ACUTE HD THEORY CLASS FINAL
COMPREHENSIVE QUESTIONS AND ANSWERS
◉ The nurse prepares to obtain a culture from a patient who has a
possible fungal infection on the foot. Which items should the nurse
gather for this procedure?
Answer: Cotton-tipped applicators
◉ A dark-skinned patient has been admitted to the hospital with
chronic heart failure. How would the nurse best assess this patient
for cyanosis?
Answer: check the lips and oral mucous membranes
◉ When examining an older patient in the home, the home health
nurse notices irregular patterns of bruising at different stages of
healing on the patient's body. Which action should the nurse take
first?
Answer: talk with the patient alone and ask about what caused the
bruising
◉ The nurse assess a circular, flat, reddened lesion about 5 cm in
diameter on a middle-aged patient's ankle. How should the nurse
determine if the lesion is related to intradermal bleeding
Answer: Press firmly on the lesion
,◉ Which integumentary assessment data from an older patient
admitted with bacterial pneumonia is of most concern for the nurse?
Answer: Reports a history of allergic rashes
◉ When taking the health history of an older adult, the nurse
discovers that the patient has worked in the landscaping business
for 40 years. The nurse will plan to teach the patient about how to
self-assess for which clinical manifestations?
Answer: actinic keratosis and erythema
◉ A patient who is scheduled for a right breast biopsy asks the
nurse the difference between a benign tumor and a malignant tumor.
Which answer by the nurse is correct?
Answer: "Malignant tumors may spread to other tissues or organs"
◉ A nurse is caring for a patient who smokes 2 packs/day. To reduce
the patient's risk of lung cancer, which action by the nurse is the
best?
Answer: Discuss the risks associated with cigarettes during every
patient encounter
◉ The nurse should include which food choice when providing
dietary teaching for a patient scheduled to receive external beam
radiation for abdominal cancer?
,Answer: Roasted chicken
◉ A patient who is diagnosed with cervical cancer that is classified
as Tis, N0, M0 asks the nurse what the letters and numbers mean.
Which response by the nurse is most appropriate?
Answer: "the cancer involves only the cervix"
◉ During the teaching session for a patient who has a new diagnosis
of acute leukemia the patient is restless and is looking away, never
making eye contact. After teaching about the complications
associated with chemotherapy, the patient asks the nurse to repeat
all of the information. Based on this assessment, which nursing
diagnosis is most appropriate for the patient?
Answer: Risk for ineffective health maintenance related to anxiety
about new leukemia
◉ A hospitalized patient who has received chemotherapy for
leukemia develops neutropenia. Which observation by the nurse
would indicate a need for further teaching
Answer: The patients visitors bring in some fresh peaches from
home
◉ The nurse receives change-of-shift report on the oncology unit.
Which patient should the nurse assess first?
, Answer: 24-year-old patient who received neck radiation and has
blood oozing from the neck
◉ An older adult patient who has colorectal cancer is receiving IV
fluids at 175mL/hour in conjunction with the prescribed
chemotherapy. Which finding by the nurse is most important to
report to the health care provider?
Answer: Patient has audible crackles in the midline posterior chest
◉ A patient with an open leg wound has a white blood cell (WBC)
count of 13,500/uL and a band count of 11%. Which action should
the nurse take first?
Answer: Obtain wound cultures
◉ A patient has an open surgical wound on the abdomen that
contains deep pink granulation tissue. How would the nurse
document this wound?
Answer: Red wound
◉ A patient from a long-term care facility is admitted to the hospital
with a sacral pressure ulcer. The base of the wound is yellow and
involves subcutaneous tissue. How should the nurse classify this
pressure ulcer?
Answer: Stage III
COMPREHENSIVE QUESTIONS AND ANSWERS
◉ The nurse prepares to obtain a culture from a patient who has a
possible fungal infection on the foot. Which items should the nurse
gather for this procedure?
Answer: Cotton-tipped applicators
◉ A dark-skinned patient has been admitted to the hospital with
chronic heart failure. How would the nurse best assess this patient
for cyanosis?
Answer: check the lips and oral mucous membranes
◉ When examining an older patient in the home, the home health
nurse notices irregular patterns of bruising at different stages of
healing on the patient's body. Which action should the nurse take
first?
Answer: talk with the patient alone and ask about what caused the
bruising
◉ The nurse assess a circular, flat, reddened lesion about 5 cm in
diameter on a middle-aged patient's ankle. How should the nurse
determine if the lesion is related to intradermal bleeding
Answer: Press firmly on the lesion
,◉ Which integumentary assessment data from an older patient
admitted with bacterial pneumonia is of most concern for the nurse?
Answer: Reports a history of allergic rashes
◉ When taking the health history of an older adult, the nurse
discovers that the patient has worked in the landscaping business
for 40 years. The nurse will plan to teach the patient about how to
self-assess for which clinical manifestations?
Answer: actinic keratosis and erythema
◉ A patient who is scheduled for a right breast biopsy asks the
nurse the difference between a benign tumor and a malignant tumor.
Which answer by the nurse is correct?
Answer: "Malignant tumors may spread to other tissues or organs"
◉ A nurse is caring for a patient who smokes 2 packs/day. To reduce
the patient's risk of lung cancer, which action by the nurse is the
best?
Answer: Discuss the risks associated with cigarettes during every
patient encounter
◉ The nurse should include which food choice when providing
dietary teaching for a patient scheduled to receive external beam
radiation for abdominal cancer?
,Answer: Roasted chicken
◉ A patient who is diagnosed with cervical cancer that is classified
as Tis, N0, M0 asks the nurse what the letters and numbers mean.
Which response by the nurse is most appropriate?
Answer: "the cancer involves only the cervix"
◉ During the teaching session for a patient who has a new diagnosis
of acute leukemia the patient is restless and is looking away, never
making eye contact. After teaching about the complications
associated with chemotherapy, the patient asks the nurse to repeat
all of the information. Based on this assessment, which nursing
diagnosis is most appropriate for the patient?
Answer: Risk for ineffective health maintenance related to anxiety
about new leukemia
◉ A hospitalized patient who has received chemotherapy for
leukemia develops neutropenia. Which observation by the nurse
would indicate a need for further teaching
Answer: The patients visitors bring in some fresh peaches from
home
◉ The nurse receives change-of-shift report on the oncology unit.
Which patient should the nurse assess first?
, Answer: 24-year-old patient who received neck radiation and has
blood oozing from the neck
◉ An older adult patient who has colorectal cancer is receiving IV
fluids at 175mL/hour in conjunction with the prescribed
chemotherapy. Which finding by the nurse is most important to
report to the health care provider?
Answer: Patient has audible crackles in the midline posterior chest
◉ A patient with an open leg wound has a white blood cell (WBC)
count of 13,500/uL and a band count of 11%. Which action should
the nurse take first?
Answer: Obtain wound cultures
◉ A patient has an open surgical wound on the abdomen that
contains deep pink granulation tissue. How would the nurse
document this wound?
Answer: Red wound
◉ A patient from a long-term care facility is admitted to the hospital
with a sacral pressure ulcer. The base of the wound is yellow and
involves subcutaneous tissue. How should the nurse classify this
pressure ulcer?
Answer: Stage III
