EAQ final exam
The nurse is interacting with a dieting obese patient. Which statement made by the patient indicates that the patient is practicing stimulus control? "I maintain a diary about my diet and eating times every day." "I decided that I will pamper myself with a massage after I lose 5 lbs." "I will treat myself with my favorite food after losing 10 pounds of weight." "I avoided going near the food court because the smell is very tempting."
"I avoided going near the food court because the smell is very tempting."
The nurse evaluates that discharge teaching for a patient hospitalized with pneumonia has been effective when the patient makes which statement? "I will seek immediate medical treatment for any upper respiratory infections." "I should continue to do deep-breathing and coughing exercises for at least 12 weeks." "I will increase my food intake to 2400 calories a day to keep my immune system well." "I must have a follow-up chest x-ray in six to eight weeks to evaluate the pneumonia's resolution."
"I must have a follow-up chest x-ray in six to eight weeks to evaluate the pneumonia's resolution."
A nurse is providing dietary instructions to a patient with pancreatitis. Which statement by the patient indicates the need for further teaching? "I should avoid fat-rich foods." "I should avoid fiber-rich foods." "I should eat protein-rich foods." "I should eat carbohydrate-rich foods."
"I should avoid fiber-rich foods."
Which statement made by a patient who underwent a bariatric surgery indicates the need for further teaching about steps to maintain proper weight? "I should reduce carbohydrates in my diet." "I should limit cheese and butter in my diet." "I should drink plenty of fluids with my meals." "I should increase the protein content in my diet."
"I should drink plenty of fluids with my meals."
Which statement made by the patient indicates effective learning about the interventions to be followed to reduce the risk of atelectasis while undergoing chest tube drainage? Select all that apply. "I should change position slowly." "I should cough at regular intervals." "I should perform incentive spirometer." "I should reduce intake of protein in my diet." "I should perform range-of-motion exercises."
"I should perform range-of-motion exercises." "I should cough at regular intervals." "I should perform incentive spirometer."
The nurse determines that additional discharge teaching is needed for a patient with pneumonia when the patient states what? "I will take all medications as prescribed." "Breathing exercises may help prevent future infections." "I should take antibiotics for all upper respiratory infections." "I will seek medical attention if I develop a fever or productive cough."
"I should take antibiotics for all upper respiratory infections."
At the first visit to the clinic, a patient with a body mass index (BMI) of 29 kg/m 2 tells the nurse, "I do not want to become obese." Which question used for assessing weight issues is the most important for the nurse to ask? "What is your waist circumference?" "How is your overall health affected by your body weight?" "What is your history of gaining weight and losing weight?" "In what ways are you interested in managing your weight differently?"
"In what ways are you interested in managing your weight differently?"
The nurse is performing education to a patient undergoing a Whipple procedure. Which statement demonstrates that the patient needs further education regarding the Whipple procedure? "It involves complete removal of the stomach." "It involves complete removal of the duodenum." "It involves removal of a portion of the bile duct." "It involves removal of a portion of the pancreas."
"It involves complete removal of the stomach."
A patient is scheduled for a secretin stimulation test and asks the nurse what this will evaluate. What is the best response by the nurse? "It will evaluate if you have Wilson's disease." "It will evaluate if you have diabetes mellitus." "It will determine if you have acute pancreatitis." "It will determine if you have chronic pancreatitis."
"It will determine if you have chronic pancreatitis."
What should the nurse include in the discharge education provided to a female patient who underwent bariatric surgery? "Postpone pregnancy for 12 to 18 months." "Irregular menstruation for 12 months is likely." "A result of the surgery is loss of fertility." "You will need hormone replacement therapy."
"Postpone pregnancy for 12 to 18 months."
What instruction does the nurse give the patient while removing the chest tube? "You should sleep in a side-lying position." "You should sleep with your leg elevated." "You should hold your breath or bear down." "You should drink juice before the procedure."
"You should hold your breath or bear down."
What discharge instructions should the nurse provide to a patient who has undergone Roux-en-Y gastric bypass surgery? Select all that apply. "You will need to take a calcium supplement." "You should take an iron supplement." "You will likely experience belching and heartburn." "Report vomiting, weakness, or faintness, which may indicate dumping syndrome." "You should experience a decrease in total cholesterol."
"You will need to take a calcium supplement." "You should take an iron supplement." "Report vomiting, weakness, or faintness, which may indicate dumping syndrome." "You should experience a decrease in total cholesterol."
When providing teaching to an obese patient, the nurse should emphasize that a healthy weight loss average is how many pounds per week? 2 pounds 3 pounds 6 pounds 8 pounds
2 pounds
What diet should the nurse provide to a patient during the immediate postoperative period after bariatric surgery? 20 mL of whole milk Porridge with water Protein-rich milk shake 30 mL water and sugar-free liquid
30 mL water and sugar-free liquid
The nurse reviews the medical records of four female patients and identifies that which patient is at increased risk for metabolic syndrome? A patient with a waist-to-hip ratio of 0.6 A patient with a body mass index (BMI) of 24 kg/m 2 A patient with a waist circumference of 37 inches A patient with a family history of obesity
A patient with a waist circumference of 37 inches
A patient reports abdominal pain and passing of greasy stools with foul odor. What does the nurse suspect is the cause of the patient's condition? Absence of bile in the small intestine Hindered bile flow into the duodenum Presence of dissolved bilirubin in urine Absence of bile salts in the duodenum
Absence of bile salts in the duodenum
A patient with cholelithiasis needs to have the gallbladder removed. Which patient assessment is a contraindication for a cholecystectomy? Low-grade fever of 100F and dehydration Abscess in the right upper quadrant of the abdomen Multiple obstructions in the cystic and common bile duct Activated partial thromboplastin time (aPTT) of 54 seconds
Activated partial thromboplastin time (aPTT) of 54 seconds
Which intervention does the nurse perform 30 minutes before removing a chest tube from a patient? Instruct the patient to eat. Administer pain medications to the patient. Instruct the patient to perform the Valsalva maneuver. Apply an airtight dressing over the chest tube insertion site.
