medical nursing
A 42 year old metalworker has been working at the turning machine for production of heavy large-size parts for 5 years. His work requires using of hand and pedal levers that involves considerable physical force. What means for osteoarthrosis prevention should be recommended? A) To go in for weightlifting B) To limit physical work C) To administer protein-and-vitamin diet D) To administer protein-and-carbohydrate diet E) To improve health at the Black sea coast
ANSWER: A
A man has lung disease caused by continuous ingress of productive dust into the lungs. He complains about cough, stabbing chest pain and dyspnea. What is the most likely diagnosis? A) Pneumoconiosis B) Decompression sickness C) Radiation sickness D) Pneumatic hammer disease E) Berylliosis
ANSWER: A
A nurse and a registered dietitian are assessing patients for partial parenteral nutrition (PPN). For which patient would the nurse suggest another route of providing nutrition? A) Patient with congestive heart failure B) Older patient with dementia C) Patient who has multiorgan failure D) Patient who is postgastric resection
ANSWER: A
A nurse assesses patients on the medical-surgical unit. Which patient would the nurse identify as at high risk for pancreatic cancer? A) A 26-year-old with a body mass index of 21 B) A 33-year-old who frequently eats sushi C) A 48-year-old who often drinks wine D) A 66-year-old who smokes cigarettes
ANSWER: D
A nurse cares for a patient who has a family history of colon cancer. The patient states, "My father and my brother had colon cancer. What is the chance that I will get cancer?" How would the nurse respond? A) "If you eat a low-fat and low-fiber diet, your chances decrease significantly." B) "You are safe. This is an autosomal dominant disorder that skips generations." C) "Preemptive surgery and chemotherapy will remove cancer cells and prevent cancer." D) "You should have a colonoscopy more frequently to identify abnormal polyps early."
ANSWER: D
A nurse cares for a patient who is hemorrhaging from bleeding esophageal varices and has an esophagogastric tube. What action would the nurse take first? A) Sedate the patient to prevent tube dislodgement. B) Maintain balloon pressure at 15 and 20 mm Hg. C) Irrigate the gastric lumen with normal saline. D) Assess the patient for airway patency.
ANSWER: D
43-year-old male patient is a foundry worker with 16 years of service record. He complains about exertional dyspnea, dry cough and sensation of chest tingling during cough. Instrumental examination revealed: restrictive type of external respiration disturbance of I degree. X-ray examination of lungs revealed: diffuse, round-shaped, small and well-defined opacities of average intensity located in the upper lung segments. The occupational pathologist suspected silicosis. What dust can cause this disease? A) Graphite B) Manganese C) Carbon D) Silicon dioxide in bound state E) Silicon dioxide in free state
ANSWER: E
A 43-year-old man complains of facial edema, dyspnea, and difficult swallowing that appeared 3 hours after he was stung by an insect. Objectively, the skin of his eyelids, cheeks, and lips is acutely hyperemic and edematous. What medicines should he be prescribed for emergency aid? A) Nonsteroidal anti-inflammatory drugs B) Diuretics C) Antihistamines D) Muscle relaxants E) Glucocorticosteroids
ANSWER: E
A nurse attempted to assist a morbidly obese patient back to bed and had immediate pain in the lower back. What action by the nurse is most appropriate? A) Ask another nurse to help next time. B) Demand better equipment to use. C) Fill out and file a variance report. D) Refuse to assist the patient again.
ANSWER: C
A nurse assesses a patient who is prescribed alosetron (Lotronex). Which assessment question would the nurse ask this patient? A) "Have you been experiencing any constipation?" B) "Are you eating a diet high in fiber and fluids?" C) "Do you have a history of high blood pressure?" D) "What vitamins and supplements are you taking?"
