NU302 first 15 exam 1

A patient is admitted to the oncology unit for diagnosis of suspected Hodgkin's disease. Which of the following symptoms is typical of Hodgkin's disease? A.Painful cervical lymph nodes. B.Night sweats and fatigue. C.Nausea and vomiting. Weight gain.

B. Symptoms of Hodgkin's disease include night sweats. fatigue. weakness. and tachycardia. The disease is characterized by painless. enlarged cervical lymph nodes. Weight loss occurs early in the disease. Nausea and vomiting are not typically symptoms of Hodgkin's disease.

A patient's potassium level is 3.0. Which foods would you encourage the patient to consume? Normal range is 3.5- 5 A. Avocados, Strawberries, and potatoes B. Cheese, collard greens, and fish C. Tofu, oatmeal, and peas D. Peanuts, bread, and corn

A. Avocados, Strawberries, and potatoes

When a client is diagnosed with aplastic anemia, the nurse monitors for changes in which of the following physiological functions? A. Bleeding tendencies B. Intake and output C. Peripheral sensation D. Bowel Function

A. Bleeding tendencies

The Hodgkin's disease patient described in the question above undergoes a lymph node biopsy for definitive diagnosis. If the diagnosis of Hodgkin's disease were correct. which of the following cells would the pathologist expect to find? A.Reed-Sternberg cells. B.Lymphoblastic cells. C.Gaucher's cells. D.Rieder's cells

A. A definitive diagnosis of Hodgkin's disease is made if Reed-Sternberg cells are found on pathologic examination of the excised lymph node

Which patient would benefit from a Nasogastric Tube? A. A stroke victim who failed their swallow evaluation B. A patient with Congestive Heart Failure C. A patient who had a left leg amputation D. A patient with a Platelet count of 50

A. A stroke victim who failed their swallow evaluation

A nurse is teaching a client who has pernicious anemia. The nurse should encourage the client to increase consumption of which of the following foods? A. Eggs B. Spinach C. Kale D. Tofu

A. Eggs

Which sign/symptom should the nurse expect to assess in the client diagnosed with hemophilia A? A. Epistaxis. B. Petechiae. C. Subcutaneous emphysema. D. Intermittent claudication.

A. Epistaxis.

A patient's blood tests show they have a critically low parathyroid hormone (PTH). What effect would this have on phosphate and calcium levels in the blood? A. Phosphate levels high, calcium levels low B. Phosphate and calcium levels high C. Phosphate and calcium levels low D. Phosphate levels low, calcium levels high

A. Phosphate levels high, calcium levels low (inverse relationship)

Which of the following is not a symptom of hyperkalemia? Normal range is 3.5- 5 A. Positive Chvostek's sign B. Decreased blood pressure C. Muscle twitches/cramps D. Weak and slow heart rate

A. Positive Chvostek's sign

A patient is admitted to the hospital with suspected polycythemia vera. Which of the following symptoms is consistent with the diagnosis? Select all that apply. A.Weight Loss B.Increased Clotting Time C.Hypertension D.Headaches

B, C, and D Polycythemia vera is a condition in which the bone marrow produces too many red blood cells. This causes an increase in hematocrit and viscosity of the blood. Patients can experience headaches. dizziness. and visual disturbances. Cardiovascular effects include increased blood pressure and delayed clotting time. Weight loss is not a manifestation of polycythemia vera.

Which of the following drugs would be ordered by the physician to improve the platelet count in a male client with idiopathic thrombocytopenic purpura (ITP)? A. Acetylsalicylic acid (ASA) B. Corticosteroids C. Methotrexate D. Vitamin K

B. Corticosteroid therapy can decrease antibody production and phagocytosis of the antibody-coated platelets, retaining more functioning platelets. Methotrexate can cause thrombocytopenia. Vitamin K is used to treat an excessive anticoagulated state from warfarin overload, and ASA decreases platelet aggregation.

Which nursing interventions should the nurse implement when caring for a client diagnosed with hemophilia A? Select all that apply. A. Instruct the client to use a razor blade to shave. B. Avoid administering enemas to the client. C. Encourage participation in noncontact sports. D. Teach the client how to apply direct pressure if bleeding occurs. E. Explain the importance of not flossing the gums

B. Avoid administering enemas to the client. C. Encourage participation in noncontact sports. D. Teach the client how to apply direct pressure if bleeding occurs.