Administer pain medications to the patient.
The nurse is administering postoperative care to a patient that underwent bariatric surgery. What is a priority intervention? Ambulating the patient Administering analgesics Providing solid foods to the patient Providing a low-protein diet to the patient
Administering analgesics
A 70-year-old patient presents to the emergency department with a cough producing yellow sputum, fever, chills, and shortness of breath. On examination the nurse finds that the patient is confused, has a respiratory rate of 42/minute, and a blood pressure of 80/50 mm Hg. The nurse expects that what will be included in the patient's treatment plan? Admit the patient to intensive care unit. Admit the patient to a general medical-surgical unit. Discharge the patient and monitor for signs of worsening infection. Admit the patient for a 23-hour observation and monitor for pulmonary embolism.
Admit the patient to intensive care unit.
What concern related to bariatric surgery can be addressed through use of cosmetic surgery? Dehiscence Dumping syndrome Altered body image Deep venous thrombosis
Altered body image
The nurse recalls that hepatic coma results primarily from accumulation of which substance in the blood? Sodium Calcium Ammonia Potassium
Ammonia
A patient with cirrhosis of the liver is admitted to the hospital. What hematologic symptoms might be noted in this patient? Select all that apply. Anemia Leukemia Leukopenia Polycythemia vera Thrombocytopenia
Anemia Leukopenia Thrombocytopenia
When the patient with a persistent cough is diagnosed with pertussis (instead of acute bronchitis), the nurse knows that treatment will include which type of medication? Antibiotic Corticosteroid Bronchodilator Cough suppressant
Antibiotic
A patient with asthma who has undergone a total hip replacement complains on the third postoperative day of shortness of breath and slight chest pain and notes that "something is wrong." Temperature is 98.8° F, blood pressure 168/98 mm Hg, pulse 96, respirations 32, and oxygen saturation is 89% on room air. What is the priority nursing action? Notify the health care provider and document the vital signs. Apply oxygen and place the patient in a semi-Fowler's position. Obtain an electrocardiogram (ECG) and administer albuterol nebulizers. Administer the prescribed antihypertensive medication and reassess in 15 minutes.
Apply oxygen and place the patient in a semi-Fowler's position.
The nurse is caring for a patient who has undergone bariatric surgery. Which nursing interventions will be beneficial to this patient? Select all that apply. Assisting the patient to walk in the evening after the surgery Administering carbohydrate-rich foods Maintaining the patient in the semi-Fowler's position Being prepared to perform a head-tilt maneuver Maintaining the patient on large quantities of liquid intake
Assisting the patient to walk in the evening after the surgery Maintaining the patient in the semi-Fowler's position Being prepared to perform a head-tilt maneuver
A patient reports shortness of breath one day after a cholecystectomy. On examination there is dullness on percussion on the right side of the chest, and breath sounds are also decreased in this region. The nurse recognizes that the most probable reason for the assessment findings is what? Atelectasis Pneumonia Pneumothorax Tension pneumothorax
Atelectasis
Which complication does the nurse expect when a patient with fractured ribs is wearing a binder on the chest? Atelectasis Chylothorax Hemopneumothorax Pulmonary embolism
Atelectasis
The nurse is caring for an obese patient who is being considered for bariatric surgery. What do the criteria guidelines for bariatric surgery include? BMI of 40 kg/m 2 or more BMI of 28 kg/m 2 or more BMI of 30 kg/m 2 or more BMI of 32 kg/m 2 or more with other significant co-morbidities
BMI of 40 kg/m 2 or more
Which physical assessment finding in a patient with a lower respiratory problem best supports the nursing diagnosis of ineffective airway clearance? Basilar crackles Respiratory rate of 28 Oxygen saturation of 85% Presence of greenish sputum
Basilar crackles
What is the name of the substance that is a mixture of cholesterol crystals and calcium salts that may be found in a patient diagnosed with pancreatitis? Apraxia Biliary sludge Biliary atresia Pancreatic abscess
Biliary sludge
The nurse suspects that a patient with cholelithiasis has developed choledocholithiasis. Increases in which assessment finding support the nurse's suspicion? Select all that apply. Bilirubin Creatinine Platelet count Body temperature Alkaline phosphatase
Bilirubin Body temperature
The nurse caring for a patient who has undergone cholecystectomy should monitor the patient for which major immediate postoperative complication? Infection Bleeding Dehydration Bowel obstruction
Bleeding
A nurse assessing a patient with pancreatitis suspects the presence of Grey Turner's sign when the patient exhibits what? Jaundice of the sclera Bluish discoloration of the flank area Bluish discoloration of the periumbilical area Left abdominal pain that occurs with movement
Bluish discoloration of the flank area
The nurse recalls that which substance is involved in the development of cholelithiasis? Albumin Calcium Sodium Globulin
Calcium
What does a nurse anticipate that the primary health care provider will prescribe for a patient with pancreatitis who reports irritability and tingling around the lips? Insulin Vitamin K Cholestyramine Calcium gluconate
Calcium gluconate
A patient experiences severe pain in the right upper quadrant of the abdomen, increased heart rate, and shortness of breath. The nurse suspects that the consumption of what food items caused the patient's symptoms? Select all that apply. Cheese Buttermilk Hamburger Sugar cookie Carbonated beverage
Cheese Hamburger
A patient presents with pain in the right side of the upper quadrant, a body temperature of 101° F, and indigestion. The laboratory reports show a white blood cell count (WBC) of 14,000 cells/µL. The nurse suspects that the patient is experiencing which condition? Cirrhosis Pancreatitis Cholecystitis Pancreatic cancer
Cholecystitis
A patient reports abdominal pain. Upon assessment, the nurse finds the presence of tachycardia and prostration. Which condition does the nurse suspect that the patient is experiencing? Pancreatitis Cholecystitis Cholelithiasis Liver cirrhosis
Cholelithiasis
The nurse is caring for a patient with gallstones and expects what assessment finding? Tachycardia Hypotension Hyperglycemia Clay-colored stools
Clay-colored stools
A patient presenting with pneumonia scores 5 on the CURB-65 scale. What action should the nurse take? Advise no treatment. Advise treating at home. Consider hospital admission. Consider admission to an intensive care unit.
