Adult Health 1
Objective Assessment
Actual Questions with Verified Answers
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➢118 OA Exam Questions w/ Answers
➢Expert Rationales included.
➢OA Study Guide & Clinical Prioritization
➢Zach's Study Guide D444
➢ Adult Health Study Guide: Core Systems & Infections
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,Table of Contents
D444 OA EXAM ................................................................................. 2
D444 OA Study Guide & Clinical Prioritization ............................... 67
Zach's Study Guide D444 ................................................................ 75
Adult Health Study Guide: Core Systems & Infections .................. 90
D444 OA EXAM
1. A client with chronic cirrhosis has esophageal varices. It is most important for the
nurse to monitor the client for the onset of which problem?
A. Hematemesis (vomiting blood)
B. Jaundice
C. Ascites
D. Hepatic encephalopathy
Correct Answer: A
Rationale: Esophageal varices are dilated veins in the lower esophagus resulting from
portal hypertension in cirrhosis. These veins are fragile and can rupture, causing life-
threatening hemorrhage. Hematemesis (vomiting blood) indicates variceal rupture,
which is a medical emergency requiring immediate intervention. While jaundice, ascites,
and hepatic encephalopathy are complications of cirrhosis, variceal bleeding poses the
most immediate threat to life.
,2. The client is a 51-year-old male with pneumonia. The client has a history of
hypertension and takes enalapril and a multivitamin daily. His surgical history includes
adenoid removal at age 4 and a surgical repair of a fractured tibia at age 20. The nurse
is preparing to set up oxygen administration and apply a simple face mask. Mark
whether the following assessment findings indicate that the treatment was effective
or ineffective:
Table
Assessment Finding Effective Ineffective
Ronchi in the right lung ☐ ☑
PaCO₂ 55 mm Hg on a blood gas ☐ ☑
Diminished breath sounds in the right lung ☐ ☑
Symmetric chest expansion ☑ ☐
Oxygen saturation greater than 94% ☑ ☐
Client ambulates without shortness of breath ☑ ☐
Rationale: Effective treatment for pneumonia should result in improved oxygenation
(SpO₂ >94%), symmetric chest expansion indicating equal lung ventilation, and the ability
to ambulate without dyspnea. Ineffective findings include persistent adventitious sounds
(ronchi), elevated PaCO₂ (normal 35–45 mm Hg), and diminished breath sounds
suggesting unresolved consolidation or atelectasis.
3. The client is a 51-year-old male with pneumonia (same scenario). Which technique
should the nurse use when assessing the client for early signs of rheumatoid arthritis?
,A. Observe the client's fingers
B. Assess the client's knee joints
C. Check the client's spine alignment
D. Palpate the client's shoulder joints
Correct Answer: A
Rationale: Early signs of rheumatoid arthritis include swelling, tenderness, and warmth
in the small joints of the hands and feet, particularly the proximal interphalangeal (PIP)
and metacarpophalangeal (MCP) joints. The nurse should observe the client's fingers for
these characteristic changes, including ulnar deviation and swan-neck deformities in
later stages.
4. Which information should the nurse include when giving discharge instructions to a
client following a left eye cataract extraction with a lens implant?
A. Administer prescribed eye drops as directed; avoid bending at the waist; avoid
rubbing the eye; wear an eye shield at night; report signs of infection immediately
B. Resume normal activities immediately including heavy lifting and strenuous exercise
C. Discontinue eye drops once vision improves
D. Remove the eye shield during sleep for comfort
Correct Answer: A
Rationale: Post-cataract surgery instructions include administering prescribed antibiotic
and anti-inflammatory eye drops, avoiding activities that increase intraocular pressure
(bending, lifting heavy objects, straining), protecting the eye with a shield especially
during sleep, and monitoring for signs of infection such as increased pain, redness, or
purulent discharge. The client should also avoid getting water in the eye during the initial
healing period.
5. The client is a 51-year-old male with pneumonia (same scenario). What should the
nurse do before applying the face mask? Select all that apply.
A. Perform hand hygiene
B. Identify the client using two client identifiers
C. Check the skin around the face
, D444 OA Study Guide & Clinical Prioritization
1. Glaucoma priority: Avoid anything that increases intraocular pressure; no
bending, coughing, or straining.
2. Cataracts post-op priority: Avoid bending, lifting, or straining to prevent
increased eye pressure.
3. Corneal Abrasions: Scratches on the cornea causing intense pain and
photophobia; treated with antibiotic ointment and sometimes patching.
4. Retinal Detachment: Separation of the retina from the epithelium; characterized
by flashing lights, floaters, and a "curtain" over the vision; an ocular emergency.
5. Meniere's Disease: Inner ear disorder characterized by vertigo, tinnitus, and
hearing loss; managed with low-sodium diet and diuretics.
6. Vertigo: Sensation of spinning or dizziness; nursing priority is safety and fall
prevention.
7. Multiple sclerosis key features: Autoimmune demyelination causing fatigue,
weakness, vision problems, and heat sensitivity.
8. Myasthenia gravis key features: Muscle weakness that worsens with activity,
improves with rest, with ptosis and dysphagia.
