Practice Final Exam Quiz

The monitor tech calls the nurse and states the client's telemetry tracing is alarming and the client is in a lethal rhythm. The nurses notices the following on the monitor. The nurse should do which of the following? Select all that apply.

assess client/ check patches

A nurse cares for a patient who has a heart rate averaging 56 beats/min with no adverse symptoms. Which activity modification would the nurse suggest to avoid further slowing of the heart rate?

avoid straining

Which of the following are signs and symptoms of Post-Transplant Rejection?

Fever Kidney tenderness Oliguria Elevated blood pressure Gradual increase in BUN and creatinine leve

Which of the following parts of the ECG tracing represents ventricular repolarization and is usually positive, rounded, and slightly asymmetric?

G

A patient who is diagnosed with Parkinson's disease (PD) states, "I can't tie my shoelaces anymore." The healthcare provider recognizes that this patient's problem is due to a deficiency in which of these neurotransmitters?

Glutamate

A nurse assesses a patient who is prescribed alosetron (Lotronex). Which assessment question would the nurse ask this patient?

Have you been experiencing any constipation?

After teaching a patient with congestive heart failure (CHF), the nurse assesses the patient's understanding. Which patient statements indicate a correct understanding of the teaching related to nutritional intake? (Select all that apply.)

"I will drink at least 3 L of water each day." "Using salt in moderation will reduce the workload of my heart." "I will eat oatmeal for breakfast instead of ham and eggs." "I'll read the nutritional labels on food items for salt content." "Substituting fresh vegetables for canned ones will lower my salt intake."

A patient is in the bariatric clinic 1 month after having gastric bypass surgery. The patient is crying and says "I didn't know it would be this hard to live like this." What response by the nurse is best?

Assess the patient's coping and support systems.

A nurse works in the rheumatology clinic and sees patients with rheumatoid arthritis (RA). Which patient would the nurse see first?

Patient with a red, hot, swollen right wrist

A nurse cares for a patient with atrial fibrillation who reports fatigue when completing activities of daily living. What interventions would the nurse implement to address this patient's concerns?

Schedule periods of exercise and rest during the day.

A nurse teaches a patient who is prescribed nicotine replacement therapy. Which statement would the nurse include in this patient's teaching? "Stopping this medication suddenly increases your risk for a heart attack. ""Make a list of reasons why smoking is a bad habit." "Rise slowly when getting out of bed in the morning."" Smoking while taking this medication will increase your risk of a stroke."

Smoking while taking this medication will increase your risk of a stroke."

The endocrine function of the pancreas is to secrete insulin via the beta cells. If the pancreas if not able to secrete insulin, the client can develop severe hyperglycemia or diabetic ketoacidosis (DKA). The nurse is aware that this is especially true for clients who have?

T1

The nurse is caring for patient with systemic sclerosis. The nurse is aware that which of the following is true?

Telangiectasia, Sclerodactyly and Raynaud's phenomenon may be present. Paraffin baths can be used to improve skin flexibility.

A client with inflammatory bowel disease has Vitamin D deficiency. Which of the following lab values would be expected in patients with a Vitamin D deficiency?

"Diabetes can cause blindness, so I should see the ophthalmologist yearly."

A nurse teaches a patient who is prescribed digoxin (Lanoxin) therapy. Which statement would the nurse include in this patient's teaching?

"Do not take this medication within 1 hour of taking an antacid."

The nurse and the student are caring for a patient with Parkinson's disease. The nurse writes a goal in the plan of care that states "to maintain optimal body function." The student asks the nurse what this means. What is the nurses best response?

"Parkinson's is a degenerative disease and many clients live for years with the disease. Our goal allows us to encourage good nutrition, encourage exercise, use of any assistive devices as needed, and provide a safe and supportive environment."

A nurse assesses several patients who have a history of asthma. Which patient would the nurse assess first?

120 bpm

A nurse assesses patients who are at risk for diabetes mellitus. Which patient is at greatest risk?

48 american indian

The nurse is caring for a patient status post gastric bypass surgery with dumping syndrome which is a passage of undiluted food into the jejunum. The nurse is aware that this causes which of the following?

A surge of insulin to be released in the body, resulting in profuse sweating, nausea, dizziness and weakness.

The patient with malnutrition may present with which of the following lab values?

