Provider 1 Quiz 2

After assessing a client with an involuntary loss of urine, the nurse suspects overflow incontinence. Which symptom supports the nurse's suspicion? 1 Constant dribbling of urine 2 Abrupt and strong urge to void 3 Loss of urine with physical exertion 4 Large amount of urine loss with each occurrence

1

After reviewing the urinalysis reports of a client with a renal disorder, the nurse concludes that the client may have a urinary tract infection. Which urinary laboratory findings enabled the nurse to make this conclusion? Select all that apply. 1 pH: 8.5 2 Specific gravity: 1.010 3 Red blood cells: 3/hpf 4 Osmolality: 1500 mOsm/kg (1500 mmol/kg) 5 White blood cells: 6/hpf

1,5

Which clinical finding should the nurse evaluate before continuing the administration of intravenous (IV) magnesium sulfate therapy? 1 Temperature and respirations 2 Patellar reflexes and urinary output 3 Urinary glucose and specific gravity 4 Level of consciousness and funduscopic appearance

2

A nurse is caring for a client whose laboratory values indicate the presence of hyponatremia. Which factors does the nurse determine were the most likely cause of the hyponatremia? Select all that apply. 1 Diabetes insipidus 2 Profuse diaphoresis 3 Excess sodium intake 4 Removal of the parathyroid glands 5 Rapid intravenous (IV) infusion of 5% dextrose in water

2,5

An older client with the diagnosis of dementia, Alzheimer type, is admitted to a nursing home. The client is confused and forgetful, wanders, and has intermittent episodes of urinary incontinence. How should the nurse plan to meet this client's elimination needs? 1 By pointing out the behavior to the client 2 By obtaining incontinence pads for the client 3 By taking the client to the bathroom at regular intervals 4 By encouraging the client to call for help when there is an urge to urinate

3

Which medication requires the nurse to monitor the client for signs of hyperkalemia? 1 Furosemide 2 Metolazone 3 Spironolactone 4 Hydrochlorothiazide

3

A client who was admitted to the hospital with a diagnosis of a renal calculus is successful in passing the stone. The nurse is preparing the client for discharge and should include what in the client's instructions? 1 "Strain all urine." 2 "Increase fluid intake." 3 "Limit dietary potassium." 4 "Maintain bed rest for 24 hours."

2

A client with a history of hypertension develops pedal edema and hepatomegaly. Which condition does the nurse determine the client is experiencing? 1 Left ventricular failure 2 Right ventricular failure 3 Restrictive pulmonary disease 4 Obstructive pulmonary disease

2

An older adult with peripheral vascular disease has stopped smoking, and the client's children want to make the home environment safe. What should the home healthcare nurse emphasize when providing instructions? 1 Observe for evidence of blurred vision 2 Use measures that can prevent thermal injuries 3 Reduce fluid intake to prevent peripheral edema 4 Limit activities to reduce the workload on the heart

2

A client with cancer of the prostate requests the urinal at frequent intervals but either does not void or voids in very small amounts. Which does the nurse conclude is most likely the causative factor? 1 Edema 2 Dysuria 3 Retention 4 Suppression

3

A nurse is assessing a client with the diagnosis of primary hypertension. Which clinical finding does the nurse identify as an indicator of primary hypertension? 1 Mild but persistent depression 2 Transient temporary memory loss 3 Occipital headache in the morning 4 Cardiac palpitation during periods of stress

3

Before a transurethral resection of the prostate (TURP), a client asks about what to expect postoperatively. Which response by the nurse is most appropriate? 1 "Your urine will be pink and free of clots." 2 "You will have an abdominal incision and a dressing." 3 "There will be an incision between your scrotum and rectum." 4 "There will be an indwelling urinary catheter and a continuous bladder irrigation in place."

4

A client is admitted with dehydration. Which findings should the nurse expect the client to exhibit? Select all that apply. 1 Supple skin turgor 2 Rapid, thready pulse 3 Decreased hematocrit 4 Elevated specific gravity 5 Adventitious breath sounds

2,4

A nurse is assessing a client for dehydration. The client has had diarrhea and vomiting for 48 hours. Which assessment findings alert the nurse that the client is dehydrated? Select all that apply. 1 Protruding eyeballs 2 Postural hypotension 3 The client reporting eating an average of three meals daily 4 The skin on the client's forehead remains tented after being pinched 5 Within four days, the client gained two pounds (0.9 kg) of weight

2,4

A client who just had a transurethral resection of the prostate reports pain in the operative area. What should the nurse do first? 1 Administer the prescribed analgesic. 2 Inspect the drainage tubing for occlusion. 3 Encourage intake of fluids to dilute urine. 4 Assess vital signs before administering an analgesic.

