Adaptive Quizzing
Which statement made by the client about sleeping positions to follow to prevent pressure ulcers indicates effective learning? SELECT ALL THAT APPLY a) "I should use pressure-relieving pads" b) "I should place a rubber ring under the sacral area" c) "I should place pillows between two bony surfaces" d) "I should keep the head of the bed elevated about 30 degrees" e) "I should keep my heels off the bed surface using a bed pillow under the ankles"
a) "I should use pressure-relieving pads" c) "I should place pillows between two bony surfaces" e) "I should keep my heels off the bed surface using a bed pillow under the ankles"
Which clinical findings would the nurse expect to identify when completing a nursing admission history and physical on a client with suspected hyperthyroidism? SELECT ALL THAT APPLY a) palpitations b) tachycardia c) thickened skin d) apathetic attitude e) missed menstrual periods
a) palpitations b) tachycardia e) missed menstrual periods
Which response would a nurse give when a client asks what to expect when beginning treatment for tuberculosis? a) "Therapy will last a few weeks" b) "Therapy will occur over two phases" c) "Therapy will involve one medication" d) "Therapy will require monitoring kidney function"
b) "Therapy will occur over two phases"
Which intervention would the nurse provide a 3-month-old infant hospitalized with RSV? a) administering an antiviral agent b) clustering care to conserve energy c) administering a bronchodilator every 4 hours d) providing an antitussive agent whenever necessary
b) clustering care to conserve energy
Which manifestation would the nurse expect to find when assessing a client with hyperthyroidism? SELECT ALL THAT APPLY a) dry skin b) weight loss c) tachycardia d) restlessness e) constipation f) exophthalmos
b) weight loss c) tachycardia d) restlessness f) exophthalmos
Which pain description would the nurse expect a client to report when describing pain associated with a suspected duodenal peptic ulcer? a) an ache radiating to McBurney point b) an intermittent, colicky right-flank pain c) a gnawing sensation in the epigastric area d) a generalized abdominal pain intensified by movement
c) a gnawing sensation in the epigastric area
Which parent education would the nurse provide for a 4-month-old infant with a newly diagnosed acute otitis media and fever? a) "Anti-inflammatory medications are recommended for this condition" b) "Typically antiviral medications are given to treat acute otitis media" c) "Current practice is to wait 72 hours to see whether the condition resolves" d) "Antibiotics are recommended for infants younger than 6 months with acute otitis media"
d) "Antibiotics are recommended for infants younger than 6 months with acute otitis media"
Which manifestations of surgically induced hypothyroidism might the client exhibit after a thyroidectomy? SELECT ALL THAT APPLY a) fatigue b) dry skin c) insomnia d) excitability e) weight loss f) intolerance to eat
a) fatigue b) dry skin
A client is admitted with the diagnosis of acute pancreatitis. Which clinical manifestations would the nurse assess in the client? SELECT ALL THAT APPLY a) jaundice b) acute pain c) hypertension d) hypoglycemia e) increased amylase
a) jaundice b) acute pain e) increased amylase
Which type of hepatitis develops into a chronic form of the disease? SELECT ALL THAT APPLY a) Hep A b) Hep B c) Hep C d) Hep D e) Hep E
b) Hep B c) Hep C d) Hep D
When monitoring a client for hyponatremia, which assessment findings would the nurse consider significant? SELECT ALL THAT APPLY a) thirst b) seizures c) erythema d) confusion e) constipation
b) seizures d) confusion
Which risk would the nurse monitor for when providing care for a client with scoliosis of the thoracic spine and lumbar spine? a) osteomyelitis b) muscle spasticity c) intervertebral disc prolapse d) cardiac function impairment
d) cardiac function impairment
Which plan of care would the nurse provide for a newborn with hypospadias? a) preparing the infant for insertion of a cystostomy tube b) explaining to the parents the genetic basis for the defect c) keeping the infant's penis wrapped with petrolatum gauze d) giving the parents reasons why circumcision should not be performed
d) giving the parents reasons why circumcision should not be performed
The nurse is taking care of a client with cirrhosis of the liver. Which clinical manifestations would the nurse assess in the client? SELECT ALL THAT APPLY a) ascites b) hunger c) pruritus d) jaundice e) headache
a) ascites c) pruritus d) jaundice
Which key feature is associated with a stage 2 pressure ulcer? a) presence of non-intact skin b) development of sinus tracts c) damage to the subcutaneous tissues d) appearance of a reddened area over a bony prominence
a) presence of non-intact skin
Which findings are consistent with hypercalcemia after prolonged immobility? SELECT ALL THAT APPLY a) bone pain b) convulsions c) muscle spasms d) tingling of extremities e) depressed deep tendon reflexes
a) bone pain e) depressed deep tendon reflexes Rationale: Increased serum calcium comes from bone demineralization, which results in bone pain. Others are signs of hypocalcemia.
