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WorksheetsFinal Exam
Total questions: 107
Worksheet time: 4hrs 34mins
When caring for a patient who has a radium implant for treatment of cervical cancer, the nurse will
assist the patient to ambulate every 2 to 3 hours.
use gloves and gown when changing the patient’s bed.
flush the toilet several times right after the patient voids.
encourage the patient to discuss any concerns by telephone.
Which patient in the women’s health clinic will the nurse expect to teach about an endometrial biopsy?
A 55-yr-old patient who has 3 to 4 alcoholic drinks each day
A 35-yr-old patient who has used oral contraceptives for 15 years
A 25-yr-old patient who has a family history of hereditary nonpolyposis colorectal cancer
A 45-yr-old patient who has had six previous full-term pregnancies and two spontaneous abortions
A healthy 24-yr-old patient who has been vaccinated against human papillomavirus (HPV) has a normal Pap test result. Which information will the nurse include in patient teaching when calling the patient with the results of the Pap test?
You can wait until after age 30 before having another Pap test.
Pap testing is recommended every 3 years for women your age.
No further Pap testing is needed until you decide to become pregnant.
Yearly Pap testing is suggested for women with multiple sexual partners
A 58-yr-old patient is on the medical-surgical unit after undergoing a radical vulvectomy for vulvar carcinoma. The greatest risk to the patient at this time is
self-care deficit.
inadequate nutrition.
wound infection.
ineffective sexual pattern.
A patient with urinary obstruction from benign prostatic hyperplasia (BPH) tells the nurse, “My symptoms are much worse this week.” Which response by the nurse is appropriate?
“Have you taken any over-the-counter (OTC) medications recently?”
“I will talk to the doctor about a prostate specific antigen (PSA) test.”
“Have you talked to the doctor about surgery such as transurethral resection of the prostate (TURP)?”
“The prostate gland changes in size from day to day, and this may be making your symptoms worse.”
After a transurethral resection of the prostate (TURP), a 64-yr-old patient with continuous bladder irrigation complains of painful bladder spasms. The nurse observes clots in the urine. Which action should the nurse take first?
Increase the flow rate of the bladder irrigation.
Administer the prescribed IV morphine sulfate.
Give the patient the prescribed belladonna and opium suppository.
Manually instill and then withdraw 50 mL of saline into the catheter.
The nurse is obtaining the pertinent health history for a man who is being evaluated for infertility. Which question focuses on a possible cause of infertility?
“Are you circumcised?”
“Have you had surgery for BPH?”
“Do you use medications to improve muscle mass?”
“Is there a history of prostate cancer in your family?”
Which assessment information collected by the nurse may present a contraindication to a testosterone replacement therapy (TRT)?
The patient has noticed a decrease in energy level for a few years.
The patient’s symptoms have increased steadily over the past few years.
The patient has been using sildenafil (Viagra) several times every week.
The patient has had a gradual decrease in the force of his urinary stream.
A 58-yr-old patient with erectile dysfunction (ED) tells the nurse he is interested in using sildenafil (Viagra). Which action should the nurse take first?
Assure the patient that ED is common with aging.
Ask the patient about any prescription drugs he is taking
Tell the patient that Viagra does not always work for ED
Discuss the common adverse effects of erectogenic drugs.
The nurse teaching a young women’s community service group about breast self-examination (BSE) will include that
BSE will reduce the risk of dying from breast cancer.
BSE should be done daily while taking a bath or shower.
annual mammograms should be scheduled in addition to BSE.
performing BSE after the menstrual period is more comfortable.
A 53-yr-old woman who is experiencing menopause is discussing the use of hormone therapy (HT) with the nurse. Which information about the risk of breast cancer will the nurse provide?
HT is a safe therapy for menopausal symptoms if there is no family history of BRCA genes.
HT does not appear to increase the risk for breast cancer unless there are other risk factors.
The patient and her health care provider must weigh the benefits of HT against the risks of breast cancer.
Natural herbs are as effective as estrogen in relieving symptoms without increasing the risk of breast cancer.
