Practicum - Medical Surgical

Which labs indicate functioning status of the kidneys

2. urine albumin 3. GFR 4. creatinine clearance 5. BMP

The nurse is caring for a client during the post surgical period after having a right femoral-popliteal bypass graft. The nurse enters the room to conduct a nursing assessment and care. .Order the actions according to priority.

Assess peripheral pulses, assess incision site, assess lung fields, assess pain/obtain medication, instruct on client positioning, and offer clear fluids

A nurse is caring for a monitored client on the telemetry unit. When analyzing a cardiac monitor strip, the nurse notes an abnormality in the QRS wave on lead II. Identify the area in the conduction cycle of the heart where the abnormality occurs.

The QRS complex reflects rapid depolarization of the right and left ventricles. (left ventricle)

a nurse is caring for a client with chronic renal failure. The lab results indicate hypocalcemia and hyperphosphatemia. When assessing the client, the nurse would be alert for which occurrence?

Trousseau's sign cardiac arrhythmias Fractures

The nurse is preparing to interpret an ECG rhythm strip. Place the following steps for analysis from first to last.

determine the rate and rhythm, analyze the P waves, measure the PR interval, measure the QRS duration, interpret the rhythm

Degenerative changes of MS

immune system attacks myelin, demyelination throughout CNS, degeneration of axons, plaque formation that interrupts nerve impulses, periodic and unpredictable exacerbations and remissions

Which findings would the nurse expect to see in small amounts in normal urine?

protein WBC

A nurse is interpreting a client's ECG strip. If the PR interval measures four small blocks, how many seconds is the PR interval?

0.16 seconds

What solution is compatible with blood administration?

0.9 NaCl

Preprocedural teaching plan for client undergoing CT

1. the test may require removal of watches, bracelets, or earrings 2. a contrast dye may be given before the test 3. throat irritation and facial flushing may occur if dye is used 6. it is necessary to report any allergies to iodine or seafood prior to procedure

Adverse effects of external radiation

1. xerostomia (dry mouth) 2. stomatitis 5 .mucositis

Indications that thyroid replacement therapy has been inadequate?

1. ECG changes 3. low body temperature 5. bradycardia

The nurse is evaluating the cardiac function of a client with a history of left ventricular hypertrophy and new dilitazem administration. Which client statements indicate therapeutic use of dilitazem leading to adequate cardiac functioning? 1. I am sleeping well in the second floor bedroom 2. I am tolerating my new low-fat diet 3. My blood pressure has been consistently in the 130/70 range 4. I am completing all of my activities of daily living independently 5. In the morning, I notice 2 plus edema in my ankles 6. My lab results reveal a serum potassium of 3.5

1. I am sleeping well in the second floor bedroom 3. My blood pressure has been consistently in the 130/70 range 4. I am completing all of my activities of daily living independently

Hepatitis A discharge teaching, which statements indicate a need for further teaching

1. I can have an occasional glass of wine with my meal as I recover 2. my family and I do not need to take any special precautions as long as I take my medication 5. my spouse and I can have intercourse and kiss 6. I should wear a mask when visitors come

A nurse is caring for a client with Raynaud's phenomenon secondary to systemic lupus erythematosus (SLE). Which of the client statements demonstrates an understanding of the nurse's teaching about this disorder? 1. My hands get pale and bluish and feel number and painful when I'm really stressed. 2. I can't continue to wash dishes and do my cleaning because of this problem. 3. I don't need to report any other skin problems with my fingers or hands to my health care provider. 4. I probably got this disorder because I am also diagnosed with lupus. 5. This problem is caused by a temporary lack of circulation in my hands. 6. I will have to discuss medication that might treat this problem with my healthcare provider.

1. My hands get pale and bluish and feel number and painful when I'm really stressed. 4. I probably got this disorder because I am also diagnosed with lupus. 5. This problem is caused by a temporary lack of circulation in my hands. 6. I will have to discuss medication that might treat this problem with my healthcare provider.