Which finding would the nurse expect in the urinalysis report of a client with diabetes insipidus? a) pH of urine: 9 b) specific gravity of urine: 0.4 c) red blood cells in urine: 6 hpf d) white blood cells in urine: 8 hpf
b) specific gravity of urine: 0.4
Which clinical manifestation will the nurse assess for in a client with a serum potassium level of 6.4 mEq/L? SELECT ALL THAT APPLY a) anorexia b) constipation c) muscle weakness d) irregular heart rhythm e) hyperactive bowel tones
c) muscle weakness d) irregular heart rhythm e) hyperactive bowel tones
Which statement explains why metabolic acidosis develops with kidney failure? a) inability of the renal tubules to secrete hydrogen ions and conserve bicarbonate b) depressed respiratory rate due to metabolic wastes, causing carbon dioxide retention c) inability of the renal tubules to reabsorb water to dilute the acid contents of blood d) impaired glomerular filtration, causing retention of sodium and metabolic waste products
a) inability of the renal tubules to secrete hydrogen ions and conserve bicarbonate
Which signs of hypokalemia would the nurse monitor in the post-op surgical client with a nasogastric tube attached to continuous low suction? SELECT ALL THAT APPLY a) irritability b) dysrhythmias c) muscle weakness d) abdominal cramps e) acidosis
b) dysrhythmias c) muscle weakness
Which food selection by the client indicates to the nurse that dietary teaching about thiazide diuretics is successful? a) apples b) kidney beans c) cherries d) brussel sprouts
b) kidney beans Rationale: Thiazide diuretics are potassium-depleting agents; kidney beans are high in potassium
Which education would the nurse provide the parent of an infant with pyloric stenosis? a) it is unlikely that surgery will be necessary b) this is a condition with an excellent prognosis c) this condition results from an error in metabolism d) special feedings will be needed for a few weeks after surgery
b) this is a condition with an excellent prognosis
The nurse is eliciting a health history from a client with ulcerative colitis. Which factor would the nurse consider to be MOST likely associated with the client colitis? a) food allergy b) infectious disease c) dietary components d) genetic predisposition
d) genetic predisposition
When teaching a client with hypertension about a 2-gram sodium diet, which foods would the nurse instruct the client to avoid? SELECT ALL THAT APPLY a) canned chili b) ground beef c) fresh salmon d) luncheon meat e) cooked broccoli
a) canned chili d) luncheon meat
A client with acute kidney injury is moved into the diuretic phase after 1 week of therapy. During this phase, which clinical indicators would the nurse assess? SELECT ALL THAT APPLY a) skin rash b) dehydration c) hypovolemia d) hyperkalemia e) metabolic acidosis
b) dehydration c) hypovolemia
Which clinical manifestation would the nurse anticipate when assessing a client with hypothyroidism? SELECT ALL THAT APPLY a) dry skin b) brittle hair c) weight loss d) resting tremors e) heat tolerance
a) dry skin b) brittle hair
Which food selections by a client with celiac disease indicate the nurse's dietary teaching was successful? SELECT ALL THAT APPLY a) green beans b) baked potato c) noodle pudding d) turkey sandwich e) whole-wheat cereal
a) green beans b) baked potato
Which effect does increased parathyroid hormone have on bones and electrolytes? SELECT ALL THAT APPLY a) increased bone breakdown b) increased serum calcium levels c) increased sodium and phosphorus excretion d) increased absorption of calcium and phosphorous e) increased net release of calcium and phosphorous
a) increased bone breakdown b) increased serum calcium levels e) increased net release of calcium and phosphorous
Which laboratory test change leads the nurse to determine that the lactulose administered to a client with cirrhosis of the liver is effective? a) decreased amylase b) decreased ammonia c) increased potassium d) increased hemoglobin
b) decreased ammonia
When a client has difficulty swallowing after a stroke, which action by the nurse would be MOST important in preventing pneumonia? a) giving influenza vaccine to the client b) having suction available during meals c) assisting the client to take deep breaths d) teaching about incentive spirometer use
b) having suction available during meals