The health care provider prescribes finasteride (Proscar) for a patient who has benign prostatic hyperplasia (BPH). When teaching the patient about the drug, the nurse informs him that
he should change position from lying to standing slowly to avoid dizziness.
his interest in sexual activity may decrease while he is taking the medication.
improvement in the obstructive symptoms should occur within about 2 weeks.
he will need to monitor his blood pressure frequently to assess for hypertension.
Which menu choice indicates that the patient understands the nurse’s teaching about recommended dietary choices for iron-deficiency anemia?
Omelet and whole wheat toast
Strawberry and banana fruit plate
Cantaloupe and cottage cheese
Cornmeal muffin and orange juice
A 52-yr-old patient has a new diagnosis of pernicious anemia. The nurse determines that the patient understands the teaching about the disorder when the patient states,
“I need to start eating more red meat and liver.”
“I will stop having a glass of wine with dinner.”
“I could choose nasal spray rather than injections of vitamin B
12
“I will need to take a proton pump inhibitor such as omeprazole (Prilosec).”
Which patient statement to the nurse indicates a need for additional instruction about taking oral ferrous sulfate?
“I will call my health care provider if my stools turn black.”
“I will take a stool softener if I feel constipated occasionally.”
“I should take the iron with orange juice about an hour before eating.”
“I should increase my fluid and fiber intake while I am taking iron tablets.”
A patient who has been receiving IV heparin infusion and oral warfarin (Coumadin) for a deep vein thrombosis (DVT) is diagnosed with heparin-induced thrombocytopenia (HIT) when the platelet level drops to 110,000/µL. Which action will the nurse include in the plan of care?
Prepare for platelet transfusion.
Discontinue the heparin infusion.
Administer prescribed warfarin (Coumadin).
Use low-molecular-weight heparin (LMWH)
Which action will the admitting nurse include in the care plan for a patient who has neutropenia?
avoid intramuscular injections
check temperature every 4 hours
omit fruits or vegetables from the diet
place a "no visitors" sign on the door
Which assessment finding should the nurse caring for a patient with thrombocytopenia communicate immediately to the health care provider?
the platelet count is 25,000
the patient is difficult to arouse
there are purpura on the oral mucosa
there are large bruises on the patients back
A patient with immune thrombocytopenic purpura (ITP) has an order for a platelet transfusion. Which information indicates that the nurse should consult with the health care
provider before obtaining and administering platelets?
platelet count is 42,000
petechiae are present on the chest
blood pressure is 94/56 mm Hg
blood is oozing from the venipuncture site
A postoperative patient receiving a transfusion of packed red blood cells develops chills, fever, headache, and anxiety 35 minutes after the transfusion is started. After stopping the transfusion, what action should the nurse take?
give the PRN diphenhydramine
send a urine specimen to the laboratory
adminester PRN acetaminophen
draw blood for a new type and crossmatch
The nurse is caring for a patient receiving intravesical bladder chemotherapy. The nurse should monitor for which adverse effect?
nausea
alopecia
hematuria
xerostomia
The nurse should suggest which food choice when providing dietary teaching for a patient scheduled to receive external-beam radiation for abdominal cancer?
fruit salad
baked chicken
creamed broccoli
toasted wheat bread
A patient develops neutropenia after receiving chemotherapy. Which information about ways to prevent infection will the nurse include in the teaching plan (select all that apply)?
cook food thoroughly before eating
choose low fiber, low residue foods
avoid public transportation such as buses
use rectal suppositories if needed for constipation
talk to the oncologist before having any dental work
After change-of-shift report on the oncology unit, which patient should the nurse assess first?
Patient who has a platelet count of 82,000/µL after chemotherapy
Patient who has xerostomia after receiving head and neck radiation
Patient who is neutropenic and has a temperature of 100.5° F (38.1° C)
Patient who is worried about getting the prescribed long-acting opioid on time
A hospitalized patient who has received chemotherapy for leukemia develops neutropenia. Which observation by the nurse would indicate a need for further teaching?
the patient ambulates around the room
the patients visitors bring in fresh peaches
the patient cleans with a warm washcloth after having a stool
the patient uses soap and shampoo to shower every other day
A patient with leukemia is considering whether to have hematopoietic stem cell transplantation (HSCT). The nurse will include which information in the patient’s teaching plan?
