Med-Surg II Midterm Study Guide Pellico: Focus on Adult Health Chp 29-44
A 52-year-old male patient has acknowledged to his primary care provider that he has been experiencing difficulty maintaining an erection in recent months. Which of the following assessment questions most directly addresses a risk factor for this problem? a) "How much alcohol do you typically drink in one day?" b) "Do you have any idea if this is a problem that your father or brothers have had?" c) "Have you been taking a lot of Tylenol or aspirin for pain?" d) "How much exercise are you getting these days?"
a) "How much alcohol do you typically drink in one day?"
A nurse who provides care for numerous older adults is aware of the high incidence and prevalence of benign prostatic hyperplasia (BPH) among older men. Which of the following statements by patients is suggestive of BPH? a) "I find that I have to get up three or four times each night to go to the bathroom." b) "The last few days, I have a dull ache in my testicles sometimes." c) "After I have an orgasm, I have throbbing pain for the next few minutes." d) "I found a creamy white discharge at the end of my penis yesterday."
a) "I find that I have to get up three or four times each night to go to the bathroom."
A patient with genital herpes is having an acute exacerbation. What medication would the nurse expect to be ordered to suppress the symptoms and shorten the course of the infection? a) Acyclovir (Zovirax) b) Clotrimazole (Gyne-Lotrimin) c) Podophyllin (Podofin) d) Metronidazole (Flagyl)
a) Acyclovir (Zovirax)
A patient's thyroid gland has secreted T3 and T4 into the bloodstream. This occurs in response to the stimulation of a hormone originating in the: a) Anterior pituitary gland b) Parathyroid gland c) Adrenal cortex d) Pancreas
a) Anterior pituitary gland
After recently being admitted to the emergency department with signs and symptoms of hyperglycemia, a 33-year-old man was subsequently diagnosed with diabetes. The patient's blood sugars have been stabilized, and the man has begun diabetes education with a nurse educator. When working with this patient, the nurse educator should first: a) Ascertain the patient's readiness and willingness to learn b) Ask the patient what questions he currently has about diabetes c) Teach the patient about the essential concepts of nutrition d) Explain the various insulin delivery devices to the patient
a) Ascertain the patient's readiness and willingness to learn
A patient with trichomoniasis comes to the walk-in clinic. In developing a care plan for this patient, the nurse would know to include what as an important aspect of treating this patient? a) Both partners are treated with metronidazole (Flagyl). b) Constipation and menstrual difficulties may occur. c) Care will involve hormonal therapy to control the pain. d) The patient should perform Kegel exercises 30 to 80 times daily.
a) Both partners are treated with metronidazole (Flagyl).
The nurse is caring for a patient diagnosed with Hashimoto's thyroiditis. When assessing this patient what symptom would the nurse expect in a patient with hypothyroidism? a) Bradycardia b) Flushed skin c) Bulging eyes d) Palpitations
a) Bradycardia
The nurse is assessing a patient diagnosed with Graves' disease. What physical characteristics of Graves' would the nurse expect to find? a) Bulging eyes b) Hair loss c) Fatigue d) Moon face
a) Bulging eyes
While taking a health history on a 20-year-old woman, the nurse ascertains that this patient is taking miconazole (Monistat). The nurse knows that this medication is used to treat what medical condition? a) Candidiasis b) Bacterial vaginosis c) Toxic shock syndrome (TSS) d) Human papillomavirus (HPV)
a) Candidiasis
A 39-year-old woman with a diagnosis of endometriosis has met with her care provider to discuss treatment options. The nurse who is planning this woman's care should prioritize which of the following nursing diagnoses? a) Chronic pain related to endometriosis b) Chronic low self-esteem related to complications of endometriosis c) Impaired adjustment related to complications of endometriosis d) Stress incontinence related to endometriosis
a) Chronic pain related to endometriosis
After initially presenting to a campus medical clinic after the emergence of a wart on her vulva, a 21-year-old woman is distraught to receive a diagnosis of human papillomavirus (HPV). The woman states, "I know I'm supposed to, but I really have no idea how I'm going to break this to my boyfriend. What will happen if I don't tell him?" What nursing diagnosis should the clinic nurse identify in this woman's care? a) Decisional conflict b) Situational low self-esteem c) Complicated grieving d) Hopelessness
a) Decisional conflict
What should the nurse suspect when hourly assessment of urine output on a postcraniotomy patient exhibits a urine output from a catheter of 1,500 mL for 2 consecutive hours? a) Diabetes insipidus b) Syndrome of inappropriate antidiuretic hormone (SIADH) c) Adrenal crisis d) Cushing's syndrome
a) Diabetes insipidus
The health care provider has ordered a fluid deprivation test on a patient. What is this patient most likely being tested for? a) Diabetes insipidus (DI) b) Hashimoto's thyroiditis c) Hyperparathyroidism d) Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
a) Diabetes insipidus (DI)
The diabetic nurse educator is teaching a class for newly diagnosed diabetics and their families. In this class, the educator is teaching about "sick day rules." What guideline applies to periods of illness in a diabetic patient? a) Do not eliminate insulin when nauseated and vomiting. b) If nauseated, do not eat solid foods. c) Seek care for glucose levels >150 mg/dL. d) Eat three meals a day.
a) Do not eliminate insulin when nauseated and vomiting.
