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A patient is admitted to the hospital with a diagnosis of diarrhea with dehydration. The nurse recognizes that increased peristalsis resulting in diarrhea can be related to a. sympathetic inhibition. b. mixing and propulsion. c. sympathetic stimulation. d. parasympathetic stimulation. Correct Answers Correct answer: d Rationale: Peristalsis is increased by parasympathetic stimulation. A patient has an elevated blood level of indirect (unconjugated) bilirubin. One cause of this finding ...

A 74-yr-old patient has just arrived in the emergency department. After assessment reveals a pulse deficit of 46 beats, the nurse will anticipate that the patient may require a. emergent cardioversion. b. a cardiac catheterization. c. hourly blood pressure (BP) checks. d. electrocardiographic (ECG) monitoring. Correct Answers d Pulse deficit _________________________ Correct Answers is a difference between simultaneously obtained apical and radial pulses. It indicates that there may b...

The nurse obtains a health history from a 65-year-old patient with a prosthetic mitral valve who has symptoms of infective endocarditis (IE). Which question by the nurse is most appropriate? a. "Do you have a history of a heart attack?" b. "Is there a family history of endocarditis?" c. "Have you had any recent immunizations?" d. "Have you had dental work done recently?" Correct Answers ANS: d. Dental procedures place the patient with a prosthetic mitral valve at risk for infect...

When describing patient education approaches, the nurse educator would explain that informal teaching is an approach that a. follows formalized plans b. has standardized content c. often occurs one-to-one d. addresses group needs Correct Answers C. Informal teaching is individualized one on one teaching which represents the majority of patient education done by nurses that occurs when an intervention is explained or a question is answered. Group needs are often the focus of formal patient ...

In severely anemic patients, the nurse would expect to find: A. dyspnea and tachycardia B. cyanosis and pulmonary edema C. cardiomegaly and pulmonary fibrosis D. ventricular dysrhythmia and wheezing Correct Answers A. dyspnea and tachycardia When obtaining assessment data from a patient with a microcytic, hypochromic anemia, the nurse would question the patient about: A. folic acid intake B. dietary intake of iron C. a history of gastric surgery D. a history of sickle cell anemia Corr...

When caring for a patient with metastatic cancer, the nurse notes a hemoglobin level of 8.7 g/dL and hematocrit of 26%. What associated clinical manifestations does the nurse anticipate observing? A) Thirst B) Fatigue C) Headache D) Abdominal pain Correct Answers B) Fatigue The patient with a low hemoglobin and hematocrit is anemic and would be most likely to experience fatigue. Fatigue develops because of the lowered oxygen-carrying capacity that leads to reduced tissue oxygenation to ...

The home care nurse visits a 73-year-old Hispanic woman with chronic heart failure. Which clinical manifestations, if assessed by the nurse, would indicate acute decompensated heart failure (pulmonary edema)? Correct Answers B Severe dyspnea and blood-streaked, frothy sputum Clinical manifestations of pulmonary edema include anxiety, pallor, cyanosis, clammy and cold skin, severe dyspnea, use of accessory muscles of respiration, a respiratory rate > 30 breaths per minute, orthopnea, wheezi...

1. The student nurse studying the gastrointestinal system understands that chyme refers to what? a. Hormones that reduce gastric acidity b. Liquefied food ready for digestion c. Nutrients after being absorbed d. Secretions that help digest food Correct Answers b A client scheduled for a percutaneous transhepatic cholangiography (PTC) denies allergies to medication. What action by the nurse is best? a. Ask the client about shellfish allergies. b. Document this information on the chart. ...

1. Which action will the nurse include in the plan of care for a 42-year-old patient who is being admitted with Clostridium difficile? a. Educate the patient about proper food storage. b. Order a diet with no dairy products for the patient. c. Place the patient in a private room on contact isolation. d. Teach the patient about why antibiotics will not be used. Correct Answers ANS: C Because C. difficile is highly contagious, the patient should be placed in a private room and contact pre...

Following assessment of a patient with pneumonia, the nurse identifies a nursing diagnosis of ineffective airway clearance. Which assessment data best supports this diagnosis? a. Weak, nonproductive cough effort b. Large amounts of greenish sputum c. Respiratory rate of 28 breaths/minute d. Resting pulse oximetry (SpO2) of 85% Correct Answers ANS: A The weak, nonproductive cough indicates that the patient is unable to clear the airway effectively. The other data would be used to suppo...