Skin Deep
Which finding during a skin assessment would be the most concerning according to the ABCDE rule for melanoma screening?
a. A flesh colored skin tag located on the neck
b. A lesion with irregular, ragged, and blurred edges
c. A scaly, rough path on the forehead on an older adult
d. A perfectly circular brown mole that is 4mm in diameter
b. A lesion with irregular, ragged, and blurred edges
The nurse is assessing a client experiencing a sympathetic "fight or flight" response due to acute stress. Which physiological finding should the nurse expect?
A. Decreased blood glucose levels
B. Constriction of the pupils
C. Increased heart rate and blood pressure
D. Increased gastrointestinal motility
C. Increased heart rate and blood pressure
A patient at the end of life is experiencing a "death rattle" due to the accumulation of respiratory secretions. Which medication should the nurse anticipate administering to manage this symptom?
A. Morphine
B. Lorazepam
C. Atropine
D. Ondansetron
C. Atropine
The nurse is caring for a client who has just had an episode of vomiting. What is the first intervention that the nurse would complete after the client has finished vomiting?
a. Assess the vital signs
b. Help the patient rinse their mouth
c. Prepare to administer an antiemetic
d. Document the volume of emesis
b. Help the patient rinse their mouth
A nurse is reviewing the laboratory results of a client suspected of having severe protein malnutrition. Which laboratory value should the nurse prioritize as the most sensitive indicator of the client's current nutritional status?
A. Albumin 3.2 g/dL
B. Prealbumin 4 mg/dL
C. BMI 17.5
D. Hemoglobin 11.0 g/dL
B. Prealbumin 4 mg/dL
A patient is scheduled for Mohs micrographic surgery to treat a skin lesion. How should the nurse describe this procedure to the patient?
a. The surgeon will use liquid nitrogen to freeze the lesion.
b. It is a procedure done in stages, removing layers of tissue until no cancer cells remain
c. The entire lesion and a wide margin of healthy skin are removed at once.
d. An electric spark is used to burn off the superficial tissue
b. It is a procedure done in stages, removing layers of tissue until no cancer cells remain
A client is being discharged with a prescription for a benzodiazepine (lorazepam) for acute anxiety. Which instruction is most important for the nurse to include in the teaching plan?
A. "Expect to see the full therapeutic effect of this medication in 4 to 6 weeks."
B. "Do not stop taking this medication abruptly; it requires a gradual taper."
C. "This medication is a GABA receptor antagonist and will increase alertness."
D. "There is no potential for abuse or addiction with this classification of drug."
B. "Do not stop taking this medication abruptly; it requires a gradual taper."
A patient with advanced cancer is receiving chemotherapy to shrink a tumor and reduce pain, while also receiving support from a palliative care team. How should the nurse best describe this care model to the family?
A. Palliative care and curative care cannot be provided at the same time.
B. Palliative care is strictly reserved for the final days of life.
C. Palliative and curative care can occur simultaneously to optimize quality of life.
D. Curative care focuses only on psychological and spiritual needs.
C. Palliative and curative care can occur simultaneously to optimize quality of life.
Which neuroreceptor is targeted by the medication ondansetron (Zofran), and where is it located?
5HT3, Chemoreceptor trigger zone (CTZ)
The nurse is educating a client on the physiological factors that regulate weight and appetite. The nurse explains that which hormone is released from fat cells to provide a feeling of satiety (fullness)?
A. Ghrelin
B. Insulin
C. Leptin
D. Glucagon
C. Leptin
A patient presents with intense itching that worsens at night and tiny, discolored “furrows” or tunnels between the fingers. Which condition should the nurse suspect?
a. Pediculosis capitis
b. Psoriasis vulgaris
c. Scabies
d. Tinea corporis
c. Scabies
The nurse is educating a client on the potential long-term complications of chronic stress and excessive sympathetic arousal. Which condition should the nurse include as a primary risk?
A. Hypotension
B. Arteriosclerotic changes
C. Enhanced immune system function
D. Improved cognitive appraisal
B. Arteriosclerotic changes
The nurse is using the Critical Care Pain Observation Tool (CPOT) to assess a terminally ill patient who is unable to communicate verbally. The nurse observes the patient "crying out and sobbing. " Which score should be assigned for the "Vocalization" sub-scale?
