Med-Surg 2 Final
The client is being discharged after a left modified radical mastectomy. Which discharge instructions should the nurse include? Select all that apply: 1. Notify HCP of temperature of 100 F 2. Carry large purses and bundles with the right hand. 3. Do not go to church or anywhere with crowds. 4. Try to keep the arm as still as possible until seen by HCP. 5. Have a mammogram of the right and left breast yearly.
1. Correct. Possible infection. 2. Correct. Risk of lymphedema. Protect arm from injury. 3. Wrong. 4.Wrong. Should be taught arm climbing exercises before DC. 5. Correct. Risk for more cancer is high in both breasts.
A client with benign prostatic hypertrophy (BPH) undergoes a transurethral resection of the prostate (TURP) and is receiving continuous bladder irrigations postoperatively. The nurse monitors the client for signs of transurethral resection (TUR) syndrome, including: 1. Tachycardia and diarrhea 2. Bradycardia and confusion 3. Increased urinary output and anemia 4. Decreased urinary output and bladder spasms
2. Bradycardia and confusion
The client has a mastectomy and asks nurse about a Tram Flap procedure. Which info should nurse provide? 1. The surgeon will insert a saline filled sac under the skin to simulate a breast. 2. The surgeon will pull the client's own tissue under the skin to create a breast. 3. The surgeon will use tissue from inside the mouth to make a nipple. 4. The surgeon can make the breast any size the client wants.
2. The surgeon will pull the client's own tissue under the skin to create a breast.
The female client admitted for an unrelated diagnosis asks the nurse to check her back because "it itches all the time in that one spot." When the nurse assesses the client's back, the nurse notes an irregular-shaped lesion with some scabbed-over areas surrounding the lesion. Which action should the nurse implement first? 1. Notify the HCP to check the lesion on rounds. 2. Measure the lesion and note the color. 3. Apply lotion to the lesion. 4. Instruct the client to make sure the HCP checks the lesion.
2. This is part of assessing the lesion and should be completed. The ABCDs of skin cancer detection include the following: (1) Asymmetry—Is the lesion balanced on both sides with an even surface? (2) Borders—Are the borders rounded and smooth or notched and indistinct? (3) Color—Is the color a uniform light brown or is it variegated and darker or reddish purple? (4) Diameter—A diameter exceed- ing 4 to 6 mm is considered suspicious.
The client who has a cold is seen in the emergency department with an inability to void. Because the client has a history of benign prostatic hyperplasia, the nurse determines that the client should be questioned about the use of which of the following medications? 1. Diuretics 2. Antibiotics 3. Antitussives 4. Decongestants
4. Decongestants
A nurse is collecting data from a client who has had benign prostatic hyperplasia (BPH) in the past. To determine if the client is currently experiencing exacerbation of BPH, the nurse asks the client about the presence of which early symptom? 1. Nocturia 2. Urinary retention 3. Urge incontinence
4. Decreased force in the stream of urine
A nurse is reviewing the client's record and notes that the health care provider has documented that the client has a renal disorder. On review of the laboratory results, the nurse would most likely expect to note which of the following? 1. Decreased hemoglobin level 2. Decreased red blood cell (RBC) count 3. Decreased white blood cell (WBC) count 4. Elevated blood urea nitrogen (BUN) level
4. Elevated blood urea nitrogen (BUN) level
Giving discharge instructions to a burn patient, the topical agent she is to apply to her wound will cause permanent staining of clothes, linen, walls and floors. Which of the following will she be using: 1. mafenide acetate ( Sulfamylon) 2. silver sulfadiazine (Silvadene) 3. bacitracin ointment 4. silver nitrate 5. O-wutagufiam
4. Silver Nitrate
Following a full-thickness (third-degree) burn of his left arm, a female client is treated with artificial skin. The client understands postoperative care of artificial skin when he states that during the first 7 days after the procedure, he will restrict: a. range of motion. b. protein intake. c. going outdoors. d. fluid ingestion.
