Med Surg Exam 2

The nurse is caring for a client after pulmonary angiography via catheter insertion into the left groin. The nurse monitors for an allergic reaction the the contrast medium by observing for the presence of what?

respiratory distress

Rifabutin is prescribed for a client with active Mycobacterium avium complex (MAC) disease with TB. The nurse should monitor for which side/adverse effects of the medication? SATA

signs of hepatitis Flu like symptoms low neutrophil count ocular pain/blurred vision

Which of the following positions is recommended for a pt experiencing a nosebleed?

sitting up leaning slightly forward

The nurse is reinforcing instructions to a hospitalized client with a diagnosis of emphysema about positions that will enhance the effectiveness of breathing during dyspenic episodes. Which position should the nurse instruct the client to assume?

sitting up on the side of the bed, leaning on an overbed table.

The nurse is gathering data on a client with a diagnosis of TB. the nurse should review the results of which diagnostic test to confirm this diagnosis

sputum

A client is receiving acetylcysteine 20% solution diluted in 0.9% normal saline by nebulizer. The nurse should have which item available for a possible adverse event after giving this medication?

suction equipment

3 most common joints that are replaced

hip, knee, finger

what measures should the nurse encourage female clients to take to prevent osteoporosis?

hormone replacement therapy after menopause, high calcium and vitamin D intake beginning in early adulthood, calcium supplements after menopause, weight-bearing exercise

A client with TB is being started on antituberculosis therapy with isoniazid. Before giving the client the first dose, the nurse ensures that which baseline study has been completed?

liver enzyme levels

a postop client has received a dose of naloxone hydrochloride for respiratory depression shortly after transfer to the nursing unit from PACU. After administration of the medication, the nurse should check the client for which s/sx?

sudden increase in pain

Which of the following assessment findings in the pt with pneumonia most indicates a need to remind the pt to cough and deep breathe?

the pt develops coarse wheezes and crackles

Cycloserine is added to the medication regiment for a client with TB. Which instruction should the nurse reinforce in the client-teaching plan regarding this medication?

to return to the clinic weekly for serum drug-level testing

Which term should be used to document the musical sounds generated by airflow through narrowed airways?

wheezes

The nurse is reinforcing discharge teaching with a client diagnosed with TB and has been on meds for 1.5 weeks. The nurse knows the client understood the info if which statement is made?

"I should not be contagious after 2-3 weeks of medication therapy"

A patient asks the nurse why he doesn't feel sick even though his TB test is positive. The nurse knows the pt has been diagnosed with latent TB. Which explanation is best to provide to the pt?

"you have TB infection, but not active disease. As long as your immune system stays strong, it can keep the infection from making you feel sick?

A client is prescribed metaproterenol (Alupent) via a metered-dose inhaler (MDI), two puffs every 4 hours. The nurse instructs the client to report side effects. Which of the following are potential side effects of metaproterenol? A. Irregular heartbeat B. Constipation C. Pedal edema D. Decreased heart rate.

A

The nurse is caring for a client with emphysema receiving oxygen. The nurse should check the oxygen flow rate to ensure the client doesn't exceed many L/min of oxygen?

2

calculate smoking history on a patient who has smoked 2.5 PPD for 10 years

25

The client dx with T1 DM is receiving Humalog, a rapid acting insulin, by sliding scale. The order reads blood glucose level: <150, zero units; 151-200, 3 units, 201-250, 6 units, >250 contact health care provider. The UAP reports to the nurse that the client's glucose is 189. how much insulin should be administered by the nurse?

3 units

The client dx with T2 DM is admitted to the intensive care unit with hyperosmolar hyperglycemic nonketonic syndrome coma. Which assessment data should the nurse expect the client to exhibit? 1. Kussmaul's respirations 2. diarrhea and epigastric pain 3. dry mucous membranes 4. ketone breath odor

3- hyperglycemia causes dry mucous membranes and occurs both with HHNS and DKA

A client has an order to have radial ABGs drawn. Before drawing the sample, a nurse occludes the:

Radial and ulnar arteries, releases one, evaluated the color of the hand, and repeats the process with the other artery - allen's test

Guaifenesin 300mg 4x daily has been ordered as an expectorant. The dosage strength of the liquid 200mg/5ml. How many ml should the nurse administer each dose? __mL

7.5 300/200 * 5

Which lab result should alert the nurse to perform further assessment on pt admitted with respiratory distress? SpO2 __%

<90 (95-100)

Auscultation of a client's lungs reveals crackles in the left posterior base. The nursing intervention is to: A. Repeat auscultation after asking the client to deep breathe and cough. B. Instruct the client to limit fluid intake to less than 2000 ml/day. C. Inspect the client's ankles and sacrum for the presence of edema. D. Place the client on bedrest in a semi-Fowler's position.

A

If a client continues to hypoventilate, the nurse will continually assess for a complication of: A. Respiratory acidosis B. Respiratory alkalosis C. Metabolic acidosis D. Metabolic alkalosis

A

The nurse teaches a patient recently diagnosed with type 1 diabetes mellitus about insulin administration. Which statement by the patient requires an intervention by the nurse? A.) "I will discard any insulin bottle that is cloudy in appearance." B.) "The best injection site for insulin administration is in my abdomen." C.) "I can wash the site with soap and water before insulin administration." D.) "I may keep my insulin at room temperature (75oF) for up to 1 month."

A

Which of the following is the priority goal for the client with COPD? A. maintaining functional ability B. Minimizing chest pain C. Increasing carbon dioxide levels in the blood D treating infectious agents

A

Which of the following health promotion activities should the nurse include in the discharge teaching plan for a client with asthma? A. Incorporate physical exercise as tolerated into the treatment plan. B. Monitor peak flow numbers after meals and at bedtime. C. Eliminate stressors in the work and home environment. D. Use sedatives to ensure uninterrupted sleep at night.

A peak flow numbers should be monitored daily, usually in the morning before taking medication, encourage breathing exercises and controlled breathing and relaxation.

The home health nurse is completing the admission assessment for a 76 y/o client diagnosed with T2DM controlled with 70/30 insulin. Which intervention should be included in the plan of care? A. assess the client's ability to read small print B. monitor the client's serum PT levels C. teach the client how to perform hbg A1C test daily D. instruct the client to check feet weekly

A - age related visual changes and diabetic retinopathy could cause the client to have difficulty in reading and drawing up insulin dosages

The nurse is assisting a patient with newly dx t2 dm to learn dietary planning as part of initial management of dm. the nurse would encourage the patient to limit intake of which foods to help reduce the % of fat in the diet? A. Cheese B. broccoli C chicken D oranges

A - cheese is a product derived from animal sources and is higher in fat and calories than veggies, fruit, and poultry. Excess fat in the diet is limited to help avoid macrovascular changes

The nurse is evaluating a patient diagnosed with t2 DM. Which symptom reported by the patient correlated with this dx? A. excessive thirst B gradual weight gain C. overwhelming fatigue D. recurrent blurred vision

A - classic sx of DM are polydipsia, polyuria, and polyphagia. Weight gain, fatigue, and blurred vision may all occur with t2 but are not classic sx.

