BAH Final

The nurse is caring for a patient suspected of having ARDS. What is the most likely diagnostic test ordered in the early stages of this disease to differentiate the patients' symptoms from those of a cardiac etiology?

Brain natriuretic peptide (BNP) level

A nurse is assessing a patient who is suspected of having bronchiectasis. The nurse should consider which of the following potential causes? Select all that apply.

Airway obstruction, Pulmonary infections, and Genetic disorders

A female client on an inpatient unit enters the common area for visiting hours dressed in a see-through blouse. Which intervention should be a nurse's first priority?

Lead the client back to her room and assist her with a change of clothing.

A patient with Parkinsons disease is experiencing episodes of constipation that are becoming increasingly frequent and severe. The patient states that he has been achieving relief for the past few weeks by using OTC laxatives. How should the nurse respond?

Lets explore other options, because laxatives can have side effects and create dependency

What is the priority of preoperative assessment

Medications

A nurse is aware that the outer layer of the skin consists of dead cells that contain large amounts of keratin. The physiologic functions of keratin include which of the following? Select all that apply.

Physically repelling pathogens and Preventing fluid loss

A female patient has been prescribed a course of antibiotics for the treatment of a UTI. When providing health education for the patient, the nurse should address what topic?

The risk of developing a vaginal yeast infection as a consequent of antibiotic therapy

A 56 year old patient has come to the clinic for routine eye exam and is told he needs bifocals. Patient asks nurse what change in his eyes has caused his need for bifocals.

There is a gradual thickening of the lens of the eyes and it can limit the eyes ability for accommodation.

You are creating a nursing care plan for a patient with a primary diagnosis of cellulitis and a secondary diagnosis of chronic pain. What common trait of patients who live with chronic pain should inform your care planning?

They can experience acute pain in addition to chronic pain.

Insulin production in our body

Type I doesn't make insulin

A 21-year-old patient is positioned on the OR bed prior to knee surgery to correct a sports-related injury.The anesthesiologist administers the appropriate anesthetic. The OR nurse should anticipate which of the following events as the teams next step in the care of this patient?

Intubating

Patient makes statement about not having glaucoma forever.

It's lifelong

New parents caring for a newborn

Knowledge deficit

2 pints = how many quarts

1 quart (qt)

A medical nurse is caring for a patient with type 1 diabetes. The patients medication administration record includes the administration of regular insulin three times daily. Knowing that the patients lunch tray will arrive at 11:45, when should the nurse administer the patients insulin?

11:15

A psychiatrist who embraces the Psychological Recovery Model tells the nurse that a client is in the Growth stage. What should the nurse expect to find when assessing this client?

A client feeling confident about achieving goals in life.

Hypoactive Sexual Desire

All of the above

A 52-year-old female patient is receiving care on the oncology unit for breast cancer that has metastasized to her lungs and liver. When addressing the patients pain in her plan of nursing care, the nurse should consider what characteristic of cancer pain?

Cancer pain can be acute or chronic and it typically requires comparatively high doses of pain medications.

Schizophrenia

Tertiary

A nurse is providing health education to the family of a patient with bronchiectasis. What should the nurse teach the patients family members?

The correct technique for providing postural drainage

***A nurse is preparing to discharge a patient after recovery from gastric surgery. What is an appropriate discharge outcome for this patient?

The patient maintains or gains weight.

A patient is admitted to the hospital with pernicious anemia. The nurse should prepare to administer which of the following medications?

Vitamin B12

A 23-year-old woman comes to the free clinic stating I think I have a lump in my breast. Do I have cancer? The nurse instructs the patient that a diagnosis of breast cancer is confirmed by what?

Fine-needle aspiration

A patient has had a myocardial infarction and has been diagnosed as having damage to the layer of the heart responsible for the pumping action. You are aware that the damage occurred where?

Myocardium

A client who is in a severely abusive relationship is admitted to a psychiatric inpatient unit. The client fears for her life. A staff nurse asks, "Why doesn't she just leave him?" Which is the nursing supervisor's most appropriate response?

"These clients are paralyzed into action by a combination of physical threats and a sense of powerlessness."

A patient has come to the clinic complaining of blood in his stool. A FOBT test is performed but is negative. Based on the patients history, the physician suggests a colonoscopy, but the patient refuses, citing a strong aversion to the invasive nature of the test. What other test might the physician order to check for blood in the stool?

A quantitative fecal immunochemical test

A patient has been discharged home after a total mastectomy without reconstruction. The patient lives alone and has a home health referral. When the home care nurse performs the first scheduled visit this patient, what should the nurse assess? Select all that apply.

