Final Exam Prelim 5-8
A client has been diagnosed with hypothyroidism in the local health care clinic. The nurse should caution the client with hypothyroidism to take precautions when exposed to which of the following
Narcotic sedatives.
A client has been diagnosed with Rheumatoid Arthritis and recently prescribed Hydroxychloroquine (Plaquenil). In teaching the client about this medication, the nurse should make sure to tell the client to visit which of the following while taking this medication?
Ophthalmologist
Which of the following is a non inflammatory disease?
Osteoarthritis
What are the most comonly reported clinical manifestations of multiple sclerosis? Select all that apply.
Pain Spasticity Fatigue
When diagnosing Alzheimer's Disease, the nurse knows that which of the following are ruled out before making a diagnosis? SELECT ALL THAT APPLY
Depression Drug toxicity Vascular dementia CVA Brain tumor
A nurse is teaching a client recovering from Addisonian crisis about the need to take fludrocortisone acetate and hydrocortisone at home. Which statement by the client indicates an understanding of the instructions?
"I'll take two-thirds of the dose when I wake up and one-third in the late afternoon"
The client is being evaluated for osteoporosis. Which of the following diagnostic tests is the most accurate when diagnosing osteoporosis?
Dual energy x-ray absorptiometry (DEXA) scan
A patient has been diagnosed with osteoporosis. Which of the following is not a risk factor for osteoporosis?
Exercising 3-4 days a week
A client with Crohn's Disease understands that this disease can potentially affect what part of the GI tract?
All of the Above B.Mouth C.Colon D.Duodenum
A client is admitted to the hospital with ulcerative colitis. The nurse should assess the client for which of the following complications of the disease?
Anemia
During assessment, the patient verbalizes pain on the right lower quadrant. The nurse knows that the organ(s) affected would be:
Appendix and cecum
The nurse is developing a plan of care for a client newly diagnosed with Bell palsy. The nurse's plan of care should address what characteristic manifestation of this disease?
Facial paralysis
A nurse is caring for a client who experiences debilitating cluster headaches. The client should be taught to take appropriate medications at what point in the course of the onset of a new headache?
As soon as the client senses the onset of symptoms
Which lifestyle adjustment may a patient have to make to best control GERD?
Attain and maintain an ideal body weight.
The client with a history of migraine headaches comes to the clinic and reports that a migraine is coming because the client is experiencing bright spots before the eyes. Which phase of migraine headaches is the client experiencing?
Aura Phase
A 28 year old woman is being seen in the primary health care clinic and has been diagnosed with Grave's disease and has exophthalmia. The nurse should include which of the following instructions to this patient?
Avoid injury by wearing sunglasses outdoors, and keeping eyes moist.
The nurse prepares to administer an H2 receptor antagonist to a client diagnosed with a sliding esophageal hernia. Which of the following drugs is an H2 receptor antagonist?
Famotidine (Pepcid)
A patient is receiving infliximab for the treatment of Crohn's disease. The nurse knows to monitor for which of the following side effects?
Fever, chills, itching
When assessing an adult client who has a continued release of growth hormone, which of the following signs and symptoms would the nurse expect to find? SELECT ALL THAT APPLY.
Barrel chest Protrusion of jaw and orbital ridges Complaints of vision changes Complaints of joint pain Complaints of headache
The nurse is assessing a woman who has come to an orthopedic clinic complaining of knee pain. Which of the following assessment data would indicate an increased risk for osteoarthritis?
Being overweight by 30 pounds.
A client is being treated weekly with Alendronate (Fosamax). The nurse knows that this medication is a _______________ used to treat _______________.
Bisphosphonate, Osteoporosis
According to the diagnostic criteria for IBS, IBS is diagnosed when patients present with all of the following symptoms except for?
Bloody diarrhea
A client is admitted with Graves' disease. Which of these clinical manifestations should the nurse anticipate during the initial assessment?
C. Diaphoresis, pretibial myxedema, and photophobia.
Ergotamine tartrate (Gynergen) is prescribed as abortive therapy for a client's migraine headaches. The client's report of which of the following indicates effectiveness.
Prevention of a full blown migraine
A patient is admitted to the medical/surgical unit post thyroidectomy. The nurse notes that the patient is exhibiting signs of latent tetany. Which of the following assessment findings are consistent with latent tetany? Select all that apply.
