PrepU review

A client with angina pectoris must learn how to reduce risk factors that exacerbate this condition. When developing the client's care plan, which expected outcome should a nurse include?

"Client will verbalize the intention to stop smoking."

A nurse is instructing the wife of a patient who suffered a stroke about the use of eating devices her husband will be using. During the teaching, the wife starts to cry and states "One minute my husband is laughing, and the next he's crying; I just don't understand what's wrong with him." The nurse's best response is which of the following?

"Following a stroke, emotional lability is common, and it usually improves with time."

When discussing physical activities with the client who has just undergone a right total hip replacement, which instruction should the nurse provide?

"Limit hip flexion to 90 degrees."

What is the most important postoperative instruction a nurse must give to a client who has just returned from the operating room after receiving a subarachnoid block?

"Remain supine for the time specified by the physician."

A client with a malignant glioma is scheduled for surgery. The client demonstrates a need for additional teaching about the surgery when he states which of the following?

"The surgeon will be able to remove all of the tumor."

When the dawn phenomenon occurs, the patient has relatively normal blood glucose until approximate what time of day?

3 AM

For the patient who is taking aspirin, it is important to stop taking this medication at least how many day(s) prior to surgery?

7

A patient has been prescribed a Fentanyl patch for pain control. The nurse understands that this patch should be replaced every:

72 hours

A nurse would question the accuracy of a pulse oximetry evaluation in which of the following conditions?

A client experiencing hypothermia

An obese white male client, age 49, is diagnosed with hypercholesterolemia. The physician orders a low-fat, low-cholesterol, low-calorie diet to reduce blood lipid levels and promote weight loss. This diet is crucial to the client's well-being because his race, sex, and age increase his risk for coronary artery disease (CAD). To determine whether the client has other major risk factors for CAD, the nurse should assess for:

A history of diabetes mellitus

A 35-year-old female client who complains of weight gain, facial hair, absent menstruation, frequent bruising, and acne is diagnosed with Cushing's syndrome. Cushing's syndrome is most likely caused by:

A pituitary adenoma

he nurse is interviewing a patient who says he has a dry, irritating cough that is not "bringing anything up." What medication should the nurse question the patient about taking?

ACE inhibitors

During a Tensilon test to determine if a patient has myasthenia gravis, the patient complains of cramping and becomes diaphoretic. Vital signs are BP 130/78, HR 42, and respiration 18. What intervention should the nurse prepare to do?

Administer atropine

You are caring for a client preoperatively who is very anxious and fearful about their surgery. You know that this client's anxiety can cause problems with the surgical experience. What type of problems can this client have because of their anxiety and fear?

Anxious clients have a poor response to surgery and are prone to complications

The nurse should be alert for a complication of bronchiectasis that results from a combination of retained secretions and obstruction that leads to the collapse of alveoli. This complication is known as

Atelectasis

A client who has sustained a fracture reports an increase in pain and decreased function of the affected extremity. The nurse would suspect which of the following?

Avascular necrosis

The nurse is caring for a client with an elevated blood pressure and no previous history of hypertension. At 0900, the blood pressure was 158/90 mm Hg. At 0930, the blood pressure is 142/82 mm Hg. The nurse is most correct when relating the fall in blood pressure to which structure?

Baroreceptors

The nurse is providing education to a group of young people about the dangers of tattoos and body piercings. Which of the following would the nurse describe as a possible result of a tongue piercing?

Brain abscess

A patient is in the operating room for surgery. Which individual would be responsible for ensuring that procedure and site verification occurs and is documented?

Circulating nurse

Which of the following medications is given to patients diagnosed with angina and is allergic to aspirin?

Clopidogrel (Plavix)

The nurse reviews the patient's drug regimen for treatment of a brain tumor. She explains to the patient why one of the following drugs would not be prescribed, even though it might have therapeutic benefits. Which drug would not be prescribed for this patient?

Coumadin

Which of the following is a symptom diagnostic of emphysema?

Dyspnea

A patient receiving vasopressin for the management of active bleeding due to esophageal varices should be assessed for evidence of the drug's most serious complication. Therefore, the nurse should frequently check the patient's:

EKG

A patient suspected of having Guillain-Barré syndrome has had a lumbar puncture for cerebrospinal fluid (CSF) evaluation. When reviewing the laboratory results, what does the nurse find that is diagnostic for this disease?

