NURS 280 PrepU- test 1

The client has been diagnosed with terminal COPD. The client and the client's family have not yet agreed on the final arrangements and are discussing options. How can the nurse best intervene in these final decisions?

Respect the client's autonomy and right to determine how to spend the rest of his or her life

A client with chronic renal failure (CRF) is receiving a hemodialysis treatment. After hemodialysis, the nurse knows that the client is most likely to experience:

weight loss

Upon hearing a blood pressure reading of 146/96 mm Hg, a 58-year-old client asks whether medication will be necessary. Which would be the best response by the nurse?

"You will need to have your blood pressure reassessed before a diagnosis can be made"

The nurse weighs a patient daily and measures urinary output every hour. The nurse notices a weight gain of 1.5 kg in a 74-kg patient over 48 hours. The nurse is aware that this weight gain is equivalent to the retention of:

1,500 mL of fluid

According to the U.S Census (2010), what percentage of people are diagnosed with a disability?

20

The nurse is planning community education on the prevalence and incidence of disabilities in the United States. The nurse includes that, according to the U.S. Census (2010), what percentage of people are diagnosed with a disability?

20

The nurse must calculate the adolescent's cardiac output. The child's heart rate is 76 beats per minute and the stroke volume is 75 mL. Calculate the child's cardiac output in mL/min. Record your answer using a whole number

5700

Sevelamer hydrochloride (Renagel) has been prescribed for a client with chronic renal failure. The physician has prescribed Renagel 800 mg orally three times per day with meals to treat the client's hyperphosphatemia. The medication is available in 400 mg tablets. How many tablets per day will the nurse administer to the client?

6

For a client to use the Medicare Hospice Benefit, life expectancy needs to be what length of time?

6 months

A client states, "My children still need me. Why did I get cancer? I am only 30." This client is exhibiting which stage according to Kubler-Ross?

Anger

Which of the following interventions should the nurse perform while providing spiritual care for a dying client?

Ask the family members about spiritual care

A client with AML has pale mucous membranes and bruises on the legs. What is the primary nursing intervention?

Assess the client's hemoglobin and platelets

A client has been hospitalized with heart failure multiple times. The home health nurse is visiting the client with the overall goal of decreasing the frequency of hospitalizations. Using the nursing process, outline the steps the nurse would do in the correct order from 1 to 5.

Assesses the client's weight as 88kg, 117% of ideal body weight Establishes the nursing diagnosis as Excess Fluid Volume Identifies a goal for the client to weigh 86kg within 1 week Intervenes by teaching the client about weighing self every day Evaluates the client's weight as 86kg 1 week later

The nurse is caring for a client who is unconscious and requires an anticholinergic drug to treat bradycardia. What drug can the nurse administer IV (by prescription) for this purpose?

Atropine

A nurse is assigned to work with a client who has a disability. The nurse believes that all people with disabilities have a poor quality of life and are dependent and nonproductive. What type of barrier will this client experience?

Attitudinal barrier

Which intervention should a nurse perform during the grieving period when caring for a dying client?

Avoiding criticizing or giving advice

A pregnant female client is at risk for the development of preeclampsia-eclampsia. Select the most important data to assess.

Blood pressure 160/100 mm Hg and proteinuria during the 30th week of pregnancy

A client presents to the emergency deparment with profuse bleeding form a crushing injury while at work. Which set of vital signs does the nurse anticipate finding in such this client?

Blood pressure 80/50 mm Hg, heart rate 120 beats/min, respiratory rate 24 breaths/min

The client with chronic renal failure complains of intense itching. Which assessment finding would indicate the need for further nursing education?

Brief, hot daily showers

The family members of a dying client are finding it difficult to verbalize their feelings for and show tenderness to the client. Which nursing interventions should a nurse perform in such a situation?

Encourage the family members to express their feelings and listen to them in their frank communication

The nurse is caring for a pediatric client who is dying. The best way to provide care and comfort to dying clients and their families is to first do which of the following?

Explore own feelings on mortality and death and dying

A nurse is conducting a spiritual assessment of a terminally ill client using the four-step FICA process and asks the question, "What gives your life meaning?" The nurse is assessing which of the following?

Faith and belief

Which of the following nursing interventions will a nurse perform to transfer heat and improve circulation in a dying client?

Gently massage the arms and legs

Which of the following causes should the nurse suspect in a client diagnosed with intrarenal failure?

