practice questions for nursing exam 4
.A client is diagnosed as having hepatitis A. The information from the health history that is most likely linked to hepatitis A is working: A. For a local plumber B. In a hemodialysis unit of a hospital C. As a dishwasher at a local restaurant D. With occupational arsenic compounds
A
27. The nurse is performing a physical assessment of a client with ulcerative colitis. The finding most often associated with a serious complication of this disorder would be: A. Decreased bowel sounds B. Loose, blood-tinged stools C. Distention of the abdomen D. Intense abdominal discomfort
A
A 54-year-old obese client arrives at the clinic complaining of epigastric distress and esophageal burning. During the health history, the client admits to binge drinking and frequent bronchitis. After diagnostic studies, a diagnosis of hiatal hernia is made. The health problem that would most likely have contributed to the development of the hiatal hernia would be: A. Obesity B. Bronchitis C. Alcoholism D. Esophagitis
A
A client who is diagnosed with a duodenal ulcer asks, "Now that I have an ulcer, what comes next?" The nurse's best response would be: A. "Most peptic ulcers heal with medical treatment." B. "Clients with peptic ulcers have pain while eating." C. "Early surgery is advisable, especially after the first attack." D. "If ulcers are untreated, cancer of the stomach can develop."
A
A client with a long history of alcohol abuse is admitted to the hospital with ascites, jaundice, and confusion. A diagnosis of hepatic cirrhosis is made. A nursing priority would be to: A. Institute safety measures B. Monitory respiratory status C. Measure abdominal girth daily D. Test stool specimens for blood
A
A client with a tentative diagnosis of cholecystitis is discharged from the emergency department with instructions to make an appointment for a definitive diagnostic workup. The recommendation that would produce the most valuable diagnostic information is: A. "Keep a journal related to your pain." B. "Save all stool and urine for inspection." C. "Follow the physician's orders exactly without question." D. "Keep a record of the amount of fluid you are drinking daily."
A
The group of characteristics that would alert the nurse that a client is at increased risk of developing gallbladder disease would be a female: A. Over the age of 40, obese. B. Under the age of 40, history of high fat intake. C. Over the age of 40, low serum cholesterol level D. Under the age of 40, family history of gallstones
A
When performing the initial history and physical examination of a client with a tentative diagnosis of peptic ulcer, the nurse expects the client to describe the pain as: A. Gnawing epigastric pain or boring pain in the back B. Located in the right shoulder and preceded by nausea C. Sudden, sharp abdominal pain, increasing in intensity D. Heartburn and substernal discomfort when lying down
A
While performing a physical assessment of a client with gout of the great toe, the nurse should assess for additional tophi (urate deposits) on the: A. Ears B. Chin C. Buttocks D. Abdomen
A
if you hear creptius while moving a patient's joint must be: A. synovial B. nonsynovial C. fixed
A
the nurse evaluates which of the following clients to be at greatest risk for developing alcoholic cirrhosis: A. a 55-year-old male who has chronic alcoholism B. A 28-year-old male who had recent exposure to a hepatotoxic drug C. A 70-year-old male who has a history of right-sided heart failure D. A 40-year-old female who has a biliary obstruction
A
when you percuss over the liver, you should hear: A. dullness B. Resonance C. tympani
A
A patient reports chronic diarrhea and malnutrition. The nurse identifies tenderness on palpation and an abdominal mass, along with perianal skin tags. Which subjective data would the nurse document as history of present illness? A. Chronic Diarrhea B. Malnutrition C. Tenderness D. Abdominal Mass E. Perianal Skin Tags
A B
The nurse is caring for a client with peptic ulcer disease. Which of the following observations should the nurse report immediately? Select all that apply: A. Hypotension B. Thirst C. Headache D. Tachycardia E. Restlessness F. Diarrhea
A D E
a patient reports experiencing syncope and localized epigastric pain that is relieved by eating. the nurse notes tachycardia, hypotension, and tenderness on palpation. which info should the nurse document as history of present illness? (select all that apply) A. Syncope B. Tachycardia C. Hypotension D. Tenderness E. Epigastric pain
A E
The nurse is caring for a client with gastroesophageal reflux disease. Which of the following measures would be essential to include in the client's discharge instructions? Select all that apply: A. small, frequent meals B. avoid fluids at mealtime C. high-calorie and high protein diet D. bulk-forming laxatives E. sleep with the head of the bed elevated F. avoid caffeine in the diet
A E F
on auscultation of the abdomen, which findings related to bowel sounds would be considered normal? (select all that apply) A. gurgles B. clicks C. irregular D. high-pitch tinkling E. absence of sound
A, B, C
A client is suspected of having a peptic ulcer. When obtaining a history from this client, the nurse should expect the reported pain to: A. Intensify when the client vomits B. Occur one to three hours after meals C. Increase when the client eats fatty foods D. Begin in the epigastrium and radiate across the abdomen
B
As a client's symptoms of acute pancreatitis subside, it is most important that the nurse instruct the client to: A. Avoid eating hot, spicy foods B Avoid ingesting alcoholic beverages C. Eat a bland diet of six small meals a day D. Eat a high-carbohydrate, low-fat, low protein diet.