2

A client with hypertension is scheduled for a scan and electrolyte studies. During an interview with the nurse, the client exclaims, "I don't know why I just can't get a prescription for high blood pressure pills; that probably is all it is. I'm missing work by being here." Which is the best response by the nurse? 1 "It might not be high blood pressure. We have to be sure." 2 "It's frustrating to miss work and not know for sure what's wrong." 3 "I know it's frustrating, but you need to have a diagnostic workup." 4 "Maybe you could ask your primary healthcare provider if the tests could be done on separate days."

2

An older client with hypertension is admitted to the hospital. Which data from the client's history and diagnostic workup represent risk factors for hypertension? Select all that apply. 1 Taking an aspirin a day 2 Occasional cocaine use 3 Reduced hemoglobin level 4 African-American heritage 5 Increased high-density lipoprotein (HDL)

2,4

Which findings in the older client are associated with a urinary tract infection (UTI)? Select all that apply. 1 Fever 2 Urgency 3 Confusion 4 Incontinence 5 Slight rise in temperature

3,4,5

Which nursing intervention should the nurse consider to be a priority for clients with fluid overload? 1 Ensuring client safety 2 Providing drug therapy 3 Providing nutritional therapy 4 Preventing future fluid overload

1

A client who has been taking spironolactone is admitted to the hospital with hypokalemia. The nurse will assess the client for which clinical findings? Select all that apply. 1 Lethargy 2 Thready, weak pulse 3 Muscle weakness 4 Hyperactive deep tendon reflexes 5 Numbness and tingling of the hands and feet

1,2,3

A client who has been immobile for a prolonged time develops hypercalcemia. Which findings are consistent with this condition? Select all that apply. 1 Bone pain 2 Convulsions 3 Muscle spasms 4 Tingling of extremities 5 Depressed deep tendon reflexes

1,5

The student nurse is collecting a clean-catch midstream urine specimen from a client suspected of urinary tract infection. After reviewing the results, the head nurse instructs the student nurse to repeat the procedure. Which finding in the urinalysis report supports the head nurse's instruction? 1 10^2 organisms/mL 2 10^4 organisms/mL 3 10^6 organisms/mL 4 10^8 organisms/mL

2

What is a clinical manifestation of hypernatremia in burns? 1 Fatigue 2 Seizures 3 Paresthesias 4 Cardiac dysrhythmias

2

A client being treated for uncontrolled hypertension and chest pain calls out to the nurse and reports a nosebleed. Upon entry to the client's room, the nurse immediately applies pressure. Which action should the nurse take next? 1 Add humidity to the client's oxygen prescribed at 2 L/minute via nasal cannula. 2 Assess the client for further injuries indicative of a possible fall. 3 Assess the client's blood pressure. 4 Assess the client's pulse rate.

3

A nurse is teaching a group of clients with peripheral vascular disease about a smoking cessation program. Which physiologic effect of nicotine should the nurse explain to the group? 1 Constriction of the superficial vessels dilates the deep vessels. 2 Constriction of the peripheral vessels increases the force of flow. 3 Dilation of the superficial vessels causes constriction of collateral circulation. 4 Dilation of the peripheral vessels causes reflex constriction of visceral vessels.

2

A nurse is weighing a client with heart failure. The client weighed 175 lb (79.4 kg) on the last visit and has had a 5% weight gain since then. The nurse suspects that the client is retaining fluid. How many liters of fluid has the client retained? Record your answer using a whole number. ___ liters

4L

A client who experienced extensive burns is receiving intravenous fluids to replace fluid loss. The nurse should monitor for which initial sign of fluid overload? 1 Crackles in the lungs 2 Decreased heart rate 3 Decreased blood pressure 4 Cyanosis

1

A client with a history of heart failure and atrial fibrillation reports a nine-pound (four kilogram) weight gain in the last two weeks. Which factor does the nurse consider as the most likely cause of this sudden weight gain? 1 Fluid retention 2 Urinary retention 3 Renal insufficiency 4 Abdominal distention

1

A client is admitted for dehydration, and an intravenous (IV) infusion of normal saline is started at 125 mL/hour. One hour later, the client begins screaming, "I can't breathe!" How should the nurse respond? 1 Discontinue the IV and notify the healthcare provider. 2 Elevate the head of the client's bed and obtain vital signs. 3 Assess the client for allergies and change the IV to an intermittent lock. 4 Contact the healthcare provider to request a prescription for a sedative.

