PN 2212 Adult Health Nursing II Winter 2025/26 final exam: Score for this quiz: 200 out of 200.

FINAL EXAM Due Apr 8 at 2:30pm Points 200 Questions 80 Available after Apr 8 at 8am Time Limit 160 Minutes Instructions Attempt History Attempt Time Score LATEST Attempt 1 23 minutes 200 out of 200 A perceived loss is more quickly resolved. A perceived loss is situational. A perceived loss has a superficial response. A perceived loss is easily overlooked. Perceived losses are easily overlooked. Ref: pg 736  Question 2 5 / 5 pts FINAL EXAM 200 points, AH 2 Score for this quiz: 200 out of 200 Submitted Apr 8 at 11:31am This attempt took 23 minutes.  Question 1 3 / 3 pts 1. How does a perceived loss differ from an actual loss? 4/8/25, 11:36 AM FINAL EXAM: PN 2212_ Adult Health Nursing II Winter 2025 1/33 Patients spend more time in rehab facilities. Patients spend more time in hospitals. More patients die at home. Due to Change in Reimbursement measures, more Patients are dying at home. Ref: pg 755 Nurses provide more care in hospitals.  Question 3 3 / 3 pts Despair Death Death is the final Stage of growth and Development Ref: pg 734 Integrity Resolution  Question 4 3 / 3 pts Bargaining 2.Changes in health care reimbursement measures have resulted in which of the following changes regarding care of the terminally ill? 3. What is the final stage of human growth and development? 4. Upon being told of her father's death, the daughter cries out, "No! Oh, God, no!" What stage of grief is the daughter in? 4/8/25, 11:36 AM FINAL EXAM: PN 2212_ Adult Health Nursing II Winter 2025 2/33 Denial The Daughter is exhibiting signs of denial, which is commonly one of the first stages of grief. Ref: pg 737 Prayer Anger  Question 5 1.5 / 1.5 pts It gives power to an agent to make decisions regarding health, property, and other assets. It directs an agent to make health care decisions. The durable power of attorney gives an agent the power to make health care decisions. It can be executed by anyone and does not extend beyond health care issues. A living will directs treatment according to the patient's wishes. Ref: 750 It can only be executed by an attorney. It directs treatment in accordance with the patient's wishes.  Question 6 3 / 3 pts Anger Denial When experiencing denial, the individual acts as though nothing has happened and may refuse to believe or understand that loss has occurred. Ref: pg 739 Depression Bargaining  5. How is a durable power of attorney helpful to an incapacitated patient? 6. When a nurse informs a patient's spouse that the patient has died, the spouse states, "You must be mistaken." Which of Kübler-Ross's stages of dying is the spouse demonstrating? 4/8/25, 11:36 AM FINAL EXAM: PN 2212_ Adult Health Nursing II Winter 2025 3/33 Question 7 1.5 / 1.5 pts Depression When experiencing depression, the individual feels overwhelmingly lonely and withdraws from interpersonal interaction. Ref: 739 Anger Bargaining Denial  Question 8 2 / 2 pts The child associates death with aggression. A child from 5 to 9 years old understands that death is final, believes one's own death can be avoided, associates death with aggression or violence, and believes wishes or unrelated actions can be responsible for death. A child between the ages of 9 to 12 years understands that death is the inevitable end of life. Ref: pg 740 The child believes his or her own death cannot be avoided. The child understands death as the inevitable end of life. The child lacks understanding of the concept of death 7. A patient whose spouse died 1 year earlier complains of feeling overwhelmingly lonely and has withdrawn from interpersonal interactions. The patient is demonstrating what stage of dying according to Kübler-Ross's stages of dying theory? 8. A nurse is caring for the dying mother of a 7-year-old child. What is important for the nurse to understand regarding the child? 4/8/25, 11:36 AM FINAL EXAM: PN 2212_ Adult Health Nursing II Winter 2025  Question 9 1.5 / 1.5 pts 9. The nurse explains to a grieving husband that the process of the resolution of the hurt and the reestablishment of his life is called the process. 4/33 denial grief The grief process includes the resolution of the hurt and the re-establishment of life activities following bereavement. Ref: pg. 736 renewal acceptance  Question 10 1.5 / 1.5 pts Use Burow's solution to help promote healing. Pruritus is responsible for most of the discomfort. Wet dressings and using Burow's solution help promote the healing process. A cool environment with increased humidity decreases the pruritus. Give daily baths with an application to cleanse the skin. Ref: 1298 Ensure that bath area is at least 85 degees and dehumidified. Limit bathing to three times a week. Rub the skin briskly to decrease pruritus.  