Adult II Exam 1 Practice Qs
The nurse provides client education to a client about to undergo hydrogen breath testing. The nurse evaluates that the client understands the test when the client makes which statement?
"I should avoid antibiotics for 1 month before the test." The client should avoid loperamide, sucralfate, and omeprazole for 1 week prior to the test, and cimetidine, famotidine, and nizatidine for 24 hours before the test.
The nurse is preparing the client for magnetic resonance imaging (MRI) of the kidney. Which statement by the client requires action by the nurse?
"I took my blood pressure medication with my morning coffee an hour ago."
A nurse is performing discharge teaching with a client who had a total gastrectomy. Which statement indicates the need for further teaching?
"I will have to take vitamin B12 shots up to 1 year after surgery."
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 1 month and the third in 6 months."
Which priority assessment(s) will the nurse perform on a client receiving continuous TPN? Select all that apply.
Monitor daily weights Monitor output Monitor glucose levels
A client has recently contracted hepatitis C. Which symptoms are most associated with this client's condition? Select all that apply.
Muscle aches Fever Headache
A client is prescribed a histamine (H2)-receptor antagonist. The nurse understands that this might include which medication(s)? Select all that apply
Nizatidine Famotidine Cimetidine
Which of the following are characteristics associated with the Zollinger-Ellison syndrome (ZES)? Select all that apply.
Severe peptic ulcers Extreme gastric hyperacidity Gastrin-secreting tumors of the pancreas
Nurse Berlinda is assigned to a 41-year-old client who has a diagnosis of chronic pancreatitis. The nurse reviews the laboratory result, anticipating a laboratory report that indicates a serum amylase level of:
300
An older adult patient with a diagnosis of chronic gastritis has achieved acceptable control of his condition with the use of an H2 receptor antagonist. This patient's symptom control is a result of what therapeutic action of this drug?
A decrease in HCl production by parietal cells
A patient is scheduled for a Billroth I procedure for ulcer management. What does the nurse understand will occur when this procedure is performed?
A partial gastrectomy is performed with anastomosis of the stomach segment to the duodenum.
Which term is used to describe stone formation in a salivary gland, usually the submandibular gland?
Sialolithiasis
A client with hemorrhoids needs to have a bowel movement but expresses fear of defecating due to the pain experienced. Which intervention might the nurse try first to help facilitate a bowel movement and prevent constipation?
Apply cold packs to the anal area followed by a warm sitz bath
A client with severe hepatitis B will present to the emergency department with which subjective and objective assessment findings? Select all that apply.
Abdominal pain INR of 4 Increased ALT/AST Positive HBsAg
A 50-year-old male patient with a history of cholelithiasis (gallstones) has presented to the emergency department (ED) with severe upper right quadrant pain. The ED nurse should anticipate the need to facilitate which of the following diagnostic tests?
Abdominal ultrasound
A client with chronic peptic ulcers is considering a vagotomy. Which information will the nurse provide to the client about this surgical procedure?
Adverse effects such as dumping syndrome and gastritis can occur.
The nurse practitioner suspects that a patient may have a gastric ulcer after completing a history and physical exam. Select an indicator that can be used to help establish the distinction between gastric and duodenal ulcers.
Amount of HCL secretion in stomach -gastric will by hyposecretion/normosecretion -duodenal will be hypersecretion
A client recovering from a laparoscopic cholecystectomy reports severe right shoulder pain 24 hours after the procedure. Which education will the nurse provide to the client?
Apply a heating pad for 15 to 20 minutes.
While caring for a patient who has had radical neck surgery, the nurse notices an abnormal amount of serosanguineous secretions in the wound suction unit during the first postoperative day. What does the nurse know is an expected amount of drainage in the wound unit?
Approximately 80 to 120 mL
A client is postoperative following a graft reconstruction of the neck. What intervention is the most important for the nurse to complete with the client?
Assess the graft for color and temperature
Following a renal biopsy, a client reports severe pain in the back, the arms, and the shoulders. Which intervention should be offered by the nurse?
Assess the patient's back and shoulder areas for signs of internal bleeding.
The nurse is caring for a male client with a diagnosis of chronic gastritis. The nurse monitors the client knowing that this client is at risk for which vitamin deficiency?
B12
The nurse explains to the client which medical history places the client at an increased risk for esophageal cancer? Select all that apply.
Barrett's esophagus GERD Tobacco and alcohol HPV
A client is scheduled for removal of the lower portion of the antrum of the stomach and a small portion of the duodenum and pylorus. What surgical procedure will the nurse prepare the client for?
