Exam 2 (V2) NSG 3250 (NSG3250) Adult Health I_ Complete Questions & Answers, Latest 100% updated 2026-27.

Galen NSG 3250 (NSG3250) Adult Health I – Exam 1 | Complete Questions & Answers. Below are **all 75 questions and multiple-choice options only** from the uploaded **NSG 3250: Adult Health I — Exam 2** PDF. Correct answers and rationales have been removed. 1. A patient presents with a painful, unilateral blistering skin eruption along the left thoracic dermatome. The nurse anticipates a prescription for which antiviral medication? A. Famciclovir B. Prednisone C. Topical Retinoid D. Methotrexate 2. A nurse is preparing to administer methotrexate to a patient with severe psoriasis. What is the priority teaching point the nurse must emphasize to this patient? A. Do not pick or scrub the silver skin plaques. B. Monitor for and report signs of infection immediately. C. Apply the medication sparingly to clean skin. D. Avoid douching and synthetic undergarments. 3. A patient with severe acne vulgaris is prescribed a topical retinoid. Which educational statement should the nurse include in the medication teaching? A. Apply a thick layer over the entire face to maximize absorption. B. Wash your face first, then apply the topical retinoid. C. Squeeze and pop any pustules before applying. D. Scrub your face aggressively twice daily. 4. A patient is admitted to the emergency department with acute shortness of breath and wheezing due to an asthma attack. Which medication should the nurse administer first? A. Beta 2 Adrenergic Agonist B. Corticosteroid Inhaler C. High-Flow Oxygen D. IV Antibiotics 5. The nurse is providing education to a patient newly prescribed a daily corticosteroid inhaler for asthma maintenance. Which side effect or warning should the nurse emphasize? A. This medication will cause immediate bronchodilation within seconds of inhalation. B. Stop taking this medication immediately once your asthma symptoms go into remission. C. Use this inhaler only as a quick-relief rescue medicine during an acute attack. D. Too much medication can weaken the immune system, increase blood sugar, and increase infection risk. 6. A nurse is screening patients at a local health clinic for the attenuated nasal influenza vaccine. For which of the following individuals would this specific vaccine be most appropriate? A. A patient reporting a history of recurrent severe epistaxis. B. A healthy 32-year-old with no chronic medical conditions. C. A 68-year-old resident of a long-term care facility. D. An immunocompromised 45-year-old on chemotherapy. 7. A patient who was recently started on oral penicillin for a bacterial infection complains of generalized itching, a burning sensation, and the appearance of papules on their skin. What is the priority nursing action? A. Instruct the patient to discontinue the medication immediately. B. Instruct the patient to finish the full treatment course of the antibiotic. C. Obtain a specimen for a skin culture and coordinate a Sitz bath. D. Apply a thick layer of topical corticosteroid to the rash. 8. A nurse is comparing atopic and nonatopic allergic responses. Which statement correctly distinguishes between the two types of hypersensitivities? A. Nonatopic allergies are characterized by elevated IgE, while atopic allergies are not. B. Atopic allergies require contact precautions, whereas nonatopic allergies require airborne isolation. C. Atopic allergies have a genetic predisposition, while nonatopic allergies have no genetic component. D. Atopic allergies include latex allergy, while nonatopic allergies include asthma and eczema. 9. A patient is diagnosed with Herpes Simplex Virus 2 (HSV2). Which nursing intervention should the nurse include in the patient's plan of care? A. Place the patient in a negative pressure airborne isolation room with the door closed. B. Scrub the genital lesions aggressively twice daily with antibacterial soap. C. Reassure the patient that HSV2 is completely curable after a 10-day antiviral course. D. Provide sitz baths, cool compresses, analgesics, and instruct the patient to wear loose clothing. 10. A patient with atopic dermatitis (eczema) is complaining of severe pruritus and excessive dryness. Which nursing intervention is most appropriate to help hydrate the skin and manage symptoms? A. Encourage the patient to consume alcohol to increase peripheral circulation. B. Instruct the patient to scrub the eczema lesions vigorously with a rough washcloth. C. Use humidification, keep the room temperature cool, and apply moisture/hydration immediately after bathing. D. Provide hot, steaming baths to promote vasodilation and open the skin pores. 