Chronic Test Questions
A group of student nurses are practicing taking blood pressure. A 56-year-old male student has a blood pressure reading of 146/96 mm Hg. Upon hearing the reading, he exclaims, "My pressure has never been this high. Do you think my doctor will prescribe medication to reduce it?" Which of the following responses by the nursing instructor would be best? A) "A single elevated blood pressure does not confirm hypertension. You will need to have your blood pressure reassessed several times before a diagnosis can be made." B) "We will need to reevaluate your blood pressure because your age places you at highrisk for hypertension." C) "Yes. Hypertension is prevalent among men; it is fortunate we caught this during class." D) "You have no need to worry. Your pressure is probably elevated because you are being tested."
A) "A single elevated blood pressure does not confirm hypertension. You will need to have your blood pressure reassessed several times before a diagnosis can be made."
An unlicensed nursing assistant (NA) reports to the nurse that a postsurgical client rates her pain as 8 on a 0-to-10 point scale. The NA tells the nurse that he thinks the client is exaggerating and does not need pain medication. What is the nurse's best response? A) "Pain is whatever the person experiencing pain says it is, existing whenever the person says it does.'" B) "Pain often comes and goes with postsurgical clients. Just ignore her for now and she will stop." C) "We need to provide pain medications because it is the law, and we must always follow the law." D) "It's not unusual for clients to misreport pain after surgery."
A) "Pain is whatever the person experiencing pain says it is, existing whenever the person says it does.'"
A newly diagnosed client with hypertension is prescribed a thiazide diuretic. What client education should the nurse provide to this client? A) "This medication can cause low blood pressure and dizziness, especially when you get up suddenly." B) "Eat a banana every day because this medication causes moderate hyperkalemia." C) "Take over-the-counter potassium pills because this medication causes your kidneys to lose potassium." D) "This medication increases sodium levels in your blood, so cut down on your salt."
A) "This medication can cause low blood pressure and dizziness, especially when you get up suddenly."
The nurse is caring for a 65-year-old client who has previously been diagnosed with hypertension. What blood pressure reading represents the threshold between high-normal blood pressure and hypertension? A) 140/90 mm Hg B) 145/95 mm Hg C) 150/100 mm Hg D) 160/100 mm Hg
A) 140/90 mm Hg
The nurse is preparing discharge teaching for an adult client diagnosed with urinary retention secondary to multiple sclerosis. The nurse will teach the client to self-catheterize at home upon discharge. What teaching method is most likely to be effective for this client? A) A discussion and demonstration between the nurse and the client B) A short video providing useful information and demonstrations C) A list of clear instructions written at a sixth-grade level D) An audio-recorded version of discharge instructions that can be accessed at home
A) A discussion and demonstration between the nurse and the client
A patient's health history is suggestive of inflammatory bowel disease. Which of the following would suggest Crohn's disease, rather that ulcerative colitis, as the cause of the patient's signs and symptoms? A) An absence of blood in stool B) Involvement of the rectal mucosa C) Severe diarrhea D) A pattern of distinct exacerbation and remissions
A) An absence of blood in stool
The nurse has just taken report on a newly admitted client who is a 15-year-old girl who is a recent immigrant. When planning interventions for this client, the nurse knows the interventions must be which of the following? Select all that apply. A) Appropriate to the client's age B) Appropriate to the nurse's preferences C) Applicable to others with the same diagnosis D) Appropriate to the client's culture E) Ethical
A) Appropriate to the client's age D) Appropriate to the client's culture E) Ethical
Which of the following statements about hemodynamics and blood pressure is TRUE? Select all that apply A) BP= CO x SVR B) Stroke volume is influenced by preload, afterload, and cardiac contractility C) An increase in Systemic Vascular Resistance will cause a decrease in blood pressure D) A decrease blood pressure is the response to increased levels of Angiotensin II E) Cardiac Output = Heart Rate X Stroke Volume
A) BP= CO x SVR B) Stroke volume is influenced by preload, afterload, and cardiac contractility E) Cardiac Output = Heart Rate X Stroke Volume
For patients in a state of malnutrition, in what order are available energy sources utilized? A) Carbohydrate stores. gluconeogenesis by liver, fat stores, muscle mass breakdown B) gluconeogenesis by liver, Carbohydrate stores, fat stores, muscle mass breakdown C) Carbohydrate stores, muscle mass breakdown, fat stores D) fat stores, muscle mass breakdown, Carbohydrate stores
A) Carbohydrate stores. gluconeogenesis by liver, fat stores, muscle mass breakdown
A nurse is caring for a patient who is being assessed following complaints of severe and persistent low back pain. The patient is scheduled for diagnostic testing in the morning. Which of the following are appropriate diagnostic tests for assessing low back pain?that apply. A) Computed tomography (CT) B) Angiography C) Magnetic resonance imaging (MRI) D) X-ray
A) Computed tomography (CT) C) Magnetic resonance imaging (MRI) D) X-ray
A nurse is reviewing the care of a patient who has a long history of lower back pain that has not responded to conservative treatment measures. The nurse should anticipate the administration of what drug? A) Cyclobenzaprine B) Aspirin C) Calcitonin D) Vitamin D
A) Cyclobenzaprine
The nurse is caring for a client whose medical history includes chronic fatigue and poorly controlled back pain. These medical diagnoses should alert the nurse to the possibility of what consequent health problem? A) Depression B) Anxiety C) Hallucinations D) Skin breakdown
A) Depression
