Chapter Quiz

1. The nurse is reviewing the chart of an older adult male client after surgery for removal of the parathyroid glands. The client reports difficulty swallowing and a feeling of “pins and needles.” The nurse expects which of the following laboratory values to be abnormal?

   1. Calcium
   2. Lipase
   3. Potassium
   4. Sodium

2. The nurse is assessing a young-adult pregnant client with no allergies who has tested positive for gonorrhea. Which of the following medications should the nurse expect to be part of the treatment plan?

   1. Tetracycline
   2. Ciprofloxacin
   3. Azithromycin
   4. Ceftriaxone

3. A client is one day post-op for abdominal surgery. The nurse is teaching the client techniques to reduce pain when he moves, coughs, or breathes deeply. Which of the following statements from the client indicates that the client understands the teaching?

   1. “I can start exercising my limbs as soon as you medicate me.”
   2. “I will just lie here for a few days until the pain goes away.”
   3. “I will use the side rail for support when I move or turn.”
   4. “I will ask for pain medication only when absolutely necessary.”

4. A 36-year-old primigravid client with a history of diabetes is admitted with preeclampsia. Which of the following actions should the nurse take FIRST?

   1. Administer low-dose aspirin as ordered.
   2. Ask the physician for an order for calcium supplements.
   3. Monitor the client’s blood pressure.
   4. Prepare the client for delivery.

5. The nurse has just answered a call light for a client who is two days post-op for abdominal surgery. The client states, “I coughed and heard this pop.” The nurse assesses the surgical site and observes dehiscence of the wound. Which of the following should the nurse do FIRST?

   1. Stay with the client and have a colleague notify the physician.
   2. Help the client to lie with his head slightly elevated and with knees bent.
   3. Apply warm, sterile normal saline soaks.
   4. Help the client to sit up, which will reduce the harmful effects of further coughing.

6. An elderly man is admitted to the hospital from the Emergency Department during the night shift. The nurse is assessing the client’s cerebellar function. Which of the following questions should the nurse ask the client?

   1. “Who is the current president of the United States?”
   2. “Do you have trouble swallowing fluids or foods?”
   3. “Do you have any muscle pain?”
   4. “Do you have problems with balance?”

7. An older adult male client with a history of myasthenia gravis is admitted to the medical/surgical unit. Which of the following tests should the nurse expect to see ordered? Select all that apply.

   1. Tensilon test
   2. Nerve conduction studies
   3. Lumbar puncture
   4. EEG
   5. Electromyography

8. A middle-aged female client with a history of atherosclerosis is admitted with complaints of abdominal tenderness during deep palpation. The nurse notices a pulsating mass in the periumbilical area. Which of the following does the nurse suspect?

   1. Appendicitis
   2. Abdominal aortic aneurysm
   3. Acute cholecystitis
   4. Paralytic ileus

9. An older adult client with a history of blood clots is in the emergency room with suspected deep vein thrombosis (DVT) of the left leg. The nurse starts IV heparin as ordered. Which of the following is LEAST likely to be included in the care plan?

   1. Ambulation as tolerated
   2. Warm, moist soaks applied to the affected area
   3. Analgesics as ordered
   4. Anti-embolism stockings

10. The nurse is caring for a client with a history of chronic liver disease and cirrhosis of the liver. Lab values reveal rising ammonia levels. Which of the following treatments should the nurse question?

    1. Calorie intake 1,800–2,400 cal/day in the form of glucose or carbohydrates
    2. Protein 100 g/day
    3. An order to administer neomycin
    4. Potassium supplements

11. The laboratory values of an adult male client reveal the presence of hepatitis B surface antigens and hepatitis B antibodies. Which of the following laboratory results should the nurse also expect to see? Select all that apply.

    1. Elevated serum albumin
    2. Low serum globulin
    3. Elevated serum transaminate (ALT and AST)
    4. Prolonged prothrombin time (PT)
    5. Low urine bilirubin

12. The nurse is assessing a client with Addison’s disease. The nurse expects to note which of the following?

    1. Anorexia
    2. Weight gain
    3. Yellow skin coloration
    4. A craving for sweets

13. A client is having a tonic-clonic seizure. Which of the following should the nurse do FIRST?

    1. Check the client’s breathing.
    2. Remove objects from the client’s surroundings.
    3. Place a tongue blade in the client’s mouth.
    4. Restrain the client.

14. A client is recovering from a bout with chronic glomerulonephritis. The nurse prepares the client for discharge and home management. Which of the following statements indicates the client understands his condition and how to control it?

    1. “I should stop taking my blood pressure medication if I feel better or have side effects.”
    2. “I will take my furosemide medications as ordered every morning.”
    3. “I will keep my negative feelings to myself, so I don’t get stressed.”
    4. “I don’t need a follow-up examination unless I’m feeling poorly.”

15. A nursing home client is admitted to the hospital with a pressure ulcer involving full-thickness loss extending to the bone. The nurse documents the pressure ulcer as being at which of the following stages?

