Adult Health I-PrepU (Chapters: 1, 24, 19, 53)

A female client presents to the health clinic for a routine physical examination. The nurse observes that the client's urine is bright yellow. Which question is most appropriate for the nurse to ask the client? "Have you noticed any vaginal bleeding?" "Do you take phenytoin daily?" "Do you take multiple vitamin preparations?" "Have you had a recent urinary tract infection?"

"Do you take multiple vitamin preparations?"

The nurse is preparing the client with an abdominal incision for discharge. Which statement by the client indicates teaching has been ineffective? "I should call my physician if I develop a fever." "My incision should become less red and tender." "I can resume my usual activities as soon as I get home." "I need to keep my follow-up appointment with the physician."

"I can resume my usual activities as soon as I get home."

The nurse is giving discharge instructions to the client following a bladder ultrasound. Which statement by the client indicates the client understands the instructions? "I can resume my usual activities without restriction." "I should increase my fluid intake for the rest of the day." "If I have difficulty urinating, I should contact my physician." "It is normal for my urine to be blood-tinged."

"I can resume my usual activities without restriction."

A home health nurse visits a client with chronic obstructive pulmonary disease who requires oxygen. Which statement by the client indicates the need for additional teaching about home oxygen use? "I lubricate my lips and nose with K-Y jelly." "I make sure my oxygen mask is on tightly so it won't fall off while I nap." "I have a 'no smoking' sign posted at my front door to remind guests not to smoke." "I clean my mask with water after every meal."

"I make sure my oxygen mask is on tightly so it won't fall off while I nap." Explanation: The client requires additional teaching if he states that he fits his mask tightly. Applying the oxygen mask too tightly can cause skin breakdown, so the client should be cautioned against wearing it too tightly. Oxygen therapy is drying to the oral and nasal mucosa; therefore, the client should be encouraged to apply a water-soluble lubricant, such as K-Y jelly, to prevent drying. Smoking is contraindicated wherever oxygen is in use; posting of a "no smoking" sign warns people against smoking in the client's house. Cleaning the mask with water two or three times per day removes secretions and decreases the risk of infection.

The nurse is preparing the client for magnetic resonance imaging (MRI) of the kidney. Which statement by the client requires action by the nurse? "I took my blood pressure medication with my morning coffee an hour ago." "I had my last cigarette 3 hours ago with my morning coffee." "I did not take my multivitamin this morning." "I do not have a pacemaker, artificial heart valve, or artificial joints."

"I took my blood pressure medication with my morning coffee an hour ago."

A student nurse observes a nurse case manager coordinating discharge for a patient diagnosed with congestive heart failure (CHF). Which statement made by the patient indicates to the student that the patient understands the role of the case manager? "The nurse case manager contacted my insurance company and has arranged for the home health nurse and physical therapist to visit me as soon as I get home." "The nurse case manager organized my daily nursing care during my hospitalization and arranged for the dietitian to teach me the importance of consuming a diet low in sodium." "The nurse case manager worked with my physician to coordinate my admission from his office to the hospital." "The nurse case manager arranged to have a wheelchair waiting to take me to my room. I was so short of breath I could not walk very far."

"The nurse case manager contacted my insurance company and has arranged for the home health nurse and physical therapist to visit me as soon as I get home." A nurse case manager coordinates care between nurses, other health care personnel, and insurance companies. Nurse case managers coordinate patient care from the time of hospital admission to the time of discharge and often after discharge from an acute care setting. Care coordination provided by the nurse care manager is not episodic.

A client with chronic obstructive pulmonary disease (COPD) and cor pulmonale is being prepared for discharge. The nurse should provide which instruction? "Limit yourself to smoking only 2 cigarettes per day." "Eat a high-sodium diet." "Weigh yourself daily and report a gain of 2 lb in 1 day." "Maintain bed rest."

"Weigh yourself daily and report a gain of 2 lb in 1 day." The nurse should instruct the client to weigh himself daily and report a gain of 2 lb in 1 day. COPD causes pulmonary hypertension, leading to right-sided heart failure or cor pulmonale. The resultant venous congestion causes dependent edema. A weight gain may further stress the respiratory system and worsen the client's condition. The nurse should also instruct the client to eat a low-sodium diet to avoid fluid retention and engage in moderate exercise to avoid muscle atrophy.The client shouldn't smoke at all.

A patient with end-stage COPD and heart failure asks the nurse about lung reduction surgery. What is the best response by the nurse? "You are not a candidate because you have heart failure." "You would have a difficult time recovering from the procedure." "At this point, do you really want to go through something like that?" "You and your physician should discuss the options that are available for treatment."

"You and your physician should discuss the options that are available for treatment."

A client is scheduled for a renal ultrasound. Which of the following would the nurse include when explaining this procedure to the client? "An x-ray will be done to view your kidneys, ureters, and bladder." "A contrast medium will be used to help see the structures better." "You don't need to do any fasting before this noninvasive test." "You'll have a pressure dressing on your groin after the test."