The nurse is preparing to administer a patient's scheduled dose of Novolin 70/30. When administering this dose of insulin, the nurse should: a) Ensure that the insulin is not given near a previous injection site b) Massage the injection site gently for 10 to 15 seconds after administration c) Use a 3 mL syringe with a 24 gauge, - to -inch needle d) Aspirate before injecting the insulin into the patient's subcutaneous tissue
a) Ensure that the insulin is not given near a previous injection site
A patient with a diagnosis of syndrome of inappropriate antidiuretic hormone secretion (SIADH) is being cared for on a medical unit, and the nurse is writing an individualized care plan. The priority nursing diagnosis for a patient with this condition is what? a) Excessive fluid volume b) Hypothermia c) Hyperthermia d) Deficient fluid volume
a) Excessive fluid volume
Choice Multiple question - Select all answer choices that apply. The nursing instructor is discussing reproductive health with the junior nursing class. Today, the instructor is talking about a sexual assessment. What are the components of a sexual assessment? Select all that apply. a) Health history b) Names of sexual partners c) How many times a month the patient has sexual intercourse d) Physical examination findings e) Laboratory results
a) Health history d) Physical examination findings e) Laboratory results
A 40-year-old woman has presented to her primary caregiver because she has been experiencing cyclical breast pain over the past several months. The caregiver's clinical examination reveals no palpable or observable abnormalities. This patient's breast pain is most likely attributable to: a) Hormonal fluctuations b) Soft-tissue injury c) Neuropathy d) An infectious process
a) Hormonal fluctuations
The nurse is presenting a class on female reproductive health to a group of college students. While discussing health promotion and disease prevention, the nurse teaches what about a Pap smear? a) It is used to detect cells that may be precursors to cervical cancer. b) The smear should be done every 6 to 12 months. c) False-negative Pap smear results occur mostly from not douching before the examination. d) The test may be performed at any time during the patient's menstrual cycle.
a) It is used to detect cells that may be precursors to cervical cancer.
A 60-year-old woman is postoperative day 2 following a transverse rectus abdominis myocutaneous (TRAM) flap. While assessing the patient near the beginning of the shift, the nurse determines that the skin adjacent to the surgical dressing is pale and cool to the touch. How should the nurse best respond to this assessment finding? a) Promptly report this assessment finding to the patient's surgeon. b) Apply warm compresses to the cool regions of the patient's skin. c) Remove the surgical dressing to more accurately assess the surgical site. d) Encourage the patient to perform active range of motion exercises to promote circulation.
a) Promptly report this assessment finding to the patient's surgeon.
The nurse is doing preoperative teaching with a patient diagnosed with endometriosis. A hysterectomy has been scheduled. What preoperative teaching should the nurse be sure to include for this patient? a) The bladder must be emptied prior to surgery, and a catheter may be placed during surgery. b) Menstrual periods will continue to occur for several months, some of them heavy. c) After a hysterectomy, hormone levels will remain balanced. d) Normal activity will be permitted following surgery.
a) The bladder must be emptied prior to surgery, and a catheter may be placed during surgery.
The nurse who is providing care for an older adult patient who has dementia has read in the patient's chart that she has developed skin breakdown in her perineum as a result of urinary and fecal incontinence. The nurse knows to specifically assess: a) The woman's labia majora and labia minora b) The skin in and around the woman's gluteal crease c) The area between the woman's vagina and rectum d) The woman's urethral meatus and the adjacent mucus membranes
a) The woman's labia majora and labia minora
The nurse is caring for a male patient with gonorrhea. The patient asks how he can reduce his risk of contracting another sexually transmitted infection (STI). The nurse should instruct the patient to: a) Wear a condom every time he has intercourse. b) Ask all potential sexual partners if they have a sexually transmitted disease. c) Expect to limit the number of sexual partners to fewer than five over his lifetime. d) Consider intercourse to be risk-free if his partner has no visible discharge, lesions, or rashes.
a) Wear a condom every time he has intercourse.
A community health nurse is participating in a health forum that has been organized by a local community group. When addressing the topic of breast cancer, what should the nurse teach participants about the risk factors for the disease? a) "Quitting smoking is one of the most important things you can do to reduce your risk of breast cancer." b) "If your mother, grandmother, or sister had breast cancer, you likely have a higher-than-average risk." c) "It's important to get regular, physical exercise because inactivity has been linked to breast cancer." d) "It's in your best interests to eat a healthy, well-balanced diet in order to lower your risk of breast cancer."
b) "If your mother, grandmother, or sister had breast cancer, you likely have a higher-than-average risk."
A community health nurse is staffing a booth at a health fair that has been sponsored by a local community center. In the course of the day, the nurse has engaged with many members of the public, several of whom have disclosed their current health complaints to the nurse. Which of the following statements should prompt the nurse to encourage the individual to be screened for diabetes? a) "I've been getting sudden, bad headaches over the past few weeks, usually in the middle of the day." b) "Lately, I just can't seem to quench my thirst no matter how much I drink." c) "I never used to be one to get indigestion, but now I seem to get an upset stomach very easily." d) "Sometimes, when I'm working at my desk, it feels like my heart just skips a beat and then goes back to normal."
b) "Lately, I just can't seem to quench my thirst no matter how much I drink."
