Caring for Patients with Chronic Conditions and Disabilities: A Comprehensive Guide, Exams of Nursing

Download Caring for Patients with Chronic Conditions and Disabilities: A Comprehensive Guide and more Exams Nursing in PDF only on Docsity! NURS 280 Chronic and Pal Care Exam 1 Questions and Answers from Actual Marking Scheme New 2024 Version Best Studying Material An elderly patient has presented to the clinic with a new diagnosis of osteoarthritis. The patients daughter is accompanying him and you have explained why the incidence of chronic diseases tends to increase with age. What rationale for this phenomenon should you describe? A) With age, biologic changes reduce the efficiency of body systems. B) Older adults often have less support and care from their family, resulting in illness. C) There is an increased morbidity of peers in this age group, and this leads to the older adults desire to also assume the sick role. D) Chronic illnesses are diagnosed more often in older adults because they have more contact with the health care system. ---------- Correct Answer --------- A A patient tells the nurse that her doctor just told her that her new diagnosis of rheumatoid arthritis is considered to be a chronic condition. She asks the nurse what chronic condition means. What would be the nurses best response? A) Chronic conditions are defined as health problems that require management of several months or longer. B) Chronic conditions are diseases that come and go in a relatively predictable cycle. C) Chronic conditions are medical conditions that culminate in disabilities that require hospitalization. D) Chronic conditions are those that require short-term management in extended-care facilities. ---------- Correct Answer --------- A A medical-surgical nurse is teaching a patient about the health implications of her recently diagnosed type 2 diabetes. The nurse should teach the patient to be proactive with her glycemic control in order to reduce her risk of what health problem? A) Arthritis B) Renal failure C) Pancreatic cancer D) Asthma ---------- Correct Answer --------- B A patient who undergoes hemodialysis three times weekly is on a fluid restriction of 1000 mL/day. The nurse sees the patient drinking a 355-mL (12 ounce) soft drink after the patient has already reached the maximum intake of fluid for the day. What action should the nurse take? A) Take the soft drink away from the patient and inform the dialysis nurse to remove extra fluid from the patient during the next dialysis treatment B) Document the patients behavior as noncompliant and notify the physician C) Further restrict the patients fluid for the following day and communicate this information to the charge nurse D) Reinforce the importance of the fluid restriction and document the teaching and the intake of extra fluid ---------- Correct Answer --------- D A patient with end-stage lung cancer has been admitted to hospice care. The hospice team is meeting with the patient and her family to establish goals for care. What is likely to be a first priority in goal setting for the patient? A) Maintenance of activities of daily living B) Pain control C) Social interaction D) Promotion of spirituality ---------- Correct Answer --------- B An international nurse has noted that a trend in developing countries is a decrease in mortality from some acute conditions. This has corresponded with an increase in the incidence and prevalence of chronic diseases. What has contributed to this decrease in mortality from some acute conditions? A) Improved nutrition B) Integration of alternative health practices C) Stronger international security measures D) Decrease in obesity ---------- Correct Answer --------- A A 37-year-old woman with multiple sclerosis is married and has three children. The nurse has worked extensively with the woman and her family to plan appropriate care. What is the nurses most important role with this patient? A) Ensure the patient adheres to all treatments B) Provide the patient with advice on alternative treatment options C) Provide a detailed plan of activities of daily living (ADLs) for the patient D) Help the patient develop strategies to implement treatment regimens ---------- Correct Answer --------- D A patient has recently been diagnosed with type 2 diabetes. The patient is clinically obese and has a sedentary lifestyle. How can the nurse best begin to help the patient increase his activity level? A) Set up appointment times at a local fitness center for the patient to attend. B) Have a family member ensure the patient follows a suggested exercise plan. C) Construct an exercise program and have the patient follow it. D) Identify barriers with the patient that inhibit his lifestyle change. ---------- Correct Answer --------- D A home care nurse is making an initial visit to a 68-year-old man. The nurse finds the man tearful and emotionally withdrawn. Even though the man lives alone and has no family, he has been managing well at home until now. What would be the most appropriate action for the nurse to take? A) Reassess the patients psychosocial status and make the necessary referrals B) Have the patient volunteer in the community for social contact C) Arrange for the patient to be reassessed by his social worker D) Encourage the patient to focus on the positive aspects of his life ---------- Correct Answer --------- A promotion initiative most directly addresses the factor that has been shown to contribute to this increase? A. A program to link residents with primary care providers B. A community-based weight-loss program C. A stress management workshop D. A cancer screening campaign ---------- Correct Answer --------- B A patient who has recently been diagnosed with chronic heart failure is being taught by the nurse how to live successfully with her chronic condition. Her ability to meet this goal will primarily depend on her ability to do which of the following? A) Lower her expectations for quality of life and level of function. B) Access community services to eventually cure her disease. C) Adapt her lifestyle to accommodate her symptoms. D) Establish good rapport with her primary care provider. ---------- Correct Answer -------- - C A major cause of health-related problems is the increase in the incidence of chronic conditions. This is the case not only in developed countries like the United States but also in developing countries. What factor has contributed to the increased incidence of chronic diseases in developing countries? A) Developing countries are experiencing an increase in average life span. B) Increasing amounts of health research are taking place in developing countries. C) Developing countries lack the health infrastructure to manage illness. D) Developing countries are simultaneously coping with emerging infectious diseases. -- -------- Correct Answer --------- D A patient with a spinal cord injury is being assessed by the nurse prior to his discharge home from the rehabilitation facility. The nurse is planning care through the lens of the interface model of disability. Within this model, the nurse will plan care based on what belief? A) The patient has the potential to function effectively despite his disability. B) The patients disabling condition does not have to affect his lifestyle. C) The patient will not require care from professional caregivers in the home setting. D) The patients disability is the most salient aspect of his personal identity. ---------- Correct Answer --------- A During the care conference for a patient who has multiple chronic conditions, the case manager has alluded to the principles of the interface model of disability. What statement is most characteristic of this model? A) This patient should be free to plan his care without our interference. B) This patient can be empowered and doesnt have to be dependent. C) This patient was a very different person before the emergence of these health problems. D) This patients physiological problems are the priority over his psychosocial status. ---- ------ Correct Answer --------- B The nurse is caring for a young adult male with a traumatic brain injury and severe disabilities caused by a motor vehicle accident when he was an adolescent. Where does the nurse often provide care for patients like this young