Adult Health Exam Mastery: Comprehensive Study Guide with Practice Questions & Expert Answers for Nursing & Healthcare Success OFFICIAL STUDY RESOURCE: FULL TEST BANK WITH RATIONALES 2026 COMPLETE EXAM SOLUTION - MULTIPLE VERSIONS INCLUDED complete

A nurse is monitoring a client who is taking spironolactone for the treatment of hypertension. Which findings denote adverse effects of the medication? Select all that apply. • Constipation • Tall T waves • Hyporeflexia • Shallow respirations • Prolonged PR interval • Hyperactive bowel sounds Correct Answer: • Tall T waves • Prolonged PR interval • Hyperactive bowel sounds Rationale: Spironolactone is a potassium-sparing diuretic, which can lead to hyperkalemia (high blood potassium levels). Cardiovascular manifestations of hyperkalemia include tall, tented T waves, prolonged PR intervals, widened QRS complexes, and flat P waves. It can also cause muscle twitching, diarrhea, and hyperactive bowel sounds due to increased gastrointestinal motility. Conversely, constipation, hyporeflexia (diminished reflexes), and shallow respirations are classic clinical indicators of hypokalemia (low blood potassium). Question A nurse is providing dietary instructions to a client with chronic obstructive pulmonary disease (COPD) who is experiencing a loss of appetite and complains of feeling "too full to eat." What does the nurse encourage the client to do? Select all that apply. • Avoid drinking fluids before and during meals • Eat a variety of dark-green vegetables, such as broccoli • Have snacks, such as crackers and cheese, between meals • Select foods that are easy to chew and are not gas forming • Consume high-calorie drinks, such as milkshakes, between meals Correct Answer: • Avoid drinking fluids before and during meals • Select foods that are easy to chew and are not gas forming Rationale: Clients with COPD often experience early satiety and dyspnea (shortness of breath) while eating due to diaphragmatic flattening and gastric compression. To maximize caloric intake, they should avoid drinking fluids immediately before and during meals to prevent abdominal distension. They must also choose easy-to-chew, non-gas-forming foods; gasproducing vegetables like broccoli can cause abdominal bloating, which pushes up on the diaphragm and worsens breathing effort. Dry foods like crackers can trigger coughing fits, while thick dairy items like milkshakes or heavy cheese can increase the viscosity of mucus secretions, making airway clearance more difficult. Question A nurse is interpreting a central venous pressure (CVP) reading from a client in whom right ventricular failure has been diagnosed. From this diagnosis, the nurse would expect that the most likely result is a pressure of: • 4 cm H2O • 8 cm H2O • 11 cm H2O • 14 cm H2O Correct Answer: 14 cm H2O Rationale: Central venous pressure (CVP) measures the pressure in the right atrium and vena cava, serving as a reflection of right ventricular preload and fluid volume status. The normal range for CVP is 7 to 12 cm H2O. When a client experiences right ventricular failure, the right ventricle loses its pumping efficiency, causing blood to back up into the systemic venous circulation and raising the CVP. Therefore, an elevated reading of 14 cm H2O aligns with this diagnosis. A reading of 4 cm H2O is low and suggests hypovolemia, while 8 and 11 cm H2O fall within standard normal parameters. Question A nurse is caring for a client who has just undergone a thyroidectomy. Which technique is the best way for the nurse to assess the surgical site for bleeding? • Asking the client whether the dressing feels wet • Looking for moisture on the top of the dressing • Removing and replacing the dry sterile dressing every 2 hours • Checking for moisture on the back of the dressing over the client's neck and shoulders Correct Answer: Checking for moisture on the back of the dressing over the client's neck and shoulders Rationale: Post-thyroidectomy hemorrhage is a critical surgical complication that can lead to rapid airway occlusion. Because of the effects of gravity and the client's supine or semi-Fowler's positioning, blood tends to track downward along the sides of the neck and pool dependently behind the neck and upper shoulders. The anterior portion of the dressing can appear completely dry even in the presence of an active hemorrhage. Relying on the client's perception or repeatedly peeling away sterile dressings unnecessarily increases the risk of wound contamination and does not substitute for proactive visual and physical inspection of dependent areas. Question A client who sustained a major burn injury is beginning to take an oral diet again. Which between-meal menu selections meet the client's needs for wound healing and tissue repair? Select all that apply. • Apple slices and skim milk • Whole-milk shake and granola • Baked potato topped with cheese • Cheese and whole-wheat crackers • Cauliflower with low-fat ranch dip Correct Answer: • Whole-milk shake and granola • Baked potato topped with cheese • Cheese and whole-wheat crackers Rationale: Burn injuries trigger a profound hypermetabolic and hypercatabolic state, demanding a diet exceptionally high in calories, proteins, and carbohydrates to achieve a positive nitrogen balance and fuel tissue regeneration. High-density choices like whole-milk shakes, cheese, granola, and whole-wheat items deliver the necessary caloric load and amino acids. While fresh fruits and low-fat vegetables are rich in micro-nutrients, selections like apple slices, cauliflower, and