Adult Health Exam III

The nurse is assessing a client with crackling breath sounds or pulmonary congestion. What is the cause of the congestion? nocturia ascites inadequate cardiac output hepatomegaly

inadequate cardiac output

The nurse is discussing life management with the client with rheumatoid arthritis in a health clinic. What assessment finding indicates the client is having difficulty implementing self-care? decreased joint pain ability to perform activities of daily living (ADL) a weight gain of 2 pounds increased fatigue

increased fatigue Fatigue is common with rheumatoid arthritis. Finding a balance between activity and rest is an essential part of the therapeutic regimen. The client is reporting being able to do ADLs and decreased joint pain. The client's weight gain of 2 pounds does not correlate with self-care problems.

Statistics show an increase in the prevalence of infective endocarditis among older adults. Which factor places older adults at risk for developing infective endocarditis? greater incidence of a history of repaired congenital heart defects increased use of prosthetic valve replacements increase in IV drug use higher rate of tuberculosis

increased use of prosthetic valve replacements The prevalence of infective endocarditis among older adults has increased in part due to the increased number of prosthetic valve replacements, including replacements for older adults, and an increase in hospital-acquired bacteremia

Which term refers to a disease of a nerve root? Radiculopathy Sequestrum Involucrum Contracture

Radiculopathy

Which liver function study is used to show the size of the liver and hepatic blood flow and obstruction? Electroencephalography (EEG) Radioisotope liver scan Angiography Magnetic resonance imaging (MRI)

Radioisotope liver scan

The nurse is caring for a client with hepatitis. Which of the following would lead the nurse to suspect that the client is in the prodromal phase? Liver function tests approaching normal Jaundice Rash Clay-colored stools

Rash During the prodromal or preicteric phase, the following signs and symptoms would be noted: urticaria; nausea; vomiting; anorexia; fever; malaise; arthralgia; headache; right upper quadrant (RUQ) discomfort; enlargement of the spleen, liver, and lymph nodes; weight loss; and rash. Jaundice and clay-colored stools would be characteristic of the icteric phase. Liver function tests returning to normal would be noted in the posticteric phase

A client with cholelithiasis has a gallstone lodged in the common bile duct. When assessing this client, the nurse expects to note: yellow sclerae. light amber urine. black, tarry stools. circumoral pallor.

yellow sclerae.

Lactulose (Cephulac) is administered to a patient diagnosed with hepatic encephalopathy to reduce which of the following? Alcohol Calcium Bicarbonate Ammonia

Ammonia

A client diagnosed with arthritis doesn't want to take medications. Physical therapy and occupational therapy have been consulted for nonpharmacologic measures to control pain. What might physical and occupational therapy include in the care plan to help control this client's pain? Cold therapy An exercise routine that includes range-of-motion (ROM) exercises Acupuncture Heat therapy and nonsteroidal anti-inflammatory medications (NSAIDs)

An exercise routine that includes range-of-motion (ROM) exercises

The medical plan of treatment for chronic mitral regurgitation would include medications to reduce afterload, such as: Diuretics Anticoagulants. Vasodilators. Angiotensin-converting enzyme (ACE) inhibitors.

Angiotensin-converting enzyme (ACE) inhibitors. Afterload reduction refers to arterial dilation, which occurs with ACE inhibitors.

Which of the following refers to fixation of a joint? Pannus Ankylosis Articulations Synovitis

Ankylosis Fixation of a joint, called ankylosis, eliminates friction, but at the drastic cost of immobility. Inflammation is manifested in the joints as synovitis. Pannus has a destructive effect on the adjacent cartilage and bone. Articulations are joints.

A client with a fractured femur is placed in skeletal traction. Which intervention will increase client independence when moving in bed? Remind to use the heel of the unaffected foot to reposition. Remove the weights prior to repositioning. Instruct to use the elbows to reposition. Apply a trapeze to the bed frame.

Apply a trapeze to the bed frame.

Which of the following procedures involves a surgical fusion of the joint? Osteotomy Arthrodesis Tenorrhaphy Synovectomy

Arthrodesis An arthrodesis is a surgical fusion of the joint. Synovectomy is the excision of the synovial membrane. Tenorrhaphy is the suturing of a tendon. An osteotomy alters the distribution of the weight within the joint.

