Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is caring for a client who has spinal stenosis. Which of the following conditions should the nurse recognize as a risk factor for spinal stenosis?
A. Chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease (COPD) is inappropriate.COPD is a chronic lung disease characterized by airflow limitation. While COPD does not directly cause spinal stenosis, some individuals with COPD may have comorbidities or risk factors, such as osteoporosis or degenerative changes in the spine, which can contribute to spinal stenosis.
B. Laminectomy
Laminectomy is appropriate. A laminectomy is a surgical procedure used to decompress the spinal cord or nerves by removing the lamina (back part of the vertebra). While a laminectomy can be a treatment option for spinal stenosis, it is not a risk factor for developing the condition.
C. Hysterectomy
Hysterectomy is inappropriate. Hysterectomy, the surgical removal of the uterus, is not directly associated with spinal stenosis. However, certain conditions or factors leading to a hysterectomy, such as pelvic tumors or endometriosis, may indirectly contribute to spinal stenosis if they cause changes in the spine or affect posture.
D. Hyperthyroidism
Hyperthyroidism is appropriate. Hyperthyroidism, a condition characterized by excessive production of thyroid hormones, is not a known risk factor for spinal stenosis.
This question is an excerpt from Nurse Dive's nursing test bank - Ati Medical Surgical Proctored Exam 1. Take the full exam now
Full Explanation
Choice A Reason:
Chronic obstructive pulmonary disease (COPD) is inappropriate.COPD is a chronic lung disease characterized by airflow limitation. While COPD does not directly cause spinal stenosis, some individuals with COPD may have comorbidities or risk factors, such as osteoporosis or degenerative changes in the spine, which can contribute to spinal stenosis.
Choice B Reason:
Laminectomy is appropriate. A laminectomy is a surgical procedure used to decompress the spinal cord or nerves by removing the lamina (back part of the vertebra). While a laminectomy can be a treatment option for spinal stenosis, it is not a risk factor for developing the condition.
Choice C Reason:
Hysterectomy is inappropriate. Hysterectomy, the surgical removal of the uterus, is not directly associated with spinal stenosis. However, certain conditions or factors leading to a hysterectomy, such as pelvic tumors or endometriosis, may indirectly contribute to spinal stenosis if they cause changes in the spine or affect posture.
Choice D Reason:
Hyperthyroidism is appropriate. Hyperthyroidism, a condition characterized by excessive production of thyroid hormones, is not a known risk factor for spinal stenosis.
Similar Questions
A nurse is reviewing the electronic medical record of a middle-aged client who was admitted following a stroke. Which of the following findings should the nurse identify as a modifiable risk factor for stroke?
A. Hypertension
Hypertension is correct. This is a modifiable risk factor for stroke. Hypertension, or high blood pressure, significantly increases the risk of stroke. Treating and controlling hypertension through lifestyle changes and medication can help reduce the risk of stroke.
B. Client's age
Client's age is incorrect. While age itself is not modifiable, age is a non-modifiable risk factor for stroke. Risk of stroke increases with age, particularly in individuals over 55 years old. However, other modifiable risk factors can be addressed to reduce overall risk.
C. History of sickle cell disease
History of sickle cell disease is incorrect. Sickle cell disease is a genetic disorder characterized by abnormal hemoglobin in red blood cells. While sickle cell disease increases the risk of certain complications, such as stroke in children, it is not a modifiable risk factor in the traditional sense.
D. Parent who has cardiovascular disease
Parent who has cardiovascular disease is incorrect. While having a parent with cardiovascular disease may indicate a genetic predisposition to certain risk factors, it is not a direct modifiable risk factor for stroke. However, individuals with a family history of cardiovascular disease may have increased awareness and motivation to address modifiable risk factors such as hypertension, smoking, and diabetes.
Full Explanation
Choice A Reason:
Hypertension is correct. This is a modifiable risk factor for stroke. Hypertension, or high blood pressure, significantly increases the risk of stroke. Treating and controlling hypertension through lifestyle changes and medication can help reduce the risk of stroke.
Choice B Reason:
Client's age is incorrect. While age itself is not modifiable, age is a non-modifiable risk factor for stroke. Risk of stroke increases with age, particularly in individuals over 55 years old. However, other modifiable risk factors can be addressed to reduce overall risk.
Choice C Reason:
History of sickle cell disease is incorrect. Sickle cell disease is a genetic disorder characterized by abnormal hemoglobin in red blood cells. While sickle cell disease increases the risk of certain complications, such as stroke in children, it is not a modifiable risk factor in the traditional sense.
Choice D Reason:
Parent who has cardiovascular disease is incorrect. While having a parent with cardiovascular disease may indicate a genetic predisposition to certain risk factors, it is not a direct modifiable risk factor for stroke. However, individuals with a family history of cardiovascular disease may have increased awareness and motivation to address modifiable risk factors such as hypertension, smoking, and diabetes.
A nurse is caring for a client who has chronic respiratory acidosis due to chronic obstructive pulmonary disease (COPD). Which of the following findings should the nurse expect with this client?
