Theory Quizzes
Which of the following processes must be in place in order for gas exchange to occur? metabolism ventilation perfusion immunosuppression transport
ventilation perfusion transport
A patient is using an ophthalmic beta-blocking agent for the treatment of glaucoma. Which instruction will the nurse give to the patient to prevent orthostatic hypotension? "Change positions quickly after administering the drops." "Take your pulse at least four times daily." "Apply pressure to the inside corner of your eye when administering the drops." "Lay down for 10 minutes after administering the drops."
"Apply pressure to the inside corner of your eye when administering the drops."
The patient tells the nurse that he keeps getting "pimples" in his ear canals from his hearing aid. Which is the nurse's best recommendation for the patient? "Clean your hearing aid with rubbing alcohol every evening and let it dry overnight." "Apply a small amount of benzoyl peroxide cream to the inside of your ear canals before you insert your hearing aid." "Clean your hearing aid with mild soap and water and make sure that it is completely dry before inserting it in your ears." "Clean your ears with half-strength hydrogen peroxide twice a day before you put in your hearing aid and after you take it out."
"Clean your hearing aid with mild soap and water and make sure that it is completely dry before inserting it in your ears."
The patient with diarrhea would be at greatest risk for which of the following conditions? hypernatremia hyperkalemia fluid volume excess hypocalcemia
hypernatremia
A hospitalized client with late-stage Alzheimer's disease says that breakfast has not been served. The nurse witnessed the client eating breakfast earlier. Which is the best approach to the patient? "I will get you some toast, you must be hungry." "You are confused about mealtimes this morning." "You ate your breakfast 30 minutes ago." "You just finished eating, you'll have lunch at noon."
"I will get you some toast, you must be hungry."
The nurse is caring for a client who has acute viral gastroenteritis. Which dietary instruction will the nurse provide to the client? "Drink plenty of water to prevent dehydration." "You can have any kind of clear liquids to drink." "Drink Gatorade if you do not like the taste of Pedialyte." "You can have sips of cola or ginger ale to help relieve the nausea."
"Drink Gatorade if you do not like the taste of Pedialyte."
Which client statement indicates understanding regarding antibiotic therapy for recurrent urinary tract infections? "If my urine becomes lighter and clear, I can stop taking my medicine." "Even if I feel completely well, I should take the medication until it is gone." "When my urine no longer burns, I will no longer need to take the antibiotics." "If my temperature goes above 100° F (37.8° C), I should take twice as much medicine."
"Even if I feel completely well, I should take the medication until it is gone."
Which statement indicates that the patient needs further teaching regarding activities that increase intraocular pressure? "I will avoid wearing tight shirt collars and ties." "I will take a stool softener to prevent straining and constipation. " "I will try not to sneeze, cough or blow my nose." "I will avoid placing my arms above my head."
"I will avoid placing my arms above my head."
The patient with Alzheimer's disease is being cared for at home. What safety instruction should the nurse include in teaching the family? "Keep exercise to a minimum." "Place a padded throw rug at the bedside." "Install deadbolt locks on all outside doors." "Keep the lights off in the bedroom at night."
"Install deadbolt locks on all outside doors."
A patient is newly diagnosed with multiple sclerosis. The woman is obviously uupset and asks "Am I going to die?". The nurse's best response is which of the following? "No, most people with this disease live a normal lifespan." "Is your familiy here? I would like to talk with everyone at once?" "Why don't you talk with your physician? She will be able to give you the details." "The prognosis varies and usually includes remissions and exacerbations."
"The prognosis varies and usually includes remissions and exacerbations."
While planning care for the patient with Parkinson's disease the nurse collaborates with the physical therapist for which purpose? Maintaining the ability to perform ADLs. Modifying eating utensils for meals. Methods to improve bladder continence. Maximizing nutritional intake.
Maintaining the ability to perform ADLs.
The patient with Parkinson's disease is experiencing constipation and irregularity. Which of the following should the nurse instruct the patient to do? Eat one banana daily. Decrease fluid intake. Take laxatives twice daily. Increase fiber in the diet.