A nurse is planning the care of a client who has been diagnosed with kidney disease, which the nurse recognizes as being a chronic condition. Which of the following descriptors apply to chronic conditions? Select all that apply. Select all that apply A) Diseases where complete cures are rare B) Diseases that do not resolve spontaneously C) Diseases that have a short, unpredictable course D) Diseases that have a prolonged course E) Diseases that resolve slowly
A) Diseases where complete cures are rare B) Diseases that do not resolve spontaneously D) Diseases that have a prolonged course
The nurse is providing care for a client with a new diagnosis of hypertension. How can the nurse best promote the client's adherence to the prescribed therapeutic regimen? A) Have the client participate in self-monitoring BP at home B) Emphasize the dire health outcomes associated with inadequate BP control C) Screen the client for visual disturbances regularly D) Encourage the client to lose weight and exercise regularly
A) Have the client participate in self-monitoring BP at home
Which of the following medications are routinely used in the treatment of hypertension? Select all that apply. A) Hydrochlorothiazide B) Diltiazem C) Lisinopril D) Clopidogrel E) Losartan
A) Hydrochlorothiazide B) Diltiazem C) Lisinopril E) Losartan
A nurse is performing blood pressure screenings at a local health fair. While obtaining subjective assessment data from a patient with hypertension, the nurse learns that the patient has a family history of hypertension and she herself has high cholesterol and lipid levels. The patient says she smokes one pack of cigarettes daily and drinks "about a pack of beer" every day. The nurse notes what modifiable risk factor for hypertension A) Hyperlipidemia B) Genetic Predisposition C) Female gender D) A Family History of Hypertension
A) Hyperlipidemia
A patient who underwent gastric banding 3 days ago is having her diet progressed on a daily basis. Following her latest meal, the patient complains of dizziness and palpitations. Inspection reveals that the patient is diaphoretic. What is the nurse's best action? A) Monitor the client closely for further signs of dumping syndrome B) Apply nasal cannula oxygen at 2L/minute C) Assess the client for signs and symptoms of separation D) Insert a nasogastric tube promptly
A) Monitor the client closely for further signs of dumping syndrome
Which of the following factors directly influence blood pressure? Select all that apply A) PRA B) COPD C) PNS stimulation D) SNS E) Renal sodium excretion
A) PRA C) PNS stimulation D) SNS E) Renal sodium excretion
Based on a client's vague explanations for recurring injuries, the nurse suspects that a community-dwelling older adult may be the victim of abuse. What is the nurse's primary responsibility? A) Report the findings to adult protective services. B) Work with the family to promote healthy conflict resolution. C) Confront the suspected perpetrator. D) Gather evidence to corroborate the abuse.
A) Report the findings to adult protective services.
A nurse is completing a health history on a patient whose diagnosis is chronic gastritis. Which of the data should the nurse consider most significantly related to the etiology of the patient's health problem? A) Smokes on pack of cigarettes daily. B) Reports a history of social drinking on a weekly basis C) Consumes one or more protein drinks daily D) Takes over-the-counter antacids frequently throughout the day
A) Smokes on pack of cigarettes daily.
The nurse is caring for a client with a newly diagnosed allergy to peanuts. What immediate goal should the nurse apply to a nursing diagnosis of "deficient knowledge related to appropriate use of an EpiPen"? A) The client will demonstrate correct injection technique with today's teaching session. B) The client will return to the clinic within 2 weeks to demonstrate the injection. C) The nurse will teach the client's family member to administer the injection. D) The client will closely observe the nurse demonstrating the injection.
A) The client will demonstrate correct injection technique with today's teaching session.
An older adult woman's current medication regimen include alendronate (Fosamax). What outcome would indicate successful therapy? A) increased bone mass B) absence of tumor spread C) relief of bone pain D) resolution of infection
A) increased bone mass
Which of the following should be included in the plan of care for a patient receiving enteral feedings via NG tube? A) intake and output B) check placement before each feeding or q8h if continous feeding C) position patient with HOB at 30-45 degrees D) flush tube with water before and after medication administration E) daily weights
A) intake and output B) check placement before each feeding or q8h if continous feeding C) position patient with HOB at 30-45 degrees D) flush tube with water before and after medication administration E) daily weights
A patient with GERD has undergone diagnostic testing and it has been determined that increasing the pace of gastric emptying may help alleviate symptoms. The nurse should anticipate that the patient may be prescribed what drug? A. Metoclopramide (Reglan) B. Omeprazole (Prilosec) C. Lansoprazole (Prevacid) D. Famotidine (Pepcid)
A. Metoclopramide (Reglan)
Which patient action indicates a good understanding of the nurse's teaching about the use of an insulin pump? A. The patient programs the pump for an insulin bolus after eating. B. The patient changes the location of the insertion site every week. C. The patient takes the pump off at bedtime and starts it again each morning. D. The patient plans for a diet that is less flexible when using the insulin pump.
A. The patient programs the pump for an insulin bolus after eating.
A client with a peptic ulcer is about to begin a therapeutic regimen that includes antacids, famotidine, and omeprazole. Before the client is discharged, the nurse should provide which instruction? A) "Increase your intake of fluids containing caffeine." B) "It is best that you do not take ibuprofen." C) "Stop taking the drugs when your symptoms subside." D) "Eat three balanced meals every day."
B) "It is best that you do not take ibuprofen."