A 44-year-old man admits to his nurse that he has been having difficulty attaining and maintaining an erection for the past few years. The patient states that he is deeply embarrassed about this problem and has not previously discussed it with anyone. How can the nurse most accurately respond to this patient's statement? a) "Rest assured that this is a physical problem that can be resolved with medication." b) "You're not alone in this. About half of all men over 40 experience this problem at some point." c) "The important thing is to relax and not think about the problem, because it will then usually resolve itself." d) "This likely means that there is some relational tension between you and your partner."
b) "You're not alone in this. About half of all men over 40 experience this problem at some point."
A hospital patient has been ordered a sliding scale of Humulin R for the duration of her admission. The patient's medication administration record specifies the first administration time of the day at 08:00 and the nurse knows that breakfast trays typically arrive on the unit between 07:45 and 07:50. When should the nurse administer the patient's insulin? a) 08:15 b) 07:30 c) 08:00 d) 07:45
b) 07:30
The nurse has cared for four patients with type 1 diabetes over the past few shifts. Based upon components of managing diabetes, which patient will likely have the greatest success in maintaining tight glucose control of his or her type 1 diabetes? a) A patient who skips breakfast when her morning glucose reading is greater than 220 mg/dL. b) A patient who adheres to a meal plan and meal schedule. c) A patient who never deviates from his prescribed dose of insulin. d) A patient who eliminates carbohydrates from her daily intake.
b) A patient who adheres to a meal plan and meal schedule.
Over time, the nurse at a women's health clinic has provided care for numerous patients who have experienced pelvic organ prolapse. The nurse should recognize a higher-than-average risk of pelvic organ prolapse among which of the following individuals? a) A woman who has had recurrent urinary tract infections (UTIs). b) A woman who has had four vaginal births. c) A woman who has a history of constipation. d) A woman who is a long distance runner.
b) A woman who has had four vaginal births.
A nurse who works on a medical unit has taken a patient's blood glucose level and obtained a reading of 53 mg/dL. The patient is appropriately responsive to questioning, but is drowsy and appears pale. What intervention should the nurse prioritize in response to this assessment finding? a) Page the patient's primary care provider b) Administer 15 g of a fast-acting carbohydrate c) Recheck the patient's glucose level in 15 minutes d) Provide the patient with 75 to 100 mL of an IV 50% dextrose solution
b) Administer 15 g of a fast-acting carbohydrate
The nurse is caring for a patient with hyperparathyroidism. What level of activity would the nurse expect the health care provider to order? a) Out of bed (OOB) to the chair twice a day b) Ambulation and activity, as tolerated c) Complete bed rest d) Bed rest with bathroom privileges
b) Ambulation and activity, as tolerated
The nurse is caring for a patient who has just had a radical mastectomy and axillary node dissection. When doing patient education, what should be included regarding hand and arm care of the affected side? a) Keep cuticles clipped. b) Avoid lifting objects greater than 10 pounds. c) Use a sunscreen with an SPF of 4 to 8. d) Avoid exercise of the arm.
b) Avoid lifting objects greater than 10 pounds.
A 50-year-old woman is scheduled for discharge this morning following a left-sided simple mastectomy that was performed yesterday to treat noninvasive breast cancer. When providing this woman's care prior to discharge, what action should the nurse prioritize? a) Remove the Steri-strips from the woman's incision to assess the incision. b) Avoid measuring the woman's blood pressure on her left arm. c) Encourage the woman to void in a commode rather than ambulating to the bathroom. d) Assess the woman's active and passive range of motion to her left arm.
b) Avoid measuring the woman's blood pressure on her left arm.
A male patient has been diagnosed with syphilis following serological testing and is now being treated with penicillin G. The nurse recognizes the importance of health education around the treatment of this disease and should prioritize which of the following educational interventions? a) Teaching the patient strategies to augment his self-esteem b) Educating the patient about the signs and symptoms of syphilis in a female c) Educating the patient on methods for the prevention of transmission d) Teaching the patient about the differences between syphilis and viral sexually transmitted infections (STIs)
b) Educating the patient about the signs and symptoms of syphilis in a female
A 28-year-old man has received a diagnosis of testicular cancer after a referral from his family health care provider and an extensive diagnostic workup. The patient's main concerns surround his sexuality and his future fertility. When the nurse addresses these topics during health education prior to radiation therapy, the nurse should inform the patient that: a) His sperm will be lower in number and unviable. b) His libido will not be significantly affected by treatment. c) He will be able to father children but will have a diminished sex drive. d) Successful treatment will usually result in infertility.
b) His libido will not be significantly affected by treatment.
A 68-year-old man comes to the clinic complaining that he is having difficulty obtaining an erection. When reviewing the patient's history, what might the nurse note that contributes to erectile dysfunction? a) Recent antibiotic use b) History of heavy alcohol use c) Lack of exercise d) Increasing age
b) History of heavy alcohol use
A patient has returned to the floor after having a thyroidectomy for thyroid cancer. The nurse knows that sometimes during thyroid surgery the parathyroid glands can be injured or removed. What laboratory finding may be an early indication of parathyroid gland injury or removal? a) Hyponatremia b) Hypocalcemia c) Hypokalemia d) Hypophosphatemia
b) Hypocalcemia
The home care nurse is conducting patient teaching with a patient beginning corticosteroid therapy. To achieve consistency with the body's natural secretion of cortisol, when would the home care nurse instruct the patient to take her corticosteroid medication? a) Prior to going to sleep at night b) In the early morning between 7 AM and 8 AM c) At noon every day d) In the evening between 4 PM and 6 PM
b) In the early morning between 7 AM and 8 AM
A nurse is presenting an educational event for a local community group. The nurse is teaching about premenstrual syndrome. What treatment guideline would the nurse teach this group? a) Premenstrual symptoms are generally psychosomatic. b) Increase exercise. c) Decrease intake of fruits and vegetables. d) Decrease water intake.
b) Increase exercise.
