Medsurg test #3 practice questions

Which condition is referred to as the inflammation of renal parenchyma and the collecting system? A. Pyelonephritis B. Interstitial cystitis C. Urethral diverticula D> Glomerulonephritis

A. Pyelonephritis

Which dietary restriction does a nurse teach the patient with uric acid stones to avoid further complications? Select all that apply. A. Avoid cheese B. Avoid herring C. Avoid spinach D. Avoid sardines E. Avoid dried fruits

B. Avoid herring D. Avoid sardines

Which factors put a patient at risk for urinary stasis? Select all that apply. A. Constipation B. Urinary retention C. Diabetes mellitus D. Renal impairment E. Urinary tract calculi

B. Urinary retention D. Renal impairment E. Urinary tract calculi

For which illness should airborne precautions be implemented? A. Influenza B. Chickenpox C. Pneumonia D. Respiratory syncytial virus

B. Chickenpox

Which endourologic procedure aids in the removal of small stones? A. Cystoscopy B. Cystolitholapaxy C. Cystoscopic lithotripsy D. Percutaneous nephrolithotomy

A. Cystoscopy

When managing a patient with urinary calculi, which conditions associated with renal stones would indicate a need for lithotripsy? Select all that apply. A. Stones that are 3 mm in diameter. B. Stones that are 9 mm in diameter. C. Stones causing occasional nausea. D. Stones causing impaired renal function. E. Stones associated with symptomatic infection.

B. Stones that are 9 mm in diameter. D. Stones causing impaired renal function. E. Stones associated with symptomatic infection.

The nurse is teaching a client with asthma about using a peak flow meter. Which statement by the client reflects a correct understanding of how to use a peak flow meter? Select all that apply . A. "Readings in the green zone mean that my asthma is under control." B. "If I get a reading in the yellow zone, I need to stop what I'm doing and rest, then recheck in an hour." C. "If I get a reading in the red zone, then I need to take my reliever drug and have my wife take me to the hospital." D. "I should check the peak flow readings at least twice a day." E. "I don't need to check my peak flow readings if I take a reliever drug."

A. "Readings in the green zone mean that my asthma is under control." C. "If I get a reading in the red zone, then I need to take my reliever drug and have my wife take me to the hospital." D. "I should check the peak flow readings at least twice a day."

A client is admitted to the hospital with chronic asthma. Which complication should the nurse monitor in this client? A. Atelectasis B. Pneumothorax C. Pulmonary edema D. Respiratory alkalosis

A. Atelectasis

What are the clinical manifestations of acute pyelonephritis? A. Chills and flank pain B. Hemoptysis and rhonchi C. Hematuria and proteinuria D. Pain and lower urinary tract symptoms

A. Chills and flank pain

The nurse is caring for a client who recently returned from another country who exhibits signs and symptoms suspicious of severe acute respiratory syndrome (SARS). Which clinical manifestations support this diagnosis? Select all that apply. A. Dry cough B. Chest pain C. Hemoptysis D. Shortness of breath E. Fever greater than 100.4° F (38° C)

A. Dry cough D. Shortness of breath E. Fever greater than 100.4° F (38° C)

A client develops acute respiratory distress, and a tracheostomy is performed. Which intervention is most important for the nurse to implement when caring for this client? A. Encouraging a fluid intake of 3 L daily B. Suctioning via the tracheostomy every hour C. Applying an occlusive dressing over the surgical site D. Using cotton balls to cleanse the stoma with peroxide

A. Encouraging a fluid intake of 3 L daily

While assessing the medical reports of a client with upper respiratory tract infections, the nurse notices that there are alterations in the platelet count. The client has a history of recent nasal surgery. Which clinical condition does the nurse suspect? A. Epistaxis B. Rhinosinusitis C. Allergic rhinitis D. Acute pharyngitis

A. Epistaxis

A client is admitted to the hospital with a diagnosis of restrictive airway disease. The nurse expects the client to exhibit which early signs of respiratory acidosis? Select all that apply. A. Headache B. Irritability C. Restlessness D. Hypertension E. Lightheadedness

