H&H: Practice Questions

A client with pancreatic cancer has the following blood chemistry profile: Glucose, fasting: 204 mg/dl (11.32 mmol/L); blood urea nitrogen (BUN): 12 mg/dl (0.67 mmol/L); Creatinine: 0.9 mg/dl (0.05 mmol/L); Sodium: 136 mEq/L (136 mmol/L); Potassium: 2.2 mEq/L (2.2 mmol/L); Chloride: 99 mEq/L (99 mmol/L); CO2: 33 mEq/L (33 mmol/L). Which result should the nurse identify as critical and report immediately? Select one: a. Potassium b. Chloride c. Sodium d. CO2

a. Potassium

For healing by secondary intention, a client's wound has been packed with medicated dressings. The nurse assesses the wound. Which finding indicates wound healing? Select one: a. The granulation tissue is at the wound edges b. The skin around the wound is edematous c. The wound drainage is serous d. The tissue surrounding the wound is red and hot

a. The granulation tissue is at the wound edges

A client who has a history of Crohn's disease is admitted to the hospital with fever, diarrhea, cramping, abdominal pain, and weight loss. The nurse should monitor the client for: Select one: a. hypokalemia b. hyperalbuminemia c. hypercalcemia d. thrombocytopenia

a. hypokalemia

An adolescent, age 14, is hospitalized for nutritional management and drug therapy after experiencing an acute episode of ulcerative colitis. Which nursing intervention is appropriate? Select one: a. providing small, frequent meals b. providing high-fiber snacks c. administering antibiotics with meals as ordered d. administering digestive enzymes before meals as ordered

a. providing small, frequent meals

An elderly client admitted with new-onset confusion, headache, and bounding pulse has been drinking copious amounts of water and voiding frequently. The nurse reviews the laboratory results (see accompanying chart). Which of the abnormal lab values is consistent with the client's symptoms? Select one: a. serum sodium b. urine specific gravity c. platelet count d. serum osmolality

a. serum sodium

Which client is at highest risk for colorectal cancer? Select one: a. the client who has been treated for Crohn's disease for 20 years b. the client who eats a vegetarian diet c. the client who has a family history of lung cancer d. the client who smokes

a. the client who has been treated for Crohn's disease for 20 years

A client who has had ulcerative colitis for the past 5 years is admitted to the hospital with an exacerbation of the disease. Which factor is of greatest significance in causing an exacerbation of ulcerative colitis? Select one: a. changing to a modified vegetarian diet b. demanding stressful job c. beginning a weight-training program d. walking 3.2 km every day

b. demanding stressful job

TPN is ordered for a client with Crohn's disease. The TPN solution is having an intended outcome when: Select one: a. the client is hydrated b. the client's nutritional needs are met. c. the client is in a negative nitrogen balance d. the client does not have metabolic acidosis

b. the client's nutritional needs are met.

A client is diagnosed with Crohn's disease after undergoing two weeks of testing. The client's employer calls the medical-surgical floor requesting to speak with the nurse-manager. He expresses concern over the client and explains that he must know the client's diagnosis for insurance purposes. Which response by the nurse is best? Select one: a. "Why don't you come in, and we can further discuss this issue." b. "Sure, I understand how demanding insurance companies can be." c. "I appreciate your concern, but I can't give out any information." d. "He has been diagnosed with Crohn's disease."

c. "I appreciate your concern, but I can't give out any information."

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? Select one: a. Incision and drainage b. Culture c. Debridement d. Irrigation

c. Debridement

Before the nurse administers IV replacement of 5% dextrose in water with potassium chloride, what nursing intervention must be completed first? Select one: a. Priming tubing using sterile technique b. Checking the rate for IV push administration c. Evaluating laboratory results for electrolytes d. Adding potassium chloride to the bag at the bedside

c. Evaluating laboratory results for electrolytes

A patient is transferred onto your ward who has been receiving penicillin for a bacterial infection he begins complaining of muscle weakness, legs cramps, and palpitations. On assessment you find that he has an decresed and irregular heart rate. With the information provided which imbalanced electrolyte is present? Select one: a. Hyponatremia b. Hypernatremia c. Hyperkalemia d. Hypokalemia

c. Hyperkalemia

Which type of solution, when administered I.V., would cause fluid to shift from body tissues to the bloodstream? Select one: a. NaCl b. Isoltonic c. Hypertonic d. Hypotonic

