MedSurg Exams
Apply ice and tell the patient to keep his head elevated
A 13-year-old boy has been brought to the emergency department by his mother after he took a powerful blow to his nose during a volleyball game. Preliminary examination suggests a nasal fracture, which should prompt the nurse to
"The type of treatment depends on the cell type of the cancer, the stage of the cancer, and the patient's health status."
A 52-year-old mother of three has just been diagnosed with lung cancer. The health care provider discusses treatment options and makes recommendations to this patient. After the health care provider leaves the room, the patient asks the nurse how the treatment is decided on. What would be the nurse's best response?
Encouraging the patient to avoid alcohol and hypnotic medications Treatments for OSA are varied but include weight loss and avoidance of alcohol and hypnotic medications initially
A 60-year-old man has been diagnosed with obstructive sleep apnea (OSA) based on his clinical symptoms and polysomnographic findings. What intervention should the nurse perform to assist this patient in the management of his health problem?
Acquired Acquired disabilities may be progression of a chronic disorder, such as multiple sclerosis
A 65-year-old client was diagnosed with multiple sclerosis 10 years ago. The client has difficulty ambulating and is seeking a prescription for a wheelchair. The nurse assesses the type of disability the client has is
Collection of a sputum sample for submission to the hospital laboratory
A 72-year-old patient who was admitted to the hospital for a total hip arthroplasty has developed increasing dyspnea and leukocytosis over the past 48 hours and has been diagnosed with hospital-acquired pneumonia (HAP). The choice of antibiotic therapy for this patient will be primarily based on which of the nurse's assessments?
located over bony prominence Rheumatoid nodules usually are nontender, movable, and evident over bony prominences, such as the elbow or the base of the spine. The nodules are not reddened.
A client asks the nurse how to identify rheumatoid nodules with rheumatoid arthritis. What characteristic will the nurse include?
"OA is a noninflammatory joint disease. RA is characterized by inflamed, swollen joints." OA is a degenerative arthritis, characterized by the loss of cartilage on the articular surfaces of weight-bearing joints with spur development. RA is characterized by inflammation of synovial membranes and surrounding structures. OA may occur in one hip or knee and not the other, whereas RA commonly affects the same joints bilaterally. RA is more common in women; OA affects both sexes equally.
A client asks the nurse what the difference is between osteoarthritis (OA) and rheumatoid arthritis (RA). Which response is correct?
Apply direct continuous pressure. The severity and location of bleeding determine the treatment of a client with epistaxis. To manage this condition, the nurse should apply direct continuous pressure to the nares for 5 to 10 minutes with the client's head tilted slightly forward.
A client comes into the Emergency Department with epistaxis. What intervention should you perform when caring for a client with epistaxis (nose bleed)?
"I've had trouble getting started when I urinate, often straining to do so." Symptoms that might alert the nurse to BPH include difficulty initiating urination and abdominal straining with urination.
A client comes to the clinic reporting urinary symptoms. Which statement would most likely alert the nurse to suspect benign prostatic hyperplasia (BPH)?
Degenerative joint disease
A client comes to the emergency department complaining of pain in the right leg. When obtaining the history, the nurse learns that the client has a history of obesity and hypertension. Based on this information the nurse anticipates the client having which musculoskeletal disorder?
Prepare the client for surgery For the client with torsion, immediate surgery is necessary to prevent atrophy of the spermatic cord and preserve fertility
A client comes to the emergency department complaining of sudden, sharp testicular pain. Further examination reveals torsion of the spermatic cord. Which of the following would the nurse expect to do next?
Two to 3 weeks after initiation of bactericidal drugs The client needs to take the prescribed medications for approximately 2 to 3 weeks before discontinuing precautions against infecting others. Effectiveness of the drug therapy is determined by negative sputum smears obtained on three consecutive days. Full course is still 6 months.
A client diagnosed with tuberculosis (TB) is taking medication for the treatment of TB. The nurse should instruct the client that they will be safe from infecting others approximately how long after initiation of the medication therapy?
"Do not smoke and avoid being around others who are smoking." A sudden and complete loss of voice and cough are symptoms of laryngitis. The nurse instructs the client to avoid irritants, such as smoking. Voice rest is indicated. Whispering places stress on the larynx. Inhaling cool steam or aerosol aids in the treatment. Dry air may make the symptoms worse. A "tickle" in the throat that many clients report is actually worsened with cold liquids.
A client exhibits a sudden and complete loss of voice and is coughing. The nurse states
Risk for falls The client with Paget's disease is at risk for falls secondary to pathological fractures and impaired gait/mobility.
A client has Paget's disease. An appropriate nursing diagnosis for this client is:
It is suggestive of rheumatoid arthritis. Rheumatoid factor is present in about 70% to 80% of patients with rheumatoid arthritis, but its presence alone is not diagnostic of rheumatoid arthritis, and its absence does not rule out the diagnosis.
A client has a serum study that is positive for the rheumatoid factor. What will the nurse tell the client about the significance of this test result?
Encourage the client to exhale slowly against pursed lips When a client with COPD exhibits shallow, rapid, and inefficient respirations, the nurse encourages the client to perform pursed-lip breathing, which includes exhaling slowly against pursed lips. Pursed-lip breathing helps slow expiration, prevents collapse of small airways, and helps the client control the rate and depth of respiration. It also promotes relaxation, enabling the client to gain control of dyspnea and reduce feelings of panic
A client has chronic obstructive pulmonary disease (COPD) and is exhibiting shallow respirations of 32 breaths per minute and a pulse oximetry of 93% despite receiving nasal oxygen at 2 L/minute. What action should the nurse take?
Plan with the client how to incorporate the regimen into the client's activities of daily living The nurse should work with the client and family to identify ways to implement the treatment regimen.
A client has lost mobility following a stroke. The nurse has established interventions that include providing direct care to the client, teaching, making referrals, and managing the case, to meet the goal. The next step is to
Encouraging increased fluid intake Increasing the client's intake of oral or I.V. fluids helps liquefy thick, tenacious secretions, and ensures adequate hydration.
A client hospitalized with pneumonia has thick, tenacious secretions. Which intervention should the nurse include when planning this client's care?
Administering large doses of I.V. antibiotics as ordered
A client is admitted with acute osteomyelitis that developed after an open fracture of the right femur. When planning this client's care, the nurse should anticipate which measure?
visceral Visceral pain arises from internal organs such as the heart, kidneys, and intestine that are diseased or injured. Visceral pain usually is diffuse, poorly localized, and accompanied by autonomic nervous system symptoms such as nausea, vomiting, pallor, hypotension, and sweating.
A client is admitted with generalized abdominal pain, nausea, vomiting, and hypotension. The client has not passed stool in over 1 week and has been in pain for the past 4 days. Which type of pain would you expect the client to be experiencing?
