ati rn concept based assessment level 3 practice b
a nurse is preparing to administer immunizations to a 2 month old infant at a well child visit. which of the following immunizations should the nurse plan to administer? a. varicella b. MMR c. Hib d. influenza.
Hib immunization
taper off before discontinuing
cyclobenzaprine
a nurse is caring for a client who is experiencing infertility. which of the following medications should the nurse expect the provider to prescribe? a. methylergonovine b. clomiphene c. misoprostol d. labetalol
clomiphene
used to shrink fibroid tumors
closure device or injection that blocks blood flow to the arteries of the tumors
a nurse is reviewing the lab report of an adolescent client who has hemophilia A. which of the following lab results should the nurse expect? a. aPTT 110 seconds. b. coagulating factor VIII 50%. c. coagulating factor IX 75%. d. PT 14 seconds.
coagulating factor VIII 50%
a CNS stimulant
cocaine
difficulty in decision making
cognitive symptom of schizophrenia
risk factor for a stroke caused by a thromboembolism.
combo oral contraceptives
hyponatremia hypoglycemia stroke increased risk for bleeding
complications of HELLP syndrome
compares two objects
concept of relationships
increases neutrophil count
filgrastim
left hemisphere stroke
right visual field deficits
the nurse should identify that experiencing auditory hallucinations, or hearing voices or sounds that do not exist, is a positive symptom of this disorder.
schizophrenia manifestation
a nurse in a provider's office is reviewing the laboratory report of a client who takes lithium for bipolar disorder. which of the following laboratory results should the nurse report to the provider? a. WBC 7000 b. BUN 15 c. potassium 4.2 d. sodium 128
sodium 128 mEq/L
agitation, dizziness, and tremor.
acute cocaine toxicity s/s
manifestation of conduct disorder
aggression
administered for the treatment of prostate cancer, but is ineffective for the treatment of melanoma.
brachytherapy
exhibited by patients with narcissistic personality disorder.
arrogance
should not be administered to children who are less than 9 years old.
HPV
recommended at 11 to 12 years of age but can be administered as early as 9.
HPV vaccine
right hemispheric stroke
constant smiling
drawing a clock displaying the time on the hands as 2:30.
constructional ability
HL
hodgkin's lymphoma
contraindicated in clients who have hypertension.
methylergonovine
can cause convulsions and myocardial infarction.
severe cocaine toxicity
may be an indication of a stroke in clients with sickle cell anemia.
severe headache
parkinson's symptom
shuffling gait
increases blood flow to the uterus and placenta optimizing the delivery of nutrients and oxygen to the fetus.
side lying position
use a variety of body movements and poses to strengthen core muscles and improve control of muscle groups.
yoga and pilates
right hemisphere stroke
poor judgment
will have a decreased hct
HELLP syndrome
4000 - 11000
WBCs
explaining familiar sayings
ability of interpretation
can lead to lithium toxicity
dehydration
left hemisphere stroke
difficulty reading
symptom of amyotrophic lateral sclerosis
fasciculations of the face
a mass in the duct with nipple discharge
intraductal papilloma breast disorder
right hemisphere stroke
loss of hearing
playing alongside but not with other children an expected finding in toddlers
parallel play
vemurafenib
targeted therapy drugs
client can expect mild to severe cramping after a uterine artery embolization to last _____________
24 hours to 2 weeks post procedure
phenytoin should be mixed with no more than ______________.
50 mL of 0.9% sodium chloride
an expected finding for a client who is pregnant.
Hct 37%
decreased visual acuity diplopia changes in peripheral vision nystagmus
MS manifestations involving the eyes
within the expected reference range of 10-20 mg/dL for a client who is pregnant. HELLP syndrome will have an elevated BUN.
BUN 15 mg/dL
exhibited by clients with borderline personality disorder.
impulsiveness
a nurse is caring for a client who has alzheimer's disease (AD). the client's daughter asks the nurse if she will have AD as well. which of the following responses should the nurse make regarding the genetic disposition of this disease? a. you can be tested for the presence of apolipoprotein, an indication of an increased risk of developing AD. b. having a family history of AD is not a known risk factor for developing the disease. c. individuals who develop AD generally have a history of freq
you can be tested for the presence of apolipoprotein, an indication of an increased risk of developing AD.
a nurse is teaching about uterine artery embolization with a client who has uterine fibroids. which of the following information should the nurse include in the teaching? a. you do not need sedation during the procedure. b. the internal fibroids are excised and removed. c. you may experience flu like illness for 7 days after the procedure. d. cramping can last 4 weeks after the procedure.
you may experience flu like illness for 7 days after the procedure.
a nurse is teaching a client who is preoperative for an abdominal hysterectomy with a bilateral salpingooopherectomy. which of the following statements should the nurse make? a. you might develop menopausal symptoms after this procedure. b. you no longer need to use condoms after this procedure. c. you might continue to have your period each month after this procedure. d. you should avoid sexual intercourse for 2 weeks after this procedure.
you might develop menopausal symptoms after this procedure.
a nurse in an infertility clinic is providing teaching to a client about her upcoming hysterosalpingography. which of the following statements should the nurse make? a. you might feel pain in your shoulder after the procedure. b. you will schedule the exam 3 to 5 days before your period is duel. c. the procedure is performed under general anesthesia. d. the procedure checks for fibroids that hinder implantation.
you might feel pain in your shoulder after the procedure.
a nurse is providing dietary management to a client who is at 10 weeks of gestation and has hyperemesis gravidarum. which of the following statements should the nurse make? a. you should eat foods at warm temps. b. you should eat protein before sweets. c. you should avoid dairy products. d. you should eat at least every 2 hours.
you should eat at least every 2 hours.
a nurse is providing teaching to the parent of a school age child who has sickle cell anemia. which of the following statements should the nurse include? a. you should report to the provider if your child has a severe headache. b. you should apply cold compresses to your child's affected joints. c. you should restrict your child's intake of fluids. d. you should administer a stool softener to your child each day.
