H and I final exam

A patient tells the nurse, "I'm told that I should reduce stress in my life, but I have no idea where to start." Which would be the best initial nursing response? "Why not start by learning to meditate? This technique would cover everything." "Physical exercise works to elevate mood and reduce anxiety." "Reading about stress and how to manage it might be a good place to start." "Let's talk about what is going on in your life and then look at some possible options."

"Let's talk about what is going on in your life and then look at some possible options."

A nurse is planning to assess the structure of the family. Which question should the nurse ask? "Who provides the support in your family." "Who does the grocery shopping?" "Who lives with you in the home?" "How old are the members of your family?"

"Who lives with you in the home?"

Which statement about the sources of stress is accurate? Chronic stress is associated with a loss of hope. Physiologic stress is self inflicted Eustress is a negative type of stress Episodic stress is associated with chronic illness

Chronic stress is associated with a loss of hope.

A patient arrives at urgent care in a hypertensive crisis. Which of the following actions is most important for the nurse to do first? Start an intravenous line Elevate head of bed Obtain a history of past and present illnesses Order a chest x-ray

Elevate head of bed

The nurse is planning to teach a patient what to expect prior to surgery for cancer. Why might it be important to suggest to the patient to bring family members with them for the patient teaching? Family can act as a means of support for the patient. Family can express their dissatisfaction with the patient's choice of treatment. Family can express their dysfunction to the nurse. Family can inflect their opinion as to whether the patient can make their own decisions.

Family can act as a means of support for the patient.

The nurse caring for a dying patient in Hospice who is breathing loudly. Which pharmacotherapy should the nurse initiate to improve breathing? Morphine Ondansetron Ampicillin Furosemide

Morphine

The nurse is assessing a patient for adequacy of ventilation. What assessment findings would indicate the patient has good ventilation? There is presence of clear, effortless breath sounds at the lung bases bilaterally. Trachea is just to the left of the sternal notch. The right side of the thorax expands more than the left. Oxygen saturation 98% Respiratory rate 24/min Nail beds are pink with capillary refill less than 2 seconds.

There is presence of clear, effortless breath sounds at the lung bases bilaterally Oxygen saturation 98% Nail beds are pink with capillary refill less than 2 seconds.

Which of the following are potential triggers for asthma attacks? Select all that apply. cigarette smoke air pollution exercise pollen dog or cat hair

cigarette smoke air pollution exercise pollen dog or cat hair

A Foley catheter should not be placed for the dying patient on Hospice as it is a risk for infection. true or false

false

Massage therapy is not covered as a Hospice option. true or false

false

In Palliative care, the patient usually has more than 6 months to live. true or false

true

Which of the following is an unexpected assessment finding based on the patient's condition and assessment data? A 24-year-old asthmatic who has a respiratory rate of 26 A 70-year-old patient with COPD who has a pulse ox of 90% An infant breathing through their nose instead of their mouth A 78-year-old with capillary refill less than 3 seconds

A 24-year-old asthmatic who has a respiratory rate of 26

Which of the following patients is at most risk for hypertension? A 40 year old who has smoked two packs per day for 25 years. A 48 year old who has an occasional drink of alchohol. A 50 year old who is a vegetarian. A 45 year old who has stress on the job.

A 40 year old who has smoked two packs per day for 25 years.

The nurse is evaluating a 3-day diet history with a patient who has an elevated lipid panel. What meal selection indicates the patient is managing this condition well? Spaghetti with meat sauce and garlic bread Baked chicken breast, broccoli and baked potatoe Fried steak, fries and iceberg lettuce Fried fish, cornbread, and peas

Baked chicken breast, broccoli and baked potatoe

Which statement about antihypertensive medication is accurate? ACE Inhibitors should not be taken with grapefruit. Calcium channel blockers should not be taken with grapefruit. Beta blockers decrease the blood volume. Diuretics decrease the apical pulse rate

Calcium channel blockers should not be taken with grapefruit.

