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Healthcare Concepts Exam 2

Total questions: 40

Worksheet time: 2hrs 58mins

Name
Class
Date
1.

A nurse is assessing a patient who has been on bed rest for two weeks. Which assessment finding would the nurse expect due to immobility?

a)

Increased muscle mass

b)

Joint flexibility and strength

c)

Orthostatic hypotension

d)

Decreased urinary stasis

2.

An older adult patient has kyphosis and decreased height. The nurse recognizes these changes are primarily due to:

a)

Spinal cord injury

b)

Thinning of intervertebral disks

c)

Increased bone density

d)

Overuse of spinal muscles

3.

During a musculoskeletal assessment, the nurse notes limited range of motion in the patient's left knee. What is the most appropriate nursing action?

a)

Encourage full weight-bearing ambulation

b)

Apply heat and continue exercise despite discomfort

c)

Stop movement and notify the provider of the limitation

d)

Immobilize the knee permanently

4.

The nurse is caring for a patient with a fracture immobilized in a cast. Which nursing intervention is most important to prevent complications?

a)

Encourage isometric exercises and monitor skin integrity

b)

Provide high-protein meals to promote healing

c)

Avoid repositioning the affected limb

d)

Limit fluid intake to prevent swelling

5.

A nurse teaches a patient about primary prevention of mobility problems. Which statement shows correct understanding?

a)

I should rest as much as possible to protect my joints.

b)

I will avoid stretching before exercising.

c)

Maintaining a healthy weight can help prevent joint stress.

d)

I’ll skip meals if I’m not exercising that day.

6.

A nurse is preparing to move a partially immobile patient from bed to chair. Which action demonstrates safe patient handling?

a)

Lifting the patient manually to maintain control

b)

Using a mechanical lift with assistance from another staff member

c)

Asking the patient to hold the nurse’s neck for stability

d)

Bending at the waist while lifting

7.

A patient with prolonged immobility is at risk for pressure ulcers. The nurse should prioritize which intervention?

a)

Turn the patient every 2 hours and assess skin regularly

b)

Apply heat packs to reddened areas

c)

Use friction to clean the skin

d)

Position the patient directly on the affected area

8.

Which diagnostic test is used to directly visualize the inside of a joint?

a)

Arthroscopy

b)

Electromyography

c)

Arthrocentesis

d)

Bone scan

9.

The nurse is caring for a patient with Parkinson disease. Which finding should the nurse expect?

a)

Sudden flaccid paralysis

b)

Involuntary jerky limb movements

c)

Muscle stiffness and shuffling gait

d)

Rapid, alternating fine motor control

10.

A nurse is assessing a patient who reports shortness of breath and chest pain after surgery. Which finding most strongly suggests a pulmonary embolism?

a)

Wheezing and pink frothy sputum

b)

Decreased breath sounds on one side

c)

Coughing up blood with sudden chest pain

d)

Dull chest pain that worsens with movement

11.

A patient on heparin therapy has an activated partial thromboplastin time (aPTT) of 95 seconds. Which action should the nurse take first?

a)

Document the result as expected

b)

Administer protamine sulfate as prescribed

c)

Increase the next heparin dose

d)

Repeat the test in 4 hours

12.

A nurse is caring for a patient with a venous thromboembolism (VTE). Which intervention should the nurse include in the plan of care?

a)

Encourage ambulation without restriction

b)

Apply compression stockings to the affected leg

c)

Elevate the affected extremity and administer anticoagulants

d)

Massage the calf to improve circulation

13.

The nurse recognizes which finding as a common symptom of thrombocytopenia?

a)

Chest pain and dyspnea

b)

Petechiae and bleeding gums

c)

Hypertension and tachycardia

d)

Painful leg swelling

14.

A patient with cirrhosis of the liver is at risk for impaired clotting because:

a)

The liver stores extra platelets

b)

The liver produces clotting factors needed for coagulation

c)

The liver increases platelet destruction

d)

The liver converts fibrin into fibrinogen

15.

The nurse is caring for a patient with hemophilia A. Which statement by the patient shows correct understanding of the disorder?

a)

I’m missing factor IX, so my blood clots too quickly.

b)

I bruise easily because I have fewer red blood cells.

c)

I’m missing factor VIII, which helps my blood form clots.

d)

I can take aspirin for pain since it doesn’t affect bleeding.

16.

The nurse is teaching a patient about warfarin therapy. Which statement indicates the patient needs further teaching?

a)

I’ll have my INR checked regularly

b)

I should eat the same amount of leafy greens each week

c)

I can take ibuprofen for a headache if needed

d)

I’ll call my provider if I notice blood in my stool

17.

A nurse notes a patient has a D-dimer level significantly above normal. This result indicates:

a)

Increased platelet destruction

b)

Active clot formation and breakdown

c)

Vitamin K deficiency

d)

Liver dysfunction

18.

Which nursing action best helps prevent venous thrombosis in an immobile patient?

a)

Encourage high-protein diet

b)

Keep the legs dependent at all times

c)

Perform range-of-motion exercises and encourage leg movement

d)

Apply cold compresses to lower legs

19.

A nurse is assessing pain in an older adult. Which statement is most accurate?

a)

Chronic pain is a normal part of aging

b)

Older adults usually have a lower pain tolerance

c)

Older adults cannot feel acute pain

d)

Pain intensity is always higher in older adults

20.

