PRACTICE QUESTIONS
20-year-old woman will soon begin taking oral contraceptives for the first time. What advice should the nurse provide to this patient? a) "Some women get some pain in their chest or abdomen when they take oral contraceptives, but this will pass as your body gets used to them." b) "It will take 10 to 12 weeks before the birth control pills will actually prevent pregnancy, so be vigilant with other contraceptives until then." c) "Make sure to seek care quickly if you experience bad headaches, calf pain, or changes in vision." d) "You need to carefully consider whether you might want to get pregnant later in your life."
"Make sure to seek care quickly if you experience bad headaches, calf pain, or changes in vision."
A woman who is at 31 weeks' gestation comes to the clinic in labor. The physician decides to use terbutaline therapy before transferring the woman to the hospital. The patient is upset and confused and asks the nurse why she can't just have the baby, that it's only 5 weeks early. An appropriate response by the nurse should be a) "This drug helps induce uterine contractions and milk ejection for breast-feeding." b) "The drug provides sufficient time for other medications to be given to improve your baby's outcome." c) "The drug that you are being given will prevent and control postpartum bleeding." d) "This drug will make your delivery in a few days less painful."
"The drug provides sufficient time for other medications to be given to improve your baby's outcome."
Conjugated estrogen therapy would be most appropriate for which one of these patients? a) A 25-year-old female with primary ovarian failure b) A 72 year old with newly diagnosed breast cancer c) A 65 year old with a history of abnormal vaginal bleeding d) A 35 year old with a history of thrombophlebitis, to prevent pregnancy
A 25-year-old female with primary ovarian failure
Oral contraceptive use would be contraindicated by which of the following in a client's medical history? a) A 40-year-old client who smokes 1 to 1½ packs of cigarettes per day b) A 50-year-old client who is taking a cholesterol-lowering medication c) A 40-year-old client who has a family history of hypofunction of the pituitary gland d) A 45-year-old client who has a family history of pancreatic cancer
A 40-year-old client who smokes 1 to 1½ packs of cigarettes per day
Which of these laboratory findings, if obtained during a physical assessment of a patient who is pregnant, should a nurse follow-up? 1. A hemoglobin level of 9.0 gm/dL. 2. A BUN of 22 g/dL. 3. A white blood cell count of 9,500/cu mm. 4. A serum sodium level of 135 mEq/L.
A hemoglobin level of 9.0 gm/dL
When assessing a patient diagnosed with hypercortisolism (Cushing's disease), a nurse should expect to find which of these physical manifestations? 1. Poor posture. 2. Thin, dry hair. 3. Abdominal striae. 4. Drooping eyelids.
Abdominal striae
When assessing an adolescent for scoliosis, which of these actions should a nurse include? 1. Ask the adolescent to raise both arms over his/her head. 2. Ask the adolescent bend both knees and squat 3. Ask the adolescent to walk on his/her tiptoes 4. Ask the adolescent to bend forward at the waist
Ask the adolescent to bend forward at the waist
A nurse is assessing a 30-week preterm infant who is in the neonatal intensive care unit. Which of these observations, if present, indicate to a nurse that the infant is experiencing early signs of respiratory distress syndrome? 1. Bradycardia. 2. Audible expiratory grunt. 3. Respiratory alkalosis. 4. Low arterial blood pressure.
Audible expiratory grunt.
A new client calls on the phone requesting a prescription for contraceptives, which she has been taking for 2 years. She has not been seen in more than a year and is unable to come into the clinic until next month. She insists she is doing fine on this medication and must have her prescription now. Your best response would be: a) As long as she is doing well on this regimen, you will get the prescription filled until she can come into the clinic. b) Before the drugs are prescribed, a complete medical history, physical examination, pap test, urinalysis, and weight and blood pressure measurements are recommended. c) As long as she had a physical within 2 years, she can get her medication refilled. d) Before the drugs are prescribed, she must see the health care provider to get an order for a mammogram.
Before the drugs are prescribed, a complete medical history, physical examination, pap test, urinalysis, and weight and blood pressure measurements are recommended.
A patient taking hormonal contraceptives turns 35 years of age and has smoked for 15 years. Which of the following is most important? a) Begin daily aspirin therapy b) Begin taking NicoDerm c) Begin smoking cessation d) Begin an exercise regime
Begin smoking cessation
The nurse is discussing the use of Depo-Provera with a 17-year-old female who desires birth control. The nurse recognizes that this medication is used in this client for what reason? a) Birth control for 3 months b) No adverse effects usually associated with medroxyprogesterone c) No vaginal bleeding for 12 months d) Decreases chance of sexually transmitted infections
Birth control for 3 months
The nurse is caring for a client who has cancer and who until recently took estrogen. The nurse knows that estrogen may have increased the risk of development of which types of cancer? (Select all that apply.) a) Breast cancer b) Brain cancer c) Endometrial cancer d) Melanoma e) Lung cancer
Breast cancer Endometrial Cancer
A female client asks the nurse about the use of progestins. The nurse shares with the client that clients who take this medication are at an increased risk for what serious adverse effect? a) Respiratory difficulties b) Renal failure c) Seizures d) Cardiovascular complications
Cardiovascular complications
Which of these manifestations should a nurse interpret as a systemic effect of neurological shock? 1. Vasoconstriction with the sympathetic nervous system. 2. Cerebral edema with continued hypoxia. 3. Release of renin as a result of anuria. 4. Tachycardia as a result of the sympathetic nervous system.