Cromolyn sodium Cromolyn sodium is contraindicated in clients with acute asthma exacerbation. Indications for cromolyn sodium are long-term prevention of symptoms in mild, persistent asthma; it may modify inflammation. Cromolyn sodium is also a preventive treatment before exposure to exercise or a known allergen.
A client is being admitted to the medical-surgical unit for the treatment of an exacerbation of acute asthma. Which medication is contraindicated in the treatment of asthma exacerbations?
Tense and relax muscles in the lower extremities Clients are encouraged to perform passive or active exercises, as tolerated, to prevent a thrombus from forming.
A client is being discharged following pelvic surgery. What would be included in the patient care instructions to prevent the development of a pulmonary embolus?
Oxygen through nasal cannula at 2 L/minute When a client presents in the emergency department with an exacerbation of COPD, the nurse should first administer oxygen therapy and perform a rapid assessment of whether the exacerbation is potentially life threatening
A client is being seen in the emergency department for exacerbation of chronic obstructive pulmonary disease (COPD). The first action of the nurse is to administer which of the following prescribed treatments?
eating organ meats and sardines During an acute attack, high-purine foods are avoided, including organ meats, gravies, meat extracts, anchovies, herring, mackerel, sardines, and scallops
A client is being treated for hyperuricemia. Part of the treatment strategy is for the client to avoid contributing factors whenever possible. Which activities might bring on an acute attack?
Administering ordered analgesics and monitoring their effects An acute exacerbation of rheumatoid arthritis can be very painful, and the nurse should make pain management her priority
A client is experiencing an acute exacerbation of rheumatoid arthritis. What should the nursing priority be?
4.6 nanograms/milliliter Normal prostate-specific antigen (PSA) levels are less than 4.0 nanograms/milliliter (ng/mL).
A client is having prostate-specific antigen (PSA) testing done. Which result would the nurse identify as abnormal?
Weight loss will reduce uric acid levels and reduce stress on joints.
A client is recovering from an attack of gout. What will the nurse include in the client teaching?
"The surgeon is going to insert a scope through my urethra to remove a portion of the gland." TURP involves the surgical removal of the inner portion of the gland through an endoscope inserted through the urethra. There is no external skin incision. Typically, the procedure is performed in an outpatient setting but may require an overnight hospital stay.
A client is scheduled for a transurethral resection of the prostate (TURP). Which statement demonstrates that the expected outcome of "client demonstrates understanding of the surgical procedure and aftercare" has been met?
That the client's past experiences with pain may influence her perception of current pain Clients who have had previous experiences with pain are usually more frightened about subsequent painful events, as in the client who experienced partial-thickness burns to more than 60% of her body. The clients in these situations are less able to tolerate pain.
A client reports abdominal pain as "8" on a pain intensity scale of 0-10 thirty minutes after receiving an opioid intravenously. Her past medical history includes partial-thickness burns to approximately 60% of her body several years ago. The nurse assesses
decrease in the force of urinary stream The symptoms of benign prostatic hyperplasia (BPH) appear gradually. At first, the client notices that it takes more effort to void. Eventually, the urinary stream narrows and has decreased force. The bladder empties incompletely. As residual urine accumulates, the client has an urge to void more often and nocturia occurs.
A client reports experiencing nocturia. The nurse obtains a thorough history including current signs and symptoms. What would the client likely include when describing the symptoms?
"Do you smoke cigarettes, cigars, or a pipe?" Persistent hoarseness may signal THROAT CANCER, which commonly is associated with tobacco use. To assess the client's risk for throat cancer, the nurse should ask about smoking habits.
A client seeks care for hoarseness that has lasted for 1 month. To elicit the most appropriate information about this problem, the nurse should ask which question?
Use sterile technique when irrigating the catheter If the catheter is blocked by blood clots, it may be irrigated according to physician's orders or facility protocol. The nurse should use sterile technique to reduce the risk of infection.
A client underwent a transurethral resection of the prostate gland 24 hours ago and is on continuous bladder irrigation. Which nursing intervention is appropriate?
Escherichia coli
A client who comes to the clinic complaining of perineal pain, dysuria, and fever is diagnosed with prostatitis. The nurse understands that which of the following organisms would be the most likely cause?
Hand and finger deformities are associated with the development of rheumatoid arthritis The nurse should explain to the client that joint deformities occur with rheumatoid arthritis, not osteoarthritis.
A client who has been diagnosed with osteoarthritis asks if he or she will eventually begin to notice deformities in the hands and fingers as the condition progresses. Which concept should the nurse include in the response?
Pneumothorax Pneumothorax (air in the pleural space) is a potential complication of all central venous access devices. Signs and symptoms include chest pain, dyspnea, shoulder or neck pain, irritability, palpitations, light-headedness, hypotension, cyanosis, and unequal breath sounds. A chest X-ray reveals the collapse of the affected lung that results from pneumothorax.
A client who has just had a triple-lumen catheter placed in his right subclavian vein complains of chest pain and shortness of breath. His blood pressure is decreased from baseline and, on auscultation of his chest, the nurse notes unequal breath sounds. A chest X-ray is immediately ordered by the physician. What diagnosis should the nurse suspect?
"I'll stop being contagious when I have a negative acid-fast bacilli test." A client with drug-resistant tuberculosis isn't contagious when he's had a negative acid-fast test. A client with nonresistant tuberculosis is no longer considered contagious when he shows clinical evidence of decreased infection, such as significantly decreased coughing and fewer organisms on sputum smears.
A client who has started therapy for drug-resistant tuberculosis demonstrates understanding of tuberculosis transmission when he says:
Initiate oxygen therapy The client's signs and symptoms suggest pulmonary embolism. Therefore, maintaining respiratory function takes priority. The nurse should first initiate oxygen therapy and then notify the physician immediately.
A client who underwent surgery 12 hours ago has difficulty breathing. He has petechiae over his chest and complains of acute chest pain. What action should the nurse take first?
Renal calculi Renal calculi commonly occur with Paget's disease, causing pain and difficulty when urinating.
A client with Paget's disease comes to the hospital and reports difficulty urinating. The emergency department health care provider consults urology. What should the nurse suspect is the most likely cause of the client's urination problem?
Administer oxygen by nasal cannula as ordered. When a pulmonary embolus places a client at risk for oxygen deprivation, the body compensates by hyperventilating. This causes respiratory alkalosis, as reflected in the client's ABG values. However, the most significant ABG value is the PaO2 value of 60 mm Hg, which indicates hypoxemia. To manage hypoxemia, the nurse should increase oxygenation by administering oxygen via nasal cannula as ordered.
A client with a pulmonary embolus has the following arterial blood gas (ABG) values: pH, 7.49; partial pressure of arterial oxygen (PaO2), 60 mm Hg; partial pressure of arterial carbon dioxide (PaCO2), 30 mm Hg; bicarbonate (HCO3-) 25 mEq/L. What should the nurse do first?