A 16-year-old patient comes to the free clinic and is diagnosed with primary syphilis. The patient states that he contracted this disease by kissing someone who has syphilis. What is the most appropriate nursing diagnosis for this patient? a) Fear related to complications b) Knowledge deficit related to modes of transmission c) Alteration in comfort related to impaired skin integrity d) Noncompliance with treatment regimen related to age
b) Knowledge deficit related to modes of transmission
A patient with a diagnosis of type 2 diabetes has been vigilant about glycemic control since being diagnosed and has committed to increasing her knowledge about the disease. To reduce her risk of developing diabetic nephropathy in the future, this patient should combine glycemic control with what other preventative measure? a) Maintenance of a low-sodium, low-protein diet b) Maintenance of healthy blood pressure and prompt treatment of hypertension c) Subcutaneous injection of 5,000 units of heparin twice daily d) Vigorous physical activity at least three times weekly
b) Maintenance of healthy blood pressure and prompt treatment of hypertension
A nursing student is doing clinical hours in the emergency department (ED) and is assisting in the care of a patient who presented to the ED with priapism of the penis. The student nurse is aware that this condition is classified as a urologic emergency because of the potential for what? a) Urinary tract infection (UTI) b) Permanent damage to the penis c) Cancer of the penis d) Bladder rupture
b) Permanent damage to the penis
A 45-year-old woman has sought care from her primary care provider because she has been experiencing signs and symptoms of perimenopause. The nurse at the clinic has undertaken to perform some health education around this life transition for the patient. When doing so, what should the nurse teach the patient? a) The symptoms associated with perimenopause can be avoided by making lifestyle changes. b) Pregnancy is possible until 1 year after the cessation of menstruation. c) Production of estrogen and progesterone ceases during menopause. d) Menopause is considered to be a pathophysiological phenomenon.
b) Pregnancy is possible until 1 year after the cessation of menstruation.
A 30-year-old type 1 diabetic has been admitted to the critical care unit with a diagnosis of diabetic ketoacidosis following a drinking binge over the course of a weekend. The nurse should anticipate that this patient will require what immediate intervention? a) IV administration of calcium gluconate b) Rapid administration of intravenous normal saline c) Subcutaneous administration of 30 units of insulin glargine (Lantus) d) Oral administration of 2 g of metformin (Glucophage)
b) Rapid administration of intravenous normal saline
A diabetes nurse is teaching an older adult patient who has been recently diagnosed with type 2 diabetes about the importance of foot care. To reduce this patient's risk of developing a diabetic foot ulcer, what practice should the nurse teach? a) The correct placement of pillows to prevent the feet from being placed in a dependent position b) Technique for daily inspection of all of the surfaces of both feet c) The correct technique for soaking the feet in Epsom salts each evening d) Exercises that can be used to promote circulation in the patient's feet
b) Technique for daily inspection of all of the surfaces of both feet
A public health nurse is teaching a health class for the male students at the local high school and has been asked about testicular cancer. What points would be appropriate to emphasize? a) Testicular cancer is the number one cause of cancer deaths in males. b) Testicular cancer is a highly curable type of cancer. c) Testicular cancer is very difficult to diagnose. d) Testicular cancer is more common in older men.
b) Testicular cancer is a highly curable type of cancer.
A patient has herpes simplex 2 viral infection (HSV-2). The nurse recognizes that which of the following should be included in teaching the patient: a) The virus causes "cold sores" of the lips. b) Treatment is aimed at relieving symptoms. c) The virus may be cured with antibiotics. d) The virus when active may not be contracted during intercourse.
b) Treatment is aimed at relieving symptoms.
A female patient tells the nurse that she thinks she has a vaginal infection because she has noted inflammation of her vulva and a yellow-green discharge. The nurse recognizes that the clinical manifestations described are typical of what vaginal infections? a) Gardnerella b) Trichomonas vaginalis c) Candidiasis d) Chlamydial infection
b) Trichomonas vaginalis
A nurse caring for a patient with diabetes insipidus is reviewing the patient's laboratory results. What is an expected urinalysis finding? a) Albumin in the urine b) Urine specific gravity of 1.001 to 1.005 c) Leukocytes in the urine d) Glucose in the urine
b) Urine specific gravity of 1.001 to 1.005
A public health nurse is aware of the importance of reaching all members of the community during health promotion and disease prevention initiatives. This nurse should be aware that which of the following groups of women is under-represented in their rate of participation in primary health care and preventive health screening? a) Women who lack a high school diploma b) Women who have disabilities c) Women over age 65 d) Women who have preschool- or elementary-aged children
b) Women who have disabilities
A nurse who works on a busy urology unit provides care for many patients who have had surgical interventions for the treatment of prostate disease. Currently, the nurse is planning necessary tasks for the morning, including surgical dressing changes as ordered. Which of the following patients will not have a visible surgical incision or dressing? a) A 57-year-old patient who is postoperative day 1 following retropubic prostatectomy b) A man who is recovering from a suprapubic prostatectomy c) A 66-year-old man who has had a transurethral resection of the prostate (TURP) d) A man whose prostate cancer required a perineal prostatectomy
c) A 66-year-old man who has had a transurethral resection of the prostate (TURP)
A patient who came to the clinic after finding a mass in her breast is scheduled for a diagnostic breast biopsy. What is a priority nursing action? a) Refer her to a breast cancer recovery group. b) Instruct the patient on prosthetic devices. c) Acknowledge the fear the patient is experiencing. d) Set up a consultation with a breast cancer survivor
c) Acknowledge the fear the patient is experiencing.