11. A patient presents with itching, burning, redness, edema, and papules on their hands after using a new brand of laundry soap. What is the most important primary care intervention for contact dermatitis? A. Scrub the hands vigorously under hot running water to wash away toxins. B. Apply hot packs directly to the affected area to reduce congestion. C. Avoid heat and remove the causative irritant agent. D. Massage the lesions with alcohol to promote immediate vasoconstriction. 12. The nurse is preparing a discharge plan for a coal miner diagnosed with pneumoconiosis (black lung disease). What key concept must the nurse understand when educating this patient? A. The disease is infectious and requires strict airborne precautions in a negative pressure room. B. The disease is preventable but not treatable; care is supportive to prevent infection and maximize comfort. C. Pneumoconiosis is fully reversible with a 6-month course of high-dose corticosteroids. D. The patient should use a daily rescue beta 2 adrenergic agonist to cure the pulmonary fibrosis. 13. A patient is admitted to the medical-surgical unit with suspected varicella (chickenpox). Which transmission-based precautions must the nurse implement? A. Droplet precautions: keep the door closed, and wear a simple face mask. B. Contact precautions: place the patient in a double-occupancy room and wear gloves and a gown. C. Droplet precautions: keep the door open, wear a face mask, and maintain 3 feet of separation. D. Airborne precautions: place the patient in a negative pressure room, keep the door closed, and wear an N95 mask. 14. A nurse is caring for a patient diagnosed with pertussis (whooping cough). Which precaution is correct when managing this patient? A. Standard precautions only: do not wear gloves or masks unless body fluids are visible. B. Contact precautions: keep the door closed and wear a gown, gloves, and N95. C. Airborne precautions: keep the door closed and wear a respirator mask. D. Droplet precautions: wear a face mask and the room door can remain open. 15. A patient is diagnosed with Clostridioides difficile (C. diff). Which nursing action is required to prevent transmission of this infection? A. Wear an N95 mask and place the patient in a negative pressure isolation room. B. Implement contact precautions, wear gloves and a gown, and perform hand hygiene before and after patient contact. C. Keep the patient's door closed at all times under strict airborne precautions. D. Limit hand hygiene to alcohol-based rubs, avoiding soap and water to prevent skin breakdown. 16. What is the primary pathophysiological cause of a Clostridioides difficile (C. diff) infection? A. Inadequate hand hygiene during a sitz bath for a viral infection. B. A genetic predisposition associated with elevated IgE levels. C. Inhalation of airborne fungal spores in a closed room. D. The overuse of antibiotics, which kills the normal protective body villi and microflora. 17. A nurse is providing discharge instructions to a patient who has been prescribed oral antibiotics for a respiratory tract infection. What must the nurse instruct the patient to do? A. Stop taking the medication as soon as symptoms go into remission. B. Finish the entire treatment course of the medication, even if all symptoms stop. C. Save the remaining pills for the next time similar symptoms occur. D. Reduce the dose by half if mild gastrointestinal side effects occur. 18. The nurse understands that the overuse of antibiotics can lead to which of the following complications? A. Overgrowth of yeast (such as candidiasis) and a weakened immune system. B. An increase in normal body villi and improved gastrointestinal function. C. Oxygen toxicity characterized by severe dyspnea and restlessness. D. Atopic dermatitis and an elevated risk of latex allergy. 19. Which statement represents a critical educational requirement for a patient newly diagnosed with chronic asthma? A. Monitor peak flow values, noting that a decrease in peak flow indicates improvement. B. Use your long-acting corticosteroid inhaler as a rescue medication during an attack. C. Limit fluid intake to prevent congestion and increase exhalation. D. Implement and strictly follow an asthma action plan to prevent an attack. 