Exam 2 - Adult Health
Which statement indicates understanding of how to observe for esophageal bleeding in the patient with cirrhosis?
"Any melena should be reported immediately."
Which question does the nurse ask to assess whether the patient has vertigo?
"Do you sense a spinning movement at times?"
Which diet instruction with the nurse give to a patient with active hepatitis?
"Eat small meals at frequent intervals."
A 52 year old patient relates to the nurse that she has never had a mammogram because she is terrified that she will have cancer. Which response by the nurse is therapeutic?
"Finding a cancer in the early stages increases the chance for cure."
Which statement by a patient with cirrhosis would cause the nurse to suspect that the patient has stage I hepatic encephalopathy?
"I am unable to sleep during the night."
Which teaching about colorectal cancer screening with the nurse give to a 56 year-old patient who has no familial adenomatous polyposis or other risk factors related to CRC?
"It is recommended you get a colonoscopy every 10 years."
A patient who is scheduled to undergo radiation for prostate cancer is admitted to the hospital by the nurse. Which statement by the patient is most important to communicate to the healthcare provider?
"My legs are numb and weak."
Which statement by a patient with cirrhosis indicates the need for further instruction about the disease?
"My liver is scarred, but the cells can regenerate themselves and repair the damage."
Which statement about the risks of lung cancer indicates a need for further teaching?
"People who are exposed to air pollutants are not at risk."
Which instruction does the nurse provide to reduce a patient's manifestations of vertigo?
"Restrict head motion, and change positions slowly."
In which way will the nurse respond to a patient diagnosed with hepatitis A who asked the nurse how this disease may have been contracted?
"You may have consumed foods contaminated with a virus."
The nurse performs follow-up care for a group of patients who has previously had TB. Which patient is at high risk for developing secondary TB?
A 34-year-old with HIV, a 75 year-old, who is recovering from a hip replacement, a 7-year-old who is undergoing chemotherapy for leukemia
The nursing team consists of a registered nurse, a license, practical nurse, and a nursing assistant. Which patient must be assigned to the RN?
A patient with end-stage cirrhosis who needs teaching about a low sodium diet
The nurse would prioritize care for which patient?
A patient with portal-systemic encephalopathy, who has become increasingly difficult to arouse
Which symptom would indicate a splenic infarction in a patient diagnosed with infectious endocarditis after an arterial embolization?
Abdominal pain, rebound tenderness, pain in the left shoulder
Which nursing action is most appropriate for a patient with metastatic breast, cancer, who experiences, severe nausea and vomiting after chemotherapy and is unable to eat?
Administer antiemetic medication as prescribed
Which is a risk factor for colorectal cancer?
Age older than 50 years, family, history of cancer, history of Crohn disease, heavy alcohol consumption
The nurse will instruct the patient recently diagnosed with cirrhosis of the liver to avoid which substance to prevent further fibrosis of the liver and allow the liver to heal and regenerate?
Alcohol, cigarettes, illicit drugs, acetaminophen
Which priority assessment confirms a diagnosis of meningitis?
Analysis of cerebrospinal fluid
Portal hypertension related to cirrhosis can result in which complication?
Ascites, hemorrhoids, esophageal varices
Which information with the nurse include when conducting a community health education class on diet and cancer risk reduction?
Avoid beef and processed meats, increase consumption of whole grains, eat colorful fruits and vegetables, including greens
Which hepatitis virus may cause liver cancer?
B and C
Which gene mutation is likely to cause breast cancer?
BRCA2
When is the best time for the nurse to begin discharge planning and community based plan of care for a patient with prostate cancer?
Before surgery
Which nursing occurrence is a cause for PEP with cART?
Being stuck by a contaminated sharp needle, being a victim of sexual assault
Elevation of which laboratory value is associated with jaundice for a patient with hepatitis?
Bilirubin
To prevent possible HIV transmission, which is the nurses priority action after getting stuck by a hollow-bore needle through a latex glove?
Bleed the wound and wash it for at least one full minute
For a patient suspected of having bacterial meningitis, which clinical manifestation with the nurse associate with a complication after lumbar puncture?
Blood pressure: 90/60 mm Hg
When a patient with rheumatoid arthritis is prescribe hydroxychloroquine, the nurse instruct the patient to report which clinical manifestation, which may indicate the most serious adverse effects associated with a medication?
Blurred vision or headache
The nurse expects that which diagnostic test will be prescribed for a patient who is suspected of having breast caner?
Breast biopsy
Which laboratory changes are most likely in a patient whose immune system is being overwhelmed by HIV?
CD4+ T-cells counts fall, viral numbers rise
For the patient with a high fever, nausea and vomiting, and neck, stiffness, secondary to meningitis, which additional clinical manifestation with the nurse anticipate the patient exhibiting?
Changes in mental status, photophobia and phonophobia, decreased level of consciousness
The nurse offers some immediate nonpharmacologic advice for pain management for a patient with inflammatory pain caused by rheumatoid arthritis. Which is the most effective advice for the patient?