Billroth I
The nurse provides care for a client who has been taking trimethoprim/sulfamethoxazole for 8 days for severe urinary tract infection (UTI) caused by three offending organisms. The nurse becomes concerned and calls the health care provider with which adverse reactions?
Blistering rash scattered around abdomen and face (Warning sign of Steven-Johnson syndrome; potentially fatal)
A patient comes to the clinic with the complaint, "I think I have an ulcer." What is a characteristic associated with peptic ulcer pain that the nurse should inquire about? Select all that apply.
Burning sensation localized in the back or mid-epigastrium Feeling of emptiness that precedes meals from 1 to 3 hours Severe gnawing pain that increases in severity as the day progresses
The nurse is caring for a hospitalized female client with a diagnosis of ulcerative colitis. Which finding, if noted on assessment of the client, would the nurse report to the physician? A. Hypotension B. Bloody diarrhea C. Rebound tenderness D. A hemoglobin level of 12 mg/dL
C. Rebound tenderness
A client is receiving a continuous tube feeding through an open system. Which action(s) will the nurse take when caring for the tube feeding system? Select all that apply.
Change the tubing every 24 hours. Use a pump to control the formula rate. Flush the feeding tube with sterile water every 4 hours. Change the formula according to the manufacturer recommendations.
The nurse has been asked to provide health information to a female patient diagnosed with a urinary tract infection. What appropriate instructions will the nurse provide? Select all that apply.
Cleanse around the perineum and urethral meatus after each bowel movement to reduce pathogens. Drink liberal amounts of fluid to flush out bacteria. Void every 2-3 hours to prevent overdistention of the bladder
A client presents to the outpatient clinic with fever and dysuria and voices concern of another urinary infection. The client has a history of 6 urinary infections over the past year. After assessing the client, the nurse interprets findings to be consistent with pyelonephritis. Which finding is characteristic of pyelonephritis? Select all that apply.
Cloudy, bloody, or foul-smelling urine. Costovertebral angle tenderness. Proteinuria. Urinary frequency
Which type of ulcer can be seen in patients with significant burn injuries?
Curling's ulcer
What information should the nurse include in the teaching plan for a client being treated for diverticulosis?
Drink at least 8 to 10 large glasses of fluid every day
The nurse is completing a routine urinalysis using a dipstick. The test reveals an increased specific gravity. The nurse should suspect which condition?
Decreased fluid intake
Which of these symptoms would the nurse expect to see in a client with a glomerular filtration rate of 15?
Foamy urine No appetite Confused and fatigued Swelling in the lower extremities
Postoperatively, a client with a radical neck dissection should be placed in which position?
Fowler
A 33-year-old male patient with a history of IV heroin and cocaine use has been admitted to the medical unit for the treatment of endocarditis. The nurse should recognize that this patient is also likely to test positive for which of the following hepatitis viruses?
Hepatitis C
A nurse is preparing a presentation for a local community group about hepatitis. Which of the following would the nurse include?
Hepatitis C increases a person's risk for liver cancer.
The nurse provides care for a client who is diagnosed with ascites and finds that the client's abdominal girth has increased by 7 cm over the past three days. The nurse determines the reasons for increased size includes which finding? (Select all that apply.)
Hyperaldosteronism increase sodium and fluid retention Liver is unable to synthesize albumin and decreased colloid oncotic pressure occurs Blood proteins are pushed out of the blood vessels, causing leakage into the peritoneal cavity
The nurse is providing preprocedure teaching about an ultrasound. The nurse informs the patient that, in preparation for an ultrasound of the lower urinary tract, the patient will require what?
Increased fluid to produce a full bladder
A client with gastroesophageal reflux disease is scheduled for esophageal manometry. Which information about the test will the nurse review with the client? Select all that apply.
Ingest no food or fluids for 8 to 12 hours before the test. Withhold taking calcium channel blocking medications for 24 to 48 hours.
A client with acute pancreatitis has been started on total parenteral nutrition (TPN). Which action should the nurse perform after administration of the TPN?
Monitor blood glucose level every 4 to 6 hours
The nurse helps a client to correctly perform peritoneal dialysis at home. The nurse must educate the client about the procedure. Which educational information should the nurse provide to the client?
Keep the dialysis supplies in a clean area, away from children and pets
Which of the following is utilized to treat cholecystitis? Select all that apply.
Lithotripsy. Laparoscopic cholecystectomy. Open cholecystectomy.
A nurse who is taking care of a patient with a spinal cord injury documents the frequency of reflex incontinence. The nurse understands that this is most likely due to:
Loss of motor control of the detrusor muscle.
Vomiting results in which of the following acid-base imbalances?
