exam

A 60-year-old female client comes to the clinic with complaints of fatigue, weight loss of 10 pounds in the past month, morning joint stiffness, and severe pain in the small joints of the hands. I feel better when I am doing any activity and have more pain at rest. The client asks the nurse, "Do I have rheumatoid arthritis (RA) or osteoarthritis (OA)?" What is the nurse's best response? "According to your signs/symptoms, you probably have rheumatoid arthritis." "According to your signs/symptoms, you probably have osteoarthritis." "Why would you think you have rheumatoid arthritis or osteoarthritis, you may have something else going on." "Have you been reading about rheumatoid arthritis and osteoarthritis?"

"according to your signs/symptoms, you probably have rheumatoid arthritis"

A client arrives at the clinic for her pre-op visit before undergoing a BKA on the left leg next week. The client asks the nurse if diabetes and her lower ankle wound that has been open for 7 months were the causes of her upcoming amputation. What is the nurse's best response? "Are you keeping your blood glucose levels below 200 mg/dl?" "How often do you check the bottoms of your feet?" "You will need to talk with your health care provider (HCP) about why you are having an amputation." "Diabetes, peripheral artery disease, and osteomyelitis can be contributing factors for amputations."

"diabetes, peripheral artery disease, & osteomyelitis can be contributing factors for amputations"

A client is brought to the ER with an open chest wound and multiple rib fractures and a suspected pneumothorax. Which interventions would be performed STAT by the nurse at the moment the client is brought in? Select all that apply. Administer oxygen as prescribed. Apply a dressing over the chest wound. Place the client in high Fowler's position. Encourage coughing and deep breathing. Suction fluids from the lungs.

administer, apply, place

The nurse is educating the client receiving treatment for high cholesterol on healthy foods for high cholesterol vs. unhealthy foods. Which foods are more appropriate for clients who have high cholesterol? Select all that apply. Almonds Grapefruits Avocados Coconut oil Plain popcorn

almonds, avocados, plain popcorn

The nursing diagnosis for a patient with a myocardial infarction is activity intolerance. The plan of care includes the patient outcome criterion of: agreeing to discontinue smoking. ambulating 50 feet without experiencing dyspnea. experiencing no dyspnea on exertion. tolerating activity well.

ambulating 50 feet without experiencing dyspnea

A client with a serum sodium level of 115 mEq/L has been receiving an intravenous infusion of 3% normal saline (NS) at 50 mL/hr for 16 hours. This morning the client feels tired and short of breath. Which action should the nurse make a priority? Slow the infusion Check the latest sodium level Notify the healthcare provider Assess for signs of fluid overload

assess for signs of fluid overload

The nurse caring for a below the knee amputation (BKA) is preparing the client's stump for a prosthesis fitting. Which actions would be priority? Select all that apply. Assess for redness and swelling at the incision site. Wrap the stump in a figure 8 pattern. Elevate the stump on a pillow to dangle. Instruct the client to hang the stump off the bed. Instruct the client to lie prone 30 minutes three times/day. Keep the stump in a dependent position.

assess, wrap, prone, dependent

The most common, preventable complication of abdominal surgery is: atelectasis. fluid and electrolyte imbalance. thrombophlebitis. urinary retention.

atelectasis

What should the nurse include in teaching when preparing the client for discharge following a laparoscopic appendectomy? Report temperature of 99.9º F (37.7º C) Remove the steri-strips 24-hours after the surgery Avoid weight-bearing exercise for the first week Avoid laxatives the first two weeks after surgery

avoid weight-bearing exercise for the first week

Which of the medicinal treatments below for a vent client with ARDS should the nurse question? Antibiotics Anticoagulants Sedatives Corticosteroids

corticosteroids

A client recently diagnosed with esophageal cancer inquires about dietary chances they should share with their family to help them lower their risks for esophageal cancer? Avoid foods with increased vitamin K, such as spinach and green tea Decrease intake of processed meats, such as hotdogs and cured ham Reduce foods with vitamin C, such as oranges and broccoli Minimize flavored drinks such as flavored water and peach tea

decrease intake of processed meats, such as hotdogs and cured ham

A 78-year-old patient is scheduled for transition to home after treatment for heart disease. The patient's spouse, who has chronic obstructive pulmonary disease, plans to care for the patient at home. The spouse says that their grown children, who live nearby, will help. The best approach to discharge planning is to: arrange nursing home placement for the couple. consult the spouse's healthcare provider about the spouse's ability to care for the patient. contact the children to ascertain their commitment to help. discuss community resources with the spouse and offer to make referrals.

discuss community resources with the spouse & offer to make referrals

The client recently diagnosed with gastroesophageal reflux disease (GERD) tells the nurse they seem to never remember to take their esomeprazole. The nurse explains to the client about the need to take the medication due to which serious condition caused by GERD? Esophageal cancer Esophageal atresia Stomach cancer Ulcerative colitis

esophageal cancer

The nurse is preparing for a client diagnosed with pernicious anemia. Which might she observe from the client? Select all that apply. Fatigue Severe pallor Paresthesias Petechiae Ataxic gait

fatigue, severe pallor, paresthesias, ataxic gait

The nurse is caring for a client with acute digoxin toxicity. Serial electrocardiograms have been performed and the client is placed on continuous cardiac monitoring for which electrolyte disturbance? Hypomagnesemia Hypercalcemia Hyperkalemia Hypokalemia

hyperkalemia

During an assessment of a patient who sustained a head injury 24 hours ago, the medical-surgical nurse notes the development of slurred speech and disorientation to time and place. The nurse's initial action is to: continue the hourly neurologic assessments. inform the neurosurgeon of the patient's status. prepare the patient for emergency surgery. recheck the patient's neurologic status in 15 minutes.