A patient reports sharp, localized pain at a surgical site. The nurse recognizes this as:

a)

Visceral pain

b)

Neuropathic pain

c)

Somatic pain

d)

Sympathetically mediated pain

21.

Which intervention demonstrates application of the Gate Control Theory of pain?

a)

Administering IV opioids

b)

Rubbing the patient's sore arm to reduce pain

c)

Monitoring vital signs before pain onset

d)

Assessing pain intensity on a 0–10 scale

22.

A patient with diabetic neuropathy reports burning, tingling pain in both feet. The nurse identifies this type of pain as:

a)

Neuropathic pain

b)

Nociceptive pain

c)

Psychogenic pain

d)

Visceral pain

23.

Which physiologic consequence of untreated pain is most concerning for post-surgical patients?

a)

Anxiety and irritability

b)

Shallow breathing leading to atelectasis

c)

Decreased appetite

d)

Social withdrawal

24.

A patient experiences breakthrough pain just before the next dose of pain medication is due. This is classified as:

a)

Incident pain

b)

Idiopathic pain

c)

End-of-dose failure

d)

Chronic pain

25.

Which action should the nurse take when reassessing a patient’s pain after administering oral analgesics?

a)

Recheck in 15 minutes

b)

Recheck in 30–60 minutes

c)

Wait 2 hours before reassessment

d)

Only reassess if patient complains again

26.

The nurse is evaluating pain in a nonverbal patient. Which is the most reliable method?

a)

Assume the patient has no pain if silent

b)

Observe facial expressions, movements, and vital signs

c)

Ask the family member how the patient feels

d)

Only give pain medication if behavior is extreme

27.

A patient with fibromyalgia reports widespread pain in muscles and joints. The nurse recognizes this as:

a)

Mixed pain

b)

Somatic pain

c)

Central pain

d)

Neuropathic pain

28.

A nurse is assessing a patient with dehydration. Which sign is most indicative of extracellular fluid (ECV) deficit?

a)

Edema in the lower extremities

b)

Weight gain over 2 days

c)

Dry mucous membranes and low blood pressure

d)

Distended neck veins

29.

A patient with hyponatremia is at risk for which complication?

a)

Muscle twitching and seizures

b)

Confusion and brain swelling

c)

Slow reflexes and constipation

d)

Low blood pressure and shock

30.

A patient with hyperkalemia is most at risk for which complication?

a)

Muscle spasms and tetany

b)

Cardiac arrest due to irregular heartbeat

c)

Seizures and twitching

d)

Constipation and fatigue

31.

Which hormone helps the body retain water by acting on the kidneys?

a)

A. Aldosterone

b)

B. Antidiuretic hormone (ADH)

c)

C. Parathyroid hormone (PTH)

d)

D. Calcitonin

32.

A patient has hypocalcemia. Which assessment finding is most characteristic?

a)

Constipation and fatigue

b)

Muscle twitching, cramps, positive Chvostek’s sign

c)

Confusion and high blood pressure

d)

Slow reflexes and drowsiness

33.

A patient is receiving magnesium supplements. Which sign would indicate hypermagnesemia?

a)

Twitching and hyperactive reflexes

b)

Drowsiness, low blood pressure, and slow heart rate

c)

Seizures and tremors

d)

Muscle cramps and tetany

34.

A nurse is educating a patient on potassium-rich foods. Which patient is at highest risk for hypokalemia?

a)

Patient taking a potassium-sparing diuretic

b)

Patient with kidney failure

c)

Patient taking loop diuretics for hypertension

d)

Patient eating bananas and oranges daily

35.

The nurse is assessing an elderly patient who reports confusion and is lethargic. Labs show high sodium. What is the likely cause?

a)

Hyponatremia from water overload

b)

Hypernatremia from dehydration

c)

Hypokalemia from diuretics

d)

Hypercalcemia from calcium supplements

36.

Which nursing action is most important when managing a patient with fluid overload (ECV excess)?

a)

Encourage increased oral intake

b)

Administer diuretics as prescribed and monitor I&O

c)

Restrict sodium intake but allow unlimited fluids

d)

Monitor for signs of dehydration

37.

Select all that apply
The nurse is providing education about complications of immobility. Which potential effects should be included in the teaching?

a)

Blood clots in the legs

b)

Increased bone mineral density

c)

Constipation and urinary retention

d)

Skin breakdown over bony prominences

e)

Enhanced respiratory expansion

38.

Select all that apply

A nurse is reviewing lab results for a patient with suspected clotting disorder. Which findings support impaired clotting or bleeding tendency?

a)

Platelet count of 95,000/mm³

b)

INR of 3.0 on warfarin therapy

c)

Petechiae on skin and mucous membranes

d)

Fibrinogen level of 150 mg/dL

e)

D-dimer negative

39.

Select all that apply

A nurse is teaching a patient about strategies to manage chronic pain. Which interventions should be included?

a)

Guided imagery and relaxation breathing

b)

Regular physical activity and stretching

c)

Heat or cold therapy for localized pain

d)

Ignoring pain to “tough it out”

e)

Acupuncture or massage

40.

Select all that apply
A nurse is teaching a patient about strategies to prevent electrolyte imbalances. Which interventions should be included?

a)

Replace fluids lost from vomiting or diarrhea with electrolyte-containing fluids

b)

Take diuretics without monitoring potassium levels

c)

Drink excessive plain water to flush electrolytes

d)

Encourage hydration during exercise

e)

Monitor daily weight and input/output