Deck 1: Adult Health

Question 1

The nurse reviews the health record of a client with melasma. The nurse would anticipate that this client will exhibit:

A) Skin that is uniformly dark in color
B) Very pale skin with little pigmentation
C) Patches of skin that have loss of pigmentation
D) Blotchy brown macules across the cheeks and forehead

Answer 1

Blotchy brown macules across the cheeks and forehead

Question 2

The client with cellulitis of the lower leg has had cultures done on the affected area. The nurse reviewing the results of the culture report interprets that which of the following organisms is not part of the normal flora of the skin?

A) Escherichia coli
B) Candida albicans
C) Staphylococcus aureus
D) Staphylococcus epidermidis

Answer 2

Escherichia coli

Question 3

The client complains of chronic pruritus. Which of the following diagnoses would the nurse expect to support this client's complaint?

A) Anemia
B) Renal failure
C) Hypothyroidism
D) Diabetes mellitus

Answer 3

Renal failure

Question 4

A client being seen in an ambulatory clinic for an unrelated complaint has a butterfly rash noted across the nose. The nurse interprets that this finding is consistent with early manifestations of which of the following disorders?

A) Hyperthyroidism
B) Pernicious anemia
C) Cardiopulmonary disorders
D) Systemic lupus erythematosus (SLE)

Question 5

The nurse notes that the older adult client has a number of bright, ruby-colored, round lesions scattered on the trunk and thighs. The nurse correctly interprets the finding as alterations in blood vessels of the skin and defines them as:

A) Purpura
B) Venous star
C) Cherry angioma
D) Spider angioma

Question 6

The client has been diagnosed with paronychia. The nurse understands that this is a disorder of the:

A) Nails
B) Hair follicles
C) Pilosebaceous glands
D) Epithelial layer of skin

Question 7

The client is diagnosed with a full-thickness burn. The nurse understands that which of the following structural areas of the skin is involved?

A) Epidermis only
B) Epidermis and deeper dermis
C) Epidermis and upper layer of dermis
D) Epidermis, entire dermis, and epithelial portion of subcutaneous fat

Question 8

A client who suffered carbon monoxide poisoning from working on an automobile in a closed garage has a carbon monoxide level of 15%. The nurse would anticipate observing which sign or symptom?

A) Coma
B) Flushing
C) Dizziness
D) Tachycardia

Question 9

A client is admitted to the hospital with cellulitis of the lower leg. The nurse would anticipate which of the following therapies to be prescribed?

A) Intermittent heat lamp treatments
B) Alternating hot and cold compresses
C) Warm compresses to the affected area
D) Cold compresses to the affected area

Question 10

The nurse has instructed the client in the correct technique for breast self-examination (BSE). For a portion of the examination, the client will lie down. If the client were to examine the right breast, the nurse would tell the client to place a pillow:

A) Under the left scapula
B) Under the left shoulder
C) Under the right shoulder
D) Under the small of the back

Question 11

The nurse would identify that which of the following foods should be increased in the diet to help decrease the risk of cancer development?

A) Bacon
B) Broccoli
C) Bologna
D) Broiled beef

Question 12

The nurse would include which of the following in a list of the most helpful foods for the vegan client wishing to increase foods high in vitamin A?

A) Peas
B) Carrots
C) Potatoes
D) Green beans

Question 13

According to the American Cancer Society, fecal occult blood testing should be done annually after the age of _____ years.

A) 30
B) 40
C) 50
D) 60

Question 14

A 27-year-old female client is undergoing evaluation of lumps in her breasts. In determining whether the client could have fibrocystic breast disorder, the nurse should ask the client whether the breast lumps seem to become more prominent or troublesome at which of the following times?

A) After menses
B) Before menses
C) During menses
D) At any time, regardless of the menstrual cycle

Question 15

The nurse is assigned to the care of a client scheduled for surgery for a right colon tumor. Which of the following is the most characteristic manifestation of cancer at this site?

A) Frequent diarrhea
B) Crampy gas pains
C) Flat, ribbon-like stools
D) Dull abdominal pain exacerbated by walking

Question 16

A client has undergone abdominal perineal resection for a bowel tumor. The nurse interprets that the client's colostomy is beginning to function if which of the following signs is noted?

