Med-Surg 1
The nurse has educated a patient with low back pain about techniques to relieve the back pain and prevent further complications. What statement by the patient shows understanding of the education the nurse provided? "I will lie prone with my legs slightly elevated." "I will bend at the waist when I am lifting objects from the floor." "I will avoid prolonged sitting or walking." "Instead of turning around to grasp an object, I will twist at the waist."
"I will avoid prolonged sitting or walking."
A client with anemia is prescribed an oral iron supplement. Which statement indicates that teaching about this supplement has been effective? "I will take it in the morning with orange juice." "I will stop taking it if my stool turns black." "I will be sure to take this medication with food." "I will limit my intake of raw fruit and vegetables."
"I will take it in the morning with orange juice."
A client with osteoarthritis expresses concerns that the disease will prevent the ability to complete daily chores. Which suggestion should the nurse offer?
"Pace yourself and rest frequently, especially after activities."
Which instruction should a nurse give to a client with diabetes mellitus when teaching about "sick day rules"? "It's okay for your blood glucose to go above 300 mg/dl while you're sick." "Follow your regular meal plan, even if you're nauseous." "Test your blood glucose every 4 hours." "Don't take your insulin or oral antidiabetic agent if you don't eat."
"Test your blood glucose every 4 hours."
A client is suspected of having rheumatoid arthritis and her diagnostic regimen includes aspiration of synovial fluid from the knee for a definitive diagnosis. The nurse knows that which procedure will be involved?
Arthrocentesis
A client with multiple myeloma reports pain along the spinal column. The client is prescribed naproxen (Aleve) and oxycodone. Prior to administering these medications, the nurse Checks the client's BUN and creatinine Questions the physician about the use of both medications Teaches the client to bend at the back when lifting objects Instructs the client not to lift more than 20 pounds
Checks the client's BUN and creatinine
A client is suspected of having CREST syndrome and is seeking medical attention. Which criterion is among those used to diagnose this client? Esophageal dysmobility Elevated white blood cell count Reduction in voice volume Change in liver enzyme values
Esophageal dysmobility
Which of the following nonsedating antihistamines is appropriate for daytime pruritus? Lorazepam (Ativan) Hydroxyzine (Atarax) Fexofenadine (Allegra) Diphenhydramine (Benadryl)
Fexofenadine (Allegra)
When the nurse is caring for a patient with type 1 diabetes, what clinical manifestation would be a priority to closely monitor? Hypoglycemia Hyponatremia Ketonuria Polyphagia
Hypoglycemia
A client is admitted with diabetic ketoacidosis (DKA). Which order from the physician should the nurse implement first? Administer sodium bicarbonate 50 mEq IV push. Infuse 0.9% normal saline solution 1 L/hr for 2 hours. Start an infusion of regular insulin at 50 U/hr. Administer regular insulin 30 U IV push.
Infuse 0.9% normal saline solution 1 L/hr for 2 hours.
During a routine assessment of a patient diagnosed with anemia, the nurse observes the patient's beefy red tongue. The nurse is aware that this is a sign of what kind of anemia? Iron deficiency Folate deficiency Megaloblastic Autoimmune
Megaloblastic
A client is diagnosed with low risk asymptomatic polycythemia vera. For which treatment will the nurse prepare teaching for this client? Phlebotomy Ruxolitinib Hydroxyurea Interferon-alfa
Phlebotomy
A client has a patient-controlled analgesia (PCA) pump at the bedside. For which requirement(s) will the nurse assess the client to determine if the PCA pump can be used for pain control? Select all that apply. Reports pain at a level of 7 or greater Experiences signs of atelectasis Physically able to self-dose Recovers from a major surgical procedure Understands the need to self-dose
Physically able to self-dose Understands the need to self-dose
A client's decreased mobility has been attributed to an autoimmune reaction originating in the synovial tissue, which caused the formation of pannus. This client has been diagnosed with which health problem?
Rheumatoid arthritis (RA)
A patient who was recently diagnosed with pruritus on the chest and back is given information about skin care and bathing. The most important advice on cleansing is to avoid: Bathing with warm water and mild soap. Using bath oils mixed with water. Washing with soap and hot water. Applying a cold compress to the area after washing.
Washing with soap and hot water.
