Adult Health Theory 1 Exam 1 Review

A hospitalized client with heart failure puts on the call light and makes the following statement: "I've become very short of breath, and I've been coughing up this pink frothy sputum." The nurse immediately suspects which of the following complications?

Pulmonary edema

A patient who was admitted to the hospital with a diagnosis of thrombophlebitis 1 day ago suddenly develops complaints of chest pain and shortness of breath and is visibly anxious. The nurse immediately assesses the patient for other signs and symptoms of which of the following problems?

Pulmonary embolism

A patient asks the nurse why his residual limb cannot be elevated on a pillow. What is the best response by the nurse?

"Elevating the leg might lead to a flexion contracture."

A nurse working in the clinic is seeing a client who has just been prescribed a new medication for hypertension. The client asks why hypertension is sometimes called the "silent killer." The nurse's correct response is which of the following?

"Hypertension often causes no symptoms."

A client spends most of his time in a wheelchair. The nurse would be especially alert for the development of pressure ulcers in which area?

Ischial tuberosity

A home health nurse is teaching a client with peripheral arterial disease ways to improve circulation to the lower extremities. The nurse encourages which of the following in teaching?

Keeping the legs in a neutral or dependent position

Which of the following statements describes accurate information related to chronic illness?

Most people with chronic conditions do not consider themselves sick or ill.

The nurse is assessing a patient's pressure ulcer and notes a full-thickness wound that extends into the subcutaneous tissue. Necrosis and infection are present. The nurse documents this ulcer as which stage?

Stage III

The most common affect or mood disorder of old age includes

depression.

A nurse is completing an assessment of a client who has just been transferred to the rehabilitation facility. During the health history, the nurse asks about the client's activities of daily living (ADLs). About which areas would the nurse gather information? Select all that apply.

• Eating • Bathing • Toileting

Which of the following is a true statement regarding characteristics of chronic conditions?

Managing chronic conditions must be a collaborative process

Target organ damage from untreated/undertreated hypertension includes which of the following? Select all that apply.

• Heart failure • Retinal damage • Stroke

A nursing instructor is preparing a class on pressure ulcers. Which of the following would the instructor most likely include as a possible risk factor? Select all that apply.

• Immobility • Anemia • Increased moisture

The nurse is obtaining a healthy history from a client with blood pressure of 146/88 mm Hg. The client states that lifestyle changes have not been effective in lowering the blood pressure. Which medication classification does the nurse anticipate first?

Thiazide diuretic

A nurse is assessing a patient brought to the emergency room by his daughter. Which statement by the daughter would most likely lead the nurse to suspect that the patient may have an infection?

"All of a sudden he seemed to become confused."

The initial sign of skin pressure is erythema, which normally resolves in less than

1 hour.

A home health nurse makes a home visit to a 90-year-old patient who has cardiovascular disease. During the visit the nurse observes that the patient has begun exhibiting subtle and unprecedented signs of confusion and agitation. What should the home health nurse do?

Arrange for the patient to see his primary care physician.

A patient is being discharged home with a venous stasis ulcer on the right lower leg. Which topic will the nurse include in patient teaching prior to discharge?

Application of graduated compression stockings

Which of the following is a factor that alters urinary elimination patterns in the older adult?

Decreased muscle tone

The nurse is working in a long-term care facility. When assessing her patients, what body system dysfunction should the nurse look for as the leading cause of morbidity and mortality in the older adult population?

Cardiovascular

A health care team is involved in caring for a client with advanced Alzheimer's disease. During a team conference, a newly hired nurse indicates that she has never cared for a client with advanced Alzheimer's disease. Which key point about the disease should the charge nurse include when teaching this nurse?

Clients with Alzheimer's disease are at high risk for injury because of their impaired memory and poor judgment.

When changing the dressing on a pressure ulcer, a nurse notes necrotic tissue on the edges of the wound. Which action should the nurse anticipate that the physician will order?

Debridement

An elderly client who lives in a retirement community is having a mild depressive episode over the past few weeks. The nurse intervenes by recommending:

Participation in a social activity

The nurse is evaluating the serum albumin of a patient newly admitted on the rehabilitation unit. The nurse determines that the serum albumin is low, indicating that the patients level of which of the following is deficient?

Protein

Which intervention should the nurse implement, when caring for the client who complains of phantom limb pain two months after amputation?

Reassure the client that phantom pain is common.

Based on a patient's vague explanations for recurring injuries, the nurse suspects that a community-dwelling older adult may be the victim of abuse. What is the nurse's primary responsibility?

Report the findings to adult protective services.

The number of people with disabilities is expected to increase over time. What is a major contributor to this prediction?

The survival of people with severe trauma, chronic disorders, and early-onset disabilites

The nurse is obtaining data on an older adult client. What finding may indicate to the nurse the early symptom of heart failure?

Dyspnea on exertion

Which of the following is a nurse's role in providing home care for a patient with Alzheimer's disease?

Provide emotional and physical support

A nurse is caring for an 86-year-old female patient who has become increasingly frail and unsteady on her feet. During the assessment, the patient indicates that she has fallen three times in the month, though she has not yet suffered an injury. The nurse should take action in the knowledge that this patient is at a high risk for what health problem?

A hip fracture