Metabolic alkalosis
The nurse provides for a client with a history of alcoholism and ascites. Assessment findings reveal a capillary refill of > 6 seconds, tachycardia, dyspnea, and blood pressure of 82/48 mm Hg. The nurse recognizes the onset of hepatopulmonary syndrome and expects to find which assessment data?
Pulse oximetry at 82% Because this syndrome impacts the ability of RBCs to absorb oxygen, the nurse anticipates hypoxemia which is evidenced by a pulse oximetry reading of 82%. Hepatopulmonary syndrome is caused by blood vessels in the lungs dilating and increasing in number, making it hard for red blood cells (RBCs) to properly absorb oxygen. Dyspnea and crackles may be observed and pulse oximetry readings will reflect hypoxemia (e.g., pulse oximetry at 82%).
When a central venous catheter dressing becomes moist or loose, what should a nurse do first?
Remove the dressing, clean the site, and apply a new dressing.
The nurse is providing care to a patient with gross ascites who is maintaining a position of comfort in the high semi-Fowler's position. What is the nurse's priority assessment of this patient?
Respiratory assessment related to increased thoracic pressure
A client presents to the ED with acute abdominal pain, fever, nausea, and vomiting. During the client's examination, the lower left abdominal quadrant is palpated, causing the client to report pain in the RLQ. This positive sign is referred to as ________ and suggests the client may be experiencing ________.
Rovsing sign; acute appendicitis
The nurse is caring for a client in acute renal failure. Which assessment findings by the nurse indicates hypervolemia in this client? Select all that apply.
S3 gallop Lung crackles
A client is recovering from gastric surgery. Toward what goal should the nurse progress the client's enteral intake?
Six small meals daily with 120 mL fluid between meals
The nurse is reviewing the client's urinalysis results. The finding that is most suggestive of dehydration of the client is:
Specific gravity 1.035
An older client is diagnosed with parotitis. What bacterial infection does the nurse suspect caused the client's parotitis?
Staphylococcus aureus
A nurse is preparing to remove a nasogastric tube from a female client. The nurse should instruct the client to do which of the following just before the nurse removes the tube?
Take and hold a deep breath
A client tells the nurse, "I am not having normal bowel movements." When differentiating between what are normal and abnormal bowel habits, what indicators are the most important?
The consistency of stool and comfort when passing stool
The nurse is teaching a client with a urinary tract infection (UTI) about use of nitrofurantoin (Macrodantin). The nurse will include which instruction on this medication?
The medication may cause rust-brownish color to the urine.
A client with chronic pancreatitis is treated for uncontrolled pain. Which complication does the nurse recognize is most common in the client with chronic pancreatitis?
Weight loss
The nurse is instructing the client on sensations commonly experienced when a contrast agent is injected into the body during diagnostic studies. Which sensation is most common?
a warm sensation
The nurse knows to assess the patient with a history of diarrhea for fluid volume deficit (FVD). Which of the following is a characteristic sign of FVD?
a weak, thready pulse
A client has been diagnosed with chronic gastritis. The nurse knows that which of the following symptoms are indicative of gastritis? Select all that apply.
belching early satiety sour taste in mouth
To ensure patency of central venous line ports, diluted heparin flushes are used
daily when not in use
A 45-year-old client has been NPO for the past 10 days. The health care provider (HCP) ordered a feeding tube to be placed into the nose and ordered Nutren 2.0 to begin at 50 ml/hr and to increase 10 milliliters per hour until the rate of 90 ml/hr. By the next day, the client is confused, weak, hypertensive, fatigued with cardiac dysrhythmias. What should be implemented at this time?
magnesium sulfate
A client undergoes surgery to remove a malignant tumor, followed by a urinary diversion procedure. The nurse's postoperative plan of care should include which action?
maintain skin and stomal integrity
Side effect of metronidazole
metallic taste in mouth
When bowel sounds are heard about every 15 seconds, the nurse would record that the bowel sounds are
normal
The nurse is completing a health history on a patient whose diagnosis is chronic gastritis. Which of the data below should the nurse consider most significantly related to the etiology of the patient's health problem?
smokes 2 packs cigarettes daily
The nurse is caring for a client who has a type of urinary diversion that requires an external ostomy bag to collect the urine. This client has:
an incontinent urinary diversion
The nurse cares for a client diagnosed with chronic glomerulonephritis. The nurse will observe the client for the development of
anemia
What is the first action of the nurse for a client on continuous TPN with increased urine output?
assess blood glucose level
A client has been diagnosed with Zenker's diverticulum. What treatment does the nurse include in the client education?
surgical removal of the diverticulum
Which is an effect of aging on upper and lower urinary tract function?
susceptibility to develop hypernatremia
The nurse is monitoring a female client for the early signs and symptoms of dumping syndrome. Which of the following indicate this occurrence?
sweating and pallor
The most significant complication related to continuous tube feedings is
the increased potential for aspiration.
