Medsurg 2
"Keep walkways free of clutter." •
A client who has osteopenia is prescribed to begin risedronate. What health teaching would the nurse include about this drug
Low calcium intake •
Which diagnostic test requires the nurse to know whether the client is allergic to iodine-based contrast
A 65 YEAR OLD FEMALE WITH OSTEOARTHRITIS
A nurse assesses the health history of a client who is prescribed ziconotide for chronic low back pain. Which assessment question would the nurse ask?
"A 24-hour urine sample will be needed to confirm the diagnosis •
A client complains of persistent fever and urinary urgency, prompting the health care provider (HCP) to order the client to provide a urine specimen for urinalysis, culture, and sensitivity analysis. The nurse ensures that the client collects the specimen properly by informing the client to collect the specimen from
SLIDING BOARD
A client continues to have persistent low back pain even after using a number of nonpharmacologic pain management strategies. Which prescribed drug would the nurse anticipate that the client might need to manage the pain?
Urine pH •
A client experiencing an acute exacerbation of ulcerative colitis underwent diagnostic testing and was found to have elevated serum osmolality and urine specific gravity. Which of the following is related to these findings
Talking with an amputee close to the client's age who has a similar amputation •
A client has undergone an elective below-the-knee amputation of the right leg as a result of severe peripheral vascular disease. In postoperative care teaching, the nurse would instruct the client to notify the primary health care provider immediately if which change occurs
Discard the first sample •
A client is admitted with a spinal cord injury at the seventh cervical vertebra secondary to a gunshot wound. Which nursing intervention is the priority for the client at this time
a chronic indwelling urinary catheter receiving intravenous diuretics •
A client is scheduled to undergo a 24-hour urinalysis, beginning at 0800 on the first day and ending 24 later at 0800 the following day. In preparation for the test, the nurse should instruct the client to do which of the following
Large amount of serosanguineous or bloody drainage •
A client who uses a computer for hours each day asks the nurse how to help prevent carpal tunnel syndrome (CTS). Which statement by the client indicates a need for further teaching
Nifedipine •
A client with a T6 spinal cord injury who is in the rehabilitation unit suddenly develops facial flushing and reports a severe headache. Blood pressure is elevated, and the heart rate is slow. Which action does the nurse take first
"See your primary health care provider for twice yearly injections." •
A middle-age female client has osteoporosis and is at risk for developing vertebral fractures. She asks the nurse about exercises to help minimize this risk. Which exercise will the nurse recommend?
don't give to psychotic patients, it can cause hallucinations (contact HCP)
A nurse promotes the prevention of lower back pain by teaching clients at a community center. Which statement(s) would the nurse include in this education? (Select all thatapply.)
"Do not allow the traction weights to rest on the ground." •
A rock climber has sustained an open fracture of the right tibia after a 20-foot (6 m) fall 2 days ago. The nurse plans to assess the client for which potential complications? (Select all that apply.)
Using nasal mupirocin for at least a week before surgery Avoiding sleeping with pets in the client's bed Showering the night before and the morning of surgery with chlorhexidine Sleeping on clean linen wearing clean nightwear •
A young female client whose mother and grandmother have osteoporosis asks whether she needs to take steps to prevent this disease in herself. What will the nurse tell this client?
"Let me look at your urine bag to ensure it's draining properly." •
An emergency department nurse is taking care of a 68-year-old female after she fell. The paramedics said that she was on the bathroom floor for approximately 10 hours. The nurse is straight catheterizing the patient for a urine sample when she notices the amount of urine reaches 800 mL. The urine is still flowing heavily. What action should the nurse take and why
Vitamin D3 •
An older adult client who has osteoporosis is discharged from the hospital. What does the nurse include in health teaching related to the client's home safety
"Now is the time to begin building strong bones." •
Buck's (skin) traction for a fractured hip is applied to a client while a urinary tract infection is treated before surgery. What instruction will the nurse give assistive personnel (AP) for providing client care related to the traction?
The client does not need to have labs drawn for PT or INR. •
The nurse is caring for a client who has a continuous femoral nerve blockade following a total knee arthroplasty. What nursing assessment does the nurse need to perform to ensure client safety
Kidney function tests •
Following a diagnosis of cystitis, a client was instructed to drink cranberry juice. Changes in which of the following assessment parameters would indicate to the nurse that this recommendation has been effective
A client with diabetes insipidus and an NG tube set to low intermittent wall suction •
Following surgery for a prolapsed bladder, a 74-year-old female client is two days postoperative with an indwelling urinary catheter. While the nurse is making morning rounds, the client states, "I feel like peeing again!" The most appropriate response for the nurse is
Goose bumps above and/or below the injury level Sudden and severe hypertension
Severe throbbing headache Profuse sweating above the injury level Nasal congestion and blurred vision Facial and skin flushing • When assessing a female client, the nurse learns that the client has several risk factors for osteoporosis. Which risk factor would be the priority for client teaching
Walk for 30 minutes three times a week. •
The nurse is caring for a client who has been treated for osteoporosis for 15 years and is starting on denosumab. What health teaching is appropriate for the nurse to include about this drug
Heart failure, Renal failure, Hormonal imbalances •
The nurse is caring for a client who has just returned from an intravenous urography procedure. Which of the following nursing interventions is most important at this time
Cefazolin •
The nurse is preparing to give apixaban for a client who recently had a total knee arthroplasty. What does the nurse recognize as the advantage of this drug over other anticoagulants?