Chvostek's sign Trousseau's sign
The nurse is assessing a client who has been taking prednisone following an exacerbation of inflammatory bowel disease. The nurse should recognize which of the following findings, all side effects of prednisone, as the priority?
Client reports elevation in body temperature.
A patient is admitted to the medical-surgical floor with a diagnosis of diverticulitis. The nurse would expect the patient to exhibit which of the following signs and symptoms associated with diverticulitis?
Crampy, left lower quadrant pain and low grade fever.
Which of these agents is a major contributing factor in the promotion of peptic ulcer disease?
Helicobacter pylori infection (H-pylori)
n the nurse's comprehensive assessment of a patient with hypothyroidism the nurse would expect to find:
High levels of TSH, complaints of fatigue, inability to tolerate cold, and periorbital edema.
The nurse is caring for a patient with Addisonian crisis. Which of the following symptoms would the nurse expect the patient to exhibit?
Hypotension, weak rapid pulse, vascular collapse
The doctor prescribes sucralfate (Carafate) to a client diagnosed with a peptic ulcer. The nurse knows that sucralfate is given for which of the following reasons?
Protect the ulcer's surface by forming a barrier and allowing for the healing of the ulcer
What is the chemical classification of Nexium (esomeprazole)?
Proton Pump Inhibitor
Your patient has just been diagnosed with Bell's Palsy. Which of the statements are true about Bell's Palsy?
It is rarely bilateral
Which of the following is the drug of choice for control of status epilepticus?
Lorazepam
Which are physical findings of Cushing's syndrome? Select all that apply.
Moon-faced" appearance Extremity muscle wasting Truncal obesity Thin, easily damaged skin
A client presents to the clinic with the following symptoms. Joint pain in both hands; Morning stiffness that won't improve until lunchtime; complaints of difficulty dressing due to swollen, warm joints in the hands; complaints of 5lb weight loss. Assessment reveals dry eyes and mouth with parotid gland enlargement; Temp 99.0. The nurse suspects which of the following musculoskeletal disorders?
Rheumatoid Arthritis
Which conditions may precipitate myxedema coma
Surgery, and rapid withdrawal of thyroid medication.
During report you learn that your patient has Guillain-Barre Syndrom. As the nurse, you know that the most common signs and symptoms of GBS are:
Symmetrical and ascending starting in the lower extremities
A nurse is caring for a client with recent history of migraines. What aspect of this client's current status may rule out the safe use of triptans?
The client has angina.
A patient is prescribed Carbidopa/Levodopa for Parkinson's disease. The nurse needs to include which of the following in the discharge instructions?
The effects of this drug will diminish by the end of year 5
The nurse is attempting to locate the thyroid gland in order to determine if it is enlarged. Where should the nurse palpate the thyroid gland?
The lower neck anterior to the trachea
Which statement is true about the pathophysiology of Multiple sclerosis:
The myelin sheath, which is made up of Schwann cells is damaged along the Axon
A client asks what the difference is between his gastric ulcer and his friend's duodenal ulcer. The nurse's response should be based on which of the following statements?
The pain of a duodenal ulcer usually occurs two to four hours after meals."
A patient with Parkinson's disease is taking Carbidopa/Levodopa and is experiencing an on-off syndrome. What does the nurse recognize that the patient's clinical symptoms will be?
The patient will have periods of near immobility, followed by a sudden return of effectiveness of the medication
The nurse explains to a family that the main physiologic reason for weight loss in a client with Crohn's disease is which of the following?
The thickening and congestion of the bowel wall results in malabsorption of nutrients.
A 36-year old female is prescribed carbamezapine. Which of the following instructions is most important for the nurse to include in discharge teaching?
This medication can cause bone marrow suppression
A 19 year-old patient is receiving discharge teaching after being diagnosed with absence seizures. The patient is prescribed Ethosuximide. The nurse is instructing the patient about adverse reactions. Which of the following should the nurse include in her discussion?
This medication causes nausea, so take it with food.
A client develops sudden seizure activity. The client's entire body first becomes very rigid. followed by alternating patterns of muscle relaxation and contraction occuring in all four extremities. The nurse documents that the client is exhibiting:
Tonic-clonic
When the nurse is conducting an initial assessment, which specific data should the nurse obtain from the client who is suspected of having peptic ulcer disease?
Use of non-steroidal anti-inflammatory drugs (NSAIDS)
A nurse is caring for a client with Buck's traction and is monitoring the patient for complications of the traction. Which assessment finding indicates a complication?