adult? A) Adult day-care facilities B) Step-down units C) Medical-surgical units D) Pediatric units ---------- Correct Answer --------- C You are caring for a young woman who has Down syndrome and who has just been diagnosed with type 2 diabetes. What consideration should you prioritize when planning this patients nursing care? A) How her new diagnosis affects her health attitudes B) How her diabetes affects the course of her Down syndrome C) How her chromosomal disorder affects her glucose metabolism D) How her developmental disability influences her health management ---------- Correct Answer --------- D You are the nurse caring for a young mother who has a longstanding diagnosis of multiple sclerosis (MS). She was admitted to your unit with a postpartum infection 3 days ago. You are planning to discharge her home when she has finished 5 days of IV antibiotic therapy. With what information would it be most important for you to provide this patient? A) A succinct overview of postpartum infections B) How the response to infection differs in patients with multiple sclerosis C) The same information you would provide to a patient without a chronic condition D) Information on effective management of multiple sclerosis in the home setting --------- - Correct Answer --------- C You have admitted a new patient to your unit with a diagnosis of stage IV breast cancer. This woman has a comorbidity of myasthenia gravis. While you are doing the initial assessment, the patient tells you that she felt the lump in her breast about 9 months ago. You ask the patient why she did not see her health care provider when she first found the lump in her breast. What would be a factor that is known to influence the patient in seeking health care services? A) Lack of insight due to the success of self-managing a chronic condition B) Lack of knowledge about treatment options C) Overly sensitive patient reactions to health care services D) Unfavorable interactions with health care providers ---------- Correct Answer --------- D The community nurse is caring for a patient who has paraplegia following a farm accident when he was an adolescent. This patient is now 64 years old and has just been diagnosed with congestive heart failure. The patient states, Im so afraid about what is going to happen to me. What would be the best nursing intervention for this patient? A) Assist the patient in making suitable plans for his care. B) Take him to visit appropriate long-term care facilities. C) Give him pamphlets about available community resources. D) Have him visit with other patients who have congestive heart failure. ---------- Correct Answer --------- A An initiative has been launched in a large hospital to promote the use of people-first language in formal and informal communication. What is the significance to the patient when the nurse uses people-first language? A) The nurse knows more clearly who the patient is. B) The person is of more importance to the nurse than the disability. C) The patients disability is the defining characteristic of the patients life. D) The nurse knows that the patients disability is a curable condition. ---------- Correct Answer --------- B A patient who is recovering from a stroke expresses frustration about his care to the nurse, stating, It seems like everyone sees me as just a problem that needs fixing. This patients statement is suggestive of what model of disability? A) Biopsychosocial model B) Social model C) Rehabilitation D) Interface model ---------- Correct Answer --------- C The interface model of disability is being used to plan the care of a patient who is living with the effects of a stroke. Why should the nurse prioritize this model? A. It fosters dependency and rapport between the caregiver and the patient. B. It encourages the provision of care that is based specifically on the disability. C. It promotes interactions with patients focused on the root cause of the disability. D. It promotes the idea that patients are capable and responsible. ---------- Correct Answer --------- D A nurse knows that patients with invisible disabilities like chronic pain often feel that their chronic conditions are more challenging to deal with than more visible disabilities. Why would they feel this way? A. Invisible disabilities create negative attitudes in the health care community. B. Despite appearances, invisible disabilities can be as disabling as visible disabilities. C. Disabilities, such as chronic pain, are apparent to the general population. D. Disabilities. Such as chronic pain, may not be curable, unlike visible disabilities. ------- --- Correct Answer --------- B A man and woman are in their early eighties and have provided constant care for their 44-year-old son who has Down syndrome. When planning this familys care, the nurse should be aware that the parents most likely have what concerns around what question?A.What could we have done better for our son? B.Why was our son born with Down syndrome while our other children are healthy? C.Who will care for our son once were unable? D.Will we experience the effects of developmental disabilities late in life? ---------- Correct Answer --------- C A) The patient may be trying to protect loved ones from the emotional effects of the illness. B) The patient is being noncompliant in order to assert power over caregivers. C) The patient may be skeptical of the benefits of the Western biomedical model of health. D) The patient thinks that treatment does not provide him comfort. ---------- Correct Answer --------- A A nurse who sits on the hospitals ethics committee is reviewing a complex case that has many of the hallmarks of assisted suicide. Which of the following would be an example of assisted suicide? A) Administering a lethal dose of medication to a patient whose death is imminent B) Administering a morphine infusion without assessing for respiratory depression C) Granting a patients request not to initiate enteral feeding when the patient is unable to eat D) Neglecting to resuscitate a patient with a do not resuscitate order ---------- Correct Answer --------- A A medical nurse is providing palliative care to a patient with a diagnosis of end-stage chronic obstructive pulmonary disease (COPD). What is the primary goal of this nurses care? A) To improve the patients and familys quality of life B. To support aggressive and innovative treatments for cure C. To provide physical support for the patient D. To help the patient develop a separate plan with each discipline of the health care team ---------- Correct Answer --------- A After contributing to the care of several patients who died in the hospital, the nurse has identified some lapses in the care that many of these patients received toward the end of their lives. What have research studies identified as a potential deficiency in the care of the dying in hospital settings? A. Families needs for information and support often go unmet. B. Patients are too sedated to achieve adequate pain control. C. Patients are not given opportunities to communicate with caregivers. D. Patients are ignored by the care team toward the end of life. ---------- Correct Answer --------- A An adult oncology patient has a diagnosis of bladder cancer with metastasis and the patient has asked the nurse about the possibility of hospice care. Which principle is central to a hospice setting? A. The patient and family should be viewed as a single unit of care. B. Persistent symptoms of terminal illness should not be treated. C. Each member of the interdisciplinary team should develop an individual plan of care. D. Terminally ill patients should die in the hospital whenever possible. ---------- Correct Answer --------- A A clinic nurse is providing patient education prior to a patients scheduled palliative radiotherapy to her spine. At the completion of the patient teaching, the patient continues to ask the same questions that the nurse has already addressed. What is the plausible conclusion that the nurse should draw from this? A) The patient is not listening effectively. B) The patient is noncompliant with the plan of care. C) The patient may have a low intelligence quotient or a cognitive deficit. D) The patient has not achieved the desired learning outcomes. ---------- Correct Answer --------- D The nurse