Pre Quiz Questions 23, 24, 27-29, 33, 34, 36-38 and practice questions

A nurse is managing the care of a client with osteoarthritis. What is the appropriate treatment strategy the nurse will teach the about for osteoarthritis? A. administration of opioids for pain control. B. administration of nonsteroidal anti-inflammatory drugs (NSAIDs) C. administration of monthly intra-articular injections of corticosteroids. D. vigorous physical therapy for the joints.

B. administration of nonsteroidal anti-inflammatory drugs (NSAIDs)

Typical candidates for a heart transplant have severe symptoms uncontrolled by medical therapy, no other surgical options, and a prognosis of less than _____ year(s) to live.

1 to 2

Antiretroviral medications as post-exposure prophylaxis for health care workers are started within ____ hours of exposure

72

The critical care nurse is caring for a client who is receiving cyclosporine postoperative heart transplant. What outcome represents a therapeutic outcome of this pharmacologic treatment? A. The client does not experience organ rejection. B. The client remains free of thrombus formation. C. The client maintains adequate cardiac output. D. The client's white cell count increases.

A. The client does not experience organ rejection.

Which tests tell the physician what the viral load is in a client with HIV/AIDS? Select all that apply. A. p24 antigen test B. T4/T8 ratio C. ELISA test D. polymerase chain reaction E. Western blot

A. p24 antigen test D. polymerase chain reaction

Adenocarcinoma is the rarest carcinoma of the lung in both men and women; it occurs peripherally as peripheral masses or nodules and often metastasizes.

FALSE

Administering oxygen to patients with COPD will result in cardiopulmonary arrest by suppressing the drive to breathe.

FALSE

An antigen is a protein substance developed by the body in response to and interacting with a specific antibody.

FALSE

Antibiotics are the initial medical treatment of choice in viral upper respiratory tract infections and pneumonia.

FALSE

Beta-blockers, such as Lopressor and Toprol, are the standard treatment for angina pectoris.

FALSE

Contact dermatitis is a type I immediate hypersensitivity disorder characterized by inflammation and hyperreactivity of the skin.

FALSE

Digitalis (digoxin) is considered the most essential and most frequently prescribed pharmacologic agent for the treatment of heart failure.

FALSE

Myocardial dysfunction occurs when irreversibly damaged heart muscle is replaced by adipose tissue.

FALSE

Often the first and only sign of mitral valve prolapse is an extra heart sound, referred to as a diastolic click.

FALSE

The most common type of heart failure is an alteration in ventricular contraction called diastolic heart failure, which is characterized by a weakened heart muscle.

FALSE

Polycythemia vera is a condition that places the patient at risk for increased infection.

False

The nurse should advise a client with iron deficiency anemia to take which action in order to prevent staining of the teeth? a. Avoid taking iron simultaneously with an antacid b. Take iron with or immediately after meals c. Dilute liquid preparations of iron with juice and drink with a straw d. Do not combine iron with other prescribed or over-the-counter medications

c. Dilute liquid preparations of iron with juice and drink with a straw

The nurse is administering injected allergens for "hyposensitization," which may produce harmful systemic reactions. Prior to administering these allergens, what medication should the nurse have at the bedside? a. Phenergan hydrochloride b. Pentazocine c. Epinephrine d. Meclizine hydrochloride

c. Epinephrine

The nurse is providing discharge education to a client diagnosed with heart failure. What should the nurse teach this client to do to assess fluid balance in the home setting? a. Monitor and record radial pulses daily b. Monitor and record blood pressures daily c. Monitor weight daily d. Monitor bowel movements

c. Monitor weight daily

A client's blood work reveals a platelet level of 17,000/mm3. When inspecting the client's integumentary system, what finding would be most consistent with this platelet level? a. Alopecia b. Dermatitis c. Petechiae d. Urticaria

c. Petechiae

The nurse is assisting the client with multiple myeloma to ambulate. What is the most important nursing intervention to help prevent fractures in the client? a. increase mobility b. encourage adequate nutrition c. promote safety d. provide adequate hydration

c. Promote safety.

A hospitalized client with heart failure puts on the call light and states, "I've become very short of breath, and I've been coughing up this pink frothy sputum." The nurse immediately suspects which of the following complications? a. Hepatomegaly b. Decreased renal perfusion pressure c. Pulmonary edema d. Decreased cardiac workload

c. Pulmonary edema

The nurse is caring for a client in the ICU admitted with ARDS after exposure to toxic fumes from a hazardous spill at work. The client has become hypotensive. What is the cause of this complication to the ARDS treatment? a. severe and progressive pulmonary hypertension b. pulmonary hypotension due to decreased cardiac output c. increased cardiac output from high levels of PEEP therapy d. hypovolemia secondary to leakage of fluid into the interstitial spaces

Hypovolemia secondary to leakage of fluid into the interstitial spaces

A nurse is caring for a teenage girl who has had an anaphylactic reaction after a bee sting. The nurse is providing client teaching prior to the client's discharge. In the event of an anaphylactic reaction, the nurse informs the client that she should self-administer epinephrine in what site? a. Thigh b. Abdomen c. Forearm d. Deltoid muscle

a. Thigh

A nurse is completing a nutritional status of a client who has been admitted with AIDS-related complications. What components should the nurse include in this assessment? Select all that apply. a. Weight history b. Blood urea nitrogen (BUN) level c. Body mass index d. Serum albumin level e. White blood cell count

a. Weight history b. Blood urea nitrogen (BUN) level c. Body mass index d. Serum albumin level

A nurse is completing a nutritional status of a client who has been admitted with AIDS-related complications. What components should the nurse include in this assessment? Select all that apply. a. Weight history b. White blood cell count c. Body mass index d. Blood urea nitrogen (BUN) level e. Serum albumin level

a. Weight history c. Body mass index d. Blood urea nitrogen (BUN) level e. Serum albumin level

A nursing student is preparing a teaching plan for a client with an immunodeficiency disorder. The student is going to include the cardinal symptoms in teaching. Which of the following would the student include? Choose all that apply. a. Chronic diarrhea b. Chronic or recurrent severe infections c. Poor response to treatment of infections d. Facial edema e. Chronic fatigue

a. chronic diarrhea b. chronic or recurrent severe infections c. poor response to treatment of infections

