Final Exam Practice Questions
A 63-year-old female patient is lactose intolerant and is recovering from a broken hip. The nurse recognizes that this patient is most likely suffering from: a.Hypocalcemia b.Hypokalemia c.Hyponatremia d.Diarrhea
a.Hypocalcemia
A patient admitted two days ago for dehydration is ready for discharge teaching. He reports that since he felt so terrible when he came in, he has been drinking about 800ml of water per hour for the last few hours to "prevent that from ever happening again". Which of these will occur if this continues? a.Hyponatremia b.Hyperkalemia c.Lowered extra cellular fluid volume d.Nothing significant
a.Hyponatremia
Improving urinary continence problems reported by a 45 y.o. patient with a BMI of 41 include teaching the patient that: select all that apply. a.Losing weight would help a lot b.Surgery will be necessary c.Stress incontinence can be normal d.Kegels are unlikely to help
a.Losing weight would help a lot
Describe immunity in terms of passive
antibodies are passively acquired (short-term)
Describe immunity in terms of active
antigens stimulate antibodies (long-term)
Which of the following is a common problem for blind people, particularly those totally without sight? a.Hordeolum b.Keratitis c.Non-24 sleep/wake disorder d.Increased ocular pressure
c.Non-24 sleep/wake disorder
What reading is considered legal blindness?
20/200
Which of the following are assessment findings common in older adults related to hearing? Select all that apply: A. Presbycusis B.Tinnitus C.Conductive hearing loss D.Alterations in balance
A. Presbycusis B.Tinnitus C.Conductive hearing loss D.Alterations in balance
Which of the following is an example of the avoidance symptom cluster for PTSD? A. Sense of a foreshadowed future B.Flashbacks C.Hypervigilance D.Distorted feelings like guilt or shame
A. Sense of a foreshadowed future
In a patient, the sound is lateralized to the left ear (unaffected ear). The nurse interprets this finding as: A. Sensorineural heating loss B.Conductive hearing loss C.Normal findings D.Suggests acoustic neuroma
A. Sensorineural hearing loss
Which of the following STIs have treatments that are curative? Select all that apply: A. Syphilis B.Genital Herpes C.Human papillomavirus D.Gonorrhea E.Chlamydia
A. Syphilis D.Gonorrhea E.Chlamydia
The patient is experiencing erectile dysfunction (ED). What should the nurse include in the teaching plan for this patient? Select all that apply: A.A common cause is sedentary lifestyle and obesity. B.ED may be due to medications or conditions like Diabetes. C.Only men 70 years or older benefit from PDE5 inhibitors. D.There are medications and devices that can help with erections.
A.A common cause is sedentary lifestyle and obesity. B.ED may be due to medications or conditions like D.There are medications and devices that can help with erections.
A patient with diabetes tells the nurse that he usually can keep his blood sugar under control with diet alone, but he has been very stressed with a very difficult work situation for the past 6 months and his blood sugars have been very high. Which response by the nurse is the most appropriate? A. "Your body decreases the production of epinephrine and cortisol to help you breathe better". B."Stress causes the release of hormones that can lead to an increase in your blood sugar levels." C."Increased blood sugar occurs because the heart and kidneys are on overload when you are stressed." D."Your diet is often different during stressful times, so that is the most likely cause of your increased glucose levels."
B."Stress causes the release of hormones that can lead to an increase in your blood sugar levels."
