Midterm Review Questions Chapters: 30, 31, 36, 37

Question 1

The nurse assesses the chest of a patient with pneumococcal pneumonia. Which finding would the nurse expect?

a. Increased tactile fremitus

b. Dry, nonproductive cough

c. Hyperresonance to percussion

d. A grating sound on auscultation

Answer 1

a. Increased tactile fremitus

Question 2

A patient with bacterial pneumonia has coarse crackles and thick sputum. Which action would the nurse plan to promote airway clearance?

a. Restrict oral fluids during the day.

b. Encourage pursed-lip breathing technique.

c. Help the patient to splint the chest when coughing.

d. Encourage the patient to wear the nasal O2 cannula.

Answer 2

c. Help the patient to splint the chest when coughing.

Question 3

The nurse provides discharge instructions to a patient who was hospitalized for pneumonia. Which statement by the patient indicates a good understanding of the instructions?

a. “I will call my health care provider if I still feel tired after a week.”

b. “I will cancel my follow-up chest x-ray appointment if I feel better.”

c. “I will continue to do deep breathing and coughing exercises at home.”

d. “I will schedule two appointments for the pneumonia and influenza vaccines.”

Answer 3

c. “I will continue to do deep breathing and coughing exercises at home.”

Question 4

Which action would the nurse plan to prevent aspiration in a high-risk patient?

a. Turn and reposition an immobile patient at least every 2 hours.

b. Raise the head of the bed for a patient who is receiving tube feedings.

c. Insert a nasogastric tube for feeding a patient with high-calorie needs.

d. Monitor respiratory symptoms in a patient who is immunosuppressed.

Answer 4

b. Raise the head of the bed for a patient who is receiving tube feedings.

Question 5

A patient with right lower-lobe pneumonia has been treated with IV antibiotics for 3 days.

Which assessment data indicates that the treatment is effective?

a. Bronchial breath sounds are heard at the right base.

b. The patient coughs up small amounts of green mucus.

c. The patient’s white blood cell (WBC) count is 6000/L.

d. Increased tactile fremitus is palpable over the right chest.

Answer 5

c. The patient’s white blood cell (WBC) count is 6000/L.

Question 6

A patient has just been admitted with probable bacterial pneumonia and sepsis. Which prescribed action would the nurse implement first?

a. Chest x-ray via stretcher

b. Blood cultures from two sites

c. Ciprofloxacin (Cipro) 400 mg IV

d. Acetaminophen (Tylenol) suppository

Answer 6

b. Blood cultures from two sites

Question 7

A patient who has just been admitted with community-acquired pneumococcal pneumonia has a temperature of 101.6F with a frequent cough and severe pleuritic chest pain. Which prescribed medication would the nurse give first?

a. Codeine

b. Guaifenesin

c. Acetaminophen (Tylenol)

d. Piperacillin/tazobactam (Zosyn)

Answer 7

d. Piperacillin/tazobactam (Zosyn)

Question 8

A patient with pneumonia has a fever of 101.4F (38.6C), a nonproductive cough, and an O2 saturation of 88%. The patient is weak and needs assistance to get out of bed. Which patient problem would the nurse assign as the priority?

a. Fatigue

b. Altered temperature

c. Musculoskeletal problem

d. Impaired respiratory function

Answer 8

d. Impaired respiratory function

Question 9

The nurse supervises assistive personnel (AP) providing care for a patient who has right lower lobe pneumonia. Which action by the AP requires the nurse to intervene?

a. AP assists the patient to ambulate to the bathroom.

b. AP helps splint the patient’s chest during coughing.

c. AP transfers the patient to a bedside chair for meals.

d. AP lowers the head of the patient’s bed to 15 degrees.

Answer 9

d. AP lowers the head of the patient’s bed to 15 degrees.

