Elsevier Adaptive Quizzing - Quiz performance PDF

Preview

Summary

Quizzes...

Description

Performance Exit

EAQ Physiological Adaptation Mastery Intermediate Quiz Due Jul 31, 2021 by 11:59 pm

Passed 193 out of 222 questions answered correctly

Completed on Jul 22, 2021 3:33 pm

Incorrect (29)

Which lesion may alter skin turgor? Cysts Patches Macules Lichenification

Rationale Increased skin thickness due to lichenification leads to decreased elasticity or turgor. Cysts, patches, and macules are primary lesions that may not alter turgor much when compared with lichenification, which is a secondary lesion.

The nurse provides education about self-care management to a client who was recently diagnosed with emphysema. The nurse concludes that further teaching is needed when the client makes which statement? "I will try to avoid smoking." "I will maintain complete bed rest." "I'll control the temperature in my home." "I'll need to clean my mouth several times a day."

Rationale Although energy should be conserved, it is not necessary to restrict all activity; the client needs further teaching. Smoking should be avoided because it is a respiratory tract irritant and it interferes with gas exchange in the alveoli. Extremes in environmental temperature and humidity place stress on the respiratory system, interfering with gaseous exchange. Meticulous oral care is advisable because of the presence of excessive mucus; also, it reduces the amount of microorganisms that can enter the tracheobronchial tree, which can precipitate infection.

The nurse observes unilateral breast enlargement in a 14-year-old male client. The client states he has had this condition for 18 months. Which treatment would the primary health care provider administer? Testosterone Plastic surgery Calcium channel blockers

Testing for Klinefelter syndrome

Rationale Gynecomastia is a condition in which the adolescent has some degree of unilateral or bilateral breast enlargement. If gynecomastia persists or is extensive enough to cause embarrassment, plastic surgery is indicated for cosmetic and psychological reasons. Administering testosterone and calcium channel blockers may aggravate the condition. When gynecomastia has a prepubertal onset, the adolescent should be evaluated for Klinefelter syndrome. Test-Taking Tip: You have at least a 25% chance of selecting the correct response in multiple-choice items. If you are uncertain about a question, eliminate the choices that you believe are wrong and then call on your knowledge, skills, and abilities to choose from the remaining responses.

The nurse is caring for a child with a diagnosis of meningitis. Which clinical findings indicate an increase in intracranial pressure? Select all that apply. One, some, or all responses may be correct. Some correct answers were not selected

Irritability Bradycardia Hyperalertness Decreased pulse pressure Decreased systolic blood pressure

Rationale Irritability is a classic sign of increased intracranial pressure, because it signals disruption of the central nervous system. Bradycardia is a classic late sign of increased

intracranial pressure. With increased intracranial pressure there is decreased alertness or loss of consciousness. The pulse pressure increases with increased intracranial pressure. The systolic blood pressure increases with increased intracranial pressure.

Which information regarding varicella is correct? Communicable until all vesicles are dry Still communicable even when dry scabs remain No longer communicable after the fever has subsided Not communicable while vesicles are surrounded by red areolas

Rationale When all the vesicles have dried, varicella (chickenpox) is no longer transmissible; dried vesicles and scabs do not harbor the varicella virus. Varicella is not associated with a fever unless a bacterial complication such as pneumonia is present. Vesicles that are surrounded by areolas occur in successive crops; they contain the varicella virus.

Which options are examples of actively acquired specific immunity? Select all that apply. One, some, or all responses may be correct. Some correct answers were not selected

Recovery from measles Recovery from chickenpox Maternal immunoglobulin in the neonate Immunization with live or killed vaccines Injection of human gamma immunoglobulin

Rationale

Clients who recovered from measles or chickenpox or those immunized with a live- or killed-virus vaccine has naturally acquired active-type immunity. Maternal immunoglobulin in a neonate and an injection of human gamma immunoglobulin into a client are examples of passively acquired specific immunity.

Which reason for a decrease in height is common in older women? Older adults have lower levels of growth hormone. Older adults are not active enough, so they lose bone mass. Older adults have poor posture, so they are shorter. Older adults may have osteoporosis-related height changes.