A nurse is caring for a client with a history of heart failure and presenting with symptoms that indicate a pulmonary embolism. The nurse documents admission findings of sudden shortness of breath, chest pain, and immobility. Which nursing diagnoses are admission priorities? 1. activity intolerance related to inadequate oxygenation 2. anxiety related to breathlessness 3. disturbed sleep pattern related to restlessness in the night 4. ineffective breathing pattern related to hypoxia 5. risk for decreased cardiac output related to failure of left ventricle 6. impaired nutrition: less than body requirements related to anorexia

1. activity intolerance related to inadequate oxygenation 2. anxiety related to breathlessness 4. ineffective breathing pattern related to hypoxia 5. risk for decreased cardiac output related to failure of left ventricle

A client with a suspected pulmonary embolus is brought to the emergency department stating shortness of breath and chest pain. Which additional signs and symptoms are anticipated? 1. anxiety 2. irregular heartbeat 3. bradycardia 4. frothy sputum 5. tachycardia 6. blood-tinged sputum

1. anxiety 2. irregular heartbeat 5. tachycardia 6. blood-tinged sputum

A client receiving chemotherapy develops myelosuppression, which instructions should the nurse include in the discharge teaching?

1. avoid people who have recently received live vaccines 2. avoid activities that may cause bleeding 3. wash hands frequently 5. avoid crowded places

24-hour urine collection

1. collect the urine in preservative-free container and keep on ice 5. encourage daily amounts of fluids 6. discard the initial voiding but save all others for 24 hours

Which findings indicate that the treatment being received for SIADH is effective?

1. decrease in body weight 4. increase in urine output 5. decrease in urine osmolarity

A nurse is caring for a client with a traumatic injury and developing tension pneumothorax. Which assessment data would be of concern? 1. decreased cardiac output 2. flattened neck veins 3. tracheal deviation to the affected side 4. hypotension 5. tracheal deviation to the unaffected side 6. bradypnea

1. decreased cardiac output 4. hypotension 5. tracheal deviation to the unaffected side

Which lab values support a diagnose of pancytopenia?

1. decreased white blood cells 3. decreased plaatelets 5. decreased RBCs

Dietary modifications for exacerbations of gout

1. eat a low purine diet 5. limit alcohol intake

A nurse is caring for a client with a T5 complete spinal cord injury. Upon assessment, the nurse notes flushed skin, diaphoresis above T5, bp 174/100, the client reports a severe, pounding headache, what interventions would be appropriate at this time?

1. elevate HOB to 90 degrees 2. loosen constrictive clothing 4. assess for bladder distention and bowel impactive 5. administer antihypertensive medication as ordered

Preprocedural bone marrow aspiration teaching

1. explain the procedure to the client 3. encourage the client to ask questioning before signing the informed consent 4. explain that the client will receive an analgesic prior to the procedure 5. administer an anxiety relieving medication prior to the procedure

Expected assessment of client with diabetes insipidus

1. extreme polyuria 2. excessive thirst 4. low urine specific gravity

A nurse is caring for a client with retroperitoneal abcess who is receiving gentamicin 300 mg intravenously every 8 hours. Which client data will the nurse monitor?

1. hearing 2. urine output 4. BUN and serum creatinine levels

A nurse is providing discharge instructions on phenytoin to a female client with tonic-clonic seizure disorder. Which instructions would the nurse include?

1. monitor the body for any skin rash 3. perform good oral hygiene, including daily brushing and flossing. 4. Receive necessary periodic blood work 5. report any problems with walking or coordination, slurred speech or nausea

While managing a client's immediate post-cardiac catheterization period, which interventions are priorities? 1. monitor vital signs every 15 minutes for the first hour 2. assess all peripheral pulses frequently 3. restrict the client to bed rest for 2 to 6 hours 4. assess the catheter insertion site every 30 minutes for 4 hours 5. note any limb discoloration and reported numbness 6. assess for any signs of hematoma formation

1. monitor vital signs every 15 minutes for the first hour 3. restrict the client to bed rest for 2 to 6 hours 4. assess the catheter insertion site every 30 minutes for 4 hours 5. note any limb discoloration and reported numbness 6. assess for any signs of hematoma formation

A nurse is counseling a client about risk factors for hypertension. While reviewing the client's history, which information is consistent with the diagnosis of primary hypertension? 1. obesity 2. glomerulonephritis 3. head injury 4. stress 5. hormonal contraceptive use 6. high intake of sodium or saturated fat

1. obesity 4. stress 6. high intake of sodium or saturated fat

A nurse is assessing a client's extra ocular eye movements as part of evaluating neurologic function. This documents the status of which cranial nerves?