2

A client seeks help for dealing with incontinence. A nursing intervention is to teach Kegel exercises. Which type of incontinence is the client most likely experiencing? 1 Reflex incontinence 2 Stress incontinence 3 Overflow incontinence 4 Functional incontinence

2

An older adult in an acute care setting is having urinary incontinence. Which interventions would help the client? Select all that apply. 1 Provide nutritional support 2 Provide voiding opportunities 3 Avoid indwelling catheterization 4 Provide beverages and snacks frequently 5 Promote measures to prevent skin breakdown

2,3,5

The nurse is planning to teach a client with heart failure about the signs and symptoms of cardiac decompensation. What clinical manifestations should the nurse include? Select all that apply. 1 Weight loss 2 Extreme fatigue 3 Coughing at night 4 Excessive urination 5 Difficulty breathing

2,3,5

A client is admitted to the hospital from the emergency department with a diagnosis of urolithiasis. The nurse reviews the client's clinical record and performs an admission assessment. Which is the priority nursing action? 1 Strain the client's urine. 2 Place the client in the high-Fowler position. 3 Administer the prescribed morphine. 4 Collect a urine specimen for culture and sensitivity.

3

A client with a long history of cardiovascular problems, including angina and hypertension, is scheduled to have a cardiac catheterization. During preprocedure teaching, what does the nurse explain to the client is the major purpose for catheterization? 1 To obtain the pressures in the heart chambers 2 To determine the existence of congenital heart disease 3 To visualize the disease process in the coronary arteries 4 To measure the oxygen content of various heart chambers

3

After a transurethral prostatectomy, a client returns to the postanesthesia care unit with a three-way indwelling catheter with continuous bladder irrigation. Which nursing action is the priority? 1 Observing the suprapubic dressing for drainage 2 Maintaining the client in the semi-Fowler position 3 Monitoring for bright red blood in the drainage bag 4 Encouraging fluids by mouth as soon as the gag reflex returns

3

A nurse assesses for hypocalcemia in a postoperative client. What is one of the initial signs that might be present? 1 Headache 2 Pallor 3 Paresthesias 4 Blurred vision

3 (tingling "pins and needles")

A nurse is conducting cholesterol screening for a manufacturing corporation during a health fair. A 50-year-old man who is 6 feet (183 cm) tall and weighs 293 pounds (133 kg) puts out his cigarette and asks the nurse how to modify his risk factors for coronary artery disease. On which risk factors should the nurse help the client focus? Select all that apply. 1 Age 2 Height 3 Weight 4 Smoking 5 Family history

3,4

A nurse in a long-term care facility is caring for a bedridden client with multiple chronic illnesses. Although usually continent, the client expresses anger through urinary incontinence. What should the nurse do to best address this situation? 1 Offer the client a bedpan every 2 hours. 2 Encourage the client to watch more television. 3 Decrease the client's fluid intake in the evening. 4 Assist the client in setting realistic short-term goals.

4

A nurse is assessing a client with a diagnosis of early left ventricular heart failure. Specific to this type of heart failure, what statement by the client would the nurse expect? 1 "My ankles are swollen." 2 "I am tired at the end of the day." 3 "When I eat a large meal, I feel bloated." 4 "I have trouble breathing when I walk rapidly."

4

A client whose total cholesterol level is found to be 210 mg/dL (5.5 mmol/L) at a screening session at a health fair asks the nurse what to do in light of this result. How should the nurse respond? 1 "Your cholesterol is high, and you may need medication." 2 "This is within the acceptable range, and no action is required." 3 "Your level is low; you should eat more foods that contain cholesterol." 4 "Your cholesterol is elevated slightly. A diet low in saturated fats should be followed."

4

A client with a history of hypertension and left ventricular failure arrives for a scheduled clinic appointment and tells the nurse, "My feet are killing me. These shoes got so tight." What is the nurse's best initial action? 1 Weigh the client. 2 Notify the primary healthcare provider. 3 Take the client's pulse rate. 4 Listen to the client's breath sounds.

4

A healthcare provider prescribes furosemide for a client with hypervolemia. The nurse recalls that furosemide exerts its effects in what part of the renal system? 1 Distal tubule 2 Collecting duct 3 Glomerulus of the nephron 4 Loop of Henle

4

While reviewing the result of an intravenous pyelogram, the nurse discovers that the client has a shortened urethra. The client also complains of urinary incontinence. Which nursing intervention is beneficial for the client? 1 Providing thorough perineal care after each voiding 2 Encouraging the client to use the toilet or bedpan every 2 hours 3 Responding quickly to the client's indication of the need to void 4 Providing privacy, assistance, and voiding stimulants over the perineum

1

When receiving hemodialysis, the client may develop hyponatremia. For which clinical findings associated with hyponatremia should the nurse assess the client? Select all that apply. 1 Diarrhea 2 Seizures 3 Chvostek sign 4 Cardiac dysrhythmias 5 Increased temperature

1,2

A client's laboratory report indicates hyperkalemia. Which responses should the nurse expect the client to exhibit? Select all that apply. 1 Anorexia 2 Vomiting 3 Constipation 4 Muscle weakness 5 Irregular heart rate

