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Complex health challenges > test 2 > Flashcards

test 2 Flashcards

1
Q

which of the following should be included in teaching about dietary management for a patient who has a colostomy?

a) diet should be high in fibre
b) experiment with an irritating food several times before eliminating it
c) diet should be high in fibre
d) cabbage should be included to aid in digestion

A

b) experiment with an irritating food several times before eliminating it

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2
Q

patients with pleural effusion are at an increased risk for:

a) pneumonia
b) pneumothorax
c) atelectasis
d) pulmonary embolism

A

c) atelectasis

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3
Q

atropine is often administered prior to a bronchoscopy for which one of the following reasons?

a) to inhibit the gag reflex to prevent vomiting and potential for aspiration
b) to stimulate adrenal receptors and the subsequent release of chatecholamines to increase heart rate
c) to slow the heart rate to prevent tachydysrythmias
d) to inhibit vagal stimulation to protect the client against bradycardia

A

d) to inhibit vagal stimulation to protect against bradycardia

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4
Q

which one of the following renal tumours is found most often in infants and children?

a) adenocarcinoma
b) renal sarcoma
c) wilms’ tumour
d) angiomyolipoma

A

c) Wilms’ Tumour

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5
Q

a client undergoes renal artery embolization for metastatic renal carcinoma. The next day the client experiences fever, pain localized to the flank and abdomen, and severe nausea. The nurse suspects which one of the following complications?

a) acute gastroenteritis
b) postinfarction syndrome
c) pyelonephritis
d) metastatic disease of the GI tract

A

b) postinfarction syndrome

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6
Q

which of the following is a goal of peritoneal dialysis?

a) to provide a faster exchange than hemodialysis
b) to remove wastes and reestablish electrolyte balance
c) to maintain dialysis treatment until a hemodialysis access matures
d) to complete as many exchanges as possible in g hours

A

b) to remove wastes and reestablish electrolyte balance

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7
Q

which of the following patients is at an increased risk for an acute pancreatitis attack?

a) a 45-year old woman with a high-fat diet
b) a 19-year old man who is a weekend binge drinker
c) a 45-year old man with chronic alcoholism
d) a 51-year old woman who smokes one pack of cigarettes per day

A

c) a 45-year old man with chronic alcoholism

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8
Q

a patient is diagnosed with acute glomerulonephritis. The nurse is aware that the patient may exhibit which of the following manifestations?

a) hematuria
b) decrease in serum creatinine levels
c) hypotension
d) glucose in the urine

A

a) hematuria

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9
Q

a patient, age 54, is admitted with a diagnosis of venous ulceration unresponsive to treatment. Which of the following is the nurse most likely to find during an assessment of a patient with venous ulceration?

a) heavy exudate
b) gangrene
c) deep wound bed
d) pale wound bed

A

a) heavy exudate

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10
Q

which of the following individuals would be most likely to develop hepatitis D?

a) someone who travelled to a country where there is endemic
b) a person who had sexual intercourse with a person infected with hep a
c) a patient who already has hep B
d) someone who came in contact with a person with Hep E

A

c) a patient who already has hep B

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11
Q

which one of the following is classified as a gram positive bacterial infection?

a) klebsiella pneumoniae pneumonia
b) pseudomonas pneumonia
c) stretococcus pneumonie sinusitis
d) legionella pneumophila pneumonia

A

c) streptococcus pneumoniae sinusitis

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12
Q

a patient who was admitted to the emergency department with bleeding from esophageal varices has had a balloon tamponade put in place and has been transferred to an acute medical unit now that he has stabilized. which of the following instructions should the nurse provide to the patient?

a) “it’s important that you only remove the balloon which a nurse is present”
b) “you’ll be placed on a minced and pureed diet for the duration of this treatment”
c) “be careful you don’t remove the balloon or pull it out, either deliberately or accidentally”
d) “it will be uncomfortable, but this method is very effective for the treatment of cirrhosis”

A

c) “Be careful you don’t remove the balloon or pull it out, either deliberately or accidentally”

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13
Q

a 59-year old male patient who has just been diagnosed with an aortic aneurysm has been assigned one-to-one nursing care, and the nurse is taking vital signs every 15 minutes. What is the rationale for the patient’s vigilant nursing care?

a) aortic aneurysm is often a precursor to cardiogenic shock
b) arterial insufficiency as a result of aortic aneurysm often results in cerebral ischemia
c) bruits within the aneurysm often cause thrombosis
d) rupture of an aortic aneurysm is a medical emergency with high mortality

