A patient with type 2 diabetes is scheduled for a follow-up visit in the clinic several months from now. Which test will the nurse schedule to evaluate the effectiveness of treatment for the patient?
Fasting blood glucose
Glycosylated hemoglobin
Urine dipstick for glucose and ketones
Oral glucose tolerance test
A young adult patient is hospitalized with massive abdominal trauma from a motor vehicle crash. The patient asks about the purpose of receiving famotidine (Pepcid). Which information would the nurse explain about the action of the medicatio
“It decreases nausea and vomiting.”
“It prevents aspiration of gastric contents.”
“It lowers the risk for H. pylori infection.”
“It inhibits development of stress ulcers.”
A patient with rheumatic fever has subcutaneous nodules, erythema marginatum, and polyarthritis. The patient reports that joint discomfort prevents favorite activities such as taking a daily walk and sewing. Which patient problem would be t
Social isolation
Altered body image
General anxiety
Activity intolerance
Propranolol (Inderal) is newly prescribed for a patient diagnosed with hypertension. Which information in the patient’s history would prompt the nurse to consult with the health care provider before giving this drug?
Myocardial infarction (MI)
Peptic ulcer disease
Daily alcohol use
Asthma
The nurse notes that a patient who was admitted with heart failure has jugular venous distention (JVD) when lying flat. Which follow-up action would the nurse take?
Assess the apical and radial pulse for a pulse deficit.
Have the patient perform the Valsalva maneuver.
Observe the neck with the patient elevated 45 degrees.
Encourage the patient to drink more liquids.
A patient with massive trauma and possible spinal cord injury is admitted to the emergency department (ED). Which assessment finding by the nurse would be consistent with a diagnosis of neurogenic shock?
Cool, clammy extremities
Inspiratory crackles
Temperature 101.2°F (38.4°C)
Heart rate 45 beats/min
A 28-yr-old male patient has just been diagnosed with polycystic kidney disease. Which information would the nurse include during the first teaching session?
Methods for treating severe chronic pain
Differences between hemodialysis and peritoneal dialysis
Options to consider for genetic counseling
Complications of renal transplantation
The nurse is assessing a male patient diagnosed with a pituitary tumor causing panhypopituitarism. Which assessment finding is consistent with panhypopituitarism?
Intermittent tachycardia
High blood pressure
Decreased facial hair
Elevated blood glucose
Which statement made by a 50-yr-old female patient indicates to the nurse that further assessment of thyroid function may be needed?
“I am so thirsty that I drink all day long.”
“I get up several times at night to urinate.”
“I notice my breasts are always tender lately.”
“I feel a lump in my throat when I swallow.”
A 46-yr-old female patient returns to the clinic with continued dysuria after being treated with trimethoprim and sulfamethoxazole for 3 days. Which action will the nurse plan to take?
Suggest that the pt use acetaminophen (Tylenol) to reli
Remind the patient about the need to drink 1000 mL of fluids
Obtain a midstream urine specimen for culture and sensitivit
Tell the pt to take the trimethoprim and sulfamethoxazo
A patient who has chronic heart failure tells the nurse, “I was fine when I went to bed, but I woke up feeling like I was suffocating!” How would the nurse document this finding?
Paroxysmal nocturnal dyspnea
Acute bilateral pleural effusion
Orthopnea
Pulsus alternans
In reviewing the medical record for a patient admitted with acute pancreatitis, the nurse sees that the patient has a positive Cullen’s sign. Indicate the area in the accompanying figure where the nurse will assess for this change.
1
3
4
2
A patient has a body mass index (BMI) of 31 kg/m2, a normal C-reactive protein level, and low serum transferrin and albumin levels. What should the nurse encourage the patient to increase in the diet?
calories
iron
carbohydrates
protein
A 19-yr-old woman admitted with anorexia nervosa is 5 ft, 6 in (163 cm) tall and weighs 88 lb (41 kg). Laboratory tests reveal hypokalemia and iron-deficiency anemia. Which patient problem has the highest priority?
Electrolyte imbalance
Nutritionally compromised
Negative self-image
Difficulty coping
An adult with E. coli O157:H7 food poisoning is admitted to the hospital with bloody diarrhea and dehydration. Which prescribed action will the nurse question?
Provide a clear liquid diet and progress diet as tolerated.
Monitor blood urea nitrogen and creatinine daily.
Infuse lactated Ringer’s solution at 250 mL/hr.
Administer loperamide (Imodium) after each stool.