ANSWER: A
A nurse assesses a patient who has appendicitis. Which clinical manifestation would the nurse expect to find? A) Severe, steady right lower quadrant pain B) Abdominal pain associated with nausea and vomiting C) Marked peristalsis and hyperactive bowel sounds D) Abdominal pain that increases with knee flexion
ANSWER: A
A nurse assesses a patient who is prescribed 5-fluorouracil (5-FU) chemotherapy intravenously for the treatment of colon cancer. Which assessment finding would alert the nurse to contact the health care provider? A) White blood cell (WBC) count of 1500/mm3 (1.5 × 109/L) B) Fatigue C) Nausea and diarrhea D) Mucositis and oral ulcers
ANSWER: A
A nurse assesses a patient who is prescribed an infusion of vasopressin (Pitressin) for bleeding esophageal varices. Which clinical manifestation would alert the nurse to a serious adverse effect? A) Nausea and vomiting B) Frontal headache C) Vertigo and syncope D) Mid-sternal chest pain
ANSWER: D
A nurse assesses a patient with a mechanical bowel obstruction who reports intermittent abdominal pain. An hour later the patient reports constant abdominal pain. Which action would the nurse take next? A) Administer intravenous opioid medications. B) Position the patient with knees to chest. C) Insert a nasogastric tube for decompression. D) Assess the patient's bowel sounds.
ANSWER: D
A nurse assesses patients at a community health center. Which patient is at highest risk for the development of colorectal cancer? A) A 37-year-old who drinks eight cups (1893 mL) of coffee daily B) A 44-year-old with irritable bowel syndrome (IBS) C) A 60-year-old lawyer who works 65 hours per week D) A 72-year-old who eats fast food frequently
ANSWER: D
A nurse assesses a patient who is recovering from a Whipple procedure. Which assessment finding alerts the nurse to urgently contact the healthcare provider? A) Drainage from a fistula B) Absent bowel sounds C) Pain at the incision site D) Nasogastric (NG) tube drainage
ANSWER: A
A nurse assesses a patient who is recovering from a paracentesis 1 hour ago. Which assessment finding requires action by the nurse? A) Urine output via indwelling urinary catheter is 20 mL/hr B) Blood pressure increases from 110/58 to 120/62 mm Hg C) Respiratory rate decreases from 18 to 14 breaths/min D) A decrease in the patient's weight by 3 lbs (1.4 kg)
ANSWER: A
A nurse assesses a patient who is recovering from an ileostomy placement. Which clinical manifestation would alert the nurse to urgently contact the health care provider? A) Pale and bluish stoma B) Liquid stool C) Ostomy pouch intact D) Blood-smeared output
ANSWER: A
A nurse assesses a patient who is recovering from an open Whipple procedure. Which action would the nurse perform first? A) Assess the patient's endotracheal tube with 40% FiO2. B) Insert an indwelling Foley catheter to gravity drainage. C) Place the patient's nasogastric tube to low intermittent suction. D) Start lactated Ringer's solution through an intravenous catheter.
ANSWER: A
A nurse assesses patients at a community health fair. Which patient is at greatest risk for the development of hepatitis B? A) A 20-year-old college student who has had several sexual partners B) A 46-year-old woman who takes acetaminophen daily for headaches C) A 63-year-old businessman who travels frequently across the country D) An 82-year-old woman who recently ate raw shellfish for dinner
ANSWER: A
A nurse cares for a patient who has _a Giardia _infection. Which medication would the nurse anticipate being prescribed for this patient? A) Metronidazole (Flagyl) B) Ciprofloxacin (Cipro) C) Sulfasalazine (Azulfidine) D) Ceftriaxone (Rocephin)
ANSWER: A
A nurse cares for a patient who has a new colostomy. Which action would the nurse take? A) Empty the pouch frequently to remove excess gas collection. B) Change the ostomy pouch and wafer every morning. C) Allow the pouch to completely fill with stool prior to emptying it. D) Use surgical tape to secure the pouch and prevent leakage.