The nurse in the emergency department is conducting an assessment of a woman who has presented with abdominal pain. While preparing to insert a urinary catheter as ordered, the nurse notes that the patient has undergone female genital mutilation (FGM) earlier in her life. When addressing this issue with the patient, it is imperative that the nurse do which of the following? a) Explain why most Americans are uncomfortable with FGM. b) Obtain a swab of the woman's genitalia and gather a urine sample for routine urinalysis. c) Adopt a mindset of respect and cultural competence. d) Assess the cultural factors that contributed to the practice.
c) Adopt a mindset of respect and cultural competence.
The nurse is giving an educational event to a local men's group about prostate cancer. What nationality should you be sure to tell the attendees of this event should receive information regarding the predisposition of prostate cancer? a) Native Americans b) Asian Americans c) African Americans d) Caucasians
c) African Americans
The nurse is caring for a type 1 diabetic patient who is being discharged home tomorrow. Patient teaching includes assessing the patient's self-care skills to determine if further diabetes teaching is required. What is the best way to assess the patient's ability to prepare and self-administer insulin? a) Ask the patient to describe the self-care skill. b) Ask the family to describe the patient's ability to perform the self-care skill. c) Directly observe the self-care skill. d) Consult the home health nurse to discuss self-care skills.
c) Directly observe the self-care skill.
A male patient in his 20s has been diagnosed with a chlamydial infection and states that he is "terrified" at the prospect of having to inform his fiancée. In light of this patient's statement, what action should the nurse first perform? a) Teach the patient assertiveness skills that he can utilize when informing his fiancée. b) Role play the discussion with the patient. c) Assess the specific reasons why the patient fears this discussion with his fiancée. d) Reiterate the patient's legal and moral obligations for having this discussion with his fiancée.
c) Assess the specific reasons why the patient fears this discussion with his fiancée.
A middle-aged athlete was diagnosed with a hydrocele several months ago but now requires treatment because of the increasing size of the mass. The nurse who is working with this patient should anticipate what aspect of care? a) Administering IV antibiotics b) Teaching the patient to use a leg collection bag for urine output c) Assessing the patient's scrotal incision d) Administering chemotherapy
c) Assessing the patient's scrotal incision
An elderly patient has come to the clinic with his daughter. The patient is a diabetic and is concerned about foot care. The nurse goes over foot care with the patient and his daughter as the nurse realizes that foot care is extremely important. Why would the nurse believe that foot care is so important to this patient? a) Drugs that patients are required to take for their diabetic condition often decrease circulation to the lower extremities. b) An elderly patient with foot ulcers experiences severe foot pain due to diabetic polyneuropathy. c) Avoiding the complications associated with foot ulcers may mean the difference between institutionalization and continued independent living. d) Hypoglycemia is a dangerous situation, and it may lead to unsteadiness and falls.
c) Avoiding the complications associated with foot ulcers may mean the difference between institutionalization and continued independent living.
A patient has just been diagnosed with type 2 diabetes. The health care provider has prescribed an oral antidiabetic agent that will inhibit the production of glucose by the liver and thereby aid in the control of blood glucose. What type of oral antidiabetic agent has been prescribed for this patient? a) Sulfonylurea b) Thiazolidinedione c) Biguanide d) Alpha glucosidase inhibitor
c) Biguanide
A patient newly diagnosed with type 2 diabetes is attending a nutrition class specifically designed for type 2 diabetics. What general guideline would it be important to teach the patients at this class? a) Protein should be exclusively from animal sources. b) Dietary fat should be eliminated from the diet. c) Calorie intake should support a reasonable body weight. d) A low fat food generally contains low sugar.
c) Calorie intake should support a reasonable body weight.
