NSG 211 Test 4

A nurse is caring for a client who has poison ivy and is prescribed diphenhydramine. Which of the following instructions should the nurse give regarding the adverse effect of dry mouth associated with diphenhydramine? -"Administer the medication with food." -"Chew on sugarless gum or suck on hard, sour candies." -"Place a humidifier at your bedside every evening." -"Discontinue the medication and notify your provider."

-"Chew on sugarless gum or suck on hard, sour candies."

A nurse is caring for a client who is taking naproxen following an exacerbation of RA. Which of the following statements by the client requires further discussion by the nurse? -"I signed up for a swimming class." -"I've been taking an antacid to help with indigestion." -"I've lost 2 pounds since my appointment 2 weeks ago." -"The naproxen is easier to take when I crush it and put it in applesauce."

-"I've been taking an antacid to help with indigestion." (NSAIDs, like naproxen, can cause serious adverse gastrointestinal reactions such as ulceration, bleeding, and perforation. Warning manifestations such as nausea or vomiting, gastrointestinal burning, and blood in the stool reported by the client require further investigation by the nurse. The client might be taking an antacid because he is experiencing one or more of these manifestations.)

A nurse is performing discharge teaching for a client who has systemic lupus erythematosus (SLE). Which of the following instructions should the nurse include? -"Avoid using moisturizing lotions on your skin." -"Wash your hair with a mild protein shampoo." -"Apply powder liberally to sensitive skin areas." -"Use a sun-blocking agent with a sun protection factor of at least 15."

-"Wash your hair with a mild protein shampoo." (Clients who have SLE are prone to hair loss and should use a mild protein shampoo and avoid treatments that can damage the hair and scalp, such as dyes and permanents.)

A nurse is teaching a client who is to begin long-term therapy with prednisone to treat RA. The nurse should instruct the client to take which of the following supplements while taking this medication? -Calcium and vitamin D -Biotin and vitamin B2 -Folic acid and vitamin C -Pantothenic acid and vitamin B6

-Calcium and vitamin D (Long-term use of glucocorticoids, such as prednisone, places the client at risk for osteoporosis. The nurse should instruct the client to take calcium and vitamin D supplements to reduce this risk.)

A nurse is completing dietary teaching on consuming a low fiber diet with a client who has ulcerative colitis. Which go the following foods should be eliminated in the client's diet? -Cooked cabbage -Dried apricots -Ripe bananas -Ice cream

Dried apricots (a nurse should instruct the client who has ulcerative colitis to consume a diet low in fiber and should eliminate dried apricots from his diet. Dried apricots are high in fiber and may cause an exacerbation of the client's disease process.)

A nurse is caring for a client following cataract surgery. Which of the following comments from the client should the nurse report to the client's provider? -"My eye really itches, but I'm trying not to rub it." -"I need something for the pain in my eye. I can't stand it." -"It's hard to see with a patch on one eye. I'm afraid of falling." -"The bright light in this room is really bothering me."

"I need something for the pain in my eye. I can't stand it." (following cataract surgery, the client should expect only mild pain and should immediately report any pain, decrease in vision, or increase in discharge from the eye. Severe eye pain after surgery might indicate increased intraocular pressure or hemorrhage.)

A nurse is reviewing discharge instructions with a client who has RS and a new prescription for prednisone. Which of the following statements by the client indicates an understanding of the teaching? -"I should take my flu vaccine within one week of starting this medication." -"I can expect a sore throat for the first week after starting this medication." -"I should eat more bananas while taking this medication." -"I should take aspirin for minor aches and pains while taking this medication."

"I should eat more bananas while taking this medication." (The nurse should instruct the client to eat more potassium-rich foods such as bananas and citrus fruits while taking this medication. Prednisone can cause a loss of potassium, and the nurse should instruct the about the manifestations of hypokalemia such as muscle weakness and cramping and to notify the provider should these occur.)

A nurse is providing discharge teaching to a client who was recently diagnosed with a latex allergy. Which of the following client statements indicates an understanding of the teaching? -"I will apply elastic bandages to cuts." -"I will use dishwashing gloves when cleaning the dishes." -"I will buy balloons for my son's birthday." -"I will use ink pens for writing."

"I will use ink pens for writing" (The client understands pencil erasers contain latex and should use pens for writing instead.)

A nurse is caring for a client who asks about the functions of the thymus, spleen, and lymph nodes. Which of the following responses should the nurse make? -"These organs support immunity." -"These organs are used in digestion." -"These organs regulate electrolyte balance." -"These organs assist vitamin absorption."

"These organs support immunity."