A nurse educator is providing information about hypertension to a small group of clients. A participant asks what she can do to decrease her blood pressure and thus her risk for heart problems. The nurse describes modifiable and nonmodifiable risk factors. Which of the following risk factors are not modifiable? A) Sedentary Lifestyle B) Age C) Alcohol Intake D) Tobacco Use
B) Age
A client with inflammatory bowel disease undergoes an ileostomy. On the first day after surgery, the nurse notes that the client's stoma appears dusky. How should the nurse interpret this finding? A) The ostomy bag should be adjusted B) Blood supply to the stoma has been interrupted C) This is a normal finding 1 day after surgery D) An intestinal obstruction has occurred
B) Blood supply to the stoma has been interrupted
The nurse caring for an older adult client with osteoarthritis is reviewing the client's chart. This client is on a variety of medications prescribed by different care providers in the community. In light of the QSEN competency of safety, what is the nurse most concerned about with this client? A) Chronic illness B) Drug interactions C) Inadequate pain control D) Depression
B) Drug interactions
A nurse is teaching about lifestyle modifications to a group of clients with known hypertension. Which of the following statements would the nurse include in the education session? A) Limit alcohol consumption to no more than 3 drinks per day B) Engage in aerobic activity at least 30 minutes/day most days of the week C) Reduce sodium intake to no more than 4 grams per day D) Lower both LDL and HDL cholesterol levels
B) Engage in aerobic activity at least 30 minutes/day most days of the week
A patient with irritable bowel syndrome has been having more frequent symptoms lately and is not sure what lifestyle changes may have occurred. What suggestion can the nurse provide to identify a trigger for the symptoms? A) Document how much fluid is being taken away to determine if the patient is overhydrating B) Keep a 1- to 2- week symptom and food diary to identify food triggers C) Discontinue the use of any medications presently being taken to determine if medication is a trigger D) Begin an exercise regimen and biofeedback to determine if external stress is a trigger
B) Keep a 1- to 2- week symptom and food diary to identify food triggers
A staff educator is reviewing the causes of gastroesophageal reflux disease (GERD) with new staffnurses. What area of the GI tract should the educator identify as the cause of reduced pressure associated with GERD? A) Pyloric sphincter B) Lower esophageal sphincter C) Hypopharyngeal sphincter D) Upper esophageal sphincter
B) Lower esophageal sphincter
A client hospitalized for treatment of hypertension is being prepared for discharge. Which teaching topic should the nurse be sure to cover? A) Drinking at least 3 liters of fluid daily B) Maintaining a low-sodium diet C) Skipping a medication dose if dizziness occurs D) Maintaining a low-potassium diet
B) Maintaining a low-sodium diet
A patient has come to the clinic for a routine annual physical. The nurse practitioner notes a palpable, painless projection of bone at the patient's shoulder. The projection appears to be at the distal end of the humerus. The nurse should suspect the presence of which of the following? A) Osteomyelitis B) Osteochondroma C) Osteomalacia D) Paget's disease
B) Osteochondroma
A patient with diabetes is attending a class on the prevention of associated diseases.What action should the patient perform to reduce the risk of osteomyelitis? A) Increase calcium and vitamin intake. B) Perform meticulous foot care. C) Exercise 3 to 4 times weekly for at least 30 minutes. D) Take corticosteroids as ordered.
B) Perform meticulous foot care.
A client is being assessed for a suspected deficit in intrinsic factor synthesis. What diagnostic or assessment finding is the most likely rationale for this examination of intrinsic factor production? A) The presence of fat in the client's stool B) Persistently low hemoglobin and hematocrit C) Chronic jaundice in the absence of liver disease D) Muscle wasting
B) Persistently low hemoglobin and hematocrit
When implementing a comprehensive plan to reduce the incidence of falls on a gerontologic unit, what risk factors should the nurse identify? Select all that apply. A) Unlimited visiting hours B) Poor lighting C) Medication effects D) Sensory impairment E) Extension cords
B) Poor lighting C) Medication effects D) Sensory impairment E) Extension cords
The nurses comprehensive assessment of a patient includes inspection for signs of oral cancer. What assessment finding is most characteristic of oral cancer in its early stages? A) Dull pain radiating to the ears and teeth B) Presence of a painless sore with raised edges C) Areas of tenderness that make chewing difficult D) Diffuse inflammation of the buccal mucosa
B) Presence of a painless sore with raised edges
A patient has been diagnosed with an esophageal diverticulum after undergoing diagnostic imaging.When taking the health history, the nurse should expect the patient to describe what sign or symptom? A) Burning pain on swallowing B) Regurgitation of undigested food C) Symptoms mimicking a heart attack D) Chronic parotid abscesses
B) Regurgitation of undigested food
A patient presents at a clinic complaining of back pain that goes all the way down the back of the leg to the foot. The nurse should document the presence of what type of pain? A) Osteoarthritis B) Sciatica C) Bursitis D) Scleroderma
B) Sciatica
According to the classification of hypertension diagnosed in the older adult, hypertension that can be attributed to an underlying cause is termed A) Pulmonary hypertension B) Secondary hypertension C) Primary hypertension D) Essential hypertension
B) Secondary hypertension
A patient presents to a clinic complaining of a leg ulcer that isn't healing; subsequent diagnostic testing suggests osteomyelitis. The nurse is aware that the most common pathogen to cause osteomyelitis is what? A) Escherichia coli B) Staphylococcus aureus C) Pseudomonas D) Proteus
B) Staphylococcus aureus
The nurse is discussing macrovascular complications of diabetes with a patient. The nurse would address what topic during this dialogue? A) The need for frequent eye examinations for patients with diabetes B) The fact that patients with diabetes have an elevated risk of myocardial infarction C) The relationship between kidney function and blood glucose levels D) The need to monitor urine for the presence of albumin
B) The fact that patients with diabetes have an elevated risk of myocardial infarction
The three major body systems involved in the stress response to protect the body from harm are A) The circulatory system, the renal system, and the nervous system B) The nervous system, endocrine system, and immune system C) The endocrine system, the neuro-renal system, and the immune system D) The nervous system, the respiratory system,
B) The nervous system, endocrine system, and immune system
The quality improvement team at a large, urban hospital has recognized the need to better integrate the principles of transcultural nursing into client care. When explaining the concept of transcultural nursing to uninitiated nurses, how should the team members describe it? A) Transcultural nursing refers to a systematic and evidence-based effort to improve health outcomes in clients who are immigrants. B) Transcultural nursing refers a specialty that focuses on the comparative study and analysis of cultures and subcultures. C) Transcultural nursing is a term used to describe interventions that seek to address language barriers in nursing practice. D) Transcultural nursing is the comparative analysis of the health benefits and risks of recognizable ethnic groups.
