Respiratory
-Barrel chest seen in chronic emphysema
1) The nurse is performing a respiratory assessment of an adult patient and is
attempting to distinguish The nurse should distinguish between these normal
breath sounds on what basis? Their location over a speci c area of the lung
2)The nurse is caring for a patient who has a pleural e usion and who underwent
a thorascopic procedure earlier in the morning. The nurse should prioritize
assessment for which of the following? shortness of breath
3)The ED nurse is assessing the respiratory function of a teenage girl who
presented with
acute shortness of breath. Auscultation reveals continuous wheezes during
inspiration and expiration. This nding is most suggestive what? asthma
4)A patient asks the nurse why an infection in his upper respiratory system is
a ecting the clarity speech? paranasal sinus
5) The conditions can a ect lung tissue compliance. The presence of what
condition would lead to an increase in lung compliance? emphysema
6) The exacerbation of her emphysema symptoms. When preparing to
auscultate, what breath sounds should the nurse anticipate? faint breath
sounds with prolonged expiration
7) The nurse assessed a 28-year-old woman who was experiencing dyspnea
severe enough to make her seek medical attention. The history revealed no prior
cardiac problems and the presence of symptoms for 6 months' duration. On
assessment, the nurse noted the presence of both inspiratory and expiratory
wheezing. Based on this data, which of the following diagnoses is likely?Asthma
8) While assessing for tactile fremitus, the nurse palpates almost no vibration.
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Which of the following conditions in this client's history will account for this
nding?
-Emphysema
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Test #3 review
a ects ventilation. A nurse is aware that a patient who has lost elasticity in the
lung tissue has a condition known as:-emphysema
10) The nurse is caring for a client who has recurrent sinusitis. Which
consideration could the nurse suggest to best decrease the frequency of
infections?-Administer an over-the-counter decongestant.
11) Which range of water pressure within the endotracheal tube cu is believed
to prevent both injury and aspiration? -15 to 20 mm Hg
12) Which of the following disease processes cause lead to increased lung
compliance?
-Emphysema
13) A patient comes to the clinic and is diagnosed with tonsillitis and adenoiditis.
What bacterial pathogen does the nurse know is commonly associated with
tonsillitis and adenoiditis? -Group A, beta-hemolytic streptococcus
14) A patient with asthma is prescribed a short acting beta-adrenergic (SABA) for
quick relief. Which of the following is the most likely drug to be prescribed?
-Proventil
15) The nurse is caring for a patient with advanced emphysema. which signs are
manifestations of the disorder? -productive cough, dyspnea, barrel chest,
cyanotic skin tone
The nurse admits a patient who has a diagnosis of acute asthma. Which
statement indicates that the patient may need teaching regarding medication
use? Ive been using my albuterol inhaler frequently over the last 4 days
A patient in metabolic alkalosis is admitted to the ED and pulse oximetry
indicates 94%. Which action should the nurse do next? Place the pt on highow oxygen
A patient experiencing an asthma attack is admitted to the ED. Which
assessment should the nurse complete rst? Listen to patients breath sounds
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The nurse in the ED receives ABGs for 4 admitted patients with obstructive
pulmonary disease. The results for which patient require the most rapid action?
pH-7.28, PaCo2-55
and PaO2-58
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9) Lung compliance (the ability of the lungs to stretch) is a physical factor that
A patient with COPD arrives in the ED reporting shortness of breath on minimal
exertion. Which assessment is most important for the nurse to report?
Respiratory rate of 10 breaths per minute
The nurse is caring for a patient who arrived in the ED with respiratory distress.
Which assessment nding requires the most rapid action? PaO2 is 45
A patient with chronic lung disease is undergoing lung functioning testing. What
test result denotes the volume of air inspired and expired with a normal breath?
Tidal volume
Vital capacity measures the maximal volume of air exhaled from the point of
maximal inspiration
Pulmonary function test measures how much air moves in and out of your lungs
when you breathe
The nurse is performing a respiratory assessment of an adult patient and is
attempting to distinguish vesicular, bronchovesicular and bronchial breath
sounds. The nurse should distinguish between these normal breath sounds on
what basis? Their location over a speci c area of the lung
pleural uid lubricates the movement of the thorax and lungs
The nurse is assessing the respiratory status of a patient who is experiencing an
exacerbation of her emphysema symptoms. When preparing to auscultate, what
breath sounds should the nurse anticipate? faint breath sounds with
prolonged expiration
The nurse has assessed a patients family history of three generations. The
presence of which respiratory disease would justify this type of assessment?