Cerebral edema with continued hypoxia
During a physical assessment, a nurse observes that a patient has rapid, jerky, involuntary motions. How should the nurse document this finding? 1. Dysreflexia. 2. Choreiform. 3. Perseveration. 4. Paresthesia.
Choreiform
Which of these laboratory test results indicates effective treatment with simvastatin (Zocor)? 1. Increased serum bilirubin level. 2. Decreased HDL cholesterol level. 3. Increased triglyceride level. 4. Decreased LDL cholesterol level.
Decreased LDL cholesterol level
When evaluating a patient who has hyperventilation, a nurse should expect to obtain which of these blood chemistry results? 1. Decreased oxyhemoglobin level. 2. Decreased pH level. 3. Decreased carbon dioxide level. 4. Decreased oxygen level.
Decreased carbon dioxide level
When a patient has decreased contraction of the diaphragm, a nurse should expect the patient to demonstrate which of these pulmonary changes? 1. Decreased pressure. 2. Increased volume. 3. Decreased volume. 4. Increased blood flow.
Decreased volume
Which of these manifestations should a nurse expect to observe in a patient who has anaphylactic shock? 1. Hypothermia. 2. Bradycardia. 3. Absent urine output. 4. Difficulty swallowing.
Difficulty swallowing
Choice Multiple question - Select all answer choices that apply. What nursing interventions are most important if the nurse has concerns that the client is developing fluid overload while receiving oxytocin (Pitocin)? Select all that apply. a) Discontinue the oxytocin infusion. b) Administer oxytocin intranasally. c) Encourage the client to force fluids. d) Increase the client's maintenance IV. e) Measure the client's output hourly.
Discontinue infusion Measure output hourly
Which of the following would a patient most likely be using if the nurse assesses the patient for signs and symptoms of hyperkalemia? a) Norethindrone b) Drospirenone c) Norgestrel d) Medroxyprogesterone
Drospirenone
Which of these manifestations should a nurse expect to assess in a patient who has left-sided heart failure? 1. Liver engorgement. 2. Jugular vein distention. 3. Dyspnea. 4. Bradycardia.
Dyspnea
Which of these measures should a nurse include when assessing a patient's jugular veins for distention? 1. Pressing firmly on the side of the neck. 2. Turning the patient's head towards the nurse. 3. Elevating the patient's head 30 degrees. 4. Placing the patient in a supine position.
Elevating the patient's head 30 degrees
Your client informs you that she had unprotected intercourse last night. She is considering requesting emergency postcoital contraception. Your best response is: a) Emergency contraception is most effective if started within 24 hours and no later than 72 hours after exposure. b) Emergency contraception is most effective if started 72 hours after exposure. c) Emergency contraception is most effective if started within 8 hours and no later than 24 hours after exposure. d) Emergency contraception is not effective if started later than 12 hours after exposure.
Emergency contraception is most effective if started within 24 hours and no later than 72 hours after exposure.
The nurse is aware that older men are more prone to urinary tract infections because of what physiologic change related to aging? a) Involuntary contractions of the bladder muscle b) Loss of muscle tone in the pelvic structures c) Reduction in renal function d) Enlargement of the prostate
Enlargement of the Prostate
Which of these manifestations is suggestive of a UTI in a 6-year-old? 1. polyphagia 2. anuria 3. hypotension 4. enuresis
Enuresis
Your client is menopausal and has been given a prescription for estrogen. She asks you what some of the risks in taking the medication are. Your best response is: a) Estrogen decreases the risk of dementia, myocardial infarctions, strokes, breast cancer, and blood clot. b) Estrogen has not been proven to increase any medical conditions. c) Estrogen increases the risk of certain cancers, myocardial infarctions, and blood clots. d) As long as estrogen and progesterone are taken together, there are no increased health risks.
Estrogen increases the risk of certain cancers, myocardial infarctions, and blood clots.
Which data from a patient's medical history should alert a nurse to suspect hyperactivity of the thyroid gland? 1. Fluid retention with weight gain. 2. Eyelid retraction or exophthalmos. 3. Diastolic hypertension with narrow pulse pressure. 4. Lethargy and drowsiness.
