NCAF Final Exam
which instruction would the nurse include in the discharge plan for a female patient diagnosed with ulcerative colitis (UC) who is going home on loperamide for symptomatic management of diarrhea?
"Be aware of the symptoms of toxic megacolon that we discussed"
which instruction does the nurse provide to a patient who is being discharged from an outpatient (same-day) surgery unit after a modified radical mastectomy?
"Elevate the affected arm on a pillow"
which statement by the patient indicates a need for further teaching about asthma medication management and the need to use a long-acting beta agonist (LABA) as directed?
"I may use the LABA as needed for wheezing and coughing"
which statement indicates an understanding of the correct use of emergency drug therapy for asthma?
"I must have my emergency inhaler with me at all times"
a patient with ulcerative colitis has stage 1 of a restorative proctocolectomy with Cleo pouch-anal anastomosis (RPC-IPAA) procedure performed. The patient asks the nurse, "How long do people with this procedure usually have a temporary ileostomy?" How would the nurse respond?
"It is usually ready to be closed in about 1 to 2 months"
which response is best when a patient asks the nurse how montelukast helps asthma?
"It prevents the synthesis of leukotrienes that can cause bronchoconstriction and inflammation"
how does the nurse respond when a patient who is scheduled for a breast mammography asks about the purpose of the diagnostic test?
"It reveals masses too small to be palpated by hand"
after discussing treatment options with a patient newly diagnosed with breast cancer, the nurse identifies that which statement by the patient indicates the need for further teaching?
"Radiation will remove the cancer, so I might not need surgery"
Which information would the nurse provide to a patient with chronic obstructive pulmonary disease (COPD) who is using home oxygen at a flow rate of 4L/min via nasal cannula but experiencing only moderate improvement of shortness of breath?
"Shortness of breath may continue even with oxygen therapy"
which instruction would the nurse give a patient when teaching about dietary methods to help manage exacerbations of diverticulitis?
"consume a low-fiber diet while your diverticulitis is active. When inflammation resolves, consume a high-fiber diet."
the nurse is providing teaching to a patient who follows a lacto-ovo vegetarian diet. Which statement by the nurse is most appropriate regarding a sufficient intake of vitamin B12?
"egg yolks contain a high amount of vitamin B12"
which explanation does the nurse give to a patient with a hard, irregularly shaped mass in the breast and enlarged axillary lymph nodes?
"it is difficult to distinguish these findings from cancer"
a patient newly diagnosed with ulcerative colitis is started on sulfasalazine. Which explanation will the nurse give the patient about the reason for the use of this drug?
"this medication is used to reduce intestinal inflammation"
which instruction would be beneficial to an asthmatic patient who is allergic to pollen and is prescribed cromolyn sodium, but the patient reports that it does not help relieve symptoms during an asthma attack?
"use cromolyn sodium on a routine basis to prevent an asthma attack, not as a rescue inhaler"
which statement about ductal carcinoma in situ (DCIS) is accurate?
DCIS is an early noninvasive form of breast cancer
a patient with suspected appendicitis reports having abdominal pain around the umbilicus for the past 2 days, associated with decreased hunger and episodes of vomiting. Which nursing statement and patient response helps confirm the diagnosis?
Nurse: "When did the pain and vomiting begin?" Patient response: "The pain started 2 days ago, and yesterday I started vomiting"
which reason is accurate as to why patients with asthma must avoid taking aspirin or NSAIDS for pain or fever?
They allow increased production of leukotrienes
the nurse expects that which diagnostic test will be prescribed for a patient who is suspected of having breast cancer?
breast biopsy
which syndrome may result in the compression of the median nerve?
carpal tunnel syndrome (CTS)
a patient with ulcerative colitis is prescribed sulfasalazine and corticosteroid therapy. as the disease improves, which change would the nurse expect in the patient's medication regimen?
corticosteroid therapy will be tapered
athletes are likely to experience which type of fracture?
fatigue
which instruction would the nurse emphasize when teaching a patient with Crohn disease about managing the disease with the drug adalimumab?