A patient in the clinic today tells the nurse that they are experiencing flashes of light and floaters in one eye and a cobweb like effect in the vision in that eye. The nurse would suspect which of the following based on this patient report? A.Cataracts B.Detaching retina C.Macular degeneration D.Glaucoma
B.Detaching retina
Which of the following are assessment findings of the visual system due to effects of aging? Select all that apply: A. Increased pupil size B.Increased "floaters" C.Reports of glare, impaired night vision D.Increased number of cones E.Decrease in accommodation
B.Increased "floaters" C.Reports of glare, impaired night vision E.Decrease in accommodation
A woman has a change in vaginal discharge, burning with urination and spotting after sex. From these symptoms which of the following STIs does the nurse suspect? A. Genital herpes B.Trichomoniasis C.Human papillomavirus D.Syphilis
B.Trichomoniasis
In taking a sexual health history, which of the following techniques are recommended? Select all that apply: A. React overtly to all the patient statements B.Use inclusive and neutral terms C.Rephrase your questions if needed D.Assess for common understanding of terms
B.Use inclusive and neutral terms C.Rephrase your questions if needed D.Assess for common understanding of terms
Which of the following is the best way to assess the client's history? a.Can you tell me why you think you've been losing so much weight? b.What is your view of why you aren't able to eat enough? c.Please tell me about your eating routine and weight. d.Please share how you are unable to maintain your weight.
c.Please tell me about your eating routine and weight.
The nurse is reviewing the health risks of her patients. Which patient has the highest risk for getting a sexually transmitted infection? A. A 55 year old sales clerk B.A 70 year old who has just been widowed C.A 24 year old who often has new sexual partners D.A 45 year old who has a monogamous sexual relationship
C. A 24 year old who often has new sexual partners
The client suffers from functional urinary incontinence. Which one of these is the best option for this person? a.Establish a routine for an in-and-out catheter b.Have the patient void every two hours on schedule c.Switch from button-up pants to elastic d.Wake the patient during the night to void
c.Switch from button-up pants to elastic
The nurse includes assessment questions about sexual health for a patient recently diagnosed with irritable bowel disease. After she states, "People with IBD sometimes have sexual difficulties", which question would be most effective? A. "What dimensions of sexual dysfunction have you experienced since your diagnosis?" B."Your diagnosis with IBD hasn't caused any discomfort with your sex life has it?" C."Can you identify any changes in your sexual activity since your diagnosis with IBD?" D."How are you doing with your sex life?"
C. Can you identify any changes in your sexual activity since your diagnosis with IBD?"
A client is in therapy to learn ways to improve their coping to stress. What is the primary goal of this therapy? A. Modify sedentary lifestyle B.Avoid stressful situations C.Alter their response to stress D.Limit major sources of stress
C.Alter their response to stress
An older patient in the clinic this morning has severe sensorineural hearing loss. The nurse reviews the patient's history. What factor in the history could have caused this hearing loss? Select all that apply: A. An occupation as a math professor for many years B.Use of softening agent to remove cerumen C.Hobby of deer hunting D.Vancomycin treatment for serious infection
C.Hobby of deer hunting D.Vancomycin treatment for serious infection
Which of the following would be included in a teaching plan for a Veteran experiencing PTSD? A. Narrowing your window of tolerance will be important to your recovery. B.Revisiting distressing parts of your traumatic event is always avoided. C.Medications such as SSRIs may be helpful in treating some of your symptoms. D.Joining in new social situations is usually discouraged.
C.Medications such as SSRIs may be helpful in treating some of your symptoms.
The nurse is delivering a class on sexually transmitted infections for her community. Which of the following are accurate teaching points about STIs? Select all that apply: A. Chlamydia is a very common STI and is highly symptomatic in both men and women. B.Syphilis is much more common than Chlamydia and poses little risk in pregnancy. C.Syphilis is a risk factor for acquiring human immunodeficiency virus (HIV) infection. D.Chlamydia can cause pneumonia and serious eye infection in the newborn.
C.Syphilis is a risk factor for acquiring human immunodeficiency virus (HIV) infection. D.Chlamydia can cause pneumonia and serious eye infection in the newborn.
