Med surg exam 3
A patient's complete blood count (CBC) shows a hemoglobin of 19 g/dL and a hematocrit of 54%. Which question should the nurse ask to determine possible causes of this finding?
"Do you have any history of lung disease?"
The nurse in a health clinic receives requests for appointments from several patients. Which patient should be seen by the health care provider first?
A 58-yr-old patient who has a painful erection that has lasted more than 6 hours
After change-of-shift report, which patient should the nurse assess first?
A 60-yr-old patient with nausea and vomiting who is lethargic with dry mucosa
Which assessment finding in a 36-yr-old patient is most indicative of a need for further evaluation?
A breast nodule that is 1 cm in size, nontender, and fixed.
A patient will need vascular access for hemodialysis. Which statement by the nurse accurately describes an advantage of a fistula over a graft?
A fistula is much less likely to clot.
What finding should the nurse expect during the assessment of a young adult with infective endocarditis (IE)?
A new regurgitant murmur
Which patient should the nurse assign as the roomMate for a patient who has aplastic anemia?
A patient with chronic heart failure
After a total proctocolectomy and permanent ileostomy, the patient tells the nurse, "I cannot manage all this. I don't want to look at the stoma." What action should the nurse take?
Ask the patient about the concerns with stoma management.
A young adult has been admitted to the emergency department with nausea and vomiting. Which action could the RN delegate to unlicensed assistive personnel (UAP)?
Assist the patient with oral care.
Which information about a patient with Goodpasture syndrome requires the most rapid action by the nurse?
Audible crackles bilaterally over the posterior chest to the midscapular level.
Which action will the nurse include in the plan of care to maintain the patency of a patient's left arm arteriovenous fistula?
Auscultate for a bruit at the fistula site.
Which information will the nurse include when teaching adults to decrease the risk for cancers of the tongue and buccal mucosa?
Avoid cigarettes and smokeless tobacco. Tobacco use greatly increases the risk for oral cancer. Human papillomavirus (HPV) infection is associated with an increased risk for oral cancer. Although chronic irritation of the oral mucosa does increase risk for oral cancer.
Which information will be included when the nurse is teaching self-management to a patient who is receiving peritoneal dialysis? (Select all that apply.)
Avoid commercial salt substitutes. Take phosphate binders with each meal. Choose high-protein foods for most meals
Which information will be included when the nurse is teaching self-management to a patient who is receiving peritoneal dialysis? (Select all that apply.)
Avoid commercial salt substitutes. Take phosphate binders with each meal. Choose high-protein foods for most meals.
Which instruction will the nurse plan to include in discharge teaching for a patient admitted with a sickle cell crisis?
Avoid exposure to crowds when possible.
Which intervention will be included in the nursing care plan for a patient with immune thrombocytopenic purpura?
Avoid intramuscular (IM) injections.
The complete blood count (CBC) indicates that a patient is thrombocytopenic. Which action should the nurse include in the plan of care?
Avoid intramuscular injections.
Nursing staff on a hospital unit are reviewing rates of health care-associated infections (HAI) of the urinary tract. Which nursing action will be most helpful in decreasing the risk for urinary HAI in patients admitted to the hospital?
Avoiding unnecessary urinary catheterization
A patient with primary hyperparathyroidism has a serum phosphorus level of 1.7 mg/dL (0.55 mmol/L) and calcium of 14 mg/dL (3.5 mmol/L). Which nursing action should be included in the plan of care?
Encourage 4000 mL of fluids daily.
Which is an appropriate nursing intervention for a hospitalized patient with severe hemolytic anemia?
Encourage alternating rest and activity.
A patient reports gas pains and abdominal distention 2 days after a small bowel resection. Which nursing action should the nurse take?
Encourage the patient to ambulate.
A 74-yr-old male patient tells the nurse that growing old causes constipation, so he has been using a suppository to prevent constipation every morning. Which action should the nurse take first?
Encourage the patient to increase oral fluid intake.
Which nursing intervention is important when providing care for a patient with sickle cell crisis?
Evaluating the effectiveness of opioid analgesics
A 51-yr-old patient with a small immobile breast lump is considering having a fine-needle aspiration (FNA) biopsy. What should the nurse explain as an advantage to this procedure?
FNA is done in the outpatient clinic, and results are available in 1 to 2 days.
