med surg 1 final
A client with acquired immune deficiency syndrome (AIDS) is brought to the clinic by a family member. The family member tells the nurse the client has become forgetful, with a limited attention span, decreased ability to concentrate, and delusional thinking. What condition is represented by these symptoms?
AIDS dementia complex (ADC)
The nurse is caring for a 2-year -old child who experienced near -drowning . The nurse will monitor for what possible complication ?
Acute respiratory distress syndrome
A client exhibits hostility towards a person from whom she wants love and approval which of the following states the clients condition
Ambivalence
The nursing student is taking a pre- nursing pharmacology class . Today , the nursing student is learning about antiarrhythmic drugs . What drug is a potassium channel blocker ?
Amiodarone
What must the nurse be assessing for in order to determine adequate care for a client with aortic stenosis?
Angina
The client asks the nurse to explain the difference between arteriosclerosis and atherosclerosis . Which is the best explanation the nurse can give to the client ?
Arteriosclerosis is a loss of elasticity of the arteries that accompanies the aging process whereas atherosclerosis is a condition in which the arteries fill with plaque."
The nurse is caring for a client postoperatively after undergoing a coronary artery bypass graft. What intervention can the nurse provide to reduce the risk of the development of wound dehiscence?
Assist the client to splint with a pillow when coughing and deep breathing.
The client arrives at the emergency room reporting symptoms of heart palpitations, tightness in the chest, and epigastric pain. The nurse asks the client what was happening when these symptoms first appeared. The client states a stressful event. The nurse is correct to correlate that the symptoms experienced stem from which system?
Autonomic nervous system
Which of the following instructions should a nurse provide a client with alcohol dependence who is prescribed disulfiram?
Avoid mixing disulfiram and alcohol.
The nurse is providing client teaching for a client undergoing chemotherapy. What dietary modifications should the nurse advise?
Avoid spicy and fatty foods
A hypertensive client is admitted to the acute care facility that has a tobacco -free policy . Which nursing intervention would be most appropriate for the nurse to assist the client who is a smoker ?
Contact the physician for a nonnicotine medication .
The nurse is caring for an elderly client with left-sided heart failure. When auscultating lung sounds, which adventitious sound is expected?
Crackles
Which of the following mood disorders as alternating sad and elated mood resembling bipolar disorder but less extreme mood shifts?
Cyclothymia
Which of the following medications does the nurse anticipate administering to a client preparing for cardioversion?
Diazepam
A client arrives at the physician's office stating dyspnea; a productive cough for thick, green sputum; respirations of 28 breaths/minute, and a temperature of 102.8° F. The nurse auscultates the lung fields, which reveal poor air exchange in the right middle lobe. The nurse suspects a right middle lobe pneumonia. To be consistent with this anticipated diagnosis, which sound, heard over the chest wall when percussing, is anticipated?
Dull
The nurse and student nurse are observing a cardioversion procedure completed by a physician. At which time is the nurse most correct to identify to the student when the electrical current will be initiated?
During ventricular depolarization
The nurse is caring for a client at risk for thrombosis. What is an appropriate nursing action when evaluating this client?
Examine the legs for color, capillary refill time, and tissue integrity.
When caring for an adolescent client recovering from rheumatic fever, which diversional activity would the nurse advise against?
Exercise
The nurse is caring for a client with accelerated hypertension. Which body system would the nurse assess to identify early signs of blood pressure progression?
Eyes
The nurse is obtaining a history from a 68- year-old client reporting memory loss. The nurse is obtaining general data about the client's condition and then asks specifically if the client and family can remember the first symptoms of memory loss. Which report by family members is typical of Alzheimer progression ?
Family members cannot remember exactly when; small things have occurred over time.
A client presents to the emergency room with characteristics of atherosclerosis. What characteristics would the client display ?
Fatty deposits in the lumen of arteries
A client is scheduled for a multiple gated acquisition (MUGA) scan the following day. What medication should the nurse be sure not to administer the morning of the procedure?
Furosemide (Lasix)
The nurse monitors a client with dark skin for signs of cyanosis. Which manifestation, documented by the nurse, indicates cyanosis for this client?
Grayish cast to the skin
A client, newly prescribed a low-sodium diet due to hypertension, is asking for help with meal choices. The client provides four meal choices, which are favorites. Which selection would be best?
Green pepper stuffed with diced tomatoes and chicken
The nurse is caring for a client who states , "Can you tell this man sitting on the chair to leave my room. I am tired of him watching me." The nurse notes that there is no one else in the room . The nurse would document the client's experience as which of the following ?
