EAQ CH: 9

Which question would the nurse ask to determine possible anorexia nervosa in a female adolescent patient who presents with marked weight loss and reports exercising 2 hours every day? -"Do you have flat feet?" -"Do your joints hyperextend?" -"Have you recently had any edema?" -"When was your last menstrual period?"

"When was your last menstrual period?"

The nurse is preparing to assess a patient with a body mass index (BMI) of 36 kg/m2 who has central trunk and cervical obesity related to Cushing syndrome. Which is the appropriate response by the nurse when the patient reports eating a healthy, low-fat diet and asks the nurse what is causing the weight gain? -"You may not be recording all the calories you take in every day." -"Does obesity run in your family? Genetics may be the cause of the weight gain." -"Your body is producing too much adrenocorticotropin (ACTH), causing weight gain." -"Your pituitary gland is manufacturing too much growth hormone leading to weight gain."

"Your body is producing too much adrenocorticotropin (ACTH), causing weight gain."

A patient with a body mass index (BMI) of 27 kg/m2 asks the nurse about the measure's reliability. Which individual patient factors may affect BMI reliability? Select all that apply. -Eating disorder -Morbid obesity -Diabetes mellitus -Loss of muscle mass

-Increased muscular tone -Loss of muscle mass

Which finding indicates a healthy body mass index (BMI)? -16.7 kg/m2 -18.1 kg/m2 -24.6 kg/m2 -28.5 kg/m2

24.6 kg/m2

During the general survey, for which clinical manifestation would the nurse assess a patient with a diagnosis of Cushing syndrome? Select all that apply. -Acne -Moon-shaped face -Thin arms and legs -Even fat distribution -Increased muscle strength

Acne Moon-shaped face Thin arms and legs

Which aspect of a patient's behavior will the nurse assess during a general survey? Select all that apply. -Affect -Symmetry -Speech pattern -Facial expression -Personal hygiene -Level of consciousness

Affect Speech pattern Facial expression Personal hygiene

The nurse is preparing to obtain the height of a 70-year-old male patient who is established at the practice, and the patient states, "I'm 5'10" tall and have been all my life, so you don't need to measure." Which response is appropriate? -"It is possible for older adults to become taller later in life." -"You seem concerned about our need to obtain your height." -"We need to have a baseline height for our medical records." -"As people age the vertebral disks thin, which decreases height."

As people age the vertebral disks thin, which decreases height."

Which information would the nurse include when preparing a presentation for school nurses on assessing teenagers for anorexia nervosa? Select all that apply. -Aversion to food -Midplace hypoplasia -Abdominal protrusion -Distorted body image -Fanatic concern about weight

Aversion to food Distorted body image Fanatic concern about weight

The school nurse is developing a presentation to help staff identify signs of child abuse. Which information would the nurse include? Select all that apply. -Avoids eye contact with others -Parent refuses to spoil the child -Parent repulsed by child's sounds -Does not show separation anxiety -Refrains from playing with other kids

Avoids eye contact with others Parent repulsed by child's sounds Does not show separation anxiety

The nurse is measuring the waist circumference of a female patient with a body mass index (BMI) of 32 kg/m2 and documents the patient's waist measurement is 37 inches. Based on this finding, which would the nurse recommend screening the patient for? Select all that apply. -Cardiovascular disease -Orthostatic hypotension -Type 1 diabetes mellitus -Peripheral vascular disease -Elevated cholesterol and lipid

Cardiovascular disease Elevated cholesterol and lipid

Which finding made during a general survey indicates need for follow-up with the health care provider? Select all that apply. -Dysphagia -Maintains balance -Arm span equals height -Propulsion with ambulation -Limited knee range of motion

Dysphagia Propulsion with ambulation Limited knee range of motion

The nurse is reviewing the laboratory reports of a patient with Cushing syndrome. Which finding would the nurse observe in this patient's reports? -Hypoglycemia -Hypercalcemia -Hypopituitarism -Hypercortisolism

Hypercortisolism

While reviewing a patient's laboratory results, the nurse notices a deficiency of growth hormone and knows that the deficiency is consistent with which condition? -Acromegaly -Cushing syndrome -Hypopituitary dwarfism -Achondroplastic dwarfism

Hypopituitary dwarfism

Which would the nurse expect to find when assessing a patient with hypopituitary dwarfism? Select all that apply. -Cardiomegaly -Hypothyroidism -Delayed puberty -Diabetes mellitus -Adrenal insufficiency

Hypothyroidism Delayed puberty Adrenal insufficiency

The nurse is preparing to measure a patient's waist circumference. Which landmark would the nurse use when placing the measuring tape? -Sacrum -Iliac crest -Ischial bone -Pubic symphysis

Iliac crest

Based on a body mass index (BMI) of 32 and a waist circumference at 38 inches, which information would the nurse provide a female patient during patient teaching? Select all that apply. -Increase activity -Risk for diabetes -Heart healthy diet -Risk for infection -Monitor blood pressure

Increase activity Risk for diabetes Heart healthy diet Monitor blood pressure

Which findings would the nurse expect to see in a 66-year-old female patient who has a waist circumference of 39 inches and a body mass index (BMI) of 34? Select all that apply. -Increased blood pressure -Decreased leukocyte count -Increased blood glucose levels -Decreased creatinine clearance -Increased blood cholesterol levels

