Nursing Care of Adults Test Questions

Course Introduction

Nursing Care of Adults focuses on the principles and practices involved in providing comprehensive nursing care to adult patients across various healthcare settings. The course explores common acute and chronic health conditions affecting adults, emphasizing patient-centered care, clinical decision-making, and evidence-based interventions. Students learn to assess patient needs, develop and implement care plans, promote health and wellness, and manage complex care situations. Emphasis is also placed on communication, collaboration with the healthcare team, ethical considerations, and cultural competence in addressing the diverse needs of adult patients.

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Medical Surgical Nursing 10th Edition by Lewis

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68 Chapters

1998 Verified Questions

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Page 2

Chapter 1: Professional Nursing Practice

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Sample Questions

Q1) The nurse is providing education to nursing staff on quality care initiatives. Which statement is an accurate description of the impact of health care financing on quality care?

A)"If a patient develops a catheter-related infection, the hospital receives additional funding."

B)"Payment for patient care is primarily based on clinical outcomes and patient satisfaction."

C)"Hospitals are reimbursed for all costs incurred if care is documented electronically."

D)"Because hospitals are accountable for overall care, it is not nursing's responsibility to monitor care delivered by others."

Answer: B

Q2) Which nursing diagnosis statement is written correctly?

A)Altered tissue perfusion related to heart failure

B)Risk for impaired tissue integrity related to sacral redness

C)Ineffective coping related to response to biopsy test results

D)Altered urinary elimination related to urinary tract infection

Answer: C

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Chapter 2: Health Disparities and Culturally Competent Care

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Sample Questions

Q1) When doing an admission assessment for a patient,the nurse notices that the patient pauses before answering questions about the health history. Which action by the nurse is most appropriate?

A)Interview a family member instead.

B)Wait for the patient to answer the questions.

C)Remind the patient that you have other patients who need care.

D)Give the patient an assessment form listing the questions and a pen.

Answer: B

Q2) A female staff nurse is assessing a male patient of Arab descent who is admitted with complaints of severe headaches. It is most important for the charge nurse to intervene if the nurse takes which action?

A)The nurse explains the 0 to 10 intensity pain scale.

B)The nurse asks the patient when the headaches started.

C)The nurse sits down at the bedside and closes the privacy curtain.

D)The nurse calls for a male nurse to bring a hospital gown to the room.

Answer: C

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Chapter 3: Health History and Physical Examination

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Sample Questions

Q1) A nurse performs a health history and physical examination with a patient who has a right leg fracture. Which assessment would be a pertinent negative finding?

A)Patient has several bruised and swollen areas on the right leg.

B)Patient states that there have been no other recent health problems.

C)Patient refuses to bend the right knee because of the associated pain.

D)Patient denies having pain when the area over the fracture is palpated.

Answer: D

Q2) The nurse is preparing to perform a focused assessment for a patient complaining of shortness of breath. Which equipment will be needed?

A)Flashlight

B)Stethoscope

C)Tongue blades

D)Percussion hammer

Answer: B

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Chapter 4: Patient and Caregiver Teaching

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Q1) A patient states,"I told my husband I wouldn't buy as much prepared food snacks,so I will go the grocery store to buy fresh fruit,vegetables,and whole grains." When using the Transtheoretical Model of Health Behavior Change,the nurse identifies that this patient is in which stage of change?

A)Preparation

B)Termination

C)Maintenance

D)Contemplation

Q2) A patient with diabetic neuropathy requires teaching about foot care. Which learning goal should the nurse include in the teaching plan?

A)The nurse will demonstrate the proper technique for trimming toenails.

B)The patient will list three ways to protect the feet from injury by discharge.

C)The nurse will instruct the patient on appropriate foot care before discharge.

D)The patient will understand the rationale for proper foot care after instruction.

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Chapter 5: Chronic Illness and Older Adults

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Q1) An older adult being admitted is assessed at high risk for falls. Which action should the nurse take first?

A)Use a bed alarm system on the patient's bed.

B)Administer the prescribed PRN sedative medication.

C)Ask the health care provider to order a vest restraint.

D)Place the patient in a "geri-chair" near the nurse's station.

Q2) The nurse is admitting an acutely ill,older patient to the hospital. Which action should the nurse take?

A)Speak slowly and loudly while facing the patient.

B)Obtain a detailed medical history from the patient.

C)Perform the physical assessment before interviewing the patient.

D)Ask a family member to go home and retrieve the patient's cane.

Q3) Which intervention should the nurse implement to provide optimal care for an older patient who is hospitalized with pneumonia?

A)Plan for transfer to a long-term care facility.

B)Minimize activity level during hospitalization.

C)Consider the preadmission functional abilities.

D)Use an approved standardized geriatric nursing care plan.

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Chapter 6: Stress and Stress Management

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Sample Questions

Q1) A patient who has frequent migraines tells the nurse,"My life feels chaotic and out of my control. I could not manage if anything else happens." Which response should the nurse make initially?

A)"Regular exercise may get your mind off the pain."

B)"Guided imagery can be helpful in regaining control."

C)"Tell me more about how your life has been recently."

D)"Your previous coping resources can be helpful to you now."

Q2) A nurse prepares an adult patient with a severe burn injury for a dressing change. The nurse knows that this is a painful procedure and wants to try providing music to help the patient relax. Which action is best for the nurse to take?

A)Use music composed by Mozart.

B)Play music that does not have words.

C)Ask the patient about music preferences.

D)Select music that has 60 to 80 beats/minute.

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Chapter 7: Sleep and Sleep Disorders

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Sample Questions

Q1) Which information regarding a patient's sleep is most important for the nurse to communicate to the health care provider?

A)A 21-yr-old student who takes melatonin to assist in sleeping when traveling from the United States to Europe

B)A 64-yr-old nurse who works the night shift reports drinking hot chocolate before going to bed in the morning

C)A 41-yr-old librarian who has a body mass index (BMI) of 42 kg/m2 says that the spouse complains about snoring

D)A 32-yr-old accountant who is experiencing a stressful week uses diphenhydramine (Benadryl) for several nights

Q2) A patient complains of difficulty falling asleep and daytime fatigue for the past 6 weeks. What is the best initial action for the nurse to take in determining whether this patient has chronic insomnia?

A)Schedule a polysomnograph (PSG).

B)Teach the patient how to use an actigraph.

C)Ask the patient to keep a 2-week sleep diary.

D)Arrange for the patient to have a sleep study.

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Page 9

Chapter 8: Pain

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Sample Questions

Q1) A patient who uses a fentanyl (Duragesic)patch for chronic abdominal pain caused by ovarian cancer asks the nurse to administer the prescribed hydrocodone tablets,but the patient is asleep when the nurse returns with the medication. Which action is best for the nurse to take?

A)Wake the patient and administer the hydrocodone.

B)Wait until the patient wakes up and reassess the pain.

C)Suggest the use of nondrug therapies for pain relief instead of additional opioids.

D)Consult with the health care provider about changing the fentanyl (Duragesic) dose.

Q2) A patient with chronic pain who has been receiving morphine sulfate 20 mg IV over 24 hours is to be discharged home on oral sustained-release morphine (MS Contin)administered twice a day. What dosage of MS Contin will be needed for each dose to obtain an equianalgesic dose for the patient? (Morphine sulfate 10 mg IV is equianalgesic to morphine sulfate 30 mg orally.)

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Chapter 9: Palliative Care at End of Life

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Sample Questions

Q1) As the nurse admits a patient in end-stage renal disease to the hospital,the patient tells the nurse,"If my heart or breathing stop,I do not want to be resuscitated." Which action should the nurse take first?

A)Place a "Do Not Resuscitate" (DNR) notation in the patient's care plan.

B)Invite the patient to add a notarized advance directive in the health record.

C)Advise the patient to designate a person to make future health care decisions.

D)Ask if the decision has been discussed with the patient's health care provider.

Q2) Which nursing actions for the care of a dying patient can the nurse delegate to a licensed practical/vocational nurse (LPN/LVN)?

A)Provide postmortem care to the patient.

B)Encourage the family members to talk with and reassure the patient.

C)Determine how frequently physical assessments are needed for the patient.

D)Teach family members about commonly occurring signs of approaching death.

E)Administer the prescribed morphine sulfate sublingual as necessary for pain control.