Glomerulonephritis

Which of the following causes should the nurse suspect in a client is diagnosed with intrarenal failure?

Glomerulonephritis

Which term is used to describe the personal feelings that accompany an anticipated or actual loss?

Grief

A client who is legally blind had orthopedic surgery 3 days ago and wants to urinate. She is using a walker for ambulation. It would be best for the nurse to

Guide the client's hand to the armrest on the bedside commode prior to the client sitting on the commode

A client with malignant hypertension is at risk for a hypertensive crisis, including the cerebral vascular system often causing cerebral edema. The nurse would assess this client for which signs and symptoms?

Headache and confusion

A nurse is working with a family of a deceased client and assisting them in working through their grief and mourning. Which of the following would be the priority to promote healthy accommodation of the loss by the family?

Helping the family recognize the loss has occurred

The nurse cares for a client after extensive abdominal surgery. The client develops an infection that is treated with IV gentamicin. After 4 days of treatment, the client develops oliguria, and laboratory results indicate azotemia. The client is diagnosed with acute tubular necrosis and transferred to the ICU. The client is hemodynamically stable. Which dialysis method would be most appropriate for the client?

Hemodialysis

The nurse is caring for a patient in acute renal failure. The nurse should expect hypertonic glucose, insulin infusions, and sodium bicarbonate to be used to treat:

Hyperkalemia

A client with chronic renal failure complains of generalized bone pain and tenderness. Which assessment finding would alert the nurse to an increased potential for the development of spontaneous bone fractures?

Hyperphosphatemia

The nurse is caring for a patient after kidney surgery. What major danger should the nurse closely monitor for?

Hypovolemic shock caused by hemorrhage

The client with blindness is hospitalized following a myocardial infarction. Which care measures would the nurse take with this client?

Identify self when walking into the client's room State when the nurse is leaving the room Orient the client to the room using a click reference

A nursing instructor is preparing a class on pressure ulcers. Which of the following would the instructor most likely include as a possible risk factor?

Immobility Anemia Increased moisture

What is a characteristic of the intrarenal category of acute kidney injury (AKI)?

Increased BUN

The nurse is caring for a patient in the oliguric phase of acute kidney injury (AKI). What does the nurse know would be the daily urine output?

Less than 400 mL

Nursing care of patients with chronic illness is varied and occurs in a variety and occurs in a variety of settings. Care must be direct and supportive. To provide supportive care, a nurse would do which of the following?

Make referrals for additional care

Which statement provides accurate information related to chronic illness?

Most people with chronic conditions do not consider themselves sick or ill

Nursing students are reviewing information about the signs and symptoms of impending death. The students demonstrate the need for additional review when they identify which of the following as a sign?

Muscle wasting

The nurse is performing a history for a black client that is concerned about developing coronary artery disease since it "ruins in the family." What risk factor, that is modifiable, does the nurse identify when taking the history?

Obese 40% over total body weight

A nurse prepares a diabetes prevention health seminar for community residents. Her teaching points should emphasize the most important factor influencing metabolic syndrome (pre-diabetes). What is that factor?

Obesity

The family of a client in hospice decides to place their loved one in a long-term care facility to establish an effective pain control regimen. Which aspects of hospice care is the family using?

Palliative care

A client is declared to have a terminal illness. What intervention will a nurse perform related to the final decision of a dying client?

Respect the client's and family members' choices

The client with polycystic kidney disease asks the nurse, "Will my kidneys ever function normally again?" The best response by the nurse is:

"As the disease progresses, you will most likely require renal replacement therapy."

A nurse is assessing a terminally ill female client. Which client statement indicates that the client is in the bargaining stage of dying?

"I just want to see my daughter graduate from college. That's all."

After teaching a group of students about how to perform peritoneal dialysis, which statement would indicate to the instructor that the students need additional teaching?

"It is appropriate to warm the dialysate in a microwave."

A nurse is caring for a client with multiple chronic conditions and some physical disabilities. The nurse is using "people first" language with the following statement during end-of-shift report:

"Last evening, Mr. Rudd, a 44-year-old patient with diabetes was admitted to the unit."

A 36-year-old female who has experienced diverse symptoms for several years has finally had her health problems attributed to scleroderma (Systemic sclerosis), and has committed herself to learning as much about the disease as she can. Which statement would her nurse want to correct or clarify?

