2026 NURS 355 CARE OF HEALTHY ADULTS AND
ELDERLY POPULATIONS (ADULT I) EXAM
2|260Qs&As| GRADED A+
Which information obtained by the nurse in the endocrine clinic about a
patient who has been taking prednisone 40 mg daily for 3 weeks is most
important to report to the health care provider?
a. Patient's blood pressure is 148/94 mm Hg.
b. Patient has bilateral 2+ pitting ankle edema.
c. Patient stopped taking the medication 2 days ago.
d. Patient has not been taking the prescribed vitamin D.
ANSWER:->>>Patient stopped taking the medication 2 days ago.
Rationale: Sudden cessation of corticosteroids after taking the medication for
a week or more can lead to adrenal insufficiency, with problems such as severe
hypotension and hypoglycemia. The patient will need immediate evaluation by
the health care provider to prevent or treat adrenal insufficiency. The other
information will also be reported but does not require rapid treatment.
Which finding for a patient who has hypothyroidism and hypertension
indicates that the nurse should contact the health care provider before
administering levothyroxine (Synthroid)?
a. Increased thyroxine (T4) level
b. Blood pressure 112/62 mm Hg
c. Distant and difficult to hear heart sounds
d. Elevated thyroid stimulating hormone level
,ANSWER :->>> Increased thyroxine (T4) level
Rationale: An increased thyroxine level indicates the levothyroxine dose needs
to be decreased. The other data are consistent with hypothyroidism and the
nurse should administer the levothyroxine.
The nurse teaches a patient about pulmonary spirometry testing. Which
statement by the patient indicates teaching was effective?
a. "I should use my inhaler right before the test."
b. "I won't eat or drink anything 8 hours before the test."
c. "I will inhale deeply and blow out hard during the test."
d. "My blood pressure and pulse will be checked every 15 minutes."
ANSWER:->>> "I will inhale deeply and blow out hard during the test."
Rationale: For spirometry, the patient should inhale deeply and exhale as long,
hard, and fast as possible. The other actions are not needed. The
administration of inhaled bronchodilators should be avoided 6 hours before
the procedure.
A patient with acute shortness of breath is admitted to the hospital. Which
action should the nurse take during the initial assessment of the patient?
a. Ask the patient to lie down for complete a full physical assessment.
b. Complete the health history and check for allergies before treatment.
c. Briefly ask specific questions about this episode of respiratory distress.
d. Delay the physical assessment to first complete pulmonary function tests.
,ANSWER:->>> Briefly ask specific questions about this episode of respiratory
distress
Rationale: When a patient has severe respiratory distress, only information
pertinent to the current episode is obtained, and a more thorough assessment
is deferred until later. Obtaining a comprehensive health history or full
physical examination is unnecessary until the acute distress has resolved. Brief
questioning and a focused physical assessment should be done rapidly to help
determine the cause of the distress and suggest treatment. Checking for
allergies is important, but it is not appropriate to complete the entire
admission database at this time. The initial respiratory assessment must be
completed before any diagnostic tests or interventions can be ordered.
The nurse prepares a patient who has a left-sided pleural effusion for a
thoracentesis. How should the nurse position the patient?
a. High-Fowler's position with the left arm extended
b. Supine with the head of the bed elevated 30 degrees
c. On the right side with the left arm extended above the head
d. Sitting upright with the arms supported on an over bed table
ANSWER:->>> Sitting upright with the arms supported on an over bed table
Rationale: The upright position with the arms supported increases lung
expansion, allows fluid to collect at the lung bases, and expands the
intercostal space so that access to the pleural space is easier. The other
positions would increase the work of breathing for the patient and make it
more difficult for the health care provider performing the thoracentesis.
, A patient with diabetes has arterial blood gas (ABG) results pH 7.28; PaCO2 34
mm Hg; PaO2 85 mm Hg; HCO3?2- 18 mEq/L. The nurse would expect which
finding?
a. Intercostal retractions
b. Kussmaul respirations
c. Low oxygen saturation (SpO2)
d. Decreased venous O2 pressure
ANSWER:->>> Kussmaul respirations
Rationale: Kussmaul (deep and rapid) respirations are a compensatory
mechanism for metabolic acidosis. The low pH and low bicarbonate result
indicate metabolic acidosis. Acidosis does not cause intercostal retractions, a
low oxygen saturation rate, and a decrease in venous O2 pressure.
On auscultation of a patient's lungs, the nurse hears low-pitched, bubbling
sounds during inhalation in the lower third bilaterally. How should the nurse
document this finding?
a. Inspiratory crackles at the bases
b. Expiratory wheezes in both lungs
c. Abnormal lung sounds in the apices of both lungs
d. Pleural friction rub in the right and left lower lobes
ANSWER:->>> Inspiratory crackles at the bases
Rationale: Crackles are low-pitched, bubbling sounds usually heard on
inspiration. Wheezes are high-pitched sounds. They can be heard during the
expiratory or inspiratory phase of the respiratory cycle. The lower third of
ELDERLY POPULATIONS (ADULT I) EXAM
2|260Qs&As| GRADED A+
Which information obtained by the nurse in the endocrine clinic about a
patient who has been taking prednisone 40 mg daily for 3 weeks is most
important to report to the health care provider?
a. Patient's blood pressure is 148/94 mm Hg.
b. Patient has bilateral 2+ pitting ankle edema.
c. Patient stopped taking the medication 2 days ago.
d. Patient has not been taking the prescribed vitamin D.
