ocial Aspects of Client Care Unit III Concepts of Health and Illness Unit IV Common Medical-Surgical Problems Unit V Caring for Clients with Respiratory Disorders Unit VI Caring for Clients with Cardiovascular Disorders Unit VII Caring for Clients with Hematopoietic and Lymphatic Disorders Unit VIII Caring for Clients with Immune Disorders Unit IX Caring for Clients with Neurologic Disorders Unit X Caring for Clients with Sensory Problems Unit XI Caring for Clients with Gastrointestinal Problems Unit XII Caring for Clients with Endocrine Problems Unit XIII Disturbances of Sexual Structures or Reproductive Function Unit XIV Caring for Clients with Urinary and Renal Problems Unit XV Caring for Clients with Musculoskeletal Problems Unit XVI Caring for Clients with Integumentary Problems Appendix: Answers MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 1) The nurse is assisting a postoperative client in using an incentive spirometer. Which of the following postoperative complications is this nurse attempting to avoid with this client? 1) A) Hemorrhage B) Pulmonary embolism C)Deep vein thrombosis D) Atelectasis 2) A client who is recovering from abdominal surgery has a penrose drain. Which of the following should the nurse include in the care of this client? 2) A)Make sure there is a safety pin on the end of the drain. B) Clean the wound with normal saline every two hours. C) Empty the drain every 30 minutes. D) Remove the drain four hours postoperatively. 3) A client is in the recovery room. Which of the following members of the healthcare team should the nurse contact regarding the client's level of pain control? 3) A)The surgeon B) The anesthesiologist C)The scrub nurse D) The circulating nurse 4) During the assessment of a postoperative client's bowel sounds, the nurse auscultates high-pitched sounds over all four abdominal quadrants. The nurse realizes this finding could indicate: 4) A) Normal bowel function. B) The onset of stool. C)The onset of flatus. D) Paralytic ileus. 5) A client is being transferred from the operating room to the recovery room. The nurse in the recovery room will be providing which phase of nursing care? 5) A) Intraoperative B) Preoperative C)Restorative D) Postoperative 6) A client is being scheduled for surgery. Which of the following should be included in the preoperative teaching provided by the nurse? 6) A) The credentials of the anesthesiologist B) Information concerning the surgical procedure which will be performed by the surgeon C) Cost of the procedure D) Planned length of stay at the hospital 7) A client is being positioned for a hip replacement procedure. In which of the following positions will this client most likely be placed? 7) A)Dorsal recumbent B) Lateral chest C)Semi-sitting D) Prone 8) A postoperative client tells the nurse, "A book I read said that I should not eat after surgery for at least a week." Which of the following statements would be an appropriate nursing response? 8) A) "You don't need any food to heal anyway." B) "That's true." C) "That's not true. You could get an infection in your stomach." D) "I'll be giving you intravenous feedings anyway." 9) An elderly postoperative client is given an antiemetic for nausea. Which of the following signs would indicate this client is experiencing a possible reaction to the medication? 9) A) Dry mouth B) Involuntary muscle movements C)Breakthrough vomiting D)Confusion 10) A client is signing a surgical consent. Afterwards, the nurse also signs the form. What is the meaning of the nursing si gnature? 10) A) It means the client was alert and aware of what was being signed. B) It means there is a likelihood of a successful outcome. C) It means the client understood the procedure as described by the nurse. D) It means the surgeon was too busy to wait for the client to sign the form. 11) A client's endotracheal tube is being removed after the surgical procedure. The intra-operative nurse realizes this client is in which phase of the general anesthesia process? 11) A) Induction B) Maintenance C)Reduction D) Emergence 12) An elderly client is being prepared for orthopedic surgery. The nurse realizes this client is at risk for which of the following? 12) A) Prolonged effects of anesthesia because of herbal supplements B)Decreased tolerance of general anesthesia C)Increased hypotensive effects of anesthesia D)Wound dehiscence 13) The client who is preparing for surgery asks the nurse to keep their glasses and hearing aid in-place until they are under anesthesia. Which of the following statements by the nurse demonstrates accurate, therapeutic communication? 13) A) "I will contact the surgery department to discuss you requests." B)"Certainly, you can keep them for that time." C) "You cannot keep those in." D) "The policies in the surgery unit will not allow it." 14) A client has just arrived in the recovery room. How often should the nurse assess the client? 14) A) Every 15 minutes for 30 minutes and then every one hour afterwards. B) Every 15 minutes for the first hour. C) Every hour. D) Every two hours. 15) A client who is being admitted for surgery asks the nurse why information is being collected about the client's use of herbal and natural supplements. Which of the following statements is an appropriate nursing response? 15) A) "The physician is in charge of medications." B) "Herbal supplements may interact with anesthesia agents." C) "Herbal remedies may cause pain relievers to be ineffective." D) "There is no need to take these preparations." 16) An elderly client is completing preoperative diagnostic testing. The nurse notes that the client's carbon dioxide level is elevated. Which of the following nursing interventions would be indicated for this client? 16) A) Monitor serum sodium level. B) Monitor serum potassium level. C) Monitor respiratory status and arterial blood gases. D) Monitor intake and output. 17) A client is prescribed patient-controlled analgesia for postoperative pain. Which of the following should the nurse instruct the client about this analgesia? 17) A)"Use this analgesia every hour on the hour." B) "Use this analgesia only when the pain is extremely severe." C) "Avoid the use of this because of the risk of addiction." D) "Use this analgesia regularly." 18) A client has received conscious sedation for a surgical procedure. The nurse realizes this client will most likely: 18) A) Respond to physical and verbal stimuli. B) Not respond to any stimuli. C) Need an endotracheal tube inserted. D) Need blood product replacements. 19) A client is in his fifth postoperative day and has sanguineous drainage with a thick, reddish appearance. The nurse realizes this client's wound is in which stage of healing? 19) A) Stage III B) Stage IV C) Stage I D) Stage II 20) A recovery room nurse is consulting with a circulating nurse about a client who is having a surgical procedure. These nurses are most likely in which zone of the surgical department? 20) A) Banned B) Semi-restricted C)Restricted D) Unrestricted 21) A nurse has delegated the collection of vital signs, including blood pressure readings, to two unlicensed assistive personnel. The of this work means the nurse is: 21) A) Not accountable for these vital signs. B)Responsible to re-measure all of the vital signs. C)Not responsible for these vital signs. D)Accountable for the care that was delegated. 22) The nurse working on a quality improvement study wants to evaluate a client care process. Which of the following can the nurse use to evaluate this process? 22) A) Variance analysis B) Critical pathway C)Evidence-based practice D) Nursing process 23) The new nurse is studying the five core competencies for healthcare providers. Which of the following are a part of these core competencies? (Select all that apply.) 