemia 4- Hyponatremia

A nurse is caring for a client following an arterial vascular bypass graft in the leg. What should the nurse plan to assess over the next 24 hours? 1- Peripheral pulses every 15 minutes after surgery 2- Ankle-arm indices every 12 hours 3- Blood pressure every 2 hours 4- Color of the leg every 4 hours

A nurse is caring for a client newly diagnosed with mitral valve prolapse. The health care provider indicates the client has probably had this condition for years. What factor is important for the nurse to consider when teaching the client about valular disease? 1- "The client with mitral valve prolapse probably had no health symptoms." 2- "The client needs premium insurance to cover the cost of medications." 3- "The client's religion may prohibit the client from seeking medical attention." 4- "The client may have to wear antiembolism stocking to help with venous return."

A nurse is caring for a diabetic patient with a diagnosis of nephropathy. What would the nurse expect the urinalysis report to indicate? 1- Albumin 2- Bacteria 3- Red blood cells 4- White blood cells

A nurse is conducting a heath history on a client with a primary diagnosis of mitral stenosis. Which disorder reported by the client is the most common cause of mitral stenosis? 1- Rheumatic endocarditis 2- Congestive heart failure 3- Atrial fibrillation 4- Myocardial infarction

A nurse is evaluating education provided to various clients being discharged to home. The nurse assesses that client most likely to be nonadherent with treatment is the one who 1- Has tuberculosis and is taking multiple antitubercular medications 2- Has pneumonia and is prescribed an oral antibiotic 3- Had abdominal surgery and will be changing the dressing daily 4- Has a duodenal ulcer and is prescribed a histamine-2 receptor blocker

A nurse is planning a health education program for a group of high school students regarding the dangers of texting and driving. Which action by the nurse illustrates the understanding of health education as a primary nursing responsibility? 1- The nurse gathers evidenced-based information related to texting and driving and coordinates the education with the school. 2- The nurse obtains the name of the school's medical director and obtains a health care provider's order to conduct the education program. 3- After consulting the literature and preparing the educational program, the nurse contacts the school's medical director for approval of the planned educational program. 4- The nurse prepares a permission slip for all students to have signed by their parents, allowing the student to participate in the educational program.

A nurse is preparing a continuous insulin infusion for a child with diabetic ketoacidosis and a blood glucose level of 800 mg/dl. Which solution is the most appropriate at the beginning of therapy? 1- 100 units of regular insulin in normal saline solution 2- 100 units of neutral protamine Hagedorn (NPH) insulin in normal saline solution 3- 100 units of regular insulin in dextrose 5% in water 4- 100 units of NPH insulin in dextrose 5% in water

A nurse is preparing to administer two types of insulin to a client with diabetes mellitus. What is the correct procedure for preparing this medication? 1- The short-acting insulin is withdrawn before the intermediate-acting insulin. 2- The intermediate-acting insulin is withdrawn before the short-acting insulin. 3- Different types of insulin are not to be mixed in the same syringe. 4- If administered immediately, there is no requirement for withdrawing one type of insulin before another.

A nurse is providing education to a client who is newly diagnosed with diabetes mellitus. What are classic symptoms associated with diabetes? 1- increased thirst, hunger, and urination 2- Increased weight loss, dehydration, and fatigue 3- Loss of appetite, increased urination, and dehydration 4- Increased weight gain, appetite, and thirst

A nurse is reevaluating a client receiving IV fibrinolytic therapy. Which finding requires immediate intervention by the nurse? 1- Altered level of consciousness 2- Minimal oozing of blood from the IV site 3- Presence of reperfusion dysrhythmias 4- Chest pain 2 of 10 (on a 1-to-10 pain scale)

A nurse is reviewing the history of a client diagnosed with erectile dysfunction. Which information would the nurse interpret as indicating that use of a PDE-5 inhibitor would be contraindicated. 1- use of nitroglycerin for angina 2- history of heart attack 2 years ago 3- hypertension controlled with medications 4- use of antiseizure medications

A nurse is teaching a client about valve replacement surgery. Which statement by the client indicates an understanding of the benefit of an autograft replacement valve? 1- "The valve is made from my own heart valve, and I will not need to take any blood-thinning drugs when I am discharged." 2- "The valve is made from a pig tissue, and I will not need to take any blood-thinning drugs when I am discharged." 3- "The valve is from a tissue donor, and I will not need to take any blood-thinning drugs when I am discharged." 4- "The valve is mechanical, and it will not deteriorate or need replacing."

A nurse is teaching a male client to perform monthly testicular self-examinations. Which point is appropriate to make? 1- Testicular cancer is a highly curable type of cancer. 2- Testicular cancer is very difficult to diagnose. 3- Testicular cancer is the number one cause of cancer deaths in males. 4- Testicular cancer is more common in older men.

A nurse is told in report that a patient has aortic stenosis. Which anatomical position should the nurse auscultate to assess the murmur? 1- Second intercostal space, right sternal notch 2- Erb's point 3- Second intercostal space, left sternal notch 4- Fourth intercostal space, left sternal border

A nurse prepares a client for a bone marrow biopsy who is suspected of having acute myeloid leukemia. What results from the bone marrow biopsy does the nurse expect? 1- Excess of immature leukocytes 2- Excess of immature erythrocytes 3- Deficiency of neutrophils 4- Deficiency of erythrocytes

A nurse who provides care in a long-term care facility has observed a sharp decline in an 88-year-old man's level of consciousness and activity over the past 36 hours. The nurse recognizes the high incidence of pneumonia among older adults. How does pneumonia present differently among the elderly than among younger patients? 1- Older adults often lack a fever when they develop pneumonia. 2- Oxygen saturation levels remain stable among older adults despite increased sputum production. 3- Pneumonia is usually intensely painful for older adults but lacks an increase in white blood cells (WBCs). 4- Older adults who have pneumonia are usually asymptomatic.

A nurse who provides care in a postsurgical care unit of a hospital is aware that reimbursement to the hospital for Medicare patients is based on diagnosis-related groups (DRGs). How are DRGs used to determine reimbursement for Medicare patients? 1- Hospitals receive payment at a fixed rate for patients with diagnoses that fall into a specific DRG. 2- Medicare patients match the hospital's reimbursement from Medicare at a dollar-for-dollar rate. 3- A Medicare patient's minimum levels of care are established by the DRG that best relates to the patient's care needs. 4- Hospitals do not receive reimbursement if it can be demonstrated that a patient falls within a DRG.

A nurse with 20 years' experience attends a hospital-required training session and learns a new method for assessing nasogastric (NG) tube placement. During the training the nurse educator provides the nurse with a bibliography of peer-reviewed articles related to NG tube placement. The nurse recognizes the change in procedure developed from which method? 1- Evidence-based practice 2- Knowledge, skills, and attitude 3- Institute of Medicine (IOM) research 4- Core measures

A nurse working in a community-based health center is engaged in teaching a client about her medications. The nurse is acting as which of the following? 1- Practitioner 2- Leader 3- Researcher 4- Delegator

A patient with a history of type 1 diabetes is being assessed for possible diabetic nephropathy, and a component of the ordered diagnostic evaluation is a urinalysis. This patient's ability to concentrate urine would be reflected in what component of urinalysis? 1- Osmolality 2- Red blood cells 3- Glucose 4- White blood cells

A nursing student observes the home care nurse provide education to a client with congestive heart failure (CHF). The nurse teaches the client how to read food labels and calculate sodium content. The nursing student recognizes that the home care nurse is aware of which basic principle of patient education? 1- Patient instruction related to self-care activities promotes patient independence 2- Patients are required to learn about their therapeutic nutritional regimen 3- The home care nurse has a physician order to teach a 2-g sodium diet 4- The home care nurse is providing hospital discharge instructions

A patient asks the nurse if there are any available nonsurgical options to terminate a pregnancy if she is only 2 weeks pregnant. What information should the nurse provide to the patient about a medication that blocks progesterone? 1- Mifepristone (RU-486, Mifeprex) is used only in early pregnancy to terminate a pregnancy nonsurgically. 2- Methotrexate is used only in early pregnancy to terminate a pregnancy nonsurgically. 3- Clomiphene (Clomid) is used only in early pregnancy to terminate a pregnancy nonsurgically. 4- Birth control pills can be used to terminate the pregnancy.

A patient diagnosed with diabetic ketoacidosis would be expected to have which type of respiratory pattern? 1- Kussmaul respirations 2- Cheyne-Stokes 3- Biot's respirations 4- Apnea

A patient experiences hypotension, lethargy, and muscle spasms while receiving bladder irrigations after a transurethral resection of the prostate (TURP). What is the first action the nurse should take? 1- Discontinue the irrigations. 2- Increase the rate of the IV fluids. 3- Administer a unit of packed red blood cells. 4- Prepare the patient for an ECG.

A patient has a probable diagnosis of polycythemia vera. The nurse reviews the patient's lab work for which diagnostic indicator? 1- Hematocrit of 60% 2- Erythrocyte count of 6.5 m/?L 3- Leukocyte count of 11,500/mm3 4- Platelet value of 350,000/mm3

A patient has been brought to the emergency department (ED) by the paramedics. The patient is suspected of having acute respiratory distress syndrome (ARDS). What action should the nurse anticipate? 1- Preparing to assist with intubating the patient 2- Setting up oxygen at 3 LPM by nasal prongs 3- Consulting physiotherapy 4- Setting up a nebulizer

A patient has been diagnosed with a Trichomoniasis vaginal infection. The nurse would expect which color of discharge? 1- Yellow-green 2- White 3- White, curd-like 4- Gray

A patient has been diagnosed with a vitamin B12 deficiency. The nurse is aware that this is a macrocytic-type anemia characterized by which of the following? 1- Increased mean corpuscular volume (MCV) 2- Increased hematocrit 3- Abnormal mean corpuscular hemoglobin (MCH) 4- Elevated hemoglobin

A patient has just had an arthroscopy. What is a nursing intervention that is necessary for the nurse to implement following an arthroscopy? 1- Wrap the joint in compression dressing. 2- Flex and lower the joint. 3- Extend and lower the joint. 4- Apply heat.

A patient has returned to the floor from the PACU after undergoing a suprapubic prostatectomy. The nurse notes urine leakage around the suprapubic tube. How should the nurse follow up this finding? 1- Give meticulous aseptic care to and around the suprapubic tube 2- Call the urologist immediately 3- Remove the suprapubic tube 4- Administer antispasmodic drugs as ordered

A patient has suffered a femoral shaft fracture in an industrial accident. What is an immediate nursing concern for this patient? 1- Hypovolemic shock 2- Infection 3- Knee and hip dislocation 4- Pain resulting from muscle spasm

A patient is being seen in a clinic to rule out mitral valve stenosis. Which assessment data would be most significant? 1- The patient reports shortness of breath when walking. 2- The patient has jugular vein distention and 3+ pedal edema. 3- The patient reports chest pain after eating a large meal. 4- The patient's has an enlarged liver and oedematous abdomen.

A patient is suspected to have diverticulosis without symptoms of diverticulitis. What diagnostic test does the nurse anticipate educating the patient about prior to scheduling? 1- Colonoscopy 2- Barium enema 3- Flexible sigmoidoscopy 4- CT scan

A patient is undergoing platelet pheresis at the outpatient clinic. What does the nurse know is the most likely clinical disorder the patient is being treated for? 1- Essential thrombocythemia 2- Extreme leukocytosis 3- Sickle cell anemia 4- Renal transplantation

A patient who had a colon resection 3 days ago is complaining of discomfort in the left calf. How should the nurse assess Homan's sign to determine if the patient may have a thrombus formation in the leg? 1- Dorsiflex the foot while the leg is elevated to check for calf pain. 2- Elevate the patient's legs for 20 minutes and then lower them slowly while checking for areas of inadequate blood return. 3- Extend the leg, plantar flex the foot, and check for the patency of the dorsalis pedis pulse. 4- Lower the patient's legs and massage the calf muscles to note any areas of tenderness.

A patient who has long-term packed RBC (PRBC) transfusions has developed symptoms of iron toxicity that affect liver function. What immediate treatment should the nurse anticipate preparing the patient for that can help prevent organ damage? 1- Iron chelation therapy 2- Oxygen therapy 3- Therapeutic phlebotomy 4- Anticoagulation therapy

A patient with a diagnosis of deep vein thrombosis (DVT) is being treated with unfractionated heparin, which is being administered intravenously. The nurse who is providing care for this patient should consequently prioritize what assessments? 1- Assessing the patient for internal or external hemorrhage 2- Monitoring the patient's intake and output, and assessing for signs of fluid volume deficit 3- Assessing the patient for adventitious lung sounds and assessing SaO2 levels 4- Assessing the patient's pain levels

A patient with a history of allergies comes to the clinic for an evaluation. The following laboratory test findings are recorded in a patient's medical record:Total serum IgE levels: 2.8 mg/mLWhite blood cell count: 5,100/cu mmEosinophil count: 4%Erythrocyte sedimentation rate: 20 mm/hThe nurse identifies which result as suggesting an allergic reaction? 1- Serum IgE level 2- White blood cell count 3- Eosinophil count 4- Erythrocyte sedimentation rate

A patient with cardiovascular disease is being treated with Norvasc, a calcium channel blocking agent. The nurse is aware that calcium channel blockers have a variety of effects. What is one of the therapeutic effects? 1- Decrease sinoatrial node and atrioventricular node conduction and decrease workload of the heart 2- Prevent platelet aggregation and subsequent thrombosis 3- Reduce myocardial oxygen consumption by blocking beta-adrenergic stimulation to the heart 4- Reduce myocardial oxygen consumption thus decreasing ischemia and relieving pain

A patient with chronic renal failure is examined by the health care provider for anemia. Which laboratory results will the nurse monitor? 1- Decreased level of erythropoietin 2- Decreased total iron-binding capacity 3- Increased mean corpuscular volume 4- Increased reticulocyte count

A patient with pericarditis is experiencing cardiac tamponade. Which collaborative intervention should the nurse anticipate for this patient? 1- Prepare for pericardiocentesis. 2- Request STAT cardiac enzymes. 3- Perform a 12-lead ECG. 4- Assess the patient's heart and lung sounds.

A patient with seasonal allergies has told the nurse that a colleague recommended pseudoephedrine hydrochloride (Sudafed) as a means of controlling signs and symptoms. The nurse should be aware that this drug provides relief for many patients but adverse effects include a risk of: 1- Anxiety 2- Decreased urine output 3- Depression 4- Gastritis

A patient's gradual decline in activity tolerance and increased shortness of breath have prompted her health care provider to assess the structure and size of her heart. Which of the following diagnostic tests is most likely to yield these assessment data? 1- Echocardiography 2- Electrocardiography (ECG) 3- Cardiac catheterization 4- Angiography

A patient's lung volumes and capacities were assessed to help determine the cause of a respiratory problem. Which of the following findings are indicative of chronic obstructive pulmonary disease (COPD)? 1- Vital capacity of 3,000 mL 2- Expiratory reserve volume of 1,100 mL 3- Residual volume of 1,200 mL 4- Functional residual capacity of 2,300 mL

A patient's most recent arterial blood gases reveal pH = 7.5; HCO3- = 29 mEq/L, and PaCO2 = 51 mm Hg. What health problem could account for these findings? 1- Volume depletion from vomiting 2- Diabetic ketoacidosis (DKA) 3- Atelectasis 4- Hyperventilation

A side-effect of chemotherapy is renal damage. To prevent this, the nurse should: 1- Encourage fluid intake, if possible, to dilute the urine. 2- Withhold medication when the blood urea nitrogen level exceeds 20 mg/dL. 3- Limit fluids to 1,000 mL/day to minimize stress on the renal tubules. 4- Modify the diet to acidify the urine, thus preventing uric acid crystallization.

A thorascentesis is performed to obtain a sample of pleural fluid or a biopsy specimen from the pleural wall for diagnostic purposes. What does bloody fluid results indicate? 1- Trauma 2- Infection 3- Malignancy 4- Emphysema

A type of nursing that includes individualized care provided by the same nurse throughout the period of care is defined as 1- primary nursing. 2- case management. 3- patient-focused nursing. 4- functional nursing.

A woman has been diagnosed with breast cancer and is being treated aggressively with a chemotherapeutic regimen. As a result of this regimen, she has an inability to fight infection due to the fact her bone marrow is unable to produce a sufficient amount of what? 1- Lymphocytes 2- Cytoblasts 3- Antibodies 4- Capillaries

A woman's routine complete blood count (CBC) revealed a highly elevated platelet level, and subsequent diagnostic testing has resulted in a diagnosis of primary thrombocythemia. The nurse has begun the relevant health education with the patient. What should the nurse teach this woman about her health problem? 1- "Primary thrombocythemia creates potential problems at both ends of the clotting spectrum: inappropriate clotting or inappropriate bleeding." 2- "Your doctor will likely order a series of blood transfusions for you over the next several months." 3- "It's very important that you try to adopt a diet that's high in organ meats and leafy green vegetables." 4- "Primary thrombocythemia makes you quite vulnerable to hemorrhage, so you'll need regular injections of some important clotting factors."

According to Maslow, which category of needs represents the most basic on the hierarchy? 1- Physiologic needs 2- Self-actualization 3- Safety and security 4- Sense of belonging

After percutaneous transluminal coronary angioplasty (PTCA), the nurse confirms that a client is experiencing bleeding from the femoral site. What will be the nurse's initial action? 1- Apply manual pressure at the site of the insertion of the sheath. 2- Review the results of the latest blood cell count, especially the hemoglobin and hematocrit. 3- Decrease anticoagulant or antiplatelet therapy. 4- Notify the health care provider.

After teaching a group of students about irritable bowel syndrome and antidiarrheal agents, the instructor determines that the teaching was effective when the students identify which of the following as an example of an opiate-related antidiarrheal agent? 1- Loperamide 2- Bismuth subsalicylate 3- Kaolin and pectin 4- Bisacodyl

An 83-year-old female demonstrating early-stage dementia has just had surgical repair to her fractured left hip. No family member is present at the discharge planning conference to discuss the next appropriate actions. Which members of the healthcare team will be instrumental in securing the client's placement in a rehabilitation center? 1- All of the responses are correct 2- Physicians 3- Social workers 4- Nurses

The nurse is caring for a client with severe diarrhea. The nurse recognizes that the client is at risk for developing which acid-base imbalance? 1- Metabolic acidosis 2- Respiratory acidosis 3- Metabolic alkalosis 4- Respiratory alkalosis

An emergency department (ED) nurse is caring for a patient complaining of dyspnea. The nurse assesses the patient's chest and hears wheezing throughout the lung fields. What might this indicate? 1- The patient is in bronchospasm. 2- The patient has pneumonia. 3- The patient needs physiotherapy. 4- The patient has a hemothorax.

An emergency room nurse is assessing a client who is complaining of dyspnea. Which sign would indicate the presence of a pleural effusion? 1- Decreased chest wall excursion upon palpation 2- Wheezing upon auscultation 3- Resonance upon percussion 4- Mottled skin seen during inspection

Because of a client's reluctance to begin hormone therapy, the advance nurse practitioner prescribes venlafaxine to decrease the risk of 1- hot flashes. 2- stroke. 3- heart attack. 4- blood clots.

Below which serum sodium concentration might convulsions or coma occur? 1- 135 mEq/L (135 mmol/L) 2- 145 mEq/L (145 mmol/L) 3- 140 mEq/L (140 mmol/L) 4- 142 mEq/L (142 mmol/L)

Chronic illnesses may contribute to immune system impairment in various ways. Renal failure is associated with 1- deficiency in circulating lymphocytes. 2- increased incidence of infection. 3- decreased bone marrow function. 4- altered production of white blood cells.

Clients with myocarditis are sensitive to which medication? 1- Digoxin 2- Furosemide 3- Penicillin 4- Corticosteroids

Clostridium difficile infection has been moving through an extended-care facility, and several of the elderly residents have been experiencing severe diarrhea. One particularly sick resident has told the nurse that he is now experiencing extreme fatigue and muscle cramps and that his heart feels like it occasionally "skips a beat." The nurse should facilitate a stat assessment of this resident's: 1- Potassium levels 2- Calcium levels 3- Cardiac biomarkers 4- Hemoglobin and hematocrit

Consuming a diet high in which of the following has been found to increase the risk for prostate cancer? 1- Red meats 2- Green leafy vegetables 3- Carbohydrates 4- Whole grains

During an allergic reaction, histamine is released in about 15 minutes. The patient usually takes an antihistamine that has an affinity for bronchiolar smooth muscle cells (an H2 receptor). Which of the following is most likely the drug described? 1- Benadryl 2- Tagamet 3- Zantac 4- Zyflo

During physical examination of the male reproductive system, which method would best provide the nurse information about the prostate's size as well as evidence of tumor? 1- digital rectal examination 2- scrotal radiography 3- inspection of the size of the scrotum 4- transillumination

Each chamber of the heart has a particular role in maintaining cellular oxygenation. Which chamber is responsible for pumping blood to all the cells and tissues of the body? 1- left ventricle 2- left atrium 3- right ventricle 4- right atrium

Each chamber of the heart has a particular role in maintaining cellular oxygenation. Which chamber is responsible for pumping blood to the lungs to be oxygenated? 1- right ventricle 2- left ventricle 3- right atrium 4- left atrium

Following a percutaneous transluminal coronary angioplasty, a client is monitored in the postprocedure unit. The client's heparin infusion was stopped 2 hours earlier. There is no evidence of bleeding or hematoma at the insertion site, and the pressure device is removed. With regards to partial thromboplastin time (PTT), when should the nurse plan to remove the femoral sheath? 1- 50 seconds or less. 2- 75 seconds or less. 3- 100 seconds or less. 4- 125 seconds or less.

Following several months of increasing dyspnea on exertion, a 71-year-old woman has been diagnosed with mitral stenosis (MS). The woman is relieved to receive a diagnosis that explains her symptoms but does not completely understand the root of her problem. How can the nurse best explain the woman's health problem? 1- "The valve in the left side of your heart has become stiff and narrowed, so your heart can't fill with all the blood that your body needs." 2- "The left side of your heart is having trouble overcoming the resistance in your blood vessels because a valve is not sealing." 3- "When your heart beats, some of the blood that should go to your body is backing up into your heart because the valve leaks." 4- "The valve between your lungs and your heart has become inelastic, so your heart can't fill up with enough blood."

Future healthcare policy in the United States will be significanly affected by a population that is: 1- aging and becoming more culturally diverse. 2- becoming skeptical about conventional medicine's reliance on pharmaceuticals and surgery. 3- becoming more knowledgeable about nutrition and more likely to undertake dietary changes. 4- aging and includes a higher percentage of people with addictions.

High or increased compliance occurs in which disease process? 1- Emphysema 2- Pneumothorax 3- Pleural effusion 4- ARDS

If a client were to develop rheumatic carditis, which cardiac structure would most likely be affected? 1- mitral valve 2- coronary arteries 3- inferior vena cava 4- septum

Incomplete closure of the mitral valve results in backflow of blood from the: 1- Left ventricle to left atrium 2- Right ventricle to the right atrium 3- Right atrium to right ventricle 4- Left atrium to left ventricle

Insulin is secreted by which of the following types of cells? 1- Beta cells 2- Melanocytes 3- Neural cells 4- Basal cells

It is important for a nurse to know how to calculate the corrected serum calcium level for a patient when hypocalcemia is seen along with low serum albumin levels. Calculate the corrected serum calcium when the serum calcium is 9 mg/dL and the serum albumin is 3 g/dL. 1- 9.8 mg/dL 2- 10.3 mg/dL 3- 11 mg/dL 4- 12 mg/dL

Lispro (Humalog) is an example of which type of insulin? 1- Rapid-acting 2- Intermediate-acting 3- Short-acting 4- Long-acting

Regulation of electrolyte balance is a management goal for patients suffering from renal disease. Which of the following lab results is considered the most life-threatening effect of renal failure? 1- Hyperkalemia 2- Hypocalcemia 3- Hypernatremia 4- Hyperphosphatemia

Statistics show an increase in the prevalence of infective endocarditis among older adults. Which factor places older adults at risk for developing infective endocarditis? 1- increased use of prosthetic valve replacements 2- greater incidence of a history of repaired 3- congenital heart defects 3- increase in IV drug use 4- higher rate of tuberculosis

Students are reviewing information about community health nursing. The students demonstrate understanding of the term "community-oriented nursing practice" by describing it as which of the following? 1- Nursing interventions that can promote wellness, reduce illness spread, and improve the health status of groups 2- Nursing care directed to specific client groups with identified needs, usually related to illness 3- Provision of primary care services, often with care being provided to underserved populations 4- Nursing care of clients with complex needs who are discharged from acute care institutions early in the recovery process

T-cell and B-cell lymphocytes are the primary participants in the immune response. What do they do? 1- T-cell and B-cell lymphocytes distinguish harmful substances and ignore those natural and unique to a person. 2- T-cell and B-cell lymphocytes respond to the body's invasion by macrophages. 3- T-cell and B-cell lymphocytes react to the body's lack of B12 . 4- T-cell and B-cell lymphocytes distinguish harmful treatments from curative treatments.

The ICU nurse is caring for a client who was admitted with a diagnosis of smoke inhalation. The nurse knows that this client is at increased risk for which of the following? 1- Acute respiratory distress syndrome 2- Lung cancer 3- Bronchitis 4- Tracheobronchitis

The National Center for Health Statistics uses data from healthcare agencies to issue quarterly and annual reports on performance related to goals for improving the health of the U.S. population. Which initiative is targeted with improving the health of all Americans? 1- Healthy People 2020 2- The Joint Commission 3- Agency for Healthcare Research and Quality 4- Quality Indicators

The body has several mechanisms to fight disease, one of which is sending chemical messengers. The messengers released by lymphocytes, monocytes, and macrophages have differing roles in the immune response. Which messenger enables cells to resist viral replication and slow viral replication? 1- interferons 2- interleukins 3- tumor necrosis factor 4- colony-stimulating factor

The critical care nurse is caring for a patient with a pulmonary artery pressure monitoring system. The nurse is aware that pulmonary artery pressure monitoring is used to assess left ventricular function (cardiac output). What else are pulmonary artery pressure monitoring systems used for? 1- To assess the patient's response to interventions such as fluid administration and drug administration 2- To obtain specimens for arterial blood gas measurements 3- They have been determined to not be clinically useful for continuous monitoring of a patient with heart failure. 4- To diagnose the etiology of chronic obstructive pulmonary disease.

The diagnosis of aortic regurgitation (AR) is confirmed by which of the following? 1- Echocardiography 2- Cardiac catheterization 3- Exercise stress testing 4- Myocardial biopsy

The home care nurse is evaluating a client's technique for self administration of medication. The nurse identifies a client's inability to pour a liquid medication into a measuring spoon. What is this teaching part of the nursing process called? 1- assessment 2- planning 3- implementation 4- evaluation

The home health nurse is planning teaching for a client with COPD and a history of noncompliance to the medication regimen. Which factor does the nurse recognize as having the most influence to enabling complete adherence of a health regimen? 1- Motivation 2- Self-esteem 3- Cost of medication 4- Education level

The immune system is a complicated and intricate system that contains specialized cells and tissues that protect us from external invaders and our own altered cells. Which term is used to define any substances capable of inducing a specific immune response and of reacting with the products of that response? 1- antigens 2- antibodies 3- lymphokines 4- lymphocytes

The instructor is talking with a nursing student who is caring for a client with pericarditis. The instructor asks the student to name the main characteristic of pericarditis. What should be the student's answer? 1- Precordial pain 2- Dyspnea 3- Fever 4- Respiratory symptoms

The most common site of aneurysm formation is in the: 1- abdominal aorta, just below the renal arteries. 2- ascending aorta, around the aortic arch. 3- descending aorta, beyond the subclavian arteries. 4- aortic arch, around the ascending and descending aorta.

The nurse auscultates the lung sounds of a client during a routine assessment. The sounds produced are harsh and cracking, sounding like two pieces of leather being rubbed together. The nurse would be correct in documenting this finding as 1- pleural friction rub. 2- crackles. 3- sonorous wheezes. 4- sibilant wheezes.

The nurse cares for a client prescribed warfarin orally. The nurse reviews the client's prothrombin time (PT) level to evaluate the effectiveness of the medication. Which laboratory values should the nurse also evaluate? 1- international normalized ratio (INR) 2- partial thromboplastic time (PTT) 3- complete blood count (CBC) 4- Sodium

The nurse cares for a client who receivies continuous enteral tube feedings and who is at low risk for aspiration. The nurse assesses the gastric residual volume to be 350 mL. The nurse determines which action is correct? 1- Monitoring the feeding closely. 2- Increasing the feeding rate. 3- Lowering the head of the bed. 4- Flushing the feeding tube.

The nurse conducts discharge education for a client who is to go home with parenteral nutrition (PN). The nurse determines the client understands the education when the client indicates a sign and/or symptom of metabolic complications is 1- loose, watery stools. 2- increased urination. 3- elevated blood pressure. 4- decreased pulse rate.

The nurse is caring for a client with suspected ARDS with a pO2 of 53. The client is placed on oxygen via face mask and the PO2 remains the same. What does the nurse recognize as a key characteristic of ARDS? 1- Unresponsive arterial hypoxemia 2- Diminished alveolar dilation 3- Tachypnea 4- Increased PaO2

The nurse develops outcome criteria for a patient with chronic obstructive pulmonary disease. Which outcome criteria are appropriate for this patient? 1- The patient will have the ability to climb a flight of stairs without experiencing difficulty in breathing. 2- The patient will not experience an alteration in skin integrity. 3- The patient will perform passive range-of-motion exercises once daily. 4- The nurse will obtain a pulse oximetry reading twice a day.