Rationale Because of the decreasing amounts of estrogen in older women, there is a loss of calcium as well, which can lead to osteoporotic bone loss and a loss in height. Older adults have decreased levels of growth hormone but that does not cause a loss of height. Sweeping statements about older adults not being active enough or having poor posture are not accurate.

Which nursing action would be appropriate when the client with alcohol withdrawal delirium begins experiencing hallucinations? Withholding intervention, because the client may be having vivid dreams Asking the client to describe the hallucinations and explaining that they are not real Administering the prescribed medication to the client to subdue the agitated behavior Pretending to visualize the imaginary things the client is describing to foster acceptance

Rationale The nurse would administer the prescribed medication to the client to subdue the agitated behavior. Alcohol withdrawal delirium is a life-threatening situation. The client's central nervous system (CNS) is overstimulated, and seizures and death can occur. CNS-depressant medications, usually benzodiazepines, are needed to blunt the withdrawal effects. The client needs intervention because the hallucinations are not dreams. Focusing on the hallucinations associated with the withdrawal syndrome is not therapeutic; it is not helpful to tell the client that the hallucinations are not real, because they are real to the client. Pretending to visualize the imaginary things is not helpful and may be unsafe. The nurse must present reality. STUDY TIP: Do not change your pattern of study. It obviously has contributed to your being here, so it worked. If you have studied alone, continue to study alone. If you have studied in a group, form or maintain a study group.

Which effect does the nurse expect after an amniotomy is performed on a client in active labor? Diminished vaginal bleeding Less discomfort with contractions Progressive dilation and effacement Increased maternal and fetal heart rates

Rationale Amniotomy permits more effective pressure of the fetal head on the cervix, enhancing dilation and effacement. Vaginal bleeding may increase because of the progression of labor. Discomfort may increase because contractions usually become more intense after amniotomy. Amniotomy should not affect maternal and fetal heart rates.

Which nursing action will help a client obtain maximum benefits after postural drainage?

Administer oxygen. Encourage coughing deeply. Place the client in a sitting position. Encourage the client to rest for 30 minutes.

Rationale Coughing is needed to raise secretions for expectoration. Oxygen will not mobilize the secretions. A sitting position will allow secretions to remain in the lungs unless coughing is encouraged. Rest should be encouraged only after coughing to bring up secretions mobilized by postural drainage.

A 10-year-old child is diagnosed with lymphocytic thyroiditis (Hashimoto disease) and develops a goiter. Which education would the nurse provide to the parents and child about this condition? The goiter is chronic. Treatment is difficult. It is an inherited disorder. The child may need thyroid replacement.

Rationale The goiter associated with Hashimoto disease is usually transient and may regress spontaneously in 1 or 2 years. The child is generally euthyroid but may show signs of hypothyroidism or hyperthyroidism. Treatment with thyroid replacement is necessary only in cases of hypothyroidism. This is not a chronic disease. Hashimoto disease is not an untreatable or fatal disorder; it can be controlled with a medical regimen. There seems to be a strong genetic predisposition, but no mode of inheritance has been identified.

Test-Taking Tip: Pace yourself while taking a quiz or exam. Read the entire question and all answer choices before answering the question. Do not assume that you know what the question is asking without reading it entirely.

Which action will the nurse take to check for subcutaneous emphysema in a client with a chest tube? Palpate around the tube insertion sites for crepitus. Auscultate the breath sounds for crackles and atelectasis. Observe the client for the presence of a barrel-shaped chest. Compare the length of inspiration with the length of expiration.

Rationale Subcutaneous emphysema occurs when air leaks from the intrapleural space through the thoracotomy or around the chest tubes into the soft tissue; crepitus is the crackling sound heard when tissues containing gas are palpated. Crackles and atelectasis are unrelated to crepitus. They occur within the lung; subcutaneous emphysema occurs in the soft tissues. Observing the client for the presence of a barrel-shaped chest is related to prolonged trapping of air in the alveoli associated with emphysema, a chronic obstructive pulmonary disease. Comparing the length of inspiration with the length of expiration is unrelated to subcutaneous emphysema, which involves gas in the soft tissues from a pleural leak. STUDY TIP: Becoming a nursing student automatically increases stress levels because of the complexity of the information to be learned and applied and because of new constraints on time. One way to decrease stress associated with school is to become very organized so that assignment deadlines or tests do not come as sudden surprises. By following a consistent plan for studying and completing assignments, you can stay on top of requirements and thereby prevent added stress.