20. The nurse is teaching a patient about asthma triggers and the inflammatory cascade. Which of the following can act as triggers by stimulating prostaglandins via the arachidonic acid pathway? A. Topical Retinoids and Corticosteroids B. Warm drinks and hot packs C. Lanolin-based moisturizers and SIT-z baths D. Aspirin and NSAIDs 21. A nurse is caring for multiple patients with respiratory distress. Which patient should the nurse identify as the highest priority for emergency intervention? A. A patient who is coughing up gray sputum after working in a coal mine. B. A patient with laryngitis who complains of a hoarse voice and sore throat. C. A patient with a normal pulse oximetry reading but a sudden decrease in wheezing. D. A patient with an O2 saturation of 91% who has a chronic dry, hacking cough. 22. When performing endotracheal or tracheal suctioning on a patient, what must the nurse prioritize and monitor closely? A. The patient's visual acuity and pupillary response. B. The skin margins for signs of keloid formation. C. The presence of a bullseye rash on the upper torso. D. The patient's oxygen saturation levels (O2 sat). 23. A patient is diagnosed with viral pharyngitis. Which of the following should be included in the patient's education and care plan? A. Increase hydration, use throat gargles, avoid irritants, and stop smoking. B. Immediately start a 10-day course of intravenous antibiotics. C. Rest the voice and consume hot, spicy liquids to clear congestion. D. Apply hot packs to the neck to reduce inflammation and bleeding. 24. The nurse is monitoring a patient with rhinosinusitis. Which of the following assessment findings must be reported to the provider immediately as a sign of a serious complication? A. A low-grade fever of 99.8 degrees Fahrenheit. B. Expectoration of thick, gray-colored sputum. C. A severe headache and a stiff neck. D. Nasal congestion and watery eyes. 25. A patient is diagnosed with laryngitis. Which of the following interventions should the nurse include in the care instructions? A. Rest the voice, drink warm liquids, and avoid dairy, meat, and very hot liquids. B. Perform deep, rapid diaphragmatic breathing exercises every hour. C. Apply topical retinoids sparingly to the throat area. D. Use voice gargles continuously and consume ice-cold beverages. 26. A nurse is assessing a patient for Obstructive Sleep Apnea (OSA). Which clinical manifestations and physical characteristics are most commonly associated with this disorder? A. A thin body shape, dependent rubor, a small uvula, and severe rest pain worse at night. B. Obesity, a short neck with excess fat, chronic fatigue, morning headaches, loud snoring, and unrefreshing sleep. C. Delineated silver plaques on the scalp, weight loss, and an anteroposterior diameter ratio of 1:2. D. An asymmetric chest wall, a dry irritating cough, and a normal-sized uvula. 27. A nurse in the emergency department is evaluating a patient with shortness of breath who has an oxygen saturation (O2 sat) of 90%. What is the correct initial oxygen therapy? A. Initiate high-flow oxygen at 15 liters per minute via a non-rebreather mask. B. Administer oxygen via a nasal cannula. C. Begin immediate mechanical ventilation with high peak airway pressure. D. Instruct the patient to take rapid, shallow breaths using a nebulizer. 28. The nurse is monitoring a patient receiving long-term high-flow oxygen therapy. Which symptoms should the nurse identify as early indicators of oxygen toxicity? A. A bullseye skin rash and sudden joint pain. B. Dyspnea, restlessness, tachycardia, and anxiety. C. Pigmentation in the gaiter area of the lower extremities. D. Thick, yellow-crusted skin lesions on the chest. 29. The nurse is preparing to administer a bronchodilator medication via a nebulizer to a patient with an asthma exacerbation. How should the nurse instruct the patient to breathe during the treatment? A. Take rapid, shallow breaths to speed up the delivery of the drug. B. Take slow, deep breaths to ensure maximum medication absorption. C. Breathe normally through your nose while keeping your mouth closed. D. Hold your breath for 10 seconds after each inhalation from the device. 