A) Adherence to the exercise plan B) Overall psychological functioning C) Integrity of surgical drains

A patient who is legally blind is being admitted to the hospital. The patient informs the nurse that she needs to have her guide dog present during her hospitalization. What is the nurses best response to the patient?

Arrangements can be made for your guide dog to be at the hospital with you during your stay

Your patient is receiving postoperative morphine through a patient-controlled analgesic (PCA) pump and the patients orders specify an initial bolus dose. What is your priority assessment?

Assessment for respiratory depression

A patients plan of care specifies postural drainage. What action should the nurse perform when providing this noninvasive therapy?

Assist the patient into a position that will allow gravity to move secretions.

A client states, "I have come to the conclusion that this disease has not paralyzed me." The nurse recognizes that this client is in which stage of the Psychological Recovery Model as described by Andresen and associate?

Awareness

A 54-year-old African American man has presented for a follow-up appointment shortly after being diagnosed with hypertension and being placed on an angiotensin-converting enzyme (ACE) inhibitor. The nurse takes the patients vital signs at the beginning of the appointment and obtains a blood pressure of 177/96 mmHg. What factor should the nurse consider in light of the patients sustained high blood pressure?

Biologic variations may be influencing the effectiveness of the medication.

A nurse is creating a teaching plan for a patient who has a recent diagnosis of scleroderma. What topics should the nurse address during health education? Select all that apply.

C) Managing Raynauds-type symptoms D) Smoking cessation E) The importance of vigilant skin care

A patient has been discharged home on parenteral nutrition (PN). Much of the nurses discharge education focused on coping. What must a patient on PN likely learn to cope with? Select all that apply.

Changes in lifestyle Loss of eating as a social behavior Sleep disturbances related to frequent urination during nighttime infusions

A patient tells the nurse that her doctor just told her that her new diagnosis of rheumatoid arthritis is considered to be a chronic condition. She asks the nurse what chronic condition means. What would be the nurses best response?

Chronic conditions are defined as health problems that require management of several months or longer.

A patient has a concentration of S. aureus located on his skin. The patient is not showing signs of increased temperature, redness, or pain at the site. The nurse is aware that this is a sign of a microorganism at which of the following stages?

Colonization

Patient has compartment syndrome

Contact primary immediately

A patient is being admitted to the preoperative holding area for a thoracotomy. Preoperative teaching includes what?

Correct use of incentive spirometry

A patient has had a sudden loss of vision after head trauma. How should the nurse best describe the placement of items on the dinner tray?

Explain the location of items using clock cues.

A gerontologic nurse is teaching students about the high incidence and prevalence of dehydration in older adults. What factors contribute to this phenomenon? Select all that apply.

Decreased kidney mass, decreased renal blood flow, decreased excretion of potassium

A newly admitted patient with type 1 diabetes asks the nurse what caused her diabetes. When the nurse is explaining to the patient the etiology of type 1 diabetes, what process should the nurse describe?

Destruction of special cells in the pancreas causes a decrease in insulin production. Glucose levels rise because insulin normally breaks it down.

A student nurse is preparing to care for a patient with bronchiectasis. The student nurse should recognize that this patient is likely to experience respiratory difficulties related to what pathophysiologic process?

Dilation of bronchi and bronchioles

A nurse is planning the care of a patient who has been diagnosed with renal failure, which the nurse recognizes as being a chronic condition. Which of the following descriptors apply to chronic conditions? Select all that apply.

Diseases where complete cures are rare, Diseases that do not resolve spontaneously, and Diseases that have a prolonged course

A diabetes nurse educator is teaching a group of patients with type 1 diabetes about sick day rules. What guideline applies to periods of illness in a diabetic patient?

Do not eliminate insulin when nauseated and vomiting.

The nurse will be teaching self-management to patients after gastric bypass surgery. Which information will the nurse plan to include?

Drink fluids between meals but not with meals.

A female patient has been experiencing recurrent urinary tract infections. What health education should the nurse provide to this patient?

Drink liberal amounts of fluids.

A patient who has a 40 pack-year history of smoking may have dysplasia of the epithelial cells in her bronchi. What would the nurse tell the patient about dysplastic cells in the bronchi?

Dysplastic cells have a high potential to become malignant.

A patient has received a diagnosis of gastric cancer and is awaiting a surgical date. During the preoperative period, the patient should adopt what dietary guidelines?

Eat small, frequent meals with high calorie and vitamin content.

A patient is one month postoperative following restrictive bariatric surgery. The patient tells the clinic nurse that he has been having trouble swallowing for the past few days. What recommendation should the nurse make?

