mdc3 exam 2
1. Mr. Jones has returned to his room following a radiation treatment. Which side effects will the nurse educate the client to monitor for? Select all that apply. a. Dry mouth b. Hoarseness c. Excessive hair growth d. Fatigue e. Skin problems
a, b, d, e
A nurse is caring for a 60- year-old client recently diagnosed with neck cancer. Which of the following assessment findings is most consistent with this diagnosis? A. Difficulty swallowing B. Weight gain C. Aphonia D. Nausea
a. difficulty swallowing
Why is proper oral care important for hospitalized patients. a. Prevention of inspissated secretions. b. Need to continue the same routine the patient had at home. c. Oral care is not necessary in the hospital. d. Reduces secretions.
a. prevention of inspissated secretions
The nurse is caring for the client with cystic fibrosis. Which of the following are common assessment findings for a client with this disorder? (select all that apply) A. Decreased forced vital capacity (FVC) B. Thick sticky mucus C. Gastroesophageal reflux D. Recurrent respiratory infections E. Steatorrhea
a?, b, c, d, e
1. When a client is diagnosed with a healthcare-acquired infection, the infection must be acquired within what time frame? a. <52 hours b. <48 hours c. <72 hours d. <90 hours
b. <48 hours
Which of the following is a common problem associated with cystic fibrosis in adults? A. Obesity B. Osteoporosis C. Hypertension D. Asthma
b. osteoporosis
1. Clients on pandemic influenza type isolation are usually on what type of isolation? a. Contact Precautions only b. Airborne Precautions only c. Droplet Precautions only d. Contact, Airborne, and Droplet Precautions
d. contact, airborne, and droplet precautions
1. When assessing the client with tb what manifestation will the nurse document? Select all that apply. a. Crackles b. Bronchial breath sounds c. Bronchovesicular sounds around the sternum d. Dullness with percussion e. Tactile fremitus absent
a, b d, e
1. The client has return from a rhinoplasty, what should the nurse observe for in the client? Select all that apply. a. Edema b. Bleeding c. Skin integrity d. Anxiety e. Coping
a, b, c
1. What triggers should the nurse educate the client with asthma to avoid? Select all that apply. a. Smoke b. Fumes c. Pets d. Insects e. Purified air
a, b, c
Anxiety is common among client who are diagnosed with chronic obstructive pulmonary disease. Which of the following intervention can assist in reducing a client anxiety? (Select all that apply) A. Written plan for dealing with anxiety B. Professional counseling C. Relaxation techniques D. Starting a vigorous exercise routine E. Plan out periods of rest throughout the day
a, b, c, e
1. Upper airway obstruction would include what structures? Select all that apply. a. Nose b. Mouth c. Ear d. Pharynx e. Larynx
a, b, d, e
The nurse is caring for a client who was recently diagnosed with asthma and is providing education on causes and triggers of asthma. Which of the following can potentially trigger the disease process? (select all that apply.) A. pollutants B. Obesity C. Cigarette smoking D. History of environmental allergies
a, c
1. The nurse is monitoring a patient with oxygen toxicity. What are the clinical manifestation of oxygen toxicity? Select all that apply. a. dyspnea b. productive cough c. Nausea/vomiting d. Crackles e. edema
a, c, e
1. When examining the chest of an client with asthma, what will the physical exam reveal? a. Antero/posterior to transverse diameter is a 4:4 b. Antero/Posterior to transverse diameter is a 2:1 or 1:1.5 c. The chest has a flat shape d. The costal angle is < 90-degree angle
a. AP to T diameter is 4:4
1. During the lecture, the nursing instructor showed an x-ray of lungs with pneumonia. The student asked about consolidation. How would the instructor explain consolidation? a. An abnormal solidification with lack of air spaces b. Swelling of soft tissue c. Invasion of pathogens into the body and causes disease or illness d. Respiratory infection caused by an organism
a. an abnormal solidification with lack of air spaces
An 84-year-older client is diagnosed with rhinosinusitis. The nurse is reviewing the client's medication history and is asking about any over the counter medication he is using to treat his symptoms. The nurse understand that which of the following medication may be inappropriate for a geriatric client? A. Analgesic B. Antipyretic C. Antihistamine D. Nasal spray
a. analgesic
1. Inflammation in clients with asthma can lead to damage of the airway and the loss of what other process? a. Cellular regulation b. Blood dyscrasias c. Domino effect of symptoms d. Sensation
a. cellular regulation
The nurse is providing discharge instructions for a client diagnosed with pneumonia. Which information is the nurse sure to include? A. Complete antibiotics as prescribed, rest, drink fluid and minimize contact with crowds. B. Take all antibiotic as order, resume diet and all activities as before hospitalization. C. No restrictions regarding activities, diet, and rest because the client is fully recovered when discharged. D. Continue antibiotic only no further signs of pneumonia are present avoid exposing immunosuppressed individuals.
