Test 2 Med surge

A patient calls the clinic and tells the nurse she has thick white, curd-like discharge from her vagina. How should the nurse best interpret this preliminary data?

The patient may have a Candida species infection.

A nurse is assessing a client who presents with a scaly rash over the palms and soles of the feet and the feeling of muscle aches and malaise. Which action by the nurse is most appropriate?

Don gloves and further assess the client's lesions.

A nurse cares for a client placed in skeletal traction. The client asks, "What is the primary purpose of this type of traction?" How would the nurse respond?

"Skeletal traction will assist in realigning your fractured bone."

A patient has had a cast placed for the treatment of a humeral fracture. The nurses most recent assessment shows signs and symptoms of compartment syndrome. What is the nurses most appropriate action?

Contact the primary care provider immediately.

A college student seeks information from the school's nurse about how to avoid sexually transmitted infections (STIs) without abstinence as a choice. Which statement by the nurse is best?

"A vaccine can prevent genital warts caused by some strains of the human papilloma virus (HPV)."

A nurse teaches assistive personnel (AP) about providing hygiene for a client in traction. Which statement would the nurse include as part of the teaching about this client's care?

"Ensure that the weights remain freely hanging at all times."

A client is prescribed celecoxib for joint pain. What statement by the client indicates a need for further teaching?

"I'll be sure to take this drug three times a day only on an empty stomach."

A client with multiple sexual partners has been assessed for symptoms of dysuria and green, malodorous vaginal discharge. The nurse administers and injection of ceftriaxone and gives the client a prescription for doxycycline. The client asks why two drugs are needed. What answer by the nurse is best?

"It is very common to be infected with both gonorrhea and chlamydia."

The nurse is teaching assistive personnel about postoperative care for an older adult who had a posterolateral total hip arthroplasty. What teaching will the nurse include? (Select all that apply.)

"Move the client slowly to prevent dizziness and a possible fall." "Encourage the client to deep breathe and cough at least every 2 hours." "Help the client use the incentive spirometer at least every 2 hours." "Keep the abduction pillow in place at all times while the client is in bed." "Let me know if the client has an elevated temperature or pulse." "Keep in mind that the client may be a little confused after surgery."

The nurse teaches assistive personnel (AP) about care of an older adult diagnosed with osteoporosis. What teaching would the nurse include?

"Osteoporosis places the client is at risk for fractures."

A premenopausal patient is complaining of vaginal spotting and sharp, colicky lower abdominal pain. She informs the nurse that her period is 2 weeks late. The nurse should recognize a need for this patient to be investigated for what health problem?

Ectopic pregnancy

A client is interested in learning about the risk factors for prostate cancer. Which factors does the nurse include in the teaching? (Select all that apply.)

1st degree relative with prostate cancer Advanced age Eating too much red meat Race

A woman aged 48 years comes to the clinic because she has discovered a lump in her breast. After diagnostic testing, the woman receives a diagnosis of breast cancer. The woman asks the nurse when her teenage daughters should begin mammography. What is the nurses best advice?

38

A 42 year-old patient tells the nurse that she has found a painless lump in her right breast during her monthly self-examination. She says that she is afraid that she has cancer. Which assessment finding would most strongly suggest that this patients lump is cancerous?

A nonmobile mass with irregular edges

A man tells the nurse that his father died of prostate cancer and he is concerned about his own risk of developing the disease, having heard that prostate cancer has a genetic link. What aspect of the pathophysiology of prostate cancer would underlie the nurses response?

A number of studies have identified an association of BRCA-2 mutation with an increased risk of prostate cancer.

A patient states that PMS that is significantly disrupting her quality of life and that conservative management has failed to produce relief. What pharmacologic treatment may benefit this patient?

A selective serotonin reuptake inhibitor (SSRI)

The surgical nurse is admitting a patient from postanesthetic recovery following the patients below-the-knee amputation. The nurse recognizes the patients high risk for postoperative hemorrhage and should keep which of the following at the bedside?