A) Absent bowel sounds
B) The passage of flatus
C) Blood drainage from the colostomy
D) The client's ability to tolerate food

Question 17

A nurse assessing a postoperative ureterostomy client will interpret that the stoma has normal characteristics if the stoma is:

A) Dry
B) Pale
C) Dark-colored
D) Red and moist

Question 18

The nurse monitoring the oncological client for early signs of vena cava syndrome would include assessment for which of the following?

A) Cyanosis
B) Arm edema
C) Periorbital edema
D) Mental status changes

Question 19

The nurse understands that which of the following hormones is directlyresponsible for maintaining the free or unbound portion of serum calcium within normal limits?

A) Thyroid hormone
B) Parathyroid hormone
C) Follicle-stimulating hormone
D) Adrenocorticotropic hormone

Question 20

The client with an endocrine disorder complains of weight loss and diarrhea, and says that he can "feel his heart beating in his chest." The nurse interprets that which of the fol lowing glands is most likely responsible for these symptoms?

A) Thyroid
B) Pituitary
C) Parathyroid
D) Adrenal cortex

Question 21

The client is experiencing an episode of hypoglycemia. The nurse understands that the physiological mechanism that should take place to combat this decrease in the blood glucose level is:

A) Decreased cortisol release
B) Increased insulin secretion
C) Decreased epinephrine release
D) Increased glucagon secretion

Question 22

The client with diabetes experiences breakdown of fats for conversion to glucose. The nurse determines that this response is occurring if the client has elevated levels of which of the following substances?

A) Glucose
B) Ketones
C) Glucagon
D) Lactic dehydrogenase

Question 23

The client with diabetes mellitus is being tested to determine long-term diabetic control. Which of the following results would the nurse expect to see if the client's long-term control is within acceptable limits?

A) Glycosylated hemoglobin of 6%
B) Fasting blood glucose level of 150 mg/dL
C) Presence of ketones in the urine
D) Presence of albumin in the urine

Question 24

The nurse is caring for a client with a dysfunctional thyroid gland and is concerne d that the client will exhibit signs of thyroid storm. Which of the following is an early indicator of this complication?

A) Hyperreflexia
B) Constipation
C) Bradycardia
D) Low-grade temperature

Question 25

The client is undergoing an oral glucose tolerance test. The nurse interprets that the client's results are not compatible with diabetes mellitus if the glucose level is lower than which of the following cutoff values after 120 minutes (2 hours)?

A) 80 mg/dL
B) 110 mg/dL
C) 140 mg/dL
D) 160 mg/dL

Question 26

A client who visits the physician's office for a routine physical reports new onset of intolerance to cold. Knowing that this is a frequent complaint associated with hypothyroidism, the nurse continues to assess for which of the following?

A) Weight loss and thinning skin
B) Complaints of weakness and lethargy
C) Increased heart rate and respiratory rate
D) Diaphoresis and increased hair growth

Question 27

The nurse is caring for a client diagnosed with suspected acute pancreatitis. When reviewing the client's laboratory results, the nurse determines that which of these findings will support the diagnosis?

A) Elevated serum lipase level
B) Elevated serum bilirubin level
C) Decreased serum trypsin level
D) Decreased serum amylase level

Question 28

A nurse is caring for a client postoperativelyfollowing creation of a colostomy. Which of the following nursing diagnoses should the nurse include in the plan of care?

A) Sexual dysfunction
B) Disturbed body image
C) Fear
D) Imbalanced nutrition: more than body requirements

Question 29

The client is experiencing blockage of the common bile duct. Which of the following food selections made by the client indicates the need to plan for further diet teaching?

A) Rice
B) Whole milk
C) Broiled fish
D) Baked chicken

Question 30

The nurse is reviewing laboratory test results for the client with liver disease and notes that the client's albumin level is low. Which of the following nursing actions is focused on the consequence of low albumin levels?

A) Evaluating for asterixis
B) Inspecting for petechiae
C) Palpating for peripheral edema
D) Evaluating for decreased level of consciousness

Question 31

Discharge teaching for a client recovering from an attack of chronic pancreatitis should include which of the following instructions?