Thick mucus Swelling of bronchial membranes Airway remodeling As asthma becomes more persistent, inflammation progresses and airway edema, mucus hypersecretion, and formation of mucus plugs can occur. Airway remodeling may occur in response to chronic inflammation, causing further airway narrowing.
A client with asthma has developed obstruction of the airway. Which of the following does the nurse understand as having potentially contributed to this problem? Choose all that apply.
Albuterol
A client with asthma is prescribed a short acting beta-adrenergic (SABA) for quick relief. Which of the following is the most likely drug to be prescribed?
implementing measures to clear pulmonary secretions
A client with bronchiectasis is admitted to the nursing unit. The primary focus of nursing care for this client includes
"Weigh yourself daily and report a gain of 2 lb in 1 day."
A client with chronic obstructive pulmonary disease (COPD) and cor pulmonale is being prepared for discharge. The nurse should provide which instruction?
"You may experience headache and some flushing with this drug." Sildenafil (Viagra) may cause headache, flushing, dyspepsia, diarrhea, nasal congestion, and lightheadedness. It is taken 30 minutes to 4 hours before sexual activity. It can be taken more than once a day, but doing so will not increase its effect. It should be taken only when the client wants to have intercourse, to a maximal dose of 100 mg/24 hours. The drug may cause low blood glucose levels and abnormal liver function tests.
A client with erectile dysfunction is prescribed sildenafil (Viagra). Which of the following would the nurse include in the teaching plan for this client?
"There might be some difficulties with your plan and fasting." Clients should avoid fasting, low-carbohydrate diets, and rapid weight loss because these measures increase the likelihood of ketone formation, which inhibits uric acid excretion. Gradual weight loss helps reduce serum uric acid levels in clients with gout.
A client with gout has been advised to lose weight. The client informs the nurse of plans to go on a "guaranteed rapid weight loss" plan that involves fasting and heavy exercise. Which response would be most appropriate?
Decreased breath sounds In pleural effusion, fluid accumulates in the pleural space, impairing transmission of normal breath sounds. Because of the acoustic mismatch, breath sounds are diminished. Crackles commonly accompany atelectasis, interstitial fibrosis, and left-sided heart failure. Rhonchi suggest secretions in the large airways. Wheezes result from narrowed airways, such as in asthma, chronic obstructive pulmonary disease, and bronchitis
A client with lung cancer develops pleural effusion. During chest auscultation, which breath sound should the nurse expect to hear?
For their immunosuppressant effects
A client with lupus has had antineoplastic drugs prescribed. Why would the physician prescribe antineoplastic drugs for an autoimmune disorder?
Delaying exercise for at least 1 hour after awakening allows the client to participate in exercise after some of the morning-related stiffness has subsided. A client with osteoarthritis has increased stiffness in the morning upon awakening. Exercise should be scheduled at least 1 hour after awakening.
A client with osteoarthritis asks for information concerning activity and exercise. When assisting the client, which concept should be included?
"Pace yourself and rest frequently, especially after activities." Because rest usually relieves the pain, the nurse should instruct the client to rest frequently, especially after activities, and to pace oneself during daily activities. Telling the client to do chores in the morning is incorrect because the pain and stiffness of osteoarthritis are most pronounced in the morning. Telling the client to do all chores after performing morning exercises or in the evening is incorrect because the client should pace oneself and take frequent rests rather than doing all chores at once.
A client with osteoarthritis expresses concerns that the disease will prevent the ability to complete daily chores. Which suggestion should the nurse offer?
"My finger joints are oddly shaped." Joint abnormalities are the most obvious manifestations of rheumatoid arthritis.
A client with rheumatoid arthritis arrives at the clinic for a checkup. Which statement by the client refers to the most overt clinical manifestation of rheumatoid arthritis?
Nonsteroidal anti-inflammatory drugs
A client with rheumatoid arthritis reports joint pain. What intervention is a priority to assist the client?
Institute isolation precautions SARS, a highly contagious viral respiratory illness, is spread by close person-to-person contact. Contained in airborne respiratory droplets, the virus is easily transmitted by touching surfaces and objects contaminated with infectious droplets
A client with suspected severe acute respiratory syndrome (SARS) comes to the emergency department. Which physician order should the nurse implement first?
Neuropathic pain An example of neuropathic pain is phantom limb pain or phantom limb sensation, in which individuals with an amputated arm or leg perceive that the limb still exists and that sensation such as burning, itching, and deep pain are located in tissues that have been surgically removed.
A client, who had an above the knee amputation of the left leg related to peripheral vascular disease from uncontrolled diabetes, complains of pain in the left lower extremity. What type of pain is the client experiencing?
Theophylline Theophylline is an example of a methylxanthine. All the others are examples of inhaled short-acting beta2 agonists
A commonly prescribed methylxanthine used as a bronchodilator is which of the following?
Have the client hold the palm of the hand up while the nurse percusses over the median nerve. If tingling, numbness, or pain is felt when the median nerve is percussed, then Tinel's sign is considered positive. To test for Tinel's sign have the client hold the palm of the hand up while the nurse percusses over the median nerve.
A healthcare provider asks a nurse to test a client for Tinel's sign to diagnose carpal tunnel syndrome. What should the nurse do to perform this assessment?
18 million/mL A sperm count of fewer than 20 million spermatozoa per milliliter results in infertility. Normal sperm count ranges on average from 60 to 100 million /mL
A male client has undergone a semen analysis for evaluation of fertility. The nurse understands that a sperm count of which of the following would suggest infertility?
Facial erythema, pericarditis, pleuritis, fever, and weight loss
A nurse assesses a client in the health care provider's office. Which assessment findings support a suspicion of systemic lupus erythematosus (SLE)?
pH 7.28, PaO2 50 mm Hg ARF is defined as a decrease in arterial oxygen tension (PaO2) to less than 60 mm Hg (hypoxemia) and an increase in arterial carbon dioxide tension (PaCO2) to >50 mm Hg (hypercapnia), with an arterial pH less than 7.35.
A nurse assesses arterial blood gas results for a patient in acute respiratory failure (ARF). Which results are consistent with this disorder?
High-protein Breathing is more difficult for clients with COPD, and increased metabolic demand puts them at risk for nutritional deficiencies. These clients must have a high intake of protein for increased calorie consumption.
A nurse consulting with a nutrition specialist knows it's important to consider a special diet for a client with chronic obstructive pulmonary disease (COPD). Which diet is appropriate for this client?