Which of the following treatments is recommended as first-line treatment for PTSD? A.Long-term psychoanalysis B.Benzodiazepines C.Trauma-focused psychotherapy D.Atypical antipsychotics
C.Trauma-focused psychotherapy
The nurse performs a diagnostic study in the clinic this morning for a patient with complaints of muffled hearing, dizziness and nausea/vomiting. The nurse places a vibrating tuning fork on the midline of the forehead and the patient is to indicate where the sound is best heard. What is the test the nurse performed? A. Auditory brainstem response B.Tympanometry C.Weber test D.Rinne test
C.Weber test
The patient presents with hematuria, low abdominal pain, and is afebrile. What should the nurse assess for next? a.Pyelonephritis b.Glomerulonephritis c.Trauma to abd or bladder d.Familial history of bladder ca
c.Trauma to abd or bladder
Myopia is the most common refractory error with about 30% of Americans having this disorder. Which of the following statements accurately reflect this disorder? A. Inability to accommodate for objects that are near. B.Person can see objects at a distance, but near objects are blurry C.May occur because of an abnormally short eye D.The tendency for myopia may be inherited
D.The tendency for myopia may be inherited (Myopia is near sidedness)
Which of the following are points to be included in a postoperative teaching plan for a patient having cataract surgery? A. Considerable postoperative pain is expected B.Photophobia is rare after surgery C.Visual acuity is usually immediate D.Avoid activities such as bending or lifting
D.Avoid activities such as bending or lifting
Give an example of how you might use the "P" component with a patient.
Giving the patient permission to raise sexual issues
What is the most common STI in the US?
HPV
What are examples of primary prevention in sexual heath?
HPV vax and education
What are the components of the PLISSIT model?
P- permission LI- Limited Information SS- Specific Suggestions IT- Intensive therapy
A 22-year-old is seen at the SHAC for lethargy, nausea and vomiting. She reportedly is not going to class for the last week and has been eating only ramen noodles since becoming vegan this term. The nurse is aware that this patient is likely showing signs of: a.Fluid volume deficit b.Fluid volume excess c.likely low B12 d.Anorexia nervosa
c.likely low B12
What are examples of tertiary prevention in sexual heath?
Prevention of PID or infertility
What are examples of secondary prevention in sexual heath?
STI screening
Which one of the following is used to determine the adequacy of ongoing enteral feedings? a.Hepatic function test b.Electrolytes c.prealbumin d.BUN & Cr
c.prealbumin
The patient needs dialysis stat due to dangerous electrolyte abnormalities. Which type of dialysis would be preferred? a.HD PD
a.HD because it's faster
The most likely lab finding on a pt with CKD is: a.High Cr b.Low Hgb c.Low RBCs d.High WBCs in urine
a.High Cr
Describe how circulation changes when the body has mild hypothermia?
Vasoconstriction (increases BP and HR)
Describe how circulation changes when the body has severe hypothermia?
Vasodilation (decreases BP and HR)
How would the nurse interpret a reading of 20/40 on the Snellen eye chart?
You must be 20 feet from things that people with "normal" vision can see at 40 feet to have the same experience.
The community health nurse is conducting a research study and is identifying clients in the community at risk for latex allergy. Which client population is most at risk for developing this type of allergy? a. Hairdressers b. The homeless c. Children in day care centers d. Individuals living in a group home
a. Hairdressers
1. The HIV positive patient demonstrates understanding of the disease when they state that it is safe to: select all that apply. a. Kiss an intimate partner on the lips b. Have unprotected sex in a monogamous relationship c. Share needles as long as cleaned between uses d. Feed the baby breastmilk after delivery e. Share utensils and cups when eating
a. Kiss an intimate partner on the lips e. Share utensils and cups when eating
The nurse is assisting in planning care for a client with a diagnosis of immunodeficiency and should incorporate which action as a priority in the plan? a. Protecting the client from infection b. Providing emotional support to decrease fear c. Encouraging discussion about lifestyle changes d. Identifying factors that decreased the immune function
a. Protecting the client from infection
A urine specific gravity can be normal, high, or low. Which of the following patients will likely have the corresponding urine specific gravity? a.A patient who had a prolonged extrication, status post rollover motor vehicle crash (MVC)- b.Patient with normal renal function recovering from fluid resuscitation after a traumatic bleed- c.A burn patient in the hospital for four months recovering from multiple grafts having PT-
a. high b. low c. normal
What word fits the description? a."I pass a lot of water each time." b."My lower back aches today." c."It burns every time that I pee." d."My grandpa can't get it started." e."My wife goes a little every hour." f."I haven't made urine this week."
