Advanced Med Surge 1 Final

A nurse is teaching a client who has chronic kidney failure about planning a low-protein diet. The client states, "Why do I have to be concerned about protein?" Which of the following responses should the nurse make?

"A low-protein diet reduces the risk for uremia.

A nurse is caring for a client who has cancer and is receiving palliative care. Which of the following statements by the client indicates they understand this type of treatment?

"I am hoping this will limit my discomfort."

A nurse is caring for a client who has named a person to serve as his health care proxy. The client states he needs clarification about his type of advance directive. Which of the following statements by the client indicates a need for clarification?

"I have to choose a family member as my health proxy"

A nurse is caring for a client who has contact dermatitis of the neck and upper chest. Which of the following is an expected finding?

Report of exposure to a skin irritant.

A nurse is monitoring an older adult female client who had a myocardial infarction (MI) for the development of an acute kidney injury. Which of the following findings should the nurse identify as indicating an increased risk of acute kidney injury (AKI) ?

Serum creatinine 1.8mg/dL

A nurse is reviewing laboratory findings for four client. Which of the following clients has manifestations of acute kidney injury?

Serum creatinine 6 mg/dL.

A nurse is caring for a client who has a new diagnosis of human immunodeficiency virus (HIV). He states, " I don't care what the doctors say, there is no way I can have HIV, and I don't need treatment for something I don't have." The nurse identifies that the client is experiencing which of the following types of crisis?

Situational

A nurse is reviewing a client's CBC findings and discovers that the client's platelet count is 9,000/mm3. The nurse should monitor the client for which of the following conditions?

Spontaneous bleeding

A nurse is admitting a client who has hepatitis C. Which of the following precautions should the nurse implement?

Standard

A nurse is administering platelets to a client who reports having lower back pain and feeling chilled and itchy. Which of the following actions should the nurse take first?

Stop the infusion

A nurse is assessing a client for suspected anaphylactic reaction following a CT scan contrast media for which of the following client findings should the nurse intervene first?

Stridor

A nurse is reviewing the medical record for a client who has health care-associate infection (HAI). The nurse should identify which of the following findings as a risk factor for acquiring an HAI?

The client is 71 years old

A nurse is setting goals for a client who has AIDS and is at the end of life. Which of the following are realistic goals?

The client will receive medication to minimize episodes of breakthrough pain

A nurse is admitting a child who has leukemia. Which of the following clients shuold the nurse place in the same room with this child?

A child who has nephrotic syndrome.

A nurse is assessing clients in a health clinic for risk factors for contracting hepatitis. Which of the following clients is at risk for developing hepatitis C?

A client who has multiple tattoos

What medication should you discontinue three months prior to a plan pregnancy?

When on Methotrexate discontinue the drug at least 3 months before planned pregnancy and use strict birth control.

A nurse is providing discharge teaching to a client following open radical prostatectomy. The client is going home with an indwelling urinary catheter. Which of the following statements by the client indicates an understanding of the teaching?

"I will change the catheter drainage bag once each week."

A client with a history of HSV-2 infection asks the nurse about future sexual activity. Which of the following responses would be most appropriate?

"Inform all potential sexual partners about the infection, even if it is inactive.".

A nurse is teaching a new group of assistive personnel (AP) about the importance of hand hygiene. Which of the following statements should the nurse include?

"Rub all surfaces of your hands with an alcohol rub for 20 to 30 seconds."

Which health teaching by the nurse is important for clients diagnosed with systemic lupus erythematosus? Select all that apply.

"Take frequent rest periods to prevent fatigue." "Avoid sun exposure to prevent disease flare-ups." "Report fever to your health care provider immediately" "Use a mild soap for bathing to prevent skin irritation."

A client states, "Why do I feel relief now that my dad is gone?" Which of the following responses should the nurse make?

"Tell me what you are thinking?"

A nurse is reviewing the cause of gout with a group of nurses. Which of the following statements should the nurse make?

"The intra-articular deposition of urate crystals causes inflammation."

A nurse is caring for a client who asks about the functions of the thymus, spleen, and lymph nodes. Which of the following responses should the nurse make?

"These organs support immunity."

A client has a white blood cell change in which the number of suppressor T-cells is well below normal and asks the nurse what type of health problem(s) could be expected as a result of this deficiency. What is the nurse's best response?

"You will be more prone to allergic reactions when exposed to allergens or drugs."