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Chapter 10: Substance Use Disorders

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Sample Questions

Q1) A 25-yr-old patient comes to the emergency department with severe chest pain and agitation. Which action should the nurse take first?

A)Ask about use of stimulant drugs.

B)Start an IV for sedative administration.

C)Assess orientation to person, place, and time.

D)Check blood pressure, pulse, and respirations.

Q2) Which assessment finding would alert the nurse to ask the patient about alcohol use?

A)Low blood pressure

B)Decreased heart rate

C)Elevated temperature

D)Abdominal tenderness

Q3) A patient admitted to the hospital after an automobile accident is alert and does not appear to be highly intoxicated. The blood alcohol concentration (BAC)is 110 mg/dL (0.11 mg%). Which action by the nurse is appropriate?

A)Restrict oral and IV fluids.

B)Maintain the patient on NPO status.

C)Administer acetaminophen for headache.

D)Monitor for hyperreflexia and diaphoresis.

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Page 12

Chapter 11: Inflammation and Wound Healing

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Sample Questions

Q1) The nurse should plan to use a wet-to-dry dressing for which patient?

A)A patient who has a pressure ulcer with pink granulation tissue

B)A patient who has a surgical incision with pink, approximated edges

C)A patient who has a full-thickness burn filled with dry, black material

D)A patient who has a wound with purulent drainage and dry brown areas

Q2) The nurse is caring for a patient with diabetes who had abdominal surgery 3 days ago. Which finding is most important for the nurse to report to the health care provider?

A)Blood glucose of 136 mg/dL

B)Oral temperature of 101° F (38.3° C)

C)Separation of the proximal wound edges

D)Patient complaint of increased incisional pain

Q3) A new nurse performs a dressing change on a stage II left heel pressure ulcer. Which action by the new nurse indicates a need for further teaching about pressure ulcer care?

A)The new nurse cleans the ulcer with half-strength peroxide.

B)The new nurse uses a hydrocolloid dressing (DuoDerm)on the ulcer.

C)The new nurse irrigates the pressure ulcer with saline using a 30-mL syringe.

D)The new nurse inserts a sterile cotton-tipped applicator into the pressure ulcer.

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Chapter 12: Genetics and Genomics

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Sample Questions

Q1) A patient with a family history of cystic fibrosis (CF)asks for information about genetic testing. Which response by the nurse is most appropriate?

A)Refer the patient to a qualified genetic counselor.

B)Ask the patient why genetic testing seems necessary.

C)Remind the patient that genetic testing has many social implications.

D)Tell the patient that cystic fibrosis is an autosomal recessive disorder.

Q2) A patient tells the nurse,"I would like to use a home genetic test to see if I will develop breast cancer." Which is the nurse's best initial response?

A)"Home genetic testing is very expensive."

B)"Are you prepared to cope with a positive result?"

C)"Are you concerned about developing breast cancer?"

D)"Genetic testing only determines if you are at higher risk for breast cancer."

Q3) When caring for a young adult patient who has abnormalities in the cytochrome P450 (CYP 450)gene,which action will the nurse include in the patient's plan of care?

A)Teach that some medications may not work effectively.

B)Teach about genetic risk for cystic fibrosis in any children.

C)Encourage scheduling screening mammograms starting at age 30.

D)Encourage the patient to watch for early symptoms of heart disease.

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Chapter 13: Altered Immune Responses and Transplantation

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Sample Questions

Q1) Which example should the nurse use to explain an infant's "passive immunity" to a new mother?

A)Vaccinations

B)Breastfeeding

C)Stem cells in peripheral blood

D)Exposure to communicable diseases

Q2) A nurse has obtained donor tissue typing information about a patient who is waiting for a kidney transplant. Which results should be reported to the transplant surgeon?

A)Patient is Rh positive and donor is Rh negative

B)Six antigen matches are present in HLA typing

C)Results of patient-donor crossmatching are positive

D)Panel of reactive antibodies (PRA) percentage is low

Q3) Ten days after receiving a bone marrow transplant,a patient develops a skin rash. What would the nurse suspect is the cause of the rash?

A)The donor T cells are attacking the patient's skin cells.

B)The patient needs treatment to prevent hyperacute rejection.

C)The patient's antibodies are rejecting the donor bone marrow.

D)The patient is experiencing a delayed hypersensitivity reaction.

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Chapter 14: Infection and Human Immunodeficiency Virus

Infection

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Sample Questions

Q1) A patient who is diagnosed with acquired immunodeficiency syndrome (AIDS)tells the nurse,"I feel obsessed with morbid thoughts about dying." Which response by the nurse is appropriate?

A)"Thinking about dying will not improve the course of AIDS."

B)"Do you think that taking an antidepressant might be helpful?"

C)"Can you tell me more about the thoughts that you are having?"

D)"It is important to focus on the good things about your life now."

Q2) A patient with human immunodeficiency virus (HIV)infection has developed Mycobacterium avium complex infection. Which outcome would be appropriate for the nurse to include in the plan of care?

A)The patient will be free from injury.

B)The patient will receive immunizations.

C)The patient will have adequate oxygenation.

D)The patient will maintain intact perineal skin.

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Chapter 15: Cancer

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Sample Questions

Q1) When caring for a patient who is pancytopenic,which action by unlicensed assistive personnel (UAP)indicates a need for the nurse to intervene?

A)The UAP assists the patient to use dental floss after eating.

B)The UAP adds baking soda to the patient's saline oral rinses.

C)The UAP puts fluoride toothpaste on the patient's toothbrush.

D)The UAP has the patient rinse after meals with a saline solution.

Q2) The nurse reviews the laboratory results of a patient who is receiving chemotherapy. Which laboratory result is most important to report to the health care provider?

A)Hematocrit 30%

B)Platelets 95,000/µL

C)Hemoglobin 10 g/L

D)White blood cells (WBC) 2700/µL

Q3) The nurse administers an IV vesicant chemotherapeutic agent to a patient. Which action is most important for the nurse to take?

A)Infuse the medication over a short period of time.

B)Stop the infusion if swelling is observed at the site.

C)Administer the chemotherapy through a small-bore catheter.

D)Hold the medication unless a central venous line is available.

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Sample Questions

Q1) The nurse assesses a patient who has been hospitalized for 2 days. The patient has been receiving normal saline IV at 100 mL/hr,has a nasogastric tube to low suction,and is NPO. Which assessment finding would be a priority for the nurse to report to the health care provider?

A)Oral temperature of 100.1°F

B)Serum sodium level of 138 mEq/L (138 mmol/L)

C)Gradually decreasing level of consciousness (LOC)

D)Weight gain of 2 pounds (1 kg) over the admission weight

Q2) Following a thyroidectomy,a patient complains of "a tingling feeling around my mouth." Which assessment should the nurse complete?

A)Presence of the Chvostek's sign

B)Abnormal serum potassium level

C)Decreased thyroid hormone level

D)Bleeding on the patient's dressing

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Chapter 17: Preoperative Care

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Sample Questions

Q1) A 38-yr-old woman is admitted for an elective surgical procedure. Which information obtained by the nurse during the preoperative assessment is most important to communicate to the anesthesiologist and surgeon before surgery?

A)The patient's lack of knowledge about postoperative pain control

B)The patient's history of an infection following a cholecystectomy

C)The patient's report that her last menstrual period was 8 weeks ago

D)The patient's concern about being able to resume lifting heavy items

Q2) When caring for a preoperative patient on the day of surgery,which actions included in the plan of care can the nurse delegate to unlicensed assistive personnel (UAP)?

A)Teach incentive spirometer use.

B)Explain routine preoperative care.

C)Obtain and document baseline vital signs.

D)Remove nail polish and apply pulse oximeter.

E)Transport the patient by stretcher to the operating room.

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Chapter 18: Intraoperative Care

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Sample Questions

Q1) Which action should the perioperative nurse take to best protect the patient from burn injury during surgery?

A)Ensure correct placement of the grounding pad.

B)Check emergency sprinklers in the operating room.

C)Verify that a fire extinguisher is available during surgery.

D)Confirm that all electrosurgical equipment is working properly.

Q2) A patient in surgery receives a neuromuscular blocking agent as an adjunct to general anesthesia. While in the postanesthesia care unit (PACU),what assessment finding is most important for the nurse to report?

