Exam 3 CoA Practice

Risk factors for the development of hiatal hernias are those that lead to increased abdominal pressure. Which of the following complications can cause increased abdominal pressure? 1. Obesity 2. Volvulus 3. Constipation 4. Intestinal obstruction

1. Obesity

Nathaniel has severe pruritus due to having hepatitis B. What is the best intervention for his comfort? 1.Give tepid baths. 2. Avoid lotions and creams. 3. Use hot water to increase vasodilation. 4. Use cold water to decrease the itching.

1.Give tepid baths.

A client with myasthenia gravis has become increasingly weaker. The primary health care provider prepares to identify whether the client is reacting to an overdose of the medication (cholinergic crisis) or an increasing severity of the disease (myasthenic crisis). An injection of edrophonium is administered. Which finding would indicate that the client is in cholinergic crisis? 1.No change in the condition 2.Complaints of muscle spasms 3.An improvement of the weakness 4.A temporary worsening of the condition

4.A temporary worsening of the condition

The nurse is assessing the adaptation of a client to changes in functional status after a stroke (brain attack). Which observation indicates to the nurse that the client is adapting most successfully? 1.Gets angry with family if they interrupt 2.Experiences bouts of depression and irritability 3.Has difficulty with using modified feeding utensils 4.Consistently uses adaptive equipment in dressing self

4.Consistently uses adaptive equipment in dressing self

A patient presents with the following sudden signs and symptoms - weakness, numbness, visual changes, dysarthria, and dysphagia. The nurse suspects which of the following pathologies? A. CVA B. Guillian-barre C. T1-T2 spinal cord injury D. MS

A. CVA

The client with a stroke has residual dysphagia. When a diet order is initiated, the nurse avoids doing which of the following? A. Giving thin liquids B. Thickening liquids C. Placing food on unaffected side D. Allowing plenty time for chewing and swallowing

A. Giving thin liquids

Which hormone should the nurse include in a teaching session regarding satiety? A. Leptin B. Estrogen C. Testosterone D. Progesterone

A. Leptin

A patient with a history of IBS presents to the clinic. The nurse would expect to conform which of the following findings for this pt to confirm the presence of IBS? A. Normal rectal and stool exam B. Abnormal proctosigmoidoscopy exam due to ulceration of bowel lining C. Frequent bloody stools D. Excessive weight gain

A. Normal rectal and stool exam

The nurse provides care to a patient who is diagnosed with Parkinson's disease. Which patient data supports the implementation of fall precautions in the plan of care? (Select all that apply) A. Rigidity B. Tremors C. Mask-like face D. Difficulty swallowing E. Orthostatic hypotension

A. Rigidity B. Tremors E. Orthostatic hypotension

The nurse provides instructions to a client about measures to treat inflammatory bowel syndrome (IBS). Which statement by the client indicates a need for further teaching? A."I need to limit my intake of dietary fiber." B."I need to drink plenty, at least 8 to 10 cups daily." C."I need to eat regular meals and chew my food well." D."I will take the prescribed medications because they will regulate my bowel patterns."

A."I need to limit my intake of dietary fiber."

A client has developed hepatitis A after eating contaminated oysters. The nurse assesses the client for which expected assessment finding? A.Malaise B.Dark stools C.Weight gain D.Left upper quadrant discomfort

A.Malaise

The nurse provides information to the caregiver of a 68-year-old man with epilepsy who has tonic-clonic seizures. Which statement, if made by the caregiver, requires further teaching? A. "It is normal for a person to be sleepy after a seizure" B. "I should call 911 if breathing stops during the seizure" C. "The jerking movements may last for 20-40 seconds" D. "Objects should not be placed in the mouth during a seizure"

B. "I should call 911 if breathing stops during the seizure"

Which of the following is a complication of Crohn's disease? A. Arthritis B. Bowel fistula formation C. Weight gain D. GI tuberculosis