The nurse is caring for a client with a T-cell disorder. What clinical manifestation does the nurse determine will be present? a. Chronic mucocutaneous candidiasis is an associated disorder. b. It is autosomal dominant. c. There is complete lack of antibody production. d. Adrenal glands fail to develop. e. Lymphopenia is usually present.

a. chronic mucocutaneous candidiasis is an associated disorder e. lymphopenia is usually present

A client with unresolved hemothorax is febrile, with chills and sweating. He has a nonproductive cough and chest pain. His chest tube drainage is turbid. A possible explanation for these findings is: a. empyema b. infected chest tube wound site c. pneumocystis carinii pneumonia d. lobar pneumonia

a. empyema

For a client with Hodgkin lymphoma, who is at a risk for ineffective airway clearance and impaired gas exchange, the nurse places the client in a high Fowler's position to a. increase lung expansion b. anticipate the need for airway management c. detect compromised ventilation d. reduce deficits in the blood oxygen concentration

a. increase lung expansion.

After undergoing skin testing, a client returns to the clinic for evaluation of the reaction. The reaction was documented as negative. Which image best depicts this finding? (picture question) a. little dot b. little dot with small surroundings c. medium dot with medium surroundings d. biggest dot with biggest surroundings

a. little dot

The client is prescribed albuterol 2 puffs as a metered-dose inhaler. Which action by the client demonstrates understanding of administration for this medication? a. positions the inhaler 2 finger widths away from the lips b. carefully holds the inhaler upright without shaking it c. holds the breath for 5 seconds after administering the medication d. immediately repeats the second puff after the first puff

a. positions the inhaler 2 finger widths away from the lips

Which action by the nurse is most appropriate when the client demonstrates subcutaneous emphysema along the suture line or chest dressing 2 hours after chest surgery? a. record the observation b. apply a compression dressing to the area c. measure the patient's pulse oximetry d. report the finding to the physician immediately

a. record the observation

Which of the following are risk factors for the development of chronic obstructive pulmonary disease (COPD)? select all that apply. a. second-hand smoke b. occupational dust c. tobacco smoke d. air pollution e. infection

a. second-hand smoke b. occupational dust c. tobacco smoke d. air pollution e. infection

A nurse assesses a client with pneumonia. Which assessments are diagnostic for pneumonia? Select all that apply. a. whispered pectoriloquy b. wheezes c. percussion dullness d. friction rubs e. presence of crackles f. egophony

a. whispered pectoriloquy b. wheezes c. percussion dullness e. presence of crackles f. egophony

Nursing interventions for the patient with acute leukemia should focus on assisting the patient to establish a balance between ___________ and _______ because fatigue and deconditioning are common symptoms of the disease.

activity and rest

Human valves, obtained from cadaver tissue donations and used for aortic and pulmonic valve replacement, are called homografts or ___________________.

allografts

A nurse is caring for a client with acute myeloid leukemia who is preparing to undergo induction therapy. In preparing a plan of care for this client, the nurse should assign the highest priority to which nursing diagnosis? a. acute confusion b. risk for infection c. activity intolerance d. risk for spiritual distress

b. Risk for Infection

What intervention is appropriate before the client begins taking efavirenz therapy? a. Teaching the client about restricted foods b. Testing for Stevens-Johnson syndrome c. Administering diphenhydramine d. Assessing renal function

b. Testing for stevens-Johnson syndrome

For a client diagnosed with pernicious anemia, the nurse emphasizes the importance of lifelong administration of a. Folic acid b. Vitamin B12 c. Vitamin C d. Vitamin A

b. Vitamin B12

A nurse is documenting the results of assessment of a client with bronchiectasis. What would the nurse most likely include in documentation? a. wheezes on auscultation b. clubbing of the fingers c. sudden onset of pleuritic chest pain d. increased anterior-posterior (AP) diameter

b. clubbing of the fingers

A client comes to the health clinic after a positive skin test for tuberculosis. What additional diagnostic tests should the nurse begin teaching the client? Select all that apply. a. complete blood count b. complete history and physical examination c. drug susceptibilty testing d. a repeat multiple-puncture skin test e. a chest radiograph

b. complete history and physical examination c. drug susceptibilty testing e. a chest radiograph

Which term refers to lung tissue that has become more solid in nature as a result of a collapse of alveoli or an infectious process? a. bronchiectasis b. consolidation c. empyema d. atelectasis

b. consolidation

A nurse is admitting a client with emphysema. What are presenting findings the nurse should assess? Select all that apply. a. tachypnea b. dyspnea c. chronic cough d. wheezing e. fever

b. dyspnea c. chronic cough d. wheezing

A patient with acute myeloid leukemia (AML) has a neutrophil count that persists at less than 100/mm3. What should the nurse cautiously monitor this patient for? a. abdominal cramps b. infection c. seizure activity d. hypertension

b. infection

Which tests tell the physician what the viral load is in a client with HIV/AIDS? Select all that apply. a. ELISA test b. polymerase chain reaction c. Western blot d. p24 antigen test e. T4/T8 ratio

b. polymerase chain reaction d. p24 antigen test

A client with asthma has developed obstruction of the airway. Which of the following does the nurse understand as having potentially contributed to this problem? Choose all that apply. a. destruction of the alveolar wall b. swelling of bronchial membranes c. thick mucus d. airway remodeling

b. swelling of bronchial membranes c. thick mucus d. airway remodeling

A client has been diagnosed with pernicious anemia. During client education, the nurse emphasizes the importance of lifelong intramuscular administration of: a. vitamin C. b. vitamin B12. c. vitamin A. d. folic acid.

b. vitamin B12.