The nurse is reviewing laboratory results for the clinic patients to be seen today. Which patient meets the diagnostic criteria for diabetes mellitus? A.) A 48-yr-old woman with a hemoglobin A1C of 8.4% B.) A 58-yr-old man with a fasting blood glucose of 111 mg/dL C.) A 68-yr-old woman with a random plasma glucose of 190 mg/dL D.) A 78-yr-old man with a 2-hour glucose tolerance plasma glucose of 184 mg/dL

A - dx criteria includes A1C >6.5%, fasting plasma glucose of 126+, 2-hour plasma glucose level of 200mg/dL+, or classic symptoms of hyperglycemia with random plasma glucose of 200mg/dL or greater

The nurse is planning to teach a client with COPD how to cough effectively. Which of the following instructions should be included? A. Take deep abdominal breaths, bend forward, and cough 3-4 times on exhale B. Lie flat on back, splint the thorax, take 2 deep breaths and cough C. Take several rapid, shallow breaths then cough forcefully D. Assume a side lying position, extend the arm over the head, and alternate deep breathing with coughing

A - goal is to conserve energy and facilitate the removal of secretions and minimize airway collapse.

Which of the following ABG abnormalities should the nurse anticipate in a client with advanced COPD? A increased PaCO2 B increased PaO2 C increased pH D increased SaO2

A - increased PaCO2 and decreased PaO2 and results in decreased pH and oxygen saturation.

The elderly client is admitted to the ICU dx with severe HHNS. Which collaborative intervention should the nurse include in the plan of care? A. infuse 0.9% NS IV B. Administer intermediate acting insulin C. Perform blood glucose checks daily D. monitor ABGs

A - initial fluid replacement is 0.9% NS IV, followed by 0.45% saline. The rate depends on client's fluid volume status and physical health - especially cardiovascular

Your patient had a femoral fracture and has skin traction. Which of the following can you perform in caring for this patient? A. Neurovascular assessments every 2 hours B. Adjusting the 60 lb. weight every 2 hours C. Remove boot every shift for at least 15 minutes. D. Have the patient turn every 2 hours.

A - neuro assessments at least 4 hrs, skin traction only has 5-10 lb weight and should not be adjusted dont remove traction without orders should not be turning or messing with traction

A client with COPD reports steady weight loss and being too tired from jut breathing to eat. Which of the following nursing diagnoses would be most appropriate when planning nutritional interventions for this client? A. Altered nutrition, less than body requirements related to fatigue B. Activity intolerance related to dyspnea C. Weight loss related to COPD D. ineffective breathing pattern related to alveolar hypoventilation

A - nutrition is the client's specific problem and the cause is the fatigue stated activity intolerance is likely a diagnosis but not related to nutritional problems, weight loss is not a nursing diagnosis, ineffective breathing pattern may be a problem but not a diagnosis for this specific problem

A new med-surg nurse is discussing reduction procedures. Which of the following statements made by her requires further teaching? A. "Closed reduction carries a higher risk of infection" B. "Open reduction may require the use of continuous passive motion (CPM) machines." C. "The patient should have anesthesia for both closed and open reduction." D. "Closed reduction is a non-surgical option."

A - open reduction carries a high risk of infection (surgery)

Which of the following physical assessment findings would the nurse expect to find in a client with advanced COPD? A. increased anteroposterior chest diameter B. underdeveloped neck muscles C. collapsed neck veins D. increased chest excursions with respirations

A - overextended alveoli neck muscles would be overdeveloped, distended neck veins, and diminished chest excursions with respirations

A 54 year old accountant presents to an urgent care complaining of pain in her hand. Which of the following statements said by a nurse needs to be corrected? A. "Let's do a Phalen's test. If you're negative, then you may have carpal tunnel." B. "If this is carpal tunnel, we can give you a steroid injection for short term relief" C. "This could be due to repetitive motion for long periods of time, such as typing." D. "We need to figure out what is causing this before we intervene"

A - positive indicates carpal tunnel

A female client is scheduled to have a chest radiograph. Which of the following questions is of most importance to the nurse assessing this client? A. "is there any chance you're pregnant?" B. "Are you wearing any metal jewelry?" C. "Can you hold your breath easily?" D. "are you able to hold your arms above your head?"

A - priority B: clients will be asked to remove jewelry, C: done at full inspiration, D: lateral view requires arms raised

The nurse is reviewing lab results for a patient with a 15 year history of t2 dm. which result reflects the expected pattern accompanying macrovascular disease as a complication dm? a. increased triglyceride levels b. increased HDL c. decreased LDL d. decreased VLDL

A - rest are all positive changes

The nurse has been teaching a patient with diabetes mellitus how to perform self-monitoring of blood glucose (SMBG). During evaluation of the patient's technique, the nurse identifies a need for additional teaching when the patient does what? A.) Chooses a puncture site in the center of the finger pad B.)Washes hands with soap and water to cleanse the site to be used C.)Warms the finger before puncturing the finger to obtain a drop of blood D.) Tells the nurse that the result of 110 mg/dL indicates good control of diabetes

A - should be sides of fingertips, not center because this area contains many nerve endings and would be painful.

The nurse is assigned to the care of a patient diagnosed with type 2 diabetes. In formulating a teaching plan that encourages the patient to actively participate in management of the diabetes, what should be the nurse's initial intervention? A.) Assess patient's perception of what it means to have diabetes. B.) Ask the patient to write down current knowledge about diabetes. C.) Set goals for the patient to actively participate in managing his diabetes. D.) Assume responsibility for all of the patient's care to decrease stress level.

A - the first step is to the assess the patient so the nurse can individualize the teaching needed for this patient

The nurse is developing a care plan for the client dx with T1DM. The nurse identifies the problem "high risk for hyperglycemia related to noncompliance with the medication regimen." which statement is an appropriate short term goal for the client? A. the client will have a blood glucose between 90-140 mg/dL B. the client will demonstrate appropriate insulin injection technique C. The nurse will monitor the client's blood glucose levels 4x/day D. the client will maintain normal kidney function with 30mL/hr urine output

A - the short term goal must address the response part of the nursing diagnosis which is "high risk for hyperglycemia" and this blood glucose level is within acceptable ranges for a client who is noncompliant

which of the following statements about dislocations is correct? A. dislocations are ortho emergencies B. A pinky is the most common dislocation site. C. Only open reduction requires the use of anesthesia. D. Future dislocations are far less likely, because the joint has grown stronger.

