510 exam 4 questions and correct detailed answers

A 53-year-old male patient with deep partial-thickness burns from a chemical spill in the workplace experiences severe pain followed by nausea during dressing changes. Which action will be most useful in decreasing the patient's nausea? - Correct AnswersAdminister the prescribed morphine sulfate before dressing changes. Which item should the nurse offer to the patient who is to restart oral intake after being NPO due to nausea and vomiting? - Correct AnswersDish of lemon gelatin A 38-year old woman receiving chemotherapy for breast cancer develops a Candida albicansoral infection. The nurse will anticipate the need for - Correct Answersadministration of nystatin (Mycostatin) tablets. Which finding in the mouth of a patient who uses smokeless tobacco is suggestive of oral cancer? - Correct AnswersRed, velvety patches on the buccal mucosa Which information will the nurse include when teaching adults to decrease the risk for cancers of the tongue and buccal mucosa? - Correct AnswersAvoid use of cigarettes and smokeless tobacco. A 46-year-old female with gastroesophageal reflux disease (GERD) is experiencing increasing discomfort. Which patient statement indicates that additional teaching about GERD is needed? - Correct Answers"I eat small meals during the day and have a bedtime snack." A 68-year-old male patient with a stroke is unconscious and unresponsive to stimuli. After learning that the patient has a history of gastroesophageal reflux disease (GERD), the nurse will plan to do frequent assessments of the patient's - Correct Answersbreath sounds. The nurse explaining esomeprazole (Nexium) to a patient with recurring heartburn describes that the medication - Correct Answerstreats gastroesophageal reflux disease by decreasing stomach acid production. Which patient choice for a snack 2 hours before bedtime indicates that the nurse's teaching about gastroesophageal reflux disease (GERD) has been effective? - Correct AnswersCherry gelatin with fruit The nurse will anticipate teaching a patient experiencing frequent heartburn about - Correct Answersproton pump inhibitors. A 58-year-old woman who recently has been diagnosed with esophageal cancer tells the nurse, "I do not feel ready to die yet." Which response by the nurse is most appropriate? - Correct Answers"Having this new diagnosis must be very hard for you." Which information will the nurse include for a patient with newly diagnosed gastroesophageal reflux disease (GERD)? - Correct Answers"Keep the head of your bed elevated on blocks." Which nursing action should be included in the postoperative plan of care for a patient after a laparoscopic esophagectomy? - Correct AnswersElevate the head of the bed to at least 30 degrees. When a 72-year-old patient is diagnosed with achalasia, the nurse will teach the patient that - Correct Answerstreatment may include endoscopic procedures. A 50-year-old man vomiting blood-streaked fluid is admitted to the hospital with acute gastritis. To determine possible risk factors for gastritis, the nurse will ask the patient about - Correct Answersuse of nonsteroidal anti-inflammatory drugs (NSAIDs). The nurse determines that teaching regarding cobalamin injections has been effective when the patient with chronic atrophic gastritis states which of the following? - Correct Answers"The cobalamin injections will prevent me from becoming anemic." Which medications will the nurse teach the patient about whose peptic ulcer disease is associated with Helicobacter pylori? - Correct AnswersAmoxicillin (Amoxil), clarithromycin (Biaxin), and omeprazole (Prilosec) Which action should the nurse in the emergency department anticipate for a 23-year-old patient who has had several episodes of bloody diarrhea? - Correct AnswersObtain a stool specimen for culture. The nurse will anticipate preparing a 71-year-old female patient who is vomiting "coffee-ground" emesis for - Correct Answersendoscopy A 57-year-old man with Escherichia coli O157:H7 food poisoning is admitted to the hospital with bloody diarrhea and dehydration. Which order will the nurse question? - Correct AnswersAdminister loperamide (Imodium) after each stool. Which information will the nurse include when teaching a patient with peptic ulcer disease about the effect of ranitidine (Zantac)? - Correct Answers"Ranitidine decreases gastric acid secretion." A family member of a 28-year-old patient who has suffered massive abdominal trauma in an automobile accident asks the nurse why the patient is receiving famotidine (Pepcid). The nurse will explain that the medication will - Correct Answersinhibit development of stress ulcers. A 68-year-old patient with a bleeding duodenal ulcer has a nasogastric (NG) tube in place, and the health care provider orders 30 mL of aluminum hydroxide/magnesium hydroxide (Maalox) to be instilled through the tube every hour. To evaluate the effectiveness of this treatment, the nurse - Correct Answersperiodically aspirates and tests gastric pH. A 44-year-old man admitted with a peptic ulcer has a nasogastric (NG) tube in place. When the patient develops sudden, severe upper abdominal pain, diaphoresis, and a firm abdomen, which action should the nurse take? - Correct AnswersCheck the