you should report to the provider if your child has a severe headache.
manifestation of left hemisphere stroke.
anxiety
the client's belief that someone is watching their every move occurs when the client becomes suspicious of the actions and intentions of others.
paranoia
is suspicious and feels that others are attacking his/her reputation.
paranoid personality disorder
can develop a precipitate when refrigerated but the precipitate dissolves at room temperature and does not affect the potency of the medication.
phenytoin
should be administered via intermittent IV bolus at a rate no greater than 50 mg/min to prevent the client from developing hypotension and bradycardia.
phenytoin
manifestations include uterine hypertonicity, abdominal pain, vaginal bleeding, and a boardlike abdomen.
placental abruption
newborns who are premature are at risk for anemia and this rather than thrombocytopenia.
polycythemia
a nurse is caring for a client following a stroke. which of the following actions should the nurse take to increase the client's cerebral perfusion? a. elevate the head of the client's bed to 90 degrees. b. position the client's head in a midline position. c. place the client in the sim's position. d. encourage the client to cough deeply.
position the client's head in a midline position.
a nurse is planning care for a newborn who was born at 33 weeks of gestation and is 2 days old. which of the following interventions should the nurse include? a. bathe the newborn daily with an alkaline based soap. b. dim the lights in the nursery for 2 hr during each 24 hr period. c. position the newborn side lying or prone while in the nursery. d. refrain from skin to skin contact until the newborn weighs 6 lb.
position the newborn side lying or prone while in the nursery.
involves the presence of behaviors that are not expected such as use of concrete thinking.
positive symptom of schizophrenia
a nurse is caring for a client who is experiencing acute alcohol withdrawal. for which of the following client outcomes should the nurse administer chlordiazepoxide? a. minimize diaphoresis b. maintain abstinence c. lessen craving d. prevent delirium tremens
prevent delirium tremens
heartburn
pyrosis
administered to treat large, deeply invasive basal cell tumors in clients who might have a poor surgical outcome.
radiation therapy
a nurse is planning care for a client who has a gambling disorder. which of the following interventions should the nurse include in the plan? a. recommend joining a self help group. b. administer antipsychotic medications. c. begin disulfiram therapy. d. initiate aversion therapy.
recommend joining a self help group.
a nurse is assessing a client who has acute pyelonephritis. the nurse should identify which of the following findings as an indication of inflammation? a. increased BUN. b. redness on the right flank. c. decreased C reactive protein. d. urinary retention.
redness on the right flank.
a nurse is caring for a client who is receiving IV oxytocin for induction of labor. the fetal heart rate tracing reveals multiple variable decelerations. which of the following actions should the nurse take? a. reposition the client. b. administer methylergonovine IM. c. administer oxygen at 2 L/min via nasal cannula. d. prepare the client for a biophysical profile.
reposition the client
a nurse is teaching a client about acute glomerulonephritis. which of the following information should the nurse include? a. expect urine to remain clear or straw colored. b. restrict fluid intake based on the previous day's output. c. include foods high in sodium in the diet. d. measure weight twice per week.
restrict fluid intake based on previous day's urine output.
a nurse is teaching a client about acute glomerulonephritis. which of the following information should the nurse include? a. expect urine to remain clear or straw colored. b. restrict fluid intake based on previous day's urine output. c. include foods high in sodium in the diet. d. measure weight twice per week.
restrict fluid intake based on the previous day's urine output.
a nurse is assessing a client who is experiencing opioid withdrawal. which of the following manifestations should the nurse expect? a. rhinorrhea b. pinpoint pupils. c. bradypnea d. increased appetite.
rhinorrhea.
recommended at 2 months of age
rotavirus vaccine
desires solitude and dislikes having close relationships with others.
schizoid personality disorder
the nurse should identify that clang association, or choosing words based on their sounds, is a positive symptom of this disorder.
schizophrenia manifestation
the nurse should identify that magical thinking, or the belief that one's thoughts affect others, is a positive symptom of this disorder.
schizophrenia manifestation
a nurse is reviewing the laboratory results for a client who has HELLP syndrome. which of the following laboratory results should the nurse expect? a. hct 37% b. BUN 15 mg/dL c. platelet count 150,000/mm3 d. serum uric acid 11 mg/dL
serum uric acid 11 mg/dL
can enable overall increased caloric intake during times of heart failure because the decreased cardiac output lowers activity tolerance which might make it difficult to meet caloric needs due to fatigue.
small, frequent feedings
a nurse is reviewing the medication record of a client who was recently diagnosed with alzheimer's disease and has a new prescription for memantine. the nurse should instruct the client that which of the following medications can interact adversely with memantine? a. sodium bicarbonate b. ibuprofen c. diphenhydramine d. omeprazole
sodium bicarbonate
30-220 units/dL
amylase
demonstrates frequent self mutilating behavior.
borderline personality disorder
adverse effect may be weight gain
carbemazepine
right hemisphere stroke
euphoria
involves manipulating soft tissue to increase circulation and induce muscle relaxation.
massage therapy
an antacid used to treat GI upset.
sodium bicarbonate
spreads systematically from one group of lymph nodes to the next group of nodes.
HL
2 months
DTaP vaccine
can be caused by viral infections such as HIV or epstein-barr virus.
HL
responds well to treatment and treatment is determined by the stage of the disease.
HL
contains a live virus and should not be administered to clients who are immunocompromised.
MMR
manifests as painless, swollen lymph nodes often found in the cervical, axillary, inguinal, and femoral areas.
NHL
spreads erratically through the lymphatic system to other lymph nodes and organ systems.