A) Alcohol should be consumed in moderation.
B) Avoid caffeine, because it may aggravate symptoms.
C) Diet should be high in carbohydrates, fats, and proteins.
D) Frothy fatty stools indicate that enzyme replacement is working.

Question 32

A client returns to the nursing unit after undergoing an esophagogastroduodenoscopy (EGD). Which of the following reflects appropriate intervention by the nurse?

A) Allow the client unassisted bathroom privileges.
B) Keep the client lying flat in bed in the supine position.
C) Withhold oral fluids until the client's gag reflex has returned.
D) Tell the client to report a sore throat immediately, because it is a serious complication.

Question 33

The nurse is assisting the physician during a colonoscopy procedure. The nurse helps the client to assume which of the following positions for the procedure?

A) Left Sims
B) Lithotomy
C) Knee chest
D) Right Sims

Question 34

The client is scheduled for oral cholecystography. For the evening meal prior to the test, the nurse provides a list of foods from which diet type?

A) Liquid
B) Fat-free
C) Low-protein
D) High-carbohydrate

Question 35

In which of the following optimal positions should the nurse plan to place the client after bolus feeding using a nasogastric tube?

A) Head of bed (HOB) flat, with client supine for at least 60 minutes
B) HOB elevated 45 to 60 degrees, with client supine for 15 minutes
C) HOB elevated 10 degrees, with client in the left lateral position for 60 minutes
D) HOB elevated 30 to 45 degrees, with client in the right lateral position for 60 minutes

Question 36

The client receiving a cleansing enema complains of pain and cramping. The nurse takes which of the following corrective actions?

A) Discontinue the enema.
B) Reassure the client, and continue the flow.
C) Raise the enema bag so that the solution can be completed quickly.
D) Clamp the tubing for 30 seconds, and restart the flow at a slower rate.

Question 37

A client presents to the urgent care center with complaints of abdominal pain and vomits bright red blood. Which of the following is the priority action taken by the nurse?

A) Take the client's vital signs.
B) Perform a complete abdominal assessment.
C) Obtain a thorough history of the recent health status.
D) Prepare to insert a nasogastric tube and test pH and occult blood.

Question 38

The client with frequent upper respiratory infections (URIs) asks the nurse why food doesn't seem to have any taste during illness. The nurse understands that this is because of which of the following?

A) Anorexia is triggered by the infectious organism.
B) Blocked nasal passages impair the senses of smell and taste.
C) The infection blocks sensation from the taste buds of the tongue.
D) The client's medication therapy has caused changes in the normal flora of the mouth.

Question 39

The nurse providing instructions to the client using an incentive spirometer tells the client to sustain the inhaled breath for 3 seconds. When the client asks the nurse about the rationale for this action, the nurse explains that the primary benefit is to:

A) Dilate the major bronchi.
B) Maintain inflation of the alveoli.
C) Increase surfactant production.
D) Enhance ciliary action in the tracheobronchial tree.

Question 40

The nurse understands that increasing the flow of oxygen to more than 2 L/min in the client with chronic obstructive pulmonary disease (COPD) could be harmful because it:

A) Is drying to nasal mucosal passages
B) Decreases diaphragmatic excursion and depth
C) Increases the risk of pneumonia and atelectasis
D) Decreases the client's oxygen-based respiratory drive

Question 41

The nurse participating in a client care conference with other health team members is discussing the condition of a client with adult respiratory distress syndrome (ARDS). The physician states that because of fluid in the alveoli, surfactant production is falling. The nurse understands that the consequence of insufficient surfactant is:

A) Atelectasis and viral infection
B) Bronchoconstriction and stridor
C) Collapse of alveoli and decreased compliance
D) Decreased ciliary action and retained secretions

Question 42

The nurse caring for a client with chronic obstructive pulmonary disease ( COPD) anticipates which of the following arterial blood gas (ABG) findings?