ANSWER:->>>Patient stopped taking the medication 2 days ago.
Rationale: Sudden cessation of corticosteroids after taking the medication for
a week or more can lead to adrenal insufficiency, with problems such as severe
hypotension and hypoglycemia. The patient will need immediate evaluation by
the health care provider to prevent or treat adrenal insufficiency. The other
information will also be reported but does not require rapid treatment.
Which finding for a patient who has hypothyroidism and hypertension
indicates that the nurse should contact the health care provider before
administering levothyroxine (Synthroid)?
a. Increased thyroxine (T4) level
b. Blood pressure 112/62 mm Hg
c. Distant and difficult to hear heart sounds
d. Elevated thyroid stimulating hormone level
,ANSWER :->>> Increased thyroxine (T4) level
Rationale: An increased thyroxine level indicates the levothyroxine dose needs
to be decreased. The other data are consistent with hypothyroidism and the
nurse should administer the levothyroxine.
The nurse teaches a patient about pulmonary spirometry testing. Which
statement by the patient indicates teaching was effective?
a. "I should use my inhaler right before the test."
b. "I won't eat or drink anything 8 hours before the test."
c. "I will inhale deeply and blow out hard during the test."
d. "My blood pressure and pulse will be checked every 15 minutes."
ANSWER:->>> "I will inhale deeply and blow out hard during the test."
Rationale: For spirometry, the patient should inhale deeply and exhale as long,
hard, and fast as possible. The other actions are not needed. The
administration of inhaled bronchodilators should be avoided 6 hours before
the procedure.
A patient with acute shortness of breath is admitted to the hospital. Which
action should the nurse take during the initial assessment of the patient?
a. Ask the patient to lie down for complete a full physical assessment.
b. Complete the health history and check for allergies before treatment.
c. Briefly ask specific questions about this episode of respiratory distress.
d. Delay the physical assessment to first complete pulmonary function tests.
,ANSWER:->>> Briefly ask specific questions about this episode of respiratory
distress
Rationale: When a patient has severe respiratory distress, only information
pertinent to the current episode is obtained, and a more thorough assessment
is deferred until later. Obtaining a comprehensive health history or full
physical examination is unnecessary until the acute distress has resolved. Brief
questioning and a focused physical assessment should be done rapidly to help
determine the cause of the distress and suggest treatment. Checking for
allergies is important, but it is not appropriate to complete the entire
admission database at this time. The initial respiratory assessment must be
completed before any diagnostic tests or interventions can be ordered.
The nurse prepares a patient who has a left-sided pleural effusion for a
thoracentesis. How should the nurse position the patient?
a. High-Fowler's position with the left arm extended
b. Supine with the head of the bed elevated 30 degrees
c. On the right side with the left arm extended above the head
d. Sitting upright with the arms supported on an over bed table
ANSWER:->>> Sitting upright with the arms supported on an over bed table
Rationale: The upright position with the arms supported increases lung
expansion, allows fluid to collect at the lung bases, and expands the
intercostal space so that access to the pleural space is easier. The other
positions would increase the work of breathing for the patient and make it
more difficult for the health care provider performing the thoracentesis.
, A patient with diabetes has arterial blood gas (ABG) results pH 7.28; PaCO2 34
mm Hg; PaO2 85 mm Hg; HCO3?2- 18 mEq/L. The nurse would expect which
finding?
a. Intercostal retractions
b. Kussmaul respirations
c. Low oxygen saturation (SpO2)
d. Decreased venous O2 pressure
ANSWER:->>> Kussmaul respirations
Rationale: Kussmaul (deep and rapid) respirations are a compensatory
mechanism for metabolic acidosis. The low pH and low bicarbonate result
indicate metabolic acidosis. Acidosis does not cause intercostal retractions, a
low oxygen saturation rate, and a decrease in venous O2 pressure.
On auscultation of a patient's lungs, the nurse hears low-pitched, bubbling
sounds during inhalation in the lower third bilaterally. How should the nurse
document this finding?
a. Inspiratory crackles at the bases
b. Expiratory wheezes in both lungs
c. Abnormal lung sounds in the apices of both lungs
d. Pleural friction rub in the right and left lower lobes
ANSWER:->>> Inspiratory crackles at the bases
Rationale: Crackles are low-pitched, bubbling sounds usually heard on
inspiration. Wheezes are high-pitched sounds. They can be heard during the
expiratory or inspiratory phase of the respiratory cycle. The lower third of