Donor bone marrow is transplanted through a sternal or hip incision.
Hospitalization is required for several weeks after the stem cell transplant.
The transplant procedure takes place in a sterile operating room to minimize the risk for infection.
Transplant of the donated cells can be very painful because of the nerves in the tissue lining the bone.
The nurse is advising a clinic patient who was exposed a week ago to human immunodeficiency virus (HIV) through unprotected sexual intercourse. The patient’s antigen and antibody test has just been reported as negative for HIV. What instructions should the nurse give to this patient?
you will need to be retested in 2 weeks
you do not need to fear infecting others
since you do not have symptoms and you have had a negative test, you do not have HIV
we won't know for years if you will develop acquired immunodeficiency syndrome (AIDS)
To evaluate the effectiveness of antiretroviral therapy (ART), which laboratory test result will the nurse review?
viral load testing
enzyme immunoassay
rapid HIV antibody testing
immunofluorescence assay
The nurse is caring for a patient who is human immunodeficiency virus (HIV) positive and taking antiretroviral therapy (ART). Which information is most important for the nurse to address when planning care?
The patient complains of feeling “constantly tired.”
The patient can’t explain the effects of indinavir (Crixivan).
The patient reports missing some doses of zidovudine (AZT).
The patient reports having no side effects from the medications.
Which action should the nurse take when giving the initial dose of oral labetalol to a patient with hypertension?
Encourage the use of hard candy to prevent dry mouth.
Teach the patient that headaches often occur with this drug.
Instruct the patient to call for help if heart palpitations occur.
Ask the patient to request assistance before getting out of bed.
The charge nurse observes a new registered nurse (RN) doing discharge teaching for a patient with hypertension who has a new prescription for enalapril (Vasotec). The charge nurse will need to intervene if the new RN tells the patient to
increase the dietary intake of high-potassium foods
make an appointment with the dietitian for teaching
check the BP at home at least once a day
move slowly when moving from lying to sitting to standing
Propranolol (Inderal) is prescribed for a patient diagnosed with hypertension. The nurse should consult with the health care provider before giving this drug when the patient reveals a history of
daily alcohol use
peptic ulcer disease
reactive airway disease
myocardial infarction (MI)
Which nursing intervention is likely to be most effective when assisting the patient with coronary artery disease to make appropriate dietary changes?
Inform the patient about a diet containing no saturated fat and minimal salt.
Help the patient modify favorite high-fat recipes by using monounsaturated oils.
Emphasize the increased risk for heart problems unless the patient makes the dietary changes.
Give the patient a list of low-sodium, low-cholesterol foods that should be included in the diet.
In preparation for discharge, the nurse teaches a patient with chronic stable angina how to use the prescribed short-acting and long-acting nitrates. Which patient statement indicates that the teaching has been effective?
“I will check my pulse rate before I take any nitroglycerin tablets.”
“I will put the nitroglycerin patch on as soon as I get any chest pain.”
“I will stop what I am doing and sit down before I put the nitroglycerin under my tongue.”
“I will be sure to remove the nitroglycerin patch before taking any sublingual nitroglycerin.”
The nurse working on the heart failure unit knows that teaching an older female patient with newly diagnosed heart failure is effective when the patient states that
she will take furosemide (Lasix) every day at bedtime.
the nitroglycerin patch is to be used when chest pain develops.
she will call the clinic if her weight goes up 3 pounds in 1 week.
an additional pillow can help her sleep if she is short of breath at night.
When teaching the patient with newly diagnosed heart failure about a 2000-mg sodium diet, the nurse explains that foods to be restricted include
canned and frozen fruits
yogurt and milk products
fresh of frozen vegetables
eggs and other high protein foods
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
limit dietary sources of potassium
take the hydrochlorothiazide before bedtimes
notify the HCP if nausea develops
take the digoxin if the pulse is below 60 bpm
Following an acute myocardial infarction, a previously healthy 63-yr-old develops clinical manifestations of heart failure. The nurse anticipates discharge teaching will include information about
B Blockers
calcium channel blockers
digoxin and potassium therapy
ACE inhibitors
Which diagnostic test will be most useful to the nurse in determining whether a patient admitted with acute shortness of breath has heart failure?
serum troponin
arterial blood gas
BNP
12 lead ECG
A patient has recently started on digoxin (Lanoxin) in addition to furosemide (Lasix) and captopril for the management of heart failure. Which assessment finding by the home health nurse is a priority to communicate to the health care provider?
