1533 practice questions #3
Which statement by the child patient's mother should warrant notifying the provider after esophageal anastomosis? a. "My child says he is experiencing difficulty swallowing" b. "My child says he is extremely hungry" c. "My child says he has a sore throat" d. "I believe the doctor should test the bacteria in his throat to see what caused this"
a. "My child says he is experiencing difficulty swallowing"
When percussing a client's chest, what should the nurse expect to hear? a. Hyperresonance b. Tympany c. Resonance d. Dullness
a. Hyperresonance
You are providing care to a patient with COPD who is receiving medical treatment for exacerbation. The patient has a history of diabetes, hypertension, and hyperlipidemia. The patient is experiencing extreme hyperglycemia. In addition, the patient has multiple areas of bruising on the arms and legs. Which medication ordered for this patient can cause hyperglycemia and bruising? a. Prednisone b. Atrovent c. Flagyl d. Levaquin
a. Prednisone
Insulin deficiency, in association with increased levels of counter-regulatory hormones and dehydration, is the primary cause of: a. diabetic ketoacidosis. b. ketone bodies. c. ketonuria. d. glucosuria.
a. diabetic ketoacidosis.
What treatment might you expect a patient to receive who is experiencing hyperventilation from intense anxiety? (SATA) a. breathing into a paper bag b. oxygen c. albuterol d. hydration e. sedatives
d. hydration
Which of the following statements are incorrect about discharge teaching that you would provide to a patient with COPD? Select-all-that-apply: a. "It is best to eat three large meals a day that are relatively low in calories." b. "Avoid going outside during extremely hot or cold days." c. "It is important to receive the Pneumovax vaccine annually." d. "Smoking cessation can help improve your symptoms."
a. "It is best to eat three large meals a day that are relatively low in calories." c. "It is important to receive the Pneumovax vaccine annually."
The nurse identifies that which of the following statements is true regarding Diabetes Mellitus? a. "Polydipsia is an early manifestation because intracellular dehydration occurs as a result of osmotic movement out of the cell from rising blood glucose levels" b. "Polyuria occurs because of Diabetes Mellitus causing inadequate secretion of ADH due to blood glucose levels rising" c. "Type 2 Diabetes will have an increased manifestation of polyphagia because the body is not processing any sugar that is consumed" d. "It is guaranteed that a patient with type 1 diabetes will pass the disease along to their offspring due to its dominant genetic nature"
a. "Polydipsia is an early manifestation because intracellular dehydration occurs as a result of osmotic movement out of the cell from rising blood glucose levels"
A client experiencing a severe anxiety attack and hyperventilating presents to the emergency department. The nurse would expect the client's pH value to be a. 7.50 b. 7.45 c. 7.35 d. 7.30
a. 7.50 b. 7.45 d. 7.30
A patient who has diabetes is nothing by mouth as prep for surgery. The patient states they feel like their blood sugar is low. You check the glucose and find it to be 52. The next nursing intervention would be to: a. Administer Dextrose 50% IV per protocol b. Continue to monitor the glucose c. Give the patient 4 oz of fruit juice d. None, this is a normal blood glucose reading
a. Administer Dextrose 50% IV per protocol
The nurse is assessing an 8-year-old child admitted with severe bronchial asthma. The nurse notes that the child is wheezing and appears cyanotic. Which of the following actions is the priority for the nurse? a. Administration of corticosteroids b. Placing the child in a sitting position c. Obtaining a pulse oximetry level d. Suctioning the child's airway
a. Administration of corticosteroids
The nurse suspects their newly admitted client to have RSV. Which of the following manifestations support this claim? (SATA) a. Clear runny nose b. Audible cough and wheeze c. Pharyngitis d. Low grade fever
a. Clear runny nose b. Audible cough and wheeze c. Pharyngitis d. Low grade fever
An alarm beeps notifying you that one of your patient's oxygen saturation is reading 89%. You arrive to the patient's room, and see the patient comfortably resting in bed watching television. The patient is already on 2 L of oxygen via nasal cannula. The patient is admitted for COPD exacerbation. Your next nursing action would be: a. Continue to monitor the patient b. Increase the patient's oxygen level to 3 L c. Notify the doctor for further orders d. Turn off the alarm settings
a. Continue to monitor the patient
A 36-year-old male is newly diagnosed with Type 2 diabetes. Which of the following treatments do you expect the patient to be started on initially? a. Diet and exercise regime b. Metformin BID by mouth c. Regular insulin subcutaneous d. None, monitoring glucose regularly at this time is sufficient enough
a. Diet and exercise regime
Signs and Symptoms of myxedema coma include all of the following EXCEPT? Select all that apply: a. Fever b. Bradycardia c. Sodium level less than 135 d. Blood glucose level greater than 350 e. Hypothermia
a. Fever b. Bradycardia
Which of the following are manifestations of Graves disease? (SATA) a. Goiter b. Weight loss c. Palpitations d. Muscle wasting e. Insomnia
