Question 1

Becky, a patient who is hypertensive, has been noncompliant in taking her antihypertensive medications. The nurse should explain that one relatively common complication of uncontrolled hypertension is:

Accepted Answer

The nurse should explain that hemorrhaging and occlusion of blood vessels in the body are relatively common complications of uncontrolled hypertension and occur in various places in the body, but most often in the brain, the eyes, the heart, and the kidneys.

Question 2

A newly licensed cardiologist requested a clinical nurse specialist to assist in doing a right heart catheterization on a cyanotic patient. The cardiologist asks the nurse what should be used to inflate the balloon. The nurse should respond:

Accepted Answer

The nurse should respond that CO2 should be used to inflate the balloon because CO2 is 20 times more soluble in blood than air. If the balloon breaks or leaks in the right heart, it will be more quickly absorbed. Since cyanotic shunts move across the septum in a R-L direction, some of the gas may pass through the R-L shunt. If it does embolize into the left heart, it might lead to a dangerous arterial embolism or stroke.

Question 3

A clinical nurse specialist provides a lecture to a group of nursing students about central venous catheterization and pressure. After the lecture, the entire group learned that central venous pressure can directly assess which of the following:

Accepted Answer

Central venous pressure directly assesses right heart preload and right ventricle function. The central venous pressure measurement also can be used to assess and manage intravascular volume status because pressure in the great thoracic veins generally correlates with the volume of venous return. The amount of blood that returns to the heart is normally ejected by the heart. Therefore, in patients with hypovolemia, a decreased CVP measurement is associated with a decreased cardiac output, whereas patients with volume overload typically have increased CVP and cardiac output.

Question 4

Benita, a 65-year-old banker, was admitted in the unit due to Gastro Esophageal Reflux Disease (GERD). The clinical nurse specialist should educate the patient to avoid which type of diet to avoid acid reflux?

Accepted Answer

The clinical nurse specialist should advice the patient to avoid foods which are high fat and carbonated and caffeinated beverages must be avoided to avoid backflow of gastric contents. Excessive caffeine reduces the tone of lower esophageal sphincter.

Question 5

A 40-year-old patient sustained full-thickness burns to both upper extremities from scalding water. A sheet graft was surgically applied to the wounds. The husband asks the nurse about the primary purpose of the graft. The nurse responds correctly by stating that it's primarily because of:

Accepted Answer

The nurse responds correctly by stating that the primary purpose of the graft is for a better cosmetic result. Sheet grafts are often used to graft burns in visible areas. Sheet grafts are done on cosmetically important areas, such as the face and hands, to avoid the meshed pattern that occurs with meshed grafts.

Question 6

A college professor was diagnosed with hepatitis A. She expresses concern over the change in her skin color that is associated with her disease. The nurse informed the patient that change in her skin color is associated with:

Accepted Answer

The nurse must recognize that the development of jaundice is associated with the inability of the liver to excrete normal amounts of bilirubin from the blood stream. Damage to the liver cells greatly affect its ability to facilitate the excretion of bilirubin from the blood, with resulting deposition in the skin and sclera.

Question 7

Benita is a 45-year-old patient who was admitted with a diagnosis of chronic obstructive pulmonary disease. One afternoon, she experienced difficulty of breathing and the nurse intervened by teaching her the proper breathing technique. To gauge the effectiveness of the teaching, the nurse should see the patient:

Accepted Answer

To gauge the effectiveness of the teaching, the nurse should see the patient hold each breath for a second at the end of inspiration. This technique allows added time for gaseous exchange of the alveolar capillary beds. Air inhalation should be through the nose and exhalation through pursed lips.

Question 8

Tamica, a 55-year-old chain smoker, was admitted with a diagnosis of ruled out chronic obstructive pulmonary disease and cor pulmonale. During the first day of hospitalization, she asked the nurse about her nutrition. The nurse should encourage the patient to:

Accepted Answer

The nurse should encourage the patient to eat small meals six times per day to limit oxygen demand. Eating small meals will decrease the amount of oxygen necessary for ingestion and digestion at any one time.

Question 9

The nurse plans to teach a patient who has been receiving hemodialysis for a couple of months to be alert for signs and symptoms of gastrointestinal bleeding. Bleeding into the gastrointestinal tract is of particular significance to a patient with chronic renal failure because:

Accepted Answer

Bleeding into the gastrointestinal tract is of particular significance to a patient with chronic renal failure because blood is digested, thus increasing the kidney's protein load. Digested blood is protein and might increase the BUN level.