a. complete antibiotics as prescribed, rest, drink fluid, and minimize contact with crowds
A 47-year-old male client presented to the emergency room with complaints of nasal and facial pain and bloody discharge. He states the symptom age and have gotten progressively worse. He states that it feels like his nose is blocked up all the time. Based on these symptoms. What of the following order will the nurse expect the provider to order? A. Computed tomography (CT) scan of the face B. Liver function test C. Complete blood count D. Tumor mapping
a. computed tomography (CT) scan of the face
1. Influenza vaccines are different between adults < 50 and those > 65 years old. What is the nursing student understanding of this difference? a. Designed to be more effective based on the client's age. b. Those greater than 65 can receive the mist. c. Those 50 and under will automatically receive the IM d. There is no difference.
a. designed to be more effective based on the client's age
1. What information should the nurse give a patient on Bedaquiline? a. Frequent ECG monitoring will be needed b. Yearly check up c. Take on empty stomach d. No need to monitor at this time
a. frequent ECG monitoring will be needed
Which statement from a client with seasonal influenza requires additional teaching? A. I'm contagious only when symptoms are present B. I should receive a new influenza vaccine every year. C. I can reduce my risk by implementing good hand hygiene D. I can be diagnosed on presentation of symptoms
a. i'm contagious only when symptoms are present
A nurse is caring for a client who has been diagnosed with chronic obstructive pulmonary disease. Which of the following will be a treatment priority for this client? A. Improve gas exchange B. Increase activity level C. Blood pressure control D. Prevention of infection
a. improve gas exchange
1. When dealing with facial trauma, the nurse needs to anticipate what type of intervention? a. Intubation b. Specimen collection c. Bleeding d. Swelling
a. intubation
A client with chronic bronchitis often shows signs of hypoxia. Which of the following is the priority to monitor for this client? A. Large amounts of thick mucus B. Barrel chest C. Nutritional status D. Clubbing of fingers
a. large amounts of thick mucus
1. With nose and sinus cancers, what is the reason for the cancer development? a. Loss of cellular regulation b. Malignant tumors c. Previous surgical procedures d. Sun exposure
a. loss of cellular regulation
A client presented to the emergency room with difficulty breathing. Upon examination, the client has pus behind the tonsils and swelling on the right side of her nick. She is diagnosed with peritonsillar abscess. Which of the following is a treatment priority for this client? A. Maintain a patent airway B. Oxygen therapy C. Analgesics D. Antibiotics
a. maintain a patent airway
The nurse is caring for a 60-year-old female client who presented to the emergency room status post motor vehicle accident. The client was an unrestrained passenger who hit the windshield, and she has multiple facial lacerations. Which of the following is a priority nursing priority nursing intervention for this client? A. Maintain a patent airway B. Pain management C. Prepare the client for testing D. Draw labs
a. maintain a patent airway!!!! always airway airway airway!!
