NURSE-UN 240 A_E I Exam 2 Practice Questions and Answers Latest Updated 2022,100% CORRECT

NURSE-UN 240 A_E I Exam 2 Practice Questions and Answers Latest Updated 2022 1. After teaching a client how to perform diaphragmatic breathing, the nurse assesses the client’s understanding. Which action demonstrates that the client correctly understands the teaching? a) The client lays on his or her side with his or her knees bent. b) The client places his or her hands on his or her abdomen. c) The client lays in a prone position with his or her legs straight. d) The client places his or her hands above his or her head. 2. A nurse cares for a client with chronic obstructive pulmonary disease (COPD). The client states that he no longer enjoys going out with his friends. How should the nurse respond? a) “There are a variety of support groups for people who have COPD.” b) “I will ask your provider to prescribe you with an antianxiety agent.” c) “Share any thoughts and feelings that cause you to limit social activities.” d) “Friends can be a good support system for clients with chronic disorders.” 3. A nurse cares for a client with a 40-year smoking history who is experiencing distended neck veins and dependent edema. Which physiologic process should the nurse correlate with this client’s history and clinical manifestations? a) Increased pulmonary pressure creating a higher workload on the right side of the heart b) Exposure to irritants resulting in increased inflammation of the bronchi and bronchioles c) Increased number and size of mucus glands producing large amounts of thick mucus d) Left ventricular hypertrophy creating a decrease in cardiac output 4. A nurse cares for a client with chronic obstructive pulmonary disease (COPD) who appears thin and disheveled. Which question should the nurse ask first? a) “Do you have a strong support system?” b) “What do you understand about your disease?” c) “Do you experience shortness of breath with basic activities?” d) “What medications are you prescribed to take each day?” 5. A pulmonary nurse cares for clients who have chronic obstructive pulmonary disease (COPD). Which client should the nurse assess first? a) A 46-year-old with a 30–pack-year history of smoking b) A 52-year-old in a tripod position using accessory muscles to breathe c) A 68-year-old who has dependent edema and clubbed fingers d) A 74-year-old with a chronic cough and thick, tenacious secretions 6. The nurse is teaching a client with chronic obstructive pulmonary disease who has been prescribed continuous oxygen therapy at home. Which statement indicates the client correctly understands the teaching? a) “I plan to wear my oxygen when I exercise and feel short of breath.” b) “I will use my portable oxygen when grilling burgers in the backyard.” c) “I plan to use cotton balls to cushion the oxygen tubing on my ears.” d) “I will only smoke while I am wearing my oxygen via nasal cannula.” 7. A nurse cares for a client who tests positive for alpha1-antitrypsin (AAT) deficiency. The client asks, “What does this mean?” How should the nurse respond? a) “Your children will be at high risk for the development of chronic obstructive pulmonary disease.” b) “I will contact a genetic counselor to discuss your condition.” c) “This is a recessive gene and should have no impact on your health.” d) “Your risk for chronic obstructive pulmonary disease is higher, especially if you smoke.” 8. The nurse instructs a client on the steps needed to obtain a peak expiratory flow rate. In which order should these steps occur? 1. “Take as deep a breath as possible.” 2. “Stand up (unless you have a physical disability).” 3. “Place the meter in your mouth, and close your lips around the mouthpiece.” 4. “Make sure the device reads zero or is at base level.” 5. “Blow out as hard and as fast as possible for 1 to 2 seconds.” 6. “Write down the value obtained.” 7. “Repeat the process two additional times, and record the highest number in your chart.” a) 4, 2, 1, 3, 5, 6, 7 b) 3, 4, 1, 2, 5, 7, 6 c) 2, 1, 3, 4, 5, 6, 7 d) 1, 3, 2, 5, 6, 7, 4 9. A nurse evaluates the following arterial blood gas and vital sign results for a client with chronic obstructive pulmonary disease (COPD): Arterial Blood Gas Results Vital Signs pH = 7.32 PaCO2 = 62 mm Hg PaO2 = 46 mm Hg HCO3– = 28 mEq/L Heart rate = 110 beats/min Respiratory rate = 12 breaths/min Blood pressure = 145/65 mm Hg Oxygen saturation = 76% Which action should the nurse take first? a) Administer a short-acting beta2 agonist inhaler. b) Document the findings as normal for a client with COPD. c) Teach the client diaphragmatic breathing techniques. d) Initiate oxygenation therapy to increase saturation to 92%. 10. A nurse teaches a client who has chronic obstructive pulmonary disease. Which statements related to nutrition should the nurse include in this client’s teaching? (Select all that apply.) a) “Avoid drinking fluids just before and during meals.” b) “Rest before meals if you have dyspnea.” c) “Have about six small meals a day.” d) “Eat high-fiber foods to promote gastric emptying.” e) “Increase carbohydrate intake for energy.” 