Cold applications
Which cancer made a patient with familial polyposis be at risk for developing in the future?
Colorectal cancer
Which factor may lead to hepatic encephalopathy for a patient with cirrhosis?
Constipation, decrease fluid volume, GI bleeding
The nurse will make which recommendation when providing dietary teaching to a patient with hepatitis?
Consuming increase carbohydrates in moderate protein
When caring for a patient admitted with a flareup of systemic lupus erythematosus receiving IV corticosteroids, which assessment with the nurse include related to this medication?
Daily weights, blood glucose, blood pressure, intake and output
Which sign or symptom is a CNS indication of AIDS?
Dementia, confusion
Which information is most important to report to the surgeon for a patient who is diagnosed with ineffective endocarditis, and who is scheduled to have a valve replacement?
Dental caries
When caring for a patient who receives chronic steroid therapy to treat rheumatoid arthritis, the nurse monitor for which complications associated with the medication use?
Diabetes mellitus, decreased immunity, fluid and electrolyte, imbalances, hypertension, osteoporosis, glaucoma
Which instruction does the nurse include in an education for a patient with breast cancer about how to prevent side effects associated with tamoxifen?
Eat flaxseed regularly
Which sign or symptom with the nurse teach a patient newly diagnosed with systemic lupus erythematosus to report to the healthcare provider?
Edema, weight gain, decreased output
Which cue indicates that the patient with progressive right ear hearing loss met the plan of care goal to use other strategies to improve communication?
Ensures lights are on in the room, asks for written directions, turns off the television and radio
When repositioning a patient with metastatic cancer, which precaution would the nurse keep in mind?
Extra care must be taken to avoid fractures
Which findings with the nurse expect during the assessment of a patient with new onset rheumatoid arthritis?
Fatigue
The nurse expects which symptom in an adult with an acute infection that has occurred within 4 weeks of first being infected with HIV?
Fever, night sweats, muscle aches
During an annual wellness check, a 21 year old female patient states "I experience a lot of pain in my breast right before my menstrual cycle begins. When my cycle is over, the pain goes away, but then it returns during the next cycle." Which benign breast disorder is a patient most likely experiencing?
Fibrocystic changes
Which type of kidney disorder may occur in a patient diagnosed with systemic lupus erythematosus?
Glomerular disease
When the HIV enters the patient's CD4+ T-cells, which is the new role served by the immune cell?
HIV factory
Which physical assessment is most important to rule out infective endocarditis?
Heart sounds
Which virus would the nurse associate with a patient diagnosed with viral meningitis who reports a history of cold sores?
Herpes simplex virus
Which findings would the nurse expect for a patient with late stage cirrhosis?
Iceterus, swollen, abdomen, prolonged partial thromboplastin time (PTT)
A patient with rheumatoid arthritis asks the nurse how to relieve pain without taking medications. Which intervention with the nurse include in the teaching plan?
Imagery, hot packs, acupuncture, heated paraffin, stress management
Which information with the nurse include when teaching a patient newly diagnosed with systemic lupus erythematosus about managing the disease and preventing setbacks?
Include aerobic exercise, plan frequent rest periods, avoid crowded public areas, stay in shady areas outdoors, use mild, nonastringent soap
For which population may PrEP for HIV be appropriate?
Injection drug users, men who have sex with men, non-monogamous heterosexually active men and women, adults who are HIV negative and in a relationship with a partner who is HIV positive
Clay-colored stools and dark urine are typically characteristic of which complication of viral hepatitis?
Intrahepatic obstruction
Which finding in a patient with rheumatoid arthritis supports the nurses conclusion of vasculitis?
Ischemic skin lesions around the nail bed
Which statement indicates understanding of hepatitis A?
It is transmitted by the fecal - oral route
Which patient condition would cause the nurse to question the use of neomycin for a patient with hepatic encephalopathy?
Kidney failure
A patient with hepatitis encephalopathy may require which pharmacologic therapy to help decrease serum ammonia levels?
Lactulose
The nurse anticipates that which medication will be prescribed for a premenopausal patient diagnosed with breast cancer who will be receiving hormonal therapy?
Leuprolide
The nurse suspects, which diagnosis when a patient presents with symptoms of hoarseness, change in respiratory pattern, persistent cough, blood-streaked sputum, dyspnea, clubbing of the fingers, and fever?
Lung cancer
Which is a common mode of transmission for cancer metastasis?
Lymphatic, blood-borne, extension into surrounding tissues.
Which is a late manifestation of rheumatoid arthritis?
Morning stiffness
Which statement pertaining to cancer development is correct?
Mutated normal cells may become neoplastic cells, secondary prevention is screening for early detection, primary prevention is preventing the exposure to causes of cancer
The nurse will emphasize avoidance of which drug for a patient with cirrhosis?
NSAIDs
The nurse with assess for which clinical manifestation in a patient hospitalized with meningitis?