B) Transcultural nursing refers a specialty that focuses on the comparative study and analysis of cultures and subcultures.
An older adult who resides in an assisted living facility has sought care from the nurse because of recurrent episodes of constipation. Which of the following actions should the nurse first perform? A)Encourage the patient to take stool softener daily. B)Assess the patients food and fluid intake. C)Assess the patients surgical history. D)Encourage the patient to take fiber supplements.
B)Assess the patients food and fluid intake.
A client is placed on a low-sodium (1000 mg/day) diet. Which client statement indicates that the nurse's nutrition teaching plan has not been effective? A) "I chose a tossed salad with a vinaigrette dressing for lunch." B) "I chose broiled chicken with a baked potato for dinner." C) "I'm glad I can still have spam and bacon sandwiches." D) "I can should not regularly eat a ham-and-cheese sandwich with potato chips for lunch."
C) "I'm glad I can still have spam and bacon sandwiches."
A client with type 1 diabetes presents with a decreased level of consciousness and a fingerstick glucose level of 39 mg/dl. His family reports that he has been skipping meals in an effort to lose weight. Which nursing intervention is most appropriate? A) Observing the client for 1 hour, then rechecking the fingerstick glucose level B) Inserting a feeding tube and provide tube feeding C) Administering 1 ampule of 50% dextrose solution, per physician's order D) Administering a 500-mL bolus of normal saline solution
C) Administering 1 ampule of 50% dextrose solution, per physician's order
A community health nurse is planning an educational campaign addressing hypertension. The nurse should anticipate that the incidence and prevalence of hypertension are likely to be highest among members of what ethnic group? A) Asian-Americans B) Pacific islanders C) African-Americans D) Hispanic-Americans
C) African-Americans
A female patient of the Islamic faith requests that only females care for her in the hospital. Which actions should the nurse manager take in response to this request? A) Explain to the client that this request cannot be fulfilled as male staff are also assigned to this unit B) Explain that the request will be forwarded to the client advocate representative C) Assure the patient that only female nurses and nursing assistants will be assigned to care for this client D) Post a sign stating only female staff may enter the room
C) Assure the patient that only female nurses and nursing assistants will be assigned to care for this client
A patient with a peptic ulcer disease has had metronidazole (Flagyl) added to his current medication regimen. What health education related to this medication should the nurse provide? A) Take the medication on an empty stomach B) Take at bedtime to mitigate the effects of drowsiness C) Avoid drinking alcohol while taking the drug D) Take up to one extra dose per day if stomach pain persists
C) Avoid drinking alcohol while taking the drug
The nurse is administering the morning mediations to a patient on the cardiac telemetry unit. Metoprolol has been prescribed for this patient. Prior to administration, the nurse would tell the patient that the medication is which type of antihypertensive? A) Angiotensin-converting enzyme (ACE) inhibitor B) Diuretic C) Beta blocker D) Vasodilator
C) Beta blocker
A patient has been admitted to the medical unit for the treatment of Paget's disease. When reviewing the medication administration record, the nurse should anticipate what medications? A) Estrogen B) Alkaline phosphate C) Biphosphonates D) Calcium gluconate
C) Biphosphonates
An elderly female with osteoporosis has been hospitalized. Prior to discharge, when teaching the patient, the nurse should include information about which major complication of osteoporosis? A) Rheumatoid arthritis B) Negative calcium balance C) Bone fracture D) Loss of estrogen
C) Bone fracture
A nurse is providing an educational class to a group of older adults at a community senior center. In an effort to prevent osteoporosis, the nurse should encourage participants to ensure that they consume the recommended adequate intake of what nutrients? A) Vitamin B12 B) Sodium C) Calcium D) Calcitonin E) vitamin D
C) Calcium E) Vitamin D
A patient with osteoarthitis (OA) will need education about which of the following medications? A) sulfasalazine (Azulfidine) B) Adalimumab (Humira) C) Capsaicin cream (Zostrix) D) Prednisone
C) Capsaicin cream (Zostrix)
The nurse is assessing a newly admitted older adult with diabetes. Assessment reveals abnormal appearance of the feet. The nurse recognizes this as which deformity? A) Claw toe deformity B) Hammer toe deformity C) Charcot foot deformity D) Hypertrophic ungula labium deformity
C) Charcot foot deformity
In the process of planning a client's care, the nurse has identified a nursing diagnosis of Ineffective Health Maintenance related to alcohol use. What must precede the determination of this nursing diagnosis? A) Establishment of a plan to address the underlying problem B) Assigning a positive value to each consequence of the diagnosis C) Evaluating the client's chances of recovery D) Collecting and analyzing data that corroborate the diagnosis
C) Evaluating the client's chances of recovery
A nurse is admitting a patient diagnosed with late-stage gastric cancer. The patient's family is distraught and angry that she was not diagnosed earlier in the course of her disease. What factor contributes to the fact that gastric cancer is often detected at a later stage? A) Gastric cancer can be critically advanced before alarming or distressing symptoms occur B) Adherence to screening recommendations for gastric cancer is very low. C) Gastric cancer has no signs or symptoms until metastasis has occurred D) Early symptoms of gastric cancer are usually attributed to constipation
C) Gastric cancer has no signs or symptoms until metastasis has occurred
Which information will the nurse include when teaching a patient who has type 2 diabetes about glyburide? A) Glyburide decreases glucagon secretion from the pancreas B) Glyburide should not be used for 48 hours after receiving IV contrast media C) Glyburide stimulates insulin production and release from the pancreas. D) Glyburide should be taken even if the morning blood glucose level is low
C) Glyburide stimulates insulin production and release from the pancreas.