vital signs. A 50-year-old patient who underwent a gastroduodenostomy (Billroth I) earlier today complains of increasing abdominal pain. The patient has no bowel sounds and 200 mL of bright red nasogastric (NG) drainage in the last hour. The highest priority action by the nurse is to - Correct Answerscontact the surgeon. Which patient statement indicates that the nurse's teaching following a gastroduodenostomy has been effective? - Correct Answers"Vitamin supplements may prevent anemia." At his first postoperative checkup appointment after a gastrojejunostomy (Billroth II), a patient report that dizziness, weakness, and palpitations occur about 20 minutes after each meal. The nurse will teach the patient to - Correct Answerslie down for about 30 minutes after eating. A 62-year-old man patient who requires daily use of a nonsteroidal anti-inflammatory drug (NSAID) for the management of severe rheumatoid arthritis has recently developed melena. The nurse will anticipate teaching the patient about - Correct Answersmisoprostol (Cytotec) to protect the gastrointestinal (GI) mucosa. The health care provider prescribes antacids and sucralfate (Carafate) for treatment of a patient's peptic ulcer. The nurse will teach the patient to take - Correct Answersantacids after meals and sucralfate 30 minutes before meals. Which information about dietary management should the nurse include when teaching a patient with peptic ulcer disease (PUD)? - Correct Answers"Avoid foods that cause pain after you eat them." A 73-year-old patient is diagnosed with stomach cancer after an unintended 20-pound weight loss. Which nursing action will be included in the plan of care? - Correct AnswersOffer supplemental feedings between meals. A 26-year-old patient with a family history of stomach cancer asks the nurse about ways to decrease the risk for developing stomach cancer. The nurse will teach the patient to avoid - Correct Answerssmoked foods such as ham and bacon. The nurse is assessing a patient who had a total gastrectomy 8 hours ago. What information is most important to report to the health care provider? - Correct AnswersTemperature 102.1° F (38.9° C) A 58-year-old patient has just been admitted to the emergency department with nausea and vomiting. Which information requires the most rapid intervention by the nurse? - Correct AnswersThe patient is lethargic and difficult to arouse. A 26-year-old woman has been admitted to the emergency department with nausea and vomiting. Which action could the RN delegate to unlicensed assistive personnel (UAP)? - Correct AnswersAssist the patient with oral care. A 49-year-old man has been admitted with hypotension and dehydration after 3 days of nausea and vomiting. Which order from the health care provider will the nurse implement first? - Correct AnswersInfuse normal saline at 250 mL/hr. Which patient should the nurse assess first after receiving change-of-shift report? - Correct AnswersA patient with esophageal varices who has a blood pressure of 92/58 mm Hg A patient returned from a laparoscopic Nissen fundoplication for hiatal hernia 4 hours ago. Which assessment finding is most important for the nurse to address immediately? - Correct AnswersThe patient has absent breath sounds in the left anterior chest. Which assessment should the nurse perform first for a patient who just vomited bright red blood? - Correct AnswersTaking the blood pressure (BP) and pulse Which order from the health care provider will the nurse implement first for a patient who has vomited 1200 mL of blood? - Correct AnswersAdminister 1000 mL of lactated Ringer's solution. The nurse is administering IV fluid boluses and nasogastric irrigation to a patient with acute gastrointestinal (GI) bleeding. Which assessment finding is most important for the nurse to communicate to the health care provider? - Correct AnswersThe patient's lungs have crackles audible to the mid-chest. After the nurse has completed teaching a patient with newly diagnosed eosinophilic esophagitis about the management of the disease, which patient action indicates that the teaching has been effective? - Correct AnswersPatient schedules an appointment for allergy testing. An 80-year-old who is hospitalized with peptic ulcer disease develops new-onset auditory hallucinations. Which prescribed medication will the nurse discuss with the health care provider before administration? - Correct AnswersMetoclopramide (Reglan) The nurse and a licensed practical/vocational nurse (LPN/LVN) are working together to care for a patient who had an esophagectomy 2 days ago. Which action by the LPN/LVN requires that the nurse intervene? - Correct AnswersThe LPN/LVN positions the head of the bed in the flat position. After change-of-shift report, which patient should the nurse assess first? - Correct Answers60-year-old with nausea and vomiting who has dry oral mucosa and lethargy Vasopressin (Pitressin) 0.2 units/min infusion is prescribed for a patient with acute arterial gastrointestinal (GI) bleeding. The vasopressin label states vasopressin 100 units/250 mL normal saline. How many mL/hr will the nurse infuse? - Correct Answers30 In which order will the nurse take the following actions when caring for a patient who develops watery diarrhea and a fever