Adult Health 1 Exam One Practice Questions With
Complete Solutions
A lobectomy is scheduled for a patient with stage I non-small
cell lung cancer. The patient tells the nurse, "I would rather have
chemotherapy than surgery." Which response by the nurse is
most appropriate?
a. "Are you afraid that the surgery will be very painful?"
b. "Did you have bad experiences with previous surgeries?"
c. "Tell me what you know about the treatments available."
d. "Surgery is the treatment of choice for stage I lung cancer."
Correct Answers c. "Tell me what you know about the
treatments available."
More assessment of the patient's concerns about surgery is
indicated. An open-ended response will elicit the most
information from the patient.
A nurse is assessing a newly admitted patient with chronic heart
failure who forgot to take
prescribed medications. The patient seems confused and short of
breath with peripheral
edema. Which assessment should the nurse complete first?
a. Skin turgor
b. Heart sounds
c. Mental status
d. Capillary refill Correct Answers ANS: C
Increases in extracellular fluid (ECF) can lead to swelling of
cells in the central nervous
system, initially causing confusion, which may progress to coma
or seizures. Although skin
,turgor, capillary refill, and heart sounds may also be affected by
increases in ECF, these are
signs that do not have as immediate impact on patient outcomes
as cerebral edema.
DIF: Cognitive Level: Analyze (analysis)
OBJ: Special Questions: Prioritization TOP: Nursing Process:
Assessment
MSC: NCLEX: Physiological Integrity
A patient diagnosed with active tuberculosis (TB) is homeless
and has a history of alcohol abuse. Which intervention by the
nurse will be most effective in ensuring adherence with the
treatment regimen?
a. Repeat warnings about the high risk for infecting others
several times.
b. Give the patient written instructions about how to take the
medications.
c. Arrange for a daily meal and drug administration at a
community center.
d. Arrange for the patient's friend to administer the medication
on schedule. Correct Answers c. Arrange for a daily meal and
drug administration at a community center.
A patient experiences a chest wall contusion as a result of being
struck in the chest with a baseball bat. The emergency
department nurse would be most concerned if which finding is
observed during the initial assessment?
a. Paradoxical chest movement c. Heart rate of 110 beats/minute
b. Complaint of chest wall pain d. Large bruised area on the
chest Correct Answers a. Paradoxical chest movement
,Paradoxical chest movement indicates that the patient may have
flail chest, which can severely compromise gas exchange and
can rapidly lead to hypoxemia.
A patient has a magnesium level of 1.3 mg/dL. Which
assessment would help the nurse
identify a likely cause of this value?
a. Daily alcohol intake
b. Dietary protein intake
c. Multivitamin with minerals
d. Over-the-counter (OTC) laxative Correct Answers ANS: A
Hypomagnesemia is associated with alcoholism. Protein intake
would not have a significant
effect on magnesium level. OTC laxatives (such as milk of
magnesia) and use of
multivitamin/mineral supplements tend to increase magnesium
levels.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Assessment MSC: NCLEX:
Physiological Integrity
A patient has a serum calcium level of 7.0 mEq/L. Which
assessment finding is most
important for the nurse to report to the health care provider?
a. The patient is experiencing stridor.
b. The patient reports generalized fatigue.
c. The patient's bowels have not moved for 4 days.
d. The patient has numbness and tingling of the lips. Correct
Answers ANS: A
Hypocalcemia can cause laryngeal stridor, which may lead to
respiratory arrest. Rapid action
, is required to correct the patient's calcium level. The other data
are also consistent with
hypocalcemia, but do not indicate a need for as immediate
action as laryngospasm.
DIF: Cognitive Level: Analyze (analysis)
OBJ: Special Questions: Prioritization TOP: Nursing Process:
Assessment
MSC: NCLEX: Physiological Integrity
A patient has acute bronchitis with a nonproductive cough and
wheezes. Which topic should the nurse plan to include in the
teaching plan?
a. Purpose of antibiotic therapy
b. Ways to limit oral fluid intake
c. Appropriate use of cough suppressants
d. Safety concerns with home O2 therapy Correct Answers c.
Appropriate use of cough suppressants
Cough suppressants are frequently prescribed for acute
bronchitis. Because most acute bronchitis is viral in origin,
antibiotics are not prescribed unless there are systemic
symptoms.