Seek medical help if he experiences inability to swallow The client should seek medical assistance if swallowing is impaired to prevent aspiration
A nurse has pharyngitis and will be providing self care at home. It is most important for the nurse to
A positive reaction indicates that the client has been exposed to the disease. A positive reaction means the client has been exposed to TB; it isn't conclusive for the presence of active disease. A positive reaction consists of palpable swelling and induration of 5 to 15 mm. It can be read 48 to 72 hours after the injection. In clients with positive reactions, further studies are usually done to rule out active disease. In immunosuppressed clients, a negative reaction doesn't exclude the presence of active disease.
A nurse is administering a purified protein derivative (PPD) test to a client. Which statement concerning PPD testing is true?
Dyspnea and wheezing In a client with bacterial pneumonia, retained secretions cause dyspnea, and respiratory tract inflammation causes wheezing. Bacterial pneumonia also produces a productive cough and fever.
A nurse is assessing a client who comes to the clinic for care. Which findings in this client suggest bacterial pneumonia?
Unresponsive arterial hypoxemia. Clinically, the acute phase of ARDS is marked by a rapid onset of severe dyspnea that usually occurs 12 to 48 hours after the initiating event. A characteristic feature is arterial hypoxemia that does not respond to supplemental oxygen.
A nurse is aware that the diagnostic feature of ARDS is sudden
"I should become involved in a weight loss program." Obesity and decreased pharyngeal muscle tone commonly contribute to sleep apnea; the client may need to become involved in a weight loss program.
A nurse is caring for a client who has a history of sleep apnea. The client understands the disease process when he says:
Cough or change in chronic cough
A nurse is caring for a client who has just been diagnosed with lung cancer. What is a cardinal sign of lung cancer?
Status asthmaticus Respiratory failure Atelectasis
A nurse is discussing asthma complications with a client and family. What complications should the nurse include in the teaching? Select all that apply.
administration of nonsteroidal anti-inflammatory drugs (NSAIDs)
A nurse is managing the care of a client with osteoarthritis. What is the appropriate treatment strategy the nurse will teach the about for osteoarthritis?
Take the supplement with meals or with orange juice Calcium supplements should be taken with meals or with a beverage high in vitamin C for increased absorption.
A nurse is performing discharge teaching for an elderly client with osteoporosis. Which instruction about a calcium supplement should the nurse include?
"You will receive IV antibiotics for 3 to 6 weeks."
A nurse is planning discharge instructions for the client with osteomyelitis. What instructions should the nurse include in the discharge teaching?
Walking Weight-bearing exercises should be incorporated into the client's lifestyle activities. Walking is a low-impact method of weight-bearing exercise and would be the most universal or most likely form of exercise for the nurse to recommend
A nurse is planning discharge teaching regarding exercise for a client at risk for osteoporosis. Which exercise would the nurse be most likely to suggest?
"Cover the stoma whenever you shower or bathe." The nurse should instruct the client to gently cover the stoma with a loose plastic bib, or even a hand, when showering or bathing to prevent water from entering the stoma. The client should cover the stoma with a loose-fitting, not tight, cloth to protect it. The client should keep his house humidified to prevent irritation of the stoma that can occur in low humidity. The client should avoid swimming, because it's possible for water to enter the stoma and then enter the client's lung, causing him to drown without submerging his face
A nurse is providing discharge teaching for a client who had a laryngectomy. Which instruction should the nurse include in her teaching?
Smoking Hypertension Diabetes
A nurse is reviewing a journal article about benign prostatic hyperplasia and possible risk factors associated with this condition. Which factor would the nurse most likely find as playing a role in increasing a man's risk for this condition? Select all that apply.
"It will get better and worse again." The client demonstrates understanding of rheumatoid arthritis if he expresses that it's an unpredictable disease characterized by periods of exacerbation and remission.
A nurse is teaching a client about rheumatoid arthritis. Which statement by the client indicates understanding of the disease process?
Change positions frequently and cough up secretions By changing positions, secretions can drain from the affected bronchioles into the bronchi and trachea and then be removed by coughing or suctioning.
A nurse should include what instruction for the client during postural drainage?
Hoarseness of more than 2 week's duration Hoarseness of more than 2 weeks' duration occurs in the patient with cancer in the glottic area, because the tumor impedes the action of the vocal cords during speech. The voice may sound harsh, raspy, and lower in pitch.
A nurse takes the initial history of a patient who is being examined for cancer of the larynx. Select the sign that is considered an early clinical indicator
Low back pain
A patient comes into the clinic frequently with complaints of pain. What would the nurse recognize as chronic benign pain in a patient?
Group A, beta-hemolytic streptococcus
A patient comes to the clinic and is diagnosed with tonsillitis and adenoiditis. What bacterial pathogen does the nurse know is commonly associated with tonsillitis and adenoiditis?
Sputum and a productive cough Chronic bronchitis, a disease of the airways, is defined as the presence of cough and sputum production for at least 3 months in each of 2 consecutive years.
A patient comes to the clinic for the third time in 2 months with chronic bronchitis. What clinical symptoms does the nurse anticipate assessing for this patient?
Streptococcus pneumoniae Streptococcus pneumoniae (pneumococcus) is the most common cause of community-acquired pneumonia in people younger than 60 years without comorbidity and in those 60 years and older with comorbidity
A patient comes to the clinic with fever, cough, and chest discomfort. The nurse auscultates crackles in the left lower base of the lung and suspects that the patient may have pneumonia. What does the nurse know is the most common organism that causes community-acquired pneumonia?
Discontinue the irrigations. Transurethral resection syndrome is a rare but potentially serious complication of TURP. Symptoms include lethargy, hypotension, and muscle spasms. The first action the nurse should take is to discontinue irrigation.
A patient experiences hypotension, lethargy, and muscle spasms while receiving bladder irrigations after a transurethral resection of the prostate (TURP). What is the first action the nurse should take?
Performing hourly neurovascular assessments for the first 24 hours
A patient had hand surgery to correct a Dupuytren's contracture. What nursing intervention is a priority postoperatively?
An antiviral agent such as acyclovir Herpes labialis is an infection that is caused by herpes simplex virus type 1 (HSV-1). It is characterized by an eruption of small, painful blisters on the skin of the lips, mouth, gums, tongue, or the skin around the mouth. The blisters are commonly referred to as cold sores or fever blisters. Medications used in the management of herpes labialis include Acyclovir (Zovirax) and Valacyclovir (Valtrex), which help to minimize the symptoms and the duration or length of flare-up.
A patient has herpes simplex infection that developed after having the common cold. What medication does the nurse anticipate will be administered for this infection?
Supine, with the knees slightly flexed and the head of the bed elevated 30 degrees Lumbar flexion is increased by elevating the head and thorax 30 degrees by using pillows or a foam wedge and slightly flexing the knees supported on a pillow
A patient is having low back pain. What position can the nurse suggest to relieve this discomfort?
Hyperuricemia
A patient is hospitalized with a severe case of gout. The patient has gross swelling of the large toe and rates pain a 10 out of 10. With a diagnosis of gout, what should the laboratory results reveal?