30. A nurse is providing discharge education to a patient newly diagnosed with psoriasis. Which instruction should the nurse include? A. Wear tight, synthetic clothing to help compress the red, blotchy plaques. B. Scrub the silver plaques vigorously daily with a coarse sponge to promote shedding. C. Psoriasis is highly contagious, so you must remain isolated under contact precautions. D. Wash the skin gently but do not scrub, do not pick the lesions, and monitor for signs of infection if taking methotrexate. 31. A patient is admitted to the hospital with cellulitis of the left lower extremity. Which nursing interventions should be implemented? A. Administer topical retinoids sparingly over the blisters and red areas. B. Gently massage the red, swollen, and painful area twice daily with antibacterial soap. C. Apply hot, dry packs to the area and keep the leg in a dependent position. D. Elevate the limb to reduce swelling and promote blood flow, and apply cool, moist compresses. 32. A pediatric nurse is teaching a parent how to care for a child diagnosed with impetigo. Which of the following instructions is correct? A. Apply a thick layer of topical corticosteroids to stop the inflammatory reaction. B. Aggressively scrub the yellow lesions with a wire brush twice daily. C. Keep the yellow, crusty lesions clean and dry, use good hand washing, and apply antibiotic ointment. D. Allow the child to share towels and toys because impetigo is non-contagious. 33. A patient presents with a painful furuncle (boil) on their neck. To prevent the development of a secondary infection or a carbuncle, what should the nurse instruct the patient to do? A. Apply warm, moist heat to promote local vasodilation and popping of the boil. B. Squeeze the lesion continuously until all purulent material is expressed. C. Bathe daily with antibacterial soap, maintain good hygiene, and do not squeeze or mess with the outbreak. D. Use a fine-tooth comb dipped in vinegar to scrub the neck area. 34. A patient is concerned about a tick bite they received 2 days ago. The nurse is teaching the patient about Lyme disease. What is the typical timeframe for the characteristic bullseye rash to manifest? A. Exactly 24 hours after the tick bite. B. Within 4 to 8 hours of the tick bite. C. 3 to 30 days after the tick bite. D. Between 6 to 8 weeks after the tick bite. 35. A patient is admitted to the hospital with a confirmed infestation of scabies. Which nursing action is essential to prevent transmission of this parasite? A. Maintain the patient in a negative pressure airborne isolation room with the door closed. B. Wear an N95 mask and restrict visitors to those who are immunized against scabies. C. Instruct the patient to wear tight, synthetic clothing to smother the skin mites. D. Place the patient in contact isolation and wear gloves and a gown when providing care. 36. The nurse is preparing to treat a patient with pediculosis capitis (head lice). Which treatment protocol is correct? A. Apply pyrethrin (RID) or a prescribed Lindane (Kwell) shampoo, and use a fine-tooth comb dipped in vinegar to remove nits. B. Instruct the patient to stay out of the sun and apply a thick layer of topical retinoids. C. Gently pat the scalp daily with antibacterial soap and keep the hair wet for 48 hours. D. Administer intravenous antivirals such as Famciclovir and use cool moist compresses. 37. Which of the following patient populations is at the highest risk for developing Kaposi Sarcoma? A. Obese patients who suffer from severe obstructive sleep apnea. B. Patients with HIV/AIDS, organ transplant recipients, or those on long-term immunosuppressants. C. Fair-skinned patients with a history of brief, intense sun exposure. D. Elderly patients with a history of occupational exposure to coal dust. 38. A nurse is teaching a community class about the prevention of skin cancers, specifically melanoma. What is the single most important preventive measure to teach? A. Demonstrate proper hand hygiene and wash lesions without scrubbing. B. Bathe daily with antibacterial soap and apply topical retinoids sparingly. C. Ensure adequate dietary intake of vitamin C and zinc to maintain positive nitrogen balance. D. Minimize sun exposure, avoid the sun between 10 AM and 4 PM, and use sunscreen with SPF 15. 