med surg 1 exam 1 EAQs
Which statement indicates that the teaching has been effective after the nurse has finished teaching a 50-year-old female client about symptoms of coronary artery disease in women? - "I don't need to worry about symptoms like chest pain or pressure" - "I will call my health care provider about any unusual fatigue" - "Women have less risk of death from heart disease than men" - "Bad cholesterol levels are usually higher in women than in men"
"I will call my health care provider about any unusual fatigue"
Which instruction will the home health nurse include when teaching a client with peripheral artery disease? (select all that apply) - "Avoid crossing your legs" - "Inspect your feet daily" - "Change positions slowly" - "Do not use compression stockings" - "Avoid green leafy vegetables in your diet"
- "Avoid crossing your legs" - "Inspect your feet daily" - "Do not use compression stockings"
Which assessment finding is consistent with a client diagnosis of right-sided heart failure? (select all that apply) - Collapsed neck veins - Distended abdomen - Dependent edema - Decreased appetite - Cool extremities
- Collapsed neck veins - Distended abdomen - Dependent edema - Decreased appetite
Which perioperative actions would the nurse plan when caring for a client scheduled for a septoplasty? - Teach the client how to use hot compresses - Encourage the client to quit smoking before surgery - Observe the surgical site for edema - Teach the client about postsurgery activities that are restricted - Assess the client's respiratory status - Encourage the client to take aspirin before the surgery
- Encourage the client to quit smoking before surgery - Teach the client about postsurgery activities that are restricted - Assess the client's respiratory status - Encourage the client to take aspirin before the surgery
Which modifiable risk factor would the nurse include in a community presentation on cardiovascular risk factors? (select all that apply) - Weight - Inactivity - Cholesterol - Tobacco use - Homocysteine
- Weight - Inactivity - Cholesterol - Tobacco use - Homocysteine
Which topic would be the most important to include in teaching when an obese client receives a diagnosis of high blood pressure? - Causes of hypertension - Symptoms of hypertension - Effect of weight loss in hypertension - Effect of lowering alcohol intake in hypertension
Effect of weight loss in hypertension
Which condition would the nurse consider as the most likely cause of pain for a client who tells the nurse, "My legs begin to hurt after walking for several blocks. The pain goes away when I stop walking, but it comes back again when I resume walking."? - Spinal stenosis - Buerger disease - Rheumatoid arthritis - Intermittent claudication
Intermittent claudication
The nurse notes a client's blood pressure of 200/110 mHg and swelling of the operative leg after a femoropopliteal bypass graft. Which action would the nurse take next? - Evaluate the client's orientation - Check pedal pulses distal to the graft - Notify the client's health care provider - Monitor blood pressure every 15 minutes
Notify the client's health care provider
In which scenario is the nurse providing tertiary prevention? - Educating a community about the proper use of environment sanitation - Educating a family about how to protect themselves from carcinogens - Providing education to a family regarding the need to pay attention to personality development - Providing education to a community about the need to integrate individuals' limb amputations into the professional sphere
Providing education to a community about the need to integrate individuals' limb amputations into the professional sphere
The nurse is providing preoperative teaching to a client who is scheduled for abdominal surgery. The client is fidgeting, slightly diaphoretic, and asking simple questions about information that was already provided during the education session. Which initial step would the nurse take? - Repeat the information, speaking slowly and distinctly - Reduce the client's level of anxiety - Teach the client about measures to lessen preoperative anxiety - Ask the client to verbalize concerns and questions
Reduce the client's level of anxiety
The registered nurse (RN) is teaching a nursing student about leadership skills for prioritizing the needs of the client. Which statement is an example of an intermediate-priority need? - The teachings of home self-care - A psychological episode of an anxiety attack - A physiological episode of an obstructed airway - The measures required to decrease postoperative complications
The measures required to decrease postoperative complications
Which steps listed by the nursing student are accurate regarding discharge planning? (select all that apply) - "Plan the client's discharge at the time of leaving the hospital." - "Teach the client the safe and effective use of medications and medical equipment." - "Remember that discharge planning is a centralized, coordinated, interdisciplinary process." - "Coordinate with just the primary health care provider when preparing discharge planning." - "Develop a care plan that moves the client from the hospital to another level of health care."