A) To prevent disruption of the artificial skin's adherence to the wound bed, the client should restrict range of motion of the involved limb. Protein intake and fluid intake are important for healing and regeneration and shouldn't be restricted. Going outdoors is acceptable as long as the left arm is protected from direct sunlight.
The nurse knows the patient with AKI has entered the diuretic phase when what assessments occur? Select all that apply. A. Dehydration B. Hypokalemia C. Hypernatremia D. BUN increases E. Serum creatinine increases
A, B. Dehydration, hypokalemia, and hyponatremia occur in the diuretic phase of AKI because the nephrons can excrete wastes but not concentrate urine. Therefore the serum BUN and serum creatinine levels also begin to decrease.
When evaluating the laboratory values of the burn-injured patient, which of the following can be anticipated? 1. decreased hemoglobin and elevated hematocrit levels 2. elevated hemoglobin and elevated hematocrit levels 3. elevated hemoglobin and decreased hematocrit levels 4. decreased hemoglobin and decreased hematocrit levels 5. hemoglobin and hematocrit levels within normal ranges
Correct Answer: 1 Rationale: Hemoglobin levels are reduced in response to the hemolysis of red blood cells. Hematocrit levels are elevated secondary to hemoconcentration, and fluid shifts from the intravascular compartment.
the client who is scheduled for breast biopsy with sentinel node dissection sates, "I don't understand. What does a sentinel node biopsy do?" 1. A dye is injected into the tumor and traced to determine spread of cells. 2. The surgeon removes the nodes that drain the diseased portion of the breast. 3. The nodes that can be felt manually will be removed and sent to pathology. 4. A visual inspection of the lymph nodes will e made while the client is sleeping.
1. A dye is injected into the tumor and traced to determine spread of cells.
The client has undergone a wedge resection for cancer on the left breast. Which discharge instruction should the nurse teach? 1. Don't life more than 5 lbs. with left hand until released by HCP 2. The cancer has been totally removed and no F/U therapy is required. 3. Client should empty Hemovac every 12 hours. 4. Client should arrange for an appt. with a plastic surgeon for reconstruction.
1. Don't life more than 5 lbs. with left hand until released by HCP
The client is admitted to the outpatient surgery center for removal of a malignant melanoma. Which assessment data indicate the lesion is a malignant melanoma? 1. The lesion is asymmetrical and has irregular borders. 2. The lesion has a waxy appearance with pearl- like borders. 3. The lesion has a thickened and scaly appearance. 4. The lesion appeared as a thickened area after an injury.
1. Malignant melanomas are the most deadly of the skin cancers. Asymmetry, irregu- lar borders, variegated color, and rapid growth are characteristic of them.
A nurse is assessing the patency of an arteriovenous fistula in the left arm of a client who is receiving hemodialysis for the treatment of chronic renal failure. Which finding indicates that the fistula is patent? 1. Palpation of a thrill over the fistula 2. Presence of a radial pulse in the left wrist 3. Absence of a bruit on auscultation of the fistula 4. Capillary refill less than 3 seconds in the nail beds of the left hand
1. Palpation of a thrill over the fistula
The client has had a squamous cell carcinoma removed from the lip. Which discharge instructions should the nurse provide? 1. Notify the HCP if a nonhealing lesion develops around the mouth. 2. Squamous cell carcinoma tumors do not metastasize. 3. Limit foods to liquid or soft consistency for one (1) month. 4. Apply heat to the area for 20 minutes every four (4) hours.
1. The client should be aware of symptoms that indicate development of another skin cancer. Squamous cell carcinoma can develop in areas of the skin and mucous membranes.
The nurse monitoring a client receiving peritoneal dialysis notes that the client's outflow is less than the inflow. The nurse should take which actions? Select all that apply. 1. Contact the health care provider (HCP). 2.Check the level of the drainage bag. 3.Reposition the client to his or her side. 4.Place the client in good body alignment. 5. Check the peritoneal dialysis system for kinks. 6. Increase the flow rate of the peritoneal dialysis solution.
2.Check the level of the drainage bag. 3.Reposition the client to his or her side. 4.Place the client in good body alignment. 5. Check the peritoneal dialysis system for kinks.