A - thumb, elbow, shoulder, hip, and knee are most common both open and closed require anesthesia future dislocations are more likely

Basilar crackles are present in a client's lungs on auscultation. The nurse knows that these are discrete, non continuous sounds that are: A. Caused by the sudden opening of alveoli. B. Usually more prominent during expiration. C. Produced by airflow across passages narrowed by secretions. D. Found primarily in the pleura.

A - usually heard during inspiration and are caused by sudden opening of alveoli. May occur when the lungs inflate or deflate.

The client dx with T1DM is found lying unconscious on the floor of the bathroom. Which intervention should the nurse implement? A. administer 50% dextrose IVP B. Notify HCP C. Move client to ICU D. Check serum glucose level

A - will work immediately

The nurse is caring for several clients with respiratory disorders. Which client is at least risk for developing TB infection?

A man who is an inspector for the US postal service

which is the best explanation to a pt by a nurse for why a health care provider doesnt prescribe antibiotics for flu?

flu is caused by virues not bacteria

A patient is admitted with diabetes mellitus, malnutrition cellulitis, and a potassium level of 5.6 mEq/L. The nurse understands that what could be contributing factors for this laboratory result (select all that apply.)? A.) The level may be increased as a result of dehydration that accompanies hyperglycemia. B.) The level may be raised as a result of metabolic ketoacidosis caused by hyperglycemia. C.) The level is consistent with renal insufficiency that can develop with renal nephropathy. D.) The patient may be excreting extra sodium and retaining potassium because of malnutrition. E.) This level demonstrates adequate treatment of the cellulitis and effective serum glucose control.

A, B, C Additional stress of cellulitis may lead to an increase in glucose levels. dehydration may cause hemoconcentration, resulting in elevated serum readings. the kidneys may have a hard time excreting K if renal probs exist. Finally, the nurse must consider the potential for metabolic ketoacidosis because K will leave the cell when H+ enters in an attempt to compensate for a low pH. Malnutrition does not cause sodium excretion, elevated K level does not demonstrate adequate treatment of cellulitis or glucose control

Which of the following patients are at risk for rotator cuff injury? SATA. A. A 26 year old that competes in competitive gymnastics. B. An 65 year old accountant. C. A 16 year old that constantly falls off his skateboard. D. A 30 year old that eats only fast food.

A, B, C causes: repetitive stress, aging, trauma

The client is admitted to ICU with DKA. Which intervention should the nurse implement? SATA A. maintain adequate ventilation B. Assess fluid volume status C. Administer IV K D. Check for urinary ketones E. Monitor intake/output

A, B, C, D, E - nurse should always address the airway when client is seriously ill, client must be assessed for fluid volume deficit and for excess after fluid replacement, electrolyte imbalance of primary concern is K, ketones are excreted in urine and should be monitored frequently, nurse must ensure the client's fluid intake and output are equal

Which of the following are true about strains and sprains? SATA. A. Strains have more bruising. B. Sprains are an injury to the ligaments. C. 3rd degree strains are considered "mild". D. Hemarthrosis is a possible complication. E. Most require surgical intervention.

A, B, D muscles have a vascular supply (more bruising), 3rd degree strains are severe, most are self limiting and resolve in 3-6 wks

The diabetic educator is teaching a class on diabetes T1 and is discussing sick-day rules. Which interventions should the DM educator include in the discussion? SATA A. take med even if unable to eat the client's normal diabetic diet B. if unable to eat, drink liquids equal to the clients normal caloric intake C. its not necessary to notify the HCP if ketones are present in urine D. test blood glucose levels and test urine ketones once a day and keep record E. call the HCP if glucose levels are higher than 180

A, B, E important to take insulin even if patient is sick because glucose levels increase with illness and stress the client should drink liquids such as regular cola and OJ or eat regular gelatin which provide enough glucose to prevent hypoglycemia when receiving insulin The HCP should be notified if the blood glucose is high. regular insulin may need to be prescribed to keep the blood glucose level within acceptable range

A 45 year old woman comes to your clinic with a rotator cuff injury. Which of the following treatments could be included in her care? SATA A. Ibuprofen B. Closed reduction C. Corticosteroids D. Strict immobilization for 3-6 weeks

A, C - open reduction could be used and immobilization should be used intermittently

Which of the following statements said by a patient with a sprain would the nurse question? SATA. A. "For the first 24 hours I should apply heat, then ice after that." B. "I should elevate my leg when I sit down." C. "When applying ice, I should place it directly on my skin." D. "I am so glad that I can have full mobility back in 7 days!"

A, C, D apply ice first 48 hrs then alternate, never place directly on skin, full mobility in about 3-6 wks

The nurse is teaching the client how to use a metered-dose inhaler (MDI) to administer a Corticosteroid drug. Which of the following client actions indicates that he is using the MDI correctly? Select all that apply. A. The inhaler is held upright. B. Head is tilted down while inhaling the medication. C. Client waits 5 minutes between puffs. D. Mouth is rinsed with water following administration. E. Client lies supine for 15 minutes following administration.

A, D

Which of the following are correct statements about body casts? SATA. A. Cast syndrome can occur if the cast is too tight B. It is normal for these patients to have hypoactive bowel sounds. C. Reposition this patient every 24 hours while it dries. D. Nausea/vomiting can occur with cast syndrome.

A, D - patient should not have decreased bowel sounds (cast syndrome) reposition every 2-3 hrs while drying

Which of the following are the most common sites of compartment syndrome? SATA. A. Upper arm B. Lower arm C. Upper leg D. Lower leg E. Abdomen

A, D upper arm: Volkmann's ischemic contracture Lower leg: anterior tibial compartment syndrome

Which of the following are not purposes of traction? SATA. A. Inducing muscle spasms to encourage re-alignment. B. Immobilizing a joint C. Preventing soft tissue damage D. Reduce a joint before major joint reconstruction E. Treat a pathological joint condition.

A, D used to prevent/reduce muscle spasms, used to expand a joint before major reconstruction or during arthroscopic procedures

When developing a discharge plan to manage the care of client with COPD, the nurse should anticipate the client will do which of the following? A. Develop infections easily B. Maintain current status C. Require less supplemental oxygen D. Show permanent improvement

A. Develop infections easily

An elderly client has been ill with the flu, experiencing headache, fever, and chills. After 3 days, she developed a cough productive of yellow sputum. The nurse auscultates her lungs and hears diffuse crackles. How would the nurse best interpret these assessment findings? A. Its likely that the client is developing a secondary bacterial pneumonia B. the assessment findings are consistent with flu and are to be expected C. The client is getting dehydrated and needs to increase fluids D. client has not been taking her meds

A. pneumonia is the most common complication of flu, especially in the elderly

Common side effects of NSAIDs

gi, tinnitus, bleeding, mild live enzyme elevation

The nurse notes that a hospitalized client has experienced a positive reaction to the tuberculin skin test. Which action by the nurse is priority?

report the findings

The nurse is preparing a list of home care instructions for the client who has been hospitalized and treated for TB. Which instructions should the nurse reinforce? SATA

Activities should be resumed gradually a sputum culture is needed every 2-4 weeks once medication therapy is initiated respiratory isolation is not necessary because family members have already been exposed cover the mouth and nose when coughing and sneezing and confine used tissues to plastic bags

A pt with recurrent pneumothorax is scheduled to have pleurodesis done in 1 hr. Which nursing intervention should take priority at this time?