23) A) Work in interdisciplinary teams. B) Use informatics to deliver care. C) Use evidence-based practice. D) Replace quality improvement initiatives with work redesign methods. E) Use primary nursing to deliver care. 24) A client tells the nurse, "I have an advance directive that I want you to follow." Which of the following will this document provide for the nurse? 24) A) A complete plan of care for the client B) The answers to any care dilemmas for the client C) The client's preferences for healthcare should the client become mentally incapacitated D) Directions regarding when to use universal precautions for the client 25) Client chart audits provide the nurses with information that impacts the future outcomes of client care. What should the nurses do with this information? 25) A)Use the information to create an action plan to address any negative findings. B) Nothing C) Submit it to the agency's accrediting body. D) Place it in a file to compare with the next set of audits. 26) The nurse is preparing a client to go home. Which of the following skills are the most important for the nurse to adequately prepare this client? 26) A)Familiarity with adult learning principles B) The ability to support client decision making C) The ability to use critical thinking D) The ability to follow written orders 27) The nurse is implementing a plan of care for a client. After providing care, what should the nurse do as the final step in the process? 27) A) Reassess the client. B) Give the charge nurse a report. C)Document D)Nothing 28) At the completion of an assessment, the nurse chooses a nursing diagnosis that best defines the client's health problems. Which type of clinical judgment will this nurse use? 28) A) Diagnostic reasoning B) Evidence-based practice C)Nursing process D) Critical pathway All answers are at the end of this document 29) A client tells the nurse, "I have pain in my leg when I stand too long." This information would be considered: 29) A) Subjective data B) Objective data C)Evaluative data D) Qualitative data 30) The nurse is consulting a critical pathway to help make client care decisions. Which type of care delivery model is this nurse most likely using to provide client care? 30) A) Team nursing B) Primary nursing C)Functional nursing D) Case management 31) While providing care to a client, the nurse stops to assess a new client problem. The assessment in this situation would be: 31) A) An objective assessment B) An initial assessment C)A focused assessment D) A subjective assessment 32) A graduate nurse is attending a seminar regarding the role of the nurse as a client advocate. After the session, the students engage in a discussion. Which of the following statements by the graduate nurse indicates the need for further education? 32) A) "Being a client advocate entails making efforts to improve client outcomes." B) "Client advocates have the authority to make decisions for the client." C)"Communicating client needs to the members of the healthcare team is a role of the client advocate." D)"Providing education to the client and family is a key way to be a positive client advocate." 33) The nurse is using a specific process to plan smoking cessation activities for a client. Which of the following is this nurse most likely using to plan the care for this client? 33) A) Evidence-based practice B) Nursing process C)Variance analysis D) Critical pathways 34) The nurse is creating outcome criteria for the nursing diagnoses for a client. Which of the following should the nurse include when creating the criteria? 34) A)They should be written as psychomotor only. B) They should be written to address the client, and be time-specific and measurable. C) They should be written as statements. D) They should be written as nursing goals. 35) The nurse stops to think about a previous client care situation before providing care to a current client. This nurse is using what critical thinking skill? 35) A)Divergent thinking B) Reflection C)Reasoning D) Clarifying 36) A client care issue has been raised about the actions taken by a nurse who was asked to provide care to a client whose healthcare decisions were considered controversial. The unit's nurse manager is concerned that care was not appropriately provided. Which of the following should be consulted to protect the client and to evaluate the care in question? 36) A) Nursing code of ethics B) Hospital quality improvement guidelines C) Critical pathway D) Nurse practice act 37) The nurse is reviewing the outcome of client care that was provided. Which of the following nursing process steps should the nurse use next? 37) A)Implementation B) Planning C)Assessment D) Evaluation 38) The nurse is preparing to provide client care information to a group of unlicensed assistive personnel. Which type of care delivery system is this nurse most likely using to provide client care? 38) A) Primary nursing B) Team nursing C)Functional nursing D) Case management 39) A new nurse tells her mentor "you always seem so poised when you interact with the client. It is as if you always know what to do. Can you teach me how to do that?" What characteristic does this mentor possess in relation to critical thinking? 39) A) Independent thinking B) Discipline C)Empathy D) Self-confidence 40) Which of the following best demonstrates a nurse using critical thinking when providing client care? 40) A) A nurse checks a laboratory manual before providing care. B) A nurse lists alternative interventions available to provide client care. C) A nurse checks every intervention with the charge nurse before providing care. D) A nurse is confused when the only planned intervention fails to help a client. SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 41) The nurse assesses a client's weight loss as being 22 lbs. How many liters of fluid did this client lose? 41) MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 42) A client is admitted with hypernatremia caused by being stranded on a boat in the Atlantic Ocean for five days without a fresh water source. Which of the following is this client at risk for developing? 42) A) Pulmonary edema B) Stress fractures C)Atrial dysrhythmias D) Cerebral bleeding 43) The blood gases of a client with an acid-base disorder show a blood pH outside of normal limits. The nurse realizes that this client is: 43) A) Fully compensated. B) In need of intravenous fluids. C)Demonstrating anaerobic metabolism. D)Partially compensated. 44) A client with fluid retention related to renal problems is admitted to the hospital. The nurse realizes that this client could possibly have which of the following electrolyte imbalances? 44) A) Hypokalemia B) Magnesium C)Carbon dioxide D) Hypernatremia 45) An elderly client who is being medicated for pain had an episode of incontinence. The nurse realizes that this client is at risk for developing: 45) A) Fecal incontinence. B) Dehydration. C)Over-hydration. D) A stroke. 46) The nurse is reviewing a client's blood pH level. Which of the systems in the body regulate blood pH? (Select all that apply.) 46) A) Buffers B) Respiratory C)Renal D) Cardiac 47) A client is prescribed 20 mEq of potassium chloride. The nurse realizes that the client is receiving this replacement: 47) A) To help regulate acid-base balance. B) To keep a vein open. C) To sustain respiratory function. D) To encourage urine output. 48) An elderly client with peripheral neuropathy has been taking magnesium supplements. The nurse realizes that which of the following symptoms can indicate hypermagnesemia? 48) A) Excessive urination B)Hyper reflexia C)Hypotension, warmth, and sweating D)Nausea and vomiting 49) An elderly client with a history of sodium retention arrives to the clinic with the complaints of "heart skipping beats" and leg tremors. Which of the following should the nurse ask this client regarding these symptoms? 