B
Because a client has bursitis, plans for nursing interventions should include: A. aggressive antibiotic therapy B. rest C. range of motion exercises D. high-protein diet
B
When teaching about the dietary control of gout, the nurse is aware that the dietary teaching is understood when the client states; "I will avoid eating: A. Eggs." B. Shellfish." C. Fried poultry." D. Cottage cheese."
B
a client has symptoms associated with salmonellosis. relevant data to gather from this client include a history of: A. any rectal cancer in the fam B. all foods eaten in past 24 hrs C. any recent extreme emotional stress D. an upper respiratory infection in past 10 days
B
a patient with kyphosis has an: A. exaggerated lateral spinal curvature B. unusually rounded thoracic curve C. abnormally concave lumbar
B
what is the main function of the gallbladder? A. rids body of waste B. concentrates/stores bile C. detoxifies harmful substances D. produces lymphocytes
B
what is the main function of the pancreas A. concentrates bile B. regulates glucose C. produces renin D. filters blood
B
when assessing a client's abdomen, the nurse palpated the area directly above the umbilicus. this area is known as: A. iliac area B. epigastric area C. hypogastric area D. suprasternal area
B
when food is swallowed, the epiglottis A. opens B. closes C. opens or closes, depending on type of food
B
your patient can't move his right arm away from his side so you document this as impaired: A. supination B. abduction C. eversion
B
During a history, the patient reports having gout. Based on this info, what findings does the nurse anticipate during a focused assessment? A. warm, tender, and deformed wrists and peripheral interphalangeal (PIP) joints bilaterally B. edema, warmth, and redness of one great toe and pea-like nodules in the ear lobes C. enlarged and tender PIP or distal interphalangeal (DIP) joints on one or several fingers D. tenderness with pronation and supination of the elbow and point tenderness on lateral epicondyle
B - accurate description of gout
in which ways does the liver function? (select all that apply) A. production of digestive juices B. synthesis of fats C. concentration of bile D. storage of vitamins E. Production of blood coagulants
B D E
which findings regarding movement would be considered normal on inspection of the abdomen? (select all that apply) A. Pulsations B. smooth movement C. even movement D. limited movement E. rippling movement
B, C
A client who is diagnosed as having a herniated intervertebral disk complains of pain. The nurse recognizes that the pain is caused by the: A. inflammation of the lamina of the involved vertebra B. shifting of two adjacent vertebral bodies out of alignment C. Compression of the spinal cord by the extruded nucleus pulposus D. Increased pressure of the cerebrospinal fluid within the vertebral column
C
A client, who has a hiatal hernia, is 5 feet 3 inches tall and weighs 140 pounds, asks the nurse how to prevent esophageal reflux. The nurse's best response would be: A. "Increase your intake of fat with each meal." B. "Lie down after eating to help our digestion." C. "Reduce your caloric intake to foster weight reduction." D. "Drink several glasses of fluid during each of your meals."
C
During an inspection of the abdomen, which of the abdominal findings should the nurse report as abnormal: A. bilateral symmetrical abdomen B. Flat abdominal contour C. Strong abdominal pulsations D. Depressed umbilicus beneath the abdominal surface
C
The nurse is discharging a client with rheumatoid arthritis who complains of morning stiffness. Which of the following measures should the nurse include in the discharge instructions: A. Encourage the client to sleep with pillows under the knees B. Instruct the client to apply ice packs to the joints before getting out of bed C. Instruct the client to take a warm shower in the morning when getting up. D. Teach the client to perform all the household chores at one time
C
rheumatoid arthritis is characterized by: A. unilateral joint involvement B. nonsynovial joint involvement C. symmetrical joint involvement
C
to test a patient for rebound tenderness, position your hand at: A. 30 degree angle to the abdomen B. 45-60 degree angle to the abdomen C. 90 degree angle to the abdomen
C
when a client develops steatorrhea, the nurse should describe the stool as: A. dry and rock hard B. clay colored and pasty C. bulky and foul smelling D. black and blood streaked
C
which abdominal structure begins at pylorus and is approximately 21 feet long? A. colon B. Gastrointestinal tract C. small intestine D. stomach
C
. A client who has had a gastric ulcer asks what to do if epigastric pain occurs. The nurse identifies that teaching is effective when the client states, "I will: A. Increase my food intake." B. Take the aspirin with milk." C. Eliminate fluids with meals." D. Take an antacid preparation."