after prolonged omeprazole (Prilosec) therapy? - Correct Answers-Place the patient on contact precautions. -Assess blood pressure and heart rate. -Contact the health care provider. -Give the PRN acetaminophen (Tylenol). The nurse evaluates that wearing bifocals improved the patient's myopia and presbyopia by assessing for - Correct Answersboth near and distant vision A nurse should instruct a patient with recurrent staphylococcal and seborrheic blepharitis to - Correct Answersuse a gentle baby shampoo to clean the lids as needed. When assisting a blind patient in ambulating to the bathroom, the nurse should - Correct Answerswalk slightly ahead of the patient and allow the patient to hold the nurse's elbow. A nurse should include which instructions when teaching a patient with repeated hordeolum how to prevent further infection? - Correct AnswersDiscard all open or used cosmetics applied near the eyes. The nurse developing a teaching plan for a patient with herpes simplex keratitis should include which instruction? - Correct AnswersWash hands frequently and avoid touching the eyes. Which teaching point should the nurse plan to include when caring for a patient whose vision is corrected to 20/200? - Correct AnswersWhere to obtain specialized magnifiers The nurse is developing a plan of care for an adult patient diagnosed with adult inclusion conjunctivitis (AIC) caused by Chlamydia trachomatis. Which action should be included in the plan of care? - Correct AnswersDiscussing the need for sexually transmitted infection testing Which topic will the nurse teach after a patient has had outpatient cataract surgery and lens implantation? - Correct AnswersAdministration of corticosteroid eye drops In reviewing a 55-year-old patient's medical record, the nurse notes that the last eye examination revealed an intraocular pressure of 28 mm Hg. The nurse will plan to assess - Correct Answersperipheral vision. A patient with a right retinal detachment had a pneumatic retinopexy procedure. Which information will be included in the discharge teaching plan? - Correct AnswersThe purpose of maintaining the head in a prescribed position A 72-year-old patient with age-related macular degeneration (AMD) has just had photodynamic therapy. Which statement by the patient indicates that the discharge teaching has been effective? - Correct Answers"I will cover up with long-sleeved shirts and pants for the next 5 days." To determine whether treatment is effective for a patient with primary open-angle glaucoma (POAG), the nurse can evaluate the patient for improvement by - Correct Answersnoting any changes in the patient's visual field. A patient with glaucoma who has been using timolol (Timoptic) drops for several days tells the nurse that the eye drops cause eye burning and visual blurriness for a short time after administration. The best response to the patient's statement is - Correct Answers"The drops are uncomfortable, but it is important to use them to retain your vision." The nurse is completing the admission database for a patient admitted with abdominal pain and notes a history of hypertension and glaucoma. Which prescribed medications should the nurse question? - Correct AnswersScopolamine patch (Transderm Scop) 1.5 mg A patient who has bacterial endophthalmitis in the left eye is restless, frequently asking whether the eye is healing, and whether removal of the eye will be necessary. Based on the assessment data, which nursing diagnosis is most appropriate at this time? - Correct AnswersAnxiety related to the possibility of permanent vision loss To decrease the risk for future hearing loss, which action should the nurse who is working with college students at the on-campus health clinic implement? - Correct AnswersDiscuss the importance of limiting exposure to amplified music. A patient diagnosed with external otitis is being discharged from the emergency department with an ear wick in place. Which statement by the patient indicates a need for further teaching? - Correct Answers"I will clean the ear canal daily with a cotton-tipped applicator." A patient who has undergone a left tympanoplasty should be instructed to - Correct Answersavoid blowing the nose The nurse is assessing a patient who has recently been treated with amoxicillin for acute otitis media of the right ear. Which finding is a priority to report to the health care provider? - Correct AnswersThe patient has a temperature of 100.6° F. A 42-year-old woman with Ménière's disease is admitted with vertigo, nausea, and vomiting. Which nursing intervention will be included in the care plan? - Correct AnswersDim the lights in the patient's room. Which statement by the patient to the home health nurse indicates a need for more teaching about self-administering eardrops? - Correct Answers"I should keep the medication refrigerated until I am ready to administer the drops." An 82-year-old patient who is being admitted to the hospital repeatedly asks the nurse to "speak up so that I can hear you." Which action should the nurse take? - Correct AnswersSpeak normally but more slowly. A 75-year-old patient with presbycusis is fitted with binaural hearing aids. Which information will the nurse include when teaching the patient how to use the hearing