Hallucination
90.The client has just been diagnosed with binge eating disorder . Which statement by the client is most indicative of this diagnosis ?
I always feel guilty after I overeat
The nurse is observing the interaction between a parent and child with schizophrenia . The child states , "The man visiting me said you went on vacation without me ." The parent replies , There is no man , you are just making that up ." When interacting with the parent privately , which reply from the parent would the nurse suggest ?
I am not on vacation . I am here with you
A is instructing the client on the sensations that can occur when contrast medium is infused during pulmonary angiography . Which client statement demonstrates an understanding of the teaching?
I will feel warm and may have chest pain
The client presents to the Emergency Department with blunt trauma causing bruising and bleeding of the heart . The nurse knows that which of the following may help stop the bleeding ?
Inactivity and pressure from blood in the pericardium
Which type of therapy is facilitated Buy a bond that developed between the therapist and the client
Interpersonal psychotherapy
A client diagnosed with pulmonary edema has a PaCO2 of 72 mm Hg and an oxygen saturation of 84%. What method of oxygen delivery would best meet the needs of this client?
Intubation and mechanical ventilation
A client comes to the clinic and states he has "broken out in hives and itching since eating strawberries this morning." The client states he has never had problems with strawberries before. What is the best response by the nurse?
It is possible to develop an allergic reaction to something you have had prior exposure to previously."
The nurse notes that the client has had a change in mental status. Why would it be important for the nurse to report extremes in the thought process of a client with cardiovascular disorder to the physician?
It may indicate a problem with oxygenation.
Which of the following is an example of subacute symptom that may be observed in the Older adult who may be depressed?
Lack of energy
The nurse is caring for a client with malignant hypertension. What would be an appropriate nursing intervention for this client?
Monitor the blood pressure (BP) every few minutes by applying an automatic BP recording machine
A female client comes to the clinic and tells the nurse, I think I have another vaginal infection and I also have some wart-like lesions on my vaginally. This is happening quite often. Which nursing action is the priority for the client?
Offer information on human immunodeficiency virus (HIV) testing
A client is brought to the emergency department following a motor vehicle accidentWhich of the following nursing assessments is significant in diagnosing this client with flail chest?
Paradoxical chest movement
The nurse is providing instruction of a community class regarding seasonal affective disorder. Which gland and hormone with the nurse stress is responsible
Pineal gland and melatonin
Following a fatal automobile accident, the client reports insomnia and terrifying nightmares. The symptoms persist for months. Diagnostic testing reveals no physical bias for these recurrent symptoms. These symptoms suggest the client is experiencing which of the following?
Post traumatic stress disorder PTSD
The instructor is talking with a nursing student who is caring for a client with pericarditis. The instructor asks the student to name the main characteristic of pericarditis. What should be the student's answer?
Precordial pain
What is the function of the thymus gland?
Programs T lymphocytes to become regulator or effector T cells.
A client has had oral anticoagulation ordered. What should you monitor for when your client is taking oral anticoagulation?
Prothrombin time (PT) or international normalized ratio (INR)
The nurse is caring a client whose status has declined since shift report The has , is restless , and displays cyanosis . Which test should the perform first?
Pulse oximetry
The nurse is performing client teaching with a client who has just been diagnosed with cardiomyopathy. What instructions should the nurse provide a client with cardiomyopathy to avoid pulmonary complications that may compromise cardiopulmonary function?
Receive yearly vaccinations
Which historical fact is of greatest value to a nurse who is interviewing a client being admitted for possible mitral regurgitation?
Rheumatic fever
A client with AIDS is admitted to the hospital with severe diarrhea and dehydration. The physician suspects an infection with Cryptosporidium. What type of specimen should be collected to confirm this diagnosis?
Stool specimen for ova and parasites
A client with heart failure informs the nurse he has not had a bowel movement in 2 days. Why would it be important for the nurse to obtain an order for a stool softener?
Straining causes(engages) the Valsalva maneuver, which can cause dangerous effects.
Which assessment finding is most important in determining nursing care of a client withdrawals from cosine?
Suicide precautions
The nurse is caring for a client who is status postoperative from a vein stripping. What would the nurse monitor for?
Swelling in the operative leg
The nurse is collecting data from a client with the autoimmune disorder, endocarditis. What does the nurse recognize as symptom of an acute exacerbation?
Temperature of 100.9° F
A client needs additional information about a heart condition . The client asks the nurse "What is considered the pacemaker of the heart ?