"You don't need to do any fasting before this noninvasive test."

The World Health Organization defines health as: "a condition of homeostasis and adaptation." "reflecting an individual's location along a wellness--illness continuum." "a state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity." "a fluid, ever-changing balance reflected through physical, mental, and social behavior."

"a state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity."

A nurse measures a patient's urinary output every 8 hours. The nurse weighs the importance of these results by comparing the normal 24-hour urinary output with the patient's condition and medication. The normal 24-hour output should be: 0.4 to 0.8 L/day 1 to 2 L/day 2.5 to 3 L/day 3.5 to 4 L/day

1 to 2 L/day

A nurse is assisting with a subclavian vein central line insertion when the client's oxygen saturation drops rapidly. He complains of shortness of breath and becomes tachypneic. The nurse suspects the client has developed a pneumothorax. Further assessment findings supporting the presence of a pneumothorax include: 1. diminished or absent breath sounds on the affected side. 2. paradoxical chest wall movement with respirations. 3. tracheal deviation to the unaffected side. 4. muffled or distant heart sounds.

1. diminished or absent breath sounds on the affected side.

When fluid intake is normal, the specific gravity of urine should be which of the following? 1.010 to 1.025. 1.000. <1.010. >1.025.

1.010 to 1.025.

A nurse is assisting the physician conducting a cystogram. The client has an intravenous (IV) infusion of D5W at 40 ml/hr. The physician inserts a urinary catheter into the bladder and instills a total of 350 ml of a contrast agent. The nurse empties 500 ml from the urinary catheter drainage bag at the conclusion of the procedure. How many milliliters does the nurse record as urine?

150 The urinary drainage bag contains both the contrast agent and urine at the conclusion of the procedure. Total contents (500 ml) in the drainage bag consist of 350 ml of contrast agent and 150 ml of urine.

The nurse is preparing to discharge a patient from the PACU using a PACU room scoring guide. With what score can the patient be transferred out of the recovery room? 5 6 7 8

8 Many hospitals use a scoring system (e.g., Aldrete score) to determine the patient's general condition and readiness for transfer from the PACU (Aldrete & Wright, 1992). Throughout the recovery period, the patient's physical signs are observed and evaluated by means of a scoring system based on a set of objective criteria. This evaluation guide allows an objective assessment of the patient's condition in the PACU (Fig. 19-3). The patient is assessed at regular intervals, and a total score is calculated and recorded on the assessment record. The Aldrete score is usually between 8 and 10 before discharge from the PACU.

What abnormal postoperative urinary output should the nurse report to the physician for a 2-hour period? <30 mL Between 75 and 100 mL Between 100 and 200 mL >200 mL

<30 mL

Which statement describes emphysema? A disease of the airways characterized by destruction of the walls of overdistended alveoli A disease that results in reversible airflow obstruction, a common clinical outcome Presence of cough and sputum production for at least a combined total of 2 to 3 months in each of two consecutive years Chronic dilatation of a bronchus or bronchi

A disease of the airways characterized by destruction of the walls of overdistended alveoli

What measurement should the nurse report to the physician in the immediate postoperative period? A systolic blood pressure lower than 90 mm Hg A temperature reading between 97°F and 98°F Respirations between 20 and 25 breaths/min A hemoglobin of 13.6

A systolic blood pressure lower than 90 mm Hg

A physician's admitting note lists a wound as healing by second intention. What does the nurse expect to find? A deep, open wound that was previously sutured A sutured incision with a little tissue reaction A wound with a deep, wide scar that was previously resutured A wound in which the edges were not approximated

A wound in which the edges were not approximated Second-intention healing (granulation) occurs in infected wounds (abscess) or in wounds in which the edges have not been approximated.

A patient has an increase in blood osmolality when the nurse reviews the laboratory work. What can this increase indicate for the patient? ADH stimulation An increase in urine volume Diuresis Less reabsorption of water

ADH stimulation

A 24-hour urine collection is scheduled to begin at 8:00 am. When should the nurse initiate the procedure? After discarding the 8:00 am specimen At 8:00 am, with or without a specimen 6 hours after the urine is discarded With the first specimen voided after 8:00 am

After discarding the 8:00 am specimen

In which statements regarding medications taken by a client diagnosed with COPD do the the drug name and the drug category correctly match? Select all that apply. Albuterol is a bronchodilator. Dexamethasone is an antibiotic. Cotrimoxazole is a bronchodilator. Ciprofloxacin is an antibiotic. Prednisone is a corticosteroid.

Albuterol is a bronchodilator. Ciprofloxacin is an antibiotic. Prednisone is a corticosteroid.

