Possible Adult Health Questions

1. A client with type 1 diabetes mellitus is on intensive insulin therapy. The client is of the Islamic faith and insists on fasting during Ramadan. What is the most important nursing action? 1) Advise the client of the risk of fasting when diabetic 2) Assess the client's clinical stability and glycemic control 3) Refer the client to the health care provider for adjustment of the insulin therapy 4) Refer the client to the registered dietitian for meal planning

2

1. A client with type I diabetes mellitus is brought to the emergency department by his wife. The client has fruity breath with rapid, deep respirations at 36 breaths per minute, reports abdominal pain, and appears weak. The nurse should anticipate implementation of which prescription(s)? Select all that apply. 1) Administer dextrose 50 mg intravenous (IV) push 2) Instruct client to breathe into a paper bag to treat hyperventilate 3) Perform a fingerstick and serum blood glucose test 4) Prepare to administer an IV infusion of regular insulin Start an IV line and administer a bolus of normal saline

3, 4, 5

Which intervention would best help a patient with a decreased level of consciousness and showing signs of a stroke? A. Elevate the HOB to 30 degrees B. Administer Narcan C. Administer heparin D. Play loud music to wake them up

A

Risks for PVD (select all that apply) a. Male (correct) b. Older (correct) c. Smoking (correct) d. Dehydration

A, B, C

1) What are the clinical manifestations for BPH? Select all that apply. a. Weak urinary stream b. Nocturia c. Frequency d. Feeling of emptying the bladder e. Intermittency

A, B, C, E

A client with end-stage renal disease (ESRD) has the problem of ineffective coping. Which nursing interventions are appropriate in working with this client? Select all that apply. a) Acknowledge the client's feelings. b) Assess the client and family's coping patterns. c) Explore the meaning of the illness with the client. d) Set limits on mood swings and expressions of hostility. e) Give the client information when the client is ready to listen.

A, B, C, E

1. A patient undergoing general anesthesia during a thoracic aortic dissection repair experiences a rapid spike in etCO2, heart rate, respiratory rate, and muscle rigidity. The surgeon places a stat order of Dantrolene. What acute medical condition is the patient experiencing? A. Hypovolemic shock B. Malignant hyperthermia C. Thyroid storm D. Anaphylaxis

B

5. Which of the following should NOT be included in the discharge plan of a patient with congestive heart failure? A. Conserve energy; the client should schedule rest periods between activities. B. Weigh self weekly and notify the provider if there is a w of 5 weight gain pounds in two weeks. C. Take diuretics in the early morning and early afternoon (if prescribed twice daily) to allow for uninterrupted sleep D. Adhere to medication regimen.

B

You are a new nurse in the operating room. Your preceptor is teaching you about malignant hyperthermia. Which symptom is often the earliest sign of malignant hyperthermia? A) Increased temperature B) Oliguria C) Tachycardia D) Hypotension

C

A client has just undergone a coronary artery bypass graft (CABG) surgery, and had two chest tubes inserted while in the OR. When the patient arrives to the unit, the nurse enters the room and notices continuous bubbling in the water seal chamber of the drainage system. What intervention should the nurse perform FIRST? A. Increase the amount of wall suction until bubbling subsides B. Document the findings as abnormal C. Call the physician suggest the patient be sent back to the OR immediately D. Check the drainage system for an air leak

D

A patient who has recently been diagnosed with cirrhosis is being taught how to care for themself. Which statement shows that the patient needs further teaching? A. "If I am having an irregular heart beat, I should call my doctor." B. "I need to take care of my skin around my belly if it is swollen." C. "I can use my pillows to support my head to help me breath when I am in my bed." D. "It is okay for me to have a drink or two during the weekends."

D

When caring for a patient with GERD , which of the following interventions should the Nurse implement? A. Place the patient in supine position after a meal and administer nonsteroidal anti- inflammatory medications as prescribed. B. Have the client remain upright at all times and exercise at least 3 times a week. C. Instruct the client to take antacids 30 minutes before each meal and to eat larger meals to avoid heartburns. D. Elevate the head of bed 30 degrees and discuss lifestyle modifications with the client.