Presence of 1+ to 2+ edema in the feet and ankles
Palpable liver edge 2 cm below the ribs on the right side
Serum potassium level 3.0 mEq/L after 1 week of therapy
Weight increase from 120 pounds to 122 pounds over 3 days
The nurse performing an assessment of a patient who has chronic peripheral artery disease (PAD) of the legs and an ulcer on the right second toe would expect to find
dilated superficial veins
swollen, dry, scaly ankles
prolonged capillary refill in all the toes
serosanguineous drainage from the ulcer
The nurse is admitting a patient newly diagnosed with peripheral artery disease. Which admission order should the nurse question?
cilostazol drug therapy
omeprazole drug therapy
use of treadmill for exercise
exercise to the point of discomfort
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?
cessation of all tobacco use
control of serum lipid levels
maintenance of appropriate weight
demonstration of meticulous foot care
The nurse is caring for a patient with critical limb ischemia who has just arrived on the nursing unit after having percutaneous transluminal balloon angioplasty. Which action should the nurse perform first?
obtain vitals
teach wound care
assess pedal pulses
check the wound site
When caring for a patient with mitral valve stenosis, it is most important that the nurse assess for
diastolic murmur
peripheral edema
exertional dyspnea
angina
When developing a community health program to decrease the incidence of rheumatic fever, which action should the community health nurse include?
Vaccinate high-risk groups in the community with streptococcal vaccine.
Teach community members to seek treatment for streptococcal pharyngitis.
Teach about the importance of monitoring temperature when sore throats occur.
Teach about prophylactic antibiotics to those with a family history of rheumatic fever.
A 21-yr-old woman is scheduled for percutaneous transluminal balloon valvuloplasty to treat mitral stenosis. Which information should the nurse include when explaining the advantages of valvuloplasty over valve replacement to the patient?
Biologic valves will require immunosuppressive drugs after surgery.
Mechanical mitral valves need to be replaced sooner than biologic valves.
Lifelong anticoagulant therapy is needed after mechanical valve replacement
Ongoing cardiac care by a health care provider is not necessary after valvuloplasty.
While caring for a 23-yr-old patient with mitral valve prolapse (MVP) without valvular regurgitation, the nurse determines that discharge teaching has been effective when the patient states that it will be necessary to
take antibiotics before any dental appointments
limit physical activity to avoid stressing the heart
avoid OTC drugs containing stimulants
take an aspirin a day to prevent clots from forming on the valve
Which statement by a patient with restrictive cardiomyopathy indicates that the nurse’s discharge teaching about self-management has been effective?
“I will avoid taking aspirin or other antiinflammatory drugs.”
“I can restart my exercise program that includes hiking and biking.”
“I will need to limit my intake of salt and fluids even in hot weather.”
“I will take antibiotics before my teeth are cleaned at the dental office.”
The nurse is obtaining a health history from a 24-yr-old patient with hypertrophic cardiomyopathy (CMP). Which information obtained by the nurse is most important?
The patient has a history of a recent upper respiratory infection.
The patient has a family history of coronary artery disease (CAD).
The patient reports using cocaine a “couple of times” as a teenager.
The patient’s 29-yr-old brother died from a sudden cardiac arrest.
The nurse teaches a patient about discharge instructions after a rhinoplasty. Which statement, if made by the patient, indicates that the teaching was successful?
“My nose will look normal after 24 to 48 hours.”
“I can take 800 mg ibuprofen every 6 hours for pain.”
“I will remove and reapply the nasal packing every day.”
“I will elevate my head for 48 hours to minimize swelling.”
The nurse discusses management of upper respiratory infections (URIs) with a patient who has acute sinusitis. Which statement by the patient indicates that additional teaching is needed?
“I will drink lots of juices and other fluids to stay well hydrated.”
“I can use nasal decongestant spray until the congestion is gone.”
“I can take acetaminophen (Tylenol) to treat my sinus discomfort.”