Weak pedal pulses
A client is diagnosed with Multiple Sclerosis (MS) and is prescribed methylprednisolone. What should the nurse include in teaching about the side effects of this medication? Select all that apply
Weight Gain Hyperglycemia Peripheral edema Mood swings Risk for infection
A 55 year old patient is being treated for Addison's disease. The nurse knows that the patient understands teaching about avoiding foods/medications that could increase potassium levels when the patient lists which of the following foods/medications to avoid? SELECT ALL THAT APPLY.
baked potatoes bananas orange juice
In doing a skin assessment on a patient with hypothyroidism the nurse should expect to find which of these characteristics?
dry coarse skin
A client is being sent home from the GI clinic with a prescription to treat GERD. Which of the following medications inhibit acid production?
lansoprazole (Prevacid)
The patient diagnosed with hypothyroidism is prescribed Levothyroxine. Which assessment data indicates the medication has been effective?The patient diagnosed with hypothyroidism is prescribed Levothyroxine. Which assessment data indicates the medication has been effective?
The patient's temperature is within normal limits
A patient is recovering from a transspheniodal hypophysectomy. What postoperative nursing interventions apply to this patient? Select all that apply.
Use stool softeners to avoid constipation and straining during a bowel movement strict monitoring fluid balance instructing the patient to alert the nurse regarding the postnasal drip
The nurse enters the room and finds the client has just had a tonic clonic seizure according to the family. He is in bed and unconscious. The nurse should assess which of the following during the postictal phase?
Vital signs
Your client returns from surgery after having an ORIF for a left hip fracture. What are the first two parameters to be assessed?
Vital signs and pulses distal to the surgical site
A client receiving thyroid replacement therapy develops influenza and forgets to take her thyroid replacement medicine. The nurse understands that skipping this medication puts the client at risk for developing which life-threatening complication?
myxedema coma
A common initial symptom of Crohn's disease is?
persistent diarrhea
A client is returning to the nursing unit following a unilateral adrenalectomy. Hydrocortisone IV is prescribed. The nurse is aware that the primary reason for this is:
prevention of addisonian crisis
A 26 year old female is being prescribed methylprednisone for the treatment of Systemic Lupus Erythematosus. The nurse knows that the patient needs further teaching about this medication when she makes which of the following statements?
"I need to avoid too much exposure to sunlight while taking this pill.
A 56 year old female is prescribed naproxen for treatment of pain associated with osteoarthritis. The nurse knows that the patient understands teaching when which of the following statements are made by the patient?
"I need to report any blood in my stool and monitor my blood pressure while taking this medication."
A 56 year old female is prescribed naproxen for treatment of pain associated with osteoarthritis. The nurse knows that the patient understands teaching when which of the following statements are made by the patient?
"I need to take this medicine with food to reduce GI upset, report any blood in my stool and monitor my blood pressure while taking this medication."
A client with SIADH is prescribed furosemide. Which of the following statements indicates that the client needs further teaching about this medication?
"I should limit my intake of potassium rich foods while taking this medication"
A client is prescribed demeclocycline for treatment of SIADH. Which of the following indicates that the client needs further teaching when discussing this medication?
"It is safe to take my calcium, iron and magnesium supplements at the same time as this medication."
A 33 year old male is admitted with a gastric ulcer. The nurse should anticipate the client to have epigastric pain:
1-2 hours after a meal
B. A 33 year old male is admitted with a gastric ulcer. The nurse should anticipate the client to have epigastric pain:
1-2 hours after a meal.
The nurse is preparing the client with peptic ulcer disease discharge instructions. The client asks the nurse which type of analgesic he may take. Which of the following responses by the nurse would be most accurate?
Acetaminophen.
The client diagnosed with an acute exacerbation of ulcerative colitis, having had multiple bloody diarrheas for the last two days. Which of the following nursing intervention(s) is priority for this patient?
Administer intravenous fluids and monitor vital signs frequently.
The nurse is aware that which of the following assessments would be indicative of hypoparathyroidism?
Calcium level 7.8 mg/dL and leg cramps.
The client presents to the ER with swelling and a noted deformity in the wrist. The client explained that she tripped and fell, causing her wrist to bend backwards. The nurse suspects the client has what type of fracture?
Colles' fracture
Which of the following diagnostic tests are the most reliable in detecting colon cancer?
