Adult Health Jeopardy 3

ARDS/Ventilation

100

Which assessments should the nurse routinely perform for a client receiving mechanical ventilation? (select all that apply): a) Oxygen saturation levels every eight hours b) Heart rate and rhythm, urine output, and blood pressure every four hours c) Assess breath sounds every two to four hours d) Monitor serial chest x-rays and ABGs

c) Assess breath sounds every two to four hours d) Monitor serial chest x-rays and ABGs

200

A 40 year-old male client is admitted to the emergency department following a motor vehicle accident. Physical assessment reveals absent breath sounds in the left lower lobe. He is dyspneic and vital signs are: blood pressure 111/68, heart rate 124, respiratory rate 38, temperature 101.4, and SpO2 92% on room air. Which of the following actions should the nurse take first? a) Obtain a chest x-ray b) Prepare for chest tube insertion c) Administer oxygen via a high-flow mask d) Obtain IV access

c) Administer oxygen via a high-flow mask

300

Which of the following clients are NOT at risk for the development of ARF/ARDS? a) A client post-coronary artery bypass graft with two chest tubes b) A client with dysphagia c) A client with a sinus infection d) A 14 year-old boy who received two minutes of CPR following a near-drowning

c) A client with a sinus infection

400

Which action should be included in the plan of care for a client with a chest tube connected to a closed water-seal drainage system? a) Strip the chest tube frequently b) Position the drainage system at chest level c) Clamp the chest tube during transportation to x-ray d) Assist to cough, turn, deep breathe, and use incentive spirometry

d) Assist to cough, turn, deep breathe, and use incentive spirometry

500

The priority nursing diagnosis for a client requiring terminal weaning from a ventilator is: a) caregiver role strain b) anticipatory grieving c) altered family processes d) impaired verbal communication

b) anticipatory grieving

Diabeetus

100

A client with type 1 diabetes mellitus typically exhibits which clinical manifestations? a) anorexia, nausea, and vomiting b) increased energy and weight gain c) abdominal cramps and diarrhea d) increased thirst, blurred vision, fatigue

d) increased thirst, blurred vision, fatigue

200

What is the most common cause of type 2 diabetes mellitus in adults? a) stress b) obesity c) smoking history d) educational level

b) obesity

300

Complaints of pain, numbness, and tingling to the lower feet of a diabetic client are suggestive of which of the following? a) leg cramps b) kidney stones c) pitting edema d) peripheral neuropathy

d) peripheral neuropathy

400

Which of these findings suggest that the client may be experiencing a hypoglycemic reaction? a) fruity breath odor b) increased energy and thirst c) abdominal craps and diarrhea d) headache, hunger, blurred vision

d) headache, hunger, blurred vision

500

When assisting the diabetic client in planning a dietary regimen, it is important for the nurse to: a) encourage a low-calorie diet b) stress the importance of avoiding snacks c) develop the plan using input from the client only d) consider the availability of food, financial, and cultural constraints

d) consider the availability of food, financial, and cultural constraints

Diabeetus/Urinary

100

Which of these replacement fluids would be ordered for a client admitted with a blood glucose level of 300 mg/dL? a) D5W b) D10W c) 0.45 % saline d) Lactated Ringers

c) 0.45% saline

200

The nurse should administer which of these dietary supplements for an alert client suspected of exhibiting symptoms of hypoglycemia? a) a regular soda b) a glass of water c) a slice of lean meat d) a cup of juice sweetened with three packs of regular sugar

a) a regular soda

300

Which of the following collaborative interventions are appropriate to control or eliminate the client's incontinence? a) Limit total daily fluid intake b) Decrease or avoid caffeine c) Use Crede maneuver d) Increase intake of calcium supplements

b) Decrease or avoid caffeine

400

In teaching health-promotion measures in the prevention of urinary tract infections for a group of postmenopausal women, the nurse should stress which of the following measures? (select all that apply): a) Douche weekly b) Wear cotton briefs c) Avoid bubble baths d) Drink 2-2.5 quarts of fluid a day e) After voiding, wipe back-to-front

b) Wear cotton briefs c) Avoid bubble baths d) Drink 2-2.5 quarts of fluid a day

500

Which of these assessment findings is most suggestive of a diagnosis of a ureteral stone? a) Cloudy urine b) Distended bladder c) Microscopic hematuria d) Severe flank pain on the affected side

d) Severe flank pain on the affected side

Renal Disorders

100

Which of the following clinical findings are expected in clients with glomerulonephritis? a) Headache b) Pulse deficit c) Polyuria d) Hypotension

a) Headache

200

Which of the following signs and symptoms should the nurse NOT monitor for in clients with nephrotic syndrome? a) Hematuria b) Hyperkalemia c) Hypotension d) Peritonitis

c) Hypotension

300

In a client with acute renal failure, which of the following is the priority nursing intervention? a) Monitor serum potassium level b) Turn client every two hours c) Offer emotional support to family d) Assess breath sounds

a) Monitor serum potassium level

400

The nurse is preparing a teaching care plan for the client diagnosed with nephrotic syndrome. Which intervention should the nurse include? a) Discontinue the use of steroid therapy immediately if symptoms develop. b) Take diuretics as needed to treat the dependent edema in ankles. c) Increase intake of dietary sodium every day to decrease fluid retention. d) Report any decrease in daily weight to the HCP.

b) Take diuretics as needed to treat the dependent edema in ankles.

500

The nurse is preparing a plan of care for the client diagnosed with acute glomerulonephritis. Which would be a long-term goal? a) The client will have a blood pressure within normal limits b) The client will show no protein in the urine c) The client will maintain renal function d) The client will have clear lung sounds

c) The client will maintain renal function

Dialysis and Transplants

100

Which of the following nursing assessments and interventions should the nurse implement immediately prior to initiating hemodialysis? a) Assess hydration status b) Assess AV fistula for bruit c) Obtain blood glucose level d) Calculate total urine output for the night

b) Assess AV fistula for bruit

200

A client with end-stage renal disease (ESRD) has an elevated blood urea nitrogen level (BUN) of 60 mg/dL. Based on this lab finding, which of the following diets would the nurse expect to be ordered? a) puree diet b) clear liquids c) regular diet d) high carbohydrate and low-protein diet

d) high carbohydrate and low-protein diet

300

In developing a plan of care for a client undergoing chronic hemodialysis, the most appropriate nursing diagnosis would be: a) fatigue b) body-image disturbance c) altered urinary elimination d) self-care deficit in toileting

a) fatigue

400

In developing a plan of care for a client undergoing continuous ambulatory peritoneal dialysis, the MOST appropriate nursing diagnosis is: a) risk for infection b) ineffective coping c) activity intolerance d) fluid volume deficit

a) risk for infection

500

In preparing a kidney transplant patient for discharge, it is important for the nurse to include which of these instructions? a) Avoid daytime naps b) Avoid crowds and ill individuals c) Resume adding salt to your foods d) Stop taking medications upon feeling better

b) Avoid crowds and ill individuals