medsurg 3

When referred to a podiatrist, a client newly diagnosed with diabetes mellitus asks, "Why do you need to check my feet when I'm having a problem with my blood sugar?" The nurse's most helpful response to this statement is:

"Diabetes can affect sensation in your feet and you can hurt yourself without realizing it."

A client is taking glyburide (DiaBeta), 1.25 mg P.O. daily, to treat type 2 diabetes. Which statement indicates the need for further client teaching about managing this disease?

"I skip lunch when I don't feel hungry."

A client with diabetes comes to the clinic for a follow-up visit. The nurse reviews the client's glycosylated hemoglobin test results. Which result would indicate to the nurse that the client's blood glucose level has been well controlled?

6.5%

A client with type 1 diabetes presents with a decreased level of consciousness and a fingerstick glucose level of 39 mg/dl. His family reports that he has been skipping meals in an effort to lose weight. Which nursing intervention is most appropriate?

Administering 1 ampule of 50% dextrose solution, per physician's order

An older adult client informs the nurse about having recurrent episodes of constipation. Which action(s) will the nurse perform first? Select all that apply. Encourage the use of a stool softener daily. Assess food intake history. Assess surgical history. Encourage the use of fiber supplements. Assess fluid intake history.

Assess food intake history. Assess fluid intake history.

An adult client with a history of dyspepsia has been diagnosed with chronic gastritis. The nurse's health education should include what guidelines? Select all that apply. Avoid drinking alcohol Adopt a low-residue diet Avoid nonsteroidal anti-inflammatories Take calcium gluconate as prescribed Prepare for the possibility of surgery

Avoid drinking alcohol Avoid nonsteroidal anti-inflammatories

A patient comes to the clinic with the complaint, "I think I have an ulcer." What is a characteristic associated with peptic ulcer pain that the nurse should inquire about? Select all that apply. Burning sensation localized in the back or mid-epigastrium Feeling of emptiness that precedes meals from 1 to 3 hours Severe gnawing pain that increases in severity as the day progresses Pain that radiates to the shoulder or jaw Vomiting without associated nausea

Burning sensation localized in the back or mid-epigastrium Feeling of emptiness that precedes meals from 1 to 3 hours Severe gnawing pain that increases in severity as the day progresses

The nurse is caring for a client who requires enteral nutrition. For which reasons will the nurse anticipate the client having a gastrostomy tube inserted? Select all that apply. Client is comatose History of diverticulosis Hyperactive bowel sounds Frequent bouts of constipation Enteral support needed for over 6 weeks

Client is comatose Enteral support needed for over 6 weeks

The primary function of the thyroid gland includes which of the following?

Control of cellular metabolic activity

A client is being treated for diverticulosis. Which points should the nurse include in this client's teaching plan? Select all that apply. Do not suppress the urge to defecate. Drink fluids, especially water and fluids that are sugar-free Limit high-fat meat and dairy products Engage in regular physical activity Limit high-fiber foods

Do not suppress the urge to defecate. Drink fluids, especially water and fluids that are sugar-free Limit high-fat meat and dairy products Engage in regular physical activity

A client who had a gastroduodenostomy reports generalized weakness, sweating, palpitations, and dizziness 15 to 30 minutes after eating. What complication does the nurse suspect is occurring? A.Malnutrition B.Bile reflux gastritis C.Dumping syndrome D.Postprandial hypoglygemia

Dumping syndrome

A nurse is applying an ostomy appliance to the ileostomy of a client with ulcerative colitis. Which action is appropriate?

Gently washing the area surrounding the stoma using a facecloth and mild soap

A client is scheduled for the creation of a continent ileostomy. What dietary guidelines should the nurse encourage during the weeks following surgery?

High intake of strained fruits and vegetables

A nurse is preparing to discharge a client with coronary artery disease and hypertension who is at risk for type 2 diabetes. Which information is important to include in the discharge teaching?

How to control blood glucose through lifestyle modification with diet and exercise

A client is evaluated for type 1 diabetes. Which client comment correlates best with this disorder?A client is evaluated for type 1 diabetes. Which client comment correlates best with this disorder?

I'm thirsty all the time. I just can't get enough to drink."

A nurse is preparing to palpate the thyroid gland. Where would the nurse expect to find this gland?

In the lower neck, anterior to the trachea

A nurse teaches a client with newly diagnosed hypothyroidism about the need for thyroid hormone replacement therapy to restore normal thyroid function. Which thyroid preparation is the agent of choice for thyroid hormone replacement therapy?

Levothyroxine (Synthroid)

A nurse is talking with a client who is scheduled to have a hemicolectomy with the creation of a colostomy. The client admits to being anxious, and has many questions concerning the surgery, the care of a stoma, and necessary lifestyle changes. What nursing action is most appropriate?

Maintain an open dialogue with the client and facilitate a referral to the wound-ostomy-continence (WOC) nurse.

