Spooky Comprehensive Medsurg

Long-term oxygen therapy has been prescribed for a patient whose chronic obstructive pulmonary disease (COPD) has recently increased severity. Which teaching this patient about this treatment modality, what information should the nurse provide?

"It's important to use your oxygen as ordered and not to base it solely on your shortness of breath at the time."

A client has been diagnosed with Raynaud's disease. Which self-care strategies minimize risks associated with this disease? Select all that apply.

-Avoid over-the-counter decongestants and cold remidies -Do not smoke, or stop smoking -Wear gloves to protect hands from injury when performing tasks

A health care provider order's a unit of packed red blood cells (PRBC) for a postoperative patient. The nurse is responsible for patient assessment and health care information pre- and post- transfusion. Which of the following are the guidelines that the nurse should follow? Select all that apply.

-Determine the history of any previous transfusions and possible reactions -Report any increase of 1 degree in temperature, during or after transfusion, which falls into a febrile range -Review the signs and symptoms of transfusion reaction

Nursing students are reviewing information about Parkinson''s disease in preparation for class the next day. The students demonstrate understanding of the material when they identify which of the following as a cardinal sign of this disorder? Select all that apply.

-Rigidy -Postural instability -Bradykinesia -Tremor

An older adult is postoperative day one, following a coronary artery bypass graft (CABG). The client's family members express concern to the nurse that the client is uncharacteristically confused. After reporting this change in status to the health care provider, what additional action should the nurse take?

Assess for factors that may be causing the client's delirium

A client who has undergone a femoral to popliteal bypass great surgery returns to the surgical unit. Which assessment should the nurse perform during the first postoperative day?

Assess pulse of affected extremity every 15 minutes at first

The nurse is caring for a client with Raynaud's disease. What are important instructions for client who is diagnosed with this disease to prevent an attack?

Avoid situations that contribute to ischemic episodes.

The nurse is caring for a client who is receiving a loop diuretic for the treatment of heart failure. What assessment should the nurse prioritize?

Blood pressure

A nurse is documenting the result of assessment of a client with bronchiectasis. What would the nurse most likely include in documentation?

Clubbing of the fingers

What finding by the nurse may indicate that the client has chronic hypoxia?

Clubbing of the fingers

A client sustains a fracture right humerus in an automobile accident. The arm is edematous, the client states that he cannot feel or move his fingers, and the nurse does not feel a pulse. The condition should the nurse be concerned about that requires emergency measures?

Compartment syndrome

What interventions can the nurse encourage the client with diabetes insipidus to do in order to control thirst and compensate for urine loss?

Consume adequate amounts of fluid

A client admitted with acute diverticulitis has experienced a sudden increase in temperature and reports a sudden onset of exquisite abdominal in uncharacteristically rigid on palpitation. What is the nurse's best response?

Contact the primary care provider promptly and report these signs of perforation.

A client is being evaluated for hypothyroidism. During assessment, the nurse should stay alert for:

Decreased body temperature and cold intolerance

A home health nurse sees a client with end-stage chronic obstructive pulmonary disease. An outcome identified for this client is preventing infection. Which finding indicates that this outcome has been met?

Decreased oxygen requirements

A client with an abdominal surgical wound sneezes and then states, "Something doesn't feel right with my wound." The nurse assess the upper half of the wound edges, noticing that they are no longer approximated and the lower half remains will approximated. The nurse would document that following a sneeze, the wound

Dehisced

A patient admitted with a stroke is coming to the unit from the emergency department. The nurse assigned to care for the patient knows that what assessment finding is indicative of a stroke?

Difficulty speaking

A nurse is caring for a client with left-sided heart failure. What should the nurse anticipate using to reduce fluid volume excess?

Diuretics

A diabetes nurse educator is teaching a group of client with type 1 diabetes about "sick day rules." What guidelines applies to period of illness in a diabetic client?

Do not eliminate insulin when nauseated and vomiting

The clinic nurse caring for a patient with Parkinson's disease notes that the patient has been taking levodopa and carbidopa (Sinamet) for 7 years. What common side effect of Sinamet would the nurse assess this patient for?

Dyskinesia

The preoperative nurse is writing a care plan for a client who has returned from surgery 2 hours ago. Which measurement should the nurse implement to most decrease the client's risk developing pulmonary emboli (PE)?

Early ambulation

Which diagnostic method is recommended to determine whether left ventricular hypertrophy has occurred?

Echocardiography

How should the nurse best position a client who has leg ulcers that are venous in origin?

Elevate the client's lower extremities

The surgeon's preoperative assessment of a client has identified that the client is at a high risk for venous thromboembolism. Once the client is admitted to the post surgical unit, what intervention should the nurse prioritize to reduce the client's risk of this complication?

