Med surg exam 6 study guide

After teaching a patient who is recovering from a complete thyroidectomy, the nurse assesses the patient's understanding. Which statement made by the patient indicates a need for additional instruction?

"After surgery, I won't need to take thyroid medication"

A nurse assesses a patient with diabetes mellitus and notes that the patient only responds to a sternal rub by moaning, has capillary blood glucose of 33mg/dl (1.8mmol/L), and has an intravenous line that is infiltrated with 0.45% normal saline. What action would the nurse take first?

Administer 1mg of intramuscular glucagon

A nurse teaches a patient who is prescribed an insulin pump. Which statement would the nurse include in this patient's discharge education?

Change the needle every three days

After teaching a male patient with a spinal cord injury at the T4 level, the nurse assesses the patient's understanding. Which patient statements indicate a correct understanding of the teaching related to sexual effects of this injury? Select all that apply.

I should be able to have an erection with stimulation Ejaculation may not be as predictable as before. I may urinate with ejaculation but this will not cause infection.

After teaching a patient who is recovering from an endoscopic transnasal hypophysectomy, the nurse assesses the patient's understanding. Which statement made by the patient indicates a correct understanding of the teaching?

I'll keep food on the upper shelves so I do not have to bend over

A patient in the intensive care unit is scheduled for a lumbar puncture (LP) today. On assessment, the nurse finds the patient breathing irregularly with one pupil fixed and dilated. What action by the nurse is best?

Notify the provider of the findings immediately

A nurse is caring for a patient with a history of renal insufficiency who is scheduled for a computed tomography scan of the head with contrast medium. Which priority intervention would the nurse implement?

Obtain a prescription for intravenous fluids

The nurse provides medication instructions to a client who is taking levothyroxine (Synthroid) and should tell the client to notify the health care provider if which problem occurs?

Tremors

A nurse witnesses a client begin to experience a tonic-clinic seizure and loss of consciousness. What action would the nurse take first?

Turn the client's head to the side

A nurse cares for a client who is experiencing status epilepticus. Which prescribed medication would the nurse prepare to administer?

Lorazepam (Ativan)

A nurse teaches a patient who is diagnosed with diabetes mellitus. Which statement would the nurse include in this patient's plan of care to delay the onset of microvascular complications?

Maintain tight glycemic control and prevent hyperglycemia

A patient with myasthenia gravis has the priority patient problem of inadequate nutrition. What assessment finding indicates that the priority goal for this patient has been met?

Weight gain of 3lbs (1.4kg) in 1 month

A patient in the family practice clinic has restless leg syndrome. Routine laboratory work reveals white blood cells 8000/mm3 (8x10*9/L). What action by the nurse is best?

Instruct the patient on magnesium supplement

A client with a spinal cord injury is prone to experiencing autonomic dysreflexia. The nurse should avoid which measure to minimize the risk of occurrence?

Limiting bladder catheterization to once every 12 hours.

After a stroke, a patient has ataxia. What interventions is most appropriate to include on the patient's plan of care?

Ambulate only with a gait belt

A nurse assesses a patient who demonstrates a positive Romberg's sign with eyes closed but not with eyes open. Which condition does the nurse associate with this finding?

Difficulty with proprioception

A client has clear fluid leaking from the nose following a basilar skull fracture. Which finding would alert the nurse that cerebrospinal fluid is present?

Fluid separates into concentric rings and tests positive for glucose.

A nurse assesses a patient recovering from a cerebral angiography via the patient's right femoral artery. Which assessment would the nurse complete?

Palpate bilateral lower extremity pulses

A nurse cares for a patient who possibly has syndrome of inappropriate antidiuretic hormone (SIADH). The patient's serum sodium level if 114mEq/L (114mmol/L). What action would the nurse take first?

Restrict the patient's fluid intake to 600mL/day

A nurse cares for a patient who is prescribed pioglitazone (Actos). After 6 months of therapy, the patient reports that his urine has become darker since starting the medication. What action would the nurse take?

Review the patient's liver function study results

A nurse cares for a patient who is recovering from a parathyroidectomy. When taking the patient's blood pressure, the nurse notes that patient's hand has gone into flexion contractions. Which laboratory result does the nurse correlate with this condition?

Serum calcium 6.9mg/dl

The nurse teaches a client with diabetes mellitus about differentiating between hypoglycemia and ketoacidosis. The client demonstrates an understanding of the teaching by stating that a form of glucose should be taken if which symptoms develop? Select all that apply.

Shakiness Palpitations Lightheadedness

A nurse teaches a patient who is prescribed an unsealed radioactive isotope. Which statements will the nurse include in this patient's education? Select all that apply.

Take a laxative 2 days after therapy to excrete the radiation Do not share utensils, plates, and cups with anyone else Wash your clothing separate from others in the household

A nurse teaches a patient who has been prescribed a 24-hour urine collection to measure excreted hormones. The patient asks, "Why do I need to collect urine for 24 hours instead of providing a random specimen?" How would the nurse respond?

This test will assess for a hormone secreted on a circadian rhythm.

