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Adult Health Exam 4/825 Questions and Answers
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Adult Health Exam 4/825Questions and Answers
A 14-year-old girl and her mother come to see the nurse practitioner for
treatment of the daughter's acne. For what should the nurse assess the
patient to show the existence of acne?
Ulcers
Wheals
Vesicles
Pustules - -Pustules
Pustules are elevated, superficial lesions filled with purulent fluid, such as
those commonly associated with acne. Wheals, ulcers, and vesicles are not
common manifestations of acne.
-A 22-year-old female patient had a physical for a new job. Her blood
pressure was 110/68. At the health fair two months later, her blood pressure
is 154/96. What renal problem should the nurse be aware of that could
contribute to this abrupt rise in blood pressure?
Renal trauma
Renal artery stenosis
Renal vein thrombosis
Benign nephrosclerosis - -Renal artery stenosis
Renal artery stenosis contributes to an abrupt rise in blood pressure,
especially in people under 30 or over 50 years of age. Renal trauma usually
causes hematuria. Renal vein thrombosis causes flank pain, hematuria,
fever, or nephrotic syndrome. Benign nephrosclerosis usually occurs in
adults 30 to 50 years of age and is a result of vascular changes resulting
from hypertension.
-A 26-year-old patient tells the nurse that the patient is afraid to use the
treatment recommended for psoriasis because the patient's mother had a lot
of problems with all the creams she used to try to treat her psoriasis. How
should the nurse respond to the patient?
,"You will only know if you try it and see."
"You may need to get counseling to help you cope."
"No treatment is medically necessary, but it can be removed."
"Topical, light therapy, and systemic medications are now available." -
-"Topical, light therapy, and systemic medications are now available."
Treatment of psoriasis usually involves a combination of strategies, including
topical treatments, phototherapy, or systemic medications, including biologic
drugs. Telling the patient that he or she will only know if he or she tries it or
that the patient may need counseling is denying the patient's concern.
Psoriasis is treated to manage the disease, because the patient may have a
weakened immune system and be at risk for cardiovascular disease.
-A 30-year-old patient has been diagnosed with hypothyroidism. What
should the nurse expect to assess in this patient's integumentary system?
Warm, flushed skin, alopecia, and thin nails
General hyperpigmentation and loss of body hair
Pale skin, pale mucous membranes, hair loss, and nail dystrophy
Cold, dry, pale skin; dry, coarse hair; and brittle, slow growing nails - -Cold,
dry, pale skin; dry, coarse hair; and brittle, slow growing nails
With hypothyroidism the patient will manifest with cold, dry, pale skin; dry,
coarse, brittle hair; and brittle, slow growing nails. With hyperthyroidism the
patient will have warm, flushed skin, alopecia with fine soft hair, and thin
nails. With Addison's disease the patient will have loss of body hair and
generalized hyperpigmentation, especially in folds. With anemia, the patient
will display pallor, pale mucous membranes, hair loss, and nail dystrophy.
-A 54-year-old patient with diabetes mellitus has cellulitis of the right lower
extremity. Which assessment finding would the nurse expect on physical
examination?
Pallor of the right toes
Delayed capillary refill time
Hot, tender edematous area
Paresthesias of the right lower extremity - -Hot, tender edematous area
,Cellulitis is a diffuse, acute infection of the skin. It is characterized by
redness and hot, tender edematous area. These changes accompany the
processes of inflammation and infection. Delayed capillary refill time and
pallor of the toes would indicate a circulatory impairment, not infection.
Paresthesias would be indicative of poorly controlled diabetes.
-A 55-year-old patient with suspected bowel obstruction has had a
nasogastric tube inserted at 8:00 AM. The tube should be checked routinely
at which times?
9:00 AM, 10:00 AM, and 12:00 PM
8:30 AM and 2:30 PM
9:00 AM, 12:00 PM, and 3:00 PM
12:00 PM and 4:00 PM - -12:00 PM and 4:00 PM
A nasogastric tube should be checked routinely at four-hour intervals.
Therefore, if the tube were inserted at 8:00 AM, it would be due to be
checked at 12:00 PM and 4:00 PM. The other time intervals are not
consistent with appropriate times to monitor the nasogastric tube.
-A 56-year-old white patient presents with a flat, dry, scaly area on the
eyebrows that is treated with a chemical peel. What should the nurse include
in the discharge teaching?
Metastasis of this type of cancer is rare.
The patient has an increased risk for melanoma.
Recurrence of the premalignant lesion is possible.
Untreated lesions may metastasize to regional lymph nodes. - -Recurrence
of the premalignant lesion is possible.
The flat or elevated dry scaly area is actinic keratosis from sun damage and
is a premalignant skin lesion common in older whites, with possible
recurrence even with adequate treatment. Metastasis of basal cell carcinoma
is rare; it is a small, slowly enlarging papule. There is an increased risk for
melanoma with atypical or dysplastic nevi. With squamous cell carcinoma,
untreated lesions may metastasize to regional lymph nodes and distant
organs, but it has a high cure rate with early detection and treatment.
, -A 61-year-old patient with suspected bowel obstruction had a nasogastric
tube inserted at 4:00 AM. The nurse shares in the morning report that the
day shift staff should check the tube for patency at what times?
7:00 AM, 10:00 AM, and 1:00 PM
8:00 AM, 12:00 PM, and 4:00 PM
9:00 AM and 3:00 PM
9:00 AM, 12:00 PM, and 3:00 PM - -8:00 AM, 12:00 PM, and 4:00 PM
A nasogastric tube should be checked for patency routinely at four-hour
intervals. Thus, if the tube were inserted at 4:00 AM, it would be due to be
checked at 8:00 AM, 12:00 PM, and 4:00 PM.
-A 72-year-old patient was admitted with epigastric pain caused by a gastric
ulcer. Which patient assessment warrants an urgent change in the nursing
plan of care?
Chest pain relieved with eating or drinking water
Back pain three or four hours after eating a meal
Burning epigastric pain 90 minutes after breakfast
Rigid abdomen and vomiting following indigestion - -Rigid abdomen and
vomiting following indigestion
A rigid abdomen with vomiting in a patient who has a gastric ulcer indicates
a perforation of the ulcer, especially if the manifestations of perforation
appear suddenly. Midepigastric pain is relieved by eating, drinking water, or
antacids with duodenal ulcers, not gastric ulcers. Back pain three to four
hours after a meal is more likely to occur with a duodenal ulcer. Burning
epigastric pain one to two hours after a meal is from an expected
manifestation with a gastric ulcer related to increased gastric secretions and
does not cause an urgent change in the nursing plan of care.
-A 72-year-old patient was admitted with epigastric pain caused by a gastric
ulcer. Which patient assessment warrants an urgent change in the nursing
plan of care?
Chest pain relieved with eating or drinking water
Back pain three or four hours after eating a meal
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