NU370 PrepU Week 1
A nurse working in a community clinic assists middle-age clients to follow guidelines for health-related screenings and immunizations. What preventive measures would the nurse recommend for this population? Select all that apply. a) A physical exam every year from age 40 on b) Clinical skin examination every 3 years c) Breast self-examination every month for women d) Pelvic examination and Pap test at least every 3 years for women e) Prostate-specific antigen (PSA) test every year for men f) Zoster vaccine live for adults 50 years and older
a) A physical exam every year from age 40 on c) Breast self-examination every month for women d) Pelvic examination and Pap test at least every 3 years for women e) Prostate-specific antigen (PSA) test every year for men f) Zoster vaccine live for adults 50 years and older - The nurse would recommend several different preventive measure that are listed. The nurse would recommend that the client have a physical exam every year from age 40 on; that the female client do a breast self-examination every month; a pelvic examination and Pap test at least every 3 years for women; a prostate-specific antigen (PSA) test every year for men; and a Zoster vaccine live vaccination for adults 50 years and older. The nurse would recommend a clinical skin examination every year.
When considering the clinical course, a disease that is characterized by remissions and exacerbations is considered to be: a) chronic b) acute c) subclinical d) preclinical
a) chronic - The clinical course describes the evolution of a disease. A disease can have an acute or chronic course. Chronic disease implies a continuous, long-term process. A chronic disease can run a continuous course or can present with exacerbations (aggravation of symptoms and severity of the disease) and remissions (a period during which there is a decrease in severity and symptoms). An acute disorder is one that is relatively severe, but self-limiting. The terms preclinical and subclinical are used when discussing the severity of the disease.
A client is seen in the clinic with symptoms of "dragging" and feeling like something is "coming down." During her assessment, the nurse should look at which risk factors for a prolapse? Select all that apply. a) vaginal birth b) repeated urinary tract infections (UTIs) c) advanced age d) increased body mass index e) diabetes
a) vaginal birth c) advanced age d) increased body mass index - The cause of prolapse is multifactorial with vaginal birth, advancing age, and increasing body mass index as the most consistent risk factors. Diabetes and frequent UTIs are not risk factors for a prolapse.
Which skin disorder seen in older adults is considered a premalignant lesion? a) Cherry angiomas b) Actinic keratosis c) Solar lentigines d) Telangiectases
b) Actinic keratosis - Actinic keratoses are the most common premalignant skin lesions that develop on sun-exposed areas. Solar lentigines are tan to brown, benign spots on sun-exposed areas. They are commonly referred to as liver spots. Senile angiomas (cherry angiomas) are smooth, cherry-red or purple, dome-shaped papules, usually found on the trunk. Telangiectases are single-dilated blood vessels, capillaries, or terminal arteries that appear on areas exposed to sun or harsh weather, such as the cheeks and the nose.
A client tells that nurse in the doctor's office that her friend developed high blood pressure on her last pregnancy. She is concerned that she will have the same problem. What is the standard of care for preeclampsia? a) Take a low-dose antihypertensive prophylactically. b) Have her blood pressure checked at every prenatal visit. c) Monitor the client for headaches or swelling on the body. d) Take one aspirin every day.
b) Have her blood pressure checked at every prenatal visit. - Preeclampsia and eclampsia are common problems for pregnant clients and require regular blood pressure monitoring at all prenatal visits. Antihypertensives are not prescribed unless the client is already hypertensive. Monitoring for headaches and swelling is a good predictor of a problem but doesn't address prevention—nor does it predict who will have hypertension. Taking aspirin has shown to reduce the risk in women who have moderate to high risk factors, but has shown no effect on those women with low risk factors.
A health educator is performing a health promotion workshop with the staff of a large, urban homeless shelter, and a component of the teaching centers around tuberculosis. One of the staff members comments, "Anyone who's had contact with tuberculosis in the past can give it to any of the other residents of the shelter, even if they didn't get sick themselves." How could the educator best respond to this comment? a) "Many people do manage to fight off the infection, but you're right—they can still spread it by coughing or sneezing." b) "If someone has been previously exposed to tuberculosis, they are particularly infectious because they are often unaware of the disease." c) "Actually, people who have the latent form of the disease won't be sick and can't spread it either." d) "There isn't any real risk of them spreading it, but we would like to vaccinate everyone who's had any contact with it in the past."
c) "Actually, people who have the latent form of the disease won't be sick and can't spread it either." - Contact with M. tuberculosis without the development of progressive primary tuberculosis results in a latent infection that is not communicable. Vaccination is not a common intervention in the United States.