The nurse educator is planning a teaching session for nursing students related to the treatment and management of gestational diabetes. The nurse educator arranges for a dietitian, pharmacist, and physician assistant to participate in the lesson plan. Which professional nurse competency is the nurse educator demonstrating? 1- Interdisciplinary teamwork 2- Patient-centered care 3- Evidence-based practice 4- Quality improvement measures

The nurse is admitting a 32-year-old woman who is to undergo major surgery and will be on bed rest for at least 48 hours. While doing the admission assessment, the patient tells the nurse that she takes oral contraceptives. The nurse should recognize that this puts the patient at an increased risk of developing what health problem? 1- Deep vein thrombosis (DVT) 2- Intermittent claudication 3- Raynaud's disease 4- Thoracic aneurysm

The nurse is assessing a client admitted with acute left-sided infective endocarditis. What is the best diagnostic test to confirm the diagnosis? 1- blood cultures 2- complete blood count 3- urinalysis 4- transesophageal echocardiogram

The nurse is assessing a client taking an anticoagulant. What nursing intervention is most appropriate for a client at risk for injury related to side effects of medication enoxaparin? 1- Report any incident of bloody urine, stools, or both. 2- Administer calcium supplements. 3- Assess for hypokalemia. 4- Assess for clubbing of the fingers.

The nurse is assessing a client who, after an extensive surgical procedure, is at risk for developing acute respiratory distress syndrome (ARDS). The nurse assesses for which most common early sign of ARDS? 1- Rapid onset of severe dyspnea 2- Inspiratory crackles 3- Bilateral wheezing 4- Cyanosis

The nurse is assessing the lungs of a patient diagnosed with pulmonary edema. Which of the following would be expected upon auscultation? 1- Crackles at lung bases 2- Egophony 3- Absent breath sounds 4- Bronchial breath sounds

The nurse is assigned to care for a client with a serum phosphorus concentration of 5.0 mg/dL (1.61 mmol/L). The nurse anticipates that the client will also experience which electrolyte imbalance? 1- Hypocalcemia 2- Hyperchloremia 3- Hypermagnesemia 4- Hyponatremia1

The nurse is caring for a client diagnosed with bulimia. The client is being treated for a serum potassium concentration of 2.9 mEq/L (2.9 mmol/L). Which statement made by the client indicates the need for further teaching? 1- "I can use laxatives and enemas but only once a week." 2- "A good breakfast for me will include milk and a couple of bananas." 3- "I will be sure to buy frozen vegetables when I grocery shop." 4- "I will take a potassium supplement daily as prescribed."

The nurse is caring for a client diagnosed with pneumonia. The nurse assesses the client for tactile fremitus by completing which action? 1- Asking the client to repeat "ninety-nine" as the nurse's hands move down the client's thorax 2- Asking the client to say "one, two, three" while the nurse auscultates the lungs 3- Instructing the client to take a deep breath and hold it while the diaphragm is percussed 4- Placing the thumbs along the costal margin of the chest wall and instructing the client to inhale deeply

The nurse is caring for a client experiencing an acute MI (STEMI). The nurse anticipates the physician will prescribe alteplase. Before administering this medication, which question is most important for the nurse to ask the client? 1- "What time did your chest pain start today?" 2- "Do your parents have heart disease?" 3- "How many sublingual nitroglycerin tablets did you take?" 4- "What is your pain level on a scale of 1 to 10?"

The nurse is caring for a client following a coronary artery bypass graft (CABG). The nurse notes persistent oozing of bloody drainage from various puncture sites. The nurse anticipates that the physician will order which medication to neutralize the unfractionated heparin the client received? 1- Protamine sulfate 2- Alteplase 3- Clopidogrel 4- Aspirin

The nurse is caring for a client presenting to the emergency department (ED) reporting chest pain. Which electrocardiographic (ECG) finding would be most concerning to the nurse? 1- ST elevation 2- Isolated premature ventricular contractions (PVCs) 3- Sinus tachycardia 4- Frequent premature atrial contractions (PACs)

The nurse is caring for a client who is in respiratory distress. The physician orders arterial blood gases (ABGs) to determine various factors related to blood oxygenation. What site can ABGs be obtained from? 1- A puncture at the radial artery 2- The trachea and bronchi 3- The pleural surfaces 4- A catheter in the arm vein

The nurse is caring for a client who reports orange urine. The nurse suspects which factor as the cause of the urine discoloration? 1- phenazopyridine hydrochloride 2- Infection 3- Phenytoin 4- Metronidazole

The nurse is caring for a client who was admitted to the telemetry unit with a diagnosis of "rule/out acute MI." The client's chest pain began 3 hours earlier. Which laboratory test would be most helpful in confirming the diagnosis of a current MI? 1- Creatinine kinase-myoglobin (CK-MB) level 2- Troponin C level 3- Myoglobin level 4- CK-MM

The nurse is caring for a client with a damaged tricuspid valve. The nurse knows that the tricuspid valve is held in place by which of the following? 1- Chordae tendineae 2- Atrioventricular tendons 3- Semilunar tendineae 4- Papillary tendons

The nurse is caring for a client with acute myeloid leukemia (AML) with high uric acid levels. What medication does the nurse anticipate administering that will prevent crystallization of uric acid and stone formation? 1- Allopurinol 2- Filgrastim 3- Hydroxyurea 4- Asparaginase

The nurse is caring for a client with aortic regurgitation. The nurse knows to expect what symptoms during the physical examination? 1- Orthopnea and dyspnea 2- Increased urine output 3- Headache and vomiting 4- Nausea and low urine output

The nurse is caring for a comatose patient and administering gastrostomy feedings. What does the nurse understand is the reason that gastrostomy feedings are preferred to nasogastric (NG) feedings in the comatose patient? 1- Gastroesophageal sphincter is intact, lessening the possibility of regurgitation. 2- Digestive process occurs more rapidly because the feedings do not have to pass through the esophagus. 3- Feedings can be administered with the patient in the recumbent position. 4- The patient cannot experience the deprivational stress of not swallowing.

The nurse is caring for a geriatric client. The client is ordered Lanoxin (digoxin) tablets 0.125mg daily for a cardiac dysrhythmias. Which of the following assessment considerations is essential when caring for this age-group? 1- Digoxin level 2- Cardiac output 3- Activity level 4- Dyspnea

The nurse is caring for a patient diagnosed with abdominal perforation. Which of the following is a clinical manifestation of this disease process? 1- Hypotension 2- Subnormal temperature 3- Bradycardia 4- Normal erythrocyte sedimentation rate (ESR)

The nurse is caring for a patient diagnosed with pericarditis. What serious complication should this patient be monitored for? 1- Cardiac tamponade 2- Decreased venous pressure 3- Hypertension 4- Left ventricular hypertrophy

The nurse is caring for a patient with a diagnosis of pericarditis. Where does the nurse understand the inflammation is located? 1- The thin fibrous sac encasing the heart 2- The inner lining of the heart and valves 3- The heart's muscle fibers 4- The exterior layer of the heart

The nurse is caring for an older adult patient experiencing fecal incontinence. When planning the care of this patient, what should the nurse designate as a priority goal? 1- Maintaining skin integrity 2- Beginning a bowel program to establish continence 3- Instituting a diet high in fiber and increase fluid intake 4- Determining the need for surgical intervention to correct the problem

The nurse is completing a routine urinalysis using a dipstick. The test reveals an increased specific gravity. The nurse should suspect which condition? 1- Decreased fluid intake 2- Increased fluid intake 3- Glomerulonephritis 4- Diabetes insipidus

The nurse is completing the intake assessment of a client new to the allergy clinic. The client states that he was taking nose drops six times a day to relieve his nasal congestion. The nasal congestion increased, causing him to increase his usage of the nasal spray to eight times a day. But again the congestion worsened. The nurse communicates to the health care provider that the client experienced 1- Rhinitis medicamentosa 2- Tolerance to nose drops 3- Leukotriene modifier 4- Atopic dermatitis

The nurse is describing the action of insulin in the body to a client newly diagnosed with type 1 diabetes. Which of the following would the nurse explain as being the primary action? 1- It carries glucose into body cells. 2- It aids in the process of gluconeogenesis. 3- It stimulates the pancreatic beta cells. 4- It decreases the intestinal absorption of glucose.

The nurse is evaluating a client's complete blood cell count and differential along with the serum immunoglobulin E (IgE) concentration. Which result might indicate that the client has an allergic disorder? 1- High IgE concentration 2- High neutrophil count 3- Low eosinophil count 4- Low white blood cell count

The nurse is making a referral to physical therapy for a client who has had a hip replacement and is going to be discharged in 2 days. The nurse understands that physical therapy as part of the client's plan of care includes the client in what discipline? 1- Inclusion in the collaborative healthcare team 2- A discipline unto themselves 3- Inclusion in the administrative team 4- Inclusion in the supervisory team

The nurse is monitoring a patient who is on heparin anticoagulant therapy. What should the nurse determine the therapeutic range of the international normalized ratio (INR) should be? 1- 2.0-3.0 2- 4.0-5.0 3- 5.0-6.0 4- 7.0-8.0

The nurse is performing a focused assessment of a patient who has a complex cardiac history. The vital signs that the nurse obtains are as follows: Temperature 99.0°F (37.2°C); pulse 94 bpm; blood pressure 142/116 mm Hg; respiration 22 breaths per minute; SaO2 90% on room air. These findings should prompt the nurse to consider the possibility that this patient has: 1- Decreased cardiac output 2- Peripheral vascular disease (PVD) 3- Angina pectoris 4- An arrhythmia

The nurse is performing a neurological assessment. What will this assessment include? 1- Ask the client to plantar flex the toes. 2- Observe for capillary refill of the great toe. 3- Palpate the dorsalis pedis pulse. 4- Inspect the foot for edema.

The nurse is preparing a client for a nuclear scan of the kidneys. Following the procedure, the nurse instructs the client to 1- drink liberal amounts of fluids. 2- maintain bed rest for 2 hours. 3- carefully handle urine because it is radioactive. 4- notify the health care team if bloody urine is noted.

The nurse is preparing a presentation for a men's community group about health promotion. Which of the following would the nurse include as a current recommendation for screening? 1- Monthly testicular self-examination (TSE) 2- Annual digital rectal examination (DRE) after age 35 years 3- Annual prostate-specific antigen (PSA) testing after age 40 years 4- Transrectal ultrasound every 5 years after age 50 years

The nurse is preparing to administer a medication that has an affinity for H1 receptors. Which medication would the nurse administer? 1- Diphenhydramine 2- Omeprazole 3- Cimetidine 4- Ranitidine

The nurse is preparing to administer a patient's scheduled dose of Novolin 70/30. When administering this dose of insulin, the nurse should: 1- Ensure that the insulin is not given near a previous injection site 2- Aspirate before injecting the insulin into the patient's subcutaneous tissue 3- Massage the injection site gently for 10 to 15 seconds after administration 4- Use a 3 mL syringe with a 24 gauge,- to-inch needle

What is the reason for chest tubes after thoracic surgery? 1- Draining secretions, air, and blood from the thoracic cavity is necessary. 2- Chest tubes allow air into the pleural space. 3- Chest tubes indicate when the lungs have re-expanded by ceasing to bubble. 4- Draining secretions and blood while allowing air to remain in the thoracic cavity is necessary.

The nurse is providing an educational event at the local community center on prostate cancer. A 53-year-old male attendee asks about the prevention and detection of prostate cancer. What information should the nurse provide to this man that would assist in the early identification of prostate cancer? 1- Have a digital rectal examination and prostate-specific antigen (PSA) test done yearly 2- Have a transrectal ultrasound every 5 years 3- Perform monthly testicular self-examinations 4- Have a complete blood count (CBC) yearly, including blood urea nitrogen (BUN) and creatinine assessment

The nurse is providing discharge education for a client going home after cardiac catheterization. What information is a priority to include when providing discharge education? 1- Avoid tub baths, but shower as desired. 2- Do not ambulate until the healthcare provider indicates it is appropriate. 3- Expect increased bruising to appear at the site over the next several days. 4- Returning to work immediately is okay.

The nurse is providing discharge teaching for a client with rheumatic endocarditis but no valvular dysfunction. On which nursing diagnosis should the nurse focus her teaching? 1- Risk for infection 2- Chronic pain 3- Impaired gas exchange 4- Impaired memory

The nurse is reviewing the client's urinalysis results. The finding that is most suggestive of dehydration of the client is: 1- Specific gravity 1.035 2- Creatinine 0.7 mg/dL 3- Protein 15 mg/dL 4- Bright yellow urine

The nurse is teaching a client who has been diagnosed with Hashimoto's thyroiditis. Which statement correctly describes the process of autoimmunity? 1- The normal protective immune response attacks the body, damaging tissues. 2- The body produces inappropriate or exaggerated responses to specific antigens. 3- The body overproduces immunoglobulins. 4- A deficiency results from improper development of immune cells or tissues.

The nurse obtains a health history from a client with a prosthetic heart valve and new symptoms of infective endocarditis. Which question by the nurse is most appropriate to ask? 1- "Have you been to the dentist recently?" 2- "Do you have a family history of endocarditis?" 3- "Have you recently vacationed outside of the United States?" 4- "Do you live with any domesticated animals in your home?"

The nurse recognizes that rheumatoid arthritis is characterized by: 1- Ulnar deviation 2- Ballottement sign 3- Clonus 4- Fasciculations

The nurse reviews a client's history and notes that the client has a history of hyperparathyroidism. The nurse would identify that this client most likely would be at risk for which of the following? 1- Kidney stones 2- Neurogenic bladder 3- Chronic renal failure 4- Fistula

The nurse should assess the patient for signs of lethargy, increasing intracranial pressure, and seizures when the serum sodium reaches what level? 1- 115 mEq/L 2- 130 mEq/L 3- 145 mEq/L 4- 160 mEq/L

The nurse understands that which of the following medications will be administered to the client for 6 to 12 weeks following prosthetic porcine valve surgery? 1- Warfarin 2- Aspirin 3- Furosemide 4- Digoxin

The occupational nurse is completing routine assessments on the employees where you work. What might be revealed by a chest radiograph for a client with occupational lung diseases? !- Fibrotic changes in lungs 2- Hemorrhage 3- Lung contusion 4- Damage to surrounding tissues

The patient with a chest tube is being transported to X-ray. Which complication may occur if the chest tube is clamped during transportation? 1- Tension pneumothorax 2- Cardiac tamponade 3- Flail chest 4- Pulmonary contusion

The school nurse informs the mother of a second-grade student that lice were found in the child's hair. The mother explains to the nurse that she has another child to pick up and cannot stay to receive education related to the treatment of lice at this time. The mother reassures the nurse that she will "look up treatment options on the Internet and take care of the child." What would be the best action of the school nurse in this situation? 1- Provide the mother with a list of credible websites related to the treatment of lice 2- Instruct the mother to treat the other child for lice in the same manner as the second-grade child 3- Perform hand hygiene and notify the second-grade teacher to wash down the classroom 4- Notify the social worker of suspected child neglect and make a referral to child protective services

There are a variety of problems that can become complications after a fracture. Which is described as a condition that occurs from interruption of the blood supply to the fracture fragments after which the bone tissue dies, most commonly in the femoral head? 1- avascular necrosis 2- fat embolism 3- pulmonary embolism 4- shock

Thrombolytic therapy is being prepared for administration to an older adult patient who has presented to the emergency department with an ST-segment elevation MI (STEMI). The nurse recognizes that the primary goal of this intervention is: 1- To restore the flow of blood through the coronary arteries 2- To restore function to infarcted myocardial cells 3- To relieve the patient's symptoms of chest pain and dyspnea 4- To prevent the rupture of atheromas

Under the Occupational Safety and Health Act (OSHA) of 1970, employers are responsible for providing a safe and healthy workplace for their employees. Which of the following would be inconsistent with the role of OSHA? 1- Financial assistance 2- Outreach 3- Education 4- Establishing partnerships

Vomiting results in which of the following acid-base imbalances? 1- Metabolic alkalosis 2- Metabolic acidosis 3- Respiratory acidosis 4- Respiratory alkalosis

What is the duration of regular insulin? 1- 4 to 6 hours 2- 3 to 5 hours 3- 12 to 16 hours 4- 24 hours

What is the most common cause of mitral stenosis? 1- Rheumatic endocarditis 2- Congestive heart failure 3- Degenerative stenosis 4- Myocardial infarction

What should the nurse tell a client who is about to begin chemotherapy and is anxious about hair loss? 1- The client should consider getting a wig or cap prior to beginning treatment. 2- Alopecia related to chemotherapy is relatively uncommon. 3- The hair will grow back within 2 months post therapy. 4- The hair will grow back the same as it was before treatment.

What type of cytokine will attract neutrophils and monocytes to remove debris? 1- Lymphokines 2- Cytotoxic T cells 3- Suppressor T cells 4- Regulator T cells

What underlying focus in any definition of nursing is the registered nurse's responsibility in practice? 1- Appraise and enhance an individual's health-seeking perspective. 2- Coordinate a patient's total health management with all disciplines. 3- Diagnose acute pathology. 4- Treat acute clinical reactions to chronic illness.

When administering heparin anticoagulant therapy, the nurse needs to make certain that the activated partial thromboplastin time (aPTT) is within the therapeutic range of: 1- 1.5 to 2.5 times the baseline control. 2- 2.5 to 3.0 times the baseline control. 3- 3.5 times the baseline control. 4- 4.5 times the baseline control.

When giving oxygen to a hypoxic patient, the nurse must remember that oxygen transport is also dependent on the arterial oxygen content. Which of the following is a blood gas analysis that would indicate the presence of hypoxemia? 1- PaO2 < 60 mm Hg 2- PaO2 = 65 mm Hg 3- PaO2 = 70 mm Hg 4- PaO2 = 75 mm Hg

When providing discharge instructions for a client who has been prescribed sublingual nitroglycerin for angina, the nurse should plan to include which instructions? 1- "See if rest relieves the chest pain before using the nitroglycerin." 2- "Call 911 if you develop a headache following nitroglycerin use." 3- "Place the nitroglycerin tablet between cheek and gum." 4- "Only take one nitroglycerin tablet for each episode of angina."

When providing discharge instructions, the nurse recognizes that which client is most likely to comply with the therapeutic treatment regimen? 1- The client with pneumonia who requires 1 week of oral antibiotics 2- The patient with newly diagnosed type 2 diabetes who requires nutritional counseling 3- The client with a positive tuberculosis skin test who requires 9 months of isoniazid T 4- he client with kidney failure who requires hemodialysis

When the nurse notes that, after cardiac surgery, the client demonstrates low urine output (less than 25 mL/h) with high specific gravity (greater than 1.025), the nurse suspects which condition? 1- Inadequate fluid volume 2- Normal glomerular filtration 3- Overhydration 4- Anuria

Which arterial blood gas (ABG) result would the nurse anticipate for a client with a 3-day history of vomiting? 1- pH: 7.55, PaCO2: 60 mm Hg, HCO3-: 28 2- pH: 7.45, PaCO2: 32 mm Hg, HCO3-: 21 3- pH: 7.28, PaCO2: 25 mm Hg, HCO3: 15 4- pH: 7.34, PaCO2: 60 mm Hg, HCO3: 34

Which assessment finding would create the greatest risk to a client ordered a phosphodiesterase inhibitor such as sildenafil? 1- Use of nitrates 2- History of hypertension 3- Type 2 diabetes 4- Use of diuretics

Which body substance causes increased gastric secretion, dilation of capillaries, and constriction of the bronchial smooth muscle? 1- Histamine 2- Bradykinin 3- Serotonin 4- Prostaglandin

Which class of medication lyses and dissolves thrombi? 1- Fibrinolytic 2- Anticoagulant 3- Platelet inhibitors 4- Factor XA inhibitors

Which client with a venous stasis ulcer is a candidate for topical hyperbaric oxygen therapy? 1- a client with a chronic, nonhealing skin lesion 2- a client whose ulcer includes necrotic tissue 3- a client with an infected stasis ulcer 4- a nonambulatory client

Which combination of adverse effects should a nurse monitor for when administering IV insulin to a client with diabetic ketoacidosis? 1- Hypokalemia and hypoglycemia 2- Hypocalcemia and hyperkalemia 3- Hyperkalemia and hyperglycemia 4- Hypernatremia and hypercalcemia

Which component of client teaching helps the nurse assist a client following treatment for cancer of the prostate gland to manage and minimize the possibility of a recurrence of the primary cancer or metastasis? 1- Have regular prostate-specific antigen (PSA) levels tested and repeat lymph node biopsies. 2- Avoid sexual intercourse for at least 2 years. 3- Undertake pelvic floor retraining exercises. 4- Avoid strenuous exercises, especially lifting.

Which electrolyte is a major anion in body fluid? 1- Chloride 2- Potassium 3- Sodium 4- Calcium

Which is a diagnostic marker for inflammation of vascular endothelium? 1- C-reactive protein (CRP) 2- Low-density lipoprotein (LDL) 3- High-density lipoprotein (HDL) 4- Triglyceride

Which is not one of the general nursing measures employed when caring for the client with a fracture? 1- cranial nerve assessment 2- administering analgesics 3- providing comfort measures 4- assisting with ADLs

Which is the most important postoperative assessment parameter for a client recovering from cardiac surgery? 1- Inadequate tissue perfusion 2- Mental alertness 3- Blood glucose concentration 4- Activity intolerance

Which medication classification is known to inhibit prostaglandin synthesis or release? 1- Nonsteroidal anti-inflammatory drugs in large doses 2- Antibiotics (in large doses) 3- Adrenal corticosteroids 4- Antineoplastic agents

Which medication is an antidote to heparin? 1- Protamine sulfate 2- Alteplase 3- Clopidogrel 4- Aspirin

Which medication is given to clients who are diagnosed with angina but are allergic to aspirin? 1- Clopidogrel 2- Amlodipine 3- Diltiazem 4- Felodipine

Which nursing action is most important in caring for the client following an arthrogram? 1- Apply ice to the joint. 2- Keep the joint below the level of the heart. 3- Administer morphine sulfate. 4- Assist the client with passive range of motion.

Which strategy would a nurse likely discuss with a client as part of health promotion? 1- making positive dietary changes 2- evaluating the merits of various diagnostic procedures 3- locating a therapist for a child with emotional problems 4- determining how often blood glucose levels should be monitored at home

Which term refers to an abnormal decrease in white blood cells, red blood cells, and platelets? 1- Pancytopenia 2- Anemia 3- Leukopenia 4- Thrombocytopenia

Which term refers to an injury to ligaments and other soft tissues surrounding a joint? 1- Sprain 2- Dislocation 3- Subluxation 4- Strain

Which term refers to the surgical removal of one or both testes? 1- Orchiectomy 2- Circumcision 3- Vasectomy 4- Hydrocelectomy

Which type of fracture is one in which the skin or mucous membrane extends to the fractured bone? 1- Compound 2- Complete 3- Incomplete 4- Simple

Which type of surgery is used in an attempt to relieve complications of cancer? 1- Palliative 2- Prophylactic 3- Reconstructive 4- Salvage

Which would the nurse stress as a lifelong necessity for a client managing infective endocarditis? 1- Antibiotic therapy 2- Antihypertensive medication 3- Exercise regimen 4- Potassium replacement

While auscultating the heart of a pediatric client who is recovering from acute rheumatic fever, the nurse hears a murmur. This sound may indicate: 1- valve damage. 2- pericarditis. 3- cardiac tamponade. 4- atrial gallop.

While taking the health history of a newly admitted client, the nurse asks for a list of the client's current medications. Which of the following medication classifications would place the client at risk for impaired immune function? 1- Antimetabolites 2- Antihypertensives 3- Inotropics 4- Pancreatic enzymes

Within the heart, several structures and several layers all play a part in protecting the heart muscle and maintaining cardiac function. The inner layer of the heart is composed of a thin, smooth layer of cells, the folds of which form heart valves. What is the name of this layer of cardiac tissue? 1- endocardium 2- myocardium 3- pericardium 4- epicardium

A client with a fractured femur is admitted to the nursing unit. Which assessment finding requires follow up by the nurse? Select all that apply. 1- "I cannot seem to catch my breath." 2- "I have a pins-and-needles sensation in my toes." 3- Dorsiplantar weak and unequal bilaterally 4- T 101.2 degrees F; HR 110; RR 28; pulse oximetry 90% 5- Both feet warm with capillary refill < 3 seconds

1,2,3,4

The nurse is providing care for a male patient who has undergone knee arthroplasty. As part of the nurse's morning assessment, the nurse is assessing for peripheral neurovascular dysfunction distal to the surgical site. When performing this assessment, what parameters should the nurse assess and document? Select all that apply. 1- The color of the patient's lower leg and foot 2- The patient's ability to move his foot 3- The patient's sensation in his foot and lower leg 4- The temperature of the patient's foot and lower leg 5- The presence or absence of hair on the patient's foot and lower leg

1,2,3,4

The statements below reflect interventions to address a person's needs. Arrange each need based on Maslow's hierarchy from most basic to highest level. 1 Providing nasogastric tube feedings 2 Explaining a new procedure 4 Encouraging a patient to start a hobby that he or she has always wanted to try 3 Referring a patient to a cancer support group

1,2,3,4

Which of the following are effective teaching strategies for elderly persons? Select all that apply. 1- Slow-paced presentation 2- Frequent repetition 3- Use of reinforcement techniques 4- Use of written materials 5- Workplace has become a center for health promotion

1,2,3,4

As part of a clinical post-conference discussion, an instructor is showing the students examples of clinical pathways used in the facility. When explaining these examples, the instructor identifies which of the following as being commonly used as a basis for developing these tools? Select all that apply. 1- Diagnosis related groups 2- Common health problems 3- Diagnostic tests 4- Treatments 5- Nursing diagnosis 6- Medications

1,2,

A client is diagnosed with infective endocarditis. What laboratory values will the nurse assess? Select all that apply. 1- elevated white blood cell (WBC) count 2- elevated C-reactive protein 3- elevated erythrocyte sedimentation rate (ESR) 4- decreased erthrocyte sedimentation rate 5- decreased C-reactive protein

1,2,3

A client who has fractured the radial head asks the nurse about factors that will promote bone healing. Which statement should the nurse include when responding to the client? Select all that apply. 1- "Immobilization of the fracture will promote healing by maximizing contact of bone fragments." 2- "Fractured bones require a good blood supply and adequate nutrition for healing." 3- "Weight bearing stimulates healing of the long bones of the leg, if the fracture is stabilized." 4- "Adults heal faster than children because adult bodies are physiologically more mature." 5- "Corticosteroids will decrease the bone and soft tissue inflammation associated with the fracture."

1,2,3

A nurse is caring for a client receiving parenteral nutrition at home. The client was discharged from the acute care facility 4 days ago. What would the nurse include in the client's plan of care? Select all that apply. 1- Daily weights 2- Intake and output monitoring 3- Calorie counts for oral nutrients 4- Daily transparent dressing changes 5- Strict bedrest

1,2,3

A patient had a cardiac catheterization and is now in the recovery area. What nursing interventions should be included in the plan of care? (Select all that apply.) 1- Assessing the peripheral pulses in the affected extremity 2- Checking the insertion site for hematoma formation 3- Evaluating temperature and color in the affected extremity 4- Assisting the patient to the bathroom after the procedure 5- Assessing vital signs every 8 hours

1,2,3

A patient had a renal angiography and is being brought back to the hospital room. What nursing interventions should the nurse carry out after the procedure to detect complications? Select all that apply. 1- Assess peripheral pulses. 2- Compare color and temperature between the involved and uninvolved extremities. 3- Examine the puncture site for swelling and hematoma formation. 4- Apply warm compresses to the insertion site to decrease swelling. 5- Increase the amount of IV fluids to prevent clot formation.

1,2,3

A patient with sickle cell anemia is to begin treatment for the disease with hydroxyurea. What does the nurse inform the patient will be the benefits of treatment with this medication? Select all that apply. 1- Fewer painful episodes of sickle cell crisis 2- Lower incidence of acute chest syndrome 3- Decreased need for blood transfusions 4- Decreased need for other analgesic medications 5- Ability to reverse the damage done from sickling of cells

1,2,3

The nurse is administering a sympathomimetic drug to a patient. What areas of concern does the nurse have when administering this drug? (Select all that apply.) 1- Causes bronchodilation 2- Constricts integumentary smooth muscle 3- Dilates the muscular vasculature 4- Causes bronchoconstriction 5- Causes laryngospasm

1,2,3

The nurse is assessing a postoperative patient who had a percutaneous transluminal coronary angioplasty (PTCA). Which possible complications should the nurse monitor for? (Select all that apply.) 1- Abrupt closure of the artery 2- Arterial dissection 3- Coronary artery vasospasm 4- Aortic dissection 5- Nerve root pressure

1,2,3

The nurse is caring for a client diagnosed with hyperchloremia. Which are signs and symptoms of hyperchloremia? Select all that apply. 1- Tachypnea 2- Weakness 3- Lethargy 4- Dehydration 5- Hypotension

1,2,3

The nurse is practicing in a community-based setting. What outcomes may be achieved by the nurse's community interventions? (Select all that apply.) 1- Promote wellness. 2- Reduce the spread of disease. 3- Improve the health status of the community. 4- Prevent hospital-acquired illness. 5- Promote the financial health of the community.