is part of the health care team at an oncology center. A patient has been diagnosed with leukemia and the prognosis is poor, but the patient is not yet aware of the prognosis. How can the bad news best be conveyed to the patient? A) Family should be given the prognosis first. B) The prognosis should be delivered with the patient at eye level. C) The physician should deliver the news to the patient alone. D) The appointment should be scheduled at the end of the day. ---------- Correct Answer --------- B A patient has just been told that her illness is terminal. The patient tearfully states, I cant believe I am going to die. Why me? What is your best response? A) I know how you are feeling. B) You have lived a long life. C) This must be very difficult for you. D) Life can be so unfair. ---------- Correct Answer --------- C The nurse has observed that an older adult patient with a diagnosis of end-stage renal failure seems to prefer to have his eldest son make all of his health care decisions. While the family is visiting, the patient explains to you that this is a cultural practice and very important to him. How should you respond? A) Privately ask the son to allow the patient to make his own health care decisions. B) Explain to the patient that he is responsible for his own decisions. C) Work with the team to negotiate informed consent. D) Avoid divulging information to the eldest son. ---------- Correct Answer --------- C One aspect of the nurses comprehensive assessment when caring for the terminally ill is the assessment of hope. The nurse is assessing a patient with liver failure for the presence of hope. What would the nurse identify as a hope-fostering category? A) Uplifting memories B) Ignoring negative outcomes C) Envisioning one specific outcome D) Avoiding an actual or potential threat ---------- Correct Answer --------- A A medical nurse is providing end-of-life care for a patient with metastatic bone cancer. The nurse notes that the patient has been receiving oral analgesics for her pain with adequate effect, but is now having difficulty swallowing the medication. What should the nurse do? A) Request the physician to order analgesics by an alternative route. B) Crush the medication in order to aid swallowing and absorption. C) Administer the patients medication with the meal tray. D) Administer the medication rectally. ---------- Correct Answer --------- A A 66-year-old patient is in a hospice receiving palliative care for lung cancer which has metastasized to the patients liver and bones. For the past several hours, the patient has been experiencing dyspnea. What nursing action is most appropriate to help to relive the dyspnea the patient is experiencing? A) Administer a bolus of normal saline, as ordered. B) Initiate high-flow oxygen therapy. C) Administer high doses of opioids. D) Administer bronchodilators and corticosteroids, as ordered. ---------- Correct Answer - -------- D The nurse is caring for a patient who has terminal lung cancer and is unconscious. Which assessment finding would most clearly indicate to the nurse that the patients death is imminent? A) Mottling of the lower limbs B) Slow, steady pulse C) Bowel incontinence D) Increased swallowing ---------- Correct Answer --------- A A patient on the medical unit is dying and the nurse has determined that the familys psychosocial needs during the dying process need to be addressed. What is a cause of many patient care dilemmas at the end of life? A) Poor communication between the family and the care team B) Denial of imminent death on the part of the family or the patient C. Limited visitation opportunities for friends and family D. Conflict between family members ---------- Correct Answer --------- A The nurse is assessing a 73-year-old patient who was diagnosed with metastatic prostate cancer. The nurse notes that the patient is exhibiting signs of loss, grief, and intense sadness. Based on this assessment data, the nurse will document that the patient is most likely in what stage of death and dying? A. Depression B. Denial C. Anger D. Resignation ---------- Correct Answer --------- A You are caring for a 50-year-old man diagnosed with multiple myeloma; he has just been told by the care team that his prognosis is poor. He is tearful and trying to express his feelings, but he is having difficulty. What should you do first? A. Ask if he would like you to sit with him while he collects his thoughts. One of the functions of nursing care of the terminally ill is to support the patient and his or her family as they come to terms with the diagnosis and progression of the disease process. How should nurses support patients and their families during this process? Select all that apply. A) Describe their personal experiences in dealing with end-of-life issues. B) Encourage the patient and family to keep fighting as a cure may come. C) Try to appreciate and understand the illness from the patients perspective. D) Assist patients with performing a life review. E) Provide interventions that facilitate end-of-life closure. ---------- Correct Answer -------- - C, D, E The nurse is admitting a 52-year-old father of four into hospice care. The patient has a diagnosis of Parkinsons disease, which is progressing rapidly. The patient has made clear his preference to receive care at home. What interventions should the nurse prioritize in the plan of care? A) Aggressively continuing to fight the disease process B) Moving the patient to a long-term care facility when it becomes necessary C) Including the children in planning their fathers care D) Supporting the patients and familys values and choices ---------- Correct Answer ------ --- D A patient has just died following urosepsis that progressed to septic shock. The patients spouse says, I knew this was coming, but I feel so numb and hollow inside. The nurse should know that these statements are characteristic of what? A) Complicated grief and mourning B) Uncomplicated grief and mourning C) Depression stage of dying D) Acceptance stage of dying ---------- Correct Answer --------- B A 67-year-old woman experienced the death of her husband from a sudden myocardial infarction 5 weeks ago. The nurse recognizes that the woman will be going through the process of mourning for an extended period of time. What processes of mourning will allow the woman to accommodate the loss in a healthy way? Select all that apply. A) Reiterating her anger at her husbands care team B) Reinvesting in new relationships at the appropriate time C) Reminiscing about the relationship she had with her husband D) Relinquishing old attachments to her husband at the appropriate time E) Renewing her lifelong commitment to her husband ---------- Correct Answer --------- B, C, D A nurse has made a referral to a grief support group, knowing that many individuals find these both comforting and beneficial after the death of a loved one. What is the most important accomplishment available by attending a grief support group? A) Providing a framework for incorporating the old life into the new life B. Normalizing adaptation to a continuation of the old life C. Aiding in adjusting to using old, familiar social skills D. Normalization of feelings and experiences ---------- Correct Answer --------- D A patients daughter has asked the nurse about helping him end his terrible suffering. The nurse is aware of the ANA Position Statement on Assisted Suicide, which clearly states that nursing participation in assisted suicide is a violation of the Code for Nurses. What does the Position Statement further stress? A. Educating families about the moral implications of assisted suicide B. Identifying patient and family concerns and fears C. Identifying resources that meet the patients desire to die D. Supporting effective means to honor the patients desire to die ---------- Correct Answer --------- B A hospice nurse is caring for a 22-year-old with a terminal diagnosis of leukemia. When updating this patients plan of nursing care, what should the nurse prioritize? A. Interventions aimed at maximizing quantity of life B.Providing financial advice to pay for care C. Providing realistic emotional preparation for death D. making suggestions to maximize family social interaction after the patient death ------- --- Correct Answer --------- C A pediatric nurse is emotionally distraught by the death of a 9-year-old girl who received care on the unit over the course of many admissions spanning several years. What action is the most appropriate response to the nurses own grief? A) Take time off from work to mourn the death. B) Post mementos of the patient on the unit. C) Solicit emotional support from the patients family. D) Attend the patients memorial service. ---------- Correct Answer --------- D As a staff member in a local hospice, a nurse deals with death and dying on a frequent basis. Where would be the safe venue for the nurse to express her feelings of frustration and grief about a patient who has recently died? A) In the cafeteria B) At a staff meeting C) At a social gathering D) At a memorial service ---------- Correct Answer --------- B A hospice nurse is well aware of how difficult it is to deal with others pain on a daily basis. This nurse should put healthy practices into place to guard against what outcome? A) Inefficiency in the provision of care B) Excessive weight gain C) Emotional exhaustion D) Social withdrawal ---------- Correct Answer --------- C The hospice nurse is caring for a 45-year-old mother of three young children in the patients home. During the most recent visit, the nurse has observed that the patient has a new onset of altered mental status, likely resulting from recently diagnosed brain metastases. What goal of nursing interventions should the nurse identify? A) Helping the family to understand why the patient needs to be sedated B) Making arrangements to promptly move the patient to an acute-care facility C) Explaining to the family that death is near and the patient needs around-the-clock nursing care D) Teaching family members how to interact with, and ensure safety for, the patient with impaired cognition ---------- Correct Answer --------- D You are caring for a patient who has just been told that his illness is progressing and nothing more can be done for him. After the physician leaves, the patient asks you to stay with him for a while. The patient becomes tearful and tries several times to say something, but cannot get the words out. What would be an appropriate response for you to make at this time? A) Can I give you some advice? B) Do you need more time to think about this? C) Is there anything you want to say? D) I have cared for lots of patients in your position. It will get easier. ---------- Correct Answer --------- B A patient who is receiving care for osteosarcoma has been experiencing severe pain since being diagnosed. As a result, the patient has been receiving analgesics on both a scheduled and PRN basis. For the past several hours, however, the patients level of consciousness has declined and she is now unresponsive. How should the patients pain control regimen be affected? A) The patients pain control regimen should be continued. B) The pain control regimen should be placed on hold until the patients level of consciousness improves. C) IV analgesics should be withheld and replaced with transdermal analgesics. D) The patients analgesic dosages should be reduced by approximately one half. -------- -- Correct Answer --------- A A nurse is describing the process by which blood is ejected into circulation as the chambers of the heart become smaller. The instructor categorizes this action of the heart as what? A) Systole B) Diastole C) Repolarization D) Ejection fraction ---------- Correct Answer --------- A During a shift assessment, the nurse is identifying the clients point of maximum impulse (PMI). Where will the nurse best palpate the PMI? A) Left midclavicular line of the chest at the level of the nipple B) Left midclavicular line of the chest at the fifth intercostal space C) Midline between the xiphoid process and the left nipple D) Two to three centimeters to the left of the sternum ---------- Correct Answer --------- B D) To diagnose the etiology of chronic obstructive pulmonary disease ---------- Correct Answer --------- A The cardiac care nurse is reviewing the conduction system of the heart. The nurse is aware that electrical conduction of the heart usually originates in the SA node and then proceeds in what sequence? A) SA node to bundle of His to AV node to Purkinje fibers B) SA node to AV node to Purkinje fibers to bundle of His C) SA node to bundle of His to Purkinje fibers to AV node D) SA node to AV node to bundle of His to Purkinje fibers ---------- Correct Answer ------- -- D A patient has had a myocardial infarction and has been diagnosed as having damage to the layer of the heart responsible for the pumping action. You are aware that the damage occurred where? A. Endocardium B. Pericardium C. Myocardium D. Visceral pericardium ---------- Correct Answer --------- C The nurse working on a cardiac care unit is caring for a patient whose stroke volume has increased. The nurse is aware that afterload influences a patients stroke volume. The nurse recognizes that afterload is increased when there is what? A) Arterial vasoconstriction B) Venous vasoconstriction C) Arterial vasodilation D) Venous vasodilation ---------- Correct Answer --------- A A nurse is preparing a patient for scheduled transesophageal echocardiography. What action should the nurse perform? A) Instruct the patient to drink 1 liter of water before the test. B) Administer IV benzodiazepines and opioids. C) Inform the patient that she will remain on bed rest following the procedure. D) Inform the patient that an access line will be initiated in her femoral artery. ---------- Correct Answer --------- c The nurse is caring for a patient admitted with angina who is scheduled for cardiac catheterization. The patient is anxious and asks the reason for this test. What is the best response? A) Cardiac catheterization is usually done to assess how blocked or open a patients coronary arteries are. B) Cardiac catheterization is most commonly done to detect how efficiently a patients heart muscle contracts. C) Cardiac catheterization is usually done to evaluate cardiovascular response to stress. D) Cardiac catheterization is most commonly done to evaluate cardiac electrical activity. ---------- Correct Answer --------- A The critical care nurse is caring for a patient who has had an MI. The nurse should expect to assist with establishing what hemodynamic monitoring procedure to assess the patients left ventricular function? A) Central venous pressure (CVP) monitoring B) Pulmonary artery pressure monitoring (PAPM) C. Systemic arterial pressure monitoring (SAPM) D. Arterial blood gases (ABG) ---------- Correct Answer --------- b A critically ill patient is admitted to the ICU. The physician decides to use intra-arterial pressure monitoring. After this intervention is performed, what assessment should the nurse prioritize in the plan of care? A. Fluctuations in core body temperature B. Signs and symptoms of esophageal varices C. Signs and symptoms of compartment syndrome D. Perfusion distal to the insertion site ---------- Correct Answer --------- D The nurse is caring for an acutely ill patient who has central venous pressure monitoring in place. What intervention should be included in the care plan of a patient with CVP in place? A. Apply antibiotic ointment to the insertion site twice daily. B. Change the site dressing whenever it becomes visibly soiled. C. Perform passive range-of-motion exercises to prevent venous stasis. D. Aspirate blood from the device once daily to test pH. ---------- Correct Answer --------- B A patient is brought into the ED by family members who tell the nurse the patient grabbed his chest and complained of substernal chest pain. The care team recognizes the need to monitor the patients cardiac function closely while interventions are performed. What form of monitoring should the nurse anticipate? A) Left-sided heart catheterization B) Cardiac telemetry C) Transesophageal echocardiography D) Hardwire continuous ECG monitoring ---------- Correct Answer --------- D The nurse is performing an intake assessment on a patient with a new diagnosis of coronary artery disease. What would be the most important determination to make during this intake assessment? A) Whether the patient and involved family members understand the role of genetics in the etiology of the disease