Which sign or symptom would the nurse expect when assessing a client with type 1 diabetes who is experiencing hypoglycemia? SELECT ALL THAT APPLY a) vomiting b) headache c) tachycardia d) cool, clammy skin e) increased respirations
b) headache c) tachycardia d) cool, clammy skin
Which clinical manifestation would lead the nurse to contact the health care provider regarding the potential development of acute osteomyelitis? SELECT ALL THAT APPLY a) presence of a foot ulcer b) temperature of 102 F c) erythema of the affected area d) tenderness of the affected area e) drainage from the affected area
b) temperature of 102 F c) erythema of the affected area d) tenderness of the affected area
Which client would benefit from the administration of prophylactic antibiotics? SELECT ALL THAT APPLY a) chickenpox infection b) fever of unknown origin c) preoperative hip replacement d) congenital bicuspid aortic valve e) current chemotherapy treatment
c) preoperative hip replacement d) congenital bicuspid aortic valve e) current chemotherapy treatment
The registered nurse is caring for a client with peptic ulcers and dysphagia. Which task would not be delegated to an unlicensed assistive personnel (UAP) who is assisting in the care of a client with peptic ulcers and dysphagia? a) assisting the client with feeding b) assisting the client with bathing c) assisting the client with oral hygiene d) assisting the client in administering the medications
d) assisting the client in administering the medications
Which parental statement indicates effective learning regarding management of nocturnal enuresis in a 6-year-old? SELECT ALL THAT APPLY a) "I should avoid giving my child fluids after dinner" b) "I should encourage my child to drink lots of water during the day" c) "I should make my child wear diapers during day hours while at school" d) "I should give my child diet soda instead of regular soda in the evening" e) "I should wake my child at the same time every night to use the bathroom"
a) "I should avoid giving my child fluids after dinner" b) "I should encourage my child to drink lots of water during the day" e) "I should wake my child at the same time every night to use the bathroom"
Which manifestation would the nurse include when teaching a client about ketoacidosis? SELECT ALL THAT APPLY a) confusion b) hyperactivity c) excessive thirst d) fruity-scented breath e) decreased urine output
a) confusion c) excessive thirst d) fruity-scented breath
A school-aged child with a fracture of the femur near the epiphyseal plate is admitted to the hospital. Which physiological characteristic of the femur would the nurse consider when teaching the family about the injury? a) growth of that leg may be affected b) risk for infection at this location is increased c) fracture repair will necessitate prolonged traction d) long bones contain marrow, which increases the risk for anemia
a) growth of that leg may be affected Rationale: The epiphyseal (growth) plate is the area on the femur in which new bone forms and increases the limb length in a growing child
Which information obtained by the nurse about a client would represent a risk factor for the client's admission diagnosis of hypertension? SELECT ALL THAT APPLY a) daily use of 1 aspirin b) occasional cocaine use c) reduced hemoglobin level d) African American/Black heritage e) increased high-density lipoprotein (HDL)
b) occasional cocaine use d) African American/Black heritage
Which information would be included in the teaching plan for the older adult client with peptic ulcer disease who is taking an antacid and sucralfate? a) antacids should be taken 30 minutes before a meal b) sucralfate should be taken on an empty stomach 1 hour before meals c) sucralfate is prescribed for the long-term maintenance of peptic ulcer disease d) sodium bicarbonate is an inexpensive over-the-counter antacid with few adverse effects
b) sucralfate should be taken on an empty stomach 1 hour before meals
Which assessment would the nurse include during routine visits for an infant being treated for talipes equinovarus who has a cast change every 2 to 3 weeks? SELECT ALL THAT APPLY a) pedal pulses of both feet b) range of motion of the foot in the cast c) color of the toes of the foot in the cast d) movement of the toes of the foot in the cast e) knee flexion and extension of the affected leg
c) color of the toes of the foot in the cast d) movement of the toes of the foot in the cast Rationale: skin color will indicate adequate or impaired circulation in the foot in a cast.