"If possible, take slow, deep breaths while your nebulizer is running."
A patient is postoperative day 3 following major bowel surgery and has been reluctant to ambulate since being admitted from postanesthetic recovery 2 days ago. As a result, the patient has developed atelectasis and is now being treated for this problem. When administering the patient's bronchodilator by nebulizer, what teaching should the nurse provide?
Pretrajectory
A patient who is at risk for developing a chronic condition because of genetic factors is said to be in which phase of the Trajectory Model?
"You should switch to wearing your glasses while taking this medication." The nurse informs the patient that rifampin may discolor contact lenses and that the patient may want to wear eyeglasses during treatment.
A patient who wears contact lenses is to be placed on rifampin for tuberculosis therapy. What should the nurse tell the patient?
Oxybutynin (Ditropan)
A patient with an indwelling catheter after a radical prostatectomy is having bladder spasms. What medication prescribed by the physician can the nurse administer to help alleviate the discomfort?
Sit in a straight-backed chair with arm rests. Avoid hip extension. Place feet flat on the floor. Sit with the buttocks "tucked under."
A provider asks the nurse to teach a client with low back pain how to sit in order to minimize pressure on the spine. Which teaching points would the nurse include? Select all that apply
location, onset, alleviating factors, and aggravating factors
According to The Joint Commission's pain assessment and management standards, which of the following are essential components of a comprehensive pain assessment?
Kegel exercises Kegel exercises are noninvasive and are recommended as the initial intervention for incontinence
After a radical prostatectomy for prostate cancer, a client has an indwelling catheter removed. The client then begins to have periods of incontinence. During the postoperative period, which intervention should be implemented first?
Bleeding The nurse should instruct the client to report bleeding immediately. Delayed bleeding may occur when the healing membrane separates from the underlying tissue — usually 7 to 10 days postoperatively. Difficulty swallowing and throat pain are expected after a tonsillectomy and typically are present even before the client is discharged
After a tonsillectomy, a client is being prepared for discharge. The nurse should instruct the client to report which sign or symptom immediately?
6 to 12 months Prophylactic isoniazid therapy must continue for 6 to 12 months at a daily dosage of 300 mg.
After diagnosing a client with pulmonary tuberculosis, the physician tells family members that they must receive isoniazid (INH [Laniazid]) as prophylaxis against tuberculosis. The client's daughter asks the nurse how long the drug must be taken. What is the usual duration of prophylactic isoniazid therapy?
Highest airflow during a forced expiration A peak flow meter is a small hand-held device that measures the fastest flow the patient can generate after taking a deep breath in and blowing out as hard and fast as possible.
An asthma educator is teaching a new patient with asthma and his family about the use of a peak flow meter. What does a peak flow meter measure?
laryngeal cancer is one of the most preventable types of cancer Laryngeal cancer is one of the most preventable types of cancer; it can be prevented by abstaining from excessive drinking and smoking.
As part of a primary cancer prevention program, an oncology nurse answers questions from the public at a health fair. When someone asks about laryngeal cancer, the nurse should explain that
Respiratory acidosis As status asthmaticus worsens, the PaCO2 increases and the pH decreases, reflecting respiratory acidosis.
As status asthmaticus worsens, the nurse would expect which acid-base imbalance?
60 Viagra needs to be taken orally 1 hour before intercourse. Stimulation is required to achieve erection.
As treatment of erectile dysfunction, Viagra is taken how many minutes before intercourse to be effective?
Low-grade fever Testicular tenderness to pressure Swelling of the scrotum Severe pain in the lower abdomen
Assessment of a patient diagnosed with epididymitis reveals the findings listed. Place the findings in the order in which they most likely occurred.
developmental disability Examples of developmental disabilities are spina bifida, cerebral palsy, and Down syndrome
Down syndrome is categorized as a
Hammer toe
During a routine physical examination of a client, the nurse observes a flexion deformity of the proximal interphalangeal (PIP) joint of two toes on the right foot. How would the nurse document this finding?
Hypercapnia Repetitive apneic events result in hypoxia and hypercapnia, which triggers a sympathetic response (increased heart rate and decreased tone and contractility of smooth muscle).
During assessment of a patient with OSA, the nurse documents which of the following characteristic signs that occurs because of repetitive apneic events?
continue to take antibiotics for the entire 10 days
During discharge teaching, a nurse is instructing a client about pneumonia. The client demonstrates his understanding of relapse when he states that he must
1,200 mg; 1,000 IU The daily recommended dosage is 1,200 mg of calcium and 1,000 IU of vitamin D
Health education for a woman over age 50 includes providing information about the importance of adequate amounts of calcium and vitamin D to prevent osteoporosis. Select the daily dosage of calcium and vitamin D that the nurse should recommend
Respiratory acidosis
In chronic obstructive pulmonary disease (COPD), decreased carbon dioxide elimination results in increased carbon dioxide tension in arterial blood, leading to which of the following acid-base imbalances?
Surgical debridement
In chronic osteomyelitis, antibiotics are adjunctive therapy in which situation?
IV Grade I is mild COPD, with an FEV1 ≥80% predicted. Grade II COPD demonstrate an FEV1 of 50-80% predicted. Grade III COPD demonstrate an FEV1 less than 30-50% predicted, with respiratory failure or clinical signs of right heart failure. Grade IV is characterized by FEV1 less 30% predicted.
In which grade of COPD is the forced expiratory volume (FEV) less than 30%?
Albuterol is a bronchodilator. Ciprofloxacin is an antibiotic. Prednisone is a corticosteroid.
In which statements regarding medications taken by a client diagnosed with COPD do the drug name and the drug category correctly match? Select all that apply
Paget disease Paget disease results in bone that is highly vascularized and structurally weak, predisposing the client to pathologic fractures.
Localized rapid bone turnover, most commonly affecting the skull, femur, tibia, pelvic bones, and vertebrae, is characterized by which bone disorder?
Alpha-adrenergic blocker Alpha-adrenergic blockers relax the smooth muscle of the bladder neck and prostate, improving urine flow and relieving BPH symptoms.
Medical management of BPH includes pharmacologic therapy. Which of the following medications would the nurse expect the health care provider to prescribe for this diagnosis?
is the most common and frequently disabling of joint disorders
Osteoarthritis is known as a disease that
A 52-year-old man in good health DRE is used to screen for prostate cancer and is recommended annually for every man older than 50 years or those 45 years old at high risk (African-American men and men with a strong family history of prostate cancer).
Several male clients are scheduled to come to the clinic for an annual physical examination. The nurse would expect to prepare which client for a digital rectal examination (DRE)?
Acquired
Spinal cord injury is an example of which type of disability?
moderate COPD. Stage II is moderate COPD. Stage 0 is at risk for COPD. Stage I is mild COPD. Stage III is severe COPD. Stage IV is very severe COPD.