Colonoscopy
A client is diagnosed with hypothyroidism. Which of the following signs/symptoms would the nurse expect the client to exhibit?
Complaints of extreme fatigue and hair loss.
A patient is diagnosed with hyperthyroidism. Which of the following signs/symptoms would the nurse expect the patient to exhibi
Complaints of profuse sweating and flushed skin.
Which of the following regulates the secretion of the parathyroid hormone as part of the negative feedback system?
Concentration of serum calcium
A patient is having diagnostic testing for suspected hyperthyroidism. Which of the following diagnostics correlate with this endocrine disorder? Select all that apply
Decrease in serum thyroid-stimulating hormone (TSH) Increased T3 Increased T4
A 58 year old client is admitted to the medical-surgical unit with complaints of gastroesophageal reflux, regurgitation, dysphagia, and belching. The physician suspects hiatal hernia. The client is scheduled for esophagogastroduodenoscopy (EGD). The nurse explains to the patient that an EGD
Directly visualizes the esophagus with a flexible fiber-optic endoscope.
Which statement about diverticular disease is accurate?
Diverticula form when colonic mucosa herniates through smooth muscle layers
A nurse is providing care to a client with Parkinson's disease. The nurse understands that the client's signs and symptoms are related to depletion of which of the following?
Dopamine
A 28 year old male has had a cast applied to the left arm for a fractured radius. In order to decrease the risk of compartment syndrome, the client should be instructed to?
Elevate his arm at heart level
A 41 year old male is admitted to the hospital after a motor vehicle accident. He has fractures on both legs and his pelvis. Skeletal traction was applied to this left femur. The patient becomes restless and confused 3 days after admission. His respirations are 38 and labored. His temperature is 103 degrees F. The nurse notices petechiae on his hard palate and buccal membranes. Based upon his symptoms and history, which of the following fracture complications does the nurse suspect?
Fat embolism syndrome
A 62 year old male is admitted to the hospital with a diagnosis of diverticulitis. The nurse understands that diverticulitis occurs due to which of the following
Fecal material or bacteria became trapped in the outpouchings of the intestine
A 41 year old male presents to the clinic with complaints of upper abdominal pain described as gnawing, burning ache that gets better when he eats. He reports one episode of vomiting. What diagnosis does the nurse suspect?
Gastritis
A patient is prescribed bromocriptine mesylate (Parlodel). Which information does the nurse teach the patient?
Get up slowly from lying position.
A client is suspected of having acromegaly. What definitive diagnostic testing is the most reliable method of confirming acromegaly?
Glucose tolerance test in combination with a GH measurement
A patient presents to the ER with the following complaints: sudden onset of severe pain to the first metatarsophalangeal joint; unable to bear weight. Upon assessment, the nurse notes swelling, warmth and redness, and the patient cries out in pain when the affected joint is touched. The nurse suspects which of the following musculoskeletal disorders.
Gout
Which of the following signs/symptoms would make the nurse suspect that the client is experiencing a thyroid storm?
HR 132, temp 103F
Which signs and symptoms are assessment findings indicative of thyroid storm? Select all that apply.
HR 138 Temp 103.1 BP 180/99
An 8 year old child who is not responding to anti-seizure medications is prescribed to start a ketogenic diet. This diet will include
High Fat, Low Carbohydrate, Medium Protien
Which of the following findings will the nurse expect to see when reviewing the chart of a client with lung cancer who is experiencing chronic SIADH?
High Urinary Specific Gravity >1.030
The nurse is teaching a caregiver about donepezil. Which of the following indicates that the caregiver understands teaching?
I should give this to my parent at night to avoid syncope"
The nurse is teaching a client with new onset of syndrome of inappropriate antidiuretic hormone (SIADH) about the disorder. Which of the following statements made by the client best indicates that he correctly understands how to manage the disease?
I should limit my fluid intake to approximately 600mL or 4 small glasses of water daily."
You are educating your patient about the treatment options for Guillian-Barre syndrom. Which statement is correct about Intravenous Immunoglobulin(IVIG) therapy?
IVIG is where IV Immunoglobulin from a donor is given to a patient to stop the antibodies that are damaging my nerves
The nurse is caring for a client who is in status epilepticus. What medication should the nurse anticipated administering to halt the seizure immediately?
Intravenous diazepam
Which statements about hypothyroidism are accurate? Select all that apply.