A client arrives in the emergency department with epistaxis. What is the nurse's priority intervention? A. Position the client upright with the head forward. B. Apply an ice pack to the nose. C. Monitor the color and amount of blood. D. Place nasal packing
a. position the client upright with the head forward
A nurse is providing education to a client recently diagnosed with pulmonary hypertension. What is the goal of drug therapy for this client? A. Reduce the pulmonary vascular pressure to slow cor pulmonia B. Decrease pain and make the client comfortable C. Improve the client's systemic blood pressure with vasoconstriction D. Increase the pulmonary vascular pressure to slow cor pulmonia
a. reduce the pulmonary vascular pressure to slow cor pulmonia
Which of the following is a major diagnostic test for cystic fibrosis? A. Sweat chloride test B. Arterial blood gas C. Chest x-ray D. CT scan of the chest
a. sweat chloride test
A client was recently diagnosed with laryngeal cancer. When the nurse begins taking the clients history. The client asks.'' Did you know that I have throat cancer and may not survive? What is the appropriate nursing response? a. Tell me more about your concerns b. Have you told your family yet? c. Are you having difficulty swallowing d. Why are you so worried about not surviving
a. tell me more about your concerns
A nurse is caring for a client who has emphysema. Which of the following findings should the nurse expect to assess in this client? (select all that apply) A. Weight gain B. Barrel chest C. Tachypnea D. Wheezing E. Distended jugular veins
b, c
The nurse is caring for a postoperative client returning to the unit after surgical removal of cancer of the head. Which actions should the nurse take initially? Select all that apply. a. Ambulation of the client postoperatively b. Ensure adequate gas exchange c. Assess the client's hemodynamic status d. Monitor for airway maintenance e. Educate the client on anesthsia effects
b, c, d
A nurse is providing discharge instruction to a client recently diagnosed with tuberculosis (TB). Which statements by the client indicates correct understanding of the teaching (select all that apply) A. I will visit the clinic every week for injection of medication. B. I will avoid alcoholic beverage while on this treatment plan C. My family does not require testing. D. I Will follow up with my healthcare provider regularly E. I need to strictly adhere to my medication schedule
b, d, e
The nurse is performing medication teaching to a client with chronic airflow limitation. What is the correct sequence for administering inhaled medications? A. Bronchodilator should be taken 5 to 10 minutes after the steroid B. Bronchodilator should be taken at least 5 minutes before other inhaled drugs C. Bronchodilator should be taken immediately after the steroid D. Bronchodilator and steroid are two different classes of drugs, so the sequence is irrelevant.
b. bronchodilator should be taken at least 5 minutes before other inhaled drugs
A client has been taking isoniazid for tuberculosis for 3 weeks. What information gathered by the public health nurse needs to be reported to the healthcare provider immediately? A. Client has been taking isoniazid daily as prescribed B. Client is drinking 4-6 alcoholic beverages per day C. Client smokes 1,5 pack of cigarettes per day D. Client was recently started on varenicline to quit smoking
b. client is drinking 4-6 alcoholic beverages per day
The change of shift report has just been completed on the medical-surgical unit. Which client will the oncoming nurse plan to assess first? A. Client with COPD who is ready for discharge but is unable to afford prescribed medication B. Client with cystic fibrosis (CF) who has an elevated temperature and a newly increased a respiratory rate of 38 breaths/min. C. Hospice client with end state pulmonary fibrosis and an oxygen saturation level of 89% D. Client with lung cancer who needs an IV antibiotic administered before going to surgery.
b. client with CF who has an elevated temperature and a newly increased RR of 38 breaths/min
A nurse admitted a client from the emergency department with new onset of dyspnea and productive cough with suspected pneumonia, the client has an oxygen saturation of 96% on and 2 L of O2 via nasal cannula and crackles in bilateral bases. Oral temperature 98.9 degrees F, heart rate 103 beats per minute and respiration rate 18 breaths per minute. The provider enters the following orders, which the nurse perform first? A. Administer broad spectrum antibiotic through Iv B. Collect sputum sample for culture C. Administer oral antipyretic for temperature over 101 degrees fahrenheit D. Collect blood sample for complete blood count
b. collect sputum sample for culture
Clients with chronic illnesses are more likely to contract pneumonia in what type of situations? a. Dehydration b. Group living c. Malnutrition d. Severe periodontal disease
b. group living
The nurse is teaching a client post rhinoplasty care. Which statement by the client indicates an understanding of the instructions? A. I will be able to breathe only from my nose B. I will have nasal packing and mustache dressing C. I should take over the counter nonsteroidal anti-inflammatory drugs (NSAIDS) for pain D. I should retain supine if possible
b. i will have nasal packing and mustache dressing
What is the benefit of exercise in patients with COPD? a. It enhances cardiovascular fitness. b. It improves respiratory muscle strength. c. It reduces the number of acute attacks. d. It worsens respiratory function and is discouraged.
