The nurse is performing a comprehensive assessment of a new female resident of a long-term care facility. The nurse reads in the resident's accompanying documentation that she had rheumatic fever as a girl.
The nurse should recognize that the resident has a significantly increased risk of developing:
A) A septal wall defect
B) Pericarditis
C) Dilated cardiomyopathy (DCM)
D) Mitral stenosis
Question 2A patient receiving chemotherapy has been told he has thrombocytopenia. He is getting ready to do his morning care. Which is an appropriate teaching measure to include?
a. Take an aspirin before beginning; it will help with your pain.
b. Trim your toenails close to prevent infection.
c. Use an electric shaver.
d. Be sure to scrub your teeth vigorously.
Question 3Following several months of increasing dyspnea on exertion, a 71-year-old woman has been diagnosed with mitral stenosis (MS).
The woman is relieved to receive a diagnosis that explains her symptoms but does not completely understand the root of her problem. How can the nurse best explain the woman's health problem?
A) The valve in the left side of your heart has become stiff and narrowed, so your heart can't fill with all the blood that your body needs.
B) The left side of your heart is having trouble overcoming the resistance in your blood vessels because a valve is not sealing.
C) When your heart beats, some of the blood that should go to your body is backing up into your heart because the valve leaks.
D) The valve between your lungs and your heart has become inelastic, so your heart can't fill up with enough blood.
Question 4A patient who has malignant cancer secondary to a high-grade lymphoma has been admitted with muscle weakness, tetany, paresthesias, and convulsion.
The nurse notices he is being treated for tumor lysis syndrome (TLS) and initial treatment has not been successful. The nurse must prepare the family for the next step in treatment, which is a. whole blood transfusion.
b. a bone marrow biopsy.
c. immediate radiation treatment.
d. dialysis.
Question 5The nurse is on the infection control committee of a hospital and is looking into three cases of hospital-acquired infective endocarditis. What classification of patient is at highest risk for hospital-acquired endocarditis?
A) Hemodialysis patients
B) Patients on immunoglobulins
C) Patients who need in-and-out catheterization
D) Chemotherapy patients
Question 6Methods of early cancer detection include
a. digital rectal examinations every year after age 60.
b. Hematest of stool for blood every year after age 70.
c. chest radiograph evaluation every year.
d. mammogram baseline at age 35 to 39, then every year after age 50 for women.
Question 7The nurse is admitting a patient who is experiencing increased signs and symptoms of dilated cardiomyopathy (DCM). What changes in the heart characterize DCM?
A) Dilated ventricles with atrophy of the ventricles
B) Dilated ventricles without hypertrophy of the ventricles
C) Hypertrophy of the ventricles with no dilation of the ventricles
D) Dilation of the atria and hypertrophy of the ventricles
Question 8Nursing interventions for the nursing diagnosis of Imbalanced nutrition: less than body requirements would include all these except:
a. provide adequate, easily digestible, soft, bland foods.
b. give small, frequent, highly nutritional meals.
c. allow extra time to eat.
d. offer three regular meals of highly nutritious foods.
Question 9The patient receiving radiation therapy often has conspicuous skin markings left on the skin after treatment. What is the most appropriate nursing implication regarding these markings?
a. They are residue of the treatment and must be washed off.
b. They are caused by radiation and will be permanent.
c. They indicate an allergic reaction and should be reported.
d. They are guidelines for treatment and should be left on.
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