Question 11 1 / 1 pts Arrange for the patient to receive gamma globulin. 10. What should the nurse do when administering a therapeutic bath to a patient who has severe pruritus? 11. A frail, older adult home health patient who had chickenpox as a child has been exposed to varicella (chickenpox) several days ago. What should the nurse do? 4/8/25, 11:36 AM FINAL EXAM: PN 2212_ Adult Health Nursing II Winter 2025 Assess frequently for herpes zoster. 5/33 Herpes zoster is caused by the same virus that causes chickenpox (Herpes varicella). The greatest risk occurs to patients who have a lowered resistance to infection, such as those on chemotherapy, aging, or receiving large doses of prednisone. in whom the disease could be fatal because of the patient's compromised immune system. Ref: pg 1290 Be aware of the patient's immunity to chickenpox. Encourage the patient to have a pneumonia vaccine.  Question 12 1.5 / 1.5 pts Use gloves The topical application requires that the nurse uses gloves, completely covers the lesion gently, then leaves it open to the air. Ref: 1289 Rub medication into lesions. After application, wrap in warm wet dressings. Apply lightly, being careful not to completely cover the lesion.  Question 13 1.5 / 1.5 pts chickenpox. herpes simplex type I. shingles impetigo. Impetigo is seen at all ages but is particularly common in children. The crust is honey-colored and easily removed and is associated with pruritus. The disease is highly contagious and spreads by contact. Ref: pg 1294 12. A patient has herpes zoster (shingles) and is being treated with acyclovir (Zovirax). What should the nurse do when administering this drug? 13. A child has been sent to the school nurse with pruritus and honey-colored crusts on the lower lip and chin. The nurse believes these lesions most likely are: 4/8/25, 11:36 AM FINAL EXAM: PN 2212_ Adult Health Nursing II Winter 2025 6/33  Question 14 2.5 / 2.5 pts Avoid alcoholic beverages. Use dependable birth control to avoid pregnancy. Accutane has a destructive effect on fetal development. Dependable birth control is important to avoid a pregnancy. Ref: pg 1302 Drink at least 1000 mL of fluid daily. Avoid exposure to the sun.  Question 15 5 / 5 pts c. 24 to 48 hours after burn trauma 24 to 36 hours after burn trauma Within 12 hours after burn trauma In a burn injury, usually the greatest fluid loss occurs within the first 12 hours. Ref: pg.1313 48 to 72 hours after burn trauma 14. What would the nurse stress to the 17-year-old girl who has been prescribed Accutane for her acne? 15. A patient, age 37, sustained partial- and full-thickness burns to 26% of the body surface area. When would the greatest fluid loss resulting from the burns occur? 4/8/25, 11:36 AM FINAL EXAM: PN 2212_ Adult Health Nursing II Winter 2025  Question 16 5 / 5 pts 16. When providing the open method of treatment for a patient who is 52 years old with burns to the lower extremities, what would a nurse include in the nursing plan? 7/33 Keep the room temperature at 85 0F (29.40C) to prevent chilling Chilling may be controlled by keeping the room temperature at 85 F (29.4 C). Strict surgical protocol is observed and analgesia should be given before the treatment. Frequent circulation checks are not a high priority with the open method. Ref: 1318 Perform circulation checks every 2 to 4 hours. Change the dressing using good medical asepsis. Provide an analgesic immediately after the dressing change.  Question 17 1.5 / 1.5 pts Hydro-fiber dressing Alginate dressing Hydrocolloid dressing Hydrocolloid dressings are useful in necrotic wounds with little exudate. Alginate and hydroflber dressings are used for wounds with copious exudate. Transparent film is not absorbent. Ref: 1318 Transparent film  Question 18 5 / 5 pts Increase the IV rate and monitor for burn shock. 0 0 17. What would the nurse dressing a necrotic pressure injury with a minimal exudate most likely use? 18. The nurse is caring for a 26-year-old male patient who was burned 72 hours ago. He has partialthickness burns to 24% of his body surface area. He begins to excrete large amounts of urine. What should the nurse do? 4/8/25, 11:36 AM FINAL EXAM: PN 2212_ Adult Health Nursing II Winter 2025 8/33 Monitor for signs of seizure activity. Assess for signs of fluid overload. As the blood volume increases, the cardiac output increases to increase renal perfusion. The result includes diuresis. However, a great risk for the patient includes fluid overload because of the rapid movement of fluid back into the intravascular space. Ref: pg 1314 Raise the foot of the bed and apply blankets.  