NU 216 FINAL EXAMS 3

Question 1 A patient with an acute pharyngitis is seen at the clinic with fever and severe throat pain that affects swallowing. On inspe ction, the throat is reddened and edematous with patchy yellow exudates. The nurse anticipates that collaborative management will include: Question 2 During the assessment of the chest in a patient with pneumococcal pneumonia, the nurse would expect to find Question 3 The nurse receives change-of-shift report on the following four patients. Which patient should the nurse assess first? Question 4 Which information will the nurse include in the patient teaching plan for a patient who is receiving rifampin (Rifadin) for treatment of tuberculosis? Question 5 Which initial physical assessment finding would the nurse expect to be present in a patient with acute left sided heart failure? Question 6 The nurse determines that which of the following blood pressures would meet the criteria for a diagnosis of stage 2 hypertension? Question 7 The nurse is caring for a patient who has acute pharyngitis caused by Candida albicans. Which action is appropriate for the nurse to include in the plan of care? Correct Answer: Teach patient to “swish and swallow” prescribed oral nystatin (Mycostatin). Question 8 Which medication should the nurse anticipate being used first in the emergency department for relief of severe respiratory distress related to asthma? Question 9 During an assessment of the patient with viral upper respiratory infection the nurse recognizes that antibiotics may be indicated based on what finding? Question 10 When admitting a patient with a myocardial infarction (MI) to the intensive care unit, which action should the nurse carry out first? Response Feedback: Because dysrhythmias are the most common complication of MI, the first action should be to place the patient on a cardiac monitor. The other actions also are important and should be accomplished as quickly as possible. Question 11 An occupational health nurse works at a manufacturing plant where there is potential exposure to inhaled dust. Which action, if recommended by the nurse, will be most helpful in reducing the incidence of lung disease? Question 12 The nurse determines that treatment of heart failure has been successful when the patient experiences: Question 13 Which of the following strategies would best assist the nurse in communicating with a patient who has a hearing loss (select all that apply) Question 14 While teaching women about the risks and incidence of CAD, what does the nurse emphasis? Question 15 The nurse is caring for an HIV+ patient who was admitted with fever, productive cough and reports a recent 10 lb weight loss. A PPD skin test was done 2 days ago. Today the nurse notes a slight area of redness with a 5 mm induration on the patient’s left forearm. The nurse would record the TB skin test as:

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Response Feedback: In patients with HIV+ or are immunocompromised, induration equal or greater than 5 mm is considered a positive test. Question 16 The nurse reviews the arterial blood gases of a patient. Which result would indicate the patient has later stage COPD? Question 17 Mr. BJ experienced a major hearing loss as a child. He is able to communicate using speech reading. The nursing assistant complains about the patient not communicating with her when she takes his vital signs. Which of the follow statements made by the nurse would be the most helpful? Response Feedback: Patients who communicate by speech reading need to have good eye contact to interpret speech. The speaker is best understood speaking slowly and normally. Question 18 What does the nurse teach the patient with intermittent allergic tinnitis is the most effective way to decrease allergic symptoms? Question 19 Which instructions are most appropriate for the nurse to provide to a patient who has an hordeolum ( sty)? Question 20 A 52-year-old man is admitted to the emergency department with severe chest pain. On what basis would the nurse suspect an MI? Question 21 The nurse develops a teaching plan to help increase activity tolerance at home for an older adult with severe chronic obstructive pulmonary disease (COPD). Which instructions would be most appropriate for the nurse to include in the plan of care? Question 22 What causes the pain that occurs with myocardial ischemia? Question 23 A patient with stage 2 hypertension who is taking hydrochlorothiazide (HydroDiuril) and lisinopril (Prinivil) has prazosin (Minipress) added to the medication regimen. What is most important fo the nurse to teach the patient to do? Question 24 While obtaining patient histories, which patient does the nurse identify as having the highest risk for CAD? Question 25 Which initial physical assessment finding would the