Midterm 3

After teaching a client who has diverticulitis, a nurse assesses the client's understanding. Which statement made by the client indicates a need for additional teaching? I will take a laxative nightly at bedtime to avoid becoming constipated." "I'll ride my bike or take a long walk at least three times a week." "I must try to include at least 25 grams of fiber in my diet every day." "I should use my legs rather than my back muscles when I lift heavy objects."

"I will take a laxative nightly at bedtime to avoid becoming constipated."

Which statement by the patient diagnosed with gastritis indicates the need for further teaching? "I will eat bland, nonspicy foods." "I will eat smaller, more frequent meals." "I will take aspirin for headaches." "I will take an antacid if my symptoms continue."

"I will take aspirin for headaches." I will take an antacid if my symptoms continue." This statement indicates correct understanding because antacids are indicated for the treatment of gastritis.

The nurse provides discharge instructions to a patient who is postoperative for an appendectomy. Which patient statement indicates a need for additional teaching? "I can go home as soon as I am able to urinate." "I will get up and walk around as much as I can." "I will take the antibiotics until I no longer have a fever." "I will use the incentive spirometer 10 times an hour while awake."

"I will take the antibiotics until I no longer have a fever."

A nurse is teaching a client who is obese and has obstructive sleep apnea how to decrease the number of nightly apneic episodes. Which of the following client statements indicates an understanding of the teaching? "If I could lose about 50 pounds, I might stop having so many apneic episodes." "I'll get a humidifier to run at my bedside at night." "I'll sleep better if I take a sleeping pill at night." "It might help if I tried sleeping only on my back."

"If I could lose about 50 pounds, I might stop having so many apneic episodes."

A nurse is preparing to administer ticarcillin / clavulanate 3.1 g by intermittent IV bolus over 30 min. Available is ticarcillin / clavulanate 3.1 g in 50 mL 0.9% sodium chloride (NSS). The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

100mL/hr

Which diagnostic test does the nurse correlate to the diagnosis of an active infection with Helicobacter pylori for a patient diagnosed with gastritis?

A urea breathing test is anticipated to detect active infection with Helicobacter pylori for a patient who is diagnosed with gastritis.

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. Explain the procedure for an upper gastrointestinal series. Test the client's emesis for blood. Administer pain medication.

Assess orthostatic blood pressure.

After teaching a client with diverticular disease, a nurse assesses the client's understanding. Which menu selection made by the client indicates the client correctly understood the teaching? Baked fish with steamed carrots and a glass of apple juice Roasted chicken with celery sticks and a cup of coffee with cream Spaghetti with meat sauce, a fresh fruit cup, and hot tea Garden salad with a cup of bean soup and a glass of low-fat milk

Baked fish with steamed carrots and a glass of apple juice Clients who have diverticular disease are prescribed a low-residue diet. Whole grains (rice pilaf), uncooked fruits and vegetables (salad, fresh fruit cup), and high-fiber foods (cup of bean soup) should be avoided with a low-residue diet. Canned or cooked vegetables are appropriate. Apple juice does not contain fiber and is acceptable for a low-residue diet.

A nurse in the emergency department is assessing an older adult client who has community- acquired pneumonia. Which of the following findings should the nurse expect? Confusion Tympany upon chest percussion Hypertension Unequal pupils

Confusion

A nurse is assessing a client who has obstructive sleep apnea (OSA). Which of the following findings should the nurse expect? Decreased energy Thyroid disease Hypotension Pneumonia

Decreased energy

On assuming care for a patient being treated for tuberculosis, which assessment finding requires immediate attention by the nurse? Dyspnea Fatigue Night sweats Rust-colored sputum

Dyspnea Initial symptoms of tuberculosis (TB) are relatively nonspecific and consist of fatigue, weight loss, and night sweats, followed by the development of a cough that produces a rusty-colored or blood-streaked sputum. As the disease progresses, dyspnea, orthopnea, and rales become evident as signs of respiratory compromise.

A nurse is caring for a client who has pneumonia. Which of the following actions should the nurse take to promote thinning of respiratory secretions? Encourage the client to increase fluid intake. Encourage coughing and deep breathing. Encourage the client to ambulate frequently. Encourage regular use of the incentive spirometer.

Encourage the client to increase fluid intake.

The nurse monitors for which clinical manifestations in the patient diagnosed with acute gastritis?

Epigastric pain Epigastric pain is a clinical manifestation associated with acute gastritis.

The nurse correlates which factor as a potential cause of an elevated ALT (alanine transaminase) in the patient with acute pancreatitis?

