Nurse209/NURS 209/ NURS209 : Theory Review Complete questions and Answers Fall 2022.

Nurse209: Theory Review Renal and Urological Problems 1. A female is suspected of having struvite urinary calculi. Which actions should the nurse implement to manage this client? Select all that apply. a. Measure the pH b. Give cholestyramine c. Take measure to acidify the urine d. Administer antimicrobial agents e. Alkalinize the urine with potassium citrate 2. A client had undergone a lithotripsy procedure and is at risk of obstruction of the ureter by edema. Which caterter should be used for preventing obstruction of the ureter? a. Urethral b. Suprapubic c. Ureteral d. Nephrostomy 3. The urinalysis of a male client reveals a high microorganism count. Which data should the nurse use to determine the area of the urinary tract that is infected? Select all that apply. a. Pain location b. Fever and chills c. Mental confusion d. Urinary hesitation e. Urethral discharge f. Post Void dribbling 4. The nurse is attending to a client with obstructing urinary calculi. The client is treated with tramsulin to help ease passage of the stones. In addition, opioids are administered to relieve colic pain. What actions should the nurse perform to ensure treatment effectiveness and client safety? Select all that apply. a. Restrict fluid intake b. Advise complete bed rest c. Encourage the client to move d. Strain all urine voided by the client e. Avoid letting the client ambulate unattended 5. When assessing a client with renal colic. Which finding indicates the possibility ofurinary calculi? Select all that apply. a. The client has nausea and vomiting b. The client wants to lie still in place c. The client is unable to be in one position d. The client has sharp and severe pain in the flank area, back or lower abdomen e. The client has flatulence and watery diarrhea 6. When teaching about home care to the caregiver of a client with a history of urinary calculi and limited mobility, which instructions should the nurse provide? Select all that apply. a. Maintain a fluid intake of 3L/day b. Change the client’s position every 2 hours c. Help the client to sit, if possible d. Include purine rich foods in the diet e. Monitor urinary output 7. The nurse is teaching clients who are at an increased risk of UTIs about the use of cranberry products in preventing UTIs. Which important instructions should the nurse include in the teaching? Select all that apply. a. Cranberry juice is more effective than cranberry capsules b. Cranberry has no effects on UTIs c. Cranberry products have a protective effect in preventing UTIs d. Drinking an adequate amount of fluid is important to prevent UTIs e. Taking cranberry capsules and not drinking water will prevent UTIs 8. Which nursing intervention is best when providing care for an adult client with newly diagnosed adults onset polycystic kidney disease (PKD)? a. Help the client with the rapid progression of the disease b. Suggest genetic counselling resources for the children of the client c. Expect the client to have polyuria and poor concentration ability of the kidneys d. Implement appropriate measures of the clients deafness and blindness in addition to the renal problems 9. A client diagnosed with an early UTI. When planning for trimethoprimsulfamethoxazole treatment for this client, which factors should the nurse evaluate? Select all that apply. a. E.coli is resistant to this medicationb. This drug is relatively inexpensive c. This drug can be taken twice daily d. The treatment is given 3-4 times a day e. The client should avoid sunlight when taking this medication 10.The nurse is evaluating the care plan for the client with a diagnosis of urinary tract calculi. Which statement by the client indicates a need for further teaching? a. “I have no pain upon urination” b. “My pain is much less now” c. “I will not need to strain my urine because the stone is visibly passed and I no longer have pain” d. “I will remain on bed rest to prevent the stone from moving” 11.A client is admitted with a urethral diverticula. Which clinical manifestation should the nurse expect to document? Select all that apply. a. Post void dribbling b. Fever c. Urinary incontinence d. Clear, yellow urine e. Gross hematuria 12.Which instruction should the nurse provide when teaching a client to exercise the pelvic floor? a. Tighten both buttocsk together b. Squeeze thighs together tightly c. Contract muscles around rectum d. Lie on back and lift legs together Neurological Problems (Delirium, Alzheimer’s and Other Dementias) 1. The nurse is interviewing a client who is seeking relief for frequent headaches. Which description is consistent with symptoms of a migraine headache? a. Extreme tenseness in the area of the neck and shoulders b. Tears flow from one eye and nasal drainage occurs with headachec. The pain of the headache wakes the client from sleep. d. The pain throbs and is synchronous with the client’s pulse 2. An older adult client with a history of cardiac arrhythmia is undergoing treatment in a long-term care facility. Which disease is the client most at risk of developing? a. Alzheimer’s disease b. Vascular dementia c. Mild cognitive impairment d. Delirium 3. Which finding is characteristic of dementia with Lewy bodies? a. Abnormal accumulation of TDP-43 protein b. Abnormal accumulation of ubiquitin protein c. Presence of alpha-synuclein protein in the brainstem. d. Accumulation of abnormally folded prion protein. 4. A client has been found to have amyotrophic lateral sclerosis. What classic symptom of the disorder does the nurse recognize? a. Dysuria b. Dyspnea c. Dysphagia d. Dysreflexia 5. The nurse is planning discharge teaching for a client with myasthenia gravis. What instructions should the nurse include in the care plan? Select all that apply. a. Eat a balanced diet that can be easily chewed and swallowed. b. Include liquid rather than solid foods in the diet. c. Plan activities with periods of rest. d. Practice hobbies such as playing golf. e. Schedule drugs so that the peak effect of the drug is at mealtime. 