6160 Final

The nurse is assessing a client who has a unilateral obstruction of the urinary tract. Which clinical finding by the nurse correlates to this diagnosis?

Increased BP

The nurse is planning care for a client with a urinary tract obstruction. The nurse includes assessment for which possible complication?

Increased blood pressure

Unilateral obstruction of the urinary tract may result in renin secretion, thereby leading to which manifestation?

Increased blood pressure

A client has developed community-acquired pneumonia and is being treated at home. What does the nurse recognize are the methods in the diagnosis of community-acquired pneumonia? Select all that apply.

- Age- Coexisting health problems- Severity of illness

A client is admitted with late manifestations of cirrhosis. Which clinical manifestations confirm this diagnosis? Select all that apply.

- GI bleeding related to esophageal varices- Splenomegaly with bleeding tendencies- Hepatomegaly felt on deep palpation

A motor vehicle accident has resulted in the driver hitting the steering wheel with subsequent fractures of the chest, sternum, and some ribs. Which manifestations would lead the nursing staff to suspect the driver has developed a tension pneumothorax? Select all that apply.

- Mediastinal shift of the trachea toward one side- Subcutaneous emphysema palpated in the upper chest/neck region

Which person is most at risk for hip fractures?

66-year-old white female with history of alcohol use disorder

The nurse has been providing dietary teaching to a client diagnosed with irritable bowel syndrome. The nurse determines that the teaching was effective when the client selects what foods?

A bran muffin, fruit, and orange juice.

The nurse is reviewing the medical history of four clients. The nurse determines that the client at greatest risk for developing peptic ulcer disease is:

A client with a prior diagnosis of Helicobacter pylori and refused treatment

Which individual likely faces the greatest risk for the development of chronic kidney disease?

A client with a recent diagnosis of type 2 diabetes who does not monitor blood sugars or control diet

Which client is displaying manifestations of having a kidney stone?

Acute onset of colicky flank pain radiating to lower (upper?) abdomen

An adult comes to the urgent care clinic reporting facial pain, headache, and copious amounts of thick purulent nasal discharge. Based on these symptoms, the nurse practitioner suspects the client is experiencing which condition?

Acute viral rhinosinusitis

Which client would be considered high risk for falling and fracturing the hip?

An 81-year-old woman taking medication for osteoporosis

The nurse in the emergency department is assessing a toddler suspected of epiglottitis. Which intervention is considered the priority when working with this client?

Assess if airway is compromised and call for health care provider assistance with intubation to establish an airway, if needed.

Prolonged immobility is implicated in the development of which disorder?

Atelectasis and pulmonary embolism

Atelectasis is the term used to designate an incomplete expansion of a portion of the lung. Depending on the size of the collapsed area and the type of atelectasis occurring, the nurse may see a shift of the mediastinum and trachea. Which way does the mediastinum and trachea shift in compression atelectasis?

Away from the affected lung

Which clinical manifestation is the most common indicator of acute kidney injury

Azotemia

Acute renal failure occurs at a high rate in seriously ill people who are in intensive care units. What is the most common indicator of acute renal failure?

Azotemia and a decrease in the GFR

Acute pyelonephritis is a result of:

Bacterial infection

A moderate hemothorax diagnosis would be confirmed by the presence of which of the following?

Blood filling approximately one-third of the pleural space

An infant who was born prematurely and developed respiratory distress syndrome was placed on mechanical ventilation for several weeks. What condition should the nurse monitor the infant for related to the long-term ventilatory support?

Bronchopulmonary dysplasia

A client who has had an intestinal bypass has developed a kidney stone. Which type of kidney stone does the nurse recognize that this client will most likely be treated for?

Calcium

A client is concerned about the possibility of having bladder cancer after his brother was diagnosed with it 2 years ago. Which assessment data obtained by the nurse would indicate that the client should be screened for this disease?

Client reports that he occasionally has blood in his urine but has no pain with it.

The nurse is assessing a client who sustained a fractured radius. A cast was applied to the extremity approximately 1 hour ago, and the client is now complaining of increased pain and numbness to the finger tips. The client is most likely experiencing:

Compartment syndrome

Which additional physical finding would you anticipate seeing in a child suspected of having a Wilms tumor?