Question 10

The nurse receives change-of-shift report on the following four patients. Which patient would the nurse assess first?

a. A 77-yr-old patient with tuberculosis (TB) who has four medications due

b. A 46-yr-old patient on bed rest who reports sudden onset of shortness of breath

c. A 35-yr-old patient with pneumonia who has a temperature of 100.2F (37.8C)

d. A 23-yr-old patient with cystic fibrosis who has pulmonary function testing scheduled

Answer 10

b. A 46-yr-old patient on bed rest who reports sudden onset of shortness of breath

Question 11

A patient who was admitted the previous day with pneumonia reports a sharp pain of 7 (on 0 to 10 scale) “whenever I take a deep breath.” Which action will the nurse take first?

a. Auscultate for breath sounds.

b. Administer as-needed morphine.

c. Have the patient cough forcefully.

d. Notify the patient’s health care provider.

Answer 11

a. Auscultate for breath sounds.

Question 12

Which health promotion information would the nurse include when teaching a patient with a 42 pack-year history of cigarette smoking? (SATA)

a. Resources for support in smoking cessation

b. Reasons for annual sputum cytology testing

c. Erlotinib (Tarceva) therapy to prevent tumor risk

d. Computed tomography (CT) screening for cancer

e. Importance of obtaining a yearly influenza vaccination

Answer 12

a. Resources for support in smoking cessation
d. Computed tomography (CT) screening for cancer
e. Importance of obtaining a yearly influenza vaccination

Question 13

The health care provider writes an order for bacteriologic testing for a patient who has a positive tuberculosis skin test. Which action would the nurse take?

a. Teach about the reason for the blood tests.

b. Schedule an appointment for a chest x-ray.

c. Teach the patient about providing specimens for 3 consecutive days.

d. Instruct the patient to collect several separate sputum specimens today.

Answer 13

c. Teach the patient about providing specimens for 3 consecutive days.

Question 14

A patient is hospitalized with active tuberculosis (TB). Which assessment finding indicates to the nurse that prescribed airborne precautions are likely to be discontinued?

a. Chest x-ray shows no upper lobe infiltrates.

b. TB medications have been taken for 6 months.

c. Mantoux testing shows an induration of 10 mm.

d. Sputum smears for acid-fast bacilli are negative.

Answer 14

d. Sputum smears for acid-fast bacilli are negative.

Question 15

The nurse teaches a patient about the transmission of pulmonary tuberculosis (TB). Which statement by the patient indicates that teaching was effective?

a. “I will take the bus instead of driving.”

b. “I will stay indoors whenever possible.”

c. “My spouse will sleep in another room.”

d. “I will keep the windows closed at home.”

Answer 15

c. “My spouse will sleep in another room.”

Question 16

A patient who is taking rifampin (Rifadin) for tuberculosis calls the clinic and reports having orange discolored urine and tears. Which response by the nurse reflects accurate knowledge about the medication and the patient’s illness?

a. Asking the patient about any visual changes in red-green color discrimination

b. Questioning the patient about experiencing shortness of breath, hives, or itching

c. Advising the patient to stop the drug and report the symptoms to the health care provider

d. Explaining that orange discolored urine and tears are normal while taking this medication

Answer 16

d. Explaining that orange discolored urine and tears are normal while taking this medication

Question 17

An older adult is receiving standard multidrug therapy for tuberculosis (TB). Which finding would the nurse report to the health care provider?

a. Yellow-tinged sclera

b. Orange-colored sputum

c. Thickening of the fingernails

d. Difficulty hearing high-pitched voices

Answer 17

a. Yellow-tinged sclera

Question 18

A patient diagnosed with active tuberculosis (TB) is homeless and has a history of chronic alcohol use. Which intervention by the nurse expect to be most effective in ensuring adherence with the TB treatment regimen?

a. Repeat warnings about the high risk for infecting others several times.

b. Give the patient written instructions about how to take the medications.

c. Arrange for a daily meal and drug administration at a community center.

d. Arrange for the patient’s friend to administer the medication on schedule.

Answer 18

c. Arrange for a daily meal and drug administration at a community center.

Question 19

After 2 months of prescribed treatment with isoniazid, rifampin, pyrazinamide, and ethambutol, a patient continues to have positive sputum smears for acid-fast bacilli (AFB). Which action would the nurse take next?

a. Teach about drug-resistant TB.

b. Schedule directly observed therapy.

c. Discuss injectable antibiotics with the health care provider.

d. Ask the patient whether medications were taken as directed.

Answer 19

d. Ask the patient whether medications were taken as directed.