The classification of Stage II of COPD is defined as
severe COPD
The classification of Stage III of COPD is defined as
very severe COPD
The classification of Stage IV of COPD is defined as
"When was your last bowel movement?" Constipation is a common side effect of opioids. The nurse needs to assess the situation first before intervening. Asking about date of last bowel movement is most important. Once the history of constipation is completed, it would then be appropriate for the nurse to ask about effectiveness of past interventions and begin teaching about interventions, such as increasing fluids and fiber.
The client is taking continuous-release oxycodone for chronic pain and now reports constipation. What should be the first question the nurse asks the client?
Finasteride (Proscar) Finasteride (Proscar) inhibits the conversion of testosterone, depriving the gland of dihydrotestosterone (more potent type of testosterone), which stimulates prostatic growth
The client with benign prostatic hyperplasia (BPH) is considering use of medication in the management of symptoms. Which of the following drugs reduces the size of the prostate without lowering circulating levels of testosterone?
60 mm Hg; 90%
The goal for oxygen therapy in COPD is to support tissue oxygenation, decrease the work of the cardiopulmonary system, and maintain the resting partial arterial pressure of oxygen (PaO2) of at least ______ mm Hg and an arterial oxygen saturation (SaO2) of at least ___%.
2 to 12 days HSV-1 is transmitted primarily by direct contact with infected secretions.
The herpes simplex virus type 1 (HSV-1), which produces a cold sore (fever blister), has an incubation period of
The survival of people with severe trauma, chronic disorders, and early-onset disabilities
The number of people with disabilities is expected to increase over time. What is a major contributor to this prediction?
Within 1 week. Surgical reduction of a fracture should occur immediately. However, with significant edema present, surgery can be delayed up to 7 days to allow time for the fluid to resolve.
The nurse advises a patient who sustained a fractured nose during an automobile accident that surgery will be necessary. Due to significant facial edema, surgery would be scheduled:
Superficial somatic pain Superficial somatic pain, also known as cutaneous pain (such as that from an insect bite or a paper cut), is perceived as sharp or burning discomfort.
The nurse asks the client about a reddened area on the left arm. The client states that he was bitten by an insect, and it burned briefly. What type of pain does the nurse document this as?
a persistent cough or sore throat" Hoarseness longer than 2 weeks with a persistent cough or sore throat are early symptoms of laryngeal cancer
The nurse at an employee wellness clinic is meeting with a client who reports voice hoarseness for more than 2 weeks. To determine if the client may have symptoms of early laryngeal cancer, the next question the nurse should ask is, "Do you have
Acute respiratory distress syndrome Factors associated with the development of ARDS include aspiration related to near drowning or vomiting; drug ingestion/overdose; hematologic disorders such as disseminated intravascular coagulation or massive transfusions; direct damage to the lungs through prolonged smoke inhalation or other corrosive substances; localized lung infection; metabolic disorders such as pancreatitis or uremia; shock; trauma such as chest contusions, multiple fractures, or head injury; any major surgery; embolism; and septicemia
The nurse caring for a 2-year-old near-drowning victim monitors for what possible complication?
Chronic fatigue, generalized muscle aching, and stiffness
The nurse intervenes to assist the client with fibromyalgia to cope with which symptoms?
Decreased ventilation owing to lung scarring Dysphagia owing to hardening of the esophagus Dyspnea owing to fibrotic cardiac tissue The left ventricle of the heart is involved, resulting in heart failure. The esophagus hardens, interfering with swallowing. The lungs become scarred, impeding respiration. Digestive disturbances occur because of hardening (sclerosing) of the intestinal mucosa. Progressive kidney failure may occur.
The nurse is assessing a patient with a diagnosis of scleroderma. What clinical manifestations of scleroderma does the nurse assess? (Select all that apply.)
Providing sufficient oxygen to improve oxygenation
The nurse is assigned to care for a patient with COPD with hypoxemia and hypercapnia. When planning care for this patient, what does the nurse understand is the main goal of treatment?
Crackles in the lung bases When clinically significant atelectasis develops, it is generally characterized by increased work of breathing and hypoxemia. Decreased breath sounds and crackles are heard over the affected area.
The nurse is auscultating the patient's lung sounds to determine the presence of pulmonary edema. What adventitious lung sounds are significant for pulmonary edema?
Noisy breathing Enlarged adenoids may produce nasal obstruction, noisy breathing, snoring, and a nasal quality to the voice.
The nurse is caring for a client diagnosed with enlarged adenoids. What condition is produced by enlarged adenoids?
Develop an alternate method of communication The client with a total laryngectomy is not able to speak. Communication needs to be established using an alternate method.
The nurse is caring for a client who had a recent laryngectomy. Which of the following is reflected in the nursing plan of care?
Alendronate
The nurse is caring for a client with a hip fracture. The physician orders the client to start taking a bisphosphonate. Which medication would the nurse document as given?
Incentive spirometry Strategies to prevent atelectasis, which include frequent turning, early ambulation, lung volume expansion maneuvers (deep breathing exercises, incentive spirometry), and coughing serve as the first-line measures to minimize or treat atelectasis by improving ventilation. In patients who do not respond to first-line measures or who cannot perform deep-breathing exercises, other treatments such as PEEP, continuous or intermittent positive pressure-breathing (IPPB), or bronchoscopy may be used
The nurse is caring for a patient at risk for atelectasis and chooses to implement a first-line measure to prevent atelectasis development in the patient. What is an example of a first-line measure to minimize atelectasis?
When the patient has less than 30 mL for 2 consecutive days Wound drains, inserted during surgery, may be in place to assist in removal of fluid and air from the surgical site. Suction also may be used, but cautiously, to avoid trauma to the surgical site and incision. The nurse observes, measures, and records drainage. When drainage is less than 30 mL/day for 2 consecutive days, the physician usually removes the drains
The nurse is caring for a patient who had a total laryngectomy and has drains in place. When does the nurse understand that the drains will most likely be removed?
Auscultate lung sounds. Major goals of intubation are to improve respirations and maintain a patent airway for gas exchange. Regular auscultation of the lung fields is essential in confirming that air is reaching the lung fields for gas exchange.
The nurse is caring for the client in the intensive care unit immediately after removal of the endotracheal tube. Which of the following nursing actions is most important to complete every hour to ensure that the respiratory system is not compromised?
Classes at community centers to teach about smoking cessation strategies Lung cancer is directly correlated with heavy cigarette smoking, and the most effective approach to reducing lung cancer in the community is to help the citizens stop smoking.
The nurse is collaborating with a community group to develop plans to reduce the incidence of lung cancer in the community. Which of the following would be most effective?
Methotrexate (Rheumatrex) Methotrexate is a DMARD that reduces the amount of joint damage and slows the damage to other tissues as well.