What type of fluid would a patient with severe hyponatremia most likely be started on? A. Hypotonic B. Hypertonic C. Isotonic D. Colloid

B. Hypertonic

•A nurse is caring for a client who has just developed a pulmonary embolism. Which of the following medications should the nurse anticipate administering? A. Furosemide B. Dexamethasone C. Heparin D. Atropine

C. Heparin

A nurse is providing discharge teaching to a client who had a sickle cell crisis. Which of the following statements indicates that the client understands the instructions? A. I should try to drink at least 5 liters of fluid per day B. I can still fly out to visit my sister in Colorado for a while C. Physical activity is good for me, but I need to avoid overexertion D. I can still go skiing during the cold winter months

C. Physical activity is good for me, but I need to avoid overexertion

A patient is being discharged home after hospitalization with hypocalcemia. Which statement by the patient indicates she understood the dietary instructions? A. "I will avoid sardines. B. "I'll avoid salt and Vitamin-D supplements." C. "I will tell my husband to only purchase skim milk." D. "I will be sure to eat lots of cheese, tofu and spinach."

D. "I will be sure to eat lots of cheese, tofu and spinach."

Which client would be most at risk for developing disseminated intravascular coagulation (DIC)? A. A 35 year old pregnant client with placenta previa B. A 42 year old client with a pulmonary embolus C. A 60 year old client receiving hemodialyasis 3 days a week D. A 78 year old client with septicemia

D. DIC is a clinical syndrome that develops as a complication of a wide variety of other disorders, with sepsis being the most common cause of DIC

Which of the following is an objective sign or symptom of Hodgkin's Lymphoma Assessment? A.Lung wheezes B.Nighttime coughing C.Hemoptysis D.Night sweats E.Bleeding F.Enlarged kidneys

D. Night sweats are characteristic of Hodgkin's lymphoma and may indicate acute infection. Since the patient may wake up drenched in sweat, teach the patient comfort measures, such as wearing loose cotton clothing to absorb sweat and install fans to circulate air

Which of the following is most likely an objective sign or symptom of non-Hodgkin's lymphoma? A.Arthralgias B.Kussmaul respirations C.Urinary frequency and urgency D.Painless lymphadenopathy E.Bronchospasm F.Orthostatic hypotension

D. Patients will experience lymphadenopathy or swelling of the lymph nodes. The enlarged lymph nodes are painless and may be made worse by drinking alcohol

A patient with a magnesium level of 3.6 would exhibit which of the signs and symptoms EXCEPT? A. Hypotension B. Profound Lethargy C. Respiratory failure D. Hyperreflexia of the deep tendons

D. Hyperreflexia of the deep tendons

A nurse is preparing an in-service presentation about the basics of hematology. Which of the following factors provides a stimulus for the production of RBC's? A.Venous stasis B.Thrombocytopenia C.Inflammation D.Tissue hypoxia

D. In response to tissue hypoxia, the kidneys release erythropoietin, which stimulates the production of erythrocytes (RBC's) n the bone marrow.

A nurse is caring for a client who develops a pulmonary embolism. Which of the following interventions should the nurse implement first? A.Give morphine IV. B.Administer oxygen therapy. C.Start an IV infusion of lactated Ringer's. D.Initiate cardiac monitoring.

B.Administer oxygen therapy.

A lack of which of these will result in abnormally large red blood cells and a condition called megaloblastic anemia? A. oxygen B. Vitamin C C. vitamin b-12 and folic acid D. carbon dioxide

C. vitamin b-12 and folic acid

Which of the following conditions is a more common cause of disseminated intravascular coagulation (DIC) than the others? A.Trauma B.Meningitis C.Acute renal failure D.AIDS

A. Trauma leads to DIC via the release of tissue factor and activation of the extrinsic pathway. Extensive surgery and severe burns may also lead to DIC. Hemorrhage is the major clinical presentation in trauma induced DIC

You're providing care to a patient with a pneumothorax who has a chest tube. On assessment of the chest tube system, you note there is no fluctuation of water in the water seal chamber as the patient inhales and exhales. You check the system for kinks and find none. What is your next nursing action? A. Keep monitoring the patient because this is a normal finding. B. Increase wall suction to the system until the water fluctuates in the water seal chamber. C. Assess patient's lung sounds to assess if the affected lung has re-expanded. D. Notify the physician.

