Lifestyle Choices and High Risk Behavior

The nurse notes these heart sounds on auscultation of a 65-year-old man: The nurse reviews the patient’s medical record for history of which conditions associated with these heart sounds? Select all that apply.

The nurse is using the Finnegan scoring system to assess a neonate for opioid withdrawal. The first score is 9 and the second score is 14. Which statement is accurate?

Which sport does the nurse recommend to the child with osteogenesis imperfecta who is interested in physical fitness?

A high school wide receiver suffered substantial head trauma during a tackle. The school nurse is concerned about concussion. The nurse provides which information to the adolescent and parents? Select all that apply.

Intoxication with which drug is most commonly associated with aggressive and violent behavior?

The patient is seeking dietary information on the difference between macronutrients and micronutrients. Which statement by the nurse is appropriate?

The women in the fertility clinic states, “I read an article that said I should increase my omega-3 fatty acid intake to improve my chances of conceiving. Which foods should I eat?” The nurse responds with which foods? Select all that apply.

The patient states, “I’m trying to be healthy, so I’ve taken twice the daily recommended doses of all my vitamins for years to ensure I get even more effect from them.” The nurse assesses for signs of toxicity from overconsumption of which nutrients? Select all that apply.

The nurse is caring for a patient who is seeking medical attention for chronic muscle aches and nonspecific pain. Upon assessment, the nurse detects bone pain upon applying moderate pressure to the patient’s sternum and tibia. The patient works with computers and has severe outdoor allergies. The nurse encourages the patient to increase intake of foods rich in which nutrient?

The patient is brought to the emergency room by friends after a night of drinking alcohol. The patient is unable to speak clearly, appears to fall asleep while talking, and cannot stand alone. The nurse anticipates which blood alcohol level?

The patient with a long history of alcohol use disorder is admitted to the hospital for observation at risk for alcohol withdrawal syndrome. The nurse anticipates which symptoms to peak 24 to 36 hours after the patient’s last drink? Select all that apply.

The nurse caring for the patient being treated for delirium tremens implements which nursing intervention for the patient?

Which food items does the nurse encourage the patient to eat? Look at the patient’s chart to make selections and select all that apply.

Which food item, if selected by the patient, would prompt the nurse to provide additional education? Review the patient’s chart to make selection.

The nurse receives report of four issues at 0800. Which situation is addressed first?

The nurse is creating a tool to screen for patients who are risk for vitamin A deficiency. The nurse includes which conditions in the screening tool? Select all that apply.

Several tenants from an apartment building are brought to the emergency department with concern for carbon monoxide poisoning. One patient presents with reddish-purple skin, a blood pressure of 94/48 mmHg, heart rate of 118 bpm, and altered consciousness (arouses when his name is shouted). The nurse anticipates testing will reveal which carbon monoxide level?

The 32-year-old female patient (60 kg) is brought via ambulance to the emergency department following a water drinking competition. The patient has a Glasgow Coma score of 6, oxygen saturation of 94% on room air, heart rate of 62 bpm, and respiratory rate of 16 breaths per minute. The nurse anticipates administering which medication?

The 19-year-old female patient is found unconscious at a party. Bystanders report the individual imbibed a significant amount of grain alcohol and ingested several different pills, including 3,4-methylenedioxymethamphetamine. They observed the patient dancing wildly for several hours; after that, the patient disappeared and was found unconscious an hour later. Vital signs are within defined limits. Which lab result is consistent with the patient’s condition?

The 22-year-old patient is brought to the emergency room with decreased level of consciousness after ingesting 3,4-methylenedioxymethamphetamine. The patient is noted to have a rectal temperature of 40°C. The nurse performs which interventions? Select all that apply.

The nurse is creating a screening form to determine which patients are at heightened risk for laryngeal cancer. Which professions does the nurse include? Select all that apply.  

The patient with high cholesterol reports forgoing the prescribed statin medication for an herbal remedy. The nurse assesses the patient for which adverse effects? Select all that apply. 

During a routine physical, the patient states, “I feel more comfortable taking herbal remedies than prescription medications for my high blood pressure.” Which response by the nurse is most important?  

The patient who was started on warfarin sodium for the treatment of atrial fibrillation has reached steady state with the current dose. Which instruction is most important to give the patient?

The 15-year-old patient attempted suicide by ingesting an entire bottle of her father’s metoprolol. She is found unresponsive by emergency medical services and is intubated due to an inability to manage her own airway. Upon arrival to the emergency department, her blood pressure is 49/32 mmHg, heart rate is 24 bpm, and the pulse oximeter reads 82%. An 18-gauge peripheral IV is placed in the left antecubital vein and a 22-gauge IV is placed in the right antecubital vein. Which interventions are included in care? Select all that apply.  

