Primary Concepts of Adult Nursing Exam October 2017, questions and Answers for Exams 1, 2, 3 and Final

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Exam 1 1. 2. When a patient with a chronic illness asks a nurse. “What is a chronic condition?” Which of these responses is best for the•nurse to answer? 4. A patient has a hemoglobin ... of 8g/dl and hematocrit of 24%. Which of these findings should the nurse expect when as•sisting the patient’s vital signs? SELECT ALL THAT APPLY 5. A nurse is conducting an admission assessment on a newly admitted older patient from a long-term care facility. W•hich of these clinical manifestations could be related to a diagnosis of anemia? 6. A nurse completed nutritional teaching with a patient with B12 deficiency. Which of these menu selections made by the•patient demonstrates adequate understanding of dietary management for this problem? 7. A nurse is conducting a health history with a patient. Which of these questions should the nurse include in this as•sessment to determine if the patient has risk factors related to vitamin B12 deficiency anemia? 8. A nurse is conducting an admission assessment on a patient with a vitamin B12 deficiency. What should the nurse inc•lude as a priority assessment for this patient? 9. A nurse is preparing to which a patient with a microcytic hypochromic anemia about the diet to follow when dis•charged. Which of these foods should be included in this diet? 10. A nurse is assessing a patient with iron deficiency anemia. Which of these findings should the nurse anticipate upon ins•pection of this patient’s nail beds? 11. After teaching a patient about iron supplements for iron deficiency anemia, which statement made by the patient ind•icates to the nurse that additional instruction is needed? 12. A nurse is caring for a patient in who has effective pain management. Which of these nursing diagnoses should take pr•iority in this patient? 13. A patient in sickle cell crisis has been admitted to the medical unit. Which of these orders prescribed by the healthcare pr•ovider (HCP) should a nurse plan implement first for this patient? 14. 15. A nurse is planning care for newly admitted patient who is in sickle cell crisis. The patient reports serve pain in his hands and feet. The pulse oximetry is 90%. Assuming that there are healthcare providers (HCP) orders for each intervention listed below, in which priority order should the nurse implement care? 3,2,4,1 a) Adjust the room temperature b) Give a bolus of intravenous (IV) fluids c) Start oxygen at 2 liters via nasal cannula d) Administer morphine sulfate 2 mg IV push 16. A nurse is providing education about sickle cell disease and lifestyle modifications. The patient says, “I was born with this disease and will have it my whole life, so why does it matter how I take care of myself?” What is the most ap•propriate response? 17. 18. A nurse is preparing to transfuse one (1) unit of packed red blood cells (RBCs) to a patient with anemia. Which of these measures should the nurse implement to decrease the possibility of a transfusion reaction in the patient? 19. A nurse is caring for a patient with serve anemia who is receiving a blood transfusion. Which of these findings should ale•rt the nurse to possible complications? The patient reports 20. A patient is to receive a blood transfusion. Based on the standards of practice, which of these actions should a nurse im•plement to ensure that the correct blood is administered to the right patient? 21. A nurse is caring for two patients who have orders to receive a blood transfusion of patients of packed red blood cells (PRBCs) Patient 1: B/P dropped from preoperative value of 130/90 to 100/50 mmHg Patient 2: Admitted for dehydration and anemia following treatment for pneumonia The registered nurse (RN) is wondering with a licensed practical nurse (LPN) and an unlicensed assistive • personnel (UAP) Which of these actions should the RN implement first? 22. A patient is receiving one (1) unit of packed red blood cells (PRBCs) Fifteen minutes into the infusion, the patient de•velops shortness of breath and reports flank pain. Which of these nursing actions should the nurse implement first? 23. A nurse is caring for a patient newly diagnosed with acute myeloid leukemia (AML) Which of these questions asked by•the nurse is most appropriate for identifying AML risk factors for this patient? 29. The nurse caring for a group of patients. Which of these patients is of greatest risk for developing acute lymphocytic leu•kemia (ALL)? 