An older adult with a chief complaint of ______________ and an elevated total protein level should be evaluated for multiple myeloma

back pain

Prevention of aortic regurgitation is primarily based on prevention of and treatment for __________________ infections.

bacterial

The nurse is educating a patient with allergic rhinitis about how the condition is induced. What should the nurse include in the education on this topic? a. Parenteral medications b. Topical creams or ointments c. Airborne pollens or molds d. Ingested foods

c. Airborne pollens or molds

A patient has been diagnosed with an allergy to peanuts. What is a priority for this patient to carry at all times? a. A medical alert bracelet b. An oral airway c. An EpiPen d. An H1 blocker

c. An EpiPen

The nurse is interviewing a client being admitted to the hospital and inquires about any allergies the client has. The client states he is allergic to aspirin and penicillin. What intervention should the nurse provide immediately to prevent complications related to allergies? a. Call the physician. b. Tape an EpiPen to the head of the bed. c. Apply an allergy bracelet and flag the chart. d. Inform the client not to take any medications with those substances in them.

c. Apply an allergy bracelet and flag the chart

Which nursing intervention should be incorporated into the plan of care to manage the delayed clotting process in a client with leukemia? a. eliminate direct contact with others who are infectious b. implement neutropenic precautions c. apply prolonged pressure to needle sites or other sources of external bleeding d. monitor temperature at least once per shift

c. Apply prolonged pressure to needle sites or other sources of external bleeding.

Influenza and ____________ are the most common causes of death from infectious diseases in the United States.

pneumonia

The nurse is teaching the client with HIV about therapy. Which elements are essential for the nurse to include in the teaching plan? Select all that apply. a. The goal of antiretroviral therapy is to prevent opportunistic infections. b. Clients rarely respond to medication therapy. c. The CD4 count is the major indicator of immune function and guides therapy. d. Medication therapy is rarely effective. e. Antiretroviral therapy targets different stages of the HIV life cycle.

c. The CD4 count is the major indicator of immune function and guides therapy. e. Antiretroviral therapy targets different stages of the HIV life cycle.

A client with a history of atrial fibrillation has contacted the clinic saying that she has accidentally overdosed on her prescribed warfarin. The nurse should recognize the possible need for what antidote? a. Factor VIII b. Factor X c. Vitamin K d. IVIG

c. Vitamin K

The nurse is preparing to administer digoxin to a client with heart failure. The nurse obtains an apical pulse rate for 1 minute and determines a rate of 52 beats/minute. What is the first action by the nurse? a. administer the medication and inform the charge nurse about the rate b. administer the medication and then notify the physician c. Withhold the medication and notify the physician of the heart rate d. Administer atropine to speed the heart rate and then administer digoxin

c. Withhold the medication and notify the physician of the heart rate

A client with thoracic trauma is admitted to the ICU. The nurse notes the client's chest and neck are swollen and there is a crackling sensation when palpated. The nurse consequently identifies the presence of subcutaneous emphysema. If this condition becomes severe and threatens airway patency, what intervention is indicated?. a. a chest tube b. a feeding tube c. a tracheostomy d. an endotracheal tube

c. a tracheostomy

A nurse is teaching a client about bronchodilators. What bronchodilators actions that relieve bronchospasm should the nurse include in the client teaching? Select all that apply. a. decrease alveolar ventilation b. reduce inflammation c. alter smooth muscle tone d. increase oxygen saturation e. reduce airway obstruction

c. alter smooth muscle tone d. increase oxygen saturation e. reduce airway obstruction

A nurse is caring for a client with left-sided heart failure. What should the nurse anticipate using to reduce fluid volume excess? a. anti embolism stockings b. oxygen c. diuretics d. anticoagulants

c. diuretics

A nurse is caring for a client with COPD. The client's medication regimen has been recently changed and the nurse is assessing for therapeutic effect of a new bronchodilator. Therapeutic effects of this medication would include which of the following? Select all that apply. a. increased respiratory rate b. negative sputum culture c. increased expiratory flow rate d. relief of dyspnea e. increased viscosity of lung secretion

c. increased expiratory flow rate d. relief of dyspnea

A client who has recently started working in a coal mine is concerned the effects on long-term health. How does the nurse advise the client to prevent occupational lung disease? Select all that apply. a. try to find another occupation as soon as possible b. do not smoke, or quit smoking if currently smoking c. wear appropriate protective equipment when around airborne irritants and dusts d. schedule an annual lung x-ray to monitor health

c. wear appropriate protective equipment when around airborne irritants and dusts b. do not smoke, or quit smoking if currently smoking

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

c.low serum potassium level

When caring for a patient who has had a pulmonary embolism, the nurse must be alert for the potential complication of right ventricular failure or ______________ shock.

cardiogenic

Disseminated intravascular coagulation (DIC) is characterized by a process of inflammation and ________ within the vasculature

coagulation

The most common valvuloplasty procedure is a ____________________.

commissurotomy

Immune deficiency disorders may be caused by a defect in, or a deficiency of, phagocytic cells, B lymphocytes, T lymphocytes, or the ______________ system.

complement

The most potent and effective anti-inflammatory medications currently available to treat asthma are _________________.

corticosteroids

A client with leukemia is being discharged from the hospital to hospice care. Which statement by the client indicates the client is not appropriately dealing with spiritual distress? a. "I am going to call my clergy to pray with me." b. "I have resources within. myself that I can depend on." c. "I know I am going to die. I want to say good-bye to my family." d. "I do not understand why this happened to me."

d. "I do not understand why this happened to me."

Which nursing intervention should be incorporated into the plan of care to manage the delayed clotting process due to thrombocytopenia in a client with leukemia? a. Eliminating direct contact with others who are infectious b. Monitoring temperature at least once per shift c. Implementing neutropenic precautions d. Applying prolonged pressure to needle sites or other sources of external bleeding

d. Applying prolonged pressure to needle sites or other sources of external bleeding

The nurse is gathering data from a client recently admitted to the hospital. The nurse asks the client about experiencing orthopnea. What question would the nurse ask to obtain this information? a. Are you coughing up blood at night? b. Are you urinating excessively at night? c. How far can you walk without becoming short of breath? d. Are you only able to breathe when you are sitting upright?

d. Are you only able to breathe when you are sitting upright?

A client with advanced leukemia is responding poorly to treatment. The nurse finds the client tearful and trying to express feelings, but he is clearly having difficulty. What is the nurse's most appropriate action? a. give the client privacy and leave the room b. tell the client that the nurse understands how he or she is feeling c. offer to call pastoral care d. ask if the client would like the nurse to sit with him while he collects thoughts

d. Ask if the client would like the nurse to sit with him while he collects thoughts.

After receiving a diagnosis of acute lymphocytic leukemia, a client is visibly distraught, stating, "I have no idea where to go from here." How should the nurse prepare to meet this client's psychosocial needs? a. assess the client's previous experience with the health care system b. reassure the client that treatment will be challenging but successful c. identify the client's plan of medical care d. assess the client's specific needs for education and support

d. Assess the client's specific needs for education and support.