A)Lethargy

B)Complaint of nausea

C)Disorientation to time

D)Weak chest movement

Q3) Which nursing action should the operating room (OR)nurse manager delegate to the registered nurse first assistant (RNFA)when caring for a surgical patient?

A)Adjust the doses of administered anesthetics.

B)Make surgical incisions and suture as needed.

C)Provide postoperative teaching about coughing.

D)Coordinate transfer of the patient to the operating table.

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Page 20

Chapter 19: Postoperative Care

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Sample Questions

Q1) The nasogastric (NG)tube is removed on the second postoperative day,and the patient is placed on a clear liquid diet. Four hours later,the patient complains of frequent,cramping gas pains. What action by the nurse is the most appropriate?

A)Reinsert the NG tube.

B)Give the PRN IV opioid.

C)Assist the patient to ambulate.

D)Place the patient on NPO status.

Q2) Which action by the nurse will be most helpful to a patient who is expected to ambulate,deep breathe,and cough on the first postoperative day?

A)Schedule the activity to begin after the patient has taken a nap.

B)Administer prescribed analgesic medications before the activities.

C)Ask the patient to state two possible complications of immobility.

D)Encourage the patient to state the purpose of splinting the incision.

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Chapter 20: Assessment of Visual and Auditory Systems

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Q1) Which assessment finding alerts the nurse to provide patient teaching about cataract development?

A)History of hyperthyroidism

B)Unequal pupil size and shape

C)Blurred vision and light sensitivity

D)Loss of peripheral vision in both eyes

Q2) A patient complains of dizziness when bending over and of nausea and dizziness associated with physical activities. The nurse will plan to teach the patient about A)tympanometry.

B)rotary chair testing.

C)pure-tone audiometry.

D)bone-conduction testing.

Q3) The nurse is assessing a 65-yr-old patient for presbyopia. Which instruction will the nurse give the patient before the test?

A)"Hold this card and read the print out loud."

B)"Cover one eye while reading the wall chart."

C)"You'll feel a short burst of air directed at your eyeball."

D)"A light will be used to look for a change in your pupils."

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Chapter 21: Visual and Auditory Problems

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Q1) Which nursing activity is appropriate for the registered nurse (RN)working in the eye clinic to delegate to experienced unlicensed assistive personnel (UAP)?

A)Instilling antiviral drops for a patient with a corneal ulcer

B)Application of a warm compress to a patient's hordeolum

C)Instruction about hand washing for a patient with herpes keratitis

D)Looking for eye irritation in a patient with possible conjunctivitis

Q2) A patient who has bacterial endophthalmitis in the left eye is restless,frequently asking whether the eye is healing and whether removal of the eye will be necessary. Based on the assessment data,which nursing diagnosis is appropriate at this time?

A)Grieving related to current loss of functional vision

B)Ineffective health management related to inability to see

C)Anxiety related to the possibility of permanent vision loss

D)Situational low self-esteem related to loss of visual function

Q3) The nurse will instruct a patient who has undergone a left tympanoplasty to A)remain on bed rest.

B)keep the head elevated.

C)avoid blowing the nose.

D)irrigate the left ear canal.

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Chapter 22: Assessment of Integumentary System

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Q1) A patient reports chronic itching of the ankles and continuously scratches the area. Which assessment finding will the nurse expect?

A)Hypertrophied scars on both ankles

B)Thickening of the skin around the ankles

C)Yellowish-brown skin around both ankles

D)Complete absence of melanin in both ankles

Q2) When performing a skin assessment,the nurse notes angiomas on the chest of an older patient. Which action should the nurse take next?

A)Suggest an appointment with a dermatologist.

B)Assess the patient for evidence of liver disease.

C)Teach the patient about skin changes with aging.

D)Discuss the use of sunscreen to prevent skin cancers.

Q3) A patient in the dermatology clinic is scheduled for removal of a 15-mm multicolored and irregular mole from the upper back. The nurse should prepare the patient for which type of biopsy?

A)Shave biopsy

B)Punch biopsy

C)Incisional biopsy

D)Excisional biopsy

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Page 24

Chapter 23: Integumentary Problems

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Q1) The health care provider prescribes topical 5-FU for a patient with actinic keratosis on the left cheek. The nurse should include which statement in the patient's instructions?

A)"5-FU will shrink the lesion to prepare for surgical excision."

B)"Your cheek area will be eroded and it will take several weeks to heal."

C)"You may develop nausea and anorexia, but good nutrition is important during treatment."

D)"You will need to avoid crowds because of the risk for infection caused by chemotherapy."

Q2) Which information should the nurse include in the teaching plan for a patient diagnosed with basal cell carcinoma (BCC)?

A)Treatment plans include watchful waiting.

B)Screening for metastasis will be important.

C)Minimizing sun exposure reduces risk for future BCC.

D)Low dose systemic chemotherapy is used to treat BCC.

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Chapter 24: Burns

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Sample Questions

Q1) A patient has just arrived in the emergency department after an electrical burn from exposure to a high-voltage current. What is the priority nursing assessment?

A)Oral temperature

B)Peripheral pulses

C)Extremity movement

D)Pupil reaction to light

Q2) Which prescribed drug is best for the nurse to give before scheduled wound debridement on a patient with partial-thickness burns?

A)ketorolac

B)lorazepam (Ativan)

C)gabapentin (Neurontin)

D)hydromorphone (Dilaudid)

Q3) A patient with extensive electrical burn injuries is admitted to the emergency department. Which prescribed intervention should the nurse implement first?

A)Assess pain level.

B)Place on heart monitor.

C)Check potassium level.

D)Assess oral temperature.

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Chapter 25: Assessment of Respiratory System

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Sample Questions

Q1) The nurse palpates the posterior chest while the patient says "99" and notes absent fremitus. Which action should the nurse take next?

A)Palpate the anterior chest and observe for barrel chest.

B)Encourage the patient to turn, cough, and deep breathe.

C)Review the chest x-ray report for evidence of pneumonia.

D)Auscultate anterior and posterior breath sounds bilaterally.

Q2) After the nurse has received change-of-shift report,which patient should the nurse assess first?

A)A patient with pneumonia who has crackles in the right lung base

B)A patient with chronic bronchitis who has a low forced vital capacity

C)A patient with possible lung cancer who has just returned after bronchoscopy

D)A patient with hemoptysis and a 16-mm induration after tuberculin skin testing

Q3) The nurse prepares a patient with a left-sided pleural effusion for a thoracentesis. How should the nurse position the patient?

A)High-Fowler's position with the left arm extended

B)Supine with the head of the bed elevated 30 degrees

C)On the right side with the left arm extended above the head

D)Sitting upright with the arms supported on an over bed table

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Chapter 26: Upper Respiratory Problems

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Sample Questions

Q1) Which action should the nurse take first when a patient develops epistaxis?

A)Pack the affected nare tightly with an epistaxis balloon.

B)Apply squeezing pressure to the nostrils for 10 minutes.

C)Obtain silver nitrate that may be needed for cauterization.

D)Instill a vasoconstrictor medication into the affected nare.

Q2) The nurse assumes care of a patient who just returned from surgery for a total laryngectomy and radical neck dissection and notes the following problems. In which order should the nurse address the problems? (Put a comma and a space between each answer choice [A,B,C,D].)

A)The patient is in a side-lying position with the head of the bed flat.

B)The patient is coughing blood-tinged secretions from the tracheostomy.

C)The nasogastric (NG) tube is disconnected from suction and clamped off.

D)The wound drain in the neck incision contains 200 mL of bloody drainage.

Q3) Which patient in the ear,nose,and throat (ENT)clinic should the nurse assess first?

A)A patient who is complaining of a sore throat and has a muffled voice

B)A patient who has a "scratchy throat" and a positive rapid strep antigen test

C)A patient who is receiving radiation for throat cancer and has severe fatigue

D)A patient with a history of a total laryngectomy whose stoma is red and inflamed

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Chapter 27: Lower Respiratory Problems

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51 Flashcards

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Sample Questions

Q1) The nurse is performing tuberculosis (TB)skin tests in a clinic that has many patients who have immigrated to the United States. Which question is most important for the nurse to ask before the skin test?

A)"Do you take any over-the-counter (OTC) medications?"