Eyelid retraction or exophthalmos
Clomiphene is administered subcutaneously as well as orally. a) True b) False
False
To assess for Kernig's sign, which of these actions should a nurse take? 1. Flex the patient's toes and observe for pain in the heel. 2. Flex the patient's hip and observe for hamstring pain. 3. Flex the patient's neck and observe for hip pain. 4. Flex the patient's neck and observe for discomfort.
Flex the patient's hip and observe for hamstring pain
When a patient is suspected of having adrenal hypofunction, which question is the most important for a nurse to ask when taking a health history? 1. Do you smoke or use tobacco products? 2. Have you ever had abdominal x-ray done or skill films made? 3. Have you experienced night sweats or coughing? 4. Do you have a family history of cancer or diabetes?
Have you experienced night sweats or coughing?
Which of the following would the nurse include in a teaching plan about the signs and symptoms of thrombophlebitis and thromboembolism that should be reported by a patient taking estrogen? a) Headaches and chest pain b) Amenorrhea c) Breast tenderness d) Cholestatic jaundice
Headaches and chest pain
The nurse is aware that intranasal oxytocin is used for what reason? a) Firm and boggy fundus in the postpartum period b) Stimulation of labor contractions c) Help with milk letdown in breastfeeding d) Control of postpartum bleeding
Help with milk letdown in breastfeeding
Which of these manifestations should a nurse expect to observe in a patient who has cancer of the larynx? 1. High-pitched voice. 2. Hoarse voice. 3. Hemoptysis. 4. Purulent sputum.
Hoarse voice
A 30-year-old pregnant woman has been prescribed administration of oxytocin. When assessing the patient's drug regimen, the nurse understands that the patient is taking vasopressors. Which of the following risks is the patient most susceptible to if oxytocin is administered along with vasopressors? a) Heart attack b) Anaphylactic shock c) Respiratory failure d) Hypertension
Hypertension
The use of methylergonovine (Methergine) is contraindicated in patients with which of the following medical conditions? (Choose one) a) Asthma b) Hypertriglyceridemia c) Hypertension d) Diabetes
Hypertension
The use of methylergonovine (Methergine) is contraindicated in patients with which of the following medical conditions? (Choose one) a) Diabetes b) Hypertension c) Hypertriglyceridemia d) Asthma
Hypertension
A patient is to receive tap water enemas until clear. Which of these electrolyte imbalances should a nurse monitor for in the patient? 1. Hypocalcemia. 2. Hyperphosphatemia. 3. Hypokalemia. 4. Hypernatremia.
Hypokalemia
A patient's computerized tomography (CT scan) report indicates there is a cerebellar infarction. A nurse should anticipate that the patient will have which of these manifestations? 1. Imbalanced walking. 2. Ipsilateral facial paralysis. 3. Impaired swallowing. 4. Homonymous hemianopsia.
Imbalanced walking
Which of these assessment findings should a nurse expect to obtain on a patient who has Cushing syndrome? 1. Decreased cortisol, decreased aldosterone, increased androgens. 2. Increased cortisol, decreased aldosterone, decreased androgens. 3. Decreased cortisol, increased aldosterone, decreased androgens. 4. Increased cortisol, increased aldosterone, increased androgens.
Increased cortisol, increased aldosterone, increased androgens
When a nurse assists a physician in conducting a liver biopsy test, which of these measures should the nurse take? 1. Instructing the patient to hold his/her breath. 2. Withdrawing the stylet. 3. Inserting the cannula. 4. Applying anesthetic agent to the skin.
Instructing the patient to hold his/her breath.
When caring for a patient receiving estrogen therapy, which of the following actions would be an appropriate part of the evaluation process? a) Teaching the patient to take estrogens and progestins with food or at bedtime to decrease nausea b) Directing the patient to weigh herelf weekly and to report sudden weight gain c) Interviewing the patient and observing for therapeutic and adverse effects d) Teaching the patient that combined estrogen-progestin therapy may increase blood sugar levels in women with diabetes
Interviewing the patient and observing for therapeutic and adverse effects
Your client is menopausal but refuses to take estrogen because she fears having a stroke. She is currently on HydroDIURIL for hypertension. She asks if taking a natural herb, such as cohosh would be safe. In addition to referring her to her medical care provider for further information, your best response would be: a) She should take estrogen instead, as the herb may lead to strokes. b) It must be used cautiously as the herb may increase the hypotensive effects of antihypertensive drugs. c) Blood pressure is not affected by herbal supplements. d) There is no difference between taking the herbal supplement or estrogen.
It must be used cautiously as the herb may increase the hypotensive effects of antihypertensive drugs.
Which of these diagnostic tests is used to determine the presence of neural defects in a fetus? 1. Maternal serum alpha-fetoprotein test. 2. Chorionic villus sampling test. 3. Maternal sonogram. 4. Contraction stress test.
Maternal serum alpha-fetoprotein test.