C. Assess patient's lung sounds to assess if the affected lung has re-expanded.

A nurse is teaching a client who has polycythemia vera about self care measures. Which of the following interventions should the nurse include? A.Drink 1 liter of fluid every day B.Continuously wear support stockings C.Elevate your legs while sitting D.Use dental floss daily

C. Clients who have polycythemia vera should elevate their legs when seated to avoid venous pooling with subsequent clot formation.

A patient has been experiencing an infection and has a fever of 102'F. On assessment, you find the patient to be confused, restless, has dry mucous membranes, and flushed skin. Which finding below correlates with the presentation of this patient? A. Sodium level of 144 B. Sodium level of 115 C. Sodium level of 170 D. Sodium level of 135

C. Sodium level of 170

A nurse is assessing a client who is receiving a unit of blood. Which of the following findings should the nurse identify as a manifestation of a hemolytic transfusion reaction? A.Bradycardia B.Paresthesia C.Hypertension D.Low back pain

D. Low back pain is a manifestation of a hemolytic transfusion reaction. Other manifestations include a headache, chest pain, tachypnea, tachycardia, and dark urine.

A patient's calcium level is 6.9. Which of the following is a nursing priority? Normal calcium levels are 8.6- 10.2. •A. Initiate seizure precautions •B. Educate patient about foods rich in calcium •C. Administer Calcitonin •D. Administer Vitamin D supplements as ordered

A. Initiate seizure precautions

A nurse is teaching a client who has iron- deficiency anemia. The nurse should encourage the client to increase her consumption of which of the following foods? A. Lentils B. Avocados C. Cabbage D. Broccoli

A. Lentils

A patient with a potassium level of 2.1 has been taking Lasix daily. Which medication will the patient most likely be switched to?Normal range is 3.5- 5 A. Spironolactone B. None the patient will likely stay on the Lasix C. Hydrochlorothiazide D. Demadex

A. Spironolactone

You're providing education to a patient about how to take their prescribed iron supplement. Which statement by the patient requires you to re-educate the patient on how to take this supplement? A. "I will take this medication on an empty stomach." B. "I will avoid taking this medication with orange juice." C. "I will wait and take my calcium supplements 2 hours after I take my iron supplement." D. "This medication can cause constipation. So, I will drink plenty of fluids and take a stool softer as needed."

B. "I will avoid taking this medication with orange juice."

A nurse is caring for a client who has femoral thrombophlebitis and a prescription for enoxaparin. Which of the following actions should the nurse take? A.Elevate the affected leg B.Place the client of bed rest C.Massage the affected leg D.Administer aspirin for pain

A. The nurse should elevate the clients affected leg when the client is in bed to reduce inflammation.

What am I? PH- 7.18 PaCO2- 38 mm HgPaO2- 70 mm HgHCO3- 15 mEq/L A.Metabolic Acidosis B.Metabolic alkalosis C.Respiratory acidosis D.Respiratory alkalosis

A.Metabolic Acidosis

The nurse devises a teaching plan for the patient with aplastic anemia. Which of the following is the MOST important concept to teach for health maintenance? A. Eat animal protein and dark leafy greens B. Avoid exposure to others with acute infection C. Practice yoga and meditation to relieve anxiety and stress D. Get 8 hours of sleep at night and take naps

B. Avoid exposure to others with acute infection

You're developing a plan of care for a patient who is at risk for the development of a deep vein thrombosis after surgery. What nursing intervention below would the nurse NOT include in the patient's plan of care to prevent DVT formation? A. The patient will eat all meals out of the bed daily by sitting in the bedside chair. B. The nurse will apply sequential compression devices (SCDs) per physician's order to the patient's lower extremities every night at bedtime. C. The nurse will administer per physician's order Enoxaparin in the subcutaneous tissue of the abdomen. D. The patient will ambulate daily.

B. Yes, the nurse would apply SCDs per MD order to help prevent DVTs, BUT they are to be applied and worn by the patient anytime they are in bed or sitting. The only time a patient should not wear the SCDs is when they're ambulating. Therefore, the nurse would NOT just apply them at bedtime but during the day too.

A nurse is caring for patients in the oncology unit. Which of the following is the most important nursing action when caring for a neutropenic patient? A.Change the disposable mask immediately after use. B.Change gloves immediately after use. C.Minimize patient contact. D.Minimize conversation with the patient.