1,2,3

The nursing instructor is teaching nursing students about myocardial contractility and ejection fractions. What diagnostic tests can determine client ejection fractions? Select all that apply. 1- Echocardiogram 2- Cardiac catheterization 3- Magnetic resonance imaging 4- Positron emission tomography scan 5- Troponin levels

1,2,3

To confirm an acid-base imbalance, it is necessary to assess which findings from a client's arterial blood gas (ABG) results? Select all that apply. 1- pH 2- PaCO2 3- HCO3 4- Glucose 5- Na+ 6- K+

1,2,3

What types of cells are the primary targets of the healthy immune system? Select all that apply. 1- infectious cells 2- foreign cells 3- cancerous cells 4- typical cells

1,2,3

Which client(s) is most likely to have compartment syndrome after sustaining a fracture? Select all that apply. 1- The client with elevated pressure within the muscles 2- The client with hemorrhage in the site of injury 3- The client with a plaster cast applied immediately after injury 4- The client who sustained a clavicle fracture 5- The client using ice to control pain in the extremity

1,2,3

Which of the following teaching strategies may be used with a patient diagnosed with a developmental disability? Select all that apply. 1- Encourage active participation. 2- Use nonverbal cues as needed. 3- Use simple explanations. 4- Demonstrate information followed by return demonstration. 5- Base information on chronologic age.

1,2,3,4

A 35-year-old client with a developmental age of 10 years is being taught to take medication every morning. The nurse assesses that the client brushes his teeth every morning. For learning to occur, which of the following techniques should the nurse employ? Select all answers that apply. 1- Use simple explanations. 2- Repeat information frequently. 3- Encourage the client to take the medication after brushing his teeth. 4- Provide written 8th-grade level information. 5- Look directly at the client when speaking.

1,2,3,5

A nurse is assigned to care for a patient who is suspected of having type 2 diabetes. Select all the clinical manifestations that the nurse knows could be consistent with this diagnosis. 1- Blurred or deteriorating vision 2- Fatigue and irritability 3- Polyuria and polydipsia 4- Sudden weight loss and anorexia 5- Wounds that heal slowly or respond poorly to treatment

1,2,3,5

Which assessment findings support the client's diagnosis of acute myeloid leukemia? Select all that apply. 1- Petechiae 2- Enlarged lymph nodes 3- Weakness and fatigue 4- Enlarged heart 5- Bone pain

1,2,3,5

A patient is diagnosed with type 1 diabetes. What clinical characteristics does the nurse expect to see in this patient? Select all that apply. 1- Ketosis-prone 2- Little endogenous insulin 3- Obesity at diagnoses 4- Younger than 30 years of age 5- Older than 65 years of age

1,2,4

What is the priority responsibility for the nurse providing patient teaching? (Select all that apply.) 1- Determining individual needs for teaching 2- Motivating each person to learn 3- Giving a test at the end of a teaching session 4- Waiting until the patient expresses a desire to learn 5- Presenting information at the level of the learner

1,2,5

A client experienced surgical resection of a tumor of the esophagus. After recovery from the anesthesia, what will the nurse include in the postoperative care plans? Select all that apply. 1- Assess lung sounds every 4 hours and prn. 2- Replace the nasogastric tube if the tube becomes dislodged. 3- Monitor drainage in the closed chest drainage system. 4- Verify rhythm on the cardiac monitoring system. 5- Maintain the client in a side-lying position.

1,3,4

A client with cancer is receiving chemotherapy and reports to the nurse that his or her mouth is painful and has difficulty ingesting food. What actions should the nurse take? Select all that apply. 1- Asks the client to open his or her mouth to facilitate inspection of the oral mucosa 2- Rinses the client's mouth with alcohol-based mouthwash every 2 hours 3- Instructs the client to brush the teeth with a soft toothbrush 4- Consults with the healthcare provider about use of nystatin 5- Teaches the client to floss the teeth once every 24 hours

1,3,4

What laboratory findings does the nurse determine are consistent with hypovolemia in a female patient? (Select all that apply.) 1- Hematocrit level of greater than 47% 2- BUN: serum creatinine ratio of greater than 12.1 3- Urine specific gravity of 1.027 4- Urine osmolality of greater than 450 mOsm/kg 5- Urine positive for blood

1,3,4

A nurse is preparing a presentation for a local community group about health, wellness, and illness. When describing the concept of wellness, which of the following features would the nurse include? Select all that apply. 1- Performing to one's best ability 2- Being completely without illness 3- Feeling that everything is together 4- Being able to adjust and adapt 5- Experiencing a feeling of well-being

1,3,4,5

The nurse is caring for a ventilated client after coronary artery bypass graft surgery. What are the criterions for extubation for the client? Select all that apply. 1- adequate cough and gag reflexes 2- inability to speak 3- acceptable arterial blood gas values 4- labile vital signs 5- breathing without assistance of the ventilator

1,3,5

`Assessment to quickly identify the presence of infection with an open fracture is an important nursing responsibility. Which of the following are indicators of an infection? Select all that apply. 1- Pyrexia 2- Bradycardia 3- Bradypnea 4- Leukocytosis 5- Warm and tender skin

1,4,5

Assessment during education

1. Asses readiness to learn Adaptations needed Leaning level Disabilities Expectations 2. Organize, analize, synthesize and summarize the collected data

Types of Diarthroses

1. Ball & socket2. Hinge3. Pivot4. Saddle5. Gliding6. Condyloid

Evaluation of education

1. Collect objective data 2. determine if goals were met 3. Collaborate 4. Alterations if needed 5. Referrals 6. continue ADPIE

Implementation during education

1. Put into action 2. appropriate communication method 3. teaching aids and resources 4. use equipment that will be sent home with patient 5. encourage active learning 6. record responses to teaching 7. provide feedback

Planning during education

1. Set goals 2. Strategies for teaching 3. Expected outcomes 4. Written teaching plan logical sequence write down key points teaching aids flexibility 5. Collaborative planning

A 20-year-old man has been admitted to the emergency department with a femoral fracture as a result of a motorcycle accident. When the nurse is taking the patient's history, he states, "I had leukemia when I was little kid but they managed to cure it." The nurse should suspect that this patient likely had what type of leukemia? 1- Acute lymphoid leukemia (ALL) 2- Chronic lymphoid leukemia (CLL) 3- Acute myeloid leukemia (AML) 4- Chronic myeloid leukemia (CML)

Normal PT

11-12.5 seconds

A 41-year-old IV heroin user has been admitted to the hospital with a diagnosis of infective endocarditis and begun on IV antibiotic therapy. The patient is eager to be discharged from the hospital and has asked the nurse when he is likely to be discharged. How should the nurse reply? 1- "You'll have to talk it over with your health care provider, but it's likely that you can change to oral antibiotics in a few days." 2- "Endocarditis involves a very resilient infection, so it's common to need several weeks of IV antibiotics." 3- "You'll probably be discharged if your blood cultures are clear in 7 days." 4- "Endocarditis takes a long time to treat, but you can probably come for IV antibiotics to the ambulatory clinic once or twice a week."

A 51-year-old woman is distraught about her new diagnosis of multiple sclerosis (MS). During a recent discussion with her nurse, the nurse mentioned the concept of wellness, which prompted the patient to state, "How can you be talking about wellness at the same time that I've got MS?" Which of the following principles should underlie the nurse's response to the patient? 1- Wellness is synonymous with health. 2- Wellness involves maximizing function despite limitations. 3- Wellness is defined as acceptance of one's disabilities. 4- Wellness is a concept that is understood better by people who have chronic illnesses than by healthy individuals.

A 68-year-old male patient has been admitted to the surgical unit from the PACU after surgical repair of an inguinal hernia. When performing the patient's admission assessment, the nurse notes that the patient has a barrel chest. This assessment finding should suggest to the nurse that the patient may have a history of what health problem? 1- Asthma 2- Emphysema 3- Tuberculosis 4- Chronic bronchitis

A black client with asthma seeks emergency care for acute respiratory distress. Because of this client's dark skin, the nurse should assess for cyanosis by inspecting the: 1- lips. 2- mucous membranes. 3- nail beds. 4- earlobes.

A child is brought into the emergency department with vomiting, drowsiness, and blowing respirations. The father reports that the symptoms have been progressing throughout the day. The nurse suspects diabetic ketoacidosis (DKA). Which action should the nurse take first in the management of DKA? 1- Give prescribed antiemetics. 2- Begin fluid replacements. 3- Administer prescribed dose of insulin. 4- Administer bicarbonate to correct acidosis.

A client calls the clinic and asks the nurse if using oxymetazoline nasal spray would be alright to relieve the nasal congestion he is experiencing due to seasonal allergies. What instructions should the nurse provide to the client to avoid complications? 1- Report white patches in the mouth because the medication can cause a fungal infection. 2- Do not overuse the medication as rebound congestion can occur. 3- Taper the dose when discontinuing the medication. 4- Do not operate machinery or drive while using the medication.

A client diagnosed with prostate cancer is to receive brachytherapy. Which of the following would the nurse include when discussing this therapy with the client? 1- Need for daily treatments over a 7- to 8-week period 2- Use of radioactive seeds implanted into the prostate 3- Surgical castration to decrease the level of circulating testosterone 4- Use of probes inserted using ultrasound to freeze the tissue

A client in the emergency department reports that he has been vomiting excessively for the past 2 days. His arterial blood gas analysis shows a pH of 7.50, partial pressure of arterial carbon dioxide (PaCO2) of 43 mm Hg, partial pressure of arterial oxygen (PaO2) of 75 mm Hg, and bicarbonate (HCO3-) of 42 mEq/L. Based on these findings, the nurse documents that the client is experiencing which type of acid-base imbalance? 1- Respiratory alkalosis 2- Metabolic alkalosis 3- Respiratory acidosis 4- Metabolic acidosis

A client is admitted to the unit with diabetic ketoacidosis (DKA). Which insulin would the nurse expect to administer intravenously? 1- Glargine 2- Regular 3- NPH 4- Lente

A client is experiencing muscle weakness in the upper extremities. The client raises an arm above the head but then loses the ability to maintain the position. Muscular dystrophy is suspected. Which diagnostic test would evaluate muscle weakness or deterioration? 1- A serum calcium test 2- An electromyography 3- An arthroscopy 4- A magnetic resonance imaging (MRI)

A client is undergoing treatment for prostate cancer. He has chemotherapy sessions regularly. However, of late he is showing symptoms of food allergy and loss of appetite. He has lost considerable weight as a result. Which is an appropriate nursing task in this situation? 1- Ensure greater fluid intake. 2- Ask the client to keep a diet diary. 3- Include fruits in the client's diet. 4- Administer serotonin blockers.

A client presents at the clinic with an allergic disorder. The client asks the nurse what an "allergic disorder" means. What would be the nurse's best response? 1- "It means you are very sensitive to something inside of yourself." 2- "It is a hyperimmune response to something in the environment that is usually harmless." 3- "It is a muted response to something in the environment." 4- "It is a harmless reaction to something in the environment."

A client presents with fatigue, nausea, vomiting, muscle weakness, and leg cramps. Laboratory values are as follows: Na + 147 mEq/L K + 3.0 mEq/L Cl - 112 mEq/L Mg ++ 2.3 mg/dL Ca ++ 1.5 mg/dL Which of the following is consistent with the client's findings? 1- Hypernatremia 2- Hypokalemia 3- Hyperchloremia 4- Hypophosphatemia

A client presents with symptoms of menstrual difficulties and infertility. Which hormone is essential in the maintenance of the endometrium? 1- Estrogen 2- Progesterone 3- Testosterone 4- Prolactin

A client recovering from gastric bypass surgery accidentally removes the nasogastric tube. What is the best action by the nurse? 1- Reinsert the nasogastric tube to the stomach. 2- Notify the surgeon about the tube's removal. 3- Place the nasogastric tube to the level of the esophagus. 4- Document the discontinuation of the nasogastric tube.

A client undergoes an invasive joint examination of the knee. What will the nurse closely monitor the client for? 1- Lack of sleep and appetite 2- Serous drainage 3- Signs of depression 4- Signs of shock

A client undergoes open reduction with internal fixation to treat an intertrochanteric fracture of the right hip. The nurse should include which intervention in the postoperative care plan? 1- Performing passive range-of-motion (ROM) exercises on the client's legs once each shift 2- Keeping a pillow between the client's legs at all times 3- Turning the client from side to side every 2 hours 4- Maintaining the client in semi-Fowler's position

A client visits the health care provider for a routine checkup. The history reveals that the client was diagnosed with a spinal curvature. Which region of the spine should the nurse assess for complications? 1- Cervical 2- Thoracic 3- Lumbar 4- Sacral

A client who was diagnosed with type 1 diabetes 14 years ago is admitted to the medical-surgical unit with abdominal pain. On admission, the client's blood glucose level is 470 mg/dl. Which finding is most likely to accompany this blood glucose level? 1- Cool, moist skin 2- Rapid, thready pulse 3- Arm and leg trembling 4- Slow, shallow respirations

A client with a diagnosed abdominal aortic aneurysm (AAA) develops severe lower back pain. Which is the most likely cause? 1- The aneurysm has become obstructed. 2- The aneurysm may be preparing to rupture. 3- The client is experiencing inflammation of the aneurysm. 4- The client is experiencing normal sensations associated with this condition.

A client with a pulmonary embolus has the following arterial blood gas (ABG) values: pH, 7.49; partial pressure of arterial oxygen (PaO2), 60 mm Hg; partial pressure of arterial carbon dioxide (PaCO2), 30 mm Hg; bicarbonate (HCO3-) 25 mEq/L. What should the nurse do first? 1- Instruct the client to breathe into a paper bag. 2- Administer oxygen by nasal cannula as ordered. 3- Auscultate breath sounds bilaterally every 4 hours. 4- Encourage the client to deep-breathe and cough every 2 hours.

A client with type 1 diabetes asks the nurse about taking an oral antidiabetic agent. The nurse explains that these medications are effective only if the client: 1- prefers to take insulin orally. 2- has type 2 diabetes. 3- has type 1 diabetes. 4- is pregnant and has type 2 diabetes.

A client with type 1 diabetes reports waking up in the middle of the night feeling nervous and confused, with tremors, sweating, and a feeling of hunger. Morning fasting blood glucose readings have been 110 to 140 mg/dL. The client admits to exercising excessively and skipping meals over the past several weeks. Based on these symptoms, the nurse plans to instruct the client to 1- administer an increased dose of neutral protamine Hagedorn insulin in the evening. 2- check blood glucose at 3:00 a.m. 3- eat a complex carbohydrate snack in the evening before bed. 4- skip the evening neutral protamine Hagedorn insulin dose on days when exercising and skipping meals.

A client with type 2 diabetes has recently been prescribed acarbose, and the nurse is explaining how to take this medication. The teaching is determined to be effective based on which statement by the client? 1- "I will take this medication in the morning, 15 minutes before breakfast." 2- "I will take this medication in the morning, with my first bite of breakfast." 3- "This medication needs to be taken after the midday meal." 4- "It does not matter what time of day I take this medication."

A client, who has undergone a percutaneous transluminal coronary angioplasty (PTCA), has received discharge instructions. Which statement by the client would indicate the need for further teaching by the nurse? 1- "I should avoid taking a tub bath until my catheter site heals." 2- "I should expect a low-grade fever and swelling at the site for the next week." 3- "I should avoid prolonged sitting." 4- "I should expect bruising at the catheter site for up to 3 weeks."

A female client is readmitted to the facility with a warm, tender, reddened area on her right calf. Which contributing factor should the nurse recognize as most important? 1- History of increased aspirin use 2- Recent pelvic surgery 3- An active daily walking program 4- A history of diabetes mellitus

A nurse assesses a client's respiratory status. Which observation indicates that the client is having difficulty breathing? 1- Diaphragmatic breathing 2- Use of accessory muscles 3- Pursed-lip breathing 4- Controlled breathing

A nurse developed a program of increased ambulation for a patient with an orthopedic disorder. This goal setting is a component of the nursing process known as: 1- Assessment 2- Planning 3- Implementation 4- Evaluation

A nurse has been assigned to care for a client with newly diagnosed insulin-dependent diabetes mellitus. When teaching the client proper injection techniques, which statement will the nurse use to promote emotional readiness in the client? 1- "Do you feel comfortable with injections?" 2- "Can you teach me what I just showed you?" 3- "What scares you the most about this?" 4- "How do you feel about needles?"

A nurse is admitting a client diagnosed with infective pericarditis. What is the initial order for the nurse to implement? 1- Administer intravenous antibiotic. 2- Obtain blood cultures times two. 3- Schedule an echocardiogram. 4-Provide bedrest with bathroom privileges.

A nurse is assigned to support a patient while a cast is being applied to treat a greenstick fracture. The nurse documents that this fracture is classified as what type of fracture? 1- Closed 2- Incomplete 3- Stress 4- Compression

A nurse is caring for a patient who is experiencing fear, anxiety, and feelings of powerlessness after receiving a diagnosis of cancer. The nurse develops a teaching plan focusing on the patient's diagnosis and treatment options to promote the patient's sense of control over the situation. Using Maslow's Hierarchy of Human Needs, which of the following categories is the nurse attempting to meet? 1- Esteem and self-respect 2- Safety and security 3- Physiology 4- Belongingness and affection

A nurse is checking laboratory values on a client who has crackles in the lower lobes, 2+ pitting edema, and dyspnea with minimal exertion. Which laboratory value does the nurse expect to be abnormal? 1- Potassium 2- B-type natriuretic peptide (BNP) 3- C-reactive protein (CRP) 4- Platelet count

During a class on exercise for clients with diabetes mellitus, a client asks the nurse educator how often to exercise. To meet the goals of planned exercise, the nurse educator should advise the client to exercise: 1- at least once per week. 2- at least three times per week. 3- at least five times per week. 4- every day.

A nurse is performing a home visit for a client who received chemotherapy within the past 24 hours. The nurse observes a small child playing in the bathroom, where the toilet lid has been left up. Based on these observations, the nurse modifies the client's teaching plan to include: 1- expected chemotherapy-related adverse effects. 2- chemotherapy exposure and risk factors. 3- signs and symptoms of infection. 4- reinforcement of the client's medication regimen.

A nurse is preparing teaching for a client with an auditory perceptual disorder. Which educational strategy will be most effective? 1- Explain important information verbally. 2- Repeat and reinforce words frequently. 3- Explain noises associated with procedures. 4- Avoid medical terminology.

A nurse is reviewing a report of a client's routine urinalysis. Which value requires further investigation? 1- Specific gravity of 1.02 2- Urine pH of 3.0 3- Absence of protein 4- Absence of glucose

A nurse is reviewing how to use an epinephrine auto-injector with a child and parents. The nurse determines that the teaching was successful when the child and parents state that after injection they will hold the pen in place for approximately: 1- 5 seconds. 2- 10 seconds. 3- 30 seconds. 4- 60 seconds.

A nurse is teaching a client with diabetes mellitus about self-management of his condition. The nurse should instruct the client to administer 1 unit of insulin for every: 1- 10 g of carbohydrates. 2- 15 g of carbohydrates. 3- 20 g of carbohydrates. 4- 25 g of carbohydrates.

A nurse practitioner is conducting a history and physical on a 42-year-old woman. One of the questions asked of someone in this age group is the type of medications that the patient's mother took during her pregnancy. The nurse is assessing for a past history of ______ use. 1- Immunosuppressive agents 2- Diethylstilbestrol 3- Cancer drugs 4- Antibiotics

A patient has been prescribed sildenafil citrate. What should the nurse teach the patient about this medication? 1- Sexual stimulation is not needed to obtain an erection. 2- The drug should be taken 1 hour prior to intercourse. 3- Facial flushing or headache should be reported to the health care provider immediately. 4- A high dose may result in a permanent change of vision.

A patient has had a successful heart transplant for end-stage heart disease. What immunosuppressant will be necessary for this patient to take to prevent rejection? 1- Nifedipine 2- Cyclosporine 3- Verapamil 4- Vancomycin

A patient has just been diagnosed with type 2 diabetes. The health care provider has prescribed an oral antidiabetic agent that will inhibit the production of glucose by the liver and thereby aid in the control of blood glucose. What type of oral antidiabetic agent has been prescribed for this patient? 1- Sulfonylurea 2- Biguanide 3- Thiazolidinedione 4- Alpha glucosidase inhibitor

A patient has presented to the emergency room with a fracture of the nose that has resulted in a skin tear and involvement of the mucous membranes of the nasal passages. The emergency room nurse is aware that this description likely indicates which type of fracture? 1- Compression 2- Open 3- Impacted 4- Transverse

A patient has returned to the nursing unit after having a percutaneous coronary intervention (PCI) in the hospital's cardiac catheterization laboratory. The nurse who is providing care for this patient should prioritize what assessment? 1- Assessing the patient's capillary refill time and peripheral pulses 2- Assessing the patient for signs and symptoms of hemorrhage 3- Assessing the patient for signs and symptoms of acute renal failure 4- Assessing the patient for signs and symptoms of infection

A patient has sustained a long bone fracture. The nurse is preparing a care plan for this patient. Which nursing action should the nurse include in the care plan to enhance fracture healing? 1- Limit weight-bearing and exercising during the recovery. 2- Monitor color, temperature, and pulses of the affected extremity. 3- Avoid prolonged immobilization of the fracture fragments. 4- Administer high doses of corticosteroids.

A patient is admitted with a diagnosis of renal failure. The patient complains of "stomach distress" and describes ingesting several antacid tablets over the past 2 days. Blood pressure is 110/70 mm Hg, face is flushed, and the patient is experiencing generalized weakness. Which is the most likely magnesium level associated with the symptoms the patient is having? 1- 11 mEq/L 2- 5 mEq/L 3- 2 mEq/L 4- 1 mEq/L

A patient is having an angiography to detect the presence of an aneurysm. After the contrast is administered by the interventionist, the patient begins to complain of nausea and difficulty breathing. What medication is a priority to administer at this time? 1- Metoprolol (Lopressor) 2- Epinephrine 3- Hydrocortisone (Solu-Cortef) 4- Cimetidine (Tagamet)

A patient was seen in the clinic for hypertension and received a prescription for a new antihypertensive medication. The patient arrived in the emergency department a few hours after taking the medication with severe angioedema. What medication prescribed may be responsible for the reaction? 1- Beta blocker 2- Angiotensin-converting enzyme (ACE) inhibitor 3- Angiotensin receptor blocker 4- Vasodilator

A patient with a diagnosis of renal cell carcinoma is being treated with chemotherapy. During a previous round of chemotherapy, the patient's tumor responded well to treatment but the chemotherapy caused intense nausea and vomiting. How should the patient's potential nausea and vomiting be addressed during this current round of treatment? 1- Prioritize nonpharmacological treatments over medications. 2- Administer antiemetics in anticipation of the patient's nausea. 3- Provide the patient with antiemetics at his first complaint of nausea. 4- Administer antiemetics if the patient vomits or believes he will soon vomit.

During a teaching session, a client who is having a valuloplasty tomorrow asks the nurse about the difference between a mechanical valve replacement and a tissue valve. What answer from the nurse is correct? 1- "A mechanical valve is less likely to generate blood clots, so long-term anticoagulation therapy is not required." 2- "A mechanical valve is thought to be more durable and so requires replacement less often." 3- "Mechanical valves are used for women of childbearing age." 4- "Mechanical valves are not always available and are very expensive."

A pregnant client who developed deep vein thrombosis (DVT) in her right leg is receiving heparin I.V. on the medical floor. Physical therapy is ordered to maintain her mobility and prevent additional DVT. A nursing assistant working on the medical unit helps the client with bathing, range-of-motion exercises, and personal care. Which collaborative multidisciplinary considerations should the care plan address? 1- The client is at risk for heparin-induced thrombocytopenia; therefore, the care plan should include sequential compression device application and strict bed rest. 2- The client is at risk for heparin-induced thrombocytopenia; therefore, the care plan should include reporting evidence of bleeding or easy bruising. 3- The client is at risk for developing another DVT; therefore, the care plan should include reporting redness, tenderness, or edema in the other lower extremity. 4- The client is pregnant and receiving I.V. heparin, placing her at risk for premature labor; therefore, the care plan should include reporting signs of premature labor.

A serum sodium concentration lower than 115 mEq/L (115 mmol/L) is associated with 1- anorexia. 2- seizure. 3- weight gain. 4- myalgia.

A son brings his father into the clinic, stating that his father's color has changed to bluish around the mouth. The father is confused, with a respiratory rate of 28 breaths per minute and scattered crackles throughout. The son states this condition just occurred within the last hour. Which of the following factors indicates that the client's condition has lasted for more than 1 hour? 1- Respiratory rate 2- Cyanosis 3- Son's statement 4- Crackles

A teenage boy is undergoing allergy testing and has had blood work drawn as part of the diagnostic workup. When reviewing the patient's laboratory results, the nurse should pay particular attention to the levels of what white blood cell (WBC) component? 1- Neutrophils 2- Eosinophils 3- Lymphocytes 4- Monocytes

After a car accident, a client is admitted to an acute care facility with multiple traumatic injuries, including a fractured pelvis. For 24 to 48 hours after the accident, the nurse must monitor the client closely for which potential complication of a fractured pelvis? 1- Compartment syndrome 2- Fat embolism 3- Infection 4- Volkmann's ischemic contracture

After a detailed diagnostic workup, a patient has been diagnosed with atrial septal defect (ASD). The nurse should recognize that this patient may exhibit many of the signs and symptoms that are typically associated with: 1- Unstable angina 2- Right-sided heart failure 3- Myocardial infarction 4- Endocarditis

After teaching nursing students about the health-illness continuum, the instructor determines that teaching was successful when the students state which of the following? 1- "A patient's care must be focused on treating the disease." 2- "A person can be both healthy and ill at the same time." 3- "A patient with a disease typically falls on the far end of the continuum." 4- "A patient with a chronic illness is considered ill."

An example of a dependent nursing action is: 1- Auscultating breath sounds on a postoperative patient. 2- Administering insulin, on a sliding scale, to a patient with diabetes. 3- Rotating a patient's position to prevent the formation of bed sores. 4- Changing the frequency of vital signs assessment based on the patient's condition.

An obese Hispanic client, age 65, is diagnosed with type 2 diabetes. Which statement about diabetes mellitus is true? 1- Nearly two-thirds of clients with diabetes mellitus are older than age 60. 2- Diabetes mellitus is more common in Hispanics and Blacks than in Whites. 3- Type 2 diabetes mellitus is less common than type 1 diabetes mellitus. 4- Approximately one-half of the clients diagnosed with type 2 diabetes are obese.

An occupational health nurse is assessing a woman who experienced an anaphylactic reaction to a dip that contained crab during an office celebration. Because the woman promptly self-administered epinephrine, her status has normalized and she is now resting in a colleague's office. What action should the nurse perform? 1- Liaise with the woman's family and arrange for her to return home. 2- Have the woman transported to a nearby emergency department. 3- Encourage the woman to limit her physical activity for the next 24 to 48 hours. 4- Provide reassurance to limit the woman's anxiety.

An older adult is postoperative day one, following a coronary artery bypass graft (CABG). The client's family members express concern to the nurse that the client is uncharacteristically confused. After reporting this change in status to the health care provider, what additional action should the nurse take? 1- Educate the family about how confusion is expected in older adults postoperatively. 2- Assess for factors that may be causing the client's delirium. 3- Document the early signs of dementia and ensure the client's safety. 4- Reorient the client to place and time.

An older adult man has been diagnosed with a femoral head fracture after falling outside his home, and his health care provider has chosen open reduction with internal fixation (ORIF). How should the nurse best explain this procedure to the patient? 1- "The surgeon will give you an anesthetic and then apply a cast." 2- "The surgeon will place plates or rods outside your hip and keep you in traction until your bones heal." 3- "The surgeon will use pins and rods to keep your bones in place until they heal." 4- "The surgeon will use a scope inserted through punctures in your skin to remove any bone fragments."

An older adult patient is in the hospital being treated for sepsis related to a urinary tract infection. The patient has started to have an altered sense of awareness, profound dehydration, and hypotension. What does the nurse suspect the patient is experiencing? 1- Systemic inflammatory response syndrome 2- Hyperglycemic hyperosmolar syndrome 3- Multiple-organ dysfunction syndrome 4- Diabetic ketoacidosis

Approximately what percentage of blood passing through the glomeruli is filtered into the nephron? 1- 10 2- 20 3- 30 4- 40

Arterial blood gas analysis would reveal which value related to acute respiratory failure? 1- PaO2 80 mm Hg 2- pH 7.28 3- PaCO2 32 mm Hg 4- pH 7.35

Before a transesophageal echocardiogram, a nurse gives a client an oral topical anesthetic spray. When the client returns from the procedure, the nurse observes no active gag reflex. What nursing action is a priority? 1- insert an oral airway. 2- withhold food and fluids. 3- position the client on his side. 4- introduce a nasogastric (NG) tube.