A

d) rupture of an aortic aneurysm is a medical emergency with high mortality

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14
Q

your patient has the following blood gas results:
pH-7.26
PaCO2- 28
HCO3 - 11mEq/L
how would the nurse interpret the results?
a) resp acidosis with no compensation
b) metabolic alkalosis with compensatory alkalosis
c) metabolic acidosis with no compensation
d) metabolic acidosis with a compensatory resp alkalosis

A

d) metabolic acidosis with a compensatory resp alkalosis

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15
Q

which of the following patient’s medical histories presents the greatest risk of developing end-stage renal disease (ESRD)?

a) history of polycystic kidney disease
b) diabetes mellitus with poorly controlled hypertension
c) history of vascular disorders
d) history of respiratory infections

A

b) diabetes mellitus with poorly controlled hypertension

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16
Q

which of the following would be the most appropriate dressing to apply on a patient with a superficial, uninfected leg ulcer?

a) a dry gauze dressing
b) a dry sterile dressing
c) a hydrocolloid dressing
d) a hydrogen peroxide dressing

A

c) a hydrocolloid dressing

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17
Q

the patient is a 48-year old man with acute renal failure. Which of the following is the most common clinical situation seen in acute renal failure?

a) decrease in BUN
b) anuria
c) oliguria
d) decrease in serum creatinine

A

c) oliguria

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18
Q

a patient with acute renal failure is being assessed to determine whether the cause is prerenal, renal, or postrenal. if the cause is postrenal, which condition most likely caused it?

a) glomerulonephritis
b) ureterolithiasis
c) heart failure
d) aminoglycoside toxicity

A

c) heart failure

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19
Q

when assessing a patient in acute resp failure, the nurse knows the normal PaCO2 levels range from _____

a) 50-65 mmHg
b) 60-80 mmHg
c) 80-100 mmHg
d) 90-100mmHg

A

c) 80-100 mmHg

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20
Q

a 32-year old woman who takes oral contraceptives is to undergo surgery and as a result will be on bedrest for 48 hours. The patient may be at an increased risk of developing what health problem?

a) deep vein thrombosis
b) intermittent claudication
c) raynaud’s disease
c) thoracic aneurysm

A

a) deep vein thrombosis

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21
Q

which of the following is NOT a phenomenon included in Virchow’s triad?

a) damage to the venous wall
b) change in blood flow
c) hyperglycemia
d) blood hypercoagulability

A

c) hyperglycemia

22
Q

the nurse is caring for a patient with acute resp distress syndrome (ARDS). what is the most likely lab finding in the early stages of this disease?

a) increased carboxyhemoglobin
b) decreased partial pressure of arterial oxygen (PaCO2)
c) increased partial pressure of arterial carbon dioxide (PaCO2)
d) decreased bicarbonate (HCO3)

A

b) decreased partial pressure of arterial oxygen (PaCO2)

23
Q

peritoneal dialysis uses which of the following to create osmotic gradient?

a) dextrose
b) potassium
c) calcium
d) sodium

A

a) dextrose

24
Q

a client with active tuberculosis has been prescribed isoniazid. the nurse knows that it will be important to monitor this client for which of the following adverse effects?

a) discolouration of bodily fluids
b) hepatoxicity
c) optic neuritis
d) gastrointestinal distress

A

b) hepatotoxicity

25
Q

which of the following is the most serious potential complication after a laparoscopic cholecystectomy?

a) pulmonary atelectasis
b) decubitus ulcer
c) would evisceration
d) bile duct injury

A

d) bile duct injury

26
Q

when implementing a regime to restore skin integrity for a patient with leg ulcers, the nurse should include:

a) cleansing the skin with alcohol
b) uses a bed cradle
c) applying heating pads to the legs
d) avoiding footwear when ambulating

A

b) using a bed cradle

27
Q

to maintain adequate tissue integrity to the lower legs of a patient with peripheral vascular disease, what should the nurse encourage the patient to do?

a) use strong soaps to clean feet
b) avoid trimming the toenails
c) eat a low-protein diet
d) wear sturdy, well-fitting shoes.