Increase fiber in the diet.
The patient is complaining of mild itching and slight swelling following cataract surgery. What is the nurse's most appropriate action? Inform the patient that this is normal. Contact the surgeon for an antibiotic order. Arrange for the surgeon to see the patient between cases. Inform the patient he will need to stay until the itching resolves.
Inform the patient that this is normal.
The patient has hypercalcemia, Which of the following is the priority nursing action? Initiate telemetry monitoring Check deep tendon reflexes Determine when patient had last stool Request SCDs to prevent DVT
Initiate telemetry monitoring
Which of the following people is at greatest risk for a fluid/electrolyte disturbance? 78-year-old man experiencing chronic diarrhea. 43- year-old woman taking calcium supplements daily. 68-year-old man who drinks 24 ounces of water daily. 58- year-old woman with mild renal disease.
78-year-old man experiencing chronic diarrhea.
During assessment of the patient with Parkinson's disease, the nurse notes that the patient has a masklike facies. Which functional assessment does the nurse make based on the findings? Ability to hear normal voice tones Ability chew and swallow Ability to sense pain in the facial area Ability to see clearly
Ability chew and swallow
a 65-year-old male complains of hearing loss and a sense of fullness in both ears. The nurse examines his ears with the understanding that a common cause of hearing loss in older adults is related to: Accumulation of cerumen in the external canal. Chronic external otitis. Exostosis
Accumulation of cerumen in the external canal.
The clinical unit is exceptionally busy due to several sudden admissions. The nurse is to hang heparin and is unable to locate another team member available to double check the medication per protocol. The nurse decides to hang the medication and check it later. 2 hours later the nurse and another team member check the heparin infusion and discover it has been infusing at too fast of a rate. What type of error has the nurse been involved in? Active error at the "sharp end" of patient care. Latent error at the "blunt end" of patient care. Preventative error at the unit level. Communication error at the system level.
Active error at the "sharp end" of patient care.
The patient is admitted with a rapid heart and respiratory rate, elevated blood pressure, decreased hemoglobin, elevated PT and slowed capillary refill. Which of the following best describes the problem the patient is experiencing? Altered tissue perfusion Reduced ventilation Altered sensation Clotting abnormalities.
Altered tissue perfusion
Which person is at greatest risk for developing a community-acquired pneumonia? A middle-aged first-grade teacher who typically eats a diet of Asian foods An older adult who smokes and has a substance abuse problem An older adult with exercise-induced wheezing A young adult aerobics instructor who skips meals and is a vegetarian
An older adult who smokes and has a substance abuse problem
The nurse is caring for a patient who is immobile from a recent stroke. Which intervention does the nurse implement to prevent complications in this patient? Position the client with the unaffected side down. Apply sequential compression stockings. Instruct the client to turn the head from side to side. Teach the client to touch and use both sides of the body.
Apply sequential compression stockings.
The nurse is caring for a patient with asthma exacerbation. Which of the following medications should the nurse anticipate as possibly part of the treatment regimen? Beta-adrenergic bronchodilator (albuterol nebulizer) anti-coagulants (aspirin 81 mg) supplemental oxygen (6 liters via mask) systemic corticosteroids (prednisone 20 mg) diuretics (furosemide 20 mg)
Beta-adrenergic bronchodilator (albuterol nebulizer) supplemental oxygen (6 liters via mask) systemic corticosteroids (prednisone 20 mg)
A nurse is caring for a client who has had rheumatoid arthritis (RA) for 5 years. Which laboratory value requires the most immediate intervention by the nurse? White blood cell count (WBC), 3800/mm3 Hemoglobin (Hgb), 10.6 g/dL Blood urea nitrogen (BUN), 16 mg/dL Creatinine, 3.2 mg/dL
Blood urea nitrogen (BUN), 16 mg/dL
Which assessment alerts the nurse to the possible presence of a cataract? Loss of central vision Loss of peripheral vision Dull aching in the eye and brow areas Blurred vision and reduced color perception
Blurred vision and reduced color perception
The patient has a latex allergy and is exposed in the health care setting. The nurse notes the patient is short of breath, appears anxious and has crackles in his lungs. Given these findings, which is the most appropriate action to carry out first? Take vitals and monitor the patient. Call the rapid response team (RRT). Inquire about previous responses to latex exposure. Ensure latex allergy is documented in the health record.