A patient with pheochromocytoma has been admitted for an adrenalectomy tomorrow. The patient is to start IV medication this evening to prevent adrenal insufficiency. What medication is the patient most likely to require? a) Parenteral nutrition b) Antihypertensives c) Corticosteroids d) Antibiotics
c) Corticosteroids
The nurse is teaching a patient about nutrition and knows that the body needs specific nutrients in order to function normally. What element is essential to thyroid function? a) Selenium b) Potassium c) Iodine d) Chlorine
c) Iodine
A 61-year-old man's elevated prostate screening antigen (PSA) levels and abnormal digital rectal examination (DRE) results prompted his care provider to refer him for treatment. The patient has subsequently been diagnosed with prostate cancer and is scheduled for surgery. The nurse should recognize that this patient's plan of nursing care should include interventions to address what potential long-term complication of prostate surgery? a) Urge incontinence b) Abdominal distention c) Erectile dysfunction d) Stress incontinence
c) Erectile dysfunction
A patient presents to the clinic complaining of symptoms that suggest diabetes mellitus. What criteria would support a diagnosis of diabetes mellitus? a) Random plasma glucose >126 mg/dL b) Fasting plasma glucose >100 mg/dL c) Fasting plasma glucose ≥126 mg/dL d) Random plasma >150 mg/dL
c) Fasting plasma glucose ≥126 mg/dL
The nurse is caring for a patient who has been diagnosed with genital herpes. When preparing a teaching plan for this patient, what general guidelines should be taught? a) Self-infection cannot occur from touching lesions during a breakout. b) Sunbathing assists in eradicating the virus. c) Good hand-washing is essential after touching lesions d) Lesions should be massaged with ointment.
c) Good hand-washing is essential after touching lesions
An 18-year-old boy with a diagnosis of type 2 diabetes has admitted to the diabetes nurse that he has been inconsistent with his self-monitoring of blood glucose (SMBG) since his last visit. He has brought in his log of SMBG to review with the nurse but there are very few entries over the past few months. How can this nurse best determine this patient's glucose levels over the period in question? a) Calculate the patient's average blood glucose level based on the available data b) Have the patient perform SMBG four to six times daily over the next 3 days c) Have a glycated hemoglobin test performed d) Review the patient's food intake over the time period
c) Have a glycated hemoglobin test performed
As a class project, a group of student nurses are developing a care plan for patients being screened for cervical cancer. When teaching patients about the risk factors of cervical cancer, what would the nurse identify as the most important risk factor? a) Postmenopausal bleeding b) Late childbearing c) Human papillomavirus (HPV) d) Obesity
c) Human papillomavirus (HPV)
The nurse is planning the care of a woman who is scheduled to begin radiation therapy for the treatment of invasive breast cancer. The nurse is aware that this treatment is often well-tolerated but that it creates a risk of which of the following nursing diagnoses? a) Acute pain b) Unilateral neglect c) Impaired skin integrity d) Ineffective thermoregulation
c) Impaired skin integrity
An adult patient is experiencing a temporary decrease in serum levels of T3 and T4. What physiological response is this state likely to result in? a) Release of sequestered T3 and T4 by the spleen b) Compensatory release of T5 by the parathyroid c) Increased release of TSH d) Increased resorption of T3 and T4 in the renal tubules
c) Increased release of TSH
During a period of heavy work and family pressures, an adult male patient with type 1 diabetes has become ill with influenza. This combination of psychological and physiological stress has culminated in ketoacidosis. The nurse who is now providing this patient's care should be aware that the presence of ketones in the blood result from: a) Increased insulin resistance b) Glycogenolysis c) Metabolism of fat d) Hypoglycemia
c) Metabolism of fat
A 42-year-old woman tells the nurse that she has found a painless lump in her right breast during her monthly self-examination. She says that she is afraid that she has cancer. Which assessment finding would strongly suggest that this patient's lump is cancerous? a) Eversion of the right nipple and mobile mass b) Mobile mass that's soft and easily delineated c) Nonmobile mass with irregular edges d) Nonpalpable right axillary lymph nodes
c) Nonmobile mass with irregular edges
A patient who is male-to-female (MTF) transgendered has been admitted to the unit, and this has resulted in much discussion among staff members. The nurse who is currently working with this patient should prioritize which of the following? a) Teaching the patient management strategies for depression and anxiety b) Assessing the patient's reasons for choosing to become transgendered c) Remaining nonjudgmental and empathic when providing care d) Teaching the patient about common female reproductive disorders
c) Remaining nonjudgmental and empathic when providing care
When doing an initial assessment that includes questions related to domestic abuse, what does the nurse need to provide? a) An introduction to others who have been abused b) A public place for assessment to ensure accountability c) Resources and referrals as needed d) Pictures of any symptoms of physical abuse
c) Resources and referrals as needed
A 34-year-old man has been diagnosed with HSV-2 and is preparing to begin treatment with acyclovir (Zovirax). When providing health education about his new medication regimen, what information should the nurse provide to this patient? a) The drug requires several months of conscientious adherence to cure HSV-2. b) This antiviral medication will prevent him from transmitting the disease to a partner. c) The drug may relieve his symptoms but it will not cure him of herpes. d) This drug will suppress his immune system but relieve the signs and symptoms of the disease.
c) The drug may relieve his symptoms but it will not cure him of herpes.
A patient is prescribed corticosteroid therapy. What would be important information for the nurse to give the patient who is prescribed corticosteroid therapy? a) There will be no change in appearance. b) The patient is at a decreased risk for development of thrombophlebitis and thromboembolism. c) The patient is at an increased risk for developing infection. d) The patient's diet should be low protein with ample fat.
c) The patient is at an increased risk for developing infection.
A 30-year-old patient is receiving analgesics and antibiotics for the treatment of epididymitis. The patient normally leads an active lifestyle and is concerned about the effect that his recovery will have on his routines. What should the nurse teach the patient about lifestyle modifications during his recovery? a) The patient should stay on bed rest until his epididymitis has resolved. b) The patient should emphasize light weight-bearing activity while recovering to strengthen his core muscles. c) The patient should avoid lifting and sexual activity until his infection is resolved. d) The patient should try to maintain his normal activity level if possible.
c) The patient should avoid lifting and sexual activity until his infection is resolved.