The nurse is preparing a client for a surgical procedure that will allow visualization of the extent of joint damage of the knee for a client with rheumatoid arthritis and also obtain a sample of synovial fluid. What procedure will the nurse prepare the client for? Needle aspiration Arthroscopy Open reduction Arthroplasty

Arthroscopy

Which New York Heart Association classification of heart failure has a poor prognosis and includes symptoms of cardiac insufficiency at rest? I II III IV

IV

A client has a serum study that is positive for the rheumatoid factor. What will the nurse tell the client about the significance of this test result? It is diagnostic for Sjögren's syndrome. It is specific for rheumatoid arthritis. It is diagnostic for systemic lupus erythematosus. It is suggestive of rheumatoid arthritis.

It is suggestive of rheumatoid arthritis. Rheumatoid factor is present in about 70% to 80% of patients with rheumatoid arthritis, but its presence alone is not diagnostic of rheumatoid arthritis, and its absence does not rule out the diagnosis.

A client diagnosed with carpal tunnel syndrome (CTS) asks the nurse about numbness in the fingers and pain in the wrist. What is the best response by the nurse? A. "CTS is a neuropathy that is characterized by bursitis and tendinitis." B. "CTS is a neuropathy that is characterized by pannus formation in the shoulder." C. "CTS is a neuropathy that is characterized by compression of the median nerve at the wrist." D. "CTS is a neuropathy that is characterized by flexion contracture of the fourth and fifth fingers."

"CTS is a neuropathy that is characterized by compression of the median nerve at the wrist." Carpal tunnel syndrome is an entrapment neuropathy that occurs when the median nerve at the wrist is compressed by a thickened flexor tendon sheath, skeletal encroachment, edema, or a soft tissue mass.

An asymptomatic client questions the nurse about the diagnosis of mitral regurgitation and inquires about continuing an exercise routine. Which is the most appropriate response by the nurse? "Continue the exercise routine but take ample rest after exercising." "Avoid strenuous cardiovascular exercise." "Avoid any type of exercise." "Continue the exercise routine unless symptoms such as shortness of breath or fatigue develop."

"Continue the exercise routine unless symptoms such as shortness of breath or fatigue develop."

The nurse is assessing a client admitted with suspected pancreatitis. Which question will the nurse prioritize when assessing this client? "When was the last time you took acetaminophen?" "How much alcohol do you consume in a day?" "How often and how long do you exercise each day? "How many meals do you eat every day?"

"How much alcohol do you consume in a day?"

A client with osteoarthritis expresses concerns that the disease will prevent the ability to complete daily chores. Which suggestion should the nurse offer? "Pace yourself and rest frequently, especially after activities." "Do all your chores in the evening, when pain and stiffness are least pronounced." "Do all your chores in the morning, when pain and stiffness are least pronounced." "Do all your chores after performing morning exercises to loosen up."

"Pace yourself and rest frequently, especially after activities." A client with osteoarthritis must adapt to this chronic and disabling disease, which causes deterioration of the joint cartilage. The most common symptom of the disease is deep, aching joint pain, particularly in the morning and after exercise and weight-bearing activities.

The nurse is teaching a newly diagnosed client about systemic lupus erythematosus(SLE). What statement by the client indicates the teaching was successful? "The belief is that it is an autoimmune disorder with an unknown trigger." "This disorder is more common in men in their thirties and forties than in women." "The symptoms are primarily localized to the skin but may involve the joints." "SLE has very specific manifestations that make diagnosis relatively easy."

"The belief is that it is an autoimmune disorder with an unknown trigger."

An older adult with rheumatoid arthritis says exercise was not effective. Which response will the nurse make to learn the reason for the failure of this treatment approach? "Why do you think the exercise didn't work?" "Do you think you are too old to exercise?" "What types of exercise were you doing?" "Does exercise usually work for you?"

"What types of exercise were you doing?"

