Comprehensive Adult Health Exam Prep: OFFICIAL STUDY RESOURCE: FULL TEST BANK WITH RATIONALES 2026 COMPLETE EXAM SOLUTION - MULTIPLE VERSIONS INCLUDED

Question 1: Spironolactone Adverse Effects A nurse is monitoring a client who is taking spironolactone for the treatment of hypertension. Which findings denote adverse effects of the medication? (Select all that apply.) • A. Tall T waves • B. Prolonged PR interval • C. Hyperactive bowel sounds • D. Constipation • E. Shallow respirations Correct Answers: A, B, and C Rationale: • A, B, and C are correct: Spironolactone is a potassium-sparing diuretic that can cause hyperkalemia (elevated serum potassium). Cardiovascular manifestations of hyperkalemia include tall, peaked T waves, a prolonged PR interval, flat P waves, and widened QRS complexes. Gastrointestinal manifestations include hyperactive bowel sounds and diarrhea due to increased smooth muscle hyperactivity. • D and E are incorrect: Constipation, hyporeflexia, and shallow respirations are classic clinical manifestations of hypokalemia (low serum potassium), not hyperkalemia. Question 2: COPD Dietary Accommodations A nurse is providing dietary instructions to a client with chronic obstructive pulmonary disease (COPD) who is experiencing a loss of appetite and complains of feeling "too full to eat." What does the nurse encourage the client to do? (Select all that apply.) • A. Drink a large glass of water right before meals. • B. Avoid drinking fluids before and during meals. • C. Select foods that are easy to chew and are not gas-forming. • D. Eat gas-forming foods like broccoli to increase fiber. • E. Snack on dry crackers and milk chocolate between meals. Correct Answers: B and C Rationale: • B and C are correct: Clients with severe COPD often experience early satiety ("feeling too full to eat") because a flattened diaphragm pushes down on the stomach. Avoiding fluids immediately before and during meals prevents gastric distention. Choosing foods that are easy to chew reduces the energy expenditure of eating, and avoiding gasforming foods prevents abdominal bloating that can compress the diaphragm and worsen dyspnea. • A is incorrect: Drinking fluids right before meals fills the stomach with non-nutritive volume, worsening early satiety. • D is incorrect: Broccoli is a known gas-forming food that causes intestinal distention, which pushes upward on the diaphragm and increases respiratory distress. • E is incorrect: Dry foods like crackers can easily trigger coughing fits in a COPD patient. Milk and chocolate should be limited as they can increase the viscosity (thickness) of saliva and respiratory secretions, making them harder to clear. Question 3: Tuberculin Skin Test (TST) in HIV A tuberculin skin test (TST) is administered to a client with a diagnosis of HIV infection. Fortyeight hours after administration, the nurse checks the test site and notes an area of induration measuring 9 mm. How should the nurse interpret this result? • A. Negative, because it is less than 10 mm. • B. Positive, indicating active tuberculosis disease. • C. Positive, indicating exposure to TB or dormant disease. • D. Inconclusive, requiring immediate re-testing. Correct Answer: C Rationale: • C is correct: In an immunocompromised individual (such as a client with an HIV infection), an induration measuring 5 mm or more is considered a positive reaction due to their decreased immune response. A positive TST signifies that the client has been exposed to TB or has a latent (inactive/dormant) infection; it does not definitively diagnose active tuberculosis disease. • A is incorrect: An induration of 10 mm or more is the threshold for individuals with moderate risk factors or healthy, non-immunosuppressed individuals, but it is too high for an HIV-positive client. • B is incorrect: A skin test cannot differentiate between active disease and a latent infection. Further diagnostics (e.g., chest X-ray, sputum cultures) are required to confirm active disease. • D is incorrect: The result is definitive and meets the strict criteria for a positive result in this patient population. Question 4: Central Venous Pressure (CVP) Interpretation A nurse is interpreting a central venous pressure (CVP) reading from a client in whom right ventricular failure has been diagnosed. From this diagnosis, the nurse would expect that the most likely result is a pressure of: • A. 4 cm H₂O • B. 8 cm H₂O • C. 11 cm H₂O • D. 14 cm H₂O Correct Answer: D Rationale: • D is correct: The normal CVP reading ranges from 7 to 12 cm H₂O (or 2 to 8 mmHg, depending on the scale utilized). Because CVP measures the pressure in the right atrium and central veins, right-sided ventricular failure will cause blood to back up into the systemic venous system, resulting in an abnormally elevated CVP reading, such as 14 cm H₂O. • A is incorrect: A reading of 4 cm H₂O is abnormally low and typically indicates hypovolemia (fluid volume deficit). • B and C are incorrect: Readings of 8 and 11 cm H₂O fall squarely within the expected, healthy reference range. Question 5: Post-Thyroidectomy Bleeding Assessment A nurse is caring for a client who has just undergone a thyroidectomy. Which technique is the best way for the nurse to assess the surgical site for bleeding? • A. Keep the client completely flat to evaluate blood pooling. • B. Ask the client every hour if the dressing feels wet. • C. Replace the dry sterile dressing every 2 hours to inspect the incision. • D. Check for moisture on the back of the dressing over the client's neck and shoulders. Correct Answer: D Rationale: • D is correct: Due to gravity, blood from a bleeding thyroid incision will naturally seep down the sides of the neck dressing and pool in the dependent