Which is the strongest predisposing factor for asthma? Congenital malformations Allergy Male gender Air pollution

Allergy

To prevent pneumonia and promote the integrity of the pulmonary system, an essential postoperative nursing intervention includes: Assisting with incentive spirometry every 6 hours Ambulating the client as soon as possible Positioning the client in a supine position Assessing breath sounds at least every 2 hours

Ambulating the client as soon as possible

Which of the following diagnostic tests would the nurse expect to be ordered to determine the details of the arterial supply to the kidneys? Radiography Angiography Computed tomography (CT scan) Cystoscopy

Angiography

A client is diagnosed with a chronic respiratory disorder. After assessing the client's knowledge of the disorder, the nurse prepares a teaching plan. This teaching plan is most likely to include which nursing diagnosis? Anxiety Imbalanced nutrition: More than body requirements Impaired swallowing Unilateral neglect

Anxiety

Although nurse practice acts may vary state by state, all recognize several basic principles supporting the legal parameters for all registered nurses. Select the activity that falls under the scope of nursing practice. Appraising and enhancing an individual's health-seeking perspective Changing a patient's health care treatment plan Diagnosing pathology based on the patient's response to treatment Prescribing a physical therapy program to treat a flare-up of a chronic condition

Appraising and enhancing an individual's health-seeking perspective

A patient who adheres to the dietary laws of Judaism is in traction and confined to bed. The patient needs assistance with the evening meal of chicken, rice, beans, a roll, and a carton of milk. Which nursing approach is most representative of promoting wellness? Remove items from the overbed table to make room for the dinner tray. Push the overbed table toward the bed so that it will be within the patient's reach when the dinner tray arrives. Ask a family member to assist the patient with the tray and the overbed table, then straighten the area in an attempt to provide a pleasant atmosphere for eating. Ask whether the patient would like to make any substitutions in the foods and fluids received.

Ask whether the patient would like to make any substitutions in the foods and fluids received.

A patient has undergone a renal biopsy. After the test, while the patient is resting, the patient complains of severe pain in the back, arms, and shoulders. Which of the following appropriate nursing interventions should be offered by the nurse? Asses the patient's back and shoulder areas for signs of internal bleeding. Distract the patient's attention from the pain. Provide analgesics to the patient. Enable the patient to sit up and ambulate.

Asses the patient's back and shoulder areas for signs of internal bleeding.

A client is at postoperative day 1 after abdominal surgery. The client is receiving 0.9% normal saline at 75 mL/h, has a nasogastric tube to low wall suction with 200 mL every 8 hours of light yellow fluid, and a wound drain with 50 mL of dark red drainage every 8 hours. The 24-hour urine output total is 2430 mL. What action by the nurse is most appropriate? Document the findings and reassess in 24 hours. Assess for signs and symptoms of fluid volume deficit. Assess for edema. Discontinue the nasogastric tube suctioning.

Assess for signs and symptoms of fluid volume deficit.

The nurse should be alert for a complication of bronchiectasis that results from a combination of retained secretions and obstruction that leads to the collapse of alveoli. This complication is known as Atelectasis Emphysema Pleurisy Pneumonia

Atelectasis Retention of secretions and subsequent obstruction ultimately cause the aveoli distal to the obstruction to collapse (atelectasis).

A patient is having a problem with retention of urine in the bladder. Which of the following diagnostic tests measures the amount of residual urine in the bladder? Bladder ultrasonography Nuclear scan Cystography IV urography

Bladder ultrasonography

The nurse is providing care to a client who has had a kidney biopsy. The nurse would need to be alert for signs and symptoms of which of the following? Bleeding Infection Dehydration Allergic reaction

Bleeding

The nurse is providing care to a client who has had a renal biopsy. The nurse would need to be alert for signs and symptoms of which of the following? Bleeding Infection Dehydration Allergic reaction

Bleeding

The nurse is caring for a client after a cystoscopic examination. Following the procedure, the nurse informs the client that which effect may occur? Blood-tinged urine Nausea and emesis Diarrhea Severe abdominal pain

Blood-tinged urine

A post op client reports severe abdominal pain. The nurse cannot auscultate bowel sounds and notes the client's abdomen is rigid. What is the nurse's priority action? Re-attempt to auscultate bowel sounds. Prepare to insert a nasogastric tube. Call the health care provider. Prepare to administer a stool softener.

Call the health care provider.

A 24-year-old patient was admitted to the emergency room after a water skiing accident. The X-rays revealed two fractured vertebrae, T-12 and L1. Based on this information, the nurse would know to perform which of the following actions? Keep the patient on bed rest for 72 hours. Place a bed board under the mattress to add support. Check the patient's urine for hematuria. Apply moist heat, every 4 hours for the first 48 hours to aid healing.

Check the patient's urine for hematuria.

Which nursing assessment finding indicates the client with renal dysfunction has not met expected outcomes? Client reports increasing fatigue. Client rates pain at a 3 on a scale of 0 to 10. Client denies frequency and urgency. Urine output is 100 ml/hr.