Which client is most likely to have low bone density? a) A 70-year-old woman with increased numbers of osteoblasts. b) A 78-year-old female whose osteoclast function is inhibited. c) A 65-year-old male who is noted to have osteopenia. d) A 68-year-old male who takes vitamin D supplements.
c) A 65-year-old male who is noted to have osteopenia. - Osteopenia is characterized by a reduction in bone mass greater than expected for age, race, or sex that occurs because of a decrease in bone formation, inadequate bone mineralization, or excessive bone deossification. Increases in osteoblasts, inhibition of osteoclasts, and vitamin D supplementation would all be associated with high bone density.
Which client has the highest risk of ovarian cancer? a) 30-year-old woman taking hormonal contraceptives b) 36-year-old woman who had her first child at age 22 c) 40-year-old woman with three children d) 45-year-old woman who has never been pregnant
d) 45-year-old woman who has never been pregnant - The incidence of ovarian cancer increases in women who have never been pregnant, are older than age 40, are infertile, or have menstrual irregularities. Other risk factors include a family history of breast, bowel, or endometrial cancer. The risk of ovarian cancer is reduced in women who have taken hormonal contraceptives, have had multiple births, or have had a first child at a young age.
Which would be the least consistent with the Native American/Canadian Indigenous view of disease? a) Disharmony with Mother Earth b) A result of negative thinking c) Violation of a taboo d) Balance of yin and yang
d) Balance of yin and yang - The Native American/Canadian Indigenous view disease as a disharmony with Mother Earth, a result of negative thinking, or violation of a taboo. Chinese medicine proposes that health is the outcome of balancing yin and yang.
A nurse is preparing a presentation for a local community group in a small rural area about hantavirus pulmonary syndrome. Which of the following would the nurse suggest as a major prevention strategy? a) Vaccinating infants and children b) Avoiding whirlpool spas c) Wearing insect repellent d) Eliminating rodent food sources in areas near humans
d) Eliminating rodent food sources in areas near humans - Prevention of hantavirus pulmonary syndrome focuses on reducing human contact with rodents and their droppings. One prevention strategy is to eliminate rodent food sources in areas close to humans and using traps in areas where humans work and rodents may enter. Vaccination would be appropriate to prevent pertussis. Avoidance of whirlpool spas eliminates a risk factor for Legionnaire's disease. Wearing insect repellent could help to prevent West Nile Virus, which is transmitted from infected mosquitoes.
Which iron-rich foods should a nurse encourage an anemic client requiring iron therapy to eat? a) shrimp and tomatoes b) lobster and squash c) cheese and bananas d) lamb and peaches
d) lamb and peaches - Iron-rich foods include lamb and peaches. Shrimp, tomatoes, lobster, squash, cheese, and bananas aren't high in iron content.
The estrogen content in the contraceptive pill performs which action? a) decreases the permeability of cervical mucus b) increases the level of luteinizing hormone (LH) c) interferes with endometrial proliferation d) suppresses follicle-stimulating hormone (FSH)
d) suppresses follicle-stimulating hormone (FSH) - Estrogen has a direct effect on the pituitary gland suppressing FSH; progesterone increases permeability of cervical mucus and endometrial proliferation.
A nurse is working with a child who has Osgood-Schlatter disease. Which client would be the most likely to develop this condition? a) A 13-year-old boy who is on his school's cross-country team b) A 9-year-old boy who is sedentary c) A 15-year-old girl who dances ballet d) An 11-year-old girl who is obese
a) A 13-year-old boy who is on his school's cross-country team - Osgood-Schlatter disease is the thickening and enlargement of the tibial tuberosity resulting from microtrauma, probably caused from overuse. It occurs more often in boys than girls and at preadolescence or early adolescence, probably because of rapid growth at these times.
The nurse explains to the client which statement is true regarding the difference between allopathic therapy and complementary and alternative therapy? a) Allopathic therapy emphasizes treatments for diseases. Complementary and alternative therapy emphasizes treatments for health. b) Allopathic therapy integrates mind and body. Complementary and alternative therapy separates mind and body. c) Allopathic therapy is the absence of illness. Complementary and alternative therapy states health is the imbalance of the body systems. d) Allopathic therapy uses herbs to treat. Complementary and alternative therapy uses medications to treat.
a) Allopathic therapy emphasizes treatments for diseases. Complementary and alternative therapy emphasizes treatments for health. - Allopathic therapy emphasizes treatments for diseases using traditional western medicine provided by an MD or DO. Examples of Allopathic therapy include pharmacotherapy, surgery, and radiology. Alternative medicine and complimentary medicine are terms that describes medical treatments that are used instead of traditional western therapies. Examples of complementary therapy include acupuncture, aromatherapy, homeopathy, and yoga. Alternative therapy includes acupuncture, homeopathy, and eastern oriental practices.