Asthma
The nurse is caring for a patient with COPD. The patient has been receiving
high- ow oxygen therapy for an extended time. What symptoms should the
nurse anticipate if the patient were experiencing oxygen toxicity? dyspnea and
substernal pain
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Mechanical ventilation and tracheostomy monitor the pressure in the cu at
least every 8 hours
The acute medical nurse is preparing to wean a patient from the ventilator.
Which assessment parameter is most important to assess? ABG levels
COPD requires precise oxygen delivery- Venturi mask
Women’s and Men’s Health
Women
1) What information should the nurse include when teaching a young women’s
community group about self-breast examination (BSE)? Performing BSE
after the menstrual period is more comfortable.
16) A patient has had left-sided lumpectomy (breast-conservation surgery) and
an axillary lymph node dissection. Which nursing intervention is appropriate to
delegate to a licensed practical/vocational nurse (LPN/LVN)?-Administering an
analgesic 30 minutes before scheduled arm exercise
3) A community health nurse is leading a health education session addressing
menopause and other aspects associated with womens health. What dietary
supplement should the nurse recommend to prevent morbidity associated with
osteoporotic features? Calcium and Vitamin D
5) The nurse is teaching breast self exams to a group of women. The nurse
should recommend that the women perform the BSE at what time? Between 5
and 7 days after menses.
28) the drug tamoxifen can reduce the chance of breast cancer.
29) A 62 year old woman diagnosed with breast cancer is scheduled for a partial
mastectomy. The oncology nurse explained that the surgeon will want to take
tissue samples to ensure that the disease has not spread to lymph nodes. What
alternative to lymph node dissection will the patient most likely undergo?
sentinel node biopsy
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5) The RN asked the student nurse to explain post-op physical changes that
occur to a patient who underwent a total abdominal hysterectomy. Which
statement made by the student nurse indicates e ective learning? You may
6) Which gynecologic patients does the charge nurse assign to the LPN? 23
year old is nauseated after her laparotomy and needs to receive antiemetic
drugs, 42 year old who had an abdominal hysterectomy whose HCP wants
to remove sutures at her bedside.
7) The nurse is performing discharge teaching for a patient who is recovering
from a total abdominal hysterectomy (TAH). Which patient statement indicates a
need for clari cation? I will need to nd a new form of birth control
4) A patient is on the surgical unit after total abdominal hysterectomy. Which
nding requires contacting the health care provider? Urine output of 125ml in
the rst 8 hours after surgery.
31) You are a community health nurse planning a program on breast cancer
screening for women. To best promote the learning, you would include? written
guidance for mammography and CBE; a discussion of the value of early
breast cancer detection
32) Risk factors for breast cancer? null parity, early menarche late
menopause, personal history of colon cancer
33) It is recommended to get mammogram every year after you turn 40
34) Which task could the RN delegate to a UAP during the care of a patient who
recently had transverse rectus abdomens musculocutaneous ap surgery?
mobilize the patient in a hunched position
reinforcing guidelines for hand and arm care
35) elevate the head of the bed to 3o degrees for a patient that has undergone
modi ed mastectomy in the great
36) perform breast exam (BSE) when lying down or showering, apply pressure
when palpating, stand in front of a mirror and inspect for abnormalities
37) 20 year old needs CBE (clinic breast exam) every 3 years until age 40
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38) A postmenopausal patient is undergoing treatment for breast cancer. To
decrease the patients risk for osteoporosis, which drug should the nurse
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have hot ushes, night sweats and vaginal dryness, if you ovaries are
removed.
anticipate will be prescribed? tamoxifen (eat ax seeds regularly to reduce
side e ects)
Autoimmune disease is higher in women
Amenrohea- no menses
Pap smear for early cervical cancer detection
Vitamins in place of hormone therapy for menopausal/ premen
Men’s
21) A 55-year old client with benign prostatic hyperplasia doesn’t respond to
medical treatment and is admitted to the facility for prostate gland removal.