Question 20

Employee health test results reveal a tuberculosis (TB) skin test of 16-mm induration and a negative chest x-ray for a staff nurse working on the pulmonary unit. The staff nurse has no symptoms of TB and has not had a positive TB skin test before. Which information would the occupational health nurse plan to teach the staff nurse?

a. Use and side effects of isoniazid

b. Standard four-drug therapy for TB

c. Need for annual repeat TB skin testing

d. Bacille Calmette-Guérin (BCG) vaccine

Answer 20

a. Use and side effects of isoniazid

Question 21

Which action, if performed by a nurse who is assigned to take care of a patient with active tuberculosis (TB), would require an intervention by the nurse supervisor?

a. The patient is offered a tissue from the box at the bedside.

b. A surgical face mask is applied before visiting the patient.

c. A snack is brought to the patient from the unit refrigerator.

d. Hand washing is performed before entering the patient’s room.

Answer 21

b. A surgical face mask is applied before visiting the patient.

Question 22

The nurse receives change-of-shift report on the following four patients. Which patient would the nurse assess first?

a. A 77-yr-old patient with tuberculosis (TB) who has four medications due

b. A 46-yr-old patient on bed rest who reports sudden onset of shortness of breath

c. A 35-yr-old patient with pneumonia who has a temperature of 100.2F (37.8C)

d. A 23-yr-old patient with cystic fibrosis who has pulmonary function testing scheduled

Answer 22

b. A 46-yr-old patient on bed rest who reports sudden onset of shortness of breath

Question 23

The nurse is performing tuberculosis (TB) skin tests in a clinic that has many patients who have immigrated to the United States. Which question is important for the nurse to ask before the skin test?

a. “Do you take any over-the-counter (OTC) medications?”

b. “Do you have any family members with a history of TB?”

c. “How long has it been since you moved to the United States?”

d. “Did you receive the Bacille Calmette-Guérin (BCG) vaccine for TB?”

Answer 23

d. “Did you receive the Bacille Calmette-Guérin (BCG) vaccine for TB?”

Question 24

A patient with a possible pulmonary embolism reports chest pain and difficulty breathing. The nurse finds a heart rate of 142 beats/min, blood pressure of 100/60 mm Hg, and respirations of 42 breaths/min. Which action would the nurse take first?

a. Administer anticoagulant drug therapy.

b. Notify the patient’s health care provider.

c. Prepare patient for a spiral computed tomography (CT).

d. Elevate the head of the bed to a semi-Fowler’s position.

Answer 24

d. Elevate the head of the bed to a semi-Fowler’s position.

Question 25

The nurse teaches a patient who has chronic bronchitis about a new prescription for combined fluticasone and salmeterol (Advair Diskus) in a dry powder inhaler. Which patient action indicates to the nurse that teaching about medication administration has been successful?

a. The patient shakes the device before use.

b. The patient rapidly inhales the medication.

c. The patient attaches a spacer to the device.

d. The patient performs huff coughing after inhalation.

Answer 25

b. The patient rapidly inhales the medication.

Question 26

The home health nurse teaches a patient how to administer formoterol (Perforomist) through a nebulizer. Which action by the patient indicates good understanding of the teaching?

a. The patient lies in supine position when using the nebulizer.

b. The patient removes the facial mask when the misting stops.

c. The patient reports washing the nebulizer mouthpiece weekly.

d. The patient inhales while holding the mask 4 inches away from the face.

Answer 26

b. The patient removes the facial mask when the misting stops.

Question 27

Which action would the nurse take to prepare a patient for spirometry?

a. Give the rescue medication immediately before testing.

b. Administer oral corticosteroids 2 hours before the procedure.

c. Withhold bronchodilators for 6 to 12 hours before the examination.

d. Ensure that the patient has been NPO for several hours before the test.

Answer 27

c. Withhold bronchodilators for 6 to 12 hours before the examination.

Question 28

Which information will the nurse include in the teaching plan for a patient newly diagnosed with asthma?

a. Use the inhaled corticosteroid when shortness of breath occurs.

b. Use the inhaled corticosteroid when shortness of breath occurs.

c. Hold your breath for 2 seconds after using the bronchodilator inhaler.

d. Tremors are an expected side effect of rapidly acting bronchodilators.

