HPA1 PrepU Questions-FINAL
A client with Alzheimer's disease is prescribed donepezil hydrochloride. When teaching the client and family about this drug, which of the following would the nurse include?
"The drug helps to control the symptoms of the disease."
During an interview, the nurse has asked a client with depression about any hopes or plans for the future. In response, the client silently made a gesture of drawing the index finger from one side of the client's throat to the other. The nurse has informed the client that this must be communicated to the care team. What is the main rationale for the nurse's action?
Ensuring the client's safety
Environmental factors may be associated with suicidal behavior. Which is an environmental factor?
Job loss
Examination of a client's bladder stones reveal that they are primarily composed of uric acid. The nurse would expect to provide the client with which type of diet?
Low purine
The nurse is assessing a client suffering from stress and anxiety. The most common physiologic response to stress and anxiety is:
gastrointestinal upset.
A hospitalized client states that the client is having difficulty resting. Which intervention would help promote rest?
Assisting the client with deep-breathing exercises
The priority concern for people with mood disorders is what?
Safety
Which is the primary concern for a client with panic-level anxiety?
Safety
Which of the following herbal remedies is used to treat symptoms of benign prostatic hypertrophy (BPH)?
Saw palmetto
A family of a patient with Alzheimer's disease asks the nurse what causes this condition? Which response by the nurse would be most appropriate?
"Evidence shows that there are changes in nerve cells and brain chemicals."
Which of the following nursing actions is most important in caring for the client following lithotripsy?
Strain the urine carefully for stone fragments.
A client who experiences panic anxiety around dogs is sitting in a room with a dog and the client's nurse therapist. The nurse therapist is using which behavioral intervention for this type of anxiety?
Systematic desensitization
A 46-year-old client has been diagnosed with major depressive disorder. The client is seeing a nurse practitioner who is deciding on an appropriate treatment regimen. The nurse practitioner knows that which will be the most effective treatment for this client's depressive disorder?
A combination of psychotherapy and medication
The nurse is conducting an admission assessment for a client with major depressive disorder. Which is the priority assessment for the nurse?
Suicide risk assessment
The nurse is assessing a 42-year-old client who is experiencing depression. The client's mother died by suicide 20 years ago. Which statement regarding this client's risk for suicide is correct?
The client has a greater risk for suicide than the general population.
The nurse is providing teaching to a client with depression. Which statement by the client would indicate that the education has been effective?
"I didn't realize so many factors could cause depression."
During a night shift, a hospitalized client with depression tells a nurse that the client is going to kill himself or herself. The client is placed on constant observation. When the client asks to use the toilet, the nurse follows the client into the bathroom. The client says, "You don't need to follow me into the bathroom. Give me some space." Which response by the nurse is most appropriate?
"I must stay with you until we are sure you will not hurt yourself."
The nurse is providing client teaching to a client with early stage Alzheimer disease (AD) and her family. The client has been prescribed donepezil hydrochloride. What should the nurse explain to the client and family about this drug?
It slows the progression of AD.
The nurse is educating a patient with urolithiasis about preventive measures to avoid another occurrence. What should the patient be encouraged to do?
Increase fluid intake so that the patient can excrete 2,500 to 4,000 mL every day, which will help prevent additional stone formation.
A nurse is completing an admission assessment of a young male client who has a history of depression and who was brought to the hospital by the client's partner. In response to the nurse's question regarding suicidal ideation, the client discloses that he is thinking about killing himself. Which question would be most appropriate for the nurse to ask next?
"What thoughts have you had about how you would kill yourself?"
A client comes to the clinic reporting urinary symptoms. Which statement would most likely alert the nurse to suspect benign prostatic hyperplasia (BPH)?
"I've had trouble getting started when I urinate, often straining to do so."
A 40-year-old client was admitted to the psychiatric unit after a suicide attempt in which the client was found standing on the edge of a bridge. Which statement made by the client would lead the nurse to suspect a potential imminent suicide attempt?
"How often does the night personnel make rounds?"