Which assessment parameter is important for the client diagnosed with congestive heart failure? a. Excess tears b. Crepitus c. Photosensitivity d. Distended veins

d. Distended veins

A client with end-stage renal disease has a decreased red blood cell production. What medication can the nurse administer with physician's order that will increase the production of erythrocytes? a. Interleukin 2 b. Filgrastim c. Pegfilgrastim d. Epoetin alfa

d. Epoetin alfa

A nurse is providing education to a client with iron deficiency anemia who has been prescribed iron supplements. What should the nurse include in health education? a. Take the iron with dairy products to enhance absorption. b. Limit foods high in fiber due to the risk for diarrhea. c.Increase the intake of vitamin E to enhance absorption. d. Iron will cause the stools to darken in color.

d. Iron will cause the stools to darken in color.

A protease inhibitor, an antiretroviral agent that can be taken without regard to meals is: a. Kaletra. b. Viracept. c. Norvir. d. Lexiva.

d. Lexiva

A client's current antiretroviral regimen includes enfuvirtide (T-20). What dietary counseling will the nurse provide based on the client's medication regimen? a. Limit sodium intake to 2 g/day. b. Limit fluid intake to 2 L/day. c. Avoid high-fat meals while taking this medication. d. Take this medication without regard to meals.

d. Take this medication without regard to meals.

A client is being treated in the ED for respiratory distress coupled with bacterial pneumonia. The client has no medical history. However, the client works in a coal mine and smokes 10 cigarettes a day. The nurse anticipates which order based on the client's immediate needs? a. completion of a 12-lead EKG b. administration of corticosteroids and bronchodilators c. client education: avoidance of irritants like smoke and pollutants d. administration of antibiotics

d. administration of antibiotics

The nursing instructor is discussing pulmonary arterial hypertension with the nursing students. What would the instructor describe as the pathophysiology of secondary pulmonary arterial hypertension? a. bronchial thickening causes increased resistance and pressure in the pulmonary vascular bed b. chronic lung disease causes scaring in the bronchioles raising pressure in the pulmonary vascular bed c. left-sided heart failure causes increased resistance and pressure in the pulmonary vascular bed d. alveolar destruction causes increased resistance and pressure in the pulmonary vascular bed

d. alveolar destruction causes increased resistance and pressure in the pulmonary vascular bed.

Which of the following is a common irritant that acts as a trigger of asthma? a. molds b. peanuts c. aspirin sensitivity d. esophageal reflux

d. esophageal reflux

An x-ray of a trauma client reveals rib fractures and the client is diagnosed with a small flail chest injury. Which intervention should the nurse include in the client's plan of care? a. immediately sedate and intubate the client b. prepare the client for surgery c. immobilize the ribs with an abdominal binder d. suction the client's airway secretions

d. suction the client's airway secretions

An older adult client has been diagnosed with COPD. What characteristic of the client's current health status would rule out the safe and effective use of a metered-dose inhaler (MDI)? a. the client requires both corticosteroids and beta2-agonists b. the client has cataracts c. the client has not yet quit smoking d. the client has severe arthritis in her hands

d. the client has severe arthritis in her hands

COPD is generally a progressive disease characterized by three primary symptoms: chronic cough, sputum production, and ________________.

dyspnea

The main symptom of pulmonary hypertension is ____________, which occurs at first with exertion and eventually at rest.

dyspnea

The first symptom of mitral stenosis often is ___________________ as a result of pulmonary venous hypertension.

dyspnea on exertion

The patient at risk for an anaphylactic response to an allergen should be instructed to carry an emergency kit containing _______________ at all times.

epinephrine

Nursing measures to prevent atelectasis include frequent turning, early mobilization, and strategies to ___________________ the lungs and to manage secretions.

expand

Hematopoiesis is characterized by a slow, continuous process of the formation and maturation of blood cells.

false

Modes of transmission for HIV include blood, semen, saliva, and casual contact.

false

The most definitive indicator of rheumatoid arthritis is the rheumatoid factor which is present in 100% of all diagnosed patients.

false

The most common symptom and complication of anemia is _________, which has the greatest negative impact on a patient's level of functioning

fatigue

_____________ is a genetic condition in which excess iron, absorbed from the GI tract, is deposited in various body organs

hemochromatosis

__________, which is released by mast cells, is a primary chemical mediator of hypersensitivity that acts within about 15 minutes after antigen contact.

histamine

Asthma causes airway____________________, mucosal edema, and mucus production

hyperresponsiveness

Left-sided heart failure refers to failure of the left ventricle, which results in ________________ congestion.

pulmonary

Because HF is a complex and progressive condition, patients are at risk for many complications, including acute decompensated HF, ________________, kidney disease, and life-threatening dysrhythmias.

pulmonary edema

The three major types or classifications of cardiomyopathy, a disease of the myocardium are as follows: dilated, hypertrophic and _______________.

restrictive

Blood vessels commonly used to bypass occluded coronary arteries include the __________________ veins of the leg.

saphenous

Common symptoms seen in polycythemia vera include a ruddy complexion and ____________ from increased blood volume and viscosity.

splenomegaly

Nursing management of a patient who requires immunosuppression must include use of __________ precautions when providing care to prevent infection.

standard

A ___________ provides structural support to a coronary artery following angioplasty to minimize the risk of vessel stenosis.

stent

The autoimmune reaction that causes rheumatoid arthritis originates in the ______________ tissue.

synovial

Management of an elevated ___________________ level focuses on weight reduction and increased physical activity.

triglyceride

Alkylating agents and purine analogues are the first line of pharmacologic therapy for people with systemic lupus erythematous because of their effect on overall immune function.

true

Many patients with PIDDs have comorbid autoimmune disorders, such as thyroid disease, rheumatoid arthritis, cytopenias, and inflammatory bowel disease.

true

Nurses need to be nonjudgmental in order to be effective in educating LGBT population about HIV/AIDS prevention methods.

true

Nursing management of patients with HIV include educating the patient to recognize the signs and symptoms of infection.

true

The majority of primary immune deficiency disorders are diagnosed during infancy.

true

A common complication of stage 3 HIV infection, _________________, is defined as a loss of more than 10% of one's body weight over a 30 day timeframe.

wasting syndrome

Scleroderma typically begins with the involvement of which system? A. Urinary B. Respiratory C. Cardiovascular D. Integumentary

D. Integumentary

While assessing a client, the nurse will recognize what as the most obvious sign of anemia? a. Jaundice b. Pallor c. Flow murmurs d. Tachycardia

b. Pallor

_______________, a noninflammatory degenerative disorder of the joints, which is the most common form of joint disease, is routinely referred to as degenerative joint disease.

