Med - Surg Final Exam (4/12/23)

A nurse is reviewing the medical record of a client who has hypertension and a new prescription for metoprolol. Which of the following findings should the nurse investigate further?

A history of left sided heart failure.

A nurse is caring for a client who has thrombophlebitis and is receiving a continuous heparin infusion. Which of the following medications should the nurse have available to reverse heparin's effects?

Protamine sulfate

A nurse is preparing a presentation about glucosamine to a group of clients. Which of the following information should the nurse include in the teaching?

"Glucosamine may help to increase joint functionality."

A nurse is teaching a client who has a new prescription for sucralfate to treat a gastric ulcer. Which of the following statements by the client indicates an understanding of the teaching?

"I will take this medication 1 hour before meals and at bedtime."

A nurse is providing discharge teaching to a client who has a new prescription for warfarin. Which of the following statements by the client indicates an understanding of the teaching?

"I'll use my electric razor for shaving."

A nurse in an acute care facility is assessing a client who had hip surgery and has Alzheimer's disease. The nurse asks the client how therapy went that morning. Which of the following statements by the client should the nurse document as confabulation?

"It was good. The Queen of England visited me there."

A nurse in a clinic is caring for a client who has a prescription for digoxin. Which of the following statements indicates the client is experiencing digoxin toxicity?

"My vision seems yellow."

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

"Report changes in hearing."

A nurse is teaching the family of a client who has Alzheimer's disease about donepezil. Which of the following information should the nurse include in the teaching?

"Syncope episodes may occur when taking this medication."

A nurse is providing teaching to a client who has peptic ulcer disease and a new prescription for sucralfate tablets. Which of the following information should the nurse provide?

"Take sucralfate 1 hr before meals."

A nurse is teaching a client who has a duodenal ulcer about his new prescription for cimetidine. The nurse should include which of the following instructions in the teaching?

"Your doctor might need to reduce your theophylline dose while taking this medication."

A nurse is caring for a group of older adult clients. Which of the following manifestations indicates one of the clients is experiencing delirium?

A client attempts to climb out of bed and repeatedly states she must get home.

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

Levodopa/carbidopa

A nurse is caring for a client who is postoperative and is at risk for developing venous thromboembolism (VTE). The nurse should instruct the client to avoid which of the following unsafe actions?

Massaging her legs.

A nurse is planning care for a client who has deep vein thrombosis of the lower leg. Which of the following interventions should the nurse include in the plan of care?

Keep the client's affected leg elevated while in bed.

A nurse is teaching a client who plans to take St. John's wort to treat her depression. Which of the following information should the nurse include in the teaching?

"You may experience vivid dreams while taking St. John's wort."

A nurse is discussing good food choices with a client who is recovering from an exacerbation of inflammatory bowel disease and is to start a low-lactose diet. Which of the following foods is the best choice for the client?

Soy milk

A nurse is providing instruction to a new nurse about caring for clients who are receiving diuretic therapy to treat heart failure. The nurse should explain that which of the following medications puts clients at risk for both hyperkalemia and hyponatremia?

Spironolactone

A nurse is teaching a group of newly licensed nurses about the progressive nature of Alzheimer's disease. Which of the following should the nurse include in the teaching as manifestations seen in the moderate stage of Alzheimer's disease? (Select all that apply.)

- Inability to perform common tasks - Difficulty with talking or reading

A nurse is performing a mental status examination (MSE) on a client who has a new diagnosis of dementia. Which of the following components should the nurse include? (Select all that apply.)

- Grooming - Long-term memory - Affect

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

Bradykinesia

A nurse is teaching a client who takes warfarin daily. Which of the following statements by the client indicates a need for further teaching?

"I have started taking ginger root to treat my joint stiffness."

A nurse is providing teaching to a client who has a new prescription for lisinopril. Which of following statements by the nurse indicates an understanding of the teaching?

"I should report a cough to my provider."