A nurse is monitoring an older client suspected of having a urinary tract infection (UTI) for signs of the infection. The nurse would be alert to the presence of: 1. Fever 2. Urgency 3. Confusion 4. Frequency
3. Confusion
The nurse is instructing a client with diabetes mellitus about peritoneal dialysis. The nurse tells the client that it is important to maintain the dwell time for the dialysis at the prescribed time because of the risk of: 1. Infection 2. Fluid overload 3. Hyperglycemia 4. Disequilibrium syndrome
3. Hyperglycemia
The client who had a right modified radical mastectomy 4 years before is being admitted for a cardiac workup for chest pain. Which intervention is most important? 1. Determine when client had chemo last. 2. Ask client if she received Adriamycin, an antineoplastic agent. 3. Post a message at the head of the bed to not use the right arm. 4. Examine the chest wall for cancer sites.
3. Post a message at the head of the bed to not use the right arm
A client newly diagnosed with chronic renal failure has recently begun hemodialysis. Knowing that the client is at risk for disequilibrium syndrome, the nurse monitors the client during dialysis for: 1. Hypertension, tachycardia, and fever 2. Hypotension, bradycardia, and hypothermia 3. Restlessness, irritability, and generalized weakness 4. Headache, deteriorating level of consciousness, and twitching
4. Headache, deteriorating level of consciousness, and twitching
A hemodialysis client with a left arm fistula is at risk for arterial steal syndrome. The nurse monitors this client for which manifestation of this disorder? 1. Warmth, redness, and pain in the left hand 2. Aching pain, pallor, and edema of the left arm 3. Edema and purpura of the left arm 4. Pallor, diminished pulse, and pain in the left hand
4. Pallor, diminished pulse, and pain in the left hand
The urinalysis of a male patient reveals a high microorganism count. What data should the nurse use to determine the area of the urinary tract that is infected (select all that apply)? A. Pain location B. Fever and chills C. Mental confusion D. Urinary hesitancy E. Urethral discharge F. Post-void dribbling
A, E. Although all the manifestations are evident with urinary tract infections (UTIs), pain location is useful in differentiating among pyelonephritis, cystitis, and urethritis because flank pain is characteristic of pyelonephritis, but dysuria is characteristic of cystitis and urethritis. Urethral discharge is indicative of urethritis, not pyelonephritis or cystitis. Fever and chills and mental confusion are nonspecific indicators of UTIs. Urinary hesitancy and postvoid dribbling may occur with a UTI but may also occur with prostate enlargement in the male patient
Which nursing diagnosis is a priority in the care of a patient with renal calculi? A. Acute pain B. Risk for constipation C. Deficient fluid volume D. Risk for powerlessness
A. Acute pain Urinary stones are associated with severe abdominal or flank pain. Deficient fluid volume is unlikely to result from urinary stones, whereas constipation is more likely to be an indirect consequence rather than a primary clinical manifestation of the problem. The presence of pain supersedes powerlessness as an immediate focus of nursing care.
The patient with type 2 diabetes has a second UTI within one month of being treated for a previous UTI. Which medication should the nurse expect to teach the patient about taking for this infection? A. Ciprofloxacin (Cipro) B. Fosfomycin (Monurol) C. Nitrofurantoin (Macrodantin) D. Trimethoprim/sulfamethoxazole (Bactrim)
A. Ciprofloxacin (Cipro) This UTI is a complicated UTI because the patient has type 2 diabetes and the UTI is recurrent. Ciprofloxacin (Cipro) would be used for a complicated UTI. Fosfomycin (Monurol), nitrofurantoin (Macrodantin), and trimethoprim/sulfamethoxazole (Bactrim) should be used for uncomplicated UTIs.
Eight months after the delivery of her first child, a 31-year-old woman has sought care because of occasional incontinence that she experiences when sneezing or laughing. Which measure should the nurse first recommend in an attempt to resolve the woman's incontinence? A. Kegel exercises B. Use of adult incontinence pads C. Intermittent self-catheterization D. Dietary changes including fluid restriction
A. Kegel exercises Patients who experience stress incontinence frequently benefit from Kegel exercises (pelvic floor muscle exercises). The use of incontinence pads does not resolve the problem, and intermittent self-catheterization would be a premature recommendation. Dietary changes are not likely to influence the patient's urinary continence.