2,4,5

The nurse assesses an elderly client with a diagnosis of dehydration and recognizes which finding as an early sign of dehydration? 1 Sunken eyes 2 Dry, flaky skin 3 Change in mental status 4 Decreased bowel sounds

3

A 75-year-old client with a history of hypertension has arrived for a routine annual health screening. The nurse obtains a sitting blood pressure in the client's left arm of 160/100 mm Hg. What action should the nurse take next? 1 Advise the client to restrict fluid and sodium intake, then begin to develop a teaching plan for the client. 2 Inform the primary healthcare provider immediately of the client's blood pressure reading. 3 Record the findings, recognizing that the result is expected for an older adult with a history of hypertension. 4 Evaluate the client for symptoms related to extreme hypertension.

4

A nurse expects that a client with right-sided heart failure will exhibit which of these signs or symptoms? 1 Oliguria 2 Pallor 3 Cool extremities 4 Distended neck veins

4

An 80-year-old client is admitted to the hospital because of complications associated with severe dehydration. The client's daughter asks the nurse how her mother could have become dehydrated, because she is alert and able to care for herself. The nurse's best response is: 1"The body's fluid needs decrease with age because of tissue changes." 2"Access to fluid may be insufficient to meet the daily needs of the older adult." 3"Memory declines with age, and the older adult may forget to ingest adequate amounts of fluid." 4"The thirst reflex diminishes with age, and therefore the recognition of the need for fluid is decreased."

4

Which clinical finding would the nurse associate with hypokalemia? 1 Edema 2 Muscle spasms 3 Kussmaul respirations 4 Muscle weakness

4

Which urinalysis finding indicates a urinary tract infection? 1 Presence of crystals 2 Presence of bilirubin 3 Presence of ketones 4 Presence of leukoesterase

4

A client with limited mobility is being discharged. To prevent urinary stasis and formation of renal calculi, what should the nurse instruct the client to do? 1 Increase oral fluid intake to 2 to 3 L/day. 2 Maintain bed rest after discharge. 3 Limit fluid intake to 1 L/day. 4 Void at least every hour.

1

The nurse provides discharge teaching for a client with a history of hypertension who had a femoropopliteal bypass graft. Which client statement indicates teaching is effective? 1 "I should massage my calves and feet every day." 2 "I should keep my foot elevated when I am in bed." 3 "I should sit in a hot bath for half an hour twice a day." 4 "I should observe the color and pulses of my legs every day."

4

The nurse is caring for a client admitted with fluid overload. Which tasks are most appropriate to be delegated to the patient care associate? Select all that apply. 1 Documenting vital signs 2 Documenting urine output 3 Assessing the laboratory findings 4 Administering diuretic intravenously 5 Repositioning the client every one or two hours

1,2,5

A client is admitted with renal calculi. Which clinical manifestations does a nurse expect the client to report? Select all that apply. 1 Blood in the urine 2 Irritability and twitching 3 Dry, itchy skin and pyuria 4 Frequency and urgency of urination 5 Pain radiating from the kidney to a shoulder

1,4

A client who develops heart failure has a serum potassium level of 2.3 mEq/L (2.3 mmol/L). Digoxin and potassium chloride are prescribed. What action should the nurse take? 1 Double the dose of potassium chloride and administer it with the prescribed digoxin. 2 Hold the dose of digoxin, administer the potassium chloride, and call the primary healthcare provider immediately. 3 Give the digoxin and potassium chloride as prescribed and report the laboratory results to the primary healthcare provider. 4 Administer the prescribed digoxin and potassium chloride with a glass of orange juice and continue to monitor the client.

2

A nurse is caring for a client with a diagnosis of renal calculi secondary to hyperparathyroidism. Which type of diet should the nurse explore with the client when providing discharge information? 1 Low purine 2 Low calcium 3 High phosphorus 4 High alkaline ash

2

A nurse is providing preoperative teaching for a client who is scheduled for a transurethral resection of the prostate. To prepare the client what to expect postoperatively, which instructions should the nurse include in the teaching session? 1 The urine will be bright red for 24 to 48 hours. 2 Spasms of the bladder occur during the first 24 to 48 hours. 3 To decrease bladder contractions, the Valsalva maneuver and Kegel exercises will be encouraged. 4 To maintain proper fluid balance, oral fluids are restricted during continuous urinary bladder irrigations.

2

An African-American woman is diagnosed with primary hypertension. She asks, "Is hypertension a disease of African-American people?" What is the nurse's best response? 1 "The prevalence of hypertension is about equal for women of all races." 2 "The higher-risk population is composed of African-American men and women." 3 "The highest-risk population consists of older Caucasian-American men and women." 4 "The prevalence of hypertension is greater for African-American men than for African-American women."

2