A

d) wear sturdy, well-fitting shoes

28
Q

the nurse is administering warfarin (Coumadin) to a patient with deep vein thrombophlebitis. which lab value indicates warfarin is at a therapeutic level?

a) partial thromboplastin time (PTT) 1 1/2 to 2 times the control
b) Prothrombin time (PT) 1 1/2 to 2 times the control
c) international normalized ratio (INR) of 3 to 4
d) hematocrit of 32%

A

b) Prothrombin time (PT) 1 1/2 to 2 times the control

29
Q

the nurse is caring for a postoperative patient. what intervention should the nurse perform to prevent thrombophlebitis?

a) encouraging the client to perform coughing and deep-breathing exercises
b) apply elastic stockings
c) massage legs gently
d) encouraging the client to turn frequently

A

b) apply elastic stockings

30
Q

which of the following statements about ventilation/perfusion (V/Q) ratio is correct?

a) a low V/Q ratio indicates that ventilation is adequate but perfusion is inadequate
b) a high V/Q ratio indicates that both ventilation and perfusion are inadequate
c) a low V/Q ratio indicates that both ventilation and perfusion are inadequate
d) a high V/Q ratio indicates that ventilation is adequate but perfusion is inadequate

A

d) a high V/Q ratio indicates that ventilation is adequate but perfusion is inadequate

31
Q

a patient is scheduled for a thoracentesis. The nurse should explain to the patient that this procedure is used in the diagnostic evaluation of:

a) collapsed alveoli
b) atelectasis
c) pleural effusions
d) lung tumours

A

c) pleural effusions

32
Q

a 46-year old male is admitted to the hospital with a suspected diagnosis of hep B. He is jaundice and complains of weakness. Which of the following should the nurse included in the patient’s care plan?

a) rest periods after small, frequent meals
b) a low-protein diet
c) menus selected by the patient
d) regular exercise

A

a) rest periods after small, frequent meals

33
Q

the most appropriate goal for a patient with peripheral arterial insufficiency is which of the following?

a) promotion of vasoconstriction
b) promotion of vasodilation
c) promotion of vascular compression
d) promotion of atherosclerosis

A

b) promotion of vasodilation

34
Q

a patient has been ordered a Mantoux test. How should the nurse administer the test?

a) intradermal injection into the inner forearm
b) intramuscular injection into the vastus lateralis
c) subcutaneous injection into the umbilical area
d) insert at a 45 degree angle into the deltoid

A

a) intradermal injection into the inner forearm

35
Q

a patient develops a pulmonary embolism after a total knee replacement surgery and must be converted from heparin to sodium warfarin (Coumadin) anticoagulation therapy. what should the nurse tell the patient?

a) coumadin will continue to break up the clot for a period of weeks
b) his prothrombin time (PT) and international normalized ratio (INR) will be periodically check for dose adjustment
c) anticoagulant therapy usually lasts 4 to 6 weeks
d) he should take a vitamin supplement containing vitamin K

A

b) his prothrombin time (PT) and international normalized ration (INR) will be periodically checks for dose adjustment

36
Q

acute pancreatitis occurs when:

a) toxic substances inflame the pancreas
b) enzyme production exceeds physiological needs
c) viruses digest the pancreas
d) pancreatic enzymes digest the pancreas

A

d) pancreatic enzymes digest the pancreas

37
Q

the nurse is teaching a patient with chronic renal failure which foods to avoid. It would be most accurate for the nurse to teach the patient to avoid foods high in:

a) monosaccharides
b) disaccharides
c) iron
d) protein

A

d) protein

38
Q

a 78-year old female with numerous chronic health problems has been admitted to the hospital from her care home with a diagnosis of failure to thrive. the nurse’s morning assessment revealed an unprecedented lack of audible breath sounds in the patient’s lower, posterior lung field. The patient denies any thoracic pain, and CT confirmed the presence of fluid in the space surrounding the patient’s lungs. Thoracentesis performed at the bedside yielded 800mls of clear fluid. which of the following diagnosis most likely caused these recent events?

a) pleurisy
b) pulmonary edema
c) pleural effusions
d) empyema

A

c) pleural effusions

39
Q

the nurse is caring for a patient on a regimen of four medications to treat tuberculosis. The nurse discovers that the patient is not talking all his medications. What is the appropriate for the nurse to say to the patient?

a) “dont you realize that resistance can develop if you dont take your medications properly?”
b) “you need to take your medications as you were instructed. Do you need supervision?”
c) why arent you taking your medications? Dont you want to get better?”
d) “taking many medications can be difficult. tell me about the difficulties you’re having.”

A

d) “taking many medications can be difficult. tell me about the difficulties you’re having”.