Consider admission to an intensive care unit.
The nurse is performing an assessment on a patient that has been admitted with severe pancreatitis and discovers a bluish discoloration of the periumbilical area. How should the nurse document this finding? Asterixis Cullen's sign Spider angioma Grey Turner's sign
Cullen's sign
Which factor places a conscious patient at risk for pneumonia? Difficulty swallowing medication Lying supine for two consecutive hours Effective postoperative pain management Adequate cough and deep breathing exercises
Difficulty swallowing medication
A patient is taking lorcaserin. The nurse should monitor for what adverse effects associated with the medication? Select all that apply. Diarrhea Dizziness Dry mouth Constipation Abdominal bloating
Dizziness Dry mouth Constipation
The nurse, while examining a patient with chylothorax, finds that the patient has lymphatic flow of 3000 mL/day. The primary health care provider prescribes pleurodesis for the patient. Which other medication does the nurse expect in the patient's prescription? Octreotide Prednisone Doxycycline Cyclosporine
Doxycycline
The nurse is monitoring a patient who has pneumonia with thick secretions. The patient is having difficulty clearing the secretions. Which of these would be appropriate nursing interventions for this patient? Select all that apply. Perform postural drainage every hour. Encourage the patient to rest and limit activity. Provide adequate hydration by encouraging fluid intake. Provide analgesics as prescribed to promote patient comfort. Teach the patient how to cough effectively to bring secretions to the mouth.
Encourage the patient to rest and limit activity. Provide adequate hydration by encouraging fluid intake. Teach the patient how to cough effectively to bring secretions to the mouth.
The nurse is caring for a patient with a nonmassive pulmonary embolism (PE). What is the best standard for treatment? Warfarin Alteplase Enoxaparin Tissue plasminogen activator
Enoxaparin
An obese patient tells the nurse, "As part of my weight loss program, I have begun exercising daily for an hour in the morning and an hour in the evening. I also have a goal of 10,000 steps a day, but I started by walking one-third of the recommended steps. I have been swimming and cycling." The patient reports feeling fatigued at the end of the day. What recommendation should the nurse make? Exercise for an hour each day. Continue swimming but do not cycle. Change the goal to 5,000 steps a day. Start by walking 2,000 steps, with incremental increases.
Exercise for an hour each day.
When teaching a patient about reducing weight by using a calorie-restricted diet, what instructions should the nurse include? Select all that apply. Skip meals if not hungry. Exercise regularly. Avoid concentrated sweets. Select fried foods. Select steamed and baked foods.
Exercise regularly. Avoid concentrated sweets. Select steamed and baked foods.
A patient takes orlistat for weight loss. The nurse anticipates that which supplement will be prescribed? Fat-soluble vitamin supplements Water-soluble vitamin supplements Iron supplement Folic acid supplement
Fat-soluble vitamin supplements
Which condition in a patient with chest trauma requires treatment of positive pressure ventilation? Flail chest Cardiac tamponade Hemopneumothorax Tension pneumothorax
Flail chest
A patient is diagnosed with chronic cholecystitis. The nurse expects what assessment finding? Urticaria Flatulence Indigestion Weight loss
Flatulence
The nurse cares for a patient with advanced cirrhosis. What indicates that the patient is experiencing a serious complication? Urine retention Increased blood glucose No bowel movement in three days Frequent nosebleeds and bruising
Frequent nosebleeds and bruising
A patient with pneumonia is being treated at home and has reported fatigue to the nurse. What instructions should the nurse include when teaching the patient about care and recovery at home? Select all that apply. Get adequate rest. Restrict fluid intake. Avoid alcohol and smoking. Resume work to build strength. Take every dose of the prescribed antibiotic
Get adequate rest. Avoid alcohol and smoking. Take every dose of the prescribed antibiotic
What should the nurse include in a postoperative plan of care for a patient who has undergone bariatric surgery? Avoid ambulating the patient. Give 30 mL of water every 2 hours. Give solid foods along with liquids. Avoid sugar-free liquids in the patient's diet.