Gallstone pancreatitis

A nurse is planning care for a client who has diverticulitis. Which of the following menu selections should the nurse include in the plan? Grilled chicken breast with white rice Pork tenderloin with raw carrots Sliced ham with green salad Turkey sandwich with celery sticks

Grilled chicken breast with white rice

A nurse is assessing a client who has obstructive sleep apnea. Which of the following findings should the nurse expect? Headache Constipation Nausea Hypotension

Headache

In providing care to the patient admitted for gastritis, which clinical manifestation requires immediate notification of the healthcare provider? Nausea Anorexia Hematemesis Epigastric pain

Hematemesis Hemorrhagic gastritis may lead to the vomiting of blood. The vomited blood can be bright red or can have a dark "coffee grounds" appearance. Immediate correction of blood loss may be required to prevent hemorrhagic shock and is dependent on the amount of blood loss and the rate of bleeding.

A nurse is teaching a client who has a new prescription for amoxicillin-clavulanate to treat diverticulitis. Which of the following statements by the client indicates an understanding of the teaching? I will stop taking this medication if I develop itching." "I will take this medication until my sore throat goes away." "I should take this medication on an empty stomach between meals." "I will double my dose, if I miss one."

I will stop taking this medication if I develop itching."

The nurse is providing care to a patient who is diagnosed with gastritis secondary to Helicobacter pylori. When planning care, the nurse correlates which medications as first-line triple dose therapy for a patient who is allergic to penicillin? Select all that apply.

Metronidazole Azithromycin Proton pump inhibitor

The nurse monitors for which clinical manifestation in the patient diagnosed with cholecystitis?

Murphy's sign is pain on palpation of the RUQ upon deep inspiration and a clinical manifestation of cholecystitis.

A nurse is planning care for a client who has diverticulitis. The nurse should plan to monitor the client for which of the following complications of diverticulitis? Peritonitis Ulcerative Colitis Dysphagia Crohn's Diseas

Peritonitis

In providing teaching to a patient about management of acute pancreatitis, the nurse explains which prescribed medication is used for digesting fats and proteins? Spasmolytics Proton pump inhibitors Anticholinergic agents Pancreatic enzymes

Pancreatic enzymes are used to help digest fats and proteins.

Which action by the patient care technician who is providing care to the patient diagnosed with appendicitis indicates the need for an intervention by the nurse? Elevating the head of the patient's bed 30 to 45 degrees Placing a heating pad on the patient's abdomen Measuring all urine output and emesis Positioning the patient with knees flexed

Placing a heating pad on the patient's abdomen This action by the patient care technician requires an intervention by the nurse because heat should never be applied to the abdomen because this increases blood flow and inflammation to the area and may cause the appendix to rupture.

The nurse is planning care for a patient diagnosed with influenza. Which intervention by the nurse is the priority when planning this patient's care? Restricting all visits from family and friends Providing staff with N95 mask respirators Placing the patient in a negative air flow room Placing the patient on droplet precaution

Placing the patient on droplet precaution To prevent the spread of influenza, the patient is placed in a private room with signs for droplet and contact precautions. It is appropriate for the healthcare workers to use appropriate personal protective equipment (PPE) for these transmission-based precautions. Place patient in droplet precautions to avoid viral transmission. Personal protective equipment required includes mask, gown, gloves, and eye protection if there is a risk of splash of body fluids.

A nurse is planning the discharge of a client who has sleep apnea and requires bi-level positive airway pressure (BiPAP) at night. The nurse should plan to consult with which of the following health care team members to help educate the client? Respiratory therapist Occupational therapist Physical therapist Case manager

Respiratory therapist

On assuming care for a patient being treated for bacterial pneumonia, which assessment finding requires immediate attention by the nurse? Fever Productive cough Restlessness Arthralgia

Restlessness Agitation, restlessness, anxiety, lethargy, and fatigue are the result of decreased tissue perfusion from altered alveolar gas exchange and require immediate action by the nurse.

In reviewing the emergency records of a patient admitted to the unit for appendicitis, the nurse notes that there is documentation the patient complained of pain in the right lower quadrant when the left lower quadrant was palpated. The nurse correlates this finding to which diagnostic sign? Cullen's McBurney's Rovsing's Turner's

Rovsing's sign is observed when palpation of the left lower quadrant of the abdomen elicits pain in the right lower quadrant in the patient with appendicitis.

In providing care to a patient admitted with an acute asthma exacerbation, the nurse prepares which "rescue" medication for administration first? Inhaled anti-inflammatories Mucolytics Long-acting beta2-adrenergic agonists Short-acting beta2-adrenergic agonists

Short-acting beta2-adrenergic agonists "Rescue" drugs are those medications used once an asthma attack has started; these are usually short-acting bronchodilators. Short-acting beta2-adrenergic agonists are the gold standard because they are most effective. Short-acting beta2-adrenergic agonists should be used for acute exacerbations of asthma only

A nurse is caring for a child who is admitted with suspected acute appendicitis. Which of the following manifestations should indicate to the nurse that the child's appendix is perforated? Sudden decrease in abdominal pain Absent Rovsing's sign Flaccid abdomen Low-grade fever

Sudden decrease in abdominal pain

A nurse is assessing a client who has pneumonia. Which of the following findings should the nurse expect? Tachypnea Hypothermia Bradycardia Pulse Deficit

Tachypnea

The nurse correlates which clinical manifestation as the earliest compensatory mechanism in the patient with influenza? Oliguria Tachycardia Tachypnea Fever

Tachypnea

The nurse monitors for which clinical manifestations of gastrointestinal bleeding in the patient hospitalized for complications associated with gastritis?

