NR 226 Adult Health I Exam 7 Study Guide 2026 |Chamberlain College
1. A nurse is educating an older adult client on how to prevent urinary tract
infections (UTIs). Which of the following instructions should the nurse include?
A. Wipe from back to front after a bowel movement.
B. Increase daily fluid intake to at least 2 to 3 liters.
C. Take daily bubble baths to ensure perineal cleanliness.
D. Wear synthetic nylon underwear to keep the area dry.
Answer: B
Rationale: Adequate hydration helps flush bacteria out of the urinary tract. Wiping should
be front to back, bubble baths can irritate the urethra, and cotton underwear is preferred
over synthetic materials.
2. Which clinical manifestation should a nurse expect to find in a client
experiencing hypoglycemia?
A. Extreme thirst and polyuria
B. Fruity breath odor
C. Diaphoresis and shakiness
D. Kussmaul respirations
Answer: C
Rationale: Hypoglycemia (low blood sugar) typically causes sympathetic nervous system
activation, leading to sweating (diaphoresis), tremors, and palpitations. Thirst and fruity
breath are signs of hyperglycemia/DKA.
,3. A client is 24 hours post-abdominal surgery. Which assessment finding
regarding bowel sounds should the nurse report to the provider?
A. High-pitched tinkling sounds
B. Hypoactive sounds in all quadrants
C. Gurgling sounds every 15 seconds
D. Absent sounds for 5 continuous minutes
Answer: D
Rationale: While hypoactive sounds are expected early post-op, the total absence of bowel
sounds for 5 minutes suggests a paralytic ileus and must be reported.
4. A nurse is providing discharge teaching to a client with a new colostomy.
Which statement by the client indicates a need for further teaching?
A. ‘I should empty my pouch when it is about one-third full.’
B. ‘I will clean the skin around the stoma with warm water.’
C. ‘I need to cut the wafer 1 inch larger than the stoma.’
D. ‘I will avoid eating high-fiber foods for the first few weeks.’
Answer: C
Rationale: The skin barrier/wafer should be cut no more than 1/8 to 1/16 of an inch
larger than the stoma to prevent skin irritation from stool; 1 inch is too large.
5. A client presents with severe colicky flank pain and hematuria. Which
intervention is the priority?
A. Strain all urine to monitor for calculi.
B. Encourage the client to ambulate in the hallway.
C. Administer prescribed opioid analgesics.
D. Collect a mid-stream urine specimen for culture.
Answer: C
Rationale: Renal colic (kidney stones) causes excruciating pain. Managing pain is the
immediate priority for client comfort and stabilization.
, 6. Which site is preferred for administering insulin to achieve the most
consistent and rapid absorption?
A. Deltoid muscle
B. Gluteus maximus
C. Vastus lateralis
D. Abdomen
Answer: D
Rationale: Insulin is absorbed most consistently and rapidly when injected into the
subcutaneous tissue of the abdomen.
7. A nurse is assessing a client with Benign Prostatic Hyperplasia (BPH). Which
symptom is most commonly associated with this condition?
A. Severe flank pain
B. Urinary hesitancy and weak stream
C. High-grade fever
D. Painless gross hematuria
Answer: B
Rationale: BPH involves prostate enlargement that compresses the urethra, leading to
obstructive symptoms like hesitancy, dripping, and a weak stream.
8. Which dietary modification should a nurse recommend to a client with
Chronic Kidney Disease (CKD) to help manage the condition?
A. Increase intake of phosphorus-rich foods.
B. Restrict protein intake as directed.
C. Use salt substitutes containing potassium.
D. Increase sodium intake to maintain blood pressure.
Answer: B
1. A nurse is educating an older adult client on how to prevent urinary tract
infections (UTIs). Which of the following instructions should the nurse include?
A. Wipe from back to front after a bowel movement.
B. Increase daily fluid intake to at least 2 to 3 liters.
C. Take daily bubble baths to ensure perineal cleanliness.
D. Wear synthetic nylon underwear to keep the area dry.
Answer: B
Rationale: Adequate hydration helps flush bacteria out of the urinary tract. Wiping should
be front to back, bubble baths can irritate the urethra, and cotton underwear is preferred
over synthetic materials.
2. Which clinical manifestation should a nurse expect to find in a client
experiencing hypoglycemia?
A. Extreme thirst and polyuria
B. Fruity breath odor
C. Diaphoresis and shakiness
D. Kussmaul respirations
Answer: C
Rationale: Hypoglycemia (low blood sugar) typically causes sympathetic nervous system
activation, leading to sweating (diaphoresis), tremors, and palpitations. Thirst and fruity
breath are signs of hyperglycemia/DKA.
,3. A client is 24 hours post-abdominal surgery. Which assessment finding
regarding bowel sounds should the nurse report to the provider?
A. High-pitched tinkling sounds
B. Hypoactive sounds in all quadrants
C. Gurgling sounds every 15 seconds
D. Absent sounds for 5 continuous minutes
Answer: D
Rationale: While hypoactive sounds are expected early post-op, the total absence of bowel
sounds for 5 minutes suggests a paralytic ileus and must be reported.
4. A nurse is providing discharge teaching to a client with a new colostomy.
Which statement by the client indicates a need for further teaching?
A. ‘I should empty my pouch when it is about one-third full.’
B. ‘I will clean the skin around the stoma with warm water.’
C. ‘I need to cut the wafer 1 inch larger than the stoma.’
D. ‘I will avoid eating high-fiber foods for the first few weeks.’
Answer: C
Rationale: The skin barrier/wafer should be cut no more than 1/8 to 1/16 of an inch
larger than the stoma to prevent skin irritation from stool; 1 inch is too large.
5. A client presents with severe colicky flank pain and hematuria. Which
intervention is the priority?
A. Strain all urine to monitor for calculi.
B. Encourage the client to ambulate in the hallway.
C. Administer prescribed opioid analgesics.
D. Collect a mid-stream urine specimen for culture.
Answer: C
Rationale: Renal colic (kidney stones) causes excruciating pain. Managing pain is the
immediate priority for client comfort and stabilization.
, 6. Which site is preferred for administering insulin to achieve the most
consistent and rapid absorption?
A. Deltoid muscle
B. Gluteus maximus
C. Vastus lateralis
D. Abdomen
Answer: D
Rationale: Insulin is absorbed most consistently and rapidly when injected into the
subcutaneous tissue of the abdomen.
7. A nurse is assessing a client with Benign Prostatic Hyperplasia (BPH). Which
symptom is most commonly associated with this condition?
A. Severe flank pain
B. Urinary hesitancy and weak stream
C. High-grade fever
D. Painless gross hematuria
Answer: B
Rationale: BPH involves prostate enlargement that compresses the urethra, leading to
obstructive symptoms like hesitancy, dripping, and a weak stream.
8. Which dietary modification should a nurse recommend to a client with
Chronic Kidney Disease (CKD) to help manage the condition?
A. Increase intake of phosphorus-rich foods.
B. Restrict protein intake as directed.
C. Use salt substitutes containing potassium.
D. Increase sodium intake to maintain blood pressure.
Answer: B