In consultation with her care team, a woman with a diagnosis of cancer has had a continent urinary diversion (Indiana pouch) created. The patient is discussing the advantages and disadvantages of this procedure with her nurse. The nurse should be aware of which of the following advantages of an Indiana pouch?
the patient does not have to wear an external collection bag
A gerontological nurse is aware of the high incidence and prevalence of urinary tract infections (UTIs) among older adults. Consequently, the nurse is implementing plans of care that attempt to reduce this risk. Which of the following actions present the greatest risk of UTIs for older adults?
the use of indwelling urinary catheters
The nurse is conducting a gastrointestinal assessment. When the client reports the presence of mucus and pus in the stool, the nurse assesses for additional signs/symptoms of which disease/condition?
ulcerative colitis
A client comes to the clinic for a follow-up visit. During the interview, the client states, "Sometimes when I have to urinate, I can't control it and do not reach the bathroom in time." The nurse suspects that the client is experiencing which type of incontinence?
urge
A group of students are reviewing information about disorders of the bladder and urethra. The students demonstrate understanding of the material when they identify which of the following as a voiding dysfunction?
urinary retention
The emergency department (ED) nurse receives hand-off communication for an older adult client with sudden onset delirium. Assessment findings are as follows: Temp: 101.2°; Pulse: 115/min; Resp: 22/min; BP: 88/54 mm Hg. The nurse interprets these findings as being consistent with which condition?
urosepsis
The nurse instructs a client to perform continuous ambulatory peritoneal dialysis correctly at home. Which educational information should the nurse provide to the client?
use aseptic technique during the procedure
A client with cholelithiasis has a gallstone lodged in the common bile duct. When assessing this client, the nurse expects to note:
yellow sclerae
The nurse is caring for a patient who has been diagnosed with gastritis. To promote fluid balance when treating gastritis, the nurse knows that what minimal daily intake of fluids is required?
1.5 L
Percentage of PUD clients who experience bleeding
15%
Which is an age-related change of the hepatobiliary system?
decreased blood flow
A patient who has been treated for uric acid stones is being discharged from the hospital. What type of diet does the nurse discuss with the patient?
low-purine diet
The nurse is reviewing the physician's orders written for a male client admitted to the hospital with acute pancreatitis. Which physician order should the nurse question if noted on the client's chart?
morphine sulfate (can cause contractions of Sphincter of Oddi)
The nurse is assessing a client with a history of cirrhosis and receives a report that the abdomen enlarged by 3 cm over the past 24 hours. The nurse contacts the health care provider because of which priority finding?
muffled heart sounds Muffled heart sounds on auscultation indicate fluid build-up in the pericardial space. This may lead to cardiac tamponade which is potentially life-threatening; therefore, this is the priority data the nurse reports to the healthcare provider.
During a home visit the nurse notes that a client recovering from peptic ulcer disease is experiencing cool clammy skin and has a heart rate of 96 beats a minute. Which action will the nurse take?
Notify HCP. (sign of hemorrhage)
A client is receiving continuous tube feedings at 75 mL/h. When the nurse checked the residual volume 4 hours ago, it was 250 mL, and now the residual volume is 325 mL. What is the priority action by the nurse?
Notify the healthcare provider.
The primary source of microorganisms for catheter-related infections are the skin and which of the following?
catheter hub
When caring for a client with cirrhosis, which symptom(s) should the nurse report immediately?
change in mental status
A client reports "bloody" urine to the nurse. What causes would the nurse relate the hematuria? Select all that apply.
acute glomerulonephritis renal stones extreme exercise
Which of the following would the nurse expect to assess in a conscious client with hepatic encephalopathy?
asterixis
The nurse is evaluating a client's ulcer symptoms to differentiate ulcer as duodenal or gastric. Which symptom should the nurse at attribute to a duodenal ulcer?
awakening in pain
The nurse working with a client after an ileal conduit notices that the pouching system is leaking small amounts of urine. What is the appropriate nursing intervention?
change the wafer and pouch
The nurse is caring for a patient who is postoperative day 3 following bowel resection and the creation of a colostomy. While changing the dressing, the nurse notes the stoma is dusky in color. How should the nurse interpret this assessment finding?
circulation to the stoma is compromised
If a client's central venous catheter accidentally becomes disconnected, what should a nurse do first?