B)"Do you have any family members with a history of TB?"

C)"How long has it been since you moved to the United States?"

D)"Did you receive the bacille Calmette-Guérin (BCG) vaccine for TB?"

Q2) The nurse provides preoperative instruction for a patient scheduled for a left pneumonectomy. Which information should the nurse include about the patient's postoperative care?

A)Bed rest for the first 24 hours

B)Positioning only on the right side

C)Frequent use of an incentive spirometer

D)Chest tube placement to continuous suction

Q3) Which action should the nurse plan to prevent aspiration in a high-risk patient?

A)Turn and reposition an immobile patient at least every 2 hours.

B)Place a patient with altered consciousness in a side-lying position.

C)Insert a nasogastric tube for feeding a patient with high calorie needs.

D)Monitor respiratory symptoms in a patient who is immunosuppressed.

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Page 29

Chapter 28: Obstructive Pulmonary Diseases

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Sample Questions

Q1) The nurse receives a change-of-shift report on the following patients with chronic obstructive pulmonary disease (COPD). Which patient should the nurse assess first?

A)A patient with loud expiratory wheezes

B)A patient with a respiratory rate of 38 breaths/min

C)A patient who has a cough productive of thick, green mucus

D)A patient with jugular venous distention and peripheral edema

Q2) A patient with chronic obstructive pulmonary disease (COPD)has a nursing diagnosis of imbalanced nutrition: less than body requirements. Which intervention would be most appropriate for the nurse to include in the plan of care?

A)Encourage increased intake of whole grains.

B)Increase the patient's intake of fruits and fruit juices.

C)Offer high-calorie protein snacks between meals and at bedtime.

D)Assist the patient in choosing foods with high vegetable content.

Q3) A patient with asthma has a personal best peak expiratory flow rate (PEFR)of 400 L/min. When explaining the asthma action plan,the nurse will teach the patient that a change in therapy is needed when the PEFR is less than ___ L/minute

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Chapter 29: Assessment of Hematologic System

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Sample Questions

Q1) A patient with pancytopenia of unknown origin is scheduled for the following diagnostic tests. The nurse will provide a consent form to sign for which test?

A)Bone marrow biopsy

B)Abdominal ultrasound

C)Complete blood count (CBC)

D)Activated partial thromboplastin time (aPTT)

Q2) The nurse notes pallor of the skin and nail beds in a newly admitted patient. The nurse should ensure that which laboratory test has been ordered?

A)Platelet count

B)Neutrophil count

C)Hemoglobin level

D)White blood cell count

Q3) The nurse examines the lymph nodes of a patient during a physical assessment. Which assessment finding would be of most concern to the nurse?

A)A 2-cm nontender supraclavicular node

B)A 1-cm mobile and nontender axillary node

C)An inability to palpate any superficial lymph nodes

D)Firm inguinal nodes in a patient with an infected foot

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Chapter 30: Hematologic Problems

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Sample Questions

Q1) Which action will the admitting nurse include in the care plan for a patient who has neutropenia?

A)Avoid intramuscular injections.

B)Check temperature every 4 hours.

C)Omit fruits or vegetables from the diet.

D)Place a "No Visitors" sign on the door.

Q2) It is important for the nurse providing care for a patient with sickle cell crisis to

A)limit the patient's intake of oral and IV fluids.

B)evaluate the effectiveness of opioid analgesics.

C)encourage the patient to ambulate as much as tolerated.

D)teach the patient about high-protein, high-calorie foods.

Q3) A patient who has acute myelogenous leukemia (AML)is considering treatment with a hematopoietic stem cell transplant (HSCT). The best approach for the nurse to assist the patient with a treatment decision is to

A)discuss the need for insurance to cover post-HSCT care.

B)ask whether there are questions or concerns about HSCT.

C)emphasize the positive outcomes of a bone marrow transplant.

D)explain that a cure is not possible with any treatment except HSCT.

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Chapter 31: Assessment of Cardiovascular System

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Sample Questions

Q1) A transesophageal echocardiogram (TEE)is ordered for a patient with possible endocarditis. Which action included in the standard TEE orders will the nurse need to accomplish first?

A)Start an IV line.

B)Start O2 per nasal cannula.

C)Place the patient on NPO status.

D)Give lorazepam (Ativan) 1 mg IV.

Q2) While listening at the mitral area,the nurse notes abnormal heart sounds at the patient's fifth intercostal space,midclavicular line. After listening to the audio clip,describe how the nurse will document the assessment finding.

A)S3 gallop heard at the aortic area

B)Systolic murmur noted at mitral area

C)Diastolic murmur noted at tricuspid area

D)Pericardial friction rub heard at the apex

Q3) To auscultate for S3 or S4 gallops in the mitral area,the nurse listens with the

A)diaphragm of the stethoscope with the patient lying flat.

B)bell of the stethoscope with the patient in the left lateral position.

C)diaphragm of the stethoscope with the patient in a supine position.

D)bell of the stethoscope with the patient sitting and leaning forward.

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Page 33

Chapter 32: Hypertension

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Sample Questions

Q1) A patient has just been diagnosed with hypertension and has been started on captopril . Which information is most important to include when teaching the patient about this drug?

A)Include high-potassium foods such as bananas in the diet.

B)Increase fluid intake if dryness of the mouth is a problem.

C)Change position slowly to help prevent dizziness and falls.

D)Check blood pressure (BP) in both arms before taking the drug.

Q2) The nurse obtains a blood pressure of 176/82 mm Hg for a patient. What is the patient's mean arterial pressure (MAP)?

Q3) A patient with hypertension who has just started taking atenolol (Tenormin)returns to the health clinic after 2 weeks for a follow-up visit. The blood pressure (BP)is unchanged from the previous visit. Which action should the nurse take first?

A)Tell the patient why a change in drug dosage is needed.

B)Ask the patient if the medication is being taken as prescribed.

C)Inform the patient that multiple drugs are often needed to treat hypertension.

D)Question the patient regarding any lifestyle changes made to help control BP.

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Chapter 33: Coronary Artery Disease and Acute Coronary Syndrome

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Sample Questions

Q1) Which patient at the cardiovascular clinic requires the most immediate action by the nurse?

A)Patient with type 2 diabetes whose current blood glucose level is 145 mg/dL

B)Patient with stable angina whose chest pain has recently increased in frequency

C)Patient with familial hypercholesterolemia and a total cholesterol of 465 mg/dL

D)Patient with chronic hypertension whose blood pressure today is 172/98 mm Hg

Q2) Which statement made by a patient with coronary artery disease after the nurse has completed teaching about the therapeutic lifestyle changes (TLC)diet indicates that further teaching is needed?

A)"I will switch from whole milk to 1% milk."

B)"I like salmon and I will plan to eat it more often."

C)"I can have a glass of wine with dinner if I want one."

D)"I will miss being able to eat peanut butter sandwiches."

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Chapter 34: Heart Failure

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Sample Questions

Q1) A patient who has chronic heart failure tells the nurse,"I was fine when I went to bed,but I woke up in the middle of the night feeling like I was suffocating!" The nurse will document this assessment finding as A)orthopnea.

B)pulsus alternans.

C)paroxysmal nocturnal dyspnea.

D)acute bilateral pleural effusion.

Q2) The nurse plans discharge teaching for a patient with chronic heart failure who has prescriptions for digoxin (Lanoxin)and hydrochlorothiazide. Appropriate instructions for the patient include

A)limit dietary sources of potassium.

B)take the hydrochlorothiazide before bedtime.

C)notify the health care provider if nausea develops.

D)take the digoxin if the pulse is below 60 beats/min.

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Chapter 35: Dysrhythmias

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Sample Questions

Q1) Which action should the nurse perform when preparing a patient with supraventricular tachycardia for cardioversion who is alert and has a blood pressure of 110/66 mm Hg?

A)Turn the synchronizer switch to the "off" position.

B)Give a sedative before cardioversion is implemented.

C)Set the defibrillator/cardioverter energy to 360 joules.

D)Provide assisted ventilations with a bag-valve-mask device.

Q2) When analyzing the rhythm of a patient's electrocardiogram (ECG),the nurse will need to investigate further upon finding a(n)

A)isoelectric ST segment.

B)PR interval of 0.18 second.

C)QT interval of 0.38 second.