The nurse determines a need for additional instructions when the patient with newly diagnosed type 1 diabetes says which of the following? A) I will need a bedtime snack because I take an evening dose of NPH insulin B) I will eat something at meal times to prevent hypoglycemia, even if I'm not hungry C) I can choose any foods, as long as I use enough insulin to cover the calories D) I can have an occasional beverage with alcohol if I include it in my meal plan
C) I can choose any foods, as long as I use enough insulin to cover the calories
The nurse is writing a care plan for an 85-year-old client who has community-acquired pneumonia. The nurse assesses decreased breath sounds to bilateral lung bases on auscultation. What is the most appropriate nursing diagnosis for this client? A) Pneumonia related to progression of disease process B) Immobility related to fatigue C) Ineffective airway clearance related to tracheobronchial secretions D) Poor ventilation related to acute lung infection
C) Ineffective airway clearance related to tracheobronchial secretions
The nurse is preparing to perform a client's abdominal assessment. What examination sequence should the nurse follow? A) Inspection, percussion, palpation, and auscultation B) Inspection, palpation, percussion, and auscultation C) Inspection, auscultation, percussion, and palpation D) Inspection, palpation, auscultation, and percussion
C) Inspection, auscultation, percussion, and palpation
A client experiences orthostatic hypotension while receiving furosemide (Lasix) to treat hypertension. How should the nurse intervene? A) Insert an indwelling urinary catheter as ordered B) Administer a vasodilator as ordered. C) Instruct the client to sit for several minutes before standing D) Administer I.V. fluids as ordered
C) Instruct the client to sit for several minutes before standing
A nurse is providing patient education for a patient with peptic ulcer disease secondary to chronic nonsteroidal anti-inflammatory drug (NSAID) use. The patient has recently been prescribed misoprostol (Cytotec). What would the nurse be most accurate in informing the patient about the drug? A) It reduces the stomach's volume of hydrochloric acid B) It increases the speed of gastric emptying C) It protects the stomach's lining D) It increases lower esophageal sphincter pressure
C) It protects the stomach's lining
A client newly diagnosed with hypertension asks the nurse what happens when uncontrolled hypertension is prolonged. The nurse explains that a client with prolonged, uncontrolled hypertension is at risk for developing what health problem? A) Glaucoma B) Anemia C) Kidney damage D) Right ventricular hypertrophy
C) Kidney damage
An occupational health nurse is screening a group of coworkers for diabetes. What statement should the nurse interpret as suggestive of diabetes? A) No matter how much sleep I get, it seems to take me hours to wake up B) I've always been a fan of sweet foods, but lately I'm turned off by them C) Lately, I drink and drink and can't seem to quench my thirst D) When I went to the washroom the last few days, my urine smelled odd
C) Lately, I drink and drink and can't seem to quench my thirst
A client's intractable neuropathic pain is being treated using a multimodal approach to analgesia. After administering a recently increased dose of IV morphine to the client, the nurse has returned to assess the client and finds the client unresponsive to verbal and physical stimulation with a respiratory rate of five breaths per minute. The nurse has called a code blue and should anticipate the administration of what drug? A) Acetylcysteine B) Acetylsalicylic acid C) Naloxone D) Celecoxib
C) Naloxone
A patient has been prescribed antihypertensives. After assessment and analysis, the nurse has identified a nursing diagnosis of risk for ineffective health maintenance related to nonadherence to therapeutic regimen. When planning this patient's care, what desired outcome should the nurse identify? A) Patient denies signs and symptoms of hypertensive urgency B) Patient is able to describe modifiable risk factors for hypertension. C) Patient takes medication as prescribed and reports any adverse effects D) Patient's BP remains consistently below 140/90 mm Hg
C) Patient takes medication as prescribed and reports any adverse effects
A patient is in the hospital for the treatment of peptic ulcer disease. The nurse finds the patient vomiting and complaining of a sudden severe pain in the abdomen. The nurse then assesses a board-like abdomen. What does the nurse suspect these symptoms indicate? A) The patient needs an antiemetic B) A reaction to the medication given for the ulcer C) Perforation of the ulcer D) The treatment for the peptic ulcer is ineffective
C) Perforation of the ulcer
The nurse is preparing to check for tube placement in the client's stomach as well as measure the residual volume. What is the main purpose of these nursing actions? A) prevent diarrhea B) prevent abdominal distention C) prevent aspiration D) check for patency E) check for gastric ulcers
C) Prevent aspiration D) Check for patency
A client presents with intense back pain, rating it an "11" on the 0 to 10 scale. He is hunched over and reports that the pain is running down his legs. What information will the nurse inquire about while obtaining the history of the present health concern? A) What the client ate and drank for lunch B) If the client exercises at least 30 minutes every day C) The client's activity just prior to the onset of pain D) The pain medication the client would like to have ordered
C) The client's activity just prior to the onset of pain
Diagnostic testing of a client with a history of dyspepsia and abdominal pain has resulted in a diagnosis of gastric cancer. The nurse's anticipatory guidance should include what information? A) The possibility of needing a short-term or long-term colostomy B) The good prognosis for clients who are treated for gastric ulcer C) The possibility of surgery, chemotherapy, and radiotherapy D) The benefits of weight loss and exercise as tolerated during recovery
C) The possibility of surgery, chemotherapy, and radiotherapy
The nurse observes a certified nursing assistant (CNA) obtaining a blood pressure reading with a cuff that is too small for the patient. The nurse informs the CNA that using a cuff that is too small can affect the reading results in what way? A) It will be significantly different with each reading. B) The results will be falsely decreased. C) The results will be falsely elevated. D) It will give an accurate reading.