Before providing preoperative and postoperative instructions to the client, Nurse
Gerry asks the surgeon which prostatectomy procedure will be done. What is
the most widely used procedure for prostate gland removal? -turp
20) After having transurethral resection of the prostate (TURP), Mr. Lim returns to
the unit with a three-way indwelling urinary catheter and continuous closed
bladder irrigation. Which nding suggests that the client’s catheter is occluded?The client reports bladder spasms and the urge to void.
19) A male client with acute pyelonephritis receives a prescription for co-
trimoxazole (Septra) P.O. twice daily for 10 days. Which nding best
demonstrates that the client has followed the prescribed regimen? -Bacteria
are absent in urine culture.
What should the nurse plan to teach a 57 year old man who is scheduled for
annual exam? PSA testing (Prostate antigen)
6) A patient has presented at the clinic with symptoms of benign prostatic
hyperplasia. What diagnostic ndings would suggest this patient has chronic
urinary retention? increased BUN
7) A 78 year old patient has been admitted with benign prostatic hyperplasia.
What is most appropriate to include in the nursing plan of care? Leave a light
on in the bathroom during the night
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8) A young male patient us seen at the primary care clinic and reports feeling
fullness after voiding with a split spraying urine stream. What should the nurse
ask about the patient’s history? Benign prostatic hyperplasia
10) Which question should the nurse ask when assessing a 60 year old patient
who has a history of BNP? Has there been a decrease in the force of your
urinary stream
11) What will the nurse ask the patient to determine the severity of BPH
symptoms? Force of urinary stream
12) A 70 year old patient who has had a TURP for BHP is being discharged
today. Which patient statement indicates a need for further instruction? I should
call the doctor if I have incontinence at home.
13) A patient with urinary obstruction from BPH tells the nurse that symptoms
are much worse this week. Which response by the nurse is appropriate? Have
you taken any OTC meds recently?
30) A 60 year old patient with a diagnosis of prostate cancer is scheduled to
have an interstitial implant for high dose radiation. What safety measure should
the nurse include in this patients plan of care? Limit the time at the bedside
STD’s
22) Reportable STI’s: syphilis, gonorhea, chlamydia, neonatal herpes, chancroid
Chlamydia s/s-discharge, dysuria, pelvic pain, irregular bleeding
Men and women
Chlamydia treatment-zithromax
PID can cause infertility and ectopic pregnancies
antibiotics, mild analgesics, rest in semi fowlers
1) Which patient would bene t from education about HIV preexposure
prophylaxis (PrEP)? A 52 year old recently single and diagnosed with
chlamydia
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9) A 76 year old with BPH is agitated and confused with a markedly distended
bladder. Which intervention prescribed by the HCP should the nurse implement
rst? Insert an indwelling catheter
2) A 20 year old female patient who is being seen in teh family medicine clinic for
an annual physical examination reports being sexually active. What topic should
the nurse plan to teach the patient? Testing for Chlamydia infection
3) A female patient is diagnosed with Chlamydia during a routine pelvic exam.
The nurse knows that teaching was successful when the patient says? My
partner will need to take antibiotics at the same time I do.
4) A nurse is caring for a pregnant patient with active herpes. The teaching plan
for this patient should include which of the following? Babies delivered
vaginally may become infected with the virus.
18) An infectious outbreak of unknown origin has occurred in a long-term care
facility. The nurse who oversees care at the facility should report the outbreak to
what organization? CDC
19) A 16-year-old male patient comes to the free clinic and is subsequently
diagnosed with primary syphilis. What health problem most likely prompted the
patient to seek care? chancre on penis
20) A patient on the medical unit is found to have pulmonary tuberculosis (TB).
What is the most appropriate precaution for the sta to take to prevent
transmission of this disease? Standard and airborne precautions
21) A clinic nurse is caring for a male patient diagnosed with gonorrhea who has
been prescribed ceftriaxone and doxycycline. The patient asks why he is
receiving two antibiotics. What is the nurses best response? Many patients
infected with gonorhea are infected with chlamydia as well
22) The nurse is caring for a patient with secondary syphilis. What intervention
should the nurse institute when caring for this patient? Wear gloves if contact
with lesions is possible.