b. it improves respiratory muscle strength
When teaching a client with COPD to conserve energy, the nurse should teach the client to lift the objects, doing what technique? a. Lift while inhaling through an open mouth. b. Lift while exhaling through pursed lips. c. After exhaling but before inhaling d. While taking a deep breath and holding it.
b. lift while exhaling through pursed lips
A nurse student is teaching a client about their new diagnosis of pulmonary fibrosis. The student would include which of the following in their teaching? A. This is an incurable, autosomal recessive genetic disease that affects many organs B. Most clients have progressive disease with a life expectancy of less than 5 years C. A sputum culture may show the presence of mycobacterium D. Inflammation of the mucous membranes in the airways can trigger an attack
b. most clients have progressive disease with a life expectancy of less than 5 years
The nurse is caring for a client 1 day after receiving radiation therapy for neck cancer. What finding would the nurse expect after radiation therapy? a. Mucus secretion b. Voice hoarseness c. Expressive aphasia d. Excessive saliva
b. voice hoarseness
The nurse teaches a client with asthma to monitor for which problem while exercising? A. Increased peak expiration flow rate. B. Wheezing from bronchospasm C. Swelling in the feet and ankles D. Respiratory muscle fatigue
b. wheezing from bronchospasm
A client presents with sign and symptoms that are often associated with lung cancer. Which clinical manifestations does the nurse expect to observe in the client? SATA A. Peripheral edema B. Hypothermia C. Chest tightness D. Frank hemoptysis E. hoarseness
c, d, e
A nurse is caring for a client with end-stage-emphysema, which of the following would be a expected finding? A. PH 7.50 B. CO2 30 mm Hg C. CO2 50 mm Hg D. Decreased CO2
c. CO2 50 mmHg
In planning care for a client with chronic obstructive pulmonary disease (COPD) the nurse acknowledges what statement is true regarding nutritional needs? a. COPD has no effect on calorie and protein needs, meals tolerance, appetite, and weight b. COPE can cause an anabolic state, which creates conditions for building body strength and muscle mass. c. COPD can increase metabolism, and the client should consume supplement for additional calories and protein d. A client with COPD should decrease intake of calories and protein as dyspnea causes actively intolerance.
c. COPD can increase metabolism and the client should consume supplement for additional calories and protein
1. When COPD worsens, what condition results causing right side heart failure caused by pulmonary disease. a. Idiopathic asthma syndrome b. Pneumonia c. Cor Pulmonale d. Ephysema
c. cor pulmonale
A client who has chronic obstructive pulmonary disease ( COPD) and asthma is receiving oxygen at 2 liters per minute. A family member tells a nurse. "My mother did not look good, so i turned her oxygen up to 7 liters; which of these nursing actions is best? a. Notify the health care provider immediately about the family member b. Thank you family member and continue to observe the client on this oxygen level c. Decrease the oxygen to 2 liter per minute and asses the client d. Elevate the head of the bed to make the client more comfortable
c. decrease the oxygen to 2 liter per minute and assess the client
.During an admission assessment the client tells the nurse that she was recently prescribed a new medication called montelukast, but she forgot to pick it up at the pharmacy. What is the best response by the nurse to assess the client's understanding of the montelukast? A. Don't you know that montelukast would have prevented you from coming to the hospital B. Why didn't you remember to get the prescription filled? C. Have you been taking the medication on a scheduled basis? D. Don't worry about it, you probably have been busy
c. have you been taking the medication on a scheduled basis?