NHL
a nurse assessing an adolescent client who has ewing sarcoma. which of the following manifestations should the nurse expect? a. client reports pain in the upper thigh. b. client reports increased urination. c. client reports swelling of the fingers. d. client reports blood in the stool.
client reports pain in the upper thigh.
a nurse is assessing a group of clients who have personality disorders. which of the following clients should the nurse identify as having characteristics of schizoid personality disorder? a. a client who suspects that others are attacking his reputation. b. a client who is uncomfortable when she is not the center of attention. c. a client who demonstrates frequent self mutilating behavior. d. a client who dislikes having close relationships with other people.
a client who dislikes having close relationships with other people.
used to treat acute acetaminophen toxicity
acetylcysteine
uses digital pressure on specific areas of the body to reduce pain and improve function.
acupuncture
periods of mood instability
affective symptom of schizophrenia
a nurse in an ED is assessing a newly admitted client. the nurse should identify that which of the following findings is a manifestation of acute cocaine toxicity? a. hypotension. b. pinpoint pupils. c. agitation. d. hypothermia.
agitation
a nurse is reviewing the lab report of a client who is at 34 weeks of gestation and has preeclampsia. which of the following results should the nurse recognize as an indication that the client could be developing HELLP syndrome? a. alanine aminotransferase 41 units/L. b. platelets 150,000. c. hgb 16 g/dL d. creatinine clearance 105 mL/min.
alanine aminotransferase 41 units/L
may increase the bleeding in a hemorrhagic stroke
alteplase therapy
rises within 12-24 hours of onset of pancreatitis.
amylase
a nurse is reviewing the laboratory findings of a client who has acute pancreatitis. which of the following findings should the nurse expect? a. calcium 10.2 mg/dL b. amylase 300 units/L c. WBC count 7000 mm3 d. blood glucose 100 mg/dL
amylase 300 units/L
lithium, carbamazepine, naltrexone.
antipsychotic meds
newborns who are premature can experience a delay of spontaneous breathing for 20 or more seconds that may be due to CNS immaturity or obstruction of the upper airways and this occurs in more than half of newborns delivered at less than 32 weeks of gestation.
apnea
a nurse is caring for an infant born at 31 weeks of gestation. for which of the following complications should the nurse anticipate and monitor the newborn? select all that apply. a. hyperthermia. b. apnea. c. thrombocytopenia. d. necrotizing enterocolitis. e. hypoglycemia.
apnea. necrotizing enterocolitis hypoglycemia
a hospice nurse is providing palliative care for a client who is near death and not responding to verbal stimuli. which of the following actions should the nurse take? a. administer morphine sulfate PO every 4 hr as needed for pain. b. apply scopolamine transdermal patch for increased oral and respiratory secretions. c. use restraints if the client is experiencing restlessness. d. place a heating pad on the client's feet to warm cool extremities.
apply a scopolamine transdermal patch for increased oral and respiratory secretions.
a nurse is caring for a client who has eclampsia and has just experienced a tonic clonic seizure. which of the following actions should the nurse take? a. apply oxygen via nonrebreather at 10 L/min. b. administer calcium gluconate. c. administer 500 mL bolus of IV fluids. d. place the client in reverse Trendelenburg position.
apply oxygen via nonrebreather at 10 L/min.
a hospice nurse is caring for a client who has end stage cancer. the client's partner asked about ways to help reduce the client's pain. which of the following palliative actions should the nurse recommend for tactile distraction? a. singing to the client. b. teaching the client to meditate. c. applying warm compresses. d. offering crossword puzzles.
applying warm compresses.
a nurse in a mental health clinic is planning care for a client who has post traumatic stress disorder. which of the following strategies should the nurse include? a. assist the client to identify their stage in the grief process. b. encourage the client to avoid discussing their trauma. c. offer the client alone time when flashbacks occur. d. provide the client with a rotating staffing assignment.
assist the client to identify their stage in the grief process.
exhibited by clients with histrionic personality disorder.
attention seeking behavior
used as a behavioral modification tool for clients who have sexual paraphilias.
aversion therapy
a nurse is teaching a client who has sickle cell anemia about preventing sickle cell crisis. which of the following information should the nurse include? a. avoid going outside when temps are extreme. b. limit your intake of fluids to 2.5 liters daily. c. engage in strenuous physical exercise several times a week. d. contact your provider if you have a fever that lasts more than 3 days.
avoid going outside when temps are extreme.
a nurse is teaching a client who has a new diagnosis of pelvic inflammatory disease and is starting oral antibiotic therapy. which of the following information should the nurse include in the teaching? a. avoid sexual activity until antibiotic therapy is complete. b. check your temperature once per week. c. apply cold packs to your abdomen. d. ambulate for 30 minutes, three times per day.
avoid sexual activity until antibiotic therapy is complete.
given to stimulate fetal lung maturity in a client who is experiencing preterm labor.
betamethasone
a technique that uses audio and visual signals that allow clients to reduce muscle tension by gaining control over autonomic physiological functions.
biofeedback
a nurse is assessing a client who has parkinson's disease. which of the following manifestations should the nurse expect? a. bradykinesia b. nuchal rigidity c. myalgia d. light sensitivity
bradykinesia
fibrocystic breast condition symptom
breast pain
adverse effect may be drowsiness or sedation.
carbamazepine
adverse effect may be urinary hesitancy or retention.
carbamazepine
adverse effect of blurred vision or double vision needs to be reported to the provider.
carbamazepine
contraindicated for clients who have hypertension.
carboprost
a nurse is caring for a client who is at 13 weeks of gestation and has a positive gonorrhea culture. which of the following medications should the nurse plan to administer? a. imiquimod. b. acyclovir. c. ceftriaxone. d. metronidazole.
ceftriaxone
a school nurse is planning an educational program for parents about bullying. which of the following information should the nurse include? a. children who are victims of bullying behavior have an increased risk of suicidal ideation. b. victims of bullying behavior in elementary school will have increased self esteem as adults. c. there is no evidence that a favorable relationship with parents can prevent bullying behavior. d. children who bully others have conduct disorder and should be eval
children who are victims of bullying behavior have an increased risk of suicidal ideation.
a nurse is assessing a client who has MS. which of the following manifestations should the nurse expect? a. fasciculations of the face. b. decreased visual acuity. c. shuffling gait. d. muscle rigidity.
