Physiological Health Problems Exam
Rated A+ (Verified)
A child with a diagnosis of pertussis (whooping cough) is being admitted to the pediatric
unit. As soon as the child arrives to the unit, the nurse first: - ANSWER-Attaches the
child to a pulse oximeter.
A client arrives at the emergency department with complaints of a headache, hives,
itching, and difficulty swallowing. The client states that he took ibuprofen (Motrin) 1 hour
earlier and believes that he is experiencing an allergic reaction to this medication. After
ensuring that the client has a patent airway, which intervention does the nurse prepare
the client for first? - ANSWER-Administration of a subcutaneous injection of epinephrine
(Adrenalin).
A client arrives in the emergency department for treatment of a surface injury sustained
when sand blew into the eye. Which action does the nurse take first? - ANSWER-
Assessing the client's vision.
A client has an arteriovenous fistula in place for hemodialysis. What should the nurse do
to assess the patency of the fistula? - ANSWER-Palpate for a vibrating sensation at the
fistula site.
A client has just had a plaster leg cast applied, and the nurse has given the client
instructions on cast care. Which statement by the client indicates the need for further
instruction? - ANSWER-"I can dry the cast faster if I use a hairdryer on the hot setting."
A client has undergone creation of an Indiana pouch for urine diversion after
cystectomy, and the nurse provides instructions about reservoir catheterization. The
nurse tells the client: - ANSWER-To plan to drain the reservoir every 2 to 3 hours
initially.
A client in the third trimester of pregnancy is experiencing painless vaginal bleeding,
and placenta previa is suspected. For which of the following interventions does the
nurse prepare the client? - ANSWER-An ultrasound examination.
A client is found to have AIDS. What is the nurse's highest priority in providing care to
this client? - ANSWER-Instituting measures to prevent infection in the client.
A client is found to have viral hepatitis, and the nurse provides home care instructions to
the client. The nurse should tell the client to: - ANSWER-Eat small frequent meals that
are low in fat and protein and high in carbohydrates.
, A client is transported to the recovery area of the ambulatory care unit after cataract
surgery. In which position does the nurse place the client? - ANSWER-Semi-Fowler.
A client who experienced a brain attack (stroke) exhibits right-sided unilateral neglect.
The nurse caring for this client plans to place the client's personal care items: -
ANSWER-Within the client's reach on the right side.
A client who experiences frequent episodes of chest pain is admitted to the hospital for
cardiac monitoring. The client suddenly complains of chest pain, and the nurse obtains
a 12-lead electrocardiogram (ECG). Which of the following findings would the nurse
expect to note in the event of an ischemic episode? - ANSWER-ST-segment
depression.
A client who is recovering from a brain attack (stroke) has residual dysphagia. Which of
the following measures does the nurse plan to implement at mealtimes? - ANSWER-
Alternating liquids with solids.
A client who sustained a fracture of the left arm requires the application of a plaster
cast. The nurse tells the client that the procedure for applying the cast involves: -
ANSWER-Applying soft padding and stockinette over the fractured arm, followed by the
application of the cast material.
A client with a leg fracture who has been placed in skeletal traction is transported to the
orthopedic unit after surgery. Which finding would indicate the need to contact the
orthopedic specialist? - ANSWER-The traction ropes are unable to move over the
pulleys.
A client with a spinal cord injury suddenly complains of a pounding headache. The
nurse quickly assesses the client and notes that the client is diaphoretic, that his blood
pressure has increased, and that his heart rate has slowed. Suspecting that the client is
experiencing autonomic dysreflexia, the nurse elevates the head of the client's bed and
immediately: - ANSWER-Checks the client's bladder for distention.
A client with cancer of the larynx is receiving external radiation therapy of the neck.
Which side effect related specifically to the site of irradiation does the nurse tell the
client to expect? - ANSWER-Dysphagia.
A client with chronic renal failure is undergoing his first hemodialysis treatment, and the
nurse is monitoring the client for signs of disequilibrium syndrome. For which signs of
this syndrome does the nurse monitor the client? - ANSWER-Headache and confusion.