A patient with Crohn's disease who is taking infliximab (Remicade) calls the nurse in the outpatient clinic about new symptoms. Which symptom is most important to communicate to the health care provider?
Fever
An 80-yr-old patient who is hospitalized with peptic ulcer disease develops new-onset auditory hallucinations. Which prescribed medication will the nurse discuss with the health care provider before administration?
Metoclopramide (Reglan)
Which action will the nurse include in the plan of care for a patient admitted with multiple myeloma?
Monitor fluid intake and output.
Which nursing action should be included in the plan of care after endovascular repair of an abdominal aortic aneurysm?
Monitor fluid intake and urine output.
A patient preparing to undergo a colon resection for cancer of the colon asks about the elevated carcinoembryonic antigen (CEA) test result. What should the nurse explain as the reason for the test?
Monitor the tumor status after surgery. CEA is used to monitor for cancer recurrence after surgery.
A patient who has had progressive chronic kidney disease (CKD) for several years has just begun regular hemodialysis. Which information about diet will the nurse include in patient teaching?
More protein is allowed because urea and creatinine are removed by dialysis.
Which menu choice by the patient with diverticulosis is best for preventing diverticulitis?
Navy bean soup and vegetable salad
Following successful treatment of Hodgkin's lymphoma for a 55-yr-old woman, which topic will the nurse include in patient teaching?
Need for follow-up appointments to screen for malignancy
An older adult patient who had a mitral valve replacement with a mechanical valve is taking warfarin. What should the nurse include in discharge teaching?
Need for frequent laboratory blood testing
The nurse has obtained the health history, physical assessment data, and laboratory results shown in the accompanying figure for a patient admitted with aplastic anemia. Which information is most important to communicate to the health care provider? • Fatigue, which has increased over last month • Frequent constipation • Conjunctiva pale pink, moist • Multiple bruises • Clear lung sounds • Hct 33% • WBC 1500/μL • Platelets 70,000/μL
Neutropenia
Which question is most pertinent for the nurse to ask a 43-yr-old patient about her risk for breast cancer?
"At what age did you start having menstrual periods?"
Which information about dietary management should the nurse include when teaching a patient with peptic ulcer disease (PUD)?
"Avoid foods that cause pain after you eat them."
A patient with a venous thromboembolism (VTE) is started on enoxaparin (Lovenox) and warfarin (Coumadin). The patient asks the nurse why two medications are necessary. Which response by the nurse is accurate?
"Enoxaparin will work right away, but warfarin takes several days to begin preventing clots."
The nurse obtains a health history from an older adult with a prosthetic mitral valve who has symptoms of infective endocarditis (IE). Which question by the nurse helps identify a risk factor for IE?
"Have you had dental work done recently?"
A patient with urinary obstruction from benign prostatic hyperplasia (BPH) tells the nurse, "My symptoms are much worse this week." Which response by the nurse is appropriate?
"Have you taken any over-the-counter (OTC) medications recently?"
Which patient statement to the nurse indicates that the patient understands self-care for pernicious anemia?
"I could choose nasal spray rather than injections of vitamin B12."
A patient who has gastroesophageal reflux disease (GERD) is experiencing increasing discomfort. Which patient statement to the nurse indicates that additional teaching about GERD is needed?
"I eat small meals and have a bedtime snack."
Which patient statement indicates that the nurse's teaching about sulfasalazine (Azulfidine) for ulcerative colitis has been effective?
"I should apply sunscreen before going outdoors."
A 70-yr-old patient who has had a transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH) is being discharged from the hospital today. Which patient statement indicates a need for the nurse to provide additional instruction?
"I should call the doctor if I have incontinence at home."
Which patient statement to the nurse indicates a need for additional instruction about taking oral ferrous sulfate?
"I should notify my health care provider if my stools turn black."
The nurse has started discharge teaching for a patient who is to continue warfarin (Coumadin) after hospitalization for venous thromboembolism (VTE). Which patient statement indicates a need for additional teaching?
"I should reduce the amount of green, leafy vegetables that I eat."
The nurse provides discharge teaching for a 61-yr-old patient who has had a left modified radical mastectomy and lymph node dissection. Which statement by the patient indicates that teaching has been successful?
"I will avoid reaching over the stove with my left hand."
Which patient statement indicates that the nurse's teaching about tamoxifen has been effective?