A client without symptoms receives a diagnosis of prostate cancer after a routine physical. What factors contributed to this diagnosis? Select all that apply. client history risk factors tumor markers use of sunscreen
client history risk factors tumor markers
A nurse is managing the care of a client with osteoarthritis. What is the appropriate treatment strategy the nurse will teach the about for osteoarthritis?
administration of nonsteroidal anti-inflammatory drugs (NSAIDs)
A nurse is caring for a client with a warm and painful toe from gout. What medication will the nurse administer?
colchicine
A client with severe anemia is prescribed 2 units of packed red blood cells. The client refuses to sign the consent form for blood administration because to do so conflicts with the client's Jehovah's Witness faith. What did the nurse fail to assess prior to witnessing consent? cultural beliefs learning readiness learning environment emotional readiness
cultural beliefs
The root cause of cancer is damage to cellular deoxyribonucleic acid (DNA) which can be caused by many factors, or carcinogens. What factors can be carcinogenic? Select all that apply. dietary substances environmental factors viruses gender age
dietary substances environmental factors viruses
Which instruction about insulin administration should a nurse give to a client? "Store unopened vials of insulin in the freezer at temperatures well below freezing." "Shake the vials before withdrawing the insulin." "Discard the intermediate-acting insulin if it appears cloudy." "Always follow the same order when drawing the different insulins into the syringe."
"Always follow the same order when drawing the different insulins into the syringe."
A nurse is caring for a client with human immunodeficiency virus (HIV). What would the nurse expect the health care provider to order to determine the effectiveness of treatment? E-rosette immunofluorescence quantification of T-lymphocytes ELISA with Western blot test enzyme-linked immunosorbent assay (ELISA)
quantification of T-lymphocytes
The nurse is administering an insulin drip to a patient in ketoacidosis. What insulin does the nurse know can be used intravenously? short-acting long-acting rapid acting intermediate-acting
short-acting
The nurse is assessing a client admitted with a deep vein thrombosis with an elevated red blood cell count. The admitting diagnosis is polycythemia vera. What is the hallmark clinical sign of PV? pale body color peripheral edema splenomegaly weight gain
splenomegaly
A nurse has been assigned to care for a client with newly diagnosed insulin-dependent diabetes mellitus. When teaching the client proper injection techniques, which statement will the nurse use to promote emotional readiness in the client? "Can you teach me what I just showed you?" "What scares you the most about this?" "How do you feel about needles?" "Do you feel comfortable with injections?"
"Can you teach me what I just showed you?"
A client with diabetes is asking the nurse what causes diabetic ketoacidosis (DKA). Which of the following is a correct statement by the nurse? "DKA can happen without a cause." "DKA will not happen with type 1 diabetes." "DKA can be caused by taking too little insulin." "DKA can be caused by taking too much insulin."
"DKA can be caused by taking too little insulin."
The nurse is caring for a client with a newly discovered tumor that may be benign or malignant. The client asks, "What makes a malignant tumor different from a benign one?" What should the nurse include in the response? Select all that apply. "The cells of the tumor bear little resemblance to the cells in the tissue where the tumor started." "It grows by invasion and infiltrates the surrounding tissues." "The tumor grows slowly and may stop." "It does not spread to other areas of the body through blood and lymph channels." "The tumor may regress after its initial growth."
"The cells of the tumor bear little resemblance to the cells in the tissue where the tumor started." "It grows by invasion and infiltrates the surrounding tissues."
What is the duration of regular insulin? 4 to 6 hours 3 to 5 hours 24 hours 12 to 16 hours
4 to 6 hours
Which patient is most in need of health education by the nurse? A 42-year-old male with acute pericarditis A 28-year-old female with abdominal pain A 62-year-old male with chronic kidney injury A 72-year-old female with a respiratory infection
A 62-year-old male with chronic kidney injury
The nurse is caring for a client with rheumatoid arthritis who suffers with chronic pain in the hands. When would be the best time for the nurse to perform range-of-motion exercises? After the client has had a warm paraffin hand bath First thing in the morning when the client wakes After the client has a diagnostic test After cool compresses have been applied to the hands
After the client has had a warm paraffin hand bath
A client is brought to the ED reporting fatigue, large amounts of bruising on the extremities, and abdominal pain localized in the left upper quadrant. A health history reveals the client has been treated for a sore throat three times in the past 2 months. Laboratory tests indicate severe anemia, significant neutropenia, and thrombocytopenia. Based on the symptoms, what could be the client's diagnosis? Hemolytic anemia Iron deficiency anemia Aplastic anemia Sickle cell anemia
Aplastic anemia
A client has a diagnosis of rheumatoid arthritis, and the primary provider has now prescribed cyclophosphamide. The nurse's subsequent assessments should address which potential adverse effect?
Bone marrow suppression
A client with systemic lupus erythematosus (SLE) has the classic rash of lesions on the cheeks and bridge of the nose. What term should the nurse use to describe this characteristic pattern?
Butterfly rash
When an infection is bloodborne, the manifestations include which symptom? Bradycardia Hypothermia Hyperactivity Chills
Chills
The nurse is preparing a teaching tool about alopecia caused by cancer treatment. Which information will the nurse emphasize in this tool? Select all that apply. Use a hair dryer to quickly dry the hair. Cut long hair before treatment begins. Use shampoo and conditioner every day. Use a wide-tooth comb to style the hair. Avoid hair dyes or permanent wave solutions.