a. polyurea b. CVA pain c. dysuria d. hesitancy e. frequency f. anuria
Which assessment finding indicates the patient's L arm AV fistula is patent? a.+ thrill over the left arm site b.Presence of radial pulse c.Visualizing the enlarged vessel at the site d.Normal cap refill on the left fingers
a.+ thrill over the left arm site
1. The nurse will assist the patient with changing their clothing. The patient's kaposi's sarcoma lesions are open and draining serous fluid. What is the appropriate PPE? a. Gloves only b. Gloves and gown c. Gloves and mask d. Gloves, gown, and mask
b. Gloves and gown
A 20 y.o. patient classified as healthy has a BMI of: a.12 b.22 c.28 d.39
b.22
Which of the following are required to include with teaching the patient about the proper use of bulk-forming laxatives? Select all that apply. a.Eat plenty of green leafy vegetables b.Adequate water intake is crucial c.Closely monitor urinary output d.Blockage can happen with fiber
b.Adequate water intake is crucial d.Blockage can happen with fiber
Which of the following is the highest priority option for a patient with large open wounds who is unable to eat? a.Change dressings on wounds twice per day b.Establish an enteral tube and start feedings c.Suggest a central line to begin total parenteral feedings d.Prepare the patient for skin grafting in the OR
b.Establish an enteral tube and start feedings
The patient states she has been doing great managing her diabetes since the last visit. She denies the need for any further education managing her sugars. Which of these could be used as evidence that she could benefit from more education for her diabetes? a.Finger stick glucose 125 b.Hg A1C 7.7 c.Potassium of 4.6 d.Cholesterol of 240
b.Hg A1C 7.7
The patient is suffering from cerebral edema, has elevated intracranial pressure (ICP), and is barely conscious. Which kind of fluid would the provider most likely order? a.Isotonic IV fluids b.Hypertonic IV fluids c.Hypotonic IV d.PO Gatorade
b.Hypertonic IV fluids
On a follow-up visit for CKD, the GFR is reduced. Which of the following is the most likely interpretation of this finding? a.There is an intrinsic renal injury occurring b.Kidney disease may be worsening c.There is a progression to AKI d.Post renal failure is likely
b.Kidney disease may be worsening
The lab results show Sodium 142, Potassium 5.7, Magnesium 2.5, Phosphorus 4.0, BUN 4, Creatinine 1. What is the priority nursing action? a.Measure strict daily weights b.Monitor for dysrhythmias c.Assess the patient's level of consciousness d.Stop all fluid intake
b.Monitor for dysrhythmias
Which one of the following inpatients is high risk for altered urinary elimination? a.Diagnosed with acute pancreatitis who is recovering from an ERCP procedure two hours ago b.Patient with cervical spine precautions with altered sensation to bilateral feet c.Status post lower G.I. imaging with IV, oral, and PR contrast administration d.Patient on a ventilator who has a urinary catheter and vasoactive drugs running I.V.