"avoid large crowds and anyone who is sick"
an older adult patient who has sustained a left hip fracture is in considerable pain. the nurse would anticipate that the patient will be placed in which type of traction?
Buck traction
which option for prevention and early detection of breast cancer is the treatment of choice for a patient with a high genetic risk?
MRI and mammography every year beginning at age 30
a patient reports pain midway between the anterior iliac crest and the umbilicus in the right lower quadrant. the nurse would document that the patient is experiencing pain in which location?
McBurney point
Which is an expected outcome for a patient with moderate chronic obstructive pulmonary disease (COPD) who usually has an oxygen saturation of 88% to 90% with 2L/min of oxygen via nasal cannula and walks to the end of the driveway and back each day? The patient's ideal body weight is 150 lb, but the patient currently weighs 130 lb.
The patient will be able to increase weight to at least 135 lb.
the nurse reviews a medical record of a female patient and identifies that which finding indicates that the patient has a high risk for developing breast cancer?
a mother and sister with breast cancer
after receiving a change-of-shift report, the nurse would assess which patient first?
a patient who has just been admitted with possible appendicitis and has a temperature of 102ºF
which factors would the nurse inquire about when taking the medical history of a patient with suspected appendicitis?
abdominal pain followed by nausea and vomiting
which examination is used to identify an enlarged appendix in a patient?
abdominal ultrasound
which classic symptom is seen in a patient with peritonitis?
abdominal wall rigidity
a patient with status asthmatics has the following assessment findings: a respiratory rate of 35 breaths/min, a heart rate of 110 beats/min, high-pitched wheezes in all lung fields, and marked use of accessory muscles to breathe. The patient is receiving an IV steroid and a continuous nebulized bronchodilator medication. Which assessment reveals a worsening of this patient's condition?
absence of wheezing
while assessing a patient who recently suffered a broken tibia, the nurse notes the presence of edema, pale skin, and weakened pulse and the patients report of severe pain. which condition would the nurse anticipate incorporating into the plan of care?
acute compartment syndrome
which complication would the nurse monitor for when caring for a patient with a tibial fracture?
acute compartment syndrome (ACS)
which intervention would be in the plan of care for the patient with peritonitis who is prescribed hypertonic IV fluids and broad spectrum antibiotics?
administer analgesics monitor daily weight, intake, and output monitor all pain assessments and interventions
which prescribed medication would the nurse administer first to a patient with asthma who has pneumonia, is reporting increased shortness of breath, and has inspiratory and expiratory wheezes?
albuterol 2 inhalations
which complications would the nurse monitor for in a patient with a pelvic fracture?
arterial bleeding blood volume loss abdominal rigidity blood in urine and stool
a patient reports a history of wrist pain after an attempt to break a fall by landing on the heel of the hand with an extended wrist. which type of fracture would the nurse suspect?
colles fracture
the nurse reviews options for breast cancer treatment and discusses that which type of treatment does not alter the outcome of the cancer?
complementary and integrative therapy
which complication of fractures manifests as a clinical triad of sensory perception abnormalities, motor dysfunction such as paresis and muscle spasm, and autonomic nervous system abnormalities?
complex regional pain syndrome (CRPS)
the nurse is caring for a patient with chronic obstructive pulmonary disease (COPD) who reports increased fatigue and nausea. The nurse notes distended neck veins, bounding peripheral pulses, dependent edema, and cyanosis of the lips and hands. The nurse notifies the health care provider of which condition?
cor pulmonale
which classic symptom is associated with appendicitis?
cramping pain in the epigastric area
when caring for a patient admitted with a flare up of systemic lupus erythematosus (SLE) receiving IV corticosteroids, which assessment would the nurse include related to this medication?
daily weights blood glucose blood pressure intake and output
a patient who is receiving an IV antibiotic begins to cough and states "My throat feels like it is swelling." Which action will the nurse take next?
discontinue infusing the antibiotic
which sign or symptom would the nurse teach a patient newly diagnosed with systemic lupus erythematosus (SLE) to report to the health care provider?
edema weight gain decreased output
the nurse includes which instruction when providing discharge teaching to a patient after breast cancer surgery?