Which of the following interventions will help prevent a pulmonary embolus (PE) in a postpartum woman? Select all that apply. a) Encourage the client to increase fluid intake. b) Teach the client leg exercises she can do in bed. c) Encourage the client to ambulate in the room. d) Give the client an anticoagulant prophylaxis. e) Elevate the client's legs on a soft pillow.
a) Encourage the client to increase fluid intake. b) Teach the client leg exercises she can do in bed. c) Encourage the client to ambulate in the room. - Pulmonary embolus (PE) is primarily caused by a clot in the veins of the leg or pelvis. Having the three elements of Virchow's triad increases the client's risk of postpartum DVT. Those elements include hypercoagulation, venous stasis, and vessel wall injury. To prevent hypercoagulation, the nurse should encourage fluid intake to prevent dehydration. Venous stasis and vessel wall injury can be prevented by early ambulation. Anticoagulation would be contraindicated in postpartum women. Elevating their legs on pillows could cause vessel wall damage.
The registered nurse is performing a nutritional assessment to ensure that the client's diet is optimal for wound healing. The nurse's intervention can be traced back to which key contributor to nursing? a) Florence Nightingale b) Clara Barton c) Dorothea Dix d) Linda Richards
a) Florence Nightingale - Florence Nightingale's contributions to nursing included the recognition of the importance of nutrition to health. Clara Barton established the Red Cross. Dorothea Dix was a pioneer for reform of treatment for the mentally ill. Linda Richards began the practice of keeping records and writing orders.
Which factors are major components of a client's general background history? a) allergies and socioeconomic status b) urine output and allergies c) gastric reflex and the client's age d) bowel habits and allergies
a) allergies and socioeconomic status - General background data consist of such components as age, allergies, medical history, habits, socioeconomic status, lifestyle, beliefs, and sensory deficits. Urine output, gastric reflex, and bowel habits are significant only if a disease affecting these functions is present.
A nurse can best help a client who is undergoing chemotherapy and using guided imagery with this by doing which of the following? a) Helping the client learn about the different poses that can be performed. b) Assisting the client to find an appropriate imagery tape to use. c) Promoting the client's use of imagery only after a stressful event occurs. d) Explaining to the client that it is not a good idea to record their own imagery tape.
b) Assisting the client to find an appropriate imagery tape to use. - Clients use imagery to help with relaxation and this can use all five senses. Many times, clients use a guided imagery tape that includes a script to help with imagery; clients also can record their own tape. Clients do not necessarily use poses with this; this would be more related to use of yoga. Guided imagery can help both during and after a stressful event to help the client relax.
A nurse reading a client's chart notes that the client's cancer is documented as carcinoma in situ of the cervix. Which term most accurately interprets what this means in terms of survival? a) Metastasizing b) Curable c) Inoperable d) Benign
b) Curable - Carcinoma in situ is a localized preinvasive lesion and can usually be removed surgically or treated so that the chances of recurrence are small. Carcinoma in situ of the cervix is 100% curable.
The nurse is caring for a client admitted for a quadruple coronary artery bypass graft. Which statements by the client indicate that preoperative teaching has not been effective? Select all that apply. a) "I know that I will have to perform deep breathing and coughing exercises to prevent complications." b) "I will be on a heart monitor and a respirator to help me breathe." c) "I will be relieved to have this surgery over with; I have a very busy schedule at work right now." d) "I understand that I need to change my eating habits and activity levels to keep my heart healthy." e) "I had stopped smoking a month before the surgery; however, I will be able to start again once I have recovered."
c) "I will be relieved to have this surgery over with; I have a very busy schedule at work right now." e) "I had stopped smoking a month before the surgery; however, I will be able to start again once I have recovered." - Both of these statements indicate that the client believes the surgery will solve the problem and lifestyle changes are not necessary. There is no demonstration of understanding of preoperative teaching. "I know that I will have to perform deep breathing and coughing exercises to prevent complications," "I will be on a heart monitor and a respirator to help me breathe," and "I understand that I need to change my eating habits and activity levels to keep my heart healthy" are all positive statements that indicate a good understanding of the teaching, indicating the client is an active participant and is following guidelines to help in recovery after the surgery and promote heart health.