A 38-year-old female client has just visited the physician and has received a prescription for birth control pills. The client calls the nurse and states that she doesn't need birth control pills because she had voluntary sterilization after her third child. The nurse explains that birth control pills may be used for what other reason? a) Breast lumps b) Thrombophlebitis c) Menstrual disorders d) Heart rhythm irregularities
Menstrual Disorders
A postmenopausal woman is receiving raloxifene as part of a treatment plan for osteoporosis. The nurse would instruct the patient that this drug is administered by which route? a) Oral b) Intravaginal c) Transdermal d) Intramuscular
Oral
Estradiol is sometimes administered to postmenopausal women to prevent which of the following conditions? a) Endometriosis b) Uterine cancer c) Osteoporosis d) Dysfunctional uterine bleeding
Osteoporosis
A nurse is caring for a patient who has been admitted to the hospital with chest pain. Which of these manifestations would differentiate a heart attack from a heartburn? 1. Pain that is felt immediately after meals. 2. Pain that responds to nitroglycerin. 3. Pain that responds to antacids. 4. Pain that is below the breastbone.
Pain that responds to nitroglycerin.
Oxytocin is an endogenous hormone produced by which of the following? (Choose one) a) Corpus luteum b) Posterior pituitary gland c) Uterus d) Adrenal gland
Posterior Pituitary Gland
Mrs. Ames is started on terbutaline therapy. What would indicate that the therapy has been successful? a) Premature birth is avoided for at least 24 hours. b) There has been less or no bleeding in the delivery. c) The mother did not require any labor induction. d) The mother does not experience adverse effects.
Premature birth is avoided for at least 24 hours
The nurse knows that, in a client whose uterus is intact, estrogen must be paired with what other drug when used to treat menopausal symptoms? a) Androgen hormone inhibitors b) Antispasmodics c) Aromatase inhibitors d) Progestins
Progestins
A client who is on estrogen therapy calls the clinic and tells the nurse that she is experiencing sudden, sharp chest pain. The nurse tells the client to go to the emergency department immediately, because the nurse suspects what adverse reaction related to estrogen therapy? a) Skeletal pain b) Deep vein thrombosis c) Breast pain d) Pulmonary embolism
Pulmonary Embolism
A nurse auscultates a rushing (high-pitched tinkling) of air on the right lower quadrant (RLQ) and silence on the left lower quadrant (LLQ) on a patient with inflammatory bowel disease (IBD). What is the best interpretation and response for the nurse to make? 1. Recognize these are symptoms of peritonitis; have the patient rate his/her discomfort. 2. Identify these as normal findings for this condition; chart the assessment. 3. Recognize these are symptoms of intestinal obstruction; ask about flatus. 4. Associate these symptoms with colon hyperactivity; assess for frequent diarrhea.
Recognize these are symptoms of intestinal obstruction; ask about flatus.
The nurse monitors a patient receiving oxytocin for water intoxication based on the understanding that this condition is the result of which of the following? a) Effects secondary to ergotism b) Stimulation of the neuroreceptor sites c) Release of antidiuretic hormone d) Blockage of estrogen receptor sites
Release of antidiuretic hormone
Choice Multiple question - Select all answer choices that apply. The nurse's ongoing assessment of outpatient clients receiving estrogen, progestin, or combination products should include which of the following? Select all that apply: a) Respiratory rate b) Blood pressure c) Pulse d) Therapeutic effects e) Temperature
Resp Rate Blood pressure Pulse Therapeutic Effects
Choice Multiple question - Select all answer choices that apply. A failure by the nurse to recognize the early symptoms of ergotism can lead to a more severe case of ergotism which is characterized by which of the following? Select all that apply: a) Coma b) Respiratory depression c) Hallucinations d) Severe hypoglycemia e) Hyperthermia
Respiratory Hallucinations Coma
Which of these infant reflexes should disappear by age 3 to 4 months? 1. Cremasteric. 2. Plantar grasp. 3. Sucking. 4. Rooting.
Rooting
A nurse is caring for a patient who has been administered menotropins by the intramuscular route for the secretion of sex hormones. The patient complains about pain after the drug is injected. Which of the following interventions should the nurse perform for the patient? a) Instruct the patient about proper injection technique. b) Report any complaints of sore throat, cough, or fever. c) Rotate sites and examine previous sites for redness. d) Observe the skin daily for localized signs of infection.
Rotate sites and examine previous sites for redness.
Which of these assessment data, if noted by a nurse on a patient who is in chronic renal failure, should be reported to a physician? 1. Shortness of breath. 2. Alterations in taste sensation. 3. Anemia. 4. Confusion.
Shortness of breath
Susan, age 21, is prescribed an oral contraceptive pill to prevent pregnancy. What is the mechanism of action of oral contraceptive pills? a) Thin the cervical mucosa b) Thicken the endometrial lining c) Suppress ovulation d) Increase production of FSH and LH
Suppress ovulation
A patient who is at 37 weeks' gestation has gained 6 pounds since her last prenatal visit two weeks ago. Which of these assessment measures is most important for a nurse to make at this time? 1. Asking the woman if she is experiencing abdominal cramping. 2. Taking her blood pressure and compare it with previous readings. 3. Assessing her lower extremities for presence of dependent edema. 4. Checking the woman's urine for sugar and acetone.