"The worst part of this so far has been learning that there aren't any treatments for scleroderma"

Which statement made by the nurse demonstrates that the nurse is providing spiritually sensitive care?

"Tell me who or what gives you strength"

The family of a terminally ill client tells the nurse that the client has been breathing irregularly and, at times, it appears that he is not breathing at all. The client's daughter states, "He moans when he breathes. Is he in pain?" Which response by the nurse would be most appropriate?

"The moaning you hear is from air moving over very relaxed vocal cords."

Which statement about the use of angiotensin-converting enzyme (ACE) inhibitors and autosomal recessive polycystic kidney disease (ARPKD) is accurate?

ACE inhibitors may interrupt the renin-angiotensin-aldosterone system to reduce renal vasoconstriction

An elderly female client who has dizziness and osteoporosis fell at home and fractured her hip. She underwent surgical intervention for repair of the fractured hip and is now being discharged to a subacute care facility. In the comeback phase of the Trajectory Model of Chronic Illness, the nurse:

Acknowledges the client's achievement when she walks to the bedside commode with her

Spinal cord injury is an example of which type of disability?

Acquired

A patient has had a traumatic amputation of the left leg above the knee following an industrial accident. What type of disability does this patient have?

Acquired disability

The client who has the chronic condition of diabetes, reports blurry vision, and admits to nonadherence to the diet and medications. The home health nurse checks the client's fasting blood glucose level, which is 412 mg/dL. What phase of the Trajectory Model of Chronic Illness does the nurse assess this client is in?

Acute

The physician is attending to a 73-year-old client with a malignant brain tumor. Family members report that the client rarely sleeps and frequently reports seeing things that are not real. Which intervention is an appropriate request for the hospice nurse to suggest to the physician?

Add haloperidol to the client's treatment plan

The nurse is reviewing the potassium lelvle of a patient with kidney disease. The results of the test are 6.5 mEq/L, and the nurse observes peaked T waves on the ECG. What priority intervention does the nurse anticipate the physician will order to reduce the potassium level?

Administration of sodium polystyrene sulfonate (Kayexalate)

The nurse identifies a nursing diagnosis of imbalanced nutrition: less than body requirements for a terminally ill client who is near the end of life. Which of the following would the nurse expect to include in the client's plan of care

Advice for the family to have fruit juices readily available at the client's bedside

A nurse practitioner would be applying the pre-trajectory model of chronic illness when she:

Advised a woman, whose mother has Huntington's chorea, and who is considering pregnancy, to get genetic testing

All nurses care for clients who are grieving. It is important for the nurse to understand the grieving process for which reason?

Allows for the nurse to facilitate the grieving process

The instructor provides corrective information to the nursing student when the student refers to the client as the

COPDer in 2016

A patient admitted with electrolyte imbalance has carpopedal spasm, ECG changes, and a positive Chvostek sign. What deficit does the nurse suspect the patient has?

Calcium

A family of a dying client reports that their loved one is experiencing more shortness of breath. Which nursing intervention is most appropriate at this time?

Call the health care provider to obtain an oxygen order

A client requires hemodialysis. Which type of drug should be withheld before this procedure?

Cardiac glycosides

The nurse is caring for a client with diabetes. Which of the following is a characteristic of chronic illness?

Chronic illness affects the entire family

Which statement is a misconception about chronic disease?

Chronic illnesses cannot be prevented

Medicare and Medicaid hospice benefit criteria allow clients with a life expectancy of 6 months or less to be admitted to hospice. However, the median length of stay in a hospice program is just 21.3 days. Which reason explains the underuse of hospice care services?

Clients and families view hospice care as giving up

Glaser and Strauss (1965) identified four "awareness context" Which awareness context occurs when the client is unaware of their terminal state, whereas others are aware?

Closed awareness

The client is admitted to the hospital with a diagnosis of acute glomerulonephritis. Which clinical manifestation would the nurse expect to find?

Cola-colored urine

The nurse is working with a client who has difficulty controlling blood sugar. The client is classified as overweight. The client does not adhere to a low-calorie diet and forgets to take medications and check blood glucose level. The client's glycohemoglobin is 8.5%. When establishing a goal for the client, what action will the take first?

Collaborates with the client to establish an agreed-upon goal

Which phase of the Trajectory Model does the nurse recognize is present when the patient is in remission, after an exacerbation of illness?