A tourniquet

A client with rheumatoid arthritis (RA) has an acutely swollen, red, and painful joint. What nonpharmacologic intervention does the nurse recommend?

Ice Packs

A woman presents at the ED with sharp, colicky pain in her right abdomen that radiates to her right shoulder. She tells the nurse that she has been spotting lightly for the past few days. The patient is subsequently diagnosed with an ectopic pregnancy. What major nursing diagnosis most likely relates to this patients needs?

Anxiety related to potential treatment options and health outcomes

A nurse is teaching a client newly diagnosed with osteoarthritis (OA) about drugs used to treat the disease. For which drug does the nurse plan health teaching?

Acetaminophen

A patient with genital herpes is having an acute exacerbation. What medication would the nurse expect to be ordered to suppress the symptoms and shorten the course of the infection?

Acyclovir (Zovirax)

A client with chronic osteomyelitis is being discharged from the hospital. What information is important for the nurse to teach this client and family? (Select all that apply.)

Adherence to the antibiotic regimen Eating high protein and high carbohydrate foods proper use of the intravenous equipment

A patient has returned to the floor after undergoing a transurethral resection of the prostate (TURP). The patient has a continuous bladder irrigation system in place. The patient tells you he is experiencing bladder spasms and asks what you can do to relieve his discomfort. What is the most appropriate nursing action to relieve the discomfort of the patient?

Administer a smooth-muscle relaxant as ordered.

A nurse assesses an older adult who was admitted 2 days ago with a fractured hip. The nurse notes that the client is confused and restless with an oxygen saturation of 88%. Which action would the nurse take first?

Administer oxygen via nasal cannula

A nurse is providing an educational event to a local mens group about prostate cancer. The nurse should cite an increased risk of prostate cancer in what ethnic group?

African Americans

A nurse is assessing a community group for dietary factors that contribute to osteoporosis. In addition to inquiring about calcium, the nurse also assesses for which other dietary components? (Select all that apply.)

Alcohol Caffeine Carbonated beverages Vitamin D

A patient who is scheduled for an open prostatectomy is concerned about the potential effects of the surgery on his sexual function. What aspect of prostate surgery should inform the nurses response?

All prostatectomies carry a risk of nerve damage and consequent erectile dysfunction.

The nurse assesses a client after a total hip arthroplasty. The client's surgical leg is visibly shorter than the other one and the client reports extreme pain. While a co-worker calls the surgeon, what action by the nurse is appropriate?

Assess neurovascular status in both legs.

A nurse is caring for a pregnant patient with active herpes. The teaching plan for this patient should include which of the following?

Babies delivered vaginally may become infected with the virus.

A physician explains to the patient that he has an inflammation of the Cowper glands. Where are the Cowper glands located?

Below the prostate, within the posterior aspect of the urethra

The nurse is teaching breast self-examination (BSE) to a group of women. The nurse should recommend that the women perform BSE at what time?

Between days 5 and 7 after menses

A patient with trichomoniasis comes to the walk-in clinic. In developing a care plan for this patient the nurse would know to include what as an important aspect of treating this patient?

Both partners will be treated with metronidazole (Flagyl).

While taking a health history on a 20-year-old female patient, the nurse ascertains that this patient is taking miconazole (Monistat). The nurse is justified in presuming that this patient has what medical condition?

Candidiasis

A primary care clinic sees some clients with sexually transmitted infections. Which diseases would the nurse be required to report to the local authority? (Select all that apply.)

Chlamydia b. Gonorrhea c. Syphilis d. Human immune deficiency virus

A 35-year-old man is seen in the clinic because he is experiencing recurring episodes of urinary frequency, dysuria, and fever. The nurse should recognize the possibility of what health problem?

Chronic bacterial prostatitis

The nurse is caring for a postoperative client who have a regional nerve blockade for a surgical tibial fracture repair this morning. What assessment finding would the nurse expect?

Client reports little to no pain.