It occurs more often in women. It can be caused by iodine deficiency. It can be caused by autoimmune thyroid destruction. Myxedema coma is a rare but serious complication
The nurse is providing client teaching to a client with early stage Alzheimer disease (AD) and her family. The client has been prescribed donepezil hydrochloride. What should the nurse explain to the client and family about this drug?
It slows the progression of AD
A client is taught hip dislocation precautions postoperatively. The nurse knows to include teaching the client to?
Keep the knees lower than the hips when sitting
Which of the following will the nurse observe in the client in the ictal phase of a generalized tonic-clonic seizure?
Loss of consciousness, body stiffening, and violent muscle contractions
A client is being sent home following an EGD with a prescription to treat GERD. Which of the following medications neutralizes stomach acid?
Magnesium Hydroxide (Maalox)
The nurse is educating a client with Myasthenia gravis about medications. THe nurse is sure to include which of the following?
Medication must be taken on time
A patient presents to the emergency room with complaints of sudden loss of vision in the left eye upon awakening. She also reports tinnitus, fatigue, weakness in the lower extremities, and urinary retention. MRI results show plaques on the optic chiasma and cerebrum. Which of the following neurological disorders does the nurse suspect?
Multiple Sclerosis
An incoherent female client with a history of hypothyroidism is brought to the emergency department by the rescue squad. Physical and laboratory findings reveal hypothermia, hypoventilation, respiratory acidosis, bradycardia, hypotension, and nonpitting edema of the face and pretibial area. Knowing that these findings suggest severe hypothyroidism, nurse Libby prepares to take emergency action to prevent the potential complication of:
Myxedema coma
A patient presents to the clinic with the following complaints: Left knee pain that gets worse when walking; morning stiffness that lasts about 15 minutes that gets better with activity. Upon assessment, the nurse notes crepitus on palpation of the knee and boney enlargements at the distal interphalangeal joints of both hands. Which of the following musculoskeletal disorders does the nurse suspect?
Osteoarthritis
A 75 year old female client comes in for her yearly check up. Upon assessment, the nurse notes that the client has slight kyphosis and has shrunk 0.5in since her last check up. The client states that she has had increased back pain as well. This client is likely experiencing signs and symptoms from what musculoskeletal problem?
Osteoporosis
A patient is treated in the emergency department for status epilepticus and is admitted to the hospital. The physician has ordered seizure precautions. What equipment does the nurse place in the room before the patient's arrival.
Oxygen and suction equipment
What would indicate a need for further teaching for a patient taking phenytoin?
Patient states, "I can consume 2 glasses of wine per day"
A 62 year old female presents to the emergency department with complaints of vomiting blood that was described as "coffee ground" appearance, and severe chest pain that woke her in the middle of the night. The nurse suspects?
Peptic Ulcer Disease
A patient presents to the clinic with complaints of the following symptoms over a period of 6 months: Stooped posture; shuffling gait; still limb movement; taking longer to dress in the mornings; fatigue; and slight tremor of the left hand while at rest. Which of the following neurological disorders does the nurse suspect?
Phenytoin
The client in the ED has just had a diagnostic lumbar puncture. To reduce the incidence of a postlumbar puncture headache, what is the nurse's most appropriate action?
Position the client prone
A 38 year old woman is returned to her room after a subtotal thyroidectomy for treatment of hyperthyroidism. Which of the following, if found by the nurse at the patient's bedside, is NOT essential?
Potassium chloride for IV administration.
A client with a seizure disorder is hospitalized for a surgical procedure. If the client has a seizure, what should the nurse do?
Record the time and pattern of the seizure
The nurse is planning care of a client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Which interventions should be implemented? SELECT ALL THAT APPLY.
Restrict fluids per physician orders Assess level of consciousness every two hours. Monitor urine and serum osmolality
After a sudden decline in cognition, a 77-year-old man who has been diagnosed with vascular dementia is receiving care in his home. To reduce this man's risk of future infarcts, what action should the nurse most strongly encourage?
Rigorous control of the client's blood pressure and serum lipid levels
A nurse is assessing a client with Parkinson's disease. Which of the following would the nurse expect to find?
Slowing of activity
A client has been treated with etanercept (Enbrel), a biologic response modifier, for RA for 3 weeks. The nurse understands the importance of checking what assessment information for a client taking this medication regimen for RA?
The WBC count, temperature and any signs of infection
A 50 year old man is scheduled for a colonoscopy this morning. Last night he had Magnesium Citrate and a soapsuds enema. This morning he passes a medium amount of soft, brown stool. What should the nurse know and report to the physician?
