MedSurg PrepU

A client with high blood pressure is receiving an antihypertensive drug. The nurse knows that antihypertensive drugs commonly cause fatigue and dizziness, especially on rising. When developing a client teaching plan to minimize orthostatic hypotension, which instruction should the nurse include?

"Flex your calf muscles, avoid alcohol, and change positions slowly."

A client is placed on a low-sodium (500 mg/day) diet. Which client statement indicates that the nurse's nutrition teaching plan has been effective?

"I chose broiled chicken with a baked potato for dinner."

A client has just been diagnosed with endometriosis. Which of the following would be most appropriate to provide the client with support and guidance about treatment options?

"It might help to include your partner in any of the discussions about options."

A client diagnosed with epididymitis is being discharged from the Emergency Department. Which of the following would be most important for the nurse to include as part of the client's discharge teaching?

"Keep your scrotum elevated on a folded towel until the swelling goes down."

Which client statement indicates a good understanding of the nutritional modifications needed to manage hypertension?

"Limiting my salt intake to 2 grams per day will improve my blood pressure."

A 32-year-old client has been diagnosed with an ovarian cyst and asks the nurse, "Should I be worried about cancer?" Which response by the nurse would be most appropriate?

"Most cysts are benign in younger women, but it's good to have it checked out."

A client, who wishes to preserve childbearing, asks the nurse to explain how taking oral contraceptives will work in the management of endometriosis. Which is the best response by the nurse?

"Symptoms of endometriosis are increased during normal menstrual cycle."

The nurse is teaching a young adult male how to perform testicular self-examination (TSE). The nurse determines that the client has understood the instructions when he states which of the following?

"The best time to do it is once a month after I take my warm morning shower."

Following a colposcopy, the confirmation of in situ carcinoma of the cervix has been determined. Which comment by the client indicates an appropriate understanding of the diagnosis?

"The cancer has not spread."

A client is scheduled for a transurethral rescection of the prostate (TURP). Which statement demonstrates that the expected outcome of "client demonstrates understanding of the surgical procedure and aftercare" has been met?

"The surgeon is going to insert a scope through my urethra to remove a portion of the gland."

A client reports loss of interest in sexual relations and discomfort during intercourse. Which is the best response by the nurse?

"These are normal, manageable symptoms of menopause."

A 77-year-old woman presents to the local community center for a blood pressure screening. The women's blood pressure is recorded as 180/90 mm Hg. The woman has a history of hypertension, but she currently is not taking her medications. Which of the following questions is most appropriate for the nurse to ask the patient first?

"Why is it that you are not taking your medications?"

According to the DASH diet, how many servings of vegetables should a person consume per day?

4 or 5

The physician orders furosemide (lasix) 2 mg/kg to be given intravenously. The client weighs 24 kg. The medication comes in a single-use vial that contains 40 mg in 4 mL (10 mg/mL). How much will the nurse draw up for this client's dose?

4.8 mL

Which of the following client scenarios would be correct for the nurse to identify as a client with secondary hypertension?

A client diagnosed with kidney disease

A patient is admitted to the emergency room with a blood pressure reading of 200/130 mm Hg. This is a hypertensive emergency situation than can lead to organ damage if not managed immediately. The nurse understands that which of the following are therapeutic goals?

Achievement of a goal pressure of about 160/100 within 2 to 6 hours. Reduction of the mean blood pressure by 25% within the first hour. Reduction to a target goal pressure over a period of days.

topical concentrated corticosteroids

Avoid applying to the face. Avoid prolonged use.

eborrheic dermatitis on the face and is prescribed a corticosteroid preparation for use

Avoid using the medication around the eyelids because it may cause cataracts and glaucoma.

Which of the following is inconsistent with a digital rectal examination (DRE)?

Can reveal a hydrocele

Which of the following is inconsistent with a digital rectal examination?

Can reveal a hydrocele

Samantha Velasquez, a 24-year-old preschool teacher, is being seen by the physician in the primary care group where you practice nursing. Over the past 2 months, she has been receiving treatment for multiple ear infections and tonsillitis. She reports a curdy white vaginal discharge and burning with urination. What is the most likely cause of her symptoms?

Candida albicans

vaginal discharge that is cottage cheese-like in appearance. Which pathogen is the most likely cause for this symptom?

Candida albicans

A client who underwent an anterior colporrhaphy 6 hours ago has not voided. She reports some discomfort in her suprapubic area. Which of the following would the nurse expect to do?

Catheterize the client.