30. A patient with acute lymphocytic leukemia (ALL) who is receiving chemotherapy develops a white blood cell (WBC) co•unt of 2500 cells/mm3. Based on this finding, a nurse should 32. A patient with Hodgkin lymphoma had an excision of a cervical lymph mode for biopsy under local anesthesia. Fo•llowing this procedure, which of these nursing assessments should take priority? 33. A nurse is caring for a patient with Non-Hodgkin lymphoma (NHL) Which of these laboratory results should the nu•rse immediately follow-up? 34. A nurse is developing a teaching plan for a patient with multiple myeloma. Which of these instructions should be most important for the nurse include in this plan? SELECT ALL THAT APPLY A nurse on the oncology unit is assigning a room to a newly admitted patient with lung cancer and WBC 2000, absolute neutrophil count (ANC) 500, and temperature of 102 F (38.9 C) Which of these rooms is most appropriate fo•r this patient? 35. 36. A•nurse is assigned to care for a patient with a radiation implant. In planning care for this patient, the nurse should 37. A patient with cancer asks a nurse “Why am I receiving radiation treatment and not chemotherapy for my cancer?” Th•e best response by the nurse should be that radioactive therapy is most effective for Cancers that are localized to one tissue or body area 38. patient receiving intravenous (IV) chemotherapy asks a nurse “Why are you wearing a mask, gloves, and gown wh•en giving the chemotherapy?” Which of these responses by the nurse is best? 39. A nurse is assessing a patient with autoimmune thrombocytopenia purpura (ATP) Which of these laboratory test sh•ould the nurse plan to monitor frequently to determine if treatment is effective? Exam 2 1. A nurse is teaching a patient newly diagnosed with systemic lupus erythematous (SLE). Which of these responses if mad•e by the patient indicates understanding of the stressors that may cause exacerbation? 2. A nurse is assessing a patient with inflammatory bowel disease (IBD). The nurse suspects the patient has ulcerative coli•tis when the patient describes bowel movements as: 3. A nurse is assessing a patient with an umbilical hernia who reports abdominal pain, nausea, and vomiting. On auscultation of the abdomen, the nurse notes hyperactive bowel sounds at the hepatic flexure and hypoactive bowel sounds along the transverse colon. Based on these findings, the nurse is concerned that this patient may be exp•eriencing: 4. A patient with “abdominal discomfort” is admitted to the medical-surgical unit. Which of these statements made by this•patient would indicate to a nurse the possibility of intestinal obstruction? 5. 6. A patient admitted to the emergency room with suspected systemic anaphylaxis from an insect bite. Which of these clin•ical manifestations should indicate to a nurse that a patient is experiencing a systemic anaphylactic reaction? 7. A nurse is teaching a patient about the management of a hiatal hernia. Which of these statements made by the patient ind•icates teaching was effective? 8. Wh•ich of these patients is most at risk for developing Barrett’s esophagus? 9. A nurse is teaching a patient with upper gastrointestinal (GI) bleeding to observe his stools for blood. Which of these inst•ructions is most appropriate for the nurse to provide to this patient? 10. A patient with lower right quadrant pain for (2) days comes to the emergency room. Which of these assessment find•ings should alert a nurse the patient has potentially developed peritonitis? 11. A young woman with newly diagnosed systemic lupus erythematous (SLE) is upset about the facial malar rash and hair loss. She refuses to see friends and does not leave her home except to visit the health clinic. Which of these n•ursing diagnoses would be appropriate for this patient? SELECT ALL THAT APPLY. 12. A patient who had fecal occult blood testing (FOBT) reports the test was negative and wishes to cancel a colonoscopy sc•heduled for the next day. Which of these responses by the nurse is best? 13. A nurse is teaching a community group about human immunodeficiency virus (HIV) transmission. Which of these tr•ansmission methods should the nurse include in the teaching plan? 14. A nurse is caring for a patient who is suspected to have diverticulosis in the sigmoid colon. Which of these diagnostic tests should the nurse anticipate being ordered for this patient to confirm the diagnosis of diverticulosis in the sigmoid c•olon? 15. A nurse is giving discharge instructions to a patient who recently underwent an appendectomy. Which of these in•structions is the most appropriate at this time? 16. 17. A nurse is providing education to a patient with ulcerative colitis. Which of these instructions should be indicated in the teaching plan? 18. A nurse identifies a nursing diagnosis of knowledge deficit for a patient with recurring heartburn and indigestion that is newly diagnosed with a hiatal hernia. Which of these statements made by the patient indicates the teaching was e•ffective? 