Call the rapid response team (RRT).
The patient calls the RN and states she needs to go to the bathroom. The RN asks the unlicensed assistive personnel (UAP) to assist the patient. Which aspect of care is the RN most specifically demonstrating? Collaboration Delegation Patient-Centered Care Evidence-Based Practice
Delegation
What is the most important means for preventing the spread or transmission of HIV? Engineering Education Isolation Counseling
Education
What age group is at a highest risk for Intracranial Regulation problems? ages 13-18 newborns Elderly over 65 ages 25-40
Elderly over 65
The patient has a venous thromboembolism and is on anticoagulation therapy. Which of the following should the nurse monitor for? Wheezing throughout lung fields Anorexia and weight loss Evidence of excess bruising Blood sugar elevations
Evidence of excess bruising
Which safety precautions should the nurse implement when caring for a hospitalized patient with seizures? Have suction equipment at the bedside. Use padded side rails per agency protocol. Permit only clear oral fluids. Keep bed rails up per agency protocol. Maintain the patient on strict bedrest. Ensure that the patient has IV access.
Have suction equipment at the bedside. Use padded side rails per agency protocol. Keep bed rails up per agency protocol. Ensure that the patient has IV access.
A 75-year-old has been taking furosemide (Lasix) regularly for 4 months when he tells the nurse he has been having trouble hearing. What is the nurse's best response to the patient's concern? Tell him that with his age he is likely to have hearing loss. Have the patient immediately report the hearing loss to his physician. Schedule the patient for audiometric testing and hearing aid evaluation. Tell the patient that the hearing loss is only temporary, once he is off the medication it will end.
Have the patient immediately report the hearing loss to his physician.
The patient exhibits cardiac dysrhythmia, weakness and constipation and has a history of a cardiac condition requiring the use of loop diuretics. Which condition does the nurse suspect the patient is experiencing? Hyponatremia Hypocalcemia Hypokalemia Hypomagnesemia
Hypokalemia
The nurse on a medical-surgical unit notices there has been an increase in the number of patient falls. Which methods would be effective in promoting quality improvement on this issue? Select all that apply. Identify causes of falls by reviewing specific patient cases. Review current research and literature on methods to prevent falls. Bring concerns to the manager regarding possible neglect by staff. Use a sit-stand alarm because these have helped other units decrease fall rates. Work with the nurse aid to make ensure implementation of current fall prevention measures.
Identify causes of falls by reviewing specific patient cases Review current research and literature on methods to prevent falls. Use a sit-stand alarm because these have helped other units decrease fall rates. Work with the nurse aid to make ensure implementation of current fall prevention measures.
On assessing a client's lower extremities, the nurse notices that one leg is pale and cooler to the touch. These symptoms are most characteristic of what condition? Anemia Impaired tissue perfusion Normal aging process Shock
Impaired tissue perfusion
A short time after cataract surgery the patient complains of nausea. Which of the following is the nurse's best response to the complaint? Instruct the patient to take a few deep breaths until the nausea subsides. Explain that this is a common side effect of medications and it will pass. Tell the patient to call the nurse promptly if vomitting occurs. Medicate the patient with an anti-emetic as ordered.
Medicate the patient with an anti-emetic as ordered.
What disease process causes inflammation problems in intracranial regulations? Stroke Mengingitis Seizures Alzheimer's
Mengingitis
The nurse is caring for a patient experiencing fluid volume excess and being treated with diuretic medication. Which of the following is the most appropriate action to assess effectiveness of treatment? Encourage the patient to reduce sodium-containing foods. Auscultate lung sounds every 2 hours. Monitor input and output along with daily weight. Teach the patient to increase potassium intake through diet.