The nurse is performing an assessment on a patient to determine the effects of hypertension on the heart and blood vessels. What specific assessment data will assist in determining this complication?

Character of apical and peripheral pulses Heart rate Heart rhythm

The nurse is administering medications on a medical surgical unit. A patient is ordered to receive 40 mg of oral Corgard (nadolol) for the treatment of hypertension. Prior to administering the medication, the nurse should complete which of the following?

Checking the patient's heart rate

therapeutic baths for its antipruritic action

Colloidal (Aveeno, oatmeal)

A nurse is working in an oncology treatment center. Which of the following clinical manifestations when reported by a patient would the nurse know may be related to metastasis from prostate cancer?

Constant achy hip discomfort

After teaching a group of student about structural abnormalities of the male reproductive system, the instructor determines that the teaching was successful when the students identify which of the following as an example?

Cryptorchidism

Which of the following is a failure of one or both or both of the testes to descend into the scrotum?

Cryptorchidism

Which of the following would the nurse expect to find when assessing a client with phimosis?

Difficulty cleaning under the foreskin

A patient experiences hypotension, lethargy, and muscle spasms while receiving bladder irrigations after a transurethral resection of the prostate (TURP). What is the first action the nurse should take?

Discontinue the irrigations.

You are doing the final checklist before sending home a 63-year-old female who has been newly diagnosed with hypertension. She is going to be starting her first antihypertensive medicine. What is one of the main things you should tell her and her husband to watch for?

Dizziness

Which of the following diagnostic tests may reveal an enlarged left ventricle?

Echocardiography

Which of the following recommendations would a nurse advocate during infancy and childhood to help reduce potential adult complications such as orchitis?

Ensure immunizations against infectious diseases such as mumps.

Which of the following is the descent of the small intestine into the vaginal vault?

Enterocele

A client who comes to the clinic complaining of perineal pain, dysuria, and fever is diagnosed with prostatitis. The nurse understands that which of the following organisms would be the most likely cause?

Escherichia coli

A client is being seen at the clinic for a routine physical when the nurse notes the client's blood pressure is 150/97. The client is considered to be a healthy, well-nourished young adult. What type of hypertension does this client have?

Essential (primary)

A nurse is preparing a presentation for a group of high school athletes about temperature regulation during activity such as practice. When describing the mechanisms of heat loss, which of the following would the nurse identify as primarily responsible when environmental temperatures are very high?

Evaporation

The client is asking if there is a pill that can be ordered to control the symptoms of menopause. Which assessment finding is most important in determining nursing care in association with hormone replacement therapy?

Family history of breast cancer

Culture of client's vaginal discharge reveals Gardnerella vaginalis. Which of the following would the nurse expect to assess?

Fishy smelling watery discharge

A blood pressure of 140/90 mm Hg is considered to be

HTN

Which of the following may result if prostate cancer invades the urethra or bladder?

Hematuria

The nurse is preparing a presentation for a local community group about prostate cancer and possible dietary risk factors. Which of the following would the nurse most likely include?

High-fat diet

A client is diagnosed with polycystic ovarian syndrome. Which of the following findings would the nurse expect to assess? Select all that apply.

Hirsutism Impaired glucose tolerance Sleep apnea

When administering an angiotensin-converting enzyme (ACE) inhibitor with spironolactone, the nurse should be aware that which electrolyte imbalance may occur?

Hyperkalemia

A 65-year-old man has to start and stop several times over a period of minutes in order to fully empty his bladder. The nurse is aware that this is not uncommon in men over the age of 60. This "double voiding" is directly related to which of the following?

Hyperplasia of the prostate gland

Which of the following describes a situation in which blood pressure is very elevated but there is no evidence of impending or progressive target organ damage?

Hypertensive urgency

Which of the following would be inconsistent as a component of metabolic syndrome?

Hypotension

Production of melanin is controlled by a hormone

Hypothalamus

The nurse understands that patient education related to antihypertensive medication should include all of the following instructions except which of the following?

If a dosage of medication is missed, double up on the next one to catch up.

The nurse is providing education regarding sexually transmitted infections. Which of the following statements regarding herpes virus 2 (herpes genitalis) is accurate?

In pregnant women with active herpes virus, babies delivered vaginally may become infected with the virus.

Aging is positively correlated to the incidence of hypertension. This is due to three of the following four structural or functional changes. Which choice is not considered a cause?

Increased ability to exert diastolic pressure

When assessing a client with benign prostatic hypertrophy, which of the following would the nurse expect the client to report as the initial complaint?