Tarry stools indicate gastrointestinal bleeding.

The nurse is assessing a patient with acute malaise and muscle aches. Which questions should the nurse ask to determine whether the patient is experiencing influenza? Select all that apply. a. Have you had a flu shot this year? b. "Is your cough productive?" c. "Have you been exposed to anyone with the flu?" d. "Have you had a recent weight loss?" e. "Do you have dizziness?"

a, b, c Based on the presenting symptoms, the nurse would ask whether the patient has had a flu shot or been exposed to the flu. Usually, the cough of an influenza patient is nonproductive. A productive cough may indicate a different diagnosis.

A nurse is teaching a client who has obstructive sleep apnea (OSA) about continuous positive airway pressure (CPAP). Which of the following instructions should the nurse include? The CPAP device should be placed over the nose. The CPAP device requires an invasive ventilation tube. Only the CPAP tubing needs to be cleaned regularly. Air leaks around the mask will not make a difference in the effectiveness or comfort of wearing a CPAP

The CPAP device should be placed over the nose

The nurse recognizes that which patient is at highest risk of developing cholecystitis? 35-year-old African American male with BMI of 27 35-year-old Caucasian female with history of weight loss surgery 30-year-old African American female with BMI of 32 30-year-old Caucasian male with BMI of 35

This patient has three risk factors—female, Caucasian, and history of weight loss surgery.

In providing teaching for a patient recently diagnosed with an active tuberculosis (TB) infection, the nurse incorporates teaching about which medications?

a, b, c, d Treatment for TB includes a basic four-drug combination that continues for 9 to 12 months. The medications include ethambutol, isoniazid, pyrazinamide, and rifampin.

A nurse is caring for an adolescent who has acute appendicitis. Which of the following results should the nurse anticipate when reviewing this client's laboratory values? WBC 17,000/mm3 Neutrophils 3,000/mm3 RBC 4.2 million/mm3 Lymphocytes 3,000/mm3

WBC 17,000/mm3 The expected reference range for a WBC count for a child is 5,000 to 10,000/mm3. A WBC count of 17,000/mm3 is elevated. The nurse should expect to see an elevated WBC count because appendicitis is an acute bacterial infection.

The nurse correlates which risk factors with tuberculosis? Select all that apply. a. Homelessness b. immunosuppression c. Caucasian race d. Malnutrition e. Obesity

a, b, d Populations at risk for tuberculosis (TB) include low socioeconomic groups with obstacles to accessing healthcare, the homeless, and incarcerated populations. There is an increased incidence among blacks, Hispanics, and Asians. Immunosuppression is also a risk factor for TB.

The nurse caring for a homeless patient at risk for tuberculosis (TB) includes which clinical manifestations of the disease when educating the patient? Select all that apply. a. Fatigue b. Green-tinged sputum c. Productive cough that later turns to a dry, hacking cough d. Weight loss e. Night sweats

a, d, e Manifestations of tuberculosis often develop insidiously and are initially nonspecific. Fatigue, weight loss, and night sweats are common. It is often at this stage that the patient first seeks medical attention.

In providing care for an older adult patient with a history of alcohol abuse, the nurse correlates which treatments as relevant to the treatment of acute pancreatitis? Select all that apply. Moderate-fat diet Opioid analgesics Total parenteral nutrition Nasogastric tube to suction

b, c, d Opioid analgesics are often necessary for the acute pain experienced by the patient. Total parenteral nutrition is initiated and a nasogastric tube is inserted and connected to suction.

The nurse monitors for which clinical manifestations of hypovolemic shock in the patient diagnosed with blunt abdominal trauma? Select all that apply. a. Elevated temperature b. Tachycardia c. Hot, dry skin d. Restlessness e. Hypotension

b, d, e Clinical manifestations of hypovolemic shock are restlessness, anxiety, cool clammy skin, confusion, weakness, pale color, tachypnea, tachycardia, and hypotension.

A patient is with a severe influenza infection is placed on droplet precautions. What actions by the nurse are relevant for this type of isolation? Select all that apply. a. N95 mask b. Surgical mask c. Negative airflow room d. Private room e. Gown and gloves

b, d, e Patients are placed on droplet precautions to avoid viral transmission. Personal protective equipment required includes mask, gown, gloves, and eye protection if there is a risk of splash of body fluids. The patient should wear a mask when outside the room. Visitors should wear a mask while in the room. A private room is desirable unless patients with similar infections are cohorted.