NR 226: Adult Health I Final Exam Practice Questions Essential Certification Manual: Comprehensive Topic Review, Realistic Practice Questions, and Full Test Bank

During a skin assessment, the nurse observes clusters of small, raised lesions in corresponding locations on the patient’s left and right upper back. Which term best describes the distribution of these lesions? A. Confluent B. Symmetric C. Linear D. Unilateral Correct Answer: B. Symmetric Rationale: Symmetric lesions appear in similar locations on opposite sides of the body. Confluent lesions merge together, linear lesions follow a line or narrow pattern, and unilateral lesions occur on only one side. Accurate documentation of lesion distribution helps clinicians identify possible causes and monitor changes. Question 2 A patient has scaling and itching between the toes, and the healthcare provider suspects a superficial fungal infection. Which equipment should the nurse obtain to collect a specimen for culture? A. Cotton-tipped applicators B. Blood culture bottles C. Sterile urinary catheter D. Large-bore aspiration needle Correct Answer: A. Cotton-tipped applicators Rationale: A sterile cotton-tipped applicator can be used to collect material from a superficial skin lesion for microbiological testing. Blood culture bottles are used for suspected bloodstream infections, urinary catheters collect urine, and aspiration needles are generally used for deeper collections such as abscesses. Question 3 A dark-skinned patient with chronic heart failure develops increasing shortness of breath. Which assessment location provides the most reliable evidence of central cyanosis? A. Forehead and cheeks B. Palms and soles C. Lips and oral mucous membranes D. Anterior surface of the lower legs Correct Answer: C. Lips and oral mucous membranes Rationale: Cyanosis can be difficult to identify in deeply pigmented skin. The lips, tongue, conjunctivae, and oral mucous membranes are more reliable sites for assessing central cyanosis because pigmentation has less influence on their appearance. The palms, soles, cheeks, and legs are less reliable for this purpose. Question 4 During a home visit, the nurse notices irregular bruises in different stages of healing on an older adult’s arms, torso, and back. The patient’s caregiver remains in the room and answers most questions. What should the nurse do first? A. Photograph the bruises without discussing them B. Contact law enforcement immediately C. Interview the patient privately about the injuries D. Ask the caregiver to explain every bruise Correct Answer: C. Interview the patient privately about the injuries Rationale: Bruising in different stages of healing may indicate abuse. The nurse should first provide a safe opportunity for the patient to describe the injuries privately, without the caregiver present. Immediate reporting may subsequently be required according to applicable law and institutional policy. Questioning the caregiver first could interfere with disclosure or increase risk to the patient. Question 5 The nurse observes a flat, red, circular lesion approximately 5 cm in diameter on a patient’s ankle. Which technique would best determine whether the discoloration results from dilated blood vessels rather than intradermal bleeding? A. Palpate the lesion for warmth B. Press firmly on the lesion C. Measure the lesion with a ruler D. Apply a warm compress for five minutes Correct Answer: B. Press firmly on the lesion Rationale: Firm pressure determines whether a lesion blanches. Redness caused by dilated superficial blood vessels usually temporarily fades with pressure, whereas petechiae, purpura, and other forms of bleeding beneath the skin do not blanch. Measurement and assessment of warmth provide additional information but do not distinguish vascular dilation from bleeding. Question 6 An older adult with bacterial pneumonia is prescribed an intravenous antibiotic. Which history finding should the nurse clarify before administering the first dose? A. Seasonal dry skin B. Previous allergic rashes C. Occasional bruising D. Reduced skin elasticity Correct Answer: B. Previous allergic rashes Rationale: A history of allergic rashes may indicate previous medication hypersensitivity and should be investigated before administering an antibiotic. Reexposure could result in a more severe reaction, including anaphylaxis. Dry skin, bruising, and reduced skin elasticity may occur with aging but are not as immediately concerning as a potential drug allergy. Question 7 A 68-year-old patient reports working outdoors in landscaping for 40 years without consistently using sunscreen. Which skin change should the nurse emphasize when teaching the patient about self-examination? A. Soft, flesh-colored skin tags B. Rough, scaly areas on sun-exposed skin C. Symmetric freckles that have remained unchanged D. Temporary redness after a warm shower Correct Answer: B. Rough, scaly areas on sun-exposed skin Rationale: Long-term ultraviolet exposure increases the risk of actinic keratosis, which commonly appears as a rough, scaly lesion on sun-exposed skin. Actinic keratoses are considered precancerous and should be evaluated. Stable freckles and skin tags are generally benign, while temporary redness after warmth is related to vasodilation. Question 8 A patient scheduled for a breast biopsy asks how a malignant tumor differs from a benign tumor. Which response by the nurse is most accurate? A. “Benign tumors always disappear without treatment.” B. “Malignant tumors can invade and spread to other tissues.” C. “Benign tumors grow faster than malignant tumors.” D. “Malignant tumors are always painful during early development.” Correct Answer: B. “Malignant tumors can invade and spread to other tissues.” Rationale: Malignant tumors can invade surrounding tissues and metastasize through the lymphatic or circulatory systems. Benign tumors generally remain localized, although they may require treatment if they compress vital structures. Growth rate varies, and neither benign nor malignant tumors are necessarily painful. Question 9 A patient who smokes two packs of cigarettes daily states, “I know smoking is unhealthy, but I am not ready to quit.” Which nursing action is most likely to support eventual smoking cessation? A. Avoid discussing smoking until the patient requests help B. Discuss smoking risks and cessation options at every encounter C. Tell the patient that treatment is ineffective unless smoking stops D. Recommend switching immediately to smokeless tobacco Correct Answer: B. Discuss smoking risks and cessation options at every encounter Rationale: Repeated, nonjudgmental smoking-cessation interventions provide opportunities to assess readiness, increase awareness, and offer counseling and medication when appropriate. Avoiding the subject misses opportunities for intervention. Threatening or shaming the patient may damage the therapeutic relationship, while smokeless tobacco is not a safe alternative. Question 10 A patient receiving external-beam radiation to the abdomen reports nausea and poor appetite. Which meal would be the most appropriate recommendation? A. Fried chicken with spicy sauce B. Roasted chicken with plain rice C. Raw vegetable salad with onions D. Chili beans with whole-grain bread Correct Answer: B. Roasted chicken with plain rice Rationale: Abdominal radiation may cause nausea, diarrhea, and gastrointestinal irritation. A bland, low-fat meal such as roasted chicken with plain rice may be better tolerated while providing protein and energy. Fried, spicy, high-fiber, and gasproducing foods may worsen nausea, cramping, or diarrhea.