D)QRS interval of 0.14 second.

Q3) A patient has a sinus rhythm and a heart rate of 72 beats/min. The nurse determines that the PR interval is 0.24 seconds. The most appropriate intervention by the nurse would be to

A)notify the health care provider immediately.

B)document the finding and monitor the patient.

C)give atropine per agency dysrhythmia protocol.

D)prepare the patient for temporary pacemaker insertion.

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Chapter 36: Inflammatory and Structural Heart Disorders

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Sample Questions

Q1) Which statement by a patient with restrictive cardiomyopathy indicates that the nurse's discharge teaching about self-management has been effective?

A)"I will avoid taking aspirin or other antiinflammatory drugs."

B)"I can restart my exercise program that includes hiking and biking."

C)"I will need to limit my intake of salt and fluids even in hot weather."

D)"I will take antibiotics before my teeth are cleaned at the dental office."

Q2) When planning care for a patient hospitalized with a streptococcal infective endocarditis (IE),which intervention is most appropriate for the nurse to include?

A)Arrange for placement of a long-term IV catheter.

B)Monitor labs for levels of streptococcal antibodies.

C)Teach the importance of completing all oral antibiotics.

D)Encourage the patient to begin regular aerobic exercise.

Q3) When caring for a patient with infective endocarditis of the tricuspid valve,the nurse should monitor the patient for the development of A)flank pain.

B)splenomegaly.

C)shortness of breath.

D)mental status changes.

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Chapter 37: Vascular Disorders

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Sample Questions

Q1) The nurse is developing a discharge teaching plan for a patient diagnosed with thromboangiitis obliterans (Buerger's disease). Which expected outcome has the highest priority for this patient?

A)Cessation of all tobacco use

B)Control of serum lipid levels

C)Maintenance of appropriate weight

D)Demonstration of meticulous foot care

Q2) A patient who is 2 days post femoral popliteal bypass graft to the right leg is being cared for on the vascular unit. Which action by a licensed practical/vocational nurse (LPN/LVN)caring for the patient requires the registered nurse (RN)to intervene?

A)The LPN/LVN has the patient to sit in a chair for 2 hours.

B)The LPN/LVN gives the prescribed aspirin after breakfast.

C)The LPN/LVN assists the patient to walk 40 feet in the hallway.

D)The LPN/LVN places the patient in Fowler's position for meals.

Q3) When assessing a patient with possible peripheral artery disease (PAD),the nurse obtains a brachial blood pressure (BP)of 147/82 mm Hg and an ankle pressure of 112/74 mm Hg. The nurse calculates the patient's ankle-brachial index (ABI)as ________ (round up to the nearest hundredth).

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Page 39

Chapter 38: Assessment of Gastrointestinal System

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Sample Questions

Q1) While interviewing a young adult patient,the nurse learns that the patient has a family history of familial adenomatous polyposis (FAP). The nurse will plan to assess the patient's knowledge about

A)preventing noninfectious hepatitis.

B)treating inflammatory bowel disease.

C)risk for developing colorectal cancer.

D)using antacids and proton pump inhibitors.

Q2) To palpate the liver during a head-to-toe physical assessment,the nurse

A)places one hand on the patient's back and presses upward and inward with the other hand below the patient's right costal margin.

B)places one hand on top of the other and uses the upper fingers to apply pressure and the bottom fingers to feel for the liver edge.

C)presses slowly and firmly over the right costal margin with one hand and withdraws the fingers quickly after the liver edge is felt.

D)places one hand under the patient's lower ribs and presses the left lower rib cage forward, palpating below the costal margin with the other hand.

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Chapter 39: Nutritional Problems

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Sample Questions

Q1) A 19-yr-old woman admitted with anorexia nervosa is 5 ft,6 in (163 cm)tall and weighs 88 lb (41 kg). Laboratory tests reveal hypokalemia and iron-deficiency anemia. Which patient problem has the highest priority?

A)Risk for activity intolerance

B)Risk for electrolyte imbalance

C)Ineffective health maintenance

D)Imbalanced nutrition: less than body requirements

Q2) When caring for a patient with a soft,silicone nasogastric tube in place for enteral feedings,the nurse will

A)avoid giving medications through the feeding tube.

B)flush the tubing after checking for residual volumes.

C)replace the tube every 3 days to avoid mucosal damage.

D)administer continuous feedings using an infusion pump.

Q3) A severely malnourished patient reports that he is Jewish. The nurse's initial action to meet his nutritional needs will be to

A)have family members bring in food.

B)ask the patient about food preferences.

C)teach the patient about nutritious Kosher foods.

D)order nutrition supplements that are manufactured Kosher.

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Page 41

Chapter 40: Obesity

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Sample Questions

Q1) Which adult will the nurse plan to teach about risks associated with obesity?

A)Man who has a BMI of 18 kg/m2

B)Man with a 42 in waist and 44 in hips

C)Woman who has a body mass index (BMI) of 24 kg/m2

D)Woman with a waist circumference of 34 inches (86 cm)

Q2) Which finding for a patient who has been taking orlistat (Xenical)is most important to report to the health care provider?

A)The patient frequently has liquid stools.

B)The patient is pale and has many bruises.

C)The patient complains of bloating after meals.

D)The patient is experiencing a weight loss plateau.

Q3) Which assessment action will help the nurse determine if an obese patient has metabolic syndrome?

A)Take the patient's apical pulse.

B)Check the patient's blood pressure.

C)Ask the patient about dietary intake.

D)Dipstick the patient's urine for protein.

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Chapter 41: Upper Gastrointestinal Problems

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Sample Questions

Q1) Which prescribed action will the nurse implement first for a patient who has vomited 1100 mL of blood?

A)Give an IV H2 receptor antagonist.

B)Draw blood for typing and crossmatching.

C)Administer 1 L of lactated Ringer's solution.

D)Insert a nasogastric (NG) tube and connect to suction.

Q2) The nurse will anticipate teaching a patient experiencing frequent heartburn about A)a barium swallow.

B)radionuclide tests.

C)endoscopy procedures.

D)proton pump inhibitors.

Q3) Which information will the nurse include for a patient with newly diagnosed gastroesophageal reflux disease (GERD)?

A)"Peppermint tea may reduce your symptoms."

B)"Keep the head of your bed elevated on blocks."

C)"You should avoid eating between meals to reduce acid secretion."

D)"Vigorous physical activities may increase the incidence of reflux."

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Chapter 42: Lower Gastrointestinal Problems

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Sample Questions

Q1) Which information will the nurse include in teaching a patient who had a proctocolectomy and ileostomy for ulcerative colitis?

A)Restrict fluid intake to prevent constant liquid drainage from the stoma.

B)Use care when eating high-fiber foods to avoid obstruction of the ileum.

C)Irrigate the ileostomy daily to avoid having to wear a drainage appliance.

D)Change the pouch every day to prevent leakage of contents onto the skin.

Q2) A 71-yr-old patient had an abdominal-perineal resection for colon cancer. Which nursing action is most important to include in the plan of care for the day after surgery?

A)Teach about a low-residue diet.

B)Monitor output from the stoma.

C)Assess the perineal drainage and incision.

D)Encourage acceptance of the colostomy stoma.

Q3) A patient has a new diagnosis of Crohn's disease after having frequent diarrhea and a weight loss of 10 lb (4.5 kg)over 2 months. The nurse will plan to teach about

A)medication use.

B)fluid restriction.

C)enteral nutrition.

D)activity restrictions.

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Chapter 43: Liver, pancreas, and Biliary Tract Problems

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Sample Questions

Q1) A patient with cirrhosis has ascites and 4+ edema of the feet and legs. Which nursing action will be included in the plan of care?

A)Restrict daily dietary protein intake.

B)Reposition the patient every 4 hours.

C)Perform passive range of motion twice daily.

D)Place the patient on a pressure-relief mattress.

Q2) During change-of-shift report,the nurse learns about the following four patients. Which patient requires assessment first?

A)A 40-yr-old patient with chronic pancreatitis who has gnawing abdominal pain

B)A 58-yr-old patient who has compensated cirrhosis and is complaining of anorexia

C)A 55-yr-old patient with cirrhosis and ascites who has an oral temperature of 102° F (38.8° C)

D)A 36-yr-old patient recovering from a laparoscopic cholecystectomy who has severe shoulder pain

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Chapter 44: Assessment of Urinary System

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Sample Questions

Q1) How will the nurse assess for flank tenderness in a patient with suspected pyelonephritis?