39. A patient is scheduled for surgical excision of a malignant melanoma. Which priority intervention should the nurse plan to implement immediately post-surgery? A. Manage the patient's pain, as melanoma surgical excision is highly painful. B. Place the patient in a negative pressure airborne isolation room. C. Administer monthly intramuscular injections of vitamin B12. D. Apply a thick layer of topical corticosteroids to the surgical margins. 40. A patient with a history of asthma arrives at the emergency department complaining of severe shortness of breath. What are the nurse's priority initial assessment and intervention? A. Check the patient's ankle-brachial index, perform chest percussion, and administer oral steroids. B. Assess the patient's O2 saturation, ask how long the shortness of breath has been occurring, and administer a rescue inhaler first. C. Obtain a sputum culture, perform a pulmonary function test, and put on IV antibiotics. D. Ask the patient if they have a history of latex allergy, perform a sitz bath, and provide voice rest. 41. A nurse is reviewing the anatomical structures of the upper respiratory tract. Which structure connects the nasal and oral cavities to the larynx? A. Trachea B. Pharynx C. Mediastinum D. Bronchioles 42. The nurse is performing chest physical therapy and postural drainage on a patient. How does the anatomy of the bronchi facilitate effective postural drainage? A. Lobar bronchi divide into segmental bronchi (10 on the right and 8 on the left), which correspond to lung segments. B. The right lung has two lobes and the left lung has three lobes to accommodate postural changes. C. The pharynx connects the nasal and oral cavities directly to the subsegmental bronchi. D. The epiglottis forms a direct, rigid connection to the alveoli for drainage. 43. During a clinical discussion, a student nurse asks about the difference between ventilation, diffusion, and perfusion. Which explanation by the clinical instructor is correct? A. Ventilation is gas exchange; diffusion is blood flow; perfusion is the physical act of inhalation. B. Ventilation is the mechanics of breathing; diffusion is gas exchange at the alveolar-capillary membrane; perfusion is blood flow through the vasculature. C. Ventilation is blood flow; diffusion is the mechanics of breathing; perfusion is gas exchange. D. Ventilation is the movement of oxygen into the pharynx; diffusion is breathing; perfusion is the use of accessory muscles. 44. A patient has a low ventilation-perfusion (V/Q) ratio, resulting in a shunt. What does this pathophysiology represent, and in which condition is it commonly seen? A. Blood flow is completely obstructed while ventilation is normal. This is seen in mild laryngitis. B. Ventilation matches perfusion exactly (1:1). This is seen in a healthy lung during deep breathing. C. Perfusion exceeds ventilation; blood bypasses alveoli without gas exchange. This is seen in pneumonia, atelectasis, tumor, or a mucus plug. D. Ventilation exceeds perfusion, causing physiologic dead space. This is seen in a healthy, resting individual. 45. A patient is admitted with a new onset of a dry, irritating, non-productive cough that produces nothing. Which class of cardiovascular medications is most commonly associated with this symptom? A. ACE Inhibitors B. Beta Blockers C. Calcium Channel Blockers D. Proton Pump Inhibitors 46. A nurse is caring for a patient experiencing hemoptysis. What are the most common potential causes of hemoptysis that the nurse should investigate? A. Obstructive sleep apnea, obesity, and excessive use of nasal CPAP therapy. B. Overuse of topical nasal decongestants and subsequent rhinitis medicamentosa. C. Allergic rhinitis, gastroesophageal reflux disease (GERD), and atopic dermatitis. D. Pulmonary infection, lung carcinoma, heart or blood vessel abnormalities, pulmonary embolism (PE), or infarction. 47. A nurse is performing a physical assessment on a dark-skinned patient in respiratory distress. Which of the following is correct regarding cyanosis? A. Cyanosis is easily detected in dark-skinned individuals by checking for dependent rubor. B. Cyanosis is an early, highly reliable indicator of mild tissue hypoxia. C. Cyanosis appears when there is at least 1 g/dL of unoxygenated hemoglobin in the tissues. D. Cyanosis is a very late indicator of hypoxia and appears dull, lifeless, or grayish in dark skin. 48. A patient with diabetic ketoacidosis (DKA) is exhibiting an increased rate and depth of breathing, which results in a decreased PaCO2 level. How should the nurse document this breathing pattern? A. Biot's