a. Goiter b. Weight loss
A patient was found unconscious in the local park with needle marks in the right arm. What manifestations might the nurse expect out of this patient? (SATA) a. Headache b. Dyspnea c. Hyperkalemia d. Hypercalcemia e. Tremors f. Seizures
a. Headache b. Dyspnea c. Hyperkalemia e. Tremors
Which of the following signs and symptoms causes concern and requires nursing intervention for a patient who recently had a thyroidectomy? a. Heart rate of 120, blood pressure 220/102, temperature 103.2 'F b. Heart rate of 35, blood pressure 60/43, temperature 95.3 'F c. Soft hair, irritable, diarrhea d. Constipation, drowsiness, goiter
a. Heart rate of 120, blood pressure 220/102, temperature 103.2 'F
Ms. Crampton is prescribed furosemide for chronic heart failure. The nurse knows that furosemide can cause electrolyte imbalances and what other serious side effect? a. Metabolic alkalosis b. Metabolic acidosis c. Compensated respiratory alkalosis d. Compensated respiratory acidosis
a. Metabolic alkalosis
A patient is placed on low intermittent NG suctioning. The nurse should watch out for which of the following manifestations that could indicate metabolic alkalosis? (SATA) a. Muscle twitching b. Tremors c. Decrease in muscle tone and reflexes d. Paresthesia e. Lethargy
a. Muscle twitching b. Tremors d. Paresthesia
Which of the following are diagnostic tests the nurse should request for a patient suspected of having RSV? (SATA) a. Nasopharyngeal washings for ELISA b. Chest x-ray c. Pulse oximetry d. Sputum culture e. Blood gases f. Daily weights
a. Nasopharyngeal washings for ELISA b. Chest x-ray c. Pulse oximetry e. Blood gases
A male client tells the nurse that he takes antacid tablets several times each day. Knowing that the brand of antacid he uses contains calcium carbonate, the nurse cautions the client that overuse could place him at risk for: a. metabolic alkalosis. b. hypocalcemia. c. hypercholesterolemia. d. metabolic acidosis.
a. metabolic alkalosis.
A patient is newly diagnosed with COPD due to chronic bronchitis. You're providing education to the patient about this disease process. Which statement by the patient indicates they understood your teaching about this condition? a. "If I stop smoking, it will cure my condition." b. "Complications from this condition can lead to pulmonary hypertension and right-sided heart failure." c. "I'm at risk for low levels of red blood cells due to hypoxia and may require blood transfusions during acute illnesses." d. "My respiratory system is stimulated to breathe due to high carbon dioxide levels rather than low oxygen levels.
b. "Complications from this condition can lead to pulmonary hypertension and right-sided heart failure."
The nurse identifies that which of the following recommendations is the best for preventing asthma exacerbation? a. Perform pursed lip breathing often b. Avoid triggers c. Administer albuterol every morning d. Limit time outside in inclement weather
b. Avoid triggers
The nurse expects which of the following manifestations in a client with tracheoesophageal fistula? (SATA) a. Paresthesia b. Coughing c. Cyanosis d. Polydipsia e. Choking
b. Coughing c. Cyanosis e. Choking
True or False: DM1 can develop into DM2 a. True b. False
b. False
A patient with diabetes has a morning glucose of 50. The patient is sweaty, cold, and clammy. Which of the following nursing interventions is the MOST important? a. Recheck the glucose level b. Give the patient ½ cup (4 oz) of fruit juice c. Call the doctor d. Keep the patient nothing by mouth
b. Give the patient ½ cup (4 oz) of fruit juice
A nurse notices that the infant client is aspirating upon feeding. What should be the nurse's first priority? a. Notify the provider b. Initiate NPO status c. Administer prescribed antiemetic d. Switch to formula
b. Initiate NPO status
A client develops hypocalcemia after thyroid surgery. Which hormonal imbalance caused this complication? a. Lack of thyroid hormone b. Lack of parathyroid hormone c. Lack of thyroid-stimulating hormone d. Lack of thyrotropic-releasing hormone
b. Lack of parathyroid hormone
A patient was recently discharged home for treatment of hypothyroidism and was ordered to take Synthroid for treatment. The patient is re-admitted with signs and symptoms of the following: heart rate 42, blood pressure 70/56, blood glucose 55, and body temperature of 96.8 'F. The patient is very fatigued and drowsy. The family reports the patient has not been taking Synthroid since being discharged home from the hospital. Which of the following conditions is this patient most likely experiencing? a. Thryoid Storm b. Myxedema Coma c. Grave's Disease d. Toxic Nodular Goiter
b. Myxedema Coma
Which of the following are NOT a cause of myxedema coma? a. Illness b. Sedatives c. Iodine Toxicity d. Thyroidectomy
b. Sedatives
Which statement best conveys an aspect of the respiratory pressures that govern ventilation? a. Intrapleural pressure slightly exceeds that of the inflated lung. b. The chest wall exerts positive pressure on the lungs, which contributes to expiration. c. The lungs are prevented from collapse by constant positive intrapulmonary pressure. d. Negative intrapleural pressure holds the lungs against the chest wall.