A nurse is teaching a client who has a new diagnosis of atopic dermatitis. Which of the following statements should the nurse include in the teaching?

"Your provider may recommend a daily antihistamine to help control your symptoms"

A nurse is caring for a group of clients on a medical-surgical unit. Which of the following situations requires that the nurse wear gloves?

- Changing an ostomy pouch. -Providing oral care. - Emptying urine from an indwelling urine collection bag.

A nurse is creating the plan of care for a client who is immunosuppressed. Which of the following precautions should the nurse include in the plan? (Select all that apply.)

- Don a mask, gloves, and gown. - Restrict visitors who have active infections - Frequent hand hygiene/ eat cooked foods

A nurse is caring for a client who is 4 hrs postoperative following a kidney biopsy. Which of the following interventions should the nurse take. (Select all that apply).

- monitor for hematuria. -check for flank pain3.

A nurse is preparing a teaching session about reducing the risk of complications of diabetes mellitus which of the following information should the nurse plan to include in the teaching? (Select all that apply)

-Enroll in a smoking cessation program -Reduce cholesterol and saturated fat intake -Maintain optimal blood pressure to prevent kidney damage -Increase physical activity and daily exercise

A clinic nurse is performing a physical assessment on a client who has systemic lupus erythematosus. Which of the following findings should the nurse expect?

A dry, red rash across the bridge of the nose and on the cheeks

A nurse is admitting a client who has multiple myeloma and a white blood cell count of 2,200/mm. Which of the following foods should the nurse prohibit the family members from bringing to the client?

A fresh fruit basket.

A group of nurses are discussing risk factors for transmission of human immunodeficiency virus (HIV) from clients. Which of the following individuals should the nurse identify as being at the greatest risk for contracting HIV?

A phlebotomist who collects blood from clients who have HIV

The client is admitted with a diagnosis of rule-out tuberculosis. Which type of isolation procedures should the nurse implement?

Airborne Precautions

A nurse is teaching a client who has gout about dietary restrictions. The nurse should teach that which beverage can trigger an attack?

Alcohol

A nurse is discussing kidney transplant with a client who has end-stage renal disease (ESRD). Which of thefollowing should the nurse identify as a contraindication for this treatment?

Alcohol use disorder

A nurse is reviewing the laboratory results of an adolescent females client and notes a WBC count of 16,000/mm3 with increased immature neutrophils (bands) and normal monocytes. Which of the following is appropriate analysis of the results?

An acute infectious process

A nurse is assessing a client who has diabetes mellitus and reports foot pain. The nurse should evaluate the client for which of the following alterations as indications that the client has an infection? (Select all that apply.)

An increase in neutrophils. Localized edema

A nurse is teaching a group of newly licensed nurses on effective techniques for counseling clients about sexually transmitted infections (STIs). Which of the following statements should the nurse include in the teaching?

Ask about the client's exposure to any past or present STIs.

A nurse is preparing to administer pot RBCs To a client who Has Hgb of 8 g/dL. Which of the following actions should the nurse plan to take during the first 15 minutes of the transfusion?

Assessed for a cute hemolytic reaction

A nurse in an emergency department is caring for a client who has anaphylaxis following a bee sting. Which of the following actions should the nurse take first?

Auscultate for wheezing.

A nurse is providing teaching to a client who has Hodgkin's Lymphoma and is undergoing external radiation treatment. Which of the following instructions should the nurse include?

Avoid direct sun exposure to the skin

A nurse is providing teaching to a client who has a new diagnosis of type 2 diabetes mellitus. The nurse should recognize that the client understands the teaching when he identifies which of the following as manifestations of hypoglycemia? Select all that apply

Blurred vision Tachycardia Moist, clammy skin

Multiply myeloma question

Bone pain is the answer.

A nurse is assessing the respiratory pattern of an older adult client who is receiving end of life care (palliative care). Which of the following findings should the nurse identify as Cheyne-stokes respiration?

Breathing ranging from a very deep to very shallow with periods of apnea

A nurse is administering an IM injection to a client who has hepatitis C. Before placing the syringe and needle in a puncture-resistant container, which of the following actions should the nurse take?

Dispose of the needle uncapped

Who is the primary person responsible for designating a patient as a DNR?

Doctor

A nurse is caring for a client who has HIV. Which of the following laboratory values is the nurse's priority?

CD4-T-cell count 180 cells/mm

A nurse in a clinic is assessing a client who has AIDS and a significantly decreased CD4-T-cell count. The nurse should recognize that the client is at risk for developing which of the following infectious oral conditions?