6. The nurse understands that generalized tonic-clonic seizures are the most common type of generalized seizure and include various phases. Arrange the phases of generalized tonic-clonic seizures in the correct order. 1. The client loses consciousness and falls to the ground. 2. The body stiffens for 10 to 20 seconds. 3. The extremities jerk for 30 to 40 seconds. 4. The client feels tired and sleepy.7. Which medication would the nurse expect to be prescribed for a client with delirium related to alcohol withdrawal? a. Phenytoin b. Carbamazepine c. Lorazepam d. Dexamethasone 8. The nurse is assessing a client who is unable to understand that he has a problem with memory and functioning. Which term is used to describe this finding? a. Aphasia b. Agnosia c. Anosognosia d. Altered perception 9. When a client with Alzheimer’s disease is in severe pain but cannot communicate, of which symptoms should the nurse be observant to recognize pain? Select all that apply. a. Agitation b. Increased vocalization c. Wandering d. Withdrawal e. Sundowning 10. A client with a history of cluster headaches in planning to travel overseas by air. What advice should the nurse give the client to decrease the likelihood of such attacks during air travel? a. Do not travel by air. b. Avoid eating chocolate while in flight. c. Take ergotamine before the flight takes off. d. Massage the neck and apply moist hot packs while in flight. 11. The client with dementia is prescribed memantine. Which outcome is the intended effect of this medication? a. Slow depression b. Stop agitation. c. Inhibit the enzyme, cholinesterase. d. Block the action of glutamate. 12. The nurse is caring for a client in the ICU who has been prescribed several medications, including a sedative. Which actions should the nurse implement to help prevent delirium in this client? Select all that apply.a. Keep the noise in the ICU to a minimum. b. Use clocks and a calendar to keep the client oriented. c. Ensure that there is minimal communication with the client. d. Give regular sponge baths to the client, and monitor urinary output. e. Back massage at bedtime. Male and Female Reproductive Challenges 1. The nurse is caring for a client with polycystic ovarian syndrome. Which nursing intervention is appropriate for this client? a. Advise absolute bed rest b. Instruct to take diet rich in carbohydrates and fat c. Suggest use of a debilitating agent or electrolysis to remove unwanted hair d. Explain the advantages of early surgical intervention 2. The nurse assesses a male client who has numerous urinary symptoms. Which early signs of Benign prostatic hypertrophy does the nurse recognize? Select all that apply. a. Nocturia b. Urinary frequency c. Erectile dysfunction d. Overflow incontinence e. Reduce force of urinary stream f. Difficulty in starting the flow of urine 3. Which diagnostic test should the nurse question when prescribed for a client diagnosed with pelvic inflammatory disease (PID)? a. Complete blood count (CBC) with differential b. Vaginal culture for Neisseria gonorrhoeae c. Throat culture for streptococcus A d. Pregnancy test 4. A client presents with a lump in the scrotum. Which findings would lead the nurse to suspect testicular cancer? Select all that apply. a. Feeling of heaviness b. Bloating in upper abdomen c. Aching in lower abdomend. Feeling of nausea and vomiting e. Nontender and firm scrotal mass 5. When assessing a client with benign prostatic hyperplasia (BPH), the nurse evaluates possible complications of urinary obstruction. Which are the most appropriate conditions that the nurse should consider? Select all that apply. a. Bladder calculi b. Cardiac disorders c. Digestive problems d. Urinary tract infection e. Acute urinary retention 6. A postmenopausal woman presents with the symptoms of dysparenia. Which information should the nurse give to this client? Select all that apply. a. Avoid sexual intercourse b. Use lubricants during sexual intercourse c. Use systemic hormone therapy d. Ask the male partner to use condoms e. Use local hormonal creams 7. To accurately monitor progression of the symptom of decreased urinary stream, the nurse should encourage the client to have which primary screening measure on a regular basis? a. Digital rectal examination b. Transurethral resection of the prostate c. Urinalysis with urine culture and sensitivity d. Prostate specific antigen (PSA) monitoring 8. When teaching clients about the use of the drug Sildenafil (Viagra), which instruction should the nurse include in the teaching? Select all that apply. a. The drug may cause an erection lasting more than four hours b. The drug should only be taken once daily c. The drug contraindicated in clients taking nitrates d. The drug should be taken three to four hours before sexula activity e. The drug should be taken 30 to 60 minutes before sexual activity 9. The nurse is preparing a community presentation related to testicular cancer. Which would be appropriate for inclusion? a. Early symptoms of testicular cancer are pain and dysuria b. Testicular cancer is the most common cancer in men older than 50 c. Males with a history of cryptorchidism are at highest risk for testicular cancerd. Testicular cancer is four times more likely to develop in african american males than in white males 10. A couple who have experienced a spontaneous abortion before 8 week sof gestation visit the nurse for counselling about increasing their chances for successful future pregnancies. Which information should the nurse provide? Select all that apply. a. Inform that the abortion may have been due to cervical incompetence