Administer a prn analgesic as ordered

Which identifies the route of transmission of TB?

Airborne

Which of the following bones are more prone to releasing fat emboli? SATA. A. Metacarpals B. Tibia C. Ribs D. Skull E. Pelvis F. Clavicle

B, C, E long bones *****

Which of the following repsonses is correct when a pt asks why the HCP didn't order a new antiviral drug for flu symptoms that started three days ago?

Antivirals only work if you start them within 48 hours after flu symptoms

A pt is admitted to the hospital with SOB. the nurse notes increasing confusion and combativeness during the past hour. Which of the following actions is appropriate first?

Assess SpO2 and apply oxygen per protocol if indicated

A client is to begin a 6 month course of therapy with isoniazid. The nurse should plan to provide which info to the client?

report yellow eyes or skin immediately (liver)

The nurse instructs a patient with diabetes mellitus about a healthy eating plan. Which statement made by the patient indicates that teaching was successful? A.) "I plan to lose 25 lb this year by following a high-protein diet." B.) "I may have a hypoglycemic reaction if I drink alcohol on an empty stomach." C.) "I should include more fiber in my diet than a person who does not have diabetes." D.) "If I use an insulin pump, I will not need to limit the amount of saturated fat in my diet."

B

The nurse is teaching a patient with type 2 diabetes mellitus how to prevent diabetic nephropathy. Which statement made by the patient indicates that teaching has been successful? A.) "Smokeless tobacco products decrease the risk of kidney damage." B.) "I can help control my blood pressure by avoiding foods high in salt." C.) "I should have yearly dilated eye examinations by an ophthalmologist." D.) "I will avoid hypoglycemia by keeping my blood sugar above 180 mg/dL."

B

A female client comes into the emergency room complaining of SOB and pain in the lung area. She states that she started taking birth control pills 3 weeks ago and that she smokes. Her VS are: 140/80, P 110, R 40. The physician orders ABG's, results are as follows: pH: 7.50; PaCO2 29 mm Hg; PaO2 60 mm Hg; HCO3- 24 mEq/L; SaO2 86%. Considering these results, the first intervention is to: A. Begin mechanical ventilation. B. Place the client on oxygen. C. Give the client sodium bicarbonate. D. Monitor for pulmonary embolism.

B - 7.50 pH indicates alkalosis, low PaCO2 indicates lungs are involved.

Which assessment data indicate the client dx with dka is responding to medical treatment? A. client has tented skin turgor and dry mucous membranes B. Client is A&O x3 C. Client's ABGs are pH 7.29, PaCO2 44, HCO3 15. D. Client's serum K is at 3.3

B - Level of consciousness can be altered due to dehydration and acidosis - if client is alert the client is getting better and responding well to treatment

A patient with diabetes mellitus who has multiple infections every year needs a mitral valve replacement. What is the most important preoperative teaching the nurse should provide to prevent a cardiac infection postoperatively? A.) Avoid sick people and wash hands. B.) Obtain comprehensive dental care. C.) Maintain hemoglobin A1C below 7%. D.) Coughing and deep breathing with splinting

B - a person with DM is at high risk for infections. the msot important preop teaching is to prevent infection in the heart is to obtain comprehensive dental care because the risk of septicemia and infective endocarditis increases with poor dental health. Avoiding sick people, hand washing, maintaining A1C below 7% and coughing and deep breathing with splint would be important for any type of surgery but are not the priority for this patient

The nurse would anticipate which of the following ABG results in a client experiencing a prolonged, severe asthma attack? A. Decreased PaCO2, increased PaO2, and decreased pH B. increased PaCO2, decreased PaO2, and decreased pH C. Increased PaCO2, increased PaO2, and increased pH D. Decreased PaCO2, decreased PaO2, and increased pH

B - as severe attack worsens, the client becomes fatigued and alveolar hypotension develops which leads to carbon dioxide retention and hypoxemia and develops respiratory acidosis

A client has just returned to a nursing unit following bronchoscopy. A nurse would implement which of the following nursing interventions for this client? A encouraging additional fluids for the next 24 hrs B. Ensuring the return of the gag reflex before offering foods or fluids C. administering atropine IV D. Administering small doses of midazolam (versed)

B - because of preoperative sedation and anesthesia additional fluids are unnecessary because no contrast dye is used, atropine would be administered before the procedure not after, no sedation is needed after procedure

The UAP on the floor tells the nurse the client dx with DKA wants something else to eat for lunch. Which intervention should the nurse implement? A. instruct UAP to get additional food B. Notify dietitian C. Request HCP increase client's caloric intake D. tell the UAP the client cannot have anything else

B - client will not be compliant with diet if he or she is still hungry. Request dietitian to talk to client to try to adjust meals so client will adhere

he client with asthma should be taught which of the following is one of the most common precipitating factors of an acute asthma attack? A. Occupational exposure to toxins. B. Viral respiratory infections. C. Exposure to cigarette smoke. D. Exercising in cold temperatures.

B - clients with asthma should avoid people with the flu or cold and should get yearly vaccinations. Asthma is a condition of acute, fully reversible airway inflammation, often following an environmental trigger

Which of the following is NOT a systemic complication of immobilization? A. Skin breakdown B. Diarrhea C. Orthostatic hypotension D. Kidney stones

B - constipation is

You are discussing care with a parent of a child with hip dysplasia. Which of the statements given by the parent indicate a need for further teaching about hip spica casts? A. "This cast will help keeps my child's legs aligned." B. "I will use the spacer bar to turn over on her side." C. "I will make sure she does not lie on her abdomen"

B - don't use spacer bar to turn her

When teaching a client with COPD to conserve energy, the nurse should teach the client to lift objects: A while inhaling through an open mouth B while exhaling through pursed lips C after exhaling but before inhaling D while taking a deep breath and holding it

B - exhaling requires less energy than inhaling therefore it saves energy and reduces perceived dyspnea

The physician has scheduled a client for a left pneumonectomy. The position that will most likely be ordered postoperatively for this is the: A. Nonoperative side or back B. Operative side or back C. Back only D. Back or either side.

B - facilitates the accumulation of serosanguineous fluid. The fluid forms a solid mass, which prevents the remaining lung from being drawn into space. Pneumonectomy is defined as the surgical removal of the entire lung.