A nurse is providing care for a patient who has recently been admitted to the postsurgical unit from PACU following a transuretheral resection of the prostate. The nurse is aware of the nursing diagnosis of Risk for Imbalanced Fluid Volume. In order to assess for this risk, the nurse should prioritize what action?

Closely monitoring the input and output of the bladder irrigation system

A nurse is caring for a patient who is being assessed following complaints of severe and persistent low back pain. The patient is scheduled for diagnostic testing in the morning. Which of the following are appropriate diagnostic tests for assessing low back pain? that apply.

Computed tomography (CT) Magnetic resonance imaging (MRI) Ultrasound X-ray

A patient has just returned to the floor following a transurethral resection of the prostate. A triple-lumen indwelling urinary catheter has been inserted for continuous bladder irrigation. What, in addition to balloon inflation, are the functions of the three lumens?

Continuous inflow and outflow of irrigation solution

A nurse practitioner is examining a patient who presented at the free clinic with vulvar pruritus. For which assessment finding would the practitioner look that may indicate the patient has an infection caused by Candida albicans?

Cottage cheese-like discharge

The nurse is assessing a 53-year-old woman who has been experiencing dysmenorrhea. What questions should the nurse include in an assessment of the patients menstrual history? Select all that apply.

Do you ever experience bleeding after intercourse? How long is your typical cycle? Do you experience cramps or pain during your cycle?

A patient is admitted to the orthopedic unit with a fractured femur after a motorcycle accident. The patient has been placed in traction until his femur can be rodded in surgery. For what early complications should the nurse monitor this patient? Select all that apply.

Deep vein thrombosis Compartment syndrome Fat embolism

A client presents to the emergency department reporting vomiting, severe lower abdominal pain, and a tender mass above one testis. What action by the nurse is most important?

Determine when he last ate or drank anything.

The nurse is leading a workshop on sexual health for men. The nurse should teach participants that organic causes of erectile dysfunction include what? Select all that apply.

Diabetes Testosterone deficiency Parkinsonism

A nurse wants to reduce the risk potential for transmission of chlamydia and gonorrhea with a client diagnosed with both infections. Which items should be included in the client's teaching plan? (Select all that apply.)

Expedited partner therapy Abstinence until therapy is completed Proper use of condoms Rescreening for infection

A nurse is performing a shift assessment on an elderly patient who is recovering after surgery for a hip fracture. The nurse notes that the patient is complaining of chest pain, has an increased heart rate, and increased respiratory rate. The nurse further notes that the patient is febrile and hypoxic, coughing, and producing large amounts of thick, white sputum. The nurse recognizes that this is a medical emergency and calls for assistance, recognizing that this patient is likely demonstrating symptoms of what complication?

Fat embolism syndrome

A 23-year-old woman comes to the free clinic stating I think I have a lump in my breast. Do I have cancer? The nurse instructs the patient that a diagnosis of breast cancer is confirmed by what?

Fine-needle aspiration

The nurse is performing a comprehensive health history of a patient who is in her 50s. The nurse should identify what risk factor that may increase this patients risk for breast cancer?

The patient gave birth to her first child at age 38.

A client who has rheumatoid arthritis is prescribed etanercept. What health teaching by the nurse about this drug is appropriate?

Giving subcutaneous injections

A nurse is teaching a 53-year-old man about prostate cancer. What information should the nurse provide to best facilitate the early identification of prostate cancer?

Have a digital rectal examination and prostate-specific antigen (PSA) test done yearly.

When teaching patients about the risk factors of cervical cancer, what would the nurse identify as the most important risk factor?

Human papillomavirus (HPV)

The orthopedic nurse should assess for signs and symptoms of Volkmanns contracture if a patient has fractured which of the following bones?

Humerus

An adolescent is identified as having a collection of fluid in the tunica vaginalis of his testes. The nurse knows that this adolescent will receive what medical diagnosis?

Hydrocele

The nurse is caring for a client who recently sustained a sports injury to his right leg. What nursing interventions are appropriate for this client? (Select all that apply.)

Immobilize the right leg. Use compression to support the leg. Obtain an x-ray to detect possible fracture. Elevate the right leg to decrease swelling.