Give 30 mL of water every 2 hours.
Assessment findings of a patient include asterixis, hyperventilation, fetor hepaticus, fatigue, a body temperature of 95° F, and continuous lip smacking. Which condition does the nurse suspect? Hepatitis Liver cirrhosis Hepatorenal syndrome Hepatic encephalopathy
Hepatic encephalopathy
The nurse cares for a patient with tuberculosis who is taking isoniazid and rifampin. About which data found in the patient's health history is the nurse most concerned? Hepatitis B Asthma attacks Rheumatic fever Allergy to penicillin
Hepatitis B
Which hepatitis virus is transmitted parenterally from mother to fetus? Hepatitis A Hepatitis B Hepatitis C Hepatitis E
Hepatitis B
The nurse assists the patient who has undergone bariatric surgery in making dietary selections. Which types of food items should be recommended? High-protein High-carbohydrate High-fat High-roughage
High-protein
Which nursing interventions will the nurse implement to help the patient expectorate mucus in a 72-year-old patient with bronchitis? Select all that apply. Humidify the oxygen. Teach pursed lip breathing. Administer a cough suppressant. Elevate the head of the bed to 45 degrees. Increase fluid intake to 3 L per day if tolerated.
Humidify the oxygen. Elevate the head of the bed to 45 degrees. Increase fluid intake to 3 L per day if tolerated.
A patient who has hepatitis B surface antigen (HBsAg) in the serum is being discharged with pain medication after knee surgery. Which medication prescription should the nurse question because it is mostlikely to cause hepatic complications? Tramadol Hydromorphone Oxycodone with aspirin Hydrocodone with acetaminophen
Hydrocodone with acetaminophen
The nurse is caring for a patient admitted to the hospital with pneumonia. Upon assessment, the nurse notes a temperature of 101.4° F, a productive cough with yellow sputum, and a respiratory rate of 20. Which most appropriate nursing diagnosis is based upon this assessment? Hyperthermia related to infectious illness Ineffective thermoregulation related to chilling Ineffective breathing pattern related to pneumonia Ineffective airway clearance related to thick secretions
Hyperthermia related to infectious illness
The nurse is planning discharge teaching for a patient after a laser laparoscopic cholecystectomy. The nurse explains to the patient about self-care at home. Which statements of the patient indicate that the patient has understood the discharge teachings? Select all that apply. I cannot bathe or shower for 10 days. I can have normal food that is low in fat. I may have mild shoulder pain for a week. I should not lift heavy weights for a few days. I should have only a liquid diet for the first week.
I can have normal food that is low in fat. I may have mild shoulder pain for a week. I should not lift heavy weights for a few days.
What dietary recommendation should the nurse give to a patient with chronic gallbladder disease? Include dairy products. Maintain a low-protein diet. Include fat-soluble vitamins. Increase the intake of refined cereals.
Include fat-soluble vitamins.
What is the priority nursing intervention in helping a patient expectorate thick lung secretions? Humidify the oxygen as able. Administer cough suppressant. Teach the patient to splint the affected area. Increase fluid intake to 3 L/day if tolerated.
Increase fluid intake to 3 L/day if tolerated.
The nurse is caring for a patient with acute pancreatitis. What laboratory studies should the nurse monitor that demonstrate a change in the pancreas? Increased levels of sodium Increased levels of glucose Increased levels of potassium Increased levels of triglycerides
Increased levels of triglycerides
Which clinical manifestation should the nurse expect to find during assessment of a patient admitted with pneumonia? Hyperresonance on percussion Vesicular breath sounds in all lobes Increased vocal fremitus on palpation Fine crackles in all lobes on auscultation
Increased vocal fremitus on palpation
When planning care for a patient with pneumonia, the nurse recognizes which intervention as the highest priority? Administering analgesics as needed for pain Keeping the patient in a calm and quiet environment Routinely checking vital signs and oxygen saturation Increasing fluids to 2 to 3 L/day unless contraindicated
Increasing fluids to 2 to 3 L/day unless contraindicated
To ease pleuritic pain caused by pneumonia, what nursing interventions should be performed? Instructing the patient to splint the chest when coughing Offering the patient an incentive spirometer every four hours Instructing the patient in how to perform abdominal breathing Encouraging the patient use shallow breathing during episodes of pain
Instructing the patient to splint the chest when coughing
The nurse is assessing a patient who has a closed chest tube drainage system attached to a water-seal chamber. The nurse notes that the tidaling has stopped. What is the priority intervention by the nurse? Continue to monitor the patient. Check all connections for a leak in the system. Investigate the chest tube for a possible occlusion. Lower the drainage collector further from the chest.
Investigate the chest tube for a possible occlusion.
A patient who underwent a cholecystectomy is now complaining of pain referred to his right shoulder. What is the most probable cause for this pain? Select all that apply. Myocardial infarction Pericarditis after surgery Gallstone left accidentally Irritation of the phrenic nerve Carbon dioxide that was used in surgery
Irritation of the phrenic nerve Carbon dioxide that was used in surgery
A patient has been diagnosed with community-acquired pneumonia (CAP). What does the nurse know is true? This is a chronic infection with mild to moderate symptoms. Antibiotics are not started until a definite diagnosis and causative organism are known. It can occur in patients who have not resided in a long-term care facility within 14 days of symptoms. The decision to hospitalize or treat at home is based upon the patient's medical insurance status.