"I will call if I have any eye problems."
The nurse is evaluating the discharge teaching outcomes for a patient with chronic peripheral artery disease (PAD). Which patient statement indicates a need for further instruction?
"I will use a heating pad on my feet at night to increase the circulation."
Which instructions should the nurse include in a teaching plan for an older adult patient newly diagnosed with peripheral artery disease (PAD)?
"It is very important that you stop smoking cigarettes."
How should the nurse explain esomeprazole (Nexium) to a patient with recurring heartburn?
"It treats gastroesophageal reflux disease by decreasing stomach acid production."
Which information will the nurse provide for a patient with newly diagnosed gastroesophageal reflux disease (GERD)?
"Keep the head of your bed elevated on blocks."
A patient newly diagnosed with stage I breast cancer is discussing treatment options with the nurse. Which statement by the patient indicates that additional teaching may be needed?
"Mastectomy is the best choice to decrease the chance of cancer recurrence."
Which patient statement supports a history of intermittent claudication?
"My legs cramp when I walk more than a block."
Which information will the nurse include when teaching a patient with peptic ulcer disease about the effect of ranitidine (Zantac)?
"Ranitidine decreases gastric acid secretion."
Which statement by a patient indicates good understanding of the nurse's teaching about preventing sickle cell crisis?
"Risk for a crisis is decreased by having an annual influenza vaccination."
A 74-yr-old patient who is progressing to stage 5 chronic kidney disease asks the nurse, "Do you think I should go on dialysis?" Which initial response by the nurse is best?
"Tell me more about what you are thinking regarding dialysis."
A 58-yr-old woman tells the nurse, "I understand that I have stage 2 breast cancer and I need to decide on a surgery, but I feel overwhelmed. What do you think I should do?" Which response by the nurse is best?
"Tell me what you understand about the surgical options that are available."
A patient with a new ileostomy asks how much it will drain. How many cups of drainage per day should the nurse explain for the patient to expect?
2
A patient in the oliguric phase after an acute kidney injury has had a 250-mL urine output and an emesis of 100 mL in the past 24 hours. What is the patient's fluid restriction for the next 24 hours?
950 mL
When planning care for a patient hospitalized with a streptococcal infective endocarditis (IE), which intervention is appropriate for the nurse to include?
Arrange for placement of a long-term IV catheter.
Which laboratory result will the nurse expect to show a decreased value if a patient develops heparin-induced thrombocytopenia (HIT)?
Activated partial thromboplastin time
What should the nurse admitting a patient with acute diverticulitis plan for initial care?
Administer IV fluids
A postoperative patient receiving a transfusion of packed red blood cells develops chills, fever, headache, and anxiety 35 minutes after the transfusion is started. After stopping the transfusion, what action should the nurse take?
Administer PRN acetaminophen (Tylenol).
Which nursing action is of highest priority for a patient with kidney stones who is being admitted to the hospital with gross hematuria and severe colicky left flank pain?
Administer prescribed analgesics.
A patient has peptic ulcer disease that has been associated with Helicobacter pylori. About which medications will the nurse plan to teach the patient?
Amoxicillin (Amoxil), clarithromycin (Biaxin), and omeprazole (Prilosec)
The health care provider prescribes antacids and sucralfate (Carafate) for treatment of a patient's peptic ulcer. What should the nurse teach the patient to take?
Antacids after meals and sucralfate 30 minutes before meals
The nurse observes scleral jaundice in a patient being admitted with hemolytic anemia. Which laboratory result the nurse should check?
Bilirubin level
What risks will the nurse plan to teach a 27-yr-old woman who smokes two packs of cigarettes daily?
Bladder cancer
A 68-yr-old male patient with a stroke is unconscious and unresponsive to stimuli. After learning that the patient has a history of gastroesophageal reflux disease (GERD), what should the nurse plan to assess more frequently than is routine?
Breath sounds
Which information will the nurse include when teaching a patient how to avoid chronic constipation? (Select all that apply.)
Bulk-forming laxatives are an excellent source of fiber. Walking or cycling frequently will help bowel motility. A good time for a bowel movement may be after breakfast. Some over-the-counter (OTC) medications cause constipation.
Which assessment data reported by a patient is consistent with a lower urinary tract infection (UTI)?