B) Whether the patient and involved family members understand dietary changes and the role of nutrition C) Whether the patient and involved family members are able to recognize symptoms of an acute cardiac problem and respond appropriately D) Whether the patient and involved family members understand the importance of social support and community agencies ---------- Correct Answer --------- c The nurse is relating the deficits in a patients synchronization of the atrial and ventricular events to his diagnosis. What are the physiologic characteristics of the nodal and Purkinje cells that provide this synchronization? Select all that apply. A) Loop connectivity B) Excitability C) Automaticity D) Conductivity E) Independence ---------- Correct Answer --------- B, C, D The nurses assessment of an older adult client reveals the following data: Lying BP 144/82 mm Hg; sitting BP 121/69 mm Hg; standing BP 98/56 mm Hg. The nurse should consequently identify what nursing diagnosis in the patients plan of care? A) Risk for ineffective breathing pattern related to hypotension B) Risk for falls related to orthostatic hypotension C) Risk for ineffective role performance related to hypotension D) Risk for imbalanced fluid balance related to hemodynamic variability ---------- Correct Answer --------- B A brain (B-type) natriuretic peptide (BNP) sample has been drawn from an older adult patient who has been experienced vital fatigue and shortness of breath. This test will allow the care team to investigate the possibility of what diagnosis? A) Pleurisy B) Heart failure C) Valve dysfunction D) Cardiomyopathy ---------- Correct Answer --------- B A lipid profile has been ordered for a patient who has been experiencing cardiac symptoms. When should a lipid profile be drawn in order to maximize the accuracy of results? A) As close to the end of the day as possible B) After a meal high in fat C) After a 12-hour fast D) Thirty minutes after a normal meal ---------- Correct Answer --------- C When hemodynamic monitoring is ordered for a patient, a catheter is inserted into the appropriate blood vessel or heart chamber. When assessing a patient who has such a device in place, the nurse should check which of the following components? Select all that apply. A) A transducer B) A flush system C) A leveler D) A pressure bag E) An oscillator ---------- Correct Answer --------- A, B, D The critical care nurse is caring for a patient who has been experiencing bradycardia after cardiovascular surgery. The nurse knows that the heart rate is determined by The nurse is caring for a patient who is undergoing an exercise stress test. Prior to reaching the target heart rate, the patient develops chest pain. What is the nurses most appropriate response? A. Administer sublingual nitroglycerin to allow the patient to finish the test. B. Initiate cardiopulmonary resuscitation. C. Administer analgesia and slow the test. D. Stop the test and monitor the patient closely. ---------- Correct Answer --------- D An older adult is newly diagnosed with primary hypertension and has just been started on a beta-blocker. The nurses health education should include which of the following? A) Increasing fluids to avoid extracellular volume depletion from the diuretic effect of the beta- blocker B) Maintaining a diet high in dairy to increase protein necessary to prevent organ damage C) Use of strategies to prevent falls stemming from postural hypotension D) Limiting exercise to avoid injury that can be caused by increased intracranial pressure ---------- Correct Answer --------- C A patient with primary hypertension comes to the clinic complaining of a gradual onset of blurry vision and decreased visual acuity over the past several weeks. The nurse is aware that these symptoms could be indicative of what? A) Retinal blood vessel damage B) Glaucoma C) Cranial nerve damage D) Hypertensive emergency ---------- Correct Answer --------- A 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 nonmodifiable risk factor for hypertension? A) Hyperlipidemia B) Excessive alcohol intake C) A family history of hypertension D) Closer adherence to medical regimen ---------- Correct Answer --------- C The staff educator is teaching ED nurses about hypertensive crisis. The nurse educator should explain that hypertensive urgency differs from hypertensive emergency in what way? A) The BP is always higher in a hypertensive emergency. B) Vigilant hemodynamic monitoring is required during treatment of hypertensive emergencies. C) Hypertensive urgency is treated with rest and benzodiazepines to lower BP. D) Hypertensive emergencies are associated with evidence of target organ damage. ---- ------ Correct Answer --------- D 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) Yes. Hypertension is prevalent among men; it is fortunate we caught this during your routine examination. B) We will need to reevaluate your blood pressure because your age places you at high risk for hypertension. C) 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. D) You have no need to worry. Your pressure is probably elevated because you are being tested. ---------- Correct Answer --------- C A 40-year-old male newly diagnosed with hypertension is discussing risk factors with the nurse. The nurse talks about lifestyle changes with the patient and advises that the patient should avoid tobacco use. What is the primary rationale behind that advice to the patient? A) Quitting smoking will cause the patients hypertension to resolve. B) Tobacco use increases the patients concurrent risk of heart disease. C) Tobacco use is associated with a sedentary lifestyle. D) Tobacco use causes ventricular hypertrophy. ---------- Correct Answer --------- B 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 patients care, what desired outcome should the nurse identify? A) Patient takes medication as prescribed and reports any adverse effects. B) Patients BP remains consistently below 140/90 mm Hg. C) Patient denies signs and symptoms of hypertensive urgency. D) Patient is able to describe modifiable risk factors for hypertension. ---------- Correct Answer --------- A The nurse is providing care for a patient with a new diagnosis of hypertension. How can the nurse best promote the patients adherence to the prescribed therapeutic regimen? A) Screen the patient for visual disturbances regularly. B) Have the patient participate in monitoring his or her own BP. C) Emphasize the dire health outcomes associated with inadequate BP control. D) Encourage the patient to lose weight and exercise regularly. ---------- Correct Answer --------- B A patient newly diagnosed with hypertension asks the nurse what happens when uncontrolled hypertension is prolonged. The nurse explains that a patient with prolonged, uncontrolled hypertension is at risk for developing what health problem? A) Renal failure B) Right ventricular hypertrophy C. Glaucoma D. Anemia ---------- Correct Answer --------- A A patient with primary hypertension complains of dizziness with ambulation. The patient is currently on an alpha-adrenergic blocker and the nurse assesses characteristic signs and symptoms of postural hypotension. When teaching this patient about risks associated with postural hypotension, what should the nurse emphasize? A. Rising slowly from a lying or sitting position B. Increasing fluids to maintain BP C. Stopping medication if dizziness persists D. Taking medication first thing in the morning ---------- Correct Answer --------- A The nurse is planning the care of a patient who has been diagnosed with hypertension, but who otherwise enjoys good health. When assessing the response to an antihypertensive drug regimen, what blood pressure would be the goal of treatment? A. 156/96 mm Hg or lower B. 140/90 mm Hg or lower C. Average of 2 BP readings of 150/80 mm Hg D. 120/88mm HG or lower ---------- Correct Answer --------- B A patient in a hypertensive emergency is admitted to the ICU. The nurse anticipates that the patient will be treated with IV vasodilators, and that the primary goal of treatment is what? A) Lower the BP to reduce onset of neurologic symptoms, such as headache and vision changes. B) Decrease the BP to a normal level based on the patients age. C) Decrease the mean arterial pressure between 20% and 25% in