Taking her blood pressure and compare it with previous readings
To assess for Chvostek's sign, which of these actions should a nurse do? 1. Rub a cotton applicator gently over the eyelid and observe for flutters. 2. Inflate the blood pressure cuff on the upper arm and observe for carpal spasms. 3. Tap over the facial nerve anterior to the ear and observe for twitching 4. Dorsiflex the foot and observe for toe extension
Tap over the facial nerve anterior to the ear and observe for twitching
A patient who is in labor is experiencing contractions every 3 to 4 minutes which last about 50 to 70 seconds. The cervix is 7 cm dilated, vertex presents at station 0, and membranes are intact. Based on these assessment data, a nurse should determine that the patient is at which of these phases of labor? 1. The final phase of labor. 2. The latent phase of labor. 3. The transition phase of labor. 4. The active phase of labor.
The active phase of labor
Which of the following findings, if obtained on a patient who has obstructive jaundice, should a nurse recognize as indicative of a complication? 1. The amylase and lipase levels are three times the normal values. 2. The bilirubin level is elevated to four times the normal value. 3. The stool is a whitish-clay color. 4. The urine is a mahogany-cola color.
The amylase and lipase levels are three times the normal values.
A laboring patient's membranes rupture. A nurse notes that the fluid is green-tinged. Which of these inferences should the nurse make? 1. The fetus is in distress. 2. The woman is dehydrated. 3. The fetus is descending into the birth canal. 4. The woman has an acute infection.
The fetus is in distress
When assessing a patient, a nurse finds the patient to have paresthesias, muscle spasms, and tetany. Based on these findings, which of these interpretations should the nurse make? 1. The finding is suggestive of increased magnesium levels. 2. The finding is suggestive of increased sodium levels. 3. The finding is suggestive of decreased calcium levels. 4. The finding is suggestive of decreased chloride levels.
The finding is suggestive of decreased calcium levels.
Which of these assessment findings of the cranial nerve V is normal? 1. The patient can shrug with equal strength bilaterally. 2. The patient can elevate both eyelids. 3. The patient can identify facial stimuli correctly. 4. The patient can repeat words said by the assessor.
The patient can identify facial stimuli correctly
Which of these assessment findings if noted, would indicate to a nurse that a patient will need to stay longer in the post-anesthesia recovery area? 1. The patient does not know the correct time. 2. The patient reports surgical site pain. 3. The patient's oxygen saturation level is 91%. 4. The patient reports nausea.
The patient's oxygen saturation level is 91%
A patient who has hypertension is receiving furosemide (Lasix) 40 mg PO daily. Which of these observations should a nurse recognize as indication that the medication is attaining the desired therapeutic effect? 1. The patient urinates every two hours during the night. 2. The patient's weight decreases by two pounds in one week. 3. The patient reports increased thirst. 4. The patient's edema occurs late in the day.
The patient's weight decreases by two pounds in one week
A nurse in the well-baby clinic is conducting an assessment on a 6-month-old infant. Which of these observations should warrant further investigation? 1. The presence of head lag. 2. Frequent grasping of the toes. 3. The infant cries when the rattler is removed. 4. The infant cries when the nurse approaches.
The presence of head lag
While monitoring a woman who is receiving IV oxytocin for induction of labor, what event would cause the nurse to contact the health care provider immediately? a) The client's pulse is 90. b) The client's blood pressure is 109/68. c) The fetal heart rate is between 136-159. d) The uterine contractions are occuring every 90 seconds.
The uterine contractions are occuring every 90 seconds.
A nurse practitioner is assessing a patient who is diagnosed with an eating disorder. The patient has these laboratory test results: potassium, 3.5 mEq/L; sodium, 146 mEq/L; BUN, 38 g/dL; glucose, 78 g/dL. Based on these findings, which interpretation should the nurse make? 1. This is suggestive of hypoglycemia. 2. This is suggestive of hypokalemia. 3. This is suggestive of dehydration. 4. This is suggestive of hypernatremia.
This is suggestive of dehydration
Which of these interpretations should a nurse make when a patient who has a mastectomy has an onset of sweating, palpitations, tachycardia, and diarrhea? 1. This is suggestive of shock. 2. This is suggestive of adhesions. 3. This is suggestive of infection. 4. This is suggestive of dumping syndrome.
This is suggestive of dumping syndrome.
A nurse practitioner is assessing a patient who is diagnosed with an eating disorder. The patient has these laboratory test results: potassium, 3.5 mEq/L; sodium, 146 mEq/L; BUN, 18 g/dL; glucose, 58 g/dL. How should the nurse interpret these findings? 1. This is suggestive of hypoglycemia. 2. This is suggestive of dehydration. 3. This is suggestive of hypernatremia. 4. This is suggestive of hypokalemia.