A hospitalized patient has activity intolerance from heart failure. Which type of perfusion impairment does the patient have? Localized perfusion from inadequate cardiac output Centralized perfusion from inadequate cardiac output Localized perfusion from loss of vessel patency Centralized perfusion from loss of vessel patency

Centralized perfusion from inadequate cardiac output

Which action should the nurse take to monitor the effects of an acute stressor on a hospitalized patient? Select all that apply. Check for elevated blood glucose levels Assess for bradycardia Observe for increased appetite Ask about epigastric pain Monitor for a decrease in respiratory rate

Check for elevated blood glucose levels Observe for increased appetite Ask about epigastric pain

A nurse teaches a patient's family members about signs and symptoms of approaching death. Which manifestations does the nurse include in this teaching? (Select all that apply.) Long periods of insomnia Congestion and gurgling Increased respiratory rate Warm and flushed extremities Decreased appetite

Congestion and gurgling Warm and flushed extremities Decreased appetite

A client's is experiencing a physiologic response to stress at the panic level. The nurse would assess the client for which of the following clinical manifestations? Obsessive thoughts and compulsive behavior. Feelings of fatigue and inability to remain awake. Dizziness, palpitations, and diaphoresis. Feelings of butterflies in the stomach.

Dizziness, palpitations, and diaphoresis.

A patient is being discharged from the hospital on Coumadin (Warfarin) following heparin therapy for a deep vein thrombosis. What discharge instructions is the nurse required to provide? Select all that apply. Driving restrictions Drug interactions Lab monitoring of INR Importance of taking the medication. Foods to avoid.

Drug interactions Lab monitoring of INR Importance of taking the medication. Foods to avoid.

Parents are just given the news their toddler has a severe intellectual disability. The mother stated she doesn't believe the physician's diagnosis, despite the obvious signs. Which type of coping is the mother displaying? Emotion-focused coping Problem-focused coping Effective coping Meaning-focused coping

Emotion-focused coping

Which nursing intervention is a priority for a patient newly diagnosed with COPD in the clinic for a routine physical and no complaints? Chest x-ray is needed Administer a short acting beta agonist Place on droplet and contact isolation. Encourage frequent small meals high in protein

Encourage frequent small meals high in protein

Which statement about essential hypertension is accurate? Essential hypertension means it is essential that it is treated. Essential hypertension is caused by another disease. Essential hypertension refers to severity of disease. Essential hypertension has no specific cause.

Essential hypertension has no specific cause.

The home health nurse is visiting a client who uses oxygen in the home. Which of the following observations demonstrate safe use of oxygen? Select all that apply. No alcohol based hand sanitizers are allowed in the house. Flammable liquids are stored in the garage. The client doesn't allow smoking in the house. Electric cords are in good working order. No pets are allowed in the house

Flammable liquids are stored in the garage. The client doesn't allow smoking in the house. Electric cords are in good working order.

Which of the following medication categories accurately matches the description? Glucocorticoids decrease the inflammation and edema in the bronchial tubes. Anticholinergics block sympathetic nervous system and constricts airways cough suppressants block parasympathetic nervous system and relax airways Mucolytics decrease inflammation and edema in the bronchial tubes

Glucocorticoids decrease the inflammation and edema in the bronchial tubes.

An obese patient with a history of deep vein thrombosis (DVT) is being evaluated in the clinic. The patient is currently taking coumadin (Warfarin). The patient lost 30 pounds since the last visit. Which of the following interventions is most important during the clinical visit? Have the patient complete a 3 day food diary. Encourage a high fiber diet with lots of green, leafy vegetables. Ask if the weight loss is intended. Measure for new compression stockings

Measure for new compression stockings

The nurse is developing a plan of care to reduce stress for a hospitalized 8-year-old child. Which approach by the nurse is most likely to reduce stress? Allow 24-hour visitation with the child's friends. Have tutoring available while the child is hospitalized. Caution against making decisions while hospitalized. Offer the child some choices for activities, such as bathing or ambulating.

Offer the child some choices for activities, such as bathing or ambulating.

A nurse wants to provide community service that helps meet the goals of Healthy People 2030 related to cardiovascular disease. What activity would best meet this goal? Set up an "ask the nurse" booth at the mall. Teach high school students heart healthy living. Provide pamphlets on heart disese at the grocery store. Participate in blood pressure screenings at the State fair.

Participate in blood pressure screenings at the State fair.