Answer 28

d. Tremors are an expected side effect of rapidly acting bronchodilators.

Question 29

The emergency department nurse is evaluating the outcomes for a patient who has received treatment during an asthma attack. Which assessment finding is the best indicator that the therapy has been effective?

a. O2 saturation is >90%.

b. No wheezes are audible.

c. Respiratory rate is 16 breaths/min.

d. Accessory muscle use has decreased.

Answer 29

a. O2 saturation is >90%.

Question 30

A patient seen in the asthma clinic has recorded daily peak flow rates that are 70% of the baseline. Which action will the nurse plan to take next?

a. Teach the patient about the use of oral corticosteroids.

b. Administer a bronchodilator and recheck the spirometry.

c. Recommend increasing the dose of the leukotriene inhibitor.

d. Instruct the patient to keep the scheduled follow-up appointment.

Answer 30

b. Administer a bronchodilator and recheck the spirometry.

Question 31

A 30-year-old patient who denies any history of smoking is seen in the clinic with a new diagnosis of chronic obstructive pulmonary disease (COPD). Which topic would the nurse plan to teach the patient?

a. A1-Antitrypsin testing

b. Leukotriene modifiers

c. Use of the nicotine patch

d. Continuous pulse oximetry

Answer 31

a. A1-Antitrypsin testing

Question 32

The home health nurse is visiting a patient with chronic obstructive pulmonary disease (COPD). Which action would the nurse implement for a patient who has an impaired breathing pattern due to anxiety?

a. Titrate O2 to keep saturation at least 90%.

b. Teach the patient how to use the pursed-lip technique.

c. Discuss a high-protein, high-calorie diet with the patient.

d. Suggest the use of over-the-counter sedative medications.

Answer 32

b. Teach the patient how to use the pursed-lip technique.

Question 33

A patient with chronic obstructive pulmonary disease (COPD) has been eating very little and has lost weight. Which intervention would be most important for the nurse to include in the plan of care?

a. Encourage increased intake of whole grains.

b. Increase the patient’s menu order of fruits and fruit juices.

c. Offer high-calorie protein snacks between meals and at bedtime.

d. Assist the patient in choosing foods with high vegetable content.

Answer 33

c. Offer high-calorie protein snacks between meals and at bedtime.

Question 34

The nurse interviews a patient with a new diagnosis of chronic obstructive pulmonary disease (COPD). Which information is specific in confirming a diagnosis of chronic bronchitis?

a. The patient relates a family history of bronchitis.

b. The patient has a 30 pack-year cigarette smoking history.

c. The patient reports a productive cough for 3 months of every winter.

d. The patient has respiratory problems that began during the past 12 months.

Answer 34

c. The patient reports a productive cough for 3 months of every winter.

Question 35

The nurse is admitting a patient diagnosed with an acute exacerbation of chronic obstructive pulmonary disease (COPD). How would the nurse determine the appropriate O2 flow rate?

a. Minimize O 2 use to avoid O 2 dependency.

b. Maintain the pulse oximetry level at 90% or greater.

c. Administer O 2 according to the patient’s level of dyspnea.

d. Avoid administration of O 2 at a rate of more than 2 L/min.

Answer 35

b. Maintain the pulse oximetry level at 90% or greater.

Question 36

A patient hospitalized with chronic obstructive pulmonary disease (COPD) is being discharged home on O2 therapy. Which instruction would the nurse include in the discharge teaching?

a. O2 use can improve the patient’s quality of life.

b. Travel is not possible with the use of O 2 devices.

c. O2 flow should be increased if the patient has more dyspnea.

d. Storage of O2 requires large metal tanks that last 4 to 6 hours.

Answer 36

a. O2 use can improve the patient‗s quality of life.

Question 37

The nurse develops a teaching plan to help increase activity tolerance at home for an older adult with severe chronic obstructive pulmonary disease (COPD). Which instructions would be appropriate for the nurse to include in the plan of care?

a. Walk until pulse rate exceeds 130 beats/min.
b. Stop exercising when you feel short of breath.
c. Walk 15 to 20 minutes a day at least 3 times/wk.
d. Limit exercise to activities of daily living (ADLs).