A patient who has nephrotic syndrome develops flank pain. Which treatment will the nurse plan to explain to this patient?
Antifungals
Antihypertensives
Anticoagulants
Antibacterials
A patient admitted with pneumonia has a total serum calcium level of 13.3 mg/dL. Which serum level would the nurse anticipate will be tested next?
Parathyroid hormone
Thyroid hormone
Calcitonin
Catecholamine
Which information from a 70-yr-old patient during a health history indicates to the nurse that the patient should be screened for hepatitis C?
The patient used IV drugs about 30 years ago.
The patient traveled to a country with poor sanitation.
The patient had a blood transfusion in 2005.
The patient frequently eats in fast-food restaurants.
Which finding in the mouth of a patient who uses smokeless tobacco is suggestive of oral cancer?
Red patches on the buccal mucosa
Painful blisters at the lip border
Curdlike plaques on the posterior tongue
Bleeding during tooth brushing
The nurse is admitting a patient who has chest pain. Which assessment data suggest that the pain may be from an acute myocardial infarction?
The pain has lasted longer than 30 minutes.
The pain is reproducible when the patient raises the arms.
The pain is relieved after the patient takes nitroglycerin.
The pain increases with deep breathing.
The nurse needs to measure the heart rate for a patient with an irregular heart rhythm. Which method will be accurate?
Calculate the number of small squares between one QRS comple
Count the number of large squares in the R-R interval and di
Print a 1-minute electrocardiogram (ECG) strip and count the
Use the 3-second markers to count the number of QRS complexe
A patient is being admitted for bariatric surgery. Which nursing action can the nurse delegate to assistive personnel (AP)?
Plan methods for turning the patient after surgery.
Develop strategies to provide privacy and decrease embarras
Demonstrate use of the incentive spirometer.
Assist with IV insertion by holding adipose tissue out of th
The nurse is caring for a patient who is receiving IV furosemide and morphine for the treatment of acute decompensated heart failure (ADHF) with severe orthopnea. Which clinical finding is the best indicator that the treatment has been effe
Patient denies experiencing chest pain or chest pressure
Weight loss of 2 lb in 24 hours
Reduced dyspnea with the head of bed at 30 degrees
Hourly urine output greater than 60 mL
A young adult employed as a hair stylist who has a 15 pack-year history of cigarette smoking arrives for an annual physical examination. Which area of increased risk would the nurse plan to teach the patient?
Kidney stones
Bladder cancer
Renal failure
Pyelonephritis
A patient who underwent a gastroduodenostomy (Billroth I) 12 hours ago reports increasing abdominal pain. The patient has no bowel sounds and 200 mL of bright red nasogastric (NG) drainage in the past hour. Which nursing action is the highe
Irrigate the NG tube.
Give prescribed morphine.
Contact the surgeon.
Monitor drainage.
Which information will the nurse include when teaching a patient with atrial flutter who is scheduled for a radiofrequency catheter ablation?
The procedure uses electrical energy to destroy areas of the
The procedure uses cold therapy to stop the formation of the
The procedure stimulates the growth of new pathways between
The procedure prevents or minimizes the patient’s risk for s
A patient being admitted with an acute exacerbation of ulcerative colitis reports crampy abdominal pain and passing 15 bloody stools a day. Which intervention would the nurse include in the patient’s plan of care?
Teach the patient about total colectomy surgery.
Instruct the patient not to eat or drink.
Administer cobalamin (vitamin B12) injections.
Administer oral metoclopramide.
Which risk factor would the nurse focus on when teaching a patient who has a 5-cm abdominal aortic aneurysm?
Age over 60 years
Hypertension
Male gender
Family history of vascular disease
A patient vomiting blood-streaked fluid is admitted to the hospital with acute gastritis. What would the nurse ask the patient about to determine possible risk factors for gastritis?
The amount of saturated fat in the diet
Use of nonsteroidal antiinflammatory drugs
A history of a large recent weight gain or loss
A family history of gastric or colon cancer
A patient is scheduled for a cardiac catheterization with coronary angiography. What information would the nurse provide before the procedure?
A flushed feeling is common with contrast injection
Arterial pressure monitoring needed for 24 hours p/test
Monitored anesthesia care is provided during the proced
Important not to move at all during the procedure
A patient who has recently had an acute myocardial infarction (AMI) ambulates in the hospital hallway. Which data would indicate to the nurse that the patient should stop and rest?
Blood pressure (BP) changes from 118/60 to 126/68 mm Hg.