clamp the catheter
A client has been newly diagnosed with chronic renal failure and will be receiving hemodialysis. Which statement describes the function of hemodialysis? Select all that apply.
cleans blood of waste products rids the body of excess fluids removes protein by-products restores electrolyte levels
The nurse is caring for a client recovering from acute pancreatitis. Which menu item should the nurse remove from the client's breakfast tray?
coffee
When caring for the patient with acute glomerulonephritis, which of the following assessment findings should the nurse anticipate?
cola-colored urine
Which value does the nurse recognize as the best clinical measure of renal function?
creatinine clearance
The nurse is obtaining a history on a patient who comes to the clinic. What symptom described by the patient is one of the first symptoms associated with esophageal disease?
dysphagia
A client is experiencing some renal secretion abnormalities, for which diagnostics are being performed. Which substance is typically reabsorbed in urine?
glucose
Which of the following instructions should be implemented for discharge teaching after a colonoscopy? Select all that apply.
high fiber diet bowel perforation smoking cessation maintain healthy weight
The nurse auscultates the abdomen to assess bowel sounds. She documents five to six sounds heard in less than 30 seconds. How does the nurse document the bowel sounds?
hyperactive
The nurse is caring for a patient in acute renal failure. The nurse should expect hypertonic glucose, insulin infusions, and sodium bicarbonate to be used to treat:
hyperkalemia
The nurse is caring for a patient after kidney surgery. What major danger should the nurse closely monitor for?
hypovolemic shock caused by hemorrhage
Which laboratory results support the diagnosis of liver failure? Select all that apply.
increased bilirubin decreased HDL increased LDL
Which is an indicator that the liver is not functioning properly?
increased total cholesterol
The nurse working in the ED is evaluating a client for signs and symptoms of appendicitis. Which of the client's signs/symptoms should the nurse report to the physician?
nausea
A client recovering from gastric bypass surgery accidentally removes the nasogastric tube. What is the best action by the nurse?
notify the surgeon about the tube's removal
A client has been taking a 10-day course of antibiotics for pneumonia. The client has been having white patches that look like milk curds in the mouth. What treatment will the nurse educate the client about?
nystatin
A nurse practitioner prescribes drug therapy for a patient with peptic ulcer disease. Choose the drug that can be used for 4 weeks and has a 90% chance of healing the ulcer.q
omeprazole
The nurse recognizes that the client diagnosed with a duodenal ulcer will likely experience
pain 2 to 3 hours after a meal.
A client undergoes renal angiography. Which postprocedure care intervention should the nurse provide to the client?
palpate pulses in the legs and feet
A client is admitted to the health care center with hyperglycemia, a 15-pound weight loss, and reports of vague upper and midabdominal pain that increases in intensity at night. The client' health history indicates alcoholism, smoking of a pack of cigarettes daily, and diabetes for the past 20 years. Upon examination the nurse finds swelling in the feet and abdominal ascites. Based on the clinical manifestations, which condition is the most likely diagnosis?
pancreatic carcinoma
Which medication may be ordered to relieve discomfort associated with a UTI?
phenazopyridine
Which characteristic is seen with a healthy stoma?
pink color moist appearance
Nurse Juvy is caring for a client with cirrhosis of the liver. To minimize the effects of the disorder, the nurse teaches the client about foods that are high in thiamine. The nurse determines that the client has the best understanding of the dietary measures to follow if the client states an intention to increase the intake of:
pork
A client has been diagnosed with acute glomerulonephritis. This condition causes:
proteinuria
A patient with a UTI is having burning and pain when urinating. What urinary analgesic is prescribed for relief of these symptoms?
pyridium
Which of the following is the most common symptom of a polyp?
rectal bleeding
Sympathomimetics have which of the following effects on the body?
relaxation of the bladder wall
The nurse is aware, when caring for patients with renal disease, that which substance made in the glomeruli directly controls blood pressure?
renin
Following a liver biopsy to confirm hepatitis B, the nurse should position the client in which position?
right side-lying
A nurse at a long-term care facility is conducting an intake assessment and health history with a new female resident and the resident's daughter. The daughter states that her mother had a Billroth II gastrectomy performed several years ago, a fact that must be accommodated into her care. The nurse would be justified in questioning the resident about her history of:
stomach cancer
A client with acute liver failure exhibits confusion, a declining level of consciousness, and slowed respirations. The nurse finds him very difficult to arouse. The diagnostic information which best explains the client's behavior is:
subnormal serum glucose and elevated serum ammonia levels.
The nurse is assisting the physician in a percutaneous liver biopsy. In assisting with positioning, the nurse should assist the client into a:
supine