c. Hypertonic

A client has had an exacerbation of ulcerative colitis with cramping and diarrhea persisting longer than 1 week. The nurse should assess the client for which complication? Select one: a. deep vein thrombosis b. heart failure c. hypokalemia d. hypocalcemia

c. hypokalemia

A client presents to the emergency department with reports of acute GI distress, bloody diarrhea, weight loss, and fever. A family history of which of the following would be significant to this client's diagnosis? Select one: a. Appendicitis b. Crohn's disease c. ulcerative colitis d. Peptic ulcers

c. ulcerative colitis

A nurse is caring for a client who has experienced an acute exacerbation of Crohn's disease. Which assessment best indicates that the disease is under control? Select one: a. the client expresses positive feelings about himself b. the client maintains skin integrity c. the client verbalizes a manageable level of discomfort d. the client exhibits signs of adequate GI perfusion with normal bowel sounds

d. the client exhibits signs of adequate GI perfusion with normal bowel sounds

A nurse should encourage a client with a wound to consume foods high in vitamin C because this vitamin: Select one: a. Enhances the oxygen transport to tissues b. Enhances protein synthesis c. Reduces edema d. Restores the inflammatory response

b. Enhances protein synthesis

Which of the following indicate sufficient client teaching in regards to hypokalemia? Select one: a. I should avoid putting flax seeds in my morning smoothie" b. "Since I am hypokalemic I am probably hyponatremic also" c. "if I eat a banana a day I will get the right amount of potassium in my diet, simple as that" d. "I am going to put salt substitutes on everything I eat to increase my potassium levels"

a. I should avoid putting flax seeds in my morning smoothie"

A client with a diagnosis of undifferentiated schizophrenia is admitted to the inpatient unit after developing water intoxication. Which nursing interventions are appropriate? Select all that apply. Select one or more: a. Maintain a structured environment. b. Weigh the client every day. c. Medicate the client at night d. Monitor the client's intake and output. e. Lock the unit's kitchen and bathroom

a. Maintain a structured environment. b. Weigh the client every day. d. Monitor the client's intake and output.

Which type of solution raises serum osmolarity and pulls fluid from the intracellular and intrastitial compartments into the intravascular compartment? Select one: a. Electrotonic b. Isotonic c. Hypotonic d. Hypertonic

d. Hypertonic

A physician orders a loop diuretic for a client. When administering this drug, the nurse anticipates that the client may develop which electrolyte imbalance? Select one: a. Hypernatremia b. Hypervolemia c. Hyperkalemia d. Hypokalemia

d. Hypokalemia

A physician orders an isotonic I.V. solution for a client. Which solution should the nurse plan to administer? Select one: a. 1/2NS b. 5DNS c. 10DW d. Lactated Ringer's

d. Lactated Ringer's

A nurse administers furosemide to treat a client with heart failure. Which adverse effect must the nurse watch for most carefully? Select one: a. Increase in blood volume b. Increase in blood pressure c. High serum sodium level d. Low serum potassium level

d. Low serum potassium level

A client with an extracapsular hip fracture returns to the nursing unit after internal fixation and pin insertion with a drainage tube at the incision site. Her husband asks, "Why does she have this tube inserted in her hip?" Which response would be best? Select one: a. "Fluid will not be allowed to accumulate at the site." b. "The tube helps us to detect a wound infection early on." c. "This way we will not have to irrigate the wound." d. "We have a way to administer antibiotics into the wound."

a. "Fluid will not be allowed to accumulate at the site."

A client is recovering from an infected abdominal wound. Which foods should the nurse encourage the client to eat to support wound healing and recovery from the infection? Select one: a. Chicken and orange slices b. Cheese omelet and bacon c. Gelatin salad and tea d. Cheeseburger and French fries

a. Chicken and orange slices

The nurse is caring for an infant with severe diarrhea that has lasted 3 days. The child has poor skin turgor and dry mucous membranes. What is the priority nursing diagnosis for the nurse to use when planning care for this child? Select one: a. Fluid volume deficit b. Alteration in nutrition c. Impaired mucous membranes d. Risk for infection

a. Fluid volume deficit

A nurse is caring for a client who had a prostatectomy for prostate cancer. The nurse is reviewing the client's vital signs and intake and output as documented by a nursing assistant. Which documented finding requires immediate action? BP - 145/85, T - 37.0, R - 22, HR - 88 Intake - 1000ml Output - 255ml Select one: a. Intake and output b. Temperature c. Blood pressure d. Heart rate