Candidiasis

A nurse is caring for an adult who has atopic dermatitis. Which of the following findings should the nurse expect?

Chronic rash with the skin

A nurse is caring for a client who is HIV positive and is one day postoperative following an appendectomy. The nurse should wear a gown as personal protective equipment when taking which of the following actions?

Completing a dressing change

A nurse is admitting a client who has a wound infection with vancomycin-resistant enterococci (VRE). Which of the following types of precautions should the nurse plan to initiate?

Contact

A nurse is caring for a client who has metastatic bone cancer. The client states, "I want to go home to die." The family is concerned about meeting the client's care needs at home. Which of the following actions should the nurse take?

Discuss initiating hospice care with the client and family

A nurse is caring for a client with an infected wound removes a dressing saturated with blood and purulent drainage. How should the nurse dispose of the dressing?

Dispose of the dressing in a biohazardous waste container.

A nurse is reviewing the laboratory results of a client who has acute leukemia and received an aggressive chemotherapy treatment 10 days ago. Which of the following hematologic laboratory values should the nurse expect? (Select all that apply.)

Decreased platelet count Decreased leukocyte count Decreased erythrocyte count

A nurse in a dialysis center is caring for a client who has a new diagnosis of end-stage kidney disease. When he arrives for his first dialysis treatment, he tells the nurse, "I decided to come today, but I am not sure if I will need to come back again this week. I am feeling much better since my discharge from the hospital and I think my kidneys are working again." The nurse should identify that this client is demonstrating which of the following Kubler-Ross stages of grief?

Denial

A nurse is caring for a client the night before a scheduled intravenous urography. Which of the following is the nurse's priority intervention?

Determine if the client has an allergy to iodine or shellfish.

A nurse is teaching a client who starting to take methotrexate to treat rheumatoid arthritis. Which of the following instructions should the nurse include in the teaching?

Drink at least 2 liters of water daily/ using contraceptive.

A nurse is admitting a client who has pertussis. Which of the following types of transmission-based precautions should the nurse initiate?

Droplet

A nurse in a community health clinic is administering the seasonal inactive influenza vaccine. before administering the nurse must confirm the client isn't allergic to .

Eggs

A nurse is caring for a client in the orientation phase of the nurse-client relationship. Which of the following communication techniques should the nurse use during this phase?

Elicit information from the client

A nurse is presenting information to the public about preventive measure to reduce the risk for contracting West Nile virus. Which of the following instructions should the nurse include?

Encourage the use of mosquito repellant

Which of the following actions should a nurse take prior to starting a blood transfusion?

Ensure that informed consent has been obtained from the client.

Which signs and symptoms does the nurse expect to find in clients with any type of anemia?

Exercise intolerance Fatigue Tachycardia

A nurse is assessing a client for early manifestations of rheumatoid arthritis (RA). Which of the following changes is an early manifestation of RA?

Fatigue

A nurse is teaching a client about the physical effects of chemotherapy. Following the teaching, the nurse asks the client to describe one physical effect. The nurse is focusing on which of the following elements of the communication process?

Feedback

A nurse is teaching a group of teenage clients about the use of condoms for the prevention of sexually transmitted infections (STIs). Which of the following statements should the nurse include in the teaching?

Female condoms can help prevent transmission of sexually transmitted viruses.

A nurse is caring for a client who received a diagnosis of the systemic scleroderma 5 years ago. The nurse plans to assess the clients to document the disease's progression. In addition to skin changes, which of the following findings should the nurse expect?

Finger contractures

A nurse is presenting a community-based program about HIV and AIDS. A client asks the nurse to describe the initial symptoms experienced with HIV infection. Which of the following manifestations should the nurse include in the explanation of initial symptoms?

Flu-like symptoms and night sweats

A nurse is assessing a client who has a history of HIV with phagocytic dysfunction. The nurse should monitor this client for which of the following conditions?

Fungal infection

A nurse has completed care procedures for a client who requires airborne precautions. Which of the following items of personal protective equipment (PPE) should the nurse remove first?

Gloves

A nurse is assessing a client in the oliguric phase of acute kidney injury. Which of the following findings should the nurse expect?

Hyperkalemia

A nurse in an allergy clinic is caring for a client who has a history of seasonal allergy symptoms. The client had a radioallergosorbent test (RAST) completed on a previous visit. The nurse should recognize that an elevation in which of the following immunoglobulins indicate a positive result?