A nurse is providing discharge teaching to a client who has peripheral arterial disease (PAD). Which of the following instructions should the nurse include in the teaching?

Adjust the thermostat so that the environment is warm.

A nurse is planning care for a client who has acute glomerulonephritis. Which of the following interventions should the nurse include in the plan?

Administer antibiotics

A nurse is caring for a client who has gastrointestinal bleeding. Which of the following actions should the nurse take first?

Assess orthostatic blood pressure.

A nurse is caring for a client who has ulcerative colitis and is teaching the client about the common link with Crohn's disease. Which of the following information should the nurse include?

Both are inflammatory

A nurse is reviewing the laboratory results of an adolescent who has chronic glomerulonephritis. Which of the following findings should the nurse expect?

BUN 50 mg/dL

A nurse in a clinic is caring for a client who has recently begun taking warfarin. The nurse is reviewing potential drug and food interaction risks and should instruct the client to avoid which of the following?

Cabbage

A nurse is caring for a client who has congestive heart failure and is taking digoxin daily. The client refused breakfast and is complaining of nausea and weakness. Which of the following actions should the nurse take first?

Check the client's vital signs

A nurse is caring for a client who is 5 hr postoperative following a transurethral resection of the prostate (TURP). The nurse notes that the client's 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 modifying the diet of a client who has Parkinson's disease and is prescribed selegiline, an MAOI. Which of the following foods should the nurse eliminate?

Cheddar cheese

A nurse is caring for a client who has a prescription for digoxin 0.25 mg PO daily. Available is digoxin 0.125 mg/tab. How many tablets should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Desired Over Have STEP 1: What is the unit of measurement the nurse should calculate? tablet STEP 2: What is the dose the nurse should administer? Dose to administer= Desired 0.25 mg STEP 3: What is the dose available? Dose available = Have 0.125 mg STEP 4: Should the nurse convert the units of measurement? No STEP 5: What is the quantity of the dose available? 1 tablet STEP 6: Set up an equation and solve for X. Desired x Quantity/Have = X 0.25 mg x 1 tablet/0.125 mg = X tablet 2 = X STEP 7: Round if necessary. STEP 8: Reassess to determine whether the amount to give makes sense. If there are 0.125 mg/1 tablet and the amount prescribed is 0.25 mg, it makes sense to administer 2 tablets. The nurse should administer digoxin 2 tablets PO.

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

Difficulty starting the flow of urine

A nurse is teaching a client who taking benztropine to treat Parkinson's disease. The nurse should instruct the client to report which of the following adverse effects?

Difficulty voiding

A nurse is providing teaching to a client who has hypertension and a new prescription for captopril. Which of the following instructions should the nurse provide?

Do not use salt substitutes while taking this medication.

A nurse is completing dietary teaching on consuming a low fiber diet with a client who has ulcerative colitis. Which of the following foods should be eliminated in the client's diet?

Dried apricots

A nurse is caring for a client who is postoperative following vascular surgery. Which of the following signs should indicate to the nurse that the client has developed a thrombus?

Dull, aching calf pain

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

Edema

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

Elevated central venous pressure (CVP).

A nurse is providing care for a client who had a laparoscopic cholecystectomy. Which of the following is an appropriate nursing action?

Encourage ambulation once fully awake.

A nurse is caring for a client who is taking digoxin for heart failure and develops indications of severe digoxin toxicity. Which of the following medications should the nurse prepare to administer?

Fab antibody fragments

A nurse is providing discharge instructions to a client who developed deep-vein thrombosis (DVT) postoperatively and is prescribed anticoagulant therapy. Which of the following instructions should the nurse include?

Flexing her knees and feet frequently

A community health nurse is providing teaching to the family of a client who has primary dementia. Which of the following manifestations should the nurse tell the family to expect?

Forgetfulness gradually progressing to disorientation.

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

Frothy sputum

A nurse is caring for a client who has heart failure and a potassium level of 2.4 mEq/L. The nurse should identify which of the following medications as the cause of the client's low potassium level?

