210 Test 3 Review

A nurse is teaching a client who has been taking prednisone to treat asthma and has a new prescription to discontinue the medication. The nurse should explain to the client to reduce the dose gradually to prevent which of the following adverse effects.?

Adrenocortical insufficiency

A nurse is reviewing the medication history of a client who has a new prescription for colchicine. Which of the following medications increases the client's risk when used in combination with colchicine for developing rhabdomyolysis?

Atorvastatin

A nurse notes increasing edema in the calf of a client who has multiple fractures of the leg. The nurse should recognize that increasing edema is a manifestation of which of the following complications?

acute compartment syndrome (increasing edema is a manifestation of acute compartment syndrome, which is a complication that occurs when excessive pressure reduces circulation.)

A nurse is caring for a client who has a fractured tibia as a result of a fall. The client x-ray shows that the bone is splintered into several pieces around the shaft. The nurse should identify that the client has which of the following types of fractures?

comminuted fracture (the impact fragments the bone into several pieces in this type of fracture)

A nurse is assessing an older adult client who has experienced some loss of bone density. The nurse observes a "hunchback" curvature of the client's spine. The nurse should expect the provider to document which of the following disorders?

kyphosis

A nurse is teaching who has a fractured femur about fat emboli syndrome. Which of the following findings should the nurse include as a manifestation of a fat embolism?

petechia on the chest; manifestations of fat embolism syndrome include dyspnea, tachypnea, agitation, headache, and petechia on the chest and neck. The nurse should instruct the client to report this finding to the provider.

A nurse is assessing a client who has a cast in place for a fractured tibia. Which of the following actions should the nurse take first?

checking capillary refill

A nurse is caring for an older client who has a fractured hip and will require rehabilitative care. The client's family asks the nurse for information about this type of care. Which of the following explanations should the nurse provide?

"This service began with the client's admission to the hospital." (Rehabilitation is a process that assists an ill person or a person with a disability or impairment to achieve the highest possible level of functioning. The process of rehabilitation begins with the client's admission to a health care facility for treatment.)

A nurse is assessing a client who is in a body cast. Which of the following manifestations should the nurse identify as possible cast syndrome?

dilated pupils (cast syndrome is a reaction to wearing a large cast, which produces physical and psychological effects on the client, similar to claustrophobia. Cast syndrome can lead to paralytic ileus, or gangrenous bowel

A nurse is caring for a client who has Addison's disease and is at risk for Addisonian crisis. Which of the following actions should the nurse take?

daily weights (addison's disease causes weight loss, muscle weakness, fatigue, low blood pressure, hyperpigmentation of the skin- daily weights alerts the nurse that dehydration is developing)

A nurse is teaching a client who has MS about a new prescription for baclofen. Which of the following instructions should the nurse include in the teaching?

do not take antihistamines with this medication

A nurse is teaching a client who has multiple sclerosis and a new prescription for dantrolene. Which of the following statements by the client indicates an understanding of the teaching?

"I need to apply a sunscreen when I go outside." This medication can cause photosensitivity.

A staff nurse is teaching a client who has Addison's disease about the disease process. The client asks the nurse what causes Addison's disease. Which of the following responses should the nurse make?

"It is caused by the lack of production of aldosterone by the adrenal gland."

A nurse is caring for a client who is scheduled for an arthroplasty. The nurse asks the client to state if he understands the procedure that is being performed. Which of the following statements by the client indicates an understanding of the procedure?

"This procedure will replace my joint to improve function." Arthroplasty is the reconstruction or replacement of a joint.

A nurse should teach which of the following clients require crutches about how to use a three-point gait?

A client who has a right femur fracture with no weight bearing on the affected leg. (A three-point gait is appropriate for the client. A three-point gait requires the client to bear all of his own weight on one foot. With a three-point gait, the client bears weight on both crutches and then on the uninvolved leg, repeating the sequence. The affected leg does not touch the ground.

A nurse is completing discharge teaching with a client following arthroscopic knee surgery. Which of the following instructions should the nurse include in the teaching?

Apply ice to the affected area. Applying ice to the affected area in the immediate postoperative period (first 24 hours) reduces pain and swelling.

A nurse is assisting a client who has hypothyroidism with meal planning. Which of the following foods should the nurses recommend that the client add to her diet?

Constipation is a classic manifestation of hypothyroidism; therefore, this client should increase her fluid and fiber intake. Whole grains provide ample amounts of fiber.

A nurse is reviewing the medical record of a client who has been on levothyroxine for several months. Which of the following findings indicates a therapeutic response to the medication?

Decrease in level of thyroid-stimulating hormone (TSH)

A nurse is assessing a client who has thyrotoxicosis after taking too high of a level of levothyroxine. Which of the following manifestations should the nurse expect.?

Heat intolerance, sweating, and hyperthermia

A nurse is caring for a client who has developed agranulocytosis as a result of taking propylthiouracil to treat hyperthyroidism. The nurse should understand that this client is at increased risk for which of the following conditions?

Infection (agranulocytosis is a failure of the bone marrow to make enough white blood cells, causing neutropenia and lowering the body's defenses against infection.)

A nurse is assessing a client who is taking levothyroxine. The nurse should recognize that which of the following findings is a manifestation of levothyroxine overdose?

Insomnia (overdose will result in manifestations of hyperthyroidism -insomnia, tachycardia, hyperthermia)

A nurse is caring for a client who has an unrepaired femur fracture of the midshaft. Which of the following techniques should the nurse use when performing an assessment of the client's neurovascular status?

Instruct the client to wiggle his toes.

A nurse is reviewing risk factors for osteoporosis with a group of nursing students. The nurse should include which of the following types of medication therapy is a risk factor for osteoporosis.