“I will watch for changes in nasal secretions or the sputum that I cough up.”
Which action should the nurse take first when a patient develops epistaxis?
Pack the affected nare tightly with an epistaxis balloon
Apply squeezing pressure to the nostrils for 10 minutes.
Obtain silver nitrate that may be needed for cauterization.
Instill a vasoconstrictor medication into the affected nare.
After being hit by a baseball, a patient arrives in the emergency department with a possible nasal fracture. Which finding by the nurse is most important to report to the health care provider?
clear nasal drainage
complaint of nasal pain
bilateral nose swelling and bruising
inability to breathe through the nose
The clinic nurse is teaching a patient with acute sinusitis. Which interventions should the nurse plan to include in the teaching session (select all that apply)?
Decongestants can be used to relieve swelling.
Blowing the nose should be avoided to decrease the nosebleed risk.
Taking a hot shower will increase sinus drainage and decrease pain.
Saline nasal spray can be made at home and used to wash out secretions.
You will be more comfortable if you keep your head in an upright position.
The nurse is performing a respiratory assessment for a patient admitted with pneumonia. Which clinical manifestation should the nurse expect to find?
hyper resonance on percussion
vesicular breath sounds in all lobes
increased vocal fremitus on palpation
fine crackles in all lobes on auscultation
The nurse evaluates that discharge teaching for a patient hospitalized with pneumonia has been effective when the patient makes which statement about measures to prevent a relapse?
“I will seek immediate medical treatment for any upper respiratory infections.”
“I should continue to do deep breathing and coughing exercises for at least 12 weeks.”
“I will increase my food intake to 2400 calories a day to keep my immune system well.”
“I must have a follow-up chest x-ray in 6 to 8 weeks to evaluate the pneumonia’s resolution.”
The nurse is caring for a group of patients. Which patient is at risk of aspiration?
A 58-yr-old patient with absent bowel sounds 12 hours after abdominal surgery
A 67-yr-old patient who had a cerebrovascular accident with expressive dysphasia
A 26-yr-old patient with continuous enteral tube feedings through a nasogastric tube
A 92-yr-old patient with viral pneumonia and coarse crackles throughout the lung fields
which medications would be used in the four-drug treatment for the initial phase of TB? SATA
isoniazid
rifampin
rifabutin
levofloxacin
ethambutol
An older patient is receiving standard multidrug therapy for tuberculosis (TB). The nurse should notify the health care provider if the patient exhibits which finding?
yellow sclera
orange colored sputum
thickening of the fingernails
difficulty hearing high-pitched voices
Employee health test results reveal a tuberculosis (TB) skin test of 16-mm induration and a negative chest x-ray for a staff nurse working on the pulmonary unit. The nurse has no symptoms of TB. Which information should the occupational health nurse plan to teach the
staff nurse?
use and side effects of isoniazid
standard 4 drug therapy for TB
need for annual repeat TB skin testing
BCG vaccine
A patient is scheduled for spirometry. Which action should the nurse take to prepare the patient for this procedure?
Give the rescue medication immediately before testing.
Administer oral corticosteroids 2 hours before the procedure.
Withhold bronchodilators for 6 to 12 hours before the examination.
Ensure that the patient has been NPO for several hours before the test.
Which information will the nurse include in the asthma teaching plan for a patient being discharged?
Use the inhaled corticosteroid when shortness of breath occurs.
Inhale slowly and deeply when using the dry powder inhaler (DPI).
Hold your breath for 5 seconds after using the bronchodilator inhaler.
Tremors are an expected side effect of rapidly acting bronchodilators.
The emergency department nurse is evaluating the effectiveness of therapy for a patient who has received treatment during an asthma attack. Which assessment finding is the best indicator that the therapy has been effective?
no wheezes are audible
O2 saturation is >90%
accessory muscle use has decreased
respiratory rate is 16 breaths/minute
The nurse teaches a patient who has asthma about peak flow meter use. Which action by the patient indicates that teaching was successful?
The patient inhales rapidly through the peak flow meter mouthpiece.
The patient takes montelukast (Singulair) for peak flows in the red zone.
The patient calls the health care provider when the peak flow is in the green zone.