b. Inform that the abortion may have been due to chromosimal defects c. Advise that any bleeding should be reported immediately d. Advise that serial monitoring of serum follicle stimulating hormone (FSH) levels should be done e. Advise absolute bed rest and abstention from intercourse to reduce the chance or spontaneous abortion 11. When explaining follow up care after treatment of testicular cancer, what investigation should the nurse tell a client to anticipate for detecting relapse? Select all that apply. a. Chest X-ray b. Semen analysis c. Assessment of human chorionic gonadotropin (hGC) and alphafetoprotein (AFP) d. Urine and stool examinations e. Regular physical examinations 12. A client receives continuous bladder irrigation (CBI) after invasive prostate surgery. Which priority action should the nurse perform? Select all that apply. a. Record intake and output b. Clean around catheter daily c. Assess for bleeding and clots d. Discontinue CBI and notify the primary health care provider if obstruction occurs e. Provide care instruction for clients being discharged with an indwelling catheter Palliative Care at the End of Life 1. The home health nurse visits a client with metastatic ovarian cancer who is receiving palliative care. The client is experiencing pain at a level of 8 (on a 10- point scale). In prioritizing activities for the visit, which action should the nurse do first?a. Auscultate for bowel sounds b. Administered as needed (PRN) pain medication c. Ask family about clients fluid intake d. Check pressure points for skin breakdown 2. A client has been receiving palliative care for the past several weeks in light of a worsening condition following a series of strokes. The caregiver has rung the call bell, stating that the client now "stops breathing for a while, then breathes fast and hard, and then stops again." Which term should the nurse use when documenting this information? a. Apnea b. Bradypnea c. Death rattle d. Cheyne-Stokes respiration 3. A client died from sepsis while in the hospital. The client's spouse is now blaming the primary health care provider for the client's death and is shouting at the staff. According to the Kubler-Ross model of grief, in which stage is the spouse? a. Bargaining b. Anger c. Depression d. Denial 4. A client is admitted to hospital with Cheyne-Stokes respirations. Which findings should the nurse expect to obtain? a. A respiratory rate of less than 5 breaths per minute b. A respiratory rate of more than 30 breaths per minute c. Alternating periods of apnea and deep, rapid breathing d. Noisy and congested breathing 5. Which approach aims to improve the quality of life of clients with life-threatening illnesses and their families through the relief of pain and suffering? a. End-of-life care b. Hospice palliative care c. Integrated palliation d. Advance care planning 6. A health care provider has written a do-not-resuscitate (DNR) order for a client with heart disease. Based on assessment findings, a nurse speculates that the client would survive a cardiac arrest if proper cardiopulmonary resuscitation (CPR) is given. Which reason is appropriate for the health care provider toprescribe the DNR order? a. The health care provider feels that the client cannot be resuscitated. b. The client's family does not believe cardiopulmonary resuscitation would be useful. c. The client had expressed the desire to not receive cardiopulmonary resuscitation. d. The health care provider feels that the client can be cured by taking medications 7. A nurse reviews the medications prescribed for a client who is in the terminal stage of cancer. The nurse finds that the client has been prescribed medications for symptom relief, and no anticancer drug has been prescribed. Which reason supports the health care provider's decision regarding prescriptions? a. The client has expressed a wish for a full code form of resuscitation. b. The client has expressed the wish for a chemical code form of resuscitation. c. The client has expressed the wish to have euthanasia. d. The client has expressed the wish to have a natural death. 8. A nurse is caring for a client who is in the terminal stage of breast cancer at a hospice palliative care centre. Which mode of treatment should be included in the hospice care for this client? a. Opioids b. Chemotherapy c. Radiation therapy d. Mastectomy 9. A client has been diagnosed with a terminal illness and refuses hospice palliative care. The client is a firm believer in God. Which reason is most likely that the client is unwilling to accept this care? a. The client cannot afford hospice care. b. The client relies on God to help cope with the disease. c. The client feels the hospice team is not trained sufficiently to provide appropriate care. d. The client has lost hope and does not believe that any type of care could help with the condition 10.Which is a goal of palliative care? a. To enhance spiritual wellness and integrate complementary treatments. b. To assist clients in accessing services for physician-assisted death. c. To offer support to the family during bereavement. d. To promote a reduction in client activity and conservation of the client's energy.11.What is the pattern of respiration characterized by alternating periods of apnea and deep, rapid breathing in a terminally ill client? a. Bradypnea b. Terminal secretions c. Death rattle respiration d. Cheyne-Stokes respiration 12.A nurse providing end-of-life care finds that the client is very restless. Which intervention would be the best for the nurse to implement in response to this issue? a. Restrain the client to avoid falls from the bed. b. Use slow and soft music to soothe the client. c. Converse in a loud, robust voice to reassure the client. d. Allow unlimited visitors to keep the client company Gastrointestinal System 1. The nurse is assessing