decreased visual acuity
occur when the client believes an external force has the ability to control his thoughts or actions.
delusions of control
the client's belief of exaggerated power or identity demonstrates this. occur when the client has a heightened sense of importance and ability.
delusions of grandeur
occur when events are interpreted as directed at the client.
delusions of reference
a nurse is assessing an infant who has down syndrome. which of the following manifestations should the nurse expect? a. enlarged pupils. b. long, thin fingers. c. depressed nasal bridge. d. concave abdomen.
depressed nasal bridge
a nurse is caring for a client who has a newborn and exhibits manifestations of postpartum depression. which of the following assessments is the nurse's priority? a. observe the client interacting with the newborn. b. determine whether the client plans to harm herself. c. ask the client if she has been sleeping less than usual. d. identify the client's available support systems.
determine whether the client plans to harm herself.
a nurse is counseling a client who has experienced intimate partner violence. which of the following instructions is the priority for the nurse to include in the teaching? a. develop a safety plan. b. arrange for legal counseling. c. open a separate bank account. d. attend a support group.
develop a safety plan.
a nurse is assessing a client who is at 24 weeks of gestation. which of the following findings should the nurse identify as an indication of gestational hypertension? a. protein in the urine. b. visual disturbances. c. systolic blood pressure 132 mmHg. d. diastolic blood pressure 98 mmHg.
diastolic blood pressure 98 mmhg
evidence of decreased arterial oxygen levels, which occurs over time and is evident as a late manifestation of COPD.
digital clubbing
the nurse is assessing a client who has end stage COPD. which of the following images should the nurse identify as a late manifestation of this terminal illness? a. flexion or contraction of the joints. b. swan neck deformation. c. tophi, related to chronic gout. d. digital clubbing.
digital clubbing
contraindicated in clients who have hypertension.
dinoprostone
a nurse is teaching the guardian of a child who has juvenile idiopathic arthritis about pain management. which of the following statements should the nurse make? a. discourage your child from taking naps during the daytime. b. place cold packs on affected joints three times per day to reduce swelling. c. decrease your child's daily intake of high fiber foods. d. limit your child's physical activities to decrease inflammation.
discourage your child from taking naps during the daytime.
a medication prescribed to deter drinking in clients who abuse alcohol.
disulfiram
a nurse is providing teaching to a client who has bipolar disorder and a new prescription for lithium. which of the following statements should the nurse make? a. take this medication on an empty stomach. b. restrict your intake of salt while taking this medication. c. drink at least 1.5 liters of fluid per day while taking this medication. d. expect a weight loss of 10 to 20 pounds with this medication.
drink at least 1.5 liters of fluid per day while taking this medication.
self help groups such as gambler's anonymous.
effective treatment for gambling disorder
the nurse should identify that a client who has acute pancreatitis can have _________.
elevated amylase level
flu like illness up to 7 days after uterine artery embolization.
embolectomy syndrome
a manifestation of ductal ectasia breast disorder.
enlarged axillary nodes
a nurse is assessing a client who had a stroke. the nurse should identify that which of the following findings is a manifestation of a right hemisphere stroke? a. anxiety b. low tolerance for frustration c. right visual field deficits. d. euphoria.
euphoria.
localized pain swelling palpable mass fever
ewing sarcoma
manifestations include pain, a palpable mass, or fever.
ewing sarcoma
a nurse is assessing a newly admitted client who has major depressive disorder. which of the following manifestations should the nurse expect in this client? a. experiences delusions of persecution. b. exhibits manipulative behavior. c. concentrates excessively on work. d. obtains attention using physical appearance.
experiences delusions of persecution.
a nurse is assessing a client who is at 24 weeks of gestation during a monthly antepartum visit. . which of the following manifestations is a potential prenatal complication and should be reported to the provider? a. facial swelling. b. leukorrhea. c. periodic numbness of the fingers. d. pyrosis.
facial swelling
twitching of the face
fasciculations of the face
a nurse is assessing a client who has ALS. which of the following findings should the nurse identify as an early manifestation of this illness? a. swelling of the tongue. b. hoarse tone of voice. c. fasciculations of the face. d. weakness and muscle atrophy of the legs.
fasciculations of the face.
breast pain and tenderness lumps in the upper, outer quadrant
fibrocystic breast disease
one of the diagnostic criteria for this is a reliance on others to provide money to help with negative financial situations that are a direct result of gambling losses. according to the american psychiatric association, a diagnosis of this requires that the client's behavior meets four of the defined criteria over the period of the past 12 months.
gambling disorder
a nurse is teaching a client who is at 22 weeks of gestation and has gestational hypertension. which of the following information should the nurse include in the teaching? a. gestational hypertension usually begins around 12 weeks of gestation. b. clients who have gestational hypertension generally have protein in their urine. c. gestational hypertension usually resolves during the first postpartum week. d. clients who have gestational hypertension generally develop headaches.
gestational hypertension usually resolves during the first postpartum week.
must be checked prior to administering digoxin
heart rate
3 or more alcoholic drinks per day
heavy alcohol use
risk factor for stroke
heavy alcohol use
a nurse is assessing an adolescent who has sickle cell anemia and is experiencing a vaso occlusive crisis. which of the following manifestations should the nurse expect? a. hematuria. b. pallor. c. tinnitus. d. tingling of the hands.
hematuria
solution for lithium toxicity
hemodialysis
a nurse in a provider's office is preparing immunizations for a 12 month old infant who is immunocompromised. which of the following immunizations should the nurse plan to administer at this time? a. varicella b. MMR c. Hepatitis B d. HPV
hepatitis b
the first immunization that a newborn will receive which is recommended to be administered within 12 hours of birth
hepatitis b vaccine
is a risk factor for developing osteoporosis.
history of hypopituitarism
uses physical appearance to obtain attention.
histrionic personality disorder
wants to be the center of attention and is uncomfortable when this is not possible.