Question 19 5 / 5 pts Armpits Scalp Soles of the feet Abdomen Tinea corporis is known as ringworm of the body. It occurs on parts of the body with little or no hair. Ref: pg 1296  Question 20 2 / 2 pts Wash area with copious amounts of water. In dermatitis venenata (poison oak or ivy), the patient should wash the affected part immediately after contact with the offending allergen. Ref: pg 1296 Apply baking soda to lesions. Expose area to air. 19. What should the nurse examine in assessing a patient for tinea corporis? 20. What is the initial intervention for relief of the pruritus of dermatitis venenata? 4/8/25, 11:36 AM FINAL EXAM: PN 2212_ Adult Health Nursing II Winter 2025 9/33 Apply cool compresses continuously.  Question 21 3 / 3 pts Respiratory complications Signs and symptoms of inhalation injury include singed nasal hairs. Breathing difficulties may take several hours to occur. Ref: pg 1314 Bradycardia Hypertension Decreased activity  Question 22 2 / 2 pts Use cool, wet dressings and baths to promote vasoconstriction. Wet dressings and using Burow's solution help promote the healing process. Cold compresses may be applied to decrease circulation to the area (vasoconstriction). Short nails prevent skin damage, but not pruritus. Ref: pg Trim the fingernails short to prevent skin damage from scratching. Expose the areas to the sun to promote drying and healing of the lesions. Wear cotton gloves and cover all other affected areas with clothing to prevent environmental initiation. 21. A patient has been admitted to the hospital with burns to the upper chest. The nurse notes singed nasal hairs. The nurse needs to assess this patient frequently for which condition? 22. A patient developed a severe contact dermatitis of the hands, arms, and lower legs after spending an afternoon picking strawberries. The patient states that the itching is severe and cannot keep from scratching. Which instruction would be most helpful in managing the pruritus? 4/8/25, 11:36 AM FINAL EXAM: PN 2212_ Adult Health Nursing II Winter 2025  Question 23 3 / 3 pts 23. What is the best instruction by the nurse regarding reducing the risk factors for melanoma? 10/33 Have all nevi removed. Watch for changes in moles, especially on the back. Use a sun lamp for tanning. Avoid exposure to the sun and use protective measures when exposure occurs. Encourage the patient to protect skin from the sun by wearing protective clothing, including a hat with 4- in brim, applying sunscreen all over the body, and avoiding the midday sun from 10 a.m. to 4p.m. Sun lamps are just as damaging as the sun. Ref: pg 1311  Question 24 2 / 2 pts Increase sodium consumption. Increase activity to promote mobility. Maintain a balance between rest and activity. Balanced rest, activity, and diet will support medication management. Limited sunlight exposure is recommended to prevent photosensitivity. SLE often has kidney involvement, which would require reduction of sodium. Ref: pg 1306 Increase exposure to the sun to increase vitamin D absorption.  Question 25 3 / 3 pts "Cellulitis can come back at any time." "Cellulitis is contagious." 24. Which patient instruction should the nurse include in the teaching plan relative to the management of systemic lupus erythematosus? 25. Which patient statement indicates that more teaching is needed regarding antibiotic therapy for the treatment of cellulitis? 4/8/25, 11:36 AM FINAL EXAM: PN 2212_ Adult Health Nursing II Winter 2025 11/33 "My skin is cleared up. I don't think I need the medication anymore." The entire amount of antibiotic medication should be completed even if the symptoms have abated to ensure the eradication of the infectious agent. Ref: pg 1294 "If I had washed that scratch with soap and water, I probably would not have gotten cellulitis."  Question 26 3 / 3 pts wavy threadlike lines on the body and pruritus. Scabies is manifested by brown threadlike lines on the body, especially the hands, anus, and body folds. Pruritus is severe. Ref: pg 1308 dry scaly patches in body creases that itch. cluster of papular lesions with pruritus. small fluid-filled blisters that sting when scratched. Stop, drop, and roll. Cover victim with clean cloth or sheet. Transport victim to hospital. Control any bleeding. Provide an open airway.  26. The school nurse recognizes the signs of scabies when a child presents with:  Question 27 1.5 / 1.5 pts 27. During the emergent phase of burn management, what is the first responder's first intervention? Remove all nonadherent clothing and jewelry. 