Neck, stiffness, muscle aches, light sensitivity
Which assessment with the nurse perform as a priority when providing care for a patient with bacterial meningitis?
Neurologic status
While performing a breast examination on a patient, the nurse identifies that which finding needs further evaluation?
Nipple retraction, dimpling on the breast skin
How is the TNM classification of TisN0Mx for a patient with lung cancer interpreted?
No metastasis, carcinoma in situ, presence of metastasis cannot be determined
Which action does the nurse take when a patient with rheumatoid arthritis report cervical pain radiating down one arm?
Notifies the primary healthcare provider immediately
Which nursing action does the nurse delegate to assistive personnel working on a cardiac telemetry unit?
Obtain daily waits for several patients with class IV heart failure
Which action is the most effective way for a college student to minimize the risk for contracting bacterial meningitis?
Obtain the meningococcal vaccine
Which intervention does the nurse perform immediately after a lumbar puncture?
Obtain vital signs, monitor for headache, assess neurologic status
For a patient with an underlying history of Ménière disease, which assessment with the nurse, include when admitting a patient with pneumonia?
Pain, balance, hearing, ear, ringing, pupil reaction
The nurse suspects, which condition when a patient with rheumatoid arthritis experiences clinical manifestation of vasculitis, including burning and tingling in the legs and foot drop?
Peripheral neuropathy
Which common clinical manifestation with the nurse associate with meningitis?
Photophobia, tachycardia, cranial, nerve dysfunction
Which precaution with the nurse implement when providing care for a patient with a Neisseria meningitidis infection?
Place the patient on droplet precautions
The nurse expects which laboratory finding in a patient who presents with symptoms of rheumatoid arthritis?
Positive total antinuclear antibody (ANA)
Lactulose may be prescribed for which purpose for a patient with cirrhosis?
Promote GI excretion of ammonia
The nurse is reviewing the results of a patient's prostate specific antigen (PSA) test and notices an elevation in the findings. Which finding may this represent?
Prostate cancer
Which institutional measure should hospitals take to prevent the transmission of hepatitis B to healthcare workers?
Provide immunoglobin injections within 14 days of exposure to the virus, develop a hospital-wide needleless system for delivery of medication, provide information about HBV transmission to at-risk employees, reinforce standard precautions procedures among all hospital employees, report, all cases of hepatitis to the local health department
Which symptom, if present, would cause the nurse to suspect renal infarction in a patient, diagnosed with infective endocarditis?
Pyuria, flank pain, hematuria
Which action will the nurse take immediately for a patient with severe cirrhosis of the liver who has a urine output of 400 mL for the past two days, despite adequate IV fluid administration?
Request an order for blood urea nitrogen (BUN) and serum creatinine levels
Which action does the emergency department nurse take when a female patient with a benign breast disorder states that she wants only women providing care for her?
Respect this request
Which disease manifest as fever, weight, loss, generalized weakness, fatigue, and the inflammation of proximal interphalangeal and metacarpophalangeal joints of the hands?
Rheumatoid arthritis
The healthcare provider prescribes laboratory testing for a patient with suspected rheumatoid arthritis. Which positive test result would support the diagnosis?
Rheumatoid factor, antinuclear antibody, erythrocyte sedimentation rate, elevated white blood cell count, high sensitivity C-reactive protein
Which complication with the nurse assess for in a patient diagnosed with infective endocarditis, who has gained 4 pounds in 24 hours and has peripheral edema?
Right-sided heart failure
A patient with systemic lupus erythematosus presents to the clinic for a three month follow up visit after beginning treatment with hydroxychloroquine. Which finding would lead the nurse to conclude the patient understands disease maintenance?
Scheduled an eye examination in three months
Which intervention with the nurse delegate to assistive personnel when providing care for a patient with meningitis, who is currently immobile and stuporous?
Scheduled repositioning
Which factor is associated with the development of infective endocarditis?
Sepsis, cystoscopy two days ago, IV heroin use
Which issue is often foremost in the minds of men who have been diagnosed with prostate cancer and must be addressed by the nurse?
Sexual function after treatment
Which is a common means of human immune deficiency virus (HIV) transmission?
Sexual, perinatal, parenteral
A patient with a new diagnosis of rheumatoid arthritis. Ask the nurse what causes the disease. Which information with the nurse provide?
The body's immune system destroys the joint cartilage
Which rationale explains the use of mild diuretics in the treatment of Ménière disease?
They decrease endolymph volume
Supplementation with which vitamin may be needed for a patient with cirrhosis if the patient is at risk for alcohol withdrawal?
Thiamine
The nurse monitor for which consequence of vasculitis in patients with rheumatoid arthritis?
Ulceration in the lower extremities
Which signs/symptoms will the nurse include when teaching a patient about cancer warning signs?
Unusual bleeding and discharge, change in bowel or bladder, habits, nagging cough or a horse voice
After teaching a patient with systemic lupus erythematosus ways to manage disease related pain by decreasing inflammation, which action made by the patient indicates a need for further instruction?
Uses acetaminophen for pain