This is suggestive of hypoglycemia.
Mrs. Garcia is a 7-month-pregnant woman who is experiencing contractions. She is admitted to the hospital in preterm labor. What will the physician prescribe in order to stop the labor? a) Estrogen b) Prostaglandins c) Tocolytics d) Oxytocics
Tocolytics
Which of these physical assessment findings, if identified in a patient who has congestive heart failure, requires follow-up by a nurse? 1. Ten mm increase in systolic blood pressure. 2. Twelve mm decrease in diastolic blood pressure. 3. Two-pound increase in body weight. 4. Three-pound decrease in body weight.
Two-pound increase in body weight.
During an abdominal assessment, a nurse finds the abdomen to be tympanitic. Which of these interpretations should the nurse make of the findings? 1. Tympany indicates organ enlargement. 2. Tympany indicates a mass. 3. Tympany indicates an area of empty stomach. 4. Tympany indicates feces-filled intestines.
Tympany indicates an area of empty stomach
A patient performs a self-breast exam using all of the following techniques. Which of these techniques suggests a need for re-teaching the patient? 1. Application of pressure during palpation of the breast. 2. Extension of circular pattern to the underarm area. 3. Up and down palpation using finger tips. 4. Circular pattern of palpation using pads of fingers.
Up and down palpation using finger tips
While assessing a patient, a nurse notes the following findings: poor skin turgor, decreased blood pressure, and a rapid pulse. The patient reports having flu-like symptoms, including nausea, vomiting, and diarrhea for the past three days. Based on the above data, which of these laboratory tests should the patient have? 1. serum amylase, cholesterol, and urine glucose 2. serum sodium, chloride, and magnesium levels 3. hemoglobin, RBC, and platelet sounds 4. urine osmolarity, BUN, and hematocrit
Urine osmolarity, BUN, and hematocrit
A pregnant patient who has diabetes has been admitted to the hospital to begin labor. Since the patient has diabetes, the physician has decided to use oxytocin (Pitocin) to initiate labor contractions. When talking to the patient about the adverse effects of the drug, the nurse should understand that the most common adverse effects of the drug include a) water intoxication. b) metabolic alkalosis. c) electrolyte imbalances. d) uterine tachysystole.
Uterine tachysystole
Which of these assessments would be a priority for a patient who takes clozapine? 1. Platelet level. 2. Hemoglobin level. 3. Serum glucose level. 4. White blood cell count.
White blood cell count.
Which of these events, if present in a patient's history, should a nurse recognize as being most significant in the development of adrenal hypofunction? 1. working outdoors in a very cold environment 2. engaging in unusually strenuous physical activity 3. consuming insufficient amounts of dietary sodium 4. abrupt cessation of glucocorticoid therapy
abrupt cessation of glucocorticoid therapy
Which of these changes in arterial blood gasses (ABGs) should a nurse expect to observe in a patient who has emphysema? 1. bicarbonate level of 30 mEq/L 2. pH above 7.5 3. carbon dioxide level of 45 mmHg 4. Oxygen level above 88 mmHg
carbon dioxide level of 45 mmHg
A nurse should monitor a patient receiving oxytocin (Pitocin) for which of the following adverse effects? (Choose one) a) Dizziness b) Hypotension c) Cardiac arrhythmias d) Headache
cardiac arrythmia
A 20-year-old woman has been prescribed estrogen. As with all women taking estrogen, the nurse will carefully monitor the patient for which of the following? a) Early epiphyseal closure b) Lack of secondary sexual characteristics c) Cardiovascular complications d) Decreased libido
cardiovascular complications
Which of these manifestations should a nurse expect to assess in a patient who has chronic anorexia nervosa? 1. diarrhea 2. oliguria 3. tachycardia 4. constipation
constipation
Which data from a patient's history should a nurse identify as a predisposition to a base deficit metabolic acidosis? 1. diuresis 2. vomiting 3. diarrhea 4. sweating
diarrhea
Which of these manifestations should a nurse assess as suggestive of arterial insufficiency of the lower extremities? 1. marked edema of both ankles 2. diminished pedal pulses 3. pain in the popliteal area upon movement 4. bluish discoloration of the legs
diminished pedal pulses
Which of these factors is a trigger for the development of autonomic dysreflexia in a patient who has a spinal cord injury? 1. headache 2. insomnia 3. distended abdomen 4. distended bladder
distended bladder
Which of these physical assessment findings, if identified in a patient who has CHF, requires follow-up by a nurse? 1. increased urine output 2. productive cough 3. dyspnea on exertion 4. nocturia
dyspnea on exertion
Which of these changes should a nurse recognize as indicative of a problem which a patient's lacrimal glands? 1. edema between the nose and lower eyelid 2. swelling of the eyelids 3. loss of peripheral vision 4. reddened conjunctiva
