342 Final

A nurse is assessing a client who reports a nevus that has increased in size and an irregular shaped lesion that varies in color. These findings are consistent with which of the following medical diagnoses?

malignant melanoma

A nurse is caring for a client who has hypertension and has a potassium level of 6.8. Which of the following actions should the nurse take?

obtain a 12-lead ECG

A nurse in a long-term care facility is caring for an older adult who had a stroke 4 weeks ago and who is unable to move independently. The nurse should monitor for which of the following complications of immobiltiy?

a reddened area over the sacrum

A nurse is caring for a client who has had a hemorrhagic stroke following a ruptured cerebral aneurysm. Which of the following manifestations should the nurse expect?

manifestations preceded by a severe headache

A nurse is caring for a client who has a left hip arthroplasty. Which of the following interventions should the nurse use to prevent dislocation?

maintain foam wedge between leg

A nurse is providing discharge teaching to a client who has PAD. Which of the following instruction should the nurse include in the teaching?

adjust the thermostat so that the environment is warm

A nurse is assessing a client who has COPD. The nurse should expect the client's chest to be which of the following shapes?

barrel

A nurse is teaching a client who has urolithiasis. The nurse should explain that which of the following conditions can increase the risk of renal calculi?

dehydration

A nurse is caring for a client who has BPH. The nurse should expect which of the following findings?

difficulty starting the flow of urine

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

edema

A nurse is caring for a client who has hypertension and develops epistaxis. Which of the following action should the nurse take?

apply pressure to the nares place ice to the bridge of the client's nose move the client into high-fowler's position

A home health nurse visits a client who has COPD and receives oxygen at 2L vis nasal cannula. The client reports difficulty breathing. Which of the following actions is the nurse's priority?

assess the client's respiratory status

A nurse in a provider's office is assessing an older adult whose son reports that the client has been sick with a respiratory infection for the past 6 days. Which of the following assessment findings is a manifestation of pneumonia in the older adult client?

confusion

A nurse in the emergency room is assessing a client who has brought in following a seizure. The nurse suspects the client may have meningoccoal meningitis when assessment finding include nuchal rigidity and a petechial rash. After implementing droplet precautions. Which of the following actions should the nurse initiate next?

assess the cranial nerves

A nurse is providing teaching about a heart heathy diet to a group of clients with hypertension. Which of the following statements by one of the clients indicates a need for further teaching?

I may eat 10 ounces of lean protein each day

A nurse is providing discharge teaching to a client following hip arthroplasty. Which of the following pieces of furniture should the nurse instruct the client to sit in at home?

a straight-backed chair with an elevated seat

A nurse is assessing a client who has parkinson's disease. Which of the following manifestation should the nurse expect?

bradykinesia

A nurse is caring for a client who has valvular heart disease and is at risk for developing left-sided heart failure. Which of the following manifestations should alert the nurse the client is developing this condition?

breathlessness

A nurse is caring for a client who is 5 hour postoperature following a TURP. The nurse notes that the client indwelling urinary catheter has not drained in the past hour. Which of the following actions should the nurse take first?

check the tubing for kinks

a nurse is providing teaching to a client who has a new diagnosis of testicular cancer. Which of the following information should the nurse include in the teaching?

close male relatives are at an increased risk of developing testicular cancer testicular cancer typically occurs between ages 15-35

A nurse is providing dietary teaching to a client who has a history of recurring calcium oxalate kidney stones. Which of the following instruction should the nurse include in the teaching?

drink 3 L of fluid every day

A nurse in a cardiac care unit is caring for a client with acute right-sided failure. Which of the following findings should the nurse expect?

elevated central venous pressure

A nurse is admitting a young adult client who has suspected bacterial meningitis. The nurse should closely monitor the client for increased intracranial pressure ICP an indicated by which of the following findings?

elevated temperature

A nurse is caring for a client who has pneumonia. Which of the following actions should the nurse take to promote thinning of respiratory secretions

encourage the client to increase fluid intake

A nurse is instructing a client's family members about feeding safety for a client who has dysphagia following a stroke. Which of the following instructions should the nurse include?