Question 10

An adult male patient who is receiving peritoneal dialysis asks the nurse why a solution is being warmed to body temperature before it is instilled in peritoneal cavity. The nurse should state that it is to:

Accepted Answer

The nurse should state that it is to encourage removal of serum urea by preventing constriction of peritoneal blood vessels. It promotes vasodilation so that urea can be shifted from the blood into the dialyzing solution since the urea is a large molecular substance.

Question 11

An adult patient had an endarterectomy. A month later, the physician ordered Clopidogrel (Plavix) 75 mg to be taken once a day at PM. The patient asks the nurse the reason for taking the medication. The nurse responded correctly when she said that it will:

Accepted Answer

The nurse responded correctly when she said that it will help to prevent further clogging of the arteries. Clopidogrel interferes with platelet aggregation that impedes the formation of thrombi.

Question 12

A patient with pulmonary edema is receiving mechanical ventilation with positive end-expiratory pressure (PEEP). The patient's relative asks the nurse about the rationale for using a PEEP. The nurse should indicate that the major purpose is that it:

Accepted Answer

The nurse should indicate that the major purpose is that it improves areas available for gas exchange. PEEP helps keep the alveoli expanded, increasing the area available for gas exchange, thus improving oxygenation.

Question 13

A patient was admitted at the hospital with a diagnosis of acute pancreatitis. The nurse validates the patient's understanding of the disease by asking what would be a possible complication if the patient was not admitted for treatment. The patient should state which of the following:

Accepted Answer

The patient should state Pneumonia as a possible complication. Acute pancreatitis if left untreated could lead to complications associated with respiratory diseases.

Question 14

A 20-year-old patient was diagnosed with neutropenia. When teaching the patient and his family, the nurse should include the avoidance of:

Accepted Answer

When teaching the patient and his family, the nurse should include the avoidance of using suppositories or enemas. A neutropenic patient is at high risk for infection, especially from bacterial infection of the gastrointestinal and respiratory tract.

Question 15

Before discharge, the nurse plans to teach a patient diagnosed with Duchenne's muscular dystrophy. The discharge teaching should include:

Accepted Answer

The discharge teaching should include range-of-motion exercises. These types of exercises are important to help achieve the primary objective of maintaining optimum muscle function for as long as possible and preventing the development of contractures. A high calorie diet could lead to obesity.

Question 16

An adult patient was admitted with a definitive diagnosis of portal hypertension and ascites. The physician ordered 2 "units" of salt-poor albumin intravenously. The nurse educates the patient and his immediate relatives that the purpose of salt-poor albumin is to:

Accepted Answer

The nurse educates the patient and his immediate relatives that the purpose of salt-poor albumin is to elevate the circulating blood volume. This increases oncotic pressure, which pulls interstitial fluid in to the blood vessels, restoring blood volume and limiting ascites.

Question 17

The nursing staff has a team conference regarding HIV/AIDS and discusses the routes of transmission of the disease (HIV). The discussion reveals that an individual has no risk of exposure to HIV when that individual:

Accepted Answer

The discussion reveals that an individual has no risk of exposure to HIV when that individual makes a donation of a bag of whole blood. Equipment used in blood donation is disposable; the donor does not come into contact with anyone else's blood.

Question 18

Donna is a 40-year-old patient diagnosed with multiple myeloma. She asks the nurse how the disease may progress. When teaching this patient, the nurse should discuss the possibility that:

Accepted Answer

When teaching this patient, the nurse should discuss the possibility that blood transfusion may be necessary. Packed RBCs or platelets are administered when warranted.

Question 19

A nurse teaches a patient with type 2 diabetes how to provide self-care to prevent infections of the feet. The nurse recognizes that the teaching was effective when the patient says that he should:

Accepted Answer

The nurse recognizes that the teaching was effective when the patient says that he should control his blood glucose level through diet, medication, and exercise. Controlling the diabetes decreases the risk of infection; this is the best prevention.

Question 20

A nurse teaches a patient with exopthalmos how to reduce discomfort and prevent corneal ulceration. The nurse recognizes that the teaching is understood when the patient says "I should…"

Accepted Answer

The nurse recognizes that the teaching is understood when the patient says, "I should avoid using a sleeping mask at night." The mask may irritate or scratch the eyes if the patient turns and lies on it during the night.

Quiz 1: Adult