4/8/25, 11:36 AM FINAL EXAM: PN 2212_ Adult Health Nursing II Winter 2025 12/33 Question 28 3 / 3 pts Initiate fluid therapy. Tetanus prophylaxis. The priority of care should proceed from the establishment of an airway, initiation of fluid therapy, insertion of Foley and NG tube, administration of analgesics, and tetanus prophylaxis. Ref: pg 1316 Insert nasogastric tube. Establish airway. Administer analgesics. Insert Foley catheter.  Question 29 1.5 / 1.5 pts Peptic ulcer A significant subjective data assessment for a peptic ulcer is the patient report that pain is associated with eating. With duodenal ulcers the patient often complains of pain I to 2 hours after eating. Ref:pg 1408 Duodenal ulcer Gastritis Achalasia  Question 30 1.5 / 1.5 pts vitamin B12 due to the loss of the intrinsic factor. 28. What is the last intervention for a hospitalized severely burned victim during the emergent phase? 29. A patient who is being evaluated for episodes of hematemesis and dyspepsia tells the nurse that pain occurs when he eats, but pain does not waken him. The nurse recognizes a diagnostic sign of which condition? 30. The nurse anticipates that the patient who has had a subtotal gastrectomy will need supplemental. 4/8/25, 11:36 AM FINAL EXAM: PN 2212_ Adult Health Nursing II Winter 2025 13/33 It is recommended that all patients with a gastrectomy have a blood serum vitamin B12 level measured every 1 to 2 years. Decreased absorption of vitamin B12 may cause pernicious anemia. Ref: pg 1416 vitamin A due to the loss of the gastric lining. bulk to prevent constipation. protein due to the loss of some of the digestive processes.  Question 31 3 / 3 pts Give patient ice chips to moisten mouth. Turn patient to right side. Attach NG tube to suction. Initially, the NG tube should be attached to suction to decompress the stomach and prevent nausea. Assessing the tube for the need of future irrigation will be part of the postoperative care. Irrigate NG tube.  Question 32 3 / 3 pts "I know famotidine will not interfere with my Coumadin." "I take both those meds at the same time every morning." Antacids should not be taken with other drugs, because the absorption of the other drugs may be affected. Ref: pg 1410 "I take the Riopan at least 2 hours after any of my other drugs." "Boy! That Riopan keeps my stomach happy!"  31. The patient has come to the PACU following an ileostomy for the treatment of ulcerative colitis. The patient is conscious and has a nasogastric tube in place and a pouch over the stoma. What should be the nurse's initial action? 32. The home health nurse evaluates a patient being treated for a peptic ulcer with Riopan (antacid) and famotidine (histamine receptor blocker). Which statement made by the patient indicates a need for further instruction? 4/8/25, 11:36 AM FINAL EXAM: PN 2212_ Adult Health Nursing II Winter 2025 14/33 Question 33 3 / 3 pts "With the appropriate pouch and loose clothing, no one will notice a thing." "If everything goes well the surgeon can close this colostomy in about a year." "This is a temporary solution. It will be closed in 6 weeks." The loop colostomy is a temporary colostomy that allows for complete bowel rest. It can be closed in as short a time as 6 weeks. Ref: pg 1437 "This seems awful now, but you won't have the problems you had before."  Question 34 2 / 2 pts Suggest that he discuss his concerns with his physician. Counsel him that everything will be all right. Encourage him to express his concern. When a colostomy is performed, the patient or significant other should be able to verbalize and demonstrate understanding of ostomy care to the nurse. Assure him that his concerns will diminish when he is able to care for his colostomy.  Question 35 1.5 / 1.5 pts Eating 6 small meals a day 33. A patient with a ruptured diverticulum in the descending colon has undergone a transverse loop colostomy. The patient is upset and says, "I didn't know it was going to be this awful. I hate this!" Which response made by the nurse would be most helpful? 34. A male patient complains that he will never adjust to his colostomy. Which is the best action for the nurse in this situation? 35. Which of the following should be included in the patient teaching of a patient with a peptic ulcer? 4/8/25, 11:36 AM FINAL EXAM: PN 2212_ Adult Health Nursing II Winter 2025 15/33 The patient with a peptic ulcer should eat frequently to keep food in the stomach. Eating 6 small meals daily is helpful. Restriction of fluid is not necessary and irritating foods, alcohol, and caffeine should be discouraged. Ref: pg 1409 Restricting fluid to 1000 mL per day Introducing irritating foods in minute amounts to desensitize the stomach Drinking alcohol and caffeine in moderation  Question 36 2 / 2 pts Application of ice bag Application of an ice bag will decrease the flow of blood to the area and impede the inflammatory process. Ref: 1428 Ambulate for short periods in the room Warm compress over entire abdomen Administration of small tap water enema  Question 37 2 / 2 pts a tap water enema warm bath glycerin suppository 36. Which of the following would be the most helpful nursing intervention to increase the comfort of a patient with appendicitis? 