Med Surg Final Exam

Which instruction would the nurse include when teaching a spouse and patient with hepatitis C about preventing the spread of infection?

"Do not share toothbrushes."

When assessing a patient with a history of multiple renal calculi formations, the nurse would associate which patient statement with increasing the patient's risk for future stone development?

"I eat large amounts of protein."

When providing discharge teachings to a patient with peripheral neuropathy secondary to diabetes, which patient statement indicates understanding of injury prevention? Select all that apply. One, some, or all responses may be correct.

"I should never go barefoot." "I should quit smoking." "I need to monitor my feet daily for blisters or skin breaks."

The nurse is obtaining a health history from a client with a diagnosis of peptic ulcer disease. The nurse identifies a possible contributory risk factor when the client makes which statement?

"I smoke one pack of cigarettes a day."

Which instruction would the nurse give a patient newly diagnosed with ulcerative colitis (UC) about diet and lifestyle choices?

"Lactose-containing foods should be reduced or eliminated from your diet."

In which way will the nurse respond to a patient diagnosed with hepatitis A who asks the nurse how this disease may have been contracted?

"You may have consumed foods contaminated with the virus."

Which intravenous (IV) solution would a nurse anticipate administering when caring for a client with a history of severe diarrhea for the past 3 days who is admitted for dehydration?

0.9% sodium chloride

The nurse is caring for a client with the following arterial blood gas (ABG) values: PO 2 89 mm Hg, PCO 2 35 mm Hg, and pH of 7.37. These findings indicate that the client is experiencing which condition?

Normal acid-base balance

Which patient with an indwelling urinary catheter would the nurse reassess to determine if continued catheterization is necessary? Select all that apply. One, some, or all responses may be correct.

3-day postoperative patient Incontinent older adult in long term care Patient in postanesthesia care unit (PACU)

Which substance causes the collecting tubules in the kidneys to reabsorb sodium as part of a blood pressure (BP) control system?

Aldosterone

According to the Centers for Disease Control and Prevention (CDC) laboratory classifications for human immune deficiency virus (HIV), which class has defining features which include a CD4+ T-cell count of less than 200 cells/mm 3 (0.2 × 10 9/L) or a percentage of less than 14%?

Class 3

A client with colitis has had a hemicolectomy. Three days after surgery the nurse identifies that the client has abdominal distention, absent bowel sounds, and vomitus of 300 mL of dark green viscous fluid. The nurse contacts the primary health care provider and anticipates which prescription?

Nasogastric tube for decompression

Which information would a nurse reinforce when teaching a client with gastroesophageal reflux disease (GERD) about antacid therapy?

Antacids commonly interfere with the absorption of other medications.

A client with gastroesophageal reflux disease (GERD) is being treated with dietary management. The client states, "I like to have a glass of juice every day." Which juice will the nurse recommend?

Apple

The nurse is caring for a patient after a spinal cord injury (SCI). The patient experiences a sudden rise in blood pressure, profuse sweating, and altered vision. Which condition would the nurse suspect?

Autonomic dysreflexia

A patient suspected of having cholecystitis presents with severe upper epigastric pain radiating to the right shoulder. The patient is vomiting and has abdominal distention. Which finding do these symptoms indicate?

Biliary colic

Elevation of which laboratory value is associated with jaundice for a patient with hepatitis?

Bilirubin

Which food would the nurse instruct the patient with urinary calcium oxalate stones to avoid to prevent future stone formation? Select all that apply. One, some, or all response may be correct.

Black tea Rhubarb Spinach

The nurse is assessing a 35-year-old patient after surgery to repair a torn meniscus to the left knee. Which cue would require the nurse to contact the health care provider (HCP)?

Capillary refill 6 seconds in the left great toe

When the chest x-ray for a client who has arrived at the emergency department with chest trauma shows multiple fractured ribs, which action will the nurse take next?

Check for paradoxical movement of the chest wall

The nurse is reviewing laboratory values for a patient recently admitted to the medical-surgical unit. Which laboratory result is of concern?

Magnesium: 6.2 mEq/L

Which parameter would the nurse monitor to assess a patient's response to fluid replacement therapy? Select all that apply. One, some, or all responses may be correct.

Monitoring pulse quality Monitoring weight change Monitoring urine output

A patient has dry skin, a heart rate of 115 beats/min, a respiratory rate of 28 breaths/min, and weight loss of 1 lb in 1 day. Which condition would the nurse suspect?

Dehydration

Which condition is a risk factor for distributive shock?

Diminished immune response

The nurse is preparing a patient for a laparoscopic cholecystectomy. After reinforcing the surgeon's preoperative teaching, the nurse would include which information?

Discuss postoperative pain medications, deep breathing, and leg exercises.