A client asks the nurse, "How can I tell if what I am experiencing is just regular worrying and not an anxiety disorder?" What is the nurse's best response?
"If you are unable to function occupationally and socially because of the anxiety"
An older adult develops sudden onset of confusion and is hospitalized. The family expresses concern that their loved one is developing Alzheimer disease. What response by the nurse is most appropriate?
"Several possible underlying factors could be causing the confusion. Alzheimer's usually does not present with sudden confusion."
The nurse is attempting to take vital signs of an older adult hospitalized following knee surgery. The client continuously yells, "It's 1999 and you are going to hurt me!" What action should the nurse do first?
Reorient the patient.
An elderly client is contemplating a move to a continuing care retirement community (CCRC). The nurse assesses that the client requires assistance with food preparation and recommends placement in
Assisted-living apartment
Medical management of BPH includes pharmacologic therapy. Which of the following medications would the nurse expect the health care provider to prescribe for this diagnosis?
Alpha-adrenergic blocker
Which risk factors predispose a client to the development of kidney stones? Select all that apply.
immobilization.
A client reports experiencing nocturia. The nurse obtains a thorough history including current signs and symptoms. What would the client likely include when describing the symptoms?
decrease in the force of urinary stream
A nurse is providing postprocedure care for a client who underwent percutaneous lithotripsy. In this procedure, an ultrasonic probe inserted through a nephrostomy tube into the renal pelvis generates ultra-high-frequency sound waves to shatter renal calculi. The nurse should instruct the client to:
notify the physician about cloudy or foul-smelling urine.
The overall goals of care for individuals experiencing a stress response are to focus on interventions to develop ...
positive coping skills.
To encourage adequate nutritional intake for a client with Alzheimer's disease, a nurse should:
stay with the client and encourage him to eat.
A client reports to the nurse that over the past few months the elderly mother has become increasingly angry, responds inappropriately to conversations, and does not respond to calls if her back is turned away. What is the nurse's best response?
Ask if the mother could come in for a hearing evaluation.
Which factor should be checked when evaluating the effectiveness of an alpha-adrenergic blocker given to a client with benign prostatic hyperplasia (BPH)?
Voiding pattern
Which would be included as a condition that can cause an elevated PSA level in the absence of prostate cancer? Select all that apply.
Acute urinary retention
A 48-year-old man recently diagnosed with benign prostatic hyperplasia (BPH) reports consuming <i>Serenoa repens</i> (saw palmetto berry). The nurse needs to intervene if the physician orders which treatment?
Finasteride
When assessing a client with benign prostatic hyperplasia, which of the following would the nurse expect the client to report as the initial complaint?
Increased effort to void
The nurse is caring for a patient with severe pain related to ureteral colic. What medication can the nurse administer with a physician's order that will inhibit the synthesis of prostaglandin E, thereby reducing swelling and facilitating passage of the stone?
Ketoralac (Toradol)
A client with moderate Alzheimer's disease has been eating poorly, losing weight, and playing with food at meals. The nurse best intervenes by
Placing one food at a time in front of the client during meals
According to the biochemical theory of mood disorders, a client with a diagnosis of depression is likely to have alterations in the levels and function of which neurotransmitters?
Serotonin, norepinephrine, and dopamine
The nurse is caring for a client who is being treated in the emergency department for a panic attack. Which nursing intervention would be most appropriate?
Stay with the client, emphasizing that the client is safe and that the nurse will remain with the client.
The most common affective or mood disorder of old age is
depression.
A client has a suspected diagnosis of bladder stones. Stones may form in the bladder or originate in the upper urinary tract and travel to and remain in the bladder. What are some signs and symptoms that this client may be experiencing? Select all that apply.
All choices are true.
A client has been scheduled to undergo a transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH). The nurse knows that the client understands preoperative teaching when he makes which statement?
"I understand I may develop urethral strictures as a result of having the TURP."
A nurse is assessing a client brought to the emergency room by his daughter. Which statement by the daughter would most likely lead the nurse to suspect that the client may have an infection?
