Adult health 3 exam questions

The health care provider has ordered collagenase for a patient with a left leg necrotic ulcer. What does the nurse understands about the use of collagenase? Select all that apply.

A: Removes necrotic tissue and absorbs small to large amounts of exudates

B: Uses the body’s own digestive enzymes to break down necrotic tissue

C: Speeds the rate at which necrotic tissue is removed

D: Uses a high moisture-vapor transmission rate to remove exudate

E: Is slower than surgical debridement

C and E

Which of the following are risk factors for malignant melanoma? Select all that apply.

A: Melanin-rich skin

B: Family history of melanoma

C: Sustained exposure to intense sunlight

D: Fair-skinned people

E: Significant history of severe sunburn

All but A

A patient who developed Stevens–Johnson syndrome 2 weeks after starting a sulfonamide medication has stabilized and is now being transferred from the intensive care unit to a medical unit with 2 beds per room. Select from the list below appropriate potential roommates for this patient.

A: A patient with methicillin-resistant Staphylococcus aureus (MRSA)

B: A patient with fever of unknown origin (FUO)

C: A patient with heart failure (HF)

D: A patient with asthma

E: A patient with gastroenteritis

C and D

Topical corticosteroid therapy has been ordered for a patient with pruritus. What information should be incorporated into the plan of care for this patient? Select all that apply

A: Apply liberally in the prescribed area.

B: Absorption is enhanced when skin is dry.

C: Local side effects may include skin atrophy and thinning.

D: Absorption is decreased when covered with an occlusive dressing.

E: Avoid applying near the eyes.

C and E

A 55-year-old patient with leukemia is being seen in the clinic for complaints of burning pain in the back. The patient has been diagnosed with shingles. The nurse would expect which medications might be ordered to reduce pain and halt the progression of the disease? Select all that apply.

A: Cytotoxic agent

B: Antiviral

C: Antibiotic

D: Antifungal

E: Analgesic

B and E

The clinic nurse assesses the skin of a patient. During the assessment, what does the nurse recognize as a normal function of the skin? Select all that apply.

A: Thermal regulation

B: Vitamin E production

C: Synthesis of vitamin D

D: Releasing of carbon dioxide

E: Barrier to epidermal water loss

A, C, E

A 52-year-old patient has just returned to the room postoperatively. The nurse examines the patient’s nail beds to assess for what condition? Select all that apply.

A: Cyanosis

B: Respiratory rate

C: Edema

D: Cellulitis

E: Capillary refill

A and E

A patient is requesting to be evaluated today for a suspicious lesion that was noticed several weeks ago. When assessing the lesion, what characteristics are you looking for ? Select all that apply.

A: Heat

B: Claudication

C: Size

D: Erythema

E: Pattern

All but B

Which of the following are associated with skin changes in older individuals? Select all that apply.

A: Epidermis and dermis thin and flatten

B: Hair growth gradually diminishes

C: Subcutaneous fat increases in distal extremities

D: Skin becomes fragile and transparent

E: Increased remodeling and repairing skin

A, B, D

When considering clubbing of the digits, the nurse recognizes that it represents which of the following? Select all that apply.

A: Clubbing is permanent change of the nailbed.

B: Clubbing is only associated with hypoxemia.

C: Clubbing may be associated with inflammatory bowel disorders.

D: Clubbing is observed by a straightening of the normal angle of the nail and nail base as well as a softening of the nail base.

E: The nails affected will be painful to touch.

C and D

A nurse is assessing a patient with joint pain. Which finding is most characteristic of rheumatoid arthritis (RA) rather than osteoarthritis (OA)?

A. Pain that worsens after activity

B. Heberden's nodes in the fingers

C. Prolonged morning stiffness lasting 90 minutes

D. Crepitus during joint movement

C

Which joint changes would the nurse expect in a patient with osteoarthritis (OA)?

A. Systemic inflammation affecting multiple organs

B. Degeneration of articular cartilage and changes to underlying bone

C. Autoimmune inflammation of the synovial membrane

D. Symmetrical joint swelling with severe fatigue

B

A patient with rheumatoid arthritis reports fatigue, low-grade fever, and swelling in both wrists. What is the best explanation for these findings?

A. RA is a systemic autoimmune inflammatory disease.

B. OA causes widespread inflammation throughout the body.

C. RA is caused by normal age-related cartilage wear.

D. OA typically causes fever and systemic fatigue.

A

Which patient statement indicates a correct understanding of osteoarthritis?

A. "My immune system is attacking the lining of my joints."

B. "This disease can cause inflammation in my lungs and blood vessels."

C. "The cartilage in my joints is wearing down over time."

D. "The same joints on both sides of my body must be affected."

C

A nurse is comparing rheumatoid arthritis and osteoarthritis. Which finding is most suggestive of RA?

A. Knee pain that worsens after walking

B. Bony enlargement of the distal finger joints

C. Joint stiffness that improves quickly after waking

D. Warm, swollen joints on both sides of the body

D

A patient with a CD4+ count of 100 cells/mm3 and not taking any antiretroviral medications is admitted to the hospital after a motor vehicle crash. In addition, the patient has a productive cough, fever, lymphadenopathy, and a history of night sweats. The patient’s purified protein derivative (PPD) test is negative. What is the nurse’s best action? Select all that apply.

A: Use standard precautions alone because the patient does not have tuberculosis.

B: Use airborne precautions alone because the patient has not started appropriate therapy for HIV.

C: Use standard precautions and airborne precautions because the patient has tuberculosis.

D: Use standard and airborne precautions until the infectious disease providers verify the patient does not have tuberculosis, and then continue using standard precautions.

E: Transfer patient to a negative-pressure room.

D and E

Which finding in the patient with HIV who started ARV treatment 3 months ago indicates that the treatment is effective? Select all that apply.

A: Increased CD4 cells

B: Decreased CD4 cells

C: Decreased viral load

D: Increased CD8 cells

E: Decreased HIV antibody levels

A, C, D

A 44-year-old patient with a longstanding diagnosis of AIDS has been admitted to the hospital with an absolute neutrophil count (ANC) of 185/mm³, an Hct of 40%, a platelet count of 150,000 mm³. When planning the patient’s care, what action should the nurse prioritize? Select all that apply.

A: Placing the patient on neutropenic precautions

B: Obtaining the patient’s blood type and cross-matching in anticipation of transfusion

C: Providing the patient with supplementary oxygen by simple face mask

D: Padding hard surfaces on the patient’s bed and observing for petechiae

E: Stressing the importance of frequent handwashing, avoiding crowds, and using an electric razor to avoid potential injury

A, E

Kaposi sarcoma, once a common manifestation of AIDS before ART was available, is seldom seen. A patient with AIDS wants to know how Kaposi sarcoma presents. What is the nurse’s best response? Select all that apply.

A: Thick, white exudate in the mouth

B: A purple-red lesion on the body

C: Weight loss

D: An increase in respiratory secretions

E: Lesion may be flat or raised

B, E

A patient with a new diagnosis of HIV has a CD4 count of 700. The client is asymptomatic. What is the expected course of action? Select all that apply.

A: Since the patient is asymptomatic, they can negotiate a time to start therapy

B: Expect that the patient will be asked to recheck the laboratory results in 1 month. If the count remains the same, then treatment may commence

C: Expect that medication therapy will start now and you will need to teach about the importance of adherence

D: Anticipate that medication therapy will not begin until the patient becomes symptomatic

E: Educate the patient on ways to mitigate transmission risk

C, E