1. optic 2. oculomotor 5. abducens

A nurse is evaluating a client with primary pulmonary hypertension for a heart-lung transplant. Which medication treatment would the nurse anticipate be included in the plan of care? 1. oxygen therapy 2. amnioglycosides 3. diuretics 4. vasodilators 5. antihistamines 6. sulfonamides

1. oxygen therapy 3. diuretics 4. vasodilators

Signs and symptoms of graves disease

1. rapid, bounding pulse 3. heat intolerance 4. mild tremors 5. nervousness

Cushing's disease lab values

1. serum sodium 3. serum potassium 4. blood glucose level 5. white blood cell count

Discharge teaching for client with systemic lupus erythematosus

1. stay out of direct sunlight 3. monitor body temperature 4. taper the corticosteroid dosage as prescribed when symptoms are under control

Signs of septic shock

1. temperature increase 2. blood pressure decrease 3. 32 mL of urine in 2 hours 5. tachypnea

The nurse is caring for a senior citizen who lives alone. When evaluating the effectiveness of adding fluticasone propionate salmeterol to the COPD regimen, which client statements would support symptom improvement? 1. I have noted an increase in sputum production 2. I have begun walking upstairs to use the bathroom 3. I can rely on the medication when I have an exacerbation of symptoms 4. I seem to feel nervous and shaky making me more productive 5. I can now push my granddaughter on the swings when she visits 6. The nurse aide no longer comes to the house to help me bathe

2. I have begun walking upstairs to use the bathroom 5. I can now push my granddaughter on the swings when she visits 6. The nurse aide no longer comes to the house to help me bathe

A nurse is caring for a client with a new prescription of digoxin. Which client statement would require further teaching about digoxin? 1. I will take the digoxin at 9 am daily 2. I will take the digoxin with my antacids at night 3. I will take my pulse before each dose of digoxin 4. If I forget a dose, I will catch up by doubling the next dose 5. I will notify my health care provider if I experience any increased fatigue or muscle weakness 6. I understand that I will need annual blood work to check therapeutic levels

2. I will take the digoxin with my antacids at night 4. If I forget a dose, I will catch up by doubling the next dose 6. I understand that I will need annual blood work to check therapeutic levels

A nurse is calling report to the medical-surgical floor staff regarding a client with acute diverticulitis. Which symptoms does the nurse anticipate?

2. cramping in the left lower abdominal 3. bowel irregularity 5. intervals of diarrhea

A client is prescribed lisinopril for the treatment of hypertension. The client asks a nurse about possible adverse effects. Which common adverse effects of angiotensin-converting enzyme (ACE) inhibitors would the nurse include in the teaching? 1. constipation 2. dry cough 3. headache 4. hyperglycemia 5. hypotension 6. impotence

2. dry cough 3. headache 5. hypotension

A client with COPD is being evaluated for a lung transplant, which initial assessment data would the nurse anticipate? 1. decreased respiratory rate 2. dyspnea on exertion 3. barrel chest 4. shortened expiratory phase 5. unintended weight loss 6. fever

2. dyspnea on exertion 3. barrel chest 5. unintended weight loss (due to work of breathing)

Side effects of antineoplastic drug, doxorubicin hydrochloride

2. hepatic impairment 3. left ventricular failure 4. complete hair loss within 3-4 weeks 5. red discoloration of urine

The nurse is caring for several clients on the respiratory unit who are receiving the beta-adrenergic bronchodilator albuterol in prescribed nebulizer treatments. Which side effects would the nurse expect to assess following administration?

2. irritability and nervousness 3. tachycardia 5. insomnia 6. anxiety

A nurse assesses a client with suspected bacterial meningitis. Which findings of meningeal irritation suggest this diagnosis?