Increased effort to void

Development of malignant melanoma is associated with which of the following risk factors?

Individuals with a history of severe sunburn

A young client presenting at the health clinic with fever and mucopurulent vaginal drainage is diagnosed with acute pelvic inflammatory disease (PID). Which long-term affect is of greatest concern in the care of this client?

Infertility

true regarding endometriosis?

It affects women of reproductive age.

A patient is diagnosed with the most common type of uterine fibroid, an intramural fibroid. The nurse includes which of the following information in teaching the patient about this type of fibroid?

It grows within the wall of the uterine muscle.

cause of scabies

Itch mite

reddish-purple to dark blue macules, plaques and nodules

Kaposi's sarcoma

hypertrophied, elevated, irregular without redness or irritation

Keloid

A patient is admitted to the intensive care unit (ICU) with a diagnosis of hypertension emergency/crisis. The patient's blood pressure (BP) is 200/130 mm Hg. The nurse is preparing to administer IV Nitropress (nitroprusside). Upon assessment, which of the following patient findings requires immediate intervention by the nurse?

Left arm numbness and weakness

lower extremities are covered with very dry skin and that the horny layer of the skin has become thickened.

Lichenification

Amy Patterson, a 50-year-old teacher, is visiting the OB-GYN practice where you practice nursing with complaints associated with menopause. After discussing treatment options with her healthcare provider, she meets with you to further discuss her treatment concerns. Which of the following is a likely recommendation to increase her interest in sexual activity?

Low-dose androgens

flat and nonpalpable skin lesion that is 0.5 cm with a circumscribed border

Macule

Typical clinical manifestations of bacterial vaginosis (BV) include which of the following?

Malodorous, gray vaginal discharge

Which of the following is a term used to describe excessive menstrual bleeding?

Menorrhagia

Which of the following is the main cause of anemia in a patient with active uterine leiomyoma?

Menorrhagia

The nurse is gathering data about a client's menstruation. The client reports that she has been experiencing some bleeding that occurs suddenly and without a regular pattern in between her normal menstrual periods. The nurse documents this finding as which of the following?

Metrorrhagia

The nurse is preparing a presentation for a men's community group about health promotion. Which of the following would the nurse include as a current recommendation for screening?

Monthly testicular self-examination (TSE)

Veronica, a 17-year-old high school student, has a history of dysmenorrhea. During her monthly menses, she experiences incapacitating cramping and passes large clots. Veronica's primary care physician explains to her and her mother that he will initiate conservative treatment. What interventions would you expect the physician to recommend?

NSAID use

painless lump in her right breast during her monthly self-examination. Which assessment finding would strongly suggest that this client's lump is cancerous?

Nonmobile mass with irregular edges Explanation: Breast cancer tumors are fixed, hard, and poorly delineated with irregular edges. A mobile mass that is soft and easily delineated is most commonly a fluid-filled benign cyst. Axillary lymph nodes may or may not be palpable on initial detection of a cancerous mass. Nipple retraction — not eversion — may be a sign of cancer

An 87-year-old client was just recently diagnosed with prehypertension. She is to meet with a dietitian and return for a follow-up with her cardiologist in 6 months. As her nurse, what would you expect her treatment to include?

Nonpharmacological interventions

places with common outbreaks of scabies

Nursing homes Military barracks Prisons Boarding schools Child care centers Anywhere large groups of people are confined

To detect cyanosis in persons with dark skin, the nurse should assess which of the following areas?

Oral mucosa

A 77-year-old client has newly diagnosed stage 2 hypertension. The physician has prescribed a thiazide and an angio-converting enzyme inhibitor. About what is the nurse most concerned?

Postural hypotension and resulting injury

A patient is taking amiloride (Midamor) and lisinopril (Zestril) for the treatment of hypertension. What laboratory studies should the nurse monitor while the patient is taking these two medications together?

Potassium level

A systolic blood pressure of 135 mm Hg would be classified as which of the following?

Prehypertension

The nurse is caring for a patient with systolic blood pressure of 135 mm Hg. This finding would be classified as which of the following?

Prehypertension

When measuring the blood pressure in each of the patient's arms, the nurse recognizes that in the healthy adult, which of the following is true?

Pressures should not differ more than 5 mm Hg between arms.

periwound skin of an African American for inflammation

Purple-gray cast

Which of the following findings indicates that hypertension is progressing to target organ damage?

Retinal blood vessel damage

The nurse is instructing a client who is newly prescribed an antihypertensive medication. Which nursing instruction is emphasized to maintain client safety?