Answer 37

c. Walk 15 to 20 minutes a day at least 3 times/wk.

Question 38

A patient with severe chronic obstructive pulmonary disease (COPD) tells the nurse, “I wish I were dead! I am just a burden on everybody.” Based on this information, which patient problem would the nurse identify?

a. Fear of death

b. Low self-esteem

c. Anticipatory grieving

d. Lack of knowledge

Answer 38

b. Low self-esteem

Question 39

Which action by the nurse would support ventilation for a patient with chronic obstructive pulmonary disease (COPD).?

a. Encourage the patient to sit upright and lean forward.

b. Have the patient rest with the head elevated 15 degrees.

c. Place the patient in the Trendelenburg position with pillows behind the head.

d. Ask the patient to rest in bed in a high-Fowler’s position with the knees flexed.

Answer 39

a. Encourage the patient to sit upright and lean forward.

Question 40

When preparing a clinic patient who has chronic obstructive pulmonary disease (COPD) for pulmonary spirometry, which question would the nurse ask?

a. “Are you claustrophobic?”
b. “Are you allergic to shellfish?”
c. “Have you taken any bronchodilators today?”
d. “Do you have any metal implants or prostheses?”

Answer 40

c. “Have you taken any bronchodilators today?”

Question 41

The nurse provides dietary teaching for a patient with chronic obstructive pulmonary disease (COPD) who has a low body mass index (BMI). Which patient statement indicates that the teaching has been effective?

a. “I will drink lots of fluids with my meals.”

b. “I can have ice cream as a snack every day.”

c. “I will exercise for 15 minutes before meals.”

d. “I will decrease my intake of beef and poultry.”

Answer 41

b. “I can have ice cream as a snack every day.”

Question 42

Which instruction would the nurse include in an exercise teaching plan for a patient with chronic obstructive pulmonary disease (COPD)?

a. “Avoid upper body exercises to prevent dyspnea.”

b. “Stop exercising if you start to feel short of breath.”

c. “Use the bronchodilator before you start to exercise.”

d. “Breathe in and out through the mouth while exercising.”

Answer 42

c. “Use the bronchodilator before you start to exercise.”

Question 43

The nurse completes an admission assessment on a patient with asthma. Which information indicates a need for discussion with the health care provider about a change in therapy?

a. The patient uses an albuterol inhaler before aerobic exercise.

b. The patient’s only medications are albuterol and salmeterol inhalers.

c. The patient’s heart rate increases slightly after using the albuterol inhaler.

d. The patient used albuterol more often when symptoms were worse in the spring.

Answer 43

d. The patient used albuterol more often when symptoms were worse in the spring.

Question 44

The nurse takes an admission history on a patient with possible asthma who has new-onset wheezing and shortness of breath. Which information may indicate a need for a change in therapy?

a. The patient has chronic inflammatory bowel disease.

b. The patient has a history of pneumonia 6 months ago.

c. The patient takes propranolol (Inderal) for hypertension.

d. The patient uses acetaminophen (Tylenol) for headaches.

Answer 44

c. The patient takes propranolol (Inderal) for hypertension.

Question 45

A patient newly diagnosed with asthma is being discharged. Which topic would the nurse include in the discharge teaching?

a. Complications associated with O2 therapy

b. Use of long-acting b-adrenergic medications

c. Side effects of sustained-release theophylline

d. Self-administration of inhaled corticosteroids

Answer 45

d. Self-administration of inhaled corticosteroids

Question 46

Which assessment finding for a patient with a history of asthma indicates that the nurse would take immediate action?

a. Pulse oximetry reading of 91%

b. Respiratory rate of 26 breaths/min

c. Use of accessory muscles in breathing

d. Peak expiratory flow rate of 240 L/min

Answer 46

c. Use of accessory muscles in breathing

Question 47

A patient who is experiencing an asthma attack develops bradycardia and a decrease in wheezing. Which action would the nurse take first?

a. Notify the health care provider.

b. Document changes in respiratory status.

c. Encourage the patient to cough and deep breathe.

d. Administer IV methylprednisolone (Solu-Medrol).