nurse expect to be present in a patient with acute left sided heart failure? Question 26 What are the manifestations of acute coronary syndrome (ACS) (select all that apply)? Question 27 Which nursing action would be highest priority when suctioning a patient with a tracheostomy? Question 28 What causes the pain that occurs with myocardial ischemia? Question 29 2.25 out of 3 points Which topics should the nurse include in the discharge teaching plan for a patient who has been hospitalized with chronic heart failure (select all that apply)? The Joint Commission Core Measures state that patients should be taught about prescribed medications, follow-up appointments, weight monitoring, and actions to take for worsening symptoms. Patients with heart failure are encouraged to begin or continue aerobic exercises such as walking, while self-monitoring to avoid excessive fatigue. Question 30 A patient is admitted to the emergency department with a severe exacerbation of asthma. Which finding is of most concern to the nurse? Question 31 In the United States, the most common cause of central vision loss in persons over 60 years of age is: Question 32 A patient’s blood pressure has not responded to the prescribed drugs for hypertension. Which of the following should the nurse assess first? Question 33 A patient who is receiving dobutamine (Dobutrex) for the treatment of acute decompensated heart failure (ADHF) has the following nursing interventions included in the plan of care. Which action will be most appropriate for the registered nurse (RN) to delegate to an experienced licensed practical/vocational nurse (LPN/LVN)? Question 34 When obtaining a health history form a patient suspected of having early TB, what manifestation should the nurse ask the patient about? Question 35 The nurse teaches a patient about pursed lip breathing. Which action by the patient would indicate to the nurse that further teaching is needed? Question 36 A patient with a history of chronic heart failure is admitted to the emergency department (ED) with severe dyspnea and a dry, hacking cough. Which action should the nurse do first? Question 37 After the nurse has finished teaching a patient about the use of sublingual nitroglycerin (Nitrostat), which patient statement indicates that the teaching has been effective? Question 38 The nurse receives an evening report on a patient who underwent posterior nasal packing for epistaxis earlier in the day. What is the first patient assessment the nurse should make? Question 39 Which statement by the patient with chronic heart failure should cause the nurse to determine that additional discharge teaching is needed? Question 40 A 38 year old man is treated for hypertension with triamterene and hydrochlorothiazide (Maxzide) and metoprolol (Lopressor). Four months after his last clinic visit, his BP returns to pretreatment levels and he admits he has not been taking his medication regularly. What is the nurse’s best response to this patient? Question 41 The acronym FACES is used to help educate patients to identify symptoms of heart failure. What does this acronym mean? Question 42 Which manifestation is an indication that a patient is having a hypertensive emergency? Question 43 The nurse is caring for a patient who had surgery two days ago to remove a right acoustic neuroma. During the morning assessment, the nurse observes little movement on the right side of the patient’s face and a slight drop to the right side of the mouth. The nurse should: Question 44 2 out of 3 points Which of the following patients would be the most at risk for aspiration pneumonia (select all that apply)? Question 45 Which manifestation is an indication that a patient is having a hypertensive emergency? Question 46 In planning care for a patient who has just returned to the unit following a PCI, the nurse may delegate which activity to a certified nursing assistant (CNA)? Question 47 2.25 out of 3 points What are nonmodifiable risk factors for primary hypertension (select all that apply)? Question 48 A 21 year old college student was seen in the ER after an altercation. His nose was bleeding and he had a significant amount of echhymosis under both eyes. After the bleeding was stopped the patient continued to have a clear to slightly blood tinged nasal drainage. The ER doctor did a quick bedside test of the fluid for glucose. A positive glucoes test indicates: Question 49 A patient with bacterial pneumonia has rhonchi and thick sputum. What is the nurse’s immediate action to promote airway clearance? Question 50 A patient in the unit has been suffering from pneumonia for the past 24 hours. They have been recieving antibiotic therapy, but they have continued to suffer from a 103.7F temperature. Which intervention would be most effective in restoring normal body temperature?