ANSWER: A
A nurse cares for a patient who has obstructive jaundice. The patient asks, "Why is my skin so itchy?" How would the nurse respond? A) "Bile salts accumulate in the skin and cause the itching." B) "Toxins released from an inflamed gallbladder lead to itching." C) "Itching is caused by the release of calcium into the skin." D) "Itching is caused by a hypersensitivity reaction."
ANSWER: A
A nurse cares for a patient who had a colostomy placed in the ascending colon 2 weeks ago. The patient states, "The stool in my pouch is still liquid." How would the nurse respond? A) "The stool will always be liquid with this type of colostomy." B) "Eating additional fiber will bulk up your stool and decrease diarrhea." C) "Your stool will become firmer over the next couple of weeks." D) "This is abnormal. I will contact your health care provider."
ANSWER: A
A nurse cares for a patient who is prescribed lactulose (Heptalac). The patient states, "I do not want to take this medication because it causes diarrhea." How would the nurse respond? A) "Diarrhea is expected; that's how your body gets rid of ammonia." B) "You may take Kaopectate liquid daily for loose stools." C) "Do not take any more of the medication until your stools firm up." D) "We will need to send a stool specimen to the laboratory."
ANSWER: A
A 38-year-old woman works in flax processing, she dries flax. She came to the hospital complaining of difficult breathing, constricting sensation in her chest, and cough attacks. These signs appear on the first day of her working week and gradually diminish on the following days. What respiratory disease is likely in this case? A) Asthmatic bronchitis B) Byssinosis C) Allergic rhinopharyngitis D) Silicosis E) Bronchial asthma
ANSWER: B
A 57-year-old man, a miner, complains of a pain in his chest, dyspnea on physical exertion, excessive sweating, constant subfebrile tempeature, and cough that produces blood-streaked sputum. He has been smoking for approximately 40 years (2 packs a day) and frequently has "pneumonias? Survey chest X-ray shows a triangular shadow in the middle lobe of the right lung. One of the apices of the shadow points to the lung root. Cardiac and mediastinal shadows are displaced toward the affected area. Make the provisional diagnosis: A) Chronic bronchitis B) Cancer of the right lung C) Right-sided pleuropneumonia D) Pneumoconiosis
ANSWER: B
A morbidly obese patient is admitted to a community hospital that does not typically care for bariatric-sized patients. What action by the nurse is most appropriate? A) Assess the patient's readiness to make lifestyle changes. B) Ensure adequate staff when moving the patient. C) Leave side rails down to prevent pressure ulcers. D) Reinforce the need to be sensitive to the patient.
ANSWER: B
A nurse assesses a patient's oral cavity and observes the condition depicted in the photo below:[mc021-1.jpg]What action by the nurse is best? A) Ask about the patient's human immunodeficiency virus (HIV) status. B) Assess the patient for dysphagia. C) Listen to the patient's lung sounds. D) Refer the patient to an oncologist.
ANSWER: B
A nurse cares for a middle-aged male patient who has irritable bowel syndrome (IBS). The patient states, "I have changed my diet and take bulk-forming laxatives, but my symptoms have not gotten better. I heard about a drug called Amitiza. Do you think it might help?" How would the nurse respond? A) "This drug is still in the research phase and is not available for public use yet." B) "Unfortunately, lubiprostone is approved only for use in women." C) "Lubiprostone works well. I will recommend this prescription to your provider." D) "This drug should not be used with bulk-forming laxatives."
ANSWER: B
A nurse cares for a patient newly diagnosed with colon cancer who has become withdrawn from family members. Which action would the nurse take? A) Contact the provider and recommend a psychiatric consult for the patient. B) Encourage the patient to verbalize feelings about the diagnosis. C) Provide education about new treatment options with successful outcomes. D) Ask family and friends to visit the patient and provide emotional support.