A. Headache B. Irritability C. Restlessness

After a spontaneous pneumothorax, the client becomes extremely drowsy, and the pulse and respirations increase. What do these client responses indicate to the nurse? A. Hypercapnia B. Hypokalemia C. Increased PO 2 D. Respiratory alkalosis

A. Hypercapnia

A patient is suspected to have acute glomerulonephritis. The nurse is evaluating the causes and risk factors for glomerulonephritis in this patient. Which patient factors would the nurse anticipate contributed to acute glomerulonephritis? Select all that apply. A. Hypertension B. Chlamydial infection C. Streptococcal throat infection D. Human immunodeficiency virus (HIV) E. Neurogenic hypersensitivity of the lower urinary tract

A. Hypertension C. Streptococcal throat infection D. Human immunodeficiency virus (HIV)

A client who is exposed to pollens reports a runny, stuffy nose and itchy, watery eyes. The nasal examination reveals swollen and pink nasal mucosa. Which finding does the nurse suspect to be present in the client's laboratory reports? A. Immunoglobulin E (IgE) level of 150 IU/mL B. Eosinophil count of 2% C. Percentage of neutrophils of 80% D. Total white blood cell (WBC) count of 3 billion cells/L

A. Immunoglobulin E (IgE) level of 150 IU/mL

A client reports fever, headache, extreme tiredness, dry cough, sore throat, runny nose, muscle aches, nausea, vomiting, and diarrhea. Which organism is responsible for this condition? A. Influenza virus B. Toxoplasma gondii C. Human herpes virus-8 D. Cryptosporidium muris

A. Influenza virus

During chest physiotherapy (CPT) a client reports fatigue, and the client's heart rate increases from 90 to 140 beats per minute. What should the nurse do next? A. Interrupt the therapy. B. Encourage deep breathing. C. Place the client in the low-Fowler position. D. Have the client complete the therapy before resting.

A. Interrupt the therapy.

A patient is diagnosed with acute poststreptococcal glomerulonephritis. On examination, the nurse finds that the patient is hypertensive and has edema and increased blood urea nitrogen (BUN) levels. What type of diet should the nurse plan for this patient? Select all that apply. A. Low-protein diet B. Low-sodium diet C. Fluid-restricted diet D. Nonvegetarian diet E. Increased fruit juices

A. Low-protein diet B. Low-sodium diet C. Fluid-restricted diet

A patient is suspected of having struvite urinary calculi. What appropriate actions should the nurse perform to manage this patient? Select all that apply. A. Measure urine pH. B. Give cholestyramine. C. Administer antimicrobial agents. D. Take measures to acidify the urine. E. Alkalinize the urine with potassium citrate.

A. Measure urine pH. C. Administer antimicrobial agents. D. Take measures to acidify the urine.

The nurse is teaching the client with chronic obstructive pulmonary disease (COPD) to use pursed-lip breathing (PLB). What is the rationale for the nurse's teaching? A. Prolonged exhalation to decrease air trapping B. Shortened inhalation to reduce bronchial swelling C. Increased respiratory rate to improve arterial oxygenation D. Decreased use of diaphragm to increase amount of inspired air

A. Prolonged exhalation to decrease air trapping

A client who is admitted with emphysema shows progressive respiratory failure and has a Paco 2 of 60. To address the problems, the nurse expects to receive a prescription for: A. Mucolytics B. Bronchodilators C. Mechanical ventilation D. Intermittent positive-pressure breathing (IPPB)

C. Mechanical ventilation

A 65-year old client is found to have dilatation of the bronchioles and alveolar ducts. Which suggestions of the nurse would help the client overcome this situation? Select all that apply. A. Suggest the use of incentive spirometry. B. Suggest that the client takes an adequate amount of calcium daily. C. Suggest that the client perform vigorous pulmonary hygiene activities. D. Suggest that the client maintain an upright position as much as possible. E. Suggest that the client talk face-to face with others as much as possible.