a client who reports pain and difficulty when swallowing. The client has a history of smoking for the past 15 years. What could be the most likely cause of the symptoms? a. Reflux disease b. Hiatal hernia c. Esophageal cancer d. Peptic ulcer disease 2. When the nurse is interviewing a client about their health history, which conditions should the nurse include as relevant to the gastrointestinal system? Select all that apply. a. Hemorrhoids b. Nasal polyps c. Monthly income d. Lactose intolerance e. Nausea and vomiting f. Abdominal distension 3. An older adult reports constipation to the nurse. What advice should the nurse provide to the client? a. Increase intake of fluids b. Decrease intake of fluids c. Halt physical activity d. Take medication for constipation daily 4. While assessing the abdomen, the nurse uses the bell of the stethoscope to auscultate below the diaphragm to assess for lower-pitched bowel sounds. What measure should the nurse take to prevent abdominal contraction while auscultating.a. Wash the bell of the stethoscope b. Warm the bell of the stethoscope with the hands c. Place the stethoscope below the diaphragm muscle for two minutes d. Auscultate the abdomen using the diaphragm of the stethoscope instead 5. A client had a stomach resection for stomach cancer. The nurse should teach the client about the loss of the hormone that stimulates gastric acid secretion and motility and maintains lower esophageal sphincter tone. Which hormone will be decreased with a gastric resection? a. Gastrin b. Secretin c. Cholecystokinin d. Gastric inhibitory peptide 6. Which sequence should the nurse follow in examining a client’s abdomen? a. Inspection first, then auscultation, percussion, and palpation b. Percussion first, then auscultation, palpation, and inspection c. Auscultation first, then palpation, percussion, and inspection d. Inspection first, then palpation, auscultation, and percussion 7. A client had a car accident and was “scared to death”. The client is now reporting constipation. The nurse understands what is affecting the gastrointestinal tract that could be contributing to the constipation? a. The client is too nervous to eat or drink, so there is no stool b. The sympathetic nervous system was activated so the GI tract was slowed c. The parasympathetic nervous system now is functioning to slow the GI tract d. The circulation in the GI system has been increased, so less waste is removed 8. Inspection of an older adult’s mouth reveals the presence of white, curd-like lesions on the client’s tongue. What is the most likely etiology for this abnormal assessment finding? a. Herpes virus b. Candida albicans c. Vitamin deficiency d. Irritation from ill-fitting dentures 9. The nurse is preparing to examine a client’s abdomen. Which procedure will the nurse perform first? a. Palpation b. Percussion c. Auscultation d. The order of procedure does not matter10.The nurse is interviewing a client with chronic constipation. The nurse finds that the client performs a Valsalva maneuver to facilitate passing of feces. How is this maneuver helpful in aiding the elimination process? a. It stimulates peristalsis b. It increases intra-abdominal pressure c. It stimulates the parasympathetic nerve fibers d. It initiates the gastrocolic and duodenocolic reflex 11.During the abdominal examination of a healthy client, which actions should the nurse perform? Select all that apply. a. Use warm hands b. Advise the client to maintain a full bladder c. Advise the client to empty the bladder d. Advise the client to assume a supine position with knees flexed e. Advise the client to stand with arms raised 12. A health-care team is assessing an adult client for acute pancreatitis after presenting to the emergency department with severe abdominal pain. Which laboratory value is the best diagnostic indicator of acute pancreatitis? a. Gastric pH b. Blood glucose c. Serum amylase d. Serum potassium Upper and Lower Gastrointestinal Problems 1. The nurse is assessing a colostomy in a client who had a colectomy 24 hours ago. Which of these assessment findings is considered normal for a new stoma? a. Pale pink colour b. Dusky blue colour c. Brown or black colour d. Dark pink to red colour 2. The nurse is aware that the primary symptoms of a sliding hiatal hernia are associated with reflux and should assess the client for which symptoms? a. Pyrosis, regurgitation and dysphagia b. Jaundice, ascite and edema c. Abdominal cramps, diarrhea and anorexia d. Lower abdominal pain, fever and abdominal rigidity 3. The nurse is caring for a postoperative client who states “I have never taken pantoprozol in the past - why am I getting this medication as I never have heartburn?” Which nursing response is best? a. “The stress of surgery is likely to cause stomach bleeding if you do notreceive it.” b. “This will reduce the amount of acid in your stomach until you can eat a regular diet again.” c. “This will prevent the heartburn that occurs as a side effect of your diabetes.” d. “This will prevent gas pains from the excess air in your small intestine.” 