Congenital anomalies, usually of the genitourinary system

A nurse reading a sigmoidoscopy report notes that a patient was found to have skip lesions. The nurse interprets this as an indication of which of the following?

Crohn's disease

Which information is important for the nurse to teach the female client about the development of osteoporosis?A. "Men are at higher risk than women for osteoporosis."B. "Screening for osteoporosis should be performed for everyone regardless of age."C. "Dietary changes will not help osteoporosis."D. "Estrogen deficiency contributes to the development of osteoporosis."

D. "Estrogen deficiency contributes to the development of osteoporosis."

When developing the plan of care for a child with respiratory distress, what nursing intervention can the nurse provide that will facilitate respiratory movements and avoid airway compression?

Elevate the head of the bed.

A parent calls 911 and states her child is having trouble breathing. The child is rushed to the emergency department. Upon assessment, the child appears pale, toxic, and lethargic and assumes a distinctive position—sitting up with the mouth open and the chin thrust forward. The parent states that the child just developed a sore throat and fever today. The health care provider determines that the child is experiencing:

Epiglottitis

The most common forms of peptic ulcer are duodenal and gastric ulcers. What bacteria are the most common risk factors for peptic ulcer disease?

Helicobacter pylori (H. pylori)

A nurse advises a client with recurring UTIs to drink large amounts of water. What normal protective action is the nurse telling the client to utilize?

Increase washout of urine

When caring for the client with acute pancreatitis, which alterations does the nurse recognize is consistent with the disease?

Hyperglycemia

A nurse is assessing a client for early manifestations of chronic kidney disease (CKD). Which would the nurse expect the client to display?

Hypertension

What is the underlying cause of respiratory failure in a child with bronchiolitis?

Impaired gas exchange

The nurse is assessing a client who states he felt fine all day and then, within 5 minutes, began to feel extremely weak and tired and began having a fever. What do these symptoms indicate that the client may be experiencing?

Influenza

A nurse is assessing a 1-year-old child diagnosed with croup. Which manifestation would most likely be present?

Inspiratory stridor and barking cough

Vitamin D metabolism is deranged in clients with chronic kidney disease (CKD). The nurse recognizes that which statement regarding vitamin D is correct?

Kidneys convert inactive vitamin D to its active form, calcitriol.

Wilms tumor is a tumor of childhood. It is usually an encapsulated mass occurring in any part of the kidney. What are the common presenting signs of a Wilms tumor?

Large asymptomatic abdominal mass and hypertension

Which of the following clients is at greatest risk for developing a urinary tract infection (UTI)?

Older adult female client admitted with an indwelling Foley catheter that has been in place for 1 month

A client presents with sudden onset of deep, localized pain and swelling in the proximal femur while undergoing diagnostic workup for suspected lung cancer. The nurse suspects the client may have developed which type of neoplasm of the skeletal system?

Osteosarcoma

When assessing a client with acute cholecystitis, the nurse anticipates the client's report of pain will be consistent with which description?

Pain in the right upper quadrant referred to the same shoulder

Three days following surgical repair of a hip fracture a client becomes anxious and complains of sudden shortness of breath. What disorder is the client most likely experiencing?

Pulmonary embolism

Upon admission, a patient tells the nurse that he takes aspirin every 4 hours every day. The nurse determines that this patient is at risk for which of the following?

Peptic ulcer

A client with a closed reduction of a wrist fracture has a plaster cast applied. Which nursing intervention is the highest priority immediately after the procedure?

Performing a peripheral circulation assessment

A patient is admitted with an abrupt onset of referred pain to the epigastric area, with an episode of nausea. On the nurse's initial assessment, the patient is lying still and taking shallow breaths, with a rigid abdomen. Which of the following problems is the patient experiencing?

Peritonitis

Premature infants who are treated with mechanical ventilation, mostly for respiratory distress syndrome, are at risk for developing bronchopulmonary dysplasia (BPD), a chronic lung disease. What are the signs and symptoms of BPD?

Rapid and shallow breathing and chest retractions

An 86-year-old client is being treated for dehydration and hyponatremia after curtailing fluid intake to prevent urinary incontinence. Given these findings, the nurse recognizes that this client is likely in what phase of acute kidney injury?

Prerenal

When teaching a client about chronic pancreatitis, which of these does the nurse relate is the long term result of this condition?