Client reports increasing fatigue.

Upon assessment, the nurse suspects that a patient with COPD may have bronchospasm. What manifestations validate the nurse's concern? (Select all that apply.) Compromised gas exchange Decreased airflow Wheezes Jugular vein distention Ascites

Compromised gas exchange Decreased airflow Wheezes

Which of the following best reflects the current trends associated with the elderly population? There are more men than there are women in the older population. The 65- to 74-year-old age group is the fastest growing segment of the population. The percentage of older adults in the population will gradually decrease in the future. Conditions affecting elderly women are a major concern due to undertreatment and underdiagnosis.

Conditions affecting elderly women are a major concern due to undertreatment and underdiagnosis.

When describing the functions of the kidney to a client, which of the following would the nurse include? Select all that apply. Regulation of white blood cell production Synthesis of vitamin K Control of water balance Secretion of the enzyme renin

Control of water balance Secretion of the enzyme renin

The client is admitted to the hospital with a diagnosis of acute pyelonephritis. Which clinical manifestations would the nurse expect to find? Costovertebal angle tenderness Suprapubic pain Pain after voiding Perineal pain

Costovertebal angle tenderness

A nurse is caring for a client with a postoperative wound evisceration. Which action should the nurse perform first? Explain to the client what is happening and provide support. Cover the protruding internal organs with sterile gauze moistened with sterile saline solution. Push the protruding organs back into the abdominal cavity. Ask the client to drink as much fluid as possible.

Cover the protruding internal organs with sterile gauze moistened with sterile saline solution. Immediately covering the wound with moistened gauze prevents the organs from drying. The gauze and the saline solution must be sterile to reduce the risk of infection. Although providing support to reduce the client's anxiety is important, it isn't the priority nursing action. The organs shouldn't be pushed back into the abdomen; doing so may tear or damage them. Evisceration requires emergency surgery; therefore, the nurse should put the client on nothing-by-mouth status immediately.

A creatinine clearance test is ordered for a client with possible renal insufficiency. The nurse must collect which serum concentration midway through the 24-hour urine collection? Blood urea nitrogen Creatinine Osmolality Hemoglobin

Creatinine

Which value does the nurse recognize as the best clinical measure of renal function? Creatinine clearance Circulating ADH concentration Volume of urine output Urine-specific gravity

Creatinine clearance

A patient is being seen in the clinic for possible kidney disease. What major sensitive indicator of kidney disease does the nurse anticipate the patient will be tested for? Blood urea nitrogen level Creatinine clearance level Serum potassium level Uric acid level

Creatinine clearance level

A patient is being seen in the clinic for possible kidney disease. What major sensitive indicator of kidney disease does the nurse anticipate the patient will be tested for? Blood urea nitrogen level Creatinine clearance level Serum potassium level Uric acid level

Creatinine clearance level

The nurse is completing a routine urinalysis using a dipstick. The test reveals an increased specific gravity. The nurse should suspect which condition? Decreased fluid intake Increased fluid intake Glomerulonephritis Diabetes insipidus

Decreased fluid intake

The nurse is assessing the client for wound complications following surgery. For which clinical manifestation should the nurse assess? Select all that apply. Atelecstasis Thrombophlebitis Dehiscence Hematoma Paralytic ileus

Dehiscence Hematoma

A client has a full bladder. Which sound would the nurse expect to hear on percussion? Tympany Dullness Resonance Flatness

Dullness

An appropriate nursing intervention for the client following a nuclear scan of the kidney is to: Encourage high fluid intake. Strain all urine for 48 hours. Apply moist heat to the flank area. Monitor for hematuria.

Encourage high fluid intake.

A nurse asks a client who had abdominal surgery 3 days ago if he has moved his bowels since surgery. The client states, "I haven't moved my bowels, but I am passing gas." How should the nurse intervene? Apply moist heat to the client's abdomen. Encourage the client to ambulate at least three times per day. Administer a tap water enema. Notify the physician.

Encourage the client to ambulate at least three times per day.

A nurse assesses a postoperative client as having abdominal organs protruding through the surgical incision. Which term best describes this assessment finding? Hernia Dehiscence Erythema Evisceration

Evisceration

Which exposure accounts for most cases of COPD? Exposure to tobacco smoke Occupational exposure Passive smoking Ambient air pollution

Exposure to tobacco smoke

Which exposure acts as a risk factor for and accounts for the majority of cases of chronic obstructive pulmonary disease (COPD)? Exposure to tobacco smoke Occupational exposure Passive smoking Ambient air pollution

Exposure to tobacco smoke

Which type of healing occurs when granulation tissue is not visible and scar formation is minimal? First intention Second intention Third intention Fourth intention

First intention When wounds heal by first intention, granulation tissue is not visible and scar formation is minimal. Many postoperative wounds are covered with a dry sterile dressing. Second-intention healing (granulation) occurs in infected wounds (abscess) or in wounds in which the edges have not been well approximated. Third-intention healing (secondary suture) is used for deep wounds that either have not been sutured early or break down and are resutured later, thus bringing together two apposing granulation surfaces. Fourth-intention is not a type of wound healing.

