Adult health 4
nurse is caring for several clients, which of the following clients are at risk for developing pyelonephritis?
a client who is at 32 weeks of gestation, a client who has kidney calculi, client who has a neurogenic bladder, client who has DM
nurse is reviewing client lab data, nurse should recognize which of the following as expected for client who has stage 4 CKD?
glomerular filtration rate 20ml/MIN
client has dysphagia and new diet prescription, what should nurse include
have suction equipment available for use, feed client thickened liquids, place food on unaffected side, teach client to swallow with neck flexed
nurse is teaching client with CKD and who is about to begin hemodialysis, which info should she include in teaching?
hemodialysis returns a balance to serum electrolytes
which of the following statements indicates understanding of the teaching regarding a new prescription for metoprolol?
i will call my dr if my pulse is less than 60
nurse completing discharge teaching to client who is postop following fundoplication. which statement by client indicated understanding of teaching?
i will elevate the head of my bed on blocks
nurse in clinic is teaching client who has ulcerative clolitis, which statement by client indicates understanding of teaching?
i will plan to limit fiber in my diet
nurse is completing discharge teaching for client who has an infection due to H. pylori. which of the following statements by client indicates understanding?
i will take a combination of medications for treatment
nurse is teaching client who has new prescription for famotidine. which statement by client indicates understanding of teaching?
i will take my pill 1 hour before meals
nurse caring for a client who has experienced a right hemispheric stroke. which findings are expected?
impulse control difficulty, left hemiplegia, loss of depth perception, lack of situational awareness
nurse is assessing client who experienced left-hemispheric stroke, what is an expected finding
inability to recognize familiar objects
nurse teaching client who has new dx of dumping syndrome following gastric surgery, which information should nurse include in teaching?
increase protein in the diet
nurse is reviewing discharge instructions with a client who had spontaneous passage of a calcium phosphate renal calculus, which of the following instructions should the nurse include in the teaching?
limit intake of food high in animal protein, reduce sodium intake, report burning with urination to the provider, increase fluid intake to 3 L/day
nurse is completing an assessment of a client who had GERD, which finding is expected?
loss of tooth enamel
nurse is planning care for client who will undergo peritoneal dialysis, which action should nurse take?
monitor serum glucose, report cloudy dialysate return, assess for SOB, check access site dressing for wetness
nurse teaching client who has new prescription for sulfasalazine, which instruction should nurse include in the teaching?
notify the provider if you experience a sore throat
nurse completing discharge teaching with a client who has HF and is encouraged to increase K+, which would the nurse include as having the highest level of K+?
1 medium baked potato
nurse is teaching a client who has HF about the need to limit sodium in the diet to 2000 mg daily. which of the following foods should the nurse recommend for the client?
1 slice cheddar cheese, 3 oz atlantic salmon, 3 oz roasted chicken breast
which of the following cardiac enzymes would confirm the MI occurred 14 days ago?
Troponin T
nurse is caring for client who has left renal calculus and an indwelling urinary catheter, which of the following assessment findings is the priority for the nurse to report to the provider?
absent urine output for 1 hr
nurse is caring for client who has a UTI, which is the priority intervention by the nurse?
administer an antibiotic
what would the nurse expect in client with new diagnosis of SLE
alopecia
which of the following findings will help the nurse distinguish angina from MI?
angina can be relieved with rest and nitroglycerin
nurse is caring for client who has a new dx of GERD. nurse should anticipate prescriptions for which of the following medications?
antacids, histamine (receptor antagonists), proton pump inhibitors
nurse is providing info to client who has knee and hip osteoarthritis, what should she include in teaching
apply heat to joints to alleviate pain, ice inflamed joints following activity, install elevated toilet seat, complete high-energy activities in morning
a nurse is caring for a client who asks why her provider prescribes a daily aspirin, which statement by nurse is correct?
aspirin reduces the formation of blood clots that could cause a heart attack
nurse is caring for client who develops disequilibrium syndrome after receiving hemodialysis, which action should the nurse take?
assess LOC
nurse is planning care for client who has stage 4 CKD, which action should nurse include in the plan of care?
assess for JVD, provide frequent mouth rinses, auscultate for pleural friction rub, monitor for dysrhythmias
nurse caring for client who has HF and reports increased SOB, nurse increases the client O2 per protocol, which of the following actions should the nurse take first?
assist the pt into high-fowlers position
nurse is completing discharge teaching with a client with IBS, which instruction would she include in the teaching?
avoid foods that trigger exacerbations
nurse is preparing educational material to present to a female client who has frequent UTI, which of the following information should the nurse include?
avoid sitting in a wet bathing suit, empty the bladder when there is an urge to void, take a shower daily
nurse is completing discharge instructions with a client who has spontaneously passed a calcium oxalate calculus, to decrease the chance of recurrence, the nurse should instruct the client to avoid which of the following foods?
black tea, spinach
nurse is planning postop care for client who received hemodialysis, which intervention should the nurse include in the plan of care?