19. A nurse is admitting a patient with a suspected exacerbation of Crohn’s disease. Which of these clinical m•anifestations confirms this diagnosis? SELECT ALL THAT APPLY. 20. A nurse is caring for a patient who recently underwent an appendectomy. During the assessment, the nurse auscultates hypoactive bowel sounds and notes that the patient’s abdomen is tender and rigid. Which of these complications has mo•st likely developed in this patient? 21. A nurse is admitting a patient for possible acute appendicitis. Which of these lab findings would indicate to the nurse the•patient has possibly developed peritonitis? SELECT ALL THAT APPLY. 22. A nurse emphasizes the need for range of motion (ROM) exercises for a patient with an acute exacerbation of rhe•umatoid arthritis (RA) including joint pain and swelling in both hands. The nurse teaches the patient that: 23. While obtaining a nursing history from a patient with inflammatory bowel disease ((IBD), a nurse recognizes the pa•tient most likely has ulcerative colitis rather than Crohn’s disease when the patient reports: 24. A registered nurse is caring for a patient with a severe allergic reaction to peanuts. Which of the following are im•portant instructions to include in the teaching plan regarding allergy management? SELECT ALL THAT APPLY. 25. A patient who had fecal occult blood testing (FOBT) reports the test was negative and wishes to cancel a colonoscopy sc•heduled for the next day. Which of these responses by the nurse is best? 26. A patient with a mechanical bowel obstruction reports abdominal pain that was previously intermittent, colicky, and no•w has become constant. Which of these actions should the nurse implement first? 27. A nurse is planning the care for a patient with peritonitis secondary to appendicitis. Which of these interventions sh•ould the nurse include in the plan of care? 28. A nurse is admitting a patient with a suspected small bowel obstruction (SBO). Which of these clinical manifestations su•pports the diagnosis of SBO? 30. 31. A nurse explains lab studies to a patient with human immunodeficiency virus (HIV). Which of these lab values is m•ost significant for this patient? 32. A nurse is admitting a patient with a suspected small bowel obstruction (SBO). Which of these clinical manifestations su•pports the diagnosis SBO? (REPEATED) 33. A patient with an acute exacerbation of rheumatoid arthritis (RA) has localized inflammation and pain. The patient’s fingers, wrists, and feet and swollen, red, and there is limited movement of these joints. A nurse is developing a plan of care with the patient to promote management of this disease. Which of these outcomes should the nurse recognize a•s priority for this patient? 34. A nurse is most concerned with which of these life-threatening complications of an unresolved large bowel o•bstruction (LBO)? 36. A nurse is planning the care for a patient diagnosed with gastroesophageal reflux disorder (GERD). Which of these in•terventions should the nurse suggest to the patient to prevent nighttime reflux? • 39. A nurse is caring for a patient with peptic ulcer disease (PUD). Which of these nursing diagnoses should the nurse c•onsider priority for this patient? 40. A nurse is preparing a teaching plan for a patient with gastroesophageal reflux (GERD). Which of these instructions should the nurse include in a dietary guide for this patient? Exam 3 1. A nurse is planning the care for patient newly diagnosed with type 2 diabetes. Which of these actions should the nurse in•clude in the plan of care for this patient? SELECT ALL THAT APPLY. • Oral hypoglycemic may be ordered 2. A nurse is discussing long-term management of a patient with alcoholic cirrhosis. Which of these statements made by th•e nurse should be most appropriate for this patient? 3. A patient with hyperthyroidism asks a nurse “Why am I losing so much weight, and I’m always so hot?” The best re•sponse by the nurse should be to explain that hyperthyroidism causes: SELECT ALL THAT APPLY 4. 5. A patient with cirrhosis is being treated with lactulose and asks a nurse “Why am I having several soft stools daily?” W•hich of these responses by the nurse is best? 6. A nurse working a medical/surgical floor is taking report on assigned patients. Which of these patients should the n•urse assess first? 7. A nurse assesses a patient with Cushing’s syndrome. Which of these lab findings should the nurse expect to find in th•is patient? 