Exam (elaborations)
Health Restoration Nursing 3 - Exam 1 Study Questions
A in course Study materials for Health Restoration III, Exam 1 Professor White
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By: kungulaban • 1 day ago
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HR Exam 1 Review Questions1. After obtaining the information shown in the accompanying figure re-
garding a patient with Addison’s disease, which prescribed action will
the nurse take first? Reports fatigue, BP 76/40, HR 126, Sodium 123,
Bronze-colored skin, Poor skin turgor, RR 24, Potassium 5.1, Glucose
62, O2Sat 94%
A. Give 4 oz of fruit juice orally.
B. Recheck the blood glucose level.
C. Infuse 5% dextrose and 0.9% saline.
D. Administer oxygen therapy as needed.
ANS C: infuse 5% dextrose and 0.9% saline
—S/S Addison crisis; patient needs immediate correction of hypovolemia
and hyponatremia
2. Which problem should the nurse anticipate for a patient admitted to the hospital
with diabetes insipidus?
e. Generalized edema
f. Fluid volume overload
g. Disturbed sleep pattern
h. Decreased gas exchange
ANS C: disturbed sleep pattern
—frequent nocturne = disturbed sleep
3. A patient has just arrived on the unit after a thyroidectomy. Which ac-
tion should the nurse take first?
i. Observe the dressing for bleeding.
j. Check the blood pressure and pulse.
k. Assess the patient's respiratory effort.
l. Support the patient's head with pillows.
ANS C: Assess the patient’s respiratory effort
—Swelling, bleeding, letany
4. When a patients urine dipstick test indicates a small amount of protein,
the nurses next action should be to:
b. send a urine specimen to the laboratory to test for ketones.
c. obtain a clean-catch urine for culture and sensitivity testing.
d. inquire about which medications the patient is currently taking.
e. ask the patient about any family history of chronic renal failure.
ANS C: inquire about medications patient taking
,—normally the urinalysis will show zero to trace amounts of protein, but
some medications may give false- positive readings
5. A hospitalized patient with possible renal insufficiency after coronary
artery bypass surgery is scheduled for creatinine clearance test. Which
equipment will the nurse need to obtain?
a. Urinary catheter
b. Cleaning towelettes
c. Large container for urine
d. Sterile urine specimen cup
ANS C: large container for urine
—creatinine clearance testing involves a 24-hour urine specimen, the
nurse should obtain a large container for the urine collection.
6. Which medication taken at home by a 47-year-old patient with de-
creased renal function will be of most concern to the nurse?
e. ibuprofen (Motrin)
f. warfarin (Coumadin)
g. folic acid (vitamin B9)
h. penicillin (Bicillin LA)
ANS A: Ibuprofen
— nonsteroidal antiinflammatory medications (NSAIDs) are nephrotoxic
and should be avoided in patients with impaired renal function
7. The nurse completing a physical assessment for a newly admitted male
patient is unable to feel either kidney on palpation. Which action should
the nurse take next?
i. Obtain a urine specimen to check for hematuria.
j. Document the information on the assessment form.
k. Ask the patient about any history of recent sore throat.
l. Ask the health care provider about scheduling a renal ultrasound.
ANS B: document the information
— kidneys are protected by the abdominal organs, ribs, and muscles of the
back, and may not be palpable under normal circumstances, so no action
except to document the assessment information is needed.
8. How will the nurse assess for flank tenderness in a 30-year-old female
patient with suspected
pyelonephritis?
m. Palpate along both sides of the lumbar vertebral column.
n. Strike a flat hand covering the costovertebral angle (CVA).
o. Push fingers upward into the two lowest intercostal spaces.
, p. Percuss between the iliac crest and ribs along the midaxillary line.
ANS: B: strike a flat hand covering the CVA
—Checking for flank pain is best performed by percussion of the CVA and
asking about pain.
9. Which nursing action is essential for a patient immediately after a renal
biopsy?
f. Check blood glucose to assess for hyperglycemia or hypoglycemia.
g. Insert a urinary catheter and test urine for gross or microscopic hematuria.
h. Monitor the blood urea nitrogen (BUN) and creatinine to assess renal function
i. Apply a pressure dressing and keep the patient on the affected side for 30 min-
utes.
ANS D: Apply a pressure dressing
—A pressure dressing is applied and the patient is kept on the affected
side for 30 to 60 minutes to put pressure on the biopsy side and decrease
the risk for bleeding.
10. When working in the urology/nephrology clinic, which patient could
the nurse delegate to an experienced licensed practical/vocational nurse
(LPN/LVN)?
j. Patient who is scheduled for a renal biopsy after a recent kidney transplant
k. Patient who will need monitoring for several hours after a renal arteriogram
l. Patient who requires teaching about possible post-cystoscopy complications
m. Patient who will have catheterization to check for residual urine after voiding
ANS D: patient wil catheterization to check for radical urine after voiding
—LPN/LVN education includes common procedures such as catheterization
of stable patients. Other patient’s require complex care outside scope of
LPN
**11. It is most important that the nurse ask a patient admitted with acute
glomerulonephritis about
n. history of kidney stones.
o. recent sore throat and fever.
p. history of high blood pressure.
q. frequency of bladder infections.
ANS B: recent sore throat and fever
—Acute glomerulonephritis frequently occurs after a streptococcal infec-
tion such as strep throat.
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