A nurse is caring for a client who had a thyroidectomy and is at risk for hypocalcemia. What should the nurse do?

Observe for muscle twitching and numbness or tingling of the lips, fingers, and toes

An older adult patient that has type 2 diabetes comes to the emergency department with second-degree burns to the bottom of both feet and states, "I didn't feel too hot but my feet must have been too close to the heater." What does the nurse understand is most likely the reason for the decrease in temperature sensation?

Peripheral neuropathy

A client was admitted with epigastric pain because of a gastric ulcer. Which client assessment warrants an urgent change in the nursing plan of care? A.Back pain 3 or 4 hours after eating a meal B.Chest pain relieved with eating or drinking water C.Burning epigastric pain 90 minutes after breakfast D.Ridgid abdomen and vomiting following indigestion

Ridgid abdomen and vomiting following indigestion

A nurse is writing a care plan for a client with a nasogastric tube in place for gastric decompression. Which risk nursing diagnosis is the most appropriate component of the care plan?

Risk for Impaired Skin Integrity Related to the Presence of NG Tube

A patient is receiving continuous tube feedings. The nurse would maintain the patient in which position at all times?

Semi-Fowler's with the head of the bed elevated 30 to 45 degrees

A client who experienced an upper gastrointestinal (GI) bleed due to peptic ulcer disease has had the bleeding controlled and is now in stable condition. Which assessment finding(s) would the nurse identify that indicate recurrence? Select all that apply. Tachycardia Tarry, foul-smelling stools Diaphoresis Sudden thirst Hypotension Tachypnea

Tachycardia Hypotension Tachypnea

A client has had a hemorrhoidectomy and is being prepared for discharge. Which discharge education will the nurse provide to the client? Select all that apply. The appropriate use of antibiotics to prevent postoperative infection The correct procedure for taking a sitz bath The need to eat a low-residue, low-fat diet for the next 2 weeks The correct technique for keeping the perianal region clean without the use of water The effective use of relaxation exercises to facilitate defecating.

The correct procedure for taking a sitz bath The effective use of relaxation exercises to facilitate defecating.

The presence of mucus and pus in the stools suggests which condition?

Ulcerative colitis

A client with type 1 diabetes is to receive a short-acting insulin and an intermediate-acting insulin subcutaneously before breakfast. The nurse would administer the insulin at which site as the preferred site?

abdomen

A typical sign/symptom of appendicitis is:

nausea

A client visits the physician's office complaining of agitation, restlessness, and weight loss. The physical examination reveals exophthalmos, a classic sign of Graves' disease. Based on history and physical findings, the nurse suspects hyperthyroidism. Exophthalmos is characterized by:

protruding eyes and a fixed stare.

The nurse teaches the client whose surgery will result in a sigmoid colostomy that the feces expelled through the colostomy will be

solid

A nurse is developing a teaching plan for a client with diabetes mellitus. A client with diabetes mellitus should:

wash and inspect the feet daily.

A client presents with right lower quadrant pain, temperature of 101°F (38.3°C) and a white blood cell count of 14,000. Which will the nurse prioritize when caring for the client? Select all that apply. Administer pain medication as prescribed. Prepare the client for surgery. Start an intravenous line. Begin the administration of antibiotics as prescribed. Notify family members of the client's admission.

Administer pain medication as prescribed. Prepare the client for surgery. Start an intravenous line. Begin the administration of antibiotics as prescribed.

Which would be included in the teaching plan for a client diagnosed with diabetes mellitus?

An elevated blood glucose concentration contributes to complications of diabetes, such as diminished vision.

After undergoing a thyroidectomy, a client develops hypocalcemia and tetany. Which electrolyte should the nurse anticipate administering?

Calcium gluconate

The nurse is caring for a client with a duodenal ulcer. Which assessment findings indicate to the nurse that the client is experiencing perforation from the ulcer? Select all that apply. Vomiting Tender and rigid abdomen Sudden drop in blood pressure Pulsating mass in the left abdominal region Abdominal pain referred to the right shoulder

Vomiting Tender and rigid abdomen Sudden drop in blood pressure Abdominal pain referred to the right shoulder

A nurse is preparing to provide care for a client whose exacerbation of ulcerative colitis has required hospital admission. During an exacerbation of this health problem, the nurse would anticipate that the client's stools will have what characteristics?

Watery with blood and mucus

The nurse is caring for a client with hypovolemia related to prolonged vomiting and decreased intake of oral fluids. What activity(ies) should the nurse include in the client's plan of care? Select all that apply. Encourage the client to drink a 16 oz (480 ml) glass of water over the course of 15 minutes. Offer the client a low-fat and high-protein meal. Inform the primary health care provider if urine output is 3.5 oz (103 ml) per day or lower. Advise the client to avoid alcohol. Administer intravenous fluids as ordered.

Advise the client to avoid alcohol. Administer intravenous fluids as ordered.