Answer 47

a. Notify the health care provider.

Question 48

A patient who is experiencing an acute asthma attack is admitted to the emergency department. Which assessment would the nurse complete first?

a. Listen to the patient’s breath sounds.

b. Ask about inhaled corticosteroid use.

c. Determine when the dyspnea started.

d. Measure forced expiratory volume (FEV) flow rate.

Answer 48

a. Listen to the patient’s breath sounds.

Question 49

Which assessment finding in a patient who has received omalizumab (Xolair) is most important to report immediately to the health care provider?

a. Pain at injection site

b. Flushing and dizziness

c. Respiratory rate 24 breaths/min

d. Peak flow reading 75% of normal

Answer 49

b. Flushing and dizziness

Question 50

The nurse in the emergency department receives arterial blood gas results for 4 recently admitted patients with obstructive pulmonary disease. The results for which patient will require the most rapid action by the nurse?

a. pH 7.28, PaCO2 50 mm Hg, and PaO2 58 mm Hg

b. pH 7.48, PaCO2 30 mm Hg, and PaO2 65 mm Hg

c. pH 7.34, PaCO2 33 mm Hg, and PaO2 80 mm Hg

d. pH 7.31, PaCO2 58 mm Hg, and PaO2 64 mm Hg

Answer 50

a. pH 7.28, PaCO2 50 mm Hg, and PaO2 58 mm Hg

Question 51

Which nursing action for a patient with chronic obstructive pulmonary disease (COPD) could the nurse delegate to experienced assistive personnel (AP)?

a. Measure O 2 saturation using pulse oximetry.

b. Monitor for increased O2 need with exercise.

c. Teach the patient about safe use of O2 at home.

d. Adjust O2 to keep saturation in prescribed parameters.

Answer 51

a. Measure O 2 saturation using pulse oximetry.

Question 52

The nurse reviews the medication administration record (MAR) for a patient having an acute asthma attack. Which medication would the nurse administer first?

a. Methylprednisolone (Solu-Medrol) 60 mg IV

b. Albuterol (Ventolin HFA) 2.5 mg per nebulizer

c. Salmeterol (Serevent) 50 mcg per dry-powder inhaler (DPI)

d. Ipratropium (Atrovent) 2 puffs per metered-dose inhaler (MDI)

Answer 52

b. Albuterol (Ventolin HFA) 2.5 mg per nebulizer

Question 53

The nurse receives a change-of-shift report on the following patients with chronic obstructive pulmonary disease (COPD). Which patient would the nurse assess first?

a. A patient with loud expiratory wheezes

b. A patient with a respiratory rate of 38 breaths/min

c. A patient who has a cough productive of thick, green mucus

d. A patient with jugular venous distention and peripheral edema

Answer 53

b. A patient with a respiratory rate of 38 breaths/min

Question 54

Which action would the nurse in the hypertension clinic take to obtain an accurate baseline blood pressure (BP) for a new patient?

a. Deflate the BP cuff at a rate of 5 to 10 mm Hg per second.

b. Have the patient sit in a chair with the feet flat on the floor.

c. Assist the patient to the supine position for BP measurement.

d. Obtain two BP readings in the dominant arm and average the results.

Answer 54

b. Have the patient sit in a chair with the feet flat on the floor.

Question 55

Which information about a patient newly diagnosed with elevated blood pressure is most important for the nurse to address with the patient?

a. Low dietary fiber intake

b. No regular physical exercise

c. Drinks a beer with dinner every night

d. Weight is 5 pounds above ideal weight

Answer 55

b. No regular physical exercise

Question 56

Which action would the nurse take when giving the first dose of oral labetalol to a patient hospitalized with hypertension?

a. Encourage the use of hard candy to prevent dry mouth.

b. Teach the patient that headaches often occur with this drug.

c. Instruct the patient to call for help if heart palpitations occur.

d. Ask the patient to request assistance before getting out of bed.

Answer 56

d. Ask the patient to request assistance before getting out of bed.

Question 57

After the nurse teaches the patient with stage 1 hypertension about diet modifications, which diet choice indicates that the teaching has been effective?

a. The patient avoids eating nuts or nut butters.

b. The patient restricts intake of chicken and fish.

c. The patient drinks low-fat milk with each meal.

d. The patient has two cups of coffee in the morning.