Long-term use of synthetic thyroid hormone such as levothyroxine can accelerate bone loss.

A nurse is caring for a client who has a syndrome of inappropriate antidiuretic hormone (SIADH) and a sodium level of 123 mEq/L. Which of the following prescriptions should the nurse anticipate?

Restrict fluid intake to 1,000mL per day. (oral fluids are restricted in an attempt to restore the fluid balance and the sodium level in the blood.)

A nurse in a clinic is reviewing the laboratory values of a client who has primary hypothyroidism. The nurse should anticipate an elevation of which of the following laboratory values?

TSH (thyroid-stimulating hormone)

A nurse is caring for a child who has Addison's disease. Which of the following actions should the nurse take?

Teach the parents about cortisol replacement therapy (administration of glucocorticoids and mineralocorticoids is necessary because inadequate supplies or a sudden cessation of the medications can cause acute adrenal crisis)

A nurse is caring for a client who sustained a femur fracture in an automobile accident and is placed into skeletal traction. The nurse may remove the weights from the traction device if which of the following occurs?

The client develops a life-threatening situation. (traction weights are never to be removed without a specific provider prescription unless there is a life-threatening situation.)

A nurse is preparing to administer enoxaparin to a client. Which of the following actions should the nurse plan to take?

The nurse should not expel the air bubble that is in the pre-filled syringe prior to administering the medication, be administered 2 inches around the umbilicus at a 90 degree angle.

A nurse is teaching an older adult client who has osteoporosis about beginning a program of regular physical activity. Which of the following recommendations should the nurse make?

Walking briskly (weight-bearing exercises are essential for maintaining bone mass.)

A nurse is assessing a client who has myxedema. Which of the following findings should the nurse expect?

facial edema (myxedema is a severe form of hypothyroidism. A client who has myxedema typically experiences non-pitting edema everywhere, especially around the eyes and in the hands and feet)

A nurse is assessing a client who has hyperthyroidism. The nurse should expect the client to report which of the following manifestations?

frequent mood changes (clients experience emotional liability that fluctuates between emotional hyper-excitability and irritability.

A nurse is assessing an adolescent who has an exacerbation of Grave's disease. Which of the following findings should the nurse expect?

heat intolerance (due to the increased metabolic rate, which leads to warm flushed moist skin and extreme diaphoresis)

A nurse is caring for a client who has fractures of the symphysis pubis and pelvis. The nurse should monitor the client for which of the following findings of a common complication of pelvic fractures?

hematuria (internal bleeding, such as blood in the urine and stool)

A nurse is presenting discharge instructions to a client who has MS. The client reports symptoms of diplopia, dysmetria, and sensory change. Which of the following nursing statements are appropriate?

implement a schedule to include periods of rest

A nurse is assessing a client who has a left lower arm fracture. Which of the following findings indicates impaired venous return in the client's affected arm?

increasing edema (a sign of impaired circulation)

A nurse is assessing an older adult client who has osteoporosis. Which of the following spinal deformities should the nurse expect to find in this client?

kyphosis

a nurse is assessing a client who has hypothyroidism. Which of the following findings should the nurse expect?

lethargy, weakness, and somnolence

A nurse is providing teaching to a client who has a new diagnosis of hypothyroidism. On which of the following medications should the nurse prepare to instruct the client?

levothyroxine

A nurse is developing a plan of care for a client who has a fracture to achieve the outcome of functional healing. To assist in meeting this goal, which of the following nursing interventions is the highest priority?

maintain immobilization and alignment

A nurse is planning care for a client who has a halo fixation device. Which of the following actions should the nurse include in the plan of care?

monitor the client for elevated temperature (manifestations of infection: fever, purulent drainage)

A nurse is planning care for a newly admitted client who has skeletal traction for a fractured femur. Which of the following interventions should the nurse include in the plan?

monitor the client's pedal pulses every hour

A nurse is assessing a client following the application of a leg cast for the treatment of a fracture. If the cast is too tight, which of the following findings should the nurse expect to observe first?

pallor of the toes (if a cast is too tight it will increase pressure on the blood vessels, impairing circulation. When this occurs, pallor for the toes is the initial finding.

A nurse is caring for a client who is postoperative following an open reduction and internal fixation of a fractured femur. Which of the following actions is the most important for the nurse to complete in the postoperative period?

perform neurovascular checks of the extremities

A nurse is planning care for a client who is postoperative following total hip arthroplasty. Which of the following interventions should the nurse include in the plan of care?

prevent hip flexion of the affected extremity (the nurse should implement measures to prevent hip flexion of the affected extremity beyond 90 degrees due to the risk of dislocation. Raised toilet seats and reclining chairs help prevent hyper-flexion.

A nurse is assessing a client who is admitted with hyperthyroidism. The client reports a weight loss of 12 lbs in the last 2 months, increased appetite, increased perspiration, fatigue, menstrual irregularity, and restlessness. Which of the following actions should the nurse take to prevent a thyroid crisis?

provide a quiet, low-stimulus environment (thyroid crisis can occur in response to a stressor, so the nurse should minimize stressful stimuli in the client's environment.

A nurse is talking to a client who is taking a calcium supplement for osteoporosis. The client tells the nurse she is experiencing flank pain. Which of the following adverse effects should the nurse suspect?

renal stones

A nurse is teaching a client about risk factors for osteoporosis. Which of the following factors should the nurse include in the teaching? (SATA)

sedentary lifestyle obesity aging caffeine secondhand smoke

A nurse is caring for a client 1hr following a subtotal thyroidectomy. In which of the following positions should the nurse place the client?

semi fowler's (decreases pressure on the suture line and prevents edema formation, which could cause respiratory distress.)