b.Patient with cervical spine precautions with altered sensation to bilateral feet
Which of the following is the most likely to lead to death? a.Wound in the larynx after intubation for surgery b.Perforation after outpatient sigmoidoscopy c.Allergic reaction to IV contrast during a CT d.Patient fall off of the table after MRI of the kidneys
b.Perforation after outpatient sigmoidoscopy
What type of AKI does the patient have related to a large tumor on the bladder? a.Intrarenal b.Postrenal c.Prerenal d.Intrinsic
b.Postrenal
The nurse is preparing to assess the assigned patients. Which of these is MOST likely to develop fluid volume deficit? a.A client with Heart Failure b.The patient with an ileostomy c.A patient on long-term corticosteroid therapy d.The client with continuous bladder irrigation
b.The patient with an ileostomy because water is absorbed in the small intestine so not as much water can be absorbed
Which of these is most likely to lead to c/o 2 days of abdominal cramping and watery stools? Select all that apply. a.Long-term diet high in large amounts of fiber b.Taking laxatives every day for several months c.Being prescribed P.O. antibiotics for a new UTI d.Having freshly unwashed lettuce in your salad
c.Being prescribed P.O. antibiotics for a new UTI d.Having freshly unwashed lettuce in your salad
A patient with a history of hypertension, BPH, and diabetes is becoming tachycardic and agitated. What should the nurse assess first? a.Cardiac enzymes and ECG b.Hg A1C and chemistries c.Bladder distension d.Lung sounds and o2 sat
c.Bladder distension
Which condition would lead to a decrease in serum osmolality? a.Type 2 diabetes b.Bolus of normal saline c.Elevated ADH d.Having a high salt meal
c.Elevated ADH because the kidneys hold water
A Grand Canyon hiker drinks as much water as she can when she rests at a water source for 30 minutes, what happens to her urine specific gravity? a.It stays the same b.It increases from higher output c.It decreased from dilution
c.It decreased from dilution
To prevent AKI in a patient with massive soft tissue trauma to the legs, the nurse knows the best way to do this is to: a.Watch for dysrhythmias b.Keep daily weights unchanged c.Maintain a high renal blood flow d.Encourage ambulation and exercise
c.Maintain a high renal blood flow
The patient has anemia due to inadequate iron intake. Which one of these is best for her? a.Nuts and milk b.Coffee and tea c.Cooked oats and fish d.Oranges and dark green leafy veggies
d.Oranges and dark green leafy veggies
Which of these should be encouraged first to improve urinary incontinence? a.Pelvic floor support devices b.Medications c.Noninvasive surgery d.Pelvic floor exercises
d.Pelvic floor exercises
A patient recovering from sepsis secondary to pneumonia suffered an acute kidney injury. The patient had very low urine output for two days and is now having up to 200 mls out per hour. Which phase is the patient in? a.Oliguria b.Anuria c.Euvolemia d.Polyuria
d.Polyuria
Which of the following is most closely tied to the proper level of hydration in the patient? a.Phosphorus b.Potassium c.Magnesium d.Sodium
d.Sodium
1.The patient with a new diagnosis of brain cancer has worsening bilateral crackles and +2 pitting ankle edema. Which one of these is the most likely cause of these recent findings? a.The tumor is causing hypernatremia b.A diuretic like Lasix was administered c.The kidneys are failing d.The tumor is causing elevated ADH
d.The tumor is causing elevated ADH
Your professors take a speed-walk around the golf course three times on a really hot day in the sun and forgot to bring any water along. One normal compensatory mechanism that should happen is: a.Intravascular volume is maintained by pulling from the interstitial space b.Intracellular fluid will increase to conserve water movement to sweating c.The endothelium in the bladder will reabsorb some fluid reducing losses d.Urine output will decrease from release of ADH to maintain blood pressure
d.Urine output will decrease from release of ADH to maintain blood pressure
Describe immunity in terms of active natural
from clinical infection
Describe immunity in terms of active artificial
from immunizations (live or killed vaccines)
Describe immunity in terms of passive artificial
injection of antibodies from human serum
What kind of STI is trichomoniasis?
parasite (protozoic)
What are the signs and symptoms of moderate hypothermia?
shivering, confusion, fine motor coordination impairment, muscle rigidity, pale skin
What are the signs and symptoms of severe hypothermia?
shivering, confusion, fine motor coordination impairment, muscle rigidity, pale skin fixed/dilated pupils, VS deteriorate, loss of radial pulse, profound bradycardia, asystole
What are the signs and symptoms of mild hypothermia?
shivering, dysarthria, muscular incoordination, mental slowness, clod diuresis, vasoconstriction
What is a loopogram?
substitute for the urinary bladder with an ostomy
Describe immunity in terms of passive natural
trans-placental and through colostrum
What is an Antinuclear antibody (ANA)?
when the body doesn't recognize itself anymore so it starts attacking itself