respiration B. Cheyne-Stokes respiration C. Kussmaul's respiration D. Apneic hypoventilation 49. The nurse is monitoring a patient's breathing pattern and notes a regular cycle where the rate and depth of breathing increase, then decrease, followed by a regularly cycled period of apnea. Which breathing pattern is this? A. Biot's respiration B. Kussmaul's respiration C. Obstructive hyperventilation D. Cheyne-Stokes respiration 50. A patient with a traumatic brain injury exhibits irregularly cycled periods of apnea interspersed with cycles of normal rate and depth. Which respiratory pattern should the nurse document? A. Kussmaul's respiration B. Biot's respiration C. Cheyne-Stokes respiration D. Hyperventilation 51. A patient in severe respiratory distress is utilizing accessory muscles. Which muscles are used during forced expiration? A. Sternocleidomastoid, scalene, and trapezius muscles. B. The epiglottis, larynx, and cricoid cartilage. C. The platysma and pectoralis major muscles. D. Abdominal and internal intercostal muscles. 52. During palpation of the thorax, the nurse notes asymmetric bulging of the intercostal spaces. The nurse understands this finding may result from which of the following? A. Increased pressure within the hemithorax, such as pneumothorax or pleural effusion. B. A normal anteroposterior-to-lateral diameter chest ratio of 1:2. C. A chronic reduction in lung volume, such as localized atelectasis. D. A congenital funnel chest deformity (pectus excavatum). 53. While performing a voice sound assessment on a patient with suspected lobar pneumonia, the nurse notes that when the patient repeats the letter 'E', the sound is transmitted through the stethoscope as 'A'. How should the nurse document this distorted sound? A. Egophony B. Whispered Pectoriloquy C. Bronchophony D. Stridor 54. While assessing a patient, the nurse hears a continuous, high-pitched, musical sound over the neck. What does this sound indicate, and what is the required action? A. Crackles; they indicate fluid in the lower alveoli and require incentive spirometry. B. Stridor; it indicates narrowing of the upper respiratory tract and warrants immediate intervention. C. Rhonchi; they indicate deep secretions in the large bronchi and require coughing exercises. D. Egophony; it indicates pulmonary consolidation and requires voice rest. 55. The nurse notes that a patient has rounded, bulbous distal phalanges and convex nail plates, with an angle between the nail plate and proximal nail fold of 185 degrees. With which clinical condition is this finding associated? A. Rebound congestion due to topical decongestant overuse. B. Acute, self-limiting viral pharyngitis. C. Chronic hypoxia and lung cancer. D. Atopic dermatitis and elevated IgE levels. 56. The nurse is reviewing Pulmonary Function Test (PFT) results for a patient with Chronic Obstructive Pulmonary Disease (COPD). Which parameter is typically reduced in COPD due to air trapping? A. Forced Vital Capacity (FVC) B. Mixed Venous Oxygen Saturation (SvO2) C. Mean Forced Expiratory Flow (FEF) D. Forced Expiratory Volume (FEV) 57. A clinical instructor asks a student to compare Arterial Blood Gas (ABG) and Venous Blood Gas (VBG) studies. Which statement is correct? A. VBG studies measure arterial carbon dioxide tensions, whereas ABG studies measure venous carbon dioxide tensions. B. ABG studies are entirely noninvasive, while VBG studies require a central venous catheter. C. ABG studies measure oxygenation status, while VBG studies provide data on oxygen delivery and consumption, with SvO2 being the most accurate indicator of balance. D. ABG studies are contraindicated in patients with metal implants, while VBG studies are not. 58. A patient's plan of care includes continuous pulse oximetry. The nurse knows that the clinical purpose of pulse oximetry is to: A. Provide noninvasive monitoring of the percentage of hemoglobin bound to oxygen (SaO2) and reduce the need for invasive ABGs. B. Characterize pulmonary nodules and evaluate local inflammatory activity. C. Directly measure the partial pressure of carbon dioxide at the end of exhalation. D. Evaluate the mechanics of ventilation and expiratory flow limitations. 