It can occur in patients who have not resided in a long-term care facility within 14 days of symptoms.
A patient has been diagnosed with cholelithiasis. The nurse will monitor for manifestations of obstructed bile flow, including which of these? Select all that apply. Jaundice Steatorrhea Dark, tarry stools Dark, amber urine Bleeding tendencies
Jaundice Steatorrhea Dark, amber urine Bleeding tendencies
A patient is admitted to the hospital after being involved in a motor vehicle accident. The patient has asymmetric chest excursion and an absence of breath sounds on the left side. The nurse suspects what? Left pneumothorax Right pneumothorax Pulmonary embolism Adult respiratory distress syndrome
Left pneumothorax
An elderly woman reports weakness, abdominal pain, and bleeding from the vagina. When reviewing the patient's diagnostic test reports, the nurse notes anemia and an enlarged spleen. The nurse suspects that the patient has what condition? Liver cirrhosis Pancreatic cancer Acute liver failure Acute pancreatitis
Liver cirrhosis
Which type of surgery involves the removal of one lobe of lung? Lobectomy Pneumonectomy Wedge resection Segmental resection
Lobectomy
An overweight patient tells the nurse, "I had a friend who lost a lot of weight on a low-carbohydrate diet. I would like to try that." The nurse should respond to the patient with what factor in mind? Low-carbohydrate diets are safe and easy to follow. Low-carbohydrate diets produce long-lasting weight loss. Low-fat diets provide more chance of success than low-carbohydrate diets. Low-carbohydrate diets reduce the opportunity to get adequate amounts of fiber, vitamins, and minerals.
Low-carbohydrate diets reduce the opportunity to get adequate amounts of fiber, vitamins, and minerals.
The nurse should recommend what type of diet for a patient with acute cholecystitis? Low-fat Low-protein Low-calcium Low-carbohydrate
Low-fat
A patient with cholecystitis receives a prescription for cholestyramine in powdered form. The nurse should provide the patient with what medication instruction? Avoid mixing the medication with water. Avoid taking the medication with fruit juice. Take the medication directly from the container. Mix the medication with four to six ounces of milk.
Mix the medication with four to six ounces of milk.
A nurse is caring for a patient with pancreatitis. Which interventions should the nurse implement while taking care of the patient? Select all that apply. Monitor calcium levels. Monitor prothrombin time. Monitor magnesium levels. Monitor blood glucose levels. Monitor blood urea nitrogen levels.
Monitor calcium levels. Monitor magnesium levels. Monitor blood glucose levels.
The nurse is caring for a patient who has a nasogastric tube. What actions should the nurse perform to prevent aspiration in this patient? Select all that apply. Monitor gastric residual volumes. Feed the patient in a reclined position. Lower the head of the bed to 10 degrees. Elevate the head of the bed 30 to 45 degrees. Encourage the patient to sit upright for all meals.
Monitor gastric residual volumes. Elevate the head of the bed 30 to 45 degrees. Encourage the patient to sit upright for all meals.
The nurse is caring for a patient with metabolic syndrome. Which nursing intervention will be beneficial for the patient? Select all that apply. Recommending a sodium-rich diet Monitoring estrogen levels Monitoring serum lipid levels Monitoring blood glucose level Recommending foods low in saturated fats
Monitoring serum lipid levels Monitoring blood glucose level Recommending foods low in saturated fats
A patient who was in a motor vehicle accident is brought to the emergency department unconscious, and cardiopulmonary resuscitation (CPR) is performed. The patient responds well, and the condition improves. After several hours, the patient experiences dyspnea and becomes cyanotic. On examination, the neck veins are distended and the patient is tachycardic. The nurse expects that the immediate plan for treatment will include what intervention? Pericardiocentesis Oxygen administration Needle decompression Placing the patient in a side-lying position
Needle decompression
When admitting a 45-year-old female with a diagnosis of pulmonary embolism, the nurse will assess the patient for which risk factors? Select all that apply. Obesity Pneumonia Malignancy Cigarette smoking Prolonged air travel
Obesity Malignancy Cigarette smoking Prolonged air travel
A patient returns to the surgical center 10 days after a cholecystectomy for his postoperative checkup. His wife is with him and is asking whether she should be concerned about having cholelithiasis as well. What is the most appropriate response by the nurse? Obesity increases the risk, especially in women. Pregnancy is not a risk factor for cholelithiasis in women. The incidence of cholelithiasis is lower in women than in men. Gender differences in the incidence decrease after 40 years of age.
Obesity increases the risk, especially in women.
Which action of the student nurse indicates effective learning about determining the effectiveness of pancreatic enzymes replacement in patients with chronic pancreatitis? Observing the patient's stool Observing the patient's urine Observing the patient's saliva Observing the patient's nasal secretions
Observing the patient's stool
The health care provider has prescribed intravenous (IV) vancomycin for a patient with pneumonia. Which action should the nurse perform first? Obtain a full set of vital signs. Obtain sputum cultures for sensitivity. Administer the antibiotic over at least 60 minutes. Draw a blood specimen to evaluate the white blood cell count.
Obtain sputum cultures for sensitivity.