"All of a sudden my dad seemed to become confused."
A client is prescribed dutasteride (Avodart) as part of treatment for benign prostatic hyperplasia (BPH). When teaching the client about this drug, the nurse integrates knowledge of the drug's action. Which statement best reflects this?
"The drug interferes with testosterone, which causes the prostate to shrink in size."
A nurse is caring for a client with dementia. A family member of the client asks what the most common cause of dementia is. Which response by the nurse is most appropriate?
"The most common cause of dementia in the elderly is Alzheimer's disease."
The plan of care for a patient with advanced Alzheimer's disease includes the nursing diagnosis of risk for injury. The nurse has identified this nursing diagnosis most likely as related to which of the following?
Impaired memory
A 27-year-old woman has a 4-month-old baby. For the past 3 months, the client has been experiencing intense sadness, anxiety, and hopelessness. After having thoughts of killing her baby, she decided to seek help. What is the likely the cause of this client's experience?
Postpartum depression
Which action is included in a nurse's role when providing home care for a client with Alzheimer disease?
Provide emotional and physical support
What is a nurse's role in providing home care for a client with Alzheimer disease?
Provide emotional and physical support.
A woman comes to her health care provider's office with signs and symptoms of kidney stones. Which of the following should be the primary medical management goal?
Relieve the pain.
A nurse is reviewing a journal article about benign prostatic hyperplasia and possible risk factors associated with this condition. Which factor would the nurse most likely find as playing a role in increasing a man's risk for this condition? Select all that apply.
Smoking Hypertension Diabetes
A 30-year-old client who has been unemployed secondary to the client's anxiety disorder states that the client would like to have a job where the client is alone and no one needs to evaluate the client's work. The nurse interprets these comments as an indicator of what?
Social anxiety disorder
Which would be an appropriate intervention for a client experiencing an anxiety attack?
Staying with the client and speaking in short sentences
The nurse understands that a certain level of anxiety is required in a client for effective learning. Which anxiety-related symptom indicates the client may be able to learn effectively?
The client has heightened awareness.
The nurse is conducting a mental status assessment with a client who has major depressive disorder. The client tells the nurse, "I really feel like I can't take it anymore." What additional information should the nurse seek out in order to determine if an emergency alert is warranted?
The client's history of previous suicide attempts
A 42-year-old client has been prescribed a monoamine oxidase inhibitor (MAOI). The client should be informed to avoid foods containing what?
Tyramine
A client is to undergo a TURP for BPH. Which statement is accurate with regard to a TURP?
Urethral strictures are more frequent for TURP than for nontransurethral procedures.
The nurse advises a patient with renal stones to avoid eating shellfish, asparagus, and organ meats. She emphasizes these foods because she knows that his renal stones are composed of which of the following substances?
Uric acid
A client comes to the emergency department complaining of a sudden onset of sharp, severe flank pain. During the physical examination, the client indicates that the pain, which comes in waves, travels to the suprapubic region. He states, "I can even feel the pain at the tip of my penis." Which of the following would the nurse suspect?
Urinary calculi
A client at an extended-care facilty who has Alzheimer's disease is awake throughout the night. The nurse intervenes with activities that will promote sleep at night, which include
Walking the client in the facility yard during the day
A nurse providing community education for parents regarding adolescent suicide should include in the teaching session that the most frequent cause or motive for suicide in this age group is what?
Feelings of alienation or isolation
The client with benign prostatic hyperplasia (BPH) is considering use of medication in the management of symptoms. Which of the following drugs reduces the size of the prostate without lowering circulating levels of testosterone?
Finasteride (Proscar)
A client has no expression when conversing with the nurse. This would be documented as which type of affect?
Flat
Which question in the assessment of a client with anxiety is most clinically appropriate?
"How do you feel about everything that is happening in your life right now?"
A client reports to the nurse that her grandmother with Alzheimer's disease recently moved in with her and her two school-aged children. The client states the grandmother becomes agitated and starts yelling and crying frequently. The woman asks, "What can I do?" The nurse first responds:
"What precipitates the outbursts?"