aids? - Correct AnswersExperiment with volume and hearing ability in a quiet environment initially. Which information will the nurse include for a patient contemplating a cochlear implant? - Correct AnswersCochlear implants require training in order to receive the full benefit. Which statement by a patient with bacterial conjunctivitis indicates a need for further teaching? - Correct Answers"I will remove my contact lenses at bedtime." Which information will the nurse include when teaching a patient with keratitis caused by herpes simplex type 1? - Correct AnswersImportance of taking all of the ordered oral acyclovir (Zovirax) The nurse at the outpatient surgery unit obtains the following information about a patient who is scheduled for cataract extraction and implantation of an intraocular lens. Which information is most important to report to the health care provider at this time? - Correct AnswersThe patient takes 2 antihypertensive medications. During the preoperative assessment of the patient scheduled for a right cataract extraction and intraocular lens implantation, it is most important for the nurse to assess - Correct Answersthe visual acuity of the patient's left eye. The nurse learns that a newly admitted patient has functional blindness and that the spouse has cared for the patient for many years. During the initial assessment of the patient, it is most important for the nurse to - Correct Answersmake eye contact with the patient and ask about any need for assistance. Which action could the registered nurse (RN) who is working in the eye and ear clinic delegate to a licensed practical/vocational nurse (LPN/LVN)? - Correct AnswersUse a Snellen chart to check a patient's visual acuity. The occupational health nurse is caring for an employee who is complaining of bilateral eye pain after a cleaning solution splashed into the employee's eyes. Which action will the nurse take first? - Correct AnswersFlush the eyes with sterile saline. Unlicensed assistive personnel (UAP) perform all the following actions when caring for a patient with Ménière's disease who is experiencing an acute attack. Which action by UAP indicates that the nurse should intervene immediately? - Correct AnswersUAP turn on the patient's television. The nurse at the eye clinic made a follow-up telephone call to a patient who underwent cataract extraction and intraocular lens implantation the previous day. Which information is the priority to communicate to the health care provider? - Correct AnswersThe patient has eye pain rated at a 5 (on a 0 to 10 scale). Which finding in an emergency department patient who reports being struck in the right eye with a fist is a priority for the nurse to communicate to the health care provider? - Correct AnswersThe patient complains of "a curtain" over part of the visual field. The charge nurse observes a newly hired nurse performing all the following interventions for a patient who has just undergone right cataract removal and an intraocular lens implant. Which one requires that the charge nurse intervene? - Correct AnswersThe nurse encourages the patient to cough. Which nursing activity is appropriate for the registered nurse (RN) working in the eye clinic to delegate to experienced unlicensed assistive personnel (UAP)? - Correct AnswersApplication of a warm compress to a patient's hordeolum A patient with a head injury after a motorcycle crash arrives in the emergency department (ED) complaining of shortness of breath and severe eye pain. Which action will the nurse take first? - Correct AnswersCheck the patient's oxygen saturation. Which prescribed medication should the nurse give first to a patient who has just been admitted to a hospital with acute angle-closure glaucoma? - Correct AnswersMannitol (Osmitrol) 100 mg IV The priority nursing diagnosis for a patient experiencing an acute attack with Meniere's disease is - Correct Answersrisk for falls related to dizziness. Which information about a patient who had a stapedotomy yesterday is most important for the nurse to communicate to the health care provider? - Correct AnswersThe patient's oral temperature is 100.8° F (38.1° C). A 75-year-old patient who lives alone at home tells the nurse, "I am afraid of losing my independence because my eyes don't work as well as they used to." Which action should the nurse take first? - Correct AnswersAsk the patient more about what type of vision problems are being experienced. A patient who received a corneal transplant 2 weeks ago calls the ophthalmology clinic to report that his vision has not improved with the transplant. Which action should the nurse take? - Correct AnswersRemind the patient it may take months to restore vision after transplant. Which action will the nurse take when performing ear irrigation for a patient with cerumen impaction? - Correct AnswersFill the irrigation syringe with body-temperature solution. Which action will the nurse include in the plan of care for a patient with benign paroxysmal positional vertigo (BPPV)? - Correct AnswersTeach the patient that canalith repositioning may be used to reduce dizziness. When teaching a patient about the treatment of acoustic neuroma, the nurse will include information about - Correct Answersways to avoid falls. Which patient