NR446 - Aff Readiness Pre quiz

A patient with a femur fracture is in a cast. Which nursing intervention is most important?

• Monitor for signs of infection

• Assess for neurovascular status

• Encourage ambulation

• Administer pain medication

Answer explanation

Assessing neurovascular status is crucial to detect complications like compartment syndrome, which can occur with femur fractures in a cast. Monitoring for infection, ambulation, and pain management are also important but secondary.

A patient with COPD is experiencing increased shortness of breath. Which assessment finding would indicate worsening respiratory status?

• Decreased respiratory rate

• Increased use of accessory muscles

• Clear lung sounds

• Decreased heart rate

Answer explanation

Increased use of accessory muscles indicates that the patient is struggling to breathe, reflecting worsening respiratory status. This is a sign of respiratory distress, unlike decreased respiratory rate or clear lung sounds.

Which of the following is a common cause of cardiomegaly?

• Hypertension

• Anemia

• Hyperthyroidism

• Hypotension

Answer explanation

Hypertension is a common cause of cardiomegaly as it increases the workload on the heart, leading to its enlargement. Anemia and hyperthyroidism can also affect heart size, but hypertension is the most prevalent cause.

Which symptom is most commonly associated with pulmonary congestion?

• Bradycardia

• Productive cough with pink frothy sputum

• Hypotension

• Cyanosis of the extremities

Answer explanation

Pulmonary congestion often leads to fluid accumulation in the lungs, causing a productive cough with pink frothy sputum, a classic sign of pulmonary edema. This symptom is more indicative than bradycardia, hypotension, or cyanosis.

Which of the following is a key teaching point for a patient with COPD?

• Increase physical activity

• Avoid smoking and secondhand smoke

• Limit fluid intake

• Use oxygen only during sleep

Answer explanation

Avoiding smoking and secondhand smoke is crucial for COPD patients as it helps prevent further lung damage and exacerbations, improving overall lung function and quality of life.

A patient’s ABG results show pH 7.45, PaCO2 35 mmHg, and HCO3 24 mEq/L. What does this indicate?

• Metabolic acidosis

• Respiratory alkalosis

• Normal acid-base balance

• Metabolic alkalosis

Answer explanation

The pH of 7.45 is within the normal range (7.35-7.45), PaCO2 is normal (35 mmHg), and HCO3 is also normal (24 mEq/L). These values indicate that the patient's acid-base balance is normal.

In which condition would crackles be most likely heard upon auscultation?

• Asthma

• Pulmonary edema

• Pneumothorax

• Emphysema

Answer explanation

Crackles are most likely heard in pulmonary edema due to fluid accumulation in the alveoli, causing abnormal lung sounds. In contrast, asthma, pneumothorax, and emphysema typically produce different auscultation findings.

What is the most common cause of iron deficiency anemia?

• Chronic blood loss

• Increased iron intake

• Hemolysis

• Vitamin B12 deficiency

Answer explanation

The most common cause of iron deficiency anemia is chronic blood loss, which can occur from conditions like gastrointestinal bleeding or heavy menstrual periods, leading to a depletion of iron stores.

What is the primary purpose of administering erythropoietin to patients?

• To increase white blood cell count

• To stimulate red blood cell production

• To decrease blood pressure

• To enhance platelet function

Answer explanation

The primary purpose of administering erythropoietin is to stimulate red blood cell production, particularly in patients with anemia or chronic kidney disease, enhancing their oxygen-carrying capacity.

Which of the following interventions is most important for preventing sacral wounds in a patient with limited mobility?

• Administering antibiotics

• Encouraging fluid intake

• Regular repositioning

• Applying heat to the area

Answer explanation

Regular repositioning is crucial for preventing sacral wounds in patients with limited mobility, as it alleviates pressure on vulnerable areas, reducing the risk of skin breakdown and ulcers.