23) A male patient comes to the clinic and is diagnosed with gonorrhea. Which
symptom most likely prompted him to seek medical attention? Foul-smelling
discharge from the penis
24) A patient who has had a positive RPR test, which action should the nurse
take rst? Ask the patient about past treatments for syphillis
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25) . A 20-yr-old female patient who is being seen in the family medicine clinic
for an annual physical examination reports being sexually active. The nurse will
plan to teach the patient about? testing for chlamydia infection
26) A patient is diagnosed with primary syphilis during her eighth week of
pregnancy. The nurse will plan to teach the patient about the IM injection on
Penicillin
27) Which patient will the nurse plan on teaching about the Gardasil vaccine? 24
year old female who has not been sexually active
18) A client comes to the outpatient department complaining of vaginal
discharge, dysuria, and genital irritation. Suspecting a sexually transmitted
disease (STD), Dr. Smith orders diagnostic tests of the vaginal discharge. Which
STD must be reported to the public health department? -gonorrhea
While taking a health history on 20 year old patient, the nurse ascertains that
this patient is taking miconazole (monistat). The nurse is justi ed in presuming
that this patient has what medical condition? Candidiasis
A patient with genital herpes is having an acute exacerbation. What medication
will the nurse expect to be ordered? Acyclovir (Zovirax)
A patient with gonorrhea should also be treated for chlamydia
vulvar surgery- Monitor the surgical site post op
Gray-white discharge that clings to external vulva- advise pt that this is an
overgrowth of normal ora.
A female patient with HIV has just been diagnosed with genital warts. What
information is most appropriate for the nurse to tell this patient? This condition
puts her at higher risk for cervical cancer therefore she should have a Pap
annually.
Ovarian cancer has clinical manifestation of increased abdominal girth
Most ovarian cancers are considered to be random with no obvious cause
A female patient tells the nurse that she thinks she has a vaginal infection
because she has noted in ammation in her vulva and the presence of a frothy,
yellow green discharge. The nurse recognizes this as? Trichomonas
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Candida albicans- cottage cheese-like discharge
The nurse is planning health education for a pt that has experienced a vaginal
infection. What guidelines should the nurse include in this program for
prevention? Avoid feminine hygiene products such a sprays
Herpes 2- treatment is aimed at relieving the symptoms and is not curable
genital herpes- hand washing is essential
weight loss for PCOS
endometriosis- acute pain related to misplaced endometrial tissues
Pelvic in ammatory disease, when providing education related to self care? Use
of condoms, appropriate use of antibiotics
genital herpes exacerbation- keep the lesion clean and dry
A public health nurse is participating in a campaign aimed at preventing cervical
cancer. What strategies should the nurse include in the campaign? SATA
Promote HPV vaccine, Encourage young women to delay rst intercourse,
smoking cessation, safe sex practice
Ileal Conduit
14) A 52-year-old patient is scheduled to undergo ileal conduit surgery. When
planning this patients discharge education, what is the most plausible nursing
diagnosis that the nurse should address? De cient knowledge related to care
of the ileal conduit
15) 12. A patient with cancer of the bladder has just returned to the unit from the
PACU after surgery to create an ileal conduit. The nurse is monitoring the
patients urine output hourly and noti es the physician when the hourly output is
less than what? 30ml
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16) A patient is postoperative day 3 following the creation of an ileal conduit for
the treatment of invasive bladder cancer. The patient is quickly learning to selfmanage the urinary diversion, but expresses concern about the presence of
mucus in the urine. What is the nurses most appropriate response? Ensure the
patient that this is expected
17) A patient has a concentration of S. aureus located on his skin. The patient is
not showing signs of increased temperature, redness, or pain at the site. The
nurse is aware that this is a sign of a microorganism at which of the following
stages? colonization
A male client with bladder cancer has had the bladder removed and an ileal
conduit created for urine diversion. While changing this client’s pouch, the nurse
observes that the area around the stoma is red, weeping, and painful. What
should Nurse Kaye conclude? -The pouch faceplate doesn’t t the stoma.
Osteoporosis, Osteomalacia and Scoliosis
1) Which action should the nurse take when caring for a patient with
osteomalacia? Teach about the use of vitamin D supplements.