Osteoarthritis

polycythemia vera is a rare form a anemia

TRUE

the patient and sickle cell trait usually has a normal hemoglobin level, a normal hematocrit and a normal blood smear

TRUE

A client's current antiretroviral regimen includes enfuvirtide (T-20). What dietary counseling will the nurse provide based on the client's medication regimen? A. Take this medication without regard to meals. B. Limit sodium intake to 2 g/day. C. Avoid high-fat meals while taking this medication. D. Limit fluid intake to 2 L/day.

A. Take this medication without regard to meals.

The nurse is teaching the client newly diagnosed with systemic lupus erythematous about the condition. Which statement by the client indicates teaching was effective? A. "I should avoid prolonged sun exposure." B. "I do not need to make any changes in my diet." C. "My medications will ultimately correct my problem." D. "My energy level will gradually increase over time."

A. "I should avoid prolonged sun exposure."

A client with rheumatoid arthritis informs the nurse that since he has been in remission and not having any symptoms, he doesn't need to take his medication any longer. What is the best response by the nurse? A. "It is important that you continue to take your medication to avoid an acute exacerbation." B. "Be sure to let the physician know after you stop your medications." C. "As long as you are not having symptoms, you can take a medication vacation." D. "If you don't take your medication, you will become very ill."

A. "It is important that you continue to take your medication to avoid an acute exacerbation."

A nursing student assists a registered nurse to admit a client with a primary immunodeficiency. The nurse explains to the student that primary immunodeficiencies predispose people to three conditions. Which of the following three are those conditions? A. Cancer B. Autoimmunity C. Malnutrition D. Severe infections E. Phagocytic dysfunction

A. Cancer B. Autoimmunity D. Severe infections

The nurse is caring for a client with a T-cell disorder. What clinical manifestation does the nurse determine will be present? A. Chronic mucocutaneous candidiasis is an associated disorder. B. There is complete lack of antibody production. C. Adrenal glands fail to develop. D. Lymphopenia is usually present. E. It is autosomal dominant.

A. Chronic mucocutaneous candidiasis is an associated disorder. D. Lymphopenia is usually present.

The client with osteoarthritis is seen in the clinic. Which assessment finding indicates the client is having difficulty implementing self-care? A. Has a weight gain of 5 pounds B. Reports ability to perform ADLs C. Shows increased joint flexibility D. Reports decreased joint pain

A. Has a weight gain of 5 pounds

The staff educator is presenting a workshop on valvular disorders. When discussing the pathophysiology of aortic regurgitation, the educator describes what consequence of this disorder? A. Left ventricular hypertrophy B. Ventricular insufficiency C. Cardiac tamponade D. Right-sided heart failure

A. Left ventricular hypertrophy

An adult client is admitted to the ED with chest pain. The client states that he had unrelieved chest pain for approximately 20 minutes before coming to the hospital. To minimize cardiac damage, the nurse should expect to administer which of the following interventions? A. Morphine sulphate, oxygen, and bed rest B. Oxygen and beta-adrenergic blockers C. Thrombolytics (fibrinolytics), oxygen administration, and nonsteroidal anti-inflammatories D. Bed rest, albuterol nebulizer treatments, and oxygen

A. Morphine sulphate, oxygen, and bed rest

A community health nurse is presenting an educational event and is addressing several health problems, including rheumatic heart disease. What should the nurse describe as the most effective way to prevent rheumatic heart disease? A. Recognizing and promptly treating streptococcal infections B. Prophylactic use of calcium channel blockers in high-risk populations C. Smoking cessation D. Adhering closely to the recommended child immunization schedule

A. Recognizing and promptly treating streptococcal infections

The nurse is caring for a client with mitral stenosis who is scheduled for a balloon valvuloplasty. The client tells the nurse that he is unsure why the surgeon did not opt to replace his damaged valve rather than repair it. What is an advantage of valvuloplasty that the nurse should cite? A. Repaired valves tend to function longer than replaced valves. B. Lower doses of antirejection drugs are required than with valve replacement. C. The procedure is not associated with a risk of infection. D. The procedure can be performed on an outpatient basis in a physician's office.

A. Repaired valves tend to function longer than replaced valves.

The nurse is admitting a client with reports of dyspnea on exertion and fatigue. The client's ECG shows dysrhythmias that are sometimes associated with left ventricular hypertrophy. What diagnostic tool would be most helpful in diagnosing cardiomyopathy? A. Exercise stress test B. Echocardiogram C. Cardiac catheterization D. Arterial blood gases

B. Echocardiogram

A nurse should advise a client with gout to avoid which foods? A. Nuts and peanut butter B. Organ meats and scallops C. Bread and cereal D. Fruits and juices

B. Organ meats and scallops

A client with angina has been prescribed nitroglycerin. Before administering the drug, the nurse should inform the client about what potential adverse effects? A. Drowsiness or blurred vision B. Throbbing headache or dizziness C. Tinnitus or diplopia D. Nervousness or paresthesia

B. Throbbing headache or dizziness

A client with early stage rheumatoid arthritis asks the nurse what to do to help ease the symptoms of the disease. What would be the best response by the nurse? A. "The health care provider could prescribe antineoplastic drugs." B. "The health care provider could prescribe anti-inflammatory drugs." C. "The health care provider could prescribe antipyretic drugs." D. "The health care provider could prescribe antihypertensive drugs."