4. The nurse is preparing to give a dose of bisacodyl (Dulcolax) to a client on the surgical unit. In explaining the medication to the client, the nurse would state that it acts by what? a. Preventing blood from pooling in the lower extremities b. Increasing appetite following surgery c. Producing a bowel movement d. Reducing pain through anti-inflammatory properties 5. The nurse is assisting a client who has been admitted with severe abdominal pain. Suddenly, the client vomits a large amount of emesis that looks similar to coffee grounds. Which action by the nurse is a priority? a. Ask the client about the timing of the last meal b. Offer the client sips of water to prevent dehydration c. Monitor the client for any further episodes of nausea and vomiting d. Notify the primary health care provider about the client’s condition 6. The nurse is planning care for an older adult client with an abdominal mass and suspected bowel obstruction. Which factor in the client’s history increases their risk for colorectal cancer? a. Osteoarthritis b. History of colorectal polyps c. History of lactose intolerance d. Use of herbs as dietary supplements 7. The nurse is preparing an education session related to gastritis for a group of nursing students. Which condition is the most common cause of chronic gastritis? a. Syphilis b. Cytomegalovirus c. Helicobacter pylori d. Mycobacterium species 8. The nurse would administer a dose of magnesium hydroxide (milk of magnesia) to a client after evaluation of which assessment findings? a. Poor oral intake over the past three days b. Weight loss of two points in 24 hours c. No bowel movement for four daysd. Irritability and tachycardia 9. A client has a newly formed ileostomy and asks the nurse, “When can I start training my ostomy to only produce stool at certain times?” What is the nurse’s appropriate response? a. “We will start training when the stoma heals” b. “When your stools transition from liquid to semisolid” c. “Because you have an ileostomy, not a colostomy, we can start any time” d. “We will not be able to train your ileostomy because of the frequent drainage from the site” 10.The nurse is caring for a client who is scheduled to receive a course of long-term, broad-spectrum antibiotic therapy. The nurse knows the client will need instruction on actions to take to prevent infection with which organism? a. Salmonella b. Clostridium difficile c. Rotavirus d. Escherichia coli 0157:H7 11.A young adult calls the office nurse and states, “I am having the worst abdominal pain! It just started this afternoon. Is there anything I can take to get relief?” Which answer by the nurse is appropriate? a. “Try taking a laxative and let us know how that works” b. “You could try an enema to see if that brings quick relief” c. “Take some aspirin or acetaminophen and let us know if the pain is not relieved” d. “Please have someone bring you into the office today so that we can do an examination” 12. The client has a prescription for raberprazole. The nurse should assess the effectiveness of the medication by noticing whether the client obtained relief from which symptom? a. Abdominal pain b. Flatulence c. Constipation d. Heartburn Endocrine System 1. A client with an oral glucose test value of 8.9 mmol/L has a high risk of developing type 2 diabetes mellitus. What should the nurse reccommend to help delay the development of DM type 2? Select all that apply. a. Maintain a healthy weight b. Include 50g/day of fibre in diet c. Consume a high-protein diet for weight lossd. Monitor for polyuria, polyphagia, and polydipsia e. Regularly monitor blood glucose and glycosylated hemoglobin levels 2. A client is brought to the ED following a car accident and is wearing a medical identification bracelet that says the client has Addison’s disease. What should the nurse expect to be included in the client’s care plan? a. Low sodium diet b. Increased glucocorticoid replacement c. Suppression of pituitary adrenocorticotropic (ACTH) synthesis d. Elimination of mineralocorticoid replacement 3. A client diagnosed with DM type 1 has had elevated blood sugar readings each morning for the past four days. Which intervention by the nurse should be performed initially? a. Check the client’s blood sugar at 3AM b. Provide the client with an evening snack c. Rotate insulin injection sites between the abdomen, thigh and arm d. Contact the health care provider to increase the evening insulin dose 4. A client is admitted with diabetic ketoacidosis. Which findings should the nurse expect to assess upon physical examination? a. Blood sugar 11.1 mmol/L and bradypnea b. Hypotension and blood sugar 3.8 mmol/L c. Diaphoresis and extreme hunger d. Dry skin and tachycardia 5. The nurse observes a return demonstration by a client who is learning how to mix regular insulin and NPH insulin into the same syringe. Which action by the client indicates the need for further teaching? a. Withdrawing the NPH insulin first b. Injecting air into the NPH insulin bottle first c. Removing air bubbles after drawing up the first insulin d. Injecting an amount of air equal to the desired dose of insulin 6. The nurse determines that a client who is receiving radioactive iodine (RAI) therapy for the treatment of hyperthyroidism needs additional instructions when they make which of the following statements? a. “I will need to flush the toilet twice after I use it” b. “I should launder my laundry separately from those in my household” c. “I will need to take antithyroid drugs for three months after I begin RAI therapy” d. “If I develop a dry mouth I may gargle with a salt and soda mixture for relief”7. The nurse is educating the client regarding administration of aspart insulin. Which statement by the client indicates correct knowledge of the onset of action of the medication? a. “I will administer my aspart 30 minutes before mealtime” b. “I will administer my aspart 60 minutes before mealtime” c. “I will administer my aspart within 15 minutes of eating my meal” d. “I will administer my aspart 30 minutes after the conclusion of my meal” 8. The nurse has been teaching a client with diabetes melitus how to perform selfmonitoring of blood glucose (SMBG). During evaluation of the client’s technique, the nurse identifies a need for additional teaching when the client does which action? a. Chooses a puncture site in the centre of the finger pad b. Washes hands with soap and water to cleanse the site to be used c. Warms the finger before puncturing it to obtain a drop of blood d. Tells the nurse that the result of 110 mg/dL indicates good control of DM 9. When