In a client with a dislocation, the nurse should initially perform neurovascular assessments a minimum of every 15 minutes until stable. Which complication does the assessments help the nurse to monitor in the client? 1- Disseminated intravascular coagulation 2- Compartment syndrome 3- Carpal tunnel syndrome 4- Fat embolism syndrome

In a client with amyotrophic lateral sclerosis (ALS) and respiratory distress, which finding is the earliest sign of reduced oxygenation? 1- Decreased heart rate 2- Increased restlessness 3- Increased blood pressure 4- Decreased level of consciousness (LOC)

Nursing has evolved from the hospital or home care of the individual during illness to caring for individuals, communities, and populations across the health care continuum. Which of the following necessitated changes in models of nursing care? 1- Fewer individuals with chronic disease 2- Increased aging population 3- Fewer inpatient settings 4- Lengthened hospital stays

On auscultation, which finding suggests a right pneumothorax? 1- Bilateral inspiratory and expiratory crackles 2- Absence of breath sounds in the right thorax 3- Inspiratory wheezes in the right thorax 4- Bilateral pleural friction rub

T-cell deficiency occurs when which gland fails to develop normally during embryogenesis? 1- Thyroid 2- Thymus 3- Pituitary 4- Adrenal

The client is receiving a 25% dextrose solution of parenteral nutrition. The infusion machine is beeping, and the nurse determines the intravenous (IV) bag is empty. The nurse finds there is no available bag to administer. What is the priority action by the nurse? 1- Request a new bag from the pharmacy department. 2- Infuse a solution containing 10% dextrose and water. 3- Flush the line with 10 mL of sterile saline. 4- Catch up with the next bag when it arrives.

The new client on the unit was admitted with acute respiratory failure. What are the signs and symptoms of acute respiratory failure? 1- Insidious onset in client who had normal lung function 2- Sudden onset in client who had normal lung function 3- Insidious onset in client who had compromised lung function 4- Sudden onset in client who had compromised lung function

The nurse administers propranolol hydrochloride to a patient with a heart rate of 64 beats per minute (bpm). One hour later, the nurse observes the heart rate on the monitor to be 36 bpm. What medication should the nurse prepare to administer that is an antidote for the propranolol? 1- Digoxin 2- Atropine 3- Protamine sulfate 4- Sodium nitroprusside

The nurse cares for a client with acute myeloid leukemia with severe bone pain. What pathophysiological concept does the nurse understand is the reason for the client's pain? 1- Abnormal blood cells deposit in small vessels. 2- Bone marrow expands. 3- Lymph nodes expand. 4- Abnormal blood cells crystalize.

The nurse caring for a 2-year-old near-drowning victim monitors for what possible complication? 1- Atelectasis 2- Acute respiratory distress syndrome 3- Metabolic alkalosis 4- Respiratory acidosis

The nurse caring for an older adult client diagnosed with diarrhea is administering and monitoring the client's medications. Because one of the client's medications is digitalis (digoxin), the nurse monitors the client closely for: 1- hyperkalemia. 2- hypokalemia. 3- hyponatremia. 4- hypernatremia.

The nurse confirms placement of a client's nasogastric (NG) tube using a combination of visual and pH assessment of the aspirate. The nurse determines that the NG tube remains properly placed when the pH of the aspirate is 1- alkaline 2- acidic 3- neutral 4- unmeasurable

The nurse determines that a patient has a characteristic symptom of pericarditis. What symptom does the nurse recognize as significant for this diagnosis? 1- Dyspnea 2- Constant chest pain 3- Fatigue lasting more than 1 month 4- Uncontrolled restlessness

The nurse identifies which symptom as a manifestation of right-sided heart failure (HF)? 1- Accumulation of blood in the lungs 2- Congestion in the peripheral tissues 3- Reduction in forward flow 4- Reduction in cardiac output

The nurse in an allergy clinic is assessing a new patient. The nurse is aware that histamine plays an important role in the immune response and that the effects of histamine can manifest in assessment findings. What response can occur as a result of histamine release? 1- Constriction of small venules 2- Contraction of bronchial smooth muscle 3- Dilation of large blood vessels 4- Decrease secretion of gastric and mucosal cells

The nurse is administering a beta blocker to a patient in order to decrease automaticity. Which medication will the nurse administer? 1- Diltiazem 2- Metoprolol 3- Amiodarone 4- Propafenone

The nurse is administering packed red blood cell (RBC) transfusions for a patient with myelodysplastic syndrome (MDS). The patient has had several transfusions and is likely to receive several more. What is a priority for the nurse to monitor related to the transfusions? 1- Creatinine and blood urea nitrogen (BUN) levels 2- Iron levels 3- Magnesium levels 4- Potassium levels

The nurse is admitting a client with a diagnosis of diverticulitis and assesses that the client has a boardlike abdomen, no bowel sounds, and reports of severe abdominal pain. What is the nurse's first action? 1- Start an IV with lactated Ringer's solution. 2- Notify the health care provider. 3- Administer a retention enema. 4- Administer an opioid analgesic.

The nurse is auscultating the heart of a client diagnosed with mitral valve prolapse. Which is often the first and only manifestation of mitral valve prolapse? 1- Fatigue 2- An extra heart sound 3- Dizziness 4- Syncope

The nurse is auscultating the heart of a client diagnosed with mitral valve prolapse. Which is often the first and only manifestation of mitral valve prolapse? 1- Fatigue 2- Extra heart sound 3- Dizziness 4- Syncope

The nurse is caring for a client who has a gastrostomy tube feeding. Upon initiating care, the nurse aspirates the gastrotomy tube for gastric residual volume (GRV) and obtains 200 mL of gastric contents. What is the priority action by the nurse? 1- Discontinue the infusion. 2- Place the client in a semi-Fowler's position with the head of the bed at 45 degrees. 3- Remove the aspirated fluid and do not reinstill. 4- Dilute the gastric tube feeding solution with water and continue the feeding.

The nurse is caring for a client who has presented to the walk-in clinic. The client verbalizes pain on urination, feelings of fatigue, and diffuse back pain. When completing a head-to-toe assessment, at which specific location would the nurse assess the client's kidneys for tenderness? 1- The upper abdominal quadrants on the left and right side 2- The costovertebral angle 3- Above the symphysis pubis 4- Around the umbilicus

The nurse is caring for a client with cardiac compromise related to mitral valve impairment. Which outcome of the eroding of the mitral valve is most significant? 1- Presence of a heart murmur 2- Heart failure 3- Activity intolerance 4- Pulmonary congestion

The nurse is developing a health-promotion program at a company in which many employees are women in their 20s and 30s. For this population, the nurse plans to include information about 1- Bone-density screening 2- Parenting issues 3- Mammography 3- Values training

The nurse is instructing a new graduate nurse. Together, they are caring for a client with infective endocarditis. What is a sign of infective endocarditis? 1- Polyarthritis 2- Splinter hemorrhage 3- Precordial pain 4- Heart murmur

The nurse is monitoring a patient who sustained an open fracture of the left hip. What type of shock should the nurse be aware can occur with this type of injury? 1- Cardiogenic 2- Hypovolemic 3- Neurogenic 4- Septicemic

The nurse is obtaining a health history from a 58-year-old client stating that he is having difficulty obtaining an erection during sexual activity. The client asks how an "erectile medication" works and if there are any side effects to the medication. The nurse explains the action of the medication and directions for use and warns of which side effect related to the client's history? 1- Asthma with beta-adrenergic inhaler use 2- Hypotension with nitrate use 3- Chronic pain with narcotic use 4- Arthritis with corticosteroid use

The nurse is obtaining a history from a male client who states having difficulty achieving and sustaining an erection. When reviewing the medication history, which medication classification does the nurse anticipate? 1- Bronchodilators 2- Antihypertensives 3- Cardiac dysrhythmics 4- Antibiotics

The nurse is planning to teach a client who was recently diagnosed with migraine headaches. It is best to teach the client 1- During the headache recovery phase 2- In a quiet room 3- With her spouse and children present 4- Immediately following a headache experience

The nurse is preparing a presentation for a group of adults at a local community center about diabetes. Which of the following would the nurse include as associated with type 2 diabetes? 1- Onset most common during adolescence 2- Insufficient insulin production 3- Less common than type 1 diabetes 4- Little relation to prediabetes

The nurse is providing care for a number of patients who are receiving treatment for health problems that have a respiratory etiology. Which of the following patients is most likely to benefit from the administration of a PO or IV diuretic? 1- A patient who presents with a barrel chest 2- A patient who has crackles on auscultation 3- A patient who has a sibilant wheeze 4- A patient who has recently complained of chest pain

The nurse is providing instruction for testicular self-examination to a group of young adolescents. Which is the most correct examination technique? 1- Palpate both testicles simultaneously for comparison. 2- Palpate each testicle separately, following a warm shower. 3- Palpate the front of the testicle first, where most tumors are found. 4- Palpate for a soft, round shape with normal ridges on the testicles.

The nurse is reviewing the blood gas results for a patient with pneumonia. What arterial blood gas measurement best reflects the adequacy of alveolar ventilation? 1- PaO2 2- PaCO2 3- pH 4- SaO2

The nurse is reviewing the lab work of a client diagnosed with infective endocarditis. Which diagnostic study confirms the diagnosis? 1- Complete blood count 2- Positive blood culture 3- Serum cardiac antigens 4- Immunosuppressant assay

The nurse is teaching a client about the development of leukemia. What statement should be included in the teaching plan? 1- "Acute leukemia develops slowly." 2- "Chronic leukemia develops slowly." 3- "In chronic leukemia, the majority of leukocytes are mature." 4- "In acute leukemia there are not many undifferentiated cells."

The nurse is teaching a client with acute lymphocytic leukemia (ALL) about therapy. What statement should be included in the plan of care? 1- "Treatment is simple and consists of single-drug therapy." 2- "Intrathecal chemotherapy is used primarily as preventive therapy." 3- "The goal of therapy is palliation." 4- "Side effects are rare with therapy."

The nurse observes dry mucous membranes in a client who is receiving tube feedings after an oral surgery. The client also reports unpleasant tastes and odors. Which measure should be included in the client's plan of care? 1- Ensure adequate hydration with additional water. 2- Provide frequent mouth care. 3- Keep the feeding formula refrigerated. 4- Flush the tube with water before adding the feedings.

The nurse understands that which cells circulate throughout the body looking for virus-infected cells and cancer cells? 1- Natural killer cells 2- Cytokines 3- Interleukins 4- Interferons

The nurse working in the clinic has had several incidences of positive chlamydia cultures return in women with pelvic pain. The nurse understands that early diagnosis and treatment are essential measures in which to reduce contagion and limit the complications related to this infection. What type of prevention will the nurse use when these infections are treated? 1- Primary prevention 2- Secondary prevention 3- Tertiary prevention 4- Prevalence

The patient presents to the emergency room with an open fracture of the femur. Which action would the nurse implement to prevent the most serious complication of an open fracture? 1- Reduce the fracture to prevent additional tissue damage. 2- Cover the wound with a sterile dressing to prevent infection. 3- Immobilize the joint to prevent movement of bone fragments. 4- Apply a pressure bandage to decrease tissue damage.

The staff educator is presenting a workshop on valvular disorders. When discussing the pathophysiology of aortic regurgitation, the educator emphasizes that aortic regurgitation causes what? 1- Cardiac tamponade 2- Left ventricular hypertrophy 3- Right-sided heart failure 4- Ventricular insufficiency

Three areas of the ureters have a propensity for obstruction. Prompt management of renal calculi is most important when the stone is located where? A) In the ureteropelvic junction B) In the ureteral segment near the sacroiliac junction C) In the ureterovesical junction D) In the urethra

Using the concept of the wellness-illness continuum, what would the nurse include in the development of a nursing care plan for a chronically ill patient? 1- Educate the patient about every possible complication associated with the specific illness. 2- Encourage positive health characteristics within the limits of the specific illness. 3- Limit all activities because of the progressive deterioration associated with all chronic illnesses. 4- Recommend activity beyond the scope of tolerance to prevent early deterioration.

When constructing a teaching plan, the steps of the nursing process are utilized. In which step are teaching strategies identified? 1- Assessment 2- Planning 3- Implementation 4- Evaluation

When evaluating a patient's symptoms that are consistent with a diagnosis of leukemia, the nurse is aware that all leukemias have which common feature? 1- Compensatory polycythemia stimulated by thrombocytopenia 2- Unregulated accumulation of white cells in the bone marrow, which replace normal marrow elements 3- Increased blood viscosity, resulting from an overproduction of white cells 4- Reduced plasma volume in response to a reduced production of cellular elements

When evaluating arterial blood gases (ABGs), which value is consistent with metabolic alkalosis? 1- HCO 21 mEq/L 2- pH 7.48 3- PaCO 36 4- O2 saturation 95%

When teaching a client with rheumatic carditis and a history of recurrent rheumatic fever, which statement by the client indicates that teaching has been successful? 1- "I will avoid milk, yogurt, and other dairy products." 2- "I may have to take prophylactic antibiotics for up to 10 years." 3- "I will take a nonsteroidal anti-inflammatory medication every day." 4- "I will avoid any kind of activity."

When the nurse places the patient in the stirrups for a pelvic exam she observes a bulge caused by rectal cavity protrusion. What does the nurse know this protrusion is called? 1- Cystocele 2- Rectocele 3- Uterine prolapse 4- Hemorrhoids

When the postcardiac surgery client demonstrates restlessness, nausea, weakness, and peaked T waves, the nurse reviews the client's serum electrolytes, anticipating which abnormality? 1- Hypercalcemia 2- Hyperkalemia 3- Hypomagnesemia 4- Hyponatremia

Which client would the nurse identify as being at highest risk for the development of testicular cancer? 1- A 45-year-old white male with a history of hypertension 2- A 25-year-old male with a history of cryptorchidism 3- A 39-year-old African American male who is HIV-negative 4- A 75-year-old white male with erectile dysfunction

Which condition is caused by improper catheter placement and inadvertent puncture of the pleura? 1- air embolism 2- pneumothorax 3- sepsis 4- fluid overload

Which could be a potential cause of respiratory acidosis? 1- Vomiting 2- Hypoventilation 3- Diarrhea 3- Hyperventilation

Which drug is considered a stimulant laxative? 1- Magnesium hydroxide 2- Bisacodyl 3- Mineral oil 4- Psyllium hydrophilic mucilloid

Which hormone causes the kidneys to reabsorb sodium? 1- Antidiuretic hormone 2- Aldosterone 3- Growth hormone 4- Prostaglandins

Which intervention is most appropriate for a client with an arterial blood gas (ABG) of pH 7.5, a partial pressure of arterial carbon dioxide (PaCO2) of 26 mm Hg, oxygen (O2) saturation of 96%, bicarbonate (HCO3-) of 24 mEq/L, and a PaO2 of 94 mm Hg? 1- Administer an ordered decongestant. 2- Instruct the client to breathe into a paper bag. 3- Offer the client fluids frequently. 4- Administer ordered supplemental oxygen.

Which intervention should the nurse include in the plan of care for a client with valvular heart disease who is experiencing pulmonary congestion? 1- Report a weight gain of 3 pounds in 1 week 2- Rest and sleep in a chair or sit in bed with head elevated 3- Take nitroglycerin if shortness of breath develops 4- Drink at least 2 L of fluid daily and monitor urine output

Which is the most common presenting symptom of colon cancer? 1- Fatigue 2- Change in bowel habits 3- Anorexia 4- Weight loss

Which is the most common type of prostate surgery? 1- Retropubic prostatectomy 2- Transurethral resection of the prostate 3- Suprapubic prostatectomy 4- Perineal prostatectomy

Which of the following best describes the health-illness continuum? 1- A person with chronic illness is at the far end of the continuum reflecting illness. 2- A person may be considered neither completely healthy or completely ill. 3- A person with high-level wellness is free of any disease or infirmity. 4- A person on the continuum remains at the point based on his or her initial state of health.

Which of the following diagnostic tests would the nurse expect to be ordered to determine the details of the arterial supply to the kidneys? 1- Radiography 2- Angiography 3- Computed tomography (CT scan) 4- Cystoscopy

Which of the following is the only definitive test that can determine if cancer of the testis is present? 1- Elevated lactate dehydrogenase 2- Tissue biopsy 3- Positive alpha-fetoprotein level 4- Computed tomography (CT) scan of the abdomen

A nurse is caring for a client diagnosed with acute renal failure. The nurse notes on the intake and output record that the total urine output for the previous 24 hours was 35 mL. Urine output that's less than 50 ml in 24 hours is known as: 1- oliguria. 2- polyuria. 3- anuria. 4- hematuria.

Patient Protection and Affordable Care Act (PPACA)

2010 federal legislation designed for comprehensive health reform, with an intent to expand coverage, control health care costs, and improve the health care delivery system

A 10-year-old boy who was brought to the emergency room after a skiing accident is diagnosed with a fracture of the distal end of the femur. Why is this type of fracture significant? 1- Osteoblast formation will stop during the time needed for fracture healing. 2- Red blood cell production will be temporarily reduced because of the damage to the medullar cavity. 3- Potential growth problems may result from damage to the epiphyseal plate. 4- Periosteal blood vessels will be damaged, thus compromising blood flow to the compact bone.

A 38-year-old client has begun to suffer from rheumatoid arthritis and is being assessed for disorders of the immune system. The client works as an aide at a facility that cares for children infected with AIDS. Which is the most important factor related to the client's assessment? 1- Age 2- Diet 3- Use of other drugs 4- Home environment

A 52-year-old client asks the nurse how she is to remember when to schedule her clinical breast examination. Which response by the nurse is most correct? 1- "The office staff can schedule your clinical breast examination twice a year." 2- "The diagnostic center will send you a reminder card to complete the annual examination." 3- "The clinical breast evaluation will be completed with annual gynecologic examination." 4- "You can complete the examination at home and report if you found anything abnormal."

A client presents with anorexia, nausea and vomiting, deep bone pain, and constipation. The following are the client's laboratory values. Na + 130 mEq/L K + 4.6 mEq/L Cl - 94 mEq/L Mg ++ 2.8 mg/dL Ca ++ 13 mg/dL Which of the following alterations is consistent with the client's findings? 1- Hyponatremia 2- Hyperkalemia 3- Hypercalcemia 4- Hypermagnesemia

A recommended approach to planning health teaching is applying the trans-theoretical model, which considers the stages of behavioral change. The stage in which the patient engages in calorie counting to reduce weight is called: 1- Contemplation 2- Preparation 3- Action 4- Maintenance

A 66-year-old man is receiving radiation therapy and chemotherapy for the treatment of small cell lung cancer. The nurse has assessed him many times since he was admitted to the hospital. This morning, he admits that his greatest challenge he is currently facing is his overwhelming fatigue. How should the nurse respond to this patient's statement? 1- "Your fatigue is actually a sign that your body is redirecting its energies toward healing and away from more common functions like mobility." 2- "I'm sure you'll agree that fatigue, even when it's severe, is much preferable to pain. It's fortunate that your pain is now well-controlled." 3- "That must be incredibly difficult for you. How would you rate your fatigue if you had to give it a number from 1 to 10?" 4- "That's entirely normal, given what your body is going through and how much treatment you're currently getting."

A client admitted to the medical-surgical unit with a venous thromboembolism (VTE) is started on enoxaparin and warfarin. The client asks the nurse why two medications are needed. Which response by the nurse is accurate? 1- "Administration of two anticoagulants decreases the risk of recurrent venous thrombosis." 2- "Enoxaparin will dissolve the clot, and warfarin will prevent any more clots from occurring." 3- "The enoxaparin will work immediately, but the warfarin takes several days to achieve its full effect." 4- "Because of the potential for a pulmonary embolism, it is important for you to take at least two anticoagulants."

A client appears to be breathing faster than during the last assessment. Which of the following interventions should the nurse perform? 1- Inquire if there have been any stressful visitors. 2- Assist the client to lie down. 3- Count the rate of respirations. 4- Assess the radial pulse.

A client comes to the emergency department reporting chest pain. An electrocardiogram (ECG) reveals myocardial ischemia and an anterior-wall myocardial infarction (MI). Which ECG characteristic does the nurse expect to see? 1- Prolonged PR interval 2- Absent Q wave 3- Elevated ST segment 4- Widened QRS complex

A client diagnosed with cancer makes the following statement to the nurse: "I guess I will tell my health care provider to forego the chemotherapy. I do not want to be throwing up all the time. I would rather die." Which of the following facts supports the use of chemotherapy for this client? 1- Nausea and vomiting are only a factor for the first 24 hours after treatment. 2- Most clients believe the discomfort is well worth the cure for cancer. 3- Chemotherapy treatment can be adjusted to optimize effects while limiting adverse effects. 4- Clinical trials are opening up new cancer treatments all the time.

A client has been diagnosed with acquired immune deficiency syndrome (AIDS). Which statement correctly describes a secondary immune deficiency? 1- The normal protective immune response attacks the body, leading to tissue damage. 2- The body produces inappropriate or exaggerated responses to specific antigens. 3- An interference develops in an already developed immune system. 4- Immune cells or tissues experience an improper development.

A client has been diagnosed with an enlarged prostate. What information should the nurse explain to the client about the effects of an enlarged prostate? 1- Painful erection 2- Inability to defecate 3- Retention of urine 4- Lower sperm count

A client in a short-procedure unit is recovering from renal angiography in which a femoral puncture site was used. When providing postprocedure care, the nurse should: 1- keep the client's knee on the affected side bent for 6 hours. 2- apply pressure to the puncture site for 30 minutes. 3- check the client's pedal pulses frequently. 4- remove the dressing on the puncture site after vital signs stabilize.

A client is admitted to the health care center with abdominal pain, nausea, and vomiting. The medical reports indicate a history of type 1 diabetes. The nurse suspects the client's symptoms to be those of diabetic ketoacidosis (DKA). Which action will help the nurse confirm the diagnosis? 1- Assess the client's ability to take a deep breath 2- Assess the client's ability to move all extremities 3- Assess the client's breath odor 4- Assess for excessive sweating

A client is admitted to the hospital with possible acute pericarditis and pericardial effusion. The nurse knows to prepare the client for which diagnostic test to confirm the client's diagnosis? 1- Cardiac cauterization 2- Computed tomography 3- Echocardiography 4- Chest x-ray

A client is experiencing anorexia related to the adverse effects of cancer treatment. Using Maslow's hierarchy, the nurse identifies this as a reflection of which need? 1- Esteem and self-respect 2- Safety and security 3- Physiologic needs 4- Belongingness and affection

A client is hospitalized for open reduction of a fractured femur. During the postoperative assessment, the nurse notes that the client is restless and observes petechiae on the client's chest. Which nursing action is indicated first? 1- Elevate the affected extremity. 2- Contact the nursing supervisor. 3- Administer oxygen. 4- Contact the health care provider.

A client is ordered a nitroglycerine transdermal patch for treatment of CAD and asks the nurse why the patch is removed at bedtime. Which is the best response by the nurse? 1- "Nitroglycerine causes headaches, but removing the patch decreases the incidence." 2- "You do not need the effects of nitroglycerine while you sleep." 3- "Removing the patch at night prevents drug tolerance while keeping the benefits." 4- "Contact dermatitis and skin irritations are common when the patch remains on all day."

A client is receiving enoxaparin and warfarin therapy for a venous thromboembolism (VTE). Which laboratory value indicates that anticoagulation is adequate and enoxaparin can be discontinued? 1- Activated partial thromboplastin time (aPPT) is half of the control value 2- Prothrombin time (PT) is 0.5 times normal. 3- International normalized ratio (INR) is 2.5. 4- K+ level is 3.5.

A client is recovering from a fractured hip. What would the nurse suggest that the client increase intake of to facilitate calcium absorption from food and supplements? 1- Amino acids 2- Vitamin B6 3- Vitamin D 4- Dairy products

A client reporting heart palpitations is diagnosed with atrial fibrillation caused by mitral valve prolapse. To relieve the symptoms, the nurse should teach the client which dietary intervention? 1- Eliminate dairy products and carbonated beverages 2- Decrease the amount of sodium and saturated fat 3- Eliminate caffeine and alcohol 4- Decrease the amount of acidic beverages and fruits

A client reports urinary frequency, urgency, and dysuria. Which of the following would the nurse most likely suspect? 1- Obstruction of the lower urinary tract 2- Acute renal failure 3- Infection 4- Nephrotic syndrome

A client sustains an injury to the ligaments surrounding a joint. What will the nurse identify this injury as? 1- Strain 2- Contusion 3- Sprain 4- Fracture

A client undergoes renal angiography. Which postprocedure care intervention should the nurse provide to the client? 1- Encourage the client to void. 2- Monitor the client for signs and symptoms of pyelonephritis. 3- Palpate the pulses in the legs and feet. 4- Assess for signs of electrolyte and water imbalances.

A client was climbing a ladder, slipped on a rung, and fell on the right side of the chest. X-ray studies reveal three rib fractures, and the client reports pain with inspiration. What is the anticipated treatment for this client? 1- Chest strapping 2- Mechanical ventilation 3- Coughing and deep breathing with pillow splinting 4- Thoracentesis

A client who has sustained a fracture reports an increase in pain and decreased function of the affected extremity. What will the nurse suspect? 1- Infection 2- Pulmonary embolism 3- Avascular necrosis 4- Hypovolemic shock

A client with Stage IV prostate cancer is to receive hormone therapy. The nurse would inform the client about possible adverse effects including which of the following? 1- Increased libido 2- Deepening of voice 3- Breast tenderness 4- Enhanced potency

A client with a forceful, pounding heartbeat is diagnosed with mitral valve prolapse. Which client statement indicates to the nurse a need for additional teaching? 1- "I should increase my fluid intake." 2- "I'll enroll in an aerobic exercise program." 3- "I can still drink coffee and tea." 4- "I should eat foods rich in protein."

A client with a gastrojejunostomy is beginning to take solid food. Which finding would lead the nurse to suspect that the client is experiencing dumping syndrome? 1- Dry skin 2- Slowed heart beat 3- Diarrhea 4- Hyperglycemia

A client with a history of allergic rhinitis comes to the clinic for an evaluation. The client is prescribed triamcinolone. What will the nurse include when teaching the client about this drug? 1- Take the drug orally before, with, or after meals. 2- Use ice chips to alleviate the symptoms of dry mouth. 3- Be aware that some nasal burning and itching may occur. 4- Place the prescribed number of drops into the conjunctiva.

A client with a myocardial infarction develops acute mitral valve regurgitation. The nurse knows to assess for which manifestation that would indicate that the client is developing pulmonary congestion? 1- A loud, blowing murmur 2- Hypertension 3- Shortness of breath 4- Tachycardia

A client with chronic arterial occlusive disease undergoes percutaneous transluminal coronary angioplasty (PTCA) for mechanical dilation of the right femoral artery. After the procedure, the client will be prescribed long-term administration of which drug? 1- aspirin or acetaminophen. 2- pentoxifylline or acetaminophen. 3- aspirin or clopidogrel. 4- penicillin V or erythromycin.

A client with chronic bronchitis is admitted to the health facility. Auscultation of the lungs reveals low-pitched, rumbling sounds. Which of the following describes these sounds? 1- Crackles 2- Pleural friction rub 3- Rhonchi 4- Bronchial

A client with diabetes mellitus develops sinusitis and otitis media accompanied by a temperature of 100.8° F (38.2° C). What effect do these findings have on his need for insulin? 1- They have no effect. 2- They decrease the need for insulin. 3- They increase the need for insulin. 4- They cause wide fluctuations in the need for insulin.

A community health nurse is organizing community training on healthy behavior change. Which action will the nurse focus on when using the transtheoretical model of change as guidance for the teaching? 1- Resources of health 2- Determinants of health 3- Motivation of individuals 4- Reasons for choosing healthy behaviors

A home care nurse visits a client diagnosed with atrial fibrillation who is ordered warfarin. The nurse teaches the client about warfarin therapy. Which statement by the client indicates the need for further teaching? 1- "I'll watch my gums for bleeding when I brush my teeth." 2- "I'll use an electric razor to shave." 3- "I'll eat four servings of fresh, dark green vegetables every day." 4- "I'll report unexplained or severe bruising to my doctor right away."

A hospitalized client reports right lower quadrant abdominal pain at a level of 8 on a 0 to 10 scale. The client is scheduled for an appendectomy. The nurse is teaching the client about use of the incentive spirometer postoperatively verbally and by demonstration. The client is on his side, clutching his abdomen. Learning is not occurring. The nurse has primarily failed to consider the client's 1- Emotional readiness 2- Learning environment 3- Physical readiness 4- Experiential readiness

A nurse is analyzing her patient's ABG values. Which result is inconsistent with the diagnosis of respiratory acidosis? 1- pH 7.3 2- PaCO2 50 3- Hyperventilation (PaCO2 25) 4- Hypoventilation (PaCO2 60)

A nurse is assigned to care for a patient with COPD. The doctor has ordered oxygen at 6 L/min. Which of the following does the nurse need to obtain to give the O2? 1- Partial rebreather mask 2- Non-rebreather mask 3- Venturi mask 4- Face tent

A nurse is caring for a client admitted with a diagnosis of exacerbation of myasthenia gravis. Upon assessment of the client, the nurse notes the client has severely depressed respirations. The nurse would expect to identify which acid-base disturbance? 1- Metabolic acidosis 2- Metabol 3- Respiratory acidosis 4- Respiratory alkalosisic alkalosis

aortic stenosis

narrowing of the valve opening between the LV and the aorta, resulting in obstruction of blood flow across the valve.

A nurse is caring for a client who is recovering from a myocardial infarction (MI). The cardiologist refers the client to cardiac rehabilitation. Which statement by the client indicates an understanding of cardiac rehabilitation? 1- "When I finish the rehabilitation program I'll never have to worry about heart trouble again." 2- "I won't be able to jog again even with rehabilitation." 3- "Rehabilitation will help me function as well as I physically can." 4- "I'll get rest during these rehabilitation classes. All I have to do is sit and listen to the instructor."