Following discharge teaching for a patient who has had a transurethral prostatectomy for benign prostatic hyperplasia (BPH), the nurse determines that additional instruction is needed when the patient says, a. "I will increase fiber and fluids in my diet to prevent constipation." b. "I should call the doctor if I have any incontinence at home." c. "I will avoid heavy lifting or driving until I get approval from my health care provider." d. "I should continue to schedule yearly appointments for prostate exams."
Answer: B Rationale: Incontinence is common for several weeks after a TURP. The other patient statements indicate that the patient has a good understanding of post-TURP instructions.
The doctor is considering whether to prescribe testosterone replacement therapy for a 62-year-old man who is concerned about a gradual decrease in sexual performance. Which information obtained by the nurse is most important to communicate to the doctor? a. The patient states that he has noticed a decrease in energy level for a few years. b. The patient has had a gradual decrease in the force of his urinary stream. c. The patient has been using sildenafil (Viagra) several times every week. d. The patient's symptoms have increased steadily over the last few years.
Answer: B Rationale: The decrease in urinary stream may indicate BPH or prostate cancer, which are contraindications to use of testosterone replacement therapy (TRT). The other patient data indicate that TRT may be a helpful therapy for the patient.
In teaching a male patient to perform testicular self-examination, the nurse includes the information that a. the only structure normally felt in the scrotal sac is the testis. b. the examination should be done when the scrotum is warm. c. an appointment with the health care provider is needed if one testis is larger than the other. d. an examination should be performed whenever the patient showers or bathes.
Answer: B Rationale: The testes will hang lower in the scrotum when the temperature is warm, and it will be easier to palpate. The epididymis is also normally palpable in the scrotum. One testis is normally larger. The patient should perform testicular self-examination (TSE) monthly.
A 22-year-old man tells the nurse at the health clinic that he has recently become unable to achieve an erection. When assessing for possible etiologic factors, which question should the nurse ask first? a. "Have you been experiencing an unusual amount of stress?" b. "Do you have any history of an erection that lasted for 6 hours or more?" c. "Are you using any recreational drugs or drinking a lot of alcohol?" d. "Do you have any chronic diseases, such as diabetes mellitus?"
Answer: C Rationale: A common etiologic factor for erectile dysfunction (ED) in younger men is use of recreational drugs or alcohol. Stress, priapism, and chronic illness also contribute to ED, but they are not common etiologic factors in younger men.
When obtaining a focused health history for a patient with possible testicular cancer, the nurse will ask the patient about any history of a. testicular torsion. b. STD infection. c. undescended testicles. d. testicular trauma.
Answer: C Rationale: Cryptorchidism is a risk factor for testicular cancer if it is not corrected before puberty. STD infection, testicular torsion, and testicular trauma are risk factors for other testicular conditions but not for testicular cancer.
The health care provider orders a blood test for prostate-specific antigen (PSA) when an enlarged prostate is palpated during a routine examination of a 56-year-old man. When the patient asks the nurse the purpose of the test, the nurse's response is based on the knowledge that a. elevated levels of PSA are indicative of metastatic cancer of the prostate. b. PSA testing is the "gold standard" for making a diagnosis of prostate cancer. c. baseline PSA levels are necessary to determine whether treatment is effective. d. PSA levels are usually elevated in patients with cancer of the prostate.
Answer: D Rationale: PSA levels are usually elevated above the normal in patients with prostate cancer. PSA testing does not determine whether metastasis has occurred. A biopsy of the prostate is needed for a definitive diagnosis of prostate cancer. Success of treatment is determined by a fall in PSA to an undetectable level; the patient's baseline PSA is not needed to determine the success of treatment.