Encourage early ambulation

A client hospitalized with pneumonia has thick, tenacious secretions. Which intervention should the nurse include when planning this client's care?

Encouraging increased fluid intake

An elderly female resident of a long term care facility has a diagnosis of Alzheimer's disease (AD). The resident is visibly anxious and is insisting to the nurse that she needs to "take care of my babies." How should the nurse respond to the resident's statement?

Engage the resident in a conversation about a different topic

A 60-year-old man with several health problems and a history of increasing joint stiffness over the past several months is being assessed for presence of rheumatic diseases. Which of the following laboratory findings is most clearly suggestive of an inflammatory process?

Erythrocyte sedimentation rate (ESR) of 22 mm/hr (Normal 0 to 20 mm/hr)

A nurse should perform which intervention for a client with Cushing's syndrome?

Explain that the client's physical changes are a result of excessive corticosteroid

A client with chronic open-angle glaucoma is being taught to self-administer pilocarpine. After the client administers the pilocarpine, the client states that her vision is blurred. Which nursing action is most appropriate?

Explaining that this is an expected adverse effect

A client experiencing dysphagia following a stroke. Which measurement may be taken by the nurse to ensure that the client's diet allows for easy swallowing?

Help the client sit upright when eating and feed slowly

The nurse is assessing a client with an ulcer for signs and symptoms of hemorrhage. The nurse interprets which condition as a sign/symptom of possible hemorrhage?

Hematemesis

Which condition should a nurse expect to find a client diagnosed with hyperparathyroidism?

Hypercalcemia

The nurse is assessing a client in the clinic who appears restless, excitable, and agitated. The nurse observes that the client has exophthalmos and neck swelling. What diagnosis do these clinical manifestations correlate with?

Hyperthyroidism

A nurse teaches a client with newly diagnosed hypothyroidism about the need or thyroid hormone replacement therapy to restore normal thyroid function. Which thyroid preparation is the agent of choice for thyroid hormone replacement therapy?

Levothyroxine (Synthroid)

After suffering a fall, an 81-year-old woman with Alzheimer's disease (AD) is being treated in the hospital. Which of the following measures should be implemented in an effort to support the patient's cognitive function?

Maintain consistent, predictable routines whenever possible

A nursing instructor is evaluating a student caring for a neutropenic client. The instructor concludes that the nursing student demonstrates accurate knowledge if neutropenia based on which intervention?

Monitoring the client's temperature and reviewing the client's complete blood count (CBC) with differential

The nurse is caring for a client who is receiving oxygen therapy for pneumonia The nurse should best assess whether the client is hyperemic by monitoring the client's:

Oxygen saturation levels

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?

Oxygen through nasal cannula at 2 L/minute

A nurse is assessing a client after a thyroidectomy. The assessment reveals muscle twitching and tingling, along with numbness in the fingers, toes, and mouth area. The nurse should suspect which complication?

Tetany

A physician calls the nurse for an update on his client who underwent abdominal surgery 5 hours ago. The physician asks the nurse for the total amount of drainage collected in the Hemovac since surgery. The nurse reports that according to documentation, no drainage has been recorded. When the nurse finishes on the telephone, she goes to assess the client. Which assessment finding explains the absence of drainage?

The Hemovac drain isn't compressed; instead its fully expanded

A nurse is caring for a client experiencing an acute asthma attack. The client stops wheezing and breath sounds aren't audible. This change occurred because:

The airways are so swollen that no air can get through

A client is prescribed pilocarpine. When preparing the client's teaching plan about this drug, which of the following would the nurse integrate?

The client may experience difficulty seeing in the dark

A patient visits a clinic for an eye examination. He describes his visual changes and mentions a specific diagnostic clinical sign of glaucoma. What is that clinical sign?

The presence of halos arounds lights

A patient with a diagnosis of peptic ulcer disease has just been prescribed omeprazole (Prilosec). How should the nurse best describe this medication's therapeutic action?

This medication will reduce the amount of acid secreted in your stomach

Early this morning a client had a subtotal thyroidectomy. During evening rounds, the nurse assesses the client (who has nausea) and records a temperature of 105 F (40.5 C), tachycardia, and extreme restlessness. What is the most likely cause of these signs?

Thyroid crisis

A patient with severe chronic liver dysfunction comes to the clinic with bleeding of the gums and blood in the stool. What vitamin deficiency does the nurse suspect the patient may be experiencing?

Vitamin K deficiency

The nurse is preparing to administer digoxin to a client with heart failure. The nurse obtains an apical pulse rate for 1 minute and determines a rate of 52 beats/minute. What is the first actin by the nurse?

Withhold the medication and notify the physician of the heart rate