B. Bowel fistula formation

A nurse educator of a college health course is discussing tattoos with the class. Which type of hepatitis associated with tattoos would the nurse include in the teaching plan? A. A B. C C. D D. E

B. C

The nurse if caring for the male client who begins to experiences seizure activity while in bed. Which of the following actions by the nurse would be contraindicated? A. Loosening restrictive clothing's B. Restraining limbs C. Removing pillow and raising padded side rails D. Positioning client to side w head flexed forward

B. Restraining limbs

A 47-year-old male patient has the following symptoms: urgent and frequent bowel movements of diarrhea that contains blood with pus and mucous, a low hemoglobin and hematocrit, and potassium level of 2.1. Based on the patient's sign and symptoms, which disease process does this describe? A. Crohn's disease B. Ulcerative Colitis C. IBS D. Hiatal hernia

B. Ulcerative Colitis

The primary health care provider has determined that a client has contracted hepatitis A based on flu-like symptoms and jaundice. Which statement made by the client supports this medical diagnosis? A."I have had unprotected sex with multiple partners." B."I ate shellfish about 2 weeks ago at a local restaurant." C."I was an intravenous drug abuser in the past and shared needles." D."I had a blood transfusion 30 years ago after major abdominal surgery."

B."I ate shellfish about 2 weeks ago at a local restaurant."

A client is diagnosed with viral hepatitis, complaining of "no appetite" and "losing my taste for food". What instruction should the nurse give the client to provide adequate nutrition? A.Select foods high in fat B.Increase intake of fluids, including juices C.Eat a good supper when anorexia is not as severe D.Eat less often, preferably only 3 large meals daily

B.Increase intake of fluids, including juices

Surgical management of UC may be performed to treat which of the following complications? A. Gastritis B. Diarrhea C. Constipation D. Bowel perforation

D. Bowel perforation

A 65 year old woman was admitted for Parkinson's disease. The charge nurse is gonging to make an initial assessment. The onset of Parkinson's disease is between 50-60 years old. This disorder is caused by: A. Chemicals B. Heredity C. Death of brain cells due to old age D. Impairment of dopamine producing cells in brain

D. Impairment of dopamine producing cells in brain

The client with seizures develops stiffening of the muscles of the arms and legs, following by an immediate loss of consciousness and jerking of all extremities. How would the nurse document seizure activity? A. atonic B. absence C. Myoclonic D. Tonic-clonic

D. Tonic-clonic

A female client with hepatitis C develops liver failure and GI hemorrhage. The blood products that would most likely bring about hemostasis in the client are: A.whole blood and albumin. B. platelets and packed red blood cells. C. fresh frozen plasma and whole blood. D. cryoprecipitate and fresh frozen plasma.

D. cryoprecipitate and fresh frozen plasma.

The nurse is monitoring a client with a diagnosis of peptic ulcer. Which assessment finding would most likely indicate perforation of the ulcer? A.Bradycardia B.Numbness in the legs C.Nausea and vomiting D.A rigid, board-like abdomen

D.A rigid, board-like abdomen

A client has undergone esophagogastroduodenoscopy. The nurse should place highest priority on which item as part of the client's care plan? A.Monitoring temperature B.Monitoring complaints of heartburn C.Giving warm gargles for a sore throat D.Assessing for the return of the gag reflex

D.Assessing for the return of the gag reflex

The nurse is caring for a client who begins to experience seizure activity while in bed. Which actions would the nurse take? *Select all that apply.* 1.Loosening restrictive clothing 2.Restraining the client's limbs 3.Removing the pillow and raising padded side rails 4.Positioning the client to the side, if possible, with the head flexed forward 5.Keeping the curtain around the client and the room door open so that when help arrives, they can quickly enter to assist

1.Loosening restrictive clothing 3.Removing the pillow and raising padded side rails 4.Positioning the client to the side, if possible, with the head flexed forward