C) The results will be falsely elevated.
When a patient who takes metformin (Glucophage) to manage type 2 diabetes develops an allergic rash from an unknown cause, the healthcare provider prescribes prednisone. The nurse will anticipate that the patient may A) develop acute hypoglycemia while taking the prednisone B) have rashes caused by metformin-prednisone interactions C) have an increase in blood sugar and may require insulin while taking prednisone D) need a diet higher in calories while receiving prednisone
C) have an increase in blood sugar and may require insulin while taking prednisone
The management of the patient's gastrostomy is an assessment priority for the home care nurse. What statement would indicate that the patient is managing the tube correctly?A)"I clean my stoma twice a day with alcohol." B)"The only time I flush my tube is when I'm putting in medications." C)"I flush my tube with water before and after each of my medications." D)"I try to stay still most of the time to avoid dislodging my tube."
C)"I flush my tube with water before and after each of my medications."
A nurse is providing care for a patient with a diagnosis of late-stage Alzheimer's disease. The patient has just returned to the medical unit to begin supplemental feedings through an NG tube. Which of the nurse's assessments addresses this patient's most significant potential complication of feeding?A)Frequent assessment of the patient's abdominal girth B)Assessment for hemorrhage from the nasal insertion site C)Frequent lung auscultation D)Vigilant monitoring of the frequency and character of bowel movements
C)Frequent lung auscultation
A patient who suffered a stroke had an NG tube inserted to facilitate feeding shortly after admission. The patient has since become comatose and the patient's family asks the nurse why the physician is recommending the removal of the patient's NG tube and the insertion of a gastrostomy tube. What is the nurse's best response? A)It eliminates the risk for infection. B)Feeds can be infused at a faster rate. C)Regurgitation and aspiration are less likely. D)It allows caregivers to provide personal hygiene more easily.
C)Regurgitation and aspiration are less likely.
The nurse is caring for a patient newly diagnosed with hypertension. Which of the following statements if made by the patient indicates the need for further teaching? A) "I will consult a dietician to help get my weight under control." B) "When getting up from bed, I will sit for a short period prior to standing up. C) "I think I'm going to sign up for a yoga class twice a week to help reduce my stress." D) "If I take my blood pressure and it is normal, I don't have to take my BP pills."
D) "If I take my blood pressure and it is normal, I don't have to take my BP pills."
The emergency department (ED) nurse is caring for an adult client who was in a motor vehicle accident. Radiography reveals an ulnar fracture. What type of pain is the nurse addressing with this client? A) Chronic B) Nociceptive C) Neuropathic D) Acute
D) Acute
A nurse is working for the summer at a camp for adolescent with diabetes. When providing information on the prevention and management of hypoglycemia, what action should the nurse promote? A) Eat a meal or snack every 8 hours B) perform exercise prior to eating whenever possible C) Check blood sugar at least every 24 hours D) Always carry a form of fast-acting sugar.