A nurse is reviewing the laboratory test results of a client with renal disease. Which of the following would the nurse expect to find? 1- Decreased blood urea nitrogen (BUN) 2- Increased serum albumin 3- Increased serum creatinine 4- Decreased potassium

A nurse is teaching a client who receives nitrates for the relief of chest pain. Which instruction should the nurse emphasize? 1- Repeat the dose of sublingual nitroglycerin every 15 minutes for three doses. 2- Store the drug in a cool, well-lit place. 3- Lie down or sit in a chair for 5 to 10 minutes after taking the drug. 4- Restrict alcohol intake to two drinks per day.

A nurse practitioner is teaching a woman how to do a BSE. While inspecting the breasts, the nurse notes this abnormal sign. Which of the following is considered an abnormal sign? 1- Unevenness in size 2- Asymmetry 3- Dimpling or retraction 4- Nipple inversion that has been present for >10 years.

A nurse suspects that a client with a recent fracture has compartment syndrome. Assessment findings may include: 1- body-wide decrease in bone mass. 2- a growth in and around the bone tissue. 3- inability to perform active movement and pain with passive movement. 4- inability to perform passive movement and pain with active movement.

A nurse understands that a major concern with type 2 diabetes is: 1- Older age (> 60 years). 2- Obesity (>20% of IBW). 3- Insulin resistance. 4- Overactive insulin secretion.

A nurse who provides care in a busy postsurgical unit recognizes that patients are at particular risk of thromboembolism during their immediate postoperative recovery. Which of the following interventions best facilitates venous blood flow and the prevention of thrombosis? 1- Correct application of compression stockings 2- Use of intermittent pneumatic compression devices 3- Early ambulation 4- Prophylactic warfarin (Coumadin)

A patient in the cardiac PACU was just extubated, 5 hours after the conclusion of a coronary artery bypass graft (CABG). How can the patient's nurse best promote adequate gas exchange for this patient? 1- Apply continuous positive airway pressure (CPAP) as ordered. 2- Perform deep suctioning q1h. 3- Reposition the patient frequently. 4- Administer nebulized bronchodilators and corticosteroids as ordered.

A patient in the recovery room after cardiac surgery begins to have extremity paresthesia, peaked T waves, and mental confusion. What type of electrolyte imbalance does the nurse suspect this patient is having? 1- Calcium 2- Magnesium 3- Potassium 4- Sodium

A patient is diagnosed with hypoxemic hypoxia. The nurse knows that the etiology directs medical and nursing interventions. Which of the following is the cause? 1- Inadequate capillary circulation 2- Decreased effective hemoglobin concentration 3- Decreased oxygen diffusion into the tissues 4- Inability of tissues to use available oxygen due to a toxic substance

A patient is recovering in the PACU following a transurethral resection of the prostate (TURP). The patient is receiving continuous bladder irrigation (CBI), and the nurse has observed several clots in the collection bag and tubing. In the last few minutes, output has ceased despite the continued infusion of normal saline through the patient's triple-lumen urinary catheter. How should the nurse respond to this assessment finding? 1- Slow the rate of CBI to half of the previous rate. 2- Reposition the patient to a semi-Fowler's position. 3- Manually irrigate the patient's catheter with normal saline. 4- Remove the triple-lumen catheter and replace it with a double-lumen catheter.

A patient was seen in the clinic 3 days previously for allergic rhinitis and was given a prescription for a corticosteroid nasal spray. The patient calls the clinic and tells the nurse that the nasal spray is not working. What is the best response by the nurse? 1- "You need to come back to the clinic to get a different medication since this one is not working for you." 2- "You may be immune to the effects of this medication and will need something else in its place." 3- "The full benefit of the medication may take up to 2 weeks to be achieved." 4- "I am sorry that you are feeling poorly but this is the only medication that will work for your problem."

A patient with End Stage Kidney Disease is taking recombinant erythropoietin for the treatment of anemia. What laboratory study does the nurse understand will have to be assessed at least monthly related to this medication? 1- Potassium level 2- Creatinine level 3- Hemoglobin level 4- Folate levels

A patient with coronary artery disease (CAD) is having a cardiac catheterization. What indicator is present for the patient to have a coronary artery bypass graft (CABG)? 1- The patient has compromised left ventricular function. 2- The patient has had angina longer than 3 years. 3- The patient has at least a 70% occlusion of a major coronary artery. 4- The patient has an ejection fraction of 65%.

A patient with diabetes insipidus presents to the emergency room for treatment of dehydration. The nurse knows to review serum laboratory results for which of the diagnostic indicators? 1- Sodium level of 137 mEq/L 2- Potassium level of 3.8 mEq/L 3- Sodium level of 150 mEq/L 4- Potassium level of 6 mEq/L

A patient with mitral stenosis exhibits symptoms of a dysrhythmia. Based on the pathophysiology of this disease process, the nurse would expect the patient to exhibit what heart rhythm? 1- Normal sinus rhythm 2- Supraventricular tachycardia 3- Atrial fibrillation 4- Electromechanical dissociation

A physician admits a client to the health care facility for treatment of an abdominal aortic aneurysm. When planning this client's care, which goal should the nurse keep in mind as she formulates interventions? 1- Decreasing blood pressure and increasing mobility 2- Increasing blood pressure and reducing mobility 3- Stabilizing heart rate and blood pressure and easing anxiety 4- Increasing blood pressure and monitoring fluid intake and output

After cancer chemotherapy, a client experiences nausea and vomiting. The nurse should assign highest priority to which intervention? 1- Serving small portions of bland food 2- Encouraging rhythmic breathing exercises 3- Administering metoclopramide and dexamethasone as ordered 4- Withholding fluids for the first 4 to 6 hours after chemotherapy administration

An important nursing assessment, post fracture, is to evaluate neurovascular status. Therefore, the nurse should check for: 1- Crepitus. 2- Shortening and deformity. 3- Capillary refill. 4- Swelling and discoloration.

An individual's exposure to an airborne pathogen has prompted an immune response that includes both cellular and humoral components. Which of the following activities is most closely associated with the humoral immune response? 1- T cells directly attack the foreign pathogen. 2- A circulating lymphocyte containing an antigenic message returns to the nearest lymph node. 3- B lymphocytes produce antibodies that are specific to the pathogen. 4- Granulocytes and macrophages engulf and destroy the invading agents.

An occupational nurse is working with patients at a construction site. According to Maslow's Hierarchy of Needs, what dimension of care should the nurse make the highest priority in working with these clients? 1- Spiritual 2- Esteem 3- Physiologic 4- Safety

An oncology nurse is caring for a client who relates that certain tastes have changed. The client states that "meat tastes bad." What nursing intervention can be used to increase protein intake for a client with taste changes? 1- Stay away from protein beverages. 2- Encourage maximum fluid intake. 3- Encourage eating cheese, eggs, and legumes 4- Suck on hard candy during treatment.

Based on Maslow's hierarchy of needs, when prioritizing a patient's plan of care, what would be the nurse's first priority? 1- Allowing the family to see a newly admitted patient 2- Ambulating the patient in the hallway 3- Administering pain medication 4- Teaching the patient to self-administer insulin

Before seeing a newly assigned client with respiratory alkalosis, a nurse quickly reviews the client's medical history. Which condition is a predisposing factor for respiratory alkalosis? 1- Myasthenia gravis 2- Type 1 diabetes mellitus 3- Extreme anxiety 4- Opioid overdose

Collaborative practice has been identified as a model of care that maximizes patient outcomes. A nurse can best implement the principles of collaborative practice by: 1- Ensuring that decisions around patient care are discussed in detail with other nurses 2- Consulting the nursing literature when choosing assessments, making diagnoses, and performing interventions 3- Adopting an attitude of "teachability" when planning and performing patient care 4- Making decisions around patient care in consultation with members of other health disciplines

During a follow-up visit 3 months after a new diagnosis of type 2 diabetes, a client reports exercising and following a reduced-calorie diet. Assessment reveals that the client has only lost 1 pound and did not bring the glucose-monitoring record. Which value should the nurse measure? 1- Fasting blood glucose level 2- Glucose via a urine dipstick test 3- Glycosylated hemoglobin level 4- Glucose via an oral glucose tolerance test

During an internal vaginal examination, the nurse practitioner notes a frothy and malodorous discharge. The nurse suspects the odor is caused by which bacteria? 1- Candida 2- Pseudomonas 3- Trichomonas 4- Escherichia coli

Economics have dictated many significant changes in the health care delivery system. What is one major effect that economic factors have had on the patient population? 1- Patients are in the hospital for a longer period of time. 2- Patients have access to greater technology at lower costs. 3- Patients with high home-care needs are being discharged into the community. 4- Patient use of ambulatory care has decreased.

Health education is important for all patients and families. Of the four groups listed below, which group is most in need of health teaching? 1- Patients under 21 years of age, because new behaviors can be practiced for many years 2- Patients who are diagnosed with acute infections, because treatment and future prevention can be immediately addressed 3- Patients with chronic illnesses, because life-long interventions and adjustments can improve the quality of life 4- Patients with a terminal illness, because the process of dying can be managed with dignity

Heparin therapy is usually considered therapeutic when the client's activated partial thromboplastin time (aPTT) is how many times normal? 1- .25 to .75 2- .75 to 1.5 3- 2.0 to 2.5 4- 2.5 to 3.0

In preparation for transesophageal echocardiography (TEE), the nurse must: 1- Instruct the patient to drink 1 L of water before the test 2- Heavily sedate the patient 3- Inform the patient that blood pressure (BP) and electrocardiogram (ECG) monitoring will occur throughout the test 4- Inform the patient that an access line will be initiated in the femoral artery

It is important for a nurse to understand cardiac hemodynamics. For blood to flow from the right ventricle to the pulmonary artery, the following must occur: 1- The atrioventricular valves must open. 2- The pulmonic valve must be closed. 3- Right ventricular pressure must be higher than pulmonary arterial pressure. 4- Right ventricular pressure must decrease with systole.

Laboratory studies indicate a client's blood glucose level is 185 mg/dl. Two hours have passed since the client ate breakfast. Which test would yield the most conclusive diagnostic information about the client's glucose use? 1- Fasting blood glucose test 2- 6-hour glucose tolerance test 3- Serum glycosylated hemoglobin (Hb A1c) 4- Urine ketones

Lung compliance (the ability of the lungs to stretch) is a physical factor that affects ventilation. A nurse is aware that a patient who has lost elasticity in the lung tissue has a condition known as: 1- Atelectasis 2- Pulmonary edema 3- Emphysema 4- Pleural effusion

Nurses should consider their own cultural orientation when interacting with patients. Which of the following is a technique that can be used to overcome a language barrier when interacting with a patient? 1- Talk loudly so that the patient will understand. 2- Give the patient a substantial amount of information. 3- Give instructions in proper sequence. 4- Talk directly to the person that accompanied the patient.

Nursing students are reviewing the roles that a nurse may assume. The students demonstrate understanding of the information when they identify which of the following as characteristic of the research role? 1- Achieving patient outcomes through direct intervention 2- Assuming responsibility for unlicensed assistive personnel 3- Replicating findings to further the science of nursing 4- Promoting health through screening and early detection

On auscultation, the nurse suspects a diagnosis of mitral valve stenosis when which of the following is heard? 1- Mitral valve click 2- High-pitched blowing sound at the apex 3- Low-pitched, rumbling diastolic murmur at the apex of the heart 4- Diastolic murmur at the left sternal border of the heart

Parathormone regulates the concentration of calcium in the blood by: 1- Stimulating osteoblastic activity. 2- Stimulating the liver to produce an insulin-like growth factor. 3- Promoting the movement of calcium from the bone. 4- Increasing the release of thyroid hormones.

Radiographic evaluation of a client's fracture reveals that a bone fragment has been driven into another bone fragment. The nurse identifies this as which type of fracture? 1- Comminuted 2- Compression 3- Impacted 4- Greenstick

Rebound hypoglycemia is a complication of parenteral nutrition caused by 1- glucose intolerance. 2- fluid infusing rapidly. 3- feedings stopped too abruptly. 4- a cap missing from the port.

Severe chest pain is reported by a client during an acute myocardial infarction. Which of the following is the most appropriate drug for the nurse to administer? 1- Isosorbide mononitrate (Isordil) 2- Meperidine hydrochloride (Demerol) 3- Morphine sulfate (Morphine) 4- Nitroglycerin transdermal patch

The client is being prepared for echocardiography when he asks the nurse why he needs to have this test. What would be the nurse's best response? 1- "This test will find any congenital heart defects." 2- "This test can tell us a lot about your heart." 3- "Echocardiography is a way of determining the functioning of the left ventricle of your heart." 4- "Echocardiography will tell your doctor if you have cancer of the heart."

The definition of nursing has evolved over time since Florence Nightingale first attempted, in 1859, to explain nursing's scope of practice. In 2003, the American Nurses' Association, in its Social Policy Statement, included which of the following activities as a significant role of nursing? 1- Modifying a medical plan of care to include nursing activities 2- Diagnosing chronic illness in the elderly 3- Identifying human responses to illness 4- Diagnosing acute illnesses in children

The hospital is having a problem with healthcare-associated infections. A committee has been established to study the problem and make recommendations. The nurse working on the committee knows that this work addresses what? 1- Inpatient quality indicators 2- Prevention quality indicators 3- National Patient Safety Goals 4- Patient safety indicators

The human body is designed to protect its vital parts. The nurse is aware that a fracture of what type of bone may interfere with the protection of vital organs? 1- Long bones 2- Short bones 3- Flat bones 4- Irregular bones

The nurse assesses soft subcutaneous nodules along the line of the tendons in a patient's hand and wrist. What does this finding indicate to the nurse? 1- The patient has osteoarthritis. 2- The patient has lupus erythematosus. 3- The patient has rheumatoid arthritis. 4- The patient has neurofibromatosis.

The nurse at the clinic explains to the patient that the surgeon will be removing a mole on the patient's back that has the potential to develop into cancer. The nurse informs the patient that this is what type of procedure? 1- Diagnostic 2- Palliative 3- Prophylactic 4- Reconstructive

The nurse attempts to unclog a client's feeding tube. Attempts with warm water agitation and milking the tube are unsuccessful. The nurse uses evidence-based practice principles when subsequently using which technqiue to unclog the tube? 1- digestive enzymes and sodium bicarbonate 2- cola mixed with cranberry juice 3- sodium bicarbonate mixed with water 4- meat tenderizer diluted with saline

The nurse is auscultating the heart sounds of a patient with mitral stenosis. The pulse rhythm is weak and irregular. What rhythm does the nurse expect to see on the electrocardiogram (ECG)? 1- First-degree atrioventricular block 2- Ventricular tachycardia 3- Atrial fibrillation 4- Sinus dysrhythmia

The nurse is caring for a client with a history of sickle cell anemia. The nurse understands that this predisposes the client to which renal or urologic disorder? 1- Kidney stone formation 2- Proteinuria 3- Chronic kidney disease 4- Neurogenic bladder

The nurse is caring for a client with multiple organ failure and in metabolic acidosis. Which pair of organs is responsible for regulatory processes and compensation? 1- Kidney and liver 2- Heart and lungs 3- Lungs and kidney 4- Pancreas and stomach

The nurse is caring for a patient admitted with unstable angina. The laboratory results reveal that the initial troponin I level is elevated in this patient. What conclusion should the nurse draw from this fact? 1- This is only an accurate indicator of myocardial damage when it reaches its peak in 24 hours. 2- Because the entry diagnosis is unstable angina, this is a poor indicator of myocardial injury. 3- This is an accurate indicator of myocardial injury. 4- It is only an accurate indicator of skeletal muscle injury.

The nurse is caring for an elderly client with left-sided heart failure. When auscultating lung sounds, which adventitious sound is expected? 1- Wheezes 2- Rhonchi 3- Crackles 4- Coarseness

The nurse is conducting discharge teaching for a client with diverticulosis. Which instruction should the nurse include in the teaching? 1- Avoid unprocessed bran. 2- Avoid daily exercise. 3- Drink 8 to 10 glasses of fluid daily. 4- Use laxatives weekly.

The nurse is giving an educational event to a local men's group about prostate cancer. What nationality should you be sure to tell the attendees of this event should receive information regarding the predisposition of prostate cancer? 1- Native Americans 2- Caucasians 3- African Americans 4- Asian Americans

The nurse is performing an assessment on a patient with acute myeloid leukemia (AML) and observes multiple areas of ecchymosis and petechiae. What laboratory study should the nurse be concerned about? 1- WBC count of 4,200 cells/mcL 2- Hematocrit of 38% 3- Platelet count of 9,000/mm3 4- Creatinine level of 1.0 mg/dL

The nurse is performing chest auscultation for a patient with asthma. How does the nurse describe the high-pitched, sibilant, musical sounds that are heard? 1- Rales 2- Crackles 3- Wheezes 4- Rhonchi

The nurse is preparing discharge teaching for a patient diagnosed with urinary retention secondary to multiple sclerosis. The nurse will teach the patient to self-catheterize at home upon discharge. What teaching method is most effective for this patient? 1- Providing the most up-to-date information available 2- Alleviating the patient's guilt associated with not knowing appropriate self-care 3- Determining the patient's readiness to learn new information 4- Building on previous information

The nurse is providing care for a patient in the hospital scheduled for discharge in the morning. The patient will require further services after discharge since recovery is not complete. What can the nurse do to ensure quality care delivery for this patient? 1- Inform the family members that someone will have to stay with the patient after discharge. 2- Inform the physician that the patient is not ready to go home yet. 3- Contact the case manager for coordination of care prior to discharge of the patient. 4- Call social services to check on the patient after discharge.

The nurse is teaching a client about self-administration of insulin and about mixing regular and neutral protamine Hagedorn (NPH) insulin. Which information is important to include in the teaching plan? 1- If two different types of insulin are ordered, they need to be given in separate injections. 2- When mixing insulin, the NPH insulin is drawn up into the syringe first. 3- When mixing insulin, the regular insulin is drawn up into the syringe first. 4- There is no need to inject air into the bottle of insulin before withdrawing the insulin.

The nurse reviews laboratory tests for cardiac biomarkers for a client suspected of suffering an MI. What is the earliest marker of an MI? 1- Creatinine kinase-myocardial band (CK-MB) 2- Total creatinine kinase (CK) 3- Myoglobin 4- Troponin I and T

The nursing instructor has given an assignment to a group of nurse practitioner students. They are to break into groups of four and complete a health-promotion teaching project and present a report back to their fellow students. What project is the best example of health-promotion teaching? 1- Demonstrating an injection technique to a patient for anticoagulant therapy 2- Explaining the side effects of a medication to an adult patient 3- Discussing the importance of preventing sexually transmitted infections (STIs) to a group of 12th-grade students 4- Instructing an adolescent patient about safe food preparation

The oncology nurse is giving chemotherapy to a client in a short stay area. The client confides that they are very depressed. The nurse recognizes depression as which of the following? 1- A psychiatric diagnosis everyone has at one time or another. 2- A side effect of the neoplastic drugs. 3- A normal reaction to the diagnosis of cancer. 4- An aberrant psychologic reaction to the chemotherapy.

The past century has seen a dramatic shift in disease patterns, which is generally considered to be a move from the predominance of infectious disease to that of chronic illness. This shift has been most clearly demonstrated by the recent patterns of incidence and prevalence of what disease? 1- Osteoporosis 2- Chronic renal failure (CRF) 3- Diabetes mellitus 4- Chronic obstructive pulmonary disease (COPD)

The patient has a heart rate of 72 bpm with a regular rhythm. Where does the nurse determine the impulse arises from? 1- The AV node 2- The Purkinje fibers 3- The sinoatrial node 4- The ventricles

The process of health education closely parallels the nursing process with its discrete phases of assessment, diagnosis, planning, implementation, and evaluation. What activity would the nurse perform during the planning phase of health education? 1- Determining the patient's current knowledge level and willingness to learn 2- Identifying the patient's learning needs 3- Documenting the goals of the health education 4- Demonstrating a necessary technique for the patient

Total parenteral nutrition (TPN) has been ordered for a male patient who has been experiencing a severe and protracted exacerbation of Crohn's disease. Before TPN can be initiated, the patient requires: 1- A random blood glucose level of ≤160 mg/dL 2- Angiography to determine the patency of his vascular system 3- The insertion of a central venous access device 4- A fluid challenge to assess his renal function

What finding by the nurse may indicate that the client has chronic hypoxia? 1- Crackles 2- Peripheral edema 3- Clubbing of the fingers 4- Cyanosis

When assessing a female client's vagina, the nurse notes copious amounts of a frothy, foul-smelling, yellow-green discharge. The nurse suspects which condition? 1- bacterial vaginosis 2- Candida infection 3- Trichomonas infection 4- atrophic vaginitis

Which area of the heart is located at the third intercostal (IC) space to the left of the sternum? 1- aortic area 2- pulmonic area 3- erb point 4- epigastric area

Which client requires immediate nursing intervention? The client who: 1- complains of epigastric pain after eating. 2- complains of anorexia and periumbilical pain. 3- presents with a rigid, boardlike abdomen. 4- presents with ribbonlike stools.

Which discharge instruction for self-care should the nurse provide to a client who has undergone a percutaneous transluminal coronary angioplasty (PTCA) procedure? 1- Cleanse the site with disinfectants and dress the wound appropriately 2- Refrain from sexual activity for 1 month 3- Monitor the site for bleeding or hematoma. 4- Normal activities of daily living can be resumed the first day after surgery

Which electrolyte is a major cation in body fluid? 1- Chloride 2- Bicarbonate 3- Potassium 4- Phosphate

Which factor inhibits fracture healing? 1- Vitamin D 2- Exercise 3- Local malignancy 4- Maximum bone fragment contact

Which is an element of nursing as defined by the American Nurses Association? 1- Putting the patient in the best condition for nature to act upon him or her 2- Helping people to carry out activities contributing to health, recovery, or a peaceful death 3- Alleviating suffering by diagnosing and treating human responses to health problems 4- Discussing what nurses would do for themselves if they had the necessary strength, will, or knowledge

Which is useful in identifying acute or chronic tears of the joint capsule or supporting ligaments of the knee, shoulder, ankle, hip, or wrist? 1- Meniscography 2- Bone densitometry 3- Arthrography 4- EMG

Which nursing diagnosis takes highest priority for a client with a compound fracture? 1- Imbalanced nutrition: Less than body requirements related to immobility 2- Impaired physical mobility related to trauma 3- Risk for infection related to effects of trauma 4- Activity intolerance related to weight-bearing limitations

Which nursing intervention is essential in caring for a client with compartment syndrome? 1- Keeping the affected extremity below the level of the heart 2- Wrapping the affected extremity with a compression dressing to help decrease the swelling 3- Removing all external sources of pressure, such as clothing and jewelry 4- Starting an I.V. line in the affected extremity in anticipation of venogram studies

Which statement by the nurse shows an understanding of the focus of the quality assurance programs developed in the 1980s? 1- "The quality assurance programs focus on individual incidents or errors and minimal expectations." 2- "The quality assurance programs focus on decreasing the cost of health care for the consumer." 3- "The quality assurance programs focus on processes used to provide care and improving those processes." 4- "The quality assurance programs focus on coordinating care for patients."

Which statement is accurate regarding sildenafil? 1- It can be taken twice daily for increased effect. 2- The medication should be taken right before intercourse. 3- Its side effects include headache, flushing, and dizziness. 4- Sexual stimulation is not needed to produce an erection.

Which symptom occurs in the client diagnosed with mitral regurgitation when pulmonary congestion occurs? 1- A loud, blowing murmur 2- Hypertension 3- Shortness of breath 4- Tachycardia

Which term describes the splitting or separating of fused cardiac valve leaflets? 1- Annuloplasty 2- Chordoplasty 3- Commissurotomy 4- Valvuloplasty

Which term refers to the failure of fragments of a fractured bone to heal together? 1- Dislocation 2- Subluxation 3- Nonunion 4- Malunion

Which valve lies between the right ventricle and the pulmonary artery? 1- Tricuspid valve 2- Mitral valve 3- Pulmonic valve 4- Chordae tendineae

While assessing for tactile fremitus, the nurse palpates almost no vibration. Which of the following conditions in this client's history will account for this finding? 1- Pneumonia 2- Funnel chest 3- Emphysema 4- Pigeon chest

While assessing the patient, the nurse observes constant bubbling in the water-seal chamber of a closed chest drainage system. What should the nurse conclude? 1- The system is functioning normally. 2- The patient has a pneumothorax. 3- The system has an air leak. 4- The chest tube is obstructed.

Your client's lab values are sodium 166 mEq/L, potassium 5.0 mEq/L, chloride 115 mEq/L, and bicarbonate 35 mEq/L. What condition is this client likely to have, judging by anion gap? 1- Metabolic acidosis 2- Respiratory alkalosis 3- Metabolic alkalosis 4- Respiratory acidosis

The nurse is documenting the results of a pelvic examination on a client's medical record. Which of the following would alert the nurse to the need for additional follow up? 1- Cervix uniformly firm on palpation 2- Uterus tipped toward abdominal wall 3- Ovaries slightly tender on palpation 4- Positive cervical motion tenderness

A client has the following arterial blood gas (ABG) values: pH, 7.12; partial pressure of arterial carbon dioxide (PaCO2), 40 mm Hg; and bicarbonate (HCO3-), 15 mEq/L. These ABG values suggest which disorder? 1- Respiratory alkalosis 2- Respiratory acidosis 3- Metabolic alkalosis 4- Metabolic acidosis

A client with multiple sclerosis is learning to perform intermittent self-catherizations of the urinary bladder. The nurse obtains the following equipment for teaching. Select all that apply. 1- Forceps 2- Syringe with sterile water 3- Anatomically correct model 4- 16-French catheters 5- Foley bag

3,4

A client hospitalized for 10 days with subacute infective endocarditis is afebrile and has no signs of heart damage. Discharge with outpatient antibiotic therapy for 2 to 6 weeks is anticipated. During discharge planning with the client, what is most important for the nurse to review? 1- Plan how needs will be met while the client continues on bed rest. 2- Teach the client to avoid crowds and exposure to upper respiratory infections. 3- Encourage use of diversional activities to relieve boredom and restlessness. 4- Assess the client's home environment in terms of family assistance and adequacy.

A 22-year-old college basketball player is undergoing diagnostic testing following a knee injury, and his primary care provider has ordered arthrography. What teaching should the nurse provide in preparation for this procedure? 1- "A computer will create a three-dimensional image of your knee based on magnetic readings." 2- "You'll be given some anesthetic and then several tissue samples will be taken from your knee joint." 3- "You'll be given a small dose of radioactive solution, and the doctor will observe its distribution in your knee." 4- "The doctor will inject some contrast solution into your joint and take a series of X-rays."

A 22-year-old man with a diagnosis of schizophrenia has been transferred from the psychiatric unit to the medical unit after drinking 5 liters of water over the past hour. Assessment reveals that the patient is oriented to person but not to time or place and that he is drowsy but rousable by touch. When reviewing this patient's most recent blood work, the nurse should pay particular attention to the patient's levels of: 1- Phosphate 2- Calcium 3- Blood urea nitrogen (BUN) 4- Sodium

A 30-year-old type 1 diabetic has been admitted to the critical care unit with a diagnosis of diabetic ketoacidosis following a drinking binge over the course of a weekend. The nurse should anticipate that this patient will require what immediate intervention? 1- IV administration of calcium gluconate 2- Subcutaneous administration of 30 units of insulin glargine (Lantus) 3- Oral administration of 2 g of metformin (Glucophage) 4- Rapid administration of intravenous normal saline

A 34-year-old client is diagnosed with chronic hepatitis C. Testing reveals that the client is a candidate for treatment. The nurse anticipates that which therapy could be used to treat the client's condition? 1- Erythropoietin 2- Interleukin-5 3- Monoclonal antibodies 4- Interferon

A 44-year-old man has come to the clinic with an asthma exacerbation. He tells the nurse that his father and brother also suffer from asthma, as does his 15-year-old son. The nurse explains that this is an allergic response based on a genetic predisposition. The specific allergen initiated by this immunological mechanism is usually mediated by: 1- Immunoglobulin A 2- Immunoglobulin M 3- Immunoglobulin G 4- Immunoglobulin E

A 70-year-old man has been diagnosed with angina pectoris and subsequently prescribed nitroglycerin spray to be used sublingually when he experiences chest pain. This drug will achieve relief of the patient's chest pain by: 1- Blocking sympathetic stimulation of the heart and reducing oxygen demand 2- Increasing contractility and consequent cardiac output 3- Blocking the a-delta pain fibers in the myocardium 4- Dilating the blood vessels and reducing preload

A Jewish patient, who adheres to the dietary laws of his faith, is in traction and confined to bed. He needs assistance with his evening meal of chicken, rice, beans, a roll, and a carton of milk. Choose the nursing approach that is most representative of promoting wellness. The nurse: 1- Removes items from the over-bed table, sets up the dinner tray, and leaves the patient so he can enjoy time with his family. 2- Pushes the over-bed table toward the bed so that it will be within the patient's reach when the dinner tray arrives. 3- Asks a family member to assist the patient with the tray and the over-bed table while the nurse straightens the surrounding area in an attempt to provide a pleasant atmosphere for eating. 4- Prepares the environment and the over-bed table and inspects the contents of the dinner tray. The nurse asks the patient whether he would like to make any substitutions in the foods and fluids he has received.

A client admitted with acute anxiety has the following arterial blood gas (ABG) values: pH, 7.55; partial pressure of arterial oxygen (PaO2), 90 mm Hg; partial pressure of arterial carbon dioxide (PaCO2), 27 mm Hg; and bicarbonate (HCO3-), 24 mEq/L. Based on these values, the nurse suspects: 1- metabolic acidosis. 2- metabolic alkalosis. 3- respiratory acidosis. 4- respiratory alkalosis.