A nurse is reviewing guidelines for prophylactic antibiotics. The nurse should identify that prophylactic antibiotic therapy is not recommended for which of the following clients? -A client who has a fever of unknown origin -A client who has a prosthetic heart valve is having dental surgery -A client following total hip arthroplasty -A client who had an emergency cesarean section

A client who has a fever of unknown origin (Prophylactic antibiotic therapy is not recommended for clients who have a fever of unknown origin.)

A nurse is preparing a presentation at a community center about systemic lupus erythrematosus (SLE). The nurse should plan to include which of the following findings as manifestations of SLE? -Hypothermia -Muscle hyperreflexia -Weight gain -A raised rash

A raised rash (butterfly rash)

A nurse in an emergency department is caring for a client who has anaphylaxis following a bee sting. Which of the following actions should the nurse take first? -assess the client's level of consciousness. -administer epinephrine -auscultate for wheezing -monitor for hypotension

Auscultate for wheezing

A nurse in an allergy clinic is caring for a client who has a history of seasonal allergy symptoms. The client had a radioallergosorbent test (RAST) completed on a previous visit. The nurse should recognize that an evaluation in which go the following immunoglobulins indicates a positive result? -Immunoglobulin G (IgG) -Immunoglobulin A (IgA) -Immunoglobulin E (IgE) -Immunoglobulin M (IgM)

Immunoglobulin E (IgE) (A RAST involves measuring the quantity of IgE present in the serum after exposure to specific antigens that are selected based on the client's symptom history. An elevated IgE indicates a positive response to a RAST.)

A nurse is planning care for a client who is postoperative following a liver transplant and weighs 65kg. Which of the following actions should the nurse plan to take? -Keep the client NPO for the first week postoperative. -Limit caloric content once the client resumes eating. -Stress the importance of safe food-handling practices. -Decrease foods high in carbohydrates once the client resumes eating.

Stress the importance of safe food-handling practices. (immunosuppressant medication makes the client more susceptible to infection)

A nurse is caring for a client who is prescribed diphenhydramine to relieve pruritus. The client asks the nurse how he can minimize the daytime sedation he is experiencing. Which of the following responses should the nurse give? -"Gradually decrease the dose once tolerance to the effect is reached." -"Distribute the dose evenly throughout the day." -"Take most of the daily dose at bedtime." -"Take medication with meals."

Take most of the daily dose at bedtime

A nurse is caring for a female client who has rheumatoid arthritis and a new prescription for methotrexate. The client tells the nurse she is planning a pregnancy. Which of the following instructions should the nurse give the client? -dietary modifications occur during pregnancy when taking this medication. -the medication should be discontinued 3 months prior to a planned pregnancy. -dosage of the medication will be reduced during pregnancy. -the client can breast feed when taking this medication.

The medication should be discontinued 3 months prior to a planned pregnancy (because of the risk for birth defects)

A clinic nurse is performing a physical assessment on a client who has systemic lupus erythematosus (SLE). Which of the following findings should the nurse expect? -a grey colored, non-purpuric papular rash -a dry, red rash across the bridge of the nose and one the cheeks -pitting edema of the hands and fingers -subcutaneous nodules on the ulnar side of the arm

a dry, red rash across the bridge of the nose and on the cheeks

A nurse is discussing kidney transplant with a client who has end-stage renal disease (ESRD). Which of the following should the nurse identify as a contraindication for this treatment? -Breast cancer survivor for 8 years -Pacemaker -65-years of age -Alcohol use disorder

alcohol use disorder (The nurse should identify that a substance use disorder is a contraindication for kidney transplant.)

A nurse is reviewing discharge instructions with a client following a right cataract extraction. Which of the following instructions should the nurse include? -Sleep on the abdomen to facilitate wound healing. -Avoid lifting anything heavier than 4.5 kg (10 lb) for 1 week. -Bend at the waist to pick objects up from the floor. -Notify the surgeon if white drainage develops on the eyelids.

avoid lifting anything heavier than 4.5kg (10lbs) for 1 week. (The nurse should instruct the client to avoid activities that increase intraocular pressure. Therefore, the nurse should instruct the client to avoid lifting anything heavier than 4.5 kg (10 lb) for 1 week following surgery.)

A nurse is assigned to care for a client diagnosed with autoimmune or idiopathic thrombocytopenia (ITP). When reviewing the client's plan of care prior to caring for the client, the nurse should recognize that the priority concern in caring for the client is to monitor for... -side effects of immunosuppressants -constipation -fatigue -bleeding

bleeding

A nurse is assessing a client who has systemic lupus erythematosus and is taking hydroxychloroquine. The nurse should report which of the following adverse effects to the provider immediately? -Diarrhea -Blurred vision -Pruritus -Fatigue

blurred vision (When using the urgent vs non-urgent approach to client care, the nurse should determine that the priority finding to report to the provider is blurred vision, as this is a manifestation of hydroxychloroquine toxicity and can be an indication of retinal damage.)