49) A) "Are you using a salt substitute?" B) "Were you doing any unusual physical activity?" C) "Have you stopped taking your digoxin medication?" D) "When was the last time you had a bowel movement?" 50) A client who is taking digoxin (Lanoxin) is admitted with possible hypokalemia. Which of the following does the nurse realize might occur with this client? 50) A) A higher dose of digoxin (Lanoxin) may be needed. B) A diuretic may be needed. C) Digoxin toxicity D) Fluid volume deficit 51) The nurse is admitting a client who was diagnosed with acute renal failure. Which of the following electrolytes will be most affected with this disorder? 51) A)Phosphorous B) Calcium C)Potassium D) Magnesium 52) A client is admitted with burns over 50% of his body. The nurse realizes that this client is at risk for which of the following electrolyte imbalances? 52) A)Hypophosphatemia B) Hypernatremia C)Hypercalcemia D) Hypermagnesemia 53) The nurse observes a client's respirations and notes that the rate is 30 per minute and the respirations are very deep. The metabolic disorder this client might be demonstrating is: 53) A) Hypertension. B) Pain. C) Increasing carbon dioxide in the blood. D)Hypernatremia. 54) A client is admitted for treatment of hypercalcemia. The nurse realizes that this client's intravenous fluids will most likely be: 54) A) Dextrose 5% and ½ normal saline. B) Normal saline. C) Dextrose 5% and water. D) Dextrose 5% and ¼ normal saline. 55) An elderly postoperative client is demonstrating lethargy, confusion, and a respiratory rate of 8 per minute. The nurse sees that the last dose of pain medication administered via a patient controlled anesthesia (PCA) pump was within 30 minutes. Which of the following acid-base disorders might this client be experiencing? 55) A) Metabolic acidosis B) Respiratory alkalosis C)Metabolic alkalosis D) Respiratory acidosis 56) A 28-year-old male client is admitted with diabetic ketoacidosis. The nurse realizes that this client will have a need for which of the following electrolytes? 56) A) Sodium B) Magnesium C)Calcium D) Potassium 57) An elderly client does not complain of thirst. What should the nurse do to assess that this client is not dehydrated? 57) A) Ask the physician to order a chest x-ray. B) Assess the urine for osmolality. C) Ask the physician for an order to begin intravenous fluid replacement. D) Ask the physician for an order for a brain scan. 58) An elderly client is at home after being diagnosed with fluid volume overload. Which of the following should the home care nurse instruct this client to do? 58) A) Avoid wearing shoes while in the home. B) Try to sleep without extra pillows. C) Keep legs in a dependent position. D) Wear support hose. 59) An elderly client comes into the clinic with the complaint of watery diarrhea for several days with abdominal and muscle cramping. The nurse realizes that this client is demonstrating: 59) A) Hyponatremia. B) Fluid volume excess. C)Hyperkalemia. D) Hypernatremia. 60) A client's blood gases show a pH greater of 7.53 and bicarbonate level of 36 mEq/L. The nurse realizes that the acid-base disorder this client is demonstrating is: 60) A) Respiratory acidosis. B) Metabolic alkalosis. C)Respiratory alkalosis. D) Metabolic acidosis. 61) After abdominal surgery a client has difficulty coughing, saying, "It hurts too much." The nurse teaches the client to: 61) A) support the abdomen with a pillow during the coughing exercises. B) ask for pain medication if the pain is severe. C) turn and deep breathe without coughing. D) cough without straining the abdomen. 62) The preoperative client asks the nurse for some tea before surgery. The nurse explains that it is important to have nothing by mouth (NPO) prior to surgery to prevent: 62) A) aspiration. B) urine formation. C)hyperglycemia. D) abdominal cramping. 63) A nurse is preparing to discharge a client who has had outpatient surgery. It is important for the nurse to assess the client's: 63) A) family support at home. B) food preferences. C)knowledge of sterile technique. D)understanding of the surgical procedure. 64) When changing the client's sterile dressings on the second postoperative day, the nurse notes that the suture line is red and slightly inflamed. The nurse recognizes these findings are: 64) A) abnormal and need to be documented. B) normal signs of the inflammatory response. C) abnormal and need to be reported to the charge nurse. D) signs of infection and need to be reported to the physician. 65) During the preoperative assessment, the nurse learns that the client had gestational diabetes with her three pregnancies. The nurse will obtain an order for the following test: 65) A) electrolytes. B)urinalysis. C) partial thromboplastin time (PTT). D) blood sugar. 66) After abdominal surgery, a client feels bloated and is unable to pass gas. Appropriate nursing interventions include: 66) A) encourage fluid intake of 3000 mL/day. B)assist with ambulation. C) restrict foods to reduce gas production. D) press gently on the abdomen to promote expulsion of gas. 67) A postoperative client complains of dizziness when getting out of bed to ambulate. The nurse should: 67) A) have the client use a walker. B)administer medication for dizziness. C)return the client to bed. D)walk alongside the client. 68) The nurse is preparing to obtain a client's signature on an informed consent. It is the nurse's responsibility to: 68) A) witness the signature. B) determine the client's understanding about the procedure. C)describe surgical risks. D)explain the procedure. 69) A client is being given 0.6 mg atropine (an anticholinergic) IM preoperatively and asks the nurse what the medication is for. The nurse explains the medication will prevent: 69) A)nausea. B) pain. C)anxiety. D) aspiration. 70) When providing preoperative teaching for a client scheduled to have abdominal surgery, the nurse should include: 70) A) changing the dressings. B) self-medication using a PCA pump. C) turning, coughing, and deep breathing (TCDB). D)assisting with the bed bath. 71) The nurse should watch for which of the following side effects when clients are receiving NSAIDs, nonsteroidal anti-inflammatory drugs, for pain: 71) A)vertigo and syncope. B) tarry black stools and epigastric pain. C) diarrhea and vomiting. D)confusion and memory loss. 72) The nurse notes a client is crying and holding the operative site, yet continues to refuse pain medication. The nurse might initially explore the client's: 72) A)socioeconomic status. B) religious beliefs. C) beliefs about the frequent use of narcotics. D) cultural beliefs. 73) The nurse evaluates the effectiveness of a client's intravenous injection of morphine sulfate, 15 mg, given for pain. How soon can the nurse expect the client to begin to get some relief? 73) A) 1 to 5 minutes B) 10 to 15 minutes C)20 to 30 minutes D) 1 to 2 hours 74) Nurses can assist clients experiencing pain by stimulating large-diameter A-delta and A-beta fibers by using techniques such as: 74) A) high-intensity exercise. B)relaxation and massage. C)group therapy. D)electrical stimulation therapy. 