When the patient is diagnosed with a lung abscess, what should the nurse teach the patient? Lobectomy surgery usually is needed to drain the abscess. Intravenous (IV) antibiotic therapy will be used for a prolonged period of time. Oral antibiotics will be used when the patient and x-ray show evidence of improvement. No further culture and sensitivity tests are needed if the patient takes the medication as prescribed.
Oral antibiotics will be used when the patient and x-ray show evidence of improvement.
The nurse identifies that a patient is at risk for developing cholelithiasis based on the patient's history of what? Antibiotic use Vasodilator therapy Anticholinergic therapy Oral contraceptive use
Oral contraceptive use
An obese patient reports consuming a high-fat diet daily. The nurse recognizes that which medication that is used to treat obesity blocks fat breakdown? A serotonin agonist A sympathomimetic Lorcaserin Orlistat
Orlistat
The nurse is caring for a patient who is at risk for a flail chest. The nurse knows which statements are true? Select all that apply. Palpation must be performed to check for crepitus. Most patients with a flail chest require mechanical ventilation. Splinting of the chest wall is seen only in the unconscious patient. Paradoxical chest movements only occur if the sternum also is fractured. Flail chest results from fracture of two or more nonconsecutive ribs on the same side. Paradoxical chest movements involve the affected portion being sucked in during expiration and bulging out during inspiration.
Palpation must be performed to check for crepitus. Most patients with a flail chest require mechanical ventilation.
Which assessment findings are associated with complications of cirrhosis of the liver? Select all that apply. Pedal edema Productive cough Mental status changes Black, tarry stools Chest pain with diaphoresis
Pedal edema Mental status changes Black, tarry stools
A patient who is receiving treatment for cholelithiasis experiences severe nausea and six episodes of vomiting. The nurse identifies that which intervention will be beneficial to the patient? Administrating lactulose Administrating rifaximin Performing gastric decompression Performing endotracheal intubation
Performing gastric decompression
The nurse finds that a patient with chest trauma exhibits cyanosis, air hunger, distension of the neck vein, profuse diaphoresis, and an increase of intrathoracic pressure. What is the priority procedure in this situation? Performing pericardiocentesis Performing needle decompression Insertion of chest tube with flutter valve Insertion of chest tube with drainage system
Performing needle decompression
What will be the immediate nursing action if the nurse, while caring for a patient with chest trauma, finds that the drainage system in the patient is broken? Milking the drainage tubes Stripping the drainage tubes Emptying the collection chamber Placing the chest tubing in a sterile water container
Placing the chest tubing in a sterile water container
Which surgical procedure involves the removal of a part of pleura in the body? Pleurodesis Pleurectomy Pleural biopsy Thoracentesis
Pleurectomy
A 72-year-old patient is in the emergency department with a temperature of 101.4° F and a productive cough with rust-colored sputum. The nurse notifies the health care provider, understanding these findings are indicative of which condition? Tuberculosis Pneumonia Pulmonary embolus Chronic heart failure (CHF)
Pneumonia
The nurse is teaching a patient about developing strategies for a weight-loss program. What should the nurse include in the education? Select all that apply. Providing information about stimulus control and self-monitoring Stating that diet therapy alone is often effective Advising to stay focused on reasons to lose weight. Recommending that weight loss medication is part of the initial plan Including a reduced-calorie diet, exercise, and behavior modification in the plan
Providing information about stimulus control and self-monitoring Advising to stay focused on reasons to lose weight. Including a reduced-calorie diet, exercise, and behavior modification in the plan
The nurse is providing care to a patient with cholecystitis that is experiencing severe nausea and vomiting. The nurse should include what intervention? Encouraging exercise Assisting with ambulation Assisting with repositioning Providing oral care every two hours
Providing oral care every two hours
A 46-year-old patient who has undergone total left knee arthroplasty complains of shortness of breath and slight chest pain. Temperature is 98° F, blood pressure 140/86 mmHg, respirations 30, and oxygen saturation 92% on room air. The nurse suspects that the patient is experiencing which condition? Pneumonia Unstable angina Pulmonary embolus Chronic obstructive pulmonary disease (COPD) exacerbation
Pulmonary embolus
A patient has been admitted with a suspected lung abscess. During the assessment, the nurse is aware that the most common manifestation of a lung abscess is which of these? Fever Vomiting Purulent sputum that has a foul odor and taste Increased breath sounds on auscultation over the involved segment of lung.
Purulent sputum that has a foul odor and taste
The diagnostic reports of a patient indicate that the patient has chylothorax. The primary health care provider has prescribed octreotide. What outcome does the nurse expect after treatment? Adequate hydration Adequate pain control Reduced risk of hypoxemia Reduced flow of lymphatic fluid
Reduced flow of lymphatic fluid
The nurse is assessing a patient with chest trauma who is on chest-tube gravity drainage. While assessing, the nurse finds that the fluid level in the chamber is very high. What is the best nursing intervention in this situation? Applying the clamp to the tube Retaping the tube connections Lowering the water-seal column Releasing the high negativity valve
Releasing the high negativity valve
The nurse provides preprocedure teaching for a patient who is scheduled for bedside thoracentesis. What does the nurse explain to be the primary purpose of thoracentesis? Determining the stage of a lung tumor Directly inspecting and examining the pleural space Obtaining a specimen of pleural tissue for evaluation Relieving an abnormal accumulation of fluid in the pleural space
Relieving an abnormal accumulation of fluid in the pleural space
The nurse is monitoring a patient who is having a thoracentesis for recurrent pleural effusion. Which of these assessment findings would be of most concern? Removal of 1000 mL of pleural fluid Restlessness and sudden complaint of dyspnea SpO 2 reading of 96% while on 2 L/minute of oxygen Patient complaint of pressure at the needle insertion site
Restlessness and sudden complaint of dyspnea
The nurse is providing discharge instructions to a patient and caregiver following a laparoscopic cholecystectomy. Which of these measures will be included in the discharge counseling? Select all that apply. Resume normal activities gradually within one week. Eat a low-fat diet for several weeks after the surgery. Keep the bandages on the puncture sites for three days. Report any bile-colored drainage or pus from any incision. Empty and measure the contents of the bile bag from the T tube every day.