Progressive destruction of the organ

Which assessment finding would lead the nurse to suspect the client has developed nephrotic syndrome?

Proteinuria and generalized edema Hyperlipidemia Lipiduria Vitamin D deficiency Hypothyroidism

A 3-year-old child has been admitted to the pediatric unit for the treatment of croup. The nurse should include which action in the child's plan of care?

Providing cool, moist air for the child to breathe

Cystic fibrosis (CF) is an autosomal recessive disorder involving the secretion of fluids in specific exocrine glands. The genetic defect in CF inclines a person to chronic respiratory infections from a small group of organisms. Which organisms create chronic infection in a child with cystic fibrosis?

Pseudomonas aeruginosa and Staphylococcus aureus

An older adult client has been hospitalized for the treatment of acute pyelonephritis. Which characteristic of the client is most likely implicated in the etiology of this current health problem?

Recently had a urinary tract infection

The GFR is considered to be the best measure of renal function. What is used to estimate the GFR

Serum creatinine

A parent of a toddler is concerned about possible side effects of influenza immunizations. What will the nurse teach the parent regarding the flu vaccine?

The Centers for Disease Control and Prevention recommends that all people 6 months of age and older should receive the annual influenza vaccine.

A nurse who provides weekly care in a homeless shelter has unknowingly inhaled airborne Mycobacterium tuberculosis (TB) and has subsequently developed latent tuberculosis infection. Which statement is accurate regarding this nurse?

The nurse is likely asymptomatic.

Urinary obstruction in the lower urinary tract triggers changes to the urinary system to compensate for the obstruction. What is an early change the system makes in its effort to cope with an obstruction

The stretch receptors in the bladder wall become hypersensitive.

A client arrives in the clinic with a cough, fever, and chest discomfort and is diagnosed with community-acquired pneumonia. What education does the nurse anticipate providing prior to discharging the client from the clinic?

The use of antibiotics

A young woman presents with signs and symptoms of urinary tract infection (UTI). The nurse notes that this is the fifth UTI in as many months. What would this information lead the nurse to believe?

There is possible obstruction in the urinary tract.

Primary biliary cirrhosis is an autoimmune disease that destroys the small intrahepatic bile ducts causing cholestasis. It is insidious in onset and is a progressive disease. What are the earliest symptoms of the disease?

Unexplained pruritus

What is the usual cause of acute pyelonephritis?

Upper UTI infection Gram negative bacteria

Which signs and symptoms are most suggestive of acute cholecystitis?

Upper right quadrant or epigastric pain

One of the most damaging effects of urinary obstruction on kidney structures is which effect?

Urinary Stasis

The parents of a child diagnosed with cystic fibrosis (CF) ask about the risk of any future children having the condition. How should the nurse respond?

You have a 25% chance that your next child will have CF.

The nurse recognizes the most common cause of acute postinfectious glomerulonephritis as:

a streptococcal infection 7 to 12 days prior to onset.

A child has been brought to an urgent care clinic. The parents state that the child is "not making water." When taking a history, the nurse learns the child had a sore throat about 1 week ago but seems to have gotten over it. "We [parents] only had to give antibiotics for 3 days for the throat to be better." The nurse should suspect the child has developed:

acute postinfectious glomerulonephritis.

An elderly patient has arrived at the physician's office complaining of a rash. Uponfurther investigation, the patient states that the rash feels like a burning pain but also hassome tingling. It is extreme sensitive to touch, and it's "like crazy." The nurse notes thatthe rash is made up of vesicles and located on the right thoracic region. The nursesuspects the patient hasA) chickenpox.B) German measles.C) herpes zoster.D) human papillomavirus.

c

An 11-year-old boy with skin lesions on his trunk characteristic of ringworm has beenbrought to the family's primary care provider by his mother. Which of the followingaspects of the clinician's assessment relates most directly to the suspected diagnosis?A) Previous infection with other parasitic wormsB) Potential contact with the fungus from pets or other childrenC) Allergic reactions to drugs and environmental substancesD) The child's infant immunization history

B

Which assessment does the nurse recognize is consistent with signs and symptoms of acute pancreatitis?

Periumbilical pain

The early stages of influenza pass by as if the infection were any other viral infection. What is the distinguishing feature of an influenza viral infection that makes it different from other viral infections?

Rapid onset of profound malaise