11. A nurse assesses a client with chronic obstructive pulmonary disease. Which questions should the nurse ask to determine the client’s activity tolerance? (Select all that apply.) a) “What color is your sputum?” b) “Do you have any difficulty sleeping?” c) “How long does it take to perform your morning routine?” d) “Do you walk upstairs every day?” e) “Have you lost any weight lately?” 12. A nurse plans care for a client who has chronic obstructive pulmonary disease and thick, tenacious secretions. Which interventions should the nurse include in this client’s plan of care? (Select all that apply.) a) Ask the client to drink 2 liters of fluids daily. b) Add humidity to the prescribed oxygen. c) Suction the client every 2 to 3 hours. d) Use a vibrating positive expiratory pressure device. e) Encourage diaphragmatic breathing. 13. A client has been diagnosed with hypertension but does not take the antihypertensive medications because of a lack of symptoms. What response by the nurse is best? a) “Do you have trouble affording your medications?” b) “Most people with hypertension do not have symptoms.” c) “You are lucky; most people get severe morning headaches.” d) “You need to take your medicine or you will get kidney failure.” 14. A student nurse asks what “essential hypertension” is. What response by the registered nurse is best? a) “It means it is caused by another disease.” b) “It means it is ‘essential’ that it be treated.” c) “It is hypertension with no specific cause.” d) “It refers to severe and life-threatening hypertension.” 15. A nurse is interested in providing community education and screening on hypertension. In order to reach a priority population, to what target audience should the nurse provide this service? a) African-American churches b) Asian-American groceries c) High school sports camps d) Women’s health clinics 16. The nurse is caring for four hypertensive clients. Which drug–laboratory value combination should the nurse report immediately to the health care provider? a) Furosemide (Lasix)/potassium: 2.1 mEq/L b) Hydrochlorothiazide (Hydrodiuril)/potassium: 4.2 mEq/L c) Spironolactone (Aldactone)/potassium: 5.1 mEq/L d) Torsemide (Demadex)/sodium: 142 mEq/L 17. A nurse is assessing a client with peripheral artery disease (PAD). The client states walking five blocks is possible without pain. What question asked next by the nurse will give the best information? a) “Could you walk further than that a few months ago?” b) “Do you walk mostly uphill, downhill, or on flat surfaces?” c) “Have you ever considered swimming instead of walking?” d) “How much pain medication do you take each day?” 18. A nursing student is caring for a client with an abdominal aneurysm. What action by the student requires the registered nurse to intervene? a) Assesses the client for back pain b) Auscultates over abdominal bruit c) Measures the abdominal girth d) Palpates the abdomen in four quadrants 19. A client has peripheral arterial disease (PAD). What statement by the client indicates misunderstanding about self-management activities? a) “I can use a heating pad on my legs if it’s set on low.” b) “I should not cross my legs when sitting or lying down.” c) “I will go out and buy some warm, heavy socks to wear.” d) “It’s going to be really hard but I will stop smoking.” 20. Which statements by the client indicate good understanding of foot care in peripheral vascular disease? (Select all that apply.) a) “A good abrasive pumice stone will keep my feet soft.” b) “I’ll always wear shoes if I can buy cheap flip-flops.” c) “I will keep my feet dry, especially between the toes.” d) “Lotion is important to keep my feet smooth and soft.” e) “Washing my feet in room-temperature water is best.” 21. The nurse working in the emergency department knows that which factors are commonly related to aneurysm formation? (Select all that apply.) a) Atherosclerosis b) Down syndrome c) Frequent heartburn d) History of hypertension e) History of smoking 22. A client with a known abdominal aortic aneurysm reports dizziness and severe abdominal pain. The nurse assesses the client’s blood pressure at 82/40 mm Hg. What actions by the nurse are most important? (Select all that apply.) a) Administer pain medication. b) Assess distal pulses every 10 minutes. c) Have the client sign a surgical consent. d) Notify the Rapid Response Team. e) Take vital signs every 10 minutes. 23. A nurse is teaching a client with diabetes mellitus who asks, “Why is it necessary to maintain my blood glucose levels no lower than about 60 mg/dL?” How should the nurse respond? a) “Glucose is the only fuel used by the body to produce the energy that it needs.” b) “Your brain needs a constant supply of glucose because it cannot store it.” c) “Without a minimum level of glucose, your body does not make red blood cells.” d) “Glucose in the blood prevents the formation of lactic acid and prevents acidosis.” 