8. A•nurse is caring for a patient with hyperparathyroidism. Which of these interventions should the nurse give priority? 9. A nurse is planning the care of a patient with syndrome of inappropriate antidiuretic hormone (SIADH). Which of th•ese interventions should the nurse include in the plan of care? SELECT ALL THAT APPLY. 10. A patient diagnosed with type 1 diabetes has a glycosylated hemoglobin (A1C) of 8.1%. Which of these in•terpretations should a nurse base this result? 11. A nurse is caring for a patient with diabetes mellitus. Which of these situations would potentially cause hypoglycemia in this patient? 12. A patient with advanced cirrhosis is confused, restless, and demonstrates asterixis. Which of these lab values should a n•urse report to the health care provider (HCP) immediately? 13. A nurse is developing a discharge plan for a patient with acute cholecystitis. Which of these dietary interventions s•hould the nurse include in the teaching plan? 14. Which of these lab results should be most important for a nurse to assess for a patient with pancreatitis from chronic • cholecystitis? 15. A nurse is planning the care of a patient with acute severe pancreatitis. Which of these diets should the nurse a•nticipate being ordered? 17. Which of these nursing interventions would best prevent the development of discomfort and pain associated with a•cute pancreatitis? 18. W• hich clinical manifestation alerts a nurse to the possibility of anterior pituitary hyperfunction? 19. A nurse assesses a patient who is admitted with serum glucose of 510 mg/dL. The vital signs are temperature 97.8 F ( 36.5 C), pulse 120 beats /minute, respiratory rate 28/minute and BP 82/54. Which of these intravenous solutions • should the nurse anticipate administering to this patient first 22. A nurse is giving discharge instructions to a patient with pheochromocytoma. Which of these should the nurse instruct t•he patient to avoid? 23. A nurse is formulating a discharge plan for a patient with Addison’s disease. The nurse should place the highest e•mphasis on? 24. ?• 25. A• nurse is planning the care of a patient with myxedema. Which of these actions should the nurse include in the plan? 26. A nurse is caring for a patient who is one-day post parathyroidectomy. Which of these assessment findings should a•lert the nurse to this condition? 27. A nurse reads in a patient’s medical record documentation of “fetor hepaticus”. Which of these assessment findings s•hould alert the nurse to this condition? 28. A nurse is giving discharge instructions to a patient with hepatitis A virus (HAV). Which of these statements made by t•he patient indicates the need for further teaching? 29. A patient with Addison’s disease is advised by a nurse to carry an emergency kit at all times containing: SELECT A•LL THAT APPLY 30. A patient is discharged with a prescription for 70/30 insulin 24 unites every morning before breakfast and 18 units e•very evening at bedtime. A nurse should inform the patient that this medication contains: 31. A nurse is assessing a patient with end-stage cirrhosis. When assessing the patient for the presence of asterixis. What • should the patient be instructed to do? 32. A patient is discharged from one of the rooms nearest o the nurses’ station. Which of these patients should a charge • nurse move to this room? 33. A nurse is interviewing a patient with acute pancreatitis. Which of these risk factors would be most significant when a•ssessing this patient? 34. A patient with hepatitis A virus (HAV) asks a nurse “How did I get this virus?” Which of these responses made by the n•urse is best? 35. A patient admitted with severe ascites is scheduled for a paracentesis. Immediately prior to the procedure, the nurse s•hould: 36. A• nurse assesses a patient with pheochromocytoma. The most critical assessment by the nurse is: 37. A nurse is caring for a patient with cholelithiasis and obstructive jaundice. Which of these assessment findings should • the nurse expect this patient to report 38. A patient has chronic gallbladder inflammation with obstructive jaundice. The family asks why the patient’s skin is • itchy. The best explanation by a nurse is: 39. A patient comes into the clinic with suspected hepatitis. Which of these manifestations should a nurse recognize as an • early symptom of hepatitis 40. A diabetic nurse educator is teaching a group of patients with type 1 diabetes regarding sick-day rules. Which of these • interventions should the nurse include in this discussion? SELECT ALL THAT APPLY. FINAL EXAM 41. A nursing educator for an assisted living facility is treating a group of unlicensed assistive personnel about common disabilities of these residents. During the teaching the nurse explains the difference between a handicap and 42. A nurse in a hematology class is caring for several patients. Which of these homological disorders should the nurse encourage the patient to increase hydration? 