B. The neutropenic patient is at risk of infection. Changing gloves immediately after use protects patients from contamination with organisms picked up on hospital surfaces. This contamination can have serious consequences for an immunocompromised patient. Changing the respiratory mask is desirable. but not nearly as urgent as changing gloves. Minimizing contact and conversation are not necessary and may cause nursing staff to miss changes in the patient's symptoms or condition.

A nurse is caring for a client who has a chest tube in place to a closed chest drainage system. Which of the following findings should indicate to the nurse that the clients lung has re-expanded? A. oxygen saturation of 95% B. No fluctuations in the water seal chamber C. No reports of pleuritic chest pain D. Occasional bubbling in the water-seal chamber

B. No fluctuations in the water seal chamber

A patient is admitted with a chest wound and experiencing extreme dyspnea, tachycardia, and hypoxia. The chest wound is located on the left mid-axillary area of the chest. On assessment, you note there is unequal rise and fall of the chest with absent breath sounds on the left side. You also note a "sucking" sound when the patient inhales and exhales. The patient's chest x-ray shows a pneumothorax. What type of pneumothorax is this known as? A. Closed pneumothorax B. Open pneumothorax C. Tension pneumothorax D. Spontaneous pneumothorax

B. Open pneumothorax

A nurse in the emergency department is caring for a client who was injured in a motor-vehicle crash. The client reports dyspnea and severe pain. The nurse notes that the client's chest moves inward during inspiration and bulges out during expiration. The nurse should identify this finding as which of the following? A.Atelectasis B.Flail chest C.Hemothorax D.Pneumothorax

B.Flail chest

What am I? PH- 7.58 PaCO2- 35mm HgPaO2- 75 mm HgHCO3- 50 mEq/L A.Metabolic Acidosis B.Metabolic alkalosis C.Respiratory acidosis D.Respiratory alkalosis

B.Metabolic alkalosis

The nurse is assessing a patient, who has many risk factors for the development of a DVT, for signs and symptoms of a deep vein thrombosis. What signs and symptoms below would possibly indicate a deep vein thrombosis is present? Select All that Apply A. Cool extremity B. Decreases pulses C. Redness D. Pain E. Warm extremity F. Swelling G. Cyanosis

C, D, E, and F. Signs and symptoms of a DVT include: redness, swelling, warm extremity, pain, positive Homan's Sign, and swelling (which can be unilateral...meaning there is more swelling in one extremity compared to the other).

A nurse is caring for a client who has a peripherally inserted central catheter (PICC) in place. Which of the following actions should the nurse take when handling the central venous access device? (S) A.Use a 5 ml syringe to flush the line B.Cleanse the insertion site with half-strength hydrogen peroxide C.Flush the line with sterile 0.9% sodium chloride before and after medication administration D.Access the PICC for blood sampling E.Perform a heparin flush at least daily when not in use.

C, D, E The nurse should flush the line with 10 ml of sterile 0.9% sodium chloride solution before and after administering medication through the PICC. The nurse should use a PICC to deliver fluids, medications, and total parenteral nutrition to the client. The PICC is also used to obtain blood samples, and the nurse should practice the appropriate technique to access and flush the line. Ideally, blood samples should come from a 4 French lumen catheter or larger. PICCs can remain in place for months or years. When not actively in use, the nurse should perform heparin flushes at least daily to prevent clotting within the line.

A patient with nasogastric suctioning is experiencing diarrhea. The patient is ordered a morning dose of Lasix 20mg IV. Patient's potassium level is 3.0. Which of the following options is correct? A. No intervention is need the potassium level is within normal range B. Administered the Lasix and notify the doctor for further orders C. Hold the dose of Lasix and notify the doctor for further orders D. Turn off the nasogastric suctioning and administered a laxative

C. Hold the dose of Lasix and notify the doctor for further orders

A nurse is monitoring a client following a thoracentesis. The nurse should identify which of the following manifestations as a complication and contact the provider right away? A. Serosanguineous drainage from the puncture site B. Discomfort at the puncture site C. Increased heart rate D. Decrease temperature

C. Increased heart rate

When the cell presents with the same concentration on the inside and outside with no shifting of fluids this is called? A. Hypotonic B. Hypertonic C. Isotonic D. Osmosis

C. Isotonic

A nurse is caring for a client who has a chest tube connected to a closed drainage system and needs to be transported to the x-ray department. Which of the following actions should the nurse take? A. clamp the chest tube prior to transferring the client to a wheelchair B. Disconnect the chest tube from the drainage system during transport C. Keep the Drainage system below the level of the client's chest at all times D. Empty the collection chamber prior to transport