A 35-year-old client diagnosed with multiple sclerosis three years ago presents the nurse with an advance directive refusing intubation, mechanical ventilation, and tube feedings. How should the nurse respond? a) "Thank you for providing this document. I will make sure to keep the information between you and me." b) "Advance directives aren't necessary for a client your age in the early stages of multiple sclerosis." c) "You should review this information with your healthcare provider at every admission." d) "Are you aware there are many new treatments for multiple sclerosis that could give good quality of life?"
c) "You should review this information with your healthcare provider at every admission." - An advance directive should be part of the client's medical record. The client should review the document with the healthcare provider at every admission because some conditions may be reversible and temporary, making portions of the advance directive inappropriate. Advance directives should be shared with all members of the healthcare team and are appropriate for clients of any age. The nurse should not attempt to negate the client's wishes by mentioning new treatments.
The nurse recognizes that which of the following clients is at the lowest risk for perioperative complications? a) A client who takes prednisone b) A client who takes clopidogrel c) A client who has a history of arthritis d) A client recently diagnosed with type 2 diabetes
c) A client who has a history of arthritis - A history of arthritis does not increase the risk for complications during the perioperative period.
During physical assessment of a 2-year-old child, the nurse becomes concerned that the child may have a cataract in one eye. Which sign or symptom suggests the child has a cataract? a) Sclera appears to be blue b) Excess watering of the eyes c) Absence of the red reflex d) Edema of the eyelids
c) Absence of the red reflex - The absence of the red reflex and a white, opaque appearance of the lens are telltale signs of a cataract. A blue tinge to the sclera and excess watering of the eyes are signs of glaucoma. Edema of the eyelids is a sign of allergic conjunctivitis.
Which process accounts for the damaging effects of the sun's radiation? a) Initiation of an autoimmune response b) Compensatory increases in melanin production c) Generation of reactive oxygen species and damage to melanin d) Hyperkeratinization and the formation of microscopic, subcutaneous lesions
c) Generation of reactive oxygen species and damage to melanin - Ultraviolet (UV) B radiation is primarily responsible for sunburns, and it acts mainly on the cells in the basal layer of the epidermis, causing the generation of reactive oxygen species and damage to melanin. It also provokes free radical production and induces a significant reduction in skin antioxidants, impairing the ability of the skin to protect itself against the free radicals that are generated. UV radiation does not provoke an autoimmune response or hyperkeratinization, although there is an inflammatory response. Increased melanin production is a protective mechanism and does not participate in the deleterious effects of UV radiation.
It is well known that cancer is not a single disease. It follows then that cancer does not have a single cause. It seems more likely that the occurrence of cancer is triggered by the interactions of multiple risk factors. What are some identified risk factors for cancer? a) Body type, age, and heredity b) Radiation, cancer-causing viruses, and color of skin c) Hormonal factors, chemicals, and immunologic mechanisms d) Immunologic mechanisms, cancer-causing viruses, and color of skin
c) Hormonal factors, chemicals, and immunologic mechanisms - Cancer occurs because of interactions among multiple risk factors or repeated exposure to a single carcinogenic (cancer-producing) agent. Among the traditional risk factors that have been linked to cancer are heredity, hormonal factors, immunologic mechanisms, and environmental agents such as chemicals, radiation, and cancer-causing viruses. More recently, there has been interest in obesity and type 2 diabetes mellitus as risk factors for a number of cancers. Body type, age, and color of skin have not been identified as risk factors for cancer.
A nurse is preparing a presentation for a local community group about familial Alzheimer's disease. As part of the presentation, the nurse is planning to discuss the possible genetic basis for this condition. The nurse would describe the inheritance as which of the following? a) Autosomal dominant b) Autosomal recessive c) Multifactorial d) X-linked
c) Multifactorial - Familial Alzheimer's disease reflects multifactorial inheritance that involves interactions among several genes and between genes and the environment as well as the individual's lifestyle. Autosomal-dominant, autosomal-recessive, and X-linked inheritance patterns are not involved.
A nurse is caring for a client who has an avulsion of her left thumb. Which description should the nurse understand as being the definition of avulsion? a) Tearing of the skin and tissue with some type of instrument; tissue not aligned b) Cutting with a sharp instrument with wound edges in close approximation with correct alignment c) Tearing of a structure from its normal position d) Puncture of the skin
c) Tearing of a structure from its normal position - An avulsion involves tearing of a structure from its normal position on the body. Tearing of the skin and tissue with some type of instrument with the tissue not aligned is a laceration. Cutting with a sharp instrument with wound edges in close approximation and correct alignment is an incision. A puncture of the skin is simply a puncture.