Burning on urination
A patient being admitted with an acute exacerbation of ulcerative colitis reports crampy abdominal pain and passing 15 bloody stools a day. What should the nurse include in the plan of care?
Discontinue the patient's oral food intake.
A 68-yr-old male patient who has bladder cancer had a cystectomy with creation of an Indiana pouch. Which topic will be included in patient teaching?
Catheterization technique and schedule
The nurse is caring for a patient who has had an ileal conduit for several years. Which nursing action could be delegated to unlicensed assistive personnel (UAP)?
Change the ostomy appliance.
A patient has arrived for a scheduled hemodialysis session. Which nursing action is appropriate for the registered nurse (RN) to delegate to a dialysis technician?
Check blood pressure before starting dialysis.
Four hours after a bowel resection, a 74-yr-old male patient with a nasogastric tube to suction reports nausea and abdominal distention. What should be the nurse's first action?
Check for tube placement and reposition it.
During routine hemodialysis, a patient reports nausea and dizziness. Which action should the nurse take first?
Check the blood pressure (BP).
An older patient with a history of an abdominal aortic aneurysm arrives at the emergency department (ED) with severe back pain and absent pedal pulses. Which action should the nurse take first?
Check the patient's blood pressure.
A patient with acute kidney injury (AKI) has longer QRS intervals on the electrocardiogram (ECG) than were noted on the previous shift. Which action should the nurse take first?
Check the patient's most recent potassium level.
A patient admitted with a peptic ulcer has a nasogastric (NG) tube in place. When the patient develops sudden, severe upper abdominal pain, diaphoresis, and a firm abdomen, which action should the nurse take?
Check the vital signs.
Which patient choice for a snack 3 hours before bedtime indicates that the nurse's teaching about gastroesophageal reflux disease (GERD) has been effective?
Cherry gelatin with fruit
A patient who was recently diagnosed with benign prostatic hyperplasia (BPH) tells the nurse that he does not want to have a transurethral resection of the prostate (TURP) because it might affect his ability to have sexual intercourse. Which action should the nurse take?
Clarify that TURP does not commonly affect erection.
What should the nurse plan to teach about to a patient with Crohn's disease who has megaloblastic anemia?
Cobalamin (B12) supplements
A patient is transferred from the recovery room to a surgical unit after a transverse colostomy. The nurse observes the stoma to be deep pink with edema and a small amount of sanguineous drainage. What action should the nurse take?
Document stoma assessment findings.
Which activity in the care of a patient with a new colostomy could the nurse delegate to unlicensed assistive personnel (UAP)?
Drain and measure the output from the ostomy.
What should the nurse include when teaching an adult patient to prevent the recurrence of kidney stones?
Drinking 3000 mL of fluid each day
What should the nurse will teach about when preparing a patient with bladder cancer for intravesical chemotherapy?
Emptying the bladder before the instillation
A 72-yr-old male patient with dehydration caused by an exacerbation of ulcerative colitis is receiving 5% dextrose in normal saline at 125 mL/hour. Which assessment finding by the nurse is most important to report to the health care provider?
Crackles are heard halfway up the posterior chest.
Which assessment finding is most important to report to the health care provider regarding a patient who has had left-sided extracorporeal shock wave lithotripsy?
Decreased urine output
A patient in the emergency department reports back pain and difficulty breathing 15 minutes after a transfusion of packed red blood cells is started. What should the nurse's first action be?
Disconnect the transfusion and infuse normal saline.
A patient who has been receiving IV heparin infusion and oral warfarin (Coumadin) for a deep vein thrombosis (DVT) is diagnosed with heparin-induced thrombocytopenia (HIT) when the platelet level drops to 110,000/μL. Which action will the nurse include in the plan of care?
Discontinue the heparin infusion.
Which assessment finding in a patient who is admitted with infective endocarditis (IE) is most important to communicate to the health care provider?
Right flank pain
A young woman with Crohn's disease develops a fever and symptoms of a urinary tract infection (UTI) with tan, fecal-smelling urine. What information will the nurse add to a general teaching plan about UTIs in order to individualize the teaching for this patient?
Fistulas can form between the bowel and bladder.
A patient who is receiving methotrexate for severe rheumatoid arthritis develops a megaloblastic anemia. Which nutrient supplement should the nurse plan to explain to the patient?
Folic acid
What will the nurse will ask the patient about to determine the severity of benign prostatic hyperplasia (BPH) symptoms?
