ADULT HEALTH - (Final) - Tests 3, 4, 5 Review Questions
A
5. The nurse is doing triage at the emergency department when a middle-aged patient presents with abdominal pain and heartburn. The patient states the symptoms have persisted for several days following a particularly spicy meal. When assessing the patient, the nurse notes the patient has a history of acute gastritis. What complication should the nurse assess for? A) Esophageal or pyloric obstruction related to scarring B) Acute systemic infection related to peritonitis C) Gastric hyperacidity related to excessive gastrin secretion D) Bruising on the patient's flanks
B
A critical care nurse is closely monitoring a patient who has recently undergone surgical repair of a bleeding peptic ulcer. The nurse should prioritize assessments of which of the following signs and symptoms of a recurrence of hemorrhage? A) Restlessness and cyanosis B) Hypotension and tachycardia C) Bradypnea and pursed lip breathing D) Peripheral and pulmonary edema
B
A patient admitted to the hospital for evaluation of chest pain has no abnormal serum cardiac markers 6 hours after onset of pain. A noninvasive diagnostic test that can differentiate angina from other types of chest pain is a A. EKG B. Exercise stress test C. Coronary angiogram D. Transesophageal echocardiogram
A
A patient comes to the clinic complaining of pain in the epigastric region. The nurse suspects that the patient's pain is related to a peptic ulcer when the patient states the pain is relieved by what? A) Eating B) Drinking milk C) Suppressing emesis D) Having a bowel movement
B
An adult patient has undergone extensive testing that has resulted in a diagnosis of a basophilic pituitary tumor. The pathophysiological effects of the patient's tumor include excessive secretion of adrenocorticotropic hormone (ACTH). As a result, this patient is likely to exhibit signs and symptoms that are characteristic of what endocrine disorder? A) Addison's disease B) Cushing's disease C) Hyperthyroidism D) Diabetes insipidus
A and E
Diagnostic testing has attributed a middle-aged man's peptic ulcer to Helicobacter pylori, and the man has been prescribed a therapeutic drug regimen. Which of the following drug families will form the basis of the man's drug therapy? Select all that apply. A) Antibiotics B) Prokinetics (GI stimulants) C) Antiemetics D) Antacids E) Proton pump inhibitors
B
In providing care for a patient hospitalized with an acute exacerbation of polycythemia vera, the nurse gives priority to which of the following activities? A. Maintaining protective activities B. Promoting leg exercises and ambulation C. Protecting the patient from injury or falls D. Promoting hydration with a large fluid intake
D
Tachycardia that is a response of the sympathetic nervous system to the pain of ischemia is detrimental because not only does it increase oxygen demand, but it A. Increases CO B. Causes reflex hypotension C. May lead to ventricular dysrhythmias D. Impairs perfusion of the coronary arteries
D
Teaching to include dietary sources of potassium is indicated for the hypertensive patient taking which medication below? A. Enalapril (Vasotec) B. Labetalol (Normodyne) C. Spironalactone (Aldactone) D. Hydrochlorothiazide (HydroDiuril)
B
The admitting nurse is assessing a patient with chronic obstructive pulmonary disease (COPD). The nurse auscultates diminished breath sounds, which signify changes in the airway. These changes indicate to the nurse the need to monitor the patient for what related signs and symptoms? A) Hypoxemia and clubbing of the fingers B) Dyspnea and hypoxemia C) Clubbing of the fingers and cyanosis D) Bronchospasm and clubbing of the fingers
C
The patient with end-stage renal disease tells the nurse that she hates the thought of being tied to the machine but is glad to start dialysis because she will be able to eat and drink what she wants. Based on this information, the nurse identifies the nursing diagnosis of: A. Self-Esteem disturbance related to dependence on dialysis B. Anxiety related to perceived threat to health status and role functioning C. Ineffective self-health management related to lack of knowledge of treatment plan D. Risk for imbalanced nutrition: more than body requirements related to increased dietary intake.
D
What should the nurse suspect when hourly assessment of urine output on a postcraniotomy patient exhibits a urine output from a catheter of 1,500 mL for 2 consecutive hours? A) Cushing's syndrome B) Syndrome of inappropriate antidiuretic hormone (SIADH) C) Adrenal crisis D) Diabetes insipidus
C
While caring for a 77y/o female who has a urinary catheter, the nurse monitors the patient for the development of a UTI. The clinical manifestations the patient is most likely to experience includes: A. Cloudy urine and fever B. Urethral burning and bloody urine C. Vague abdominal pain and disorientation D. Suprapubic pain and slight decline in body temperature
D
A middle-aged female patient has been diagnosed with hyperthyroidism and admitted to the hospital for treatment. When providing care for this patient, the nurse should prioritize: A) Vigilant monitoring of intake and output B) Teaching the patient about the pathophysiology of the disease C) Performing constant blood sugar monitoring D) Providing a calm, low-stimulation environment
C
A 26-year-old woman is thankful to be alive after rear-ending a truck with her car. However, she experienced a sternal fracture from the force of her car's airbag and has been breathing shallowly to avoid exacerbating her pain. The nurse should consequently prioritize assessments related to: A) Respiratory acidosis B) Pulmonary effusion C) Atelectasis D) Pleurisy
D
During the physical assessment of the patient with severe anemia, which of the following findings is of the most concern to the nurse? A. Anorexia B. Bone Pain C. Hepatomegaly D. Dyspnea at rest
A
2. The nurse is conducting a patient teaching with a patient who has just been prescribed lansoprazole (Prevacid). What statement would indicate that the patient correctly understands the action of this medication? A) "The medication inhibits acid secretions." B) "The medication is an antibiotic." C) "The medication is an analgesic." D) "The medication will repair my ulcer."