24. A nurse reviews laboratory results for a client with diabetes mellitus who presents with polyuria, lethargy, and a blood glucose of 560 mg/dL. Which laboratory result should the nurse correlate with the client’s polyuria? a) Serum sodium: 163 mEq/L b) Serum creatinine: 1.6 mg/dL c) Presence of urine ketones d) Serum osmolarity: 375 mOsm/kg 25. After teaching a young adult client who is newly diagnosed with type 1 diabetes mellitus, the nurse assesses the client’s understanding. Which statement made by the client indicates a correct understanding of the need for eye examinations? a) “At my age, I should continue seeing the ophthalmologist as I usually do.” b) “I will see the eye doctor when I have a vision problem and yearly after age 40.” c) “My vision will change quickly. I should see the ophthalmologist twice a year.” d) “Diabetes can cause blindness, so I should see the ophthalmologist yearly.” 26. A nurse assesses a client who has a 15-year history of diabetes and notes decreased tactile sensation in both feet. Which action should the nurse take first? a) Document the finding in the client’s chart. b) Assess tactile sensation in the client’s hands. c) Examine the client’s feet for signs of injury. d) Notify the health care provider. 27. A nurse cares for a client who has a family history of diabetes mellitus. The client states, “My father has type 1 diabetes mellitus. Will I develop this disease as well?” How should the nurse respond? a) “Your risk of diabetes is higher than the general population, but it may not occur.” b) “No genetic risk is associated with the development of type 1 diabetes mellitus.” c) “The risk for becoming a diabetic is 50% because of how it is inherited.” d) “Female children do not inherit diabetes mellitus, but male children will.” 28. A nurse teaches a client who is diagnosed with diabetes mellitus. Which statement should the nurse include in this client’s plan of care to delay the onset of microvascular and macrovascular complications? a) “Maintain tight glycemic control and prevent hyperglycemia.” b) “Restrict your fluid intake to no more than 2 liters a day.” c) “Prevent hypoglycemia by eating a bedtime snack.” d) “Limit your intake of protein to prevent ketoacidosis.” 29. A nurse cares for a client with diabetes mellitus who asks, “Why do I need to administer more than one injection of insulin each day?” How should the nurse respond? a) “You need to start with multiple injections until you become more proficient at self-injection.” b) “A single dose of insulin each day would not match your blood insulin levels and your food intake patterns.” c) “A regimen of a single dose of insulin injected each day would require that you eat fewer carbohydrates.” d) “A single dose of insulin would be too large to be absorbed, predictably putting you at risk for insulin shock.” 30. A nurse assesses a client with diabetes mellitus and notes the client only responds to a sternal rub by moaning, has capillary blood glucose of 33 g/dL, and has an intravenous line that is infiltrated with 0.45% normal saline. Which action should the nurse take first? a) Administer 1 mg of intramuscular glucagon. b) Encourage the client to drink orange juice. c) Insert a new intravenous access line. d) Administer 25 mL dextrose 50% (D50) IV push. 31. 18.An emergency department nurse assesses a client with ketoacidosis. Which clinical manifestation should the nurse correlate with this condition? a) Increased rate and depth of respiration b) Extremity tremors followed by seizure activity c) Oral temperature of 102° F (38.9° C) d) Severe orthostatic hypotension 32. A nurse assesses a client who has diabetes mellitus. Which arterial blood gas values should the nurse identify as potential ketoacidosis in this client? a) pH 7.38, HCO 22 mEq/L, PCO 38 mm Hg, PO 98 mm Hg b) pH 7.28, HCO 18 mEq/L, PCO 28 mm Hg, PO 98 mm Hg c) pH 7.48, HCO 28 mEq/L, PCO 38 mm Hg, PO 98 mm Hg d) pH 7.32, HCO 22 mEq/L, PCO 58 mm Hg, PO 88 mm Hg 33. A nurse cares for a client experiencing diabetic ketoacidosis who presents with Kussmaul respirations. Which action should the nurse take? a) Administration of oxygen via face mask b) Intravenous administration of 10% glucose c) Implementation of seizure precautions d) Administration of intravenous insulin 34. A nurse teaches a client with diabetes mellitus who is experiencing numbness and reduced sensation. Which statement should the nurse include in this client’s teaching to prevent injury? a) “Examine your feet using a mirror every day.” b) “Rotate your insulin injection sites every week.” c) “Check your blood glucose level before each meal.” d) “Use a bath thermometer to test the water temperature.” 35. A nurse assesses a client with diabetes mellitus. Which clinical manifestation should alert the nurse to decreased kidney function in this client? a) Urine specific gravity of 1.033 b) Presence of protein in the urine c) Elevated capillary blood glucose level d) Presence of ketone bodies in the urine 36. A nurse assesses a client who has diabetes mellitus and notes the client is awake and alert, but shaky, diaphoretic, and weak. Five minutes after administering a half-cup of orange juice, the client’s clinical manifestations have not changed. Which action should the nurse take next? a) Administer another half-cup of orange juice. b) Administer a half-ampule of dextrose 50% intravenously. c) Administer 10 units of regular insulin subcutaneously. d) Administer 1 mg of glucagon intramuscularly. 