A nurse is caring for a patient who has suffered a hip fracture and who will require an extended hospital stay. The nurse should ensure that the patient does which of the following in order to prevent common complications associated with a hip fracture?

Increase fluid intake and perform prescribed foot exercises.

A patient has presented at the clinic with symptoms of benign prostatic hyperplasia. What diagnostic findings would suggest that this patient has chronic urinary retention?

Increased blood urea nitrogen (BUN)

A 42-year-old man has come to the clinic for an annual physical. The nurse notes in the patients history that his father was treated for breast cancer. What should the nurse provide to the patient before he leaves the clinic?

Instructions about breast self-examination (BSE)

A nurse teaches a client with a fractured tibia about external fixation. Which advantages of external fixation for the immobilization of fractures would the nurse share with the client? (Select all that apply.)

It leads to minimal blood loss. It allows for early ambulation. It promotes healing.

A patient with a genital herpes exacerbation has a nursing diagnosis of acute pain related to the genital lesions. What nursing intervention best addresses this diagnosis?

Keep the lesions clean and dry.

A patient is 24 hours postoperative following prostatectomy and the urologist has ordered continuous bladder irrigation. What color of output should the nurse expect to find in the drainage bag?

Light pink

The nurse is caring for a couple trying to get pregnant and have not been able to for over a year. The couple asks what kind of problems a man can have that can cause infertility. What should be the nurses response?

Men can have problems that increase the temperature around their testicles and decrease the quality of their semen.

A client has returned from a transurethral resection of the prostate with a continuous bladder irrigation. Five hours after the operation, the nurse notes the drainage is bright red with clots. What action should the nurse take first?

Notify the primary health care provider immediately.

A nurse cares for a client with a recently fractured tibia. Which assessment would alert the nurse to take immediate action?

Numbness in the extremity

A man comes to the clinic complaining that he is having difficulty obtaining an erection. When reviewing the patients history, what might the nurse note that contributes to erectile dysfunction?

The patient has a history of hypertension.

The nurse is assessing a client with long-term rheumatoid arthritis (RA) who has been taking prednisone for 10 years. For which complications of chronic drug therapy would the nurse assess? (Select all that apply.)

Osteoporosis Diabetes mellitus Glaucoma Hypertension Hypokalemia Decreased immunity

After a breast examination, the nurse is documenting assessment findings that indicate possible breast cancer. Which abnormal findings need to be included as part of the client's electronic medical record? (Select all that apply.)

Peau d'orange Nipple retraction Mobile mass at 2 o'clock Skin ulceration

A patient with diabetes is attending a class on the prevention of associated diseases. What action should the patient perform to reduce the risk of osteomyelitis?

Perform meticulous foot care.

A nurse is caring for four clients. After the hand-off report, which client would the nurse see first?

Post-microvascular bone transfer client whose distal leg is cool and pale

A patient was fitted with an arm cast after fracturing her humerus. Twelve hours after the application of the cast, the patient tells the nurse that her arm hurts. Analgesics do not relieve the pain. What would be the most appropriate nursing action?

Prepare the patient for opening or bivalving of the cast.

What information does the nurse teach a women's group about osteoporosis?

Primary osteoporosis occurs in postmenopausal women due to lack of estrogen."

A nurse practitioner is assessing a 55-year-old male patient who is complaining of perineal discomfort, burning, urgency, and frequency with urination. The patient states that he has pain with ejaculation. The nurse knows that the patient is exhibiting symptoms of what?

Prostatitis

A client came to the clinic with erectile dysfunction. What are some possible causes of this condition that the nurse could discuss with the client during history taking? (Select all that apply.)

Recent prostatectomy Long-term hypertension Diabetes mellitus Consumption of beer each night

A client returned from a transurethral resection of the prostate 8 hours ago with a continuous bladder irrigation. The client reports headache and dizziness. What action by the nurse is most appropriate?

Report the findings to the surgeon immediately.