75) A 5-year-old client was admitted with severe dog bites and was experiencing pain. The nurse can best evaluate level of pain intensity by: 75) A) recognizing the level of intensity cannot be evaluated at that early age. B)asking the parents about how much pain the client seems to be experiencing. C) asking the child to rate the pain on a scale of 1 to 10. D) showing pictures of happy, sad, and crying faces and have the client point to the one like him. 76) A client feels reluctant to ask for pain medication frequently to keep from bothering the nurse. The nurse recognizes an appropriate type of pain control for this client would be: 76) A) relaxation exercises. B) narcotic tablets left at the bedside. C) transcutaneous electrical nerve stimulation (TENS) unit. D)patient-controlled analgesia (PCA) pump. 77) A client with a right lower extremity amputation complains of pain in the lost limb. The nurse plans care of the client based on the understanding that phantom limb pain should be: 77) A) referred to a grief counselor. B) ignored, as it is not possible to have pain in the lost limb. C) treated as any other client experiencing pain. D) given small doses of pain medication to prevent addiction. 78) A client who has just had a heart attack reports experiencing intense pain in the left shoulder. The nurse explains this type of pain is called: 78) A)referred pain. B) phantom pain. C)acute pain. D) chronic pain. 79) A client in hospice care has received large doses of morphine but is still unable to sleep. The nurse should administer which of the following adjuvant drugs? 79) A) lisinopril (Zestril) B) acetaminophen (Tylenol) C)amitriptyline (Elavil) D) meperidine (Demerol) 80) The nurse is caring for a postoperative client who is experiencing sweating, tachycardia, and increased blood pressure. The nurse recognizes these symptoms are due to: 80) A) chronic pain. B) acute pain. C)postoperative shock. D) phantom pain. 81) A client with a history of lumbar spinal cord nerve compression continues to complain of burning pain. The nurse realizes that this client is experiencing: 81) A) Phantom limb pain. B)Myofascial pain syndrome. C)Complex regional pain syndrome. D)Chronic post-operative pain. 82) A client with chronic pain is being started on a "patch". Which of the following should be included when instructing the client about this pain-relieving delivery system? 82) A) Dosing will start with a lower dose. B) The client will never overdose with this delivery method. C) The client will never experience breakthrough pain. D) It will not work as well as oral pain medications. 83) A client is seen talking and laughing in the clinic's waiting room yet complains of excruciating pain. The nurse realizes this client is most likely demonstrating: 83) A) The desire for narcotics. B) Inconsistent behavioral response to pain. C)Fake pain. D)Denial. 84) A client learns that he has no physical cause for the ongoing back pain he experiences. The nurse realizes this client might be experiencing: 84) A)Psychogenic pain. B) Central pain. C)Phantom pain. D) Chronic postoperative pain. 85) A client with a history of chronic pain tells the nurse, "I do a variety of things to make my body produce its own pain reliever." The nurse realizes that this client is describing: 85) A) A theory of denial. B) The body's ability to make endorphins. C) A belief in alternative methods D) One reason to reduce the amount of pain medication prescribed. 86) The nurse is assessing a client's pain perception. Which of the following methods of assessment would be useful for this? 86) A) PQRST guide B) Biofeedback rating C)Psychological evaluation tool D) FACES scale 87) A 47-year-old female client has a history of scoliosis and back pain. Which of the following types of pain does the nurse realize this client most likely is experiencing? 87) A) Chronic intractable nonmalignant pain syndrome. B)Recurrent acute pain. C) Chronic nonmalignant pain. D) Ongoing time-limited pain. 88) A client is complaining of muscle pain. The nurse realizes that the transmission of this pain is: 88) A) Over the A-delta fibers. B) Over the C nerve fibers. C)Over the B nerve fibers. D) Over the D nerve fibers. 89) A client has periodic severe nerve pain that is not being well-controlled with pain medication. The nurse thinks that this client might benefit from: 89) A) A narcotic. B) A local anesthetic. C) An antidepressant. D) A nonsteroidal anti-inflammatory drug (NSAID). 90) The client complaining of pain has been waiting for medication to relieve the pain. Which of the following should the nurse realize about this client? 90) A) The client wants attention. B) The client is demanding. C) The client's pain is real. D) The client just wants medication. 91) The nurse is assessing a client's vital signs. Which of the following should be assessed during this time? 91) A) Pain B) Peripheral pulses C)Urine output D) Ability to ambulate 92) A client with chronic pain tells the nurse that he "rarely sleeps more than 3 hours a night." The nurse realizes that this client is at risk for developing: 92) A)Depression. B) Chronic insomnia. C) High pain tolerance. D) Adult attention deficit disorder. 93) A client who is receiving pain medication around the clock complains of an acute exacerbation of pain. What should the nurse do to help this client? 93) A)Give the client a nonsteroidal anti-inflammatory drug (NSAID). B)Provide the medication ordered for breakthrough pain. C)Encourage the client to ignore the pain. D)Talk the client through the pain. 94) The nurse is helping a client in pain by gently massaging the painful area. The nurse is utilizing which form of pain control with the client? 94) A)Guided imagery B) Biofeedback C)Cutaneous stimulation D) Acupuncture 95) A client with a long history of pain rarely appears to be in pain and often forgoes the use of pain medication. The nurse realizes that this client: 95) A) Is addicted to pain medication. B) Does not really have pain. C) Has a low pain tolerance. D) Has a high pain tolerance. 96) A client asks the nurse, "What does it matter what grade the tumor I had in my stomach?" The best response by the nurse is: 96) A) "It explains if the tumor has spread." B) "It explains how aggressive the tumor is." C) "It is a method of explaining the extent of the tumor to your insurance provider." D) "It is a way to name the tumor." 97) A client with uterine cancer is prescribed a treatment in which radioactive material will be inserted and maintained within her vagina. Which of the following types of treatment does this describe? 97) A) Extracavitary radiation B) Chemotherapy C)Brachytherapy D) Teletherapy 98) A client who is newly diagnosed with cancer says to the nurse, "I don't want to spend my final days on earth in a hospital bed." The best response by the nurse is: 98) A) "Why do you feel so negative about being in the hospital?" B) "If I were you I would go home and enjoy the life you have left." C) "Please tell me more about how you are feeling right now." D) "I know how you feel. It must be hard to know that you are dying." 99) The nurse is preparing to change the postoperative dressing of a client with a mastectomy. During the dressing change the client looks away. Which of the following should the nurse do to assist this client? 99) A) Recommend that the client receive home care upon discharge because the client will not be able to provide self dressing changes. B) Hand the client a mirror so that she can look at the incision while the dressing is being changed. C) Suggest that the client identify a family member who will have to do the dressing since the client refuses to learn. D) Support the client; however, do not avoid discussing the incision. 100) A client is informed that the tumor removed from his abdomen had well-defined borders, was encapsulated, and totally removed. The nurse realizes that this client has just learned the tumor was most likely: 100) A) Benign. B) Malignant. C) One that would not respond to chemotherapy. D)Metastatic. 101) A 65-year-old male client is diagnosed with lymphoma while being treated for bladder cancer. The nurse realizes that this client is demonstrating: 101) A)A weakened immune system. B)Two unrelated cancers. C)Identification of the primary cancer. D)Metastasis. 