Med Surg Nearpod Questions

Which clinical manifestations are seen with hepatitis? Select all that apply A. Hepatomegaly B. Low grade fever C. Elevated liver enzymes D. Decreased sense of taste E. Jaundice

A, B, C, E

Which health teaching will the nurse include as part of the discharge planning related to the client's DVT management and prevention of a new DVT? Select all that apply. A. Elevate your legs on a couple of pillows when in bed B. Wear knee-high graduated compression stockings C. Apply prolonged pressure over cuts and nosebleeds D. Weigh yourself each morning on the same scale E. Avoid eating foods that are high in fat and cholesterol F. Increase your activity slowly and rest when needed G. Take over the counter pain medications for mild pain H. Keep your scheduled appointment at the Coumadin (warfarin) clinic I. Contact your primary health care provider if your stool is black and tarry J. If you miss a dose of warfarin, take a double dose the following day K. Monitor your heart rate and blood pressure daily

A, B, C, E, F, G, H, I, K

Which information would the nurse emphasize while teaching a patient ways to avoid exposure to hepatitis B infection? Select all that apply. A. Use disposable needles and syringes B. Avoid sharing toothbrushes and razors C. Avoid eating foods prepared in unhygenic ways D. Avoid touching or coming in contact with people with hepatitis B E. Avoid unsafe sex with multiple partners, and always use condoms

A, B, E

Which intervention(s) would the nurse expect in the treatment plan for a client who is admitted to the hospital with ascites? Select all that apply. A. Paracentesis B. High sodium diet C. Increase fluid intake D. Monitor electrolytes E. Administer albumin

A, D, E

A nurse is caring for a client with colorectal cancer who is receiving total parenteral nutrition (TPN). The provider has prescribed the TPN to infuse at 150 mL/hr. The TPN bag holds 2400 mL How long will it take for the TPN to infuse to the nearest whole hour? A. 16 hr B. 24 hr C. 8 hr D. 32 hr

A. 16 hr

A client with a medical diagnosis of cirrhosis has been admitted to a medical unit, and the nurse is doing an assessment. What complaint from the client requires immediate follow up? A. Bloody expectorant with coughing episodes B. Jeans cannot zip because of enlarged abdomen C. Swelling in the feet and lower legs D. Yellowing of the eyes and mucous membranes

A. Bloody expectorant with coughing episodes

You provide teaching on proper care of his feet and lower extremities, then use "teachback" to assess S.P.'s learning. Which statements by S.P. indicate a need for further education? Select all that apply. A. I can go barefoot in the house, but not outside B. I will wear shoes that are roomy and protective C. I will avoid exposing my feet to extremes of heat and cold D. I will soak my feet in water once a day to make sure they are clean E. I will out lotion on my feet and lower legs, but not in between my toe

A. I can go barefoot in the house, but not outside D. I will soak my feet in water once a day to make sure they are clean

The nurse is providing discharge teaching for a client with newly diagnosed Crohn's disease about dietary measures to implement during exacerbation episodes. Which statement made by the client indicates a need for further instruction? A. I need to increase the fiber in my diet B. I will need to avoid caffeinated beverages C. I'm going to learn some stress-reduction techniques D. I can have exacerbations and remissions with Crohn's disease

A. I need to increase the fiber in my diet

The nurse is monitoring a client admitted to the hospital with a diagnosis of appendicitis who is scheduled for surgery in 2 hours. The client begins to complain of increased abdominal pain and begins to vomit. On assessment, the nurse notes that the abdomen is distended and bowel sounds are diminished. Which is the most appropriate nursing intervention? A. Notify the surgeon B. Administer the prescribed pain medication C. Call and ask the operating room team to perform surgery as soon as possible D. Reposition the client and apply a heating pad on the warm setting to the client's abdomen

A. Notify the surgeon

You ask further questions about the clinical manifestations of PAD. Which of these would you expect S.P. to have, given the diagnosis of PAD? Select all that apply. A. Paresthesia B. Elevation Pallor C. Dependent rubor D. Rest pain at night E. Pruritus of the lower leg F. Constant, dull ache In his calf or thigh