A female patient has just been diagnosed with condylomata acuminata (genital warts). What information is appropriate to tell this patient? a) The potential for transmission to her sexual partner will be eliminated if condoms are used every time they have sexual intercourse. b) The most common treatment is metronidazole (Flagyl), which should eradicate the problem within 7 to 10 days. c) This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) test annually. d) The human papillomavirus (HPV), which causes condylomata acuminata, can't be transmitted during oral sex.
c) This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) test annually.
A nurse provides care on a surgical unit where a large number of patients are admitted following breast cancer surgery. The nurse is aware that breast cancer surgery creates a significant risk of disturbed body image. When should the nurse anticipate that this risk will be the highest? a) When the patient is admitted to the PACU from the operating room b) When the patient is met on the unit by her husband or partner c) When the patient sees her incision for the first time d) When the patient is faced with the prospect of leaving the unit after discharge
c) When the patient sees her incision for the first time
A newly admitted patient with type 1 diabetes asks the nurse what caused her diabetes. In response, the nurse is explaining to the patient the etiology of type 1 diabetes. Which of the following is the most appropriate explanation by the nurse? a) "The secretion of placental hormones is causing your body to be resistant to insulin." b) "The tissues in your body are resistant to the action of insulin, making insulin less effective." c) "An acidic substance forms when your liver breaks down fatty acids because of the lack of insulin in your body." d) "Destruction of special cells in the pancreas causes a decrease in insulin production, and the level of sugar in your bloodstream increases."
d) "Destruction of special cells in the pancreas causes a decrease in insulin production, and the level of sugar in your bloodstream increases."
A 30-year-old woman has come to the clinic stating, "I'm pretty sure that I've got a yeast infection, so I need something for it." Which of the nurse's assessment questions most directly addresses a risk factor for vulvovaginal candidiasis (VVC)? a) "Do you normally shower or do you prefer to bathe?" b) "Have you been drinking a lot of fluids in recent weeks?" c) "When was your last menstrual period?" d) "Have you been on antibiotics for an infection lately?"
d) "Have you been on antibiotics for an infection lately?"
A patient on a surgery unit is received continuous bladder irrigation (CBI) to prevent clots in the hours following prostate surgery. Consequently, the nurse is carefully monitoring the patient's intake and output and documenting this hourly. Over the past hour, 3,000 mL of irrigant has infused and 3,150 mL of output has been drained from the patient's collection bag. How should the nurse document this patient's hourly urine output? a) 2850 mL b) 75 mL c) 3150 mL d) 150 mL
d) 150 mL
A nurse is conducting a comprehensive assessment of a 73-year-old male patient. When performing an assessment of this patient's genitourinary system, the nurse should anticipate which of the following age-related changes? a) Erythema on the skin of the penile shaft b) Increased difference in the size between the patient's testicles c) Atrophy of the patient's penis d) A scrotum that hangs lower than that of younger men
d) A scrotum that hangs lower than that of younger men
A nurse in a campus medical clinic is meeting with a 23-year-old student who states that she has been experiencing malodorous vaginal discharge over the past several days. The nurse should recognize that this patient is describing a sign that is characteristic of: a) Vulvovaginal candidiasis (VVC) b) Human papillomavirus (HPV) c) Dysmenorrhea d) Bacterial vaginosis (BV)
d) Bacterial vaginosis (BV)
The health care provider has explained to a patient that he has an inflammation of the Cowper's glands. Where are the Cowper glands located? a) Near the urethra, alongside the vas deferens b) Within the anterior aspect of the urethra, just above the prostate c) Within the epididymis d) Below the prostate, within the posterior aspect of the urethra
d) Below the prostate, within the posterior aspect of the urethra
While reading a medical patient's admission documentation, the nurse notes that the patient has a history of parathyroid dysfunction. Accordingly, the nurse should pay particular attention to this patient's: a) Blood pressure b) Cognition c) Potassium levels d) Calcium levels
d) Calcium levels
A 48-year-old man has presented to the outpatient radiology department for a scheduled transrectal ultrasound (TRUS). The nurse in this department should be aware that this patient has likely had: a) A history of infertility b) Evidence of erectile dysfunction (ED) c) Urinary retention d) Elevated prostate-specific antigen (PSA)
d) Elevated prostate-specific antigen (PSA)
The nurse is providing an educational event at the local community center on prostate cancer. A 53-year-old male attendee asks about the prevention and detection of prostate cancer. What information should the nurse provide to this man that would assist in the early identification of prostate cancer? a) Have a digital rectal examination and prostate-specific antigen (PSA) test done yearly b) Perform monthly testicular self-examinations c) Have a transrectal ultrasound every 5 years d) Have a complete blood count (CBC) yearly, including blood urea nitrogen (BUN) and creatinine assessment
d) Have a complete blood count (CBC) yearly, including blood urea nitrogen (BUN) and creatinine assessment
A nurse who works in a busy, urban clinic is aware of the importance of a thorough assessment of sexual history for the women who are patients of the clinic. When initiating such assessments, the nurse should begin by: a) Asking the patient if she feels like she is accepting of her sexuality b) Briefly explaining the health consequences of sexually transmitted infections (STIs) c) Asking the patient if she has any friends or family who have experienced sexual health issues d) Informing the patient that she will be asked some questions about her sexual health
d) Informing the patient that she will be asked some questions about her sexual health
A 60-year-old woman has just been diagnosed with hypothyroidism after a diagnostic workup. What sign or symptom most likely motivated the woman to originally seek care? a) Flushed skin and pruritus b) Aggression and increased appetite c) Abnormal hair growth and excessive perspiration d) Lethargy and apathy
d) Lethargy and apathy
A patient is recovering in the PACU following a transurethral resection of the prostate (TURP). The patient is receiving continuous bladder irrigation (CBI), and the nurse has observed several clots in the collection bag and tubing. In the last few minutes, output has ceased despite the continued infusion of normal saline through the patient's triple-lumen urinary catheter. How should the nurse respond to this assessment finding? a) Reposition the patient to a semi-Fowler's position. b) Slow the rate of CBI to half of the previous rate. c) Remove the triple-lumen catheter and replace it with a double-lumen catheter. d) Manually irrigate the patient's catheter with normal saline.