A)Palpate along both sides of the lumbar vertebral column.

B)Strike a flat hand covering the costovertebral angle (CVA).

C)Push fingers upward into the two lowest intercostal spaces.

D)Percuss between the iliac crest and ribs at the midaxillary line.

Q2) Which medication taken at home by a patient with decreased renal function will be of most concern to the nurse?

A)ibuprofen (Motrin)

B)warfarin (Coumadin)

C)folic acid (vitamin B9)

D)penicillin (Bicillin C-R)

Q3) A young adult who is employed as a hairdresser and has a 15 pack-year history of cigarette smoking is scheduled for an annual physical examination. The nurse will plan to teach the patient about the increased risk for

A)renal failure.

B)kidney stones.

C)pyelonephritis.

D)bladder cancer.

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Page 46

Chapter 45: Renal and Urologic Problems

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Sample Questions

Q1) When planning teaching for a patient with benign nephrosclerosis,the nurse should include instructions regarding

A)preventing bleeding with anticoagulants.

B)monitoring and recording blood pressure.

C)obtaining and documenting daily weights.

D)measuring daily intake and output volumes.

Q2) After change-of-shift report,which patient should the nurse assess first?

A)Patient with a urethral stricture who has not voided for 12 hours

B)Patient who has cloudy urine after orthotopic bladder reconstruction

C)Patient with polycystic kidney disease whose blood pressure is 186/98 mm Hg

D)Patient who voided bright red urine immediately after returning from lithotripsy

Q3) To determine possible causes,the nurse will ask a patient admitted with acute glomerulonephritis about

A)recent bladder infection.

B)history of kidney stones.

C)recent sore throat and fever.

D)history of high blood pressure.

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Chapter 46: Acute Kidney Injury and Chronic Kidney Disease

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Sample Questions

Q1) After receiving change-of-shift report,which patient should the nurse assess first?

A)Patient who is scheduled for the drain phase of a peritoneal dialysis exchange

B)Patient with stage 4 chronic kidney disease who has an elevated phosphate level

C)Patient with stage 5 chronic kidney disease who has a potassium level of 3.4 mEq/L

D)Patient who has just returned from having hemodialysis and has a heart rate of 124/min

Q2) After the insertion of an arteriovenous graft (AVG)in the right forearm,a patient complains of pain and coldness of the right fingers. Which action should the nurse take?

A)Teach the patient about normal AVG function.

B)Remind the patient to take a daily low-dose aspirin tablet.

C)Report the patient's symptoms to the health care provider.

D)Elevate the patient's arm on pillows to above the heart level.

Q3) A patient in the oliguric phase after an acute kidney injury has had a 250-mL urine output and an emesis of 100 mL in the past 24 hours. What is the patient's fluid restriction for the next 24 hours?

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Chapter 47: Assessment of Endocrine System

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Sample Questions

Q1) A registered nurse (RN)is caring for a patient with a goiter and possible hyperthyroidism. Which action by the RN indicates that the charge nurse needs to provide the RN with additional teaching?

A)The RN checks the blood pressure in both arms.

B)The RN palpates the neck to assess thyroid size.

C)The RN orders saline eye drops to lubricate the patient's bulging eyes.

D)The RN lowers the thermostat to decrease the temperature in the room.

Q2) Which laboratory value should the nurse review to determine whether a patient's hypothyroidism is caused by a problem with the anterior pituitary gland or with the thyroid gland?

A)Thyroxine (T4) level

B)Triiodothyronine (T3) level

C)Thyroid-stimulating hormone (TSH) level

D)Thyrotropin-releasing hormone (TRH) level

Q3) A patient is admitted with tetany. Which laboratory value should the nurse plan to monitor?

A)Total protein

B)Blood glucose

C)Ionized calcium

D)Serum phosphate

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Chapter 48: Diabetes Mellitus

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Sample Questions

Q1) After the nurse has finished teaching a patient who has a new prescription for exenatide (Byetta),which patient statement indicates that the teaching has been effective?

A)"I may feel hungrier than usual when I take this medicine."

B)"I will not need to worry about hypoglycemia with the Byetta."

C)"I should take my daily aspirin at least an hour before the Byetta."

D)"I will take the pill at the same time I eat breakfast in the morning."

Q2) Which statement by the patient indicates a need for additional instruction in administering insulin?

A)"I need to rotate injection sites among my arms, legs, and abdomen each day."

B)"I can buy the 0.5-mL syringes because the line markings will be easier to see."

C)"I do not need to aspirate the plunger to check for blood before injecting insulin."

D)"I should draw up the regular insulin first, after injecting air into the NPH bottle."

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Chapter 49: Endocrine Problems

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Sample Questions

Q1) A 29-yr-old woman with systemic lupus erythematosus has been prescribed 2 weeks of high-dose prednisone therapy. Which information about the prednisone is most important for the nurse to include?

A)"Weigh yourself daily to monitor for weight gain."

B)"The prednisone dose should be decreased gradually."

C)"A weight-bearing exercise program will help minimize risk for osteoporosis."

D)"Call the health care provider if you have mood changes with the prednisone."

Q2) Which intervention will the nurse include in the plan of care for a patient with syndrome of inappropriate antidiuretic hormone (SIADH)?

A)Encourage fluids to 2 to 3 L/day.

B)Monitor for increasing peripheral edema.

C)Offer the patient hard candies to suck on.

D)Keep head of bed elevated to 30 degrees.

Q3) Which assessment finding for a 33-yr-old female patient admitted with Graves' disease requires the most rapid intervention by the nurse?

A)Heart rate 136 beats/min

B)Severe bilateral exophthalmos

C)Temperature 103.8° F (40.4° C)

D)Blood pressure 166/100 mm Hg

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Page 51

Chapter 50: Assessment of Reproductive System

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Sample Questions

Q1) A woman calls the clinic because she is having an unusually heavy menstrual flow. She tells the nurse that she has saturated three tampons in the past 2 hours. The nurse estimates that the amount of blood loss over the past 2 hours is _____ mL.

A)20 to 30

B)30 to 40

C)40 to 60

D)60 to 90

Q2) Which question should the nurse ask when assessing a 60-yr-old patient who has a history of benign prostatic hyperplasia (BPH)?

A)"Have you noticed any unusual discharge from your penis?"

B)"Has there been any change in your sex life in the past year?"

C)"Has there been a decrease in the force of your urinary stream?"

D)"Have you been experiencing any difficulty in achieving an erection?"

Q3) The nurse will plan to teach a 51-yr-old man who is scheduled for an annual physical examination about a(n)

A)increased risk for testicular cancer.

B)possible changes in erectile function.

C)normal decreases in testosterone level.

D)prostate specific antigen (PSA) testing.

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Page 52

Chapter 51: Breast Disorders

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Sample Questions

Q1) The nurse is providing preoperative teaching about the transverse rectus abdominis musculocutaneous (TRAM)procedure to a patient. Which information will the nurse include?

A)Saline-filled implants are placed under the pectoral muscles.

B)Recovery from the TRAM surgery takes at least 6 to 8 weeks.

C)Muscle tissue removed from the back is used to form a breast.

D)TRAM flap procedures may be done in outpatient surgery centers.

Q2) Which nursing action should be included in the plan of care for a patient returning to the surgical unit after a left modified radical mastectomy with dissection of axillary lymph nodes?

A)Obtain a permanent breast prosthesis before the patient is discharged from the hospital.

B)Teach the patient to use the ordered patient-controlled analgesia (PCA) every 10 minutes.

C)Post a sign at the bedside warning against venipunctures or blood pressures in the left arm.

D)Insist that the patient examine the surgical incision when the initial dressings are removed.

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Page 53

Chapter 52: Sexually Transmitted Infections

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Sample Questions

Q1) A patient in the sexually transmitted infection (STI)clinic tells the nurse that she is concerned she may have been exposed to gonorrhea. To determine whether the patient has gonorrhea,the nurse will plan to

A)interview the patient about symptoms of gonorrhea.

B)take a sample of cervical discharge for Gram staining.

