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Adult Health Review Exam Questions And Correct Answers
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Adult Health Review Exam Questions And Correct AnswersWhat nursing interventions should the nurse initiate for a client diagnosed with
pyelonephritis?
Select all that apply
1. Observe urine for dark, cloudy, foul smelling urine.
2. Put client on intake and output monitoring.
3. Limit fluid intake to 1 liter/day.
4. Inform client that urine may change color with administration of nitrofurantoin.
5. Monitor for hypotension, tachycardia, fever. - ANSWER 1., 2., 4., & 5. Correct: With
pyelonephritis urine will be dark, cloudy and foul smelling due to the bacteria. Anytime a
client has a renal problem, that client should be placed on I&O. Nitrofurantoin, an
antibiotic, will turn the urine brown. Monitor for septic shock, a complication of
pyelonephritis. S/S include hypotension, tachycardia, and fever.
3. Incorrect: Increase fluid intake to 2-3 liters/day unless contraindicated.
Acute pyelonephritis is an infection of the renal pelvis and kidney that usually results
from ascent of a bacterial pathogen up the ureters from the bladder to the kidneys. The
classic presentation in clients include: Fever - This is not always present, but when it is,
it is not unusual for the temperature to exceed 103°F (39.4°C); Costovertebral angle pain
- Pain may be mild, moderate, or severe; flank or costovertebral angle tenderness is
most commonly unilateral over the involved kidney, although bilateral discomfort may
be present; Nausea and/or vomiting-These vary in frequency and intensity, from absent
to severe; anorexia is common in clients with acute pyelonephritis. Blood pressure is
usually within the reference range, except when client has underlying hypertension;
then the pressure may be higher than client's baseline. A systolic blood pressure less
than 90 mm Hg indicates shock secondary to sepsis.
A construction worker comes to the occupational health nurse complaining of chest
,heaviness. The nurse should further assess the client for which of the following signs
and symptoms?
Select all that apply
1. Headache
2. Dry, flushed skin
3. Lightheadedness
4. Dyspnea
5. Irregular pulse ANSWER 3., 4. & 5. Correct: The nurse should be thinking myocardial
infarction (MI)! All of these are signs of an MI. When cardiac output goes down,
perfusion to the brain goes down. Dyspnea is difficulty breathing. There is a lack of
oxygen reaching the lungs. The heart muscle is irritable and leads to arrhythmias.
1. Incorrect: Headaches may accompany MI.
2. Incorrect: The client experiencing an MI, will experience hypotension and possibly
cardiogenic shock due to decreasing cardiac output. Remember, dead tissue doesn't
pump well. The skin would be cool and clammy rather than warm, dry and flushed.
If you think worst when you see the clue "chest heaviness", what should you think is
happening to the client? The client is having an MI. This question is trying to determine if
the test taker can identify additions signs and symptoms of an MI. Remember, people do
not always present with classic signs and symptoms.
Common heart attack symptoms and warning signs may include:
Chest pain or discomfort: feeling of pressure, fullness, or a squeezing pain in the center
of the chest that lasts for more than a few minutes or goes away and comes back. Pain
or discomfort in one or both arms, the back, neck, jaw, or stomach. Unexplained
dyspnea, possibly with chest discomfort, dyspnea and tachypnea. Other symptoms may
include diaphoresis, cool and clammy skin, nausea or vomiting, lightheadedness,
anxiety, restlessness, indigestion, unexplained fatigue, irregular pulse.
A community health nurse is preparing a lecture about prevention of the spread of
, influenza in the community. What should the nurse include?
1. The flu is spread through the influenza vaccine.
2. Into a shirtsleeve if coughing or sneezing
3. Tissues remain the most effective way of minimising flu transmission.
4. Influenza is treatable with antibiotics. - ANSWER 2. Correct: A shirtsleeve should be
used as a barrier when coughing or sneezing. This prevents germs being spread via the
hands.
1. Incorrect The flu vaccine is made up of a dead virus, which in no way can cause the
flu. The flu vaccine does however give clients symptoms of the flu, although they will not
acquire the actual virus.
3. Incorrect Tissues are effective in decreasing the spread of the flu if disposed of in the
trash after use. Hand washing is also very important in decreasing the spread of germs.
4. Antibiotics do not fight the flu. The treatments for the flu are antipyretics, fluids, and
rest. Antibiotics treat infections caused by bacteria, not viruses.
A nurse is providing education to a client family member who has a client with
middle-stage Alzheimer's disease about promoting independence with meals. Which of
the following should the nurse include?
Select all that apply
1. Allow 30 minutes to eat
2. Offer finger foods
3. Offer one food at a time
4. Do not worry about messiness - ANSWER 2, 3, & 4. Correct: Too many foods at one
time may be confusing. Simplify by offering one food at a time. For example, mashed
potatoes followed by meat. Offer finger foods, which are foods easy to pick up to eat. Do
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