43. A young adult is admitted in sickle cell crisis. Which of these interventions should be of highest priority for this patient? 44. A patient with a hematocrit of 22.3%and hemoglobin of 7.7 mg/dL is to receive two (2) units of packed red blood cells (PRBCs) Which of these actions should a nurse implement? SELECT ALL THAT APPLY 45. A patient with leukemia asks a nurse. “Why am I susceptible to infection when my white blood cell count is so high?” Which of these responses by the nurse is best? 46. A patient presents to the hematology clinic with a painless enlarged lymph node in the neck, night sweats, and temperature 47. A nurse explains to a patient with neutropenia the best method for the presence of infections is monitoring 48. A patient comes to the emergency department complaining of dyspnea and wheezing after eating at a seafood restaurant. 49. A patient with peritonitis has an order for a nasogastric tube (NGT) to low, intermittent suction. A nurse understands the purpose of the NGT tube is to 50. A nurse is monitoring a patient with inflammatory bowel disease (IBD). Which of these lab findings would indicate this patient has ulcerative colitis? 51. After being bitten by an unknown insect, a patient who is allergic to wasp stings is brought to the clinic by a co- worker. Upon arrival, the patient is anxious and tachypneic. Which of these actions should the nurse implement first? 52. A nurse is caring for a patient with diverticulitis. Which of these statements made by the patient indicates to the nurse this patient understands the disorder? 53. A nurse is caring for a patient with peptic ulcer disease (PUD). Which of these clinical manifestations should indicate to the nurse that this patient has a duodenal ulcer? 54. A nurse is obtaining a nursing history from a patient with a duodenal ulcer. Which of these clinical manifestations should the nurse anticipate the patient reporting? 55. A nurse is assessing a patient’s neck dressing after a thyroidectomy. The nurse should: 56. A patient has acute cholecystitis resulting from an obstruction of the cystic duct by gallstones. A nurse understands this patient is at risk for: 57. A nurse is caring for a patient with diabetes insipidus (DI). Which of these responses demonstrates to the nurse the treatment for DI is effective? 58. A nurse is teaching a patient with Cushing’s syndrome about nutritional needs. Which of these dietary alterations should the nurse plan for this patient? 59. A nurse is caring for a patient with ascites. Which of these orders by the healthcare provider should the nurse question 60. The nurse is assessing a client who has Pheochromocytoma. The most critical assessment by the nurse is 61. 20)The nurse is assigned to care for a client whose reason for seeking healthcare is a "Gastroesophageal Reflux Disorder (GERD)." Which of the following should the nurse include in a teaching plan for this client?. 62. 25) A nurse is preparing a teaching plan for a client with gastroesophageal reflux disorder (GERD). Which of the following instructions should you include in a dietary guide for this client? 63. 27) What clinical manifestation would indicate that the client has a duodenal ulcer? SELECT ALL THAT APPLY 64. 28) The nurse is caring for a client who has peptic ulcer disease. Which of the following nursing diagnoses should be considered a priority for the client? 65. 35) The family of a client diagnosed with SIADH (Syndrome of Inappropriate Antidiuretic Hormone) asks the nurse if the water restriction is a punishment for the client's uncooperative behavior. What is the nurse's best response? 66. 39) On the second postoperative day after a subtotal thyroidectomy, 67. A new client diagnosed with HIV is concerned about telling others he has HIV. In discussing this concern, the most appropriate response by the nurse will be - 68. A client has undergone testing for HIV. The client asks the nurse what will be done next after 2 ELISA’s are positive. 