102) A client who was treated for bladder cancer 15 years ago tells the nurse, "I live each day like it is my last yet plan for the future." The nurse realizes that this client is demonstrating which phase of cancer survival? 102) A)Diagnosis and treatment B) Extended survival C)Permanent survival D) Watchful waiting 103) A client is receiving bleomycin (Blenoxane) as part of his chemotherapy cancer treatment. Which of the following should the nurse do prior to his treatment? 103) A) Evaluate the degree of hair loss since the last treatment. B) Measure vital signs and cardiovascular status. C) Assess for diarrhea. D) Evaluate for motor weakness. 104) A client thinks she has cancer because her last Pap smear identified cervical dysplasia. The best response by the nurse is: 104) A) "This means the cells of your cervix have lost their useful function." B) "This confirms that the cells are cancerous." C) "This means the cells are normal." D) "This means the cells are abnormal because of irritation." 105) The family of a client with terminal metastatic cancer asks thenurse for guidelines regarding when to call for help when theclient is discharged to home. Which of thefollowing would indicate this client needs medical intervention? (Select all that apply.) 105) A)Rectal temperature greater than 101.5 F B)Improvement in ankle edema C)Resting comfortably, and reading D)Extreme hunger E)Difficulty breathing F)Onset of bleeding 106) A 30-year-old client has been informed of an abnormal mammogram and is to return to theradiology department for additional testing. thenurse realizes that this client will most likely need to have a: 106) A) Ultrasound. B) Chest x-ray. C) Computed tomography (CT) scan. D) Nuclear scan. 107) A client is prescribed external radiation as part of his cancer treatment. Which of thefollowing should be included in this client's instructions? (Select all that apply.) 107) A) Do not wash off thetreatment marks. B) Wash theskin with soap and water. C) Use an electric razor to shave thetreatment area. D) Avoid applying heat or cold to thearea. 108) A client with cancer is diagnosed with pain associated with thecancer treatment. thenurse realizes that this client is most likely experiencing: 108) A)Metastatic bone pain. B) Incisional pain. C) No pain. D) Pain within a hollow visceral organ. 109) A client who is being treated for cancer says, "I thought thepain that I had before I was diagnosed with cancer was bad. This is horrible." thenurse's best response is: 109) A) "Pain is a frame of mind." B) "The treatment for thecancer must not be working." C) "Pain is themain indication of cancer." D) "The pain might be worse because of thecancer treatment." 110) A client with abdominal cancer is asking why thephysician wants to perform surgery. An appropriate response for thenurse to make to this client is: 110) A)"Maybe thephysician wants to confirm that you don't have cancer." B) "The physician must think this will help get rid of thecancer." C) "Surgical resection is used for diagnosis and staging of 90% of all cancers." D)"That's a good question." 111) The client tells thenurse, "The doctor says my breast tumor was at B stage. What does that mean?" thenurse explains thestaging describes: 111) A) "Where thetumor tissue first originated." B) "The size of thetumor and extent of thecancer." C) "The rate of growth of thecancer cells." D) "The type of cancer cells." 112) Which of thefollowing statements indicates a need for further teaching by the nurse for a client with radiation implants? 112) A)"I might feel unusually fatigued." B) "I may have nausea and vomiting." C) "I will spend some time with my grandson and my daughter who is expecting again." D) "I need to take good care of theskin around theradiation implant." 113) A client is being prepared for a bone marrow transplant. thenurse knows to prepare for which of thefollowing administration routes? 113) A)incision and instillation B) intramuscular C)intrathecal D) intravenous 114) An 86-year-old client asks thenurse why cancer affects mostly theelderly. An accurate response would be: 114) A) "The elderly have a longer time to be affected by all carcinogens." B) "The cells of theelderly are more fragile and more susceptible to cancer." C) "It may take 10 to 20 years after damage to theDNA for thecancer to appear." D) "The elderly have more oncogenes." 115) A client suffers from claustrophobia, thefear of being in enclosed places. thenurse knows that theclient may have difficulty with thefollowing test: 115) A)MRI B) CT scan C)x-ray imaging D) ultrasonography 116) An elderly client told thenurse she had been smoking for 70 years and did not have lung cancer. thenurse explained that other factors need to be taken into account, such as: 116) A)type of cigarettes smoked. B) genetic predisposition. C)history of alcohol abuse. D) type of diet. 117) The nurse is caring for a hospitalized cancer client with a radiation implant. thenurse plans to take thefollowing precautions: 117) A) Avoid touching thepatient. B) Encourage family involvement with client care. C)Wear a lead apron when administering care. D)Organize care to limit exposure. 118) A client with breast cancer who is receiving chemotherapy tells thenurse she does not care what happens to her anymore, since she cannot work or care for her family. thenurse can assist by: 118) A) finding a helper for her. B) allowing her to express her feelings, fears, and concerns. C) telling her that she has theright to feel depressed. D)referring her to counseling services. 119) An eighth-grade class is taking a field trip to thebeach to explore sea life. theschool nurse suggests that thestudents: 119) A) use SPF 15 lotion on their exposed skin to prevent sunburn. B) go on thefield trip in theevening to avoid exposure to thesun. C) wear long-sleeved shirts and long pants to protect them from thesun. D) stay out of thewater. 120) A 78-year-old client has been diagnosed with prostate cancer. thenurse should educate theclient about theprevention or treatment of: 120) A)urinary retention. B) recurrent headaches. C)constipation. D) urinary incontinence. 121) A client in theoutpatient clinic is scheduled to have blood drawn for an iron level. Recognizing that certain medications will affect theresults, thenurse should determine if theclient is taking: 121) A)acetaminophen. B) antidepressants. C)antihypertensives. D) oral contraceptives. 122) When checking laboratory values, thenurse notes theclient's platelet count is 100,000 mm3. thenurse should include which of thefollowing actions in theclient's plan of care? 122) A)Hold pressure over injection sites to ensure clotting has occurred. B)Encourage client to increase ambulation to prevent a deep venous thrombosis. C)Use strict sterile technique with wound care in order to prevent infection. D)Instruct client to increase intake of vitamin C to assist in blood coagulation. 123) It is reported a client has leukocytosis. When checking thelaboratory results, thenurse will expect to find: 123) A)white blood cell count is less than 5,000/mm3. B)neutrophil count is greater than 50%. C) eosinophil count is less than 5%. D) white blood cell count is greater than 10,000/mm3. 124) While bathing theclient, thenurse observes large purple-colored rashes on theclient's chest. thenurse documents that theclient has: 124) A)purpura. B) eythema. C)papules. D) petechiae. 125) During thechange-of-shift report thenurse learns that an assigned client has a hemoglobin level of 8 g/dL. Based on this information thenurse plans to: 125) A) prevent exposure to infectious diseases. B) keep theclient on strict bed rest to restrict activity. C) space activities in order to conserve energy. D)encourage ambulation to prevent thrombophlebitis. 