- "Teach the client the safe and effective use of medications and medical equipment." - "Remember that discharge planning is a centralized, coordinated, interdisciplinary process." - "Develop a care plan that moves the client from the hospital to another level of health care."
The registered nurse (RN) delegates the care of a client in the immediate postoperative period to the unlicensed assistive personnel (UAP). Which tasks are in the scope of practice of the UAP? (select all that apply) - Feeding the client - Ambulating the client for the first time - Monitoring the vital signs - Assisting the client with bathing - Teaching leg exercises to the client
- Feeding the client - Assisting the client with bathing
Which topic would the nurse include in teaching for a client with a new diagnosis of hypertension? (select all that apply) - Reason for daily low-dose aspirin use - Use of a home blood pressure monitor - Adverse effects of tobacco on blood pressure - Avoidance of any alcohol consumption - Benefits of moderate daily exercise
- Use of a home blood pressure monitor - Adverse effects of tobacco on blood pressure - Benefits of moderate daily exercise
In which order would the nurse perform the nursing interventions for an older adult client during the intraoperative stage? - Follow aseptic technique - Carefully monitor the input and output of fluids, including blood - Use a small pillow under the client's head - Pad bony prominences to prevent pressure sores - Cover the client's head and feet - Use warning device to prevent hypothermia - Warm intravenous (IV) and irrigation fluids as indicated by agency policy and manufacturer's recommendations - Lift the client into position to prevent shearing forces - Position arthritic and artificial joints carefully to prevent postoperative pain
1) Use a small pillow under the client's head 2) Lift the client into position to prevent shearing forces 3) Position arthritic and artificial joints carefully to prevent postoperative pain 4) Pad bony prominences to prevent pressure sores 5) Use warning device to prevent hypothermia 6) Cover the client's head and feet 7) Warm intravenous (IV) and irrigation fluids as indicated by agency policy and manufacturer's recommendations 8) Follow aseptic technique 9) Carefully monitor the input and output of fluids, including blood
Which intervention would the public-health nurse prioritize to support secondary prevention efforts for cardiovascular disease? - Offer routine blood pressure screenings at various community sites including worksites, schools, and faith institutions - Advocate for policy changes to support healthy environments that include opportunities for safe physical activity - Provide educational opportunities regarding prevention of cardiovascular disease through a variety of venues - Support access to healthy food options in the local community of all residents
Offer routine blood pressure screenings at various community sites including worksites, schools, and faith institutions
Which clinical manifestation would the nurse expect to identify when performing an admission history and physical for a client with chronic peripheral arterial disease? - Edema of the feet and ankles - Reddened and painful areas on the calves - Pain when exercising and thickening of the toenails - Ulcers around the ankles and reports of a dull ache in the legs
Pain when exercising and thickening of the toenails
Which action by a client who requires an above-the-knee amputation for peripheral arterial disease best indicates emotional readiness for the surgery? - Explains the goals of the procedure - Displays few signs of anticipatory grief - Participates in learning perioperative care - Verbalizes acceptance of permanent dependency needs
Participates in learning perioperative care
Which statement from a client who has received prescriptions for digoxin, furosemide, and a 2-g sodium diet indicates that further teaching is needed? - "I must check my pulse every day" - "I can gradually increase my exercise as long as I take rest periods" - "I should call my health care provider if I have difficulty breathing when I am lying flat" - "I can use a little table salt on my food as long as I do not use it when cooking food"
"I can use a little table salt on my food as long as I do not use it when cooking food"
Which statement by a client is consistent with a diagnosis of heart failure? - "I see spots before my eyes" - "I am tired at the end of the day" - "I feel bloated when I eat a large meal" - "I have trouble breathing when I climb a flight of stairs"
"I have trouble breathing when I climb a flight of stairs"
Which statement by the client would the nurse expect when assessing a client with a diagnosis of left ventricular failure? - "My ankles are swollen" - "My appetite is not very good" - "When I eat a large meal, I feel bloated" - "I have trouble breathing when I walk rapidly"
"I have trouble breathing when I walk rapidly"
Which response would the nurse make to a 30-year-old client diagnosed with hyperlipidemia and hypertension who asks the nurse to explain why treatment is important, stating "I feel fine, so I don't really see the need to make any changes."? - "Both high blood pressure and high cholesterol contribute to development of heart disease" - "Lifestyle adaptations alone will be adequate as long as you continue to be asymptomatic" - "Usually someone with these diagnoses will have symptoms of heart disease already" - "You should discuss your questions about medical problems with the health care provider"
"Both high blood pressure and high cholesterol contribute to development of heart disease"
The nurse is providing preoperative education to a client scheduled for orthopedic surgery at 8:00AM the next day. Which instruction would the nurse include? - "Have your dinner completed by 6:00PM tonight and then no food or fluids after that." - "Drink whatever liquids you want tonight and then only clear liquids tomorrow morning." - "Consume a light evening meal tonight and then no food or fluids after midnight." - "Eat lunch today and then do not drink or eat anything until after your surgery."