A patient has just been admitted with probable bacterial
pneumonia and sepsis. Which order should the nurse implement
first?
a. Chest x-ray via stretcher
b. Blood cultures from two sites
c. Ciprofloxacin (Cipro) 400 mg IV
d. Acetaminophen (Tylenol) rectal suppository Correct Answers
b. Blood cultures from two sites
Complete Solutions
A lobectomy is scheduled for a patient with stage I non-small
cell lung cancer. The patient tells the nurse, "I would rather have
chemotherapy than surgery." Which response by the nurse is
most appropriate?
a. "Are you afraid that the surgery will be very painful?"
b. "Did you have bad experiences with previous surgeries?"
c. "Tell me what you know about the treatments available."
d. "Surgery is the treatment of choice for stage I lung cancer."
Correct Answers c. "Tell me what you know about the
treatments available."
More assessment of the patient's concerns about surgery is
indicated. An open-ended response will elicit the most
information from the patient.
A nurse is assessing a newly admitted patient with chronic heart
failure who forgot to take
prescribed medications. The patient seems confused and short of
breath with peripheral
edema. Which assessment should the nurse complete first?
a. Skin turgor
b. Heart sounds
c. Mental status
d. Capillary refill Correct Answers ANS: C
Increases in extracellular fluid (ECF) can lead to swelling of
cells in the central nervous
system, initially causing confusion, which may progress to coma
or seizures. Although skin
,turgor, capillary refill, and heart sounds may also be affected by
increases in ECF, these are
signs that do not have as immediate impact on patient outcomes
as cerebral edema.
DIF: Cognitive Level: Analyze (analysis)
OBJ: Special Questions: Prioritization TOP: Nursing Process:
Assessment
MSC: NCLEX: Physiological Integrity
A patient diagnosed with active tuberculosis (TB) is homeless
and has a history of alcohol abuse. Which intervention by the
nurse will be most effective in ensuring adherence with the
treatment regimen?
a. Repeat warnings about the high risk for infecting others
several times.
b. Give the patient written instructions about how to take the
medications.
c. Arrange for a daily meal and drug administration at a
community center.
d. Arrange for the patient's friend to administer the medication
on schedule. Correct Answers c. Arrange for a daily meal and
drug administration at a community center.
A patient experiences a chest wall contusion as a result of being
struck in the chest with a baseball bat. The emergency
department nurse would be most concerned if which finding is
observed during the initial assessment?
a. Paradoxical chest movement c. Heart rate of 110 beats/minute
b. Complaint of chest wall pain d. Large bruised area on the
chest Correct Answers a. Paradoxical chest movement
,Paradoxical chest movement indicates that the patient may have
flail chest, which can severely compromise gas exchange and
can rapidly lead to hypoxemia.
A patient has a magnesium level of 1.3 mg/dL. Which
assessment would help the nurse
identify a likely cause of this value?
a. Daily alcohol intake
b. Dietary protein intake
c. Multivitamin with minerals
d. Over-the-counter (OTC) laxative Correct Answers ANS: A
Hypomagnesemia is associated with alcoholism. Protein intake
would not have a significant
effect on magnesium level. OTC laxatives (such as milk of
magnesia) and use of
multivitamin/mineral supplements tend to increase magnesium
levels.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Assessment MSC: NCLEX:
Physiological Integrity
A patient has a serum calcium level of 7.0 mEq/L. Which
assessment finding is most
important for the nurse to report to the health care provider?
a. The patient is experiencing stridor.
b. The patient reports generalized fatigue.
c. The patient's bowels have not moved for 4 days.
d. The patient has numbness and tingling of the lips. Correct
Answers ANS: A
Hypocalcemia can cause laryngeal stridor, which may lead to
respiratory arrest. Rapid action
, is required to correct the patient's calcium level. The other data
are also consistent with
hypocalcemia, but do not indicate a need for as immediate
action as laryngospasm.
DIF: Cognitive Level: Analyze (analysis)
OBJ: Special Questions: Prioritization TOP: Nursing Process:
Assessment
MSC: NCLEX: Physiological Integrity
A patient has acute bronchitis with a nonproductive cough and
wheezes. Which topic should the nurse plan to include in the
teaching plan?
a. Purpose of antibiotic therapy
b. Ways to limit oral fluid intake
c. Appropriate use of cough suppressants
d. Safety concerns with home O2 therapy Correct Answers c.
Appropriate use of cough suppressants
Cough suppressants are frequently prescribed for acute
bronchitis. Because most acute bronchitis is viral in origin,
antibiotics are not prescribed unless there are systemic
symptoms.
A patient has just been admitted with probable bacterial
pneumonia and sepsis. Which order should the nurse implement
first?
a. Chest x-ray via stretcher
b. Blood cultures from two sites
c. Ciprofloxacin (Cipro) 400 mg IV
d. Acetaminophen (Tylenol) rectal suppository Correct Answers
b. Blood cultures from two sites