A student accepted into a nursing program must begin receiving the hepatitis B series of injections. The student asks when the next two injections should be administered. What is the best response by the instructor? "You must have the second one in 2 weeks and the third in 1 month." "You must have the second one in 1 year and the third the following year." "You must have the second one in 1 month and the third in 6 months." "You must have the second one in 6 months and the third in 1 year."

"You must have the second one in 1 month and the third in 6 months."

A nurse is caring for four clients on the cardiac unit. Which client has the greatest risk for contracting infective endocarditis? A client 4 days postoperative after mitral valve replacement A client with a history of repaired ventricular septal defect A client 1 day post coronary stent placement A client with hypertrophic cardiomyopathy

A client 4 days postoperative after mitral valve replacement

A client is experiencing an acute exacerbation of rheumatoid arthritis. What should the nursing priority be? A. Administering ordered analgesics and monitoring their effects B. Providing comprehensive client teaching; including symptoms of the disorder, treatment options, and expected outcomes C. Performing meticulous skin care D. Supplying adaptive devices, such as a zipper-pull, easy-to-open beverage cartons, lightweight cups, and unpackaged silverware

Administering ordered analgesics and monitoring their effects

A client whose glucose levels were within normal limits is now concerned because their blood glucose levels have been trending from 210 mg/dL to 330 mg/dL since surgery. Which hormone(s) will the nurse explain is causing the increase in blood glucose level? Select all that apply. Epinephrine Insulin Adrenocorticosteroids Glucagon Thyroid hormone

Adrenocorticosteroids Glucagon Thyroid hormone Epinephrine

Total parental nutrition (TPN) should be used cautiously in clients with pancreatitis because such clients: A. cannot tolerate high-glucose concentration. B. are at risk for gallbladder contraction. C. are at risk for hepatic encephalopathy. D. can digest high-fat foods.

A. cannot tolerate high-glucose concentration.

The nurse is assisting the physician with a procedure to remove ascitic fluid from a client with cirrhosis. What procedure does the nurse ensure the client understands will be performed? Thoracentesis Upper endoscopy Abdominal paracentesis Abdominal CT scan

Abdominal paracentesis

An important message for any nurse to communicate is that drug-induced hepatitis is a major cause of acute liver failure. The medication that is the leading cause is: Dextromethorphan Ibuprofen Benadryl Acetaminophen

Acetaminophen

A client is evaluated for severe pain in the right upper abdominal quadrant, which is accompanied by nausea and vomiting. The physician diagnoses acute cholecystitis and cholelithiasis. For this client, which nursing diagnosis takes top priority? Deficient knowledge related to prevention of disease recurrence Acute pain related to biliary spasms Anxiety related to unknown outcome of hospitalization Imbalanced nutrition: Less than body requirements related to biliary inflammation

Acute pain related to biliary spasm

The nurse is planning care for a client following an incisional cholecystectomy for cholelithiasis. Which intervention is the highest nursing priority for this client? Assisting the client to turn, cough, and deep breathe every 2 hours Performing range-of-motion (ROM) leg exercises hourly while the client is awake Assisting the client to ambulate the evening of the operative day Teaching the client to choose low-fat foods from the menu

Assisting the client to turn, cough, and deep breathe every 2 hours

The nurse is planning care for a client following an incisional cholecystectomy for cholelithiasis. Which intervention is the highest nursing priority for this client? Performing range-of-motion (ROM) leg exercises hourly while the client is awake Assisting the client to ambulate the evening of the operative day Assisting the client to turn, cough, and deep breathe every 2 hours Teaching the client to choose low-fat foods from the menu

Assisting the client to turn, cough, and deep breathe every 2 hours

The nurse is caring for a patient with cirrhosis of the liver and observes that the patient is having hand-flapping tremors. What does the nurse document this finding as? Ataxia Constructional apraxia Fetor hepaticus Asterixis

Asterixis

The nurse understands that a client with which cardiac arrhythmia is most at risk for developing heart failure? Supraventricular tachycardia Sinus tachycardia Atrial fibrillation First-degree heart block

Atrial fibrillation Cardiac dysrhythmias such as atrial fibrillation may either cause or result from heart failure; in both instances, the altered electrical stimulation impairs myocardial contraction and decreases the overall efficiency of myocardial function.