Albumin level 2.3 g/dL

A patient with End Stage Kidney Disease (ESKD) on dialysis is curious about the transplant candidate selection criteria. The nurse is aware that which of the following is correct? Select all that apply.

Alcoholism or chemical dependency do not exclude clients Clients who have HIV or Hepatitis are not eligible for transplant Diabetics are excluded from the transplant list because the risk is too great Clients with peptic ulcers require treatment before the transplant Patients free of cancer for more than 2-5 years can be considered Clients who have uncorrectable cardiac disease are excluded

When working with older adults to promote good nutrition, what actions by the nurse are most appropriate? (Select all that apply.) Assess dentures for appropriate fit. Serve high-calorie, high-protein snacks. Allow uninterrupted time for eating. Provide salty foods that the patient can taste. Ensure that the patient has glasses on when eating.

Assess dentures for appropriate fit. Serve high-calorie, high-protein snacks. Allow uninterrupted time for eating. Ensure that the patient has glasses on when eating.

A nurse is teaching patients with gastroesophageal reflux disease (GERD) about foods to avoid. Which foods would the nurse include in the teaching? (Select all that apply.)

Citrus fruits Tomato sauce Chocolate Peppermint

The nurse is caring for a client who is 70 years old, African-American, Diabetic, and smokes 1 pack of cigarettes per day. The nurse is aware that this client is at highest risk for? Hallux valgus Sexually transmitted diseases Coronary artery disease Pregnancy

CAD

Which of the following is included in the client preparation for a cardiac catheterization? Select all that apply.

Client has not had any clear liquids in the last 2 hours or any other food/liquids in the last 6 hours Reviewed all preop labs and tests for abnormalities Client is assessed including peripheral pulses, heart and lung sounds, and vital signs Client understands the procedure and what to expect Client is asked about a history of allergy to iodine-based contrast agents

A nurse reviews a patient's laboratory results. Which findings would alert the nurse to the possibility of atherosclerosis? (Select all that apply.)

Low-density lipoprotein cholesterol: 160 mg/dL (4.1 mmol/L) Triglycerides: 200 mg/dL (2.3 mmol/L) Total cholesterol: 280 mg/dL (7.3 mmol/L)

A nurse assesses patients at a health fair. Which patients would the nurse counsel to be tested for diabetes?

Male with a body mass index greater than 25 kg/m2 56-year-old African-American male 28-year-old female who gave birth to a baby weighing 9.2 lbs (4.2 kg) 48-year-old woman with a sedentary lifestyle

A patient is taking warfarin (Coumadin) and asks the nurse if taking St. John's wort is acceptable. What response by the nurse is best?

Monitor the daily activated partial thromboplastin time (aPTT) results. Assess the patient for bleeding. Use an IV pump for the infusion.

The nurse states, "This should be applied to a non-hairy, nonfatty area of your body no longer than 12-14 hours a day. You need to rotate the sites, so you don't hurt your skin and a headache is expected when you are taking this." The nursing student is aware that the nurse is providing teaching for which medications?

Nitroglycerin Patch

The nurse is caring for a patient with peptic ulcer disease who reports sudden onset of sharp abdominal pain. On palpation, the patient's abdomen is tense and rigid. What action takes priority?

Notify the health care provider immediately.

A patient tells the nurse about losing weight and regaining it multiple times. Besides eating and exercising habits, for what additional data should the nurse assess as the priority?

Psychosocial influences on weight

An emergency room nurse obtains the health history of a patient. Which statement by the patient would alert the nurse to the occurrence of heart failure?

SOB

A nurse plans care for a patient who has chronic diarrhea. Which actions would the nurse include in this patient's plan of care? (Select all that apply.)

Using premoistened disposable wipes for perineal care Applying a barrier cream to the skin after cleaning Turning the patient from right to left every 2 hours

The nurse has received a patient in the holding area who is scheduled for a left femoral-popliteal bypass. What are the priority safety measures for this patient before surgery? Select all that apply.The patient is instructed to verify any family members waiting. The patient is asked to confirm the marked operative limb. The patient is positively identified by checking the name and date of birth. The patient is identified by checking the name and room number. The patient is kept on NPO status. The operative limb is marked by the surgeon.

The patient is asked to confirm the marked operative limb. The patient is positively identified by checking the name and date of birth. The patient is kept on NPO status. The operative limb is marked by the surgeon.