The patient uses an albuterol (Ventolin HFA) inhaler for peak flows in the yellow zone.
A patient with an acute exacerbation of chronic obstructive pulmonary disease (COPD) needs to receive precise amounts of oxygen. Which equipment should the nurse prepare to use?
oxygen tent
venturi mask
nasal cannula
oxygen-conserving cannula
The physician has prescribed salmeterol (Serevent) for a patient with asthma. In reviewing the use of dry powder inhalers (DPIs) with the patient, what instructions should the nurse provide?
“Close lips tightly around the mouthpiece and breathe in deeply and quickly.”
“To administer a DPI, you must use a spacer that holds the medicine so that you can inhale it.”
“You will know you have correctly used the DPI when you taste or sense the medicine going into your lungs.”
“Hold the inhaler several inches in front of your mouth and breathe in slowly, holding the medicine as long as possible.”
The nurse is teaching a patient how to self-administer ipratropium via a metered-dose inhaler (MDI). Which instruction given by the nurse is most appropriate to help the patient learn the proper inhalation technique?
“Avoid shaking the inhaler before use
“Breathe out slowly before positioning the inhaler.”
“Using a spacer should be avoided for this type of medication.”
“After taking a puff, hold the breath for 30 seconds before exhaling.”
The nurse teaches a 53-yr-old male patient with chronic obstructive pulmonary disease (COPD) how to administer fluticasone by metered-dose inhaler (MDI). Which statement by the patient to the nurse indicates correct understanding of the instructions?
“I should not use a spacer device with this inhaler.”
“I will rinse my mouth each time after I use this inhaler.”
“I will feel my breathing improve over the next 2 to 3 days.”
“I should use this inhaler immediately if I have trouble breathing.”
A patient with diabetes mellitus is scheduled for a fasting blood glucose level at 8:00 AM. The nurse instructs the patient to only drink water after what time?
6:00 PM on the evening before the test
Midnight before the test
4:00 AM on the day of the test
7:00 AM on the day of the test
Which patient with type 1 diabetes mellitus would be at the highest risk for developing hypoglycemic unawareness?
A 58-yr-old patient with diabetic retinopathy
A 73-yr-old patient who takes propranolol
A 19-yr-old patient who is on the school track team
A 24-yr-old patient with a hemoglobin A1C of 8.9%
The nurse instructs a patient with diabetes mellitus about a healthy eating plan. Which statement made by the patient indicates that teaching was successful?
“I plan to lose 25 lb this year by following a high-protein diet.”
“I may have a hypoglycemic reaction if I drink alcohol on an empty stomach.”
I should include more fiber in my diet than a person who does not have diabetes.”
“If I use an insulin pump, I will not need to limit the amount of saturated fat in my diet.”
The nurse teaches a patient recently diagnosed with type 1 diabetes mellitus about insulin administration. Which statement by the patient requires an intervention by the nurse?
“I will discard any insulin bottle that is cloudy in appearance.”
“The best injection site for insulin administration is in my abdomen.”
“I can wash the site with soap and water before insulin administration.”
“I may keep my insulin at room temperature (75oF) for up to 1 month.”
The newly diagnosed patient with type 2 diabetes has been prescribed metformin. What should the nurse teach the patient to best explain how this medication works?
Increases insulin production from the pancreas
Slows the absorption of carbohydrate in the small intestine
Reduces glucose production by the liver and enhances insulin sensitivity
Increases insulin release from the pancreas, inhibits glucagon secretion, and decreases gastric emptying
The patient received regular insulin 10 units subcutaneously at 8:30 PM for a blood glucose level of 253 mg/dL. The nurse plans to monitor this patient for signs of hypoglycemia at which time related to the insulin’s peak action?
8:40 PM to 9:00 PM
9:00 PM to 11:30 PM
10:30 PM to 1:30 AM
12:30 AM to 8:30 AM
The nurse caring for a patient hospitalized with diabetes mellitus would look for which laboratory test result to obtain information on the patient’s past glucose control?
prealbumin level
urine ketone level
fasting glucose level
glycosylated hemoglobin level
Which information will the nurse include when teaching a patient who has type 2 diabetes about glyburide ?
Glyburide decreases glucagon secretion from the pancreas.