Which medication will the nurse question when it is prescribed for a client with acute pancreatitis? a) ranitidine b) cimetidine c) meperidine d) promethazine
c) meperidine
Which observation by the nurse indicates a client with pneumonia is able to use an incentive spirometer correctly? SELECT ALL THAT APPLY a) records the volume of the air inspired b) performs 10 breaths per session every hour c) inhales air fully before inserting the mouthpiece d) takes a long, slow, deep breath keeping the mouthpiece in place e) exhales deep breaths with the mouthpiece in their mouth
a) records the volume of the air inspired b) performs 10 breaths per session every hour d) takes a long, slow, deep breath keeping the mouthpiece in place
Which clinical indicators would the nurse expect to find when assessing a client with Parkinson disease? SELECT ALL THAT APPLY a) resting tremors b) flattened affect c) muscle flaccidity d) tonic-clonic seizures e) slow voluntary movements
a) resting tremors b) flattened affect e) slow voluntary movements
A client is scheduled for a cholecystectomy and asks the primary nurse about the function of the gallbladder. Which explanation would the nurse give? a) stores and concentrates bile b) releases bile into the pancreatic duct c) connects the common bile duct and the pancreas d) controls the flow of fat through the sphincter of Oddi
a) stores and concentrates bile
Which event occurs in the proliferative phase of wound healing? a) thinning of scar tissue b) strengthening of collagen c) formation of granulation tissue d) increase in capillary permeability
c) formation of granulation tissue
The nurse is caring for a client with a bowel obstruction. Which assessment findings indicate the possible onset of peritonitis? SELECT ALL THAT APPLY a) diarrhea b) bradycarda c) rebound tenderness d) diminished bowel sounds e) rigid, boardlike abdomen
c) rebound tenderness d) diminished bowel sounds e) rigid, boardlike abdomen
Which assessment findings would indicate a possible asthma exacerbation? SELECT ALL THAT APPLY a) fever b) stridor c) wheezing d) tachycardia e) hypotension
c) wheezing d) tachycardia
Which etiology is the primary cause of otitis media in young children? a) sinusitis b) recurrent tonsilitis c) an inflamed mastoid process d) an obstructed eustachian tube
d) an obstructed eustachian tube
Which assessment finding for a client with pneumonia would be MOST important for the nurse to communicate to the health care provider? a) cough productive of rust-colored sputum b) sharp chest pain with deep inspiration c) oral temperature 103 F d) respiratory rate 38 breaths per minute
d) respiratory rate 38 breaths per minute Rationale: Indicates respiratory distress
The nurse is caring for a 4-year-old child who has been hospitalized with an acute asthma exacerbation. Which assessment finding would require immediate action by the nurse? a) diminished breath sounds b) pulse rate of 110 beats per minute c) pulse oximetry reading of 95% d) respiratory rate of 24 breaths per minute
a) diminished breath sounds
Which medications would the nurse anticipate teaching the parent about for a preschooler newly diagnosed with cystic fibrosis? SELECT ALL THAT APPLY a) steroids b) antibiotics c) antihistamines d) pancreatic enzymes e) fat-soluble vitamines
b) antibiotics d) pancreatic enzymes e) fat-soluble vitamines
Which information about benign prostatic hyperplasia (BPH) is important for the nurse to consider when caring for a client with that condition? a) it is a congenital abnormality b) a malignancy usually results c) it predisposes to hydronephrosis d) prostate-specific antigen decreases
c) it predisposes to hydronephrosis Rationale: Inability to empty the bladder as a result of pressure exerted by the enlarging prostate on the urethra causes a backup of urine into the ureters and finally the kidneys (hydronephrosis)
A client is admitted with an acute onset of right lower quadrant pain at McBurney point, and appendicitis is suspected. For which clinical indicator would the nurse assess the client to determine if the pain is secondary to appendicitis? a) urinary retention b) gastric hyperacidity c) rebound tenderness d) increased lower bowel motility
c) rebound tenderness
The nurse is completing the health history of a client admitted to the hospital with osteoarthritis. Which joint would the nurse expect the client to report as having been involved first? SELECT ALL THAT APPLY a) hips b) knees c) ankles d) shoulders e) metacarpals
a) hips b) knees Rationale: osteoarthritis affects the weight-bearing joints first because they bear the most body weight