assessing a client with hypothyroidism, which finding does the nurse anticipate? a. Dehydration b. Goitre c. Cyanosis d. Dry eyes 10. The nurse caring for a client hospitalized with DM should analyze which lab test result to obtain information on the client’s past glucose control? a. Prealbumin level b. Urine ketone level c. Fasting glucose level d. A1c blood level 11. A client who had been diagnosed with prediabetes six months ago is following up in the outpatient diabetes clinic. The nurse is reviewing the assessment data and understands that which outcome is the best reflection of good management of this condition? a. An 8kg weight loss b. Hemoglobin A1c of 5.5% c. Reduction of total cholesterol d. Decrease in polyuria, polydipsia, and polyphagia 12. The nurse creates a care plan for a client with Grave’s disease. What is an appropriate expected outcome? a. The client will be free of infection b. The client will remain awake, alert, and orientedc. The client will be compliant with fluid restrictions d. The client will demonstrate maintenance of his weight Cardiovascular System 1. A teenage girl survived an episode of sudden cardiac death (SCD) and is recovering in the intensive care unit (ICU). The nurse anticipates which intervention to prevent a recurrence? a. Drug therapy with beta-blocker b. Coronary artery bypass graft (CABG) c. Percutaneous coronary intervention (PCI) d. Implantable cardioverter-defibrillator (ICD) 2. In reviewing medication instructions with a client prescribed lisinopril (Prinivil), the nurse should include which statement? a. “You should not take this medication if you have asthma” b. “You may develop a dry cough while taking this medication” c. “Never take this medication on an empty stomach” d. “Discontinue use of this medication if you develop a drop in your blood pressure” 3. The nurse is teaching the client diagnosed with hypertension about developing an exercise program. Which instructions should the nurse include? a. Encourage the client to perform weightlifting in a daily basis b. Recommend jogging for at least 20 mins 3 days a week c. Perform high intensity aerobic exercises daily for at least 30 mins d. Exercise weekly and do not combine moderate intensity and high intensity exercises 4. When teaching a client about physical activity guidelines following acute coronary syndrome, the nurse recommends isotonic (static) activities. Which definition is accurate for isotonic activities according to the FITT (frequency, intensity, type, and time) formula? a. An increase in heart rate of at least 20 bpm over the resting heart rate b. A steady load on the heart and a gradual increase in time and intensity c. A rapid increase in heart rate and blood pressure d. A stretching of muscles but no increase in heart rate and blood pressure 5. The nurse has identified a group of people who are at risk for developing coronary artery disease. To prevent atherosclerosis, the nurse advises a reduction in salt consumption. How does salt consumption increase the risk of developing atherosclerosis? a. It causes hormonal imbalances b. It causes water retention c. It increases the fat levels in the bodyd. It increases homocysteine levels in the body 6. The nurse is assessing a client taking full doses of an appropriate three-drug therapy regimen, including a diuretic. The client is exhibiting resistant hypertension. What behaviour would the nurse discuss with the client as a cause for resistant hypertension? a. Mild exercise b. Minimal salt intake c. Adherence to drug regimen d. Increasing obesity 7. The nurse just received a shift report. Which client should the nurse assess first? a. The client who is complaining about dizziness and whose blood pressure is 150/92 b. The client with a hip fracture who is complaining of a pain of 2/10 c. The client who is complaining about severe headache and has a nose bleed d. The client complaining of fatigue and who just received an angiotensinconverting enzyme (ACE) inhibitor 8. Postop care of a client undergoing coronary artery bypass graft (CABG) surgery includes monitoring for which common complication? a. Dehydration b. Paralytic ileus c. Atrial dysrhythmias d. Acute respiratory distress syndrome 9. The nurse is describing to the client hte progressive development of coronary artery disease (CAD). Place the developmental stages of CAD into their proper order. a. Fatty streaks: streaks of fat develop within the smooth muscle cells b. Fibrous plaque: collagen plaques form in the artery and blood flow is reduced c. Complicated lesion: thrombus formation occurs d. Collateral circulation: new blood circulation routes are created or utilized 10.A client is scheduled for a dose of metoprolol. The nurse should withhold the dose and consult the health care provider after noticing which assessment finding? a. Migraine headache b. Pulse 112 bpm c. Expiratory crackles d. Blood sugar 12 mmol/L11. Which statement by a client diagnosed with stable angina indicates understanding of the disease process? a. “Decreased oxygen level in blood is causing my chest pain” b. “Angina is causing an irreversible damage to cardiac muscles by cardiac ischemia” c. “Anginal pain is caused by increased demand for oxygen and decreased supply of oxygen” d. “Symptoms of angina start when the process of atherosclerosis completely occludes the coronary artery” 12. Upon taking a lipid-lowering medication for hyperlipidemia, a client reports muscle pain. The nurse notes the client has elevated liver enzymes and creatine kinase levels. It is most likely that, which lipid-lowering medication was taken by the client? a. Nicotinic acid b. Simvastatin c. Gemfibrozil d. Colestipol Postoperative Care 1. The nurse is monitoring a postop client in the Phase 1 postanesthesia care unit (PACU). Which discharge criteria are included for this phase? Select all that