What have the models of health promotion and illness prevention been used for? a) To define a medical framework for the care of the disabled. b) To create a forum for improving rehabilitative care. c) To help health care providers understand health-related behaviors. d) To formulate care plans for the disabled population.
c) To help health care providers understand health-related behaviors. - Several models of health promotion and illness prevention have been used to help health care providers understand health-related behaviors and adapt care to people from diverse economic and cultural backgrounds. The models include the health belief model, the health promotion model, the health-illness continuum model, and the agent-host-environment model. These models do not define a medical framework in the care of the disabled; these models do not create a forum for improving rehabilitative care; and these models do not formulate care plans for use with the disabled.
A client has been exposed to bacterial pneumonia. The client has been eating poorly, with limited intake of nutrients. This factor would predispose a client to the development of pneumonia. Poor nutritional intake is classified as the a) Host b) agent c) environment d) disease
c) environment - The environment is factors that are physical, social, economic, emotional, or spiritual. They create the likelihood or the predisposition for the person to develop disease.
Which findings are considered positive signs of pregnancy? a) fatigue and skin changes b) quickening and breast enlargement c) fetal heartbeat and fetal movement on palpation d) abdominal enlargement and Braxton Hicks contractions
c) fetal heartbeat and fetal movement on palpation - Fetal heartbeat and fetal movement on palpation are considered positive signs of pregnancy because they can't be caused by any other condition. Fatigue can be caused by chronic illness or anemia. Skin changes can result from cardiopulmonary disorders, estrogen-progesterone hormonal contraceptives, obesity, or a pelvic tumor. Excessive flatus or increased peristalsis can cause the perception of quickening. Breast changes can be related to hyperprolactinemia induced by sedatives, infection, prolactin-secreting pituitary tumor, pseudocyesis, or premenstrual syndrome. Abdominal enlargement can result from ascites, obesity, or uterine or pelvic tumor, and the perception of Braxton Hicks contractions can result from hematometra or a uterine tumor.
The nurse is assessing a client who is bedridden. For which condition would the nurse consider this client to be at risk? a) increase in the movement of secretions in the respiratory tract b) increase in circulating fibrinolysin c) predisposition to renal calculi d) increased metabolic rate
c) predisposition to renal calculi - In a bedridden client, the kidneys and ureters are level, and urine remains in the renal pelvis for a longer period of time before gravity causes it to move into the ureters and bladder. Urinary stasis favors the growth of bacteria that, when present in sufficient quantities, may cause urinary tract infections. Poor perineal hygiene, incontinence, decreased fluid intake, or an indwelling urinary catheter can increase the risk for urinary tract infection in an immobile client. Immobility also predisposes the client to renal calculi, or kidney stones, which are a consequence of high levels of urinary calcium; urinary retention and incontinence resulting from decreased bladder muscle tone; the formation of alkaline urine, which facilitates growth of urinary bacteria; and decreased urine volume. The client would be at risk for decreased movement of secretion in the respiratory tract, due to lack of lung expansion. The client would suffer from decreased metabolic rate due to being bedridden. The client would not have an increase in circulating fibrinolysin.
A nurse has been teaching a new mother how to feed her infant who was born with a cleft lip and palate. Which action by the mother indicates that the teaching has been successful? a) placing the baby flat during feedings b) providing fluids with a small spoon c) placing the nipple in the cleft palate d) burping the baby frequently
d) burping the baby frequently - Because an infant with a cleft lip and palate can not grasp a nipple securely, the infant may swallow a large amount of air during feedings and, therefore, require frequent burping. An infant with a cleft lip and palate should be fed in an upright position to reduce the risk of aspiration. Spoons shouldn't be used. A neonate with a cleft lip and palate may use specially prepared nipples for feeding. Placing the nipple in the cleft palate increases the risk of aspiration.
The nurse is attempting to control the infectious process while caring for a client. The nurse changes the client's wound dressing when the dressing becomes soiled. Which link of the chain of infection is the nurse interrupting with this intervention? a) reservoir b) portal of exit c) mode of transmission d) susceptible host
a) reservoir - The reservoir is the place where a microorganism grows and reproduces. Dressings left unchanged leave a dark, warm, moist environment for microorganisms to thrive. Covering the mouth and using personal protective equipment are ways to control portals of exit. Modes of transmission can be controlled with handwashing and personal protective equipment. The susceptible host is the person who is susceptible to developing an infection. Promotion of natural defenses is a good way to prevent infection.