histrionic personality disorder
a nurse is assessing a client who has depression. which of the following manifestations should indicate to the nurse that the client is experiencing low self esteem? a. expresses lack of meaning in life. b. hypersensitivity to criticism. c. impaired problem solving ability. d. difficulty falling asleep.
hypersensitivity to criticism.
a nurse is assessing a client who has PTSD after a workplace explosion 3 months ago. which of the following findings should the nurse expect? a. hypervigilance. b. delusions. c. somnolence. d. amnesia.
hypervigilance
fetal glycogen stores develop primarily in the last trimester meaning that the lack of glycogen stores and the difficulty regulating temperature increase the risk of hypoglycemia in preterm newborns.
hypoglycemia
result from pushing too much phenytoin too quickly.
hypotension and bradycardia
the nurse should monitor for this when infusing phenytoin intermittent IV bolus and plan to decrease the rate of the infusion if these cardiac conditions occur.
hypotension and bradycardia
newborns who are premature are more prone to heat loss due to decreased fat stores and a limited ability to maintain a flexed position.
hypothermia
a nurse is teaching a client who has tobacco use disorder about the use of nicotine patches as an aid in smoking cessation. which of the following statements indicates the client understands the teaching. a. i should leave each nicotine patch on for 12 hours before replacing. b. i should expect to have heartburn while using a nicotine patch. c. i should adjust the dosage of the nicotine patch if i crave a cigarette. d. i should gradually decrease the dose of the nicotine patch over several w
i should gradually decrease the dose of the nicotine patch over several weeks.
a nurse is teaching a client about the use of risedronate for the treatment of osteoporosis. the nurse should identify which of the following statements as an indication that the client understands the teaching? a. i will drink a glass of milk when i take the risedronate. b. i will take the risedronate 15 minutes after my evening meal. c. i should take an antacid with the risedronate to avoid nausea. d. i should sit up for 30 minutes after taking the risedronate.
i should sit up for 30 minutes after taking the risedronate.
a nurse is assessing a client who has epilepsy. the nurse should identify that which of the following client statements indicates the preictal phase of a seizure? a. i open my eyes and cannot remember what happened. b. my entire body goes stiff. c. i suddenly smell a foul odor. d. only one side of my body is affected.
i suddenly smell a foul odor.
a nurse is caring for a client who has schizophrenia and states, "the government has spies here monitoring me in my room." which of the following responses should the nurse give? a. the government is not monitoring your room. b. what would you like me to do about the government being here? c. i understand that you believe the government is here, but i don't see any evidence of this. d. let's go see if the government is monitoring your room.
i understand that you believe the government is here, but i don't see any evidence of this.
a nurse is providing discharge teaching to a client who is receiving radiation therapy for hodgkin's lymphoma. which of the following client statements indicates an understanding of the teaching? a. i will floss my teeth after each meal. b. i can take aspirin if i get a headache. c. i can use a suppository if i experience constipation. d. i will apply ice to the area if i get a bruise.
i will apply ice to the area if i get a bruise.
a nurse is providing discharge teaching to a client following gastric bypass surgery for management of obesity. which of the following client statements indicates an understanding of the teaching? a. i will apply moisturizing lotion between skin folds. b. i will remain in a reclining position for 30 minutes after i eat. c. i will return to my normal diet in 3 weeks. d. i will need to take digestive enzymes daily.
i will remain in a reclining position for 30 minutes after i eat.
a nurse at a crisis center is meeting with a client who reports that his adolescent daughter has been increasingly defiant since his divorce 2 years ago. the client states, "i'm so stressed that i can't take this anymore." which of the following actions should the nurse take first? a. refer the client and his daughter for family therapy. b. recommend that the client attend a support group for guardians of adolescents. c. identify the client's current coping strategies. d. teach the client st
identify the client's current coping strategies.
a nurse is providing discharge teaching to a client who is at 32 weeks of gestation and had an episode of preterm labor. which of the following should the nurse include in the instructions? a. increased watery vaginal discharge will occur as pregnancy progresses. b. if contractions recur, drink 2 to 3 glasses of water. c. maintain complete bed rest for the remainder of the pregnancy. d. there is no need to report painless contractions to the provider.
if contractions recur, drink two or three glasses of water.
a nurse is assessing a client who has borderline personality disorder. which of the following characteristics should the nurse expect? a. arrogance. b. attention seeking behavior. c. impulsiveness. d. suspicion.
impulsiveness
a nurse is assessing a client who is taking propylthiouracil for the treatment of grave's disease. which of the following findings should the nurse identify as an indication that the medication has been effective? a. decrease in WBC count. b. decrease in amount of time sleeping. c. increase in appetite. d. increase in ability to focus.
increase in ability to focus
a nurse is reviewing the laboratory report of a school age child who has acute poststreptococcal glomerulonephritis. which of the following laboratory values should the nurse expect? a. increased specific gravity. b. decreased creatinine. c. decreased BUN. d. positive urine culture.
increased urine specific gravity
a nurse is planning to administer recommended immunizations to a 65 year old client. which of the following immunizations should the nurse plan to administer? select all that apply. a. influenza vaccine b. HPV vaccine c. herpes zoster vaccine (shingles) d. pneumococcal vaccine e. inactivated polio virus vaccine
influenza vaccine herpes zoster vaccine (shingles) pneumococcal vaccine
a nurse is caring for a client following a hemorrhagic stroke. which of the following routine prescriptions should the nurse clarify? a. perform neurologic checks hourly. b. maintain the head of the bed at 20 degrees. c. initiate alteplase infusion. d. implement seizure precautions.
initiate alteplase infusion.
a nurse is planning care for a client who has adenocarcinoma and associated thrombocytopenia. which of the following actions should the nurse plan to take? a. apply pressure to the client's venipuncture sites for a total of 5 min. b. use a firm bristled toothbrush to remove bacteria from the client's teeth. c. initiate fall precautions for the client. d. check the client's IV site for bleeding every 8 hr.
initiate fall precautions for the client.