check BUN and serum creatinine, administer meds the nurse withheld prior to dialysis, observe for signs of hypovolemia, assess the access site for bleeding
nurse is completing assessment of client who has a gastric ulcer. which of the following should the nurse expect?
client reports a sensation of bloating, client states that pain occurs 30 mins to 1 hr after a meal, client experiences pain upon palpation of the epigastric region
nurse assessing client who has been taking prednisone following exacerbation of IBD, nurse should recognize which of the following findings as a priority?
client reports having an elevated body temp
nurse is completing the admission assessment of a client who has renal calculi, which of the following findings should the nurse expect?
diaphoresis
risk factors for gout
diuretic use, obesity, cardiovascular disease
nurse is planning care for client with SBO and NG suctioning in place, which intervention should nurse include?
document the NG drainage with clients output, assess bowel sounds, provide oral hygiene every 2 hr, monitor NG tube placement
nurse completing discharge teaching with a client with crohn's, which instructions should the nurse include in teaching?
drink canned protein supplements
nurse caring for client with SBO from adhesions, which findings are consistent with this dx?
emesis greater than 500ml with fecal odor, report of spasmodic abdominal pain, high-pitches bowel sounds
nurse is reviewing serum lab results of client with acute exacerbation of crohn's disease, which lab test should the nurse expect to be elevated?
erythrocyte sedimentation rate, WBC
what is used to diagnose RA
erythrocyte sedimentation rate, wbc count, antinuclear antibody titer
nurse is planning care for client with acute gastritis, which nursing intervention should the nurse include?
evaluate intake and output, monitor lab reports of electrolytes, observe stool characteristics
nurse is teaching about pernicious anemia with a client who has chronic gastritis. which info should she include in the teaching?
expect a monthly injection of vitamin B12
nurse teaching a client who has a hiatal hernia, which statements indicates understanding of teaching?
peppermint tea will increase my indigestion
client has left homonymous hemianopsia, which is appropriate?
place bedside table on right side
nurse is reviewing urinalysis results for four clients, which of the following urinalysis results indicates a urinary tract infection?
positive for leukocyte esterase
nurse providing discharge teaching for client with HF and on fluid restriction of 2000ml/day. client asks nurse how to determine appropriate amount of fluids he is allowed?
pour the amount of fluid into an empty 2-liter bottle to keep track of how much you drink
nurse is planning care for client with pre renal acute kidney injury following abdominal aortic aneurysm repair, urinary output is 60ml in past 2 hr, and blood pressure is 92/58, which intervention should the nurse anticipate?
prepare to administer a fluid challenge
nurse is planning care for a client with chronic pyelonephritis, which actions should the nurse plan to take?
provide a referral for nutrition counseling, palpate the costovertebral angle, monitor output, administer antibiotics
nurse is planning care for client with a post renal AKI due to metastatic cancer, client has serum creatinine of 5mg, which intervention should nurse include in plan?
provide high-protein diet, assess urine for blood, monitor for intermittent anuria
client with rheumatoid arthritis complains of joint tenderness and swelling, what should nurse expect
recent influenza, decreased range of motion, pain at rest
nurse assessing client who has pre renal AKI, which finding should nurse expect?
reduced urine output, elevated serum creatinine
nurse is preparing to initiate hemodialysis for client who has an acute kidney injury, which action should the nurse take?
review the meds the client currently takes, assess the AV fistula for a bruit, measure the clients weight, check the serum electrolytes
nurse in ED is completing assessment of client who has suspected stomach perforation due to peptic ulcer, which finding should the nurse expect?
rigid abdomen, tachycardia, rebound tenderness
which of the following changes should the nurse recommend be made first to prevent angina and MI?
smoking cessation
client has global aphasia (receptive and expressive) what should she include
speak to client at slower rate, assist client to use flash cards with pictures, give instructions one step at a time
nurse is teaching a client who is scheduled for extracorporeal shock wave lithotripsy (ESWL), which of the following indicates understanding by client?
straining my urine following the procedure is important
nurse is completing admission assessment of a client who has suspected pulmonary edema. which of the following manifestations are expected findings?
tachypnea, persistent cough, orthopnea
nurse is teaching a client who has a duodenal ulcer and a new prescription for esomeprazole. which of the following should the nurse include in the teaching?
take the medication 1 hr before a meal, limit NSAID's when taking this med.
nurse assessing older adult client in an extended care facility, nurse should recognize which finding as a manifestation of obstruction of large intestine due to fecal impaction?
the client is having small, frequent, liquid stools
charge nurse is teaching group of unit nurses about client who has chronic gastritis and is scheduled for selective vagotomy, which statement by unit nurse indicated understanding about purpose of procedure?
the client will have a reduction of gastric acid secretions
nurse is completing admission assessment for client who has SBO, which finding should nurse report to provider?
urine specific gravity 1.040, Hct 60%, serum K+ 3.0
nurse is admitting a client who has esophageal varices, nurse should anticipate a prescription for which of the following meds?
vasopressin
nurse is providing discharge teaching for client who has new prescription for aluminum hydroxide. which info should she include in teaching?
wait 1 hr before taking other oral meds