Which statement is accurate regarding the treatment of breast cancer? a) Because breast cancer is often a systemic disease, chemotherapy is not effective. b) Often, the first treatment option for breast cancer is surgery. c) Women with hormone-sensitive cancers often have a poor prognosis and require many different types of treatment. d) Immunotherapy is seldom used as an adjunct therapy.
b) Often, the first treatment option for breast cancer is surgery. - Often, the first treatment option presented to women diagnosed with breast cancer is surgical removal of the tumor. Women with hormone-sensitive cancers have a good prognosis and often need only hormonal treatment. Immunotherapy is often used as an adjunct to surgery. Chemotherapy is effective in treating systemic cancers.
A neonate born by elective cesarean birth weighs 7 lb, 3 oz (3,267 g). The nurse closely monitors for which assessment finding related to a complication from this type of birth? a) fluctuating body temperature b) respiratory distress c) peripheral and circumoral cyanosis d) fluctuating blood glucose results
b) respiratory distress - One of the most crucial adaptations the newborn makes at birth is adjusting from a fluid-filled intrauterine environment to a gaseous extrauterine environment. The fluid from the intrauterine life environment must be removed so the infant can breathe. Passage through the birth canal allows intermittent compression of the thorax, which helps eliminate the fluid. If a mother has a cesarean birth, this compression does not occur, and transient tachypnea (respiratory rate above 60) can develop. Unstable blood sugars, poor thermoregulation, and peripheral and circumoral cyanosis (acrocyanosis) are associated with all newborns and not necessarily related to cesarean delivery.
The nurse is teaching a client about surgical treatments available for chronic viral hepatitis. Which of these is appropriate for the nurse to relate? a) Hepatectomy b) Removal of the diseased portion of the liver c) Liver transplant d) Portosystemic shunt
c) Liver transplant - Chronic viral hepatitis is the principal cause of chronic liver disease, cirrhosis, and hepatocellular cancer in the world and now ranks as the chief reason for liver transplantation in adults.
A young child develops type 1A diabetes. The parents ask, "They tell us this is genetic. Does that mean our other children will get diabetes?" The best response by the health care provider would be: a) "Probably not. Since genetically your other children have a different cellular makeup, they just might not become diabetic." b) "If you put all your children on a low-carbohydrate diet, maybe they won't get diabetes." c) "We don't know what causes diabetes, so we will just have to wait and see." d) "This autoimmune disorder causes destruction of the beta cells, placing your children at high risk of developing diabetes."
d) "This autoimmune disorder causes destruction of the beta cells, placing your children at high risk of developing diabetes." - Type 1 diabetes is subdivided into two types: type 1A, immune-mediated diabetes, and type 1B, idiopathic diabetes. Type 1A diabetes is characterized by autoimmune destruction of beta cells. The other choices are not absolutely correct. The fact that type 1 diabetes is thought to result from an interaction between genetic and environmental factors led to research into methods directed at prevention and early control of the disease. These methods include the identification of genetically susceptible persons and early intervention in newly diagnosed persons with type 1 diabetes.
Hyperresonance is audible when which area is percussed? a) Overinflated lung tissue b) Liver c) Thigh d) Air-filled stomach
a) Overinflated lung tissue - Hyperresonance is audible when overinflated lung tissue is percussed, such as in a client with emphysema. Percussion over the liver produces a dull sound. Percussion of the thigh produces a flat sound. Tympany is the drum-like sound produced by percussing an air-filled stomach.
A nurse preparing a presentation about the practice of nursing for a group of first-year nursing students plans to incorporate the American Nurses Association phenomena of care. Which of the following would the nurse include? Select all that apply. a) emotions b) lifespan changes c) decision making d) self-care e) culture f) ethics
a) emotions b) lifespan changes c) decision making d) self-care - The American Nurses Association has identified the following phenomena as the focus of nursing care: self-care processes; emotions related to health and illness; transitions across the lifespan; decision-making and ability to make choices. Although culture and ethics are important components of nursing practice, they are not identified as phenomena of care.
Which type of spinal neural tube defect does the nurse recognize as common and usually benign? a) myelomeningocele b) spina bifida c) meningocele d) spina bifida occulta
d) spina bifida occulta - Spina bifida occulta usually is benign and is estimated to affect 10% to 20% of the population. It is a defect in the vertebral body without protrusion of the spinal cord or its coverings. Spina bifida is a general term that is often used to refer to all neural tube disorders of the spinal cord. Meningocele and myelomeningocele do involve protrusion of elements of the spinal portion of the central nervous system and require treatment.