apply. a. No nausea or vomiting b. No respiratory depression c. Oxygen saturation above 90% d. Written discharge instructions understood e. No excess bleeding or discharge 2. A client with a history of deep vein thrombosis is recovering in the PACU after abdominal surgery. The client is receiving oxygen therapy. Considering that the client is at risk for developing pulmonary embolism, for which signs should the nurse monitor? Select all that apply. a. Tachycardia b. Tachypnea c. Dyspnea d. Coarse crackles e. Noisy respirations 3. A client has undergone a major orthopedic surgery and is immobilized. On the third postop day, the client reports dyspnea. On examination, the nurse finds that the client has tachypnea, tachycardia, hypotension, and reduced oxygen saturation. Which actions should the nurse implement to relieve the client ofdyspnea? Select all that apply. a. Administer lidocaine b. Administer oxygen therapy c. Administer anticoagulant therapy d. Administer bronchodilators e. Administer skeletal muscle relaxant 4. An older adult client wakes up from anesthesia, becomes restless and agitated, and starts thrashing and shouting. The nurse finds that the client was administered benzodiazepines during surgery. Which interventions should be included in the client’s plan of care? Select all that apply. a. Use drugs to reverse the benzodiazepines b. Administer an antianxiety drug c. Administer an antipsychotic drug d. Administer a narcotic analgesic e. Ensure client safety 5. A client is complaining of abdominal distension and gas pains. Which actions should the nurse implement to help to treat the problem? Select all that apply. a. Ambulate the client b. Reposition frequently c. Administer morphine d. Request bowel scan e. Turn the client onto the left side f. Discontinue the nasal gastric tube (NGT) 6. In the PACU, the nurse finds that a postop client is agitated. Which actions should the nurse take? Select all that apply. a. Evaluate respiratory status b. Sedate the client if the client is not hypoxemic c. Put the side rails up d. Use clocks to orient the client if needed e. Monitor fluid intake and output 7. A client who has been admitted to the PACU following a major abdominal surgery develops noisy respirations. On auscultation, the nurse finds coarse crackles in the lungs. Which interventions should the nurse implement to prevent pulmonary complications in the client? Select all that apply. a. Suction the airways b. Provide IV hydration c. Administer sedatives d. Encourage abdominal exercises e. Administer cough suppressants8. When administering an analgesic to a postop client, which nursing actions should the nurse implement? Select all that apply. a. Assess the location, quality, and intensity of the pain b. Assess the client’s sleep/wake cycle and sensory and motor status c. Time the analgesic administration for effectiveness during painful activities d. Assess the client’s level of orientation and ability to follow commands e. Monitor the client for nausea, vomiting, and respiratory depression 9. The nurse caring for a postop client assesses the clinical manifestations of early pulmonary edema secondary to heart failure. Which manifestation should the nurse determine correlates with this disorder? a. Early-morning cough b. Increased urine output c. Nonproductive cough d. Crackles heard on auscultation 10. A client who was on mechanical ventilation through an endotracheal tube develops inspiratory stridor and sternal retraction upon the removal of the endotracheal tube. Which actions should the nurse implement to ensure oxygenation? Select all that apply. a. Suction the airway b. Administer oxygen therapy c. Administer muscle relaxants d. Provide positive pressure ventilation e. Tilt the head and thrust the chin 11. A client on the postop unit develops an airway obstruction due to the tongue falling back. Which actions should the nurse implement to ensure a patent airway. Select all that apply. a. Suction the airway b. Administer oxygen therapy c. Tilt the chin and thrust the jaw d. Place in side position e. Insert an artificial airway 12. The nurse finds that a postop client has an oxygen saturation of 85%. On auscultation, the client has decreased breath sounds. Which nursing interventions should the nurse implement? Select all that apply. a. Restrict intake of fluid b. Administer oxygen therapy c. Administer diuretics as advised d. Encourage deep breathing exercises e. Help the client to walk around, if toleratedLiver, Pancreas, and Biliary Tract Problems 1. Following a laparoscopic cholecystectomy, a client without pre- or postop complications is being discharged from the hospital. Which instructions should the nurse include in the discharge teaching? Select all that apply. a. Take a shower b. Take complete bed rest for at least 2 weeks c. Wait 1 week after surgery to return to work d. Increase fat in the diet during recovery e. Notify the surgeon of any redness and swelling at the incision site 2. The nurse is caring for a client with Hepatitis C. Which information related to nutrition should the nurse teach to the client to obtain the best nutrition possible? Select all that apply. a. Avoid very hot or very cold foods b. Provide the client with ore liquid foods such as soups c. Provide the client with only raw foods such as fruits and salads until healthy d. Ensure the client drinks at least mL of water every day e. Ensure that the client has a good breakfast and small or moderate breakfast 3. A client with cirrhosis of the liver is admitted to the hospital. Which complications of cirrhosis is the nurse likely to find in the client? Select all that apply. a. Edema of the feet b. Difficulty breathing c. Blood in the stools or black stools d. Disorientation and lethargy e. Severe pain in the chest with a cold sweat 4. A client has undergone cholecystectomy. Which