A nurse assesses a patient who is prescribed a medication that stimulates beta-1 receptors. Which assessment finding would alert the nurse to urgently contact the healthcare provider?

Heart rate of 50 beats/min

A nurse cares for a patient with a spinal cord injury. With which interdisciplinary team member would the nurse consult to assist the patient with activities of daily living?

Occupational therapist

A nurse is teaching a patient with multiple sclerosis who is prescribed cyclophosphamide (cytoxan) and methylprednisolone (Medrol). Which statement would the nurse include in this patient's discharge teaching?

"Avoid crowds and people with colds"

A patient has trigeminal neuralgia and has begun skipping meals and not brushing his teeth, and his family believes that the patient has become depressed. What action by the nurse is best?

Ask the patient to explain feelings related to this disorder.

A nurse cares for a patient with excessive production of thyrocalcitonin (calcitonin). For which electrolyte imbalance would the nurse assess?

Calcium

A nurse plans care for an older adult who is admitted to the hospital for pneumonia. The patient has no known drug allergies and no significant health history. Which action would the nurse include in this patient's plan of care?

Offer fluids every hour or two

A nurse prepares to provide perineal care to a client with meningococcal meningitis. Which personal protective equipment would the nurse wear? Select all that apply.

Gloves Surgical mask

A nurse assesses a patient with a neurologic disorder. Which assessment finding would the nurse identify as a late manifestation of amyotrophic lateral sclerosis (ALS)?

Impairment of respiratory muscles

A nurse is caring for a patient after a stroke. What actions may the nurse delegate to the unlicensed assistive personnel (UAP)? Select all that.

Position the patient supine with the head in a neutral midline position Check and document oxygen saturation every 1 to 2 hours

A nurse plans care for a patient who has a hypoactive response to a test of deep tendon reflexes. Which intervention would the nurse include in this patient's plan of care?

Provide the patient with assistance when ambulating.

A patient is admitted with Guillain-Barré syndrome (GBS). What assessment takes priority?

Respiratory system

While assessing a patient with Grave's disease, the nurse notes that the patient's temperature has risen 1*F (1*C). What does the nurse do first?

Turn the lights down and shut the patient's door.

A nurse plans care for a patient with Cushing's disease. Which action would the nurse include in this patient's plan of care to prevent injury?

Use a lift sheet to change the patient's position.

A nurse assesses a female patient who presents with hirsutism. Which question would the nurse ask when assessing this patient?

"How do you feel about yourself?"

A nurse assesses a patient's recent memory. Which patient statement confirms that the patient's remote memory is intact?

"I ate oatmeal with wheat toast and orange juice for breakfast"

A patient has a brain tumor and is receiving phenytoin (Dilantin). The spouse questions the use of the drug, saying that the patient does not have a seizure disorder. What response by the nurse is best?

"Increased pressure form the tumor can cause seizures."

A patient with myasthenia gravis (MG) asks the nurse to explain the disease. What response by the nurse is best?

"MG is an autoimmune problem in which nerves do not cause muscles to contract."

A nurse is caring for a patient who was prescribed high dose corticosteroid therapy for 1 month to treat a severe inflammatory condition. The patient's symptoms have now resolved and the patient asks, "When can I stop taking these medications?" How would the nurse respond?

"Once you start corticosteroids, you have to be weaned off them"

A nurse is teaching a client who experiences migraine headaches and is prescribed a beta-blocker. Which statement would the nurse include in this client's teaching?

"Take this drug as prescribed, even when feeling well, to prevent vascular changes associated with migraine headaches."

After teaching a patient with diabetes mellitus to inject insulin, the nurse assesses the patient's understanding. Which statement made by the patient indicates a need for additional teaching?

"The lower abdomen is the best location because it is closest to the pancreas."

A nurse cares for a patient with amyotrophic lateral sclerosis (ALS). The patient states, "I do not want to be placed on a mechanical ventilator." How would the nurse respond?

"What would you like to be done if you begin to have difficulty breathing?"

A nurse cares for a male patient with hypopituirarism who is prescribed testosterone hormone replacement therapy. The patient asks, "How long will I need to take this medication?" How would the nurse respond?

"When your beard thickens and your voice deepens, the dose is decreased, but treatment will continue forever."

A nurse cares for a patient who has hypothyroidism as a result of Hashimoto's thyroiditis. The patient asks, "How long will I need to take this thyroid medication?" How does the nurse respond?

"You'll need thyroid pills for life because your thyroid won't start working again."

After teaching the wife of a client who has Parkinson's disease, the nurse assesses the wife's understanding. Which statement by the client's wife indicates that she correctly understands changes associated with this disease?

He may have trouble chewing, so I will offer bite-sized portions

Carbidopa-levodopa (Sinemet) is prescribed for a client with Parkinson's disease. The nurse monitors the client for side/adverse effects to the medication. Which finding indicates that the client is experiencing an adverse effect?

Impaired voluntary movements

A nurse caring for four patients in the neurologic/neurosurgical intensive care unit. Which patient would the nurse assess first?

Patient receiving tissue plasminogen activator (t-PA) who has a change in respiratory pattern and rate