Furosemide

A nurse is assessing a client who is African-American and has jaundice. Which of the following areas is the most reliable for the nurse to inspect the client for jaundice?

Hard palate

A nurse is assessing a client who has peptic ulcer disease. Which of the following findings should the nurse identify as the priority?

Hematemesis

A nurse on a medical-surgical unit is caring for four clients who are 24 to 36 hr postoperative. Which of the following surgical procedures places the client at risk for deep-vein thrombosis?

Hip arthroplasty

A nurse is caring for an infant who has inadequate motility of part of the intestine resulting in a mechanical obstruction. The nurse should identify this finding as a manifestation of which of the following disorders?

Hirschsprung's disease

A nurse is caring for a client who has heart failure and a prescription for digoxin. Which of the following statements by the client indicates an adverse effect of the medication?

I feel nauseated and have no appetite.

While performing an admission assessment for a client, the nurse notes that the client has varicose veins with ulcerations and lower extremity edema with a report of a feeling of heaviness. Which of the following nursing diagnoses should the nurse identify as being the priority in the client's care?

Impaired tissue perfusion

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

Inject the medication into the abdomen above the level of the iliac crest.

A nurse is caring for a male infant who has a palpable mass in the upper right quadrant and stools mixed with blood and mucus. The nurse should recognize that which of the following diagnoses is associated with these findings?

Intussusception

A nurse is reviewing blood pressure classifications with a group of nurses at an in-service meeting. Which of the following should the nurse include as a risk factor for the development of hypertension?

Obstructive sleep apnea (OSA)

A nurse is caring for a client who has peripheral vascular disease and reports difficulty sleeping because of cold feet. Which of the following nursing actions should the nurse take to promote the client's comfort?

Obtain a pair of slipper-socks for the client.

A nurse is assessing a toddler who has heart failure. Which of the following findings should the nurse expect?

Orthopnea

A nurse is caring for a client who has a new prescription for propranolol. The nurse should monitor the client for which of the following adverse reactions to this medication?

Postural hypotension

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 in a PACU is assessing a client who has a newly created colostomy. Which of the following findings should the nurse report to the provider?

Purplish-colored stoma

A nurse is caring for a client who has chronic glomerulonephritis. The nurse should expect to find a decrease in which of the following serum laboratory values?

RBC

A nurse is monitoring a client who received epinephrine for angioedema after a first dose of losartan. Which of the following data indicates a therapeutic response to the epinephrine?

Respirations are unlabored

A nurse is teaching a client who has cholecystitis about required dietary modifications. The nurse should include which of the following foods as appropriate for the client's diet?

Roast turkey

A nurse is assessing a client who is receiving dopamine IV to treat left ventricular failure. Which of the following findings should indicate to the nurse that the medication is having a therapeutic effect?

Systolic blood pressure is increased

A nurse is monitoring the cardiac output of a client who has left-sided heart failure using pulse pressure analysis. Which of the following findings can compromise the readings?

The client is experiencing premature atrial contractions.

A nurse is completing a medical interview with a client who has elevated cholesterol levels and takes warfarin. The nurse should recognize that which of the following actions by the client can potentiate the effects of warfarin?

The client uses garlic to lower cholesterol levels.

A nurse is talking with a client who has cholelithiasis and is about to undergo an oral cholangiogram. Which of the following client statements indicates to the nurse understanding of the procedure?

They are going to examine my gallbladder and ducts.

A nurse is providing discharge teaching for a client who has a new prescription for warfarin. Which of the following instructions should the nurse include in the teaching?

Use an electric razor while on this medication.

A nurse is caring for an older adult client who has dementia and handles anxiety by confabulating. The nurse should recognize confabulation when the client

makes up stories when he is unable to remember actual events

A nurse is providing teaching to a parent of a child who has Hirschsprung disease is scheduled for initial surgery. Which of the following statements by the parent indicates an understanding of the teaching?

"I'm glad that my child's ostomy is only temporary."