a nurse is planning care to decrease the risk of bowel perforation for a client who is in the acute phase of diverticulitis. which of the following interventions should the nurse include in the plan? a. avoid use of opioid analgesics. b. administer an enema to rest the bowel. c. provide the client with a high fiber diet. d. instruct the client to avoid coughing.
instruct the client to avoid coughing.
manifestation of ADHD along with decreased attention span, talkativeness, decreased ability to follow instructions, inability to complete tasks, poor social skills, poor impulse control, and intrusive behaviors.
intrusiveness
a nurse is teaching a client about ways to prevent melanoma. which of the following instructions should the nurse include in the teaching? a. limit exposure in tanning beds to 15 min per session. b. avoid sun exposure after 1500. c. keep a body map of skin abnormalities. d. inspect the entire body once every 3 months for lesions.
keep a body map of skin abnormalities.
primarily caused by impaired oxygenation to the placenta.
late decelerations
the nurse should identify digital clubbing when assessing a client who has this disorder.
late manifestation of COPD
an expected finding for viral meningitis.
light sensitivity
take with meals because it can irritate gastric mucosa
lithium
left hemisphere stroke
low tolerance for frustration
a nurse is assessing a client who has schizophrenia. which of the following manifestations should the nurse identify as positive symptoms of schizophrenia? select all that apply. a. magical thinking. b. clang association. c. auditory hallucinations. d. flat affect. e. emotional ambivalence.
magical thinking clang association auditory hallucinations
a nurse is assessing a client who has schizophrenia. which of the following manifestations should the nurse identify as positive symptoms of schizophrenia? select all that apply. a. magical thinking. b. clang association. c. auditory hallucinations. d. flat affect. e. emotional ambivalence.
magical thinking. clang association. auditory hallucinations.
used to prevent seizures in clients who have preeclampsia.
magnesium sulfate
a nurse is assessing the fluid balance of a school age child who has acute poststreptococcal glomerulonephritis and is experiencing inflammation. which of the following actions is the nurse's priority? a. monitor the childs BUN and creatinine levels regularly. b. keep a precise daily account of the child's intake and output. c. measure the child's bp manually every 4 hr. d. maintain a strict record of the child's daily weight.
maintain a strict record of the child's daily weight.
while taking lithium because low can lead to lithium retention causing toxicity.
maintain adequate sodium intake
demonstrates delusions of persecution or somatic delusions regarding physical health problems.
major depressive disorder
exhibits psychomotor retardation rather than manipulative behavior.
major depressive disorder
has difficulty concentrating and loses focus when attempting tasks.
major depressive disorder
impaired problem solving ability confusion difficulty concentrating inappropriate thinking memory deficits
manifestations of disturbed thought processes
difficulty falling asleep lack of energy verbal reports of not feeling well rested difficulty concentrating
manifestations of insomnia
hypersensitivity to criticism guilt shame expression of helplessness lack of eye contact pessimistic outlook
manifestations of low self esteem
bradykinesia mask-like features soft volume of speech pill rolling movements
manifestations of parkinson's disease
expresses lack of meaning in life. anger refusing interactions with family or spiritual leaders discontinuing routine spiritual practices.
manifestations of spiritual distress
nuchal rigidity fever headache nausea vomiting sensitivity to light and noise myalgia
manifestations of viral meningitis
exhibited in client who have bipolar disorder and personality disorders.
manipulative behavior
a nurse is caring for a client who is 4 hour postpartum and is experiencing excessive vaginal bleeding. which of the following actions is the nurse's priority? a. administer oxytocin IV. b. massage the client's fundus. c. assist the client to the bathroom to void. d. apply oxygen via nonrebreather face mask.
massage the client's fundus.
contains 3.1 g of fiber
medium banana
a nurse is caring for a client who is experiencing a postpartum hemorrhage. which of the following medications should the nurse plan to administer? a. methylergonovine b. magnesium sulfate c. terbutaline d. betamethasone
methylergonovine
causes contraction of the uterine muscle, decreasing bleeding.
methylergonovine
a nurse is reviewing the medical record of a client who requests a prescription for an oral contraceptive. which of the following findings should the nurse identify as a contraindication to an oral contraceptive? a. history of gestational diabetes. b. migraine with aura. c. history of asthma. d. renal lithiasis.
migraine with aura because migraines with neurologic symptoms increase the risk of stroke
a nurse is reviewing the medical record of a client who reports a prescription for an oral contraceptive. which of the following findings should the nurse identify as a contraindication to an oral contraceptive? a. history of gestational diabetes mellitus. b. migraine with aura. c. history of asthma. d. renal lithiasis.
migraine with aura.
a nurse is caring for a client who has gestational hypertension and is experiencing postpartum hemorrhage. which of the following medications should the nurse anticipate administering? a. dinoprostone. b. misoprostol. c. methylergonovine. d. carboprost.
misoprostol
administered to the client who has gestational hypertension and is experiencing a postpartum hemorrhage.
misoprostol
administered during the uterine artery embolization procedure to decrease anxiety and pain.
moderate sedation
a nurse is teaching a client who has a new prescription for sildenafil to treat erectile dysfunction. which of the following information should the nurse include in the teaching? a. use this medication no more than twice per day. b. expect this medication to cause drowsiness. c. take this medication 6 hr before sexual activity. d. monitor for dizziness while on this medication.
monitor for dizziness while on this medication.
a nurse is caring for a client who is in active labor and has a history of sexually transmitted infections. upon examination, the nurse notes a large, cauliflower like cluster of lesions near the vagina. which of the following actions should the nurse take? a. prepare the client for a cesarean section to prevent newborn contact with the lesions. b. initiate contact precautions for the client. c. monitor the client for progressive fetal descent. d. administer penicillin G to the client IV to
monitor the client for progressive fetal descent.
a nurse is caring for a client who is experiencing a sickle cell crisis. which of the following actions should the nurse take? a. flex the client's knees. b. initiate fluid restrictions for the client. c. elevate the head of the bed to 90 degrees. d. monitor the temperature of the client's toes.
monitor the temperature of the client's toes.