The bowel prep is incomplete.
A client states "My doctor told me to quit taking aspirin since I've developed this ulcer. But I have to take aspirin to keep my arthritis from hurting. I don't know what to do." Which response on the part of the nurse is most appropriate?
"Aspirin is one of the medications that makes your ulcer worse. Another medicine can be ordered by the doctor for your arthritis."
A 52 year old male is diagnosed with Gout. The physician prescribes allopurinol. The nurse knows that the patient needs further teaching when he states which of the following?
"I need to avoid crowds and weigh myself daily while taking this medication.
The physician orders metronidazole (Flagyl) 250mg PO TID for 7 days for a 35 year old client. The nurse teaches the client about the medication. Which of the following statements, if made by the client, would indicate that teaching has been effective and understood?
"I should NOT drink alcohol while I am taking this medication."
The nurse teaches a client how to prepare for a barium enema. Which statement by the client would indicate a correct understanding of the teaching?
"I'll cleanse my bowel with laxatives and enemas before the test."
A new client in the clinic asks the nurse," What is the difference between osteoarthritis and rheumatoid arthritis?" The nurse's appropriate response would be?
"Osteoarthritis is a noninflammatory joint disease. Rheumatoid arthritis is an inflammatory joint disease."
A 58 year old male has been prescribed allopurinol for gout. Which of the following should the nurse include in testing?
"Take this medication with food and increase your fluid intake to 2-3 Liters a day."
A client is taking tizanidine for symptom management related to Multiple Sclerosis. Which of the following would indicate that the client needs further teaching about this medication?
"This drug causes peripheral edema so I should expect some weight gain"
A client diagnosed with Rheumatoid Arthritis is prescribed methotrexate and folic acid supplementation. Which of the following statements indicates to the nurse that the client needs further teaching about folic acid?
"This medication is to help my platelet number stay up as a result of methotrexate.
The nurse is preparing a client for a flexible sigmoidoscopy. The nurse explains that the difference between a flexible sigmoidoscopy and a colonoscopy is?
A Flexible sigmoidoscopy is advanced the length of the sigmoid colon, and a colonoscopy is advanced to the cecum.
Which of the following clients would not be a candidate for a Capsule Endoscopy?
A client who complains of dysphagia
A client who is recovering from GI surgery has been advanced from a clear liquid diet to a full liquid diet. The nurse would offer which item to the client on a full liquid diet?
A rigid, board-like abdomen
A patient is prescribed a succinimide. The nurse knows that the client is diagnosed with what type of seizure?
Absence seizures
A patient with a history of epilepsy has consecutive seizures lasting more than 5 minutes and is in status epilepticus. Which intervention should be included in this patients immediate treatment? SELECT ALL THAT APPLY
Administer oxygen and protect the airway. Prepare for endotracheal intubation Administer lorazepam intravenously Continue to protect the patient from injury
A clinic nurse is caring for a client diagnosed with migraine headaches. During the client teaching session, the client questions the nurse regarding alcohol consumption. What would the nurse be correct in telling the client about the effects of alcohol?
Alcohol causes vasodilation of the blood vessels.
Which of the following increases the risk for developing Gout? Select all that apply.
Alcohol consumption; especially beer Dietary intake of dairy products Chronic kidney disease Diet high in red meat and shellfish Female gender Serum uric acid less than 6.8 mg/dl BMI of 24
A client presents to the family medicine clinic with reports of fatigue and depression. Upon examination, the provider notes anomia, dysarthria and reports of sundowning by the spouse. Which of the following does the nurse practitioner suspect?
Alzheimer's disease mid stage
When assessing the client with a diagnosis of peptic ulcer disease, which physicalassessment examination skill should the nurse implement first?
Auscultate the client's bowel sounds in all four quadrants
A patient is being seen in the primary health clinic with hypoparathyroidism. The nurse knows to include diet modification instructions to the patient. Which of the following diet instructions should the nurse include in teaching? SELECT ALL THAT APPLY
Avoid milk or milk products. Avoid egg yolk and spinach.
A patient who is postoperative day 1 following neck dissection surgery has rung his call bell complaining of numb fingers, stiff hands, and a tingling sensation in his lips and around his mouth. The nurse should anticipate that this patient may require the IV administration of:
Calcium gluconate
The nurse is assessing a patient after a thyroidectomy. The client complains of tingling lips. This is most likely due to:
Calcium level 7.5 mg/dl
when assessing the client with a fractured left tibia and fibula, which data should the nurse report to the health care provider immediately?