The nurse is auscultating the heart sounds of a patient with mitral stenosis. The pulse rhythm is weak and irregular. What rhythm does the nurse expect to see on the electrocardiogram (ECG)? First-degree atrioventricular block Atrial fibrillation Ventricular tachycardia Sinus dysrhythmia

Atrial fibrillation In mitral stenosis, the pulse is weak and often irregular because of atrial fibrillation (caused by strain on the atrium).

The nurse is teaching a group of clients with heart failure about how to decrease leg edema. What dietary advice will the nurse give to clients with severe heart failure? Avoid the intake of canned fruit and fruit juices. Encourage increased intake of vegetables with natural sodium. Avoid the intake of processed and commercially prepared foods. Encourage increased intake of red meat.

Avoid the intake of processed and commercially prepared foods.

The nurse is planning teaching for a client with gout. Which topics will the nurse include in the teaching? Select all that apply. Avoiding purine-rich foods Limiting exercise Decreasing alcohol intake Weight loss Restricting the intake of water

Avoiding purine-rich foods Decreasing alcohol intake Weight loss Management between the attacks of gout include lifestyle changes to include weight loss, decreasing alcohol intake, and avoiding purine-rich foods. Exercise does not need to be limited and water does not need to be restricted.

A client with heart failure is having a decrease in cardiac output. What indication does the nurse have that this is occurring? Blood pressure 80/46 mm Hg Oxygen saturation 94% Heart rate of 72 beats/minute Respiratory rate of 20 breaths/minute

Blood pressure 80/46 mm Hg The body can compensate for changes in heart function that occur over time. When cardiac output falls, the body uses certain compensatory mechanisms designed to increase stroke volume and maintain blood pressure. These compensatory mechanisms can temporarily improve the client's cardiac output but ultimately fail when contractility is further compromised. A heart rate of 72 beats/minute is within normal range as well as the respiratory rate and oxygen saturation.

A patient in severe pulmonary edema is being intubated by the respiratory therapist. What priority action by the nurse will assist in the confirmation of tube placement in the proper position in the trachea? Attach a pulse oximeter probe and obtain values. Call for a chest x-ray. Listen for breath sounds over the epigastrium. Observe for mist in the endotracheal tube.

Call for a chest x-ray.

When caring for a client with advanced cirrhosis and hepatic encephalopathy, which assessment finding should the nurse report immediately? Constipation for more than 2 days Weight loss of 2 pounds in 3 days Change in the client's handwriting and/or cognitive performance Anorexia for more than 3 days

Change in the client's handwriting and/pr cognitive performance

A client has been prescribed furosemide 80 mg twice daily. The asymptomatic client begins to have rare premature ventricular contractions followed by runs of bigeminy with stable signs. What action will the nurse perform next? Administer potassium. Notify the health care provider. Calculate the client's intake and output. Check the client's potassium level.

Check the client's potassium level.

Which is a clinical manifestation of cholelithiasis? Clay-colored stools Nonpalpable abdominal mass Abdominal pain in the upper left quadrant Epigastric distress before a meal

Clay-colored stools

The nurse is teaching a client about the characteristics of osteoarthritis. The nurse determines the client teaching was successful when the client states that which of the following may occur with osteoarthritis? Clients will develop boutonniere deformity. Clients may develop Heberden nodes. Clients will have an ulnar deviation. Clients may have swan neck deformity.

Clients may develop Heberden nodes.

The nurse is caring for a client recovering from acute pancreatitis. Which menu item should the nurse remove from the client's breakfast tray? Orange slices Coffee Toast Oatmeal

Coffee

A nurse is teaching a client about an upcoming surgery to separate fused cardiac leaflets. Which term is used to describe this surgery? Annuloplasty Valvuloplasty Chordoplasty Commissurotomy

Commissurotomy

A client discharged after a laparoscopic cholecystectomy calls the surgeon's office reporting severe right shoulder pain 24 hours after surgery. Which statement is the correct information for the nurse to provide to this client? A. "This pain is caused from your incision. Take analgesics as needed and as prescribed and report to the surgeon if pain is unrelieved even with analgesic use." B. "This pain may be caused by a bile duct injury. You will need to go to the hospital immediately to have this evaluated." C. "This may be the initial symptoms of an infection. You need to come to see the surgeon today for an evaluation." D. "This pain is caused from the gas used to inflate your abdominal area during surgery. Sitting upright in a chair, walking, or using a heating pad may ease the discomfort."