37. To assist a family with a bowel-training program to reduce fecal incontinence, the nurse would suggest the use of an optimal time to stimulate defecation. 4/8/25, 11:36 AM FINAL EXAM: PN 2212_ Adult Health Nursing II Winter 2025 The use of a glycerin suppository for fecal stimulation is a helpful aid in a bowel-training program. The suppository is administered at what the family and patient have determined is the optimal time for a bowel movement. 16/33 Ref: pg 1441 large glass of warm lemonade omeprazole Correct Answers ranitidine (Zantac) sucralfate (Carafate) omeprazole (Prilosec) olsalazine (Dipentum)  Question 39 2 / 2 pts It protects the gastric mucosa. It inhibits gastric acid secretion. It neutralizes or reduces the acidity of stomach contents. It eradicates H. pylori. Antibiotic therapy eradicates H. pylori. Ref: pg 1409  Question 40 1.5 / 1.5 pts "You should confirm that the acupuncturist is licensed." "YIKES! An acupuncturist?"  Question 38 3 / 3 pts 38. The nurse takes into consideration that a proton pump inhibitor drug, such as ________ will completely eradicate gastric acid production. 39. Which of the following is the purpose of antibiotic therapy in treating peptic ulcers? 40. The patient with irritable bowel syndrome (IBS) tells the home health nurse she is going to an acupuncturist for therapy for her condition. Which of the following would be the best nursing response? 4/8/25, 11:36 AM FINAL EXAM: PN 2212_ Adult Health Nursing II Winter 2025 17/33 "It may help, but there has been no clinical proof of its effectiveness." While it is true that some have found relief, there is no evidence that these therapies relieve the symptoms of IBS. REF: pg. 1420 "Go for it. Alternative medicine does great things."  Question 41 3 / 3 pts Check for allergy to contrast media or to shellfish. Have patient void immediately before procedure. To prevent the puncturing of the bladder, the patient must void immediately before the procedure. A permit is required but it is not a safety precaution for the patient. There is no contrast media used in a paracentesis. REF: pg. 1449 Pad side rails. Have patient sign a permit.  Question 42 2 / 2 pts To improve diaphragmatic expansion and prevention of atelectasis. To keep the duct open and allow drainage of the bile until edema resolves. If the stones are in the common bile duct and edema is present, a biliary drainage tube, or T tube, will be inserted to keep the duct open and allow drainage of the bile until the edema resolves. REF: pg. 1465 41. What is an essential nursing measure to prevent injury to the patient who is to receive a paracentesis? 42. A patient was scheduled for a laparoscopic cholecystectomy, but complications developed, and he underwent an open cholecystectomy with a T tube inserted into the common bile duct. What is the purpose of the T tube? 4/8/25, 11:36 AM FINAL EXAM: PN 2212_ Adult Health Nursing II Winter 2025 18/33 To decompress the duct and relieve pain caused by stimulation of the sphincter of Oddi. To shorten postoperative recovery and hasten the healing process.  Question 43 3 / 3 pts place the collection bag so the tube is not kinked. Irrigate the T tube with normal saline to ensure the free flow of bile. open the T tube to the air so that it will drain freely. position and secure the drainage bag at the chest level. The T tube is placed below the level of the common bile duct to prevent the reflux of bile. The bag must be positioned so the tube is not kinked, or bile cannot drain from the liver. Normally T tubes are not irrigated. REF: 1465  Question 44 3 / 3 pts As an attempt to get the nurse's attention As an indication of respiratory obstruction from varices As spasticity As asterixis 43. The nurse caring for a patient who has had an open cholecystectomy with a T Tube will: 44. The patient with cirrhosis has a rising ammonia level and is becoming disoriented. The patient waves to the nurse as she enters the room. How should the nurse interpret this? 4/8/25, 11:36 AM FINAL EXAM: PN 2212_ Adult Health Nursing II Winter 2025  Question 45 3 / 3 pts 45. How does the administration of neomycin (Mycifradin) reduce the production of ammonia? 