PrepU Adult Health: Practice Exam 1

A client is being assessed for acute laryngitis. The nurse knows that clinical manifestations of acute laryngitis include a. a moist cough. b. hoarseness. c. a sore throat that feels worse in the evening. d. a nonedematous uvula

b. hoarseness.

After diagnosing a client with pulmonary tuberculosis, the physician tells family members that they must receive isoniazid (INH [Laniazid]) as prophylaxis against tuberculosis. The client's daughter asks the nurse how long the drug must be taken. What is the usual duration of prophylactic isoniazid therapy? a. 6 to 12 months b. 1 to 3 weeks c. 2 to 4 months d. 3 to 5 days

a. 6 to 12 months

The nurse is caring for clients on a telemetry unit. Which nursing consideration best represents concerns of altered rhythmic patterns of the heart? a. Altered patterns frequently affect the heart's ability to pump blood effectively. b. Altered patterns frequently cause a variety of home safety issues. c. Altered patterns frequently produce neurological deficits. d. Altered patterns frequently turn into life-threatening arrhythmias.

a. Altered patterns frequently affect the heart's ability to pump blood effectively.

Which statement is true about both lung transplant and bullectomy? a. Both procedures improve the overall quality of life of a client with COPD. b. Both procedures treat end-stage emphysema. c. Both procedures cure COPD. d. Both procedures treat patients with bullous emphysema.

a. Both procedures improve the overall quality of life of a client with COPD.

You are monitoring the results of laboratory tests performed on a client admitted to the cardiac ICU with a diagnosis of myocardial infarction. Which test would you expect to show elevated levels? a. Enzymes b. WBC c. Platelets d. RBC

a. Enzymes

The nurse is assessing a patient's blood pressure. What does the nurse document as the difference between the systolic and the diastolic pressure? a. Pulse pressure b. Auscultatory gap c. Pulse deficit d. Korotkoff sound

a. Pulse pressure

Which term is refers to hypertension in which blood pressure that is controlled with therapy becomes uncontrolled (abnormally high) when the therapy is discontinued? a. Rebound b. Primary c. Secondary d. Essential

a. Rebound

A client is admitted to the intensive care unit (ICU) with a diagnosis of hypertension emergency/crisis. The client's blood pressure (BP) is 200/130 mm Hg. The nurse is preparing to administer IV nitroprusside. Upon assessment, which finding requires immediate intervention by the nurse? a. Nausea and severe headache b. Numbness and weakness in the left arm c. Urine output of 40 mL over the past hour d. Chest pain score of 3 (on a scale of 1 to 10)

b. Numbness and weakness in the left arm

A nurse is assessing a client's right lower leg, which is wrapped with an elastic bandage. Which signs and symptoms suggest circulatory impairment? a. Redness, cool skin temperature, and swelling b. Numbness, cool skin temperature, and pallor c. Numbness, warm skin temperature, and redness d. Swelling, warm skin temperature, and drainage

b. Numbness, cool skin temperature, and pallor

The nurse is caring for a client admitted with a diagnosis of bacterial pharyngitis. The nurse anticipates the client will be ordered which medication? a. Tylenol with codeine b. Penicillin c. Robitussin DM d. Tylenol

b. Penicillin

In chronic obstructive pulmonary disease (COPD), decreased carbon dioxide elimination results in increased carbon dioxide tension in arterial blood, leading to which of the following acid-base imbalances? a. Respiratory alkalosis b. Respiratory acidosis c. Metabolic alkalosis d. Metabolic acidosis

b. Respiratory acidosis

Which of the following is the most effective intervention for preventing progression of vascular disease? a. Use neutral soaps b. Risk factor modification c. Avoid trauma d. Wear sturdy shoes

b. Risk factor modification

The nurse is caring for a client who is prescribed medication for the treatment of hypertension. The nurse recognizes that which medication conserves potassium? a. Chlorothiazide b. Spironolactone c. Chlorthalidone d. Furosemide

b. Spironolactone

Which condition leads to chronic respiratory acidosis in older adults? a. Decreased renal function b. Thoracic skeletal change c. Overuse of sodium bicarbonate d. Erratic meal patterns