D. "This pain is caused from the gas used to inflate your abdominal area during surgery. Sitting upright in a chair, walking, or using a heating pad may ease the discomfort."

A client comes to the emergency department complaining of pain in the right leg. When obtaining the history, the nurse learns that the client has a history of obesity and hypertension. Based on this information the nurse anticipates the client having which musculoskeletal disorder? Scoliosis Paget's disease Muscular dystrophy Degenerative joint disease

Degenerative joint disease

A client with mitral stenosis comes to the physician's office for a routine checkup. When listening to the client's heart, the nurse expects to hear which type of murmur? Diastolic, rumbling, low-pitched Diastolic, blowing, decrescendo Systolic, harsh, crescendo-decrescendo Pansystolic, blowing, high-pitched

Diastolic, rumbling, low-pitched Mitral stenosis causes a diastolic, rumbling, low-pitched murmur audible at the apex. A pansystolic, blowing, high-pitched murmur characterizes mitral insufficiency. A systolic, harsh, crescendo-decrescendo murmur occurs with aortic stenosis. A diastolic, blowing, decrescendo murmur accompanies aortic insufficiency.

A client with mitral stenosis is admitted to the hospital. What assessment findings would indicate right ventricular failure? Dyspnea, distended jugular veins, orthopnea Distended jugular veins, pedal edema, nausea Orthopnea, nausea, pedal edema Dyspnea, orthopnea, pulmonary edema

Distended jugular veins, pedal edema, nausea

The diagnosis of heart failure is usually confirmed by which of the following? Echocardiogram Electrocardiogram (12-lead) Ventriculogram Chest x-ray

Echocardiogram

A client is admitted to the healthcare facility suspected of having acute pancreatitis and undergoes laboratory testing. Which of the following would the nurse expect to find? Decreased white blood cell count Elevated urine amylase levels Decreased liver enzyme levels Increased serum calcium levels

Elevated urine amylase levels Elevated serum and urine amylase, lipase, and liver enzyme levels accompany significant pancreatitis. If the common bile duct is obstructed, the bilirubin level is above normal. Blood glucose levels and white blood cell counts can be elevated. Serum electrolyte levels (calcium, potassium, and magnesium) are low.

A nurse assesses a client in the health care provider's office. Which assessment findings support a suspicion of systemic lupus erythematosus (SLE)? A. Hypothermia, weight gain, lethargy, and edema of the arms B. Photosensitivity, polyarthralgia, and painful mucous membrane ulcers C. Weight gain, hypervigilance, hypothermia, and edema of the legs D. Facial erythema, pericarditis, pleuritis, fever, and weight loss

Facial erythema, pericarditis, pleuritis, fever, and weight loss

The nurse is caring for a client diagnosed with infective endocarditis and awaiting blood culture results. The client asks, "Where did I pick up these bacteria?" The nurse is most safe to speculate which of the following? From the fecal-oral route From ingestion of a food From droplets from a cough From a break in the skin

From a break in the skin The microorganisms that cause infective endocarditis include bacteria and fungi. Streptococci and staphylococci are the bacteria most frequently responsible for this disorder. Both bacteria are abundantly found on the skin. These organisms are not found in the other locations.

The nurse is caring for a client with suspected right-sided heart failure. What would the nurse know that clients with suspected right-sided heart failure may experience? Sleeping in a chair or recliner Increased perspiration Gradual unexplained weight gain Increased urine output

Gradual unexplained weight gain Clients with right-sided heart failure may have a history of gradual, unexplained weight gain from fluid retention. Left-sided heart failure produces paroxysmal nocturnal dyspnea, which may prompt the client to use several pillows in bed or to sleep in a chair or recliner. Right-sided heart failure does not cause increased perspiration or increased urine output.