skim milk lack the concentrated energy density required by a recovering major burn client. Question A client is found to have hypoparathyroidism. Which nutritional supplement does the nurse, teaching the client about measures to manage the disorder, tell the client to take on a daily basis? • Vitamin C • Phosphorus • Beta-carotene • Calcium carbonate with vitamin D Correct Answer: Calcium carbonate with vitamin D Rationale: Hypoparathyroidism causes a deficiency in parathyroid hormone (PTH), which leads to hypocalcemia (low serum calcium) and hyperphosphatemia (high serum phosphorus). Therapeutic management centers on elevating calcium levels while safely controlling phosphorus. Standard maintenance involves daily oral calcium supplementation (such as calcium carbonate) paired with vitamin D, which is mandatory to facilitate optimal intestinal absorption of calcium. Additional phosphorus supplementation is strictly contraindicated, and vitamins like Vitamin C or beta-carotene do not impact the underlying calcium-phosphorus imbalance. Question A nurse participating in a free health screening at the local mall obtains a random blood glucose level of 190 mg/dL (10.6 mmol/L) and a total cholesterol level of 210 mg/dL (5.4 mmol/L) in an otherwise healthy client. What should the nurse tell the client to do next? • Seek treatment for diabetes mellitus • Ask the health care provider about starting insulin therapy • Consult with a nutritionist about foods that are high in cholesterol • Call his health care provider to have these values rechecked as soon as possible Correct Answer: Call his health care provider to have these values rechecked as soon as possible Rationale: A definitive diagnosis of diabetes or hyperlipidemia cannot be established using a single, isolated random screening value in an asymptomatic individual. A random plasma glucose level greater than 200 mg/dL (11.1 mmol/L) alongside classic symptoms, or an elevated fasting plasma glucose level on two separate occasions, is required to diagnose diabetes mellitus. The total cholesterol screening value is mildly elevated (ideal is less than 200 mg/dL). The nurse's priority action is to refer the client to their primary care provider for diagnostic fasting panels to confirm or rule out metabolic or cardiovascular conditions before initiating any therapeutic or dietary regimens. Question Levothyroxine sodium is prescribed for a client with hypothyroidism, and the nurse provides information to the client about the medication. Which occurrences does the nurse tell the client to report to the health care provider? Select all that apply. • Lethargy • Chest pain • Palpitations • Weight gain • Constipation • Rapid heart rate Correct Answer: • Chest pain • Palpitations • Rapid heart rate Rationale: Levothyroxine sodium replaces thyroxine levels, stimulating the metabolic rate and increasing myocardial oxygen consumption. If the dose is too high, the client can develop manifestations of thyrotoxicosis or hyperthyroidism, which place excessive stress on the cardiovascular system and can provoke angina (chest pain), palpitations, or tachyarrhythmias (rapid heart rate). These findings require immediate reporting to prevent cardiac injury. Lethargy, constipation, and weight gain are standard clinical features of under-managed hypothyroidism, which should gradually resolve as therapeutic drug levels are reached. Question A nurse is developing a plan of care for an older client with diabetic neuropathy of the lower extremities resulting from type 2 diabetes mellitus. Which problem does the nurse recognize as the highest priority for this client? • Change in body image • Increased risk for injury • Increased risk of depression • Lower level of physical activity Correct Answer: Increased risk for injury Rationale: Diabetic peripheral neuropathy causes a loss of protective sensation, proprioception, and pain awareness in the lower extremities. This sensory deficit leaves the client highly susceptible to unrecognized skin breakdown, deep tissue ulcers, infections, and falls. According to Maslow's Hierarchy of Needs and basic physiological safety priorities, preventing physical injury and subsequent limb-threatening complications takes precedence over secondary concerns, such as reduced physical mobility or psychosocial adjustments like depression and altered body image. Question The nurse is teaching a client with newly diagnosed diabetes mellitus who has been prescribed NPH insulin how to recognize the signs of hypoglycemia. The client states that he must look for certain signs and symptoms in the late afternoon, indicating to the nurse that he has understood the instructions. What are these signs and symptoms? Select all that apply. • Shakiness • Drowsiness • Blurred vision • Increased thirst • Feelings of hunger • Nausea and vomiting Correct Answer: • Shakiness • Blurred vision • Feelings of hunger Rationale: NPH insulin is an intermediate-acting insulin with an onset of 1 to 2 hours, a peak effect occurring 6 to 12 hours post-injection, and a duration of 16 to 24 hours. When administered in the morning, its maximal glucose-lowering activity peaks during the late afternoon, creating a high-risk window for hypoglycemia if caloric intake is inadequate. Adrenergic and neuroglycopenic manifestations of hypoglycemia include shakiness, diaphoresis, anxiety, hunger, and blurred vision. Conversely, increased thirst, drowsiness, polyuria, nausea, and vomiting are classic clinical hallmarks of hyperglycemia or diabetic ketoacidosis.