The nurse is discussing the new medication that a client will be taking for treatment of rheumatoid arthritis. Which disease-modifying antirheumatic drug (DMARD) will the nurse educate the client about?
pain
The nurse is performing a health history with a new client in the clinic. What is the most common reason for a client to seek medical attention for arthritis?
Performing perineal exercises frequently throughout the day After a prostatectomy, the client should be instructed in how to perform perineal exercises and to perform them hourly throughout the day, each day. In addition, the client should avoid bearing down (straining) to urinate because of the increased risk for hematuria. He should also avoid strenuous exercise, which increases the tendency to rebleed. The client should be instructed to urinate as soon as he feels the first urge to do so.
The nurse is preparing a discharge teaching plan for a client who has had a prostatectomy. Which of the following would be appropriate to include?
High-fat diet Although the cause of prostatic cancer is unknown, there seems to be a relationship with increased testosterone levels and a diet high in fat.
The nurse is preparing a presentation for a local community group about prostate cancer and possible dietary risk factors. Which of the following would the nurse most likely include?
Avoid sports activities for 6 weeks.
The nurse is providing discharge instructions to a client who has nasal packing in place following nasal surgery. Which discharge instructions would be most appropriate for the client?
Elevated erythrocyte sedimentation rate The erythrocyte sedimentation rate (ESR) may be elevated, particularly as the disease progresses. ESR shows inflammation associated with RA
The nurse is reviewing the diagnostic test findings of a client with rheumatoid arthritis. What would the nurse expect to find?
colchicine
The nurse is reviewing the medication administration record of the client. Which medication would lead the nurse to suspect that the client is suffering from an acute attack of gout?
Clients may develop Heberden nodes Heberden nodes are a characteristic finding of osteoarthritis. Swan neck deformity, boutonniere deformity, and ulnar deviation are characteristic of rheumatoid arthritis
The nurse is teaching a client about the characteristics of osteoarthritis. How will the nurse determine the client teaching was successful?
Collaborates with the client to establish an agreed-upon goal When establishing a goal, the nurse should collaborate with the client. The nurse does not dictate to the client what the goal will be. Goals must be consistent with the abilities and motivation of the client. The long-term and short-term goals may not be realistic for this client
The nurse is working with a client who has difficulty controlling her blood sugar. The overweight client does not adhere to a low-calorie diet and forgets to take medications and check her blood glucose level. The client's glycohemoglobin is 8.5%. When establishing a goal for the client, the nurse first
Raynaud's phenomenon
The nurse knows that a patient who presents with the symptom of "blanching of fingers on exposure to cold" would be assessed for what rheumatic disease?
Few early symptoms Because lung cancer produces few early symptoms, its mortality rate is high.
The nurse knows the mortality rate is high in lung cancer clients due to which factor?
Hallux valgus
The nurse notes that the client's left great toe deviates laterally. This finding would be recognized as
Atelectasis
The nurse should be alert for a complication of bronchiectasis that results from a combination of retained secretions and obstruction that leads to the collapse of alveoli. This complication is known as
Walk or perform weight-bearing exercises outdoors Risk-lowering strategies for osteoporosis include walking or exercising outdoors, performing a regular weight-bearing exercise regimen, increasing dietary calcium and vitamin D intake, smoking cessation, and consuming alcohol and caffeine in moderation
The nurse teaches the client with a high risk for osteoporosis about risk-lowering strategies, including which action?
Symptoms often do not appear until the disease is well established
The nursing instructor is talking with the junior class of nursing students about lung cancer. What would be the best rationale the instructor could give for the difficulty of early diagnosis of lung cancer?
Fibrotic changes in lungs For a client with occupational lung diseases, a chest radiograph may reveal fibrotic changes in the lungs.
The occupational nurse is completing routine assessments on the employees where you work. What might be revealed by a chest radiograph for a client with occupational lung diseases?
gout
The presence of crystals in synovial fluid obtained from arthrocentesis is indicative of
Compromised gas exchange Decreased airflow Wheezes
Upon assessment, the nurse suspects that a client with COPD may have bronchospasm. What manifestations validate the nurse's concern? Select all that apply.
Comatose clients Examples include those with respiratory difficulty, comatose clients, those undergoing general anesthesia, and clients with extensive edema of upper airway passages
What client would be most in need of an endotracheal tube?
Decreased height
What clinical manifestation would the nurse expect to find in a client who has had osteoporosis for several years?
Broccoli Calcium is important for the prevention of osteoporosis. Broccoli is high in calcium.
What food can the nurse suggest to the client at risk for osteoporosis?
Physical therapy and exercise Clients with osteoarthritis need to maintain joint mobility. To preserve joint function, individuals need to learn appropriate activities.
What intervention is a priority for a client diagnosed with osteoarthritis?
Draining secretions, air, and blood from the thoracic cavity is necessary After thoracic surgery, draining secretions, air, and blood from the thoracic cavity is necessary to allow the lungs to expand
What is the reason for chest tubes after thoracic surgery?
Hypercapnia, hypoventilation, and hypoxemia
When caring for a client with acute respiratory failure, the nurse should expect to focus on resolving which set of problems?
Swimming The nurse provides the client and family with the following postoperative instructions: water should not enter the stoma because it will flow from the trachea to the lungs. Therefore, the nurse instructs the client to avoid swimming and to use a handheld shower device when bathing.
When the nurse gives a client and family instructions after laryngeal surgery, which does the nurse indicate should be avoided?
Administer bronchodilator as ordered
Which action should the nurse take first in caring for a client during an acute asthma attack?
prostate
Which cancer ranks second as the cause of death in American men?
A 27-year-old Black female SLE strikes nearly 10 times as many women as men and is most common in women between ages 15 and 40. SLE affects more Black women than white women; its incidence is about 1 in every 250 Black women, compared to 1 in every 700 white women.
Which client is most likely to develop systemic lupus erythematosus (SLE)?
Scleroderma Scleroderma occurs initially in the skin but also occurs in blood vessels, major organs, and body systems, potentially resulting in death
Which connective tissue disorder is characterized by insoluble collagen being formed and accumulating excessively in the tissues?
Scleroderma Scleroderma occurs initially in the skin but also occurs in blood vessels, major organs, and body systems, potentially resulting in death.
Which connective tissue disorder is characterized by insoluble collagen being formed and accumulating excessively in the tissues?
European American women Small-framed, nonobese European American women are at greatest risk for osteoporosis. Asian American women of slight build are at risk for low peak bone mineral density
Which group is at the greatest risk for osteoporosis?
Use enteral feedings after the procedure Enteral feedings are used 10 to 14 days after a laryngectomy to avoid irritation to the sutures and reduce the risk of aspiration. When oral intake resumes, the nurse offers small amounts of thick liquids.