A. 0
B. 1
C. 2
D. 4
C. 2
A patient is experiencing motion sickness and vertigo. Which medication class is indicated to suppress the receptors in the vestibular apparatus?
a. Prokinetics
b. Selective serotonin antagonists
c. Dopamine antagonists
d. Histamine blockers
d. Histamine blockers
A client is being evaluated as a candidate for bariatric surgery. Which finding in the client’s medical history would the nurse identify as an exclusion criterion for the procedure?
A. BMI of 36 kg/m² with obstructive sleep apnea
B. Failure of previous non-surgical weight loss attempts
C. Current substance use disorder (SUD)
D. Type 2 diabetes with poor glycemic control
C. Current substance use disorder (SUD)
the provider orders a Tzanck smear for a patient with a blistering skin rash. The nurse understands this test is primarily used to identify:
a. Dermatophyte fungal infections.
b. Multinucleated giant cells associated with herpes viruses
c. The specific antibiotic sensitivity of a bacterial wound
d. High-risk types of Human Papillomavirus (HPV)
b. Multinucleated giant cells associated with herpes viruses
A nurse is practicing trauma-informed care while preparing a client for an invasive procedure. Which action by the nurse best demonstrates this approach?
A. Performing the procedure quickly to minimize the duration of the stressor.
B. Limiting the amount of information shared to avoid overwhelming the client.
C. Asking the client for permission before touching them or starting the procedure.
D. Ensuring the nurse maintains total control of the environment at all times.
C. Asking the client for permission before touching them or starting the procedure.
A registered nurse (RN) is preparing to pronounce the death of a patient in a healthcare facility. According to the provided Washington state regulations (WAC 246-840-830), which condition is required for the RN to assume this responsibility?
A. The RN must also certify the cause of death on the death certificate.
B. There must be written policies and procedures in the organization regarding RN pronouncement.
C. The patient must have been under the care of a licensed social worker.
D. The nurse must wait for a physician to be physically present before performing the assessment.
B. There must be written policies and procedures in the organization regarding RN pronouncement.
Which set of clinical findings would most strongly suggest that a patient is developing hypovolemic shock as a complication of vomiting?
a. hyperactive bowel sounds and abdominal pain
b. increased capillary refill and polyuria
c. tachycardia and low urine output
d. hypertension and bradycardia
c. tachycardia and low urine output
A client with a history of alcoholism is admitted to the hospital. Based on the factors associated with nutritional deficits, which consequence should the nurse monitor for most closely in this client?
A. Inadequate intake of high-fiber foods
B. Malabsorption due to decreased taste perception
C. Vitamin deficiencies and increased consumption of "empty" calories
D. Increased protein requirement due to increased catabolism
C. Vitamin deficiencies and increased consumption of "empty" calories
When assessing a patient with Herpes Zoster (Shingles), what characteristic distribution of lesions does the nurse expect to find?
a. Generalized vesicles covering the entire body
b. Circular, red patches with scaly borders on the trunk
c. Linear vesicles that follow a specific nerve dermatome
d. Pustules located primarily around hair follicles
c. Linear vesicles that follow a specific nerve dermatome
During a pathophysiology review of the stress response, the nurse identifies the sequence of the hypothalamus-pituitary-adrenal (HPA) axis. Which hormone is released by the pituitary gland to stimulate the adrenal cortex?
A. Corticotropin-releasing hormone (CRH)
B. Epinephrine (EPI)
C. Adrenocorticotropic hormone (ACTH)
D. Norepinephrine (NE)
C. Adrenocorticotropic hormone (ACTH)
The nurse is caring for a client who is actively dying. Which findings are expected?
Select all that apply.
A. Decreased appetite and fluid intake
B. Increased social interaction
C. Changes in breathing pattern
D. Increased need for sleep
E. Cool extremities
F. Increased urinary output
A. Decreased appetite and fluid intake
C. Changes in breathing pattern
D. Increased need for sleep
E. Cool extremities
Which medication is specifically mentioned as a treatment for pregnancy-related nausea?
a. metoclopramide
b. doxylamine
c. ondansetron
d. scopolamine
b. doxylamine
A nurse is assessing a client for malnutrition. Which findings should the nurse identify as indicators?
Select all that apply.
A. Unintentional weight loss
B. Muscle wasting
C. Delayed wound healing
D. Dry mucous membranes
E. Poor skin integrity
A. Unintentional weight loss
B. Muscle wasting
C. Delayed wound healing
E. Poor skin integrity