A nurse is teaching a client who has a new prescription for colesevelam to lower his low-density lipoprotein level. Which of the following instructions should the nurse include?

"Take this medication 4 hr after other medications."

A nurse is caring for an older adult client who has had surgery for an intestinal obstruction and has an NG tube to wall suction. Which of the following interventions should the nurse include in the client's postoperative plan of care? (Select all that apply.)

- Discontinue suction when assessing for peristalsis - Irrigate the NG tube with 0.9% sodium chloride irrigation solution. - Place sequential compression devices on the bilateral lower extremities. - Reposition the client from side to side every 2 hr.

A nurse is preparing to administer a transfusion of RBCs to a client who has heart failure. For which of the following manifestations should the nurse monitor to prevent fluid volume overload? (Select all that apply.)

- Dyspnea - Jugular vein distention - Confusion

A nurse is assessing a client who is experiencing prostatic hypertrophy. Which of the following findings associated with urinary retention should the nurse expect? (Select all that apply.)

- Report of feeling pressure - Tenderness over the symphysis pubis - Distended bladder - Voiding 30 mL frequently

A nurse is caring for a male client who has peripheral vascular disease (PVD), is taking dietary supplements, and has a new prescription for warfarin. The nurse should instruct the client to stop which of the following supplements prior to starting the warfarin? (Select all that apply.)

- Saw palmetto - Glucosamine - Gingko biloba

A nurse is caring for a client who is 1 day postoperative following a transurethral resection of the prostate (TURP) and has a continuous bladder irrigation in place. Which of the following actions should the nurse take? (Select all that apply.)

- Use sterile technique when preparing the irrigation solution. - Ensure the drainage tubing is patent and without obstruction. - Notify the surgeon if the urine is bright red in appearance or has large clots.

A nurse is admitting a client who has acute heart failure following myocardial infarction (MI). The nurse recognizes that which of the following prescriptions by the provider requires clarification?

0.9% normal saline IV at 50 mL/hr continuous

A nurse is teaching a client who reports taking gingko biloba to improve his memory. Which of the following adverse effects should the nurse include?

Bleeding gums

A nurse is teaching a client who has hypertension and a new prescription for atenolol. Which of the following findings should the nurse include as adverse effects of this medication?

Bradycardia

A nurse is caring for a client who has an active upper gastrointestinal bleed. After inserting a NG tube into the client, which of the following findings should the nurse anticipate?

Coffee ground drainage

A nurse is caring for a client who has suspected cholecystitis. The nurse should expect the client's urine to appear which of the following colors?

Dark and foamy

A nurse is caring for a client who is taking lisinopril. Which of the following outcomes indicates a therapeutic effect of the medication?

Decreased blood pressure

A nurse is planning care for a client who has deep-vein thrombosis (DVT) and is receiving anticoagulation therapy. Which of the following interventions should the nurse include in the plan of care?

Encourage the client to walk.

A nurse is caring for a client who is postoperative following hip arthroplasty. The nurse should anticipate which of the following prescriptions for this client?

Enoxaparin

A nurse is preparing to administer amoxicillin 30 mg/kg/day divided equally every 12 hr to a toddler who weighs 33 lb. Available is amoxicillin 200 mg/5 mL suspension. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

Follow these steps for the Desired Over Have method of calculation: Step 1: What is the unit of measurement the nurse should calculate? kg Step 2: Set up an equation and solve for X. Client's weight in lb × 1 kgX kg = 2.2 lb 33 lb × 1 kgX kg = 2.2 lb X kg = 15 kg Step 3: What is the unit of measurement the nurse should calculate? mg Step 4: Set up an equation and solve for X. X mg = Dose per kg × Client's weight in kg X mg = 30 mg × 15 X mg = 450 mg The dose is divided equally every 12 hours; therefore, divide X by 2. 450 mg = 225 mg2 Step 5: What is the unit of measurement the nurse should calculate? mL Step 6: What is the dose the nurse should administer? Dose to administer = Desired 225 mg Step 7: What is the dose available? Dose available = Have 200 mg Step 8: Should the nurse convert the units of measurement? No Step 9: What is the quantity of the dose available? 5 mL Step 10: Set up an equation and solve for X. Desired × QuantityX = Have 225 mg × 5 mLX mL = 200 mg X mL = 5.625 mL Step 11: Round if necessary. 5.625 = 5.6 mL Step 12: Reassess to determine whether the amount to give makes sense. If there is 200 mg/5 mL and the prescription reads 225 mg, it makes sense to give 5.6 mL. The nurse should administer amoxicillin suspension 5.6 mL PO every 12 hr.

