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A nurse is caring for a client who has receptive aphasia. Which of the following communication problems should the nurse expect when assessing the client?

The client is unable to understand words or sentences she hears.

A nurse is caring for a client who has a tracheostomy with an inflated cuff in place. Which of the following findings indicates that the nurse should suction the client's airway secretions?

The nurse auscultates coarse crackles in the lung fields.

A nurse is teaching a client who has coronary artery disease about the difference between angina pectoris and myocardial infarction (MI). which of the following manifestations should the nurse identify as indications of MI? (SATA)

Nausea and vomiting Diaphoresis and dizziness Anxiety and feelings of doom

During a neurological assessment, a nurse asks the client to name all of his children, their ages, and their birth dates. Which of the following types of memory is the nurse testing?

Remote

A nurse is caring for a client who has a brainstem injury. Which of the following physiological functions should the nurse monitor?

Respiratory effort

A nurse is providing teaching to a client who has gout and urolithiasis. The client asks how to prevent future uric acid stones. Which of the following suggestions should the nurse provide? (SATA)

Take allopurinol as prescribed Exercise several times a week Limit intake of foods high in purine

A nurse is teaching a client about the manifestations of an allergic reaction. The release of histamine causes which of the following reactions?

Increased mucus secretion

A nurse is caring for a client who is receiving mechanical ventilation and develops acute respiratory distress. Which of the following actions should the nurse take first?

Initiate bag-valve-mask ventilation

A nurse in a clinic is providing teaching to an adolescent client who has recurrent external otitis. Which of the following instructions should the nurse include in the teaching?

Instill diluted alcohol solution into the ear after swimming

A nurse is providing teaching for a client following a below-the-knee amputation. Which of the following pieces of information should the nurse include in the teaching?

Instruct the client to lie prone while in bed.

A nurse is caring for a client who has chronic phantom limb pain following an above-knee amputation. Which of the following medication prescriptions should the nurse verify with the provider?

Meperidine

A nurse is providing discharge teaching for a client who has a newly inserted permanent pacemaker. Which of the following instructions should the nurse include in the teaching?

"Keep your cell phone 6 inches away from your pacemaker when making a call."

A nurse is caring for a client who underwent radioallergosorbent (RAST) testing due to seasonal allergies. The nurse should anticipate an elevation in which of the following immunoglobulin laboratory values?

IgE

A nurse is planning dietary teaching for a client who has diabetes mellitus. Which of the following actions should the nurse plan to take first?

Ask the client to identify the types of foods she prefers

A nurse in the emergency department is caring for a client who has bleeding esophageal varices. The nurse should anticipate a prescription for which of the following medications?

C. Vasopressin

A nurse is caring for a client who has recovered from acute diverticulitis. The nurse should instruct the client to increase his intake of which of the following foods when the inflammation subsides?

Cabbage and peaches

A nurse is performing medication reconciliation for a newly admitted client who has rheumatoid arthritis (RA). Which of the following medications should the nurse identify as the treatment for this condition?

Celecoxib

A nurse in an emergency department is assessing a client who has extensive burns, including on her face. Which of the following assessments should the nurse perform first?

Characteristics of the cough and sputum

A nurse is assessing a client who has a fractured left femur and is in skeletal traction. Which of the following findings should the nurse report to the provider?

Chest petechiae

A nurse is caring for a client who has a fractured hip and was placed in Buck's traction 4 hr ago. Which of the following actions should the nurse take?

Encourage the client to perform dorsiflexion of the affected extremity every 2hr

A nurse is caring for a client who is 2 days postoperative. Which of the following findings indicates that the client is developing an infection?

Erythema at the incision site

A nurse is providing teaching to a client who has a diagnosis of hepatitis A. Which of the following statements by the client indicates an understanding of the teaching?

"I should stop eating raw clams."

A nurse is preparing a client for cardiac catheterization. Which of the following pieces of information should the nurse give the client before the procedure?

"You'll have to lie flat for several hours after the procedure." "You'll receive medication to relax you before the procedure." "You'll have to keep your leg straight after the procedure."

A nurse is providing discharge instructions for a client who is postoperative following inner maxillary fixation with wiring. Which of the following pieces of information should the nurse include? A. Cut the wiring if emesis occurs B. Consume 3 meals daily as part of a low-protein diet C. Swab the mouth with hydrogen peroxide if wiring produces oral irritation D. Resume a soft diet in 3 to 5 days.

A Cut the wiring if emisis occurs

A charge nurse is observing a newly licensed nurse administer an IV medication to a client who has an implanted venous access port. Which of the following observations requires interventions by the charge nurse?

A solution of 5mL heparin 1,000 units/mL has been prepared

A nurse is preparing a client for a bronchoscopy. Which of the following actions should the nurse take? (SATA)

Explain that the client will receive sedation and will not remember the procedure. Verify that the client understands the purpose and nature of the procedure.

A nurse is assessing a client who has osteoarthritis. The client's medical record indicates the presence of Heberden's nodes. Which of the following findings should the nurse expect?

Hard lumps over the joints of the fingers

A nurse is monitoring a newly licensed nurse who is caring for a client. The client has active pulmonary tuberculosis, was placed on airborne precautions, and is scheduled for a chest x-ray. The nurse should instruct the newly licensed nurse to take which of the following actions?

Have the client wear a surgical mask

A nurse is caring for a client with Addison's disease who has been admitted with muscle weakness, dehydration, and nausea and vomiting for the past 2 days. Which of the following prescribed medications should the nurse plan to administer?

Hydrocortisone

A nurse is monitoring a client who has syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which of the following findings should the nurse expect?

Hyponatremia

A nurse is providing discharge instructions to a client who is postoperative following surgical excision of a basal cell carcinoma. Which of the following findings should the nurse include as an indication of a mole's potential malignancy?

Ulceration

A client who just learned that he has variant (Prinzmetal's) angina asks the nurse how this type of angina compares with stable angina. Which of the following replies should the nurse make?

Variant angina can cause changes on your electrocardiogram."

A nurse is assessing a client who has Guilain-Barre syndrome. Which of the following findings should the nurse expect?

Weakness of the lower extremities


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