Capillary refill time of 9 seconds and increasing pain
Which of the following would the nurse teach the patient to improve symptoms of osteomyelitis? Select all that apply
Continue antibiotic therapy as prescribed Consume a high protein diet Stop antibiotics when symptoms disappear Rest
An 18 year old client is being evaluated for a knee injury. He states that his knee swells after exercise and sometimes "catches" when attempting flexion. When the nurse flexes the client's knee, a grating sensation is felt and a crackling sound is noted. This is referred to as?
Crepitus
Addisonian crisis is precipitated by which of these events?
Critical drop in or withdrawal of corticosteroids.
The nurse is explaining to a client diagnosed with Rheumatoid Arthritis why DMARDs are prescribed to clients with autoimmune diseases. The nurse would be correct to explain to the client that DMARDs do what to help with their symptoms?
DMARDs slow down the progression of the disease and improve the quality of life for most clients.
A client diagnosed with MS has been admitted to the medical unit for treatment of an MS exacerbation. Included in the admission orders is baclofen. What should the nurse identify as an expected outcome of this treatment?
Decreased muscle spasms in the lower extremities
The physician orders multiple labs in a client with suspected Systemic Lupus Erythematosus. Which of the following labs reveals inflammation within the body?
ESR (erythrocyte sedimentation rate) & CRP (C-reactive protein)
A male client is sitting in a chair and his entire body is rigid with his arms and legs are contracting and relaxing. Th client is not aware of what is going on and is making gutteral sounds. Which action should the nurse implement first?
Ease the client to the floor
The nurse is caring for a client diagnosed with GERD. Which of the following nursing interventions should be implemented?
Elevate the head of the bed 30 degrees and discuss lifestyle modifications with the client.
During your discharge teaching to a patient with multiple sclerosis, you educate the patient on how to avoid increasing symptoms and relapses. You tell the patient to avoid
Extreme temperatures, Infection, stress, injury
Which of the following characteristics of Crohn's disease is accurate?
Internal intestine has cobblestone appearance
A focused GI assessment begins with a complete history and physical examination. Identify the quadrant of the abdomen to be palpated or percussed for a patient with sigmoid colon pain.
Left lower
A client is being treated for acute osteomyelitis. The nurse notes that the results of the client's bone biopsy revealed that the osteomyelitis was caused by a gram negative bacteria. The nurse anticipates what antibiotic being prescribed for this patient?
Levaquin, a fluoroquinolone antibiotic
The nurse is reviewing the record of a client with Crohn's disease. Which stool characteristic should the nurse expect to find documented in the patient's record?
Loose, watery
The nurse is providing care for an 82-year-old man whose signs and symptoms of Parkinson disease have worsened over the past several months. The man states that he can no longer do as many things for himself as he used to be able to. What factor should the nurse recognize as impacting the client's life most significantly?
Loss of independence
The nurse is caring for a 19 year old freshman at the local university who presents to the emergency room with complaints of severe headach, photophobia, BP 128/78, Respirations 22, Temperature of 101.4, pulse is 111beats per minute, chills, nausea and vomiting. The patient's roomate reports the patient is acting "strange." When you examine the patient, she pulls up her knees when you bend her neck so that her chin touches her chest.
Lumbar Puncture with evaluation of the CSF
A client with possible bacterial meningitis is admitted to the ICU. What assessment finding would the nurse expect for a client with this diagnosis?
Neck flexion produces flexion of knees and hips
The nurse explains to the patient with gastroesophageal reflux disease that this disorder:
Often involves relaxation of the lower esophageal sphincter, allowing stomach content to back up into the esophagus
You have a patient who has a brain tumor and is at risk for seizures. In the patient's plan of care you incorporate seizure precautions. Select below all the proper steps to take in initiating seizure precautions
Oxygen and suction at the bedside Remove all pillows from the patient's bed IV access Remove restrictive objects and clothing from the patient's body Padded Bed Rails
A 42 year old male presents to the ER with complaints of sudden, severe upper abdominal pain with hematemesis. Upon assessment, the nurse notes a rigid, board-like abdomen and absent bowel sounds. Diagnostic tests reveal WBC 18.9 and free air noted on abdominal xray. Vital signs: BP 89/48, HR 140, RR 42, O2 sats 89% and temp 101.6. The nurse suspects?