Immunoglobulin E (IgE)

A nurse is preparing to administer lispro insulin to a client who has type 1 diabetes mellitus. Which of the following actions should the nurse take

Inject the insulin 15 min before a meal.

A nurse is planning a presentation about HIV for a church-based group. Which of the following information about HIV transmission should the nurse include?

It is primarily transmitted through direct contact with infected body fluids.

A nurse is a provider's office is assessing a client who has AIDS. Then nurse notes that the client has multiple and widespread raised, purplish-blown skin lesions. The nurse should recognize that these findings indicate which of the following conditions?

Kaposi's sarcoma

Nephrotic syndrome diagnosed by

Kidney biopsy

A nurse is planning care for a client who has immunosuppression following chemotherapy. Which of the following interventions should the nurse include in the plan of care?

Limit the number of health care workers entering the room.

A nurse is planning care for a client who has an absolute neutrophil count less than 1,000/mm3. Which of the following interventions should the nurse include in the plan

Limit visitors to healthy adults.

nurse is assessing a client who has a puncture wound on his foot. which of the following findings is a manifestation of acute osteomyelitis.

Localized erythema

A nurse has completed care procedures for a client who requires airborne precautions. Which of the following items of PPE should the nurse remove last?

Mask

A nurse is caring for a client who requires droplet precautions Which of the following personal protective equipment should the nurse wear when setting up the client's meal tray?

Mask

A nurse is teaching with a client about taking high doses of oral glucocorticoids for an extended period of time to treat RA. Which of the following instructions should the nurse include in the teaching?

Monitor for compression fractures of the back and neck

A nurse is caring for a client who is participating in a research study for an experimental chemotherapy medication. After three treatments, the experimental medication is discontinued due to evidence of rapidly advancing kidney failure. The nurse should understand discontinuing this medication demonstrates which of the following ethical principles?

Non-malificience

A nurse is implementing a plan of care for a client who has AIDS with recurring pneumonia. Which of the following actions should the nurse take?

Obtain a sputum culture

A nurse in a clinic is caring for a female client who was exposed to gonorrhea. Which of the following actions should the nurse take?

Obtain information about the client's recent sexual experiences

A nurse preceptor is observing a newly licensed nurse on the unit who is preparing to administer a blood transfusion to an older adult client. Which of the following actions by the newly licensed nurse indicates an understanding of the procedure?

Obtains VS every 15 min throughout the procedure

A nurse is teaching a newly hired group of assistive personnel (AP) about infection-control measures on the unit. It is crucial for the nurse to remind the APs that which of the following is the most effective way to prevent the spread of pathogens during client care?

Performing hand hygiene frequently and consistently

A nurse is preparing the admission of a client who has active TB. Which of the following precautions should the nurse take?

Place the client in a private room with ventilation system./ Assign the client to a negative airflow pressure room.

A nurse is planning care for a client who has manifestations of Clostridium difficile (C.Difficile) infection. Which of the following actions should the nurse plan to take?

Place the client on contact precautions

A nurse is reviewing laboratory values of a client who has immune thrombocytopenic purpura (ITP). Which of the lab results should the nurse expect to be decreased?

Platelets

The nurse is caring for a client with chronic kidney disease. Arterial blood gas results indicate a pH of 7.30 (7.30), a Paco2 of 32 mm Hg (32 mm Hg), and a bicarbonate concentration of 20 mEq/L (20 mmol/L). Which laboratory value should the nurse expect to note?

Potassium level of 5.2 mEq/L (5.2 mmol/L)

A nurse is reviewing the medication list for a client who has a new diagnosis of type 2 diabetes mellitus. The nurse should recognize which of the following medications can cause glucose intolerance?

Prednisone

A nurse is caring for a client who has had an allogeneic hematopoietic stem-cell transplant. Which of the following infection-control precautions should the nurse use while care for this client?

Protective Environment

A nurse sees an AP entering the room of a client who requires transmission based precautions without using the appropriate PPE. Which of the following actions should the nurse take first?

Provide the appropriate PPE to the AP

A nurse is caring for a client who experienced an infection at the insertion site of her intravenous catheter. Which of the following findings should the nurse expect?

Purulent drainage is noted from the site.

A patient has recently had CD4 level testing, and the result was found to be 98 cells/mm3. The nurse realizes which condition has developed?