Glyburide stimulates insulin production and release from the pancreas.
Glyburide should be taken even if the morning blood glucose level is low.
Glyburide should not be used for 48 hours after receiving IV contrast media.
A patient informs the nurse that they are having burning on urination, dysuria, and frequency. What is the best response by the nurse?
“Drink less fluid so you don’t have to void so often.”
“Take some acetaminophen to decrease the discomfort.”
“Come in so we can check a clean-catch urine specimen.”
“Avoid caffeine and spicy food to decrease inflammation.”
To prevent recurrence of uric acid renal calculi, the nurse teaches the patient to avoid eating
milk and cheese
sardines and liver
spinach and chocolate
legumes and dried fruit
The nurse provides nutritional counseling for a 45-yr-old man with nephrotic syndrome. The nurse determines teaching has been successful if the patient selects which breakfast menu?
Scrambled eggs, milk, yogurt, and sliced ham
Oatmeal, nondairy creamer, banana, and orange juice
Cottage cheese, peanut butter, white bread, and coffee
Waffle, bacon strips, tomato juice, and canned peaches
The nurse is caring for a 73-yr-old male patient with a history of benign prostatic hyperplasia and symptoms of a urinary tract infection. Which diagnostic finding would support this diagnosis?
White blood cell count is 7500 cells/µL.
Antistreptolysin-O (ASO) titer is 106 Todd units/mL.
Glucose, protein, and ketones are present in the urine.
Nitrites and leukocyte esterase are present in the urine.
A 52-yr-old man with stage 2 chronic kidney disease is scheduled for an outpatient diagnostic procedure using contrast media. Which priority action should the nurse perform?
Assess skin turgor to determine hydration status.
Insert a urinary catheter for the expected diuresis.
Evaluate the patient’s lower extremities for edema.
Check the patient’s urine for the presence of ketones.
A frail 72-yr-old woman with stage 3 chronic kidney disease is cared for at home by her family. The patient has a history of taking many over-the-counter medications. Which over-the-counter medications should the nurse teach the patient to avoid?
aspirin
acetaminophen
diphenhydramine
aluminum hydroxide
The home care nurse visits a 34-yr-old woman receiving peritoneal dialysis. Which statement indicates a need for immediate follow-up by the nurse?
drain time is faster if I rub my abdomen
the fluid draining from the catheter is cloudy
the drainage is bloody when I have my period
I wash around the catheter with soap and water
Which diagnostic study is most indicative of chronic kidney disease (CKD)?
serum creatinine
serum potassium
microalbuminuria
GFR
During hemodialysis, the patient develops light-headedness and nausea. What should the nurse do first?
adminester hypertonic saline
adminester a blood transfusion
decrease the rate of fluid removal
give an antimetic
Which findings will the nurse expect when caring for a patient with chronic kidney disease (CKD) (select all that apply.)?
anemia
dehydration
hypertension
ekevated WBC
hyperkalemia
A 74-yr-old female patient with osteoporosis is diagnosed with gastroesophageal reflux disease (GERD). Which over-the-counter medication to treat GERD should be used with caution?
sucralfate
cimetidine
omeprazole
metoclopramide
The nurse determines a patient has experienced the beneficial effects of therapy with famotidine when which symptom is relieved?
nausea
belching
epigastric pain
difficulty swallowing
which statement by a patient with dumping syndrome should lead the nurse to determine that further dietary teaching is needed?
I should eat bread and jam with every meal
I should avoid drinking fluids with my meals
I should eat smaller meals about 6 times a day
I need to lie down for 60 min after my meals
To determine possible risk factors for gastritis, the nurse will ask the patient about
the amount of saturated fat in the diet
a family history of gastric or colon cancer
a history of a large recent weight gain or loss
use of NSAIDs
When teaching the patient about the diet for diverticular disease, which foods should the nurse recommend?