d) Manually irrigate the patient's catheter with normal saline.
A patient has been admitted to a medical unit with respiratory symptoms that are characteristic of tuberculosis. When transporting the patient to radiology for a chest x-ray, the nurse has applied a mask that covers the patient's nose and mouth. This action addresses which component of the chain of infection? a) Causative organism b) Portal of entry c) Susceptible host d) Mode of exit
d) Mode of exit
A 26-year-old woman has experienced debilitating pelvic pain accompanied by uterine bleeding for many months and has finally received a diagnosis of uterine fibroids. The nurse is aware that this patient desires to have children in the future. Consequently, the nurse should expect that the patient's health care provider will likely recommend what treatment? a) Oral antiviral medication b) Radiation therapy c) Hysterectomy d) Myomectomy
d) Myomectomy
A 45-year-old woman comes into the Ob-Gyn clinic for her yearly check-up. The woman mentions to the nurse that she has a dimpling of the right breast that has occurred in the last few months. What assessment would be appropriate for the nurse to first make? a) Call the health care provider to schedule a biopsy b) Order an immediate mammogram c) Assess the woman's previous experience with breastfeeding d) Palpate the area for a breast mass
d) Palpate the area for a breast mass
A hospital patient's most recent blood work reveals a Ca2+ level of 14.2 mg/dL (normal 8.5 to 10.5 mg/dL) and a phosphorus level of 1.4 mg/dL (normal 3.0 to 4.5 mg/dL). What hormone has the potential to cause this alteration in the patient's electrolyte levels? a) Calcitonin b) Corticotropin-releasing hormone (CRH) c) Thyroid hormone d) Parathyroid hormone
d) Parathyroid hormone
A school nurse who is teaching a health course at the local high school is presenting information on human development and sexuality. When talking about the role of hormones in sexual development, which hormone does the nurse teach the class is the most important for developing and maintaining the female reproductive organs? a) Follicle-stimulating hormone b) Estrogen c) Androgens d) Progesterone
d) Progesterone
A patient in her 30s has two young children and has just had a modified radical mastectomy with immediate reconstruction. The patient shares with the nurse that she's worried about her future, but she seems to be adjusting well to her diagnosis and surgery. What nursing intervention is appropriate to support this patient's coping? a) Encourage the patient to proceed with the next phase of treatment. b) Recommend that the patient remain cheerful for the sake of her children. c) Tell the patient's spouse or partner to be supportive while she recovers. d) Refer the patient to the American Cancer Society's Reach to Recovery program or another support program.
d) Refer the patient to the American Cancer Society's Reach to Recovery program or another support program.
The PACU staff have brought a patient to the unit following a thyroidectomy. To promote comfort for this patient, how should the nurse position this patient? a) Head of the bed elevated 30 degrees and no pillows placed under the head b) Flat, with a small roll supporting the neck c) Side-lying (lateral) with one pillow under the head d) Semi-Fowler's with the head supported on two pillows
d) Semi-Fowler's with the head supported on two pillows
A 29-year-old patient has just been told that he has testicular cancer and needs to have surgery. The surgery is scheduled for the following week. That afternoon, the patient calls the nurse and tells her he wants to cancel the surgery because he thinks he might be better off dead. The nurse asks him why he feels that way. The patient states "My wife won't want to have sex with me anymore. He says he feels like he's spoiled a happy, satisfying sex life with his wife and he starts to cry. Based on these statements, which nursing diagnosis would be most appropriate for creating a plan of care for this patient? a) Social isolation b) Risk for loneliness c) Inability to function d) Situational low self-esteem
d) Situational low self-esteem
The nurse is assisting with the preparation of a patient who will undergo a radioactive iodine uptake (RAIU) test. The nurse should understand that this patient is being assessed for dysfunction of the: a) Adrenal medulla b) Anterior pituitary c) Adrenal cortex d) Thyroid gland
d) Thyroid gland
A 15-year-old boy is brought to the emergency department with symptoms of hyperglycemia. Following diagnostic testing, a diagnosis of diabetes mellitus is made. What classification will be used to describe a 15-year-old with diabetes who requires daily insulin injections? a) Type 2 diabetes b) Juvenile diabetes c) Prediabetes d) Type 1 diabetes
d) Type 1 diabetes