A nurse is preparing to administer amantadine 150 mg PO every 12 hr. Available is amantadine 50 mg/5 mL syrup. How many mL should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Follow these steps for the Desired Over Have method of calculation: Step 1: What is the unit of measurement the nurse should calculate? mL Step 2: What is the dose the nurse should administer? Dose to administer = Desired 150 mg Step 3: What is the dose available? Dose available = Have 50 mg Step 4: Should the nurse convert the units of measurement? No Step 5: What is the quantity of the dose available? 5 mL Step 6: Set up an equation and solve for X. Desired × QuantityX = Have 150 mg × 5 mLX mL = 50 mg X mL = 15 mL Step 7: Round if necessary. Step 8: Reassess to determine whether the amount to give makes sense. If there are 50 mg/5 mL and the amount prescribed is 150 mg, it makes sense to administer 15 mL. The nurse should administer amantadine 15 mL PO per dose.

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

Keep familiar personal items at the bedside.

A nurse is assessing a client who has heart failure and is prescribed furosemide. Which of the following findings is an adverse effect of this medication?

Leg cramps

A nurse is caring for a client who has a gastric ulcer. Which of the following herbal supplements should the nurse recommend?

Licorice

A nurse is caring for a client who has dementia. The client is agitated and is having difficulty staying in his chair. Which of the following actions should the nurse take first?

Place a seat alarm in the client's chair.

A nurse is reviewing the laboratory data on a client who has a new prescription for heparin for treatment of a pulmonary embolism. Which of the following data should the nurse report to the provider?

Platelets 74,000/mm3

A nurse is caring for a client who receives furosemide to treat heart failure. Which of the following laboratory values should the nurse monitor for this client due to this medication?

Potassium

A nurse is planning to administer digoxin to a client who has heart failure. Which of the following laboratory results is the priority for the nurse to review prior to administering the medication?

Potassium

A nurse is caring for a client who has peptic ulcer disease. The nurse should monitor the client for which of the following findings as an indication of gastrointestinal perforation?

Sudden abdominal pain

A nurse is providing discharge teaching about clean intermittent self-catheterization for a client who has benign prostatic hyperplasia. Which of the following instructions should the nurse include?

Use soap and water to wash the catheter after each use.

A nurse is caring for a client who has a new diagnosis of essential hypertension. The nurse should monitor the client for which of the following findings that is consistent with this diagnosis?

Vertigo

A nurse is caring for a client who is on warfarin therapy for atrial fibrillation. The client's INR is 5.2. Which of the following medications should the nurse prepare to administer?

Vitamin K

A nurse is reviewing the medication list for a client who has a new prescription for warfarin. The nurse should recognize that which of the following medications is incompatible with warfarin?

Vitamin K

A nurse is creating a plan of care to maintain the skin integrity of a client who experiences frequent diarrhea due to ulcerative colitis. Which of the following interventions should the nurse include in the plan?

Wipe perianal area with warm water and apply a barrier cream

A nurse is assessing a toddler who has acute nephrotic syndrome. Which of the following findings should the nurse report to the provider?

Yellow or green nasal discharge is an indication of an upper respiratory infection. Children who have nephrotic syndrome are at constant risk for infection. The nurse should report this manifestation to the provider so the child can receive appropriate and prompt treatment.