Monitor input and output along with daily weight.
The nurse is caring for 2 patients, one who has had a stroke and one with multiple sclerosis. Which complication common to both disorders will the nurse monitor for? cogwheel type gait Impared cognition difficulty swallowing Non-intention type tremors
Non-intention type tremors
The nurse is caring for a patient with a serum sodium level of 155 mEq/L. (normal 134-145 mEq/L) The patient is weak and confused, only oriented to self. What nursing intervention is most appropriate at this time? Place the nurse call light within reach. Implement fluid restriction. Administer antiemetic medication. Initiate seizure precautions.
Place the nurse call light within reach.
The patient has had abdominal surgery and has decreased mobility due to pain and fatigue. The patient is started on warfarin therapy. Which of the following best describes the reason for warfarin therapy? Reduce workload of the heart and improve fatigue. Improve tissue perfusion by managing hypertension. Assist to manage incisional pain and healing. Prevent clots which could lead to DVT and pulmonary embolism.
Prevent clots which could lead to DVT and pulmonary embolism.
Why is it important for patients with atrial fibrillation to take anticoagulants as prescribed? Prevent stroke associated with clot development. . Thin the blood to make it easier to pump. Treat the cause of atrial fibrillation. Break up any clots which form.
Prevent stroke associated with clot development. .
The patient with COPD is noted to have a barrel-shaped chest and becomes short of breath while completing typical daily cares. Which of the following is the nurse's best response to these findings? Notify the physician, ask for an evaluation of the chest. Encourage patient to try to finish cares more quickly. Provide the patient with extra time to complete daily activities. Inquire about the shape of the chest and how long it has been this way.
Provide the patient with extra time to complete daily activities.
The patient uses timolol maleare (Timoptic) eyedrops. What is the action of this drug related to glaucoma treatment? Constriction of pupils. Dilating the canals of Schlemm. Reducing aqueous humor formation. Improving the ability of the ciliary muscle to contract.
Reducing aqueous humor formation.
The patient is 58 years-old, has smoked 1 pack of cigarettes daily for 44 years, has a history of alcoholism, uses a walker to ambulate and lives in a rural area. Which action is most appropriate to reduce the patient"s modifiable risk factor for gas exchange impairment? Encourage breathing excercises Encourage the patient to move to an urban area Refer the patient for respiratory therapy evaluation Refer the patient for smoking cessation counseling
Refer the patient for smoking cessation counseling
Which of the following is most appropriate to teach the patient to manage claudication pain associated with peripheral arterial disease (PAD)? Take warm baths daily. Slow or stop walking if pain occurs. Wear antiembolism stockings daily. Ensure feet are elevated 3 times daily
Slow or stop walking if pain occurs.
The patient asks the nurse how to decrease morning stiffness due to rhuematoid arthritis. Which of the following should the nurse recommend? Wear warm, loose-fitting clothes. Plan short rest breaks throughout the day. Avoid excess physical stress and fatigue. Take a hot bath or shower in the morning.
Take a hot bath or shower in the morning.
Which of the following best describes the importance of using a system such as SBAR to communicate patient information? SBAR helps the nurse to recall patient problems and concerns. The SBAR format provides a systematic way to improve safety through communication. SBAR is a key component of the 5 QSEN competencies for nurses. The SBAR tool encourages patients to be an active participant in their care.
The SBAR format provides a systematic way to improve safety through communication.
The patient is receiving services from multiple disciplines including nursing, medicine, dietician and physical and speech therapy. Which of the following demonstrates the most effective way for the group to communicate. The designated team leader tells the group what the patient needs from each one. The physician emails the group to express her concerns with the patient's progress. The group participates in patient rounds together. The group provides written progress notes in the chart.
The group participates in patient rounds together.
The patient is admitted to outpatient surgery for a cataract removal. The patient asks, "What causes cataracts in old people?" Which of the following is the most appropriate response? Chronic disease such as heart conditions lead to cataracts. The normal aging process leads to cataracts. Injuries to the eye when you were younger probably leads to cataracts. If you used drugs at any time you will likely have cataracts.