9. Myasthenia gravis priority: Maintain airway and give pyridostigmine before
meals.
10. Parkinson's Disease key features: Resting tremor, rigidity, slow movement,
and shuffling gait.
11. Parkinson's priority: Give levodopa on time and prevent falls.
12. Seizure Disorders Priority: Protect airway, turn patient on side, do not restrain.
13. Pulmonary embolism priority: Oxygen first, then anticoagulants.
14. Melanoma: Most aggressive skin cancer; identified by the ABCDE rule
(Asymmetry, Border, Color, Diameter, Evolving).
, Zach's Study Guide D444
Eye Injuries
Table
Condition Key Points
Ocular Priority intervention: Immediate irrigation to prevent permanent
Chemical damage
Burn
Ocular Nursing intervention: Evaluate for redness, tearing,
Scratches photophobia, or foreign body sensation. Patient teaching: Apply
cold compress, lubricating eye drops, oral analgesics, eye patch,
avoid rubbing
Corneal S/Sx: Severe pain, tearing, photophobia, blurred vision. Nursing
Abrasion intervention: Apply topical cycloplegic drops for pain; use
prescribed topical antibiotic drops. Patient teaching: Avoid
topical anesthetics at home (delay healing); avoid contact lenses
until healed
Summary of Eye Injuries
Table
Injury Treatment
Chemical burns Immediate copious irrigation, pH eye testing, eye shield,
urgent referral
, Adult Health Study Guide: Core Systems & Infections
Ophthalmology, Respiratory, Gastrointestinal and Infectious Disease
OPHTHALMOLOGY
1. What are the types of ocular injuries?
Answer: Chemical burns, trauma (blunt, penetrating, foreign body), thermal
2. What is the immediate intervention for chemical burns in the eye?
Answer: Begin irrigation immediately with sterile saline or water and do not stop
until emergency personnel arrive
3. What are common assessment findings for ocular injuries?
Answer: Abnormal or decreased vision, abnormal IOP, absent eye movements,
blood in anterior chamber, fluid drainage, pain, photophobia, prolapsed globe,
redness, swelling, tearing, visible field defects
4. What is primary open-angle glaucoma (POAG)?
Answer: The most common type of glaucoma caused by aqueous humor
overproduction or decreased outflow, leading to increased IOP
5. What are the signs and symptoms of primary open-angle glaucoma?
Answer: Gradual loss of peripheral vision, mild aching in eyes
6. What is closed-angle glaucoma?
, Answer: Also known as angle-closure glaucoma (ACG), it is less common and
caused by forward displacement of the iris, blocking aqueous humor outflow and
rapidly increasing IOP
7. What are the signs and symptoms of closed-angle glaucoma?
Answer: Severe eye pain, nausea, vomiting, blurred vision, halos around lights,
reddened eye
8. What is the normal range for intraocular pressure (IOP)?
Answer: 10-20 mmHg; >21 mmHg is indicative of glaucoma
9. What is the treatment for acute closed-angle glaucoma?
Answer: Mannitol, an osmotic diuretic that rapidly decreases IOP
10. What are common risk factors for glaucoma?
Answer: Aging, genetics, diabetes, hypertension
11. What is a cataract?
Answer: Lens opacity that impairs vision due to deterioration and clumping of
proteins in the lens
12. What are the risk factors for developing cataracts?
Answer: Aging, trauma, family history, systemic diseases like diabetes
13. What are the signs and symptoms of cataracts?
Answer: Gradual, painless vision loss, complaints of blurry or double vision, pupil
becomes white or gray, absent red reflex upon examination
14. What is the primary treatment for cataracts?
Answer: Surgical removal of the cataract
15. What post-operative care is necessary after cataract surgery?
Answer: Use of antibiotic, steroid, and NSAID eye drops; wear dark sunglasses
outside; avoid activities that increase IOP
, DERMATOLOGY & INFECTIOUS DISEASE
16. What is tinea pedis?
Answer: Common fungal infection known as athlete's foot, caused by
dermatophytes in warm, moist environments
17. What are the signs and symptoms of tinea pedis?
Answer: Scaly, peeling, cracked skin, itchiness, burning sensation, bad smell,
inflamed skin, blisters
18. What is the treatment for tinea pedis?
Answer: Topical antifungal agents like clotrimazole, miconazole, ketoconazole; oral
antifungal agents may also be prescribed
19. What is psoriasis?
Answer: Chronic inflammatory disease causing thick, red patches with silver scales
due to autoimmune overproduction of skin cells
20. What are the types of psoriasis?
Answer: Plaque psoriasis, nail psoriasis, guttate psoriasis, inverse psoriasis,
pustular psoriasis, erythrodermic psoriasis
21. What are common treatments for psoriasis?
Answer: Topical medications (steroids, salicylic acid), systemic treatments (UVB
therapy, methotrexate, biologic agents)
22. What is candida and its common forms?
Answer: Fungal infection due to imbalance of local flora; common forms include
oral thrush and vaginal yeast infections
23. What are the signs and symptoms of a yeast infection?
Answer: Red and irritated skin with burning and itching
24. What are the treatments for candida infections?
Answer: Antifungal agents and patient education on hygiene and prevention