A nurse consulting with a nutrition specialist knows it's important to consider a special diet for a client with chronic obstructive pulmonary disease (COPD). Which diet is appropriate for this client? Full-liquid High-protein 1,800-calorie ADA Low-fat

High-protein

In which grade of COPD is the forced expiratory volume in 1 second (FEV1) greater than 80% predicted? I II III IV

I COPD is classified into four grades depending on the severity measured by pulmonary function tests. However, pulmonary function is not the only way to assess or classify COPD; pulmonary function is evaluated in conjunction with symptoms, health status impairment, and the potential for exacerbations. Grade I (mild): FEV1/FVC <70% and FEV1 ≥80% predicted. Grade II (moderate): FEV1/FVC <70% and FEV1 50% to 80% predicted. Grade III (severe): FEV1/FVC <70% and FEV1 <30% to 50% predicted. Grade IV (very severe): FEV1/FVC <70% and FEV1 <30% predicted.

A nurse notes that the FEV1/FVC ratio is less than 70% and the FEV1 is 25% for a patient with COPD. What stage should the nurse document the patient is in? I II III IV

IV

A nurse is reviewing the laboratory test results of a client with renal disease. Which of the following would the nurse expect to find? Decreased blood urea nitrogen (BUN) Increased serum albumin Increased serum creatinine Decreased potassium

Increased serum creatinine

A patient who complains of a dull, continuous pain in the suprapubic area that occurs with, and at the end of, voiding would most likely be diagnosed with which of the following? A kidney stone Interstitial cystitis Acute pyelonephritis Prostatic cancer

Interstitial cystitis

A client has a history of chronic obstructive pulmonary disease (COPD). Following a coughing episode, the client reports sudden and unrelieved shortness of breath. Which of the following is the most important for the nurse to assess? Lung sounds Skin color Heart rate Respiratory rate

Lung sounds

Corticosteroids have which effect on wound healing? Reduce blood supply Mask the presence of infection Cause hemorrhage May cause protein-calorie depletion

Mask the presence of infection

Histamine, a mediator that supports the inflammatory process in asthma, is secreted by Eosiniphils Lymphocytes Mast cells Neutrophils

Mast cells

A client is scheduled for a renal angiography. Which of the following would be appropriate before the test? Monitor the client for signs of electrolyte and water imbalance. Monitor the client for an allergy to iodine contrast material. Assess the client's mental changes. Evaluate the client for periorbital edema.

Monitor the client for an allergy to iodine contrast material.

Which is an effect of aging on upper and lower urinary tract function? Increased glomerular filtration rate More prone to develop hypernatremia Increased blood flow to the kidneys Acid-base balance

More prone to develop hypernatremia

A nurse is preparing a presentation for a local community group addressing the influences on health care delivery. Which of the following would the nurse include in presentation when describing disease patterns? Most infectious diseases have been controlled or eradicated. The prevalence of chronic illness is decreasing due to the emphasis on healthy living. Obesity along with conditions associated with it has become a major health concern. People with acute illnesses are considered the largest group of health care consumers.

Obesity along with conditions associated with it has become a major health concern.

Which term best describes a total urine output less than 500 mL in 24 hours? Polyuria Oliguria Nocturia Dysuria

Oliguria

Urine specific gravity is a measurement of the kidney's ability to concentrate and excrete urine. The specific gravity measures urine concentration by measuring the density of urine and comparing it with the density of distilled water. Which is an example of how urine concentration is affected? On a hot day, a person who is perspiring profusely and taking little fluid has low urine output with a high specific gravity. On a hot day, a person who is perspiring profusely and taking little fluid has high urine output with a low specific gravity. A person who has a high fluid intake and who is not losing excessive water from perspiration, diarrhea, or vomiting has scant urine output with a high specific gravity. When the kidneys are diseased, the ability to concentrate urine may be impaired and the specific gravity may vary widely.

On a hot day, a person who is perspiring profusely and taking little fluid has low urine output with a high specific gravity.

The nurse has medicated a postoperative client who reported nausea. Which medication would the nurse document as having been given? Ondansetron Warfarin Prednisone Propofol

Ondansetron Odansetron is an antiemetic and one of the most commonly prescribed medications for nausea and vomiting. Warfarin is an anticoagulant. Prednisone is a corticosteroid. Propofol is an anesthetic agent.

