AN Final

A patient has been diagnosed with hypertension but does not take the antihypertensive medications because of a lack of symptoms. What response by the nurse is best? Question 14 Answer a."You are lucky; most people get severe morning headaches." B. Most people with hypertension do not have symptoms c."Do you have trouble affording your medications?" d."You need to take your medicine or you will get kidney failure."

. Most people with hypertension do not have symptoms

A patient had a femoral-popliteal bypass graft with a synthetic graft. What action by the nurse is most important to prevent wound infection? A. Appropriate hand hygiene before giving care. b.Monitoring the patient's daily white blood cell count c.Clean technique when changing dressings d.Assessing the patient's temperature every 4 hours

A. Appropriate hand hygiene before giving care

A nurse assesses a patient 2 hours after a cardiac angiography via the left femoral artery. The nurse notes that the left pedal pulse is weak. What action would the nurse take? A. Assess the color and temperature of the left leg b.Elevate the leg and apply a sandbag to the entrance site. c.Increase the flow rate of intravenous fluids. d.Document the finding as "left pedal pulse of +1/4."

A. Assess the color and temperature of the left leg

A patient has been diagnosed with a deep-vein thrombosis and is to be discharged on warfarin (Coumadin). The patient is adamant about refusing the drug because "it's dangerous." What action by the nurse is best? A. Assess the reason behind the patients fear b.Tell the patient that drugs are safer today than before. c.Remind the patient about laboratory monitoring. d.Warn the patient about consequences of noncompliance.

A. Assess the reason behind the patients fear

After teaching the wife of a client who has Parkinson disease, the nurse assesses the wife's understanding. Which statement by the client's wife indicates that she correctly understands changes associated with this disease? A. He may have trouble chewing, so i will offer bite-sized portions B. His manlike face makes it difficult to communicate, so I will use a white board. C. He should not socialize outside of the house due to uncontrollable drooling D. This disease is associated with anxi

A. He may have trouble chewing, so I will offer bite sized portions.

The nurse is caring for a client with lower extremity peripheral arterial disease (PAD). Which statement made by the client regarding self-management requires further health teaching? [Select all that apply] A. I will elevate my legs above the level of my heart B.I will avoid crossing my legs at all times. C. I will use a heating pad to promote circulation d.I need to quit smoking as soon as I can

A. I will elevate my legs above the level of my heart C. I will use a heating pad to promote circulation

An emergency room nurse assesses a female patient. Which assessment findings would alert the nurse to request a prescription for an electrocardiogram?(Select all that apply.) A. Indigestion B. Hypertension C. Fatigue despite adequate rest D. Shortness of breath E. Abdominal pain

A. Indigestion B. Fatigue despite adequate rest D. Shortness of breath

A nurse obtains a focused health history for a patient who is scheduled for magnetic resonance imaging. Which condition would alert the nurse to contact the provider and cancel the procedure? A. Internal insulin pump B. BUN of 50 mg/dl C. Atrioventricular graft D. CPK of 100 IU/l

A. Internal insulin pump

A nurse obtains a health history on a client prior to administering prescribed sumatriptan succinate for migraines . Which condition would alert the nurse to hold the medication and contact the provider? A. Prinzmetals angina B. DM C. Bronchial asthma D. Chronic kidney disease

A. Prinzmetal angina

A nurse reviews a patient's laboratory results. Which findings would alert the nurse to the possibility of atherosclerosis?(Select all that apply.) A. Total cholesterol: 280 mg/dl b.High-density lipoprotein cholesterol: 50 mg/dL (1.3 mmol/L) C. Triglycerides: 200 mg/dl D. Low density lipoprotein cholesterol: 160 mg/dl E. Serum albumin: 4 g/dl

A. Total cholesterol: 280 mg/dl C. Triglycerides: 200 mg/dl D. Low density lipoprotein cholesterol: 160 mg/dl

A nurse cares for a patient who is recovering from a myocardial infarction. The patient states, "I will need to stop eating so much chili to keep that indigestion pain from returning." What is the nurse's best response? A. What do you understand about what happened to you? b."The provider has prescribed an antacid for you to take every morning." c."Chili is high in fat and calories; it would be a good idea to stop eating it." d."When did you start experiencing this indigestion?"