A. Suggest the use of incentive spirometry. C. Suggest that the client perform vigorous pulmonary hygiene activities. D. Suggest that the client maintain an upright position as much as possible.

A client is hospitalized with a diagnosis of emphysema. The nurse provides teaching and should begin with which aspect of care? A. The disease process and breathing exercises B. How to control or prevent respiratory infections C. Using aerosol therapy, especially nebulizers D. Priorities in carrying out everyday activities

A. The disease process and breathing exercises

A client is admitted to the emergency department with allergic rhinitis and asthma. The laboratory report shows histamines and prostaglandins. Which type of hypersensitivity reaction may have occurred? A. Type I B. Type II C. Type III D. Type IV

A. Type I

The primary healthcare provider has prescribed fluticasone nasal spray for a client with sinusitis. Which of these instructions regarding the use of the spray are appropriate for the client? Select all that apply. A. Use the drug on a regular basis, not PRN B. Clear the nasal passages before using the drug C. Discontinue use of the drug if nasal infection develops D. Remember that driving may be dangerous because of the drug's sedative effect E. Begin taking the drug 2 weeks before pollen season starts and use it throughout the season

A. Use the drug on a regular basis, not PRN B. Clear the nasal passages before using the drug C. Discontinue use of the drug if nasal infection develops

Which is a leukotriene modifier used to manage and prevent allergic rhinitis? A. Zileuton B. Ephedrine C. Scopolamine D. Cromolyn sodium

A. Zileuton

The arterial blood gases of a client with chronic obstructive pulmonary disease (COPD) deteriorate, and respiratory failure is impending. Which clinical indicator should the nurse assess first? A. Cyanosis B. Bradycardia C. Mental confusion D. Distended neck veins

C. Mental confusion

Which instructions by the nurse are beneficial to a patient with acute pyelonephritis? Select all that apply. A. "Avoid using vaginal deodorant sprays." B. "Drink at least eight glasses of fluid every day." C. "Avoid clothing that creates suprapubic pressure." D. "Avoid sexual intercourse until symptoms subside." "E. Take the full course of antibiotics to ensure that the bacteria are eradicated."

B. "Drink at least eight glasses of fluid every day." "E. Take the full course of antibiotics to ensure that the bacteria are eradicated."

A client presents with sneezing; lacrimation; swelling with an airway obstruction; and pruritus around the eyes, nose, throat, and mouth. The nurse interprets these findings as a Type I hypersensitivity reaction. Which disease might have occurred in the client? A. Angioedema B. Allergic rhinitis C. Contact dermatitis D. Goodpasture syndrome

B. Allergic rhinitis

A client is diagnosed with emphysema. What long-term problem should the nurse monitor in this client? A. Localized tissue necrosis B. Carbon dioxide retention C. Increased respiratory rate D. Saturated hemoglobin molecules

B. Carbon dioxide retention

A client who was recently diagnosed with emphysema develops a malignancy in the right lower lobe of the lung, and a lobectomy is performed. After surgery, the client is receiving oxygen by nasal cannula at 2 L per minute. Blood gas results demonstrate respiratory acidosis. What should be the initial nursing intervention? A. Administer oral fluids. B. Encourage deep breathing. C. Increase the oxygen flow rate. D. Perform nasotracheal suctioning.

B. Encourage deep breathing.

A nurse is involved in an international committee to address global health problems. What suggestion is most appropriate for the nurse to make to best meet the challenge associated with a potential emerging influenza pandemic? A. Stockpile antibiotics. B. Establish a global surveillance plan. C. Limit vaccination programs to school-aged children. D. Initiate vaccination programs during the months of August and September.

B. Establish a global surveillance plan.

The nurse is teaching a patient who recently had an episode of urolithiasis with calcium oxalate stones about nutritional therapy. What instructions should the nurse include? Select all that apply. A. Increase intake of milk. B. Limit consumption of colas. C. Increase consumption of coffee. D. Take in at least 3 L of fluid daily. E. Limit intake of dried fruits and nuts.