The client with T2DM controlled with biguanide oral diabetic med is scheduled for a computed tomography (CT) scan with contrast of the abdomen to evaluate pancreatic function. Which intervention should the nurse implement? A. provide a high fat diet 24 hrs prior to test B. hold biguanide med for 48 hrs prior to test C. Obtain informed consent D. administer pancreatic enzymes prior

B - hold med bc it increases risk of lactic acidosis which leads to renal problems

Your 16-year-old neighbor comes to you with a question, knowing that you are a nurse. She asks "I hurt my knee in my basketball game a few hours ago. It keeps popping and it really hurts. What should I do?" You reply saying.... A. "Elevate your knee and ice it. If it still hurts in 2 days, go see your doctor." B. "Go see your doctor as soon as possible." C. "You probably fractured your knee. Let me put on a cast for you!" D. "Try doing some stretches before you work out tomorrow. That should help."

B - injured knees should be examined within 24 hrs, risk of quadricep atrophy, stretching is only good for prevention

The nurse has taught a patient admitted with diabetes principles of foot care. The nurse evaluates that the patient understands the principles of foot care if the patient makes what statement? A.) "I should only walk barefoot in nice dry weather." B.) "I should look at the condition of my feet every day." C.) "I am lucky my shoes fit so nice and tight because they give me firm support." D.) "When I am allowed up out of bed, I should check the shower water with my toes."

B - inspect feet daily no tight shoes, bare feet or testing temp with feet

The nurse is teaching a patient who has diabetes about vascular complications of diabetes. What information is appropriate for the nurse to include? A.) Macroangiopathy does not occur in type 1 diabetes but rather in type 2 diabetics who have severe disease. B.) Microangiopathy is specific to diabetes and most commonly affects the capillary membranes of the eyes, kidneys, and skin. C.) Renal damage resulting from changes in large- and medium-sized blood vessels can be prevented by careful glucose control. D.) Macroangiopathy causes slowed gastric emptying and the sexual impotency experienced by a majority of patients with diabetes.

B - microangiopathy occurs in DM. When it affects the eyes, it is called diabetic reintopathy. When the kidneys are affected, the patient has nephropathy. When the skin is affect, it can lead to diabetic foot ulcers. Macroangiopathy can occur in T1 or T2 and contributes to cerebrovascular, cardiovascular, and peripheral vascular disease. Sexual impotency and slowed gastric emptying result from microangiopathy and neuropathy

A client is admitted to the hospital with acute bronchitis. While taking the client's VS, the nurse notices he has an irregular pulse. The nurse understands that cardiac arrhythmias in chronic respiratory distress are usually the result of: A. Respiratory acidosis B. A build-up of carbon dioxide C. A build-up of oxygen without adequate expelling of carbon dioxide. D. An acute respiratory infection.

B - not enough oxygen and build up of carbon dioxide causes the heart to be in a constant state of hypoxia. often present as premature ventricular and/or supraventricular beats and less freq of atrial fibrillation.

A client with COPD has developed secondary polycythemia. Which nursing diagnosis would be included in the plan of care because of the polycythemia? A. Fluid volume deficit related to blood loss. B. Impaired tissue perfusion related to thrombosis. C. Activity intolerance related to dyspnea. D. Risk for infection related to suppressed immune response.

B - polycythemia (blood cancer which increased blood viscosity and risk of thrombosis)

Assessing a client who has developed atelectasis postoperatively, the nurse will most likely find: A. A flushed face. B. Dyspnea and pain. C. Decreased temperature. D. Severe cough and no pain.

B - sob, high temp, and usually severe pain but do not have severe cough. typically occurs within 72 hrs of general anesthesia and a well known complication

Which electrolyte replacement should the nurse anticipate being ordered by the HCP in the client diagnosed with DKA who has just been admitted? A. Glucose B. Potassium C. Calcium D. Sodium

B - the DKA patient loses potassium from increased urinary output, acidosis, catabolic state, and vomiting. Replacement is essential for preventing cardiac dysrhythmias secondary to hypokalemia

A client's arterial blood gas levels are as follows: pH 7.31, PaO2 80mmHg, PaCO2 65mmHg, HCO3 36 mEq/L. Which symptoms would the nurse expect? A cyanosis B flushed skin C irritability D anxiety

B - the high PaCO2 levels cause flushed skin due to vasodilation. The client also becomes drowsy and lethargic bc carbon dioxide has a depressant effect on the CNS. On the contrary, chronic respiratory acidosis may be caused by COPD where there is a decreased responsiveness of the reflexes to states of hypoxia and hypercapnia Cyanosis is a late sign of hypoxia, irritability is not common with a PaCO2 level of 65 but is associated with hypoxia, clinical presentation of respiratory acidosis is usually a manifestation of its underlying cause (anxiety)

A patient with diabetes mellitus is scheduled for a fasting blood glucose level at 8:00 AM. The nurse instructs the patient to only drink water after what time? A.) 6:00 PM on the evening before the test B.) Midnight before the test C.) 4:00 AM on the day of the test D.) 7:00 AM on the day of the test

B - typically pt is ordered to be NPO 8 hours before fasting glucose.

Which patient with type 1 diabetes mellitus would be at the highest risk for developing hypoglycemic unawareness? A.) A 58-yr-old patient with diabetic retinopathy B.) A 73-yr-old patient who takes propranolol (Inderal) C.) A 19-yr-old patient who is on the school track team D.) A 24-yr-old patient with a hemoglobin A1C of 8.9%

B - unawareness is a condition in which a person does not experience the warning s/sx of hypoglycemia until person becomes incoherent and combative or LOC. its related to autonomic neuropathy of DM that interferes w the secretion of counter regularly hormones that produces these symptoms. Older patients and patients who use beta blockers are at risk for this

an 18 year old female client that is 5'4, weighs 113kg (248lbs), comes to the clinic for a non healing wound on her lower leg, which she has had for 2 weeks. Which disease process should the nurse suspect the client has developed? A) T1 DM B) T2 DM 3. Gestational DM 4. Acanthosis Nigricans

B - us.ually occurs around age 40 but it is now being detected in young adults and kids as result of obesity. nonhealing wounds are a hallmark sign of T2 DM t1 - born with, gestational =pregm acanthosis nigricans is dark discoloration and velvety thickening of skin

A client states that the physician said the tidal volume is slightly diminished and asks the nurse what this means. The nurse explains that the tidal volume is the amount of air: A. Exhaled forcibly after a normal expiration. B. Exhaled after there is a normal inspiration. C. Trapped in the alveoli that cannot be exhaled. D. Forcibly inspired over and above a normal respiration.

B -avg is 500-400 expiratory reserve volume is air that can be forcibly exhaled after the expiration of a normal tidal volume Residual volume is volume of air still remaining in the lungs after the expiratory reserve volume is exhaled inspiratory reserve volume is the additional air that can be forcibly inhaled after the inspiration of a normal tidal volume

A pt with SOB is being tested for lung cancer. Which diagnostic test will be most conclusive?