19/33 By decreasing the bacteria in the gut The buildup of ammonia can be prevented with the use of lactulose (Chronulac) and neomycin. Ammonia is produced in the gut by bacterial action. By reducing the bacteria, less ammonia is produced. REF: 1455 By reducing ascites By helping to digest fats and proteins By assisting the hepatic cells to regenerate  Question 46 3 / 3 pts Sexual contact Needles Blood transfusion Food or water Hepatitis A virus is transmitted when a person puts something in his or her mouth that is contaminated with fecal material (called fecal-oral transmission). Teach patients the importance of good hand washing after the bathroom or changing a diaper, as well as proper food preparation, to prevent the spread of HAV. REF: 1459  Question 47 2 / 2 pts Diligent hand washing Hepatitis B vaccine The best preventive measure against the contraction of hepatitis B is HBV vaccine. REF: 1459 Hb immune globulin injections Wearing protective gear  46. What should the nurse avoid contamination from to prevent the transmission of hepatitis A? 47. What is the most appropriate method used by high-risk health workers to prevent hepatitis B? 4/8/25, 11:36 AM FINAL EXAM: PN 2212_ Adult Health Nursing II Winter 2025 20/33 Question 48 3 / 3 pts increases blood supply to transplant. increases the rate of the regeneration of liver cells. can overcome complications presented by hepatitis C. does not suppress bone marrow.  Question 49 3 / 3 pts Cirrhosis Coronary artery disease Alcoholism and biliary tract disease History of myocardial infarction  Question 50 3 / 3 pts "Resting your GI tract will cure your pancreatitis." "Eating causes the need for a bowel movement, which excretes your medication too rapidly." "Diagnostic tests depend on you not eating anything." "The pancreas is stimulated whenever you eat or drink and causes pain." 48.The nurse explains that the use of cyclosporine as an immunosuppressant has been successful in the reduction of rejection of liver transplants because the drug: 49. Which factors are most commonly associated with pancreatitis? 50. A patient with pancreatitis is NPO. The patient asks the nurse why he is unable to have anything by mouth. Which of the following is the best response? 4/8/25, 11:36 AM FINAL EXAM: PN 2212_ Adult Health Nursing II Winter 2025  Question 51 3 / 3 pts 51. Which assessment would indicate possible gallbladder disease in an older adult? 21/33 Distention of veins in upper part of body Aching muscles and tenderness in the liver Changes in color of urine or stool Dull pain in the right upper quadrant region  Question 52 3 / 3 pts Fluid removal over at least 30 minutes The fluid removed during a paracentesis is removed over a period of 30 to 90 minutes to prevent sudden changes in blood pressure leading to syncope. The bed should be in a high Fowler's position. Food and fluid restriction is usually not necessary. REF: pg 1453 Seizure Hypervolemia The urinary output  Question 53 3 / 3 pts Notify the physician. Increase the IV fluids. Change the T-tube dressing. Unclamp the tube immediately. While the tube is clamped, the patient may show signs of abdominal pain, nausea, vomiting, etc. Unclamp the tube immediately to allow for drainage and relief of both nausea and pain. 52. What should the nurse monitor in caring for the patient undergoing a paracentesis? 53. A patient with a T tube for an open cholecystectomy has resumed oral intake. The T tube is clamped 2 hours before meals and unclamped 2 hours after meals to aid in the digestion of fat. During the time the tube is clamped the patient complains of abdominal pain and nausea. Which intervention is most appropriate? 4/8/25, 11:36 AM FINAL EXAM: PN 2212_ Adult Health Nursing II Winter 2025 22/33 REF: pg 1464  Question 54 2 / 2 pts Fibrotic regeneration Hepatic insufficiency Destruction Liver disease Liver deterioration follows a pattern of stages: destruction, inflammation, fibrotic regeneration; hepatic insufficiency then presents as liver disease. REF: pg. 1450 Inflammation  Question 55 3 / 3 pts Less sodium The diet should be lower in sodium to help decrease edema. REF: pg. 1720 More carbohydrates More calories Less potassium 54. The nurse clarifies that deterioration progresses through stages before presenting with liver disease. The first stage is destruction. What is the last stage? 55. To which diet should a patient with Cushing syndrome adhere? 4/8/25, 11:36 AM FINAL EXAM: PN 2212_ Adult Health Nursing II Winter 2025  Question 56 3 / 3 pts 56. The patient is a 20-year-old college student who has type 1 diabetes and normally walks each evening as part of an exercise regimen. The patient plans to enroll in a swimming class. Which adjustment should be made based on this information? 