A nurse assesses a patient with irritable bowel syndrome (IBS). Which questions would the nurse include in this patient's assessment? (Select all that apply.) Have you lost a significant amount of weight lately?"" Are your stools soft, watery, and black in color?"" Which food types cause an exacerbation of symptoms?"" Do you experience nausea associated with defecation?"" Where is your pain and what does it feel like?"

Which food types cause an exacerbation of symptoms?"" Do you experience nausea associated with defecation?"" Where is your pain and what does it feel like?"CAD

The nurse has taught a patient about lifestyle modifications for gastroesophageal reflux disease (GERD). What statements by the patient indicate good understanding of the teaching? (Select all that apply.)

all except pipe

The nurse is aware that which factors are related to the development of gastroesophageal reflux disease (GERD)? (Select all that apply.)

all except viral infections

A nurse assesses a patient after administering isosorbide mononitrate (Imdur). The patient reports a headache. What action would the nurse take?

acetaminophen

What is the priority nursing assessment when a patient is admitted to the PACU?

airway and gas exchange

A nurse assesses a patient with asthma and notes bilateral wheezing, decreased pulse oxygen saturation, and suprasternal retraction on inhalation. What actions would the nurse take? Select all that apply. -Administer prescribed salmeterol (Serevent) inhaler. -Administer prescribed albuterol (Proventil) inhaler. -Perform peak expiratory flow readings. -Administer oxygen to keep saturations greater than 94%.Assess the patient for a midline trachea.

albuterol, oxygen

Which of the following is true regarding prevention and detection of HIV? -Clients who think they've been exposed to HIV in the last 3 days can be started on Post Exposure Prophylaxis (PEP) immediately. -Truvada can be used to prevent HIV but is not a second layer of protection until 4 days of consistent dosing. -A western blot test is a confirmatory test for HIV infection. -HIV can be spread by sharing needles and toilets of infected patients. -Clients who are high risk should be encouraged to test regularly. -Using condoms, the right way every time you have anal or vaginal sex can prevent HIV.

all

A nursing student learns about modifiable risk factors for coronary artery disease. Which factors does this include? (Select all that apply.)

all but age

Which of the following are opportunistic infections?

all except UTI/ BPH

A nurse assesses patients on a medical-surgical unit. Which patient would the nurse identify as having the greatest risk for cardiovascular disease?

all except aerobics, supplements

A nurse is educating a post-transplant patient regarding common complications associated with taking immunosuppressants. Which of the following should be included?

all except cat litter

The patient has a great toe the drifts laterally at the first metatarsophalangeal joint and an enlarged first metatarsal. Which of the following surgeries may be used to treat this patient?

bunionectomy

A nurse assesses a patient with diabetes mellitus. Which clinical manifestation would alert the nurse to decreased kidney function in this patient?

ketone bodies

A nurse supervises an unlicensed assistive personnel (UAP) applying electrocardiographic monitoring. Which statement would the nurse provide to the UAP related to this procedure?

clean and cip

The nurse is caring for a patient who has short bowel syndrome on a soluble-fiber diet, calcium supplements, and the amino acid glutamine. Which of the following foods should not be on any of his food trays?

cookie

A patient is being taught about drug therapy for Helicobacter pylori infection. What assessment by the nurse is most important?

willingness

A nurse is caring for a patient with systemic sclerosis. The patient's facial skin is very taut, limiting the patient's ability to open the mouth. After consulting with a registered dietitian for appropriate nutrition, what other consultation would the nurse facilitate?

dentist

At 4:45 PM, a nurse assesses a patient with diabetes mellitus who is recovering from an abdominal hysterectomy 2 days ago. The nurse notes that the patient is confused and diaphoretic. The nurse reviews the assessment data provided in the chart below: Capillary Blood Glucose Testing (AC/HS) At 06:30—95 At 11:30—70 At 16:30—47 Breakfast: 10% eaten—patient states that she is not hungry Lunch: 5% eaten—patient is nauseous; vomits once After reviewing the patient's assessment data, which action is appropriate at this time?

dextrose

The nurse is asked to place a nasogastric tube for decompression. The nurse is aware that

double lumen

A client is who is status post total knee arthroplasty (TKA) is complaining of a sudden onset of pain, swelling, warmth, tenderness, and redness in the left leg and the physician has ordered a contrast venography. The nurse is aware that the client is at risk for?