Biopsy

A client with acute asthma is prescribed short-term corticosteroid therapy. What is the rationale for the use of steroids in clients with asthma? A. Corticosteroids promote bronchodilation. B. Corticosteroids act as an expectorant. C. Corticosteroids have an anti-inflammatory effect. D. Corticosteroids prevent development of respiratory infections.

C

A fifty-year-old client has a tracheostomy and requires tracheal suctioning. The first intervention in completing this procedure would be to: A. Change the tracheostomy dressing. B. Provide humidity with a trach mask. C. Apply oral or nasal suction. D. Deflate the tracheal cuff.

C

The most reliable index to determine the respiratory status of a client is to: A. Observe the chest rising and falling. B. Observe the skin and mucous membrane color. C. Listen and feel the air movement. D. Determine the presence of a femoral pulse.

C

The nurse is assessing the feet of a client with long term T2 DM. which assessment data warrant immediate intervention by the nurse? A. the client has crumbling toenails B. The client has athletes foot C. the client has a necrotic big toe D. The client has thickened toenails

C

The nurse is discussing ways to prevent DKA with the client diagnosed with type 1 diabetes. Which instruction is most important to discuss with the client? A. Refer the client to the American Diabetes Association. B. Do not take any over-the-counter medications. C. Take the prescribed insulin even when unable to eat because of illness. D. Explain the need to get the annual flu and pneumonia vaccines.

C

Which of the following is the most important factor in the prevention of a fat embolism? A. Giving oxygen B. Proper hydration C. Careful immobilization of fracture D. Applying heat to the site of injury.

C

Your 16 year old patient came to the emergency department with a tibia fracture. He said he hurt his leg doing a skateboard trick 30 minutes ago. Should you be worried about a fat embolism? A. "Yes, there is risk of fat embolism from the time of injury until 48 hours after." B. "Yes, until the bone is healed, fat embolism is a major concern." C. "No, they generally occur 12-72 hours after the injury." D. "No, fat emboli are not a risk in patients this young."

C

The charge nurse is making client assignments in the ICU. Which client should be assigned to the most experienced nurse? A. The client with type 2 diabetes who has a blood glucose level of 348 mg/dL. B. The client diagnosed with type 1 diabetes who is experiencing hypoglycemia. C. The client with DKA who has multifocal premature ventricular contractions. D. The client with HHNS who has a plasma osmolarity of 290 mOsm/L.

C - PVCs are secondary to hypokalemia and can occur in clients with DKA and are potentially life threatening.

An acceleration in oxygen dissociation from hbg and this oxygen delivery to the tissues is caused by; A. A decreasing oxygen pressure in the blood. B. An increasing carbon dioxide pressure in the blood. C. A decreasing oxygen pressure and/or an increasing carbon dioxide pressure in the blood. D. An increasing oxygen pressure and/or a decreasing carbon dioxide pressure in the blood.

C - The lower the PO2 and the higher the PCO2, the more rapidly oxygen dissociated from the oxyhemoglobin molecule. Factors that contribute to a right-shift in the oxygen dissociation curve and favor the unloading of oxygen correlate with exertion. These include increased body temperature, decreased pH (due to increased production of CO2), and increased 2,3-BPG. (Figure) This right shift of the oxyhemoglobin curve can be viewed as an adaptation for physical exertion.

A cyanotic client with an unknown diagnosis is admitted to the E.R. In relation to oxygen, the first nursing action would be to: A. Wait until the client's lab work is done. B. Not administer oxygen unless ordered by the physician. C. Administer oxygen at 2 L flow per minute. D. Administer oxygen at 10 L flow per minute and check the client's nail beds.

C - administer no more than 2L/min, if too much O2 is received the client will develop CO2 narcosis

A patient is newly dx with T1 and reports HA, vision changes, and being anxious but does not have a portable blood glucose present. Which action should the nurse advise? A eat some pizza B drink some diet pop C eat 15g of simple carbs D take an extra dose of rapid acting insulin

C - hypoglycemia fat in pizza and soda would not allow the blood glucose to increase to eliminate the sx.

A patient admitted with type 2 diabetes asks the nurse what "type 2" means. What is the most appropriate response by the nurse? A.) "With type 2 diabetes, the body of the pancreas becomes inflamed." B.) "With type 2 diabetes, the patient is totally dependent on an outside source of insulin." C.) "With type 2 diabetes, insulin secretion is decreased, and insulin resistance is increased." D.) "With type 2 diabetes, the body produces autoantibodies that destroy β-cells in the pancreas."

C - in T2DM, the secretion of insulin by the pancreas is reduced and/or the cells of the body become resistant to insulin. T1: The pancreas becomes inflamed with pancreatitis. The patient is totally dependent on exogenous insulin and may have autoantibodies destroy beta cells

The newly diagnosed patient with type 2 diabetes has been prescribed metformin. What should the nurse teach the patient to best explain how this medication works? A.) Increases insulin production from the pancreas B.) Slows the absorption of carbohydrate in the small intestine C.) Reduces glucose production by the liver and enhances insulin sensitivity D.) Increases insulin release from the pancreas, inhibits glucagon secretion, and decreases gastric emptying

C - metformin is a biguanide that reduces glucose production by the liver and enhances the tissue's insulin sensitivity. sulfonylureas and meglitinides increase insulin production from the pancreas a-glucosidase inhibitors slow the absorption of carbohydrate in the intestine Glucagon like peptide receptor agnosists increase insulin synthesis and release from the pancreas, inhibit gluagon secretion and decreased gastric emptying

The patient received regular insulin 10 units subcutaneously at 8:30 PM for a blood glucose level of 253 mg/dL. The nurse plans to monitor this patient for signs of hypoglycemia at which time related to the insulin's peak action? A.) 8:40 PM to 9:00 PM B.) 9:00 PM to 11:30 PM C.) 10:30 PM to 1:30 AM D.) 12:30 AM to 8:30 AM

C - regular insulin exerts peak action in 2-5 hr. rapid acting onset is between 10-30 min and will peak between 9-1130 pm. intermediate acting would occur from 1230am-830am

The client received 10 units of Humulin R, fast acting insulin, at 0700. At 1030 the UAP tells the nurse the client has a HA and is really acting "funny." which intervention should the nurse implement first? A. instruct the UAP to obtain the blood glucose level. B. Have the client drink 8 ounces of OJ C. Go to client's room and assess client for hypoglycemia D. Prepare to administer 1 ampule of 50% dextrose IV

C - regular insulin peaks n 2-4 hrs, therefore the nurse should think about the posibility the client is having hypoglycemic reaction and assess the client. The nurse should not delegate to UAP if patient is unstable

Immediately following a thoracentesis, which clinical manifestations indicate that a complication has occurred and the physician should be notified? A. Serosanguineous drainage from the puncture site. B. Increased temperature and blood pressure. C. Increased pulse and pallor. D. Hypotension and hypothermia.