The patient has AIDS.

A nurse is caring for a client who has chemotherapy-induced peripheral neuropathy. The nurse should expect the client to report having experienced which of the following symptoms?

Tingling feeling in the extremities.

A nurse is caring for a client who is taking aspirin for arthritis. The nurse should identify which of the following findings as an adverse effect of this medication?

Tinnitus

A nurse is caring for a client who has a delayed hypersensitivity reaction. The nurse should expect which of the following manifestations?

Tissue damage at the site 36 hours after exposure.

A nurse is teaching a client who has a new diagnosis of genital herpes. Which of the following statements by the client indicates the need for further teaching?

Transmission of the disease will not occur when my lesions are gone

A nurse is caring for a group of clients in an infectious disease unit. The nurse should wear an OSHA-approved N95 respirator mask when caring for a client with which of the following infectious diseases?

Tuberculosis

A nurse is providing discharge teaching about clean intermittent self-catheterization for a client who has benign prostatic hyperplasia. Which of the following instructions should the nurse include?

Use soap and water to wash the catheter after each use

A nurse is teaching a client who has a new prescription for topical betamethasone to treat contact dermatitis. Which of the following instructions should the nurse include?

Use the cream for a few days after application."

A nurse working on a medical unit is completing the admission of a client who reports a severe allergy to penicillin. Which of the following actions should the nurse take?

Verify the client's medication prescriptions do not include cephalosporin.

A nurse is reviewing a client's laboratory values. Which of the following values should the nurse report to the provider?

WBC 1,700/mm3

A nurse is admitting a client who requires droplets precautions due to influenza. Which of the following actions should the nurse take?

Wear a mask when providing care to the client.

A nurse is caring for a client who has methicillin-resistant Staphylococcus aureus (MRSA) in an abdominal wound. The nurse enters the room to check the client's pulse. Which of the following actions should the nurse take?

Wear clean gloves.

Hiv stage

aids cd4 below 200 hiv cd4 above 500

a nurse is reviewing the lab results of an adolescent female client and notes a WBC count of 16,000/ mm3 with increased immature neutrophils and normal monocyteswhich of the following is the appropriate analysis of the results?

an acute infectious process

A nurse is preparing to perform hand hygiene, which of the following actions should the nurse take?

apply 4 to 5 mL of liquid soap to hands

A nurse is assessing a client who has chronic kidney disease for fluid volume increase. Which of the following provides a reliable measure of fluid retention?

daily weight

A nurse in a provider's office is assessing a client who has rheumatoid arthritis. Which of the following findings is a late manifestation of this condition?

decreased range of motion

a nurse is reviewing the laboratory results from a client who has prerenal acute kidney injury (AKI). which of the following electrolyte imbalances should the nurse expect

hyperkalemia

A nurse is assessing a client who has type 1 diabetes mellitus and finds the client lying in bed, sweating, and reportingfeeling anxious. Which of the following complications should the nurse suspect?

hypoglycemia

a nurse is caring for a client who has a nephrotic syndrome and is receiving high dose corticosteroid therapy. for which of the following electrolyte imbalances should the nurse monitor

hypokalemia

A nurse is completing a physical examination of a client and notes that lab values indicate leukocytes. The nurse should recognize that which of the following manifestations is associated with leukocytes?

inflamation

A nurse is caring for a male client who has a new diagnosis of genital herpes (HSV2). Which of the following findings should the nurse expect?

influenza-like symptoms

A nurse is teaching a client who has herpes simplex virus type 2 about disease transmission. Which of the following statements by the client indicates understanding of the teaching?

itching or tingling occurs at the site where a blister forms

When administering a transfusion of packed red blood cells, it is important to

make sure the entire unit is transfused within 4 h

A nurse is caring for a patient with chronic kidney disease. What should the nurse suspect their ABGs to look like?

pH 7.25, HCO3- 19 mEq/L, PaCO2 30mm Hg

A nurse is reviewing the ABG results of a patient who the provider suspects has metabolic acidosis. Which of the following results should the nurse expect to see?

pH<7.35

A nurse is assessing a client who has systemic lupus erythematosus (SLE). Which of the following findings is the highest priority for the nurse to report to the provider

presence of peripheral edema/ increase serum creatinine levels

a nurse cant wear fake nails, because

transmits bacteria

A nurse is admitting a client who requires droplet precautions due to influenza. Which of the following actions should the nurse take?

wear a mask when providing care to the client.