A nurse is preparing a presentation for a local community group about health, wellness, and illness. When describing the concept of wellness, which of the following features would the nurse include? Select all that apply. Performing to one's best ability Being completely without illness Feeling that everything is together Being able to adjust and adapt Experiencing a feeling of well-being

Performing to one's best ability Feeling that everything is together Being able to adjust and adapt Experiencing a feeling of well-being

A nurse prepares to suction a client's tracheostomy tube. Place the procedure steps in correct order. 5 Apply intermittent suction while withdrawing the catheter. 1 Position the client in Fowlers position. 2 Don sterile gloves. 3 Lubricate the sterile suction catheter. 4 Insert suction catheter into the lumen of the tube.

Position the client in Fowlers position. Don sterile gloves. Lubricate the sterile suction catheter. Insert suction catheter into the lumen of the tube. Apply intermittent suction while withdrawing the catheter.

The nurse is caring for the postoperative client in the postanesthesia care unit. Which of the following is the priority nursing action? Monitor vital signs for early detection of shock. Assess the incisional dressing to detect hemorrhage. Position the client to maintain a patent airway. Administer antiemetics to prevent nausea and vomiting.

Position the client to maintain a patent airway.

Retention of which electrolyte is the most life-threatening effect of renal failure? Calcium Sodium Potassium Phosphorous

Potassium

A child is having an asthma attack and the parent can't remember which inhaler to use for quick relief. The nurse accesses the child's medication information and tells the parent to use which inhalant? Cromolyn sodium Theo-Dur Serevent Proventil

Proventil Short-acting beta2-adrenergic agonists (albuterol [AccuNeb, Proventil, Ventolin], levalbuterol [Xopenex HFA], and pirbuterol [Maxair]) are the medications of choice for relief of acute symptoms and prevention of exercise-induced asthma. Cromolyn sodium (Crolom, NasalCrom) and nedocromil (Alocril, Tilade) are mild to moderate anti-inflammatory agents and are considered alternative medications for treatment. These medications stabilize mast cells. These medications are contraindicated in acute asthma exacerbations. Long-acting beta2-adrenergic agonists are not indicated for immediate relief of symptoms. These include theophylline (Slo-Bid, Theo- Dur) and salmeterol (Serevent Diskus).

What complication is the nurse aware of that is associated with deep venous thrombosis? Pulmonary embolism Immobility because of calf pain Marked tenderness over the anteromedial surface of the thigh Swelling of the entire leg owing to edema

Pulmonary embolism

The nurse recognizes which symptom as a clinical manifestation of shock? Flushed face Warm, dry skin Increased urine output Rapid, weak, thready pulse

Rapid, weak, thready pulse

A nurse is describing the renal system to a client with a kidney disorder. Which structure would the nurse identify as emptying into the ureters? Nephron Renal pelvis Parenchyma Glomerulus

Renal pelvis

Which of the following hormones is secreted by the juxtaglomerular apparatus? Renin Aldosterone Antidiuretic hormone (ADH) Calcitonin

Renin

A patient is being treated for status asthmaticus. What danger sign does the nurse observe that can indicate impending respiratory failure? Respiratory acidosis Respiratory alkalosis Metabolic acidosis Metabolic alkalosis

Respiratory acidosis

As status asthmaticus worsens, the nurse would expect which acid-base imbalance? Respiratory alkalosis Metabolic alkalosis Respiratory acidosis Metabolic acidosis

Respiratory acidosis

In chronic obstructive pulmonary disease (COPD), decreased carbon dioxide elimination results in increased carbon dioxide tension in arterial blood, leading to which of the following acid-base imbalances? Respiratory acidosis Respiratory alkalosis Metabolic alkalosis Metabolic acidosis

Respiratory acidosis

Which method of wound healing is one in which wound edges are not surgically approximated and integumentary continuity is restored by granulation? Primary-intention healing First-intention healing Second-intention healing Third-intention healing

Second-intention healing When wounds dehisce, they are allowed to heal by secondary intention. Primary or first-intention healing is the method of healing in which wound edges are surgically approximated and integumentary continuity is restored without granulation. Third-intention healing is a method of healing in which surgical approximation of wound edges is delayed and integumentary continuity is restored by bringing apposing granulations together.

The nurse is reviewing the client's urinalysis results. The finding that is most suggestive of dehydration of the client is: Specific gravity 1.035 Creatinine 0.7 mg/dL Protein 15 mg/dL Bright yellow urine

Specific gravity 1.035

To help prevent infections in clients with COPD, the nurse should recommend vaccinations against two bacterial organisms. Which of the following are the two vaccinations? Streptococcus pneumonia and Haemophilus influenzae Streptococcus pneumonia and varicella Haemophilus influenzae and varicella Haemophilus influenzae and Gardasil

Streptococcus pneumonia and Haemophilus influenzae

Which is an effect of aging on upper and lower urinary tract function? Increased glomerular filtration rate Susceptibility to develop hypernatremia Increased blood flow to the kidney Acid-base balance

Susceptibility to develop hypernatremia

A postoperative client is being evaluated for discharge and currently has an Aldrete score of 8. Which of the following is the most likely outcome for this client? The client can be discharged from the PACU. The client must remain in the PACU. The client should be transferred to an intensive care area. The client must be put on immediate life support.