Which type of immunity would a 4-year-old child develop during the

course of an infection with varicella? Active natural immunity Active artificial immunity Passive natural immunity Passive artificial immunity

Rationale In active natural immunity, the infected child's immune system responds to the invading organism (varicella) by producing antibodies specific to the antigen. Passive natural immunity is acquired by the fetus from the mother. Active artificial immunity is acquired by the injection of antigens; after this, the child develops antibodies. Passive artificial immunity is acquired through the injection of antibodies.

Which sign or symptom leads the nurse to suspect that a client is experiencing a tubal pregnancy? A painful, tender area in the epigastric region after meals Lower abdominal cramping of 1 week's duration with constipation Leukorrhea or dysuria occurring a few days after the first missed menstrual period A sharp pain in the lower right or left side of the abdomen, radiating to the shoulder

Rationale A fallopian tube is unable to contain and sustain a pregnancy to term; as the fertilized ovum grows, there is excessive stretching or rupture of the affected fallopian tube, resulting in pain. At this stage the products of conception are too small to form a mass; the pain is lateral, not centered. The pain is sudden, intense, and knifelike, not prolonged or cramping. Leukorrhea and dysuria may be indicative of a vaginal or

bladder infection. Test-Taking Tip: Become familiar with reading questions on a computer screen. Familiarity reduces anxiety and decreases errors.

Which heat-loss mechanism would the nurse minimize by swaddling a newborn infant with a blanket? Radiation Conduction Active transport Fluid vaporization

Rationale Radiation, or the transfer of heat from a warm object to the atmosphere, is prevented by covering the child with a blanket. Reducing body surface area (e.g., flexing all extremities in toward the body) also limits heat loss through radiation. Conduction is the transfer of heat from one molecule to another with contact between the two. Active transport is not related to loss of heat; this is a process that moves ions or molecules across a cell membrane against a concentration gradient. Vaporization is the conversion of liquid or solid into a vapor; it occurs when a person is perspiring. STUDY TIP: A word of warning: do not expect to achieve the maximum benefits of this review tool by cramming a few days before the examination. It doesn't work! Instead, organize planned study sessions in an environment that you find relaxing, free of stress, and supportive of the learning process.

The nurse is teaching Hands-Only Basic Life Support for adults in the community. After determining that the victim is not responding and the emergency medical system has been activated, which action would the rescuer take?

Identify the absence of pulse. Give two rescue breaths with a CPR mask.

Perform the head tilt-chin lift

maneuver. Perform chest compressions at a rate of 100/min.

Rationale Once the community rescuer verifies that the person is unresponsive and has activated the emergency medical response system, the rescuer should immediately begin chest compressions at a rate of 100/minute to a depth of 2 inches (5 cm), allowing full chest recoil between compressions. Performing the head tilt-chin lift maneuver, giving rescue breaths, and checking the pulse are not part of the Hands-Only Basic Life Support method of cardiopulmonary resuscitation (CPR). This method was designed to make it easier for community people to perform CPR. It quickly circulates the blood until trained assistance arrives.

Which Korotkoff sound represents the diastolic pressure in children? First Second Fourth Fifth

Rationale The fourth Korotkoff sound represents the diastolic pressure in children. The first Korotkoff sound represents the systolic pressure. The fifth Korotkoff sound represents the diastolic pressure in adults and adolescents. A blowing or swishing sound occurs in the second Korotkoff sound.

Which skin color change would the nurse expect to see if a client with

dark skin develops cyanosis? Gray Purple Dark red Purple-to-brownish

Rationale In dark-colored skin, cyanosis can be identified by a gray color, which is mostly seen in the conjunctiva of the eye. A purple skin color is an indication of erythema. In a lightskinned client, a dark red color is an indicator of ecchymosis. A purple-to-brownish color identifies ecchymosis. Test-Taking Tip: Recall the identifications of cyanosis and compare with the options given to choose a right answer option.