The nurse is instituting seizure precautions for a client who is being admitted from the emergency department. Which measures would the nurse include in planning for the client's safety? *Select all that apply.* 1.Padding the side rails of the bed 2.Placing an airway at the bedside 3.Placing the bed in the high position 4.Putting a padded tongue blade at the head of the bed 5.Placing oxygen and suction equipment at the bedside 6.Flushing the intravenous catheter to ensure that the site is patent

1.Padding the side rails of the bed 2.Placing an airway at the bedside 5.Placing oxygen and suction equipment at the bedside 6.Flushing the intravenous catheter to ensure that the site is patent

Jerod is experiencing an acute episode of ulcerative colitis. Which is priority for this patient? 1.Replace lost fluid and sodium. 2. Monitor for increased serum glucose level from steroid therapy. 3. Restrict the dietary intake of foods high in potassium. 4. Note any change in the color and consistency of stools.

1.Replace lost fluid and sodium.

The nurse is teaching a client with myasthenia gravis about the prevention of myasthenic and cholinergic crises. Which client activity suggests that teaching is most effective? 1.Taking medications as scheduled 2.Eating large, well-balanced meals 3.Doing muscle-strengthening exercises 4.Doing all chores early in the day while less fatigued

1.Taking medications as scheduled

The nurse is assigned to care for a client with complete right-sided hemiparesis from a stroke (brain attack). Which characteristics are associated with this condition? *Select all that apply.* 1.The client is aphasic 2.The client has weakness on the right side of the body 3.The client has complete bilateral paralysis of the arms and legs 4.The client has weakness on the right side of the face and tongue 5.The client has lost the ability to move the right arm but is able to walk independently 6.The client has lost the ability to ambulate independently but is able to feed and bath self without assistance

1.The client is aphasic 2.The client has weakness on the right side of the body 4.The client has weakness on the right side of the face and tongue

A client with a peptic ulcer reports epigastric pain that frequently awakens her at night, a feeling of fullness in the abdomen, and a feeling of anxiety about her health. Based on this information, which nursing diagnosis would be most appropriate? 1. Imbalanced Nutrition: Less than Body Requirements related to anorexia. 2. Disturbed Sleep Pattern related to epigastric pain 3. Ineffective Coping related to exacerbation of duodenal ulcer 4. Activity Intolerance related to abdominal pain

2. Disturbed Sleep Pattern related to epigastric pain

The nurse has given medication instructions to a client receiving phenytoin. Which statement indicates that the client has an adequate understanding of instructions? 1."Alcohol is not contraindicated while taking this medication." 2."Good oral hygiene is needed, including brushing and flossing." 3."The medication dose may be self-adjusted, depending on side effects." 4."The morning dose of the medication needs to be taken before a medication level is drawn."

2."Good oral hygiene is needed, including brushing and flossing."

The hospitalized client with GERD is complaining of chest discomfort that feels like heartburn following a meal. After administering an ordered antacid, the nurse encourages the client to lie in which of the following positions? 1. Supine with the head of the bed flat 2. On the stomach with the head flat 3. On the left side with the head of the bed elevated 30 degrees 4. On the right side with the head of the bed elevated 30 degrees.

3. On the left side with the head of the bed elevated 30 degrees

A client with Guillain-Barré syndrome has ascending paralysis and is intubated and receiving mechanical ventilation. Which strategy would the nurse incorporate in the plan of care to help the client cope with this illness? 1.Giving client full control over care decisions and restricting visitors 2.Providing positive feedback and encouraging active range of motion 3.Providing information, giving positive feedback, and encouraging relaxation 4.Providing intravenously administered sedatives, reducing distractions, and limiting visitors

3.Providing information, giving positive feedback, and encouraging relaxation

You're discharging Nathaniel with hepatitis B. Which statement suggests understanding by the patient? 1."Now I can never get hepatitis again." 2. "I can safely give blood after 3 months." 3. "I'll never have a problem with my liver again, even if I drink alcohol." 4. "My family knows that if I get tired and start vomiting, I may be getting sick again."