126) The nurse checks theresults of a client's Schilling's test and notes theexcretion of vitamin B12 is less than 10% in 24 hours. thenurse should plan to: 126) A)observe client for signs of bleeding tendencies. B) explain theneed and rationale for supplemental vitamin B12. C) instruct client to increase intake of foods high in iron. D) measure client's oxygen saturation levels. 127) The physician has informed theparents that theresults of a hemoglobin electrophoresis performed on their child indicate thepresence of hemoglobin S. When theparent asks what this means, thenurse explains: 127) A) "It is indicative of sickle cell disease or trait." B) "It verifies thepresence of hemolytic anemia." C)"Hemoglobin S is a type of immature red blood cell." D)Hemoglobin S is found in people with pernicious anemia." 128) The nurse checks thecoagulation studies on a client who is not receiving any type of anticoagulant therapy. Which of thefollowing findings should be reported to thephysician? 128) A) Platelet count is 250,000 mm3. B) APPT is 25 seconds. C) INR is 2.5. D) Prothrombin time is 20 seconds. 129) A nurse is bathing a client who had a bone marrow aspiration from theright iliac crest 5 days ago. Which of thefollowing findings would be of concern to thenurse? 129) A) The client is doing isometric leg exercises. B) The needle insertion site is scabbed over and without drainage. C) The needle aspiration site is ecchymotic. D) The client complains of moderate pain in theright iliac crest. 130) A client being prepared to have a bone marrow transplant expresses concern theprocedure will be painful. thenurse explains: 130) A) "You will be given some analgesic since it can be painful." B) "It should not be any more painful than having an injection." C) "The procedure is very quick and not very painful." D) "A local anesthetic is given and so you won't feel any pain." 131) When making morning rounds, a client with acute leukemia reports having nosebleeds off and on throughout thenight. Which of thefollowing actions should be taken by thenurse? 131) A)Determine if client has pain anywhere. B)Apply a water-soluble lubricant to thenares. C) Check theclient's blood pressure and pulse. D) Report thefindings to thephysician. 132) A client with hemophilia A is being prepared to receive a transfusion of clotting factors and expresses concern about contracting HIV from thetransfusion. thebest explanation thenurse can provide is: 132) A) "The blood that is donated is screened so you should not worry." B) "That certainly is always a concern. You can refuse thetreatment if you prefer." C)"Rigorous screening of donors and treatment of donated blood has significantly reduced therisk." D)"You won't be receiving whole blood so you shouldn't worry about HIV contamination." 133) When caring for a client with a history of alcoholism thenurse recognizes theclient is at increased risk for which of thefollowing conditions? 133) A)hemolytic anemia B) Von Willibrand's disease C)folic acid deficiency D) pernicious anemia 134) The nurse is preparing a client recovering from sickle cell crisis for discharge. To prevent future crises from occurring, thenurse instructs theclient to: 134) A)keep well hydrated. B) avoid doing any types of exercise. C) eat a high-protein diet. D) abstain from alcohol use. 135) A client with multiple myeloma has been started on filgrastin (Neupogen) for treatment of neutropenia. thenurse identifies thedrug is being effective when: 135) A) the client is no longer hypotensive. B) the hemoglobin level is within normal limits. C) the client no longer has bone pain. D) an increase in thewhite blood cell count occurs. 136) Infectious mononucleosis is suspected in a client being seen in theclinic. In addition to swollen lymph glands and an increased lymphocyte count, thenurse can expect theclient to: 136) A) have petechiae over theanterior chest. B) have an enlarged liver. C) report having insomnia. D) complain of headaches and malaise. 137) The nurse learns a client with sepsis has developed disseminated intravascular coagulation (DIC). thenurse should plan to: 137) A)encourage frequent ambulation in thehallway. B)restrict fluid intake to prevent vascular fluid overload. C) keep client in a low-Fowler's position to promote venous return. D) check peripheral pulses and capillary refill frequently. 138) A client with secondary polycythemia being seen in theclinic informs thenurse he will be taking a long flight overseas in thenear future. thenurse reminds theclient: 138) A) to be sure to wear support stockings during theflight. B) that he will need supplemental oxygen when at a higher altitude. C) to restrict intake of high-protein foods theday of theflight. D) that he should start taking an antibiotic 1 week before leaving. 139) A client with chronic lymphangitis of thelower extremities asks thenurse how often she should wear elastic stockings. thenurse explains: 139) A) "It is only necessary to wear them if you notice an increase in swelling." B) "You should wear them at all times, only taking them off to bathe." C) "You should wear them when your legs feel heavy or are painful for you." D) "It is best to wear them during thewaking hours and remove them when sleeping." 140) When caring for theclient with a history of pica thenurse assesses theclient for signs of chronic iron deficiency anemia. These may include: 140) A)chelosis. B) clubbing of thefingernails. C)jaundice. D) petechiae. 141) A client tells thenurse, "I had this arthritis pain under control but then I learned I might lose my job." Which of thefollowing should thenurse say in response to this client? 141) A) "Stress can cause an exacerbation of thearthritis." B) "Well, we better do everything to help you before you lose your health benefits." C) "I'm sure you'll find another job." D) "Have you considered going on disability?" 142) During thephysical assessment of a client, thenurse wants to include theclient's immunity function. Which of thefollowing techniques would provide thenurse with thebest information? 142) A)Auscultation of theheart B) Palpation of theabdomen C)Percussion of thelungs D) Inspection of theskin 143) The client is diagnosed with a type IV hypersensitivity response. thenurse realizes that this client will most likely need treatment with: 143) A)Renal dialysis. B) Antihistamines. C)Endotracheal intubation. D) Cardiac output medications. 144) A differential diagnosis for a client is food allergies. thenurse escorts theclient into an examination room and begins to ask questions about what theclient has most recently eaten. Which of thefollowing has thenurse observed about this client? 144) A)Cachexia B) Obesity C) Anorexia D) Urticaria 145) An HIV positive client is not adhering to theprescribed medication therapy. Which of thefollowing actions by thenurse will best improve client compliance and long-term treatment of thedisease process? 145) A) Talk with theclient about not adhering to themedication schedule. B) Refer theclient to a social worker so that lower-cost medications can be obtained. C) Suggest that theclient take themedication at bedtime to prevent nausea. D) Confront theclient about thenoncompliant behavior. 146) The nurse is preparing to instruct a class of young adults about ways to achieve safe sex. What should be included in thenurse's presentation? (Select all that apply.) 146) A) Only use water-based lubricants with condoms. B) Be HIV tested if entering into a new monogamous relationship and have thetest repeated in six months. C) Avoid sexual activity until both partners found HIV negative for two tests. D) Avoid spermicidal agents. 