Which assessment findings would the nurse consider as abnormal? Select all that apply. One, some, or all responses may be correct. Some correct answers were not selected

Joint crepitation Muscular atrophy Muscle strength of 5 Tenderness of the spine Full range of joint motion

Rationale

Crepitation, a cracking and popping sound of the joint, is not a normal assessment finding. Muscular atrophy, wasting of the muscle, is also an abnormal finding. Spine

tenderness on palpation of spine, joints, or muscles is not a normal finding on physical assessment of the musculoskeletal system. Muscle strength of 5 indicates active movement of the muscle against full resistance without evident fatigue, or normal muscle strength. Full range of motion in the joints is a normal finding.

Which clinical findings would the nurse expect to find when caring for a client with hyperthyroidism? Select all that apply. One, some, or all responses may be correct. Some correct answers were not selected

Lethargy Tachycardia Weight gain Constipation Exophthalmos

Rationale Tachycardia is associated with hyperthyroidism and is caused by the increase in the basal metabolic rate. Exophthalmos is associated with hyperthyroidism and results from accumulation of fluid behind the eyeball. Lethargy is associated with hypothyroidism; hyperactivity occurs with hyperthyroidism. Weight gain occurs with hypothyroidism; weight loss occurs with hyperthyroidism because of the high metabolic rate. Constipation is associated with hypothyroidism; frequent loose stools occur with hyperthyroidism.

Initially after a stroke, a client's pupils are equal and reactive to light. Later, the nurse assesses that the right pupil is reacting more slowly than the left and that the systolic blood pressure is rising. Which complication would the nurse plan to address? Spinal shock

Hypovolemic shock Transtentorial herniation Increased intracranial pressure

Rationale Increased intracranial pressure compresses vital brain tissue; this is manifested by a sluggish pupillary response and an increased systolic blood pressure. Spinal shock is manifested by decreased systolic blood pressure, with no pupillary changes. Hypovolemic shock is indicated by decreased systolic pressure and tachycardia, with no changes in pupillary reaction. Transtentorial herniation is manifested by dilated pupils and severe posturing. STUDY TIP: Focus your study time on the common health problems that nurses most frequently encounter.

Which assessment finding would the nurse recognize as common in infants with Down syndrome? Bulging fontanels Stiff lower extremities Abnormal heart sounds Unusual pupillary reactions

Rationale Cardiac anomalies (that produce abnormal heart sounds) often accompany genetic problems such as Down syndrome; 30% to 40% of affected infants also have congenital heart defects. Infants with Down syndrome do not have increased intracranial pressure; the fontanels should be flat. The extremities will more likely be relaxed. Children with Down syndrome exhibit the usual pupillary reaction to light.

Test-Taking Tip: Being emotionally prepared for an examination is key to your success. Proper use of resources over an extended period of time ensures your understanding and increases your confidence about your nursing knowledge. Your lifelong dream of becoming a nurse is now within your reach! You are excited, yet anxious. This feeling is normal. A little anxiety can be good because it increases awareness of reality; but excessive anxiety has the opposite effect, acting as a barrier and keeping you from reaching your goal. Your attitude about yourself and your goals will help keep you focused, adding to your strength and inner conviction to achieve success.

Which are the current leading causes of death in the United States? Select all that apply. One, some, or all responses may be correct. Stroke Cancers Dementia Accidents Infections

Rationale Researchers revealed that conditions such as stroke, cancers, and dementia are the leading causes of death in the United States. Accidents and infections are not the current leading causes of death in the United States; they were the leading causes of death a century ago.

Which condition results in elevated serum adrenocorticotropic hormone (ACTH) and urine cortisol levels? Diabetes insipidus Adrenal Cushing syndrome Pituitary Cushing syndrome

Syndrome of inappropriate antidiuretic hormone

Rationale In pituitary Cushing syndrome, urine cortisol and serum ACTH levels are raised. Diabetes insipidus is the result of decreas...