parkinson's symptom
muscle rigidity
an expected finding for viral meningitis.
myalgia
a nurse is planning care for a client who has alcohol use disorder. which of the following medications should the nurse expect the provider to prescribe? a. bupropion b. naltrexone c. buprenorphine d. methadone
naltrexone
newborns who are premature have an increased risk of developing this due to intestinal ischemia, immature immune systems, and the type of formula feeding.
necrotizing enterocolitis
involves the absence of expected abilities or behaviors such as demonstration of social withdrawal.
negative symptom of schizophrenia
a nurse is caring for a client who is at 33 weeks of gestation and has a new diagnosis of preeclampsia. which of the following medications should the nurse expect the provider to prescribe? a. nifedipine. b. terbutaline. c. methylergonovine. d. misoprostol.
nifedipine
may be a sign of intraductal papilloma breast disorder or a manifestation of ductal ectasia breast disorder.
nipple discharge
NHL
non hodgkin's lymphoma
a nurse is educating a group of staff nurses about the difference between non hodgkin's lymphoma and hodgkin's lymphoma. the nurse should include which of the following statements in the teaching? a. non hodgkin's involves painful lymph nodes. b. hodgkin's is the result of a previous bacterial infection. c. non hodgkin's progresses erratically throughout the lymphatic system. d. hodgkin's rarely responds to treatment.
non hodgkin's lymphoma progresses erratically through the lymphatic system.
2.7-7.3
normal serum uric acid level
an expected finding for a client who has viral meningitis.
nuchal rigidity
a nurse is planning care for a client who is being admitted for treatment of anorexia nervosa. which of the following actions should the nurse include in the plan? a. emphasize nutritional value of foods during meals. b. limit the client's exercise to no more than 30 min per day. c. observe the client for 60 min after meals. d. weigh the client every other day.
observe the client for 60 min after meals.
a nurse is caring for an infant who has a patent ductus arteriosus and heart failure. which of the following interventions should the nurse perform? a. weigh the infant every other day on the same scale. b. offer the infant small, frequent feedings. c. position the infant supine or side lying. d. assess the infant's radial pulse every 2 hr.
offer the infant small, frequent feedings.
a nurse is caring for an infant who has a patent ductus arteriosus and heart failure. which of the following interventions should the nurse perform? a. weigh the infant every other day on the same scale. b. offer the infant small, frequent feedings. c. position the infant supine or side lying. d. assess the infant's radial pulse every 2 hr.
offer the infant, small frequent feedings.
a nurse is updating the meal plan for a client who has resolving diverticulitis and is being advanced to a high fiber diet. the nurse should recognize that which of the following foods is the best source of fiber? a. 1 cup green grapes. b. 1 cup lettuce. c. one medium banana. d. one medium cucumber.
one medium banana.
used to relieve moderate to severe pain and while it can decrease bowel motility, it does not increase the risk of perforation.
opioid analgesics
caused by dehydration from fluid loss and electrolyte imbalance in patients with gastroenteritis presenting with diarrhea and vomiting.
orthostatic hypotension
a nurse is discussing palliative care with the family of a client who is terminally ill. which of the following information should the nurse include? a. palliative care begins once life saving treatments have been stopped. b. palliative care includes a variety of therapies. c. palliative care requires the client to sign a DNR. d. palliative care must be provided in the home setting.
palliative care includes a variety of therapies.
a nurse is reviewing the medication record of a client who was recently diagnosed with alzheimer's disease and has a new prescription for memantine. the nurse should instruct the client that which of the following medications can interact adversely with memantine? a. sodium bicarbonate. b. ibuprofen. c. diphenhydramine. d. omeprazole.
sodium bicarbonate
this medication alkalizes the client's urine, which increases the accumulation of memantine, leading to toxicity.
sodium bicarbonate
a nurse is caring for a client who has schizophrenia. which of the following statements made by the client indicates delusions of reference? a. someone is trying to get a message to me through this newspaper. b. i am possessed by the evil one and will destroy the world. c. i know these nurses are watching my every move. d. the dentist put a radio transmitter in my tooth to control me.
someone is trying to get a message to me through this newspaper.
a nurse is caring for a client who has HELLP syndrome. the nurse should monitor the client for which of the following manifestations? a. hypernatremia. b. hyperglycemia. c. dvt d. stroke.
stroke
forms a protective barrier in the stomach over ulcers
sucralfate
can result in hypotension, which diminishes blood flow to the uterus and placenta.
supine positioning
exhibited by clients with paranoid personality disorder.
suspicion
touch distraction used to reduce pain by stimulation of the skin.
tactile distraction
a nurse is teaching about disease management with a client who has parkinson's disease. which of the following statements should the nurse include in the teaching? a. schedule appointments early in the morning. b. take medications at the same time each day. c. plan low calorie meals which are high in fiber. d. lean forward and watch your feet when walking.
take medications at the same time each day.
a nurse is reviewing the medical history of a client. the nurse should identify that which of the following findings indicates the client is at risk for a stroke? a. history of hypopituitarism. b. takes a combination oral contraceptive. c. drinks 150 mL of wine each day. d. avoids saturated fats in cooking.
takes a combination oral contraceptive
a nurse is reviewing the medical history of a client. the nurse should identify that which of the following findings indicates the client is at risk for a stroke? a. history of hypopituitarism. b. takes a combination oral contraceptive. c. drinks 150 mL of wine each day. d. avoids saturated fats in cooking.
takes a combination oral contraceptive.
a nurse is teaching a client who has melanoma about nonsurgical treatment options. the nurse should include which of the following options in the teaching? a. brachytherapy b. topical chemotherapy c. targeted therapy d. radiation therapy
targeted therapy
targets specific molecules and interferes with cell division and the growth and progression of melanoma
targeted therapy
a nurse in an acute mental health unit is caring for a newly admitted client who has obsessive compulsive disorder. the client is repeatedly washing her hands. which of the following actions should the nurse take? a. physically prevent the client from repeating compulsive acts. b. teach the client to use thought stopping techniques. c. allow the client to choose from a list of alternative activities. d. administer diphenhydramine IV to the client.