The normal aging process leads to cataracts.
The nurse is caring for a patient with chronic pancreatitis. The patient states she prefers to eat roasted chicken rather than fried. How does the nurse interpret the patient's statement? The patient needs further education regarding her diet. The patient appears to understand dietary restrictions. The patient needs assistance to prepare her meals and a referral will be made. The patient needs assistance to prepare her meals and a referral will be made.
The patient appears to understand dietary restrictions
The patient with meningitis reports pain in the left hand, the radial pulse is very weak, the hand feels cool and capillary refill is sluggish. Faint purplish spots are noted on the left hand and wrist. How does the nurse interpret the findings? This is a common and expected finding. The patient has vascular complications developing. The symptoms are likely related to medication side effects. This is an abnormal finding but not associated with meningitis.
The patient has vascular complications developing.
The patient with a history of asthma develops shortness of breath and anxiety. Which is the best interpretation of the findings? The patient likely has emotional stress and needs reassurance. The patient is displaying early signs of an asthma exacerbation and needs a short-acting bronchodilator. The patient shows signs of an irreversible asthma complication. The patient is in status asthmaticus and needs aggressive emergency treatment.
The patient is displaying early signs of an asthma exacerbation and needs a short-acting bronchodilator.
The nurse is conducting a health screening and the patient describes a family history of hypertension. Which assessment finding would indicate the nurse needs to include teaching about prevention of a stroke (brain attack). The patient describes eating oatmeal for breakfast each day. The patient has a blood pressure of 136/78. The patient uses oral contraceptives. The patient is the manager of a busy retail store and jogs 2 miles daily.
The patient uses oral contraceptives.
The patient with peripheral arterial disease and claudication tells the nurse that burning pain has started awakening him from sleep. What is the most appropriate interpretion of the patient's report? The patient has developed venous thrombosis. The patient is now at risk for a stroke The patient's disease is worsening. The patient needs assessed for hypertension
The patient's disease is worsening.
The patient is given an antibiotic via IV infusion and begins to have an allergic response. Which of the following if noted would indicate the patient is progressing to anaphylactic response? dry throat wheezing stuffy nose decreased blood pressure anxiety
wheezing decreased blood pressure anxiety
The patient with asthma and COPD has been provided albuterol for treatment of his condition. Which of the following is most appropriate for the nurse include in patient teaching? This medication is used for short-term relief of symptoms such as wheezing. In order to maintain medication effectiveness take it as prescribed every day. This medication may cause yeast infections, report mouth sores if they occur. In order to be effective, this medication requires the use of oral corticosteroids.
This medication is used for short-term relief of symptoms such as wheezing.
Intracranial regulation would be a priority concern for the nurse caring for the patient with which of the following admission diagnosis? Faliure to thrive Rhuematoid arthritis Pnuemonia Traumatic brain injury
Traumatic brain injury
(T or F) A disruption in cerebral perfusion can lead to a variety of intracranial regulation problems.
True
(T or F) Intracranial Regulation involves the mechanisms and conditions that impact function and intracranial processing
True
(T or F) The use of the electronic health record is one example of Informatics in healthcare.
True
The nurse suspects a change in the patient's level of consciousness. Which assessment is most appropriate for the nurse to evaluate the change? Ask the client to state her name, where she is, and what time it is. Ask the patient to repeat a series of numbers stated. Use the Glascow Coma scale Evaluate all cranial nerves
Use the Glascow Coma scale
The patient demonstrates a decline in stability including increased heart rate, decreasing blood pressure and decreasing responsiveness. Which action by the nurse demonstrates the most appropriate way to protect the patient from harm? activate the rapid response team (RRT) notify the charge nurse of the change contact the interdisciplinary team review the shift report received
activate the rapid response team (RRT)
In assessing clients' risks for development of any type of cancer, the nurse identifies which as the greatest risk? advancing age Cigarette smoking Genetic predisposition Declining immune function
advancing age
The patient with COPD demonstrates low albumin levels, weight loss and areas of mild skin breakdown. Which of the following is the nurse most concerned about at this time? breathing effectiveness episodes of anxiety chronic fatigue respiratory infections
breathing effectiveness
The patient has started a new antihypertensive medication. Which of the following indicates the patient is experiencing a side effect of the medication? Heart rate 78 dizziness, lightheadedness Blood pressure 156/82 cool legs with no hair present
dizziness, lightheadedness
A nurse notices that a patient has ascites, which indicates the presence of fluid. feces. flatus. fibroid tumors.
fluid.