147) A client who received a kidney transplant six months prior is demonstrating an alteration in his blood-urea-nitrogen level. thenurse realizes that this client is demonstrating: 147) A) An allergic response. B) A functional decline as an early indicator of rejection. C) An expected response. D) A functional decline as an early indicator of acceptance. 148) An HIV-positive client is being treated for thrush. Client teaching by thenurse should include which of thefollowing side effects? 148) A) "Hepatitis can develop as a side effect." B) "Nausea, vomiting, and diarrhea are common side effects." C) "Skin discoloration is a common side effect." D) "There are few side effects associated with themedication to treat thrush." 149) A client tells thenurse, "I've never had this before" and exposes an area of redness, itching, and skin thickness on his left hand. thenurse realizes that this client is demonstrating which of thefollowing? 149) A)A type I allergic response B) A type IV allergic response C)A type II allergic response D) A type III allergic response 150) A client is prescribed a monoclonal antibody after an allograft on his left thigh. Which of thefollowing should be done for this client? 150) A)Closely observe theclient for four hours following theoriginal dose. B)Encourage theclient to have a chest x-ray one week after thefirst dose. C)Premedicate with hydrocortisone. D)Instruct theclient that side effects will occur after at least six doses of themedication. 151) A client with an autoimmune disorder tells thenurse, "My family keeps telling me that I don't look sick." thenurse should utilize which of thefollowing nursing diagnoses to help this client? 151) A)Ineffective Coping B) Activity Intolerance C)Interrupted Family Processes D) Ineffective Protection 152) A young HIV female client tells thenurse she does not want to see thegynecologist because, "I'm going to die anyway." Which of thefollowing should thenurse say in response to this client? 152) A) "But you still should be on birth control." B) "The gynecologist will help diagnose any Hodgkin's disease." C) "Why do you think that you are going to die?" D) "Having a PAP smear will help detect theonset of cervical cancer." 153) An adolescent client asks thenurse about sexual practices and theonset of HIV. Which of thefollowing should thenurse instruct this client? 153) A) The only safe sex is no sex. B) Be sure to be tested for HIV every six months. C) There is no such thing as safe sex. D) Always use a condom. 154) An HIV positive client comes into theclinic complaining of increasing pain in his feet and legs. thenurse realizes that this client is demonstrating: 154) A)A reaction to themedication. B) A nervous system manifestation of thedisease. C) An opportunistic infection. D) A secondary cancer. 155) Before a bone marrow transplant, a client is prescribed ganciclovir (Cytovene). Which of thefollowing should be included in theinstructions to theclient about this medication? 155) A) It will maintain cardiac output. B) It will prevent thedevelopment of cytomegaloviral pneumonia. C) It will prevent thedevelopment of herpes pneumonia. D) It will decrease theonset of bacterial infections. 156) A client is found to be allergic to several allergens from theepicutaneous testing. Which of thefollowing should be done next to help this client? 156) A)Undergo patch testing. B) Undergo intradermal testing of theallergens. C) Keep a food diary. D)Determine treatment. 157) A client is demonstrating signs of anaphylactic shock. Which of thefollowing should thenurse do first to assist this client? 157) A) Maintain an airway. B) Administer subcutaneous epinephrine. C)Place on a cardiac monitor. D)Provide calm reassurance. 158) A client is recovering from a skin graft where thethumb of his right hand is sutured to theskin on his abdomen. thenurse realizes this client has which of thefollowing types of grafts? 158) A)Xenograft. B) Allograft. C)Autograft. D) Isograft. 159) A client has been given instructions on collection of a sputum specimen for analysis of mycobacterium tuberculosis. Which statement by theclient indicates he understands thedirections? 159) A) "I will need to drink a radioactive dye before coughing up secretions." B) "They will need to collect three specimens." C) "It is best to collect a specimen after drinking warm liquids." D) "I will need to take a sedative before thesecretions are suctioned." 160) The nurse uses palpation of thechest in order to assess theclient for: 160) A)tactile fremitus. B) retractions and bulging. C)use of accessory muscles. D) pleural rub. 161) A client scheduled for a pulmonary function test asks what is involved in thetest. thenurse explains: 161) A) "You will be asked to breathe in breathe in a specific manner and measurements are taken." B) "An x-ray of your lungs is taken after a dye is injected into your vein." C) "You will have blood drawn from an artery in your wrist." D) "A sensor is placed on your fingertip or earlobe and your oxygen levels will be measured." 162) The nurse obtains a pulse oximetry reading of 95% on a client 2 days postoperative. Which of thefollowing actions should be taken by thenurse? 162) A) Increase level of oxygen delivery by 1 L/min. B) Document thefindings. C) Encourage client to do more coughing and deep breathing. D)Recheck thepulse oximetry after ambulating client. 163) A client has blood drawn for an arterial blood gas. When applying pressure to thepuncture site it is important for thenurse to: 163) A) hold thepressure for at least 60 seconds. B) have a tourniquet available in case bleeding does not stop. C) keep theextremity elevated above theheart. D) hold pressure for 2 minutes or longer. 164) The nurse is assessing an elderly client who is 2 days postop abdominal surgery. thenurse recognizes alterations in therespiratory system of theelderly put theclient at risk for: 164) A)increased vital capacity. B) upper respiratory infections. C)pulmonary embolus. D) rib fractures. 165) When assessing therespiratory status of a client, thenurse auscultates thelungs by: 165) A)checking breath sounds in theanterior and posterior thorax. B)listening for air exchange in thebronchus and anterior lobes. C)checking for adventitious sounds while having client cough. D)listening to breath sounds in theanterior and posterior lung bases. 166) The nurse caring for a client who has sustained a head trauma closely monitors respirations because: 166) A)breathing is controlled by therespiratory center in thebrain. B)the client will be unable to cough and clear secretions. C) the client will be lethargic and forget to breathe. D) the trauma may cause theclient to be disoriented. 167) The nurse observes theserum alpha1-antitrypsin level of a client is 40 mg/dL and recognizes this reading could be influenced by which of thefollowing client conditions? 167) A)gastroesophageal reflux disease B)cellulitis of a lower extremity C)osteoporosis D)migraine headaches 168) A client scheduled to have blood drawn for a serum alpha1-antitrypsin level asks thenurse if any special preparation is necessary. Since theclient has a history of hyperlipidemia thenurse explains: 168) A) "A low-fat diet should be eaten for twenty-four hours prior to thetest." B) "A fasting specimen will be necessary." C) "No special preparation is needed." D) "Any lipid-lowering medications should be held theday of thetest." 