A) pH, 7.40; PaO₂, 90 mm Hg; CO₂, 39 mEq/L; HCO₃, 23 mEq/L
B) pH, 7.32; PaO₂, 85 mm Hg; CO₂, 57 mEq/L; HCO₃, 26 mEq/L
C) pH, 7.47; PaO₂, 82 mm Hg; CO₂, 30 mEq/L; HCO₃, 31 mEq/L
D) pH, 7.31; PaO₂, 95 mm Hg; CO₂, 22 mEq/L; HCO₃, 19 mEq/L

Question 43

The chest x-ray report for a client states that the client has a left apical pneumothorax. The nurse would monitor the status of breath sounds in that area by placing the stethoscope:

A) Near the lateral 12th rib
B) Just under the left-sided clavicle
C) In the fifth intercostal space
D) Posteriorly, under the left-sided scapula

Question 44

The nurse would determine that tracheal suctioning is needed if which of the following is noted?

A) Arterial oxygen level of 90 mm Hg
B) Congested breath sounds in the lung fields
C) Two hours elapsed since the last suctioning
D) Respiratory rate of 18 breaths/min, up from 16 breaths/min

Question 45

The client with chronic obstructive pulmonary disease (COPD) is experiencing exacerbation of the disease. The nurse would determine that which of the following documented in the client's record is an expected finding with this client?

A) Increased oxygen saturation with ambulation
B) Hyperinflation of lungs documented by chest x-ray
C) A widened diaphragm documented by chest x-ray
D) A shortened expiratory phase of the respiratory cycle

Question 46

The nurse is caring for a postoperative client who has lost a significant amount of blood because of complications during a surgical procedure. Which of the following assessment findings would be indicative of further fluid volume deficit?

A) Pulse rate increases from 100 beats/min to 136 beats/min
B) +4 edema noted in lower extremities
C) Blood pressure rises from 116/68 to118/74 mm Hg
D) Crackles auscultated from lung bases to apices

Question 47

The nurse is preparing to take an apical pulse on an assigned client. The nurse places the diaphragm of the stethoscope at which cardiac site?

A) Aortic area
B) Mitral area
C) Tricuspid area
D) Pulmonic area

Question 48

The nurse reading the operative record of a client who had cardiac surgery notes that the client's cardiac output immediately after surgery was 3.2 L/min. Evaluation of the cardiac output results leads the nurse to make which of the following conclusions?

A) The cardiac output is above the normal range.
B) The cardiac output is in the high-normal range.
C) The cardiac output is in the low-normal range.
D) The cardiac output is below the normal range.

Question 49

The nurse is listening to a 56-year-old client's apical heart rate before giving digoxin (Lanoxin) and notes that the heart rate is 48 beats/min. Which of the following would be an appropriate course of action taken by the nurse?

A) Withhold the digoxin, and reevaluate the heart rate in 4 hours.
B) Administer half the prescribed dose to avoid a further decrease in heart rate.
C) Withhold the digoxin; assess for signs of decreased cardiac output and digoxin toxicity.
D) Administer the digoxin; the heart rate would be considered normal because of the client's age.

Question 50

The nurse is assisting in admitting a client who has a diagnosis of hypothermia. The nurse anticipates that this client will exhibit which of the following vital signs?

A) Increased heart rate and increased blood pressure
B) Increased heart rate and decreased blood pressure
C) Decreased heart rate and increased blood pressure
D) Decreased heart rate and decreased blood pressure

Question 51

A client has been admitted with left-sided heart failure. When planning care for the client, interventions should be focused around reduction of which specific problem associated with this type of heart failure?

A) Ascites
B) Pedal edema
C) Bilateral lung crackles
D) Jugular vein distention

Question 52

A client with angina complains that the anginal pain is prolonged, severe, and occurs at the same time each day, most often in the morning. On further assessment, a nurse notes that the pain occurs in the absence of precipitating factors. How would the nurse best describe this type of anginal pain?

A) Stable angina
B) Unstable angina
C) Variant angina
D) Nonanginal pain

Question 53

A client's total cholesterol level is 344 mg/dL, low-density lipoprotein cholesterol (LDL-C) level is 164 mg/dL, and high-density lipoprotein cholesterol (HDL-C) level is 30 mg/dL. Based on analysis of the data, how should the nurse direct client teaching?

A) The client should maintain the current dietary regimen but increase activity levels.
B) Results are inconclusive unless the triglyceride level is also screened, so teaching is not indicated at this time.
C) The client is at high risk for cardiovascular disease, and measures to modify all identified risk factors should be taught.
D) The client is at low risk for cardiovascular disease, so the client should be encouraged to continue to follow the current regimen.