A nurse is caring for a client who has ulcerative colitis and is teaching the client about the common link with Crohn's disease. Which of the following information should the nurse include? -Both are inflammatory -Both begin in the rectum -Both manifest fistula formation -Both require frequent surgery

both are inflammatory

A nurse is assessing a client who has a new diagnosis of systemic lupus erythematosus (SLE). The nurse should identify which of the following as a cutaneous manifestation of SLE? -Facial pallor -muscle atrophy -foot ulcers -butterfly rash on face

butterfly rash on face

A nurse is teaching a client who has a history of ulcerative colitis and a new diagnosis of anemia. Which of the following manifestations of colitis should the nurse identify as a contributing factor to the development of the anemia? -dietary iron restrictions -intestinal malabsorption syndrome -chronic blood loss -intestinal parasites

chronic blood loss (A client with long-standing ulcerative colitis is most likely anemic due to chronic blood loss in small amounts that occurs over time, although the colitis may result in erosion of the intestine and hemorrhage. These clients often report bloody stools and are therefore at increased risk for developing anemia.)

A nurse is preparing to teach about communicable diseases. During which of the following stages is the period in which a disease is contagious? -Communicability period -Convalescent period -Incubation period -Prodromal period

communicability period

A nurse is caring for a client who has a new diagnosis of systemic lupus erythematosus (SLE) and asks where this disease originates within the body. The nurse should tell the client that SLE originates in which of the following locations in the body? ​-Muscle tissue ​-Connective tissue -Lymphatic system -Peripheral vascular system

connective tissue (SLE originates in the connective tissues of the body and affects all organ systems)

A nurse is teaching a client who has a new prescription to treat RA. the nurse should inform the client that which of the following is a therapeutic effect of the medication? -Reduces risk of infection -Decreases inflammation -Improves peripheral blood flow -Increases bone density

decreases inflammation

A nurse is teaching a client who has rheumatoid arthritis about taking methotrexate. Which of the following information should the nurse include? -take an antiemetic 1 hour following administration -drink 2 to 3 L of water per day -take the medication with an NSAID -rinse mouth 2 times per day with an alcohol-based mouthwash

drink 2 to 3L of water per day

A nurse is teaching a female client who has a new diagnosis of systemic lupus erythematosus (SLE). The nurse should recognize the need for further teaching when the client identifies which of the following as a factor that can exacerbate SLE? -sunlight -pregnancy -infection -exercise

exercise (reconditioning and muscle atrophy occurs as a result of lack of mobility. The nurse should encourage the client to engage in conditioning exercises alternated with periods of rest.)

A nurse is assessing a client who has systemic lupus erethematosus (SLE). Which of the following findings should the nurse expect? -Wrinkles in the skin -Constipation -Iritis -Facial rash

facial rash (butterfly rash)

A nurse is assessing a client for early manifestations of rheumatoid arthritis (RA). Which of the following changes is an early manifestation of RA? -morning stiffness -fatigue -temporomandibular joint pain -Baker's cyst

fatigue

A nurse is caring for a client who received a diagnosis of systemic scleroderma 5 years ago. The nurse plans to assess the client to document the disease's progression. In addition to skin changes, which of the following findings should the nurse expect? -periorbital edema -excessive salivation -finger contractures -thinning of the skin

finger contractures (scleroderma is a chronic disease that can cause thickening, hardening, or tightening of the skin, blood vessels, and internal organs. Manifestations include skin changes, Raynaud's phenomenon, arthritis, muscle weakness, and dryness of the mucous membranes. Contractures occur with advanced systemic scleroderma unless the client follows a regimen of range-of-motion and muscle-strengthening, pain management, and joint protection.)

A nurse is monitoring a client who is receiving a blood transfusion. Which of the following findings indicates an allergic transfusion reaction? -Generalized urticaria. -Blood pressure 184/92 mm Hg. -Distended jugular veins. -Bilateral flank pain.

generalized urticaria (The nurse should recognize urticaria as an indicator of an allergic transfusion reaction. Other clinical manifestations include itching and signs of anaphylaxis with bronchospasm.)

A nurse in an ophthalmology clinic is interviewing a client who was referred by his primary care provider for suspicion of cataracts. The nurse should expect the client to report... -loss of central vision. -having a loss of peripheral vision. -seeing bright flashes of light and floaters. -having a decreased ability to perceive colors.

having a decreased ability to perceive colors (Symptoms of cataracts include painless blurred vision and a decrease in the ability to perceive colors.)

A nurse is planning care for a client who is to undergo a stem cell transplant. Which of the following actions should the nurse plan to take? -Place the client in a negative airflow room. -Keep blood pressure equipment in the client's room. -Monitor the client's vital signs once every 8 hr. -Provide the client with 1,000 mL of water to drink every 12 hr.

keep blood pressure equipment in the client's room.