dvt

The patient is complaining of frequent stools and cramping abdominal pain. The nurse is aware that ulcerative colitis includes which of the following?

edema/ inflammation

PKD results in kidney cysts and is caused by a genetic mutation. Priority interventions include avoiding aspirin and constipation.

false

Post-transplant Chronic rejection occurs 1 week to any time after surgery and occurs over days to weeks.

false

Standard precautions and wearing a mask within 3 feet of a client are effective in not contracting an infection from an HIV infected patient.

false

A nurse teaches a patient with heart failure about energy conservation. Which statement would the nurse include in this patient's teaching?

gather everything

A nurse plans care for a client with Parkinson's disease. Which priority intervention would the nurse include in this client's plan of care?

head of bed

A patient is getting out of bed into the chair for the first time after an uncemented hip replacement. What action by the nurse is most important?

help

A patient has a serum ferritin level of 8 ng/mL (18 pmol/L) and microcytic red blood cells. What action by the nurse is best?

hemoccult

A nurse teaches a patient with a new permanent pacemaker. Which instructions would the nurse include in this patient's teaching? (Select all that apply.)

lift arms/ submerge/ report pulse

A patient's small-bore feeding tube has become occluded after the nurse administered medications. What actions by the nurse are best? (Select all that apply.)

meds in liquid, flush, flush

Which of the following medications decreases sugar production in the liver, reduces insulin resistance, and must be taken with meals?

metformin

A patient is taking warfarin (Coumadin) and asks the nurse if taking St. John's wort is acceptable. What response by the nurse is best?

no

A nurse inserts a nasogastric (NG) tube for an adult patient who has a bowel obstruction. Which actions does the nurse perform correctly? (Select all that apply.) Instructs the patient to extend the neck against the pillow once the NG tube has reached the oropharynx Performs hand hygiene and positions the patient in high-Fowler's position, with pillows behind the head and shoulders Secures the NG tube by taping it to the patient's nose and pinning the end to the pillowcase Connects the NG tube to intermittent medium suction with an antireflux valve on the air vent Connects the NG tube to intermittent medium suction with an antireflux valve on the air vent

Performs hand hygiene and positions the patient in high-Fowler's position, with pillows behind the head and shoulders Connects the NG tube to intermittent medium suction with an antireflux valve on the air vent Connects the NG tube to intermittent medium suction with an antireflux valve on the air vent

The postanesthesia care unit (PACU) nurse is assessing an older adult patient for postoperative pain. Which nonverbal manifestations by the patient suggest pain to the nurse?

restlessness, increased BP, confusion, profuse sweating

After teaching a patient who has an ileostomy, a nurse assesses the patient's understanding. Which dietary items chosen for dinner indicate that the patient needs additional teaching? (Select all that apply.)

rice, beans, corn

A patient with a history of heart failure and hypertension is in the clinic for a follow-up visit. The patient is on lisinopril (Prinivil) and warfarin (Coumadin). The patient reports new-onset cough. What action by the nurse is most appropriate?

assess lung sounds

Which of the following should be included in the education for a patient with FMS?

avoid stress

Which of the following diseases are hereditary, resulting in muscle weakness and wasting, and is treated with Tetrabenazine (Xenazine) to suppress the chorea?

huntingtons

The nurse is assessing a client with diabetes and notes fatigue, dry mouth, headache, blurred vision, and restlessness. The nurse knows the patient is experiencing signs of?

hyperglycemia

A student nurse asks what "essential hypertension" is. What response by the registered nurse is best?

no specific cause

A nurse is teaching a patient with heart failure who has been prescribed enalapril (Vasotec). Which statement would the nurse include in this patient's teaching?

salt

A nurse reviews the chart of a patient who has Crohn's disease and a draining fistula. Which documentation would alert the nurse to urgently contact the provider for additional prescriptions?

serum potassium

The nurse instructs a patient on the steps needed to obtain a peak expiratory flow rate. In which order would these steps occur? 1. "Take as deep a breath as possible." 2. "Stand up (unless you have a physical disability)." 3. "Place the meter in your mouth, and close your lips around the mouthpiece." 4. "Make sure the device reads zero or is at base level." 5. "Blow out as hard and as fast as possible for 1 to 2 seconds." 6. "Write down the value obtained." 7. "Repeat the process two additional times, and record the highest number in your chart."