B. Limit consumption of colas. D. Take in at least 3 L of fluid daily. E. Limit intake of dried fruits and nuts.

A client with a 10-year history of emphysema is admitted in acute respiratory distress. During assessment, what does the nurse expect to identify? A. Chest pain on inspiration B. Prolonged expiration with use of accessory muscles C. Signs and symptoms of respiratory alkalosis D. Decreased respiratory rate

B. Prolonged expiration with use of accessory muscles

Which interventions should the nurse perform while collecting subjective data from a client during a focused respiratory assessment? Select all that apply. A. Palpate the chest and back for masses B. Question the client about shortness of breath C. Check the hematocrit and hemoglobin values D. Inspect the skin and nails for integrity and color E. Ask the client about color and quantity of sputum

B. Question the client about shortness of breath E. Ask the client about color and quantity of sputum

A client has a tracheostomy tube attached to a tracheostomy collar for the delivery of humidified oxygen. What is the primary reason identified by the nurse for suctioning the client? A. Humidified oxygen is saturated with fluid. B. The tracheostomy tube interferes with effective coughing. C. The inner cannula of the tracheostomy tube irritates the mucosa. D. The weaning process increases the amount of respiratory secretions.

B. The tracheostomy tube interferes with effective coughing.

A client's sputum smears for acid-fast bacilli (AFB) are positive, and transmission-based airborne precautions are prescribed. What should the nurse teach visitors to do? A. Put on a gown and gloves. B. Wear a particulate respirator mask. C. Avoid touching objects in the client's room. D. Limit contact with the client's nonexposed family members.

B. Wear a particulate respirator mask.

A 67-year-old client has tested positive for influenza A. The client also has asthma. Which drug would the nurse recommend be avoided in this client? A. Ribavirin B. Zanamivir C. Oseltamivir D. Amantadine

B. Zanamivir

The nurse should provide a patient with what education specifically related to inflammation of the urethra? Select all that apply. A. "Avoid clothing that creates suprapubic pressure." B. "Use a vaginal deodorant spray for improved hygiene." C. "Avoid sexual intercourse until the symptoms subside." D. "Take warm sitz baths to relieve bothersome symptoms." E. "Properly cleanse the perineal area after bowel movements and urinating."

C. "Avoid sexual intercourse until the symptoms subside." D. "Take warm sitz baths to relieve bothersome symptoms." E. "Properly cleanse the perineal area after bowel movements and urinating."

Which suggestion of the nurse would help the client prevent respiratory problems? A. "You should start painting your house." B. "You should engage in heavy physical activity." C. "You should wear a mask while working in certain industries." D. "You should move from a rural to an urban area."

C. "You should wear a mask while working in certain industries."

A client's arterial blood gas report indicates that pH is 7.25, PCO 2 is 35 mm Hg, and HCO 3 is 20 mEq/L (20 mmol/L). Which client should the nurse consider is most likely to exhibit these results? A. A 54-year-old with vomiting B. A 17-year-old with panic attacks C. A 24-year-old with diabetic ketoacidosis D. A 65-year-old with advanced emphysema

C. A 24-year-old with diabetic ketoacidosis

Which medication is prescribed for a patient with alkaline urine and struvite stones in the kidney? A. Allopurinol B. Potassium citrate C. Acetohydroxamic acid D. Alpha-penicillamine and tiopronin

C. Acetohydroxamic acid

A client develops respiratory alkalosis. When the nurse is reviewing the laboratory results, which finding is consistent with respiratory alkalosis? A. An elevated pH, elevated PCO 2 B. A decreased pH, elevated PCO 2 C. An elevated pH, decreased PCO 2 D. A decreased pH, decreased PCO 2

C. An elevated pH, decreased PCO 2

The nurse is developing a plan of care for a client who had a chest tube removed. To promote respiratory exchange, what should the nurse add to the plan of care? A. Careful monitoring for crepitus B. Bed rest with range-of-motion exercises C. Coughing and deep breathing every hour D. Covering the chest tube site with a sterile dressing

C. Coughing and deep breathing every hour

While assessing the patient's risk of developing urinary tract infections, what questions should the nurse ask? Select all that apply. A. Is your work putting too much stress on you? B. Have you ever received a blood transfusion? C. Do you have a recent history of urinary calculi? D. Do you hold your urine for long periods of time? E. Did you have any condition that required urinary catheterization?