Answer 57

c. The patient drinks low-fat milk with each meal.

Question 58

Which information would the nurse teach the patient who has been prescribed captopril?

a. Include high-potassium foods such as bananas in the diet.

b. Increase fluid intake if dryness of the mouth is a problem.

c. Change position slowly to help prevent dizziness and falls.

d. Check the blood pressure in both arms before taking the drug.

Answer 58

c. Change position slowly to help prevent dizziness and falls.

Question 59

Propranolol (Inderal) is newly prescribed for a patient diagnosed with hypertension. Which information in the patient’s history would prompt the nurse to consult with the health care provider before giving this drug?

a. Asthma

b. Daily alcohol use

c. Peptic ulcer disease

d. Myocardial infarction (MI)

Answer 59

a. Asthma

Question 60

A 62-year-old patient who has no history of hypertension has a blood pressure (BP) of 198/110 mm Hg during a routine wellness check. After reconfirming the BP, which information would the nurse provide to the patient?

a. A BP recheck should be scheduled in a few weeks.

b. Dietary sodium and fat content should be decreased.

c. Diagnosis, treatment, and monitoring will be needed.

d. There is danger of a stroke, requiring hospitalization.

Answer 60

c. Diagnosis, treatment, and monitoring will be needed.

Question 61

12. Which blood pressure (BP) finding by the nurse indicates that no changes in therapy are needed for a 48-year-old patient with newly diagnosed hypertension?

a. 98/56 mm Hg

b. 128/76 mm Hg

c. 128/92 mm Hg

d. 142/78 mm Hg

Answer 61

b. 128/76 mm Hg

Question 62

Which information is important for the nurse to include when teaching a patient newly diagnosed with hypertension?

a. Most people can control hypertension through dietary changes.

b. Annual BP checks are needed to monitor treatment effectiveness.

c. Hypertension is usually asymptomatic until organ damage occurs.

d. Increasing physical activity controls hypertension for most people.

Answer 62

c. Hypertension is usually asymptomatic until organ damage occurs.

Question 63

The nurse on the intermediate care unit received change-of-shift report on four patients with hypertension. Which patient would the nurse assess first?

a. 48-yr-old with a BP of 160/92 mm Hg who reports chest pain

b. 50-yr-old with a BP of 190/104 mm Hg whose creatinine is 1.7 mg/dL

c. 52-yr-old with a BP of 198/90 mm Hg who has intermittent claudication

d. 43-yr-old with a BP of 172/98 mm Hg whose urine shows microalbuminuria

Answer 63

a. 48-yr-old with a BP of 160/92 mm Hg who reports chest pain

Question 64

The nurse is reviewing the laboratory test results for a patient who has recently been diagnosed with hypertension. Which result is important to communicate to the healthcare provider?

a. Serum creatinine of 2.8 mg/dL

b. Serum potassium of 4.5 mEq/L

c. Serum hemoglobin of 14.7 g/dL

d. Blood glucose level of 96 mg/dL

Answer 64

a. Serum creatinine of 2.8 mg/dL

Question 65

A patient who has a history of hypertension treated with a diuretic and clonidine (Catapres) arrives in the emergency department. The patient reports a severe headache and nausea and has a blood pressure (BP) of 238/118 mm Hg. Which question would the nurse ask to follow up on these findings?

a. “Have you recently taken any antihistamines?”

b. “Have you consistently taken your medications?”

c. “Did you take any acetaminophen (Tylenol) today?”

d. “Have there been recent stressful events in your life?”

Answer 65

b. “Have you consistently taken your medications?”

Question 66

The nurse is assessing a patient who has been admitted to the intensive care unit (ICU) with a hypertensive emergency. Which finding is most urgent to report to the health care provider?

a. Urine output over 8 hours is 250 mL less than the fluid intake.

b. The patient cannot move the left arm and leg when asked to do so.

c. Tremors are noted in the fingers when the patient extends the arms.

d. The patient reports a headache with pain at level 7 of 10 (0 to 10 scale).

Answer 66

b. The patient cannot move the left arm and leg when asked to do so.