the first hour of treatment. D) Reduce the BP to 120/75 mm Hg as quickly as possible. ---------- Correct Answer ----- ---- c The nursing lab instructor is teaching student nurses how to take blood pressure. To ensure accurate measurement, the lab instructor would teach the students to avoid which of the following actions? A) Measuring the BP after the patient has been seated quietly for more than 5 minutes B) Taking the BP at least 10 minutes after nicotine or coffee ingestion C) Using a cuff with a bladder that encircles at least 80% of the limb D) Using a bare forearm supported at heart level on a firm surface ---------- Correct Answer --------- B A) Reduced intake of protein and carbohydrates B) Increased intake of calcium and vitamin D C) Reduced intake of fat and sodium D) Increased intake of potassium, vitamin B12 and vitamin D ---------- Correct Answer --- ------ C The critical care nurse is caring for a patient just admitted in a hypertensive emergency. The nurse should anticipate the administration of what medication? A) Warfarin (Coumadin) B) Furosemide (Lasix) C) Sodium nitroprusside (Nitropress) D) Ramipril (Altace) ---------- Correct Answer --------- C A patient in hypertensive emergency is being cared for in the ICU. The patient has become hypovolemic secondary to natriuresis. What is the nurses most appropriate action? A) Add sodium to the patients IV fluid, as ordered. B) Administer a vasoconstrictor, as ordered. C) Promptly cease antihypertensive therapy. D) Administer normal saline IV, as ordered. ---------- Correct Answer --------- D During an adult patients last two office visits, the nurse obtained BP readings of 122/84 mm Hg and 130/88 mm Hg, respectively. How would this patients BP be categorized? A) Normal B) Prehypertensive C) Stage 1 hypertensive D) Stage 2 hypertensive ---------- Correct Answer --------- B A patient comes to the walk-in clinic complaining of frequent headaches. While assessing the patients vital signs, the nurse notes the BP is 161/101 mm Hg. According to JNC 7, how would this patients BP be defined if a similar reading were obtained at a subsequent office visit? A) High normal B) Normal C) Stage 1 hypertensive D) Stage 2 hypertensive ---------- Correct Answer --------- D A patient has been diagnosed as being prehypertensive. What should the nurse encourage this patient to do to aid in preventing a progression to a hypertensive state? A) Avoid excessive potassium intake. B) Exercise on a regular basis. C) Eat less protein and more vegetables. D) Limit morning activity. ---------- Correct Answer --------- B The nurse is screening a number of adults for hypertension. What range of blood pressure is considered normal? A) Less than 140/90 mm Hg B) Less than 130/90 mm Hg C) Less than 129/89 mm Hg D) Less than 120/80 mm Hg ---------- Correct Answer --------- D A community health nurse teaching a group of adults about preventing and treating hypertension. The nurse should encourage these participants to collaborate with their primary care providers and regularly monitor which of the following? A) Heart rate B) Sodium levels C) Potassium levels D) Blood lipid levels ---------- Correct Answer --------- D 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) Pacific Islanders B) African Americans C) Asian-Americans D) Hispanics ---------- Correct Answer --------- D The home health nurse is caring for a patient who has a comorbidity of hypertension. What assessment question most directly addresses the possibility of worsening hypertension? A) Are you eating less salt in your diet? B) How is your energy level these days? C) Do you ever get chest pain when you exercise? D) Do you ever see spots in front of your eyes? ---------- Correct Answer --------- D A student nurse is taking care of an elderly patient with hypertension during a clinical experience. The instructor asks the student about the relationships between BP and age. What would be the best answer by the student? A) Because of reduced smooth muscle tone in blood vessels, blood pressure tends to go down with age, not up. B) Decreases in the strength of arteries and the presence of venous insufficiency cause hypertension in the elderly. C) Structural and functional changes in the cardiovascular system that occur with age contribute to increases in blood pressure. D) The neurologic system of older adults is less efficient at monitoring and regulating blood pressure. ---------- Correct Answer --------- C A 55-year-old patient comes to the clinic for a routine check-up. The patients BP is 159/100 mm Hg and the physician diagnoses hypertension after referring to previous readings. The patient asks why it is important to treat hypertension. What would be the nurses best response? A) Hypertension can cause you to develop dangerous blood clots in your legs that can migrate to your lungs. B) Hypertension puts you at increased risk of type 1 diabetes and cancer in your age group. C) Hypertension is the leading cause of death in people your age. D) Hypertension greatly increases your risk of stroke and heart disease. ---------- Correct Answer --------- D The nurse is reviewing the medication administration record of a patient who takes a variety of medications for the treatment of hypertension. What potential therapeutic benefits of antihypertensives should the nurse identify? Select all that apply. A) Increased venous return B) Decreased peripheral resistance C) Decreased blood volume D) Decreased strength and rate of myocardial contractions E) Decreased blood viscosity ---------- Correct Answer --------- B, C, D A newly diagnosed patient with hypertension is prescribed Diuril, a thiazide diuretic. What patient education should the nurse provide to this patient? A) Eat a banana every day because Diuril causes moderate hyperkalemia. B) Take over-the-counter potassium pills because Diuril causes your kidneys to lose potassium. C) Diuril can cause low blood pressure and dizziness, especially when you get up suddenly. D) Diuril increases sodium levels in your blood, so cut down on your salt. ---------- Correct Answer --------- C A patient in hypertensive urgency is admitted to the hospital. The nurse should be aware of what goal of treatment for a patient in hypertensive urgency? A) Normalizing BP within 2 hours B) Obtaining a BP of less than 110/70 mm Hg within 36 hours C) Obtaining a BP of less than 120/80 mm Hg within 36 hours D) Normalizing BP within 24 to 48 hours ---------- Correct Answer --------- D A patients medication regimen for the treatment of hypertension includes hydrochlorothiazide. Following administration of this medication, the nurse should anticipate what effect? A) Drowsiness or lethargy B) Increased urine output C) Decreased heart rate D) Mild agitation ---------- Correct Answer --------- B A patients recently elevated BP has prompted the primary care provider to prescribe furosemide (Lasix). The nurse should closely monitor which of the following? A) The clients oxygen saturation level B) The patients red blood cells, hematocrit, and hemoglobin The nurse is caring for a patient in acute kidney injury. Which of the following complications would most clearly warrant the administration of polystyrene sulfonate (Kayexalate)? A. Hypernatremia B. Hypomagnesemia C. Hyperkalemia D. Hypercalcemia ---------- Correct Answer --------- C Renal failure can have prerenal, renal, or postrenal causes. A patient with acute kidney injury is being assessed to determine where, physiologically, the cause is. If the cause is found to be prerenal, which condition most likely caused it? A) Heart failure B) Glomerulonephritis C) Ureterolithiasis D) Aminoglycoside toxicity ---------- Correct Answer --------- A A 45-year-old man with diabetic nephropathy has ESKD and is starting dialysis. What should the nurse teach the patient about hemodialysis? A) Hemodialysis is a treatment option that is usually required three times a week. B) Hemodialysis is a program that will require you to commit to daily treatment. C) This will require you to have surgery and a catheter will need to be inserted into your abdomen. D) Hemodialysis is a treatment that is used for a few months until your kidney heals and starts to produce urine again. ---------- Correct Answer --------- A A patient with ESKD receives continuous ambulatory