The client can be discharged from the PACU.

Why would a client with COPD report feeling fatigued? Select all that apply. The client is using all expendable energy just to breathe. Muscle function gradually decreases over time in clients with COPD. The client is using all expendable energy for activities of daily living (ADLs). Lung function gradually decreases over time in clients with COPD.

The client is using all expendable energy for activities of daily living (ADLs). Lung function gradually decreases over time in clients with COPD.

Which nursing assessment finding indicates the client has not met expected outcomes? The client voids 75 cc four hours post cystoscopy. The client reports a pain rating of 3 two hours post-kidney biopsy. The client has blood-tinged urine following brush biopsy. The client consumes 75% of lunch following an intravenous pyelogram.

The client voids 75 cc four hours post cystoscopy.

The nurse is caring for a client who has presented to the walk-in clinic. The client verbalizes pain on urination, feelings of fatigue, and diffuse back pain. When completing a head-to-toe assessment, at which specific location would the nurse assess the client's kidneys for tenderness? The upper abdominal quadrants on the left and right side The costovertebral angle Above the symphysis pubis Around the umbilicus

The costovertebral angle

The nurse is educating a patient about preparation for an IV urography. What should the nurse be sure to include in the preparation instructions? A liquid restriction for 8 to 10 hours before the test is required The patient may have liquids before the test. The patient will have enemas until the urine is clear. The patient is restricted from eating or drinking from midnight until after the test.

The patient may have liquids before the test.

A commonly prescribed methylxanthine used as a bronchodilator is which of the following? Theophylline Levalbuteral Terbutaline Albuteral

Theophylline

The nurse is teaching the client about patient-controlled analgesia. Which of the following would be appropriate for the nurse to include in the teaching plan? The client can self-administer oral pain medication as needed with patient-controlled analgesia. Family members can be involved in the administration of pain medications with patient-controlled analgesia. Therapeutic drug levels can be maintained more evenly with patient-controlled analgesia. There are no advantages of patient-controlled analgesia over a PRN dosing schedule.

Therapeutic drug levels can be maintained more evenly with patient-controlled analgesia.

A group of students is reviewing for a test on the urinary and renal system. The students demonstrate understanding of the information when they identify which of the following as part of the upper urinary tract? Bladder Urethra Ureters Pelvic floor muscles

Ureters

The most frequent reason for admission to skilled care facilities includes which of the following? Urinary incontinence Congestive heart failure Stroke Myocardial infarction

Urinary incontinence

The nurse is caring for a client who is describing urinary symptoms of needing to go to the bathroom with little notice. When the nurse is documenting these symptoms, which medical term will the nurse document? Urinary frequency Urinary urgency Urinary incontinence Urinary stasis

Urinary urgency

Which of the following clinical manifestations increase the risk for evisceration in the postoperative client? Hypovolemia Edema Valsalva maneuver Hypoxia

Valsalva maneuver

The client asks the nurse about ways to control pain other than taking pain medication. Which strategy should the nurse include when responding to the client? Select all that apply. Listening to music An On-Q pump Watching television An epidural infusion Changing position

Watching television changing position listening to music

A nurse is giving a presentation about community-oriented nursing practice to a group of new graduates. Which of the following would the nurse include as a central focus of this practice? Select all that apply. Wellness promotion Reduced illness transmission Improved health of individuals Levels of prevention Research dissemination

Wellness promotion Reduced illness transmission Levels of prevention

Nursing assessment findings reveal a temperature of 103.2°F, tachycardia, and client complaints of increased incisional pain. The nurse recognizes the client is experiencing: Hyperthermia Atelectasis Wound infection Uncontrolled pain

Wound infection

The nurse is concerned that a postoperative patient may have a paralytic ileus. What assessment data may indicate that the patient does have a paralytic ileus? Abdominal tightness Abdominal distention Absence of peristalsis Increased abdominal girth

absence of peristalsis

A client had a nephrectomy 2 days ago and is now complaining of abdominal pressure and nausea. The first nursing action should be to: auscultate bowel sounds. palpate the abdomen. change the client's position. insert a rectal tube.

auscultate bowel sounds.

Following a splenectomy, a client has a hemoglobin (Hb) level of 7.5 g/dl and has vertigo when getting out of bed. The nurse suspects abnormal orthostatic changes. The vital sign values that most support the nurse's analysis are: blood pressure of 150/100 mm Hg and pulse of 130 beats/minute. blood pressure of 150/100 mm Hg and pulse of 50 beats/minute. blood pressure of 80/40 mm Hg and pulse of 50 beats/minute. blood pressure of 80/40 mm Hg and pulse of 130 beats/minute.

blood pressure of 80/40 mm Hg and pulse of 130 beats/minute.

