jarvis physical examination and health assessment 9th edition test bank

Questions 37

ATI RN

ATI RN Test Bank

jarvis physical examination and health assessment 9th edition test bank Questions

Question 1 of 5

A patient often seems to have difficulty coming up with the right words. He says, "I was on my way to work, and when I got there, the thing that you step into that goes up was so full that I decided to take the stairs.' The nurse will note on his chart that he is using or experiencing:

Correct Answer: C

Rationale: The correct answer is C: Circumlocution. This patient is using circumlocution, which is a communication strategy where a person describes something in a roundabout way instead of using the specific word. In this case, the patient is describing an elevator as "the thing that you step into that goes up." This is a common feature of language difficulties seen in conditions like aphasia. A: Blocking is when a person suddenly stops speaking in the middle of a sentence due to an inability to recall a word, which is not happening in this scenario. B: Neologism is the creation of new words or phrases, which is not evident here. D: Circumstantiality is a speech pattern where the person includes unnecessary details and goes off on tangents, which is not demonstrated in the patient's response.

Question 2 of 5

A nurse is caring for a patient with chronic kidney disease. The nurse should monitor for which of the following signs of fluid overload?

Correct Answer: A

Rationale: The correct answer is A, shortness of breath and weight gain, because fluid overload in patients with chronic kidney disease can lead to pulmonary edema and weight gain due to retained fluid. Shortness of breath occurs as the excess fluid accumulates in the lungs. Increased urine output and fatigue (B) are more indicative of dehydration. Dizziness and hypotension (C) are symptoms of hypovolemia, not fluid overload. Nausea and vomiting (D) are nonspecific symptoms and not typically associated with fluid overload.

Question 3 of 5

Which of the following is an example of a first-level priority problem?

Correct Answer: D

Rationale: The correct answer is D because shortness of breath and respiratory distress indicate a potentially life-threatening emergency requiring immediate intervention. This problem falls under the first-level priority as it addresses airway, breathing, and circulation, which are essential for survival. Choices A, B, and C are not first-level priorities as they do not pose an immediate threat to the patient's life or require urgent intervention. Postoperative pain, diabetes teaching, and a small foot laceration are important but can be addressed at a later time without immediate harm to the patient.

Question 4 of 5

A nurse is caring for a patient with diabetes. Which of the following symptoms should the nurse recognize as a sign of hypoglycemia?

Correct Answer: C

Rationale: The correct answer is C: Tremors and dizziness. Hypoglycemia is characterized by low blood sugar levels. Tremors and dizziness are common symptoms due to the brain not receiving enough glucose for energy. Tachycardia and nausea (choice A) are more indicative of hyperglycemia. Polyuria and polydipsia (choice B) are classic symptoms of hyperglycemia in diabetes. Weight loss and fatigue (choice D) are not specific symptoms of hypoglycemia.

Question 5 of 5

A female nurse is interviewing a male patient who is close in age to the nurse. During the interview, the patient makes an overtly sexual comment. The nurse's best response would be:

Correct Answer: D

Rationale: The correct answer is D because it directly addresses the inappropriate behavior, sets a boundary, and communicates the nurse's discomfort in a professional manner. By stating that the comment makes them uncomfortable and asking the patient to refrain from such behavior, the nurse asserts their professionalism while maintaining respect for both parties. Choice A is too abrupt and may escalate the situation. Choice B dismisses the behavior, which is inappropriate. Choice C could be perceived as confrontational and potentially lead to a defensive response from the patient.

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