Resume normal activities gradually within one week. Eat a low-fat diet for several weeks after the surgery. Report any bile-colored drainage or pus from any incision.
What gallbladder change is associated with an acute attack of cholecystitis? A fistula Scarring Occlusion of the cystic duct Inflammation of the biliary duct
Scarring
Complications of pneumonia occur more frequently in older patients. The nurse knows that potential complications include which of these? Select all that apply. Sepsis Pleurisy Bronchitis Encephalitis Pleural effusion Congestive heart disease
Sepsis Pleurisy Pleural effusion
The nurse is caring for an obese patient and anticipates that what diagnostic studies will be performed? Select all that apply. Serum glucose Liver function tests Chest x-ray Magnetic resonance imaging (MRI) Electrocardiogram (ECG)
Serum glucose Liver function tests Chest x-ray Electrocardiogram (ECG)
The nurse is attending to a patient with tentative diagnosis of acute pancreatitis. Which diagnostic tests should the nurse anticipate for the health care provider to prescribe to confirm the diagnosis? Select all that apply. Liver biopsy Serum lipase Serum amylase Serum alpha-fetoproteins Computed tomography (CT) scan
Serum lipase Serum amylase Computed tomography (CT) scan
What is the most evident symptom of flail chest in an unconscious patient? Cyanosis Shallow respiration Distension of neck vein Symmetric movement of thorax
Shallow respiration
The nurse makes a nursing diagnosis of "impaired gas exchange" for a patient with pneumonia based upon which physical assessment findings? Select all that apply. SpO 2 of 85% PaCO 2 of 65 mm Hg Presence of thick yellow mucus Respiratory rate 24 breaths/minute Absent breath sounds in right lung lobes
SpO 2 of 85% PaCO 2 of 65 mm Hg Absent breath sounds in right lung lobes
The nurse is assessing a young male patient who came to the emergency department complaining of sudden shortness of breath. He has no other visible problems. The nurse notes that, upon auscultation, there are no breath sounds on the right upper lobe of the lung. The nurse suspects that the patient has which of these conditions? Tension pneumothorax Iatrogenic pneumothorax Traumatic pneumothorax Spontaneous pneumothorax
Spontaneous pneumothorax
Which condition does the nurse expect is present in a patient with chronic obstructive pulmonary disorder (COPD) who has a rupture of small blebs on the apex of the lung? Tension pneumothorax Traumatic pneumothorax Iatrogenic pneumothorax Spontaneous pneumothorax
Spontaneous pneumothorax
Which interventions by the student nurse while assessing a patient who has a chest tube may result in increased intrapleural pressure? Stripping the chest tube Placing the tube below the chest Moving the clamp down the tubing Placing the occlusive tape at the site
Stripping the chest tube
A patient has just been admitted to the intensive care unit with a suspected diagnosis of pulmonary embolism (PE). The patient's condition is stable. The nurse will prepare for which intervention? Oral administration of warfarin Thrombolytic therapy with alteplase Subcutaneous administration of enoxaparin Intravenous administration of unfractionated heparin
Subcutaneous administration of enoxaparin
A patient is diagnosed with a pneumothorax, and the health care provider has inserted a chest tube with chest drainage system. The nurse who is monitoring the system finds that there is no bubbling. The nurse checked all the connections and found no problems. What are the most probable reasons for the absence of bubbling? Select all that apply. Suctioning is not present. Suction pressure is very high. Suction pressure is very low. Pleural air leak is too large to be drained. There is collection of blood in pleural space.
Suctioning is not present. Suction pressure is very low. Pleural air leak is too large to be drained.
A patient with a body mass index (BMI) of 22 kg/m 2 asks the nurse for weight-reducing medications. How should the nurse respond? Suggest a healthy diet to the patient. Suggest a low-dose form of orlistat. Report the BMI to the primary health care provider. Instruct the patient to avoid carbohydrates in the diet.
Suggest a healthy diet to the patient.
A patient comes to the emergency room presenting with dyspnea, tachycardia, violent agitation, tracheal deviation, neck vein distension, and hyperresonance to percussion. Which condition should the nurse suspect? Flail chest Hemothorax Cardiac tamponade Tension pneumothorax
Tension pneumothorax
The patient with a history of lung cancer and hepatitis C has developed liver failure and is considering liver transplantation. After the comprehensive evaluation, the nurse knows that which factor discovered may be a contraindication for liver transplantation? The patient has completed a college education. The chest x-ray showed another lung cancer lesion. The patient has been able to stop smoking cigarettes. The patient has well controlled type 1 diabetes mellitus.
The chest x-ray showed another lung cancer lesion.