Elevated protein levels in the CSF

When taking a patient history, the nurse notes that the patient is taking herbal remedies in addition to acetaminophen. Which herb, when taken in conjunction with acetaminophen, enhances the risk of bleeding?

Ginkgo

The client is taking oxycodone (Oxycontin) for chronic back pain and reports decreased pain relief when he began taking a herb to improve his physical stamina. The nurse asks if the herb is

Ginseng

Which of the following is a modifiable risk factor for transient ischemic attacks and ischemic strokes?

History of smoking

Which of the following conditions does the nurse need to confirm when he or she taps the facial nerve of a client who has dysphagia?

Hypomagnesemia

What is Chostvek's a sign of?

Hypomagnesemia and hypocalcemia

The typical triad of manifestations seen in a patient diagnosed with pheochromocytoma includes all of the following except

Hypotension

Asthma is cause by which type of response?

IgE-mediated

Prostaglandins are chemical substances with which of the following properties?

Increased sensitivity of pain receptors

A client with a diagnosis of acute appendicitis is awaiting surgical intervention. The nurse listens to bowel sounds and hears none and observes that the abdomen is rigid and boardlike. What complication does the nurse determine may be occurring at this time?

Peritonitis

Which of the following, approved by the U.S. Food and Drug Administration, is the only use for lidocaine 5% (Lidoderm) patch?

Postherpetic neuralgia

A patient with a traumatic amputation of the right lower leg is refusing to look at the leg. Which of the following actions by the nurse is most appropriate?

Provide feedback on the patient's strengths and available resources.

As status asthmaticus worsens, the nurse would expect which acid-base imbalance?

Respiratory acidosis

The nurse observes the physician palpating the abdomen of a client that is suspected of having acute appendicitis. When the abdomen is pressed in the left lower quadrant the client complains of pain on the right side. What does the nurse understand this assessment technique is referred to?

Rovsing's sign

A client who speaks Korean only had emergency surgery. No pain scale was established prior to surgery. To assess the client's pain postoperatively, the nurse

Uses a language translation phone line

Which of the following hormones is secreted by the posterior pituitary?

Vasopressin

Select the nutrient that is important for postoperative wound healing because it helps form collagen.

Vitamin C

Patients diagnosed with malabsorption syndrome may have vitamin and mineral deficiency. Patient who easily bleed have which of the following deficiencies?

Vitamin K

A patient's serum sodium concentration is within the normal range. What should the nurse estimate the serum osmolality to be?

275-300

How should the administration of analgesics be scheduled to provide a uniform level of pain relief to a client?

Administering the analgesics every 3 hours

A patient visited a health care clinic for treatment of upper respiratory tract congestion, fatigue, and sputum production that was rust-colored. Which of the following diagnoses is likely based on this history and inspection of the sputum?

An infection with pneumococcal pneumonia

A group of students are reviewing information about cast composition in preparation for a discussion on the advantages and disadvantages of each. The students demonstrate understanding of the topic when they cite which of the following as an advantage of a plaster cast?

Better molding to the client

A patient has stepped in a hole in the yard, causing an ankle injury. The ankle is edematous and painful to palpation. How long should the nurse inform the patient that the acute inflammatory stage will last?

Between 24 and 48 hours

Which of the following diseases is a chronic, progressive, hereditary disease of the nervous system that results in progressive involuntary dancelike movements and dementia?

Huntington disease

The nurse caring for an elderly patient diagnosed with diarrhea is administering and monitoring the patient's medications. Because one of the patient's medications is digitalis (digoxin [Lanoxin]), the nurse monitors the patient closely for which of the following?

Hypokalemia

The nurse reviews a patient's lab results and notes a serum calcium level of 7.9 mg/dL. The nurse knows that this reading can also be associated with which of the following?

Impaired myocardial contractility

A nurse is assisting a client with mild chronic obstructive pulmonary disease (COPD) to set a goal related to the condition. Which of the following is an appropriate goal for this client?

Increase walking distance around a city block without shortness of breath

A patient has been brought to the ED with altered LOC, high fever, and a purpura rash on the lower extremities. The family states the patient was complaining of neck stiffness earlier in the day. What action should the nurse do first?