D
6. A woman was diagnosed with peptic ulcers several months ago and has been vigilant about implementing the nurse's recommended lifestyle modifications. The woman states that she is motivated to control her ulcers because she has a sister who had to be hospitalized for the treatment of a bleeding ulcer. A bleeding ulcer is strongly suggested when a patient exhibits: A) Chronic constipation B) Early morning heartburn C) Nausea that is relieved by eating D) Melena stool
D
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? A) IV administration of calcium gluconate B) Subcutaneous administration of 30 units of insulin glargine (Lantus) C) Oral administration of 2 g of metformin (Glucophage) D) Rapid administration of intravenous normal saline
A
A 32-year-old man who has a body mass index of 32 (morbidly obese) is considering bariatric surgery. In the time leading up to this surgery, which of the following nursing diagnoses will be the primary focus of interventions? A) Knowledge deficit related to the implications of bariatric surgery B) Altered growth and development related to obesity C) Risk for injury related to obesity D) Spiritual distress related to low body image
D
A 42-year-old man with a history of pheochromocytoma is being treated in the intensive care unit after experiencing an acute exacerbation of his condition. This patient will require the nurse to perform which of the following assessments most frequently? A) Motor and sensory function B) Orientation and cognition C) Urine testing for osmolality D) Blood pressure (BP) and heart rate
A
A 62 y/o woman has hypertension and smokes a pack of cigarettes per day. She has no symptoms of CAD, but a recent LDL level is 154mg/dL. Based on these findings, the nurse would expect that treatment for the patient would include: A. Diet therapy only B. Drug therapy only C. Diet and drug therapy D. Exercise instruction only
B
A 72-year-old patient who was admitted to the hospital for a total hip arthroplasty has developed increasing dyspnea and leukocytosis over the past 48 hours and has been diagnosed with hospital-acquired pneumonia (HAP). The choice of antibiotic therapy for this patient will be primarily based on which of the nurse's assessments? A) Auscultation and percussion of the patient's thorax B) Collection of a sputum sample for submission to the hospital laboratory C) Analysis of the patient's leukocytosis and the white blood cell (WBC) differential D) Assessment of the patient's activities of daily living
D
A 78-year-old patient with type 2 diabetes is brought to the emergency department by his daughter. The patient is found to have a blood glucose level of 623 mg/dL. The patient's daughter reports that the patient recently had a gastrointestinal virus and has been confused for the last 3 hours. A diagnosis of hyperglycemic hyperosmolar non-ketotic syndrome (HHNS) is made. What nursing action would be the priority? A) Administering antihypertensive medications B) Administering sodium bicarbonate intravenously for low bicarbonate levels C) Reversing acidosis by administering insulin D) Replacing fluids and electrolytes
B
A female patient with a UTI has a nursing diagnosis of risk for infection related to lack of knowledge regarding prevention of recurrence. Which of the following should the nurse include in her teaching plan? A. Empty the bladder at least 4 times a day. B. Drink at least 2 quarts of water everyday. C. Wait to urinate until the urge is very intense. D. Clean the urinary meatus with an antiinfective agent after voiding.
A, B, D
A nurse is performing health education with the family member of a patient who has ascites. The nurse should be cognizant of which physiologic processes that cause ascites? Select all that apply. A) Sodium and water retention B) A damaged liver C) Insufficient renal flow D) Increased lymphatic flow E) Decreased synthesis of immunoglobulin G
A
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? A) Older adults often lack a fever when they develop pneumonia. B) Oxygen saturation levels remain stable among older adults despite increased sputum production. C) Pneumonia is usually intensely painful for older adults but lacks an increase in white blood cells (WBCs). D) Older adults who have pneumonia are usually asymptomatic.
A
A nurse who works on a medical unit has taken a patient's blood glucose level and obtained a reading of 53 mg/dL. The patient is appropriately responsive to questioning, but is drowsy and appears pale. What intervention should the nurse prioritize in response to this assessment finding? A) Administer 15 g of a fast-acting carbohydrate B) Page the patient's primary care provider C) Provide the patient with 75 to 100 mL of an IV 50% dextrose solution D) Recheck the patient's glucose level in 15 minutes
D
A nursing responsibility in the management of the patient with a hypertensive urgency often includes: A. Monitoring hourly urine output for drug effectiveness. B. Providing for continuous ECG monitoring to detect side effects of the drugs. C. Titrating intravenous drug dosages based on BP measurements every 2 to 3 minutes. D. Instructing the patient to follow up with a health care professional 24 after outpatient treatment.