While managing care for a patient with chronic kidney disease, the registered nurse (RN) will plan to delegate which action to the assistive personnel (AP)? Select all that apply. One, some, or all responses may be correct.

Document the amount the patient drinks throughout the shift Obtain the patient's predialysis weight

When a patient's 7:00 a.m. finger stick blood glucose readings are between 286 and 353 mg/dL for three mornings in a row, which finding supports the nurse's suspicion that the patient may have dawn phenomenon?

Early morning glucose elevations

Which assessment finding in a hospitalized client with a history of chronic kidney disease would alert the nurse to suspect kidney insufficiency?

Edema and pruritus

Which laboratory change would the nurse expect in a patient with chronic kidney disease? Select all that apply. One, some, or all responses may be correct.

Elevated creatinine Elevated blood urea nitrogen (BUN)

Which disorder would the nurse associate with a 67-year-old male patient with a history of chronic kidney disease who presents with shortness of breath, lungs with bilateral course crackles, and laboratory tests revealing a blood urea nitrogen (BUN) of 6 mg/dL and a BUN/creatinine ratio of 4?

Excess fluid volume

A patient who is admitted with severe diabetic ketoacidosis has an arterial blood gas result that reveals a pH of 7.21. Which factor is causing this patient's acidosis?

Excessive breakdown of fatty acids

Which assessment finding indicates that a patient with a T4 spinal cord injury is developing autonomic dysreflexia? Select all that apply. One, some, or all responses may be correct.

Heart rate 52 beats/min and irregular Blood pressure 190/90 mmHg Flushing of the neck Profuse diaphoresis

Which electrolyte abnormality would the nurse anticipate when reviewing laboratory data for a patient admitted with metabolic acidosis?

Hyperkalemia

A client had a pancreaticoduodenectomy for cancer of the pancreas. The nurse provides education about long-term complications related to this type of surgery, including information about hypoinsulinism. The nurse would instruct the client to report which symptom that may be indicative of the complication?

Increased thirst

Which organ plays a major role in maintaining pH balance in the body? Select all that apply. One, some, or all responses may be correct.

Kidneys Lungs

Which factor in a patient's health history would the nurse identify as increasing the risk for multiple sclerosis (MS)? Select all that apply. One, some, or all responses may be correct.

Living in a cold climate Family history of MS Age 20 to 50 years

Two weeks after sustaining a spinal cord injury, a client begins vomiting thick, coffee-ground material and appears restless and apprehensive. Which is the most important initial nursing action?

Prepare for insertion of a nasogastric tube

Which clinical findings in a patient indicate ulcerative colitis?

Presence of blood and mucus in the stool

A patient with a T6 spinal cord injury who is in the rehabilitation unit suddenly develops facial flushing and reports a severe headache. Blood pressure is elevated, and the heart rate is slow. Which action would the nurse take first?

Raise the head of the bed

Which nursing intervention or practice is most effective in helping to prevent urinary tract infections (UTI) in hospitalized patients?

Re-evaluating the need for indwelling catheters

A laboratory report for a patient shows the following results: pH 7.32; bicarbonate 24 mEq/L; partial pressure of arterial oxygen (PaO 2) 77 mm Hg; and partial pressure of arterial carbon dioxide (PaCO 2) 48 mm Hg. These findings are consistent with which acid-base imbalance?

Respiratory acidosis

The nurse is caring for a client after abdominal surgery and encourages the client to engage in deep-breathing exercises and turn from side to side. Which complication is the nurse trying to prevent?

Respiratory acidosis

Which change in the arterial blood gases would the nurse expect in a client with hyperventilation due to anxiety?

Respiratory alkalosis

Which features of the human immune deficiency virus (HIV) convert its ribonucleic acid (RNA) into DNA and insert it into the host's DNA?

Reverse transcriptase and integrase enzymes

The nurse will assist a patient into which position to help relieve postoperative nausea and vomiting?

Side-lying, with the head in a neutral position

The nurse is caring for a patient admitted with an exacerbation of multiple sclerosis (MS). The patient reports urinary incontinence. Which primary urinary bladder alteration related to MS is the likely cause?

Spastic bladder

A patient is experiencing bleeding related to peptic ulcer disease (PUD). Which action would the nurse take?

Starting a large-bore IV

When performing preoperative teaching for a patient who smokes a pack of cigarettes a day, which instruction is a priority?

Teach the patient how to use the incentive spirometer.

The health care provider prescribed IV fluids, antiemetics, and continuous telemetry monitoring for a patient at risk for hypovolemic shock secondary to GI fluid losses. Which cue would lead the nurse to conclude the interventions are effective?

Urine output 950 ml/24 hr