An older adult's most recent laboratory findings indicate a decrease in creatinine clearance. When performing an assessment related to potential causes, the nurse should: confirm all of the medications and supplements normally taken. assess the client's usual intake of sodium. confirm which beverages the client normally consumes. palpate the client's bladder before and after voiding.

confirm all of the medications and supplements normally taken.

A nursing student knows that there are three most common symptoms of asthma. Choose the three that apply. Cough Wheezing Dyspnea Crackles

cough wheezing dyspnea

While interviewing a patient, the nurse notices that the patient is wearing a medallion around his neck. The patient tells the nurse, "It's a medal that everyone in my family wears to protect against cancer." The nurse interprets this statement as most likely reflecting which of the following? Culture Race Religion Morality

culture

A client with an abdominal surgical wound sneezes and then states, "Something doesn't feel right with my wound." The nurse asses the upper half of the wound edges, noticing that they are no longer approximated and the lower half remains well approximated. The nurse would document that following a sneeze, the wound dehisced. eviscerated. pustulated. hemorrhaged.

dehisced.

A nurse is caring for a client who underwent a skin biopsy and has three stitches in place. This wound is healing by: first intention. second intention. third intention. fourth intention.

first intention. Wounds with a small amount of tissue damage that are the result of procedures that use sterile technique and that are properly closed, such as with stitches, heal by first intention. Granulation tissue is generally not visible and scar formation is minimal. Second intention healing occurs in infected wounds or wounds with edges that aren't approximated. These wounds are usually packed with moist dressings. Third intention healing occurs with deep wounds that aren't sutured together, resulting in a deep, wide scar. There is no fourth intention of wound healing.

A client with chronic obstructive pulmonary disease tells a nurse that he feels short of breath. The client's respiratory rate is 36 breaths/minute and the nurse auscultates diffuse wheezes. His arterial oxygen saturation is 84%. The nurse calls the assigned respiratory therapist to administer an ordered nebulizer treatment. The therapist says, "I have several more nebulizer treatments to do on the unit where I am now. As soon as I'm finished, I'll come and assess the client." The nurse's most appropriate action is to: notify the primary physician immediately. stay with the client until the therapist arrives. administer the treatment by metered-dose inhaler. give the nebulizer treatment herself.

give the nebulizer treatment herself.

A client is experiencing some secretion abnormalities, for which diagnostics are being performed. Which substance is typically reabsorbed and not secreted in urine? glucose potassium creatinine chloride

glucose

A client is having a blood urea nitrogen (BUN) test. BUN level is: increased in renal disease and urinary obstruction. decreased in nephrotic syndrome. decreased in renal disease and urinary obstruction. unchanged in renal disease.

increased in renal disease and urinary obstruction.

The primary objective in the immediate postoperative period is controlling nausea and vomiting. relieving pain. maintaining pulmonary ventilation. monitoring for hypotension.

maintaining pulmonary ventilation.

The term used to describe total urine output less than 0.5 mL/kg/hr is oliguria. anuria. nocturia. dysuria.

oliguria

The client is experiencing nausea and vomiting following surgery. The nurse expects the surgeon to order: chlorpromazine (Thorazine) omeprazole (Prilosec) ondansetron (Zofran) ranitidine (Zantac)

ondansetron (Zofran)

Which is a classic sign of hypovolemic shock? Dilute urine Pallor High blood pressure Bradypnea

pallor

The nurse is caring for a client who reports orange urine. The nurse suspects which factor as the cause of the urine discoloration? phenazopyridine hydrochloride Infection Phenytoin Metronidazole

phenazopyridine hydrochloride

A postoperative client is experiencing a flash pulmonary edema. What finding in the client's sputum is consistent with this problem? Pink color Copious red blood in the sputum Foul smell Pieces of vomitus

pink color Flash pulmonary edema that occurs when protein and fluid accumulate in the alveoli unrelated to elevated pulmonary artery occlusive pressure. Signs and symptoms include agitation, tachypnea, tachycardia, decreased pulse oximetry readings, frothy, pink sputum, and crackles on auscultation.

A client is scheduled for a renal arteriogram. When the nurse checks the chart for allergies to shellfish or iodine, she finds no allergies recorded. The client is unable to provide the information. During the procedure, the nurse should be alert for which finding that may indicate an allergic reaction to the dye used during the arteriogram? Increased alertness Hypoventilation Pruritus Unusually smooth skin

pruritus

The classification of Stage III of COPD is defined as at risk for COPD. mild COPD. severe COPD. very severe COPD. moderate COPD.

severe COPD. Stage III is severe COPD. Stage 0 is at risk for COPD. Stage I is mild COPD. Stage II is moderate COPD. Stage IV is very severe COPD.

You are caring for a client who needs to ambulate. What considerations should be included when planning the postoperative ambulatory activities for the older adult? Respiratory depressive effects Tolerance Convalescent period Detailed medication history

tolerance