A patient comes to the clinic for a routine physical. The nurse takes the blood pressure and gets a reading of 142/92 on the right arm. Upon subsequent visits to the clinic, the blood pressures are 146/94, and 152/94. What patient teaching is most important for this patient? Patient teaching should include methods to avoid needing medications. Patient teaching should include dietary supplements. Patient teaching should include the importance of taking antihypertensives. Patient teaching should include herbal supplements.

Patient teaching should include the importance of taking antihypertensives.

A hospice nurse plans care for a patient who is experiencing pain. Which complementary therapies does the nurse incorporate in this patient's pain management plan? (Select all that apply.) Rub lavender lotion on the patient's feet. Massage tissue that is tender from radiation therapy. Ambulate the patient in the hall twice a day. Administer intravenous morphine Play music that the patient enjoys.

Play music that the patient enjoys. Rub lavender lotion on the patient's feet.

A client develops a first impression of the situation after receiving a cancer diagnosis. Which appraisal best describes the client's response? Ineffective Coping Secondary appraisal Reappraisal Primary appraisal

Primary appraisal

The nurse enters the room only to find a new patient lying supine in bed. The patient complains of shortness of breath. Which nursing action should the nurse perform first? Raise the head of bed to 45 degrees. Take the pulse oxygen saturation level. Assess the BP and heart rate Notify the provider the patient is complaining of shortness of breath.

Raise the head of bed to 45 degrees.

The nurse observes a newly hospitalized client is experiencing shaking, hyperventilation, and tachycardia. The nurse suspects the client is experiencing stress. Which independent nursing action is appropriate treatment for the client's stress? Pharmacologic therapy Cognitive Behavioral therapy Relaxation techniques Psychotherapy

Relaxation techniques

A nurse assesses a patient who is dying. Which manifestation of a dying patient does the nurse assess to determine whether the patient is near death? Bowel sounds Level of consciousness Respiratory rate Pain level on a 0-to-10 scale

Respiratory rate

Which of the following assessment findings are most concerning? BP 120/80 Pulse rate 72 regular temperature 37.4 C (99.3 F) Respiratory rate 28/min

Respiratory rate 28/min

The nurse reviews a family assessment. Which of the following are categories of the Calgary Family Assessment Model? Select all that apply. Structural Developmental Political view Functional

Structural Developmental Functional

The nurse is planning to teach a patient how to use relaxation techniques to prevent elevation of blood pressure and heart rate. The nurse is teaching the patient to control which physiological function? Replace stress-producing thoughts and activities with daily stress-reducing thoughts and activities. Reduce catecholamine production and promote the production of additional B-endorphins. Switch from sympathetic mode of the autonomic nervous system to the parasympathetic mode. Alter the internal state by modifying signals related to physiologic stress processes.

Switch from sympathetic mode of the autonomic nervous system to the parasympathetic mode.

A patient has not been sleeping well because he is worried about losing his job and not being able to support his family. The nurse takes the patient's vital signs: HR 112, RR 26/min, BP 166/88. Which patient teaching should be done first? Take slow deep breaths and say something positive to yourself. Go to sleep 30-60 minutes earlier each night to get adequate rest. Spend time relaxing with your pet dog. Consider that a new job may be better than your present one.

Take slow deep breaths and say something positive to yourself.

A hospice nurse is caring for a dying patient and her family members. Which interventions does the nurse implement? (Select all that apply.) encourage the management of adverse symptoms. Assist family members by offering an explanation for their loss. Encourage reminiscence by both patient and family members. Teach family members about physical signs of impending death. Avoid spirituality because the patient's and the nurse's beliefs may not be congruent.

Teach family members about physical signs of impending death. Encourage reminiscence by both patient and family members. encourage the management of adverse symptoms.

Which of the following situation alerts the nurse to possible dysfunctional family dynamics? The husband and the wife verbally abuse each other daily. A woman is caring for her older mother in their home along with 5 children of her own. The grandmother babysits for her grandchildren while the parents are at work. The mother of a child with a disability attend to the child's physical needs.

The husband and the wife verbally abuse each other daily.