"Consume a light evening meal tonight and then no food or fluids after midnight."
Which finding in a client seen at the outpatient clinic supports a diagnosis of an arterial ulcer? (select all that apply) - Lack of hair - Thickened toenails - Copious ulcer drainage - Diminished pedal pulse - Brown skin discoloration
- Lack of hair - Thickened toenails - Diminished pedal pulse
Which finding would the nurse expect when assessing a client with peripheral arterial disease? (select all that apply) - Pallor of feet - Warm extremities - Ulcers on the toes - Thick, hardened skin - Delayed capillary refill
- Pallor of feet - Ulcers on the toes - Delayed capillary refill
The nurse is preparing an intraoperative care plan for a client. Which intervention would be excluded from the care plan? - Ensuring the client's skin integrity - Reviewing the preoperative instructions - Administering a general anesthetic to the client - Placing the client in the correct position on the operating table
Administering a general anesthetic to the client
How would the nurse describe heart failure to a client? - A cardiac condition caused by inadequate circulating blood volume - An acute state in which the pulmonary circulation pressure decreases - An inability of the heart to pump blood in proportion to metabolic needs - A chronic state in which the systolic blood pressure drops below 90 mmHg
An inability of the heart to pump blood in proportion to metabolic needs
Which action is the priority when the preoperative nurse learns that a client is taking several herbal supplements? - Provide the client with information about the usefulness of herbal therapies - Inform the client about taking supplemental vitamins rather than herbs - Teach the client about herbal supplements - Ask the client which herbs have been taken
Ask the client which herbs have been taken
Which medication prescribed for a client with an acute episode of heart failure would the nurse question? - Diuretic - Beta blocker - Long-acting nitrate - Angiotensin receptor blocker
Beta blocker
Which symptoms requires the most rapid action by the nurse when caring for a client with known peripheral arterial disease who calls the clinic and tells the nurse about experiencing several symptoms? - Anxiety - Chest pain - Weak pulse quality - Cool and pale lower legs
Chest pain
Which activity would the nurse expect to cause the most distress when assessing a client with heart failure for activity tolerance? - Getting up from bed in the morning - Walking to visit the next-door neighbor - Climbing a flight of stairs to the bedroom - Leaving the table immediately after a meal
Climbing a flight of stairs to the bedroom
Which type of lung sounds would the nurse expect to hear when caring for a client with heart failure? - Stridor - Crackles - Wheezes - Rhonchi
Crackles
Which priority intervention would the nurse expect to initiate for a postoperative care client with hypotension? - Start oxygen (O2) therapy - Inspect the surgical incision - Administer intravenous (IV) fluid boluses - Administer vasoconstrictive agents
Start oxygen (O2) therapy
Which topic will the nurse include in teaching for a client with Raynaud disease? - Tobacco avoidance - Dietary salt reduction - Need for increased exercise - Low-fat, low-cholesterol diet
Tobacco avoidance
Which action by a client with peripheral arterial disease indicates that more teaching about how to manage the disease is needed? - Applying a hot water bottle to the abdomen - Using a heating pad to warm the extremities - Drinking a warm cup of tea when feeling chilly - Turning the room thermostat above 72 degF (23.3 degC)
Using a heating pad to warm the extremities