4213567

What is the Mean Arterial Pressure of a patient with a blood pressure of 68/44? Record your answer to the nearest whole number.

52

The client has a cardiac output of 3.5 L/min and a stroke volume of 64 mL/beat. What is the patient's heart rate in bpm? Record your answer to the nearest whole number.

55

A nurse assesses an older adult patient who has multiple chronic diseases. The patient's heart rate is 48 beats/min. What action would the nurse take first?

Assess the client's medications.

The healthcare provider is caring for a patient who reports increasing fatigue over the past 44 months. The patient has no significant past medical history and takes no daily medications. A complete blood count was ordered. What do these results reveal about the patient? Select all that apply. Hemoglobin 10g/dLHematocrit 29%Decreased mean corpuscular volume (MCV)Decreased mean corpuscular hemoglobin concentration (MCHC)

Red blood cells are small and pale. The patient is deficient in iron. Tissue oxygenation is impaired.

The nurse is listening to a client's heart sounds and hears and S4 atrial gallop. The nurse is aware that this occurs as blood enters the ventricles during the active filling phase at the end of ventricular diastole. The nurse suspects the client has a history of?

hypertension

The nurse is assessing a client with diabetes and notes moist skin, dizziness, anxiety, and trembling. The nurse knows the patient is experiencing signs of?

hypoglycemia

A nurse assesses a patient who has prescribed varenicline (Chantix) for smoking cessation. Which manifestations would the nurse identify as adverse effects of this medication? Select all that apply.

impaired judgement/ visual hallucinations

The healthcare provider is reviewing the medical record of a patient who reports increasing fatigue and shortness of breath when taking walks. A series of fecal occult blood tests are noted to be positive. Further testing of the patient's blood is likely to reveal which of these red blood cell characteristics?

microcytic, hypochromic

A 75-year-old patient is having an exploratory laparotomy tomorrow. The wife tells the nurse that at night the patient gets up and walks around his room. What priority action does the nurse take after hearing this information?

notify provider

A nurse is caring for a patient with a deep vein thrombosis (DVT). What nursing assessment indicates that a priority outcome has been met?

oxygen saturation

A nurse assesses a patient after administering a prescribed beta-blocker. Which assessment would the nurse expect to find?

pulse decreased

When positioning to promote comfort in the postoperative patient, which intervention is most appropriate?

reposition every 2 hours

A nurse teaches a patient who has chronic obstructive pulmonary disease. Which statements related to nutrition would the nurse include in this patient's teaching? Select all that apply. -"Rest before meals if you have dyspnea." -"Have about six small meals a day."" -Eat high-fiber foods to promote gastric emptying."" -Avoid drinking fluids just before and during meals."" -Increase carbohydrate intake for energy."

rest, 6 meals, fluids

A nurse cares for a patient with chronic obstructive pulmonary disease (COPD). The patient states that he no longer enjoys going out with his friends. How would the nurse respond?

share thoughts

A nurse assesses a patient admitted to the cardiac unit. Which statement by the patient alerts the nurse to the possibility of right-sided heart failure?

shoes

A nurse cares for a patient who states, "My husband is repulsed by my colostomy and refuses to be intimate with me." How would the nurse respond?

talk to the nurse

The healthcare provider is caring for a patient who reports increasing fatigue over the past 44 months. The patient has no significant past medical history and takes no daily medications. A complete blood count was ordered. What do these results reveal about the patient? Select all that apply.

tissue, rbc, iron

When planning care for a patient diagnosed with Parkinson's disease (PD), which of these patient outcomes should receive priority in the patient's plan of care?

toileting/ bathing

A patient has returned to the nursing unit after an open Nissen fundoplication. The patient has an indwelling urinary catheter, a nasogastric (NG) tube to low continuous suction, and two IVs. The nurse notes bright red blood in the NG tube. What action would the nurse take first?

vitals

A nurse cares for a patient with right-sided heart failure. The patient asks, "Why do I need to weigh myself every day?" How would the nurse respond?

weight is the best indication

A nurse teaches a patient with diabetes mellitus and a body mass index of 42 who is at high risk for coronary artery disease. Which statement related to nutrition would the nurse include in this patient's teaching?

weight loss/ nutrients