A. What do you understand about what happened to you

A nurse assesses patients on a medical-surgical unit. Which patient would the nurse identify as having the greatest risk for cardiovascular disease? a.A 53-year-old postmenopausal woman who is on hormone therapy B. A 45 year old American Indian women with diabetes mellitus C.A 32-year-old Asian-American man with colorectal cancer d.An 86-year-old man with a history of asthma

B. A 45 year old American Indian women with diabetes mellitus

The nurse is caring for four hypertensive patients. Which drug-laboratory value combination would the nurse report immediately to the healthcare provider? a.Hydrochlorothiazide (Hydrodiuril)/potassium: 4.2 mEq/L B. Furosemide/lasix/potassium: 2.1 mEq/L c.Spironolactone (Aldactone)/potassium: 5.1 mEq/L d.Torsemide (Demadex)/sodium: 142 mEq/L

B. Furosemide/lasix/potassium: 2.1 mEq/L

A nurse is teaching a client who experiences migraine headaches and is prescribed a beta-blocker. Which statement would the nurse include in this clients teaching? A. This medication will have no effect on you're HR or BP because you are taking it for migraines B. Take this drug as prescribed even when feeling well, to prevent vascular changes associated with migraine headaches. C. Take this drug only when you have prodromal symptoms indicating the onset of a migraine headache. D. This drug will

B. Take this drug as prescribed even when feeling well to prevent vascular changes associated with migraine headaches.

A nurse cares for a client who has Alzheimer's disease. Which communication techniques would the nurse implement? (Select all that apply.) A. Open ended questions B validate client feelings C. Gestures when speaking D. Pictures with instructions E. Multiple choices

B. Validate client feelings C. Gestures while speaking D. Pictures with instructions

A nurse assesses a patient who is scheduled for a cardiac catheterization. Which assessment would the nurse complete prior to this procedure? a.Ability to turn self in bed b.Patient's level of anxiety C. Allergies to iodine based agents D. Cardiac rhythm and heart rate

C allergies to iodine based agents

A nurse is teaching a patient with cerebellar function impairment. Which statement would the nurse include in this patients discharge teaching? A. Label you're faucet knobs with hot and cold signs B. Connect a light to flash when you're door bell rings C. Ask a friend to drive you to your follow up appointments D. Use a natural gas detector with an audible alarm

C. Ask a friend to drive you to your follow up appointments

The nurse is evaluating a 3-day diet history with a patient who has an elevated lipid panel. What meal selection indicates that the patient is managing this condition well with diet? A. A 4-ounce steak, French fries, iceberg lettuce b.Fried catfish, cornbread, peas C. Baked chicken breast, broccoli, tomatoes d.Spaghetti with meat sauce, garlic bread

C. Baked chicken breast, broccoli, tomatoes

A nurse cares for a client with adavanced Alzheimer's disease. The clients caregiver states, "she is always wondering off. What can I do to manage this restless behavior?" How would the nurse respond? A. This is a sign of fatigue. The client would benefit from a daily nap B. It sounds like this is difficult for you. I will consult the social worker. C. Engage the client in scheduled activities throughout the day. D. The provider can prescribe a mild sedative for restlessness.

C. Engage the client in scheduled activities throughout the day.

A nurse assesses a client who has Parkinson disease. Which manifestations would the nurse recognize as a key feature of this disease? (Select all that apply.) A. Tachycardia B. Long, extended steps C. Flexed trunk D. Uncontrolled drooling E. Slow movements

C. Flexed trunk D. uncontrolled drooling E. Slow movements.

A nurse witnesses a client with late-stage Alzheimer's disease eat breakfast. Afterward the client states, "I am hungry and want breakfast." How would the nurse respond? A. It appears you are confusing this morning B. You ate you're breakfast 30 minutes ago C. I see you're still hungry. I will get you some toast D. Your family will be here soon. Let's get you dressed.

C. I see you're still hungry. I will get you some toast

A nurse prepares to discharge a client with Alzheimer's disease. Which statement would the nurse include in the discharge teaching for this client's caregiver? A. Place a padded throw rug at the bedside B. Provide a high calorie and high protein diet C. Install deadbolt locks on all outside doors D. Allow the client to rest most of the day

C. Instal deadbolt locks on all outside doors

A nurse is teaching a larger female patient about alcohol intake and how it affects hypertension. The patient asks if drinking two beers a night is an acceptable intake. What answer by the nurse is best? a."Yes, since you are larger, you can have more alcohol." b."No, you should not drink any alcohol with hypertension." C. No, women should only have one beer a day as a general rule. D."Yes, two beers per day is an acceptable amount of alcohol."