4. "My family knows that if I get tired and start vomiting, I may be getting sick again."

The client with GERD complains of a chronic cough. The nurse understands that in a client with GERD this symptom may be indicative of which of the following conditions? 1. Development of laryngeal cancer 2. Irritation of the esophagus 3. Esophageal scar tissue formation 4. Aspiration of gastric contents

4. Aspiration of gastric contents

Rob is a 46 y.o. admitted to the hospital with a suspected diagnosis of Hepatitis B. He's jaundiced and reports weakness. Which intervention will you include in his care? 1.Regular exercise. 2. A high-protein diet. 3. Allow patient to select his meals. 4. Rest period after small, frequent meals.

4. Rest period after small, frequent meals.

Which of the following conditions can cause a hiatal hernia? 1. Increased intrathoracic pressure 2. Weakness of the esophageal muscle 3. Increased esophageal muscle pressure 4. Weakness of the diaphragmatic muscle

4. Weakness of the diaphragmatic muscle

The nurse is instructing a client with Parkinson's Disease about preventing falls. Which client statement reflects a need for further teaching? 1."I can sit down to put on my pants and shoes." 2."I try to exercise every day and rest when I'm tired." 3."My son removed all loose rugs from my bedroom." 4."I don't need to use my walker to get to the bathroom."

4."I don't need to use my walker to get to the bathroom."

The nurse is admitting a client with Guillain-Barré syndrome to the nursing unit. The client has complaints of inability to move both legs and reports a tingling sensation above the waistline. Knowing the complications of the disorder, the nurse would bring which most essential items into the client's room? 1.Nebulizer and pulse oximeter 2.Blood pressure cuff and flashlight 3.Nasal cannula and incentive spirometer 4.Electrocardiographic monitoring electrodes and intubation tray

4.Electrocardiographic monitoring electrodes and intubation tray

Carbidopa-levodopa is prescribed for a client with Parkinson's disease. The nurse monitors the client for side and adverse effects of the medication. Which finding indicates that the client is experiencing an adverse effect? 1.Pruritus 2.Tachycardia 3.Hypertension 4.Impaired voluntary movements

4.Impaired voluntary movements

The client is admitted to the hospital with a diagnosis of Guillain-Barré syndrome. Which past medical history finding makes the client most at risk for this disease? 1.Meningitis or encephalitis during the last 5 years 2.Seizures or trauma to the brain within the last year 3.Back injury or trauma to the spinal cord during the last 2 years 4.Respiratory or gastrointestinal infection during the previous month

4.Respiratory or gastrointestinal infection during the previous month

Mrs. Jones is a 68 year-old female admitted to your unit with a new diagnosis of liver cancer. Which of the following clinical manifestations may be present in a patient with liver cancer? Select all that apply. A. Ascites B. Fatigue C. Periumbilical pain D. Jaundice E. Hemoptysis

A. Ascites B. Fatigue D. Jaundice

Which non-pharmacological intervention for GERD? (Select all that apply) A. Avoiding late-night meals B. Consuming a glass of wine with meals C. Drinking soft drinks D. Losing weight E. Stopping smoking F. Sit upright/elevated

A. Avoiding late-night meals D. Losing weight E. Stopping smoking F. Sit upright/elevated

A patient with Crohn's disease is taking corticosteroids. The patient is complaining of extreme thirst, polyuria, and blurred vision, What is your next nursing action? A. Check glucose level B. Give pt food containing sugar C. Administer O2 via nasal cannula D. Assess bowel sounds

A. Check glucose level

The nurse is aware that which factors are related to the development of gastroesophageal reflux disease? (Select all that apply) A. Delayed gastric emptying B. Eating large meals C. Hiatal hernia D. Obesity E. Viral infection

A. Delayed gastric emptying B. Eating large meals C. Hiatal hernia D. Obesity

Which dietary guide instructions should the nurse include in a teaching plan for a client with GERD? A. Eat 4-6 small meals a day B. Avoid eating 3 hours before going to bed C. Eat slowly and chew thoroughly D. Increase ingestions of carbonated beverages before bed