C - symptoms associated with shock. A compromised venous return may occur if there is a mediastinal shift as a result of excessive fluid removal. Usually no more than 1L of fluid is removed at one time to prevent this from occurring

The ED nurse is caring for a client dx with HHNS who has blood glucose of 680mg/dL. Which q should the nurse ask the client to determine the cause of this acute complication? A. "when was the last time you took your insulin?" B. "when did you have your last meal?" C. "Have you had some type of infection lately?" D. "how long have you had DM?"

C - the most common precipitating factor is infection, the manifestations may be slow to appear, with onset ranging from 24 hrs - 2 weeks

An OA patient with type 2 diabetes has a urinary tract infection (UTI), is difficult to arouse, and has a blood glucose of 642 mg/dL. When the nurse assesses the urine, there are no ketones present. What nursing action is appropriate at this time? A.) Routine insulin therapy and exercise B.) Administer a different antibiotic for the UTI. C.) Cardiac monitoring to detect potassium changes D.) Administer IV fluids rapidly to correct dehydration.

C - this patient has manifestations of HHS. cardiac monitoring will be needed bc of the changes in K levels related to fluid/insulin therapy and the osmotic diuresis from elevated glucose. Routine insulin would not be enough and exercise could be dangerous for this pt. extra insulin will be needed. antibiotic will not affect. there will be a large amount of iv fluid administered but slowly to avoid overload

Which of the following are true about the stages of bone healing? SATA. A. A fracture hematoma will form within 24 hours. B. The callus is the new basis for a bone. C. The fracture can still be viewed on x-ray during ossification. D. The cast can be removed with granulation of tissue. E. Consolidation can occur for up to a year.

C, E fracture hematoma forms within 72 hrs osteoid is the new basis for bone cast can be removed with ossification

A nurse teaches a client about the use of a respiratory inhaler. Which action by the client indicated a need for further teaching? A. Removes the cap and shakes the inhaler well before use B. Press the canister down with your finger as he breathes in C. Inhales the mist and quickly exhales D. waits 1-2 minutes between puffs if more than one puff has been prescribed

C. hold breath for 10 secs

Aminophylline (theophylline) is prescribed for a client with acute bronchitis. A nurse administers the medication, knowing that the primary action of this medication is to: A. promote expectoration B. suppress the cough C. relax smooth muscles of the bronchial airway D. prevent infection

C. Aminophylline is a bronchodilator that directly relaxes the smooth muscles of the bronchial airway

Which of the following individuals would the nurse consider to have the highest priority for receiving an influenza vaccination? A. 60 y/o man with hiatal hernia B. 36 y/o woman with 3 children C. 50 y/o woman caring for a spouse with caner D. 60 y/o woman with osteoarthritis

C. high risk individuals - cancer older clients should get vaccinated although the vaccine may be less effected but reduces the incidence of severe disease and reduces hospital admissions/deaths

As a nursing student, you are assigned a patient with skeletal traction. You walk into your patient's room and they say "This traction is killing me, it's so painful! Can you please just remove it for like 10 minutes?" How do you reply? A. "Sure, but let me go get my nurse first since I'm only a student." B. "I can, but I need to get your blood pressure first to make sure you won't have orthostatic hypotension." C. "I'm sorry, we can't remove it unless there's an emergency." D. "The traction needs to fall off on its own. Within 48 hours, your pain should be relieved."

C. never disrupt traction unless life threatening

The client is dx with type 1 DM has a glycosylatedd hemogoblin A1C of 8.1%. Which interpretation should the nurse make based on this result? A. the result is below normal levels B. The result is within acceptable levels C. The result is above recommended levels D. This result is dangerous high

C. this result parallels a serum of blood glucose level of approximately 180-200. A1c reflects an avg blood glucose level over 3 month period

Steps for obtaining sputum culture (in order)

Check order. Obtain appropriate container. Teach pt to inhale deeply several times. Have pt cough deeply from lung. Send specimen immediately to lab

The nurse is teaching a patient with type 2 diabetes mellitus about exercise to help control blood glucose. The nurse knows the patient understands when the patient elicits which exercise plan? A.) "I want to go fishing for 30 minutes each day; I will drink fluids and wear sunscreen." B.) "I will go running each day when my blood sugar is too high to bring it back to normal." C.) "I will plan to keep my job as a teacher because I get a lot of exercise every school day." D.) "I will take a brisk 30-minute walk 5 days per week and do resistance training three times a week."

D

What type of fracture is incomplete, with one side being fractured and the other side bent? A. Avulsion fracture B. Comminuted fracture C. Displaced fracture D. Greenstick fracture E. Oblique fracture

D

Which of the following is not an intervention used to prevent DVTs? A. SCDs B. TED stockings C. Heparin D. Bed rest E. Wiggling fingers/toes

D

Which of the following is the primary reason to teach pursed lip breathing to clients with emphysema? A. to promote oxygen intake B. To strengthen the diaphragm C. To strengthen the intercostal muscles D. To promote carbon dioxide elimination

D

Your patient has a tibia fracture. Which cast would you suspect to be placed on this patient? A. Short arm B. Long arm C. Short leg D. Long leg

D

The nurse is caring for a patient hospitalized with DM would look for which lab test result to obtain info on the patient's past glucose control? A. prealbumin B urine ketone C fasting glucose D glycosylated hbg level

D - A1C, glucose attaches to RBC and remains there for life of cell which is approx 120 days

Which ABG result should the nurse expect in the client dx with DKA? A. pH 7.34, PaO2 99, PaCO2 48, HCO3 24 B. pH 7.38, PaO2 95, PaCO2 40, HCO3 22 C. pH 7.46, PaO2 85, PaCO2 30, HCO3 26 D. pH 7.30, PaO2 90, PaCO2 30, HCO3 18

D - ABG indicates metabolic acidosis which is expected in a client dx with DKA (ROME) respiratory opposite, metabolic same ***

The nurse is discussing the importance of exercising with a client diagnosed with t2 DM whose DM is well controlled with diet and exercise. Which info should the nurse include in the teaching about DM? A. eat simple carb snacks before exercising B. Carry pb crackers when exercising C. Encourage the client to walk 20 min 3x/week D. perform warmup and cool down exercises

D - all clients who exercises should do to prevent injury/strain

A 34-year-old woman with a history of asthma is admitted to the emergency department. The nurse notes that the client is dyspneic, with a respiratory rate of 35 breaths/minute, nasal flaring, and use of accessory muscles. Auscultation of the lung fields reveals greatly diminished breath sounds. Based on these findings, what action should the nurse take to initiate care of the client? A. initiate oxygen therapy and reassess in 10 min B. Draw ABG and send client for chest xray C. encourage client to relax and breathe slowly through the mouth D. administer bronchodilators

D - in an acute asthma attach, diminished or absent breath sounds can be an ominous sign indicating lack of air movement in the lungs and impending resp failure which require immediate intervention

While assessing your skeletal traction patient, you notice yellow drainage and swelling at the pin sites. As a super smart nursing student, you know that this could lead to.... A. Diabetes mellitus B. Avulsion fracture C. Turner syndrome D. Osteomyelitis

D - infection!!!!!