D

Which problem should the nurse identify as priority for a client who is 1 day post-op? A. Potential for infection B. Potential for injury C. Potential for fluid volume excess D. Potential for hemorrhage

D

1. Along with persistent chest pain, indigestion and nausea which signs/symptoms would make the nurse suspect that the client is experiencing a myocardial infarction? 1. Bradycardia and tachypnea 2. Pale and moist skin 3. Jaundice of the skin 4. Jugular vein distention and 3+ pitting edema

2

1. The nurse cares for a client with type 2 diabetes mellitus and hemoglobin A1C results of 8% at an outpatient health clinic. Which statement by the nurse will best address these results? 1) "It is important for us to review the signs and symptoms of a hypoglycemic reaction" 2) "Let's review your diet, exercise, and medication regimen over the past 2-3 months" 3) "Please describe what you have eaten in the last 24-48 hours" 4) "You should fast for at least 8 hours prior to your morning blood work"

2

A client who suffered hypovolemic shock during a cardiac incident has developed acute renal failure. Which is the best nursing rationale for this complication? a) Decrease in the blood flow through the kidneys b) Obstruction of urine flow from the kidneys c) Structural damage affecting in the nephrons d) A blood clot formed in the kidneys interfering with flow

A

The nurse assesses a female client with a diagnosis of primary adrenal insufficiency (addison disease). The nurse recognizes which finding associated with the disease? Answer = A a.) Bronze pigmentation of the skin b.) Increased body or facial hair c.) Purple or red striae on the abdomen d.) Supraclavicular fat pad

A

The nurse observes bloody drainage on the surgical dressing of the client who has just arrived on the nursing unit post-op. Which intervention should the nurse plan to do next? A. Outline the drainage with a pen and record the date and time next to the drainage. B. Make the client NPO and order a stat hemoglobin and hematocrit. C. Remove the dressing, assess the wound, and apply a new sterile dressing. D. Take the client's vital signs and call the surgeon.

A

A patient you are caring for was admitted with a brain infection and has now developed an excessive secretion of vasopressin/aldosterone. What clinical manifestations might you see? Select all that apply. A. Muscle weakness B. Irritability and restlessness C. Increased urine output D. Seizure E. Weak pulse

A, B, D

. A patient has been recently diagnosed with Peptic ulcer disease (PUD), which of the following patient education statement is most accurate for the nurse give to the patient relating to the new diagnosis? A. "Your medications will prevent any further damage so you are able to maintain your current diet and decrease your symptoms " B. "Eliminating alcohol from your diet can be helpful in reducing ulcer occurrences" C. "You should always try to eat a high protein, low carb, high-fat diet" D. "It may be helpful to eat a small snack about an hour before bed" E. "It may be helpful to consume 3 large meals at 7, 12, and 5 to allow proper time for digestion"

B

A woman is brought to the ED and complains of a sharp, tight pain in her buttocks whenever she walks around her neighborhood. She states that it disappears at rest. What is your initial diagnosis for what this patient is experiencing? a.) Raynaud's Disease b.) Intermittent Claudication (correct) c.) Arterial Ulcer d.) Acute Arterial Occlusion

B

. A client is undergoing diagnostic tests for suspected prostate cancer. Which tests would the nurse anticipate for this client? (Select all that apply.) A) Fecal occult blood test B) PSA (prostate-specific antigen) test C) Needle biopsy D) Papanicolaou test E) Digital rectal exam

B, C, E

Which lab value, when elevated for a long time, is an early indicator of acute pancreatitis? Select all that apply. a. Serum calcium b. Serum amylase c. Serum creatinine d. Serum lipase

B, D

1. A nurse who provides care in a walk-in clinic assesses a wide range of individuals. The nurse should identify which of the following patients as having the highest risk for chronic pancreatitis? A) A 45-year-old obese woman with a high-fat diet B) An 18-year-old man who is a weekend binge drinker C) A 39-year-old man with chronic alcoholism D) A 51-year-old woman who smo

C

A client comes to the clinic and is diagnosed with an Abdominal Aortic Aneurysm (AAA). Which of the following assessment findings indicates that the aneurysm ruptured? a) Chest pain b) Shortness of breath c) Sudden severe abdominal pain d) High blood pressure

C

A patient is admitted with a new diagnosis of Cushing Syndrome. Which of the following are manifestations of this condition? A. Hypotension B. Weight loss and decreased appetite C. Central obesity and musculoskeletal changes D. Increased potassium levels

C

A patient presents to the emergency center with nausea, diarrhea, abdominal pain, cramping, weight loss, rectal bleeding, rectal urgency, and extreme fatigue. What is the most likely cause of this patient's symptoms? A. GERD B. Peptic Ulcer Disease C. Ulcerative Colitis D. Diverticulitis

C

The nursing instructor is discussing Conn's Syndrome in lecture and explains that the condition is a result of primary aldosteronism, or the increased release of aldosterone. The student nurse correctly demonstrates their understanding of this condition and its treatment by stating the following a.) "This patient will present with diminished DTRs and hyperalgesia as well as significant urine output." b.) "This patient has a diminished sense of thirst and is hypotensive." c.) "This patient would benefit from spironolactone therapy with the goal of regulating serum volume, BP, and K+ levels." d.) "This patient should avoid steroid therapy and be placed on short acting insulin."

