NURS 355 Exam 2 Questions with correct answers
Which information obtained by the nurse in the endocrine clinic about a
patient who has been taking prednisone 40 mg daily for 3 weeks is most
important to report to the health care provider?
a. Patient's blood pressure is 148/94 mm Hg.
b. Patient has bilateral 2+ pitting ankle edema.
c. Patient stopped taking the medication 2 days ago.
d. Patient has not been taking the prescribed vitamin D. Correct Answer-
Answer: Patient stopped taking the medication 2 days ago.
Rationale: Sudden cessation of corticosteroids after taking the
medication for a week or more can lead to adrenal insufficiency, with
problems such as severe hypotension and hypoglycemia. The patient
will need immediate evaluation by the health care provider to prevent or
treat adrenal insufficiency. The other information will also be reported
but does not require rapid treatment.
Which finding for a patient who has hypothyroidism and hypertension
indicates that the nurse should contact the health care provider before
administering levothyroxine (Synthroid)?
a. Increased thyroxine (T4) level
b. Blood pressure 112/62 mm Hg
c. Distant and difficult to hear heart sounds
,d. Elevated thyroid stimulating hormone level Correct Answer-Answer:
Increased thyroxine (T4) level
Rationale: An increased thyroxine level indicates the levothyroxine dose
needs to be decreased. The other data are consistent with
hypothyroidism and the nurse should administer the levothyroxine.
The nurse teaches a patient about pulmonary spirometry testing. Which
statement by the patient indicates teaching was effective?
a. "I should use my inhaler right before the test."
b. "I won't eat or drink anything 8 hours before the test."
c. "I will inhale deeply and blow out hard during the test."
d. "My blood pressure and pulse will be checked every 15 minutes."
Correct Answer-Answer: "I will inhale deeply and blow out hard during
the test."
Rationale: For spirometry, the patient should inhale deeply and exhale as
long, hard, and fast as possible. The other actions are not needed. The
administration of inhaled bronchodilators should be avoided 6 hours
before the procedure.
,A patient with acute shortness of breath is admitted to the hospital.
Which action should the nurse take during the initial assessment of the
patient?
a. Ask the patient to lie down for complete a full physical assessment.
b. Complete the health history and check for allergies before treatment.
c. Briefly ask specific questions about this episode of respiratory
distress.
d. Delay the physical assessment to first complete pulmonary function
tests. Correct Answer-Answer: Briefly ask specific questions about this
episode of respiratory distress
Rationale: When a patient has severe respiratory distress, only
information pertinent to the current episode is obtained, and a more
thorough assessment is deferred until later. Obtaining a comprehensive
health history or full physical examination is unnecessary until the acute
distress has resolved. Brief questioning and a focused physical
assessment should be done rapidly to help determine the cause of the
distress and suggest treatment. Checking for allergies is important, but it
is not appropriate to complete the entire admission database at this time.
The initial respiratory assessment must be completed before any
diagnostic tests or interventions can be ordered.
The nurse prepares a patient who has a left-sided pleural effusion for a
thoracentesis. How should the nurse position the patient?
, a. High-Fowler's position with the left arm extended
b. Supine with the head of the bed elevated 30 degrees
c. On the right side with the left arm extended above the head
d. Sitting upright with the arms supported on an over bed table Correct
Answer-Answer: Sitting upright with the arms supported on an over bed
table
Rationale: The upright position with the arms supported increases lung
expansion, allows fluid to collect at the lung bases, and expands the
intercostal space so that access to the pleural space is easier. The other
positions would increase the work of breathing for the patient and make
it more difficult for the health care provider performing the
thoracentesis.