White bread, cheese, and green beans
Fresh tomatoes, pears, and corn flakes
Oranges, baked potatoes, and raw carrots
Dried beans, All Bran (100%) cereal, and raspberries
Which clinical manifestations of inflammatory bowel disease does the nurse determine are common to both patients with ulcerative colitis (UC)
restricted to the rectum
strictures are common
bloody, diarrhea stools
cramping abdominal pain
lesions penetrate intestine
A hospitalized patient has just been diagnosed with diarrhea due to Clostridium difficile. Which nursing interventions should be included in the patient’s plan of care? SATA
initiate contact isolation precautions
place the patient on a clear liquid diet
disinfect the room with 10% bleach solution
teach any visitors to wear gloves and gowns
use hand sanitizer before and after patient contact
The nurse identifies that which patient is at highest risk for developing colon cancer?
A 28-yr-old man who has a body mass index of 27 kg/m2
A 32-yr-old woman with a 12-year history of ulcerative colitis
A 52-yr-old man who has followed a vegetarian diet for 24 years
A 58-yr-old woman taking prescribed estrogen replacement therapy
The nurse is aware of potential complications related to cirrhosis. Which interventions would be included in a safe plan of care (select all that apply.)?
Provide a high-protein, low-carbohydrate diet.
Teach the patient to use soft-bristle toothbrush and electric razor.
Teach the patient to avoid vigorous blowing of nose and coughing.
Apply gentle pressure for the shortest possible time after venipuncture.
Use the smallest gauge needle possible when giving injections or drawing blood.
the family members of a patient with hepatitis A ask if there is anything that will prevent them from developing the disease. What is the best response by the nurse?
"no immunization is available for hep A, nor are you likely to get the disease"
those who have had household contact with the patient should receive IgG
All family members should receive the hep A vaccine to prevent infection
only those individuals who have had sexual contact with the patient should receive immunizations
what is one of the most challenging nursing interventions to promote healing in the patient with viral hepatitis?
providing adequate nutritional intake
promoting strict bed rest during the icteric phase
providing pain relief without using liver-metabolized drugs
providing quiet diversional activities during periods of fatigue
what laboratory test results should the nurse expect to find in a patient with cirrhosis?
serum albumin: 7.0
total bilirubin: 3.2 mg/dL
serum cholesterol: 260 mg/dL
aspartate aminotransferase (AST): 6
what manifestations in the patient does the nurse recognize as an early sign of hepatic encephalopathy?
manifests asterixis
becomes unconscious
has increasing oliguria
impaired computational skills
Which action will the nurse include in the plan of care for a patient with a new diagnosis of rheumatoid arthritis (RA)?
Instruct the patient to purchase a soft mattress.
Encourage the patient to take a nap in the afternoon.
Teach the patient to use lukewarm water when bathing.
Suggest exercise with light weights several times daily
Which information will the nurse include when preparing teaching materials for a patient with an exacerbation of rheumatoid arthritis?
Affected joints should not be exercised when pain is present.
Applying cold packs before exercise may decrease joint pain.
Exercises should be performed passively by someone other than the patient.
Walking may substitute for range-of-motion (ROM) exercises on some days.
The nurse suggests that a patient recently diagnosed with rheumatoid arthritis (RA) plan to start each day with
a brief routine of isometric exercises
a warm bath followed by a short rest
active range-of-motion exercises
stretching exercises to relieve joint stiffness
Which information will the nurse include when teaching a patient with newly diagnosed ankylosing spondylitis (AS) about management of the condition?
exercise by taking long walks
do daily deep-breathing exercises
sleep on the side with hips flexed
take frequent naps during the day
The nurse notices a circular lesion with a red border and clear center on the arm of a summer camp counselor who is in the clinic complaining of chills and muscle aches. Which action should the nurse take to follow up on that finding?
palpate the abdomen
auscultate the heart sounds
ask the patient about recent outdoor activities
question the patient about immunization history
Which statement by a patient with systemic lupus erythematosus (SLE) indicates the patient has understood the nurse’s teaching about the condition?
I will exercise even if I am tired
I will use sunscreen when I am outside
I should avoid NSAIDs
I should take birth control pills to avoid getting pregnant
The home health nurse is making a follow-up visit to a patient with recently diagnosed rheumatoid arthritis (RA). Which assessment made by the nurse indicates more patient teaching is needed?
the patient take a 2-hour nap each day
the patient has been taking 16 aspirins each day
the patient sits on a stool while preparing meals
the patient sleeps with two pillows under the head