To decrease glandular cellular activity and prostate size, an 83-year-old patient has been prescribed finasteride (Proscar). When performing patient education with this patient, the nurse should be sure to tell the patient what?

Report the planned use of dietary supplements to the physician.

A 55-year-old man presents at the clinic complaining of erectile dysfunction. The patient has a history of diabetes. The physician orders tadalafil (Cialis) to be taken 1 hour before sexual intercourse. The nurse reviews the patients history prior to instructing the patient on the use of this medication. What disorder will contraindicate the use of tadalafil (Cialis)?

Retinopathy

A nurse is writing a care plan for a patient admitted to the emergency department (ED) with an open fracture. The nurse will assign priority to what nursing diagnosis for a patient with an open fracture of the radius?

Risk for Infection

A couple has come to the infertility clinic because they have been unable to get pregnant even though they have been trying for over a year. Diagnostic tests are planned for the woman to ascertain if ovulation is regular and whether her endometrium is adequately supported for implantation. What test would the nurse expect to have ordered for this woman?

Serum progesterone

The nurse is teaching a client about side effects and adverse reactions of a PDE5 inhibitor. What information does the nurse include? (Select all that apply.)

Stop using this drug if your primary health care provider prescribes a nitrate. Do not drink alcohol before having sexual intercourse Muscle cramps, nausea, and vomiting are possible if you take more than 1 pill a day. Change positions slowly especially if you also take an anti-hypertensive drug

A nurse is providing education to a community women's group about lifestyle changes helpful in preventing osteoporosis. What topics does the nurse cover? (Select all that apply.)

Strengthening exercises are important. Take recommended calcium and vitamin D Walk for 30 minutes at least three times a week.

The nurse is caring for a 52-year-old woman whose aunt and mother died of breast cancer. The patient states, My doctor and I talked about Tamoxifen to help prevent breast cancer. Do you think it will work? What would be the nurses best response?

Tamoxifen is known to be a highly effective protective measure.

The outpatient clinic nurse has assessed a woman who reports a month-long history of feeling full, urinary frequency, and bloating. What action by the nurse is best?

Teach the woman about CA-125 test

The primary health care provider prescribes methotrexate (MTX) for a client with a new diagnosis of rheumatoid arthritis. The nurse provides health teaching about the drug. What statement by the nurse is appropriate to include about methotrexate?

The drug can increase your risk for infection, so you should avoid crowds

A patient has been prescribed sildenafil. What should the nurse teach the patient about this medication?

The drug should be taken 1 hour prior to intercourse.

A female patient with HIV has just been diagnosed with condylomata acuminata (genital warts). What information is most appropriate for the nurse to tell this patient?

This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) test annually.

You are caring for a patient who has been diagnosed with genital herpes. When preparing a teaching plan for this patient, what general guidelines should be taught?

Thorough handwashing is essential.

A female patient tells the nurse that she thinks she has a vaginal infection because she has noted inflammation of her vulva and the presence of a frothy, yellow-green discharge. The nurse recognizes that the clinical manifestations described are typical of what vaginal infection?

Trichomonas vaginalis

Following a recent history of dyspareunia and lower abdominal pain, a patient has received a diagnosis of pelvic inflammatory disease (PID). When providing health education related to self-care, the nurse should address which of the following topics? Select all that apply.

Use of condoms to prevent infecting others Appropriate use of antibiotics

The nurse assesses a client with rheumatoid arthritis (RA) and Sjögren syndrome. What assessment would be most important for this client?

Visual acuity

A patient has been diagnosed with polycystic ovary syndrome (PCOS). The nurse should encourage what health promotion activity to address the patients hormone imbalance and infertility?

Weight loss

A client with genital herpes has painful blisters on her vulva. After teaching the client self-care measures, which statement indicated the need for further education?

When I don't have lesions, I am not contagious to my sexual partner."

A public health nurse is participating in a campaign aimed at preventing cervical cancer. What strategies should the nurse include is this campaign? Select all that apply.

promotion of HPV immunization Encouraging young women to delay first intercourse Smoking cessation Using safer sex practices