69. The nurse is caring for a patient who has anaphylaxis. The nurse should include which nursing intervention? SELECT ALL THAT APPLY 70. A client is hospitalized with an acute exacerbation of ulcerative colitis 71. A client with an exacerbation of ulcerative colitis has been placed on TPN. The client asks why food may not be given by mouth. What is the nurse best response? - 72. A client comes to the ER complaining of the lower right abdomen for two days. Which of the following assessments by the nurse might suspect that the client has developed peritonitis 73. A nurse is caring for a client who is diagnosed with acute appendicitis. Which of the following interventions will be contraindicated for the client - 74. A 76-year old client has been sick with fever and diarrhea for several days and is now diagnosed with gastroenteritis. The nurse plans to monitor the client for - 75. A nurse is taking care of a client with Crohn’s disease. Which complication should the nurse assess for - 76. A client as admitted for acute appendicitis. Which laboratory value should alert the nurse that the condition might be a case of peritonitis - 77. What dietary alterations should the nurse plan for the client with Cushing’s disease?- 78. Which of the following laboratory results would the nurse expect to find in a client with Cushing’s syndrome? - 79. Which of the following alterations in laboratory data are expected in a client admitted with pancreatitis as a result of chronic Cholecystitis?- 80. Which statement made by a client with chronic pancreatitis would indicate a need for further teaching regarding dietary management of the disease? 81. A client with advanced hepatic cirrhosis has become confused, restless, and demonstrates asterixis. Which of the following laboratory tests should the nurse consider as a priority? - 82. The nurse is caring for a client with hepatic encephalopathy. When entering the room the nurse observes the patient’s lunch tray. Which of the following should the nurse remove? - 83. In caring for a client admitted to the hospital for treatment of cirrhosis, which of the following client problems is a priority? 84. In formulating an education plan with a new type 2 diabetic client, it is important that the nurse encourage the client to become an active participant in the management of his or her diabetes. 85. A client with diabetes describes tingling and decreased sensation in the lower extremities. extremities and notes pallor, cold to touch, and shiny appearance bilaterally. For teaching this client about potential complications related to diabetes, which of the following should be a priority nursing diagnosis? - 86. A nurse is conducting an admissions assessment on a newly admitted older adult patient from a long-term care facility . Which of the following symptoms could be related to a diagnosis of anemia? 87. A nurse is conducting a health history with a patient. Which of these questions should the nurse include in his assessment to determine if the patient is at risk factors related to Vitamin B12 deficiency anemia 88. A patient has a nursing diagnosis of activity intolerance related to low hemoglobin levels. Which of these expected outcomes should indicate to a nurse the goal has been achieved for this patient? 89. A patient has hemoglobin of 8mg/dl and hematocrit of 24%. Which of these findings should the nurse expect when assessing the patient vital signs? SELECT ALL THAT APPLY 90. A nurse on the oncology unit assessing a room to a newly admitted patient who has a diagnosis of lung cancer with WBC of 2900 absolute neutrophils count (ANC) 500 and a temperature of 38.9 C (102 F). Which of these rooms is most appropriate for this patient? 91. A nurse is assessing a patient with autoimmune thrombocytopenia purpura (ATP). Which of these laboratory results should the nurse plan to monitor frequently to determine if treatment is effective? 92. A nurse is caring for a patient who is experiencing chills and develops a rash during a blood transfusion. Which of these actions should a nurse implement first? 93. A nurse is caring for a patient diagnosed with severe anemia who is to receive blood transfusion therapy. Which of these findings should alert the nurse to a possible complication? 94. A patient is to receive a blood transfusion. Based on the standards of practice, which of these actions should a nurse implement to ensure that the correct blood is administered to the right patient? 95. A nurse initiates a chemotherapy infusion at 0800 for a patient. At 0815, the patient begins to experience itching, shortness of breath, and a heart rate of 120 beats per minute. Which of these interventions takes priority at this time? 96. pt with cirrhosis and ascites should avoid ? 97. pt that may have developed peritonitis, the nurse asses for 98. pt with DM causes of hypoglycemia? 99. what intervention would have more priority when caring for a pt with cirrhosis? 100. If a patient has renal calculi what can they be at risk for? 101. If you have a dialysis patient with right AV fistula. What is it going to look like asses? [Show More]

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