C. Do you have a recent history of urinary calculi? D. Do you hold your urine for long periods of time? E. Did you have any condition that required urinary catheterization?

Which is a clinical manifestation of urethral stricture? A. Foamy urine B. Hyperlipidemia C. Frequent urge to urinate D. Sharp pain in flank area

C. Frequent urge to urinate

The nurse is assessing a client's arterial blood gases and determines that the client is in compensated respiratory acidosis. The pH value is 7.34; which other result helped the nurse reach this conclusion? A. PO 2 value is 80 mm Hg. B. PCO 2 value is 60 mm Hg. C. HCO 3 value is 50 mEq/L (50 mmol/L). D. Serum potassium value is 4 mEq/L (4 mmol/L).

C. HCO 3 value is 50 mEq/L (50 mmol/L).

What response provides evidence that a client with chronic obstructive pulmonary disease (COPD) understands the nurse's instructions about an appropriate breathing technique? A. Inhales through the nose with the mouth closed B. Increases the respiratory rate C. Holds each breath for a second at the end of inspiration D. Progressively increases the length of the inspiratory phase

C. Holds each breath for a second at the end of inspiration

The nurse is caring for a client who has metabolic acidosis as a result of severe dehydration. What type of respirations does the nurse expect the client to exhibit? A. Dyspnea B. Hyperpnea C. Kussmaul breathing D. Cheyne-Stokes breathing

C. Kussmaul breathing

A patient presents with discomfort in the lower abdomen, and on assessment, the nurse suspects a lower urinary tract infection. Which symptoms should the nurse evaluate? Select all that apply. A. Fever B. Pain in the flank C. Pain while urinating D. Increased frequency of urination E. Feeling of pressure in the suprapubic region

C. Pain while urinating D. Increased frequency of urination E. Feeling of pressure in the suprapubic region

Which disorder would the nurse state is related to the tonsils? A. Rhinitis B. Sinusitis C. Pharyngitis D. Pneumonia

C. Pharyngitis

Which treatment does the nurse expect for a patient who presents with hematuria, flank pain, and a palpable mass in the abdomen? Select all that apply. A. Ileal conduit B. Marsupialization C. Radical nephrectomy D. Cystoscopic lithotripsy E. Radiofrequency ablation

C. Radical nephrectomy E. Radiofrequency ablation

The nurse observes a client with chronic obstructive pulmonary disease (COPD) breathing rapidly and using accessory muscles of respiration. The nurse auscultates the lungs and hears crackles and wheezes. What action should the nurse take? A. Encourage the client to take slow, deep breaths and administer 5 L/min oxygen per nasal cannula. B. Place the client in a side-lying position and perform chest physiotherapy using clapping and vibration. C. Raise the head of the bed to a high-Fowler position and administer 2 L/min oxygen per nasal cannula. D. Assist the client in assuming a position of comfort and perform postural drainage.