a. Intake and output

A client must receive a blood transfusion of packed red blood cells (RBCs) for severe anemia. What isotonic I.V. fluid should the nurse use to prime the tubing before hanging this blood product? Select one: a. Normal saline solution as this is considered an isotonic solution b. Dextrose 5% in water as this is considered an isotonic solution c. D10W solution as this is considered an isotonic solution d. Current guidelines suggest that no priming is needed since blood products must be infused alone

a. Normal saline solution as this is considered an isotonic solution

A client on prolonged bed rest has developed a pressure ulcer. The wound shows no signs of healing even though the client has received skin care and has been turned every 2 hours. Which factor is most likely responsible for the failure to heal? Select one: a. Low calcium level b. Inadequate protein intake c. Inadequate vitamin D intake d. Inadequate massaging of the affected area

b. Inadequate protein intake

Which disciplines should be consulted when caring for a client with a stage III heel ulcer? Select one: a. Plastic surgery and cardiology b. Nutrition support and orthotics c. Occupational therapy and infectious disease d. Physical therapy and respiratory therapy

b. Nutrition support and orthotics

The nurse is caring for a 5-year-old child who had a hernia repair 1 day ago. The child is vomiting, has a nasogastric (NG) tube to low intermittent suction, and has diarrhea. Which of the following laboratory results would be the immediate priority for the nurse to assess? Select one: a. Calcium level b. Potassium level c. Magnesium level d. Chloride level

b. Potassium level

After being sick for 3 days, a client with a history of diabetes mellitus is admitted to the hospital with diabetic ketoacidosis (DKA). The nurse should evaluate which diagnostic test results to prevent arrhythmias? Select one: a. Serum chloride level b. Serum potassium level c. Serum sodium level d. Serum calcium level

b. Serum potassium level

You have a patient that has been admitted with hyperkalemia. What would be a priority in your QPA? Select one: a. Check for edema b. Take their BP and pulse, listen for cardiac arrhythmia c. Listen to their bowel sounds to assess if the smooth muscle is hyperactive d. Assess the strength of their muscles, especially in lower limbs

b. Take their BP and pulse, listen for cardiac arrhythmia

A 13-year-old girl is being evaluated for possible Crohn's disease. The nurse expects to prepare her for which diagnostic study? Select one: a. genetic testing b. colonoscopy with biopsy c. myelography d. cystoscopy

b. colonoscopy with biopsy

Which intervention is essential when performing dressing changes on a client with a diabetic foot ulcer? Select one: a. Applying a heating pad b. Debriding the wound three times per day c. Cleaning the wound with a povidone-iodine solution d. Using sterile technique during the dressing change

d. Using sterile technique during the dressing change

A client is admitted with a diagnosis of ulcerative colitis. The nurse should assess the client for: Select one: a. steatorrhea b. alternating periods of constipation and diarrhea c. constipation d. bloody, diarrheal stools

d. bloody, diarrheal stools

A 9-year-old client is brought to the emergency department with a sutured wound with purulent drainage. The area around the wound is red and warm to the touch, and the child is febrile. The parents want to know the significance of the purulent drainage. What is the best response by the nurse? Select one: a. "The drainage is an indication that the sutures were not tight enough." b. "The drainage contains enzymes that are necessary for wound healing." c. "Antibiotics cause the cells of the tissues to produce purulent drainage." d. "If a wound heals on the surface but infection remains, it will open and drain.

d. "If a wound heals on the surface but infection remains, it will open and drain.

Following a modified radical mastectomy, a client has an incisional drainage tube attached to Hemovac suction. The nurse determines the suction is effective when: Select one: a. The intrathoracic pressure is decreased and the client breathes easier. b. There is an increased collateral lymphatic flow toward the operative area c. No adhesions are formed between the skin and chest wall in he operative area d. Accumulated serum and blood in the operative area are removed

d. Accumulated serum and blood in the operative area are removed

A child is admitted with a 5-day history of severe vomiting and diarrhea. Which intervention is the highest priority for the nurse? Select one: a. Administering an antiemetic medication b. Applying protective ointment on the perineal area for breakdown c. Encouraging a soft, bland diet high in protein d. Administering IV fluids with electrolyte correction

d. Administering IV fluids with electrolyte correction

Which findings indicate that a client has developed water intoxication secondary to treatment for diabetes insipidus? Select one: a. Tetany and increased blood urea nitrogen (BUN) levels b. Flaccidity and thirst c. Sunken eyeballs and spasticity d. Confusion and seizures

d. Confusion and seizures