C)draw a blood specimen or rapid plasma reagin (RPR) testing.

D)obtain secretions for a nucleic acid amplification test (NAAT).

Q2) A patient with gonorrhea is treated with a single IM dose of ceftriaxone (Rocephin)and is given a prescription for doxycycline (Vibramycin)100 mg bid for 7 days.

The nurse explains to the patient that this combination is prescribed to

A)prevent reinfection during treatment.

B)treat any coexisting chlamydial infection.

C)eradicate resistant strains of N.gonorrhoeae.

D)prevent the development of resistant organisms.

Q3) Which patient will the nurse plan on teaching about the Gardasil vaccine?

A)A 24-yr-old female patient who has not been sexually active

B)A 34-yr-old female patient who has multiple sexual partners

C)A 24-yr-old female patient who is pregnant for the first time

D)A 34-yr-old female patient who is in a monogamous relationship

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Page 54

Chapter 53: Female Reproductive and Genital Problems

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49 Flashcards

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Sample Questions

Q1) Which statement by the patient indicates that the nurse's teaching about treating vaginal candidiasis was effective?

A)"I will tell my partner that we cannot have intercourse for a month."

B)"I should clean carefully after each urination and bowel movement."

C)"I can douche with warm water if the itching continues to bother me."

D)"I will insert the antifungal cream right before I get up in the morning."

Q2) A 22-yr-old patient tells the nurse that she has not had a menstrual period for the past 3 months. Which action is most important for the nurse to take?

A)Obtain a urine specimen for a pregnancy test.

B)Ask about any recent stressful lifestyle changes.

C)Measure the patient's current height and weight.

D)Question the patient about prescribed medications.

Q3) A 32-yr-old patient has oral contraceptives prescribed for endometriosis. The nurse will teach the patient to

A)expect to experience side effects such as facial hair.

B)take the medication every day for the next 9 months.

C)take calcium supplements to prevent developing osteoporosis during therapy.

D)use a second method of contraception to ensure that she will not become pregnant.

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Chapter 54: Male Reproductive and Genital Problems

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Sample Questions

Q1) A patient who has been recently diagnosed with benign prostatic hyperplasia (BPH)tells the nurse that he does not want to have a transurethral resection of the prostate (TURP)because it might affect his ability to have sexual intercourse. Which action should the nurse take?

A)Discuss alternative methods of sexual expression.

B)Teach about medication for erectile dysfunction (ED).

C)Clarify that TURP does not commonly affect erection.

D)Offer reassurance that fertility is not affected by TURP.

Q2) A 53-yr-old patient is scheduled for an annual physical examination. The nurse will plan to teach the patient about the purpose of A)urinalysis collection.

B)uroflowmetry studies.

C)prostate specific antigen (PSA) testing.

D)transrectal ultrasound scanning (TRUS).

Q3) Which information will the nurse teach a patient who has chronic prostatitis?

A)Ibuprofen (Motrin) should provide good pain control.

B)Prescribed antibiotics should be taken for 7 to 10 days.

C)Intercourse or masturbation will help relieve symptoms.

D)Cold packs used every 4 hours will decrease inflammation.

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Page 56

Chapter 55: Assessment of Nervous System

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Sample Questions

Q1) An unconscious male patient has just arrived in the emergency department with a head injury caused by a motorcycle crash. Which order should the nurse question?

A)Obtain x-rays of the skull and spine.

B)Prepare the patient for lumbar puncture.

C)Send for computed tomography (CT) scan.

D)Perform neurologic checks every 15 minutes.

Q2) The nurse performing a focused assessment of left posterior temporal lobe functions will assess the patient for

A)sensation on the left side of the body.

B)reasoning and problem-solving ability.

C)ability to understand written and oral language.

D)voluntary movements on the right side of the body.

Q3) The nurse will anticipate teaching a patient with a possible seizure disorder about which test?

A)Cerebral angiography

B)Evoked potential studies

C)Electromyography (EMG)

D)Electroencephalography (EEG)

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Chapter 56: Acute Intracranial Problems

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Sample Questions

Q1) The nurse is caring for a patient who has a head injury. Which finding,when reported to the health care provider,should the nurse expect will result in new prescribed interventions?

A)Pale yellow urine output of 1200 mL over the past 2 hours.

B)Ventriculostomy drained 40 mL of fluid in the past 2 hours.

C)Intracranial pressure spikes to 16 mm Hg when patient is turned.

D)LICOX brain tissue oxygenation catheter shows PbtO2 of 38 mm Hg.

Q2) When assessing a 53-yr-old patient with bacterial meningitis,the nurse obtains the following data. Which finding requires the most immediate intervention?

A)The patient exhibits nuchal rigidity.

B)The patient has a positive Kernig's sign.

C)The patient's temperature is 101° F (38.3° C).

D)The patient's blood pressure is 88/42 mm Hg.

Q3) A patient who is suspected of having an epidural hematoma is admitted to the emergency department. Which action will the nurse expect to take?

A)Administer IV furosemide (Lasix).

B)Prepare the patient for craniotomy.

C)Initiate high-dose barbiturate therapy.

D)Type and crossmatch for blood transfusion.

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Page 58

Chapter 57: Stroke

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Sample Questions

Q1) A female patient who had a stroke 24 hours ago has expressive aphasia. An appropriate nursing intervention to help the patient communicate is to

A)ask questions that the patient can answer with "yes" or "no."

B)develop a list of words that the patient can read and practice reciting.

C)have the patient practice her facial and tongue exercises with a mirror.

D)prevent embarrassing the patient by answering for her if she does not respond.

Q2) A patient arrives in the emergency department with hemiparesis and dysarthria that started 2 hours previously,and health records show a history of several transient ischemic attacks (TIAs). The nurse anticipates preparing the patient for

A)surgical endarterectomy.

B)transluminal angioplasty.

C)intravenous heparin drip administration.

D)tissue plasminogen activator (tPA) infusion.

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Chapter 58: Chronic Neurologic Problems

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Sample Questions

Q1) Which information about a patient who has a new prescription for phenytoin (Dilantin)indicates that the nurse should consult with the health care provider before administration of the medication?

A)Patient has tonic-clonic seizures.

B)Patient experiences an aura before seizures.

C)Patient has minor elevations in the liver function tests.

D)Patient's most recent blood pressure is 156/92 mm Hg.

Q2) The nurse expects the assessment of a patient who is experiencing a cluster headache to include

A)nuchal rigidity.

B)unilateral ptosis.

C)projectile vomiting.

D)throbbing, bilateral facial pain.

Q3) Which assessment is most important for the nurse to make regarding a patient with myasthenia gravis?

A)Pupil size

B)Grip strength

C)Respiratory effort

D)Level of consciousness

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Page 60

Chapter 59: Dementia and Delirium

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Sample Questions

Q1) A patient who is hospitalized with pneumonia is disoriented and confused 3 days after admission. Which information indicates that the patient is experiencing delirium rather than dementia?

A)The patient was oriented and alert when admitted.

B)The patient's speech is fragmented and incoherent.

C)The patient is oriented to person but disoriented to place and time.

D)The patient has a history of increasing confusion over several years.

Q2) A patient with Alzheimer's disease (AD)who is being admitted to a long-term care facility has had several episodes of wandering away from home. Which action will the nurse include in the plan of care?

A)Reorient the patient several times daily.

B)Have the family bring in familiar items.

C)Place the patient in a room close to the nurses' station.

D)Ask the patient why the wandering episodes have occurred.

Q3) When administering a mental status examination to a patient with delirium,the nurse should

A)wait until the patient is well-rested.

B)administer an anxiolytic medication.

C)choose a place without distracting stimuli.

D)reorient the patient during the examination.

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Chapter 60: Spinal Cord and Peripheral Nerve Problems

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Sample Questions

Q1) To prevent autonomic hyperreflexia,which nursing action will the home health nurse include in the plan of care for a patient who has paraplegia at the T4 level ?

A)Support selection of a high-protein diet.

B)Discuss options for sexuality and fertility.

C)Assist in planning a prescribed bowel program.

D)Use quad coughing to strengthen cough efforts.

Q2) A patient with Bell's palsy refuses to eat while others are present because of embarrassment about drooling. The best response by the nurse is to

A)respect the patient's feelings and arrange for privacy at mealtimes.