B
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? A) Sulfonylurea B) Biguanide C) Thiazolidinedione D) Alpha glucosidase inhibitor
C
A patient is admitted to the hospital for evaluation and treatment of thrombocytopenia. Which of the following actions is most important for the nurse to implement? A. Taking the temperature every 4 hours to assess for fever B. Maintaining the patient on strict bed rest to prevent injury C. Monitoring the patient for headaches, vertigo, or confusion D. Removing the oral crusting and scabs with a soft brush 4 times a day
B
A patient on a medical unit has a potassium level of 6.8mEq/L. What priority nursing action is required? A. Check the patient's BP B. Place the patient on a cardiac monitor C. Instruct the patient to avoid high potassium foods D. Call the lab and request a redraw of the lab to verify results
A
A patient presents to the walk-in clinic complaining of vomiting and burning in his mid-epigastria. The nurse knows that to confirm peptic ulcer disease, the health care provider is likely to order a diagnostic test to detect the presence of what? A) Infection with Helicobacter pylori B) Excessive stomach acid secretion C) Gastric irritation caused by nonsteroidal anti-inflammatory drugs (NSAIDs) D) Inadequate production of pancreatic enzymes
D
A patient with heart failure has tachypnea, severe dyspnea, and an SpO2 of 84%. The nurse identifies a nursing diagnosis of impaired gas exchange related to increased preload and mechanical failure. An appropriate nursing intervention for this diagnosis is to A. Assist the patient to cough and deep breathe q2hr B. Assess intake and output q8hr and weighthe patient daily C. Encourage alternate rest and activity periods to reduce cardiac workload D. Place the patient in high Fowler's position with the feet dangling over the bedside
C
A patient with portal hypertension has been admitted to the medical floor. What will the nurse assess for related to portal hypertension? A) Bowel obstruction B) Vitamin A deficiency C) Ascites D) Hepatic encephalopathy
A
Computed tomography of a patient with a sudden onset of severe nausea and vomiting has revealed the presence of a pyloric obstruction. Which of the following interventions is the nurse's priority in the immediate care of this patient? A) Insertion of a nasogastric (NG) tube to suction to decompress the stomach B) Insertion of a central line for parenteral nutrition C) Administration of a saline enema to purge the lower bowel D) Gastric lavage
A
The diabetic nurse educator is teaching a class for newly diagnosed diabetics and their families. In this class, the educator is teaching about "sick day rules." What guideline applies to periods of illness in a diabetic patient? A) Do not eliminate insulin when nauseated and vomiting. B) Seek care for glucose levels >150 mg/dL. C) Eat three meals a day. D) If nauseated, do not eat solid foods.
A
The nurse has been asked to give a workshop on chronic obstructive pulmonary disease (COPD) for a local community group. When talking about what can be done for patients with COPD, the nurse encourages a COPD patient not to smoke because smoking has what effect? A) Increases the amount of mucus production B) Deoxygenates the hemoglobin C) Shrinks the alveoli in the lungs D) Collapses the alveoli in the lungs
C
The nurse is completing a health history on a patient whose diagnosis is chronic gastritis. Which of the data below should the nurse consider most significantly related to the etiology of the patient's health problem? A) Consumes one or more protein drinks daily B) Takes over-the-counter antacids frequently C) Smokes two packs of cigarettes daily D) Reports a history of social drinking on a weekly basis
A
The nurse is encouraging a sedentary patient with major risks for CAD to perform physical exercise on a regular basis. In addition to decreasing the risk factor of physical inactivity, the nurse tells the patient that exercise will also directly contribute to reducing the risk factors of A. Hyperlipidemia and obesity B. Diabetes mellitus and hypertension C. Elevated serum lipids and stressful lifestyle D. Hypertension and elevated serum homocysteine
A
The nurse is planning the care of a complex elderly patient who has been admitted to the medical ward for the treatment of cellulitis. The nurse notes that the patient has a longstanding history of chronic obstructive pulmonary disease (COPD). What assessment finding would most clearly indicate the need for oxygen therapy? A) SaO2 of 86% on room air B) Respiratory rate (RR) of 25 breaths per minute at rest C) Presence of bilateral fine crackles to lower lung fields on auscultation D) Presence of an occasional productive cough
D
While caring for the patient in the oliguric phase of AKI, the nurse monitors the patient for associated collaborative problems, notifying the physician when: A. Urine output is 300ml/day. B. Edema occurs of the feet, legs and sacrum. C. The cardiac monitor reveals a depressed T wave and a sagging ST segment. D. The patient experiences increasing muscle weakness and abdominal cramping.