arriving at the urgent care center will the nurse assess first? - Correct AnswersPatient with acute right eye pain that occurred while using home power tools The nurse is working in an urgent care clinic that has standardized treatment protocols for implementation by nursing staff. After reviewing the history, physical assessment, and vital signs for a 60-year-old patient as shown in the accompanying figure, which action should the nurse take first? - Correct AnswersReport the vision change to the health care provider. The nurse is providing health promotion teaching to a group of older adults. Which information will the nurse include when teaching about routine glaucoma testing? - Correct AnswersA Tono-pen will be applied to the surface of the eye. The nurse is performing an eye examination on a 76-year-old patient. The nurse should refer the patient for a more extensive assessment based on which finding? - Correct AnswersThe patient reports persistent photophobia The nurse performing an eye examination will document normal findings for accommodation when - Correct Answersthe pupils constrict while fixating on an object being moved closer to the patient's eyes. Which assessment finding alerts the nurse to provide patient teaching about cataract development? - Correct AnswersBlurred vision and light sensitivity Assessment of a patient's visual acuity reveals that the left eye can see at 20 feet what a person with normal vision can see at 50 feet and the right eye can see at 20 feet what a person with normal vision can see at 40 feet. The nurse records which finding? - Correct AnswersOS 20/50; OD 20/40 When assessing a patient's consensual pupil response, the nurse should - Correct Answersshine a light into one pupil and observe the response of both pupils. The nurse is observing a student who is preparing to perform an ear examination for a 30-year-old patient. The nurse will need to intervene if the student - Correct Answerschooses a speculum larger than the ear canal. When obtaining a health history from a 49-year-old patient, which patient statement is most important to communicate to the primary health care provider? - Correct Answers"I can't see as far over to the side." A 65-year-old patient is being evaluated for glaucoma. Which information given by the patient has implications for the patient's treatment? - Correct Answers"I take metoprolol (Lopressor) daily for angina." The nurse is testing the visual acuity of a patient in the outpatient clinic. The nurse's instructions for this test include asking the patient to - Correct Answersstand 20 feet from the wall chart. A patient who underwent eye surgery is required to wear an eye patch until the scheduled postoperative clinic visit. Which nursing diagnosis will the nurse include in the plan of care? - Correct AnswersRisk for falls related to temporary decrease in stereoscopic vision Which information will the nurse provide to the patient scheduled for refractometry? - Correct Answers"You will need to wear sunglasses for a few hours after the exam." The nurse is assessing a 65-year-old patient for presbyopia. Which instruction will the nurse give the patient before the test? - Correct Answers"Hold this card and read the print out loud." A patient arrives in the emergency department complaining of eye itching and pain after sleeping with contact lenses in place. To facilitate further examination of the eye, fluorescein angiography is ordered. The nurse will teach the patient to - Correct Answersreport any burning or pain at the IV site. A patient complains of dizziness when bending over and of nausea and dizziness associated with physical activities. The nurse will plan to teach the patient about - Correct Answerstympanometry. When the nurse is taking a health history of a new patient at the ear clinic, the patient states, "I have to sleep with the television on." Which follow-up question is most appropriate to obtain more information about possible hearing problems? - Correct Answers"Have you noticed ringing in your ears?" When the patient turns his head quickly during the admission assessment, the nurse observes nystagmus. What is the indicated nursing action? - Correct AnswersPlace a fall-risk bracelet on the patient. The nurse recording health histories in the outpatient clinic would plan a focused hearing assessment for adult patients taking which medication? - Correct AnswersIbuprofen (Advil) taken for 20 years to treat osteoarthritis The charge nurse must intervene immediately if observing a nurse who is caring for a patient with vestibular disease - Correct Answersencouraging the patient to ambulate independently. The nurse in the eye clinic is examining a 67-year-old patient who says "I see small spots that move around in front of my eyes." Which action will the nurse take first? - Correct AnswersUse an ophthalmoscope to examine the posterior eye chambers. The nurse should report which assessment finding immediately to the health care provider? - Correct AnswersThe tympanum is blue-tinged. Which equipment will the nurse obtain to perform a Rinne test? - Correct AnswersTuning fork Which action should the nurse take when providing patient teaching to a 76-year-old with mild presbycusis? - Correct AnswersAsk for permission