Initiate isolation precautions

A patient is being seen in the ER following a motor vehicle accident (MVA). He is having severe back pain. The preferred route of administration of medication in the most acute care situations is which of the following routes?

Intravenous

A nurse is working with a student nurse who is caring for a client with an acute bleeding cerebral aneurysm. Which action by the student nurse requires further intervention?

Keeping the client in one position to decrease bleeding

Which diagnostic is most commonly used for spinal cord compression?

MRI

A black client with asthma seeks emergency care for acute respiratory distress. Because of this client's dark skin, the nurse should assess for cyanosis by inspecting the:

Mucous membranes

An elderly client is preparing to undergo surgery. The nurse participates in preoperative care knowing that which of the following is the underlying principle that guides preoperative assessment, surgical care, and postoperative care for older adults?

Older adults have less physiologic reserve (or ability to regain physical equilibrium) than younger clients

A patient is scheduled to have a cholecystectomy. Which of the nurse's finding is least likely to contribute to surgical complications?

Osteoporosis

Which medication does the nurse anticipate administering to antagonize the effects of potassium on the heart for a patient in severe metabolic acidosis?

Sodium bicarbonate

Which client would the nurse recognize as having the greatest risk for complications during the intraoperative or postoperative period?

The 35-year-old client with non-insulin dependent diabetes

Perfusion refers to blood supply to the lungs, through which the lungs receive nutrients and oxygen. What are the two methods of perfusion?

The bronchial and pulmonary circulation

When should the nurse plan the rehabilitation of a patient who is having an ischemic stroke?

The day the patient has the stroke

A perioperative nurse is conducting an in-service education program about maintaining surgical asepsis during the intraoperative period. Which of the following would the nurse emphasize?

The edges of a sterile package, once opened, are unsterile

The body of a critically ill client may use which of the following homeostatic mechanisms to maintain normal pH?

The lungs eliminate carbonic acid by blowing off more CO2

You are caring for a client who needs to ambulate. What considerations should be included when planning the postoperative ambulatory activities for the older adult?

Tolerance

A 53-year-old male is a regular client in the respiratory group where you practice nursing. As with all adults, millions of alveoli form most of the pulmonary mass. The squamous epithelial cells lining each alveolus consist of different types of cells. Which type of the alveoli cells produce surfactant?

Type II cells

A perioperative nurse is assigned to complete a preoperative assessment on a patient who is scheduled for surgery for kidney stones. The nurse knows that the surgery is scheduled the following day and would therefore be classified as:

Urgent

The client is postoperative for a total hip arthroplasty and denies pain when asked by the nurse. The client remains still in the bed and refuses to move. She finally reports feeling pressure at the site upon continued questioning by the nurse. The best nursing intervention is to

Use the term "pressure" when asking the client about pain

A client with heart failure must be monitored closely after starting diuretic therapy. The best indicator for the nurse to monitor is:

Weight

After surgery to treat a hip fracture, a client returns from the postanesthesia care unit to the medical-surgical unit. Postoperatively, how should the nurse position the client?

With the leg on the affected side abducted

A patient with symptoms of Cushing syndrome is admitted to the hospital for evaluation and treatment. The nurse is creating a plan of care for the patient. Which of the following is an appropriate nursing diagnosis?

Self-care deficit related to weakness, fatigue, muscle wasting, and altered sleep patterns

A client with heart failure has been receiving an intravenous infusion at 150 mL/hr. Now the client is short of breath. The nurse auscultates crackles bilaterally and notes neck vein distention and tachycardia. Using critical thinking skills, what should the nurse do first?

Slow the infusion and notify the physician

The surgical client has been intubated and general anesthesia has been administered. The client exhibits cyanosis, shallow respirations, and a weak, thready pulse. The nurse recognizes that the client is in which stage of general anesthesia?

Stage IV

The nurse receives an order to obtain a sputum sample from a client with hemoptysis. When advising the client of the physician's order, the client states not being able to produce sputum. Which suggestion, offered by the nurse, is helpful in producing the sputum sample?

Take deep breaths and cough forcefully

The nurse informs the patient that a preventive approach for pain relief will be used, involving nonsteroidal anti-inflammatory drugs. What will this mean for the patient?

The pain medication will be administered before the pain is experienced.