A client experienced an open fracture to the left femur during a horse-riding accident. For which complication is this client at highest risk? Malunion Infection Depression Complex regional pain syndrome

Infection

Which nursing diagnosis takes highest priority for a client with a compound fracture? Impaired physical mobility related to trauma Activity intolerance related to weight-bearing limitations Infection related to effects of trauma Imbalanced nutrition: Less than body requirements related to immobility

Infection related to effects of trauma

A client with right upper quadrant pain and weight loss is diagnosed with liver cancer. For which treatment will the nurse prepare the client when it is determined that the disease is confined to one lobe of the liver? Liver resection Laser hyperthermia Radiation Chemotherapy

Liver Resection Surgical resection is the treatment of choice when liver cancer is confined to one lobe of the liver and the function of the remaining liver is considered adequate for postoperative recovery

A client has undergone an external fixation. Which actions would be the priority for this client? Monitoring the client's urine output. Planning the client's diet. Monitoring the client's blood pressure. Maintaining pin care.

Maintaining pin care.

A client with acute pancreatitis has been started on total parenteral nutrition (TPN). Which action should the nurse perform after administration of the TPN? Auscultate the abdomen for bowel sounds every 4 hours Monitor for reports of nausea and vomiting Measure abdominal girth every shift Measure blood glucose concentration every 4 to 6 hours

Measure blood glucose concentration every 4 to 6 hours

A nurse is admitting a client diagnosed with infective pericarditis. What is the initial order for the nurse to implement? Schedule an echocardiogram. Obtain blood cultures times two. Administer intravenous antibiotic. Provide bedrest with bathroom privileges.

Obtain blood cultures times two.

A health care provider admits a client with a history of I.V. drug abuse to the medical-surgical unit for evaluation for infective endocarditis. What will an assessment by the nurse most likely reveal? a scratchy pericardial friction rub. Osler's nodes and splinter hemorrhages. retrosternal pain that worsens during supine positioning. pulsus paradoxus.

Osler's nodes and splinter hemorrhages. Infective endocarditis occurs when an infectious agent enters the bloodstream, such as from I.V. drug abuse or during an invasive procedure or dental work. Typical assessment findings in clients with this disease include Osler's nodes (red, painful nodules on the fingers and toes), splinter hemorrhages, fever, diaphoresis, joint pain, weakness, abdominal pain, a new or altered heart murmur, and Janeway's lesions (small, hemorrhagic areas on the fingers, toes, ears, and nose). Retrosternal pain that worsens when the client is supine, pulsus paradoxus, and pericardial friction rub are common findings in clients with pericarditis, not infective endocarditis.

What initial measure can the nurse implement to reduce risk of injury for a client with liver disease? Raise all four side rails on the bed Prevent visitors, so as not to agitate the client Apply soft wrist restraints Pad the side rails on the bed

Pad the side rails on the bed

A client diagnosed with acute pancreatitis is being transferred to another facility. The nurse caring for the client completes the transfer summary, which includes information about the client's drinking history and other assessment findings. Which assessment findings confirm the diagnosis of acute pancreatitis? Pain with abdominal distention and hypotension Presence of easy bruising and bradycardia Presence of blood in the client's stool and recent hypertension Adventitious breath sounds and hypertension

Pain with abdominal distention and hypotension

A client with cirrhosis has portal hypertension, which is causing esophageal varices. What is the goal of the interventions that the nurse will provide? A. Promote optimal neurologic function. b. Cure the cirrhosis. C. Reduce fluid accumulation and venous pressure. D. Treat the esophageal varices.

Reduce fluid accumulation and venous pressure.