Which intervention regarding nutrition is implemented for clients who have undergone laryngectomy?
Ensure mouth breathing For a client who has undergone surgery for a nasal obstruction, it is important for the nurse to emphasize that nasal packing will be in place postoperatively, necessitating breathing through the mouth.
Which is a priority nursing intervention that the nurse should perform for a client who has undergone surgery for a nasal obstruction?
It is most contagious during the second week of illness
Which is a true statement regarding severe acute respiratory syndrome (SARS)?
Plasma testosterone levels decrease Changes in gonadal function include a decline in plasma testosterone levels and reduced production of progesterone. The testes become smaller and more firm.
Which is an age-related change affecting the male reproductive system?
Amoxicillin Antibiotics should be administered as soon as the diagnosis of ABRS is established. Amoxicillin-clavulanic acid is the antibiotic of choice
Which is the antibiotic of choice used to treat acute bacterial rhinosinusitis (ABRS)?
Osteoarthritis (OA)
Which is the leading cause of disability and pain in the elderly?
Transurethral resection of the prostate
Which is the most common type of prostate surgery?
Allergy
Which is the strongest predisposing factor for asthma?
Metatarsophalangeal The metatarsophalangeal joint of the big toe is the most commonly affected joint (90% of clients); this is referred to as podagra.
Which joint is most commonly affected in gout?
Calcitonin (Miacalcin)
Which medication directly inhibits osteoclasts, thereby reducing bone loss and increasing BMD?
A severe asthma episode that is refractory to initial therapy Status asthmaticus is a severe asthma episode that is refractory to initial therapy. It is a medical emergency. Patients report rapid progressive chest tightness, wheezing, dry cough, and shortness of breath. It may occur with little or no warning
Which of the following is accurate regarding status asthmaticus?
Hemorrhagic shock The immediate dangers after prostate surgery are bleeding and hemorrhagic shock.
Which of the following is an immediate danger after a prostate surgery?
Osteogenic sarcoma (osteosarcoma)
Which of the following is the most common and most fatal primary malignant bone tumor?
Collaborate with the client about his or her goal for a level of pain relief.
Which of the following nursing interventions contributes to achieving a client's pain relief?
How to perform a testicular self-examination The nurses should teach all men, especially those who have had cryptorchidism, to perform testicular self-examination to detect any abnormal mass in the scrotum
Which of the following should nurses teach all men, especially those who have had cryptorchidism?
Using a reliable method of contraception for several weeks It may take several weeks or more after surgery before the ejaculatory fluid is free of sperm, and the client is informed to use a reliable method of contraception until sperm no longer are present. The client should apply ice packs to the scrotum to reduce swelling and use a mild analgesic such as aspirin or acetaminophen for pain relief. The client typically can resume sexual activity when comfortable, usually in 1 week
Which of the following would be most important to include in a teaching plan for a client who has had a vasectomy?
Take prescribed antibiotics Home care for a client with epididymitis and orchitis includes instructions to continue administering prescribed antibiotics, take Sitz baths, apply local heat after scrotal swelling subsides, avoid lifting, and refrain from sexual intercourse until symptoms are relieved.
Which should be included as part of the home care instructions for a client with epididymitis and orchitis?
Management of plantar fasciitis includes stretching exercises Management also includes wearing shoes with support and cushioning to relieve pain, orthotic devices (e.g., heel cups, arch supports), and the use of nonsteroidal anti-inflammatory drugs. Plantar fasciitis, an inflammation of the foot-supporting fascia, presents as acute-onset heel pain experienced upon taking the first steps in the morning. The pain is localized to the anterior medial aspect of the heel and diminishes with gentle stretching of the foot and Achilles tendon. Unresolved plantar fasciitis may progress to fascial tears at the heel and eventual development of heel spurs.
Which should be included in the teaching plan for a client diagnosed with plantar fasciitis?
A disease of the airways characterized by destruction of the walls of overdistended alveoli Emphysema is a category of COPD.
Which statement describes emphysema?
"Because I had a previous reaction to the test, this time I need to get a chest X-ray." A client who previously had a positive PPD test (a reaction to the antigen) can't receive a repeat PPD test and must have a chest X-ray done instead.
Which statement indicates a client understands teaching about the purified protein derivative (PPD) test for tuberculosis?
Its side effects include headache, flushing, and dizziness. Side effects of sildenafil include headache, flushing, and dizziness. Is should be taken 30 minutes to 4 hours before intercourse. The client will have no erection if stimulation does not occur.
Which statement is accurate regarding sildenafil?
Only one tablet of the prescribed dose should be taken each day. Taking sildenafil more than once a day will not improve its effects and the client may experience back and leg aches, as well as nausea and vomiting
Which statement should be included in the teaching plan for a client prescribed sildenafil?
Social Isolation related to change in body image, tracheal stoma, and change in or loss of speech
You are a clinic nurse caring for a client who is 2 months post laryngectomy. What is a nursing diagnosis pertaining to this client?
Airway patency The nurse monitors for potential complications and checks airway patency frequently. Secretions can rapidly clog the inner lumen of the tracheostomy tube, resulting in severe respiratory difficulty or death by asphyxiation
You are a nurse caring for a client who has just had a tracheostomy. What should you monitor frequently?
See if there are leaks in the system Bubbling in the water-seal chamber occurs in the early postoperative period. If bubbling is excessive, the nurse checks the system for any kind of leaks.
You are caring for a client status post lung resection. When assessing your client you find that the bubbling in the water-seal chamber for the chest tubes is more than you expected. What should you check when bubbling in the water-seal chamber is excessive?
To assess damage to the optic nerve A client who has undergone a sinus surgery faces a serious risk of damage to the optic nerve. Therefore, the nurse assesses postoperative visual acuity by asking the client to identify the number of fingers displayed
You are caring for a client who is post sinus surgery. When you assess this client you ask them how many fingers you are holding up. Why do you assess postoperative visual acuity?
Progressive loss of lung function associated with chronic disease In chronic respiratory failure, the loss of lung function is progressive, usually irreversible, and associated with chronic lung disease or other disease.
You are caring for a client with chronic respiratory failure. What are the signs and symptoms of chronic respiratory failure?
They prolong bleeding. The nurse must find out the bleeding tendencies of clients scheduled for tonsillectomy and adenoidectomy. Therefore, the nurse asks the clients about any recent use of herbal supplements. The nurse must ask about the use of these supplements because they may prolong bleeding.
You are performing a preoperative assessment on a client who is scheduled for a tonsillectomy. Why would you ask the client about the use of herbal supplements?
Provide alternative methods of communication Provide alternative methods of communication: paper and pen, wipe board, or word or picture board. Having supplies available provides comfort to client.
Your client is status post total laryngectomy and cannot talk. What intervention should you make to help this client communicate?