2. nuchal rigidity 3. positive Brudzinski's sign 4. positive Kernig's sign 6. photophobia

Signs of suspected right hip fracture

2. right leg is shorter than the left leg 4. the right leg is adducted 5. the right leg is externally rotated

A nurse is comparing the neurologist status of a client who suffered a head injury with the status on the previous shift. Using the Glasgow Coma Scale, the nurse determines that the client's score has changed from 11 to 15, which responses did the nurse assess?

2. spontaneous eye opening 4. orientation to person, place and time

A nurse is evaluating the 12-lead ECG of a client experiencing an inferior wall myocardial infarction (MI). While conferring with the health care team, which ECG changes associated with an evolving MI does the nurse correctly identify? 1. notched T wave 2. presence of a U wave 3. T-wave inversion 4. prolonged PR interval 5. ST-segment elevation

3. T-wave inversion 5. ST-segment elevation

A fireman is admitted with superficial skin wounds and a sprained back following an intense fire. No respiratory concerns are verbalized. Nearly 24 hours after admission, the fireman reports dyspnea, a harsh cough and hoarseness. Which interventions would the nurse add to the plan of care? 1. monitor for fever 2. prepare for chest tube insertion 3. auscultate the lungs for adventitious breath sounds 4. assess for increased pulse rate 5. monitor for increased anxiety levels

3. auscultate the lungs for adventitious breath sounds 4. assess for increased pulse rate 5. monitor for increased anxiety levels

parathyroid hormone deficiency lab values

3. calcium 6. phosphorus

A client is admitted to the emergency department after reporting acute chest pain radiating down the left arm. The client appears anxious, dyspneic, and diaphoretic. Which laboratory studies would the nurse anticipate? 1. hemoglobin and hematocrit 2. serum glucose 3. creatine kinase (CK) 4. troponin T and troponin I 5. myoglobin 6. blood urea nitrogen

3. creatine kinase 4. troponin T and troponin I 5. myoglobin

A nurse is awaiting the arrival of a client from the emergency department with a diagnosis of anterior wall myocardial infarction. In caring for this client, the nurse would be alert for which signs and symptoms of left-sided heart failure. 1. JVD 2. hepatomegaly 3. dyspnea 4. crackles 5. tachycardia 6. skin tenting

3. dyspnea 4. crackles 5. tachycardia

A client is hospitalized following a report of dizziness, SOB, and chest pain. Based on the rhythm the client is scheduled for a transesophageal echocardiogram (TEE) today. Which intervention would be appropriate at this time? 1. initiate a heparin drip 2. encourage deep breathing exercises 3. prepare the client for cardioversion 4. administer oxygen via nasal cannula as prescribed

4. administer oxygen via nasal cannula as prescribed

A nurse places electrodes on a collapsed individual who was visiting a hospitalized family member; the monitor exhibits the following. Which intervention would the nurse do first? 1. place the client on oxygen 2. confirm the rhythm with a 12-lead 3. administer amiodarone IV as prescribed 4. assess the client's airway, breathing, and circulation

4. assess the client's airway, breathing, and circulation - assess whether V-tach is stable, unstable or pulseless

A client is admitted with Crohn's, when planning care what would be included?

4. corticosteroid therapy 5. antidiarrheal medications

A nurse is presenting health information at a community organization when one of the attendees passes out. The nurse assesses the attendee as being unresponsive. Place the following actions in chronological order

appoint a person to call 911, perform chest compression, perform a head tilt-chin lift maneuver, check for normal breathing, deliver two rescue breaths, check for a pulse

Lab results consistent with cirrhosis of liver

prothrombin time 22 seconds (normal 10-13) ammonia 96 platelets 75,000

A client comes to the emergency department with status asthmaticus. His respiratory rate is 48 breaths/minute, and he is wheezing. An arterial blood gas analysis reveals a pH of 7.52, a partial pressure of arterial carbon dioxide (PaCO2) of 30 mm Hg, PaO2 of 70 mm Hg, and bicarbonate (HCO3??') of 26 mEq/L. What disorder is indicated by these findings?

respiratory alkalosis

A nurse is preparing a staff education program on innovative devices in pulmonary circulation. Beginning with basic concepts, place the structures in order to trace the pathway of normal pulmonary circulation.

right ventricle, pulmonary artery, arterioles, alveoli, pulmonary vein, left atrium