A. Eat 4-6 small meals a day B. Avoid eating 3 hours before going to bed C. Eat slowly and chew thoroughly

What is used to diagnose a seizure disorder? (Select all that apply.) A. Electroencephalogram B. Lumbar puncture C. Metabolic panel D. Coagulation studies E. Electromyogram

A. Electroencephalogram B. Lumbar puncture C. Metabolic panel

A patient is receiving treatment for Crohn's disease, Which food on the patient's tray should the patient avoid? A. Fresh salad B. White rice C. Baked chicken D. Skinless baked apples

A. Fresh salad

A nurse is planning a lecture on obesity. He knows that common causes of obesity can include: (Select all that apply) A. Genetic factors such as heredity B. Environmental factors such as medications C. Behavioral factors such as lifestyle D. Neuroendocrine malfunction such as hypothyroidism

A. Genetic factors such as heredity B. Environmental factors such as medications C. Behavioral factors such as lifestyle D. Neuroendocrine malfunction such as hypothyroidism

The nurse is providing discharge teaching for a client with newly diagnosed Crohn's disease about dietary measures to implement during exacerbation episodes. Which statement made by the client indicates a need for further instruction? A."I should increase the fiber in my diet." B."I will need to avoid caffeinated beverages." C."I'm going to learn some stress reduction techniques." D."I can have exacerbations and remissions with Crohn's disease."

A."I should increase the fiber in my diet."

A female client who has just been diagnosed with hepatitis A asks, "How could I have gotten this disease?" What is the nurse's best response? A."You may have eaten contaminated restaurant food." B. "You could have gotten it by using I.V. drugs." C. "You must have received an infected blood transfusion." D. "You probably got it by engaging in unprotected sex."

A."You may have eaten contaminated restaurant food."

A client presents to the emergency department with upper gastrointestinal bleeding and is in moderate distress. In planning care, what is the priority nursing action for this client? A.Assessment of vital signs B.Completion of abdominal examination C.Insertion of the prescribed nasogastric tube D.Thorough investigation of precipitating events

A.Assessment of vital signs

The nurse is planning to teach a client with gastroesophageal reflux disease (GERD) about substances to avoid. Which items should the nurse include on this list? Select all that apply. A.Coffee B.Chocolate C.Peppermint D.Nonfat milk E.Fried chicken F.Scrambled eggs

A.Coffee B.Chocolate C.Peppermint E.Fried chicken

Which findings indicate that a patient may have fluid volume excess? Select all that apply. A.Increased, bounding pulses B.Jugular venous distension C.Presence of crackles on lung auscultation D.Excessive thirst E.Elevated blood pressure F.Orthostatic hypotension

A.Increased, bounding pulses B.Jugular venous distension C.Presence of crackles on lung auscultation E.Elevated blood pressure

A client with hiatal hernia chronically experiences heartburn following meals. The nurse should plan to teach the client to avoid which action because it is contraindicated with a hiatal hernia? A.Lying recumbent following meals B.Consuming small, frequent, bland meals C.Taking H2-receptor antagonist medication D.Raising the head of the bed on 6-inch (15 cm) blocks

A.Lying recumbent following meals

Exposure to hepatitis A can potentially occur in which of the following situations (select all that apply) A.Swimming in contaminated in waters B. Hanging blood produces using PPE C.Eating shellfish from contaminated waters D. Neglecting to wash hands after handling a stool specimen

A.Swimming in contaminated in waters C.Eating shellfish from contaminated waters D. Neglecting to wash hands after handling a stool specimen

A women who had a stroke 2 days earlier has left-sided paralysis. She has begun to regain some movement in her left side. What can the nurse tell the family about the client's potential recovery period? A. The quicker movement is recovered, the better the prognosis is for recovery B. She will continue to need some assistance as deficiencies resolve however C. May every attempt to meet all of her self-care needs for her. She will need her rest. D. She will never total function