edema between the nose and lower eyelid
A patient who is taking an estrogen complains of swelling and weight gain. The nurse notes some peripheral edema. Which nursing diagnosis would the nurse identify as the priority? a) Acute pain b) Fluid volume excess c) Ineffective peripheral tissue perfusion d) Imbalanced nutrition, less than body requirements
fluid volume excess
When examining a newborn infant, which of these sinuses should a nurse expect to be absent at birth? 1. ethmoid 2. dorsal 3. maxillary 4. frontal
frontal
Which of these manifestations should a nurse expect to assess in a patient who has central cord syndrome? 1. ipsilateral motor loss above the level of the lesion 2. greater motor loss in upper rather than lower extremities 3. complete paralysis below the level of the lesion 4. loss of light touch and proprioception from the neck downward
greater motor loss in upper rather than lower extremities
A nurse should expect a patient who is diagnosed with hyperthyroidism to report which of these manifestations? 1. weight gain 2. heat intolerance 3. fatigue 4. slow movement
heat intolerance
A nurse obtains all of the following laboratory results for a 6-year-old child prior to a tonsillectomy. Which one should the nurse report to a physician? 1. decreased hematocrit level 2. increased platelet count 3. increased prothrombin time 4. decreased white blood cell count
increased prothrombin time
Why are measures of hemoglobin saturation not necessarily a good measure of the oxygen-carrying capacity of blood?
it is the oxygen content of the blood rather than the PO2 or hemoglobin saturation that determines the amount of oxygen that is carried in the blood and delivered to the tissues. An anemic, such as this patient with a hemoglobin of 6, may have a normal PO2 and hemoglobin saturation level but a decreased oxygen content because of the lower amount of hemoglobin for binding oxygen.
A 27-year-old pregnant woman of 30 weeks gestation has been administered terbutaline because of the onset of preterm labor. This drug is effective in stopping preterm labor because a) it stimulates beta-2 receptors, inhibiting contractility of smooth muscle. b) it relaxes smooth muscle by decreasing the amount of free acetylcholine. c) it prevents calcium influx into the cells for cellular contraction. d) it is an antagonist of endogenous oxytocin.
it stimulates beta-2 receptors, inhibiting contractility of smooth muscle.
A nurse should recognize that normal fetal blood flow through the heart is from the right atrium to the 1. aorta 2. left atrium 3. left ventricle 4. pulmonary artery
left atrium
After teaching a patient who is prescribed estradiol vaginal cream, the nurse determines that the patient has understood the instructions when she states that she will administer the medication at which frequency?
once a day
Which of these manifestations should a nurse expect to assess in a patient who has hyperphosphatemia? 1. polyuria 2. hunger 3. hypotonic reflexes 4. oral numbness
oral numbness
After teaching a woman who is receiving estrogen hormonal therapy about substances to avoid, the nurse determines that additional teaching is needed when the patient cites which of the following? a) Orange juice b) Grapefruit juice c) Smoking d) St. John's wort
orange juice
Kalie, age 18, is prescribed progesterone for the treatment of primary amenorrhea. Which adverse effect would need to be reported immediately to the physician? a) Breast tenderness b) Weight gain c) Pain in one leg d) Abnormal menstrual bleeding
pain in one leg
A nurse if planning to perform a physical assessment of the abdomen. The nurse should perform which of these assessments last? 1. palpation 2. inspection 3. auscultation 4. percussion
palpation
A patient who is 34 weeks' gestation has painless vaginal bleeding that started suddenly is admitted to the labor and delivery suite. A nurse should suspect that the patient might have which of these conditions? 1. abdominal pregnancy 2. ectopic pregnancy 3. placenta previa 4. abruptio placenta
placenta previa
A 70-year-old patient reports flank pain and a fever. Which additional findings, if noted, would indicate to a nurse that the patient might have renal colic or calculi? 1. positive CVA tenderness 2. negative Babinski sign 3. Urine specific gravity is 1.025 4. blood pressure is 148/80 mmHg
positive CVA tenderness
A 31-year-old pregnant woman has been prescribed administration of a tocolytic drug. During which period is a tocolytic drug usually administered? a) Antepartum b) Postpartum c) Second stage of labor d) Pre-term labor
pre-term labor
When assessing a person's movements, a nurse should understand that dorsiflexion involves 1. pulling the sole of the foot outwards. 2. pulling the foot up towards the leg. 3. pointing the sole of the foot inwards. 4. pointing the foot downwards towards the ground.