Question 67

A patient with hypertension who was prescribed atenolol (Tenormin) 2 weeks ago returns to the health clinic for a follow-up visit. The blood pressure (BP) is unchanged from the previous visit. Which action would the nurse take first?

a. Tell the patient why a change in drug dosage is needed.

b. Ask the patient if the medication is being taken as prescribed.

c. Review with the patient any lifestyle changes made to help control BP.

d. Teach the patient that multiple drugs are often needed to treat hypertension.

Answer 67

b. Ask the patient if the medication is being taken as prescribed.

Question 68

The registered nurse (RN) is caring for a patient with a hypertensive crisis who is receiving sodium nitroprusside. Which nursing action can the nurse delegate to an experienced licensed practical/vocational nurse (LPN/VN)?

a. Evaluate effectiveness of nitroprusside therapy on blood pressure (BP).

b. Assess the patient’s environment for adverse stimuli that might increase BP.

c. Titrate nitroprusside to decrease mean arterial pressure (MAP) to 115 mm Hg.

d. Set up the automatic noninvasive BP machine to take readings every 15 minutes.

Answer 68

d. Set up the automatic noninvasive BP machine to take readings every 15 minutes.

Question 69

The charge nurse observes a new registered nurse (RN) doing discharge teaching for a patient with hypertension who has a prescription for enalapril (Vasotec). Which statement by the new nurse to the patient requires the charge nurse’s intervention?

a. “Make an appointment with the dietitian for teaching.”

b. “Increase your dietary intake of high-potassium foods.”

c. “Check your blood pressure at home at least once a day.”

d. “Move slowly when moving from lying to sitting to standing.”

Answer 69

b. “Increase your dietary intake of high-potassium foods.”

Question 70

A patient is receiving IV furosemide to treat stage 2 hypertension. Which assessment finding is most important to report to the health care provider?

a. Blood glucose level of 175 mg/dL

b. Serum potassium level of 3.0 mEq/L

c. Orthostatic systolic BP decrease of 12 mm Hg

d. Current blood pressure (BP) reading of 168/94 mm Hg

Answer 70

b. Serum potassium level of 3.0 mEq/L

Question 71

Which action would the nurse take first to assist a patient with newly diagnosed stage 1 hypertension in making needed dietary changes?

a. Collect a detailed diet history.

b. Provide a list of low-sodium foods.

c. Help the patient make an appointment with a dietitian.

d. Teach the patient about foods that are high in potassium.

Answer 71

a. Collect a detailed diet history.

Question 72

The nurse is developing a teaching plan for a patient with coronary artery disease (CAD). Which factor would the nurse focus on during the teaching session?

a. Family history of coronary artery disease

b. Elevated low-density lipoprotein (LDL) level

c. Greater risk associated with the patient’s gender

d. Increased risk of cardiovascular disease with aging

Answer 72

b. Elevated low-density lipoprotein (LDL) level

Question 73

Which nursing intervention is likely to be most effective when assisting the patient with coronary artery disease to make dietary changes?

a. Inform the patient about a diet containing no saturated fat and minimal salt.

b. Emphasize the increased cardiac risk unless the patient makes dietary changes.

c. Help the patient modify favorite high-fat recipes by using monounsaturated oils.

d. Give the patient a list of low-sodium, low-cholesterol foods to include in the diet.

Answer 73

c. Help the patient modify favorite high-fat recipes by using monounsaturated oils.

Question 74

Which statement made by a patient with coronary artery disease indicates that further diet teaching is needed?

a. “I will switch from whole milk to 1% milk.”

b. “I like salmon and I will plan to eat it more often.”

c. “I can have a glass of wine with dinner if I want one.”

d. “I will miss being able to eat peanut butter sandwiches.”

Answer 74

d. “I will miss being able to eat peanut butter sandwiches.”

Question 75

Which assessment finding in a patient who has had coronary artery bypass grafting using a right radial artery graft is most important for the nurse to communicate to the health care provider?

a. Complaints of incisional chest pain

b. Pallor and weakness of the right hand

c. Fine crackles heard at both lung bases

d. Redness on both sides of the sternal incision

Answer 75

b. Pallor and weakness of the right hand