C

Which of the following is not an expected finding for a patient suffering from Crohn's Disease? A. Pain after meals B. Vomiting C. Constipation D. Weight loss

C

A patient with a history of hypertension reports to the ER complaining of a headache that he describes as "explosive". After witnessing him vomit and become confused you infer that he is suffering from: A. Hemianopsia B. Hemorrhagic stroke C. Ischemic stroke D. Cheyne stroke

D

The patient donated a kidney, and early ambulation is included in her plan of care. But the patient refuses to get up and walk. What rationale should the nurse explain to the patient for early ambulation? a. "Early walking keeps your legs limber and strong." b. "Early ambulation will help you be ready to go home." c. "Early ambulation will help you get rid of your syncope and pain." d. "Early walking is the best way to prevent postoperative complications."

D

1. The nurse teaches disease management to a group of clients with type I diabetes mellitus. Which of the following should the nurse teach as signs or symptoms associated with hypoglycemia? Select all that apply. 1) Diaphoresis 2) Flushing 3) Pallor 4) Polyuria 5) Trembling

1, 3, 5

Which intervention should the nurse plan to implement to decrease the client's risk for injury during the intraoperative period? A. Assess the client for allergies. B. Verify the client's preoperative vital signs. C. Allow the client to verbalize fears. D. Keep the family informed of the client's status.

A

At handoff, the morning nurse reports a 65-year-old patient was admitted with pulsating pain in the left femur that increases during movement. The physician suspects hematogenous osteomyelitis and has ordered x-rays and blood cultures. Along with pain, what symptoms would be consistent with osteomyelitis? a) Heart rate of 108 b) Temperature of 102.2 c) Positive Chvostek sign d) Respiratory rate of 24 e) 3+ pitting edema of the lower left extremity

A, B, D

The nurse assesses a client with Cushing syndrome. Which clinical manifestation should the nurse expect? (Select all that apply) a.) Hyperglycemia b.) Hypertension c.) Hyponatremia d.) Truncal obesity e.) Weight loss

A, B, D

Which of the following are clinical manifestations of Rheumatoid Arthritis? (select all that apply) a) Symmetric joint pain and stiffness in the morning that lasts more than 1 hr b) Spongy joints upon palpation c) Cyanosis of the fingers and toes that is triggered by cold temperatures d) Swelling, warmth, erythema, and loss of function of affected joints

A, B, D

The nurse cares for a client with Addison's disease who was involved in a motor vehicle accident and hospitalized for a fracture of the right femur. Which client information is most important to report to the primary health care provider? a.) Blood pressure change from 128/80mm Hg to 90/50 mm Hg b.) Developments of a 1st degree atrioventricular block on ECG c.) Reports of right femur pain of 7 on a scale of 1-10 d.) Vesicular breath sounds auscultated over the lung tissue

A

The nurse is examining a 78 year old male who was diagnosed with an Abdominal Aortic Aneurysm (AAA) and suspects that the aneurysm is expanding based on what assessment finding? a. Lower back pain b. Angina c. Dysphagia d. Hypoxemia

A

A patient presents to the PCP's office for their annual checkup and receives a comprehensive physical assessment and lab workup. Which of the following findings indicate Cushing Syndrome? a.) Increased na+ levels, reports frequent infections, purple striae, increased blood glucose levels b.) Slow healing wounds, bronzed skin, scaphoid abdomen, menstrual irregularities c.) Increased inflammatory response, metabolic syndrome, growth of peripheral extremities. d.) Increased K+, metabolic acidosis, muscular hypertrophy, protruding collar bones

A

1. The nurse is teaching a group of clients diagnosed with diabetes mellitus. Which lesson regarding foot care should be included? Select all that apply. 1) Cut toenails straight across and file along the curve of the toes 2) Rub feet vigorously with a towel after bathing to ensure dryness 3) Use a mild foot powder on perspiring feet 4) Use cotton or lamb's wool to separate overlapping toes 5) Use an over-the-counter corn removal kit to remove corns or calluses