pulling the foot up towards the leg
Which of these instructions should a nurse include when teaching testicular self-examination? 1. Have the physician check if the left testicle is lower than the right 2. roll each testicle gently between your thumb and fingers 3. report to the physician if one testis feels larger than the other 4. palpate each testis every morning during bath
roll each testicle gently between your thumb and fingers
During a physical examination of a 15-year-old female who reports a sore throat, a nurse notes that the patient has severely eroded tooth enamel and swollen salivary glands. The nurse should plan to check which of these patient laboratory tests? 1. serum electrolytes 2. mumps titer 3. T-cell count 4. White blood cell count
serum electrolytes
Which of these assessment findings, if present in a patient who has advanced chronic obstructive pulmonary disease (COPD), is consistent with arterial blood gases (ABGs) revealing a pH of 7.31? 1. shallow, rapid respirations 2. hyperreflexia 3. widening of pulse pressure 4. Kussmaul respirations
shallow, rapid respirations
Which of these EKG changes would be suggestive of hypercalcemia? 1. high peaked T waves 2. shortened QT intervals 3. shortened PR intervals 4. presences of U waves
shortened QT intervals
A patient is receiving estrogen therapy. Which of the following would the nurse instruct the patient to report immediately? a) Dizziness b) Shortness of breath c) Weight gain d) Abdominal bloating
shortness of breath
A patient's chart indicates the presence of petechiae on the anterior thorax, arms, and neck. Which of these manifestations should a nurse expect to observe? 1. star-snapped, reddish, raised spots on the skin and mucous membranes 2. dime-sized purple-white, raised blotches across all affected skin surfaces 3. small reddish-purplish, flat spots on the skin or mucous membranes 4. large brown spots on the front of the chest, around the arms, and over the neck
small reddish-purplish, flat spots on the skin or mucous membranes
Which if these manifestations should a nurse expect to observe in a 3-month-old infant who is diagnosed with dehydration? 1. hyperreflexia 2. tachycardia 3. agitation 4. bradypnea
tachycardia
Relate the efficiency and work of breathing to changes in the tidal volume and respiratory rate observed in persons with: Increased airway resistance in emphysema.
the efficiency of breathing is determined by matching the tidal volume and respiratory rate in a manner that provides an optimal minute volume while minimizing the work of breathing. In emphysema, the lung tissues are overstretched. This causes the elastic components of the lung to lose their recoil, making the lung more compliant and easier to inflate but more difficult to deflate because of its inability to recoil. Persons with increased airway resistance usually find it less difficult to inflate their lungs and increase their tidal volume while breathing at a slower rate.
Relate the efficiency and work of breathing to changes in the tidal volume and respiratory rate observed in persons with: Decreased lung compliance in fibrotic lung disease
the efficiency of breathing is determined by matching the tidal volume and respiratory rate in a manner that provides an optimal minute volume while minimizing the work of breathing. In fibrotic lung disease, the lungs become stiff and noncompliant as the elastin fibers are replaced with the collagen fibers of scar tissue. Persons with stiff and noncompliant lungs usually find it easier to keep their tidal volume low and breathe at a more rapid rate.
Which of the following assessment data is the best indication that a nurse can safely start a nasogastric tube feedings? 1. bowel sounds are auscultated at 20 gurgles/minute 2. the patient's gastric residual volume is 90 mL 3. the patient's gastric residual pH is 7.5 4. The last feeding was given 6 hours ago
the patient's gastric residual volume is 90 mL
Which of these assessment findings, if present, would indicate to a nurse that an infant has developmental hip dysplasia? 1. the presence of asymmetric gluteal folds 2. the presence of atrophy of the feet 3. the femoral pulses are symmetrical 4. there is discoloration of the affected leg
the presence of asymmetric gluteal folds
It is usually recommended that the hemoglobin saturation of persons with chronic lung disease be maintained at about 89% when they are receiving supplemental low-flow oxygen. What would their PO2 be at this level of hemoglobin saturation, and what is the rationale for keeping the PO2 at this level?
this person would have a PO2 of 60mm Hg. In regard to patients with chronic lung disease, it is suggested to maintain the oxygenation status at this point because of the role of peripheral chemoreceptors. Individuals with chronic lung disease will have chronic high levels of CO2. The central chemoreceptors, which respond to changes in blood carbon dioxide levels, would become desensitized. These individuals no longer respond to the stimulus for increased ventilation from the central chemoreceptors. Therefore, the peripheral chemoreceptors, which respond to hypoxia below approximately 60 mm Hg, operate as the only respiratory drive mechanism for these individuals. If the PO2 were allowed, with increased levels of supplemental oxygen, to rise above 60 mm Hg, the individuals' respiratory drive would not exist.
Which of the following is an adverse effect caused by all uterine stimulants because of their antidiuretic effect? (Choose one) a) Water intoxication b) Dehydration c) Hypotension d) Polydipsia
water intoxication
Which of these assessment data, if noted by a nurse, would indicate that a patient is responding effectively to fluid imbalance correction? 1. weight has stabilized 2. alert to place and person 3. skin turgor returns slowly 4. breath sounds are noisy
weight has stabilized
