N433 Final clicker questions (solution)
The nurse has been assigned to provide care for four clients at the beginning of the day
shift. In what order should the nurse assess these clients?
A. A client awaiting surgery for a hiatal hernia repair @ 11 AM.
B. A client with suspected gastric cancer who is nothing by mouth (NPO) status for
tests.
C. A client with peptic ulcer disease experiencing a sudden onset of acute stomach
pain.
D. A client who is requesting pain medication 2 days after surgery to repair a fractured
jaw.
C,B, D, A
A client with peptic ulcer disease tells the nurse that he has black stools, which he has
not reported to his physician. Based on this information, which nursing diagnosis would
be appropriate for this client?
A. Ineffective coping related to fear of diagnosis of chronic illness
B. Deficient knowledge related to unfamiliarity with significant signs and symptoms.
C. Constipation related to decreased gastric motility.
D. Imbalanced nutrition: Less than body requirements related to gastric bleeding.
B. Peptic Ulcer disease-may be referred as gastric, duodenal or esophageal ulcer,
depending on it's location. A peptic ulcer is an excavation (hollowed out area) that forms
in in the mucosal wall. It is caused from an erosion of the mucous membrane. May be
caused from H pylori.
Black tarry stools are a warning of bleeding in peptic ulcer disease
A client with peptic ulcer disease reports that he has been nauseated most of the day
and is now feeling light headed and dizzy. Based upon these findings, which nursing
actions would be most appropriate for the nurse to take? Select all that apply
A. Administering an antacid hourly until nausea subsides.
B. Monitoring the client's vital signs.
C. Notifying the physician of the client's symptoms.
D. Initiating oxygen therapy
E. Reassessing the client in an hour.
B,C The nausea and dizziness may be indicative of a hemorrhage
Which of the following instructions should the nurse include in the teaching plan for a
client who is experiencing gastroesophageal reflux disease (GERD)?
A. Limit caffeine intake to two cups of coffee per day.
B. Do not lie down for 2 hours after eating.
C. Follow a low protein diet.
D. Take medication with milk to decrease irritation.
, B CAFFEINATED BEVERAGES decease pressure in the lower esophageal sphincter
and milk increases gastric secretion so these beverages should be avoided
The nurse is preparing to teach a client with a peptic ulcer about the diet that should be
followed after discharge. The nurse should explain that the diet will most likely consist of
which of the following?
A. Bland Foods.
B. High protein foods.
C. Any foods that are tolerated.
D. Large amounts of milk.
C
A patient presents to the emergency department complaining of increasing shortness of
breath. The nurse assessing the patient notes a history of left sided heart failure. The
patient is agitated and coughing up pink tinged, foamy sputum. What should the nurse
recognize these signs and symptoms of?
A) Right sided heart failure
B) Acute pulmonary edema
C) Pneumonia
D) Cardiogenic shock
Answer B: decreased perfusion to the brain -> agitation
You are assessing a patient suspected of having right-sided heart failure. What
assessment finding may indicate right- sided heart failure?
A) Pulmonary edema
B) Distended neck veins
C) Dry cough
D) Orthopnea
B: distended neck veins
with left sided failure you will hear S3 (ken-tuck-y)
ventricular gallop
A patient with heart failure cannot take ACE inhibitors because of cough. What drugs
can be used as an alternative to ACE inhibitors?
A) Calcium channel blockers
B) Loop diuretics
C) Anti-hypertensives
D) Angiotensin II receptor blockers
Answer D: Angiotensin II receptor blockers
You are caring for a patient with heart failure. You know the overall goals of
management for this patient are what? (mark all that apply)
A. Improve functional status
B. Increase cardiac contractility
C. Extend survival
The nurse has been assigned to provide care for four clients at the beginning of the day
shift. In what order should the nurse assess these clients?
A. A client awaiting surgery for a hiatal hernia repair @ 11 AM.
B. A client with suspected gastric cancer who is nothing by mouth (NPO) status for
tests.
C. A client with peptic ulcer disease experiencing a sudden onset of acute stomach
pain.
D. A client who is requesting pain medication 2 days after surgery to repair a fractured
jaw.
C,B, D, A
A client with peptic ulcer disease tells the nurse that he has black stools, which he has
not reported to his physician. Based on this information, which nursing diagnosis would
be appropriate for this client?
A. Ineffective coping related to fear of diagnosis of chronic illness
B. Deficient knowledge related to unfamiliarity with significant signs and symptoms.
C. Constipation related to decreased gastric motility.
D. Imbalanced nutrition: Less than body requirements related to gastric bleeding.
B. Peptic Ulcer disease-may be referred as gastric, duodenal or esophageal ulcer,
depending on it's location. A peptic ulcer is an excavation (hollowed out area) that forms
in in the mucosal wall. It is caused from an erosion of the mucous membrane. May be
caused from H pylori.
Black tarry stools are a warning of bleeding in peptic ulcer disease
A client with peptic ulcer disease reports that he has been nauseated most of the day
and is now feeling light headed and dizzy. Based upon these findings, which nursing
actions would be most appropriate for the nurse to take? Select all that apply
A. Administering an antacid hourly until nausea subsides.
B. Monitoring the client's vital signs.
C. Notifying the physician of the client's symptoms.
D. Initiating oxygen therapy
E. Reassessing the client in an hour.
B,C The nausea and dizziness may be indicative of a hemorrhage
Which of the following instructions should the nurse include in the teaching plan for a
client who is experiencing gastroesophageal reflux disease (GERD)?
A. Limit caffeine intake to two cups of coffee per day.
B. Do not lie down for 2 hours after eating.
C. Follow a low protein diet.
D. Take medication with milk to decrease irritation.
, B CAFFEINATED BEVERAGES decease pressure in the lower esophageal sphincter
and milk increases gastric secretion so these beverages should be avoided
The nurse is preparing to teach a client with a peptic ulcer about the diet that should be
followed after discharge. The nurse should explain that the diet will most likely consist of
which of the following?
A. Bland Foods.
B. High protein foods.
C. Any foods that are tolerated.
D. Large amounts of milk.
C
A patient presents to the emergency department complaining of increasing shortness of
breath. The nurse assessing the patient notes a history of left sided heart failure. The
patient is agitated and coughing up pink tinged, foamy sputum. What should the nurse
recognize these signs and symptoms of?
A) Right sided heart failure
B) Acute pulmonary edema
C) Pneumonia
D) Cardiogenic shock
Answer B: decreased perfusion to the brain -> agitation
You are assessing a patient suspected of having right-sided heart failure. What
assessment finding may indicate right- sided heart failure?
A) Pulmonary edema
B) Distended neck veins
C) Dry cough
D) Orthopnea
B: distended neck veins
with left sided failure you will hear S3 (ken-tuck-y)
ventricular gallop
A patient with heart failure cannot take ACE inhibitors because of cough. What drugs
can be used as an alternative to ACE inhibitors?
A) Calcium channel blockers
B) Loop diuretics
C) Anti-hypertensives
D) Angiotensin II receptor blockers
Answer D: Angiotensin II receptor blockers
You are caring for a patient with heart failure. You know the overall goals of
management for this patient are what? (mark all that apply)
A. Improve functional status
B. Increase cardiac contractility
C. Extend survival