D
A client is diagnosed as having a peptic ulcer. When teaching about peptic ulcers, the nurse should instruct the client to report any stools that appear: A. Frothy B. Ribbon shaped C. Pale or clay colored D. Dark brown or black
D
A client is diagnosed with hepatitis A and asks the nurse how to avoid infecting other family members. The nurse's response would be based on the understanding that the spread of hepatitis A is primarily: A. sexual contact with an infected person who does not show symptoms of the disease B. by contaminated needles from a person who has some form of hepatitis C. through blood transfusions of improperly prepared blood D. from person to person through fecal contamination of contaminated food and water
D
A traveling salesman develops gastric bleeding and is hospitalized. An important etiologic clue for the nurse to explore while taking this client's history would be: A. Any recent foreign travel B. The client's usual dietary pattern C. Any change in status of family relationships D. The medications that the client has been taking
D
The most pronounced functional change of GI tract in older adults is A. decreased hydrochloric acid production B. Increased motility C. decreased bile absorption D. decreased motility
D
The nurse asks a client to make a list of the foods that cause dyspepsia. If the client has cholecystitis, the foods that are most likely to be included on this list would be: A. Nuts and popcorn B. Meatloaf and baked potato C. Chocolate and boiled shrimp D. Fried chicken and buttered corn
D
The nurse assists a client with osteoporosis to make which of the following menu selections: A. Scrambled eggs and a banana B. Bagel with cream cheese and half a grapefruit C. 3 oz grilled chicken and a baked potato D. Sardines and cooked broccoli
D
The nurse instructs a client diagnosed with hepatitis type A about untoward signs and symptoms related to hepatitis that may develop. The one that should be reported to the physician would be: A. Fatigue B. Anorexia C. Yellow urine D. Clay-colored stools
D
The nurse performs full range of motion on a client's extremities. When putting an ankle through range of motion, the nurse must perform: A. Flexion, extension, and rotation B. Abduction, flexion, adduction, and extension C. Pronation, supination, rotation, and extension D. Dorsiflexion, plantar flexion, eversion, and inversion
D
relaxation or incompetence of the lower esophageal sphincter causes A. peptic ulcer disease B. hiatal hernia C. Crohn disease D. gastroesophageal reflux disease
D
the nurse should teach the client with gastroesophogeal reflux disease that after meals the client should: A. take a short walk B. drink 8 ounces of water C. lie down for at 20 min D. rest in a sitting position for one-half-hour
D
a patient reports a history of compression of the left cranial nerve XI (spinal accessory nerve) from an old sports injury. Based on this info, what technique does the nurse include in the focused assessment? A. asking the patient to rotate the head against resistance of the nurse's hand on patients chin B. asking the patient to flex the chin to the chest against resistance of the nurse's hand on forehead C. asking patient to extend the head back against resistance of nurse's hand on back of head D. asking patients to shrug shoulder while nurse attempts to push down on them
D - cranial nerve XI is tested by doing this
Which abdominal organs also produce hormones and function as endocrine glands? A. Liver and gallbladder B. Stomach and spleen C. Gallbladder and pancreas D. Pancreas and kidneys
D - pancreas produces insulin, kidneys produce erythropoietin
a patient reports joint pain interfering with sleep and morning joint stiffness in the first hour after getting out of bed. considering this report, what abnormal findings does the nurse anticipate during examination? A. abrupt onset of local tenderness, edema, and decreased range of motion of the shoulder and hip bilaterally B. decreased range of motion of one hip and knee with pain on flexion and crepitus during movement of these joints C. erythema in one great toe, ankle, and lower leg that is painful to touch D. hot, painful, deformed, and edematous wrists and peripheral interphalangeal joints bilaterally
D - patient reports are consistent with rheumatoid arthritis
The nurse is admitting a client after falling from a ladder and recognizes that grating sound when the ends of a broken bone are moved is known as________________.
crepitus
the correct sequence for an abdominal assessment is ... ?
inspection, auscultation, palpation, percussion