empty the drain twice daily
Which benign breast disorder is the most similar to breast cancer?
fibroadenoma
during an annual wellness check, a 21-year-old female patient states, "I experience a lot of pain in my breasts right before my menstrual cycle begins. When my cycle is over, the pain goes away, but then it returns during the next cycle." Which benign breast disorder is the patient most likely experiencing?
fibrocystic changes (FCCs)
which complication is most commonly seen in Crohn disease?
fistulas
Which potential complication is associated with Crohn Disease?
fistulas osteoporosis malabsorption abscess formation
the nurse is instructing a patient with recently diagnosed diverticular disease about diet. which food would the nurse suggest the patient include?
five-grain bread
which finding would the nurse expect to see on a patient's chest x-ray who has chronic obstructive pulmonary disease (COPD) with a barrel chest and expiratory wheezes in the lower lobes, decreased remits, and hyper resonance with chest percussion?
flattening of the diaphragm
the nurse suspects which cause of skin excoriation that is present under the breasts of an obese female patient?
fungal infection
an African-american patient taking a thiazide diuretic develops hemolytic anemia. The nurse notifies the health care provider and anticipates a prescription to test this patient for which type of anemia?
glucose-6-phosphate dehydrogenase (G6PD) deficiency
which laboratory parameter would the nurse assess in the patient who presents with symptoms of diverticulitis?
hematocrit hemoglobin white blood cell (WBC) count
a patient presents to the emergency department with a new onset of bruising and a petechial rash around the upper chest and arms. The patient's laboratory results demonstrate a platelet count of 51,000 platelets/mL. Which action by the nurse is most appropriate
implement bleeding precautions
which information would the nurse include when teaching a patient newly diagnosed with SLE about managing the disease and preventing setbacks?
include aerobic exercise plan frequent rest periods avoid crowded public areas stay in shady areas outdoors use mild, nonastringent soap
which laboratory finding is consistent with ulcerative colitis (UC)?
increased C-reactive protein decreased potassium levels
a patient with iron deficiency anemia has a prescription for ferrous sulfate. Which finding by the nurse indicates a positive outcome from the medication?
increased energy
which physiologic change related to acute compartment syndrome is responsible for symptoms of flexed posture and unequal pulses in a patient?
increased production of lactic acid
diverticulitis
inflammation of the diverticulum, especially in the colon. CIPROFLOXACIN should be administered in this condition to reduce inflammation.
a patient has a low-grade fever and tenesmus. which other clinical manifestation may indicate ulcerative colitis?
inflammation of the joints
the nurse is caring for a patient who has weakness, pallor, fatigue, reduced exercise tolerance, and fissures at the corners of the mouth. The nurse recognizes these symptoms are associated with which condition?
iron deficiency anemia
which action will the nurse do next when a patient's family is expressing concern about the new diagnosis of chronic pulmonary disease (COPD) in their loved one?
listen to the basis of the family's concerns, and then develop a focused teaching plan
which side effect is associated with aromatase inhibitors that are used to treat breast cancer?
loss of bone density
which intervention does the nurse include in a plan of care for a patient who underwent a modified radical mastectomy?
monitor the volume and amount of drainage observe the wound for signs of swelling or infection avoid using the affected arm for measuring blood pressure
which complication is associated with compartment syndrome?
myoglobinuria renal failure
which assessment finding indicates to the nurse that a patient is at high risk for a malignant breast lesion?
nipple retraction and dimpling
which IV solution is compatible for administration of blood products?
normal saline
a patient was admitted to the hospital for evaluation of abdominal pain. The patient is unable to pass flatus, and the abdomen has become firm and distended. The nurse is unable to hear bowel sounds. The patient has a heart rate of 90 beats/min and a temperature of 39ºC (102.2ºF). Which action would the nurse take?
notify the health care provider immediately of this potentially life threatening situation (the patient is showing signs of peritonitis, which is a life-threatening condition)
the nurse questions which item that is listed on a postoperative plan of care for a patient after a modified radical mastectomy of the left breast?
obtain the patient's blood pressure on the left arm
which condition increases a patient's risk for hospital-acquired infection?