23/33 Time the morning insulin injection so that the peak action will occur during swimming class. Delete normal walks on swimming class days. Monitor glucose level before, during, and after swimming to determine the need for alterations in food or insulin. Delay the meal before the swimming class until the session is over.  Question 57 3 / 3 pts Adrenocorticotropic hormone (ACTH) Antidiuretic hormone (ADH) Diabetes insipidus develops when there is a decrease in production of ADH from the posterior pituitary or the action of ADH is diminished. REF: pg. 1703 Thyroid-stimulating hormone (TSH) Follicle-stimulating hormone (FSH)  Question 58 2.5 / 2.5 pts stimulate the thyroid gland. depress the pituitary. alter the stimulus from the pituitary. destroy some of the thyroid tissue. 57. In diabetes insipidus, a deficiency of which hormone causes clinical manifestations? 58. The purpose of the use of radioactive iodine in the treatment of hyperthyroidism is to: 4/8/25, 11:36 AM FINAL EXAM: PN 2212_ Adult Health Nursing II Winter 2025 Radioactive iodine 13 1 destroys some of the hyperactive thyroid gland to produce a more normally functioning gland. REF: pg. 1710 24/33  Question 59 2.5 / 2.5 pts Supine Semi-Fowler Side-lying Prone  Question 60 2 / 2 pts a. Large bandage scissors Water-sealed drainage system Ventilator Tracheotomy tray There should be a suction apparatus and tracheotomy tray available for emergency use. REF: pg. 1711  Question 61 3 / 3 pts 15 Correct Answers 15 59. What is the postoperative position for a person who has had a thyroidectomy? 60. What extra equipment should the nurse provide at the bedside of a new postoperative thyroidectomy patient? 50. The human insulin whose onset of action occurs within minutes is lispro (Humalog). 4/8/25, 11:36 AM FINAL EXAM: PN 2212_ Adult Health Nursing II Winter 2025 25/33  Question 62 1.5 / 1.5 pts It can increase muscle bulk and may result in malabsorption of insulin. It can decrease the need for insulin and may result in hypoglycemia. It can decrease metabolic demand and may result in metabolic acidosis. It can increase the need for insulin and may result in hyperglycemia.  Question 63 1.5 / 1.5 pts Osteoporosis Kidney stones Lethargy Laryngeal spasms  Question 64 1.5 / 1.5 pts encouraging physical exercise. discouraging daytime naps. limiting fluids to 1500 mL a day. protecting patient from injury.  Question 65 1.5 / 1.5 pts 62. What should the nurse caution a type I diabetic about excessive exercise? 63. A patient has undergone tests that indicate a deficiency of the parathyroid hormone secretion. She should be informed of which potential complication? 64. The nurse caring for a 75-year-old man who has developed diabetes insipidus following a head injury will include in the plan of care provisions for: 4/8/25, 11:36 AM FINAL EXAM: PN 2212_ Adult Health Nursing II Winter 2025 26/33 hunger and a trembling sensation. dyspnea and pallor. abdominal pain and nausea. flushing of the skin and headache.  Question 66 1.5 / 1.5 pts Calorie-restricted meals Fluid restrictions Caffeine-rich beverages Frequent small meals high in carbohydrates  Question 67 1.5 / 1.5 pts At room temperature After rolling bottle between hands to warm At body temperature Straight from the refrigerator  Question 68 1.5 / 1.5 pts 65. The nurse teaching a patient with type 1 diabetes mellitus (IDDM) about early signs of insulin reaction would include information about: 66. A 27-year-old patient with hypothyroidism is referred to the dietitian for dietary consultation. What should nutritional interventions include? 67. How should the nurse administer insulin to prevent lipohypertrophy? 68. What information should be obtained from the patient before an iodine-131 test? 4/8/25, 11:36 AM FINAL EXAM: PN 2212_ Adult Health Nursing II Winter 2025 27/33 Status of possible pregnancy Iodine-131 is not a radiation hazard to the nonpregnant patient but is absolutely contraindicated during pregnancy. Pregnant nurses should not care for this patient for several days. REF: 1710 Use of prescription drugs for hypertension Presence of metal in the body Allergy to sulfa drugs  Question 69 1.5 / 1.5 pts White bread Pork Eggs The hypothyroid diet should be adequate in intake of iodine, in foods such as saltwater fish, milk, and eggs; fluids should be increased to help prevent constipation. REF: 1714 Skinless chicken  Question 70 1.5 / 1.5 pts Drop in blood pressure 69. The patient being treated for hypothyroidism should be instructed to eat well-balanced meals including intake of iodine. Which of the following foods contains iodine? 70. The nurse is caring for a patient who is receiving calcium gluconate for treatment of hypoparathyroid tetany. Which assessment would indicate an adverse reaction to the drug? 4/8/25, 11:36 AM FINAL EXAM: PN 2212_ Adult Health Nursing II Winter 2025 Indications of an adverse effect of calcium gluconate are dyspnea, bradycardia, and hypotension. 