peritoneal dialysis. The nurse observes that the dialysate drainage fluid is cloudy. What is the nurses most appropriate action? A) Inform the physician and assess the patient for signs of infection. B) Flush the peritoneal catheter with normal saline. C) Remove the catheter promptly and have the catheter tip cultured. D) Administer a bolus of IV normal saline as ordered. ---------- Correct Answer --------- A The nurse is planning patient teaching for a patient with ESKD who is scheduled for the creation of a fistula. The nurse would include which of the following in teaching the patient about the fistula? A) A vein and an artery in your arm will be attached surgically. B) The arm should be immobilized for 4 to 6 days. C) One needle will be inserted into the fistula for each dialysis treatment. D) The fistula can be used 2 days after the surgery for dialysis treatment. ---------- Correct Answer --------- A A patient with ESKD is scheduled to begin hemodialysis. The nurse is working with the patient to adapt the patients diet to maximize the therapeutic effect and minimize the risks of complications. The patients diet should include which of the following modifications? Select all that apply. A) Decreased protein intake B) Decreased sodium intake C) Increased potassium intake D. Fluid restriction E. Vitamin D supplementation ---------- Correct Answer --------- A, B, D A patient on the critical care unit is postoperative day 1 following kidney transplantation from a living donor. The nurses most recent assessments indicate that the patient is producing copious quantities of dilute urine. What is the nurses most appropriate response? A. Assess the patient for further signs or symptoms of rejection. B.Recognize this as an expected finding. C. Inform the primary care provider of this finding. D. Administer exogenous antidiuretic hormone as ordered. ---------- Correct Answer ------ --- B A patient is scheduled for a CT scan of the abdomen with contrast. The patient has a baseline creatinine level of 2.3 mg/dL. In preparing this patient for the procedure, the nurse anticipates what orders? A. Monitor the patients electrolyte values every hour before the procedure. B. Preprocedure hydration and administration of acetylcysteine C.Hemodialysis immediately prior to the CT scan D. Obtain a creatinine clearance by collecting a 24- hours urine specimen ---------- Correct Answer --------- B The nurse is caring for a patient with acute glomerular inflammation. When assessing for the characteristic signs and symptoms of this health problem, the nurse should include which assessments? Select all that apply. A. Percuss for pain in the right lower abdominal quadrant. B. Assess for the presence of peripheral edema. C. Auscultate the patients apical heart rate for dysrhythmias. D. Assess the patients BP. E. Assess the patients orientation and judgment. ---------- Correct Answer --------- B, D A patient is admitted to the ICU after a motor vehicle accident. On the second day of the hospital admission, the patient develops acute kidney injury. The patient is hemodynamically unstable, but renal replacement therapy is needed to manage the patients hypervolemia and hyperkalemia. Which of the following therapies will the patients hemodynamic status best tolerate? A. Hemodialysis B. Peritoneal dialysis C. Continuous venovenous hemodialysis (CVVHD) D. Plasmapheresis ---------- Correct Answer --------- C A patient has presented with signs and symptoms that are characteristic of acute kidney injury, but preliminary assessment reveals no obvious risk factors for this health problem. The nurse should recognize the need to interview the patient about what topic? A) Typical diet B) Allergy status C) Psychosocial stressors D) Current medication use ---------- Correct Answer --------- D An 84-year-old woman diagnosed with cancer is admitted to the oncology unit for surgical treatment. The patient has been on chemotherapeutic agents to decrease the tumor size prior to the planned surgery. The nurse caring for the patient is aware that what precipitating factors in this patient may contribute to AKI? Select all that apply. A) Anxiety B) Low BMI C) Age-related physiologic changes D) Chronic systemic disease E) NPO status ---------- Correct Answer --------- C, D A patient is being treated for AKI and the patient daily weights have been ordered. The nurse notes a weight gain of 3 pounds over the past 48 hours. What nursing diagnosis is suggested by this assessment finding? A) Imbalanced nutrition: More than body requirements B) Excess fluid volume C) Sedentary lifestyle D) Adult failure to thrive ---------- Correct Answer --------- B A 15-year-old is admitted to the renal unit with a diagnosis of postinfectious glomerular disease. The nurse should recognize that this form of kidney disease may have been precipitated by what event? A) Psychosocial stress B) Hypersensitivity to an immunization C) Menarche D) Streptococcal infection ---------- Correct Answer --------- D A patient on the medical unit has a documented history of polycystic kidney disease (PKD). What principle should guide the nurses care of this patient? A) The disease is self-limiting and cysts usually resolve spontaneously in the fifth or sixth decade of life. B) The patients disease is incurable and the nurses interventions will be supportive. C) The patient will eventually require surgical removal of his or her renal cysts. D) The patient is likely to respond favorably to lithotripsy treatment of the cysts. ---------- Correct Answer --------- B The nurse is providing a health education workshop to a group of adults focusing on cancer prevention. The nurse should emphasize what action in order to reduce participants risks of renal carcinoma? A) Avoiding heavy alcohol use The nurse is caring for a patient who has just returned to the post-surgical unit following renal surgery. When assessing the patients output from surgical drains, the nurse should assess what parameters? Select all that apply. A) Quantity of output B) Color of the output C) Visible characteristics of the output D) Odor of the output E) pH of the output ---------- Correct Answer --------- A, B, C The nurse is caring for a patient after kidney surgery. The nurse is aware that bleeding is a major complication of kidney surgery and that if it goes undetected and untreated can result in hypovolemia and hemorrhagic shock in the patient. When assessing for bleeding, what assessment parameter should the nurse evaluate? A) Oral intake B) Pain intensity C) Level of consciousness D) Radiation of pain ---------- Correct Answer --------- C A nurse on the renal unit is caring for a patient who will soon begin peritoneal dialysis. The family of the patient asks for education about the peritoneal dialysis catheter that has been placed in the patients peritoneum. The nurse explains the three sections of the catheter and talks about the two cuffs on the dialysis catheter. What would the nurse explain about the cuffs? Select all that apply. A) The cuffs are made of Dacron polyester. B) The cuffs stabilize the catheter. C) The cuffs prevent the dialysate from leaking. D) The cuffs provide a barrier against microorganisms. E) The cuffs absorb dialysate ---------- Correct Answer --------- A, B, C, D A patient with chronic kidney disease is completing an exchange during peritoneal dialysis. The nurse observes that the peritoneal fluid is draining slowly and that the patients abdomen is increasing in girth. What is the nurses most appropriate action? A) Advance the catheter 2 to 4 cm further into the peritoneal cavity. B) Reposition the patient to facilitate drainage. C) Aspirate from the catheter using a 60-mL syringe. D) Infuse 50 mL of additional dialysate. ---------- Correct Answer --------- B The nurse caring for a client with emphysema has determined that a priority nursing diagnosis for this client is "Imbalanced Nutrition: Less Than Body Requirements related to difficulty breathing while eating." Based upon this diagnosis, which of the following is an appropriate nursing intervention to include in the client's care plan? A) Provide six small meals daily. B) Provide three large meals daily. C) Encourage the client to eat immediately before breathing treatments. D) Encourage the client to alternate