The client with cardiac failure is taught to report which symptom to the health care provider or clinic immediately? Increased appetite Ability to sleep through the night Weight loss Persistent cough

Persistent cough

The nurse has created a care plan for a client admitted with acute pericarditis and a nursing diagnosis of acute pain related to pericardial inflammation. What is an appropriate nursing intervention for this client? Administering around-the-clock opioids as prescribed Promoting progressive relaxation techniques with the use of slow, deep breathing Positioning the patient on the right side with the head of the bed elevated 15 degrees Placing the patient in the high-Fowler's position with an over-the-bed table for the patient to lean on

Placing the patient in the high-Fowler's position with an over-the-bed table for the patient to lean on Clients with acute pericarditis require pain management with analgesics, positioning, and psychological support. Relief of pain is achieved by rest. Because sitting upright and leaning forward is the posture that tends to relieve pain, chair rest may be more comfortable. The pain has a sharp, pleuritic quality that changes with respiration, and patients take shallow breaths. Anti-inflammatory medications may be used to help pain; opioids are not usually indicated.

A client being treated for pancreatitis faces the risk of atelectasis. Which of the following interventions would be important to implement to minimize this risk? Instruct the client to avoid coughing. Reposition the client every 2 hours. Withhold oral feedings for the client. Monitor pulse oximetry every hour.

Reposition the client every 2 hours.

In what location would the nurse palpate for the liver? Left upper quadrant Right upper quadrant Right lower quadrant Left lower quadrant

Right upper quadrant

The nurse is assessing a client admitted with infective endocarditis. Which manifestation would the nurse expect to find? Bruising on the palms of the hands and soles of the feet Small painful lesions on the pads of the fingers and toes Involuntary muscle movements of the extremities Raised red rash on the trunk and face

Small painful lesions on the pads of the fingers and toes

The nurse is concerned about potassium loss when a diuretic is prescribed for a patient with ascites and edema. What diuretic may be ordered that spares potassium and prevents hypokalemia? Bumetanide (Bumex) Furosemide (Lasix) Spironolactone (Aldactone) Acetazolamide (Diamox)

Spironolactone (Aldactone)

Which of the following disorders is characterized by an increased autoantibody production? Polymyalgia rheumatic Scleroderma Rheumatoid arthritis (RA) Systemic lupus erythematosus (SLE)

Systemic lupus erythematosus (SLE)

A nurse is teaching a client about heart failure. What will the nurse explain is causing the heart to fail? The heart is pumping too fast to adequately meet the body's metabolic needs. The heart cannot pump sufficient blood to meet the body's metabolic needs. The heart is pumping too slow to disseminate nutrients to the body. The heart is fibrillating.

The heart cannot pump sufficient blood to meet the body's metabolic needs.

A nurse is teaching a client about preventing osteoporosis. Which teaching point is correct? A. Obtaining an X-ray of the bones every 3 years is recommended to detect bone loss. B. To prevent fractures, the client should avoid strenuous exercise. C. The recommended daily allowance of calcium may be found in a wide variety of foods. D. Obtaining the recommended daily allowance of calcium requires taking a calcium supplement.

The recommended daily allowance of calcium may be found in a wide variety of foods. Premenopausal women require 1,000 mg of calcium per day. Postmenopausal women require 1,500 mg per day. Clients usually can get the recommended daily requirement of calcium by eating a varied diet.

The nurse is preparing a client to have his cast cut off after having it for 6 weeks to treat a fractured tibia. What should the nurse inform the client prior to the cast being removed? The leg will look moist and will have small bumps that will go away in a few days. The skin may be covered with a yellowish crust that will shed in a few days. The leg strength is enforced by the wearing of the cast. The leg will look as it did prior to the cast being applied.

The skin may be covered with a yellowish crust that will shed in a few days. Once the cast is off, the skin appears mottled and may be covered with a yellowish crust composed of accumulated body oil and dead skin. The client usually sheds this residue in a few days.

Which term indicates an accumulation of crystalline depositions in articular surfaces, bones, soft tissue, and cartilage? Pannus Joint effusion Subchondral bone Tophi

Tophi

Which medication is used to decrease portal pressure, halting bleeding of esophageal varices? Cimetidine Vasopressin Nitroglycerin Spironolactone

Vasopressin

A client with left-sided heart failure reports increasing shortness of breath and is agitated and coughing up pink-tinged, foamy sputum. The nurse should recognize these findings as signs and symptoms of what condition? acute pulmonary edema. right-sided heart failure. cardiogenic shock. pneumonia.

acute pulmonary edema.