To calculate the ideal body weight for a woman, the nurse allows a) 100 lb for 5 ft of height. b) 106 lb for 5 ft of height. c) 6 lb for each additional inch over 5 ft. d) 80 lb for 5 ft of height.
a) 100 lb for 5 ft of height. - To calculate the ideal body weight of a woman, the nurse allows 100 lb for 5 ft of height and adds 5 lb for each additional inch over 5 ft. The nurse allows 106 lb for 5 ft of height in calculating the ideal body weight for a man. The nurse adds 6 lb for each additional inch over 5 ft in calculating the ideal body weight for a man. Eighty pounds for 5 feet of height is too little.
Assessment of a patient reveals a flat and nonpalpable skin lesion that is 0.5 cm with a circumscribed border. The nurse documents this lesion as which of the following? a) Macule b) Patch c) Papule d) Plaque
a) Macule - A flat, nonpalpable, circumscribed lesion less than 1 cm is a macule. A patch is a macule larger than 1 cm, and possibly with an irregular border. A papule is an elevated palpable solid mass with a circumscribed border and less than 0.5 cm. A plaque is a papule greater than 0.5 cm.
Cancer prognosis has improved most dramatically when treatment plans include which of the following? a) Multiple types of treatment b) Surgical procedures c) Aggressive chemotherapy d) Pinpointed radiation
a) Multiple types of treatment - Treatment plans that use more than one type of therapy, often in combination, are providing cures for a number of cancers that a few decades ago had a poor prognosis, and in turn are increasing the life expectancy. The remaining options can be components of a multi-pronged treatment plan.
Which term describes an opening between the bladder and the vagina? a) Vesicovaginal fistula b) Cystocele c) Rectocele d) Rectovaginal fistula
a) Vesicovaginal fistula - A vesicovaginal fistula may occur because of tissue injury sustained during surgery, vaginal birth, or a disease process. A cystocele is a downward displacement of the bladder toward the vaginal orifice. A rectocele is a bulging of the rectum into the vagina. A rectovaginal fistula is an opening between the rectum and the vagina.
A nurse is assessing a 1-hour-old neonate in the special care nursery. Which assessment finding indicates a metabolic response to cold stress? a) arrhythmia b) hyperglycemia c) hypoglycemia d) hypertension
c) hypoglycemia - Hypoglycemia, not hyperglycemia, occurs as a result of cold stress. When a neonate is exposed to a cold environment his metabolic rate increases as the neonate's body attempts to warm itself. The increase in metabolic rate causes glucose consumption resulting in hypoglycemia. Arrhythmia and hypertension are associated with cardiopulmonary problems.
A woman has been treated for a tumor of the left breast that has not responded to chemotherapy. The woman has just found out that she has the BRCA mutations and discusses her options with her primary care provider. Which treatment would be most difficult for this woman? a) more aggressive chemotherapy b) left mastectomy c) radiation therapy d) bilateral mastectomy
d) bilateral mastectomy - Chemotherapy, left mastectomy, and radiation therapy may be difficult for the woman, but the most difficult and controversial treatment is bilateral mastectomy. Right mastectomy is considered a prophylactic mastectomy, which is a primary prevention modality. Clients who are considering prophylactic mastectomy are often faced with a very controversial and emotional decision.
Following a stroke, injury to nerve cells within the central nervous system needs to be repaired. The health care provider knows that which process explains how this occurs? a) Astrocytes fill up the space to form a glial scar, repairing the area and replacing the CNS cells that cannot regenerate. b) The microglia are responsible for cleaning up debris after cerebral infection, or cell death. c) Ependymal cells are responsible for phagocytosis. d) Oligodendrocytes are responsible for integrative metabolism.
a) Astrocytes fill up the space to form a glial scar, repairing the area and replacing the CNS cells that cannot regenerate. - Astrocytes are the largest and most numerous of neuroglia and are particularly prominent in the gray matter of the CNS. They form a network within the CNS and communicate with neurons to support and modulate their activities. Astrocytes are also the principal cells responsible for repair and scar formation in the brain. The microglia is a small phagocytic cell that is available for cleaning up debris after cellular infection or cell death. The ependymal cell forms the lining of the neural tube cavity, the ventricular system. The oligodendrocytes form the myelin in the CNS. Instead of forming a myelin covering for a single axon, these cells reach out with several processes, each wrapping around and forming a multilayered myelin segment around several different axons.
Many factors contribute to the incontinence that is common among older adults. A major factor is increased: a) limited finances. b) intake of liquids and water. c) urethral closing pressure. d) use of multiple medications.
d) use of multiple medications. - Use of multiple medications for other health problems can affect bladder function, especially diuretics. Drugs such as hypnotics, tranquilizers, and sedatives can interfere with the conscious inhibition of voiding, leading to urge incontinence. Detrusor muscle function and urethral closing pressure are decreased in older adults, causing incontinence. Finances of older adults do not impact incontinence. Decreased fluid and water intake causes problems of bowel impaction and urinary tract infection.