B. "The health care provider could prescribe anti-inflammatory drugs."

A client with pericarditis has just been admitted to the CCU. The nurse planning the client's care should prioritize what nursing diagnosis? A. Anxiety related to pericarditis B. Acute pain related to pericarditis C. Ineffective breathing pattern related to pericarditis D. Ineffective tissue perfusion related to pericarditis

B. Acute pain related to pericarditis

The nurse is providing an educational workshop about coronary artery disease (CAD) and its risk factors. The nurse explains to participants that CAD has many risk factors, some that can be controlled and some that cannot. What risk factors should the nurse list that can be controlled or modified? A. inactivity, stress, gender, and smoking B. Cholesterol levels, hypertension, and smoking C. Gender, obesity, family history, and smoking D. Stress, family history, and obesity

B. Cholesterol levels, hypertension, and smoking

The nurse is reviewing the echocardiography results of a client who has just been diagnosed with dilated cardiomyopathy (DCM). What changes in heart structure is this client experiencing? A. Dilation and hypertrophy of all four heart chambers B. Dilated ventricles without hypertrophy of the ventricles C. Dilated ventricles with atrophy of the ventricles D. Dilation of the atria and hypertrophy of the ventricles

B. Dilated ventricles without hypertrophy of the ventricles

Patients with systemic lupus erythematosus (SLE) are likely to manifest a _________-shaped rash across the bridge of the nose and cheeks.

Butterfly

A client with mitral stenosis exhibits new symptoms of a dysrhythmia. Based on the pathophysiology of this disease process, the nurse would expect the client to exhibit what heart rhythm? A. Ventricular fibrillation (VF) B. Sinus bradycardia C. Atrial fibrillation D. Ventricular tachycardia (VT)

C. Atrial fibrillation

A client with systemic lupus erythematosus (SLE) has the classic rash of lesions on the cheeks and bridge of the nose. What term should the nurse use to describe this characteristic pattern?

C. Butterly rash

A client who has undergone a valve replacement with a mechanical valve prosthesis is due to be discharged home. During discharge teaching, the nurse should discuss the importance of antibiotic prophylaxis prior to which of the following? A. Exposure to immunocompromised individuals B. Live vaccinations C. Dental procedures D. Future hospital admissions

C. Dental procedures

A client is complaining of severe pain in the left great toe. What lab studies that the nurse reviews indicate that the client may have gout? A. Decreased hemoglobin and hematocrit B. Elevated white blood count C. Elevated uric acid levels D. Increased AST and ALT

C. Elevated uric acid levels

The nurse is caring for a client who has been diagnosed with an elevated cholesterol level. The nurse is aware that plaque on the inner lumen of arteries is composed chiefly of what? A. Lipoproteins B. High-density cholesterol C. Lipids and fibrous tissue D. White blood cells

C. Lipids and fibrous tissue

The nurse is caring for a client with a history of endocarditis. What topic should the nurse prioritize during health promotion education? A. Dietary guidelines B. Fluid intake C. Oral hygiene D. Physical activity

C. Oral hygiene

Primary gout is often caused by an inherited disorder in which type of metabolism? A. Carbohydrate B. Glucose C. Purine D. Fat

C. Purine

The nurse is teaching the client with HIV about therapy. Which elements are essential for the nurse to include in the teaching plan? Select all that apply. A. The goal of antiretroviral therapy is to prevent opportunistic infections. B. Medication therapy is rarely effective. C. The CD4 count is the major indicator of immune function and guides therapy. D. Clients rarely respond to medication therapy. E. Antiretroviral therapy targets different stages of the HIV life cycle.

C. The CD4 count is the major indicator of immune function and guides therapy. E. Antiretroviral therapy targets different stages of the HIV life cycle.

The nurse is working with a client who had an MI and is now active in rehabilitation. The nurse should teach this client to cease activity if which of the following occurs? A. The client's oxygen saturation level drops below 96%. B. The client's respiratory rate exceeds 30 breaths/min. C. The client experiences chest pain, palpitations, or dyspnea. D. The client experiences a noticeable increase in heart rate during activity.

C. The client experiences chest pain, palpitations, or dyspnea.

Family members bring a client to the ED with pale cool skin, sudden midsternal chest pain unrelieved with rest, and a history of CAD. How should the nurse best interpret these initial data? A. The symptoms indicate a pulmonary etiology rather than a cardiac etiology. B. Treatment should be determined pending the results of an exercise stress test. C. The symptoms indicate an acute coronary episode and should be treated as such. D. The symptoms indicate angina and should be treated as such.

C. The symptoms indicate an acute coronary episode and should be treated as such.

Which of the following would the nurse expect to assess as the most common finding associated with fibromyalgia? A. Heberden's nodes B. Butterfly facial rash C. Widespread chronic pain D. Jaw locking

C. Widespread chronic pain

A physician orders corticosteroids for a child with systemic lupus erythematosus (SLE). The nurse knows that the purpose of corticosteroid therapy for this child is to: A. promote diuresis. B. prevent platelet aggregation. C. combat inflammation. D. prevent infection.

C. combat inflammation

The nurse is caring for an adult client who had symptoms of unstable angina upon admission to the hospital. What nursing diagnosis underlies the discomfort associated with angina? A. ineffective breathing pattern related to decreased cardiac output B. Anxiety related to fear of death C. Impaired skin integrity related to CAD D. Ineffective cardiopulmonary tissue perfusion related to coronary artery disease (CAD)

D. Ineffective cardiopulmonary tissue perfusion related to coronary artery disease (CAD)

A client has been admitted to the medical unit with signs and symptoms suggestive of endocarditis. The health care provider's choice of antibiotics would be primarily based on what diagnostic test? A. Full blood count B. Echocardiography C. Cardiac aspiration D. Blood cultures

D. Blood cultures

A client presents to the clinic complaining of intermittent chest pain on exertion, which is eventually attributed to angina. The nurse should inform the client that angina is most often attributable to what cause? A. Decreased cardiac contractility B. Decreased cardiac output C. Infarction of the myocardium D. Coronary arteriosclerosis

D. Coronary arteriosclerosis

The triage nurse in the ED assesses an adult client who presents with reports of midsternal chest pain that has lasted for the last 5 hours. If the client's symptoms are due to an MI, what will have happened to the myocardium? A. It has been irreparably damaged, so immediate treatment is no longer necessary. B. It may be responsive to restoration of the area of dead cells with proper treatment. C. It will probably not have more damage than if the client came in immediately. D. It may have developed an increased area of infarction during the time without treatment.

D. It may have developed an increased area of infarction during the time without treatment.

A protease inhibitor, an antiretroviral agent that can be taken without regard to meals is: A. Norvir. B. Viracept. C. Kaletra. D. Lexiva.