Force of urinary stream
A patient with a history of polycystic kidney disease is admitted to the surgical unit after having shoulder surgery. Which of the routine postoperative orders is most important for the nurse to discuss with the health care provider?
Give ketorolac 10 mg PO PRN for pain.
A patient is hospitalized with acute kidney injury (AKI). Which information will be most useful to the nurse in evaluating improvement in kidney function?
Glomerular filtration rate (GFR)
What information should the nurse include when performing discharge teaching for a patient after a vasectomy?
He should continue to use other methods of birth control for 6 weeks.
A patient had a cystectomy with an ileal conduit yesterday. Which new assessment data is most important for the nurse to communicate to the health care provider?
Heart rate 102 beats/min
Which nursing intervention for a patient who had an open repair of an abdominal aortic aneurysm 2 days previously is appropriate for the nurse to delegate to unlicensed assistive personnel (UAP)?
Help the patient to use a pillow to splint while coughing.
An adult male with chronic anemia is experiencing increased fatigue and occasional palpitations at rest. Which laboratory data would the nurse identify as consistent with these symptoms?
Hemoglobin (Hgb) of 8.6 g/dL (86 g/L)
The nurse notes pallor of the skin and nail beds in a newly admitted patient. The nurse should ensure that which laboratory test has been ordered?
Hemoglobin level
The health care provider prescribes finasteride (Proscar) for a patient who has benign prostatic hyperplasia (BPH). What information should the nurse provide when teaching the patient about the drug?
His interest in sexual activity may decrease while he is taking the medication.
What topic should the nurse plan to teach a female patient who has genital warts?
Importance of regular Pap tests
Several hours after a patient had an open surgical repair of an abdominal aortic aneurysm, the UAP reports to the nurse that urinary output for the past 2 hours has been 45 mL. What should the nurse anticipate will be prescribed?
Increased IV fluids
Which potential complication should the nurse identify as a high risk for a patient admitted to the hospital with idiopathic aplastic anemia?
Infection
A patient reports leg cramps during hemodialysis. What action should the nurse take?
Infuse a bolus of normal saline.
A 49-yr-old man has been admitted with hypotension and dehydration after 3 days of nausea and vomiting. Which prescribed action will the nurse implement first?
Infuse normal saline at 250 mL/hr.
A patient who has benign prostatic hyperplasia (BPH) with urinary retention is admitted to the hospital with elevated blood urea nitrogen (BUN) and creatinine. Which prescribed therapy should the nurse implement first?
Insert a urinary retention catheter.
A 76-yr-old with benign prostatic hyperplasia (BPH) is agitated and confused, with a markedly distended bladder. Which intervention prescribed by the health care provider should the nurse implement first?
Insert an indwelling urinary catheter.
A patient who has chronic constipation asks the nurse about the use of psyllium (Metamucil). Which information will the nurse include in the response?
Large amounts of fluid should be taken to prevent impaction or bowel obstruction.
A patient who has non-Hodgkin's lymphoma is receiving combination treatment with rituximab (Rituxan) and chemotherapy. Which patient assessment finding requires the most rapid action by the nurse?
Lip swelling
The nurse in the dialysis clinic is reviewing the home medications of a patient with chronic kidney disease (CKD). Which medication reported by the patient indicates that patient teaching is required?
Magnesium hydroxide
The nurse is planning care for a patient with severe heart failure who has developed increased blood urea nitrogen (BUN) and creatinine levels. What will be the primary treatment goal in the plan?
Maintaining cardiac output
When caring for a patient on the first postoperative day after an abdominal aortic aneurysm repair, which assessment finding is most important for the nurse to communicate to the health care provider?
Maroon-colored liquid stool
After having frequent diarrhea and a weight loss of 10 lb (4.5 kg) over 2 months, a patient has a new diagnosis of Crohn's disease. What should the nurse plan to teach the patient?
Medication use
The nurse is caring for a patient immediately after repair of an abdominal aortic aneurysm. On assessment, the patient has absent popliteal, posterior tibial, and dorsalis pedis pulses. The legs are cool and mottled. Which action should the nurse take first?
Notify the surgeon and anesthesiologist.
A woman receiving chemotherapy for breast cancer develops a Candida albicans oral infection. Which intervention should the nurse anticipate?