A health care team is involved in caring for a client with advanced Alzheimer's disease. During a team conference, a newly hired nurse indicates that she has never cared for a client with advanced Alzheimer's disease. Which key point about the disease should the charge nurse include when teaching this nurse?
Clients with Alzheimer's disease are at high risk for injury because of their impaired memory and poor judgment.
A client with Alzheimer's disease is admitted for hip surgery after falling and fracturing the right hip. The client's spouse tells the nurse about feeling guilty for letting the accident happen and reports not sleeping well lately because the spouse has been getting up at night and doing odd things. Which nursing diagnosis is most appropriate for the client's spouse?
Risk for caregiver role strain related to increased client care needs
Which of the following should be included when teaching a client about the management of benign prostatic hyperplasia (BPH)? Select all that apply.
Do not delay the urge to void. Schedule digital rectal exams.
Which condition is characterized by a decline in intellectual functioning?
Dementia
A client states, "I'm worthless, and I don't deserve to live." This theme in the client's expressed thought may signal a maladaptive response to which disorder?
Depression
A nurse is preparing a presentation for family members of clients who have been diagnosed with depression. When describing the family response to depression, which would the nurse include?
Depression in one family member affects the entire family.
Which action by the nurse demonstrates ageism
Directing all health decisions to the older adult's child
A client with Alzheimer disease becomes agitated while the nurse is attempting to take vital signs. What action by the nurse is most appropriate?
Distract the client with a familiar object or music.
A client has been recently diagnosed with depression and has just started taking an antidepressant medication. Which of the client's statements indicates an accurate understanding of this aspect of treatment?
"I understand that I probably won't feel much better for a couple of weeks after I start the drugs."
Based on the nurse's knowledge of the probable first indicator of prostate cancer, which of the following questions should be included in the history and physical examination?
"Do you have any perineal discomfort?"
The nurse walks into the client's room and finds the client sobbing uncontrollably. When the nurse asks what the problem is, the client responds, "I am so scared. I have never known anyone who goes into a hospital and comes out alive." On this client's care plan the nurse notes a nursing diagnosis of ineffective coping related to stress. What is the best outcome to be expected for this client?
Client will adapt relaxation techniques to reduce stress.
An adult client was admitted to the psychiatric mental health unit following a suicide attempt. The client has responded well to treatment, so discharge is being considered. In anticipation of the client's discharge, the nurse should:
Collaborate with the family to make sure the client's home environment is safe.
A male client who is admitted with the diagnosis of urinary calculi complains of excruciating pain. The pain is suspected to be caused by increased pressure in the renal pelvis. Which measure would be most appropriate to provide pain relief?
Encourage frequent ambulation.
A client has recently brought her elderly mother home to live with her family. The client states that her mother has moderate Alzheimer's disease and asks about appropriate activities for her mother. The nurse tells the client to
Ensure that the mother does not have access to car keys or drive an automobile.
Which of the following is a cause of a calcium renal stone?
Excessive intake of vitamin D
In a client with benign prostatic hyperplasia (BPH), which assessment finding provides the best indication of urinary retention?
Frequency
The nurse is planning a presentation to a group of nursing students on the topic of anxiety disorders. Which would the nurse include when describing panic disorder?
Individuals may believe they are having a heart attack when a panic attack occurs.
A nurse is planning discharge teaching for an older adult client with mild short-term memory loss. The discharge teaching will include how to perform basic wound care for the venous ulcer on the client's lower leg. When planning the necessary health education for this client, the nurse should:
keep teaching periods short.
A nurse is caring for an elderly adult client admitted to the hospital from a nursing home because of a change in behavior. The client has a diagnosis of Alzheimer's disease and has started to experience episodes of incontinence. The hospital staff is having difficulty with toileting because the client wanders around the unit all day. To assist with elimination, a nurse should:
incorporate the client's toileting schedule into the pattern of his wandering