Question 54

The ambulatory care nurse measures the blood pressure of a client and finds it to be 156/94 mm Hg. Which of the following areas is unnecessary to emphasize when providing client education for blood pressure control?

A) Instruct the client to limit protein intake.
B) Teach the client to avoid adding salt to foods.
C) Discuss the rationale for reducing or maintaining weight.
D) Stress the importance of a regular exercise program.

Question 55

The nurse identifies that a client is having occasional premature ventricular contractions (PVCs) on the cardiac monitor. The nurse reviews the client's laboratory results and determines that which of the following results would be consistent with the observation?

A) Serum sodium level of 150 mEq/L
B) Serum chloride level of 95 mEq/L
C) Serum calcium level of 11.5 mg/dL
D) Serum potassium level of 2.8 mEq/L

Question 56

The client who has had intracranial surgery is experiencing diabetes insipidus. The nurse understands that the client is experiencing which of the following problems?

A) Water intoxication
B) Excess production of dopamine
C) Excess production of angiotensin II
D) Insufficient production of antidiuretic hormone (ADH)

Question 57

The client is admitted to the hospital with a tentative diagnosis of bladder cancer. The nurse expects the client history to reveal which of the following earliest manifestations of the disease?

A) Proteinuria and dysuria
B) Hematuria with no pain
C) Painful urination and hematuria
D) Pyuria and palpable abdominal mass

Question 58

The client with glomerulonephritis has developed acute renal failure (ARF) as a complication. The nurse would expect to note which of the following abnormal findings documented on the client's medical record?

A) Decreased cardiac output
B) Hypertension
C) Bradycardia
D) Decreased central venous pressure

Question 59

The client has been diagnosed with pyelonephritis. The nurse interprets that which of the following health problems has placed the client at risk for this disorder?

A) Diabetes mellitus
B) Intravenous (IV) contrast medium
C) Orthostatic hypotension
D) Coronary artery disease

Question 60

The nurse has a prescription to collect a 24-hour urine specimen from a client. The nurse should avoid which of the following errors in technique when implementing this procedure?

A) Do not remove urine from the collection container for other specimens.
B) Place the specimen in the appropriate container necessary for the test.
C) Ask the client to save a sample voided at the end of the collection time.
D) Ask the client to void, save the specimen, and note the start time.

Question 61

The nurse who is collecting data from the client notes that the client's left-sided eyelid is drooping. The nurse documents that the client is exhibiting which of the following conditions?

A) Ptosis
B) Arcus senilis
C) Abnormal corneal reflex
D) Blockage of the lacrimal duct

Question 62

The nurse is attempting to inspect the lacrimal apparatus of the cl ient's eye. Because of its anatomical location, the nurse should do which of the following?

A) Retract the upper eyelid, and ask the client to look down.
B) Retract the upper eyelid, and ask the client to look up.
C) Retract the lower eyelid, and ask the client to look up.
D) Retract the lower eyelid, and ask the client to look down.

Question 63

The nurse conducting an eye examination notes that the client exhibits rapid, involuntary, oscillating movements of the eyeball when looking at the nurse. The nurse documents this finding as:

A) Nystagmus
B) Photophobia
C) Unequal pupils
D) Impaired consensual response

Question 64

The nurse who is assessing the client's eyes notes that the pupil gets larger when looking at an object in the distance and gets smaller when looking at a near object. The nurse documents this finding as:

A) Myopia
B) Hyperopia
C) Photophobia
D) Accommodation

Question 65

The nurse suspects the client may be experiencing dysfunction in the area of the semicircular canals of the ear if the client experiences:

A) Disturbance in balance
B) Conduction hearing loss
C) Tinnitus
D) Sensorineural hearing loss

Question 66

A client is experiencing blockage of the eustachian tubes. Which of the following activities by the client may forcibly open the eustachian tube?

A) Performing the Valsalva maneuver
B) Tapping the side of the head lightly
C) Using cotton-tipped applicators in the ears
D) Chewing food using exaggerated mouth movements

Question 67

A nurse is caring for a client diagnosed with Ménière's disease. The nurse plans care, understanding that this disorder is characterized by:

A) Dizziness
B) Blurred vision
C) Hemianopsia
D) Photophobia

Question 68

The client has a cerebellar lesion. The nurse would plan to obtain which of the following for use by this client?