D) Always carry a form of fast-acting sugar
A parent informs the nurse that immunizations are contrary to her religious beliefs, and she does not want her child to receive them. The nurse proceeds to inform the parent that the child will be in grave danger of illness all her life and will not be allowed to start school unless she is immunized. The nurse also informs the parent that she had all of her own children vaccinated with no adverse effects. The nurse's behavior is an example of what? A) Acculturation B) Stereotyping C) Ethnocentrism D) Cultural imposition
D) Cultural imposition
A client with prediabetes states, "The doctor said if my blood sugars remain stable, I may not need to take any medication." Which response by the nurse is most appropriate? A) You will be placed on a strict low-sugar diet for better control B) Some doctors do not trust blood sugar elevation until symptoms appear C) You misunderstood the doctor. Let's ask for clarification D) Diet, exercise, and weight loss may eliminate the need for medication
D) Diet, exercise, and weight loss may eliminate the need for medication
Client A. is scheduled to receive Humalog (Lispro) during lunch time. Which of the following would be foremost in your mind? A) She should have her meal tray within 30 minutes after the insulin is administered B) She should eat within 1 hour after the administration of insulin C) It does not matter when she eats, as lispro is a basal insulin D) Ensure that she eats within 10-15 minutes after the insulin is administered
D) Ensure that she eats within 10-15 minutes after the insulin is administered
A client admitted with right leg thrombophlebitis is to be discharged from an acute care facility. Following treatment with a heparin infusion, the nurse notes that the client's leg is pain free, without redness or edema. Which step of the nursing process does this reflect? A) Diagnosis B) Analysis C) Implementation D) Evaluation
D) Evaluation
A client presents to the clinic reporting symptoms that suggest diabetes. What criteria was support checking blood levels for the diagnosis of diabetes? A) Random plasma glucose greater than 150 mg/dL (8.3 mmol/L) B) Fasting plasma glucose greater than 116 mg/dL (6.4 mmol/L) on two separate occasions C) Random plasma glucose greater than 126 mg/dL (7.0 mmol/L) D) Fasting blood glucose greater than or equal to 126 mg/dL (7.0 mmol/L)
D) Fasting plasma glucose greater than or equal to 126 mg/dL (7.0 mmol/L)
A clinic patient has described recent dark-colored stools;the nurse recognizes the need for fecal occult blood testing (FOBT). What aspect of the patients current health status would contraindicate FOBT? A) Gastroesophageal reflux disease (GERD) B) Recurrent nausea and vomiting C) Peptic ulcer D) Hemorrhoids
D) Hemorrhoids
A nurse is preparing to place a client's prescribed nasogastric tube. What anticipatory guidance should the nurse provide to the client? A) Insertion will cause some short-term pain B) Topical anesthetics will be used to reduce discomfort during insertion C) A narrow-gauge tube will be inserted before being replaced with a larger-gauge tube D) Insertion is likely to cause some gagging.
D) Insertion is likely to cause some gagging.
A client reports pain in the epigastric region. What statement suggests the presence of a duodenal ulcer? A) I seem to have bowel movements more often than I usually do B) The pain really interferes with the quality of life C) I know that my father and grandfather both had ulcers D) My pain resolves when I have something to eat
D) My pain resolves when I have something to eat
A nurse caring for a patient with a newly created ileostomy. The nurse assesses the patient and notes that the patient has had not ostomy output for the past 12 hours. The patient also complains of worsening nausea and a bloated feeling. What is the nurse's priority action? A) Contact the physician and obtain a swab of the stoma for culture B) Facilitate a referral to the wound-ostomy-continence (WOC) nurse C) Encourage the client to mobilize in order to enhance motility D) Report signs and symptoms of obstruction to the health care provider
D) Report signs and symptoms of obstruction to the health care provider
A client taking metronidazole for the treatment of H. pylori states that the medication is causing nausea. What teaching should the nurse provide to the client to alleviate the nausea? A) Tell the patient to ask the physician to prescribe another type of antibiotic B) Crush the medication and put it in applesauce C) Discontinue the use of the medication D) Take the medication with meal to decrease the nausea
D) Take the medication with meal to decrease the nausea
A patient with diabetes and a recent diagnosis of hypertension has experienced hypoglycemia twice in the last week. Which of the following history and assessment data are important to report to the provider? A) Drinks grapefruit juice daily with breakfast B) Takes psyllium daily as a fiber laxative with breakfast C) Drinks skim milk every night with dinner D) Takes metoprolol daily after breakfast and dinner
D) Takes metoprolol daily after breakfast and dinner
The home health nurse is making an initial home visit to an older adult client who is a widower. The client takes multiple medications for the treatment of varied chronic health problems. The client states that he has also begun taking some herbal remedies. What should the nurse be sure to include in the client's teaching? A) Herbal remedies are often cheaper than prescribed medication. B) Herbal remedies are consistent with holistic health care. C) It is safest to avoid the use of herbal remedies. D) There is a need to inform his primary care provider and pharmacist about the herbal remedies.
D) There is a need to inform his primary care provider and pharmacist about the herbal remedies.
Which of the following interventions would the nurse expect to see for a patient with pernicious anemia? A) Increased dietary intake of folic acid B) Administer ferrous sulfate supplements C) Transfuse 2 units of packed red blood cells D) Weekly injections of vitamin B12
D) Weekly injections of vitamin B12
A patient with type 2 diabetes is scheduled for a follow-up visit in the clinic several months from now. Which test will the nurse schedule to evaluate the effectiveness of treatment for the patient? a. Urine dipstick for glucose b. Oral glucose tolerance test c. Fasting blood glucose level d. Hemoglobin A1C (glycosylated hemoglobin)
D) hemoglobin A1C (glycosylated hemoglobin)
A nurse is talking with a patient who is scheduled to have a hemicolectomy with the creation of a colostomy. The patient admits to being anxious, and has many questions concerning the surgery, the care of a stoma, and necessary lifestyle changes. Which of the following nursing actions is most appropriate? A)Reassure the patient that the procedure is relatively low risk and that patients are usually successful in adjusting to an ostomy. B)Provide the patient with educational materials that match the patients learning style. C)Encourage the patient to write down these concerns and questions to bring forward to the surgeon. D)Maintain an open dialogue with the patient and facilitate a referral to the wound-ostomy-continence (WOC) nurse.
D)Maintain an open dialogue with the patient and facilitate a referral to the wound-ostomy-continence (WOC) nurse.