37. A nurse reviews the laboratory results of a client who is receiving intravenous insulin. Which should alert the nurse to intervene immediately? a) Serum chloride level of 98 mmol/L b) Serum calcium level of 8.8 mg/dL c) Serum sodium level of 132 mmol/L d) Serum potassium level of 2.5 mmol/L 38. A nurse assesses a client who is being treated for hyperglycemic-hyperosmolar state (HHS). Which clinical manifestation indicates to the nurse that the therapy needs to be adjusted? a) Serum potassium level has increased. b) Blood osmolarity has decreased. c) Glasgow Coma Scale score is unchanged. d) Urine remains negative for ketone bodies. 39. A nurse reviews laboratory results for a client with diabetes mellitus who is prescribed an intensified insulin regimen: Fasting blood glucose: 75 mg/dL Postprandial blood glucose: 200 mg/dL Hemoglobin A1C level: 5.5% How should the nurse interpret these laboratory findings? a) Increased risk for developing ketoacidosis b) Good control of blood glucose c) Increased risk for developing hyperglycemia d) Signs of insulin resistance 40. A nurse teaches a client with diabetes mellitus about foot care. Which statements should the nurse include in this client’s teaching? (Select all that apply.) a) “Do not walk around barefoot.” b) “Soak your feet in a tub each evening.” c) “Trim toenails straight across with a nail clipper.” d) “Treat any blisters or sores with Epsom salts.” e) “Wash your feet every other day.” 41. A nurse provides diabetic education at a public health fair. Which disorders should the nurse include as complications of diabetes mellitus? (Select all that apply.) a) Stroke b) Kidney failure c) Blindness d) Respiratory failure e) Cirrhosis 42. The nurse is monitoring a client with hypoglycemia. Glucagon provides which function? a) It enhances the activity of insulin, restoring blood glucose levels to normal more quickly after a high-calorie meal. b) It is a storage form of glucose and can be broken down for energy when blood glucose levels are low. c) It converts excess glucose into glycogen, lowering blood glucose levels in times of excess. d) It prevents hypoglycemia by promoting release of glucose from liver storage sites. 43. Which client is at greatest risk for undiagnosed diabetes mellitus? a) Young, muscular white man b) Young African-American man c) Middle-aged Asian woman d) Middle-aged American Indian woman 44. A client with diabetes has frequent blood glucose readings higher than 300 mg/dL. Which action does the nurse teach the client about self-care? a) Check urine ketones when blood glucose readings are high. b) Increase the insulin dose after two high glucose readings in a row. c) Change the diet to include a 10% increase in protein. d) Work out on the treadmill whenever glucose readings are high. 45. The nurse has been reviewing options for insulin therapy with several clients. For which client does the nurse choose to recommend the pen-type injector insulin delivery system? a) Older adult client who lives at home alone but has periods of confusion b) Client on an intensive regimen with frequent, small insulin doses c) Client from the low-vision clinic who has trouble seeing the syringe d) “Brittle” client who has frequent episodes of hypoglycemia 46. The nurse is teaching a client with diabetes about self-care. Which activity does the nurse teach that can decrease insulin needs? a) Reducing intake of liquids to 2 L/day b) Eating animal organ meats high in insulin c) Limiting carbohydrate intake to 100 g/day d) Walking 1 mile each day 47. Three hours after surgery, the nurse notes that the breath of the client with type 1 diabetes has a “fruity” odor. Which is the nurse’s best first action? a) Document the finding in the client’s chart. b) Increase the IV fluid flow rate. c) Test the serum for ketone bodies. d) Perform pulmonary hygiene. 48. A client with a history of diabetes mellitus has new onset of microalbuminuria. Which component of the diet must the client reduce? a) Percentage of total calories derived from carbohydrates b) Percentage of total calories derived from proteins c) Percentage of total calories derived from fats d) Total caloric intake 49. The nurse is teaching a client with type 2 diabetes about acute complications. Which teaching point by the nurse is most accurate? a) Ketosis is less prevalent among obese adults owing to the protective effects of fat. b) People with type 2 diabetes have normal lipid metabolism, so ketones are not made. c) Insulin produced in type 2 diabetes prevents fat catabolism but not hyperglycemia. d) Oral antidiabetic agents do not promote the breakdown of fat for fuel (lipolysis). 50. A client was admitted with diabetic ketoacidosis (DKA). Which manifestations does the nurse monitor the client most closely for? a) Shallow slow respirations and respiratory alkalosis b) Decreased urine output and hyperkalemia c) Tachycardia and orthostatic hypotension d) Peripheral edema and dependent pulmonary crackles