SNLE Adult Health Nursing 3 — Questions and Answers
Question 1: A patient is diagnosed with deep vein thrombosis (DVT). Which nursing intervention is contraindicated?
- Massaging the affected leg (Correct answer)
- Elevating the affected extremity
- Applying warm compresses as ordered
- Administering anticoagulants as prescribed
Correct answer: Massaging the affected leg
Massaging a limb with known or suspected DVT is contraindicated because it can dislodge the thrombus, causing a potentially fatal pulmonary embolism. Elevation, warmth, and anticoagulation are appropriate interventions.
Question 2: Which dietary instruction is most important for a patient taking warfarin?
- Maintain consistent vitamin K intake and avoid drastic dietary changes (Correct answer)
- Eat as many leafy greens as possible
- Eliminate all vitamin K from the diet
- Avoid protein-rich foods
Correct answer: Maintain consistent vitamin K intake and avoid drastic dietary changes
Warfarin works by inhibiting vitamin K-dependent clotting factors. Sudden large increases in vitamin K intake (from leafy greens) antagonize warfarin and reduce anticoagulation. Consistency is more important than elimination.
Question 3: A patient has a blood urea nitrogen (BUN) of 45 mg/dL and creatinine of 3.2 mg/dL. What condition does this suggest?
- Renal impairment (Correct answer)
- Liver failure
- Dehydration alone
- Normal kidney function
Correct answer: Renal impairment
Elevated BUN and creatinine indicate impaired renal filtration. BUN normal range is 7–20 mg/dL and creatinine 0.6–1.2 mg/dL. Both elevated together strongly suggest acute kidney injury or chronic kidney disease.
Question 4: Which finding indicates that a patient's nasogastric tube is properly placed in the stomach?
- Aspiration of gastric contents with pH 1–5 and confirmation by X-ray (Correct answer)
- Bubbling sounds on chest auscultation
- Clear aspirate without pH testing
- Air bubbling in water when tube end is submerged
Correct answer: Aspiration of gastric contents with pH 1–5 and confirmation by X-ray
X-ray remains the gold standard for initial NG tube placement verification. Aspirating gastric contents and checking pH (gastric pH typically 1–5) is used for ongoing verification. Auscultation alone is unreliable.
Question 5: What is the most common complication following coronary artery bypass graft (CABG) surgery?
- Dysrhythmias, particularly atrial fibrillation (Correct answer)
- Deep vein thrombosis
- Renal failure
- Stroke
Correct answer: Dysrhythmias, particularly atrial fibrillation
Atrial fibrillation occurs in 20–40% of patients after CABG, typically on post-operative day 2–4. It results from pericardial inflammation, electrolyte imbalances, and sympathetic stimulation from surgery.
Question 6: A patient with chronic kidney disease is placed on a renal diet. Which nutrient is most commonly restricted?
- Potassium, phosphorus, and sodium (Correct answer)
- Only sodium
- Only protein
- Only fluid
Correct answer: Potassium, phosphorus, and sodium
CKD patients require restriction of potassium (to prevent hyperkalemia and cardiac arrhythmias), phosphorus (to prevent renal osteodystrophy), and sodium (to control fluid retention and hypertension). Protein and fluid may also be restricted.
SNLE Adult Health Nursing 3
A patient is diagnosed with deep vein thrombosis (DVT).
Which nursing intervention is contraindicated?