A client with gastroenteritis who has been vomiting and has diarrhea is admitted to the
hospital with a diagnosis of dehydration. For which clinical manifestations that correlate
with this fluid imbalance would the nurse assess the client? - ANSWER-Decreased
urine output
Increased respiratory rate
Rated A+ (Verified)
A child with a diagnosis of pertussis (whooping cough) is being admitted to the pediatric
unit. As soon as the child arrives to the unit, the nurse first: - ANSWER-Attaches the
child to a pulse oximeter.
A client arrives at the emergency department with complaints of a headache, hives,
itching, and difficulty swallowing. The client states that he took ibuprofen (Motrin) 1 hour
earlier and believes that he is experiencing an allergic reaction to this medication. After
ensuring that the client has a patent airway, which intervention does the nurse prepare
the client for first? - ANSWER-Administration of a subcutaneous injection of epinephrine
(Adrenalin).
A client arrives in the emergency department for treatment of a surface injury sustained
when sand blew into the eye. Which action does the nurse take first? - ANSWER-
Assessing the client's vision.
A client has an arteriovenous fistula in place for hemodialysis. What should the nurse do
to assess the patency of the fistula? - ANSWER-Palpate for a vibrating sensation at the
fistula site.
A client has just had a plaster leg cast applied, and the nurse has given the client
instructions on cast care. Which statement by the client indicates the need for further
instruction? - ANSWER-"I can dry the cast faster if I use a hairdryer on the hot setting."
A client has undergone creation of an Indiana pouch for urine diversion after
cystectomy, and the nurse provides instructions about reservoir catheterization. The
nurse tells the client: - ANSWER-To plan to drain the reservoir every 2 to 3 hours
initially.
A client in the third trimester of pregnancy is experiencing painless vaginal bleeding,
and placenta previa is suspected. For which of the following interventions does the
nurse prepare the client? - ANSWER-An ultrasound examination.
A client is found to have AIDS. What is the nurse's highest priority in providing care to
this client? - ANSWER-Instituting measures to prevent infection in the client.
A client is found to have viral hepatitis, and the nurse provides home care instructions to
the client. The nurse should tell the client to: - ANSWER-Eat small frequent meals that
are low in fat and protein and high in carbohydrates.
, A client is transported to the recovery area of the ambulatory care unit after cataract
surgery. In which position does the nurse place the client? - ANSWER-Semi-Fowler.
A client who experienced a brain attack (stroke) exhibits right-sided unilateral neglect.
The nurse caring for this client plans to place the client's personal care items: -
ANSWER-Within the client's reach on the right side.
A client who experiences frequent episodes of chest pain is admitted to the hospital for
cardiac monitoring. The client suddenly complains of chest pain, and the nurse obtains
a 12-lead electrocardiogram (ECG). Which of the following findings would the nurse
expect to note in the event of an ischemic episode? - ANSWER-ST-segment
depression.
A client who is recovering from a brain attack (stroke) has residual dysphagia. Which of
the following measures does the nurse plan to implement at mealtimes? - ANSWER-
Alternating liquids with solids.
A client who sustained a fracture of the left arm requires the application of a plaster
cast. The nurse tells the client that the procedure for applying the cast involves: -
ANSWER-Applying soft padding and stockinette over the fractured arm, followed by the
application of the cast material.
A client with a leg fracture who has been placed in skeletal traction is transported to the
orthopedic unit after surgery. Which finding would indicate the need to contact the
orthopedic specialist? - ANSWER-The traction ropes are unable to move over the
pulleys.
A client with a spinal cord injury suddenly complains of a pounding headache. The
nurse quickly assesses the client and notes that the client is diaphoretic, that his blood
pressure has increased, and that his heart rate has slowed. Suspecting that the client is
experiencing autonomic dysreflexia, the nurse elevates the head of the client's bed and
immediately: - ANSWER-Checks the client's bladder for distention.
A client with cancer of the larynx is receiving external radiation therapy of the neck.
Which side effect related specifically to the site of irradiation does the nurse tell the
client to expect? - ANSWER-Dysphagia.
A client with chronic renal failure is undergoing his first hemodialysis treatment, and the
nurse is monitoring the client for signs of disequilibrium syndrome. For which signs of
this syndrome does the nurse monitor the client? - ANSWER-Headache and confusion.
A client with gastroenteritis who has been vomiting and has diarrhea is admitted to the
hospital with a diagnosis of dehydration. For which clinical manifestations that correlate
with this fluid imbalance would the nurse assess the client? - ANSWER-Decreased
urine output
Increased respiratory rate