Sit on the edge of the chair and rise slowly.

Of the following diuretic medications, which conserves potassium?

Spironolactone (Aldactone)

A client with heart failure is admitted to an acute care facility and is found to have a cystocele. When planning care for this client, the nurse is most likely to formulate which nursing diagnosis?

Stress urinary incontinence

A patient is having a DRE in the physician's office and the nurse is to assist in the examination. What can the nurse instruct the client to do to decrease the discomfort from the exam?

Take a deep breath and exhale when the physician inserts a gloved finger into the rectum.

A client with vaginitis complains of itching and burning of the perineum. Which suggestion would be most appropriate to relieve the client's symptoms?

Take sitz baths frequently.

Which of the following is not a definition of erectile dysfunction?

The inability to achieve an erection after sexual activity

the nurse palpates the client's breast and finds a small lump. Which of the following would lead the nurse to suspect possible breast cancer?

The lump is irregularly shaped. Correct Explanation: Generally, breast cancer lesions are nontender, fixed rather than mobile, and hard with irregular borders. Diffuse breast pain and tenderness with menstruation are usually associated with benign breast disease.

Why is it important for the nurse to implement measures to relieve emotional stress for patients with hypertension?

The reduction of stress decreases the production of neurotransmitters that constrict peripheral arterioles.

A female client has just been diagnosed with condylomata acuminata (genital warts). What information is appropriate to tell this client?

This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) smear annually.

superficial fungal infections begin in the skin between the toes and spreads to the soles of the feet?

Tinea pedis

While caring for a client who is being treated for severe pelvic inflammatory disease (PID), the nurse insists on keeping her in a semisitting position. What would be the best possible reason for the nurse's advice?

To facilitate pelvic drainage and to minimize the upward extension of infection

A 12-year-old adolescent is being seen in the primary care office where you practice nursing. She has just had her first menses, and you are advising her on how to use a tampon. Your instructions include using the least absorbent tampon and to change tampons frequently, at least every 4 to 6 hours. Which of the following conditions are you most likely trying to prevent?

Toxic shock syndrome

What is the most widely used procedure for prostate gland removal?

Transurethral resection of the prostate (TURP)

When the female patient reports a frothy yellow-green vaginal discharge, the nurse suspects the patient has a vaginal infection caused by which of the following?

Trichomonas vaginalis

A client comes to the emergency department complaining of visual changes and a severe headache. The nurse measures the client's blood pressure at 210/120 mm Hg. However, the client denies having hypertension or any other disorder. After diagnosing malignant hypertension (hypertensive emergency), a life-threatening disorder, the physician initiates emergency intervention. What is the most common cause of malignant hypertension (hypertensive emergency)?

Untreated hypertension

The students demonstrate understanding of breast structure when they identify the tail of Spence as an extension of which quadrant?

Upper outer The tail of Spence is an area of breast tissue that extends from the upper outer quadrant of the breast into the axilla. The upper and lower inner quadrants are closer to the midline. The lower outer quadrant is below the upper outer quadrant.

Which of the following instructions regarding future sexual activity should a nurse give a patient with a vasectomy?

Use a reliable method of contraception until the physician ensures that sperm are no longer present.

Following a vasectomy, which is the most important instruction to provide to the client?

Use another form a birth control until further notice.

Which of the following statements are true when the nurse is measuring blood pressure (BP)?

Using a BP cuff that is too small will give a higher BP measurement. Ask the patient to sit quietly while the BP is being measured. The patient's arm should be positioned at the level of the heart.

Which of the following terms describes an opening between the bladder and the vagina?

Vesicovaginal fistula

Which factor should be checked when evaluating the effectiveness of an alpha-adrenergic blocker given to a client with benign prostatic hyperplasia (BPH)?

Voiding pattern

A patient with HIV has recently completed a 7-day regimen of use of antibiotics. She reports vaginal itching and irritation. In addition, the patient has a white, cottage cheese-like vaginal discharge. Which of the following is the patient most likely suffering?

Vulvovaginal candidiasis

A client is ordered a vaginal cream for the treatment of a yeast infection. As the nurse provides instruction, which step for inserting vaginal medications should be highlighted?