C. No, women should only have one beer a day as a general rule.

A nursing student is caring for a patient with an abdominal aneurysm. What action by the student requires the registered nurse to intervene? a.Auscultates over abdominal bruit b.Measures the abdominal girth C. Palpates the abdomen in four quadrants d.Assesses the patient for back pain

C. Palpates the abdomen in four quadrants

A nurse prepares a patient for lumbar puncture (LP). Which assessment finding would alert the nurse to contact the healthcare provider? A. Patient is claustrophobic B. Absence of IV access C. Shingles on the patients back D. Paroxysmal nocturnal dyspnea

C. Shingles on the patients back

A nurse prepares a patient for coronary cardiac catheterization surgery. The patient states, "I am afraid I might die." What is the nurse's best response? a."This is a routine test and the risk of death is very low." b."Would you like to speak with a chaplain prior to test?" C. Tell me more about you're concerns about the test d."What support systems do you have to assist you?"

C. Tell me more about you're concerns about the test

A nurse delegates care to the UAP. Which statement would the nurse include when delegating care for a patient with cranial nerve 11 impairment? A. Assist the patient by placing the fork in the left hand B. Place the patient in a high Fowlers position for all meals. C. Tell the patient where food items are on the breakfast tray D. Make sure the patients food is visually appetizing

C. Tell the patient where food items are on the breakfast tray.

A nurse is interested in providing community education and screening on hypertension. In order to reach a priority population, to what target audience would the nurse provide this service? a.High school sports camps b.Asian-American groceries c.Women's health clinics D. African American churches

D. African American churches

A nurse assesses a patient and notes the patient's position as indicated in the illustration below: (Arms at chest with hands folded inward, toes extended and pointing in.) How would the nurse document this finding? Question 1 Select one: a. Decerebrate posturing b. Atypical hyperreflexia c. Spinal cord degeneration d. Decorticate posturing

D. Decorticate posturing

A nurse obtains a focused health history for a patient who is scheduled for magnetic resonance angiography. Which priority question would the nurse ask before the test? A. Have you had a recent blood transfusion B. Do you currently take oral contraceptives C. Are you taking any cardiac medications? D. Do you have any allergies to iodine or shellfish?

D. Do you have any allergies to iodine or shellfish?

A student nurse asks what "essential hypertension" is. What response by the registered nurse is best? a."It means it is caused by another disease." b."It means it is 'essential' that it be treated." c."It refers to severe and life-threatening hypertension." D. It is hypertension with no specific cause

D. It is hypertension with no specific cause

A nurse assesses a patient who has aortic regurgitation. In which location in the illustration shown below would the nurse auscultate to best hear a cardiac murmur related to aortic regurgitation?

D. The aortic valve is auscultated in the second intercostal space just to the right of the of the sternum

A nurse performs an assessment of pain discrimination on an older adult. The patient correctly identifies with eyes closed, a sharp sensation on the right hand when touched with a pin. Which action would the nurse take next. A. Contact the provider with the assessment results B. Continue the assessment on the patients feet C. Ask the patient about current medications D. Touch the pin on the same area of the left hand.

D. Touch the pin on the same area of the left hand.

A nurse teaches a patient with diabetes mellitus and a body mass index of 42 who is at high risk for coronary artery disease. Which statement related to nutrition would the nurse include in this patient's teaching? a."If you exercise more frequently, you won't need to change your diet." b."The best way to lose weight is a high-protein, low-carbohydrate diet." c."A nutritionist will provide you with information about your new diet." D. You should balance weight loss with consuming necessary nutri

D. You should balance weight loss with consuming necessary nutrients

A nurse assesses a patient after administering a prescribed beta-blocker. Which assessment would the nurse expect to find? A.Pulse decreased from 100 to 80 beats/min B.Oxygen saturation increased from 88% to 96% c.Respiratory rate decreased from 25 to 14 breaths/min d.Blood pressure increased from 98/42 to 132/60 mm Hg

a.Pulse decreased from 100 to 80 beats/min