A patient undergoing a TURP returns from surgery with a three-way urinary catheter with continuous bladder irrigation in place. The nurse observes that the urine output has decreased and the urine is clear red with multiple clots. The patient is complaining of painful bladder spasms. The most appropriate action by the nurse is to a. administer the ordered IV morphine sulfate, 4 mg. b. increase the flow rate of the continuous bladder irrigation. c. give the ordered the belladonna and opium suppository. d. manually instill 50 ml of saline and try to remove the clots.
Answer: D Rationale: The assessment suggests that obstruction by a clot is causing the bladder spasms, and the nurse's first action should be to irrigate the catheter manually and to try to remove the clots. IV morphine will not decrease the spasm, although pain may be reduced. Increasing the flow rate of the irrigation will further distend the bladder and may increase spasms. The belladonna and opium suppository will decrease bladder spasms but will not remove the obstructing blood clot.
A 46-year-old man has had erectile dysfunction (ED) for about 3 years when he finally seeks help for the problem. He tells the nurse that he decided to seek help because his wife "is losing patience with the situation." The most appropriate nursing diagnosis for the patient is a. risk for anxiety related to inability to perform sexually. b. situational low self-esteem related to loss of satisfying sexual activity. c. ineffective sexuality patterns related to ED. d. ineffective role performance related to effects of ED.
Answer: D Rationale: The patient's statement indicates that the relationship with his wife is his primary concern. Although anxiety, low self-esteem, and ineffective sexuality patterns may also be concerns, the data in the stem suggest that addressing the role performance problem will lead to the best outcome for this patient.
A patient who has a total abdominal hysterectomy is anxious to resume her activities because she has young children at home. What postprocedure information does the nurse provide to the patient? (select all that apply) a. Climb stairs to build strength and endurance b. Avoid sitting for prolonged periods c. Do not lift anything heavier than 5 to 10 lbs d. Walk or jog at least 1-2 miles every day e. when sitting, do not cross the legs
B, C, E
A patient with a history of end-stage kidney disease secondary to diabetes mellitus has presented to the outpatient dialysis unit for his scheduled hemodialysis. Which assessments should the nurse prioritize before, during, and after his treatment? A. Level of consciousness B. Blood pressure and fluid balance C. Temperature, heart rate, and blood pressure D. Assessment for signs and symptoms of infection
B. Blood pressure and fluid balance Although all of the assessments are relevant to the care of a patient receiving hemodialysis, the nature of the procedure indicates a particular need to monitor the patient's blood pressure and fluid balance.
Which assessment finding is a consequence of the oliguric phase of AKI? A. Hypovolemia B. Hyperkalemia C. Hypernatremia D. Thrombocytopenia
B. Hyperkalemia In AKI the serum potassium levels increase because the normal ability of the kidneys to excrete potassium is impaired. Sodium levels are typically normal or diminished, whereas fluid volume is normally increased because of decreased urine output. Thrombocytopenia is not a consequence of AKI, although altered platelet function may occur in AKI.
An elderly male patient visits his primary care provider because of burning on urination and production of urine that he describes as "foul smelling." The health care provider should assess the patient for which of the following factors that may dispose him to urinary tract infections (UTIs)? A. High-purine diet B. Sedentary lifestyle C. Benign prostatic hyperplasia (BPH) D. Recent use of broad-spectrum antibiotics
BPH
An older male patient visits his primary care provider because of burning on urination and production of urine that he describes as "foul smelling." The health care provider should assess the patient for what factor that may put him at risk for a urinary tract infection (UTI)? A. High-purine diet B. Sedentary lifestyle C. Benign prostatic hyperplasia (BPH) D. Recent use of broad-spectrum antibiotics
C. Benign prostatic hyperplasia (BPH) BPH causes urinary stasis, which is a predisposing factor for UTIs. A sedentary lifestyle and recent antibiotic use are unlikely to contribute to UTIs, whereas a diet high in purines is associated with renal calculi.