A) Walker
B) Slider board
C) Raised toilet seat
D) Adaptive eating utensils

Question 69

The client has sustained damage to Wernicke's area in the temporal lobe from a brain attack (stroke). Which of the following should the nurse anticipate when caring for this client?

A) The client will be unable to recall past events.
B) The client will demonstrate difficulty articulating words.
C) The client will have difficulty understanding language.
D) The client will have difficulty moving one side of the body.

Question 70

The nurse is preparing to administer a prescribed antibiotic to a client with bacterial meningitis. The nurse understands that the selection of an antibiotic to treat meningitis is based on which of the following?

A) It has a long half-life.
B) It acts within minutes to hours.
C) It is able to cross the blood-brain barrier.
D) It can be easily excreted in the urine.

Question 71

The client who is experiencing an inferior wall myocardial infarction has had a drop in heart rate into the 50 to 56 beats/min range. The client is also complaining of nausea. The nurse interprets that these symptoms are because of stimulation of which cranial nerve (CN)?

A) Vagus (CN X)
B) Hypoglossal (CN XII)
C) Spinal accessory (CN XI)
D) Glossopharyngeal (CN IX)

Question 72

The client is being scheduled for a positron emission tomography (PET) scan. The nurse provides which of the following explanations to the client?

A) "The test uses magnetic fields to produce images."
B) "The test provides cross-sectional views of the brain."
C) "The test detects abnormal glucose metabolism in the brain."
D) "The test views bones of the skull, nasal sinuses, and vertebrae."

Question 73

The nurse is caring for a client who is scheduled to have electroencephalography. The nurse determines that the client is ready for the procedure after noting which of the following?

A) The client's hair has been shampooed.
B) The client has not had any breakfast.
C) The client has had two cups of coffee with breakfast.
D) The morning dose of an anticonvulsant has been administered.

Question 74

The nurse should ask the client to do which of the following when testing the function of the spinal accessory nerve (CN XI)?

A) Swallow a sip of water.
B) Elevate the shoulders.
C) Open the mouth and say "ah."
D) Vocalize the sounds "la-la," "mi-mi," and "kuh-kuh."

Question 75

The nurse is assessing the client's muscle strength and notes that when asked, the client cannot maintain his or her hands in a supinated position with the arms extended and eyes closed. How would the nurse correctly document this finding on the medical record?

A) Client is demonstrating ataxia.
B) Client is exhibiting pronator drift.
C) Client examination reveals hyperreflexia.
D) Client appears to have nystagmus.

Question 76

The nurse is testing the client for graphesthesia and asks the client to close his e yes. Which of the following would the nurse have the client do?

A) Identify three objects placed in the hand, one at a time.
B) Identify three numbers or letters traced in the client's palm.
C) Identify the smallest distance between two skin pricks after pricking the skin with two pins at varying distances.
D) State whether one or two skin pricks are felt, after applying sharp stimuli bilaterally to symmetrical areas of the client's skin.

Question 77

The nurse plans care for the older adult female client with a diagnosis of osteoporosis knowing that the client is at greatest risk for which of the following?

A) Fractures
B) Phosphatemia
C) Hypocalcemia
D) Muscle atrophy

Question 78

The clinical picture of the client with osteitis deformans (Paget's disease) includes back and leg pain, a crouched forward posture, and legs that bow outward. The nurse plans care, knowing that these manifestations are caused by disturbances of which of the following?

A) Muscle metabolism and growth
B) Bone resorption and regeneration
C) Nervous system impulse transmission
D) Joint integrity and synovial fluid production

Question 79

The nurse understands that the most significant rationale for the application of heat to an area of contusion 72 hours after the injury is to:

A) Prevent abscess formation.
B) Promote muscle relaxation.
C) Reabsorb blood from the injured tissue.
D) Reduce the likelihood of strain as a complication.

Question 80

The nurse is assisting in performing a physical assessment of a right-handed client's musculoskeletal system. Which of the following would be an abnormal finding?

A) Presence of fasciculations
B) Muscle strength of normal power
C) Symmetrical movements bilaterally
D) Hypertrophy of right upper arm of 1 cm