28/33 REF: 1718 Urticaria Flushing of face and neck Increase in heart rate.  Question 71 1.5 / 1.5 pts Spiritual Emotional Financia Physical Intellectual The five areas of human function are physical, emotional, intellectual, sociocultural, and spiritual. REF: pg 739-740  Question 72 1.5 / 1.5 pts regular checkups if dysphagia is present. good oral care. reducing excessive weight. 71. Which of the five aspects of human functioning must a nurse address when dealing with a grieving person? (Select all that apply.) 72. In designing a teaching plan to present to a group of older adults regarding the prevention of esophageal cancer, the nurse would include information about the significance of: (Select all that apply.) 4/8/25, 11:36 AM FINAL EXAM: PN 2212_ Adult Health Nursing II Winter 2025 29/33 cessation of smoking. limiting alcohol consumption. reduction of consumption of citrus fruits. Preventive measures include cessation of smoking and alcohol consumption, good oral care, and medical evaluation of dysphagia. Weight and reduction of citrus fruits are noncontributory to prevention of esophageal cancer. REF:  Question 73 1.5 / 1.5 pts Blood in stool Onset associated with change in stool consistency or frequency. Nausea and vomiting associated with onset Pain relieved by defecation Excessive flatulence Discomfort at least 3 days a month The Rome Criteria include that the patient experience discomfort at least 3 days a month within the last 3 months, pain relieved by defecation, onset associated with change in stool frequency, and onset in association with a change in stool appearance. Although increased flatus is associated with diverticulitis, it is not part of the Rome Criteria. REF: 1420  Question 74 1.5 / 1.5 pts 73. The home health nurse is caring for a patient who has frequent abdominal pain and diarrhea. The nurse uses the Rome Criteria to direct assessment for irritable bowel syndrome. What is included in the Rome Criteria? (Select all that apply.) 74. What are the indications for a liver transplant? (Select all that apply.) 4/8/25, 11:36 AM FINAL EXAM: PN 2212_ Adult Health Nursing II Winter 2025 30/33 Chronic hepatitis Hepatic malignancy Cirrhosis due to alcoholism Gallbladder disease Congenital biliary abnormalities Contaminated items may be disposed of with regular trash. Articles soiled with feces do not require extra care.  Question 76 2 / 2 pts Diaphoresis Irritability Deep respirations Fruity breath Dry mouth Tremors Indications for liver transplantation include congenital biliary abnormalities, inborn errors of metabolism, hepatic malignancy (confined to the liver), sclerosing cholangitis, and chronic end-stage liver disease. REF: 1460  Question 75 2 / 2 pts 75. Viral hepatitis may be treated at home. What should be taught to the patient's family? (Select all that apply.) Clothes should be laundered separately with hot water. Personal items and drinking glasses should not be shared. 76.Which of the following are signs and symptoms of hypoglycemia? (Select all that apply.) 4/8/25, 11:36 AM FINAL EXAM: PN 2212_ Adult Health Nursing II Winter 2025 31/33 Hypoglycemic reaction: rapid shallow respirations, tremors, excessive perspiration, and possibly loss of consciousness. REF: 1737  Question 77 2 / 2 pts high phosphorus foods. tofu. bananas. vitamin D supplements. canned fish with the bones. cucumbers. The hypocalcemic patient should eat a high-calcium, low-phosphorus diet that includes canned fish, cucumbers, tofu, and vitamin D supplements as an aid to the absorption of the calcium. REF: 1718  Question 78 5 / 5 pts Pepsin lipids acid enzymes Pepsin is activated by the hydrochloric acid to break down protein for digestion. REF: 1393 77.The nurse would instruct a patient who is hypocalcemic from hypoparathyroidism about a diet that should include: (Select all that apply) 78. The nurse explains that, the chief enzyme of gastric juice, is activated by hydrochloric acid to begin digestion of protein. 4/8/25, 11:36 AM FINAL EXAM: PN 2212_ Adult Health Nursing II Winter 2025 32/33 Pepsin is activated by the hydrochloric acid to break down protein for digestion. REF: 1393  Question 79 5 / 5 pts True False Diabetic lipids Ketoacidosis GLUCOSE Quiz Score: 200 out of 200 79. Hepatitis D is usually seen as a coinfection with Hepatitis B. Hepatitis D is usually seen as a coinfection with hepatitis B. REF: 1458 Hepatitis D is usually seen as a coinfection with hepatitis B. REF: 1458  Question 80 5 / 5 pts 80. Another term for hyperglycemic reaction is _________. 4/8/25, 11:36 AM FINAL EXAM: PN 2212_ Adult Health Nursing II Winter 2025 33/33