A 70-year-old patient has experienced a sunburn over much of the body. What self-care technique is MOST important to emphasize to an older adult in dealing with the effects of the sunburn? 1. increasing fluid intake 2. applying mild lotions 3. taking mild analgesics 4. maintaining warmth 5. using sunscreen
Correct Answer: 1 Rationale: Older adults are especially prone to dehydration; therefore, increasing fluid intake is especially important. Other manifestations could include nausea and vomiting. All the measures help alleviate the manifestations of this minor burn which include pain, skin redness, chills, and headache. Use of sunscreen is a preventative, not a treatment measure.
A patient is scheduled for surgery to graft a burn injury on the arm. Which of the following statements should the nurse include when instructing the patient prior to the procedure? 1. "You will begin to perform exercises to promote flexibility and reduce contractures after five days." 2. "You will need to report any itching, as it might signal infection." 3. "Performing the procedure near the end of the hospitalization will reduce the incidence of infection and improve success of the procedure." 4. "The procedure will be performed in your room." 5. "You will need to be in protective isolation for several weeks after the graft is performed."
Correct Answer: 1 Rationale: The patient will begin to perform range-of-motion exercises after five days. Itching is not a symptom of infection but an anticipated occurrence that signals cellular growth. The ideal time to perform the procedure is early in the treatment of the burn injury. The procedure is performed in a surgical suite. Patients with skin grafts do not require protective isolation.
A patient receiving treatment for severe burns over more than half of his body has an indwelling urinary catheter. When evaluating the patient's intake and output, which of the following should be taken into consideration? 1. The amount of urine will be reduced in the first 24-48 hours, and will then increase. 2. The amount of urine output will be greatest in the first 24 hours after the burn injury. 3. The amount of urine will be reduced during the first eight hours of the burn injury and will then increase as the diuresis begins. 4. The amount of urine will be elevated due to the amount of intravenous fluids administered during the initial phases of treatment. 5. The amount of urine is expected to be decreased for three to five days.
Correct Answer: 1 Rationale: The patient will have an initial reduction in urinary output. Fluid is reduced in the initial phases as the body manages the insult caused by the injury and fluids are drawn into the interstitial spaces. After the shock period passes, the patient will enter a period of diuresis. The diuresis begins between 24 and 36 hours after the burn injury.
A patient has a scald burn on the arm that is bright red, moist, and has several blisters. The nurse would classify this burn as which of the following? Select all that apply. 1. a superficial partial-thickness burn 2. a thermal burn 3. a superficial burn 4. a deep partial-thickness burn 5. a full-thickness burn
Correct Answer: 1,2 Rationale: Superficial partial-thickness burn if often bright red, has a moist, glistening appearance and blister formation. Thermal burns result from exposure to dry or moist heat. A superficial burn is reddened with possible slight edema over the area. A deep partial-thickness burn often appears waxy and pale and may be moist or dry. A full-thickness burn may appear pale, waxy, yellow, brown, mottled, charred, or non-blanching red with a dry, leathery, firm wound surface.
A patient arrives at the emergency department with an electrical burn. What assessment questions should the nurse ask in determining the possible severity of the burn injury? Select all that apply. 1. What type of current was involved? 2. How long was the patient in contact with the current? 3. How much voltage was involved? 4. Where was the patient when the burn occurred? 5. What was the point of contact with the current?
Correct Answer: 1,2,3 Rationale: The severity of electrical burns depends on the type and duration of the current and amount of voltage. Location is not important in determining possible severity. Location is not important in determining possible severity.
During the acute phase of burn treatment, important goals of patient care include which of the following? Select all that apply. 1. providing for patient comfort 2. preventing infection 3. providing adequate nutrition for healing to occur 4. splinting, positioning, and exercising affected joints 5. assessing home maintenance management
Correct Answer: 1,2,3,4 Rationale: The goals of treatment for the acute period include wound cleansing and healing; pain relief; preventing infection; promoting nutrition; and splinting, positioning, and exercising affected joints. Assessment of home maintenance management is an important goal in the rehabilitative stage, not the acute stage
he patient has had type 1 diabetes mellitus for 25 years and is now reporting fatigue, edema, and an irregular heartbeat. On assessment, the nurse finds that the patient has newly developed hypertension and difficulty with blood glucose control. The nurse should know that which diagnostic study will be most indicative of chronic kidney disease (CKD) in this patient? A. Serum creatinine B. Serum potassium C. Microalbuminuria D. Calculated glomerular filtration rate (GFR)
D. Calculated glomerular filtration rate (GFR
When caring for a patient during the oliguric phase of acute kidney injury (AKI), what is an appropriate nursing intervention? A. Weigh patient three times weekly. B. Increase dietary sodium and potassium. C. Provide a low-protein, high-carbohydrate diet. D. Restrict fluids according to previous daily loss.