b. The chest wall exerts positive pressure on the lungs, which contributes to expiration.
Which of the following statements by the nurse demonstrates inadequate education regarding RSV? a. "I should focus on supportive treatment for RSV clients" b. "It is okay for me to isolate RSV patients together" c. "I should recommend the client use their entire course of antibiotics to treat their RSV" d. "Families of the patients should wash their hands frequently to prevent the spread of RSV"
c. "I should recommend the client use their entire course of antibiotics to treat their RSV"
Which of the following statements by the patient demonstrates adequate education regarding levothyroxine? a. "If I miss a dose, I should take another to make up for it" b. "This medication will make my skin sensitive to sunlight" c. "I should take this medication at the same time every morning before breakfast" d. "It is okay for me to take NSAIDs while taking this medication"
c. "I should take this medication at the same time every morning before breakfast"
Which statements are INCORRECT regarding Diabetic Ketoacidosis? (SATA) a. DKA occurs mainly in Type 1 diabetics. b. Ketones are present in the urine in DKA. c. Cheyne-stokes breathing will always present in DKA. d. Severe hypoglycemia is a hallmark sign in DKA. e. A patient with DKA may experience impaired LOC
c. Cheyne-stokes breathing will always present in DKA. d. Severe hypoglycemia is a hallmark sign in DKA.
A patient is presenting with chronic obstructive pulmonary disease. The patient has a chronic productive cough with dyspnea on excretion. Arterial blood gases show a low oxygen level and high carbon dioxide level in the blood. On assessment, the patient has cyanosis in the lips and edema in the abdomen and legs. Based on your nursing knowledge and the patient's symptoms, you suspect the patient suffers from what type of COPD? a. Emphysema b. Aspiration Pneumonia c. Chronic bronchitis d. Pneumothorax
c. Chronic bronchitis
Which of the following conditions are likely to put a patient into metabolic acidosis? (SATA) a. shock b. salicylate toxicity c. DKA d. obesity e. heavy exercise f. seizures
c. DKA e. heavy exercise f. seizures
A patient is admitted with complaints of palpations, excessive sweating, and unable to tolerate heat. In addition, the patient voices concern about how her appearance has changed over the past year. The patient presents with protruding eyeballs and pretibial myxedema on the legs and feet. Which of the following is the likely cause of the patient's signs and symptoms? a. Thyroiditis b. Deficiency of iodine consumption c. Grave's Disease d. Hypothyroidism
c. Grave's Disease
A patient with emphysema may present with all of the following symptoms EXCEPT? a. Barrel chest b. Hyperinflation of the lungs c. Hypoventilation d. Hypercapnia
c. Hypoventilation
Which of the following manifestations is the nurse more likely to see in a patient with DM 1 as opposed to DM 2? a. Polydipsia b. Polyuria c. Polyphagia d. Diaphoresis
c. Polyphagia
The nurse is assessing a client who is receiving mechanical ventilation. Which assessment data obtained by the nurse may indicate that the client is experiencing respiratory alkalosis? a. Negative Trousseau sign b. Hypotonia c. Positive Chvostek sign d. Negative Homans sign
c. Positive Chvostek sign
When percussing a client's chest, what should the nurse expect to hear? a. Hyperresonance b. Tympany c. Resonance d. Dullness
c. Resonance
The nurse knows that insulin compensates acidity and electrolyte imbalances in the body by: a. pulling sodium out of the cell b. reabsorbing calcium into bones c. guiding potassium back into the cell d. suppressing magnesium in the stomach
c. guiding potassium back into the cell
A patient has just received a blood transfusion and his lab results read as follows: pH 7.51, HCO3 29, PaCO2 52. What acid-base imbalance is the patient experiencing? a. uncompensated metabolic acidosis b. partially compensated respiratory alkalosis c. partially compensated metabolic alkalosis d. compensated respiratory acidosis
c. partially compensated metabolic alkalosis