"A 24-hour urine sample will be needed to confirm the diagnosis." •
The infection control nurse assesses clients at risk for a urinary tract infection (UTI). Which client is at the greatest risk of developing a UTI? A client with
Check that the client can dorsiflex and plantar flex the foot on the operative leg. •
The nurse has provided health teaching for a female client starting on methotrexate (MTX) for early rheumatoid arthritis. What statement by the client indicates a need for further teaching
•
The nurse has taught a client about a scheduled intravenous (IV) urography (pyelogram). Which of the following statements by the client would indicate a correct understanding of the teaching
High alcohol intake A history of smoking •
The nurse is caring for a client who is at risk for osteoporosis. What lifestyle changes might the client be able to implement to decrease this risk? (Select all that apply.) Avoiding excessive alcohol consumption Decreasing consumption of carbonated beverages Preventing a sedentary daily lifestyle Seeking a smoking cessation program, if needed Including more calcium-rich foods into the diet • The nurse is preparing a client for a total hip arthroplasty today. What IV antibiotic would the nurse likely administer if the client has no drug allergies
"When lifting something, the back should be straight and the knees bent.", "Do not wear high-heeled shoes.", "Begin a regular exercise program to strengthen your back." •
The nurse is caring for a client who sustained a complete cervical spinal cord injury and is at risk for autonomic dysreflexia. Which assessment findings would the nurse anticipate if this complication occurs? (Select all that apply)
"Keep straws available for drinking fluids." •
The nurse is caring for a client with a spinal cord injury resulting from a diving accident, who has a halo fixator and an indwelling urinary catheter in place. The nurse notes that the blood pressure is elevated and that the client is reporting a severe headache. The nurse anticipates that the primary health care provider will prescribe which medication
"Have eye examinations every 6 months while on the drug." •
The nurse is caring for a postoperative client with total hip arthroplasty. What actions would the nurse take to prevent venous thromboembolism (VTE) postoperatively? (Select all that apply.)
Computed tomography (CT) - stop metformin 24 hrs before and 48 hrs after •
The nurse is caring for an older adult client diagnosed with osteomalacia. The nurse anticipates that the primary health care provider will request which supplement
Positioning the client to maximize ventilation potential •
The nurse is providing instructions to a client with a cervical spinal cord injury about caring for the halo fixator device. The nurse plans to include which instructions
Deficient fluid volume •
The nurse is caring for an older, alert adult client diagnosed with osteoarthritis. Which client statement indicates to the nurse that the client is using effective coping strategies
Help the client sit up. •
The nurse is developing a teaching plan for a client with a history of low back pain. Which instructions does the nurse plan to include in teaching the client about preventing low back pain and injury? (Select all that apply.)
"The bus is coming to pick me up from the senior center three times a week so I can play cards." •
The nurse is going over the list of assigned clients for the shift. The nurse knows which client is most at risk for experiencing a fluid volume deficit
"I can drink alcohol in small amounts at night to help me relax." •
The nurse is planning health teaching for a client starting hydroxychloroquine for rheumatoid arthritis. What instruction would the nurse include in the teaching
"I will take a laxative the night before to clear my bowels." •
The nurse is precepting a new graduate who will be caring for a client with bacterial cystitis. Which of the following statements by the new graduate requires follow-up
"Do not touch the inside of the container." •
The nurse is teaching a client how to provide a clean-catch urine specimen. Which client statement indicates that teaching was effective
"I need to exercise repetitively to strengthen my wrists." •
The nurse is teaching a client who needs a clean-catch urine specimen. What teaching will the nurse include
"Participate in an exercise program to strengthen back muscles." , "Wear flat instead of high-heeled shoes to work each day." , "Avoid prolonged standing or sitting, including driving."
The nurse is teaching assistive personnel (AP) about the risk for osteoporosis associated with race or ethnicity. Which population typically has a decreased incidence of osteoporosis when compared to Euro-Americans?
Stop draining the patient's bladder because the patient is at risk for developing bladder spasms. •
The nurse is working with a client who has been diagnosed with hypervolemia. Which of the following conditions can cause hypervolemia
Apply pneumatic or sequential compression devices Administer anticoagulant therapy. Ambulate the client on the day of surgery. Elevate the client's legs. •
The nurse recognizes that a client who has persistent pain may have difficulty with pain management after a total joint arthroplasty. What collaborative interventions are needed to help the client manage postoperative pain? (Select all that apply.)
The midstream urine from the bladder •
There is a new patient in your clinic. Six months ago, he had a kidney transplant and is taking immunosuppressive drugs. Recently, he has been experiencing repeated bacterial infections and was switched to different antibiotics throughout the past six months. The physician suspected kidney infection. He is admitted to the hospital and administered gentamicin 300 mg daily by IV infusion. Which of the following tests should the nurse monitor
AFRICAN AMERICANS
There is a new patient in your clinic. Six months ago, he had a kidney transplant and is taking immunosuppressive drugs. Recently, he has been experiencing repeated bacterial infections and was switched to different antibiotics throughout the past six months. The physician suspected kidney infection. He is admitted to the hospital and administered gentamicin 300 mg daily by IV infusion. Which of the following tests should the nurse monitor?
"Remain in an upright position for 30 minutes after taking the drug." •
What will the nurse recommend as the most appropriate way to decrease the risk for osteoporosis in a client who has just been determined to be at high risk for the disease
Acute compartment syndrome (ACS) Fat embolism syndrome (FES) Osteomyelitis. •
Which intervention would the nurse suggest to a client who has undergone a leg amputation to help cope with loss of the limb
Encourage the client to drink at least 1 L of fluid •
Which of the following statements by the new graduate requires follow-up
Yoga •
Which risk factors are shared by male clients who have osteoporosis or osteomalacia? (Select all that apply.)