59. A nurse is caring for a patient in the intensive care unit who has end-tidal CO2 (ETCO2) monitoring. What information does this continuous monitoring provide? A. The exact forced expiratory volume in the middle half of the FVC. B. Direct measurement of the percentage of unoxygenated hemoglobin in the peripheral tissue. C. Immediate information about ventilation, perfusion, and metabolism. D. A visual representation of anatomical structures of the lungs and mediastinum. 60. A patient is scheduled for a pulmonary magnetic resonance imaging (MRI) study. Which of the following is an absolute contraindication for this diagnostic test? A. A history of smoking or chronic COPD. B. Metal implants or support devices. C. An allergy to iodine-based contrast dye. D. An elevated blood glucose level. 61. A patient complains of severe, worsening nasal congestion. Upon review of the patient's history, the nurse notes that the patient has been using an over-the-counter nasal decongestant spray (oxymetazoline) multiple times daily for the past two weeks. What is the likely cause of the patient's congestion? A. Allergic Rhinitis B. Rhinitis Medicamentosa C. Viral Rhinitis D. Nonallergic Rhinitis 62. A patient with allergic rhinitis is prescribed an intranasal corticosteroid spray. Which of the following are recognized side effects and contraindications for this medication? A. Side effects: elevated blood sugar and severe systemic fluid loss. Contraindications: a history of penicillin allergy. B. Side effects: voice loss and a dry non-productive cough. Contraindications: use of an N95 respirator mask. C. Side effects: severe rebound congestion and diarrhea. Contraindications: a history of asthma or eczema. D. Side effects: nasal irritation, headache, epistaxis, dry nose/throat. Contraindications: recurrent epistaxis, glaucoma, and cataracts. 63. A patient is admitted with active, severe epistaxis (nosebleed). What is the correct initial medical and nursing management? A. Apply hot compresses to the nose and neck area while instructing the patient to blow their nose aggressively. B. Pinch the bridge of the nose intermittently for 1 minute while having the patient tilt their head back to prevent aspiration. C. Have the patient sit upright with the head tilted forward, pinch the soft outer portion of the nose continuously for 5 to 10 minutes, and apply a topical vasoconstrictor. D. Instruct the patient to lie flat on their back with the head tilted backward, and pack the nose with dry gauze. 64. A patient is scheduled for a classic radical neck dissection. The nurse understands that this surgical procedure involves the removal of which structures? A. The sternocleidomastoid muscle and internal jugular vein while completely preserving all lymphatic chains. B. The spinal accessory nerve, the vocal cords, the hyoid bone, and the thyroid gland. C. The sternocleidomastoid muscle, the internal jugular vein, and all cervical lymphatic tissue from the jaw ramus to the clavicle. D. The cricoid cartilage, the epiglottis, the trachea, and the palatine tonsils. 65. Following a neck dissection, the nurse notes a milky, cream-colored drainage in the surgical chest/neck tube. The nurse should immediately suspect which potential complication? A. A severe bacterial infection of the mediastinum. B. An acute hemorrhage of the internal jugular vein. C. An injury to the hypoglossal nerve. D. A chyle leak (lymphatic leak). 66. A nurse is reviewing risk factors for Health Care-Associated Pneumonia (HCAP). Which of the following increases a patient's risk for HCAP? A. Overuse of topical nasal decongestants and subsequent nosebleeds. B. Residency in a long-term care facility, recent antibiotic therapy, or chemotherapy. C. A history of seasonal allergic rhinitis and atopic dermatitis. D. Living in a rural community and having no recent healthcare contact. 67. Which patient has the highest risk for infection with drug-resistant pneumococci? A. A patient who completed a course of oral penicillin for pharyngitis 1 year ago. B. A healthy 24-year-old student who has no history of chronic medical illnesses. C. A 35-year-old patient with mild contact dermatitis who uses topical moisturizers. D. An 68-year-old patient with multiple medical comorbidities who received beta-lactam therapy 2 months ago. 68. A nurse is caring for a patient on mechanical ventilation. Which bundle of interventions should the nurse implement to prevent Ventilator-Associated Pneumonia (VAP)? A. Instruct the patient to use an incentive spirometer 10 times per hour while keeping the head of the bed flat. B. Maintain the patient in a flat supine position, provide continuous heavy sedation, and perform daily suctioning. C. Elevate the head of the bed to 30-45 degrees, provide daily sedation vacations, perform daily oral care with 0.12% chlorhexidine, and implement peptic ulcer and DVT prophylaxis. D. Maintain negative pressure room isolation, keep the room door closed, and perform chlorhexidine gargles hourly. 