ANSWER: B
A nurse cares for a patient who has cirrhosis of the liver. What action would the nurse take to decrease the presence of ascites? A) Monitor intake and output. B) Provide a low-sodium diet. C) Increase oral fluid intake. D) Weigh the patient daily.
ANSWER: B
A 45-year-old drillman complains about aching hand pain disturbing him at night, creeping sensation, hands chill, headache and sleep disorder. In addition, notes blanching of fingers after washing hands with cold water. What disease might be suspected? A) Anthracosis B) Silicatosis C) Pneumatic hammer disease D) Siderosis E) Silicosis
ANSWER: C
A mechanic gets wheezy every time he uses two-part paint. You diagnose occupational asthma after various investigations have been undertaken. Which of the following is correct? A) IgE is always raised in occupational asthma B) You can get rhinitis with the condition C) Can be diagnosed with twice daily peak flow readings for 2 weeks at home and at work D) Does not require health surveillance of other workers E) Is not an IIDB
ANSWER: C
A nurse answers a patient's call light and finds the patient in the bathroom, vomiting large amounts of bright red blood. Which action would the nurse take first? A) Assist the patient back to bed. B) Notify the provider immediately. C) Put on a pair of gloves. D) Take a set of vital signs.
ANSWER: C
A nurse assesses a patient who has cholecystitis. Which clinical manifestation indicates that the condition is chronic rather than acute? A) Temperature of 100.1° F (37.8° C) B) Positive Murphy's sign C) Light-colored stools D) Upper abdominal pain after eating
ANSWER: C
A nurse assesses a patient who has ulcerative colitis and severe diarrhea. Which assessment would the nurse complete first? A) Inspection of oral mucosa B) Recent dietary intake C) Heart rate and rhythm D) Percussion of abdomen
ANSWER: C
A nurse assesses a patient who is hospitalized with an exacerbation of Crohn's disease. Which clinical manifestation would the nurse expect to find? A) Positive Murphy's sign with rebound tenderness to palpitation B) Dull, hypoactive bowel sounds in the lower abdominal quadrants C) High-pitched, rushing bowel sounds in the right lower quadrant D) Reports of abdominal cramping that is worse at night
ANSWER: C
A nurse assesses patients at a community health center. Which patient is at highest risk for pancreatic cancer? A) A 32-year-old with hypothyroidism B) A 44-year-old with cholelithiasis C) A 50-year-old who has the_ BRCA2_ gene mutation D) A 68-year-old who is of African-American ethnicity
ANSWER: C
A nurse assesses patients on the medical-surgical unit. Which patient is at greatest risk for the development of carcinoma of the liver? A) A 22-year-old with a history of blunt liver trauma B) A 48-year-old with a history of diabetes mellitus C) A 66-year-old who has a history of cirrhosis D) An 82-year-old who has chronic malnutrition
ANSWER: C
A nurse assessing a patient with colorectal cancer auscultates high-pitched bowel sounds and notes the presence of visible peristaltic waves. Which action would the nurse take? A) Ask if the patient is experiencing pain in the right shoulder. B) Perform a rectal examination and assess for polyps. C) Contact the provider and recommend computed tomography. D) Administer a laxative to increase bowel movement activity.
ANSWER: C
A nurse cares for a patient who has chronic cirrhosis from substance abuse. The patient states, "All of my family hates me." How would the nurse respond? A) "You should make peace with your family." B) "This is not unusual. My family hates me too." C) "I will help you identify a support system." D) "You must attend Alcoholics Anonymous."
ANSWER: C
A female patient hospitalized for an unrelated problem has a large pearly white lesion on her lip, to which she continues to apply lipstick that she will not remove for inspection. The patient refuses to discuss the lesion with the nurse or health care provider. What action by the nurse is best? A) Ask the patient why her appearance is so important. B) Ignore the lesion since the patient will not discuss it. C) Inform the patient that early-stage cancer is curable. D) Work with the patient to establish a trusting relationship.
ANSWER: D