A. Paresthesia B. Elevation Pallor C. Dependent rubor D. Rest pain at night

The health care provider prescribes lactulose for a client with hepatic encephalopathy. Which data would the nurse monitor for effectiveness of this medication? Select all that apply. A. Liver enzymes B. Stool frequency C. Urine output D. Abdominal pain E. Serum lipase F. Ammonia levels

B and F

Which diagnostic test(s) would the nurse anticipate will be prescribed to confirm a client's diagnosis of acute pancreatitis? Select all that apply. A. Liver biopsy B. Serum lipase C. Serum amylase D. CT scan

B, C, D

In addition to risk factor modification, what other measures to improve tissue perfusion or prevent skin damage should you recommend to S.P.? Select all that apply A. Limit fluid intake B. Avoid exposure to cold temperatures C. Use a heating pad or hot water bottle D. Avoid crossing the legs E. Take steps to prevent trauma or injury to the skin

B. Avoid exposure to cold temperatures D. Avoid crossing the legs E. Take steps to prevent trauma or injury to the skin

A client is returned to the surgical unit after an abdominal cholecystectomy. Which is the main reason why the nurse would assess for clinical indicators of respiratory complications? A. Client has a history of asthma B. Client is at risk for developing pneumonia C. Client is immunocompromised because bile is in the blood D. The bloodstream is invaded by mircoorganisms from the biliary tract

B. Client is at risk for developing pneumonia

Which action is likely to exacerbate the condition of a client who has pancreatitis? A. Checking for fatty stools B. Eating three large meals C. Taking omeprazole 1 hour after meals D. Taking pancreatic enzymes along with meals

B. Eating three large meals

The clinic nurse is interviewing a new client, who presents with increasing frequency of stools and says the last healthcare provider gave a diagnosis of ulcerative colitis. What statement by the client requires immediate follow-up? A. I'm having more frequent loose stools than I did last week B. I've developed a high fever and severe abdominal pain since yesterday C. My last healthcare provider said I have a genetic link for developing this disease D. This is a depressing disease to have

B. I've developed a high fever and severe abdominal pain since yesterday

A 13 year old client is receiving total parenteral nutrition (TPN) as a treatment for Crohn's disease. The client asks the rationale for this treatment. Which statement by the nurse accurately describes the reason for this treatment? A. The nutrition in your intravenous line is more complete than what you can eat B. TPN allows your intestines to rest and heal for a while C. This treatment assists you in getting the nutrients you need without the allergies D. With this treatment you do not need to eat by mouth so you can get the rest you need

B. TPN allows your intestines to rest and heal for a while

You decide to look at S.P.'s lower extremities. What signs do you expect to find with PAD? Select all that apply A. Ankle edema B. Thick, brittle nails C. Cool or cold extremity D. Thin, shiny, and taught skin E. Brown discoloration of the skin F. Decreased or absent pedal pulses

B. Thick, brittle nails C. Cool or cold extremity D. Thin, shiny, and taught skin F. Decreased or absent pedal pulses

A client who is receiving heparin therapy is started on warfarin. Which nursing explanation is appropriate? A. "You will need both drugs long-term to provide long-term anticoagulation." B. "Warfarin is easier on your stomach so you can take it long-term C. "It takes several days for warfarin to begin working, so both drugs are required for a short time." D. "These drugs work the same, but one is taken by mouth, so it is easier to take at home."

C. "It takes several days for warfarin to begin working, so both drugs are required for a short time."

Which measurement would provide the most specific information about the outcome of a paracentesis for a client who has ascites? A. Cardiac output B. Blood pressure C. Abdominal girth D. Pain scale

C. Abdominal girth

Which condition may require a patient's scheduled percutaneous liver biopsy to be rescheduled? A. Chronic hepatitis B. Cirrhosis C. Bleeding disorder D. Pancreatitis

C. Bleeding disorder

A client undergoes a laparotomy in the epigastric region for a small bowel obstruction. Which nursing intervention is indicated to prevent the most concerning complication of this surgery? A. Sterile dressing changes and IV antibiotics B. A high fiber diet with adequate oral and IV hydration C. Coughing and using an incentive spirometer every 2 hours D. Turning every 2 hours and padding under bony prominences