A client arrives at the orthopedic physician's office stating knee pain sustained while playing soccer. A history and physical assessment is completed. The knee appears reddened with edema. Which other diagnostic testing would the nurse anticipate? 1- A bone densitometry 2- A bone scan 3- An arthrocentesis 4- An arthroscopy

A client has been diagnosed with an intestinal obstruction and has a nasogastric tube set to low continuous suction. Which acid-base disturbance is this client at risk for developing? 1- Respiratory acidosis 2- Respiratory alkalosis 3- Metabolic acidosis 4- Metabolic alkalosis

A client in the emergency department reports squeezing substernal pain that radiates to the left shoulder and jaw. The client also complains of nausea, diaphoresis, and shortness of breath. What is the nurse's priority action? 1- Complete the client's registration information, perform an electrocardiogram, gain I.V. access, and take vital signs. 2- Alert the cardiac catheterization team, administer oxygen, attach a cardiac monitor, and notify the health care provider. 3- Gain I.V. access, give sublingual nitroglycerin, and alert the cardiac catheterization team. 4- Administer oxygen, attach a cardiac monitor, take vital signs, and administer sublingual nitroglycerin.

A client is diagnosed with deep vein thrombosis (DVT). Which nursing diagnosis should receive highest priority at this time? 1- Impaired gas exchange related to increased blood flow 2- Excess fluid volume related to peripheral vascular disease 3- Risk for injury related to edema 4- Ineffective peripheral tissue perfusion related to venous congestion

A client is diagnosed with hypertension. The client also reports skin discoloration, weight gain, and nausea. Which contraceptive preparations would the nurse practitioner recommend for this client? 1- Monophasic 2- Biphasic 3- Triphasic 4- Progestin-only

A client is having prostate-specific antigen (PSA) testing done. Which result would the nurse identify as abnormal? 1- 2.7 nanograms/milliliter 2- 3.2 nanograms/milliliter 3- 3.8 nanograms/milliliter 4- 4.6 nanograms/milliliter

A client is scheduled for a transurethral rescection of the prostate (TURP). Which statement demonstrates that the expected outcome of "client demonstrates understanding of the surgical procedure and aftercare" has been met? 1- "I'll have to stay in the hospital for about 3 to 4 days after the surgery." 2- "I'll have a small incision on my lower abdomen after the procedure." 3- "The surgeon is going to remove the entire prostate gland." 4- "The surgeon is going to insert a scope through my urethra to remove a portion of the gland."

A client is undergoing a diagnostic workup for suspected testicular cancer. When obtaining the client's history, the nurse checks for known risk factors for this type of cancer. Testicular cancer has been linked to: 1- testosterone therapy during childhood. 2- sexually transmitted disease. 3- early onset of puberty. 4- cryptorchidism.

A client who had a prosthetic valve replacement was taking warfarin to reduce the risk of postoperative thrombosis. The client visited the nurse at a clinic once a week. What INR level would alert the nurse to notify the health care provider? 1- 2.6 2- 3.0 3- 3.4 4- 3.8

A client who is being treated for AML has bruises on both legs. What is the nurse's mostappropriate action? 1- Ask the client whether they have recently fallen. 2- Evaluate the client's INR. 3- Keep the client on bed rest. 4- Evaluate the client's platelet count.

A client who is undergoing chemotherapy for AML reports pain in the low back. What is the nurse's first action? 1- Refer the client to a chiropractor. 2- Place heating pads on the client's back. 3- Administer pain medication, as ordered. 4- Assess renal function.

A client with a tentative diagnosis of hyperosmolar hyperglycemic nonketotic syndrome (HHNS) has a history of type 2 diabetes that is being controlled with an oral diabetic agent, tolazamide. Which laboratory test is the most important for confirming this disorder? 1- Serum potassium level 2- Serum sodium level 3- Arterial blood gas (ABG) values 4- Serum osmolarity

A client with chronic renal failure has a serum potassium level of 6.8 mEq/L. What should the nurse assess first? 1- Blood pressure 2- Respirations 3- Temperature 4- Pulse

A client with metastatic bone cancer sustained a left hip fracture without injury. What type of fracture does the nurse understand occurs without trauma or fall? 1- Impacted fracture 2- Transverse fracture 3- Compound fracture 4- Pathologic fracture

A client with suspected multiple myeloma is reporting back pain. What is the priority nursing action? 1- Have the client lie on a hard surface. 2- Have the client rest. 3- Encourage ambulation. 4- Send the client for a spinal x-ray study.

A client with type 1 diabetes mellitus is being taught about self-injection of insulin. Which fact about site rotation should the nurse include in the teaching? 1- Avoid the abdomen because absorption there is irregular. 2- Choose a different site at random for each injection. 3- Rotate sites from area to area every other day. 4- Use all available injection sites within one area.

A geriatric nurse is performing an assessment of an 85-year-old patient. The nurse realizes that what particular change is an age-related effect on the renal or urinary system? 1- Increased ability to concentrate urine 2- Increased bladder capacity 3- Urinary incontinence 4- Decreased glomerular filtration rate

A gerontological nurse is aware that older adults experience numerous age-related physiological changes that place them at risk of fluid and electrolyte imbalances. Age-related changes to kidney function and the thirst mechanism create a particular risk of what problem? 1- Hypermagnesemia 2- Hypokalemia 3- Fluid volume excess 4- Hypernatremia

A group of students are studying for an examination on joints. The students demonstrate understanding of the material when they identify which of the following as an example of a synarthrodial joint? 1- Between the vertebrae 2- In the fingers 3- At the hip 4- Skull at the temporal and occipital bones

A health care provider asked a nurse to teach a patient how to self-administer subcutaneous insulin. After collecting her assessment data and drafting her plan, the nurse selected the teaching strategy that research has indicated has the highest chance of reinforcing knowledge. Which of the following strategies did the nurse select? 1- Providing reading materials with illustrations of how to perform the injection 2- Showing the equipment and explaining the procedure 3- Asking the patient to hold the syringe and insulin while viewing a slide show about the process 4- Assisting the patient to perform the skill in a simulated setting

A health care provider prescribed fluticasone for a client with a severe case of allergic rhinitis. The client took a first dose on February 2. What is the latest date by which the drug will be fully effective? 1- February 6 2- February 9 3- February 12 4- February 15

A man with severe ulcerative colitis has been informed by his health care provider that he will require a colectomy and an ileostomy. The patient has been told by his health care provider that he is candidate for a continent ileal reservoir (Kock pouch). The patient's nurse recognizes which of the following advantages to the use of a Kock pouch as an alternative to the creation of an ileal stoma? 1- The patient's abdominal wall will remain intact. 2- The patient will soon be able to resume normal bowel function. 3- The patient will have to make minimal dietary modifications. 4- The patient will not have to wear an external collection bag.

A newly admitted patient with type 1 diabetes asks the nurse what caused her diabetes. In response, the nurse is explaining to the patient the etiology of type 1 diabetes. Which of the following is the most appropriate explanation by the nurse? 1- "The tissues in your body are resistant to the action of insulin, making insulin less effective." 2- "An acidic substance forms when your liver breaks down fatty acids because of the lack of insulin in your body." 3- "The secretion of placental hormones is causing your body to be resistant to insulin." 4- "Destruction of special cells in the pancreas causes a decrease in insulin production, and the level of sugar in your bloodstream increases."

A nurse can estimate serum osmolality at the bedside by using a formula. A patient who has a serum sodium level of 140 mEq/L would have a serum osmolality of: 1- 210 mOsm/kg. 2- 230 mOsm/kg. 3- 250 mOsm/kg. 4- 280 mOsm/kg.

A nurse expects to find which signs and symptoms in a client experiencing hypoglycemia? 1- Polyuria, headache, and fatigue 2- Polyphagia and flushed, dry skin 3- Polydipsia, pallor, and irritability 4- Nervousness, diaphoresis, and confusion

A nurse is caring for a client who had a three-vessel coronary bypass graft 4 days earlier. The client's cholesterol profile is as follows: total cholesterol 265 mg/dl, low-density lipoprotein (LDL) 139 mg/dl, and high-density lipoprotein (HDL) 32 mg/dl. The client asks the nurse how to lower his cholesterol. What is the best response by the nurse? 1- Cholesterol is within the recommended guidelines and the client doesn't need to lower it. 2- Client should take statin medication and not worry about cholesterol. 3- Client should begin a running program, working up to 2 miles per day. 4- The nurse will ask the dietitian to talk with the client about modifying the diet.

A nurse is caring for a postoperative patient on POD 2. The patient had a large upper abdominal incision. While assessing the patient at the beginning of the shift, the nurse noted decreased breath sounds, crackles, and a mild cough. What is the patient most likely experiencing?Atelectasis 1- Pneumonia 2- Acute 3- bronchitis 4- Hypoxemia

A nurse is conducting an assessment of a patient's musculoskeletal system and assessing for joint function. How should the nurse best perform this assessment? 1- Ask the patient to clearly describe any recent changes in mobility or flexibility. 2- Assess the patient's expectations around function and mobility. 3- Palpate and percuss each of the patient's joints bilaterally. 4- Assess the range of motion (ROM) of each of the patient's joints.

A nurse is explaining treatment options to a client diagnosed with an immune dysfunction. Which statement by the client accurately reflects the teaching about current stem cell research? 1- "Stem cell transplantation has been discontinued based on concerns about safety, efficacy, resource allocation, and human cloning." 2- "Currently, stem cell transplantation has only been performed in the laboratory, but future research with embryonic stem cell transplants for humans with immune dysfunction has been promising." 3- "Stem cell clinical trials have only been attempted in clients with acquired immune deficiencies, but plans are underway to begin human cloning using embryonic stem cells." 4- "Stem cell transplantation has been carried out in humans with certain types of immune dysfunction, and clinical trials using stem cells are underway in clients with a variety of disorders with an autoimmune component."

A nurse is instructing a client about using antiembolism stockings. Antiembolism stockings help prevent deep vein thrombosis (DVT) by: 1- encouraging ambulation to prevent pooling of blood. 2- providing warmth to the extremity. 3- elevating the extremity to prevent pooling of blood. 4- forcing blood into the deep venous system.

A nurse is preparing a teaching plan regarding biological tissue valve replacement. What is a disadvantage of this type of valve replacement? 1- The patient must take lifelong anticoagulant therapy. 2- The patient's infections are easier to treat. 3- There is a low incidence of thromboembolism. 4- The valve has to be replaced frequently.

A nurse is providing care to a female client with infertility. Testing reveals a problem with hypothalmic stimulation of the pituitary gland to release hormones. Which agent would the nurse expect to be prescribed? 1- Menotropins 2- Follitropin-alpha 3- Leuprolide 4- Clomiphene

A nurse is providing dietary instructions to a client with hypoglycemia. To control hypoglycemic episodes, the nurse should recommend: 1- increasing saturated fat intake and fasting in the afternoon. 2- increasing intake of vitamins B and D and taking iron supplements. 3- eating a candy bar if light-headedness occurs. 4- consuming a low-carbohydrate, high-protein diet and avoiding fasting.

A nurse is reading a journal article about medications used to treat allergic rhinitis. The nurse demonstrates understanding of the information when identifying which medication as being the most effective maintenance therapy for chronic allergic rhinitis? 1- Second-generation antihistamines 2- Mast cell stabilizers 3- Adrenergic agents 4- Intranasal corticosteroids

A nurse is teaching a client recovering from diabetic ketoacidosis (DKA) about management of "sick days." The client asks the nurse why it is important to monitor the urine for ketones. Which statement is the nurse's best response? 1- "Ketones are formed when insufficient insulin leads to cellular starvation. As cells rupture, they release these acids into the blood." 2- "When the body does not have enough insulin, hyperglycemia occurs. Excess glucose is broken down by the liver, causing acidic by-products to be released." 3- "Excess glucose in the blood is metabolized by the liver and turned into ketones, which are an acid." 4- "Ketones accumulate in the blood and urine when fat breaks down in the absence of insulin. Ketones signal an insulin deficiency that will cause the body to start breaking down stored fat for energy."

A nurse knows that a person with a 3-week-old femur fracture is at the stage where angiogenesis is occurring. What are the characterisitics of this stage? 1- The formation of a hematoma and fibrin. 2- Inflammation and the stimulation of osteoblasts and osteoclasts. 3- Cartilage cells forming matrix villa that regulate calcification of the cartilage. 4- New capillaries producing a bridge between the fractured bones.

A nurse knows to assess a patient with type 1 diabetes for postprandial hyperglycemia. The nurse knows that glycosuria is present when the serum glucose level exceeds: 1- 120 mg/dL 2- 140 mg/dL 3- 160 mg/dL 4- 180 mg/dL

A nurse on a postsurgical unit has performed health education on the correct technique for emptying a drain for a woman who will be discharged home with a drain in situ. The nurse has asked the patient to demonstrate the correct technique and will now provide feedback. Which of the following statements provides the most effective feedback for the patient? 1- "You did a really good job of emptying your drain. You'll do great when you get home." 2- "How did you feel about that?" 3- "You should be proud of yourself; this certainly isn't a skill that comes naturally to anyone." 4- "You kept the drain clean when you emptied it, and you restored the negative pressure effectively."

A patient comes to the clinic with fever, cough, and chest discomfort. The nurse auscultates crackles in the left lower base of the lung and suspects that the patient may have pneumonia. What does the nurse know is the most common organism that causes community-acquired pneumonia? 1- Staphylococcus aureus 2- Mycobacterium tuberculosis 3- Pseudomonas aeruginosa 4- Streptococcus pneumoniae

A patient comes to the emergency department complaining of a knifelike pain when taking a deep breath. What does this type of pain likely indicate to the nurse? 1- Bacterial pneumonia 2- Bronchogenic carcinoma 3- Lung infarction 4- Pleurisy

A patient had gastric bypass surgery 3 years ago and now, experiencing fatigue, visits the clinic to determine the cause. The patient takes pantoprazole for the treatment of frequent heartburn. What type of anemia is this patient at risk for? 1- Aplastic anemia 2- Iron deficiency anemia 3- Sickle cell anemia 4- Pernicious anemia

A patient has developed severe contact dermatitis with burning, itching, cracking, and peeling of the skin on her hands. What should the patient be instructed to do? 1- Wear powdered latex gloves. 2- Wash her hands with antibacterial soap. 3- Maintain the room temperature at 80°F. 4- Keep her hands well moisturized.

A patient has enlarged lymph nodes in his neck and a sore throat. This inflammatory response is an example of a cellular immune response whereby: 1- Antibodies reside in the plasma 2- Antibodies are released into the bloodstream 3- B-lymphocytes respond to a specific antigen 4- Lymphocytes migrate to areas of the lymph node

A patient has recently returned to the cardiac care unit from PACU following coronary artery bypass graft (CABG). During the nurse's assessment of the patient, the patient acknowledges pain that he rates at 9 on a 0-to-10 pain scale. How should the nurse best respond to this assessment finding? 1- Determine how the patient's pain responds to increased physical activity. 2- Explain to the patient that significant pain is expected during the immediate postoperative phase. 3- Teach the patient nonpharmacologic interventions for pain management. 4- Try to differentiate between incisional pain and anginal pain.

A patient in his 40s is considering immunotherapy as a treatment for his longstanding allergic rhinitis, a problem which is taking an increasing toll on his quality of life. The nurse at the allergy clinic should ensure that the patient knows that allergy control by this method usually requires treatment for how long? 1- Six to eight months 2- One year to 18 months 3- Two to three years 4- Three to five years

A patient sustained an open fracture of the femur 24 hours ago. While assessing the patient, the nurse observes the patient is having difficulty breathing, and oxygen saturation decreases to 88% from a previous 99%. What does the nurse understand is likely occurring with this patient? 1- Spontaneous pneumothorax 2- Cardiac tamponade 3- Pneumonia 4- Fat emboli

A patient with a diagnosis of colon cancer has undergone a bowel resection with the creation of an ileostomy. The patient's ileostomy output has been unexpectedly high in the 2 days since surgery, and the patient's most recent blood work indicates a K+ level of 2.7 mEq/L. This potassium level should prompt the nurse to assess for which of the following physical manifestations? 1- Confusion and decreased level of consciousness 2- Shortness of breath, rales, and peripheral edema 3- Dysphagia, tetany, and emotional lability 4- Fatigue, cramps, and weakness

A patient with polycythemia vera has a high red blood cell (RBC) count and is at risk for the development of thrombosis. What treatment is important to reduce blood viscosity and to deplete the patient's iron stores? 1- Blood transfusions 2- Radiation 3- Chelation therapy 4- Phlebotomy

A patient with renal insufficiency has been hospitalized on a medical unit. The patient knows that renal function depends upon the functional status of nephrons. The patient asks the nurse when she will need to start dialysis based upon loss of nephron function. How should the nurse respond? 1- "When about 50% of the nephrons are no longer functioning." 2- "When about 60% of the nephrons are no longer functioning." 3- "When about 70% of the nephrons are no longer functioning." 4- "When about 80% of the nephrons are no longer functioning."

A patient's vasa recta have detected a precipitous drop in the patient's blood pressure. In response to feedback from the vasa recta, the patient's kidneys will: 1- Increase the pH of the blood 2- Synthesize angiotensin 3- Increase water excretion 4- Secrete renin

After a person experiences a closure of the epiphyses, which statement is true? 1- The bone grows in length but not thickness. 2- The bone increases in thickness and is remodeled. 3- Both bone length and thickness continue to increase. 4- No further increase in bone length occurs.

After teaching a group of students about health, wellness and illness, a nursing instructor determines that additional instruction is necessary when the students identify which of the following as a component of wellness? 1- Performing to the best of one's ability 2- Reporting a feeling of well-being 3- Adjusting to varying situations 4- Feeling together about one part of life

An asymptomatic client questions the nurse about the diagnosis of mitral regurgitation and inquires about continuing an exercise routine. Which is the most appropriate response by the nurse? 1- "Continue the exercise routine but take ample rest after exercising." 2- "Avoid any type of exercise." 3- "Avoid strenuous cardiovascular exercise." 4- "Continue the exercise routine unless symptoms such as shortness of breath or fatigue develop."

An elderly patient has come to the clinic for a regular check-up. While reviewing a patient's history, the nurse notes that the patient has an increased thoracic curvature of the spine. What term describes this assessment finding? 1- Scoliosis 2- Epiphyses 3- Lordosis 4- Kyphosis

An emergency department nurse is assessing an 80-year-old patient who has presented with a complaint of abdominal pain. The nurse performs a rapid inspection of the patient and notes multiple significant findings, including kyphosis. The nurse should understand that this assessment finding is suggestive of what musculoskeletal disease? 1- Malignant bone neoplasm 2- Paget's disease 3- Muscular dystrophy 4- Osteoporosis

An experiment is designed to determine specific cell types involved in cell-mediated immune response. The experimenter is interested in finding cells that attack the antigen directly by altering the cell membrane and causing cell lysis. Which cells should be isolated? 1- Macrophages 2- Helper T cells 3- B cells 4- Cytotoxic T cells

As women age, many experience an increased sense of urgency to void, as well as an increased risk of incontinence. This is usually the result of age-related changes in which part of the renal system? 1- Kidney 2- Nephron 3- Tubule system 4- Bladder

Changes in population demographics over the next 40 years will significantly affect the delivery of health care services. Select the one change that will have the most impact on the practice of nursing. 1- Immigration patterns will result in a more diverse population. It is projected that, by 2030, more than 20% of Americans will be immigrants. 2- Hispanics will become the largest minority group in the United States, constituting about 29% of the population. 3- The non-Hispanic, white population will reach 47%. 4- The number of adults over age 65 will double in size.

During a preadmission assessment, the nurse finds increased tactile fremitus. She knows this sign is consistent with which of the following diagnoses? 1- Bronchitis 2- Emphysema 3- Atelectasis 4- Pneumonia

Health education is an integral component of all nurse-person interactions. However, certain individuals have a greater need for health education than others. Which one of the following individuals likely has the greatest need for health education? 1- An IV drug user who is receiving antibiotics for the treatment of endocarditis 2- A young adult who has suffered traumatic injuries in a motorcycle accident 3- The parents of an infant who has been admitted for treatment of respiratory syncytial virus (RSV) 4- An elderly woman who has just been diagnosed with congestive heart failure (|CHF)

It is important for a nurse to be aware of the normal hemodynamics of blood flow to recognize and understand pathology when it occurs. The nurse should know that incomplete closure of the tricuspid valve results in a backward flow of blood from the: 1- Aorta to the left ventricle. 2- Left atrium to the left ventricle. 3- Right atrium to the right ventricle. 4- Right ventricle to the right atrium.

Nursing management of a patient receiving heparin includes monitoring for heparin-induced thrombocytopenia. Choose the result that indicates the potential for spontaneous intracranial hemorrhage, which is life-threatening. A platelet count of: 1- 90,000 to 150,000 mm3 2- 50,000 to 80,000 mm3 3- 20,000 to 40,000 mm3 4- 10,000 to 14,500 mm3

Part of health promotion in the adolescent population is health screening. What is the goal of health screening in this population? 1- To teach teenagers about health risks 2- To teach coping strategies 3- To discuss chronic health problems 4- To detect health problems at an early age, so that they can be treated at this time

Pulselessness, a very late sign of compartment syndrome, may signify 1- Venous congestion 2- Nerve involvement 3- Diminished arterial perfusion 4- Lack of distal tissue perfusion

Radiographs were ordered for a 10-year-old boy who had his right upper arm injured. The radiographs show that the humerus appears to be fractured on one side and slightly bent on the other. What type of fracture is this an example of? 1- Impacted 2- Compound 3- Compression 4- Greenstick (incomplete)

Recent exacerbation of a patient's mitral valve regurgitation prompted her cardiologist to perform a mitral valve replacement in which the patient received a mechanical valve. In the weeks following the patient's surgery, which of the following blood tests will be most relevant to the patient's potential complications? 1- Blood urea nitrogen (BUN) and creatinine 2- Serum potassium level 3- White blood cell (WBC) differential 4- International normalized ratio (INR)

The Emergency Department (ED) nurse is caring for a client with a possible acid-base imbalance. The physician has ordered an arterial blood gas (ABG). What is one of the most important indications of an acid-base imbalance that is shown in an ABG? 1- PaO2 2- PO2 3- Carbonic acid 4- Bicarbonate

The Healthy People 2020 initiative targets the improvement of health for all. In addition to eliminating health disparities, what are the broad goals of this plan? 1- Increasing technological innovations 2- Preventing treatable problems 3- Applying a systematic approach to health improvement 4- Increasing the quality and length of a healthy life

The anatomy and physiology instructor is explaining a cell-mediated response to the pre-nursing students. What actions would the instructor explain occur in a cell-mediated response? 1- Toxins of invading antigens are neutralized. 2- The invading antigens link together (agglutination). 3- The invading antigens precipitate. 4- T-cell lymphocytes survey proteins in the body and attack the invading antigens.

The client asks the nurse to explain the reason for a chest tube insertion in treating a pneumothorax. Which is the best response by the nurse? 1- "Chest tube will allow air to be restored to the lung." 2- "The tube will drain secretions from the lung." 3- "Chest tubes provide a route for medication instillation to the lung." 4- "The tube will drain air from the space around the lung."

The client with a fractured left humerus reports dyspnea and chest pain. Pulse oximetry is 88%. Temperature is 100.2 degrees Fahrenheit (38.5 degrees Centigrade); heart rate is 110 beats per minute; respiratory rate is 32 breaths per minute. The nurse suspects the client is experiencing: 1- Complex regional pain sydrome 2- Delayed union 3- Compartment syndrome 4- Fat embolism syndrome

The gynecologist tells the nurse that the patient she just examined was complaining of tenderness over the area known as the "tail of Spence." The doctor asks the nurse to verify her findings. The nurse knows to palpate the: 1- Upper, outer quadrant of the abdomen. 2- Left lower quadrant of the breast. 3- Mid-point area between the umbilicus and the symphysis pubis. 4- Top of the breast near the axilla.

The home health nurse is assisting a patient and his family in planning the patient's return to work after an extensive illness. On which level of Maslow's hierarchy of basic needs does the patient's need for self-fulfillment fit? 1- Physiologic 2- Safety and security 3- Love and belonging 4- Self-actualization

The nurse analyzes a urinalysis report. He is aware that the presence of this substance in the urine indicates a blood level that exceeds the kidney's reabsorption capacity. Select the substance. 1- Sodium 2- Bicarbonate 3- Creatinine 4- Glucose

The nurse assessed a 28-year-old woman who was experiencing dyspnea severe enough to make her seek medical attention. The history revealed no prior cardiac problems and the presence of symptoms for 6 months' duration. On assessment, the nurse noted the presence of both inspiratory and expiratory wheezing. Based on this data, which of the following diagnoses is likely? 1- Acute respiratory obstruction 2- Adult respiratory distress syndrome 3- Pneumothorax 4- Asthma

The nurse caring for a client who is suspected of having cardiovascular disease has a stress test ordered. The client has a co-morbidity of multiple sclerosis, so the nurse knows the stress test will be drug-induced. What drug will be used to dilate the coronary arteries? 1- Thallium 2- Ativan 3- Diazepam 4- Dobutamine

The nurse has completed a plan of care for a patient who has been hospitalized for the treatment of acute leukemia. When planning this patient's care, the nurse has specified that assessments be performed more often than is the unit norm. Frequent, thorough assessments are indicated in the treatment of patients with acute leukemia because: 1- Changes in condition must be identified early because treatment options do not normally exist. 2- Patients with leukemia are often unable to accurately describe their symptoms. 3- Leukemia has characteristics of chronic diseases as well as acute illnesses. 4- Patients with leukemia often experience clinical changes that may be subtle and nonspecific.

The nurse has created a care plan for a client admitted with acute pericarditis and a nursing diagnosis of acute pain related to pericardial inflammation. What is an appropriate nursing intervention for this client? 1- Administering around-the-clock opioids as prescribed 2- Promoting progressive relaxation techniques with the use of slow, deep breathing 3- Positioning the patient on the right side with the head of the bed elevated 15 degrees 4- Placing the patient in the high-Fowler's position with an over-the-bed table for the patient to lean on

The nurse is assessing a patient and feels a pulse with quick, sharp strokes that suddenly collapse. The nurse knows that this type of pulse is diagnostic for which disorder? 1- Mitral insufficiency 2- Tricuspid insufficiency 3- Tricuspid stenosis 4- Aortic regurgitation

The nurse is assessing a patient who has been admitted with possible ARDS. What findings would distinguish ARDS from cardiogenic pulmonary edema? 1- Elevated white blood count 2- Elevated troponin levels 3- Elevated myoglobin levels 4- Elevated B-type natriuretic peptide (BNP) levels

The nurse is caring for a client diagnosed with chronic obstructive pulmonary disease (COPD) and experiencing respiratory acidosis. The client asks what is making the acidotic state. The nurse is most correct to identify which result of the disease process that causes the fall in pH? 1- The lungs are unable to breathe in sufficient oxygen. 2- The lungs are unable to exchange oxygen and carbon dioxide. 3- The lungs have ineffective cilia from years of smoking. 4- The lungs are not able to blow off carbon dioxide.

The nurse is caring for a client with a decrease in airway diameter causing airway resistance. The client experiences coughing and mucus production. Upon lung assessment, which adventitious breath sounds are anticipated? 1- Crackles 2- Rhonchi 3- Rubs 4- Wheezes

The nurse is caring for a client with an exacerbation of COPD and scheduled for pulmonary function studies using a spirometer. Which client statement would the nurse clarify? 1- "My study is scheduled for 10 AM, several hours after I eat." 2- "I brought comfortable clothes and shoes for the test." 3- "I am ordered a bronchodilator to note lung improvement following use." 4- "I will breathe in through my mouth and out through my nose."

The nurse is caring for a patient who has dumping syndrome from high carbohydrate foods being administered over a period of less than 20 minutes. What is a nursing measure to prevent or minimize the dumping syndrome? 1- Administer the feeding at a warm temperature to decrease peristalsis. 2- Administer the feeding by bolus to prevent continuous intestinal distention. 3- Administer the feeding with about 100 mL of fluid to dilute the high carbohydrate concentration. 4- Administer the feeding with the patient in semi-Fowler's position to decrease transit time influenced by gravity.

The nurse is caring for a patient who has started anticoagulant therapy with warfarin (Coumadin). When does the nurse understand that therapeutic benefits will begin? 1- Within 12 hours 2- Within the first 24 hours 3- In 2 days 4- In 3 to 5 days

The nurse is collecting data at the clinic from a new client who is being seen for an employee physical. The client informs the nurse that both parents have a history of high blood pressure and his father had a stroke at age 52 years. The nurse discusses diet and exercise programs that may benefit the client. What is the nurse displaying with this information? 1- Early detection 2- Health maintenance 3- Health promotion 4- Illness prevention

When assessing a client, which adaptation indicates the presence of respiratory distress? 1- Respiratory rate of 14 breaths per minute 2- Productive cough 3- Sore throat 4- Orthopnea

The nurse is obtaining information from a client with Crohn's disease about his medication history. What medication would the nurse include when asking about what medications the client has taken for suppression of the inflammatory and immune response? 1- Nonsteroidal anti-inflammatory 2- Angiotensin-converting enzyme inhibitors (ACE-I) 3- Diuretics 4- Corticosteroids

The nurse is performing a community screening for colorectal cancer. Which characteristic should the nurse include in the screening? 1- Age younger than 40 years 2- Low-fat, low-protein, high-fiber diet 3- History of skin cancer 4- Familial polyposis

The nurse is performing a musculoskeletal assessment on a patient with arthritis. During passive range-of-motion exercises, the nurse hears grating and cracking sounds. This assessment finding is referred to as what? 1- Fasciculations 2- Clonus 3- Effusion 4- Crepitus

The nurse is performing an assessment on an older adult patient and observes the patient has an increased forward curvature of the thoracic spine. What does the nurse understand this common finding is known as? 1- Lordosis 2- Scoliosis 3- Osteoporosis 4- Kyphosis

The nurse is providing preoperative information about hip replacement to a group of clients scheduled for this surgery. One of the clients is slightly hearing impaired. What is the best action of the nurse? 1- Speak in a loud voice. 2- Position the hearing-impaired client 8 feet away. 3- Turn to any client who asks questions. 4- Use a model of the hip.