b. Thoracic skeletal change

A client who is newly diagnosed with hypertension is going to be starting antihypertensive medicine. What is one of the main things the client and the client's spouse should watch for? a. blurred vision b. dizziness c. persistent cough d. tremor

b. dizziness

A nurse assesses arterial blood gas results for a patient in acute respiratory failure (ARF). Which results are consistent with this disorder? a. pH 7.46, PaO2 80 mm Hg b. pH 7.28, PaO2 50 mm Hg c. pH 7.35, PaCO2 48 mm Hg d. pH 7.36, PaCO2 32 mm Hg

b. pH 7.28, PaO2 50 mm Hg

The nurse is caring for a patient with systolic blood pressure of 135 mm Hg. This finding would be classified as a. normal. b. prehypertension. c. stage 1 hypertension. d. stage 2 hypertension

b. prehypertension.

Which community-acquired pneumonia demonstrates the highest occurrence during summer and fall? a. Viral pneumonia b.Legionnaires disease c.Mycoplasmata pneumonia d. Streptococcal (pneumococcal) pneumonia

b.Legionnaires disease

The nurse is caring for a client with allergic rhinitis. The client asks the nurse about measures to help decrease allergic symptoms. Which is the best response by the nurse? a. "You need to see your ear, nose, and throat specialist monthly." b. "Be sure to receive your influenza vaccination each year." c. "You should try to reduce exposure to irritants and allergens." d. "Take over-the-counter nasal decongestants when you experience symptoms."

c. "You should try to reduce exposure to irritants and allergens."

You are presenting a workshop at the senior citizens center about how the changes of aging predisposes clients to vascular occlusive disorders. What would you name as the most common cause of peripheral arterial problems in the older adult? a. Aneurysm b. Coronary thrombosis c. Atherosclerosis d. Raynaud's disease

c. Atherosclerosis

A client presents to the emergency department with fluid overload. The nurse is concerned about fluid accumulation in the lungs. On which of the following areas would the nurse focus the lung assessment? a. Right lower lobe b. Anterior bronchial tree c. Bilateral lower lobes d. Posterior bronchioles

c. Bilateral lower lobes

The nurse is assessing a patient with severe hypertension. When performing a focused assessment of the eyes, what does the nurse understand may be observed related to the hypertension? a. Retinal detachment b. Glaucoma c. Papilledema d. Cataracts

c. Papilledema

You are caring for a client status post lung resection. When assessing your client you find that the bubbling in the water-seal chamber for the chest tubes is more than you expected. What should you check when bubbling in the water-seal chamber is excessive? a. See if the wall suction unit has malfunctioned. b. See if a kink has developed in the tubing. c. See if there are leaks in the system. d. See if the chest tube is clogged.

c. See if there are leaks in the system.

An 80-year-old man, newly diagnosed with primary hypertension, has just been started on a beta-blocker. The nurse knows that in addition to teaching the patient about his medication (ie, side effects, purpose, and schedule), she should also focus her teaching on what? a. Maintaining a diet high in dairy to increase protein necessary to prevent organ damage b. Limiting exercise to avoid injury that can be caused by postural hypotension c. Use of supportive devices such as hand rails and walkers to prevent falls stemming from postural hypotension d. Limiting fluids in order to decrease vascular volume

c. Use of supportive devices such as hand rails and walkers to prevent falls stemming from postural hypotension

The nurse auscultates the apex beat at which anatomical location? a. 2.5 cm to the left of the xiphoid process b. 5 cm to the left of the lower end of the sternum c. fifth intercostal space, midclavicular line d. midsternum

c. fifth intercostal space, midclavicular line

The classification of Stage III of COPD is defined as a. very severe COPD. b. moderate COPD. c. severe COPD. d. at risk for COPD. e. mild COPD.

c. severe COPD.