The nurse overhears a colleague preparing a dose of naltrexone. The nurse offers to assist and ensures the colleague takes which actions? Select all that apply.  

The patient with acquired immunodeficiency syndrome who has been noncompliant with highly active antiretroviral therapy (HAART) presents to the emergency department with a productive cough, fever, night sweats, and weight loss. The patient’s chest x-ray reveals diffuse infiltrates bilaterally and the CD4 count is 182 cells/µL. Which question by the nurse is most important?  

The 48-year-old patient is brought via ambulance to the emergency room after being found unresponsive by her son. She has a prescription for transdermal fentanyl patches for treatment of cancer pain related to her breast cancer that has metastasized to her pelvis. The patient’s heart rate is 72 bpm, respiratory rate is 4 breaths per minute, and her oxygen saturation is 88%. Her arterial blood gas results are: pH 7.21, PaCO₂ 72 mmHg, PaO₂ 74, HCO₃¯ 23. A thorough assessment reveals 2 fentanyl patches on the patient’s skin. The nurse advocates for which initial action?  

The 38-year-old patient who strictly adheres to a vegan diet complains of weakness and tingling in her lower extremities. She retains the strength in her lower extremities but proprioception is decreased.  Her complete blood count reveals a megaloblastic anemia. Which statement by the nurse is most appropriate? 

The 38-year-old patient who strictly adheres to a vegan diet complains of weakness and tingling in her lower extremities. She retains the strength in her lower extremities but proprioception is decreased.  Her complete blood count revealed a hemoglobin of 10.2 mg/dL, white blood cell count of 9 x 10³ cells/µL, and a mean corpuscular volume of 110. Which information does the nurse provide to the patient?  

The 58-year-old patient presents to the emergency department complaining of worsening back pain that started a few days ago. He states, “I thought maybe I had slept wrong and gotten a spasm, but I’m not sure. I didn’t fall or get hit or anything. The ibuprofen I took definitely didn’t help.” His blood pressure is 174/96 mmHg and heart rate is 96 bpm. He reports being out of his antihypertensive medication for the past week while he was out of town. Other history is notable for arthritis in the hands and a 44-pack-year smoking history. He drinks socially but denies illicit drug use. Which assessment is most important? 

The patient with human immunodeficiency virus (HIV) presents with a disseminated rash. The nurse notes purple papules over the trunk, arms, and on mucous membranes. Some are scabbed. The patient’s CD4 count is 64. Although highly active antiretroviral therapy (HAART) has been prescribed, the patient reports being noncompliant because of intolerable side effects. The nurse suspects which infection is most responsible for this new rash? 

The patient with human immunodeficiency virus and a CD4 count of 158 has a purified protein derivative (PPD) skin test performed and is found to have a 7-mm induration with circumferential erythema. Which statement does the nurse make to the patient?  

The 28-year-old patient checks himself into a center for detoxification from opiates, which he has used daily for 3 years. The patient begins to experience pain, diarrhea, salivation, and diaphoresis and is started on buprenorphine. Worsening pain throughout the body and uncontrollable diarrhea prompts stepwise increase of buprenorphine dose to the maximum dose without relief of withdrawal symptoms. The nurse contacts the provider to request an order for which medication?  

The 24-year-old patient presents with flu-like symptoms and a diffuse maculopapular rash across her chest, trunk, and palms of the hands. Upon palpation, cervical lymph nodes are enlarged. The patient uses intravenous drugs and reports having unprotected sex. The patient’s labs are notable for negative HIV test, positive human chorionic gonadotropin test, and positive rapid plasma reagin test. The patient reports a history of anaphylaxis with penicillin administration. The nurse educates the patient about which treatment? 

The patient with cirrhosis is admitted with severe confusion, ascites, and jaundice. He has gained 10 kg in 2 weeks. He has been coughing blood and his stool is dark and tarry. Therapeutic paracentesis results are concerning for infection.  The nurse anticipates the patient to report not taking which medications that are ordered? Select all that apply.  

The 20-year-old healthy soccer player is brought to the emergency department after collapsing at the end of a summer soccer game. The patient is lethargic and confused about the event. Upon assessment, the nurse notes flushed, dry skin that is warm to the touch. The oral mucosa is dry, as well. Vitals are as follows: temperature 40.7°C, heart rate 122 bpm, respiratory rate 20, and blood pressure 116/64 mmHg. Which lab studies does the nurse obtain? Select all that apply.  

The nurse witnesses a healthy 19-year-old collapse while playing football. The individual is arousable but confused and irritable. The skin is warm, dry, and flushed. The nurse instructs a teammate to bring the water cooler and pours it over the victim. The teammate shouts, “Why did you do that?! Won’t he go into shock?”  The nurse bases the response on the need for rapid cooling to prevent which conditions? Select all that apply.