An infant with persistent diarrhea is subject to significant fluid and electrolyte alterations. Which physiologic imbalance would the nurse MOST likely encounter? SELECT ALL THAT APPLY a) hypovolemia b) hyperkalemia c) hypercalcemia d) metabolic acidosis e) decreased hematocrit
a) hypovolemia d) metabolic acidosis
A client reports nausea, dyspnea, and right upper quadrant pain unrelieved by antacids. The pain occurs MOST often after eating ground beef, sausage, or hot dogs. Which diet would the nurse instruct the client to follow? a) low fat b) low carbohydrate c) soft-textured and bland d) high protein and kilocalories
a) low fat Rationale: The presence of fat in the duodenum stimulates painful contractions of the gallbladder to release bile, causing right upper quadrant pain
Which finding would the nurse expect when assessing a client with peripheral arterial disease? SELECT ALL THAT APPLY a) pallor of feet b) warm extremities c) ulcers on the toes d) thick, hardened skin e) delayed capillary refill
a) pallor of feet c) ulcers on the toes e) delayed capillary refill Rationale: Peripheral arterial disease affects circulation and results in delayed and impaired circulation to the extremities . As a result, the extremities exhibit pallor, ulcers on the feet and toes, cool skin, and capillary refill longer than 3 seconds.
Which complication would the nurse be concerned about if there is removal of the parathyroid glands during a thyroidectomy? a) tetany b) myxedema c) hypovolemic shock d) adrenocortical stimulation
a) tetany Rationale: parathyroid removal eliminates the body's source of parathyroid hormone, which increases the blood calcium level. The resulting low body fluid calcium affects muscles resulting in tetany.
Which medication would the nurse anticipate being beneficial for a client on antipsychotic medication therapy who develops parkinsonism? SELECT ALL THAT APPLY a) levodopa b) benztropine c) amantadine d) bromocriptine e) diphenhydramine
b) benztropine c) amantadine e) diphenhydramine
Which documented condition will the nurse observe in the electronic medical record of a client presenting with red, inflamed skin covered with papules, vesicles, and bullae from a type IV hypersensitivity reaction? a) allergic rhinitis b) contact dermatitis c) goodpasture syndrome d) systemic lupus erythematosus (SLE)
b) contact dermatitis
Which assessment finding indicates to the nurse that a client with COPD who is receiving oxygen is retaining carbon dioxide? SELECT ALL THAT APPLY a) anxiety b) drowsiness c) irregular pulse d) mental confusion e) increased respirations
b) drowsiness c) irregular pulse d) mental confusion Rationale: Co2 retention depresses the CNS, leading to drowsiness, confusion, and decreased respiratory depth and rate. Also, dysrhythmias and lethargy
Which perioperative actions would the nurse plan when caring for a client scheduled for a septoplasty? SELECT ALL THAT APPLY a) teach the client how to use hot compresses b) encourage the client to quit smoking before surgery c) observe for surgical site edema d) teach the client about postsurgery activities that are restricted e) assess the client's respiratory status f) encourage the client to take aspirin before the surgery
b) encourage the client to quit smoking before surgery c) observe for surgical site edema d) teach the client about postsurgery activities that are restricted e) assess the client's respiratory status
Which nursing intervention assists in decreasing the potential occurrence of pressure ulcers when providing care for a client with quadriplegia? a) avoid massaging the client's legs b) frequently reposition the client on a scheduled basis c) increase the fiber content in the client's food d) encourage the client to participate in weight-bearing exercises
b) frequently reposition the client on a scheduled basis
Which pathophysiological rationale explains why a client who is 4 days post-abdominal surgery has not passed flatus and has hypoactive bowel sounds and why a paralytic ileus is suspected of developing? a) decreased blood supply b) impaired neural functioning c) perforation of the bowel wall d) obstruction of the bowel lumen
b) impaired neural functioning
Which action would the nurse include in the plan for care for a 6-month-old infant with RSV who is in respiratory distress? a) begin a clear fluid diet b) maintain droplet and contact precautions c) administer prescribed antibiotic immediately d) allow parents and siblings to room in with the infant
b) maintain droplet and contact precautions