The nurse is reviewing the results of a client's renal function study. The nurse understands that which value represent a normal BUN-to-creatinine ratio? 1- 4:1 2- 6:1 3- 8:1 4- 10:1

The nurse is teaching a client with diabetes how to perform checks of blood glucose level. To optimize learning, it is best for the nurse to 1- Verbally tell the client. 2- Demonstrate to the client. 3- Provide written instructions. 4- Have the client return demonstrate.

The nurse practitioner worked with a registered dietitian to customize a 1,800-calorie diabetic diet for a 53-year-old man with special dietary needs. Which of the following percent distribution of calories should be provided? 1- Carbohydrates 35%, fat 10%, and protein 5% 2- Carbohydrates 40%, fat 15%, and protein 10% 3- Carbohydrates 45%, fat 20%, and protein 15% 4- Carbohydrates 50%, fat 25%, and protein 20%

The nurse working in the emergency department receives a call from the x-ray department communicating that the client the nurse is caring for has a fracture in the shaft of the tibia. The nurse tells the physician that the client's fracture is in the 1- epiphysis. 2- lordosis. 3- scoliosis. 4- diaphysis.

The nurse, caring for a client in the emergency room with a severe nosebleed, becomes concerned when the client asks for a bedpan. The nurse documents the stool as loose, tarry, and black looking. The nurse suspects the client may have thrombocytopenia. What should be the nurse's priority action? 1- Stop the nosebleed 2- Put in an IV line 3- Ask someone to clean the bedpan 4- Notify the physician

The nursing instructor is discussing pulmonary arterial hypertension with the nursing students. What would the instructor describe as the pathophysiology of secondary pulmonary arterial hypertension? 1- Bronchial thickening causes increased resistance and pressure in the pulmonary vascular bed. 2- Chronic lung disease causes scaring in the bronchioles raising pressure in the pulmonary vascular bed. 3- Left-sided heart failure causes increased resistance and pressure in the pulmonary vascular bed. 4- Alveolar destruction causes increased resistance and pressure in the pulmonary vascular bed.

The provider suspects that a patient has multifocal tumors in the same quadrant of the right breast. The nurse informs the patient that the provider will probably order which of the following tests? 1- Follow-up mammography 2- Galactography 3- Ultrasonography 4- Magnetic resonance image (MRI)

To evaluate a client for hypoxia, the physician is most likely to order which laboratory test? 1- Red blood cell count 2- Sputum culture 3- Total hemoglobin 4- Arterial blood gas (ABG) analysis

Today, increasing emphasis is placed on health, health promotion, wellness, and self-care. Which of the following activities in the care of a female patient with a recent diagnosis of diabetes mellitus is most congruent with the philosophy of health promotion? 1- Providing the patient with a new glucometer and test strips which have been recently brought to market 2- Introducing the patient to a diabetes educator who is in charge of a diabetes support group in the community 3- Helping the patient to schedule hemoglobin A1C testing at an outpatient laboratory 4- Teaching the patient about measures that she can take to minimize the long-term health effects of her disease

Two days after undergoing a total abdominal hysterectomy, a client complains of left calf pain. Venography reveals deep vein thrombosis (DVT). When assessing this client, the nurse is likely to detect: 1- pallor and coolness of the left foot. 2- a decrease in the left pedal pulse. 3- loss of hair on the lower portion of the left leg. 4- left calf circumference 1" (2.5 cm) larger than the right

What clinical indication of hyperphosphatemia does the nurse assess in a patient? 1- Bone pain 2- Paresthesia 3- Seizures 4- Tetany

What does the nurse expect to see on the ECG reading when serum potassium levels rise to greater than 6 mEq/L? 1- Peaked, widened T waves 2- ST-segment elevation 3- Lengthened QT interval 4- ST-segment depression

What does the nurse understand is the rationale for administering allopurinol for a patient receiving chemotherapy? 1- It stimulates the immune system against the tumor cells. 2- It treats drug-related anemia. 3- It prevents alopecia. 4- It lowers serum and uric acid levels.

What is the function of the thymus gland? 1- Produce stem cells 2- Programs B lymphocytes to become regulator or effector Bcells. 3- Develop the lymphatic system 4- Programs T lymphocytes to become regulator or effector T cells.

What is the primary focus of the nurse advocacy role in managing a clinical pathway? 1- Continuity of care 2- Cost-containment practices 3- Effective utilization of services 4- A patient's progress toward desired outcomes

When caring for a client with acute respiratory failure, the nurse should expect to focus on resolving which set of problems? 1- Hypotension, hyperoxemia, and hypercapnia 2- Hyperventilation, hypertension, and hypocapnia 3- Hyperoxemia, hypocapnia, and hyperventilation 4- Hypercapnia, hypoventilation, and hypoxemia

Which category of oral antidiabetic agents exerts the primary action by directly stimulating the pancreas to secrete insulin? 1- Thiazolidinediones 2- Biguanides 3- Alpha-glucosidase inhibitors 4- Sulfonylureas

Which hormone is primarily responsible for stimulating the production of progesterone? 1- Follicle-stimulating hormone 2- Estrogen 3- Androgen 4- Luteinizing hormone

Which information should be included in the teaching plan for a client receiving glargine, which is "peakless" basal insulin? 1- Administer the total daily dosage in 2 doses. 2- Draw up the drug first, then add regular insulin. 3- Glargine is rapidly absorbed and has a fast onset of action. 4- Do not mix with other insulins.

Which is a neurovascular problem caused by pressure within a muscle area that increases to such an extent that microcirculation diminishes? 1- Remodeling 2- Hypertrophy 3- Fasciculation 4- Compartment syndrome

Which laboratory study indicates the rate of bone turnover? 1- Urine calcium 2- Serum calcium 3- Serum phosphorous 4- Serum osteocalcin

Which nursing intervention is appropriate for minimizing muscle spasms in the client with a hip fracture? 1- Apply a soft compression dressing. 2- Assist the client with use of a trapeze. 3- Maintain the internal fixator. 4- Maintain Buck's traction.

Which of the following is an accurate statement with regard to adult learner readiness? 1- Learning readiness is based solely on past life experiences. 2- Physical skills play little role in learner readiness. 3- Experimental readiness is not related to emotional readiness. 4- Learner readiness is based on culture, attitude, and personal values.

Which precautions should a nurse include in the care plan for a client with leukemia and neutropenia? 1- Have the client use a soft toothbrush and electric razor, avoid using enemas, and watch for signs of bleeding. 2- Put on a mask, gown, and gloves when entering the client's room. 3- Provide a clear liquid, low-sodium diet. 4- Eliminate fresh fruits and vegetables, avoid using enemas, and practice frequent hand washing.

Which type of insulin acts most quickly? 1- Regular 2- NPH 3- Lispro 4- Glargine

While assessing a patient with pericarditis, the nurse cannot auscultate a friction rub. Which action should the nurse implement? 1- Notify the health care provider. 2- Document that the pericarditis has resolved. 3- Ask the patient to lean forward and listen again. 4- Prepare to insert a unilateral chest tube.

While caring for a client with a chest tube, which nursing assessment would alert the nurse to a possible complication? 1- Skin around tube is pink. 2- Bloody drainage is seemed in the collection chamber. 3- Absence of bloody drainage in the anterior/upper tube 4- The tissues give a crackling sensation when palpated.

While monitoring the patient's eosinophil level, the nurse suspects a definite allergic disorder when seeing an eosinophil value of what percentage of the total leukocyte count? 1- 1% to 3% 2- 3% to 4% 3- 5% to 10% 4- 15% to 40%

You are caring for a client admitted with chronic bronchitis. The client is having difficulty breathing, and the family asks you what causes this difficulty. What would be your best response? 1- "Anytime there is a chronic disease process it is hard for the person to breathe." 2- "Having a chronic respiratory disease scars the lung and affects the effort it takes to breathe." 3- "In this particular case your family member is just overly tired and having problems breathing." 4- "Conditions such as chronic bronchitis cause thickening of the bronchial mucosa so it makes it harder to breathe."

You are caring for a client status post lung resection. When assessing your client you find that the bubbling in the water-seal chamber for the chest tubes is more than you expected. What should you check when bubbling in the water-seal chamber is excessive? 1- See if the chest tube is clogged. 2- See if the wall suction unit has malfunctioned. 3- See if a kink has developed in the tubing. 4- See if there are leaks in the system.

The nurse is scheduling an appointment for Pap test with a client. What information should the nurse provide to the client to ensure the test is accurate? Select all that apply. 1- "It is best if you come during your menstrual period." 2- "Ensure you have used any vaginal medication creams prior to the test." 3- "Use vaginal cleansers such as douche to prepare for the test." 4- "Avoid sexual intercourse for at least 2 days prior to the test." 5- "Use a sanitary pad instead of tampon 2 to 3 days prior to the test."

4,5

Normal urine sodium level

40 to 220 mEq every 24 hours usually contains more than 40 mEq/L of sodium in random catch

A 48-year-old man has presented to the outpatient radiology department for a scheduled transrectal ultrasound (TRUS). The nurse in this department should be aware that this patient has likely had: A) Elevated prostate-specific antigen (PSA) B) Evidence of erectile dysfunction (ED) C) Urinary retention D) A history of infertility

A nurse is aware that even though tube feedings are generally well-tolerated by most patients, there is a still a risk of dumping syndrome. Which of the following actions has the greatest potential to reduce a patient's risk of experiencing dumping syndrome? A) Administering feedings at a low, continuous rate rather than by bolus B) Administering diuretics prior to initiating a feeding C) Diluting feedings at a 1:2 ratio of feedings to water D) Administering feedings with the patient in a supine position to slow motility

A nurse is caring for a 73-year-old male patient with a urethral obstruction related to prostatic enlargement. The nurse is aware this may result in what? A) A urinary tract infection (UTI) B) Enuresis C) Polyuria D) Proteinuria

A patient has been diagnosed with an abdominal aortic aneurysm (AAA). Because of the small size of the patient's AAA, the care team has opted for conservative management. When the nurse is providing health education for this patient, what topic should be prioritized? A) Management of blood pressure and lifestyle modifications to address hypertension B) The importance of regular physical activity and smoking cessation C) The effects of hyperlipidemia and strategies for reducing dietary cholesterol intake D) The importance of ensuring that the patient's heart rate never exceeds 100 beats per minute

A patient has been exposed to a pathogen during an outbreak of a nosocomial (hospital-acquired) infection. The patient's immune system has responded appropriately to the virus, and the response has included the production of memory B cells. These particular B cells will have what effect? A) The patient will have a more pronounced immune response to the virus during future exposure. B) B cells will be able to produce antibodies without the assistance of T cells. C) The patient will have life-long immunity to the specific virus. D) The patient's B cells will have the ability to directly ingest the virus during a subsequent exposure.

A patient who came to the clinic after finding a mass in her breast is scheduled for a diagnostic breast biopsy. What is a priority nursing action? A) Acknowledge the fear the patient is experiencing. B) Refer her to a breast cancer recovery group. C) Set up a consultation with a breast cancer survivor. D) Instruct the patient on prosthetic devices.

A patient with a diagnosis of deep vein thrombosis (DVT) is being treated with unfractionated heparin, which is being administered intravenously. The nurse who is providing care for this patient should consequently prioritize what assessments? A) Assessing the patient for internal or external hemorrhage B) Monitoring the patient's intake and output, and assessing for signs of fluid volume deficit C) Assessing the patient for adventitious lung sounds and assessing SaO2 levels D) Assessing the patient's pain levels

A surgical nurse is careful to include an assessment question addressing latex allergies for each patient who is admitted to the surgical day care unit. This nurse should be aware that which of the following patients tend to have an increased risk of latex allergies? A) Patients who have undergone multiple surgeries and medical procedures B) Patients who have autoimmune diseases such as rheumatoid arthritis C) Patients who have decreased neutrophil counts D) Patients who have type 1 or type 2 diabetes mellitus

A woman has been diagnosed with breast cancer and is being treated aggressively with a chemotherapeutic regimen. As a result of this regimen, she has an inability to fight infection due to the fact her bone marrow is unable to produce a sufficient amount of what? A) Lymphocytes B) Cytoblasts C) Antibodies D) Capillaries

An increase in the osmolality of a patient's blood has prompted the release of antidiuretic hormone (ADH) from the patient's posterior pituitary gland. What effect will result from the release of this hormone? A) The patient's kidneys will resorb more water than usual. B) The patient will retain more sodium than normal. C) The patient's kidneys will reduce their filtration rate. D) Excretion of water by the kidneys will increase.

In response to the presence of a bloodborne pathogen, an individual's immune system has mounted a successful response in which antibodies have produced agglutination between offending antigens. The process of agglutination will be followed by what consequent activity of the immune system? A) Phagocytosis B) Opsonization C) Release of histamine D) Release of slow-reacting substance

The inflammatory response is an important nonspecific component of the immune system that is elicited in response to tissue injury or pathogens. A nurse is aware that dysfunctional inflammatory responses are responsible for numerous pathophysiological conditions. Which of the following patients most clearly exemplifies this? A) A 71-year-old woman who uses a quad cane because of mobility limitations brought on by rheumatoid arthritis B) A male patient who has begun chemotherapy after the discovery of colorectal cancer that has metastasized to his liver C) A woman who frequently experiences gastroesophageal reflux disease (GERD) after meals D) A 59-year-old man who has required the insertion of a urinary catheter because of urinary retention that resulted from benign prostatic hyperplasia (BPH)

The nurse is caring for a patient admitted with symptoms of an anorectal infection. Cultures obtained from a rectal swab indicate that the patient has a viral infection. What medication will the nurse anticipate the health care provider to order for this anorectal infection? A) Acyclovir (Zovirax) B) Doxycycline (Vibramycin) C) Penicillin (Penicillin G) D) Metronidazole (Flagyl)

The nurse is conducting a medication reconciliation of a newly admitted hospital patient, during which the patient states that he has begun taking loratadine (Claritin) every day because of his longstanding allergies. What teaching point should the nurse consequently provide to this patient? A) He should not take the drug every day because increased tolerance and reduced effectiveness will result. B) The patient should take an increased dose during nonallergy seasons to increase serum levels of the drug when symptoms appear. C) The patient should take the drug consistently, regardless of the presence or absence of allergy symptoms. D) The drug will be ineffective if the patient's allergy triggers include environmental allergens.

The nurse is preparing to administer an IV fat emulsion simultaneously with parenteral nutrition (PN). What approach to the administration of a fat emulsion is appropriate? A) IV fat emulsions may be infused simultaneously with PN through a Y-connector close to the infusion site and should not be filtered. B) The nurse should prepare for placement of another IV line, as IV fat emulsions may not be infused simultaneously through the line used for PN. C) IV fat emulsions may be infused simultaneously with PN through a Y-connector close to the infusion site after running the emulsion through a filter. D) The IV fat emulsions can be piggy-backed into any existing IV solution that is infusing.

A 45-year-old woman comes into the Ob-Gyn clinic for her yearly check-up. The woman mentions to the nurse that she has a dimpling of the right breast that has occurred in the last few months. What assessment would be appropriate for the nurse to first make? A) Assess the woman's previous experience with breastfeeding B) Palpate the area for a breast mass C) Order an immediate mammogram D) Call the health care provider to schedule a biopsy

acute respiratory distress syndrome (ARDS)

a sudden and progressive pulmonary edema, increasing bilateral infiltrates on chest x-ray, hypoxemia refractory to supplemental oxygen, and reduced lung compliance mortality rate as high as 50% to 60% from multisystem organ failure decrease in functional residual capacity (FRC) and severe hypoxemia

A 50-year-old woman was recently diagnosed with non-Hodgkin's lymphoma (NHL) and has begun a treatment regimen that includes simultaneous radiation therapy and chemotherapy. The combination of severe symptoms and aggressive therapy has necessitated admission to the hospital. When providing care for this patient, which of the following actions should the nurse implement? A) Encouraging frequent mobilization and independence in activities of daily living B) Applying standard precautions conscientiously to reduce the patient's risk of infection C) Providing meticulous skin care and turning the patient at least once every 2 hours D) Monitoring the patient's bowel pattern and facilitating a high-fiber diet

A 55-year-old man presents at the clinic complaining of erectile dysfunction. The patient has a history of diabetes mellitus. The health care provider orders tadalafil (Cialis) to be taken 1 hour before sexual intercourse. The nurse reviews the patient's history prior to instructing the patient on the use of this medication. What disorder will contraindicate the use of tadalafil (Cialis) and sildenafil (Viagra)? A) Cataracts B) Retinopathy C) Hypotension D) Lung cancer

ventilation-perfusion mismatching occurs in ARDS because

Alveoli collapse because of the inflammatory infiltrate, blood, fluid, and surfactant dysfunction

Tricuspid regurgitation

Backflow of blood through incompetent tricuspid valve into RA usually occurs with mitral stenosis

Perspective Payment System

Based on diagnosis-related groups (DRGs), prospective payment sets the rates of reimbursement for hospital services for Medicare patients. Hospitals receive payment at a fixed rate for patients with diagnoses that fall into a specific DRG

A 16-year-old has been brought to the emergency department by his parents after falling through the glass of a storm door. The fall resulted in a 6 cm laceration of the right antecubital. The nurse caring for this patient knows that the site of the injury will have an invasion of what? A) Interferon B) Phagocytic cells C) Apoptosis D) Cytokines

A 58-year-old with a longstanding diagnosis of diverticulitis has been admitted to the hospital due to an acute exacerbation in her symptoms. The care team has deemed surgery unnecessary, but is pursuing aggressive medical treatment. What pathophysiological process is contributing to this woman's health problem? A) Proliferation of bacteria in the woman's large bowel has eliminated her normal flora. B) Food and bacteria have accumulated in a herniated area of the patient's colon. C) Uncoordinated peristalsis has resulted in irritation of the colon and stagnation of the bowel's contents. D) Stenosis of the ileocecal valve has created an infected obstruction.

A 60-year-old man has been brought to the emergency department (ED) by ambulance after his wife phoned 911 when he experienced a sudden onset of severe chest pain. In the ED, the patient has received morphine, had an electrocardiogram (ECG), and had blood work drawn. In the event of a myocardial infarction, which of the following cardiac biomarkers would usually be first detectable? A) CK-MB B) Myoglobin C) Troponin T D) Troponin I

A 60-year-old woman had a right hemicolectomy and the creation of an ileostomy 4 days ago, and she has been admitted to the postsurgical unit for a 7-day recovery. The nurse's assessment at the beginning of the shift has focused on common postsurgical complications and the patient's stoma and output. At this stage in the patient's recovery, what type of output should the nurse expect from the patient's ileostomy? A) Brown, semi-formed stool B) Continuous output of liquid effluent C) Intermittent output of semi-liquid stool D) Output has not likely begun at this point

A 70-year-old man attended a scheduled check-up with his primary care provider, during which he exhibited lymphadenopathy and splenomegaly. The man's primary care provider has ordered blood work to assess the man for chronic lymphocytic leukemia (CLL). The nurse at the clinic would recognize that a diagnosis of CLL would be most consistent with what laboratory finding? A) Increased hemoglobin and hematocrit B) Increased lymphocytes C) Decreased platelets D) Decreased leukocytes

A nurse is aware of the important role that interferons (IFNs) perform in the normal function of the immune system. As well, the nurse has provided care for patients who have benefited from interferon therapy. IFN therapy is most likely to be effective in the treatment of which of the following patients? A) An 80-year-old man who is debilitated from Clostridium difficile-related diarrhea B) A 68-year-old woman who is being treated for chronic myeloid leukemia (CML) C) A 60-year-old man with motor and sensory deficits resulting from an ischemic stroke D) A 36-year-old woman who is in danger of developing sepsis after suffering full-thickness burns

A nurse is caring for a patient with acute myeloid leukemia (AML) who is preparing to undergo induction therapy. In preparing a plan of care for this patient, the nurse should assign the highest priority to which nursing diagnoses? A) Activity intolerance B) Risk for infection C) Ineffective coping D) Risk for spiritual distress

A patient has been admitted to the hospital with signs and symptoms of acute renal failure. Knowing the vital role that the kidneys play in maintaining fluid and electrolyte balance, the care team is monitoring the patient's laboratory values closely. Which of the following laboratory values is suggestive of renal failure? A) Na+ 141 mmol/L B) K+ 7.1 mmol/L C) Albumin 42 g/L D) Cl− 105 mmol/L

A patient in her mid-30s has sought advice from her nurse because she has heard conflicting advice about the usefulness of breast self-examination (BSE). What should the nurse teach the patient about the use of BSE as a cancer screening tool? A) "BSE is falling out of favor because it tends to cause a lot of anxiety for many of the women who practice it." B) "BSE can be a useful tool in detecting cancer because you're most familiar with your own breasts." C) "BSE is often a useful substitute for examinations by your primary care provider." D) "BSE is actually responsible for most of the 'false alarms' around breast cancer diagnosis."

A patient is admitted with an infected leg, and the nurse notes an increase in his white blood cell (WBC) count. The nurse is aware that, during the immune response, pathogens are engulfed by WBCs that ingest foreign particles. What is this process known as? A) Apoptosis B) Phagocytosis C) Antibody response D) Cellular immune response

A patient with renal failure is experiencing decreased erythropoietin production. Upon analysis of the patient's complete blood count (CBC), the nurse will expect which of the following results? A) An increased hemoglobin and hematocrit B) A decreased hemoglobin and hematocrit C) A decreased mean corpuscular volume (MCV) and mean corpuscular hemoglobin concentration (MCHC) D) An increased MCV and MCHC

An older woman has been receiving enteral feeds by nasogastric (NG) tube for the past several days due to a decrease in her level of consciousness. How can the nurse best assess the patient's tolerance of the current formula and rate of delivery? A) Carefully document the number and consistency of bowel movements. B) Aspirate and measure the stomach contents on a regular basis. C) Monitor the patient's skin turgor and the color of her sclerae. D) Perform regular chest auscultation and monitor her oxygen saturation levels.

An otherwise healthy 33-year-old woman experienced debilitating and persistent fatigue over a period of several weeks and was subsequently diagnosed with acute myeloid leukemia (AML). The woman has been admitted to the hospital for treatment. The nurse who is providing care for this patient should prioritize which of the following assessments? A) Assessing the woman for thrombosis and embolism B) Assessing the woman for signs and symptoms of infection C) Assessing the woman's heart rate, rhythm, and circulation D) Assessing the woman for signs and symptoms of fluid volume overload

The nurse is conducting a focused assessment of a male patient who has a history of poorly controlled hypertension. Which of the following findings would indicate the presence of renal artery bruits? A) S1 and S2 sounds over the kidneys B) A whooshing sound over the kidneys C) A lack of audible sounds over the kidneys D) Gurgles and clicks over the kidneys

The patient is concerned about leakage of gastric contents out of the gastric sump tube the nurse has just inserted. What would the nurse do to prevent reflux gastric contents from coming through the blue vent of a gastric sump tube? A) Prime the tubing with 20 mL of normal saline. B) Keep the vent lumen above the patient's stomach level. C) Maintain the patient in a high Fowler's position. D) Have the patient pin the tube to the thigh.

Metoprolol (Lopressor, Toprol) and atenolol (Tenormin)

Beta blockers reduce O2 consumption of the heart sympathetic stimulation reduced heart rate and BP reduces contractility reduce incidence of angina, infarction and cardiac mortality

Angiotensin-converting enzyme (ACE) inhibitors

Block conversion of angiotensin I to angiotensin II preventing death and remodeling of heart cells do not give if: hypotensive, hyponatremic, hypovolemic, or hyperkalemic

antigens

a toxin or other foreign substance that induces an immune response in the body, especially the production of antibodies.

A male patient with advanced leukemia is responding poorly to treatment. The nurse finds the patient tearful and trying to express his feelings, but he is clearly having difficulty. What would be the nurse's best response? A) Tell him that she'll leave for now but she'll be back in while. B) Offer to call pastoral care. C) Ask if he would like her to sit with him while he collects his thoughts. D) Tell him that she can understand how he's feeling.

A nurse is conducting a head-to-toe assessment of a middle-aged female patient. The nurse has palpated the breasts of a patient and believes that a mass is palpable in one of her breasts. How should the nurse best document this assessment finding? A) "Medium-sized mass palpable in the medial portion of the left breast." B) "Malignant mass palpable in the upper left lobe of the patient's left breast." C) "One-centimeter mass palpable 2 cm from nipple at the two o'clock position." D) "Mass palpable in the subcutaneous tissue of patient's left breast, approximately 4 cm from sternum."

A patient has been placed on telemetry following treatment for a non-ST wave elevation myocardial infarction (NSTEMI). Which of the patient's following statements indicates that the nurse should perform further patient teaching? A) "The nurse said that I can be up and around the unit while I'm hooked up to telemetry." B) "I've been told that telemetry gives a longer-term view of my heart's electrical activity than an electrocardiogram (ECG)." C) "If I get chest pain or shortness of breath, it will show up on my telemetry monitor." D) "I'll let someone know if one of the leads gets detached from my chest."

An individual's exposure to an airborne pathogen has prompted an immune response that includes both cellular and humoral components. Which of the following activities is most closely associated with the humoral immune response? A) T cells directly attack the foreign pathogen. B) A circulating lymphocyte containing an antigenic message returns to the nearest lymph node. C) B lymphocytes produce antibodies that are specific to the pathogen. D) Granulocytes and macrophages engulf and destroy the invading agents.

One of a hospital patient's scheduled 08:00 medications is finasteride (Proscar), a 5-alpha-reductase inhibitor that the nurse recognizes as a treatment for benign prostatic hyperplasia (BPH). The nurse should be aware that this drug achieves a therapeutic effect by: A) Increasing the osmolality of urine, facilitating easier passage through the urethra B) Relaxing the smooth muscle of the bladder neck and prostate C) Inhibiting the conversion of testosterone to dihydrotestosterone D) Increasing the tone of the bladder's detrusor muscle

The nurse is caring for a patient suspected of having renal dysfunction. When reviewing laboratory results for this patient, the nurse recalls that several substances are filtered from the blood by the glomerulus and these substances are then excreted in the urine. The nurse identifies the presence of which substances in the urine as abnormal findings? A) Potassium and sodium B) Bicarbonate and urea C) Glucose and protein D) Creatinine and chloride

The nurse knows that a specific classification of drugs leads to immunosuppression. What classification of drugs is this? A) Antibiotics (in small doses) B) Nonsteroidal anti-inflammatory drugs (NSAIDs, in large doses) C) Antineoplastics D) Antithyroids

The nurse providing care for a patient post percutaneous transluminal coronary angioplasty (PTCA) knows to monitor the patient closely. What does the nurse know to monitor for? Select all that apply. A) Abrupt closure of the coronary artery B) Venous insufficiency C) Bleeding at the insertion site D) Retroperitoneal bleeding E) Arterial occlusion

a, c,d,e

A 59-year-old patient has just been diagnosed with prostate cancer and is scheduled for brachytherapy next week. The patient and his wife are unsure of having the procedures because their daughter is 3 months pregnant, and they are concerned about exposing her to radiation. What is the most appropriate teaching the nurse should provide to this family? A) The patient should not be in contact with the baby when it is born. B) The patient will be in the hospital for a period of a few days after surgery. C) The patient and his wife can have sexual intercourse without difficulty. D) The patient should avoid close contact with his daughter for 2 months.

A 46-year-old man has been diagnosed with pericarditis and has begun treatment. When assessing this patient, the nurse should prioritize assessments relevant to what complications of pericarditis? Select all that apply. A) Cardiac tamponade B) Pericardial effusion C) ST elevation myocardial infarction (STEMI) D) Cardiac arrest E) Transient ischemic attacks (TIAs)

a,b

A 77-year-old female patient experienced an ischemic stroke 6 days ago and has a nasogastric (NG) tube in place to facilitate tube feeding. The care team has arranged for many of the patient's medications to be made available in liquid form but not all of her medications are available in liquid form. As a result, the nurses have been crushing some of the patient's pills and administering them with warm tap water. Which of the following medications should not be administered in this manner? A) Tylenol with codeine B) Levothyroxine (Synthroid) C) Metoprolol (Lopressor) D) Enteric-coated ASA

health education is

an independent nursing function primary nursing responsibility

A 28-year-old man has received a diagnosis of testicular cancer after a referral from his family health care provider and an extensive diagnostic workup. The patient's main concerns surround his sexuality and his future fertility. When the nurse addresses these topics during health education prior to radiation therapy, the nurse should inform the patient that: A) Successful treatment will usually result in infertility. B) He will be able to father children but will have a diminished sex drive. C) His sperm will be lower in number and unviable. D) His libido will not be significantly affected by treatment.