Wash applicator after each use.

exam used to determine if rash is a fungal rash using UV light

Wood's light exam

The nurse is correct to realize that a 24-hour urine is ordered to determine if the cause of hypertension is related to the dysfunction of which of the following?

adrenal gland

absence of pigment melanin

albinism

causing odor in perspiration

bacteria on the skin

positive reactive patch testing

blister pain ulceration

Herpes simples/ zoster skin

circumscribed and elevated masses >0.5cm

transfer of heat from body to cooler object

conduction

skin tight and shiny

fluid retention

Tzanck smear

herpes zoster

Papilledema is a fairly common symptom of elevated blood pressure. The best way to detect this condition is through:

ophthalmic examination

bleeding tendencies or emboli to the skin?

petechia

very small, round, red and purple macules

petechiae

silvery white, thick scales on scalp, elbow and hands

psoriasis

vascular lesion

spider angioma

A nursing class is practicing measurement of blood pressure. One otherwise healthy participant, 46 years old, is 138/90. This man requires follow-up. In which classification of hypertension is he according to the JNC 7 (Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood pressure) recommendation?

stage 1

Students preparing for a test are reviewing the structure and function of the male reproductive system. They demonstrate understading of the material when they identify which of the following as the site of spermatogenesis?

testes

herpes simplex/zoster skin lesion

vesicle

lesion is elevated, sharply defined, less than 0.5 cm in diameter, filled with serous fluid

vesicle

destruction of melanocytes

vitiligo

patchy, milky white spots

vitiligo

xanthelasma

yellowish waxy deposits on upper eyelids

A client has undergone a total abdominal hysterectomy and bilateral salpingo-oopherectomy as treatment for endometrial cancer. When providing postoperative care to this client the nurse would be alert for signs and symptoms of which of the following?

Bladder dysfunction

Which of the following are the earliest and the most common symptom of endometrial cancer?

Bleeding

Which of the following involves implantation of interstitial radioactive seeds under anesthesia to treat prostate cancer?

Brachytherapy

A client with Stage IV prostate cancer is to receive hormone therapy. The nurse would inform the client about possible adverse effects including which of the following?

Breast tenderness

Assessment of a client reveals evidence of a cystocele. The nurse interprets this as which of the following?

Bulging of the bladder into the vagina

Which of the following statements made by the nurse demonstrates effective communication techniques when initiating a discussion about sex with a 25-year-old female patient?

"What questions do you have related to your sexual health?"

Which client has the highest risk of ovarian cancer?

45-year-old woman who has never been pregnant

The nurse is reviewing the medical record of a client who has been diagnosed with prostate cancer. The nurse notes that the Gleason score was used to grade the cancer. Which total score would the nurse interpret as indicating a highly aggressive cancer?

9

Which of the following patients is most likely to develop prostate cancer according to a nurse working at a health screening at the local mall?

A 56-year-old African American man

A patient reports to the nurse that she has a sense of pelvic pressure and urinary problems such as incontinence, frequency, and urgency. The problem has gotten much worse since the birth of her third child. What does the nurse suspect the patient is experiencing?

A cystocele

Over the past 2 months, the client has been receiving treatment for multiple ear infections and tonsillitis. She reports vaginal discharge and itching at this appointment. What would you expect to be the cause of her vaginitis?

Antibiotics

effective treatment for trichomoniasis?

Metronidazole (Flagyl)

downward displacement of the bladder toward the vaginal orifice?

Cystocele

While caring for a patient who is being treated for severe pelvic inflammatory disease (PID), which of the following nursing actions minimizes transmission of infection?

Performing hand hygiene when entering the room

The nurse is preparing a discharge teaching plan for a client who has had a prostatectomy. Which of the following would be appropriate to include?

Performing perineal exercises frequently throughout the day

Nursing students are reviewing information about the male reproductive system and normal age-related changes. They demonstrate understanding of the topic when they identify which of the following as occurring?

Plasma testosterone levels decrease.

A client comes to the Emergency Department complaining of sudden sharp testicular pain. Further examination reveals torsion of the spermatic cord. Which of the following would the nurse expect to do next?

Prepare the client for surgery

Following a radical vulvectomy, the nurse is preparing the client for discharge to home. Which care intervention would be considered the priority for this client?

Prevention of wound complications

Which of the following is an early symptom of vulvar cancer?

Pruritus with genital burning

Which of the following is the extrusion of the rectum into the posterior vagina?

Rectocele

Petechia associated with

Thrombocytopenia

Which of the following should be included as part of the home care instructions for a patient with epididymitis and orchitis?

antibiotics.

Intertrigo

irritation of opposing skin surfaces caused by friction

wrinkle among older adults

loss of subcutaneous tissue

most common cause of hair loss

male pattern baldness

pigment influences hair color

melanin