Which finding would indicate a need to refer a client to a health care provider when the nurse is screening clients for hypertension? a) report of pain as the blood pressure cuff is inflated b) systolic blood pressure result higher than 120 mmHg c) diastolic blood pressure reading greater than 89 mmHg d) loud korotkoff sounds as the blood pressure cuff is deflated
c) diastolic blood pressure reading greater than 89 mmHg
Which information provides the rationale for a nurse writing a goal of preventing renal calculi in a care plan for a client who has paraplegia? a) high fluid volume intake b) increased calcium intake c) inadequate kidney function d) accelerated bone demineralization
d) accelerated bone demineralization Rationale: calcium that has left the bones as a response to prolonged inactivity enters the blood and may precipitate in the kidneys, forming calculi
A client asks the nurse what causes Parkinson disease. Which description of pathology would the nurse provide in response to the client? a) disintegration of the myelin sheath b) breakdown of upper and lower neurons c) reduced acetylcholine receptors at synapses d) degeneration of neurons of the basal ganglia
d) degeneration of neurons of the basal ganglia
Which nursing action is MOST important for a client with urinary retention related to benign prostatic hyperplasia who has a secondary diagnosis of delirium related to urosepsis and a prescription for the insertion of an indwelling catheter? a) secure a prescription for wrist restraints b) orient the client to time, place, and person c) involve family members in the client's care d) determine whether any unsafe behavior patterns exist
d) determine whether any unsafe behavior patterns exist
Which action would the nurse take after obtaining client blood pressures of 172/104 mmHg and 164/98 mmHg during a blood pressure screening? a) provide health teaching about a low-sodium diet b) call the paramedics for transport to the hospital c) suggest ways to decrease the client's stress level d) refer the client to a primary health care provider
d) refer the client to a primary health care provider
Which clinical manifestation is associated with cellulitis? a) lymphadenopathy b) occasional papules c) vesicles that evolve into pustules d) Isolated erythematous pustules
a) lymphadenopathy
Which medication is classified as an H2 receptor antagonist? SELECT ALL THAT APPLY a) nizatidine b) ranitidine c) famotidine d) lansoprozole e) metoclopramide
a) nizatidine b) ranitidine c) famotidine
Which assessment findings are systemic manifestations of acute osteomyelitis? SELECT ALL THAT APPLY a) malaise b) restlessness c) night sweats d) warmth at the infection site e) swelling at the infection site
a) malaise b) restlessness c) night sweats
Which instruction will the home health nurse include when teaching a client with peripheral artery disease? SELECT ALL THAT APPLY a) "Avoid crossing your legs" b) "Inspect your feet daily" c) "Change positions slowly" d) "Do not use compression stockings" e) "Avoid green leafy vegetables in your diet"
a) "Avoid crossing your legs" b) "Inspect your feet daily" d) "Do not use compression stockings"
Which clinical finding would the nurse expect to identify when caring for a client with a left leg venous thrombosis? SELECT ALL THAT APPLY a) pain in the left calf b) intermittent claudication c) redness in the affected area d) swelling of the lower left leg e) ecchymotic areas at the left ankle f) localized warmth in the lower left leg
a) pain in the left calf c) redness in the affected area d) swelling of the lower left leg f) localized warmth in the lower left leg
Which medication may contribute to development of a peptic ulcer in a client receiving immunosuppressive therapy? a) prednisone b) azathioprine c) cyclosporine d) cyclophosphamide
a) prednisone
A client sustained minor skin injuries after an accident. Which event occurs close to the time of injury? a) thinning of the scar tissue b) formation of granulation tissue c) migration of leukocytes to the site of injury d) arrival of fibroblasts to the site of infection
c) migration of leukocytes to the site of injury Rationale: beginning at the time of injury and lasting 3 to 5 days is the inflammatory phase in which migration of leukocytes takes place. Scar tissue is formed in the maturation phase. Formation of granulation tissue and migration of fibroblasts occurs in the proliferative phase.
Which autoimmune disease affects the central nervous system? a) uveitis b) celiac disease c) multiple sclerosis d) goodpasture syndrome
c) multiple sclerosis
Which clinical manifestation would the nurse associate with benign prostatic hyperplasia? a) perineal edema b) urethral discharge c) flank pain radiating to the groin d) distention of the lower abdomen
d) distention of the lower abdomen