D. Lexiva.

The nurse is preparing a client for cardiac surgery. During the procedure, the client's heart will be removed and a donor heart implanted at the vena cava and pulmonary veins. What procedure will this client undergo? A. Xenograft B. Heterotopic transplant C. Homograft D. Orthotopic transplant

D. Orthotopic transplant

A nurse in the emergency department is caring for a client with acute heart failure. Which laboratory value is most important for the nurse to check before administering medications to treat heart failure? a. Platelet count b. WBC c. Calcium d. Potassium

D. Potassium

A client with cardiovascular disease is being treated with amlodipine, which is intended to cause what therapeutic effect? A. Preventing platelet aggregation and subsequent thrombosis B. Increasing the efficiency of myocardial oxygen consumption, thus decreasing ischemia and relieving pain C. Reducing myocardial oxygen consumption by blocking adrenergic stimulation to the heart D. Reducing the heart's workload by decreasing heart rate and myocardial contraction

D. Reducing the heart's workload by decreasing heart rate and myocardial contraction

What intervention is appropriate before the client begins taking efavirenz therapy? A. Assessing renal function B. Teaching the client about restricted foods C. Administering diphenhydramine D. Testing for Stevens-Johnson syndrome

D. Testing for Stevens-Johnson syndrome

Three distinct characteristics of the pathophysiology of rheumatic diseases are inflammation, autoimmunity, and ______________.

Degeneration

_________________ is a clinical syndrome that is characterized by a progressive decline in cognitive, behavioral, and motor functions as a direct result of HIV infection.

HIV encephalopathy

The diagnosis of Hodgkin lymphoma is made by means of an excisional lymph node biopsy and the finding of the __________________ cell.

Reed--Sternberg

A patient with pulmonary edema should be positioned upright, preferably with the legs dangling over the side of the bed, if possible.

TRUE

ACE inhibitors are recommended for prevention of HF in patients at risk due to vascular disease and diabetes.

TRUE

Adequate treatment of upper respiratory tract infection is one of the major factors in the prevention of acute bronchitis.

TRUE

Allergic rhinitis is induced by airborne pollens or molds.

TRUE

Anemia is the most common hematologic condition affecting older adults, particularly those admitted to hospitals or those in long-term care facilities

TRUE

Asthma is considered a distinct, separate disorder from COPD and is classified as an abnormal airway condition characterized primarily by reversible inflammation.

TRUE

Bronchospasm, which occurs in many pulmonary diseases, reduces the caliber of the small bronchi and may cause dyspnea, static secretions, and infection.

TRUE

Clopidogrel (Plavix) is commonly prescribed in addition to aspirin in patients at high risk for MI.

TRUE

Fluid overload and decreased tissue perfusion result when the heart cannot generate cardiac output (CO) sufficient to meet the body's demands for oxygen and nutrients.

TRUE

For a patient to be considered a candidate for a coronary artery bypass graft (CABG), the coronary arteries to be bypassed must have approximately a 70% occlusion (60% if the affected artery is the left main coronary artery).

TRUE

Immunoglobulins of the IgE class are involved in allergic disorders and some parasitic infections.

TRUE

Iron deficiency anemia, the most common type of anemia in all age groups, also is the most common anemia in the world

TRUE

Latex allergy is an allergic reaction to natural rubber proteins.

TRUE

Mitral valve prolapse is a deformity that usually produces no symptoms.

TRUE

Smoking cessation is the single most cost-effective intervention to reduce the risk of developing COPD and to stop its progression.

TRUE

Tachypnea, dyspnea, and mild-to-moderate hypoxemia are hallmarks of the severity of atelectasis.

TRUE

The major cause of death in ARDS is nonpulmonary multiple organ dysfunction syndrome, often with sepsis.

TRUE

The most characteristic clinical manifestation of pericarditis is a creaky or scratchy friction rub that can be clearly heard during auscultation at the left lower sternal border.

TRUE

The most common cause of cardiovascular disease in the United States is atherosclerosis, an abnormal accumulation of lipid, or fatty substances, and fibrous tissue in the lining of arterial blood vessel walls.

TRUE

The pathophysiology of all cardiomyopathies is a series of events that culminates in impaired cardiac output

TRUE

The pathophysiology of emphysema involves destruction of the walls of the alveoli leading to impaired oxygen diffusion.

TRUE

To date, amiodarone (Cordarone) is the only drug shown to reduce the incidence of arrhythmogenic sudden cardiac death.

TRUE

A hallmark of rheumatologic diseases is autoimmunity, where the body mistakenly recognizes its own tissue as a foreign pathogen (antigen).

True

A primary nursing diagnosis for a patient with acute leukemia is impaired nutritional intake due to the pain and discomfort associated with mucositis and stomatitis.

True

Chronic lymphocytic leukemia the most common form of leukemia and may require no treatment in the early stages.

True

Gout is the most common form of inflammatory arthritis.

True

Multiple myeloma is a malignant disease of plasma cells in bone marrow.

True

Risk factors for osteoarthritis and its progression include older age, female gender, and obesity.

True

________________ is a type I hypersensitive allergic reaction of the skin characterized by the sudden appearance of pinkish, edematous elevations that vary in size and shape, itch, and cause local discomfort.

Urticaria

A client is receiving immunotherapy as part of the treatment plan for an allergic disorder. After administering the therapy, the client states, "I guess I can go home now." Which response by the nurse would be most appropriate? a. "You need to stay about another half-hour so we can make sure you don't have a reaction." b. "You must stay here so that you can get another injection of a different substance to which you're allergic." c. "It's okay to leave but make sure to call us if you start to feel strange after an hour or so." d. "We need to schedule your next appointment first and then you can leave."

a. "You need to stay about another half-hour so we can make sure you don't have a reaction."