The nurse is caring for a client with heart failure. What sign will lead the nurse to suspect right-sided heart failure? warm extremities weight loss resting bradycardia ascites

ascites

Which is not a risk factor for osteoporosis? being postmenopausal family history being male small-framed, thin White or Asian women

being male

A client who has developed congestive heart failure must learn to make dietary adaptations. The client should avoid: angel food cake. canned peas. dried peas. ready-to-eat cereals.

canned peas Canned vegetables are usually very high in salt or sodium, unless they have labels such as low-salt or sodium free or salt free. It is important to read food labels and look for foods that contain less than 300 mg sodium/serving.

A client is admitted for suspected GI disease. Assessment data reveal muscle wasting, a decrease in chest and axillary hair, and increased bleeding tendency. The nurse suspects the client has: cholelithiasis. appendicitis. cirrhosis. peptic ulcer disease.

cirrhosis.

The nurse is caring for a client with a new onset of gout. What medication does the nurse anticipate will be ordered by the health care provider? anturane probenecid allopurinol colchicine

colchicine

A preoperative client scheduled to have an open cholecystectomy says to the nurse, "The doctor said that after surgery, I will have a tube in my nose that goes into my stomach. Why do I need that?" What most common reason for a client having a nasogastric tube in place after abdominal surgery should the nurse include in a response? gavage lavage decompression instillation

decompression Negative pressure exerted through a tube inserted in the stomach removes secretions and gaseous substances from the stomach, preventing abdominal distention, nausea, and vomiting

The nurse is gathering a health history for a client with osteoarthritis. What clinical manifestation will the nurse expect to find? subcutaneous nodules joint pain that increases with rest early morning stiffness small joint involvement

early morning stiffness

A client is being treated for hyperuricemia. Part of the treatment strategy is for the client to avoid contributing factors whenever possible. Which activities might bring on an acute attack? eating organ meats and sardines frequently ingesting salicylates high carbohydrate intake frequently drinking coffee

eating organ meats and sardines

A client has been having cardiac symptoms for several months and is seeing a cardiologist for diagnostics to determine the cause. How will the client's ejection fraction be measured? electrocardiogram echocardiogram cardiac catheterization cardiac ultrasound

echocardiogram

The type of fracture described as having one side of the bone broken and the other side bent would be: greenstick. oblique. transverse. spiral.

greenstick.

Osteoarthritis is known as a disease that A. affects the cartilaginous joints of the spine and surrounding tissues. B. is the most common and frequently disabling of joint disorders. C. affects young males. D. requires early treatment because most of the damage seems to occur early in the course of the disease.

is the most common and frequently disabling of joint disorders.

A nurse is admitting a client with hypertrophic cardiomyopathy (HCM). What medication order will the nurse question? isosorbide dinitrate spironolactone enalapril metoprolol

isosorbide dinitrate Isosorbide dinitrate is a nitrates that should be avoided in HCM to maintain cardiac output. Enalapril is an ACE inhibitor, metoprolol is a beta blocker, and spironolactone is an aldosterone antagonist used for HCM.

If a client were to develop rheumatic carditis, which cardiac structure would most likely be affected? septum mitral valve coronary arteries inferior vena cava

mitral valve

A nurse is assigned to the medical intensive care unit. The nurse auscultates a water-hammer pulse. What will the sound resemble? mitral click low-pitched diastolic murmur at the apex high-pitched blowing sound at the apex quick, sharp strokes that suddenly collapse

quick, sharp strokes that suddenly collapse With the water-hammer (Corrigan's) pulse, the pulse strikes the palpating finger with a quick, sharp stroke and then suddenly collapses. Water-hammer pulse is not low or high pitched. A clicking sound is heard with a valve replacement.

The nurse is teaching a client with osteoarthritis about the disease. What is the most important client focus for disease management? strategies for remaining active prevention of joint deformity disease-modifying antirheumatic drug therapy detection of systemic complications

strategies for remaining active The goals of osteoarthritis disease management are to decrease pain and stiffness and improve joint mobility. Strategies for remaining active are the most important client focus