postop care should the nurse implement for this client? Select all that apply. a. Maintain a low-fat diet b. Monitor for any bleeding c. Instruct not to do deep breathing d. Place the client in shock position e. Place the client in Sims position 5. The nurse is attending to a client suffering from cirrhosis of the liver. Which clinical manifestations should the nurse expect to find upon physical examination? Select all that apply. a. White patches on skin b. Deposits of dark pigments c. Small areas of bleeding into the skin d. Vascular lesions formed by small blood vessels e. Small dilated blood vessels with spider-like branches6. A client with cancer of the head of the pancreas is admitted to the hospital. Which manifestations should the nurse expect to find in this client? Select all that apply. a. Clay-coloured stools b. Itching and irritation of the skin c. Swelling of the face and extremities d. Ulcers of the back and abdomen e. Extreme pain in the upper abdomen that may radiate to the back 7. A client with cirrhosis of the liver is admitted to the hospital. Which hematological symptoms might be noted in this client? Select all that apply. a. Anemia b. Leukemia c. Leukopenia d. Polycythemia vera e. Thrombocytopenia 8. When caring for a client with a biliary obstruction, the nurse will anticipate administering which vitamin supplements? Select all that apply. a. Vitamin A b. Vitamin D c. Vitamin E d. Vitamin K e. Vitamin B 9. The nurse finds that a client admitted to the hospital with cirrhosis of the liver is disoriented, lethargic, drowsy and has abnormal reflexes. Based on the client’s signs and symptoms, the nurse understands that the client is in which grade of hepatic encephalopathy? a. Grade 0 b. Grade 1 c. Grade 2 d. Grade 3 e. Grade 4 10. A client with chronic Hepatitis C virus infection is admitted to the hospital. Which factors contribute to a high risk for development of cirrhosis of the liver? Select all that apply. a. Nonalcoholic fatty liver disease b. Alcohol consumption c. History of regular smoking d. Obesity e. Diet high in sodium and fatty foods11. A client who underwent a cholecystectomy is now having pain that is referred to the right shoulder. Which causes are probable for this pain? Select all that apply. a. Myocardial infarction b. Pericarditis after surgery c. Gallstone left accidentally d. Carbon dioxide that was used in surgery e. Irritation of the phrenic nerve 12. A client has been diagnosed with cholelithiasis. Which parameters should the nurse assess for manifestations of obstructed bile flow? Select all that apply. a. Jaundice b. Steatorrhea c. Dark, tarry stools d. Dark, amber urine e. Bleeding tendencies Endocrine Problems 1. A client has sought care because of a loss of 11 kg over the past six months during which the client claims to have made no significant dietary changes. For which potential problem should the nurse assess the client? a. Thyroid disorders b. Diabetes insipidus c. Pituitary dysfunction d. Parathyroid dysfunction 2. A client's laboratory reports indicate an abnormal decrease in blood Ca + levels, most likely due to impaired absorption of calcium from the intestine. The nurse recognizes, that which hormone is likely to be released? a. Thyroxine (T4) b. Calcitonin (CT) c. Parathormone (PTH) d. Triiodothyronine (T3) 3. The hypothalamus secretes releasing hormones and inhibiting hormones. Which area is the target tissue of these releasing and inhibiting hormones? a. Pineal b. Adrenal cortex c. Posterior pituitary d. Anterior pituitary 4. A client reports weight loss, increased appetite, chest pain, and hair loss. Assessment findings include large and protruding eyes, skin that is warm, smooth, and moist, an elevated blood pressure, and an increased heart rate. The nurse suspects that the client has which condition?a. Goitre b. Hyperthyroidism c. Addison’s disease d. Hypoparathyroidism 5. The nurse is caring for a client with a head injury. Results of the computed tomography (CT) brain scan indicate pineal gland damage. The nurse anticipates that the client will experience a decrease in the secretion of which hormone? a. Insulin b. Cortisol c. Calcitonin d. Melatonin 6. A client's recent medical history is indicative of diabetes insipidus. The nurse would perform client teaching related to which diagnostic test? a. Thyroid scan b. Fasting glucose test c. Oral glucose tolerance d. Water deprivation test 7. Which assessment parameter is of highest priority when caring for a client undergoing a water deprivation test? a. Serum glucose b. Client weight c. Arterial blood gasses d. Client temperature 8. A client exhibits signs of hyperthyroidism but preliminary medical reports reveal normal levels of thyroxine (T4) hormone. Which further diagnostic test is performed to confirm the diagnosis of hyperthyroidism? a. Ultrasonography b. Thyroglobulin serum study c. Triiodothyronine (T3) serum study d. Computed tomography with contrast media 9. The nurse suspects that a client has hypothyroidism based on which total thyroxine (T4) and free thyroxine (FT4) levels? a. 60 nmol/L; 5 pmol/L b. 60 nmol/L; 20 pmol/L c. 70 nmol/L; 30 pmol/L d. 80 nmol/L; 35 pmol/L 10. Which anterior pituitary hormone promotes tissue repair? a. Prolactinb. Calcitonin c. Epinephrine d. Somatotropin 11. A client with low levels of parathormone in the blood is experiencing frequent muscle spasms in the extremities. Which diet should the nurse suggest to this client? a. Calcium rich diet b. Folic acid rich diet c. Potassium rich diet d. Carbohydrate rich diet 12. The nurse is assessing a client diagnosed with Addison's disease. Which assessment should the nurse expect to find in this client? a. Patchy areas of light skin b. Warm, smooth, moist skin c. Darkened skin on the knuckles, elbows, and palmar creases d. Purplish red marks on the abdomen