UNIT 1 IGGY PRACTICE QUESTIONS

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 client with Paget's disease is hospitalized for an unrelated issue. The client reports pain and it is not yet time for more medication. What comfort measures can the nurse delegate to the unlicensed assistive personnel (UAP)? (Select all that apply.)

- Applying a heating pad - Providing a massage

A client is admitted with a bone tumor. The nurse finds the client weak and lethargic withdecreased deep tendon reflexes. What actions by the nurse are best? (Select all that apply

- Assess the daily serum calcium level. - Consult the provider about a loop diuretic. - Instruct the client to call for help out of bed.

A client with bone cancer is hospitalized for a limb salvage procedure. How can the nurse best address the client's psychosocial needs?

Assess the client's coping skills and support systems.

A nurse cares for a client who is scheduled for a paracentesis. Which intervention should the nurse delegate to an unlicensed assistive personnel (UAP)?

Assist the client to void before the procedure.

A nurse sees clients in an osteoporosis clinic. Which client should the nurse see first?

Client taking raloxifene (Evista) who reports unilateral calf swelling

The nurse sees several clients with osteoporosis. For which client would bisphosphonates not be a good option?

Client with a spinal cord injury who cannot tolerate sitting up

The nurse is conducting a history on a male client to determine the severity of symptoms associated with prostate enlargement. Which finding is cause for prompt action by the nurse?

Cloudy urine

A client has a metastatic bone tumor. What action by the nurse takes priority?

Handle the affected extremity with caution.

A hospitalized client is being treated for Ewing's sarcoma. What action by the nurse is most important?

Handling and disposing of chemotherapeutic agents per policy

A nurse and an unlicensed assistive personnel (UAP) are caring for a client with an open radical prostatectomy. Which comfort measure could the nurse delegate to the UAP?

Helping the client transfer from the bed to the chair

A nurse assesses a client after administering prescribed levetiracetam (Keppra). Which laboratory tests should the nurse monitor for potential adverse effects of this medication?

Kidney function tests

A nurse cares for a postmenopausal client who has had two episodes of bacterial urethritis in the last 6 months. The client asks, I never have urinary tract infections. Why is this happening now? How should the nurse respond?

Low estrogen levels can make the tissue more susceptible to infection.

A nurse assesses a client who is prescribed an infusion of vasopressin (Pitressin) for bleeding esophageal varices. Which clinical manifestation should alert the nurse to a serious adverse effect?

Mid-sternal chest pain

A client has a bone density score of -2.8. What action by the nurse is best?

Planning to teach about bisphosphonates

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

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

A client with an intestinal obstruction has pain that changes from a "colicky" intermittent type to constant discomfort. What does the nurse do first?

Prepares the client for emergency surgery

A nurse assesses a client who is recovering from a paracentesis 1 hour ago. Which assessment finding requires action by the nurse?

Urine output via indwelling urinary catheter is 20 mL/hr

A client is being evaluated in the emergency department for a possible small bowel obstruction. Which signs and/or symptoms does the nurse expect to assess?

Upper abdominal distention, metabolic alkalosis, and great amount of vomiting

A nurse teaches a young female client who is prescribed amoxicillin (Amoxil) for a urinary tract infection. Which statement should the nurse include in this clients teaching?

Use a second form of birth control while on this medication.

A nurse obtains a focused health history for a client who is suspected of having bacterial meningitis. Which question should the nurse ask?

"Do you live in a crowded residence?"

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

"For 5 years after menopause you lose 2% of bone mass yearly."

A nurse delegates hygiene care for a client who has advanced cirrhosis to an unlicensed nursing personnel (UAP). Which statements should the nurse include when delegating this task to the UAP? (Select all that apply.)

- "Apply lotion to the client's dry skin areas." - "For the client's oral care, use a soft toothbrush." - "Provide clippers so the client can trim the fingernails."

A nurse assesses a male client who has symptoms of cirrhosis. Which questions should the nurse ask to identify potential factors contributing to this laboratory result? (Select all that apply.)

- "How frequently do you drink alcohol?" - "Have you ever had sex with a man?" - "Were you previously incarcerated?"

A nurse cares for a client who is prescribed lactulose (Heptalac). The client states, "I do not want to take this medication because it causes diarrhea." How should the nurse respond?

"Diarrhea is expected; that's how your body gets rid of ammonia."

After teaching a client who has been diagnosed with hepatitis A, the nurse assesses the client's understanding. Which statement by the client indicates a correct understanding of the teaching?

"I may have been exposed when we ate shrimp last weekend."

After teaching a client who has alcohol-induced cirrhosis, a nurse assesses the client's understanding. Which statement made by the client indicates a need for additional teaching?

"I need to avoid protein in my diet."

After teaching a client who has plans to travel to a non-industrialized country, the nurse assesses the client's understanding regarding the prevention of viral hepatitis. Which statement made by the client indicates a need for additional teaching?

"I should eat plenty of fresh fruits and vegetables."