Eating more slowly and chewing food more thoroughly

A patient will be undergoing a total hip arthroplasty later in the day and it is anticipated that the patient may require blood transfusion during surgery. How can the nurse best ensure the patients safety if a blood transfusion is required?

Ensure that the patient has had a current cross-match.

A nurse in the preoperative holding area is admitting a woman prior to reduction mammoplasty. What should the nurse include in the care given to this patient? Select all that apply.

Establishing an IV line, verifying the surgical site with the patient, and taking measures to ensure the patients comfort

A patient has been brought to the emergency department by EMS after being found unresponsive. Rapid assessment reveals anaphylaxis as a potential cause of the patients condition. The care team should attempt to assess for what potential causes of anaphylaxis? Select all that apply.

Foods, Medications, and Insect stings

A patient has been experiencing disconcerting GI symptoms that have been worsening in severity. Following medical assessment, the patient has been diagnosed with lactose intolerance. The nurse should recognize an increased need for what form of health promotion?

Frequent screening for osteoporosis

In your role as a school nurse, you are presenting at a high school health fair and are promoting the benefits of maintaining a healthy body weight. You should refer to reductions in the risks of what diseases? Select all that apply.

Heart disease, Stroke, Diabetes, and Hypertension

A brain (B-type) natriuretic peptide (BNP) sample has been drawn from an older adult patient who has been experienced vital fatigue and shortness of breath. This test will allow the care team to investigate the possibility of what diagnosis?

Heart failure

In your role as a community health nurse, you are focusing your current health promotion efforts on diseases that are disproportionately represented among ethnic and racial minorities. Which of the following diseases would you likely address? Select all that apply.

Human immunodeficiency virus (HIV), Cancer, and Heart disease

You are the surgical nurse caring for a 65-year-old female patient who is postoperative day 1 following a thyroidectomy. During your shift assessment, the patient complains of tingling in her lips and fingers. She tells you that she has an intermittent spasm in her wrist and hand and she exhibits increased muscle tone. What electrolyte imbalance should you first suspect?

Hypocalcemia

The nurse is preparing to perform a patient's abdominal assessment. What examination sequence should the nurse follow?

Inspection, auscultation, percussion, and palpation

A patient has been admitted to the emergency department with signs of anaphylaxis following a bee sting. The nurse knows that if this is a true allergic reaction the patient will present with what alteration in laboratory values?

Increased eosinophils

A patient has a diagnosis of rheumatoid arthritis and the primary care provider has now prescribed cyclophosphamide (Cytoxan). The nurses' subsequent assessments should address what potential adverse effect?

Infection

What is an Arthrography?

Inject dye to ligament of the knee and have patient move the knee while taking pictures.

A 35-year-old male patient presents at the emergency department with symptoms of a small bowel obstruction. In collaboration with the primary care provider, what intervention should the nurse prioritize?

Insertion of a nasogastric tube

A nurse is caring for a patient admitted with a suspected malabsorption disorder. The nurse knows that one of the accessory organs of the digestive system is the pancreas. What digestive enzymes does the pancreas secrete? Select all that apply.

Lipase, Amylase, and Trypsin

Cancers of head and neck has a longer recovery because of what?

Lymph nodes

A nurse is assessing a client diagnosed with sexual masochistic disorder. What would differentiate this paraphilic disorder from sexual sadistic disorder?

Masochistic acts can be performed alone, whereas sadistic acts must have a consenting or non-consenting partner.

A patient has a gastrostomy tube that has been placed to drain stomach contents by low intermittent suction. What is the nurses priority during this aspect of the patients care?

Measure and record drainage.

A client states, "My illness is so devastating, I feel like my life is on hold." The nurse recognizes that this client is in which stage of the Psychological Recovery Model as described by Andersen and associates?

Moratorium

A patient has been scheduled for a bone marrow biopsy and admits to the nurse that she is worried about the pain involved with the procedure. What patient education is most accurate?

Most people feel some brief, sharp pain when the needle enters the bone.

A patient has sought care because of recent dark-colored stools. As a result, a fecal occult blood test has been ordered. The nurse should instruct the patient to avoid which of the following prior to collecting a stool sample?

NSAIDs

Patient had bariatric surgery

Patient must eat six small meals and encourage fluids.

A 76-year-old with a diagnosis of penile cancer has been admitted to the medical floor. Because the incidence of penile cancer is so low, the staff educator has been asked to teach about penile cancer. What risk factors should the educator cite in this presentation? Select all that apply.