C. Raise the head of the bed to a high-Fowler position and administer 2 L/min oxygen per nasal cannula.

A client with chronic obstructive pulmonary disease (COPD) has a blood pH of 7.25 and PCO 2 of 60 mm Hg. These blood gases require nursing attention because they indicate which condition? A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis

C. Respiratory acidosis

A client with chronic obstructive pulmonary disease (COPD) has a blood pH of 7.25 and a PCO 2 of 60 mm Hg. What complication does the nurse conclude the client is experiencing? A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis

C. Respiratory acidosis

After abdominal surgery a client should be encouraged to turn from side to side and to engage in deep breathing exercises. The nurse explains that these activities are essential to prevent which condition? A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis

C. Respiratory acidosis

A patient in heart failure experiences a neurohormonal response of the renin-angiotensin-aldosterone system (RAAS). What does this response trigger? A. Vasodilation B. Decreased cardiac output C. Retention of sodium and water D. Decreased release of the antidiuretic hormone (ADH)

C. Retention of sodium and water

A nurse is performing a physical examination on a patient suspected of having urinary tract calculi. For what primary manifestation should the nurse be observant during the assessment? A. Fever B. Abdominal distension C. Sharp pain in the flanks D. Bacteria on a urine analysis

C. Sharp pain in the flanks

A client has chronic obstructive pulmonary disease (COPD). To decrease the risk of CO 2 intoxication (CO 2 narcosis), what should the nurse do? A. Initiate pulmonary hygiene to clear air passages of trapped mucus B. Instruct to deep breathe slowly with inhalation longer than exhalation C. Encourage continuous rapid panting to promote respiratory exchange D. Administer oxygen at a low concentration to maintain respiratory drive

D. Administer oxygen at a low concentration to maintain respiratory drive

A client with a history of emphysema is admitted with a diagnosis of acute respiratory failure with respiratory acidosis. Oxygen is being administered at 3 L/min nasal cannula. Four hours after admission, the client has increased restlessness and confusion followed by a decreased respiratory rate and lethargy. What should the nurse do? A. Question the client about the confusion. B. Change the method of oxygen delivery. C. Percuss and vibrate the client's chest wall. D. Discontinue or decrease the oxygen flow rate.

D. Discontinue or decrease the oxygen flow rate.

Which part of the upper respiratory system is involved in equalizing the pressure within the middle ear while swallowing? A. Glottis B. Paranasal sinus C. Palatine tonsils D. Eustachian tubes

D. Eustachian tubes

The patient questions why anesthesia is needed when the lithotripsy being done is noninvasive. The nurse explains that the anesthesia is required to ensure the position is maintained during the procedure. The nurse knows that this type of lithotripsy is called what? A. Laser lithotripsy B. Electrohydraulic lithotripsy C. Percutaneous ultrasonic lithotripsy D. Extracorporeal shock-wave lithotripsy (ESWL)

D. Extracorporeal shock-wave lithotripsy (ESWL)

As a result of pulmonary tuberculosis, a client has a decreased surface area for gas exchange in the lungs. Which physiologic process does the nurse consider will be affected as a result? A. Osmosis B. Filtration C. Active transport D. Molecular diffusion

D. Molecular diffusion

What finding in the client is a sign of allergic rhinitis? A. Presence of high-grade fever B. Reduced breathing through the mouth C. Presence of pinkish nasal discharge D. Reduced transillumination on the skin over the sinuses

D. Reduced transillumination on the skin over the sinuses

A nurse works with a large population of immigrant clients and is concerned about the debilitating effects of influenza. Which action by the nurse is the first line of defense against an emerging influenza pandemic? A. Complying with quarantine measures B. Instituting strict international travel restrictions C. Seeking aid from the international public health community D. Reporting surveillance findings to appropriate public health officials

D. Reporting surveillance findings to appropriate public health officials

A client with a history of emphysema develops a respiratory infection and is admitted to the hospital in acute respiratory distress. The client's arterial blood studies indicate pH 7.30, PO 2 60 mm Hg, PCO 2 55 mm Hg, and HCO 3 23 mEq/L (23 mmol/L). How should the nurse interpret these findings? A. Hypocapnia B. Hyperkalemia C. Generalized anemia D. Respiratory acidosis

D. Respiratory acidosis

A client is experiencing severe respiratory distress. Which response should the nurse expect the client to exhibit? A. Tremors B. Anasarca C. Bradypnea D. Tachycardia

D. Tachycardia