A client with emphysema is at a greater risk for developing which acid-base imbalance? a.respiratory alkalosis b.metabolic acidosis c.chronic respiratory acidosis d.metabolic alkalosis

c.chronic respiratory acidosis

What is the term for the ability of the cardiac muscle to shorten in response to an electrical impulse? a. repolarization b. depolarization c. contractility d. diastole

c. contractility

You are doing an admission assessment on a client who is having outpatient testing done for cardiac problems. What should you ask this client during your assessment? a. "Have you had any episodes of dizziness or fainting?" b. "Have you had any episodes when you are to nauseous?" c. "Have you had any episodes of mottling in your hands?" d. "Have you had any episodes of pain radiating into your lower extremities?"

a. "Have you had any episodes of dizziness or fainting?"

A 61-year-old man has a longstanding history of peripheral artery disease that has progressed in recent months to acute limb ischemia (ALI). As a result, he has just undergone bilateral arterial bypass grafts and is postoperative day 1. The nurse's most recent assessment reveals that the patient's left foot is cold to touch and dusky in appearance with nonpalpable peripheral pulses. How should the nurse respond to this assessment finding? a. Report the finding to the surgeon immediately. b. Encourage the patient to perform light activity and assist with range of motion exercises. c. Place a warm compress on the patient's foot to stimulate circulation. d. Administer a dose of the patient's prescribed anticoagulant.

a. Report the finding to the surgeon immediately.

A patient with a history of poorly controlled type 1 diabetes has begun displaying the characteristic signs and symptoms of diabetic nephropathy. The patient's nurse recognizes that the patient is at risk of disruptions to fluid balance. What role do the kidneys play in the maintenance of normal fluid balance? a. Selectively retaining needed substances and excreting waste products b. Synthesizing and releasing angiotensin in cases of fluid volume deficit c. Maintaining the correct concentration of H+ ions in the blood d. Secreting or withholding antidiuretic hormone in response to extracellular fluid volume

a. Selectively retaining needed substances and excreting waste products

A patient comes to the clinic for the third time in 2 months with chronic bronchitis. What clinical symptoms does the nurse anticipate assessing for this patient? a. Sputum and a productive cough b. Fever, chills, and diaphoresis c. Chest pain during respiration d. Tachypnea and tachycardia

a. Sputum and a productive cough

The nurse is instructing the patient with asthma in the use of a newly prescribed leukotriene receptor antagonist. What should the nurse be sure to include in the education? a. The patient should take the medication an hour before meals or 2 hours after a meal. b. The patient should take the medication separately without other medications. c. The patient should take the medication with a small amount of liquid. d. The patient should take the medication with meals since it may cause nausea.

a. The patient should take the medication an hour before meals or 2 hours after a meal

A patient has returned to the cardiac care unit after undergoing cardioversion. When providing care for this patient during the immediate recovery period, the nurse should prioritize assessments related to: a. Thromboembolism b. Infectious cardiac disorders c. Acute renal failure d. Visual and auditory disturbances

a. Thromboembolism

During discharge teaching, a nurse is instructing a client about pneumonia. The client demonstrates his understanding of relapse when he states that he must: a. continue to take antibiotics for the entire 10 days. b. turn and reposition himself every 2 hours. c. maintain fluid intake of 40 oz (1,200 ml) per day. d. follow up with the physician in 2 weeks.

a. continue to take antibiotics for the entire 10 days.

The nurse understands that an overall goal of hypertension management is that a. there is no indication of target organ damage. b. there is no report of postural hypotension. c. the client maintains a normal blood pressure reading. d. there are no reports of sexual dysfunction.

a. there is no indication of target organ damage.

The amount of air inspired and expired with each breath is called: a. tidal volume. b. residual volume. c. dead-space volume. d. vital capacity.

a. tidal volume.

A nurse on a busy medical unit is aware of the importance of accurate blood pressure (BP) measurement. To ensure accuracy when assessing patients' blood pressures, the nurse should always: a. Alternate blood pressure readings between patients' right and left arms b. Ensure that the correct cuff size is used for each patient c. Take serial blood pressure readings on each patient d. Use a manual, rather than automated, sphygmomanometer

b. Ensure that the correct cuff size is used for each patient

A client has recently been diagnosed with malignant lung cancer. The nurse is calculating the client's smoking history in pack-years. The client reports smoking two packs of cigarettes a day for the past 11 years. The nurse correctly documents the client's pack-years as a. 11. b. 22. c. 5. d. 10.

b. 22.