C. Coughing and using an incentive spirometer every 2 hours

A client has chronic diarrhea, bloating, and abdominal pain. The healthcare provider is ruling out celiac disease. The client asks the nurse about dietary guidelines. What would be the best answer from the nurse? A. You will need to eat foods that bind the bowels like bananas, rice, toast, and applesauce B. You should eat a low-fiber diet that limits fibers including nuts, seeds, and popcorn. C. Foods that you cannot eat include wheat proteins or gluten based starches or fillers D. You will need to discuss your dietary needs with a nutritionist to develop a meal plan

C. Foods that you cannot eat include wheat proteins or gluten based starches or fillers

A client is admitted with ascites from cirrhosis with liver failure. Spironolactone 100 mg is administered. Which sign or symptom would indicate a serious complication for the client? A. Blurry vision B. Low potassium C. Increasing thirst D. Leg pain

C. Increasing thirst

Which instruction would the nurse include in the discharge teaching when a client with hepatitis A infection is leaving the hospital? A. Do not share your razors B. Isolate yourself from your family members C. Wash your hands thoroughly after having a bowel movement D. Take acetaminophen every 4 hours if your fever persists

C. Wash your hands thoroughly after having a bowel movement

A client returns from surgery for placement of a colostomy secondary to ulcerative colitis. Two hours after the surgery the nurse is most concerned about which assessment? A. Hypoactive bowel sounds in a four quadrants B. Decreased breath sounds in the bases of the lungs C. Slight distention of the bladder D. A blood pressure below the baseline value

D. A blood pressure below the baseline value

Which information would the nurse include in the teaching plan for a client who is stable after treatment of recently diagnosed esophageal varices? A. Decrease fluid intake to avoid irritating the varices B. Eat foods quickly so they do not get cold and cause distress C. Avoid exercise because it may cause bleeding of the varices D. Avoid straining during defecation to keep venous pressure low

D. Avoid straining during defecation to keep venous pressure low

A client on the surgical unit is preparing to be discharged after a colectomy for an intestinal obstruction. The nurse finds the client passed out on the bathroom floor. Which response by the nurse would be most appropriate? A. Call another nurse to help get the patient back to bed B. Call the client's provider from the room C. Check the client's abdominal wound for bleeding D. Determine if the client is breathing and has a pulse

D. Determine if the client is breathing and has a pulse

A client experiences occasional right upper quadrant pain attributed to cholecystitis. To prevent or minimize dyspepsia, the nurse would instruct the client to avoid which food items? A. Nuts and popcorn B. Meatloaf and baked potato C. Chocolate and boiled shrimp D. Fried chicken and buttered popcorn

D. Fried chicken and buttered popcorn

When planning care for a patient who has cirrhosis with significant abdominal ascites, which patient problem has the highest priority? A. Excess fluid volume B. Imbalanced nutrition C. Impaired skin integrity D. Ineffective breathing pattern

D. Ineffective breathing pattern

Which action will the nurse include when developing the postprocedure plan of care for a patient who underwent a liver biopsy? A. Keep an abdominal binder in place over the needle insertion site B. Encourage coughing and deep breathing exercises C. Maintain bedrest for 24 hours D. Keep the patient side-lying on the right side

D. Keep the patient side-lying on the right side

A client reports nausea and abdominal pain. The nurse notices bluish discoloration in the area between the client's last rib and the hip and records a body temperature of 99.1°F (37.3°C). The laboratory reports reveal a white blood cell count (WBC) of 12,000 cells/µL. Which condition would the nurse suspect in this client? A. Cirrhosis B. Esophageal varicies C. Cholelithiasis D. Pancreatitis

D. Pancreatitis

EMS transports a known IV drug user to the ED. The client reports flu-like symptoms for the last week, jaundice, and inability to keep food down. What safety precautions should the nurse utilize? A. Droplet precautions only B. Full gown, gloves, mask with shield C. Report the client to the CDC D. Standard precautions of gloves and handwashing

D. Standard precautions of gloves and handwashing