open fractures
which reason is the most important for prescribing inhaled, rather than oral, corticosteroids for patients with asthma?
oral corticosteroids have more adverse effects
an older-adult patient who underwent an open reduction internal fixation (ORIF) reports constipation. Which drug would the nurse suspect may have caused this complication?
oxycodone
Which finding prompts the nurse to notify the health care provider when assessing a patient who has chronic obstructive pulmonary disease (COPD) 15 minutes after an aerosolized bronchodilator has been administered?
oxygen saturation of 87%
which symptoms are a typical clinical manifestation of anemia?
pallor, fatigue, tachycardia, dyspnea on exertion
which patient does the nurse consider at risk for folic acid deficiency anemia?
patient with Crohn disease
which discharge instruction does the nurse provide to a patient who underwent a lymph node dissection?
perform reaching and stretching exercise only until the point of pain
a patient has aplastic anemia. the nurse regularly assesses which diagnostic test result?
platelets, white blood cells, hemoglobin/hematocrit
which nursing action is the highest priority for a patient with Crohn disease who has developed a fistfula between the bowel and bladder?
providing adequate nutrition and fluid and electrolytes
which nursing action would help minimize a patient's discomfort when experiencing an exacerbation of ulcerative colitis?
restricting lactose-containing foods
when administering an antibiotic IV for the first time, which action is first before checking the five rights?
review the clinical records and ask the patient about any known allergies
the nurse is to administer packed red blood cells to a patient. How does the nurse ensure proper patient identification?
reviews all information with another registered nurse
the nurse is teaching a patient with iron deficiency anemia about increasing the intake of dietary iron. The nurse considers the teaching successful when the patient makes which food selection?
roast beef
a patient with SLE presents to the clinic for a 3-month follow-up visit after beginning treatment with hydroxychloroquine. Which finding would lead the nurse to conclude the patient understands disease maintenance?
scheduled an eye examination in 3 months
which disease can be categorized as an autoimmune disease?
scleroderma, rheumatic fever, good pasture syndrome
which advantages are seen with open reduction and external fixation over other surgical techniques?
stabilizes comminuted fractures requiring bone grafting maintains closed fracture alignment not possible with a cast facilitates early ambulation and exercise while relieving pain promotes minimal blood loss compared with internal fixation
which classic symptom is seen in celiac disease?
steatorrhea abdominal pain diarrhea and/or constipation
a patient has been diagnosed with immunohemolytic anemia. Which treatment does the nurse anticipate administering for this disorder?
steroids
which hypersensitivity reaction symptom requires the most immediate action by the nurse?
stridor
Which nursing intervention will help prevent chronic fatigue in patients with chronic obstructive pulmonary diseases (COPD)?
teaching the patient to not rush through morning activities
which statement about the early detection of breast masses is correct?
the goal of screening for breast cancer is early detection
Which symptom is specific for asthma compared with other chronic lung disorders
the patient is symptom-free between exacerbations
which rationale is accurate as to why blood cultures are obtained in a patient with peritonitis?
to determine septicemia
for which purpose does the nurse observe a patient's reaction to the surgical incision from breast cancer surgery?
to evaluate the patient's coping skills
a patient has glucose-6-phosphate dehydrogenase (G6PD) deficiency. The nurse teaches the patient to avoid which substance?
trimethoprim-sulfamethoxazole
which instruction for joint protection does the nurse recommend for a patient with a connective tissue disease?
use long-handled devices such as a reacher use adaptive devices such as velcro closures
after teaching a patient with systemic lupus erythematosus (SLE) ways to manage disease-related pain by decreasing inflammation, which action made by the patient indicates a need for further instruction?
uses acetaminophen for pain
a patient has pallor; jaundice; a smooth, beefy-red tongue; has been experiencing difficulty with balance; and reports tingling of the hands and feet. the patient's laboratory workup indicates macrocytic anemia. the nurse notifies the health care provider of these findings and anticipates a prescription for which medication?
vitamin B12
which sign or symptom is significant in diagnosing asthma in a nonsmoker?
wheezing