A nurse is caring for a client using oxygen via nasal cannula while in the hospital. Which finding demonstrates the patient outcome for safe oxygen use is being met? The patient has the same weight over the past 3 days. The patient understands the need for oxygen. The patient eats 100% of all meals. The patient has intact skin behind ears.

The patient has intact skin behind ears.

A patient with cancer asks why they need an advanced directive. Which response by the nurse is most accurate? "To ensure you will die in your home instead of a hospital." "To ensure you receive pain medication at the end of life." "So your family doesn't receive a bill from the hospital." "To ensure your end-of-life wishes are carried out."

To ensure your end-of-life wishes are carried out."

A beta-blocking agent is added to the pharmacologic therapy of a client with heart failure and hypertension. Which of the following is an expected therapeutic effect? a decrease in complaints of fatigue. a decrease in the heart rate. an increase in blood pressure. an increase in diuresis.

a decrease in the heart rate.

Which of the following medications is a short-acting beta agonist? salmeterol tiotropium singulair (montelukast) albuterol

albuterol

A patient with deep vein thrombosis in the right calf complains of pain in the calf. Which of the following comfort interventions should the nurse delegate to the nursing assistant for the patient with a DVT? massage the calf for the patient apply a cold pack apply TED stockings apply a warm moist pack

apply a warm moist pack

A 56 year old patient with diabetes is admitted for community acquired pneumonia. The patient's temperature is 38.2 F (100.8 F) taken with a temporal thermometer. Which assessment data are needed in planning interventions for this patient? Select all that apply. heart rate presence of diaphoresis recent bowel movement respiratory rate blood pressure in the right arm pulse oximetry at rest and with activity

heart rate presence of diaphoresis respiratory rate pulse oximetry at rest and with activity

A nurse is caring for a patient at risk for deep vein thrombosis (DVT). What nursing interventions help prevent DVT? Select all that apply. a diet high in protein anticoagulant therapy venous plexus foot pump antihypertensive therapy hydration sequential compression devices

hydration sequential compression devices anticoagulant therapy venous plexus foot pump

A nurse cares for a dying patient. Which manifestation of dying does the nurse treat first? Pain Nausea Hair loss Anorexia

pain

Which of the following symptoms do most dying patients fear the most? Shortness of breath Incontinence Nausea and vomiting Pain

pain

A family member of the patient criticizes them for their lifestyle choices while the patient is very ill in a hospital bed. The nurse observes a lack of support in the family. Which of the following is the most important intervention for this scenario? Ask the primary care doctor what to do. Monitor the interactions between family members. Enforce visitor policies role model support for autonomy in decision making.

role model support for autonomy in decision making.

Which nursing intervention is appropriate for preventing atelectasis in the patient who just had surgery? postural drainage chest physiotherapy use of incentive spirometry suctioning

use of incentive spirometry

Regarding family dynamics, in which situation is there a need for additional nursing interventions? when extended family offers to help. when family members share memories. when the ill family members are demanding attention. when family members express concern.

when the ill family members are demanding attention.

A patient is admitted with severe pneumonia. Which of the following findings indicate a need for suctioning of the oral airway? Decreased ability to cough Coughing up thin watery sputum Coughing up thick sputum occasionally Lungs sound clear after coughing

Decreased ability to cough

The nurse is caring for a patient who has decreased mobility. Which intervention is a cost effective method for reducing the risk of aspiration pneumonia? Antibiotics Chest physiotherapy Oxygen humidification Place the head of bed in Fowler's position

Place the head of bed in Fowler's position

Which statement about the asthma action plan is accurate? When the reading is in the red zone, the patient should take their SABA and get help immediately. When the reading is 80% or greater, the patent should take their SABA. When the reading is in the yellow zone, the patient doesn't need to take action. When the reading is in the green zone, the patient should get help immediately.

When the reading is in the red zone, the patient should take their SABA and get help immediately.

In Hospice care, the doctor must come to the home and pronounce them dead. true or false

false

After teaching a patient about advance directives, a nurse assesses the patient's understanding. Which statement indicates that the patient correctly understands the teaching? "An advance directive will be completed as soon as I'm incapacitated and can't think for myself." . "An advance directive will allow me to keep my children from fighting over my money when I'm gone." "An advance directive will specify what I want done when I can no longer make decisions about health care." "An advance directive will keep me from being placed in long term care."