A patient with diabetes has arterial blood gas (ABG) results pH 7.28;
PaCO2 34 mm Hg; PaO2 85 mm Hg; HCO3?2- 18 mEq/L. The nurse
would expect which finding?
a. Intercostal retractions
b. Kussmaul respirations
c. Low oxygen saturation (SpO2)
d. Decreased venous O2 pressure Correct Answer-Answer: Kussmaul
respirations
Which information obtained by the nurse in the endocrine clinic about a
patient who has been taking prednisone 40 mg daily for 3 weeks is most
important to report to the health care provider?
a. Patient's blood pressure is 148/94 mm Hg.
b. Patient has bilateral 2+ pitting ankle edema.
c. Patient stopped taking the medication 2 days ago.
d. Patient has not been taking the prescribed vitamin D. Correct Answer-
Answer: Patient stopped taking the medication 2 days ago.
Rationale: Sudden cessation of corticosteroids after taking the
medication for a week or more can lead to adrenal insufficiency, with
problems such as severe hypotension and hypoglycemia. The patient
will need immediate evaluation by the health care provider to prevent or
treat adrenal insufficiency. The other information will also be reported
but does not require rapid treatment.
Which finding for a patient who has hypothyroidism and hypertension
indicates that the nurse should contact the health care provider before
administering levothyroxine (Synthroid)?
a. Increased thyroxine (T4) level
b. Blood pressure 112/62 mm Hg
c. Distant and difficult to hear heart sounds
,d. Elevated thyroid stimulating hormone level Correct Answer-Answer:
Increased thyroxine (T4) level
Rationale: An increased thyroxine level indicates the levothyroxine dose
needs to be decreased. The other data are consistent with
hypothyroidism and the nurse should administer the levothyroxine.
The nurse teaches a patient about pulmonary spirometry testing. Which
statement by the patient indicates teaching was effective?
a. "I should use my inhaler right before the test."
b. "I won't eat or drink anything 8 hours before the test."
c. "I will inhale deeply and blow out hard during the test."
d. "My blood pressure and pulse will be checked every 15 minutes."
Correct Answer-Answer: "I will inhale deeply and blow out hard during
the test."
Rationale: For spirometry, the patient should inhale deeply and exhale as
long, hard, and fast as possible. The other actions are not needed. The
administration of inhaled bronchodilators should be avoided 6 hours
before the procedure.
,A patient with acute shortness of breath is admitted to the hospital.
Which action should the nurse take during the initial assessment of the
patient?
a. Ask the patient to lie down for complete a full physical assessment.
b. Complete the health history and check for allergies before treatment.
c. Briefly ask specific questions about this episode of respiratory
distress.
d. Delay the physical assessment to first complete pulmonary function
tests. Correct Answer-Answer: Briefly ask specific questions about this
episode of respiratory distress
Rationale: When a patient has severe respiratory distress, only
information pertinent to the current episode is obtained, and a more
thorough assessment is deferred until later. Obtaining a comprehensive
health history or full physical examination is unnecessary until the acute
distress has resolved. Brief questioning and a focused physical
assessment should be done rapidly to help determine the cause of the
distress and suggest treatment. Checking for allergies is important, but it
is not appropriate to complete the entire admission database at this time.
The initial respiratory assessment must be completed before any
diagnostic tests or interventions can be ordered.
The nurse prepares a patient who has a left-sided pleural effusion for a
thoracentesis. How should the nurse position the patient?
, a. High-Fowler's position with the left arm extended
b. Supine with the head of the bed elevated 30 degrees
c. On the right side with the left arm extended above the head
d. Sitting upright with the arms supported on an over bed table Correct
Answer-Answer: Sitting upright with the arms supported on an over bed
table
Rationale: The upright position with the arms supported increases lung
expansion, allows fluid to collect at the lung bases, and expands the
intercostal space so that access to the pleural space is easier. The other
positions would increase the work of breathing for the patient and make
it more difficult for the health care provider performing the
thoracentesis.
A patient with diabetes has arterial blood gas (ABG) results pH 7.28;
PaCO2 34 mm Hg; PaO2 85 mm Hg; HCO3?2- 18 mEq/L. The nurse
would expect which finding?
a. Intercostal retractions
b. Kussmaul respirations
c. Low oxygen saturation (SpO2)
d. Decreased venous O2 pressure Correct Answer-Answer: Kussmaul
respirations