A nurse is teaching a 78-year-old client about the importance of the pneumonia vaccination. Which statement by the client indicates an understanding of the teaching? A. Only the flu vaccination is recommended at my age. B. I only need pneumonia vaccination upon admission to a nursing home. C. I need two different vaccination to prevent pneumonia D. I've already had pneumonia, so I only need one vaccination
c. i need two different vaccinations to prevent pneumonia
The nurse is providing education to a client who is prescribed a long- acting beta agonist. Which statement by the client indicates the client understands the teaching? A. I will carry this medication with me at all times in case I need it. B. I will take this medication when I start to experience an asthma attack. C. I will take this medication every morning to prevent asthma attacks. D. I will only take this medication when I am admitted to the hospital
c. i will take this medication every morning to prevent asthma attacks
A nurse is caring for several older clients in the hospital that the nurse identifies as being at high risk for healthcare-associated pneumonia. To reduce this risk, what activity should the nurse delegate to the unlicensed assistive personal (UAP)? A. Encourage between-meal snacks B. Monitor temperature every 4 hours. C. Provide oral care every 4 hours D. Report any new onset of cough
c. provide oral care every 4 hours
1. What organism occurs most commonly in community-acquired pneumonia in adults? a. Haemophilus pneumoniae b. Klebsiella pneumoniae c. Streptococcus pneumoniae d. Klebsiella oxytoca
c. streptococcus pneumoniae
A client has a positive Mantoux skin test result. What explanation does the nurse give to the client? A. There is active disease, but you are not infectious to others. B. There is active disease, and you need immediate treatment. C. You have been infected, but this does not mean active disease is present D. A repeat skin test is necessary because the test could give a false- positive result.
c. you have been infected, but this does not mean active disease is present
A nurse is assessing a client admitted with status asthmaticus. Initially the nurse heard wheezes in the lungs, but now the lungs sounds are inaudible. What is the priority intervention? A. Education to prevent future exacerbations B. Administration of a long- acting bronchodilator C. Measures to reduce anxiety D. Activation of the rapid response term to secure an airway
d. activation of the rapid response team to secure an airway
1. Which risk factor for puts patients at higher risk of tuberculosis (tb)? a. Drug/alcohol b. Low socioeconomic groups c. Reduced immunity d. Constant, frequent contact with untreated
d. constant, frequent contact with untreated
A nurse is providing education to a client recently diagnosed with sleep apnea. Which of the following statements by the client indicates an understanding of the teaching? A. I should contact the provider for a prescription for sleep medication B. I should begin treatment only if my snoring impacts my partner C. Sleep apnea only has an impact on my mental concentration D. I should contact the provider if my oxygen level is below 90%
d. i should contact the provider if my oxygen level is below 90%
1. What is the pathophysiological mechanism that occur in the lung parenchyma which allows pneumonia to develop? a. Atelectasis b. Bronchiectasis c. Effusion d. Inflammation
d. inflammation
A client is being discharged on long-term therapy for tuberculosis (TB). What referral by the nurse is most appropriate? A. Department of health for community infection control isolation B. Occupational therapy for employment placement and housing C. Physical therapy for muscle strengthening to prevent home falls D. Outpatient public health visiting nurses for direct observation
d. outpatient public health visiting nurses for direct observation
The nurse is assessing a client who reports being struck in the face and head several times. During the assessment, the nurse observes pink-tinged drainage from the client's nares. What nursing action provides relevant assessment data? A. Have the client gently blow their nose and observe for bloody mucus B. Test the drainage with reagent to check the PH C. Ask the client to describe the appearance of the face before the injury D. Place a drop of the drainage on filter paper and look for a yellow ring
d. place a drop of the drainage on filter paper and look for a yellow ring
Which intervention promotes comfort in dyspnea management for a client with lung cancer? A. Administer morphine only when the client requests it B. Place the client in a supine position with a pillow under the knees and legs C. Encourage exercise and independent ambulation around the room D. Provide supplemental oxygen via nasal cannula or mask.
d. provide supplemental oxygen via nasal cannula or mask
The nurse knows which of the following is the purpose of a montelukast inhaler for a client with asthma? A. constricts the smooth muscles of the airway and bronchioles B. Act as a bronchodilator in severe asthmatics episodes C. Reduces obstruction of the airways by decreasing agent D. Reduces histamine effect of the triggering agent.
d. reduces histamine effect of the triggering agent
The nurse knows that which of the following test is needed to confirm a tuberculosis diagnosis? A. Complete blood count B. Chest x-ray C. Mantoux skin test D. Sputum culture
d. sputum culture
A client with a recent diagnosis of sinus cancer states that he wants another course of antibiotics because he believes he has severe sinus infection. What is the nurse best response? A. I will tell the physician to order an antibiotic B. Why are you doubting your doctor's diagnostic C. Let me bring you a brochure about sinus cancer D. Tell me more about your understanding of sinus cancer symptoms
d. tell me more about your understanding of sinus cancer symptoms