teach the client to use thought stopping techniques.
a nurse is developing a plan of care for a newly admitted client who has bulimia nervosa. which of the following actions should the nurse plan to take? a. weigh the client weekly for the first month. b. tell the client that privileges are based on treatment compliance. c. stay with the client for 15 min following each meal. d. allow the client to be responsible for scheduling mealtimes throughout the week.
tell the client that privileges are based on treatment compliance.
used in the treatment of preterm labor because it causes the relaxation of smooth muscle of the uterus.
terbutaline
a nurse is providing nutritional teaching to a client who has leukemia and is experiencing neutropenia. which of the following instructions should the nurse include? select all that apply. a. refrigerate foods within 2 hr of purchase from the grocery store. b. discard leftovers after 5 days. c. thaw frozen foods in the refrigerator. d. avoid buffet style restaurants. e. refrigerate leftovers within 3 hr.
thaw frozen foods in the refrigerator. avoid buffet style restaurants.
a nurse in a mental health clinic is assessing a client who states, "I don't think my gambling is as big of a problem as my friends think it is." which of the following findings should the nurse identify as meeting the diagnostic criteria of gambling disorder? a. the client makes no attempts to stop gambling. b. the client gambles when feeling happy or enthusiastic. c. the client gambles the same amount of money each week. d. the client asks others for money to compensate for gambling losses
the client asks others for money to compensate for gambling losses.
a nurse is assessing a newly admitted client who has borderline personality disorder. which of the following manifestations should the nurse expect? a. the client needs others to be responsible for decisions about his life. b. the client has a sense of self importance and requires admiration. c. the client exhibits a pattern of unstable interpersonal relationships. d. the client is preoccupied with following the rules and being organized.
the client exhibits a pattern of unstable interpersonal relationships.
a nurse is assessing a client who is in the early stages of alzheimer's disease. which of the following findings should the nurse expect? a. the client cannot recall the year. b. the client exhibits a more aggressive personality. c. the client misplaces familiar objects. d. the client is unable to manage personal finances.
the client misplaces familiar objects.
a nurse is assessing a client who is a survivor of intimate partner violence. which of the following findings indicate that the client is in the tension building phase of battering? a. the client rationalizes the partner's battering behavior. b. the client purposefully provokes anger from the batterer. c. the client shows evidence of severe battering injuries. d. the client believes that their partner can control the battering behavior.
the client rationalizes the partner's battering behavior.
a community health nurse is assessing an older adult client. which of the following situations should the nurse identify as a possible indication of undue influence? a. the client stays with her son one night each week. b. the client's niece moves into her home to provide care. c. the client rarely signs legal documents regarding her medical care. d. the client has increased her attendance at family gatherings.
the client's niece moves into her home to provide care.
a nurse is teaching a client who is scheduled for the placement of a penile implant for the treatment of erectile dysfunction. which of the following statements by the client indicates an understanding of the teaching? a. this implant has a suction device that will draw blood into my penis. b. this implant can be deflated by pushing a button in my scrotum. c. this implant uses a rubber ring to help maintain my erection. d. this implant will protect me from sexually transmitted infections.
this implant can be deflated by pushing a button in my scrotum.
administered for the treatment of multiple actinic keratoses or for widespread superficial basal cell carcinoma.
topical chemotherapy
a nurse is providing teaching to a client who has preeclampsia without severe symptoms. which of the following instructions should the nurse include? a. monitor temperature twice each day. b. restrict fluid intake to four 245 mL glasses a day. c. maintain a dark, quiet environment as much as possible. d. use a side lying position when resting in bed or on the couch.
use a side lying position when resting in bed or on the couch.
a nurse is caring for a client who has moderate dementia and is experiencing frequent episodes of confusion. which of the following actions should the nurse take? a. use large calendars that are easy for the client to read. b. keep the client's room completely dark at night. c. provide thorough explanations when speaking with the client. d. speak loudly when communicating with the client.
use large calendars that are easy for the client to read.
a nurse is teaching about approaches to care with the family of a client who has a new diagnosis of dementia with confusion. which of the following information should the nurse include in the teaching? a. place abstract pictures on the walls rather than family pictures. b. allow the client to make choices about clothes to wear. c. turn the client's television on in the evening before bedtime. d. use pictures and gestures when giving instructions.
use pictures and gestures when giving instructions.
a nurse is assessing a client who is at 35 weeks of gestation and is experiencing a placental abruption. which of the following findings should the nurse expect? a. fundal height 34 cm. b. polyuria. c. hypertension. d. uterine hypertonicity.
uterine hypertonicity
cord compression
variable decelerations
chickenpox vaccine
varicella
contains a live virus and should not be administered to clients who are immunocompromised.
varicella
recommended at 12 to 15 months of age.
varicella vaccine
a nurse is teaching about pancreatic enzyme replacement therapy with the client who has chronic pancreatitis and is starting to take pancrelipase capsules. which of the following information should the nurse include when teaching about pancrelipase? a. administer the enzyme capsules after each meal. b. vary the amount of medication taken based on the amount of food consumed. c. sprinkle the medication capsule contents on protein rich food. d. take the medication capsules with calcium carbonat
vary the amount of medication taken based on the amount of food consumed.
hematuria jaundice painful swelling of the hands and feet painful joints
vaso occlusive crisis s/s
a nurse is assessing a client following a stroke. the nurse should identify that which of the following findings is a manifestation of increased intracranial pressure? a. sudden onset of eye pain. b. kussmaul respirations. c. vomiting. d. hypotension.
vomiting
a common adverse effect of lithium therapy.
weight gain
naming common objects
word finding ability
a nurse is teaching a client who has epilepsy and a prescription for valproic acid. the nurse should instruct the client to report which of the following as an adverse effect of the medication? a. yellow sclera. b. elevated temperature. c. bleeding gums. d. respiratory depression.
yellow sclera