B)teach the patient to chew food on the unaffected side of the mouth.

C)offer the patient liquid nutritional supplements at frequent intervals.

D)discuss the patient's concerns with visitors who arrive at mealtimes.

Q3) A patient hospitalized with a new diagnosis of Guillain-Barré syndrome has numbness and weakness of both feet. The nurse will anticipate teaching the patient about

A)infusion of immunoglobulin

B)intubation and mechanical ventilation.

C)administration of corticosteroid drugs.

D)insertion of a nasogastric (NG) feeding tube.

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Page 62

Chapter 61: Assessment of Musculoskeletal System

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Sample Questions

Q1) The nurse finds that a patient can flex the arms when no resistance is applied but is unable to flex when the nurse applies light resistance. The nurse should document the patient's muscle strength as level

A)0.

B)1.

C)2.

D)3.

Q2) Which finding for a 77-yr-old patient seen in the outpatient clinic requires further nursing assessment and intervention?

A)Symmetric joint swelling of fingers

B)Decreased right knee range of motion

C)Report of left hip aching when jogging

D)History of recent loss of balance and fall

Q3) After completing the health history,the nurse assessing the musculoskeletal system will begin by

A)having the patient move the extremities against resistance.

B)feeling for the presence of crepitus during joint movement.

C)observing the patient's body build and muscle configuration.

D)checking active and passive range of motion for the extremities.

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Page 63

Chapter 62: Musculoskeletal Trauma and Orthopedic Surgery

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Sample Questions

Q1) A patient is admitted to the emergency department with a left femur fracture. Which information obtained by the nurse is most important to report to the health care provider?

A)Ecchymosis of the left thigh

B)Complaints of severe thigh pain

C)Slow capillary refill of the left foot

D)Outward pointing toes on the left foot

Q2) The second day after admission with a fractured pelvis,a patient suddenly develops confusion. Which action should the nurse take first?

A)Take the blood pressure.

B)Assess patient orientation.

C)Check the O2 saturation.

D)Observe for facial asymmetry.

Q3) A pedestrian who was hit by a car is admitted to the emergency department with possible right lower leg fractures. The initial action by the nurse should be to

A)elevate the right leg.

B)splint the lower leg.

C)assess the pedal pulses.

D)verify tetanus immunization.

Page 64

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Chapter 63: Musculoskeletal Problems

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Sample Questions

Q1) An appropriate nursing intervention for a patient who has acute low back pain and muscle spasms is to teach the patient to

A)keep both feet flat on the floor when prolonged standing is required.

B)twist gently from side to side to maintain range of motion in the spine.

C)keep the head elevated slightly and flex the knees when resting in bed.

D)avoid the use of cold packs because they will exacerbate the muscle spasms.

Q2) Which action should the nurse take before administering gentamicin (Garamycin)to a patient with acute osteomyelitis?

A)Ask the patient about any nausea.

B)Obtain the patient's oral temperature.

C)Review the patient's serum creatinine.

D)Change the prescribed wet-to-dry dressing.

Q3) Which assessment finding for a patient who has had surgical reduction of an open fracture of the right radius requires notification of the health care provider?

A)Serous wound drainage

B)Right arm muscle spasms

C)Right arm pain with movement

D)Temperature 101.4° F (38.6° C)

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Chapter 64: Arthritis and Connective Tissue Diseases

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Sample Questions

Q1) A patient hospitalized with a fever and red,hot,painful knees is suspected of having septic arthritis. Information obtained during the nursing history that indicates a risk factor for septic arthritis is that the patient

A)had several knee injuries as a teenager.

B)recently returned from South America.

C)is sexually active with multiple partners.

D)has a parent who has rheumatoid arthritis.

Q2) Which information will the nurse include when preparing teaching materials for a patient with an exacerbation of rheumatoid arthritis?

A)Affected joints should not be exercised when pain is present.

B)Applying cold packs before exercise may decrease joint pain.

C)Exercises should be performed passively by someone other than the patient.

D)Walking may substitute for range-of-motion (ROM) exercises on some days.

Q3) The nurse determines that colchicine has been effective for a patient with an acute attack of gout upon finding

A)reduced joint pain.

B)increased urine output.

C)elevated serum uric acid.

D)increased white blood cells (WBC).

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Page 66

Chapter 65: Critical Care

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Sample Questions

Q1) The nurse is caring for a patient who has an intraaortic balloon pump in place. Which action should be included in the plan of care?

A)Avoid the use of anticoagulant medications.

B)Measure the patient's urinary output every hour.

C)Provide passive range of motion for all extremities.

D)Position the patient supine with head flat at all times.

Q2) A patient with respiratory failure has arterial pressure-based cardiac output (APCO)monitoring and is receiving mechanical ventilation with peak end-expiratory pressure (PEEP)of 12 cm H2O. Which information indicates that a change in the ventilator settings may be required?

A)The arterial pressure is 90/46.

B)The stroke volume is increased.

C)The heart rate is 58 beats/minute.

D)The stroke volume variation is 12%.

Q3) A patient's vital signs are pulse 90,respirations 24,and BP 128/64 mm Hg,and cardiac output is 4.7 L/min. The patient's stroke volume is _____ mL. (Round to the nearest whole number.)

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Chapter 66: Shock, sepsis, and Multiple Organ Dysfunction Syndrome

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Sample Questions

Q1) The health care provider orders the following interventions for a 67-kg patient who has septic shock with a blood pressure of 70/42 mm Hg and O? saturation of 90% on room air. In which order will the nurse implement the actions? (Put a comma and a space between each answer choice [A,B,C,D,E].)

A)Give vancomycin 1 g IV.

B)Obtain blood and urine cultures

C)Start norepinephrine 0.5 mcg/min.

D)Infuse normal saline 2000 mL over 30 minutes.

E)Titrate oxygen administration to keep O? saturation above 95%.

Q2) An older patient with cardiogenic shock is cool and clammy. Hemodynamic monitoring indicates a high systemic vascular resistance (SVR). Which intervention should the nurse anticipate?

A)Increase the rate for the dopamine infusion.

B)Decrease the rate for the nitroglycerin infusion.

C)Increase the rate for the sodium nitroprusside infusion.

D)Decrease the rate for the 5% dextrose in normal saline (D5/.9 NS) infusion.

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Chapter 67: Acute Respiratory Failure and Acute

Respiratory Distress Syndrome

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Sample Questions

Q1) The nurse is caring for a patient who is intubated and receiving positive pressure ventilation to treat acute respiratory distress syndrome (ARDS). Which finding is most important to report to the health care provider?

A)Red-brown drainage from nasogastric tube

B)Blood urea nitrogen (BUN) level 32 mg/dL

C)Scattered coarse crackles heard throughout lungs

D)Arterial blood gases: pH of 7.31, PaCO2 of 50, and PaO2 of 68

Q2) The nurse is caring for an older patient who was hospitalized 2 days earlier with community-acquired pneumonia. Which assessment information is most important to communicate to the health care provider?

A)Persistent cough of blood-tinged sputum.

B)Scattered crackles in the posterior lung bases.

C)Oxygen saturation 90% on 100% O2 by nonrebreather mask.

D)Temperature 101.5° F (38.6° C) after 2 days of IV antibiotics.

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Chapter 68: Emergency and Disaster Nursing

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Sample Questions

Q1) An unresponsive 79-yr-old patient is admitted to the emergency department (ED)during a summer heat wave. The patient's core temperature is 105.4° F (40.8° C),blood pressure (BP)is 88/50 mm Hg,and pulse is 112 beats/min. The nurse will plan to A)apply wet sheets and a fan to the patient.

B)provide O2 at 2 L/min with a nasal cannula.

C)start lactated Ringer's solution at 1000 mL/hr.

D)give acetaminophen (Tylenol) rectal suppository.

Q2) A 19-yr-old patient is brought to the emergency department (ED)with multiple lacerations and tissue avulsion of the left hand. When asked about tetanus immunization,the patient denies having any previous vaccinations. The nurse will anticipate giving A)tetanus immunoglobulin (TIG) only.

B)TIG and tetanus-diphtheria toxoid (Td).

C)tetanus-diphtheria toxoid and pertussis vaccine (Tdap) only.

D)TIG and tetanus-diphtheria toxoid and pertussis vaccine (Tdap).

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