The SA node
A nurse stops at the scene of an accident and it tends to assist a client who is lying in an overturned vehicle. When the nurse crawls into the vehicle, the client start screaming incoming incoming and is violently thrashing and attempting to kick the nurse. What is the best interpretation by the nurse?
The accident has triggered a flashback
The nurse is beginning the physical examination of a client who has reported fatigue . What documentation will the nurse provide to describe this general appraisal of the client's health ?
The client appears mildly I'll, listless and disheveled
A client arrives at the physician's office stating 2 days of febrile illness, dyspnea, and cough. Upon assisting the client into a gown, the nurse notes that the client's sternum is depressed, especially on inspiration. Crackles are noted in the bases of the lung fields. Based on inspection, which will the nurse document?
The client has a funnel chest.
The nurse provides care for a dying client following a massive myocardial infarction (MI) The nurse notes the client is experiencing dyspnea and has a barely palpable pulse . Which documentation of pulse quality by the nurse is appropriate ?
The client is exhibiting a thready pulse
The nurse is discharging four clients from the behavioral health unit . Which client would be the best candidate for long -term inpatient care ?
The client with suspicion and anger
The nurse is working on a clinical research study, obtaining data evaluating central aortic systolic pressure and brachial arm systolic pressure. The client notes difference in the readings. Which response by the nurse is most accurate?
The difference is due to the location of pressure measurement."
The nursing instructor is teaching a class on thrombophlebitis. What should the nurse tell the students about the inflammatory response in thrombophlebitis?
The inflammatory response is caused by accumulated waste products in the blocked vessel.
The nurse researcher and committee Monitoring are working with an a research study administering study medications to study participants. If the nurse researcher is administering study medications and a double blind study, who is knowledgeable of the specifics of the medication?
The study committee
Why would it be important for the nurse to question the client about sexual practices, history of substance abuse, and his lifestyle during the interview process?
To determine if the client has practices that put him at risk for acquired immunodeficiency syndrome (AIDS)
A client that is HIV+ has been diagnosed with Pneumocystis pneumonia caused by P. jiroveci. What medication does the nurse expect that the client will take for the treatment of this infection?
Trimethoprim-sulfamethoxazole
the nurse is reveiwing diagnostic lab work of a client developing shock. which does the nurse note as a key in determining the type of shock?
WBC: 42,000/mm3
Which of the following instructions should a nurse give to clients with opiate dependency who take methadone?
Wear a MedicAlert tag
The nurse is suctioning a client who is unable to expectorate respiratory secretions. At which point does the nurse expect the client to experience coughing?
When the catheter reaches the point of the carina
Which of the following data is most important for a nurse to obtain when a client with alcohol dependence admits consuming alcohol during the assessment?
When the last drink was consumed
A teenager who is attending a clinic for eating disorders has shown improvement in weight , but the laboratory values remain poor . Which behavior would the nurse identify as the likely cause of this finding?
drinking water before weighing
The nurse is teaching a client about hypertension and the effects on the left ventricle. What diagnostic test will the nurse describe?
echocardiography
The nurse is instructing a client with chronic fatigue syndrome about what type of dietary sources are the best to eat to supply eicosapentaenoic acid (EPA). What statement by the client demonstrates the instruction is understood?
fresh salmon is one of my favorites and I will eat it twice a week
the nurse on a surgical unit is caring for a client recovering from recent surgery with the placement of a nasogastric tube to low continuous suction. which acid base imbalance is most likely to occur?
metabolic alkalosis
A family brings a parent to the physician's office to discuss the parent's decline in cognitive status The family states that the parent is forgetful and needs reminders to be able to live alone. Following assessment, which stage of Alzheimer disease does the nurse anticipate?
mild cognitive impairment
a client is in a driving accident creating a spinal cord injury. the nurse caring for a client realizes that the client is at risk for which type of shock?
neurogenic
the nurse is caring fa an older adult client receiving dopamine therapy for the treatment of shock. for which complication should the nurse monitor?
rapid increase in blood pressure
the nurse is caring for a client with shock accompanied by lung congestion, how would the nurse position this client?
semi-fowler's with lower extremities raised to approximately 15o
Which neuropeptide transmits the sensation of pain?
substance P
a client with sever mitral valve insufficiency has been admitted to your unit. the client has heart failure and has developed pulmonary edema. what would be the best course of treatment for this client?
surgery
A client requires a blood transfusion for anemia and tells the nurse "I don't want a transfusion because I don't want to get AIDS." Which is the best response from the nurse to the client?
the blood is screened, and your risk is one in two million.