A nose obtains a clients's health history at a community health clinic. Which statement alerts the nurse to prove health teaching to this client?

"I take a lot of Tylenol for my arthritis pain."

A nurse cares for a client who has chronic cirrhosis from substance abuse. The client states, "All of my family hates me." How should the nurse respond?

"I will help you identify a support system."

A client has been prescribed denosumab (Prolia). What instruction about this drug is most appropriate?

"Make appointments to come get your shot."

A nurse teaches a client with hepatitis C who is prescribed ribavirin (Copegus). Which statement should the nurse include in this client's discharge education?

"Use a pill organizer to ensure you take this medication as prescribed."

A nurse cares for a client with hepatitis C. The client's brother states, "I do not want to contract this infection, so I will not go into his hospital room." How should the nurse respond?

"Viral hepatitis is not spread through casual contact."

A telehealth nurse speaks with a client who is recovering from a liver transplant 2 weeks ago. The client states, "I am experiencing right flank pain and have a temperature of 101° F." How should the nurse respond?

"You should go to the hospital immediately to have your new liver checked out."

The nurse is administering finasteride (Proscar) and doxazosin (Cardura) to a 67-year-old client with benign prostatic hyperplasia. What precautions are related to the side effects of these medications? (Select all that apply.)

- Assessing for blood pressure changes when lying, sitting, and arising from the bed - Immediately reporting any change in the alanine aminotransferase laboratory test - Asking the client to report any weakness, light-headedness, or dizziness

The nurse studying osteoporosis learns that which drugs can cause this disorder? (Select all that apply.)

- Barbiturates - Corticosteroids - Loop diuretics

A nurse evaluates the results of diagnostic tests on a client's cerebrospinal fluid (CSF). Which fluid results alerts the nurse to possible viral meningitis? (Select all that apply.)

- Clear - Increased protein level - Normal glucose level

A nurse assesses a client who has encephalitis. Which manifestations should the nurse recognize as signs of increased intracranial pressure (ICP), a complication of encephalitis? (Select all that apply.)

- Dilated pupils - Widened pulse pressure - Bradycardia

A nurse assesses a client who has liver disease. Which laboratory findings should the nurse recognize as potentially causing complications of this disorder? (Select all that apply.)

- Elevated international normalized ratio (INR) - Elevated serum ammonia - Elevated prothrombin time (PT)

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.)

- Family history of prostate cancer - Advanced age - Eating too much red meat - Race

A nurse teaches a client about self-care after experiencing a urinary calculus treated by lithotripsy. Which statements should the nurse include in this clients discharge teaching? (Select all that apply.)

- Finish the prescribed antibiotic even if you are feeling better. - Drink at least 3 liters of fluid each day. - The bruising on your back may take several weeks to resolve.

A nurse teaches a client with a history of calcium phosphate urinary stones. Which statements should the nurse include in this clients dietary teaching? (Select all that apply.)

- Limit your intake of food high in animal protein. - Read food labels to help minimize your sodium intake. - Reduce your intake of milk and other dairy products.

A nurse inserts a nasogastric (NG) tube for an adult client who has a bowel obstruction. Which actions does the nurse perform correctly? (Select all that apply.)

- Performs hand hygiene and positions the client in high-Fowler's position, with pillows behind the head and shoulders - Checks for correct placement by checking the pH of the fluid aspirated from the tube - Connects the NG tube to intermittent medium suction with an anti-reflux valve on the air vent

An infection control nurse develops a plan to decrease the number of health care professionals who contract viral hepatitis at work. Which ideas should the nurse include in this plan? (Select all that apply.)

- Policies related to consistent use of Standard Precautions - Implementation of a needleless system for intravenous therapy - Number of sharps used in client care reduced where possible - Postexposure prophylaxis provided in a timely manner

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

A nurse is caring for a client with meningitis. Which laboratory values should the nurse monitor to identify potential complications of this disorder? (Select all that apply.)

- Sodium level - Clotting factors

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 30 minutes at least 3 times a week.

A nurse prepares to provide perineal care to a client with meningococcal meningitis. Which personal protective equipment should the nurse wear? (Select all that apply.)

- Surgical mask - Gloves

An emergency room nurse assesses a client with potential liver trauma. Which clinical manifestations should alert the nurse to internal bleeding and hypovolemic shock? (Select all that apply.)

- Tachycardia - Confusion

Post transurethral resection of the prostate, a client has a three-way catheter with a continuous bladder irrigation. Over the last 12 hours, there has been 1400 mL of irrigation solution infused and 2000 mL measured in output from the drainage bag. What is the recording of the urinary output for the 12-hour period? (Record your answer using a whole number.) ____ mL

600 mL

A nurse assesses clients at a community health fair. Which client is at greatest risk for the development of hepatitis B?

A 20-year-old college student who has had several sexual partners

A nurse assesses clients on the medical-surgical unit. Which client is at greatest risk for the development of carcinoma of the liver?