A client presents to the emergency department via ambulance with a heart rate of 210 beats/minute and a sawtooth waveform pattern per cardiac monitor. The nurse is most correct to alert the medical team of the presence of a client with which disorder? a. Ventricular fibrillation b. Atrial flutter c. Premature ventricular contraction d. Asystole

b. Atrial flutter

You are caring for a client who is 42-years-old and status post adenoidectomy. You find the client in respiratory distress when you enter their room. You ask another nurse to call the physician and bring an endotracheal tube into the room. What do you suspect? a. Infection b. Edema of the upper airway c. Post operative bleeding d. Plugged tracheostomy tube

b. Edema of the upper airway

A client with venous insufficiency asks the nurse what they can do to decrease their risk of complications. What advice should the nurse provide to clients with venous insufficiency? a. Elevate the legs periodically for at least an hour. b. Elevate the legs periodically for at least 15 to 20 minutes. c. Avoid foods with iodine. d. Refrain from sexual activity for a week.

b. Elevate the legs periodically for at least 15 to 20 minutes.

While doing rounds at the beginning of a shift, the nurse notices a sputum specimen sitting on the bedside table in a patient's room and asks the patient when she produced the sputum specimen. Learning the specimen is about 4 hours old, what action should the nurse take? a. Refrigerate the sputum specimen. b. Immediately take the sputum specimen to the laboratory. c. Wait an additional 2 hours before sending the specimen to the laboratory. d. Discard the specimen and assist the patient in obtaining another specimen

d. Discard the specimen and assist the patient in obtaining another specimen

The nurse identifies which of the following as a potential cause of premature ventricular complexes (PVCs)? a. Hypovolemia b. Bradycardia c. Alkalosis d. Hypokalemia

d. Hypokalemia

Which rhythm is also termed a ventricular escape rhythm? a. First degree AV block b. Ventriuclar asystole c. Ventricular fibrillation d. Idioventricular rhythm

d. Idioventricular rhythm

A nurse is providing instructions for the client with chronic rhinosinusitis. The nurse accurately tells the client: a. Do not perform saline irrigations to the nares. b. Caffeinated beverages are allowed. c. You may drink 1 glass of alcohol daily. d. Sleep with the head of bed elevated.

d. Sleep with the head of bed elevated.

A patient with diabetes insipidus presents to the emergency room for treatment of dehydration. The nurse knows to review serum laboratory results for which of the diagnostic indicators? a. Potassium level of 3.8 mEq/L b. Potassium level of 6 mEq/L c. Sodium level of 137 mEq/L d. Sodium level of 150 mEq/L

d. Sodium level of 150 mEq/L

The nurse is admitting a client who just had a bronchoscopy. Which assessment should be the nurse's priority? a. Medication allergies b. Presence of carotid pulse c. Ability to deep breathe d. Swallow reflex

d. Swallow reflex

Mr. Faulkner is a 69-year-old man who has enjoyed generally good health for his entire adult life. As a result, he has been surprised to receive a new diagnosis of hypertension after a series of visits to his primary care provider. The nurse who is working with Mr. Faulkner should recognize which of the following aspects of aging and hypertension? a. Older adults are less vulnerable to the pathophysiological effects of hypertension than are younger adults. b. The diagnostic criteria for hypertension in adults over 65 differ from those for younger adults. c. Blood pressure remains stable throughout adulthood but tends to be assessed more often by health care providers of older adults. d. The incidence and prevalence of hypertension increase with age.

d. The incidence and prevalence of hypertension increase with age.

The nurse is caring for a client diagnosed with chronic obstructive pulmonary disease (COPD) and experiencing respiratory acidosis. The client asks what is making the acidotic state. The nurse is most correct to identify which result of the disease process that causes the fall in pH? a. The lungs have ineffective cilia from years of smoking. b. The lungs are unable to exchange oxygen and carbon dioxide. c. The lungs are unable to breathe in sufficient oxygen. d. The lungs are not able to blow off carbon dioxide.

d. The lungs are not able to blow off carbon dioxide.