The nurse is caring for a client on a behavioral health unit . What would support the theory that mental illness is a psychobiologic disorder ?
the client has an alteration in neurotransmitter levels
the nurse is caring for a motor vehicle accident client who is unresponsive on arrival to the emergency department. the client has numerous fractures, internal abdominal injuries, and a large lacerations on the head and torso. the family arrives and seeks an update on the client's condition. a family member asks., 'what causes the body to go into shock?' giving the client's condition, which statement is most correct?
the client is in shock because the blood volume has decrease in the system
An older adult client, who leads a sedentary lifestyle, and a younger client, who has a very stressful and active lifestyle, require a vaccine against a particular viral disorder. The nurse knows that in one of these clients, the vaccine will be less effective . In which client is the vaccine more likely to be less effective and why ?
the older client because of age
Client is recovering from a craniotomy with tumor debulking. Which comment by the client indicates to the nurse a correct understanding of what surgery entailed?
"I guess the doctor couldn't remove the entire tumor."
The nurse is caring for a client who has recurrent sinusitis. Which consideration could the nurse suggest to best decrease the frequency of infections?
Administer an over-the-counter decongestant.
The nurse provides care for an older adult client who is diagnosed with valvular heart disease. On auscultation of the client's heart sounds , the nurse notes an erratic heart rhythm . Which age- related change is the most likely cause for this finding?
A stiffening of the aorta
A client has been admitted for a commissurotomy. You know that a commissurotomy repairs which of the following?
A valve
The nurse is evaluating the types of medications prescribed for a client's hypertension. Which of the following medication classifications establishes an action on vasoconstrictive hormones in the blood stream?
ACE inhibitor
The nurse working in the radiology clinic is assisting with a pulmonary angiography The nurse knows that when monitoring clients after a pulmonary angiography , what should the physician be notified about ?
Absent distal pulses
The nurse is using a theory which includes positive reinforcement with rewarding client behavior in group participation activities. From which theorist is the nurse deriving these strategies?
B.F Skinner
a client with pulmonary edema has been admitted to the ICU. what would be the standard care for this client?
BP and pulse measurements every 15 to 30 minutes.
A client is taking a corticosteroid for the treatment of systemic lupus erythematosus. When the nurse is providing instructions about the medication to the client, what priority information should be included?
Be alert for signs and symptoms of infection and report them immediately to the physician.
The nursing instructor is giving a class on assessing cardiac clients after thoracic surgery. What assessment is most important for the nurse to perform when caring for this client?
Blood pressure
The clinic nurse is caring for a client with acute bronchitis. The client asks what may have caused the infection What may induce bronchitis ?
Chemical irritation
Which of the following conditions triggers the general adaptation syndrome?
Distress
A nurse is canceling a client diagnosed with depression. When asked questions the lien to respond with words of self blame in self-pity. When the nurse she is is the Monoamine hypnosis, which chemical is thought to be elevated?
Dopamine
The nurse is caring for a client with a valvular disorder. The client is at risk for decreased cardiac output. What nursing intervention should a nurse perform for this client?
Measure urine output
Which level of anxiety is constructive and prepares any person to take action in appropriate situations?
Mild
the nurse is caring for clients on a Telemetry unit. Which nursing consideration best represents concerns of altered rhythmic patterns of the heart?
alter patterns frequently affect the heart's ability to pump blood
A client visits the nurse complaining of diarrhea after every meal. The client has AIDS and wants to know what to do to stop having diarrhea. What should the nurse advise?
avoid fibrous, food lactose, fats, and caffeine
The nurse is obtaining data from a client with a respiratory disorder. Which information would be considered a part of the functional assessment and assist in the diagnosis of an occupational lung disease?
black streaked sputum
your client has returned to the floor with a transthoracic pacemaker ready to be connected. You know that our transthoracic pacemaker is a temporary pacemaker used in what situation?
transthoracic pacemakers are used in a client who has had an open heart surgery
While being prepared for echocardiography when he asks you why he needs to have this test. What would be your best response? Echocardiography is a way of determining the functioning of the left
ventricle of your heart."
A client with suspected exposure to HIV has been tested with the enzyme-linked immunosorbent assay (ELISA) with positive results twice. The next step for the nurse to explain to the client for confirmation of the diagnosis is to perform a:
western blot for confirmation of diagnosis