A 79-year-old female resident of a long-term care facility has reported urinary frequency to the nurse. As a result, the nurse has conducted a bladder ultrasound immediately following the woman's most recent void. When assessing the resident's urinary post-void residual, the nurse should understand that: A) A post-void residual of ≤ 250 mL is considered normal. B) The bladder should not contain any urine after voiding. C) The volume of residual urine is dependent on the volume of the preceding void. D) There will likely be 50 to 100 mL of residual urine in the woman's bladder.

A kidney biopsy has been scheduled for a patient with a history of acute renal failure. The patient asks the nurse why this test has been scheduled. What is the nurse's best response? A) "A biopsy is routinely ordered for all patients with renal disorders." B) "A biopsy is generally ordered following abnormal X-ray findings of the renal pelvis." C) "A biopsy is often ordered for patients before they have a kidney transplant." D) "A biopsy is sometimes necessary for diagnosing and evaluating the extent of kidney disease."

A middle-aged woman will soon begin treatment for a gastric tumor that has just been discovered by endoscopy. The woman's natural killer (NK) cells are already actively opposing the tumor cells, because the tumor cells lack "self" markers of major histocompatibility complex (MHC) class I. This aspect of the patient's immune response is characteristic of: A) Active immunity B) Humoral immunity C) Phagocytic immunity D) Natural immunity

A nurse in the intensive care unit is caring for a patient who is being treated for urosepsis. Over the past several hours, the patient's condition has deteriorated, and the care team believes that the patient is experiencing disseminated intravascular coagulation (DIC). What assessment should the nurse prioritize in the immediate care of this patient? A) Close observation for signs of internal or external hemorrhage B) Monitoring the patient for signs of fluid overload due to polycythemia C) Assessment of the patient's arterial blood gases (ABGs) D) Assessing the patient's passive range of motion to gauge thrombus formation

A patient who developed a deep vein thrombosis (DVT) is being treated with unfractionated heparin. The hospital's protocol for this treatment specifies analysis of the patient's activated partial thromboplastin time (aPTT) every 6 hours. When reviewing the patient's aPTT levels, the nurse should be aware that the desired levels for this patient will be: A) 60% to 70% of the normal reference range B) Slightly below or equal to the normal reference range C) Within normal reference range D) 1.5 to 2.5 times the normal reference range

A patient with a diagnosis of immune thrombocytopenic purpura (ITP) is currently receiving IVIG for the treatment of her health condition. The nurse who is providing this patient's care is aware that ITP is a consequence of: A) Inappropriate platelet aggregation on the walls of the great vessels B) Impaired liver function and the sequestering of platelets by hepatocytes C) Hemolysis of platelets in individuals who lack immunity to the Epstein-Barr virus D) Platelet destruction and impaired platelet production resulting from an autoimmune process

A patient's kidneys have just increased the amount of erythropoietin that they release. This action is likely a response to what feedback? A) The patient is experiencing a fluid volume deficit. B) The patient's blood pH has decreased. C) The patient is experiencing physiological stress. D) The patient has decreased oxygen tension.

After presenting to the emergency department with abdominal pain, a 21-year-old man was diagnosed with appendicitis and underwent a laparoscopic appendectomy. The patient has just been brought to the postsurgical unit from the PACU and is being admitted by the nurse. How should the nurse best position this patient? A) Left-side lying B) Supine C) Semi-Fowler's D) High Fowler's

An elderly patient has been admitted to the emergency department (ED) after accidentally overdosing on warfarin, and the patient's initial blood work reveals a dangerously high international normalized ratio (INR). The ED nurse should anticipate the need to administer: A) Calcium gluconate B) Fresh frozen plasma C) Low-molecular weight heparin D) Vitamin K

An emergency department (ED) nurse has provided care for many patients who have primary and secondary diagnoses of immune dysfunction. Which of the following patients likely has the highest risk of a disruption to normal immune functioning? A) A woman who was motivated to come to the ED because of a severe migraine B) A woman who presented for care for a complaint of vertigo C) A child who has just been treated for a greenstick fracture to her radius D) A man who has recently completed medical treatment for prostate cancer

Education Diagnosis

Effective therapeutic regimen management Ineffective therapeutic regimen management Ineffective family therapeutic regimen management Health-seeking behaviors Ineffective health maintenance Readiness for enhanced management of therapeutic regimen Deficient knowledge Readiness for enhanced knowledge

Hypokalemia symptoms

Fatigue, Anorexia, N/V, Muscle weakness, Decreased GI motility, Dysrhythmias, Paresthesia, Flat T or inverted T waves on ECG or both, depressed ST segments

A patient with angina is beginning nitroglycerin. Before administering the drug, the nurse informs the patient that, immediately after administration, the patient may experience what? A) Nervousness or paresthesia B) Throbbing headache or dizziness C) Drowsiness or blurred vision D) Tinnitus or diplopia

Methods for pain relief after CABG

IV and oral NSAIDs opiods

Following several months of increasing dyspnea on exertion, a 71-year-old woman has been diagnosed with mitral stenosis (MS). The woman is relieved to receive a diagnosis that explains her symptoms but does not completely understand the root of her problem. How can the nurse best explain the woman's health problem? A) "The valve in the left side of your heart has become stiff and narrowed, so your heart can't fill with all the blood that your body needs." B) "The left side of your heart is having trouble overcoming the resistance in your blood vessels because a valve is not sealing." C) "When your heart beats, some of the blood that should go to your body is backing up into your heart because the valve leaks." D) "The valve between your lungs and your heart has become inelastic, so your heart can't fill up with enough blood."

Hyperkalemia signs and symptoms

Intestinal colic, areflexia, weakness, peaked T wave, prolonged QRS and PR, low P, ventricular arrhythmias, cardiac arrest, skeletal muscle weakness and even paralysis

acute lymphoid leukemia (ALL)

Malignant, immature lymphocytes multiply in the blood, bone marrow, and lymphatic system.

Following the morning assessment of an older adult patient, the nurse has documented, "Edema 3+ present to ankles and feet; dorsalis pedis and posterior tibial pulses palpable bilaterally." The nurse should recognize that this patient may be exhibiting symptoms of: A) Heart failure B) Angina pectoris C) Intermittent claudication D) Hypertension

The critical care nurse is caring for a patient with a pulmonary artery pressure monitoring system. The nurse is aware that pulmonary artery pressure monitoring is used to assess left ventricular function (cardiac output). What else are pulmonary artery pressure monitoring systems used for? A) To assess the patient's response to interventions such as fluid administration and drug administration B) To obtain specimens for arterial blood gas measurements C) They have been determined to not be clinically useful for continuous monitoring of a patient with heart failure. D) To diagnose the etiology of chronic obstructive pulmonary disease.

Hypercalcemia symptoms

Muscle flaccidity Proximal muscle weakness of the lower extremities Bone tenderness Decreased neuromuscular activity of the bowel, causing constipation High calcium concentrations in the urine, which increase susceptibility to renal calculi Ventricular arrhythmias Dulled consciousness Depression Anorexia, nausea, vomiting, and ulcers Hyperreflexia Tongue fasciculations

What are the intracellular anions?

Phosphates and sulfates 150 mEq/L HCO3- 10 mEq/L Proteinate 40 mEq/L Total 200 mEq/L

Mifepristone (RU-486)

Progesterone and glucocorticoid inhibitor: abortifacient, antineoplastic

interferon

Protein produced by cells in response to being infected by a virus; helps other cells resist the virus.

Antibodies

Protein that is produced by lymphocytes and that attaches to a specific antigen.

Virchow's triad

Pulmonary embolism (triad = blood stasis, endothelial damage, hyper-coagulation) from a venous thrombus

management of prostate cancer

Radical prostatectomyBrachytherapyRadiotherapyHormonal therapy (GnRH analogues) - decrease testosterone (surgical castration)Bisphosphonates for bone diseasecryotherapy manage painmanage urinary cathetersbe sensitive about sexual function and body image

Cancer of prostate

Rarely occurs rarely before 40 years of age, but it is the second leading cause of death from cancer in American men; high risk groups include those with a history of multiple sexual partners, STDs and certain viral infections good outcome asymptomatic initially urinary obstruction dribbling uti retention hematuria metastasis - to bone, pain and anemia, weightless, weakness, nausea, oliguria

right atrium

Receives deoxygenated blood from the body

Short acting insulin

Regular - Humulin R, Novolin R short acting onset 30-60 min 2-3 hours duration 4-5 hours

memory T cells

Remember antigen and quickly stimulate immune response on reexposure

Hyperchloremia S/S

Tachypnea Weakness Lethargy Deep, rapid respirations Diminished cognitive abilities Hypertension

S/S of heart failure

Tachypnea, Crackles, Tachycardia, (sometimes HTN), S3/or S4, patient may have peripheral edema -Right Sided Failure= Peripheral Edema -Left Sided Failure= Pulmonary Edema

humoral immune response

The branch of adaptive immunity that involves the activation of B cells and that leads to the production of antibodies, which defend against bacteria and viruses in body fluids.

The nurse is auscultating a patient's chest for breath sounds and is unsure if the sounds are crackles or simply the friction of the stethoscope's diaphragm against the patient's chest hairs. What should the nurse do? A) Move the location of the diaphragm slightly and listen for a few more breaths. B) Prioritize the assessment findings from percussion and inspection. C) Move the diaphragm slowly across the surface of the patient's skin while auscultating. D) Auscultate the patient's lateral thorax rather than his anterior thorax.

The nurse is caring for a patient with a diagnosis of hypoproliferative anemia. When planning this patient's care, the nurse should be aware that this type of anemia is due to what? A) Lack of production of red blood cells (RBCs) B) Loss of RBCs C) Injury to the RBCs in circulation D) Abnormality of RBCs

The nurse is currently planning the care of a patient with multiple myeloma who is experiencing bone destruction. When reviewing the patient's most recent blood work, what value would the nurse pay particular attention to? A) Hypercalcemia B) Hyperproteinemia C) Elevated serum viscosity D) Elevated red blood cell (RBC) count

The nurse is on the infection control committee of a hospital and is looking into three cases of hospital-acquired infective endocarditis. What classification of patient is at highest risk for hospital-acquired endocarditis? A) Hemodialysis patients B) Patients on immunoglobulins C) Patients who need in-and-out catheterization D) Chemotherapy patients

You are a nurse who works in a public health setting. As such, you participate in many health promotion activities that are ultimately aimed at reducing the high incidence and prevalence of cancer in American society. Which of the following activities is an example of secondary prevention? A) Teaching older adults why and how to perform fecal occult blood tests B) Educating middle school students about the health risks of smoking C) Conducting a campaign aimed at encouraging parents to apply sunscreen to their young children D) Teaching workers at a factor about possible carcinogens in their workplace

Inotropics

Which of the following medications has not been delivered as an aerosol by a respiratory therapist?

A 12-year-old girl on the oncology unit at children's hospital tells the nurse that she has discovered that there are several different kinds of leukemia. The child asks the nurse to explain what makes them all "leukemia." What should the nurse reply? A) The different leukemias all have unregulated proliferation of white blood cells. B) The different leukemias all have unregulated proliferation of red blood cells. C) The different leukemias all have decrease in production of white blood cells. D) The different leukemias all have decrease in production of red blood cells.

A 61-year-old man has a longstanding history of peripheral artery disease that has progressed in recent months to acute limb ischemia (ALI). As a result, he has just undergone bilateral arterial bypass grafts and is postoperative day 1. The nurse's most recent assessment reveals that the patient's left foot is cold to touch and dusky in appearance with nonpalpable peripheral pulses. How should the nurse respond to this assessment finding? A) Report the finding to the surgeon immediately. B) Encourage the patient to perform light activity and assist with range of motion exercises. C) Place a warm compress on the patient's foot to stimulate circulation. D) Administer a dose of the patient's prescribed anticoagulant.

A patient who is postoperative day 2 following a coronary artery bypass graft (CABG) has been experiencing significant pain in the region of his sternal incision. What patient teaching should the nurse perform with this patient? A) "Try to hug a folded blanket across your chest when you move or breathe deeply." B) "If possible, try to avoid coughing and breathe as shallowly as possible to relieve pressure on your incision." C) "The less you can move, the less pain you're likely to have in the area of your incision." D) "Getting you up and mobilizing as soon as possible will help with this problem."

A patient who is recovering from a coronary artery bypass graft (CABG) is anxious about resuming normal levels of activity and mobility, citing a fear of putting undue strain on his heart, as well as being unable to safely mobilize. Consequently, the patient has expressed his intention to remain on bed rest for several days. How should the nurse respond to this patient's concerns about activity and mobility? A) "There are actually a lot of benefits of moving early and often. While you're mobilizing, we'll keep you safe." B) "Actually, your plan of care already includes several days of bed rest to make sure that your heart is fully recovered." C) "It would be ideal if you could do some light mobilizing soon, but you can let us know when you would like to begin this." D) "You'll have to get permission from your cardiologist if you want to stay in bed for longer than normal."

A patient with a recent history of infective endocarditis has asked his nurse practitioner about the use of prophylactic antibiotics before getting his teeth cleaned at his dentist. The patient states that he read about such measures on a website. Which of the following guidelines will underlie the nurse's response to the patient? A) Low-risk individuals are no longer required to receive antibiotic prophylaxis before dental work. B) The patient should take a broad-spectrum antibiotic for 7 to 10 days before having dental work. C) If the patient received IV antibiotics for the treatment of endocarditis, prophylaxis is not necessary. D) The patient will need peripheral IV access for the administration of antibiotics.

An older adult patient has been admitted to a medical unit, and the nurse is conducting a comprehensive assessment of the patient in order to plan care appropriately. Which of the nurse's following assessments directly relate to the known risk factors for cardiovascular disease? Select all that apply. A) Measuring the patient's random glucose level B) Assessing the patient's oxygen saturation levels by pulse oximetry C) Measuring the patient's blood pressure D) Auscultating the patient's lungs E) Measuring the patient's temperature orally

a,c

Hyperkalemia occurs with

adrenal insufficiency

A health care provider orders a unit of packed red blood cells (PRBC) for a postoperative patient. The nurse is responsible for patient assessment and health care information pre- and post-transfusion. Which of the following are the guidelines that the nurse should follow? Select all that apply. a. Determine the history of any previous transfusions and possible reactions. b. Review the signs and symptoms of a transfusion reaction. c. Explain that since 1985 the supply of blood available for transfusions is risk-free. d. Report any increase of 1 degree in temperature, during or after transfusion, which falls into a febrile range. e. Explain that urticaria is a harmless, common reaction to a transfusion occurring at least 50% of the time.

alb,d

surgical treatment of regurgitation

annuloplasty, leaflet, chrodoplasty

heparin-induced thrombocytopenia

antibody-mediated reaction to heparin that may result in thrombosis. Patients who have received heparin within the past 3 months and those who have been receiving UFH for 5 to 15 days are at high risk for HIT.

Nursing is the profession that

assists the individual sick or well to perform normal everyday tasks

common complications of impaired mass exchange after CABG

atelectasis decreased profussion

how do reverse hypotension and bradycardia

atropine

A 68-year-old male patient has been admitted to the surgical unit from the PACU after surgical repair of an inguinal hernia. When performing the patient's admission assessment, the nurse notes that the patient has a barrel chest. This assessment finding should suggest to the nurse that the patient may have a history of what health problem? A) Asthma B) Emphysema C) Tuberculosis D) Chronic bronchitis

A patient has been admitted with endocarditis. The patient asks the nurse how the health care provider knows what medicines to order to kill the bacteria. The nurse knows that to find the most appropriate antibiotic treatment, what test would be the most helpful? A) Echocardiogram B) Blood cultures C) Arterial blood gases (ABGs) D) Complete blood count (CBC)

A patient has been diagnosed with mitral valve prolapse (MVP) following an echocardiogram and will begin treatment imminently. When planning this patient's care, the nurse will prioritize: A) Protecting the patient from infection B) Preserving the patient's existing level of function C) Reducing the patient's risk of ischemic heart disease D) Teaching the patient the signs and symptoms of pericardial effusion

A patient newly admitted to the telemetry unit is experiencing progressive fatigue, hemoptysis, and dyspnea as a result of pulmonary venous hypertension. What valvular disorder would cause pulmonary venous hypertension? A) Aortic regurgitation B) Mitral stenosis C) Mitral valve prolapse D) Aortic stenosis

A patient with a diagnosis of renal cell carcinoma is being treated with chemotherapy. During a previous round of chemotherapy, the patient's tumor responded well to treatment but the chemotherapy caused intense nausea and vomiting. How should the patient's potential nausea and vomiting be addressed during this current round of treatment? A) Prioritize nonpharmacological treatments over medications. B) Administer antiemetics in anticipation of the patient's nausea. C) Provide the patient with antiemetics at his first complaint of nausea. D) Administer antiemetics if the patient vomits or believes he will soon vomit.

A patient with chest trauma is admitted to the ICU. The nurse notes the patient's chest and neck are swollen and there is a crackling sensation when palpated. The nurse knows the patient has subcutaneous emphysema. If this condition becomes severe, what treatment is most likely indicated? A) A chest tube B) A tracheostomy C) An endotracheal tube D) A feeding tube

A patient with pericarditis has been admitted to the CCU. The nurse caring for the patient knows that the most common clinical manifestation of pericarditis is what? A) Palpitations B) Chest pain C) Burning sensation in chest D) Pounding heart rate

A water seal system for chest drainage has been inserted into a patient who suffered chest trauma during a motor vehicle accident. At the beginning of the night shift, the nurse has entered the patient's room to assess the system and the patient's condition. Which of the following assessment findings suggests that the system is operating correctly and the patient is maintaining oxygenation? A) There is constant bubbling in the water seal chamber. B) The water level in the water seal chamber increases when the patient inhales. C) The level in the water seal chamber stays constant throughout the ventilation cycle. D) The water level reaches the top of the water seal chamber with each breath.

After a detailed diagnostic workup, a patient has been diagnosed with atrial septal defect (ASD). The nurse should recognize that this patient may exhibit many of the signs and symptoms that are typically associated with: A) Unstable angina B) Right-sided heart failure C) Myocardial infarction D) Endocarditis

The nurse assesses the patient and records the data collected. What would lead the nurse to anticipate that the patient will experience a decrease in cardiac output? A) An order for the patient to receive digoxin B) A heart rate of 54 beats per minute C) A pulse oximetry reading of 98% D) An increase in preload related to ambulation in the hall

The nurse who is caring for a patient suspected of having pericarditis is aware that the patient's chest pain must be clearly differentiated from chest pain that may be attributable to myocardial infarction. When assessing the patient, how should the nurse make this differentiation? A) "Would you describe your pain as a stabbing pain or is it more of a dull ache?" B) "When you breathe in deeply, does your pain get more intense?" C) "When exactly did you first sense that you were having chest pain?" D) "Is your pain worse when you're lying down, or is it worse when you're sitting up?"

The nursing educator is teaching a group of nurses about constipation and the elderly. What recommendation for this population should a nurse can make about treating chronic constipation? A) Take a mild laxative, such as magnesium citrate, when necessary. B) Take a stool softener, such as docusate sodium (Colace), daily. C) Administer a tap water enema weekly. D) Administer a phospho-soda (Fleet) enema when necessary.

The staff educator is presenting a workshop on valvular disorders. When discussing the pathophysiology of aortic regurgitation, the educator emphasizes that aortic regurgitation causes what? A) Cardiac tamponade B) Left ventricular hypertrophy C) Right-sided heart failure D) Ventricular insufficiency

immunoglobulins

bind with specific antigens in the antigen-antibody response IgA, IgD, IgE, IgG, IgM

if mitral valve is affected

blood will flow back into the left atrium (LA) during systole preload is increased

if aortic valve is affected

blood will flow backward into the left ventricle (LV) during diastole

Greenstick (incomplete)

bone partially bent and partially broken; often occurs in children

compound fracture

break in the bone where the bone comes through the skin; open fracture

impacted fracture

broken bone ends are forced into each other

A 40-year-old man who is normally in good health has presented to the emergency department with an acute onset of sharp, mid-chest pain that is exacerbated by movement. Diagnostic testing is negative for myocardial infarction (MI), causing the care team to suspect that the patient is experiencing what health problem? A) Unstable angina B) Endocarditis C) Pericarditis D) Dilated cardiomyopathy (DCM)

A 73-year-old man with aortic stenosis has had percutaneous aortic balloon valvuloplasty performed because he is not a candidate for valve replacement. Following this procedure, the nurse should prioritize assessments related to: A) Anginal pain B) Signs and symptoms of myocardial infarction C) Ventricular arrhythmias D) Pericarditis

A clinic nurse has been charged with the responsibility of teaching avoidance strategies to an adult patient who has allergic rhinitis. What measure should the nurse recommend to this patient? A) "Make sure that there are never air drafts in your home." B) "Avoid the use of air conditioning whenever possible." C) "If possible, make sure that no one smokes tobacco in your home." D) "Keep your windows open to ensure adequate air circulation."

A comatose patient is receiving oral care. What oral care regimen would be most effective in decreasing the patient's risk of tooth decay and plaque accumulation? A) Irrigating the mouth using a syringe filled with a bacteriocidal mouthwash B) Applying a water-soluble gel to the teeth and gums C) Wiping the teeth and gums with a gauze pad D) Gently stroking the teeth and gums with a lemon and glycerine swab

A nurse is receiving change-of-shift report about an older adult patient who has a diagnosis of chronic obstructive pulmonary disease (COPD). The nurse's colleague reports that she has applied oxygen at 6 L/min by nasal prongs in an effort to bring the patient's oxygen saturation levels above 92%. How should the nurse best interpret this colleague's action? A) Supplementary oxygen should not normally be given to patients who have a history of COPD. B) The patient should be given oxygen by simple face mask rather than by nasal prongs. C) Giving oxygen at a high rate has the potential to interfere with the patient's hypoxic drive. D) The patient will require 2 to 3 hours of oxygen therapy before an increase in oxygen saturation occurs.

A patient with a history of primary hypertension has undergone echocardiography after being referred to a specialist for blood pressure management. The patient's echocardiogram revealed ventricular hypertrophy and a decreased ejection fraction. The nurse who is providing care for this patient should recognize that these findings are characteristic of what valvular disorder? A) Mitral valve regurgitation B) Mitral valve stenosis C) Aortic stenosis (AS) D) Tricuspid regurgitation

A patient with mitral stenosis exhibits symptoms of a dysrhythmia. Based on the pathophysiology of this disease process, the nurse would expect the patient to exhibit what heart rhythm? A) Normal sinus rhythm B) Supraventricular tachycardia C) Atrial fibrillation D) Electromechanical dissociation

Allergy testing has revealed that an elementary school-aged child has a severe hypersensitivity to insect stings. When conducting health education with the child's parents, the nurse should address which of the following subjects? A) The importance of limiting the child's activity level when outdoors B) The importance of keeping a metered-dose inhaler of albuterol with the child C) The need for the child to carry an EpiPen D) The need to provide antihistamine tablets to the child's teacher and caregivers

The nurse is admitting a patient to the cardiac care unit with complaints of dyspnea on exertion and fatigue. The patient's electrocardiogram (ECG) shows dysrhythmias associated with left ventricular hypertrophy. What diagnostic tool would be the most helpful in diagnosing cardiomyopathy? A) Cardiac catheterization B) Arterial blood gases (ABGs) C) Echocardiogram D) Swan-Ganz analysis

The nurse is caring for a patient admitted with chronic obstructive pulmonary disease. During assessment, the nurse finds that the patient is experiencing a change in his respiratory and mental status. The nurse is aware that the most accurate measurement of the concentration of oxygen in the patient's blood is what? A) A capillary blood sample B) Pulse oximetry C) An arterial blood gas (ABG) study D) Assessment of the patient's nail beds

The nurse is caring for a patient with acute pericarditis. What nursing management would be instituted to minimize complications? A) The nurse keeps the patient isolated to prevent nosocomial infections. B) The nurse encourages coughing and deep breathing. C) The nurse helps the patient with activity restrictions until the pain and fever subside. D) The nurse encourages increased fluid intake until dehydration is resolved.

Your patient has recently completed her first round of chemotherapy in the treatment of lung cancer. When reviewing this morning's blood work, what findings would be suggestive of myelosuppression? A) Decreased sodium levels and decreased potassium levels B) Increased creatinine and blood urea nitrogen (BUN) C) Decreased platelets and red blood cells D) Increased white blood cells and c-reactive protein (CRP)

Your patient is receiving carmustine, a chemotherapy agent. A significant side effect of this medication is thrombocytopenia. What symptom would the nurse assess for in a patient at risk for thrombocytopenia? A) Interrupted sleep pattern B) Hot flashes C) Nose bleed D) Increased weight

A 68-year-old female patient has returned to the cardiac care unit from PACU following a successful coronary artery bypass graft (CABG). The nurse who is providing care for this patient during her immediate postsurgical period must prioritize respiratory assessment because of the patient's high risk of: A) Atelectasis B) Empyema C) Pulmonary embolism (PE) D) Pleural effusion

A patient with a small bowel obstruction has had a Levin tube inserted and is admitted to a medical unit. The nurse who is caring for this patient is now checking that the wall suction settings are correct and should anticipate which of the following settings? A) Continuous high suction B) Intermittent high suction C) Continuous low suction D) Intermittent low suction

Mrs. Bedard is a 72-year-old woman who has been admitted to the acute care for elders (ACE) unit due to an exacerbation of chronic obstructive pulmonary disease (COPD). The nurse has conducted a focused respiratory assessment. Which of the following assessment findings should the nurse recognize as being anomalous? A) Tactile fremitus is present. B) The ratio of the anteroposterior diameter of Mrs. Bedard's chest to the lateral diameter is 1:2. C) Thoracic percussion over Mrs. Bedard's lung fields is resonant. D) Mrs. Bedard's resting respiratory rate is 26 breaths per minute.

The nurse is performing a comprehensive assessment of a new female resident of a long-term care facility. The nurse reads in the resident's accompanying documentation that she had rheumatic fever as a girl. The nurse should recognize that the resident has a significantly increased risk of developing: A) A septal wall defect B) Pericarditis C) Dilated cardiomyopathy (DCM) D) Mitral stenosis

The nurse is providing care for a hemodynamically unstable patient in a critical care setting. The nurse has read in the patient's chart that his most recent echocardiogram prior to admission indicated a low stroke volume, which the nurse recognizes as being a function of preload, afterload, and contractility. Which of the following statements best describes afterload? A) The pressure that the ventricles exert on the atria after the conclusion of systole B) The mean arterial pressure during diastole C) The quantity of blood that remains in the ventricle at the end of systole D) The amount of resistance to the ejection of blood from the ventricle

The nurse is teaching a patient diagnosed with aortic stenosis the importance of attempting to relieve the symptom of angina without drugs. What should the nurse teach the patient? A) To eat a small meal before taking nitroglycerin B) To drink a glass of milk before taking nitroglycerin C) To engage in 15 minutes of light exercise before taking nitroglycerin D) To rest and relax before taking nitroglycerin

You are an oncology nurse who has reconstituted a patient's scheduled chemotherapeutic drug. What action should you perform prior to administering this drug? A) Aspirate 5 to 10 mL of blood from the patient's IV access device. B) Teach the patient about the pharmacodynamics of the drug. C) Administer a prophylactic antibiotic as ordered. D) Have a colleague confirm the chemotherapy dose.

Cytotoxic T cells

destroy pathogens and release chemicals called cytokines

sympathomimetic drug

enhances adrenergic function by binding to receptors, increase norepinephrine production and release, and/or may block removal of norepinephrine (phenylephrine, cocaine, caffeine)

what to hormones surge during ovulation

estrogen LH

s/s of testicular cancer

lump or enlargement in either testicle, feeling of heaviness in the scrotum, dull ache in the abdomen or groin, sudden collection of fluid in the scrotum, pain or discomfort in testicle or scrotuminitially painlesshematuriainvasion of urethramatastis - back pain, weight loss, generalized weakness, to lymph nodes

health-illness continuum

makes it possible to view a person as simultaneously possessing degrees of both health and illness

Normal hematocrit values

male: 42-52% female: 36-48%

Patients with ARDS usually require

mechanical ventilation with a higher-than-normal airway pressure

Hypokalemia occurs with

metabolic alkalosis,excessive excretion, vomiting

Methotrexate (Rheumatrex)

rheumatoid arthritis

false aneurysm

rupture of the arterial walls, causing swelling

Sildenafil (Viagra)

s/s: headache, heartburn, diarrhea, flushing, nosebleeds, parathesias, changes in color visionContradicted in clients taking nitrates, anticoags, anti HTN

hydrocele

sac of clear fluid in the scrotum - lining of testes or spermatic chordsurgery usually not needed

screening for prostate cancer

screening for prostate cancer 1. Men age 40-50, do yearly digital rectal exam2. Men age > 50, do yearly digital rectal plus PSA (Prostate Specific Antigen)3 if suspected, a transrectal ultrasonogram is usually the next best step, followed by needle biopsy and then staging

a high serum phosphorus concentration tends to cause a low

serum calcium concentration

types of joints

synarthrosis, amphiarthrosis, diarthrosis

signs of hypoxemia

tachypnea tachycardia restlessness use of accessory muscles nasal flaring

phagocytic immune response

the immune system's first line of defense, involving white blood cells that have the ability to ingest foreign particles

Scope of practice is determined by

the state of which the nurse is practicing in

Galactography

the use of mammography after an injection of radiopaque dye to diagnose problems in the ductal system of the breast

Why are arterial grafts preferred over venous

they do not develop atherosclerotic changes as quickly and remain patent longer

Calcintonin

thyroid glandlowers blood calciuminhibits bone resorption, reduces the renal resorption of calcium and phosphate, and increases the deposit of calcium in bone

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