areas behind the client's neck and upper shoulders. The front/anterior part of the dressing may appear completely dry even during an active hemorrhage. • A is incorrect: Keeping a post-thyroidectomy client completely flat increases venous pressure in the neck and can compromise the airway; the head of the bed should be elevated (semi-Fowler's). • B is incorrect: Relying on subjective client reports is unsafe, as significant pooling can occur before the client becomes aware of it. • C is incorrect: Frequently removing and replacing an intact surgical dressing unnecessarily disrupts the wound, introduces bacteria, and increases the risk of infection. Question 6: Nutritional Selections for Burn Healing A client who sustained a major burn injury is beginning to take an oral diet again. Which between-meal menu selections meet the client's needs for wound healing and tissue repair? (Select all that apply.) • A. Whole-milk shake and granola • B. Baked potato topped with cheese • C. Cheese and whole-wheat crackers • D. Fresh fruit salad with skim milk • E. Tossed green salad with light dressing Correct Answers: A, B, and C Rationale: • A, B, and C are correct: Major burn injuries cause a massive hypermetabolic and catabolic state. To promote proper wound healing, tissue remodeling, and a positive nitrogen balance, the client requires a diet exceptionally high in calories, protein, and carbohydrates. Milkshakes, granola, cheese, and whole-wheat crackers are energydense options that fulfill these requirements. • D and E are incorrect: While fresh fruits, vegetables, and skim milk are highly nutritious, they are low in calories and protein. During the acute healing phase of a major burn, high-calorie and full-fat versions of foods are strictly preferred over low-calorie alternatives. Question 7: Hypoparathyroidism Supplements A client is found to have hypoparathyroidism. Which nutritional supplement does the nurse tell the client to take on a daily basis while teaching measures to manage the disorder? • A. Calcium carbonate with vitamin D • B. Calcium citrate with vitamin C • C. Potassium chloride with beta-carotene • D. Phosphorus supplements Correct Answer: A Rationale: • A is correct: Hypoparathyroidism results in a deficiency of parathyroid hormone (PTH), leading to hypocalcemia (low calcium) and hyperphosphatemia (high phosphorus). Management requires lifetime supplementation of oral calcium (such as calcium carbonate) to maintain serum levels, combined with Vitamin D to enhance gastrointestinal calcium absorption. • B is incorrect: While calcium citrate is an acceptable form of calcium, Vitamin C does not play a direct role in regulating or absorbing calcium for parathyroid disease. • C is incorrect: Potassium and beta-carotene do not manage the mineral imbalances associated with PTH deficiencies. • D is incorrect: Phosphorus must be restricted in these clients, not supplemented, because their baseline serum phosphorus levels are already abnormally high. Question 8: Health Screening Referrals A nurse participating in a free health screening at the local mall obtains a random blood glucose level of 190 mg/dL (10.6 mmol/L) and a total cholesterol level of 210 mg/dL (5.4 mmol/L) in an otherwise healthy client. What should the nurse tell the client to do next? • A. Go directly to the emergency department for immediate intervention. • B. Call his health care provider to have these values rechecked as soon as possible. • C. Start a strict low-carbohydrate, low-fat diet and recheck in six months. • D. Ignore the values, as random screenings outside a lab are highly unreliable. Correct Answer: B Rationale: • B is correct: A diagnosis of diabetes mellitus or hypercholesterolemia cannot be confirmed from a single screening test. A random plasma glucose level approaching 200 mg/dL and a total cholesterol reading over the normal 200 mg/dL threshold require formal diagnostic evaluation and fasting blood draws by a primary provider to determine an appropriate treatment plan. • A is incorrect: While these numbers are elevated, they do not represent an acute, lifethreatening emergency (like diabetic ketoacidosis) that warrants an ER visit, provided the client is asymptomatic. • C is incorrect: The nurse should not prescribe independent long-term dietary changes for chronic conditions before a formal medical diagnosis is secured. • D is incorrect: These numbers are significantly out of range and must not be ignored, as early detection of metabolic disorders prevents long-term vascular complications. Question 9: Levothyroxine Side Effects Levothyroxine sodium is prescribed for a client with hypothyroidism, and the nurse provides information to the client about the medication. Which occurrences does the nurse tell the client to report to the health care provider immediately? (Select all that apply.) • A. Chest pain • B. Palpitations • C. Rapid heart rate • D. Weight gain • E. Constipation Correct Answers: A, B, and C Rationale: • A, B, and C are correct: Levothyroxine is a synthetic thyroid hormone replacement that accelerates the body's metabolic rate and increases cardiac workload and myocardial oxygen demands. If the dose is too high, it can induce hyperthyroidism or trigger cardiac dysrhythmias and myocardial ischemia. Clients must immediately report signs of cardiotoxicity, such as chest pain, palpitations, or tachycardia (rapid heart rate). • D and E are incorrect: Weight gain, constipation, and lethargy are classic symptoms of hypothyroidism. While they indicate that the current levothyroxine dosage may be inadequate, they are expected baseline manifestations that should improve over time and do not constitute an acute medical warning sign like cardiac symptoms.