169) When assessing a client with streptococcal pharyngitis, thenurse can expect theclient to complain of pain and: 169) A)headache. B) dysphagia. C)nausea and vomiting. D) palpitations 170) A postoperative client with a tracheostomy requires tracheal suctioning. thefirst intervention in completing this procedure would be to: 170) A) change thetracheostomy dressing. B) perform oral or nasal suctioning. C) provide humidity with a trach mask. D) deflate thetracheal cuff. 171) When caring for clients who have had a tonsillectomy, thenurse should monitor closely for which of thefollowing complications: 171) A) hemorrhage. B) nausea and vomiting. C) throat pain and headache. D)temperature elevation of 100.6°F. 172) A postoperative laryngectomy and radical neck dissection client has a nursing diagnosis of Impaired Verbal Communication. Which of thefollowing interventions should be included in thecare plan? 172) A) Instruct theclient to speak softly when talking. B) Provide uninterrupted time for theclient to attempt communication with thenurse and health care team. C) Provide theclient with a pen and paper for writing. D) Teach theclient to read lips. 173) The client with chronic rhinitis asks thenurse why he cannot use his nasal spray as often as he needs. thenurse's best response is: 173) A) "Too much medication is absorbed through themucosa and has a systemic effect on thecirculation." B) "Continuous use of nasal spray causes nosebleeds." C)"Prolonged use of nasal spray dries thenasal mucosa." D)"Continuous use causes rebound congestion, which increases frequency of use." 174) The nurse provides discharge teaching to a client with laryngitis. Which of thefollowing statements by theclient indicates an understanding of theinstruction? 174) A) "I should massage my throat to stimulate thevocal cords." B) "I should rest my voice by not speaking." C) "I can whisper but not speak in a regular voice." D) "I can speak as much as I want as long as it is not painful." 175) A cyanotic client with an unknown diagnosis is admitted to theemergency department. In relation to oxygen, thefirst nursing action would be to: 175) A)not administer oxygen unless ordered by thephysician. B)administer oxygen at a flow of 6 L/min and check O2 sats. C)administer oxygen at a flow of 2 L/min. D)wait until theclient's STAT lab work is completed. 176) The nurse monitors a client with suspected nasal bone fractures for cerebrospinal fluid leakage by: 176) A)gently palpating nose for presence of crepitus. B)determining theamount of postnasal drainage. C)checking nasal or ear drainage for glucose. D)checking thenasal drainage for blood. 177) The nurse is preparing a client for discharge who has had endoscopic sinus surgery for obstruction. thenurse instructs theclient: 177) A)"Irrigate your sinuses with warm saline solution." B)"Sleep on your back or in a semireclining position only." C) "Avoid blowing your nose and strenuous exercising for a week." D) "Sneeze with your mouth closed." 178) The nurse is caring for a patient who develops epistaxis. Which of thefollowing nursing interventions is advisable? 178) A) Apply heat to theclient's nose. B) Have theclient tilt his head back and hold pressure to thenose by pinching thenares toward theseptum. C) Have theclient lie supine and place ice packs to theforehead. D) Have theclient tilt thehead forward and apply pressure by pinching thenares toward theseptum. 179) The nurse assesses a client suspected of having chronic bronchitis. It would be most important for thenurse to question theclient about which of thefollowing? 179) A)pain location B) characteristics of thecough C)medication history D) occupation history 180) A client is brought in with a gunshot wound to thechest. thenurse assesses for tension pneumothorax. What signs and symptoms of tension pneumothorax can thenurse expect to find? 180) A) high blood pressure B) deviated trachea C) wheezes in all lung fields D) audible sucking sounds on inspiration 181) The nurse auscultates crackles at thebases of thelungs of a client with adult respiratory distress syndrome (ARDS). thenurse knows that these adventitious lung sounds are due to: 181) A)hyperinflated alveoli. B) fluid in thealveoli. C)constriction of theairways. D) mucus in theairways. 182) A client with tuberculosis has been on drug therapy for several months, but his sputum is still positive for tuberculosis bacilli. It would be most important for thenurse to ask which of thefollowing questions? 182) A) "Have you had any reaction to your medications?" B) "Are you feeling better now that you are taking medicine?" C) "Have you taken all of your medicines as prescribed?" D) "When did you last take your medications?" 183) The nurse caring for a client admitted with a diagnosis of suspected lung cancer might expect to find which of thefollowing on assessment? 183) A)hemoptysis B) cyanosis C)dysphagia D) night sweats 184) The nurse is caring for a client admitted with pneumonia. Which of thefollowing assessment findings would pro vide themost accurate information about thetype of pneumonia theclient has? 184) A) client's complaint of shortness of breath B) productive cough with large amounts of rust-colored sputum C)client's complaint of chest pain D)temperature of 38.3°C (101°F) 185) The nurse assesses theclient's chest tube drainage system. Which of thefollowing findings should be reported to thephysician? 185) A)serosanguinous drainage in thecollection chamber B) bubbling in thesuction control chamber C) bubbling in thewater seal chamber when theclient coughs D) fluid in thewater seal chamber that rises and falls with respirations 186) The nurse instructs theclient with chronic obstructive pulmonary disease (COPD) to practice pursed-lip breathing and explains that this breathing technique is done: 186) A) to prolong exhalation to help remove carbon dioxide from thelungs. B) to use theabdominal muscles to breathe, giving thediaphragm a rest. C) to break up mucus that has accumulated in theairway. D) to prolong inhalation to help bring more oxygen to thelungs. 187) A client informs thenurse he is having pleuritic pain. Before documenting this complaint, thenurse should verify if thepain: 187) A)is constant along thecostal borders. B)increases with expiration. C) subsides when client coughs. D)increases with deep breathing. 188) A client has just been diagnosed with a pulmonary embolism. thenurse anticipates thephysician will order which of thefollowing medication therapies? 188) A)antibiotic therapy B)nitroglycerin therapy C)heparin therapy D) bronchodilator and nebulizer treatments 189) A client who was diagnosed with theflu is demonstrating rapid, shallow respirations. Which of thefollowing is this client most at risk for developing? 189) A)Increased tidal volume B) Pneumonia C)Dehydration D) Atelectasis 190) A client tells thenurse, "After I leave here, I need to get to thedentist. My upper teeth are hurting and I don't know why." Which of thefollowing should thenurse do? 190) A) Tell theclient there is nothing wrong with his teeth. B) End thevisit so theclient can get to thedentist. C)Reschedule theappointment at another time. D)Assess theclient for a sinus infection. 191) While eating a meal in thehospital, a client begins to demonstrate difficulty breathing and signs of choking. thenurse realizes that theclient is experiencing: 191) A)An acute myocardial infarction. B)Pulmonary emboli. C)Epiglottitis. D)Laryngeal obstruction. 192) The nurse observes a client's respirations during sleep and notes the absence of respirations that lasts from 15 to 45 seconds. This finding is consistent with: 192) A)Respiratory acidosis. B) Renal failure. C)Laryngeal spasm. D) Sleep apnea. 193) A client says, "My nose is always congested and it just seems to get worse with the nasal spray I've been using." The nurse realizes that this client is describing: 193) A) Rebound nasal congestion. B) A side effect of the nasal spray. C) An incorrect use of the nasal spray. D) An acute sinus infection that needs to be treated with antibiotics. 194) During an assessment, the nurse learns that the only thing that helps a client with a daily morning headache is "taking a mentholated cough drop" befor