The mother of a patient who is post-op for esophageal anastomosis for tracheoesophageal fistula asks the nurse when can her child start eating normally. What is the nurse's best response? a. "Your child can start oral feedings now that they are out of surgery" b. "TEF is a lifelong condition and your child will always need to have parenteral feedings" c. "You will need to wait approximately 4-6 weeks before your child can begin oral feedings" d. "Your child should begin oral feedings one week after the surgery"
d. "Your child should begin oral feedings one week after the surgery"
The nurse notes a client's PaCO2 on an arterial blood gas is 55 mm Hg (7.32 kPa). The client asks if this means he or she has carbon dioxide poisoning. How should the nurse explain how carbon dioxide became present in the client's blood? a. It is a normal end-product of aerobic cellular respiration but you are not eliminating it efficiently. b. It develops due to lack of oxygen and anaerobic metabolism, so administering oxygen will help. c. It is inhaled from the atmosphere, but your lungs are not properly converting the carbon dioxide to oxygen. d. Carbon dioxide builds up in the blood when cells are not performing cellular respiration properly.
d. Carbon dioxide builds up in the blood when cells are not performing cellular respiration properly.
The nurse knows that which of the following treatments could aid in decreasing potassium levels in the blood during acidosis? a. Calcium gluconate b. Vitamin K c. Naloxone d. Insulin
d. Insulin
A nurse is caring for a client in the compensatory stage of shock. What clinical finding would the client exhibit? a. PaCO2 <32 mm Hg b. Compensatory respiratory alkalosis c. Heart rate >20 bpm d. Metabolic acidosis
d. Metabolic acidosis
Which statement best conveys an aspect of the respiratory pressures that govern ventilation? a. Intrapleural pressure slightly exceeds that of the inflated lung. b. The chest wall exerts positive pressure on the lungs, which contributes to expiration. c. The lungs are prevented from collapse by constant positive intrapulmonary pressure. d. Negative intrapleural pressure holds the lungs against the chest wall.
d. Negative intrapleural pressure holds the lungs against the chest wall.
Alveolar oxygen levels directly impact the blood vessels in the pulmonary circulation. In a person with lung disease, there is vasoconstriction throughout the lung, causing a generalized hypoxia. What can prolonged hypoxia lead to? a. Hypertension and increased workload on the left heart b. Pulmonary hypertension and left ventricular hypertrophy c. Hypertension and increased workload on the right heart d. Pulmonary hypertension and increased workload on the right heart.
d. Pulmonary hypertension and increased workload on the right heart.
A 77-year-old client diagnosed with chronic obstructive pulmonary disease (COPD) is experiencing impaired gas exchange and CO2 retention, despite a rapid respiratory rate. Which pathophysiologic principle would the health care team expect if the client's compensatory mechanisms are working? a. Arterial blood gas sampling indicates a pH in the range of 7.45-7.55. b. The kidneys are likely to reabsorb H+ and secrete HCO3-. c. The body will produce excess metabolic CO2. d. The kidneys will adapt with an increase in plasma HCO3- and the pH will increase.
d. The kidneys will adapt with an increase in plasma HCO3- and the pH will increase.
A client presents to the emergency department, reporting that they have been vomiting every 30 to 40 minutes for the past 8 hours. Frequent vomiting puts this client at risk for which imbalances? a. metabolic acidosis and hyperkalemia b. metabolic acidosis and hypokalemia c. metabolic alkalosis and hyperkalemia d. metabolic alkalosis and hypokalemia
d. metabolic alkalosis and hypokalemia
A child has just been admitted for severe, persistent diarrhea over the past 3 days. The patient's lab results are: pH of 7.29, PaCO2 41, and HCO3 of 18. Which acid-base imbalance might the patient be experiencing? a. uncompensated metabolic alkalosis b. compensated metabolic alkalosis c. partially compensated metabolic acidosis d. uncompensated metabolic acidosis
d. uncompensated metabolic acidosis