69. During a pathophysiology lecture on Tuberculosis (TB), the instructor describes the formation of a Ghon tubercle. What is a Ghon tubercle? A. An overdistended alveolus that impairs O2 and CO2 gas exchange. B. A hard, transparent plate of keratin that causes rounding of the distal phalanx. C. A silver, red, and blotchy plaque that spreads along a nerve route. D. A protective granulomatous wall formed by macrophages containing a central portion of necrotic material. 70. To prevent atelectasis, a nurse implements the ICOUGHS program. What are the key components of this evidence-based program? A. Intravenous antibiotics, Cool compress, Oral liquids, Unilateral positioning, Gentle hand washing, and Sitz baths. B. Intranasal corticosteroids, CPAP use, Oral hygiene, Unilateral chest chest drainage, Hydration, and Skin care. C. Incentive spirometry, Continuous oxygen, Oral care, Unilateral elevation, Gown and gloves, and Suture debridement. D. Incentive spirometry, Coughing and deep breathing, Oral care, Understanding (education), Getting out of bed at least 3 times daily, and Head-of-bed elevation. 71. A nurse is reviewing the risk factors for pulmonary aspiration. Which of the following conditions places a patient at the highest risk for aspiration? A. Atopic dermatitis, food allergy to peanuts, and a history of latex allergy. B. A history of pelvic organ prolapse, Kegel exercises, and uterine cancer. C. Occupational exposure to coal dust, chronic dry cough, and asbestos inhalation. D. A decreased level of consciousness, flat body positioning, stroke, seizure activity, or swallowing disorders. 72. Which of the following nursing interventions is correct for preventing pulmonary aspiration in a patient receiving continuous enteral tube feedings? A. Check tube placement by inflating 50 mL of air, and maintain the patient in a low Fowler position during meals only. B. Assess gastric residual volume once every 24 hours and hold the feeding only if the residual is greater than 500 mL. C. Maintain the head of the bed elevated at 30 to 45 degrees, use sedatives sparingly, confirm tube tip location, and assess gastric residual volume every 4 hours. D. Place the patient in a flat supine position, administer bolus feedings rapidly, and flush the tube with 100 mL of water. 73. What is the primary pathophysiology of Acute Respiratory Distress Syndrome (ARDS) that leads to severe, refractory hypoxemia? A. Accumulation of lipids and calcium plaques in the pulmonary artery, blocking blood flow to the lungs. B. Severe bronchoconstriction and mucus plugging that blocks the trachea, causing instant asphyxiation. C. Inflammatory triggers injure the alveolar-capillary membrane, causing alveoli to collapse, severe V/Q mismatch, and blood shunting through nonventilated areas. D. A gradual, slowly progressive airway obstruction and emphysematous destruction of overdistended alveoli. 74. A nurse is evaluating laboratory and clinical findings for a patient in respiratory distress. Which of the following criteria indicates a need for mechanical ventilation? A. An SpO2 of 92% on a 2L nasal cannula and a sore throat with voice loss. B. PaO2 of 90 mm Hg, PaCO2 of 38 mm Hg, pH of 7.40, and a dry, irritating cough. C. PaO2 55 mm Hg, PaCO2 50 mm Hg, pH 7.32, apnea, or respiratory distress with confusion. D. An FVC of 85% predicted, an ABI of 1.10, and a heart rate of 80 beats per minute. 75. A patient is suspected of having Pulmonary Hypertension (PH). Which clinical manifestations should the nurse expect to find during the assessment? A. Thick white vaginal discharge, severe pelvic pressure, constipation, and uncontrollable gas. B. Dependent rubor, dry shiny skin, hair loss, and sharp claudication pain in the lower extremities. C. Dyspnea (first with exertion, then at rest), substernal chest pain, fatigue, syncope, and signs of right-sided heart failure (edema, distended neck veins). D. A dry irritating cough, a normal AP-to-lateral chest ratio, and silver plaques on the knees.