A. Osteoporosis
Osteoporosis is inappropriate. Chronic respiratory acidosis can lead to osteoporosis over time due to several factors, including chronic hypoxemia, which can affect bone metabolism and lead to bone loss.
B. Polyuria
Polyuria is inappropriate. Polyuria, or increased urination, is not typically associated with chronic respiratory acidosis. In fact, respiratory acidosis tends to cause retention of bicarbonate ions, which can lead to compensatory metabolic alkalosis and decreased urine output.
C. Anxiety and depression
Anxiety and depression is inappropriate. Chronic respiratory acidosis can lead to symptoms such as lethargy, confusion, and decreased mental acuity due to the effects of elevated CO2 levels on the central nervous system. While anxiety and depression are not direct consequences of chronic respiratory acidosis, individuals with COPD may experience anxiety and depression as a result of their chronic respiratory condition.
D. Delirium
Delirium is correct. Delirium, characterized by an acute change in mental status, confusion, and altered consciousness, can occur in severe cases of chronic respiratory acidosis, especially during acute exacerbations. Elevated CO2 levels can affect brain function and lead to symptoms of delirium.
Full Explanation
Choice A Reason:
Osteoporosis is inappropriate. Chronic respiratory acidosis can lead to osteoporosis over time due to several factors, including chronic hypoxemia, which can affect bone metabolism and lead to bone loss.
Choice B Reason:
Polyuria is inappropriate. Polyuria, or increased urination, is not typically associated with chronic respiratory acidosis. In fact, respiratory acidosis tends to cause retention of bicarbonate ions, which can lead to compensatory metabolic alkalosis and decreased urine output.
Choice C Reason:
Anxiety and depression is inappropriate. Chronic respiratory acidosis can lead to symptoms such as lethargy, confusion, and decreased mental acuity due to the effects of elevated CO2 levels on the central nervous system. While anxiety and depression are not direct consequences of chronic respiratory acidosis, individuals with COPD may experience anxiety and depression as a result of their chronic respiratory condition.
Choice D Reason:
Delirium is correct. Delirium, characterized by an acute change in mental status, confusion, and altered consciousness, can occur in severe cases of chronic respiratory acidosis, especially during acute exacerbations. Elevated CO2 levels can affect brain function and lead to symptoms of delirium.
A client who has a history of migraines reports to a clinic with a throbbing headache. Which of the following questions should the nurse include in the assessment?
(Select All that Apply.)
A. "Have you had any nausea and vomiting with your headache?"
"Have you had any nausea and vomiting with your headache?": This question is appropriate. Nausea and vomiting are common symptoms associated with migraines. Asking about these symptoms can help confirm the diagnosis of a migraine headache.
B. "Are you bothered by the lights in here?"
"Are you bothered by the lights in here?" This question is appropriate. Sensitivity to light, known as photophobia, is a classic symptom of migraines. Inquiring about light sensitivity can provide additional evidence for the diagnosis.
C. "Have you noticed any confused or cloudy thinking?"
"Have you noticed any confused or cloudy thinking?". This question is inappropriate. Confusion or cognitive symptoms are not typical of migraines. However, some individuals may experience difficulty concentrating or cognitive symptoms during a migraine aura. This question may help assess for aura symptoms.
D. "Have you experienced or are you experiencing any strange smells?"
Have you experienced or are you experiencing any strange smells?" This question is appropriate. Some individuals may experience olfactory hallucinations or sensitivity to odors during a migraine aura. Asking about strange smells can help identify possible aura symptoms.
E. "Did you feel weak before the headache started or do you feel weak now?"
"Did you feel weak before the headache started or do you feel weak now?" This question is inappropriate. While weakness is not a typical symptom of migraines, some individuals may experience fatigue or muscle weakness during a migraine attack. This question may help assess the overall impact of the headache on the client.
Full Explanation
Choice A Reason:
"Have you had any nausea and vomiting with your headache?": This question is appropriate. Nausea and vomiting are common symptoms associated with migraines. Asking about these symptoms can help confirm the diagnosis of a migraine headache.
Choice B Reason:
"Are you bothered by the lights in here?" This question is appropriate. Sensitivity to light, known as photophobia, is a classic symptom of migraines. Inquiring about light sensitivity can provide additional evidence for the diagnosis.
Choice C Reason:
"Have you noticed any confused or cloudy thinking?". This question is inappropriate. Confusion or cognitive symptoms are not typical of migraines. However, some individuals may experience difficulty concentrating or cognitive symptoms during a migraine aura. This question may help assess for aura symptoms.
Choice D Reason
Have you experienced or are you experiencing any strange smells?" This question is appropriate. Some individuals may experience olfactory hallucinations or sensitivity to odors during a migraine aura. Asking about strange smells can help identify possible aura symptoms.
Choice E Reason:
"Did you feel weak before the headache started or do you feel weak now?" This question is inappropriate. While weakness is not a typical symptom of migraines, some individuals may experience fatigue or muscle weakness during a migraine attack. This question may help assess the overall impact of the headache on the client.