A client is having symptoms suggestive of Crohn disease. Which assessment data obtained by the client support this diagnosis? Select all that apply. A pattern of distinct exacerbations without remission Crampy pain triggered by eating Secondary anemia Lower right quadrant abdominal pain Cobblestone appearance of distal ileum

Crampy pain triggered by eating Secondary anemia Lower right quadrant abdominal pain Cobblestone appearance of distal ileum

A client is diagnosed with diabetes mellitus. Which assessment finding best supports a nursing diagnosis of Ineffective coping related to diabetes mellitus?

Crying whenever diabetes is mentioned

An adult client diagnosed with diverticular disease will be treated on an outpatient basis. What components of treatment should the nurse anticipate? Select all that apply. Anticholinergic medications Increased fiber intake Enemas on alternating days Reduced fat intake Fluid reduction

Increased fiber intake Reduced fat intake

An older adult client reports experiencing hemorrhoids of increasing severity in recent months. Which education will the nurse provide to reduce the severity of occurrence? Select all that apply. Regular application of an antibiotic ointment Increased fluid intake Daily use of OTC glycerin suppositories Use of an NSAID to reduce inflammation Increased fiber intake

Increased fluid intake Increased fiber intake

A nurse is providing education to a client who is newly diagnosed with diabetes mellitus. What are classic symptoms associated with diabetes?

Increased thirst, hunger, and urination

A client is experiencing an increase in blood glucose levels. The nurse understands that which of the following hormones would be important in lowering the client's blood glucose level?

Insulin

When caring for a client with peptic ulcer disease, the client reports that he has been nauseated most of the day and is feeling lightheaded and dizzy. Based upon these findings, which nursing actions would be most appropriate for the nurse to take? Select all that apply A.Administering an antacid hourly until nausea subsides B.Monitoring the client's vital signs C.Notifying the physician of the client's symptoms D.Initiating oxygen therapy E.Reassessing the client in an hour

Monitoring the client's vital signs Notifying the physician of the client's symptoms

Hypocalcemia is associated with which of the following manifestations?

Muscle twitching

A nurse is preparing to discharge a client home on parenteral nutrition. What should an effective home care teaching program address? Select all that apply. Preparing the client to troubleshoot for problems Teaching the client and family strict aseptic technique Teaching the client and family how to set up the infusion Teaching the client to flush the line with sterile water Teaching the client when it is safe to leave the access site open to air

Preparing the client to troubleshoot for problems Teaching the client and family strict aseptic technique Teaching the client and family how to set up the infusion

The nurse is caring for a client with an ileostomy because of inflammatory bowel disease. Which assessment findings indicate to the nurse that the ileostomy is functioning as expected? Select all that apply. Stoma is pink and shiny Stoma is edematous and bleeding Formed stool in collection pouch Continuous liquid flows from the stoma Slight skin excoriation around the stoma

Stoma is pink and shiny Continuous liquid flows from the stoma

A client recovering from surgery for gastric cancer develops dumping syndrome. Which teachings will the nurse provide to reduce the symptoms of this condition? Select all that apply. Drink fluids with meals. Select foods high in sugar. Ingest 6 small meals a day. Remain upright after meals. Eat foods low in carbohydrates

Ingest 6 small meals a day. Eat foods low in carbohydrates

A client with peptic ulcer disease wants to know nonpharmacologic ways to prevent recurrence. Which of the following measures would the nurse recommend? Select all that apply. Smoking cessation Substituting decaffeinated products for all forms of coffee Avoidance of alcohol Eating whenever hungry Following a regular schedule for rest, relaxation, and meals

Smoking cessation Substituting decaffeinated products for all forms of coffee Avoidance of alcohol Following a regular schedule for rest, relaxation, and meals

The nurse is caring for a client with chronic gastritis. The nurse monitors the client, knowing that the client is at risk for which of the following vitamin deficiencies? A.Vitamin A B.Vitamin B12 C.Vitamin C D.Vitamin E

Vitamin B12

A client with newly diagnosed type 2 diabetes is admitted to the metabolic unit. The primary goal for this admission is education. Which goal should the nurse incorporate into her teaching plan?

Weight reduction through diet and exercise

The nurse is caring for a client who is suspected to have developed a peptic ulcer hemorrhage. Which action should the nurse include in the plan of care?

Monitor hourly urine output.

A nurse assesses a client with a newly created ileostomy and observes that the client has had no ostomy output for the past 12 hours. The client reports worsening nausea. Which is the nurse's priority action? Select all that apply. Facilitate a referral to the wound-ostomy-continence (WOC) nurse. Report signs and symptoms of obstruction to the primary health care provider. Encourage mobilization in order to enhance motility. Contact the primary health care provider and obtain a swab of the stoma for culture. Educate client regarding the common signs of intestinal obstruction.

Report signs and symptoms of obstruction to the primary health