B. She will continue to need some assistance as deficiencies resolve however

A male patient with a diagnosis of Parkinson's disease has been admitted recently to a long-term care facility. Which action should the health care team take in order to promote adequate nutrition for this patient? A. Provide diet that is low in complex carb and high in protein B. Small frequent meals throughout the day that are easy to chew and swallow C. Provide with minced or purred diet this is high in K and low in sodium D. Request placement of a feeding tube

B. Small frequent meals throughout the day that are easy to chew and swallow

A client with hepatitis C is. Being treated in an acute care facility. Because the client requires enteric contact precautions, the nurse should: A. Place the patient in a semi-private room B. Wear a gown and gloves when providing personal care to the client C. Wear a mask when handling the client's bedpan D. This patient requires no isolation precautions because they are not contagious

B. Wear a gown and gloves when providing personal care to the client

A male client has just been diagnosed with hepatitis A. On assessment, the nurse expects to note: A.severe abdominal pain radiating to the shoulder. B. anorexia, nausea, and vomiting. C. eructation and constipation. D. abdominal ascites.

B. anorexia, nausea, and vomiting.

Nurse Kristine is trying to communicate with a client with stroke and aphasia. Which of the following actions by the nurse would be least helpful to the client? A. Speaking in the client at a slower rate B. Allowing plenty of time for the client to respond C. Completing the sentences that the client cannot finish D. Looking directly at the client during attempts at speech

C. Completing the sentences that the client cannot finish

The incidence of ischemic strokes in patient with TIA's and other risk factors is reduced with the administration of which medication? A. Furosemide (Lasix) B. Lovastatin (Mevacor) C. Daily low-dose aspirin D. Nimodipine (Nimotop)

C. Daily low-dose aspirin

The nursing is preparing discharge instruction for a client recently diagnosed with seizures. Which if the following statements by the patient indicates a need for clarification? A. I should maintain my appt schedule B. I should report any changes in seizure activity C. I can stop my meds if I have not had seizure in 6months D. I should take my meds as scheduled

C. I can stop my meds if I have not had seizure in 6months

A recently hospitalized patient with MS is concerned about generalized weakness and fluctuating physical status. What is the priority nursing intervention for this patient? A. Teach that disease process is not chronic B. Encourage one of the patients relatives to stay at bedside C. Space activity throughout the day D. Encourage bedrest

C. Space activity throughout the day

When caring for an older client with hypertension who has been hospitalized with a transient ischemic attack, which topic is the most important for the nurse to include in the discharge teaching? A. Effect pf atherosclerosis on blood vessels B. Mechanism of action anticoagulant therapy C. Symptoms indicating that the patient should contact the health care provider D. Impact of patient's fam history on likelihood of developing a serious stroke

C. Symptoms indicating that the patient should contact the health care provider

You are teaching Mr. Jones about the medications prescribed, including metronidazole, esomeprazole, and amoxicillin. Which statement by the patient indicates the best understanding of the medication regiment? A. My ulcer will heal because these medications will kill the bacteria B. These medications are only taken when I have pain from my ulcer C. the medications will kill the bacteria and stop the acid production D. These medications will coat the ulcer and decrease the acid production in my stomach

C. the medications will kill the bacteria and stop the acid production

A female client with viral hepatitis A is being treated in an acute care facility. Because the client requires enteric precautions, the nurse should: A.place the client in a private room. B. wear a mask when handling the client's bedpan. C. wash the hands after touching the client. D. wear a gown when providing personal care for the client

C. wash the hands after touching the client.

The nurse is doing an admission assessment on a client with a history of duodenal ulcer. To determine whether the problem is currently active, the nurse should assess the client for which manifestation of duodenal ulcer? A.Weight loss B.Nausea and vomiting C.Pain relieved by food intake D.Pain radiating down the right arm

C.Pain relieved by food intake