O2 saturation drops from 99% to 95%.
Respiratory rate goes from 14 to 20 breaths/min.
Heart rate increases from 66 to 98 beats/min.
The health care provider prescribes heparin infusion and daily partial thromboplastin time (PTT) testing for a patient with venous thromboembolism (VTE). Which action would the nurse include in the plan of care?
Decrease the infusion when the PTT value is 65 seconds.
Obtain a Doppler for monitoring bilateral pedal pulses.
Have vitamin K available in case reversal of the heparin is
Avoid giving IM medications to prevent localized bleeding.
Which assessment will the nurse perform to evaluate the effectiveness of the pantoprazole given to a patient with systemic inflammatory response syndrome (SIRS)?
Auscultate bowel sounds.
Check stools for occult blood.
Ask the patient about nausea.
Palpate for abdominal tenderness.
Which information would the nurse teach patients about self-management after gastric bypass surgery?
Choose foods high in fiber to promote bowel function.
Choose high-fat foods for at least 30% of intake.
Drink fluids between meals but not with meals
Developing flabby skin can be prevented by exercise.
The registered nurse (RN) is caring for a patient with a hypertensive crisis who is receiving sodium nitroprusside. Which nursing action can the nurse delegate to an experienced licensed practical/vocational nurse (LPN/VN)?
Evaluate effectiveness of nitroprusside therapy on blood pre
Assess the patient’s environment for adverse stimuli that m
Titrate nitroprusside to decrease mean arterial pressure (MA
Set up the automatic noninvasive BP machine to take readings
Which menu choice best indicates that the patient is implementing the nurse’s suggestion to choose high-calorie, high-protein foods?
Fresh fruit salad with yogurt topping
Baked fish with applesauce
Beef noodle soup and canned corn
Fried chicken with potatoes and gravy
The nurse is planning care for a patient with severe heart failure who has developed increased blood urea nitrogen (BUN) and creatinine levels. Which aim will be the primary treatment goal
Augmenting fluid volume
Diluting nephrotoxic substances
Maintaining cardiac output
Preventing systemic hypertension
Which finding indicates to the nurse that demeclocycline has been effective for a patient with syndrome of inappropriate antidiuretic hormone (SIADH)?
Urinary output has increased.
Weight has increased.
Peripheral edema has increased.
Urine specific gravity has increased.
The nurse obtains a rhythm strip on a patient who has had a myocardial infarction and makes the following analysis: no visible P waves, PR interval not measurable, ventricular rate of 162, R-R interval regular, QRS complex wide and distorte
Ventricular tachycardia
Sinus tachycardia
Atrial flutter
Ventricular fibrillation
Which patient statement indicates that the nurse’s teaching about carvedilol (Coreg) for preventing anginal episodes has been effective?
“It is important not to suddenly stop taking the carvedilol
“Carvedilol will increase the blood flow to my heart muscle
“I can expect to feel short of breath when taking carvedilo
“Carvedilol will help my heart muscle work harder.”
A 26-yr-old woman is being evaluated for vomiting and abdominal pain. Which question from the nurse will be most useful in determining the cause of the patient’s symptoms?
“What is your usual elimination pattern?”
“What type of foods do you eat?”
“Can you tell me more about the pain?”
“Is it possible that you are pregnant?”
Which item would the nurse offer to the patient restarting oral intake after being NPO due to nausea and vomiting?
Dish of lemon gelatin
Glass of orange juice
Bowl of hot chicken broth
Cup of coffee with cream
A patient recovering from heart surgery develops pericarditis and reports level 6 (0 to 10 scale) chest pain with deep breathing. Which prescribed PRN medication will likely be the most helpful in relieving the pain?
Fentanyl 1 mg IV
Oral ibuprofen (Motrin) 600 mg
Oral acetaminophen (Tylenol) 650 mg
IV morphine sulfate 4 mg
To evaluate an obese patient for adverse effects of Plenity, which action will the nurse take?
Ask about bowel movements.
Measure the apical pulse.
Check sclera for jaundice.
Assess for agitation or restlessness.
A patient is being treated for heart failure. Which laboratory test result will the nurse review to determine the effects of the treatment?
Low-density lipoprotein (LDL)
Homocysteine (Hcy)
B-type natriuretic peptide (BNP)
Troponin
A patient has cirrhosis and 4+ pitting edema. Which focused data would the nurse assess?
acidity level
hemoglobin
temperature
albumin level
Which statement by a patient with interstitial cystitis indicates to the nurse that further instruction is needed?