Increased blood pressure Increased blood glucose levels Increased blood cholesterol levels

Which action performed by the nurse requires correction when obtaining a patient's height and weight? -Has patient remove the shoes -Instructs patient to stand facing the wall -Places traction under the jaw -Aligns the headpiece with scalp

Instructs patient to stand facing the wall

Which would the nurse assess for in the general survey of a patient with osteoporosis? -Kyphosis -Dysphagia -Tripod stance -Fluid overload

Kyphosis

Which would the nurse know is a normal finding while assessing the mobility of a young adult patient? Select all that apply. -Lack of involuntary movements -Able to balance without assistance -Foot stance equal to shoulder width -Notable propulsion during ambulation -Symmetric arm swing during ambulation

Lack of involuntary movements Able to balance without assistance Foot stance equal to shoulder width Symmetric arm swing during ambulation

A patient with a body mass index (BMI) of 27 kg/m2 asks the nurse about the measure's reliability. Which individual patient factors may affect BMI reliability? Select all that apply. -Eating disorder -Morbid obesity -Diabetes mellitus -Loss of muscle mass -Increased muscular tone

Loss of muscle mass Increased muscular tone

Which clinical manifestation would the nurse expect to find when performing a general survey on a patient with achondroplastic dwarfism? Select all that apply. -Enlarged hands -Lumbar lordosis -Thoracic kyphosis -Midface hypoplasia -Extreme weight loss

Lumbar lordosis Thoracic kyphosis Midface hypoplasia

The nurse obtains the weight of a patient and notices a 15-pound weight loss from the last visit. Which disorder can cause unintentional weight loss? Select all that apply. -Malignancy -Depression -Heart failure -Liver disease -Type 1 diabetes mellitus

Malignancy Depression Type 1 diabetes mellitus

Which landmarks would the nurse use to ensure accurate chest circumference of a 12-month-old infant? -Axillae -Umbilicus -Nipple line -Occipital bone

Nipple line

Which clinical manifestations noted in an assessment of a patient indicate possible nutritional disorders? Select all that apply. -Obesity -Atrophy -Cachexia -Waist circumference 28 inches -Body mass index (BMI) 17.0 kg/m2

Obesity Cachexia Body mass index (BMI) 17.0 kg/m2

Which explanation would the nurse provide to a patient with a new diagnosis of acromegaly who asks the nurse what caused the disorder? -Genetic disorder causing shortened height -Deficiency of growth hormone in childhood -Overproduction of adrenocorticotropin (ACTH) -Overproduction of growth hormone in adulthood

Overproduction of growth hormone in adulthood

Which would the nurse document as an abnormal skin finding during the general survey? Select all that apply. -Pallor -Cyanosis -Jaundice -Cachexia -Dysarthria

Pallor Cyanosis Jaundice

After performing physical examinations on a group of older adult patients at a community center, the nurse finds that several of the patients are shorter than they were 10 years ago. Which could help explain this loss of height? Select all that apply. -Shortening of the long bones -Postural changes of kyphosis -Thickening of the vertebral disks -Postural changes of kyphosis

Postural changes of kyphosis Thickening of the vertebral disks Postural changes of kyphosis

After reviewing the medical record of an older patient with kyphosis, which would the nurse include in the assessment related to this finding? -Gait -Posture -Mobility -Range of motion

Posture

When assessing the mobility of a patient, which information would the nurse document in the medical record if the patient has difficulty stopping during ambulation? -Kyphosis -Dysarthria -Propulsion -Hypertrophy

Propulsion

Which are the different criteria that the nurse would observe while doing a body structure assessment of a patient during a general survey? Select all that apply. -Facial features -Stature -Symmetry -Skin color -Contour

Stature Symmetry Contour

Which would the nurse expect to find when performing a general survey on a patient with Marfan syndrome? Select all that apply. -Tall and thin -Pectus excavatum -Moon-shaped face -High plantar arches -Hyperextensible joints

Tall and thin Pectus excavatum Hyperextensible joints

Which diagnosis is consistent for a patient's who has a body mass index (BMI) of 37? -The patient is overweight -The patient has class 1 obesity. -The patient has class 2 obesity. -The patient has class 3 obesity.

The patient has class 2 obesity.

Which patient would not have a reliable assessment of the body mass index (BMI)? -The patient with dyslipidemia -The patient who is highly muscular -The patient who has abdominal ascites -The patient who has a large waist circumference

The patient who is highly muscular

Which would the nurse instruct the patient care technician (PCT) to do when obtaining daily weights on a patient? Select all that apply. -Use the same scale -Wear the same shoes -Don the same clothing -Obtain the same time of day -Record findings in same place

Use the same scale Don the same clothing Obtain the same time of day

Which would the nurse assess when observing an older patient wearing clothes that are too large and a belt with new holes in it? Select all that apply. -Height -Weight -Hygiene -Appetite -Finances

Weight Appetite

Which measurement would the nurse include in the plan of care for a patient admitted with an exacerbation of heart failure? Select all that apply. -Height -Weight -Arm span -Body mass index -Waist circumference

Weight Waist circumference

Which would the nurse assess for during the general survey in a patient admitted with a possible cardiopulmonary event? Select all that apply. -Wheezing -Diaphoresis -Rigidity of the neck -Shortness of breath -Unilateral facial drooping

Wheezing Diaphoresis Shortness of breath