"An advance directive will specify what I want done when I can no longer make decisions about health care."

A mother is concerned about her 5-year-old child after the unexpected death of the child's father. How should the nurse explain grief for a child at this age? "Children at this age feel a sense of guilt for any wrongdoing and blame themselves for the death." "Children at this age experience a fear of death." "Children at this age do understand the permanency of death, so it might help to see a counselor." "Children at this age don't understand the permanency of death. They learn how to respond to death from their parents."

"Children at this age don't understand the permanency of death. They learn how to respond to death from their parents."

A patient newly diagnosed with hypertension asks how she could have developed hypertension. What is the nurse's best response? "Hypertension is caused by your poor diet." "Hypertension is caused by lack of exercise." "Hypertension happens to everyone with age." "Hypertension is a narrowing of the arterial blood vessels for which the cause is not always known."

"Hypertension is a narrowing of the arterial blood vessels for which the cause is not always known."

A nurse is caring for a dying patient. The patient's spouse states, "I think he is choking to death." How should the nurse respond? "I will have another nurse assist me to turn your husband on his side." "Do not worry. The choking sound is normal during the dying process." "I can ask the respiratory therapist to suction secretions out through his nose." "I will administer more acetaminophen to keep your husband comfortable."

"I will have another nurse assist me to turn your husband on his side."

When providing patient teaching for a patient newly diagnosed with COPD, which statement indicates a lack of understanding? "If I have trouble breathing at night, I'll use pillows to assist my breathing." "If I get short of breath, I'll just increase my oxygen level to 6L/min." "I'll allow myself more time to complete activities of daily living." "I'll make sure to rest so I don't get out of breath."

"If I get short of breath, I'll just increase my oxygen level to 6L/min."

Which of the following statements made by the nurse work to meet the psychosocial needs of the grieving person? Select all that apply. "It sounds like you had a special relationship." "Would you like for me to call the hospital chaplain?" "Sorry, I have to take care of my other patients." "In my culture, we believe in discussing our feelings about death." "He should have gotten vaccinated!"

"It sounds like you had a special relationship." "Would you like for me to call the hospital chaplain?"

A patient has been diagnosed with hypertension but reports he doesn't take antihypertensives because he has no symptoms. How should the nurse respond to the patient? "Are you having trouble affording your medications?" "You are fortunate that you don't have symptoms." "Who told you not to take the medications?" "It's important to take the antihypertensives even if you don't have symptoms."

"It's important to take the antihypertensives even if you don't have symptoms."

A nurse is caring for a patient who is terminally ill. The patient's spouse states, "I am concerned because he does not want to eat." How does the nurse respond? "Force him to eat even if he does not feel hungry, or he will die sooner." "He is getting all the nutrients he needs through his intravenous catheter." "A feeding tube can be placed in the nose to provide important nutrients." "Let him know that food is available if he wants it, but do not insist that he eat."

"Let him know that food is available if he wants it, but do not insist that he eat."

The nurse is providing instructions to a patient prescribed an SSRI and is taking it for the first time. Which patient statement expresses understanding of this instruction? "The medication is habit forming." "The medication might not work for 4 weeks." "This medication is an herbal supplement." "This medication causes a dry mouth."

"The medication might not work for 4 weeks."

A patient newly diagnosed with hypertension asks what complications are associated with high blood pressure. Which of the following responses by the nurse is accurate? Select all that apply. "Untreated hypertension can lead to stroke." "Untreated hypertension can lead to retinopathy." "Untreated hypertension can lead to liver failure." "Untreated hypertension can lead to pancreatic cancer." "Untreated hypertension can lead to kidney failure."

"Untreated hypertension can lead to stroke." "Untreated hypertension can lead to retinopathy." Untreated hypertension can lead to kidney failure."

A patient has been bedridden for three days after knee surgery. Which actions by the nurse prevent deep vein thrombosis (DVT) for this patient? Select all that apply. Assist with ambulation Teach leg exercises. Encourage coughing and deep breathing. Offer fluids frequently Apply compression stockings.