1, 3, 4

1. The nurse cares for a client with type 2 diabetes mellitus. The client is alert and oriented but also shaky, pale, and diaphoretic. The client's fingerstick blood glucose is 50 mg/dL (2.8 mmol/L). Which of the following is the bestnext step the nurse can take? 1) Administer dextrose 50 mg IV push 2) Give client 6 oz. of orange juice or low-fat milk 3) Inject the client with glucagon 2 mg intramuscularly 4) Verify fingerstick blood glucose with serum blood draw

2

1. When no changes are made to the diet or prescribed insulin, which client with type I diabetes mellitus does the nurse anticipate having the highest risk of developing hypoglycemia? 1) A 29-year-old with new onset of influenza 2) A 40-year-old experienced bicycle rider who adds 10 extra miles to his route 3) A 65-year-old with cellulitis in the right leg 4) A 72-year-old with emphysema who is taking prednisone

2

1. A patient with hypertension has a newly diagnosed atrial fibrillation. What medication does the nurse anticipate administering to prevent the complication of atrial thrombi? 1. Adenosine 2. Amiodarone 3. Warfarin 4. Atropine

3

6. A nurse is caring for a client who has a diagnosis of heart failure. Patient asks, "How can I limit fluid intake to 2000ML per day?". Which of the following responses should the nurse give to the client? A. "Pour the amount of fluid you drink into an empty two liter bottle to keep you track of how much you drink." B. "Each glass contains 8 ounces. There are 30 milliliters per oz, so you can have a total of 8 glasses or cups of fluids each day." C. "This is the same as 2 quarts, or about the same as two pots of coffee." D. "Take sips of water or ice chips so you will not take in too much fluid"

A

A 38 year old female client comes into the ER and has an EKG done. Her readings show tall, peaked T waves. What electrolyte imbalance does this indicate?a)Hyperkalemia b) Hyponatremia c) Hypernatremia d) Hypercalcemia

A

A client is admitted to the ED with the diagnosis of acute cholecystitis. Which of the following clinical manifestations does the nurse expect to find on assessment? Select all that apply: A. Pain that spreads to right shoulder or back B. Abdomen tender to palpation C. Pain in left lower quadrant (LLQ) of abdomen D. Pruritus E. Nausea/Vomiting

A, B, E

A nurse is caring for a patient who has just undergone a chest tube insertion. The nurse should monitor the water chamber for which of the following? (Select all that apply): A. Air leaks B. Tidaling C. Proper clamping D. Small bubbles E. Increased negative pressure

A, B, E

1) A patient is getting ready to be discharged with a diagnosis of benign prostatic hypertrophy. The nurse understands that patient teaching has been effective by which statement? a. "I will limit my exercise to avoid straining my prostate." b. "I will avoid caffeine and alcohol and stop drinking after 5 p.m." c. "BPH increases my risk for prostate cancer, so I will follow up with my physician to get tested." d. "I will increase my fluid intake to more than 2 L a day."

B

A nurse is caring for five clients. For which clients would the nurse assess a high risk for developing a pulmonary embolism (PE)? (Select all that apply.) a. Client who had a reaction to contrast dye yesterday b. Client with a new spinal cord injury on a rotating bed c. Middle-aged man with an exacerbation of asthma d. Older client who is 1-day post hip replacement surgery e. Young obese client with a fractured femur

B, D, E

. A nurse is caring for a patient with a chest tube. The nurse enters the room to take the patients vital signs. While sitting the patient up to take his blood pressure the chest tube becomes completely dislodged from the patient's chest. What should the nurse do first? A. Notify the physician. B. Re-insert the chest tube. C. Place sterile dressing over the insertion site and tape it on three sides. D. Assess breath sounds.

C

1) A nurse is caring for a patient who is post-op from lithotripsy treatment for kidney stones. What assessment finding by the nurse should be prioritized in an SBAR communication to the primary care provider? a) Oral temperature of 99.0F b) Pain rated 3/10 that radiates to the back c) New vibrant deep cherry red urine measuring 300mL every 30 minutes d) Crystalline structure found in the gauze strain after voiding 200mL of clear urine

C

A patient is admitted to the unit for a thyroid disorder. The PCA informs the nurse that the patient has a high fever, chest pains, and dyspnea. Base on this information, the nurse believes the patient is experience what disorder? A. Hyperthyroidism B. Addisonian Crisis C. Thyroid storm D. Myxedema coma

C

Which client would be most likely to develop an abdominal aortic aneurysm? a) A 45-year-old female with a history of osteoporosis b) An 80-year-old female with congestive heart failure. c) A 69-year-old male with peripheral vascular disease d) A 30-year-old male with a genetic predisposition to AAA.