Nystatin tablets
The nurse is planning to administer a transfusion of packed red blood cells (PRBCs) to a patient with blood loss from gastrointestinal hemorrhage. Which action can the nurse delegate to unlicensed assistive personnel (UAP)?
Obtain the patient's temperature and blood pressure before the transfusion.
A 73-yr-old patient is diagnosed with stomach cancer after an unintended 20-lb weight loss. Which nursing action will be included in the plan of care?
Offer supplemental feedings between meals.
Which menu choice indicates that the patient understands the nurse's recommendations about dietary choices for iron-deficiency anemia?
Omelet and whole wheat toast
The nurse is admitting a patient newly diagnosed with peripheral artery disease who takes clopidogrel. Which admission order should the nurse question?
Omeprazole drug therapy
A 28-yr-old male patient has just been diagnosed with polycystic kidney disease. Which information should the nurse include in teaching during the first teaching session?
Options to consider for genetic counseling
Which admission order written by the health care provider for a patient admitted with infective endocarditis (IE) and a fever would be a priority for the nurse to implement?
Order blood cultures from two sites.
A patient at the clinic says, "I always walk after dinner, but lately my leg cramps and hurts after just a few minutes. The pain goes away after I stop walking, though." What focused assessment should the nurse make?
Palpate for the presence of dorsalis pedis and posterior tibial pulses.
A healthy 24-yr-old patient who has been vaccinated against human papillomavirus (HPV) has a normal Pap test result. Which information will the nurse include in patient teaching when calling the patient with the results of the Pap test?
Pap testing is recommended every 3 years for women your age.
After receiving change-of-shift report, which patient should the nurse assess first?
Patient who has just returned from having hemodialysis with a heart rate of 110/min.
A patient admitted with acute kidney injury due to dehydration has oliguria, anemia, and hyperkalemia. Which prescribed action should the nurse take first?
Place the patient on a cardiac monitor.
Which information shown in the table below about a patient who has just arrived in the emergency department is most urgent for the nurse to communicate to the health care provider?
Platelet count Patient History • BP 110/68 • Pulse 98 beats/min • Brisk capillary refill • Multiple ecchymoses on arms • Hgb 10.6 g/dL • Hct 30% • WBC 5100/μL • Platelets 19,500/μL • Occasional aspirin use • Abdominal pain x 1 week • Large, dark stool this morning
A patient with immune thrombocytopenic purpura (ITP) has an order for a platelet transfusion. Which information indicates that the nurse should consult with the health care provider before obtaining and administering platelets?
Platelet count is 42,000/L. Platelet transfusions are not usually indicated until the platelet count is below 10,000 to 20,000/L unless the patient is actively bleeding
Which menu choice by the patient who is receiving hemodialysis indicates that the nurse's teaching has been successful?
Poached eggs, whole-wheat toast, and apple juice
A patient is awaiting surgery for acute peritonitis. Which action will the nurse plan to include in the preoperative care?
Position patient with the knees flexed.
Which nursing action should be included in the plan of care for a patient returning to the surgical unit after a left modified radical mastectomy with dissection of axillary lymph nodes?
Post a sign at the bedside warning against venipunctures or blood pressures in the left arm.
A patient has chronic peripheral artery disease (PAD) of the legs and an ulcer on the right second toe. What should the nurse expect to find on assessment?
Prolonged capillary refill in all the toes.
What should the nurse anticipate teaching a patient with a new report of heartburn?
Proton pump inhibitors
The nurse notes bilateral enlargement of the breasts during examination of a 62-yr-old male patient. Which action should the nurse take first?
Question the patient about current medications.
Which assessment finding should the nurse expect when a patient with acute kidney injury (AKI) has an arterial blood pH of 7.30?
Rapid, deep respirations
Which finding in the mouth of a patient who uses smokeless tobacco is suggestive of oral cancer?
Red patches on the buccal mucosa
Which intervention will be included in the plan of care for a patient with acute kidney injury (AKI) who has a temporary vascular access catheter in the left femoral vein?
Restrict physical activity to bed rest.
A 31-yr-old patient who has been diagnosed with human papillomavirus (HPV) infection gives a health history that includes smoking tobacco, taking oral contraceptives, and having been treated twice for vaginal candidiasis. Which topic will the nurse include in patient teaching?