40
Q

the nurse is providing care for a 60-year old female patient who has been recently diagnosed with nephrotic syndrome. Which of the following teaching points should the nurse prioritize?

a) activity management and energy-saving strategies
b) infection control measures and the importance of keeping immunizations current
c) self-monitoring of blood pressure and the importance of fluid restriction
d) close adherence to dietary and medication regimens

A

d) close adherence to dietary and medication regimens

41
Q

which of the following complications results from portal hypertension?

a) bowel obstruction
b) vitamin A deficiency
c) ascites
d) hepatic encephalopathy

A

c) ascites

42
Q

the patient with acute renal failure has a serum potassium value of 7.1 mmol/L. The nurse should prepare the patient for which of the following?

a) immediate dialysis
b) renal biopsy
c) a dopamine infusion
d) total parenteral nutrition

A

a) immediate dialysis

43
Q

the nurse is caring for a 45-year old male patient with end stage cirrhosis. the patient has been a heavy drinker for 19 years and his liver has become small and nodular over time. this patient’s history and the condition of his liver are characteristic of which one of the following types of cirrhosis?

a) post-necrotic
b) biliary
c) cardiac
d) laennec’s

A

d) laennec’s

44
Q

the care team in the ER is assessing an 81-year old female patient who has been brought to the hospital because of her recent and increasing malaise and anorexia. The care team wishes to rule out pneumonia as a cause of the patient’s symptoms. Which of the following principles is an accurate guide to the assessment and diagnosis of pneumonia in older patients?

a) cough, pain, and sputum production are more pronounced in the elderly, owing to their decreased physiologic reserve
b) most diagnoses of pneumonia in the elderly are manifestations of chronic obstructive pulmonary disease (COPD) rather than infectious processes
c) atypical signs and symptoms, such as confusion, tachycardia, and abdominal symptoms, may be present
d) most bacterial and viral lung infections in the elderly are asymptomatic, a fact that leads to increased mortality

A

c) atypical signs and symptoms, such as confusion, tachycardia, and abdominal symptoms, may present

45
Q

of the following clinical manifestations, which will indicate to the nurse that the patient is demonstrating decompensated cirrhosis?

a) ankle edema
b) intermittent mild fever
c) morning indigestion
d) clubbing of the fingers

A

d) clubbing of the fingers

46
Q

the nurse is assisting with a subclavian vein central line insertion when the patient’s oxygen saturation rapidly drops. He complains of SOB and becomes tachypneic. The nurse suspects a pneumothorax has developed. Further assessment findings supporting the presence of a pneumothorax include which of the following?

a) diminished or absent breath sounds on the affected side
b) paradoxic chest wall movement with respirations
c) tracheal deviation to the unaffected side
d) muffled or distant heart sounds

A

a) diminished or absent breath sounds on the affected side

47
Q

which of the following measures should the nurse implement when providing elastic compressions stockings for a patient with a diagnosis of deep vein thrombosis (DVT)?

a) stockings should be rolled down three to four turns at the top to prevent venous stasis
b) regular pantyhose can be substituted for elastic prescription stockings provided they fit properly
c) ankle-high stockings can be used for patients with difficulty applying knee-high or thigh-high stockings
d) for ambulatory patients, stockings should be removed at night and reapplied first thing in the morning

A

d) for ambulatory patients, stockings should be removed at night and reapplied first thing in the morning

48
Q

a 67-year old male has presented to his primary care provider with complaints of recent constipation and pencil-then stools despite his healthy diet and lifelong commitment to exercise. Fecal occult blood testing (FOBT) performed in the clinic is positive, and the patient acknowledges that he as experienced recent fatigue and has lost 4 kg in the last 2 months. which of the following diagnostics should the clinician prioritize?

a) abdominal ultrasound
b) Carcinoembryonic antigen (CEA)
c) colonoscopy
d) stool testing for parasites

A

c) colonoscopy.

49
Q

a 26-year old male patient has just been brought to the ER by paramedics after suffering a sudden onset of severe dyspnea at home. The ED team’s rapid diagnostic workup suggests the presence of a pulmonary embolism. Which of the following actions should the nurse perform in light of this diagnosis?

a) administering oxygen and starting an IV
b) obtaining a thoracentesis kit
c) calming the patient and helping him to perform deep breathing and coughing exercises
d) preparing the patient for cardiac catheterization

A

a) administering oxygen and starting an IV

50
Q

which of the following occupations is at the greatest risk for contracting hep b?

a) healthcare workers
b) flight attendants
c) fire fighters
d) restaurant workers

A

a) healthcare workers

Complex health challenges (1 decks)

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