    1. Stage I
    2. Stage II
    3. Stage III
    4. Stage IV

16. A client with Raynaud’s disease is experiencing an acute attack. The nurse should anticipate which of the following assessment findings?

    1. Involuntary muscle contractions and twitching
    2. Unilateral facial weakness and drooping mouth
    3. Numbness and tingling of fingers and blanching of the skin at the fingertips
    4. Photophobia

17. The physician orders a CT scan of the client’s chest with IV contrast. Which of the following findings in the client’s history should the nurse report to the physician?

    1. Hypertension
    2. Allergy to shellfish
    3. Urinary tract infection (UTI)
    4. Allergy to penicillin

18. The oncologist examines a client in the clinic and subsequently admits the client to the hospital with severe bone marrow depression. The client’s therapy included radiation and chemotherapy. Which of the following nursing diagnoses takes priority in the client’s care plan?

    1. Imbalanced nutrition: less than body requirements
    2. Risk for infection
    3. Pain
    4. Risk for injury

19. The nurse is preparing to discharge a client who is stable after a sickle-cell anemia crisis. Which of the following instructions should the nurse provide to the client to avoid future crises? Select all that apply.

    1. Limit your fluid intake.
    2. Avoid strenuous exercise.
    3. Apply cold compresses to painful areas.
    4. Take pain medications as ordered.
    5. Avoid tight clothing.

20. The clinic nurse is updating the medications being taken by an anxious middle-aged client, and sees that the physician prescribed an antidiuretic hormone. The nurse knows the medication has which of the following effects on the kidneys?

    1. Increases water reabsorption and urine concentration
    2. Decreases water reabsorption and dilutes the urine
    3. Regulates sodium retention
    4. Controls potassium secretion

21. The nurse is performing an assessment on a client who has developed cirrhosis. Which of the following signs and symptoms should the nurse expect to see? Select all that apply.

    1. Dull abdominal ache
    2. Cyanosis
    3. Poor tissue turgor
    4. Bruises
    5. Fruity breath

22. The physician orders 0.5 mg of digoxin for a client with atrial fibrillation. The pharmacy has 250-mcg tablets available. How many tablets will the nurse give?

    _______________________

23. The nurse is preparing to administer a red blood cell transfusion to a client with a low hemoglobin level and low hematocrit. The nurse knows which of the following statements about blood transfusion practice is true?

    1. The client should be monitored for at least one hour after the start of the transfusion.
    2. The transfusion should be completed within 2 hours.
    3. The transfusion should be started within 30 minutes of removing the blood or blood components from the blood bank.
    4. The only solution that should be added to blood or blood components is 0.45% sodium chloride (half normal saline solution).

24. The nurse is providing discharge teaching to a client stabilized after an acute attack of primary gout. Which of the following foods should the nurse instruct the client to avoid to prevent future attacks?

    1. Cauliflower, asparagus, and mushrooms
    2. Anchovies, liver, and lentils
    3. Cherries, strawberries, and blueberries
    4. Cereal, pasta, and rice

25. In the emergency room, the nurse is caring for a client who reports substernal pain radiating to the arm and jaw, shortness of breath, and a feeling of impending doom. The client had a stroke one month ago. The client’s vital signs are blood pressure 146/72, pulse 128, and respirations 36. The 12-lead ECG reveals evolving acute myocardial infarction (MI). Which of the following physician orders should the nurse question?

    1. Beta-adrenergic blocker
    2. Morphine for pain
    3. IV nitroglycerin
    4. Thrombolytic therapy

26. An older adult female, newly diagnosed with type 2 diabetes, is ready for discharge. When providing discharge instructions, the nurse teaches the client that the key to preventing diabetic foot complications is which of the following?

    1. Taking the medication as ordered
    2. Following the recommended diet
    3. Surgical intervention
    4. Regular evaluation of the look and feel of her feet

27. The nurse knows that the physician is most likely to order which of the following laboratory tests to evaluate a client for hypoxia?

    1. Hematocrit
    2. Sputum analysis
    3. Arterial blood gas (ABG) analysis
    4. Total hemoglobin

28. The nurse is performing a 12-lead ECG on a client who has come to the emergency room reporting chest pain. Where should the nurse place lead V1?

    

    1. A
    2. B
    3. C
    4. D

29. The nurse is assessing a client admitted with a cerebrovascular accident (CVA). The physician has ordered a swallow study. The nurse knows which of the following lobes of the cerebral hemisphere is involved in the control of voluntary muscle movement, including those necessary for the production of speech and swallowing?

    1. Frontal
    2. Parietal
    3. Temporal
    4. Occipital

30. The nurse is preparing to do the Heimlich maneuver on a choking middle-aged adult male client. Arrange the following steps in the order the nurse should perform them. All options must be used.

    1. Make a fist with one hand.
    2. Stand behind the client.
    3. Wrap your other arm around the client and place that hand on top of your fist.
    4. Place your thumb toward the client, below the rib cage and above the waist, and wrap one arm around the client.
    5. Ask the client if he is choking.
    6. Thrust upward 6–10 times.