A patient is being admitted with a diagnosis of pertussis. The nurse knows which of these are true? Select all that apply. The cough may last from 6 to 10 weeks. This is a highly contagious respiratory tract infection. Treatment usually includes antibiotics such as macrolides. Cough suppressants and antihistamines should not be used. Corticosteroids and bronchodilators are very useful in reducing symptoms. Lifetime immunity results from one vaccination of diphtheria, pertussis, or tetanus (DPT).
The cough may last from 6 to 10 weeks. This is a highly contagious respiratory tract infection. Treatment usually includes antibiotics such as macrolides. Cough suppressants and antihistamines should not be used.
The nurse is caring for a patient who is on a chest drainage tube with wet suction system. The nurse finds that the suction control chamber has no bubbles. What does the nurse expect from this finding? The drainage system is blocked. The chamber is getting evaporated. The patient will have lung expansion. The patient has a high pleural air leak
The patient has a high pleural air leak
When examining a patient after transthoracic needle aspiration, the nurse finds that the patient has excess air in the pleural space. What does the nurse interpret from this finding? The patient has hemothorax. The patient has cardiac tamponade. The patient has iatrogenic pneumothorax. The patient has spontaneous pneumothorax
The patient has iatrogenic pneumothorax.
What does the nurse interpret from finding excessive bubbling in the water-seal chamber while monitoring a patient who is on chest tube drainage? The patient may have lung expansion. The patient may have a bronchopleural leak. The patient may have a large pleural air leak. The patient may have an infection at the drainage site.
The patient may have a bronchopleural leak.
What does the nurse infer from finding that a patient with a pneumothorax has limited fluid accumulated in the intrapleural space, with no other body parts affected? The patient will have spontaneous resolution. The patient will require treatment with chest tube drainage. The patient will require aspiration using a large-bore needle. The patient will have effective treatment with needle decompression.
The patient will have spontaneous resolution.
When developing a weight-reduction plan for an overweight patient, it is important for the nurse to first assess the presence of which factor? The patient's readiness to make lifestyle changes The patient's current body mass index (BMI) The patient's waist-to-hip circumference ratio The patient's current employment status
The patient's readiness to make lifestyle changes
A patient with hepatitis A asks whether other family members are at risk for "catching" the disease. The nurse's response will be based on the knowledge that hepatitis A is transmitted primarily in which way? During sexual intercourse By contact with infected body secretions Through fecal contamination of food or water Through kissing that involves contact with mucous membranes
Through fecal contamination of food or water
The nurse provides discharge education to a patient who has undergone bariatric surgery. Why does the nurse instruct the patient to restrict foods that are high in carbohydrates? To reduce the risk of hernia To reduce the risk of venous stasis To reduce the risk of dumping syndrome To reduce the risk of small bowel obstruction
To reduce the risk of dumping syndrome
A patient comes to the emergency room with acute abdominal pain after eating a large fast-food meal. The physician takes a history of events while the nurse draws blood to assess for liver function and white blood cell count. What should the nurse tell the patient is the most likely next step in the evaluation? Administration of antibiotics Insertion of a nasogastric tube Transport to the operating room Transport to radiology for an ultrasound scan
Transport to radiology for an ultrasound scan
A patient tells the nurse, "I often feel fatigued. I think it's related to my obesity." What action should the nurse take? Identify a medical professional who specializes in treating fatigue. Help the patient obtain reimbursement for a weight management program. Explain that a loss of 3-5% of weight will produce multiple health benefits. Use motivational interviewing principles to explore the patient's desires.
Use motivational interviewing principles to explore the patient's desires.
Which type of surgery allows the surgeon to manipulate instruments passed into the pleural space? Decortication Segmental resection Exploratory thoracotomy Video-assisted thoracoscopic surgery
Video-assisted thoracoscopic surgery
A community health nurse is conducting an assessment of a new patient. Which assessments should the nurse include when screening the patient for metabolic syndrome? Select all that apply. Blood pressure Resting heart rate Physical endurance Waist circumference Fasting blood glucose
Waist circumference Fasting blood glucose Blood pressure
A patient with hepatitis A infection is being discharged from the hospital. What is the most important instruction that the nurse should include in the discharge teaching? Do not share razors or toothbrushes. Isolate the patient from other family members. Wash hands carefully after bowel movements. Take acetaminophen every four hours if fever persists.
Wash hands carefully after bowel movements.
A patient who is scheduled for gastric bypass surgery asks for information about dumping syndrome. How should the nurse explain dumping syndrome? The inability to digest high-fat foods When the passage of food into the small intestine occurs too rapidly A decrease in the secretion of insulin caused by carbohydrates An increase in the secretion of both bile and pancreatic enzymes
When the passage of food into the small intestine occurs too rapidly
The nurse would determine that levofloxacin therapy has not been effective after noting which indicator? Temperature 99.7° F Increased respiratory rate Adventitious lung sounds White blood cell count 14,000/mm 3
White blood cell count 14,000/mm 3
The nurse is reviewing the laboratory reports for the patient receiving cefuroxime. The nurse determines that the medication is having the intended effect by noting which laboratory result? Sodium 138 mEq/L Platelets 175,000 per µL White blood cell count 4500/mm³ Blood urea nitrogen (BUN) 8 mmol/L
White blood cell count 4500/mm³
Which wound is described as a penetrating trauma on the chest wall? Wound caused by gunshot Wound caused by crush injury Wound caused by pedestrian accident Wound caused by motor vehicle accident
Wound caused by gunshot
