The nurse is taking the health history of a patient being treated for Emphysema and
Chronic Bronchitis. After being told the patient has been smoking cigarettes for 30
years, the nurse expects to note which assessment finding?
1. Increase in Forced Vital Capacity (FVC)
2. A narrowed chest cavity
3. Clubbed fingers
4. An increased risk of cardiac failure
Correct Answer: 3
Rationale: Clubbed fingers are a sign of a long-term, or chronic, decrease in oxygen
levels.
Question 2
The nurse is taking the health history of a 70-year-old patient being treated for a
Duodenal Ulcer. After being told the patient is complaining of epigastric pain, the nurse
expects to note which assessment finding?
1. Melena
2. Nausea
3. Hernia
4. Hyperthermia
Correct Answer: 1
Rationale: Melena is the finding that there are traces of blood in the stool which
presents as black, tarry feces. This is a common manifestation of Duodenal Ulcers,
since the Duodenum is further down the gastric anatomy.
Question 3
A nurse is providing discharge teaching for a patient with severe Gastroesophogeal
Reflux Disease. Which of these statements by the patient indicates a need for more
teaching?
1. "I'm going to limit my meals to 2-3 per day to reduce acid secretion."
,2. "I'm going to make sure to remain upright after meals and elevate my head when I
sleep"
3. "I won't be drinking tea or coffee or eating chocolate anymore."
4. "I'm going to start trying to lose some weight."
Correct Answer: 1
Rationale: Large meals increase the volume and pressure in the stomach and delay
gastric emptying. It's recommended instead to eat 4-6 small meals a day.
Question 4
The nurse in the Emergency Room is treating a patient suspected to have a Peptic Ulcer.
On assessing lab results, the nurse finds that the patient's blood pressure is 95/60, pulse
is 110 beats per minute, and the patient reports epigastric pain. What is the PRIORITY
intervention?
1. Start a large-bore IV in the patient's arm
2. Ask the patient for a stool sample
3. Prepare to insert an NG Tube
4. Administer intramuscular morphine sulphate as ordered
Correct Answer: 1
Rationale: The nurse should suspect that the patient is hemorrhaging and will need a
fluid replacement therapy, which requires a large bore IV.
Question 5
A female patient with atrial fibrillation has the following lab results: Hemoglobin of 11
g/dl, a platelet count of 150,000, an INR of 2.5, and potassium of 2.7 mEq/L. Which
result is critical and should be reported to the physician immediately?
1. Hemoglobin 11 g/dl
2. Platelet of 150,000
3. INR of 2.5
4. Potassium of 2.7 mEq/L
Correct Answer: 4
, Rationale: A potassium imbalance for a patient with a history of dysrhythmia can be
life-threatening and can lead to cardiac distress.
Question 6
While receiving normal saline infusions to treat a GI bleed, the nurse notes that the
patient's lower legs have become edematous and auscultates crackles in the lungs. What
should the nurse do first?
1. Stop the saline infusion immediately
2. Notify Physician
3. Elevate the patient's legs
4. Continue the infusion, since these are normal findings
Correct Answer: 1
Rationale: The patient has a fluid volume overload as a result of overly rapid fluid
replacement. The nurse should stop the infusion and notify the physician.
Question 7
The nurse is working in a support group for clients with HIV. Which point is most
important for the nurse to stress?
1. They must inform household members of their condition
2. They must take their medications exactly as prescribed
3. They must abstain from substance use
4. They must avoid large crowds
Correct Answer: 2
Rationale: Antiretrovirals must be taken exactly as prescribed to prevent drug-
resistant strains. Even missed doses can reduce the effectiveness of future treatment.
Question 8
A nurse finds a 30-year-old woman experiencing anaphylaxis from a bee sting.
Emergency personnel have been called. The nurse notes the woman is breathing but
short of breath. Which of the following interventions should the nurse do first?