Phimosis, Increasing age, and Lack of circumcision

A nurse educator is reviewing the indications for chest drainage systems with a group of medical nurses. What indications should the nurses identify? Select all that apply.

Post thoracotomy, Spontaneous pneumothorax, and Chest trauma resulting in pneumothorax

A patient arrives in the emergency department with an attack of acute bronchiectasis. Chest auscultation reveals the presence of copious secretions. What intervention should the nurse prioritize in this patients' care?

Postural chest drainage

After working with a patient who as human immunodeficiency (HIV) for several weeks, the nurse has become more aware of the role of health disparities. Which of the following variables are known to underlie health disparities? Select all that apply.

Poverty, Isolated geographic location, and Over dependence on publicly funded facilities

A client was recently admitted to the inpatient unit after a suicide attempt. He has been placed on a tricyclic antidepressant. In terms of medication, what steps should be taken to maintain the client's safety when he is discharged?

Provide a 1-week supply of medication, with refills authorized only after he visits his provider.

A client diagnosed with obsessive-compulsive disorder states, "I really think my future will improve because of my successful treatment choices. I'm going to make my life better." Which guiding principle of recovery has assisted this client?

Recovery emerges from hope

A patient is being treated in the ICU after a medical error resulted in an acute hemolytic transfusion reaction. What was the etiology of this patient's adverse reaction?

The donor blood was incompatible with that of the patient

A patient has been prescribed sildenafil. What should the nurse teach the patient about this medication?

The drug should be taken 1 hour prior to intercourse.

Patient on hemodialysis 3 times a week, 1,000 cc a day, patient had 350ml of soft drink. Patient education?

Reinforce teaching and document extra fluid taken.

A patient has been scheduled for a urea breath test in one months time. What nursing diagnosis most likely prompted this diagnostic test?

Risk For Impaired Skin Integrity Related to Peptic Ulcers

Hearing loss related to damage to cochlea

Sensory neural hearing loss

A patient is receiving a blood transfusion and complains of a new onset of slight dyspnea. The nurses rapid assessment reveals bilateral lung crackles and elevated BP. What is the nurses most appropriate action?

Slow the infusion rate and monitor the patient closely.

A 42-year-old woman comes to the clinic complaining of occasional urinary incontinence when she sneezes. The clinic nurse should recognize what type of incontinence?

Stress incontinence

A patient who experienced an upper GI bleed due to gastritis has had the bleeding controlled and the patients condition is now stable. For the next several hours, the nurse caring for this patient should assess for what signs and symptoms of recurrence?

Tachycardia, hypotension, and tachypnea

A geriatric client is confused and wandering in and out of every door. Which scenario reflects the least restrictive alternative for this client?

The client is monitored by an ankle bracelet.

A 16-year-old male patient comes to the free clinic and is subsequently diagnosed with primary syphilis. What health problem most likely prompted the patient to seek care?

The emergence of a chancre on his penis

A patient diagnosed with arthritis has been taking aspirin and now reports experiencing tinnitus and hearing loss. What should the nurse teach this patient?

The hearing loss will likely resolve with time after the drug is discontinued.

A patient is scheduled for a splenectomy. During discharge education, what teaching point should the nurse prioritize?

The need to report any signs or symptoms of infection promptly

Your patient has just returned from the post anesthetic care unit (PACU) following left tibia open reduction internal fixation (ORIF). The patient is complaining of pain, and you are preparing to administer the patients first scheduled dose of hydromorphone (Dilaudid). Prior to administering the drug, you would prioritize which of the following assessments?

The patients allergy status

Your patient is 12-hours post ORIF right ankle. The patient is asking for a breakthrough dose of analgesia. The pain-medication orders are written as a combination of an opioid analgesic and a nonsteroidal anti-inflammatory drug (NSAID) given together. What is the primary rationale for administering pain medication in this manner?

To achieve better pain control than with one medication alone.

A patient is exhibiting signs of a pneumothorax following tracheostomy. The surgeon inserts a chest tube into the anterior chest wall. What should the nurse tell the family is the primary purpose of this chest tube?

To remove air from the pleural space

A 15-year-old child is brought to the emergency department with symptoms of hyperglycemia and is subsequently diagnosed with diabetes. Based on the fact that the childs pancreatic beta cells are being destroyed, the patient would be diagnosed with what type of diabetes?

Type 1 diabetes

The nurse is caring for a patient who describes changes in his voiding patterns. The patient states, I feel the urge to empty my bladder several times an hour and when the urge hits me I have to get to the restroom quickly. But when I empty my bladder, there doesn't seem to be a great deal of urine flow. What would the nurse expect this patient's physical assessment to reveal?

Urine retention