A nurse in a provider's office is assessing a client who has RA. Which of the following findings is a late manifestation of this condition? -Anorexia -Knuckle deformity -Low-grade fever -Weight loss

knuckle deformity

A nurse is assessing a client who is 2 weeks postoperative following a kidney transplant. Which of the following manifestations should the nurse identify as possible organ rejection? -Temperature 36.1° C (97.0° F) -Insomnia -Oliguria -Weight loss

oliguria (The nurse should identify little to no urine output as possible manifestations of kidney rejection.)

A nurse is assessing a client who has systemic lupus erythamatosus (SLE). Which go the following findings is the highest priority for the nurse to report to the provider? -client report of feelings of depression -dry, raised rash on the face -presence of peripheral edema -joint pain in hands and knees

presence of peripheral edema (the client who has SLE is at greatest risk for death from lupus nephritis. Therefore, according to the safety and risk reduction priority-setting framework, findings that indicate impairment of renal function are the highest priority to report.)

A nurse is providing teaching about a low-FODMAP diet for a client who has irritable bowel syndrome (IBS). The nurse should instruct the client to avoid which of the following foods? -Bananas -Carrots -Raisins -Spinach

raisins (A low-FODMAP diet limits the intake of foods that contain high amounts of fructose and other short-chain carbohydrates, which have been found to decrease the incidence and severity of symptoms in clients who have IBS. Dried fruits, such as raisins, have an increased amount of fructose, which can increase the severity and incidence of symptoms in clients who have IBS.)

A nurse is caring for a client who is being admitted for an acute exacerbation of ulcerative colitis. Which of the following actions should the nurse take first? -Review the client's electrolyte values. -Check the client's perianal skin integrity. -Investigate the client's emotional concerns. -Obtain a dietary history from the client.

review the client's electrolyte values (The greatest risk to this client is injury from impaired function of cardiac or respiratory muscles; therefore, the first action the nurse should take is to review the client's electrolyte values. The client might have low sodium, potassium, and chloride from frequent diarrhea.)

A home health nurse is assessing an older adult client in the home who has decreased vision due to a history of glaucoma. Which of the following findings should the nurse identify as a safety risk? -electrical cords are placed along the walls. -scatter rugs are present in the kitchen. -handrails are present in the bathroom. -uses a microwave for cooking.

scatter rugs are present in the kitchen

A nurse is reviewing laboratory values for a client who has systemic lupus erythematosus (SLE). Which of the following values should give the nurse the best indication of the client's renal function?

serum creatinine (A renal function disorder reduces the excretion of creatinine, resulting in increased levels of blood creatinine. Creatinine is a specific and sensitive indicator of renal function.)

A nurse is caring for a client who has streptococcal pneumonia and a prescription for penicillin G by IV bolus. 10 minutes into the infusion of the third dose, the client reports the IV site itches and that he feels dizzy and short of breath. Which of the following actions should the nurse take first? -stop the infusion -call the client's provider -elevate the head of the bed -auscultate the client's breath sounds

stop the infusion

A nurse is assessing a client for suspected anaphylactic reaction following a CT scan with contrast media. For which of the following client findings should the nurse intervene first? -Urticaria -Stridor -Vomiting -Hypotension

stridor

A nurse is caring for a client who has Crohn's disease. Which of the following food choices would follow the recommended diet for clients who have Crohn's disease? -Vanilla milkshake -Buttered popcorn -Tossed green salad -Toast with jelly

toast with jelly (Toast with jelly is an appropriate food choice by the client. It does not contain large amounts of lactose, fat, or fiber.)

A nurse is preparing to transfuse one unit of packed RBCs to a client who experienced a mild allergic reaction during a previous transfusion. The nurse should administer diphenhydramine prior to the transfusion for which of the following allergic responses? -Urticaria -Fever -Fluid overload -Hemolysis

urticaria (hives)

A nurse is providing teaching to a client who has a new prescription for hydroxychloroquine to treat mild manifestations of RA. Which of the following information should the nurse include in the teaching? -This medication should be taken between meals. -This medication can turn skin an orange color. -Wear sunglasses when out in bright sunshine. -Avoid crushing the medication.

wear sunglasses when out in bright sun (The nurse should instruct the client to wear sunglasses to decrease photophobia when taking hydroxychloroquine. Clients should have an ophthalmologic examination before treatment because the medication can cause retinopathy.)

A nurse is providing education for a client who has glaucoma. Which of the following statements should the nurse include in the teaching? -"Without treatment, glaucoma can cause blindness." -"Double vision is a common symptom of glaucoma." -"Glaucoma is caused by inadequate production of fluid within the eye." -"Use of eye drops will improve vision over time."

without treatment, glaucoma can cause blindness