ATI RN
jarvis physical examination and health assessment 9th edition test bank Questions
Question 1 of 9
A nurse is caring for a patient with a history of diabetes. The nurse should monitor for which of the following complications?
Correct Answer: D
Rationale: The correct answer is D: Hyperglycemia. Patients with diabetes are at risk for high blood sugar levels, leading to hyperglycemia. This can result in various complications such as diabetic ketoacidosis or hyperosmolar hyperglycemic state. The nurse should monitor the patient's blood glucose levels regularly to prevent these serious complications. Explanation for incorrect choices: A: Hypoglycemia - While hypoglycemia is a concern for diabetic patients, hyperglycemia is a more common and immediate risk. B: Hyperkalemia - While hyperkalemia can occur in some diabetic patients, hyperglycemia is a more common and primary concern. C: Hypotension - While diabetic patients can experience hypotension, hyperglycemia poses a more immediate threat to their health.
Question 2 of 9
A nurse is caring for a patient with a history of hypertension and diabetes. The nurse should monitor for which of the following complications?
Correct Answer: B
Rationale: Step 1: The patient has a history of hypertension and diabetes, putting them at risk for cardiovascular complications. Step 2: Among the choices, stroke is a common complication associated with uncontrolled hypertension and diabetes. Step 3: Monitoring for signs of stroke is crucial to prevent serious consequences in this patient population. Step 4: Hyperglycemia (A) is a common complication of diabetes, but it is not directly related to the patient's hypertension. Step 5: Hypokalemia (C) is an electrolyte imbalance that can occur in some conditions but is not as directly linked to the patient's history. Step 6: Hypoglycemia (D) is a potential complication in diabetic patients but is not as common as hyperglycemia and is not directly related to hypertension.
Question 3 of 9
A nurse is caring for a patient who has a history of hypertension and reports a new onset of headaches, nausea, and dizziness. The nurse should be most concerned about which of the following?
Correct Answer: A
Rationale: The correct answer is A: Hypertensive crisis. The nurse should be most concerned about this option because the patient has a history of hypertension and is experiencing new onset symptoms such as headaches, nausea, and dizziness, which could indicate a sudden and severe increase in blood pressure. This condition, if left untreated, can lead to serious complications such as stroke or heart attack. Summary: - B: Migraine headache is unlikely as the symptoms described are not typical of a migraine. - C: Benign positional vertigo is unlikely as it does not explain the presence of headaches and nausea. - D: Tension headache is less concerning compared to hypertensive crisis, given the patient's history of hypertension and the severity of symptoms.
Question 4 of 9
A nurse is teaching a patient with diabetes about blood glucose management. Which of the following statements by the patient indicates proper understanding?
Correct Answer: A
Rationale: Correct Answer: A Rationale: 1. Regular blood glucose monitoring helps in understanding patterns and making informed decisions. 2. Adjusting insulin based on blood glucose levels is crucial for effective diabetes management. 3. This statement shows the patient's understanding of the need for personalized insulin adjustments. 4. It promotes self-management and proactive approach to blood sugar control. Summary: B: Stopping insulin abruptly can lead to dangerous complications. C: Skipping meals can disrupt blood sugar levels and is not recommended. D: Waiting for high blood sugar to use insulin can result in uncontrolled levels and complications.
Question 5 of 9
A nurse is teaching a patient about managing hypertension. Which of the following statements by the patient indicates the need for further education?
Correct Answer: C
Rationale: The correct answer is C. This statement indicates the need for further education because it suggests the patient plans to stop taking medication once blood pressure is normal, which can lead to hypertension returning. Monitoring blood pressure, taking medication as prescribed, and decreasing sodium intake are all appropriate actions for managing hypertension. Stopping medication abruptly can be dangerous and should only be done under a healthcare provider's guidance.
Question 6 of 9
When performing a physical assessment, the first technique the nurse will use is:
Correct Answer: B
Rationale: The correct answer is B: Inspection. This is because visual observation is typically the initial step in a physical assessment to gather information about the patient's overall appearance, skin color, posture, and any obvious abnormalities. Palpation (A) involves touching and feeling for abnormalities, which usually follows inspection. Percussion (C) is the technique of tapping on the body to assess underlying structures, and auscultation (D) is listening to sounds produced by the body, both of which typically come after inspection and palpation. Inspecting the patient first allows the nurse to establish a baseline before moving on to more detailed assessment techniques.
Question 7 of 9
A nurse is caring for a patient with pneumonia. The nurse should prioritize which of the following interventions?
Correct Answer: B
Rationale: The correct answer is B because encouraging deep breathing and coughing exercises helps to improve lung function and prevent complications in pneumonia. This intervention can help clear secretions, improve oxygenation, and prevent respiratory distress. Administering antibiotics (choice A) is important but not the priority for immediate patient care. Providing pain relief (choice C) is essential but addressing respiratory function is more critical. Monitoring oxygen saturation levels (choice D) is necessary, but promoting lung function through exercises takes precedence.
Question 8 of 9
A 40-year-old woman presents to the clinic with complaints of fatigue and weight gain. On assessment, the nurse finds that the patient has cold intolerance, dry skin, and a slow heart rate. The nurse suspects:
Correct Answer: B
Rationale: The correct answer is B: Hypothyroidism. In this case, the patient's symptoms of fatigue, weight gain, cold intolerance, dry skin, and slow heart rate are indicative of hypothyroidism. The thyroid gland is underactive, leading to decreased production of thyroid hormones, which regulate metabolism. These symptoms align with the typical clinical presentation of hypothyroidism. Other choices are incorrect because hyperthyroidism (choice A) would present with symptoms like weight loss, heat intolerance, and a fast heart rate. Cushing's syndrome (choice C) and Addison's disease (choice D) are both conditions related to the adrenal glands and would have different symptom presentations compared to what is described in the case scenario.
Question 9 of 9
A patient is experiencing dizziness, blurred vision, and nausea. The nurse should first assess the patient's:
Correct Answer: B
Rationale: The correct answer is B, Blood pressure. Dizziness, blurred vision, and nausea can be symptoms of hypotension or hypertension. Assessing the patient's blood pressure first is crucial to determine if the symptoms are related to blood pressure fluctuations. Electrolyte levels (A) and blood glucose levels (C) may be assessed later but do not address the immediate concern. Temperature and respiratory rate (D) are important assessments but are not the priority in this scenario where cardiovascular status needs to be evaluated first.