Perforation of bowel
A client presents with symptoms indicative of Parkinson's disease. Which of the following are cardinal signs of Parkinson's disease?
Postural instability; bradykinesia; rigidity; tremor
client presents with symptoms indicative of Parkinson's disease. Which of the following are cardinal signs of Parkinson's disease?
Postural instability; bradykinesia; rigidity; tremor
The critical care nurse is admitting a client in myasthenic crisis to the ICU. The nurse should prioritize what nursing action in the immediate care of this client?
Providing ventilatory assistance
A patient with hypothyroidism is admitted to the intensive care department diagnosed with myxedema coma. Which of the following assessment data would warrant immediate intervention by the nurse?
Pulse oximeter reading of 88%.
After teaching a group of school teachers about seizures, the teachers role play scenario inovling a student experiencing a generalized tonic-clonic seizure. Which of the following actions, when performed first, indicates that the nurse's teaching has been successful?
Removing any nearby objects that could harm the student
vThe nurse is admitting a client diagnosed with SIADH. Which clinical manifestations should be reported to the physician immediately
Serum sodium of 112 mEq/L and a headache.
A patient is just admitted to the emergency room after a motor vehicle collision. The patient presents with an open fracture to the right femur. The nurse performs her initial assessment and notes the following: BP 88/40; pulse 131; respiratory rate 28 and labored; diaphoretic, pale and restless. The nurse suspects which of the following fracture complications?
Shock
A client presents to the clinic with the following complaints: tenderness and swelling to fingers and wrists; breaks out in a rash when exposed to the sun. Upon examination, the nurse notes several ulcers in the patient's mouth, and malar rash. The patient's lab results reveal protein in the urine, and a platelet count of 10,000. Which of the following musculoskeletal disorders does the nurse suspect
Systemic Lupus Erythematous
Which of the following is a preventative measure for diverticular disease
Taking bulk forming laxative agents
A client is diagnosed with ulcerative colitis. When assessing this client, which of the following signs and symptoms would the nurse expect to find?
Ten bloody stools a day
The nurse is caring for a client with late-stage Alzheimer disease. The client's wife states that the client has now become completely dependent and that she feels guilty if she takes any time for herself. What outcomes would be appropriate for the nurse to develop in order to assist the client's wife?
The caregiver distinguishes essential obligations from those that can be controlled or limited.
A patient being admitted for surgery has a vagus nerve stimulation (VNS) device that was implanted several months earlier for seizure management. The nurse determines that the VNS is working properly when which situation occurs?
The patient activates the device with a magnet to stop a seizure from occuring
Which of the following assessment findings should the nurse recognize as pertinent to a diagnosis of Cushing's syndrome?
Thin extremities with easy bruising and truncal obesity.
Hydroxychloroquine is prescribed for a client with rheumatoid arthritis. The nurse educates a patient for signs of an adverse effect related to the medication. Which of the following adverse effects should the patient understand is very serious and should be reported immediately?
Vision disturbances
A client is admitted for a series of tests to verify the diagnosis of Cushing's syndrome. Which of the following assessment findings, if observed by the nurse, would support this diagnosis?
Weight gain, hyperglycemia, and hypernatremia.
For which electrolyte abnormality should the nurse most carefully monitor in a client with SIADH?
hyponatremia
The nurse is developing a postoperative nursing care plan for a client. On assessment the nurse notes that the patient is experiencing some shortness of breath and fever of 101F. Which of the following complications associated with total hip replacement would the nurse suspect?
pneumonia
The clinic nurse is performing diet teaching with a 67 year old client with acute gout. The nurse should teach the client to limit his intake of what?
red meat and shellfish
Which of the following factors increase the risk for developing GERD? Select all that apply.
smoking, alcohol consumption, pregnancy, history of DM, hiatal hernia, sedentary lifestyle, overweight
The nurse should ensure that calcium gluconate or calcium chloride for IV administration is available in the postoperative management of the patient having thyroid surgery to treat which of these emergencies?
tetany
A client diagnosed with diabetes insipidus is receiving Desmopressin acetate intranasally. Which assessment data indicates that the medication is effective?
the client is urinating every 4 hours
The nurse is planning discharge education for a client with trigeminal neuralgia. The nurse knows to include information about factors that precipitate an attack. What would the nurse be correct in teaching the client to avoid?
washing his face