“I should call the doctor about increased bladder pain or fo
“I will start taking high potency multiple vitamins every mo
“I will buy calcium glycerophosphate (Prelief) at the pharma
“I should stop having coffee and orange juice for breakfast
Which information about an 80-yr-old male patient at the senior center is of most concern to the nurse?
Difficulty chewing food
Unintended weight loss
Occasional indigestion
Decreased appetite
After an arteriovenous graft is inserted in a patient’s right forearm, the patient reports pain and coldness in the right fingers. Which action would the nurse take?
Teach the patient about normal arteriovenous graft function
Remind the patient to take a daily low-dose aspirin tablet.
Elevate the patient’s arm on pillows above the heart level.
Report the patient’s symptoms to the health care provider.
A patient who has acute glomerulonephritis is hospitalized with hyperkalemia. Which information will the nurse monitor to evaluate the effectiveness of the prescribed calcium gluconate IV?
Urine volume
Calcium level
Cardiac rhythm
Neurologic status
The nurse obtains a health history from an older adult with a prosthetic mitral valve who has symptoms of infective endocarditis (IE). Which question by the nurse helps identify a risk factor for IE?
“Do you have a family history of endocarditis?”
“Have you had dental work done recently?”
“Do you have a history of a heart attack?”
“Have you had any recent immunizations?”
A serum potassium level of 3.2 mEq/L (3.2 mmol/L) is reported for a patient with cirrhosis who has scheduled doses of spironolactone (Aldactone) and furosemide (Lasix) due. Which action would the nurse take?
Withhold both drugs.
Administer the spironolactone.
Administer the furosemide.
Administer both drugs.
A young woman with Crohn’s disease develops a fever and symptoms of a urinary tract infection (UTI) with tan, fecal-smelling urine. Which information will the nurse add to a teaching plan about UTIs for this patient that goes beyond a gener
Bacteria in the perianal area can enter the urethra.
Empty the bladder before and after sexual intercourse.
Drink adequate fluids to maintain normal hydration.
Fistulas can form between the bowel and bladder.
An 81-yr-old patient who has been in the intensive care unit (ICU) for a week with sepsis is now stable and transfer to the progressive care unit is planned. On rounds, the nurse notices that the patient has new onset confusion with stable
Give PRN lorazepam (Ativan) and cancel the transfer.
Notify the health care provider and postpone the transfer.
Obtain an order for restraints as needed and transfer the pa
Inform the receiving nurse and then transfer the patient.
A patient with hypertension received the first dose of nadolol (Corgard) during the previous shift. Which information indicates that the patient needs immediate intervention?
The patient reports that the fingers and toes feel quite col
The patient’s blood pressure (BP) reading is now 158/92 mm H
The patient has developed wheezes throughout the lung fields
The patient’s pulse has dropped from 68 to 57 beats/min.
Which group of drugs will the nurse plan to include when teaching a patient who has a new diagnosis of peripheral artery disease (PAD)?
Thrombolytics
Antibiotics
Statins
Anticoagulants
A 28-yr-old male patient with type 1 diabetes reports how he manages his exercise and glucose control. Which behavior indicates a need for the nurse to implement additional teaching?
Pt increases daily exercise when ketones are present in urin
Pt always carries hard candies when engaging in exercise.
Pt has a peanut butter sandwich before riding a bike
Pt goes for a vigorous walk when his glucose is 200 mg/dL.
A patient who has just been admitted with pulmonary edema is scheduled to receive the following medications. Which medication would the nurse question before giving?
Digoxin (Lanoxin) 0.125 mg
Carvedilol (Coreg) 3.125 mg
Captopril (Capoten) 25 mg
Furosemide (Lasix) 60 mg
The nurse is caring for a patient receiving a continuous norepinephrine IV infusion. Which finding indicates that the infusion rate may need to be adjusted?
Heart rate is slow at 58 beats/min.
Pulmonary artery wedge pressure (PAWP) is low.
Mean arterial pressure (MAP) is 56 mm Hg.
Systemic vascular resistance (SVR) is elevated.
The nurse receives the following information about a patient who is scheduled for a colonoscopy. Which information would the nurse communicate to the health care provider before preparing the patient for the procedure?
The patient has had an allergic reaction to shellfish and io
The patient is worried about discomfort during the examinati
The patient declined to drink the prescribed laxative soluti
The patient has a permanent pacemaker to prevent bradycardia