Risk factors for cervical cancer
What nursing assessment finding for a patient with infective endocarditis would be consistent with embolized vegetations from the tricuspid valve?
Shortness of breath
A patient with a family history of stomach cancer asks the nurse about ways to decrease the risk for developing stomach cancer. What should the nurse teach the patient to avoid?
Smoked foods such as ham and bacon
Which group of drugs will the nurse plan to include when teaching a patient who has a new diagnosis of peripheral artery disease (PAD)?
Statins
A young adult patient is admitted to the hospital for evaluation of right lower quadrant abdominal pain with nausea and vomiting. Which action should the nurse take?
Suggest the patient lie on the side, flexing the right leg.
After a patient has had a hemorrhoidectomy at an outpatient surgical center, which instructions will the nurse include in discharge teaching?
Take prescribed pain medications before you expect a bowel movement.
After a 48-yr-old patient has had a modified radical mastectomy, the pathology report identifies the tumor as an estrogen-receptor positive adenocarcinoma. What topic should the nurse plan to teach the patient?
Tamoxifen
What topic should the nurse anticipate teaching a patient who is diagnosed with lobular carcinoma in situ (LCIS)?
Tamoxifen
Which action should the nurse take when a 35-yr-old patient whose repeat cervical Pap test was abnormal?
Teach the patient about colposcopy.
The nurse assesses a patient with pernicious anemia. Which finding would the nurse expect?
Tender, bleeding gums
Which action by a patient who is using peritoneal dialysis (PD) indicates that the nurse should provide more teaching about PD?
The patient cleans the catheter while in the bathtub each day.
Which assessment information collected by the nurse may present a contraindication to a testosterone replacement therapy (TRT)?
The patient has had a gradual decrease in the force of his urinary stream.
Which information from a patient who had a transurethral resection with fulguration for bladder cancer 3 days ago is most important to report to the health care provider?
The patient has seen clots in the urine.
Which assessment finding should the nurse caring for a patient with thrombocytopenia communicate immediately to the health care provider?
The patient is difficult to arouse.
A patient has just been admitted to the emergency department with nausea and vomiting. Which information requires the most rapid intervention by the nurse?
The patient is lethargic and difficult to arouse.
What will the nurse teach a patient with metastatic breast cancer who has a new prescription for trastuzumab (Herceptin)?
The patient should call if she notices ankle swelling.
A 22-yr-old female patient with an exacerbation of ulcerative colitis is having 15 to 20 stools daily and has excoriated perianal skin. Which patient behavior indicates that teaching regarding maintenance of skin integrity has been effective?
The patient uses witch hazel compresses to soothe irritation.
A female patient with chronic kidney disease (CKD) is receiving peritoneal dialysis with 2-L inflows. Which information should the nurse report promptly to the health care provider?
The patient's peritoneal effluent appears cloudy.
A patient diagnosed with breast cancer asks the nurse what "triple negative" means. What should an accurate response from the nurse about triple-negative breast cancer include?
The tumor is not likely to be responsive to hormone therapy.
A 33-yr-old male patient with a gunshot wound to the abdomen undergoes surgery, and a colostomy is formed as shown in the accompanying figure. Which information will be included in patient teaching?
This type of colostomy is usually temporary.
A patient who has a history of a transfusion-related acute lung injury (TRALI) is to receive a transfusion of packed red blood cells (PRBCs). Which action by the nurse will decrease the risk for TRALI for this patient?
Transfuse leukocyte-reduced PRBCs
Which risk factor should the nurse focus on when teaching a patient who has a 5-cm abdominal aortic aneurysm?
Uncontrolled hypertension
A 62-yr-old female patient has been hospitalized for 4 days with acute kidney injury (AKI) caused by dehydration. Which information will be most important for the nurse to report to the health care provider?
Urine output over an 8-hour period is 2500 mL.
Which assessment finding(s) indicate to the nurse that a patient with infective endocarditis has decreased cardiac output?
Urine production of 25 mL/hr
Which information will the nurse include in teaching a patient who had a proctocolectomy and ileostomy for ulcerative colitis?
Use care when eating high-fiber foods to avoid obstruction of the ileum.
What should the nurse assess for when performing a focused examination to determine possible causes of infertility?
Varicocele
To prevent recurrence of uric acid kidney stones, the nurse teaches the patient to avoid eating:
sardines and liver.