C. Keep the Drainage system below the level of the client's chest at all times

A nurse is caring for a client who has a new diagnosis of pernicious anemia. The nurse should expect the client's provider to prescribe which of the following medications for the client? A. Ferrous sulfate B. Epoetin alfa C. Vitamin B12 D. Folic acid

C. Vitamin B12

Which patient below is at risk for experiencing Hypovolemic Hyponatremia? A.Patient with congestive heart failure B. Patient with cirrhosis of the liver C. Patient on IV saline at 250 cc/hr D. Patient with nasogastric tube suction experiencing diarrhea

D. Patient with nasogastric tube suction experiencing diarrhea

A nurse is assessing a client who is 1 day postoperative following a lobectomy and has a chest tube drainage system in place. Which of the following findings indicates a need for intervention? A.Chest tube eyelets not visible B.Continuous bubbling in the suction control chamber C.Presence of tidal fluctuation in the water seal chamber D.Development of subcutaneous emphysema

D.Development of subcutaneous emphysema

Which of the following best explains the general pathology of disseminated intravascular coagulation (DIC)? A.Kidney failure B.Bone marrow failure C.Bleeding state D.Aplastic anemia E.Antibodies form against platelets

C. Over-activation of the coagulation cascade leads to consumption of platelets, fibrin, and clotting factors. Without these important factors for clotting, hemorrhage results.

You have completed diet teaching with a patient who has hypernatremia. Which statement by the patient causes concern? A. "I will buy fresh fruits and vegetables." B. "I will avoid eating canned foods." C. "I'm glad I cant still eat sandwiches with bologna." D. "I will avoid cooking with butter."

C. "I'm glad I cant still eat sandwiches with bologna."

Based on the previous question, which of the following options below is a nursing intervention you would provide to this patient? •A. Place the patient in supine position •B. Place a non-occlusive dressing over the chest wound •C. Place a sterile occlusive dressing over the chest wound and tape it on three sides •D. Prepare the patient for a thoracentesis

C. Place a sterile occlusive dressing over the chest wound and tape it on three sides

A client is receiving a platelet transfusion. The nurse determines that the client is gaining from this therapy if the client exhibits which of the following? A. Less frequent febrile episodes B. Increased level of hematocrit C. Less episodes of bleeding D. Increased level of hemoglobin

C. Platelet transfusions may be given to prevent bleeding when the platelet count falls down.

A patient is admitted with iron- deficiency anemia and has been receiving iron supplementation. The patient voices concern about how their stool is dark black. As the nurse, you would? A. Notify the doctor B. Hold the next dose of iron C. Reassure the patient this is a normal side effect of iron supplementation D. None of the options are correct

C. Reassure the patient this is a normal side effect of iron supplementation

A nurse is preparing to transfuse a unit of packed red blood cells for a client who has anemia. Which of the following actions should the nurse take first? A.Hang an IV infusion of 0.9 % sodium chloride B.Check clients identification number and compare with blood C.Witness the informed consent document D.Obtain pretransfusion vital signs

C. The nurse should apply the least invasive priority-setting framework, which assigns priority to nursing interventions that are the least invasive to the client, as long as those interventions do not jeopardize the clients safety. Unless it is an emergency, informed consent should be obtained prior to initiating a blood transfusion for a client.

You are assessing a client who has pernicious anemia. Which of the following findings should the nurse except? A.Thick, white coating on the client's tongue B.Decreased pulse rate C.Paresthesia in the hands and feet D.Joint pain in the extremities

C.Paresthesia in the hands and feet

What am I? PH- 7.20 PaCO2- 67 mm HgPaO2- 47 mm Hg HCO3- 37 mEq/L A.Metabolic Acidosis B.Metabolic alkalosis C.Respiratory acidosis D.Respiratory alkalosis

C.Respiratory acidosis

A patient receiving treatment for a pneumothorax calls on the call light to tell you something is wrong with their chest tube. When you arrive to the room you note that the drainage system has fallen on its side, and there is a large crack in the system. A. Place the patient in supine position and clamp the tubing. B. Notify the physician immediately. C. Disconnect the drainage system and get a new one. D. Disconnect the tubing from the drainage system and insert the tubing 1 inch into a bottle of sterile water and obtain a new system.

D. Disconnect the tubing from the drainage system and insert the tubing 1 inch into a bottle of sterile water and obtain a new system.