inform the neurosurgeon of the patient's status

For a patient with Crohn's disease, the medical-surgical nurse recommends a diet that is: high in fiber, and low in protein and calories. high in potassium. low in fiber, and high in protein and calories. low in potassium.

low in fiber, & high in protein & calories

The main goal of treatment for acute glomerulonephritis is to: encourage activity. encourage high protein intake. maintain fluid balance. teach intermittent urinary catheterization.

maintain fluid balance

To prepare a patient on the unit for a bronchoscopic procedure, the medical-surgical nurse administers the IV sedative. The nurse then instructs the licensed practical/vocational nurse to: educate the patient about the pending procedure. give the patient small sips of water only. measure the patient's blood pressure and pulse readings. take the patient to the bathroom one more time.

measure the patient's blood pressure & pulse readings

A patient who received spinal anesthesia four hours ago during surgery is transferred to the surgical unit and, after one and a half hours, now reports severe incisional pain. The patient's blood pressure is 170/90 mm Hg, pulse is 108 beats/min, temperature is 99oF (37.2oC), and respirations are 30 breaths/min. The patient's skin is pale, and the surgical dressing is dry and intact. The most appropriate nursing intervention is to: medicate the patient for pain. place the patient in a high Fowler position and administer oxygen. place the patient in a reverse Trendelenburg position and open the IV line. report the findings to the provider.

medicate the patient for pain

After completing a thorough neurological and physical assessment of a patient who is admitted for a suspected stroke, the medical-surgical nurse anticipates the next step in the immediate care of this patient to include: administering tissue plasminogen activator. obtaining a computed tomography scan of the head without contrast. obtaining a neurosurgical consultation. preparing for carotid Doppler ultrasonography.

obtaining a CT of the head without contrast

A client arrives at the emergency department following an automobile accident and has multiple fractured ribs. The nurse suspects a flail chest because of which cardinal sign? Paradoxical chest movement. Dyspnea on expiration. Blue nail beds. Hypertension.

paradoxical

The nurse is caring for a client with a peritonsillar abscess scheduled for needle aspiration who is complaining of sudden onset symptoms of chills, difficulty breathing, and a productive cough. Vital check reveals a temperature of 103.2 F (39.6 C), respiratory rate of 26, pulse of 120 and blood pressure of 136/89. The nurse is concerned for which complication of peritonsillar abscess? Pleural effusion Sepsis Pneumonia Airway obstruction

pneumonia

The nurse provides care for a client with acute renal failure. For which electrolyte will the nurse monitor for an imbalance? Calcium Potassium Magnesium Phosphorus

potassium

The nurse is caring for a female client with Crohn's disease and imbalanced nutrition, less than body requirements. Which lab values below reflect these nursing diagnoses? Potassium 2.9 mmol/L, serum calcium 7.4 mg/dL, B12 118 pg/mL, albumin 1.7 g/dl Potassium 3.5, mmol/L, serum calcium 9.0 mg/dL, B12 450 pg/mL, albumin 3.7 g/dL Rheumatoid Factor 20 IU/ml, ESR 30 mm/hr, CRP 10 mg/L, anti-CCP 20 EU/ml Hemoglobin 12 g/dL, hematocrit 44 percent, BUN 7 mg/dL creatinine 0.6 mg/dL

potassium 2.9mmol/L, serum calcium 7.4mg/dL, B12 118pg/mL, albumin 1.7g/dl

Which medication(s) does the nurse expect the healthcare provider to order for a client's new gastroesophageal reflux disease symptoms? Select all that apply. Lactulose Ranitidine Amoxicillin Esomeprazole Misoprostol

ranitidine, esomeprazole

An 80-year-old patient is placed in isolation when infected with methicillin-resistant Staphylococcus aureus. The patient was alert and oriented on admission, but is now having visual hallucinations and can follow only simple directions. The medical-surgical nurse recognizes that the changes in the patient's mental status are related to: a fluid and electrolyte imbalance. a stimulating environment. sensory deprivation. sundowning.

sensory deprivation

A client has been vomiting and has had numerous episodes of diarrhea. Which laboratory test should the nurse monitor? Serum sodium. Serum calcium. Serum potassium. Serum phosphorus.

serum potassium

The nurse is caring for a 5-year-old with encopresis. Which assessment findings would the nurse expect? Social withdrawal from friends and family Passage of frequent small, hard stools Hyperactive bowel sounds Spending a long time on the toilet.

social withdrawal from friends & family

Which statement by a patient with diabetes mellitus indicates an understanding of the medication insulin glargine (Lantus)? "Lantus causes weight loss." "Lantus is used only at night." "The duration of Lantus is six hours." "There is no peak time for Lantus."

there is no peak time for Lantus