Assist with ambulation Teach leg exercises. Offer fluids frequently Apply compression stockings.

A patient with pneumonia is receiving oxygen via 4 L nasal cannula. His respiratory rate is 26/min and pulse ox reads 92%. Which information is most helpful in determining the priority interventions? Activity order Medication list Baseline vital signs Patient's perception of dyspnea

Activity order Baseline vital signs

Which intervention is needed for the client who is a 14-year-old and newly diagnosed with asthma complaining of wheezing? Select all that apply. Administer a short acting beta agonist Request provider to order antibiotics for a total of 21 days Teach client how to use an inhaler and when to call contact primary provider Administer influenza vaccine if ordered.

Administer influenza vaccine if ordered.

A nurse is teaching a female patient about alcohol intake and how it affects hypertension. The patient asks if drinking two alcoholic drinks a day is acceptable. What answer by the nurse is best? "It depends on your size." "Alcohol should be limited to one drink per day for women." "Alcohol should not be consummed if you have hypertension." "Two drinks per day is acceptable."

Alcohol should be limited to one drink per day for women."

Which of the following conditions is caused by an oxygenation transport problem? Pneumonia Anemia Asthma COPD

Anemia

A nurse is caring for a terminally ill patient who has just died in a hospital setting with family members at the bedside. Which action will the nurse take first? Ask family members if they would like to spend time alone with the patient. Call for emergency assistance so that resuscitation procedures can begin. Request family members to prepare the patient's body for the funeral home. Ensure that a death certificate has been completed by the physician

Ask family members if they would like to spend time alone with the patient.

The provider ordered ACE inhibitor lisinopril (Zestril) 10 mg po daily for a patient who was already taking hydrochlorothiazide 25 mg po daily. Which of the following actions is most important? Monitor the client's apical heart rate. Assess the client's cardiac rhythm. Assess for dizziness and lightheadedness. Monitor the urine output.

Assess for dizziness and lightheadedness.

A patient with hypertension and lifestyle risk factors is overwhelmed by the dietary and activity recommendations. Which of the following nursing interventions is most important? Ask the patient to delegate responsibilities. Assess the support system. Assist the patient in identifying one change that patient can control. Determine the patient's ability to make rapid changes.

Assist the patient in identifying one change that patient can control.

A patient has been working on reducing his stress. After two weeks, the patient returns to the clinic. Which objective data best suggests that the patient is successfully using these techniques to cope more effectively with stress? He spends more time alone. He says he feels better and things aren't bothering him as much. His systolic BP goes from 140's to the 120's He reports a good appetite, mood and improved energy levels.

His systolic BP goes from 140's to the 120's

The nurse is reviewing the plan of care for a patient having difficulty coping with stress. Which action should the nurse implement to assist the patient? Identify the cause of fear Identify relaxation methods Review an educational pamphlet Access the community support group

Identify the cause of fear

The nurse is developing a plan of care for a patient with ineffective coping skills. Which intervention would be an example of a problem-focused coping strategy? Attend a support group for families Identifying a confidant to share feelings Attend a seminar on treatment options Schedule a regular exercise program

Identifying a confidant to share feelings

The orders for a hospitalized patient read: 50% oxygen via mask. The nurse assesses the mask, finds that it fits snugly and the rate is at 1 L/minute. What action by the nurse is best? Immediately increase the rate of flow of oxygen Document the findings in the chart Assess the patient's oxygen saturation Turn the flow of oxygen to 0.5 L/min

Immediately increase the rate of flow of oxygen

Which of the following are symptoms at the end of life? Select all that apply. Inability to eat Labored breathing Decreased urine output Cool, purple-colored skin

Inability to eat Labored breathing Decreased urine output Cool, purple-colored skin

A hospice nurse is caring for a variety of patients who are dying. Which end-of-life and death ritual is paired with the correct religion? Islam—an ill or a dying person should receive the Sacrament of the Sick. Roman Catholic—autopsies are not allowed except under special circumstances. Judaism—a person who is extremely ill and dying should not be left alone. Christian—upon death, a religious leader should perform rituals of bathing and wrapping the body in cloth.

Judaism—a person who is extremely ill and dying should not be left alone.