eating and using a nebulizer during meal time. ------ ---- Correct Answer --------- A The nurse is developing a plan of care for a client admitted with pneumonia. The nurse has determined that apriority nursing diagnosis for this client is "Ineffective Airway Clearance related to copious and tenacious secretions." Based 2. upon this nursing diagnosis, what is an appropriate nursing intervention to include in the client's care plan? A) Encouraging the client to consume two to three quarts of clear fluids daily B) Creating an environment that is likely to reduce anxiety C) Positioning the client supine D) Encouraging the client to decrease the number of cigarettes smoked daily ---------- Correct Answer --------- A While the nurse is providing morning hygiene for a client who has a chest tube, the client has rolled over quickly and the chest tube has become disconnected from the drainage unit. How should the nurse first respond to this event? A) Submerge the end of the tube in sterile water. B) Clamp the tube near the end and also near the insertion point. C) Place the end of the tube on a sterile surface and seek help promptly. D) Clean the end of the tube with an alcohol swab and reconnect it to the drainage unit. ---------- Correct Answer --------- A A client has had a head injury affecting the brain stem. What is located in the brain stem that may affect respiratory 4. function? A) Chemoreceptors B) Stretch receptors C) Respiratory center D) Oxygen center ---------- Correct Answer --------- C Which of the following diseases may result in decreased lung compliance? A) Emphysema B) Appendicitis C) Acne D) Chronic diarrhea ---------- Correct Answer --------- A A nurse is caring for a client with pneumonia. The client's oxygen saturation is below normal. What abnormal 6. respiratory process does this demonstrate? A) changes in the alveolar-capillary membrane and diffusion B) alterations in the structures of the ribs and diaphragm C) rapid decreases in atmospheric and intrapulmonic pressures D) lower-than-normal concentrations of environmental oxygen ---------- Correct Answer - -------- A In what age group would a nurse expect to assess the most rapid respiratory rate? A) Older adults B) Middle adults C) Adolescents D) Infants ---------- Correct Answer --------- D A father of a preschool-age child tells the nurse that his child "has had a constant cold since going to daycare." How 8. would the nurse respond? A) "Your child must have a health problem that needs medical care." B) "Children in daycare have more exposure to colds." C) "Are you washing your hands before you touch the child?" D. Be sure and have your child wear a protective mask at school ---------- Correct Answer --------- B A woman 90 years of age has been in an automobile crash and sustained four fractured ribs on the left side of her thorax. 9. Based on her age and the injury, she is at risk for what complication? A) Pneumonia B) Altered thought processes C) Urinary incontinence D) Viral influenza ---------- Correct Answer --------- A Which individual is at greater risk for respiratory illnesses from environmental causes? A) A farmer on a large farm B) A factory worker in a large city C) A woman living in a small town D) A child living in a rural area ---------- Correct Answer --------- B A nurse is beginning to conduct a health history for a client with respiratory problems. He notes that the client is having 11. respiratory distress. What would the nurse do next? A) Continue with the health history, but more slowly. B) Ask questions of the family instead of the client. C) Conduct the interview later and let the client rest. D) Initiate interventions to help relieve the symptoms. ---------- Correct Answer --------- D An emergency room nurse is auscultating the chest of a child who is having an asthmatic attack. Auscultation reveals the 12. presence of wheezes. During what part of respirations do wheezes occur? A) Inspiration and expiration B) Only on inspiration C) Only on expiration D) When coughing ---------- Correct Answer --------- A A client is experiencing hypoxia. Which of the following nursing diagnoses would be appropriate? A) Anxiety B) Nausea C) Pain D) Hypothermia ---------- Correct Answer --------- A A) It can cause the nasal mucosa to dry in case of high flow. B) It can cause anxiety in clients who are claustrophobic. C) It can create a risk of suffocation. D) It can result in an inconsistent amount of oxygen. ---------- Correct Answer --------- A A nurse is conducting a health promotion program for adolescents to educate them about the hazards of smoking. When 27. describing the effects on the respiratory system, which of the following would the nurse most likely include? A) Decreased production of mucus B) Inhibition of mucus removal C) Increase in the mucous escalator D) Inhibition of bacterial colonization ---------- Correct Answer --------- B The nurse is caring for a postoperative adult client who has developed pneumonia. The nurse should assess the client 28. frequently for symptoms of A) Atelectasis B) Bronchospasm C) Croup D) Epiglottitis ---------- Correct Answer --------- A The home care nurse visits a client who has dyspnea. The nurse notes the client has pitting edema in his feet and ankles. 29. What additional assessment would the nurse expect to observe? A) Crackles in the lower lobes B) Inspiratory stridor C) Expiratory stridor D) Wheezing in the upper lobes ---------- Correct Answer --------- A A nurse is caring for an older adult client who is to be discharged from the health care facility. The client has been prescribed the use of a liquid oxygen unit at home to continue with oxygen therapy. What should the nurse tell the client 30. regarding the potential problems of using a liquid oxygen unit? Select all that apply. A) Liquid oxygen may leak during warm weather. B) The unit may give off a bad smell if not cleaned regularly. C) The unit's outlet may become occluded because of frozen moisture. D) Portable liquid oxygen is more expensive. E. The unit may require a secondary source of O2. ---------- Correct Answer --------- A, C, D A nurse is educating a postoperative client on how to use an incentive spirometer. Which of the following is an accurate 31. step that should be included in the teaching plan? A) Instruct the client to inhale normally and then place the lips securely around the mouthpiece. B) Instruct the client to inhale slowly and as deeply as possible through the mouthpiece, without using the nose. C) When the client cannot inhale anymore, the patient should hold his or her breath and count to 10. D) Encourage the client to perform incentive spirometry two to three times every one to two hours, if possible. ---------- Correct Answer --------- B A nurse is delivering oxygen to a client via an oxygen mask. Which of the following is a recommended guideline for this 32. procedure? A) Adjust the mask so it fits tightly around the face. B) For a mask with a reservoir, fill the reservoir half-full of oxygen. C) Remove the mask and dry the skin every two to three hours if the oxygen is running continuously. D) If the client is experiencing redness around the mask, remove and apply powder to the mask. ---------- Correct Answer --------- C A physician is choosing a chest drainage system for a client who is ambulating daily. Which of the following systems 33. would be the best choice for this client? A) Traditional water seal B) Wet suction C) Dry suction water seal D) Dry suction/one-way valve system ---------- Correct Answer --------- D A client visits the health care facility for a scheduled physical assessment. What should the nurse do when physically 34. assessing the quality of the client's oxygenation? Select all that apply. A) Monitor the client's respiratory rate. B) Note the amount of oxygen administered. C) Check the symmetry of the client's chest. D) Observe the breathing pattern and effort. E) Check the devices used to deliver oxygen. ---------- Correct Answer --------- A, C, D A nurse assesses the vital signs of a healthy newborn infant. What respiratory rate could be expected based on the 35. developmental level of this client? A) 15 to 25 breaths/minute B) 16 to 20 breaths/minute C) 20 to 44 breaths/minute D) 30 to 55 breaths/minute ---------- Correct Answer --------- D