Which of the following diets would be most appropriate for a client with COPD? A. low fat, low cholesterol B. Bland, soft diet C. Low sodium D. high calorie, high protein

D - maintain nutritional status and prevent weight loss that results from the increased work of breathing. Eat small, frequent meals with high protein and fiber to ensure strong respiratory muscles

The nurse assesses the respiratory status of a client who is experiencing an exacerbation of COPD secondary to an upper respiratory tract infection. Which of the following findings would be expected? A normal breath sounds B prolonged inspiration C normal chest movement D coarse crackles and rhonchi

D - secretions would be present causing crackles and rhonchi

The best method of oxygen administration for client with COPD uses: A. Cannula B. Simple Face mask C. Non-rebreather mask D. Venturi mask

D - venturi delivers controlled oxygen

The client dx with HHS was admitted yesterday w blood glucose level of 780mg/dL. The client's blood glucose is now 300mg/dL. Which intervention should the nurse implement? A. increase regular insulin IV drip. B. Check the client's urine for ketone C. Provide the client with therapeutic diabetic meal D. Notify the HCP to obtain an order to decrease insulin

D - when the glucose level is decreased to around 300, therapy is decreased. SQ insulin will be administered per sliding scale

A client with allergic rhinitis asks the nurse what he should do to decrease his symptoms. which of the following instructions would be appropriate for the nurse to give the client? A. Use your nasal decongestant spray regularly to help clear your nasal passages B. Ask the doctor for antibiotics. Antibiotics will help decrease the secretion C. it is important to increase your activity. A daily brisk walk will help promote drainage D. Keep a dairy when your symptoms occur. This can help you identify what precipitates your attacks

D. It is important for clients to determine precipitating factors so they can be avoided decongestant sprays should be used regularly because of rebound effect. Antibiotics are inappropriate. increasing activity will not control symptoms

Which of the following outcomes would be appropriate for a client with COPD who has been discharged to home. The client: A. Promises to do pursed lip breathing at home B. States actions to reduce pain C. States that he will use oxygen via a nasal cannula at 5L/minute D. Agrees to call the physician if dyspnea on exertion increases

D; physician should be notified if client is experiencing complications promises are not an outcome criterion, pain is not common of COPD, clients using oxygen should only use 1-2L

Which of the following would be an expected outcome for a client recovering from an upper respiratory tract infection? the client will: A. Maintain a fluid intake of 800mL every 24hrs B. Experience chills only once a day C. Cough productively without chest discomfort D. Experience less nasal obstruction and discharge

D. meds can limit cough, congestion, and other symptoms in adults daily fluid intake should be increased to more than 1L every 24hr to liquefy secretions no chills/diaphoresis and no fever chest pain indicates pulmonary infection

A client has a rx to take guaifenesin every 4 hr as needed. the nurse determines that the client understands the most effective use of this medication if the client makes which statement?

I will take tablet with full glass of water guaifenesin (mucinex) is an expectorant. SE: GI upset, drowsiness, dizziness

Drugs used to treat arthritis

NSAIDs and corticosteroids

The nurse is instructing a client about pursed lip breathing and the client asks the nurse about the purpose. the nurse should tell the client that the primary purpose of pursed lip breathing is which?

Promote carbon dioxide elimination

RA vs osteoarthritis

RA: inflammatory and deterioration of synovium of the joints - inflammation occurs bilaterally OA: noninflammatory and characterized by degeneration of cartilage (Wear and Tear) and occurs asymmetrically

The nurse is reinforcing discharge instructions to the client with pulmonary sarcoidosis. The nurse knows that the client understands the info if the client verbalizes which early sign of exacerbation?

SOB

A pt with end-stage COPD has a nursing diagnosis of 'impaired gas exchange' which assessment finding shows that interventions have been effective?

SpO2 is 92% on 2L of oxygen

Which of the following interventions is most appropriate for the pt with an ineffective breathing pattern?

Teach the pt controlled diaphragmatic breathing

A client being discharged from the hospital to home with a diagnosis of TB is worried about the possibility of infecting family members and others. which info should reassure the client that contaminating family members is not likely?

The family will receive prophylactic therapy, and the client will not be contagious after 2-3 consecutive weeks of medication therapy.

The low pressure alarm sounds on the ventilator. The nurse checks the client then attempts to determine the cause of the alarm but is unsuccessful. Which initial action should be done?

Ventilate the client manually

The nurse knows that the patient understands teaching related to prevention of influenza transmission when the pt demonstrates which behaviors?

Wash hands frequently, cover nose and mouth when sneezing/coughing, avoid sharing eating utensils with others

Your patient is experiencing pain, and increased pressure in his lower leg after being treated for a fracture. It is not relieved by opioids, and you cannot palpate a pedal pulse. Which of the following interventions may be done? SATA. A. Removal of cast B. Elevation the leg C. Ice the leg D. Fasciotomy E. Amputation

a, d ,e should use use RICE w compartment syndrome neuro assessments can help prevent fasciotomy (high risk of infection) and amputation

After a laryngectomy, which of the following assessments takes priority?

airway patency

what is the priority nursing intervention used with clients taking NSAIDS?

bleeding and take with food or milk

A client has been started on long term therapy with rifampin. Which info about this med should the nurse provide to the client?

causes red-orange discoloration of sweat, tears, urine, and feces

Which of the following assessment findings does the nurse expect in the pt with emphysema?

diminished breath sounds

describe post op residual limb care for first 48 hrs

elevate for first 24 hrs, but not past 48 hrs keep residual limb in extended position turn client to prone position 3x/day to prevent flexion contracture

A nurse is assessing a client with chronic airflow limitation and notes that the client has a "barrel chest." The nurse interprets that this client has which of the following forms of chronic airflow limitation?

emphysema hyperinflation of the alveoli and flattening of the diaphragm causes barrel shaped chest. Chronic bronchitis and asthma would not cause barrel chest

The nurse is reading the results of a tuberculin skin test on a client with no documented health problems. The site has no induration and a 1mm area of ecchymosis. Which interpretation should the nurse make of these results?

negative (induration = positive)

nursing care for the client who is experiencing phantom limb pain after amputation.

pain meds

A client has been taking isoniazid for 2 months. The client complains of numbness, paresthesias, and tingling in the extremities. The nurse interprets that the client is experiencing which problem?

peripheral neuritis

Which of the following communication methods is inappropriate for the pt with a total laryngectomy?

placing a finger over the stoma

The nurse has given a client taking ethambutol info about the medication. The nurse determines that the client understands the instructions if the client states to report which occurrence immediately?

problems with visual acuity