D. Restrict fluids according to previous daily loss. Patients in the oliguric phase of acute kidney injury will have fluid volume excess with potassium and sodium retention. Therefore they will need to have dietary sodium, potassium, and fluids restricted. Daily fluid intake is based on the previous 24-hour fluid loss (measured output plus 600 ml for insensible loss). The diet also needs to provide adequate, not low, protein intake to prevent catabolism. The patient should also be weighed daily, not just three times each week.
Which urinalysis result should the nurse recognize as an abnormal finding? A. pH 6.0 B. Amber yellow color C. Specific gravity 1.025 D. White blood cells (WBCs) 9/hpf
D. White blood cells (WBCs) 9/hpf Normal WBC levels in urine are below 5/hpf, with levels exceeding this indicative of inflammation or urinary tract infection. A urine pH of 6.0 is average; amber yellow is normal coloration, and the reference ranges for specific gravity are 1.003 to 1.030.
The patient reports itching, change in vaginal discharge, and an order. The nurse suspects that the patient has vulvovaginitis. Based on knowledge about the common causes of vulvovaginitis, which question would the nurse ask? a. "Have you recently been taking antibiotics?" b. "Have you been swimming in a lake or pond?" c. "Do you consistently wipe from front to back?" d. "Do you use tampons or menstrual pads?"
a. "Have you recently been taking antibiotics?
Which information will the nurse monitor in order to determine the effectiveness of prescribed calcium carbonate (Caltrate) for a patient with chronic kidney disease (CKD)? a. Blood pressure b. Phosphate level c. Neurologic status d. Creatinine clearance
b. Phosphate level Rationale: Normally, the kidneys control the levels of phosphate in your blood, and the balance between phosphate and calcium in your body. When your kidneys are not working, the level of phosphate in your blood can build up. Serum phosphate level must be lowered before calcium or vitamin D is administered.
The nurse is teaching self care management to a 39 year old woman who had an abdominal hysterectomy. Which point would be emphasized to avoid complications of this surgery? a. Bathe and douche daily to prevent infection b. Take temperature twice a day for the first 3 days after surgery c. Resume typical exercise routines as soon as possible d. Gently massage calves if tenderness or swelling occurs
b. Take temperature twice a day for the first 3 days after surgery
A woman with ovarian cancer has been told that she is in stage three of the cancer. The nurse is reviewing the information with her. Which of the following statements would help in the woman's understanding of stage three ovarian cancer? a) The growth involves one or both ovaries. b) The cancer is limited to the ovaries. c) The growth has spread to the lymph nodes and other areas/organs in the abdominal cavity. d) The cancer has spread to distant sites.
c: The staging and diagnosis is performed by a laparoscopy. The staging is 1-4. Stage three means the cancer has spread to the lymph nodes and other areas in the abdominal cavity. A five-year survival rate for this stage is 30%-60%
What self management strategy would the nurse recommend to a patient to prevent vovaginitis? a. Wear nylon underwear b. Douche daily to remove vaginal secretions c. Apply antiseptic cream daily to perineal area d. Avoid wearing tight fitting clothing
d. Avoid wearing tight fitting clothing
After receiving change-of-shift report, which patient should the nurse assess first? a. Patient who is scheduled for the drain phase of a peritoneal dialysis exchange b. Patient with stage 4 chronic kidney disease who has an elevated phosphate level c. Patient with stage 5 chronic kidney disease who has a potassium level of 3.4 mEq/L d. Patient who has just returned from having hemodialysis and has a heart rate of 124/min.
d. Patient who has just returned from having hemodialysis and has a heart rate of 124/min.