A 66-year-old who has a history of cirrhosis

The nurse is administering sulfamethoxazole-trimethoprim (Bactrim) to a client diagnosed with bacterial prostatitis. Which finding causes the nurse to question this medication for this client?

Allergy to sulfa medications

A nurse cares for a client who has kidney stones from secondary hyperoxaluria. Which medication should the nurse anticipate administering?

Allopurinol (Zyloprim)

A nurse assesses a client who is recovering from extracorporeal shock wave lithotripsy for renal calculi. The nurse notes an ecchymotic area on the clients right lower back. Which action should the nurse take?

Apply an ice pack to the site.

A client with osteoporosis is going home, where the client lives alone. What action by the nurse is best?

Arrange a home safety evaluation.

A client has been advised to perform weight-bearing exercises to help minimize osteoporosis. The client admits to not doing the prescribed exercises. What action by the nurse is best?

Ask the client about fear of falling.

An emergency room nurse assesses a client after a motor vehicle crash and notes ecchymotic areas across the client's lower abdomen. Which action should the nurse take first?

Assess for abdominal guarding or rigidity.

A nurse cares for a client who is hemorrhaging from bleeding esophageal varices and has an esophagogastric tube. Which action should the nurse take first?

Assess the client for airway patency.

A client is in the internal medicine clinic reporting bone pain. The client's alkalinephosphatase level is 180 units/L. What action by the nurse is most appropriate?

Assess the client for leg bowing.

A nurse assesses a client with a mechanical bowel obstruction who reports intermittent abdominal pain. An hour later the client reports constant abdominal pain. Which action should the nurse take next?

Assess the client's bowel sounds.

A client has scoliosis with a 65-degree curve to the spine. What action by the nurse takes priority?

Assess the client's cardiac and respiratory systems.

A client with a bowel obstruction is ordered a nasogastric (NG) tube. After the nurse inserts the tube, which nursing intervention is the highest priority for this client?

Connecting the tube to low intermittent suction

A nurse is assessing an older client and discovers back pain with tenderness along T2 and T3. What action by the nurse is best?

Consult with the provider about an x-ray.

When assessing a client with acute glomerulonephritis, which finding causes the nurse to notify the provider?

Crackles throughout the lung fields

A nurse assesses a client who presents with renal calculi. Which question should the nurse ask?

Do any of your family members have this problem?

A client in a nursing home refuses to take medications. She is at high risk for osteomalacia. What action by the nurse is best?

Ensure the client gets 15 minutes of sun exposure daily.

A client is scheduled for a bone biopsy. What action by the nurse takes priority?

Ensuring that informed consent is on the chart

After teaching a client with a history of renal calculi, the nurse assesses the clients understanding. Which statement made by the client indicates a correct understanding of the teaching?

I should drink at least 3 liters of fluid every day.

A client is diagnosed with benign prostatic hyperplasia and seems sad and irritable. After assessing the clients behavior, which statement by the nurse would be the most appropriate?

Nocturia could cause interruption of your sleep and cause changes in mood.

A nurse reviews the laboratory findings of a client with a urinary tract infection. The laboratory report notes a shift to the left in a clients white blood cell count. Which action should the nurse take?

Notify the provider and start an intravenous line for parenteral antibiotics.

A nurse assesses a male client who is recovering from a urologic procedure. Which assessment finding indicates an obstruction of urine flow?

Overflow incontinence

A 55-year-old African-American client is having a visit with his health care provider. What test should the nurse discuss with the client as an option to screen for prostate cancer, even though screening is not routinely recommended?

Prostate-specific antigen

A nurse cares for a client who has cirrhosis of the liver. Which action should the nurse take to decrease the presence of ascites?

Provide a low-sodium diet.

When taking the health history of a client with acute glomerulonephritis (GN), the nurse questions the client about which related cause of the problem?

Recent respiratory infection

A 70-year-old client returned from a transurethral resection of the prostate 8 hours ago with a continuous bladder irrigation. The nurse reviews his laboratory results as follows: Sodium 128 mEq/L Hemoglobin 14 g/dL Hematocrit 42% Red blood cell count 4.5 What action by the nurse is the most appropriate?

Slow down the bladder irrigation if the urine is pink.

A client has returned from a transurethral resection of the prostate with a continuous bladder irrigation. Which action by the nurse is a priority if bright red urinary drainage and clots are noted 5 hours after the surgery?

Take vital signs and notify the surgeon immediately.

A client is diagnosed with metastatic prostate cancer. The client asks the nurse the purpose of his treatment with the luteinizing hormonereleasing hormone (LH-RH) agonist leuprolide (Lupron) and the bisphosphonate pamidronate (Aredia). Which statement by the nurse is most appropriate?

The treatment reduces testosterone and prevents bone fractures.

The nurse is teaching a client with benign prostatic hyperplasia (BPH). What statement indicates a lack of understanding by the client?

There should be no problem with a glass of wine with dinner each night.

Which sign or symptom, when assessed in a client with chronic glomerulonephritis (GN), warrants a call to the health care provider?

Third heart sound (S3)