3) An older adult patient has symptoms of osteoporosis and is being assessed
during her annual physical examination. The assessment shows that the patient
will require further testing related to a possible exacerbation of her osteoporosis.
The nurse should anticipate what diagnostic test? Bone densitometry
4) broccoli for osteoporosis
5) Caucasian women are at greatest risk for Osteoporosis
6) To prevent osteoporosis women need an adequate amount of sunshine
7) women over 50 need calcium 1200 and vitamin D 1000
31) A 72-year-old patient with kyphosis is scheduled for dual-energy X-ray
absorptiometry (DXA) testing. The nurse will plan to? explain the procedure
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32) The nurse is reinforcing health teaching about osteoporosis with a 72 year
old patient admitted to the hospital. In reviewing this disorder, what should the
nurse explain to the patient? Even with a family history of osteoporosis, the
calcium loss from bones can be slowed by increased calcium intake and
exercise.
33) The nurse determines that dietary teaching for a 75 year old patient with
osteoporosis has been successful when the patient selects which high calcium
meal? A sardine (3oz) sandwich on whole wheat bread, 1 cup of fruit yogurt,
and 1 cup of skim milk
34) The nurse is caring for a client with over ow urinary incontinence related to
diabetic neuropathy. Which of the following interventions are appropriate? SATA
encourage the client to bear down while attempting to void, inspect the
perineal area for evidence of skin breakdown, measure port void residual
volume as prescribed, tell the client to wait 30 seconds after voiding and
then attempt to void again
23) Which menu choice by a patient with osteoporosis indicates that the nurse’s
teaching about appropriate diet has been e ective? Oatmeal with skim milk
and fruit yogurt
27) Which action will the nurse take when caring for a patient with
osteomalacia? Teach about the use of Vitamin D supplements.
28) Musculoskeletal assessment is an important component of care for patients
on what type of long term therapy? Corticosteroids
29) A female patient with a long standing history of RA has sought care because
of increasing pain in her right knee that has culminated in complete xation of
the joint. The nurse would document the presence of which problem? ankylosis
30) Which medication will the nurse identify as a concern for a patient’s
musculoskeletal status? The patient has severe asthma and requires
frequent therapy with oral corticosteroids.
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Kyphosis is in the cervical
Scoliosis is in the lateral part of the spine
Lordosis is in the lumbar
Rheumatoid Arthritis
8) A nurse is providing care for a patient who has just been diagnosed as being
in the early stage of rheumatoid arthritis. The nurse should anticipate the
administration of which of the following? Methotrexate
9) A nurses plan of care for a patient with rheumatoid arthritis includes several
exercise-based interventions. Exercises for patients with rheumatoid disorders
should have which of the following goals? Preserve and increase range of
motion while limiting joint stress
10) A patient with rheumatoid arthritis comes into the clinic for a routine checkup. On assessment the nurse notes that the patient appears to have lost some
of her ability to function since her last o ce visit. Which of the following is the
most appropriate action? Arrange for the patient to be assessed in her home
11) The nurse is reviewing medical records for 5 patients who are coming for
their physical exam. Which patient should receive the inactivated u vaccine? 76
year old home resident, 36 year old pregnant female, 30 year old pt who
takes corticosteroids with rheumatoid arthritis
12) Rheumatoid arthritis: Take warm bath or shower upon arising, apply
warm compresses to joints, eating a balanced diet and omega 3 ,
exercising, administer Nsaids meds
2) A public health nurse is organizing a campaign that will address the leading
cause of musculoskeletal-related disability in the United States. The nurse
should focus on what health problem? Arthritis
24) The nurse suggests that a patient recently diagnosed with Rheumatoid
arthritis (RA) plan to start each day with a warm bath followed by a short rest
25) Which action will the nurse include in the plan of care for a patient with a
new diagnosis of RA? Encourage the patient to take a nap in the afternoon
26) A patient with RA complains to the clinic nurse about having chronic dry
eyes. Which action by the nurse is appropriate? Suggest the patient use OTC
arti cial tears
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A patients decreased mobility is ultimately the result of an autoimmune disorder
originating in the synovial tissue, which caused formation of panes. This patient
is most likely diagnosed with? Rheumatoid arthritis