C

While reviewing a newly admitted patient's chart the nurse observes that the patient is noted to have hyperglycemia, significant history of steroid use, and central obesity. From these manifestations what is the patient most likely at risk for? a.) Conn's syndrome b.) Hyperthyroidism c.) Cushing Syndrome d.) Addison's Disease

C

The provider has just come down to remove a patient's chest tube. Immediately after removal which is the most importing nursing intervention? A) Taking a full set of vital signs B) Assaulting lung sounds in all lobes C) Obtaining a focused respiratory assessment D) Apply an occlusive dressing

D

A client has end-stage renal failure. Which of the following should the nurse include when teaching the client about nutrition to limit the effects of azotemia? a) Increase carbohydrates and limit protein intake. b) Decrease sodium intake and this affects the kidneys c) Keep an eye on how much potassium he/she gets from foods d) Increase protein intake to help the kidneys

A

The nurse is reviewing lab results for a patient with cirrhosis and notes that the ammonia level is elevated. Which diet is the physician most likely to prescribe for the patient? A) Low-protein B) High-protein C) Moderate-fat D) High-carb

A

1. A patient's assessment and diagnostic testing are suggestive of acute pancreatitis. When the nurse is performing the health interview, what assessment questions address likely etiologic factors? Select all that apply. A) How many alcoholic drinks do you typically consume in a week? B) Have you ever been tested for diabetes? C) Have you ever been diagnosed with gallstones? D) Do you eat a particularly high-fat diet? E) Does anyone in your family have cystic fibrosis

A, C

Which of the following blood laboratory values would support a diagnosis of liver cirrhosis? Select all that apply: A. Increased levels of Bilirubin B. Decreased levels of Ammonia C. Increased levels of both alanine transaminase (ALT) and aspartate transaminase (AST) D. Decreased levels of creatinine E. Increased levels of Albumin

A, C

What signs and symptoms are indicative of peripheral arterial disease? Select all that apply. A. I often wake up at night with leg pain and the only thing that relieves it is dangling my legs from the bed. (correct) B. If I sit or stand too long my legs feel heavy and achy. C. It hurts when I elevate my legs(correct) D. When I walk, I get leg cramps and they tingle so much I cannot keep walking (correct)

A, C, D

6. John, a 63 year old with a history of HTN, has noticed he has become increasingly fatigued and weak while preforming standard activities of daily living. Which of the following symptoms suggest that John is suffering from congestive heart failure? Select all that apply. A. Dyspnea upon exertion B. Bradycardia C. Dyspnea upon lying down D. Edema in lower extremities E. Nocturia

A, C, D, E

A patient presents to the ED with increased intracranial pressure. What are some late signs of increased ICP?Select all that apply. a. Cushing's triad b. Irritability c. Projectile vomiting d. Kussmaul respiration e. Cheyne-stokes respiration f. Increased brainstem reflexes

A, C, E

Peter is a 42 year old at his primary care providers office for his annual physical. Peter suffers from HTN and elevated cholesterol levels. Peter's primary care provider educates him about prevention methods to avoid developing heart disease and also gives him a printed handout that reiterates said methods. Which of the following prevention methods may be included in the handout? Select all that apply. A. Quit smoking B. Follow a strict high protein diet C. Exercise at least 5 times/week D. Maintain a healthy weight E. Reduce stress

A, D, E

A 19-year-old comes into the emergency department with acute asthma. His respiratory rate is 44 breaths/minute, and he appears to be in acute respiratory distress. Which of the following actions should be taken first? A. Take a full medication history B. Give a bronchodilator by nebulizer C. Apply a cardiac monitor to the client D. Provide emotional support to the client

B

A nurse is assessing a client after a thyroidectomy. The assessment reveals muscle twitching and tingling, along with numbness in the fingers, toes, and mouth area. The nurse should suspect which complication? a. Hypoglycemia b. Hypocalcemia c. Atelectasis d. Infection

B

A patient who is scheduled for surgery in a week tells the nurse doing the preoperative assessment about an allergy to bananas, kiwifruit, and latex products. Which action is most important for the nurse to take? a.Notify the dietitian about the food allergies. b.Alert the surgery center about the latex allergy. c.Reassure the patient that all allergies are noted on the medical record. d.Ask whether the patient uses antihistamines to reduce allergic reactions.

B

Which statement made by the patient makes the nurse suspect the patient is experiencing hypothyroidism? A."I'm constantly feeling hot, even when I strip layers, I can't seem to feel cool." B."These day I feel constantly thirsty for cold water." C."I've noticed that I've been gaining weight, particularly in my face." D."Lately I haven't had an appetite, yet I'm still gaining weight."

D