Cut long hair before treatment begins. Use a wide-tooth comb to style the hair. Avoid hair dyes or permanent wave solutions.
An obese Hispanic client, age 65, is diagnosed with type 2 diabetes. Which statement about diabetes mellitus is true? Nearly two-thirds of clients with diabetes mellitus are older than age 60. Type 2 diabetes mellitus is less common than type 1 diabetes mellitus. Diabetes mellitus is more common in Hispanics and Blacks than in Whites. Approximately one-half of the clients diagnosed with type 2 diabetes are obese.
Diabetes mellitus is more common in Hispanics and Blacks than in Whites.
The client diagnosed with osteosarcoma is scheduled for a surgical amputation. Which nursing diagnosis would be a priority for this client compared with other surgical clients? Impaired physical mobility Disturbed body image Inadequate nutrition Risk for infection
Disturbed body image
You are caring for a 13-year-old diagnosed with sickle cell anemia. The client asks you what they can do to help prevent sickle cell crisis. What would be an appropriate answer to this client? Drink at least 8 glasses of water every day. Stay on oxygen therapy 24/7. Avoid any activity that makes you short of breath. Avoid any sports that tire you out.
Drink at least 8 glasses of water every day.
Which of the following mobility criteria must a postoperative client meet to be discharged to home? Select all that apply. Get out of bed without assistance Pass a stress test Ambulate the length of the client's house Be able to self-toilet Be able to drive to the grocery
Get out of bed without assistance Ambulate the length of the client's house Be able to self-toilet
A patient has suffered a femoral shaft fracture in an industrial accident. What is an immediate nursing concern for this patient? Pain resulting from muscle spasm Knee and hip dislocation Hypovolemic shock Infection
Hypovolemic shock
A nurse is performing the health history and physical assessment of a client who has a diagnosis of rheumatoid arthritis (RA). What assessment finding is most consistent with the clinical presentation of RA?
Joint stiffness lasting longer than 1 hour, especially in the morning
A 67-year-old client is admitted for diagnostic studies to rule out cancer. The patient is white, married, has been employed as a landscaper for 40 years, and has a 36-year history of smoking a pack of cigarettes daily. What significant risk factors does the nurse recognize this patient has? Select all that apply. Occupation Race Marital status Age Cigarette smoking
Occupation Age Cigarette smoking
A nurse is caring for an asymptomatic client with acute myelogenous leukemia. The client has a total white blood cell (WBC) count of 0, a platelet count of 3,000 mm2, and a hemoglobin level of 9 mg/dl. The client has a single lumen central venous catheter in place and the health care provider has ordered the nurse to administer imipenem cilastatin 500 mg every 8 hours, transfuse 1 unit packed red blood cells (RBCs), give amphotericin B 40 mg I.V. over 4 hours, and transfuse 2 pheresis units of platelets. In what order should the nurse infuse these medications and blood products? Platelets, imipenem cilastatin, amphotericin B, packed RBCs Amphotericin B, imipenem cilastatin, platelets, packed RBCs Packed RBCs, amphotericin B, imipenem cilastatin, platelets Packed RBCs, platelets, imipenem cilastatin, amphotericin B
Platelets, imipenem cilastatin, amphotericin B, packed RBCs
The nurse's plan of care for a client with stage 3 HIV addresses the diagnosis of Risk for Impaired Skin Integrity Related to candidiasis. What nursing intervention best addresses this risk? Promoting nutrition and adequate fluid intake Administering prophylactic antibiotics Applying skin emollients as needed Providing thorough oral care before and after meals
Providing thorough oral care before and after meals
A client with systemic lupus erythematosus (SLE) is prescribed hydroxychloroquine. Which teaching will the nurse include for this client? Vitamin D supplements Smoking cessation High-protein diet Exercise
Smoking cessation
A client with chronic osteomyelitis has undergone 6 weeks of antibiotic therapy. The wound appearance has not improved. What action would the nurse anticipate to promote healing? Wound packing Surgical debridement Vitamin supplements Wound irrigation
Surgical debridement
A client is diagnosed with pneumocystis pneumonia (PCP). What medication does the nurse anticipate educating the client about for treatment? TMP-SMZ Azithromycin Garamycin Cephalexin
TMP-SMZ
The nurse is reviewing a list of surgical clients. Which clients would the nurse recognize as having the greatest risk for complications during the intraoperative or postoperative period? Select all that apply. The 47-year-old client who stopped smoking 4 years ago. The 25-year-old client who occasionally smoked marijuana in high school. The 27-year-old client with non-insulin dependent diabetes. The 70-year-old client who takes no routine medications. The 43-year-old client with past surgeries.
The 27-year-old client with non-insulin dependent diabetes. The 70-year-old client who takes no routine medications.