A nurse is caring for a patient with a nasogastric tube for feeding. During shift assessment, the nurse auscultates a new onset of bilateral lung crackles and notes a respiratory rate of 30 breaths per minute. The patient's oxygen saturation is 89% by pulse oximetry. After ensuring the patient's immediate safety, what is the nurse's most appropriate action? A)Perform chest physiotherapy. B)Reduce the height of the patient's bed and remove the NG tube. C)Speak with the dietitian to obtain a feeding solution with lower osmolarity. D)Report possible signs of aspiration pneumonia to the primary care provider.
D)Report possible signs of aspiration pneumonia to the primary care provider.
A nurse is caring for a client with type 1 diabetes who is being discharged home tomorrow. What is the best way to assess the clients ability to prepare and self administer insulin. A) Provide a health education session reviewing the main points of insulin delivery B) Ask the client to describe the process in detail C) Observe the client drawing up and administering the insulin D) Review the client's first hemoglobin A1c result after discharge
Observe the client drawing up and administering the insulin.
Which information will the nurse include in teaching a female patient who has peripheral arterial disease, type 2 diabetes, and sensory neuropathy of the feet and legs? a. Choose flat-soled leather shoes. b. Set heating pads on a low temperature. c. Use callus remover for corns or calluses. d. Soak feet in warm water for an hour each day.
a. Choose flat-soled leather shoes.
The nurse has administered 4 oz of orange juice to an alert patient whose blood glucose was 62 mg/dL. Fifteen minutes later, the blood glucose is 67 mg/dL. Which action should the nurse take next? a. Give the patient 4 to 6 oz more orange juice. b. Administer the PRN glucagon (Glucagon) 1 mg IM. c. Have the patient eat some peanut butter with crackers. d. Notify the health care provider about the hypoglycemia.
a. Give the patient 4 to 6 oz more orange juice.
During assessment of the patient with fibromyalgia, the nurse would expect the patient to report which of the following (select all that apply)? a. Sleep disturbances b. Multiple tender points c. Cardiac palpitations and dizziness d. Multijoint inflammation and swelling e. Widespread bilateral, burning musculoskeletal pain
a. Sleep disturbances b. Multiple tender points e. Widespread bilateral, burning musculoskeletal pain
Which laboratory result will the nurse monitor to determine if prednisone has been effective for a patient with an acute exacerbation of rheumatoid arthritis? a. Blood glucose b. C-reactive protein c. Serum electrolytes d. Liver function tests
b. C-reactive protein
Which result for a patient with chronic systemic lupus erythematosus (SLE) is most important for the nurse to communicate to the health care provider? a. Decreased C-reactive protein (CRP) b. Elevated blood urea nitrogen (BUN) and creatinine c. Positive antinuclear antibodies (ANA) d. Positive lupus erythematosus cell prep
b. Elevated blood urea nitrogen (BUN) and creatinine
A patient is being discharged after 1 week of IV antibiotic therapy for acute osteomyelitis in the right leg. Which information will be included in the discharge teaching? a. How to apply warm packs to the leg to reduce pain b. How to monitor and care for a long-term IV catheter c. The need for daily aerobic exercise to help maintain muscle strength d. The reason for taking oral antibiotics for 7 to 10 days after discharge
b. How to monitor and care for a long-term IV catheter
When the nurse brings medications to a patient with rheumatoid arthritis, the patient refuses the prescribed methotrexate. The patient tells the nurse, "My arthritis isn't that bad yet. The side effects of methotrexate are worse than the arthritis." The most appropriate response by the nurse is a. "You have the right to refuse to take the methotrexate." b. "Methotrexate is less expensive than some of the newer drugs." c. "It is important to start methotrexate early to decrease the extent of joint damage." d. "Methotrexate is effective and has fewer side effects than some of the other drugs."
c. "It is important to start methotrexate early to decrease the extent of joint damage."
A new clinic patient with joint swelling and pain is being tested for systemic lupus erythematosus. Which test will provide the most specific findings for the nurse to review? a. Rheumatoid factor (RF) b. Antinuclear antibody (ANA) c. Anti-Smith antibody (Anti-Sm) d. Lupus erythematosus (LE) cell prep
c. Anti-Smith antibody (Anti-Sm)
The health care provider suspects the Somogyi effect in a 50-year-old patient whose 6:00 AM blood glucose is 230 mg/dL. Which action will the nurse teach the patient to take? a. Avoid snacking at bedtime. b. Increase the rapid-acting insulin dose. c. Check the blood glucose during the night d. Administer a larger dose of long-acting insulin.
c. Check the blood glucose during the night
A 26-year-old female with type 1 diabetes develops a sore throat and runny nose after caring for her sick toddler. The patient calls the clinic for advice about her symptoms and a blood glucose level of 210 mg/dL despite taking her usual glargine (Lantus) and lispro (Humalog) insulin. The nurse advises the patient to a. use only the lispro insulin until the symptoms are resolved. b. limit intake of calories until the glucose is less than 120 mg/dL. c. monitor blood glucose every 4 hours and notify the clinic if it continues to rise. d. decrease intake of carbohydrates until glycosylated hemoglobin is less than 7%.
c. monitor blood glucose every 4 hours and notify the clinic if it continues to rise.
Which finding indicates a need to contact the health care provider before the nurse administers metformin (Glucophage)? a. The patient's blood glucose level is 174 mg/dL. b. The patient has gained 2 lb (0.9 kg) since yesterday. c. The patient is scheduled for a chest x-ray in an hour. d. The patient's creatinine has risen from 1.3 to 1.9 mg/dL.
d. The patient's creatinine has risen from 1.3 to 1.9 mg/dL.