The patient is taking the diuretic furosemide (Lasix). Which assessment if present indicates the patient may be suffering an electrolyte disturbance related to the medication? generalized weakness diarrhea deep and rapid respirations increased deep tendon reflexes
generalized weakness
Which assessment finding does the nurse expect in the patient with atrial fibrillation? irregular heart rate weakness on the left side blood pressure 160/100 loss of hair on the lower legs
irregular heart rate
Which of the following demonstrates an appropriate way to improve medication safety? Instruct the patient to: choose a nurse as his advocate. avoid questioning the treatment plan. keep a list of current medications and their use. utilize any near-by health care facility when needed.
keep a list of current medications and their use.
Which of the following indicates the patient has a gas exchange problem? labored breathing pulse ox reading 94% slowed capillary refill wheezing heard on auscultation weakness on left side
labored breathing pulse ox reading 94% wheezing heard on auscultation
The patient is experiencing hyponatremia. Which nursing assessment would be most helpful in determining if the condition is worsening? urinary output lung sounds heart rate and rhythm level of consciousness
level of consciousness
Which of the following symptoms would indicate possible onset of multiple sclerosis (MS)? hyperresponsive reflexes somnolence nystagmus heat intolerance
nystagmus
Cerebral edema negatively affects which of the following in the cranium? perfusion and oxygenation neurotransmission and mobility functional ability brain tumors
perfusion and oxygenation
The patient who has a diagnosis of COPD is noted to be using oxygen at 5 liters per nasal canula. Which of the following is the nurse's best response to this finding? check the patient's pulse ox question the amount of oxygen being used assess for the presence of wheezing review the patient's smoking history
question the amount of oxygen being used
The nurse is caring for the patient experiencing nausea and vomiting. Which of the following assessments if present is most indicative of a fluid volume deficit? seizure activity dyspnea rapid thready pulse constipation
rapid thready pulse
The client comes to the physician's office complaining of severe hay fever and allergic rhinitis. Which finding would the nurse expect to see upon assessment? red, itchy watery eyes decreased blood pressure anemia swollen joints
red, itchy watery eyes
Which of the following conditions demonstrates a neurological transmission problem of intracanial regulation? meningitis stroke alzheimer's seizures
seizures
Which of the following is used to track osmolality in the clinical setting? potassium levels sodium concentration calcium levels albumin concentration
sodium concentration
The patient has long-standing hypertension, smokes 1 pack per day and is 45 pounds overweight. Which finding indicates she has likely experienced a complication of her risk factors? wheezes throughout all lung fields palpitations and irregular heart rate slowed capillary refill sudden inability to talk
sudden inability to talk
What are signs that provide clues to a nurse that the patient is having possible problems with intracranial regulation? sudden severe headache blurry vision and slurred speech nausea and vomiting smiling and hunger
sudden severe headache blurry vision and slurred speech nausea and vomiting
Which population group has the highest risk for injury-related intracranial regulation problems? elderly population traditional college age students 40-50 year-olds children under 8 years-old
traditional college age students
The patient with asthma identifies that he frequently experiences symptoms with excercise. Which of the following should the nurse teach the patient regarding asthma management in this situation? use a corticosteroid medication just before excercise use a bronchodilator inhaler 30 minutes prior to excercise Avoid dust and smoke while excercising Avoid stressors and learn to manage anxiety
use a bronchodilator inhaler 30 minutes prior to excercise
Which of the following is a symptom of increased intracranial pressure? dehydration hunger vomiting leg pain
vomiting