encourage the client to take small bites

A nurse is providing discharge teaching to a client who has a new diagnosis of heart failure. Which of the following instruction should the nurse include in the teaching?

exercise at least three times per week

A nurse is caring for an older client who has left-sided heart failure. Which of the following assessment findings the nurse expect?

frothy sputum

A nurse is assessing a client who has left-sided heart failure. Which of the following findings should the nurse expect?

hacking cough

A nurse is caring for a client who is 2 days postoperature following a above the knee amputation. which of the following is an appropriate nursing intervention for this client at this time?

have the client lie prone every 3 hours for 20 minutes at a time

A nurse is assessing a client at a dermatology clinic. Which of following findings places the client at risk for developing malignant melanoma?

history of chronic skin irritation

A nurse is caring for a client who has heart failure and is receiving IV furosemide. The nurse should monitor the client for which of the following electrolyte imbalances?

hyperuricemia

A nurse in the emergency department is monitoring a client who has a cervical spinal cord injury from a fall. The nurse should monitor the client for which of the following complication?

hypotension absence of bowel sounds weakened gag reflex

A nurse is caring for a female client who has recurrent kidney stones and is scheduled for an intravenous pyelogram. Which of the following statements by the client should the nurse report to the provider?

i don't eat shellfish because it gives me hives

a nurse is reinforcing teaching with a client regarding reduction of risk factors for coronary artery disease. Which of the following statements by the client indicates an understanding of the teaching?

i must stop smoking i need to monitor my weight i am limiting my intake of fast food

A nurse is teaching the partner of a client who had a stroke about manifestation of dysphagia. Which of the following statement by the client's partner indicates the need for further teaching?

i will monitor my husband for tilting his head forward when he swallows

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 caring for a client who has aphasia following a stroke. A family member asks the nurse how she should communicate with the client. Which of following responses by the nurse is appropriate?

incorporate nonverbal cues in the conversation

A nurse is developing a plan of care for a client who has COPD. The nurse include which of the following interventions in the plan?

instruct the client to use pursed-lip breathing

A nurse is caring for a client who has peripheral arterial disease PAD. Which of the following symptoms should the nurse expect to find in the early stage of the disease?

intermittent claudication

A nurse in a provider's clinic is caring for a client who reports erectile dysfunction and requests a prescription for sildenafil. Which of the following medication currently prescribed for a client is a contraindication to taking sildenafil?

isosorbide

A nurse is providing teaching to a client who has a new diagnosis of parkinson's disease. On which of the following medication should the nurse prepare to instruct the client?

levodopa/carbidopa

A nurse is caring for a client who is 2 hours postoperature following a transurethral resection of the prostate gland. Which of the following assessment should the nurse view to be an indication of a postoperative complication?

output of burgundy colored urine

A nurse is providing teaching to a client who has a family history of hypertension. The nurse should inform the client that his blood pressure of 124/84 places him in the which of the following categories?

prehypertension

A nurse is providing teaching to the family of a client who has parkinson's disease. Which of the following information should the nurse include in the teaching?

provide client supervision

A nurse is teaching a group of nursing students about pyelonephritis. Which of the following statements should the nurse include in the teaching?

pyelonephritis increases a pregnant woman's risk for preterm labor

A nurse is teaching about risk factors of developing a stroke with a group of older adult clients. Which of the following non-modifiable risk factors should then nurse include in the teaching?

race

A nurse caring for a client who had a right sided stroke and is exhibiting homonymous hemianopsia when eating. Which of the following actions should the nurse take?

remind the client to look for food on the left side of the tray

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

severe headache

A nurse is establishing health promotion goals for a female client who smokes cigarettes, has hypertension, and has a BMI of 26. Which of the following goals should then nurse include?

the client will walk for 30 minutes 5 days a week

A nurse is caring for a client who has hypertension and is afraid to take his blood pressure medication. Which of the following nursing statement is an example of the therapeutic communication response of reflection?

you seem upset about taking your blood pressure medication