Comeback

Which is the initial stage of grief, according to Kubler-Ross?

Denial

A client is in end-stage chronic renal failure and is being added to the transplant list. the nurse explains to the client how donors are found for clients needing kidneys. Which statement is accurate

Donors are selected from compatible living or deceased donors

A 90-year-old home care client's son has been designated to make decisions regarding the client's medical care when the client is no longer able to do so. As the client nears the end of life, the son is consulted on an ever-increasing basis. What legal instrument activates the son's decision-making designation?

Durable power of attorney for health care

A client diagnosed with a terminal illness appoints her oldest son as the authorized individual to make medical decisions on her behalf when she is no longer able to speak for herself. Which proxy directive is the patient using?

Durable power of attorney for health care

A nursing instructor is discussing the causes of the increasing number of people with chronic conditions. Which of the following would the nurse correctly identify as a cause?

Early detection and treatment of diseases

A nurse is talking on the phone with a doctor and states, "I am calling you about Mrs. Nye, my client with cancer in room 213." This is an example of what type of language that is important to all people?

People-first

A patient who is at risk for developing a chronic condition because of genetic factors is side to be in which phase of the Trajectory Model?

Pretrajectory

The nursing is caring for a client who communicates via sign language. What should the nurse do to promote communication?

Provide a sign language interpreter

Which cardiovascular findings indicate to the nurse that the condition of the dying client is worsening?

Pulse 104 beats/minute in the morning, 62 beats/minute in the afternoon with mottled feet and ankles

A nurse is reviewing the history of a client who is suspected of having glomerulonephritis. Which of the following would the nurse consider significant?

Recent history of streptococcal infection

The client had cerebrovascular accident with dropping of the face. Speech is slurred. The nurse is obtaining the admission assessment data. It would be best for the nurse to

Repeat back what the client states

A client with renal failure is undergoing continuous ambulatory peritoneal dialysis. Which nursing diagnosis is the most appropriate for this client?

Risk of infection

According to the classification of hypertension diagnosed in older adults, hypertension that can be attributed to an underlying cause is termed

Secondary

The laboratory results for a patient with renal failure, accompanied by decreased glomerular filtration, would be evaluated frequently. Which of the following is the most sensitive indicator of renal function?

Serum creatinine of 1.5 mg/dL

As the moment of death approaches, which of the following does the nurse encourage the family to do?

Speak to the client in a calm and soothing voice

The nurse is with a client who has a chronic illness and is reinforcing positive behaviors and teaching about health promotion. For which phase of the trajectory model of chronic illness are these nursing actions appropriate?

Stable

Hyperkalemia is a serious side effect of acute renal failure. Identify the electrocardiogram (ECG) tracing that is diagnostic for hyperkalemia.

Tall, peaked T waves

Which of the following describes the crisis phase of the trajectory model of chronic illness?

The client is experiencing a critical or life-threatening situation requiring emergency

In spite of administering the prescribed pain medication, a dying client is still experiencing dyspnea due to fear and anxiety. Which nursing intervention should the nurse use to potentiate the effects of pain medication and help reduce the dyspnea?

Use imagery, humor, and progressive relaxation

The nurse is providing supportive care to a client receiving hemodialysis in the management of acute renal failure. Which statement from the nurse best reflects the ability of the kidneys to recover from acute renal failure?

The kidneys can improve over a period of months

When describing the term "grief" to a group of students, which of the following would the instructor include?

The response experienced by anyone who has suffered a loss

The most common cause of ischemic stroke is:

Thrombosis

Which phase in the trajectory model of chronic illness is characterized by the reactivation of an illness in remission?

Unstable

A nurse assesses a client shortly after living donor kidney transplant surgery. Which postoperative finding must the nurse report to the physician immediately?

Urine output of 20mL/hour

Which of the following is the most accurate indicator of fluid loss or gain?

Weight

A nurse is evaluating a client with a terminal illness. What should the nurse report so that the health care tean can consider alternative nutritional approaches and fluid administration routes for the client at the end of life?

Weight loss and inadequate food intake

Because of difficulties with hemodialysis, peritoneal dialysis is initiated to treat a client's uremia. Which finding during this procedure signals a significant problem?

White blood cell (WBC) count of 20,000/mm3

The nurse is administering calcium acetate (PhosLo) to a patient with end-stage renal disease. When is the best time for the nurse to administer this medication?

With food