Which patient does the nurse recognize as being most likely to be affected by sickle cell disease? a. A 14-year-old African American boy b.A 28-year-old Israeli man c. A 26-year-old Eastern European Jewish woman d. An 18-year-old Chinese woman

a. A 14-year-old African American boy

The clinic nurse is caring for a client diagnosed with leukopenia. What does the nurse know this client has? a. a general reduction in neutrophils and basophil b. a decrease in granulocytes c. too many erythrocytes d. a general reaction in all white blood cells

a. A general reduction in all white blood cells

The nurse is talking with a client who was stung by a bee and began having difficulty breathing. What serious complication from injected venom should the nurse discuss with the client? a. Airway obstruction b. Hives c. Itching d. Diarrhea

a. Airway obstruction

An office worker takes a cookie that contains peanut butter. The worker begins wheezing, with an inspiratory stridor and air hunger and the occupational health nurse is called to the office. The nurse should recognize that the worker is likely suffering from which type of hypersensitivity? a. Anaphylactic (type 1) b. Delayed-type (type IV) c. Immune complex (type III) d. Cytotoxic (type II)

a. Anaphylactic (type 1)

A patient is seen in the emergency department (ED) with heart failure secondary to dilated cardiomyopathy. What key diagnostic test does the nurse assess to determine the severity of the patient's heart failure? a. B-type natriuretic peptide (BNP) b. CBC c. Serum electrolytes d. Blood urea nitrogen (BUN)

a. B-type natriuretic peptide (BNP)

The nurse is assessing a client with leukemia. How would the nurse assess for enlargement and tenderness over the liver and spleen? a. by palpating the abdomen b. by looking for evidence of bruising c. by calculating the absolute neutrophil count d. by reviewing laboratory test results

a. By palpating the abdomen

A client with leukemia has developed a cough and increased fatigue. What is the primary nursing intervention? a. evaluate the client for potential infection b. medicate the client to relieve pain c. place a cooling blanket on the client d. administer an antitussive

a. Evaluate the client for potential infection.

The nurse assists the client to the bathroom, which is approximately 10 feet from the bed. The client ambulates 3 feet and states, "I cannot catch my breath." How would the nurse document this finding? a. Experiences exertion dyspnea when walking 3 feet states, "I cannot catch my breath" b. "Cant walk without becoming short of breath" c. "Has paroxysmal nocturnal dyspnea when walking" d. "Has orthopnea when walking"

a. Experiences exertion dyspnea when walking 3 feet states, "I cannot catch my breath"

A client seen in the outpatient clinic has common variable immunodeficiency. It is important for the nurse to teach the client about the need for more frequent screening for which complication? a. Malignancy b. Human immunosuppressive virus c. Allergies d. Autoimmune disorders

a. Malignancy

Which is a potassium-sparing diuretic used in the treatment of heart failure (HF)? a.Spironolactone b.Ethacrynic Acid c. Chlorothiazide d. Bumetanide

a. Spironolactone

The most severe hypersensitivity reaction is ______________, an unanticipated allergic reaction often accompanied by hypotension, bronchospasm, and cardiovascular collapse in severe cases.

anaphylaxis

The cornerstone pharmacologic therapy of bronchiectasis management is the use of ___________________.

antibiotics

The major class of medications prescribed for the symptomatic relief of allergic rhinitis is __________________.

antihistamines

A female client with the beta-thalassemia trait plans to marry a man of Italian ancestry who also has the trait. Which client statement indicates that she understands the teaching provided by the nurse? a. "Thalassemia is treated with iron supplements." b. "I'll see a genetic counselor before starting a family." c. "If my fiancé was of Middle Eastern descent, I wouldn't be worried about having children." d. "I need to learn how to give myself vitamin B12 injections."

b. "I'll see a genetic counselor before starting a family."

A client with Hodgkin lymphoma is receiving information from the oncology nurse. The client asks the nurse why it is necessary to stop drinking and smoking and stay out of the sun. What would be the nurse's best response? a. "you don't want to develop a second cancer, do you?" b. "It's important to reduce other factors that increase the risk of second cancers" c. "You need to do this just to be on the safe side" d. "everyone should do these things because they're health promotion activities that apply to everyone"

b. "It's important to reduce other factors that increase the risk of second cancers."

A nursing student assists a registered nurse to admit a client with a primary immunodeficiency. The nurse explains to the student that primary immunodeficiencies predispose people to three conditions. Which of the following three are those conditions? a. Malnutrition b. Autoimmunity c. Severe infections d. Cancer e. Phagocytic dysfunction

b. Autoimmunity c. Severe infections d. Cancer

A nursing student is preparing a teaching plan for a client with an immunodeficiency disorder. The student is going to include the cardinal symptoms in teaching. Which of the following would the student include? Choose all that apply. a. Chronic fatigue b. Chronic diarrhea c. Facial edema d. Chronic or recurrent severe infections e. Poor response to treatment of infections

b. Chronic diarrhea d. Chronic or recurrent severe infections e. Poor response to treatment of infections

Which is a primary chemical mediator of hypersensitivity? a. Serotonin b. Histamine c. Bradykinin d. Heparin

b. Histamine

A client seen in the outpatient clinic has common variable immunodeficiency. It is important for the nurse to teach the client about the need for more frequent screening for which complication? a. Human immunosuppressive virus b. Malignancy c. Autoimmune disorders d. Allergies

b. Malignancy

The nurse is caring for an older adult client who has a hemoglobin of 9.6 g/dL and a hematocrit of 34%. To determine where the blood loss is coming from, what intervention can the nurse provide? a. Observe the sputum for signs of blood. b. Observe stools for blood. c. Observe client for facial droop. d. Observe the gums for bleeding after the client brushes teeth.

b. Observe stools for blood.

Two primary complications seen in acute myeloid leukemia (AML), bleeding and __________, are the major causes of death for these patients.

infection

a patient with neutropenia is at an increased risk for _______, which increases proportionately with the decrease in the neutrophil count.

infection

Angina pectoris is chest pain resulting from myocardial _________ of the heart muscle.

ischemia

_____________ causes myocardial dysfunction in heart failure because it deprives heart cells of oxygen and causes cellular damage.

ischemia

Fractures of the first three ribs are rare but can result in a high mortality rate because they are associated with _________________ of the subclavian artery or vein.

laceration

Hypertension also increases the work of the __________________ ventricle, which must pump harder to eject blood into the arteries.

left

Pulmonary edema can also develop slowly, especially when it is caused by _________________ disorders such as kidney disease and other conditions that cause fluid overload.

noncardiac

The major goal when caring for a patient with rheumatic disease is ____________.

pain control

The overall goals of ________________ care are to manage symptoms and improve the quality of life for patients and families with advanced COPD.

palliative

Patients with ____________ anemia develop a smooth sore red tongue

pernicious