Which client is at greatest risk of developing bladder cancer? a) A 65-year-old white male with a history of bladder stones b) A 50-year-old white woman with a history of two bladder infections c) A 40-year-old black male with a history of prostate enlargement d) A 30-year-old black female with a 2-year history of diabetes
a) A 65-year-old white male with a history of bladder stones - Cancer of the bladder is the sixth most common malignancy in the United States, accounting for 7% of cancers in men and 3% of cancers in women. Black Americans have only half the risk of white European Americans. Most cancers appear in older persons and are rare under the age of 50 years. Cigarette smoking is an important risk factor. Other risk factors include the presence of arsenic in the drinking water and industrial exposure to the breakdown products of aromatic amines used in the dye industry, and to chemicals used in the manufacture of rubber, textiles, paint, and petroleum products. Diabetes does not increase the risk factor for the development of bladder cancer.
The control systems of the body act in many ways to maintain homeostasis. These control systems regulate the functions of the cell and integrate the functions of different organ systems. What else do they do? a) Control life processes b) Feed cells under stress c) Act on invading organisms d) Shut down the body at death
a) Control life processes - The body's control systems regulate cellular function, control life processes, and integrate functions of the different organ systems. Homeostatic control systems do not feed cells when they are under stress, they do not act on invading organisms, and they do not shut down the body at death.
A group has asked the nurse to discuss how lifestyle factors affect heart health. Which statements by members of the group would indicate that the teaching was effective? Select all that apply. a) "Chewing tobacco rather than smoking it lessens the negative effect on the heart." b) "Gradually increasing my exercise levels will help enhance circulation through the heart." c) "If I change my diet and lessen my intake of saturated fats and trans fatty acids, this may decrease my cholesterol levels." d) "As a borderline diabetic, if I lose weight and lessen my intake of simple carbohydrates, this should benefit my heart." e) "Walking is excellent exercise to strengthen my heart."
b) "Gradually increasing my exercise levels will help enhance circulation through the heart." c) "If I change my diet and lessen my intake of saturated fats and trans fatty acids, this may decrease my cholesterol levels." d) "As a borderline diabetic, if I lose weight and lessen my intake of simple carbohydrates, this should benefit my heart." e) "Walking is excellent exercise to strengthen my heart." - Increasing exercise levels, diet changes, losing weight, and walking are all important elements of heart health. Chewing tobacco is still harmful to the body.
Which statement about types of obesity is most accurate? a) Upper body obesity is often referred to as being shaped like a "pear." b) A waist-hip ratio greater than 1.0 in men can be interpreted to mean upper body obesity. c) Waist circumference is a measurement of subcutaneous abdominal adipose tissue but not intra-abdominal adipose tissue. d) A waist circumference of 40 inches or less in women is considered normal and therefore not associated with increased health risk.
b) A waist-hip ratio greater than 1.0 in men can be interpreted to mean upper body obesity. - A waist-hip ratio greater than 1.0 in men and 0.8 in women indicates upper body or central [abdominal] obesity. Upper body obesity is referred to as being shaped like an apple. Waist circumference measures mostly subcutaneous and intra-abdominal adipose tissue. In males, a waist circumference greater than 40 inches (or 35 inches in females) is associated with increased health risk.
A client, now 37 weeks pregnant, calls the clinic because she is concerned about being short of breath and is unable to sleep unless she places three pillows under her head. After listening to the client's concerns, the nurse should take which action? a) Make an appointment because the client needs to be evaluated. b) Explain that these are expected problems for the latter stages of pregnancy. c) Arrange for the client to be admitted to the birth center and prepare for birth. d) Tell the client to go to the hospital; she may be experiencing signs of heart failure.
b) Explain that these are expected problems for the latter stages of pregnancy. - The nurse must distinguish between normal physiologic complaints of the latter stages of pregnancy and those that need referral to the health care provider. In this case, the client indicates normal physiologic changes caused by the growing uterus and pressure on the diaphragm. These signs don't indicate heart failure. The client doesn't need to be seen or admitted to the birth center.
A client suffers from chronic pain. The nurse suggests the client have monthly massages. This is an example of: a) adjuvant medicine. b) palliative medicine. c) alternative medicine. d) allopathic medicine.
c) alternative medicine. - The use of conventional therapy as seen with CAM includes the use of herbal medicine, massage, megavitamins, self-help groups, folk remedies, energy healing, and homeopathy.
