Med Surg Practice Quiz

A practical nurse (PN) is coordinating the care of four clients on an oncology unit. Which neutrophil count should the PN identify as a risk for a life-threatening infection in one of the clients? 500/mm3. 1000/mm3. 2000/mm3. 3000/mm3.

500/mm3.

Which client should the practical nurse consider at greatest risk for bacterial cystitis? A middle-aged female who has never been pregnant. An older female who does not use estrogen replacement. An older male with heart failure. A male who uses sildenafil (Viagra).

An older female who does not use estrogen replacement.

Which instruction should the practical nurse (PN) reinforce with a female client about skin care after her first radiotherapy treatment? Cleanse the area with bar soap and water. Moisten the skin with lotions after treatment. Avoid using ice packs on the exposed area. Protect the skin from exposure to air.

Avoid using ice packs on the exposed area.

Which action should the practical nurse (PN) implement to reduce the risk of infection for a client who is receiving total parenteral nutrition (TPN)? Administer antibiotics secondary to the TPN fluid. Replace the peripheral cannula every 48 hours. Change the transparent dressing every 72 hours. Use a semipermeable dressing on the insertion site.

Change the transparent dressing every 72 hours.

The practical nurse (PN) is reviewing the admission laboratory results for a client with cirrhosis of the liver. Which finding should the practical nurse (PN) report to the healthcare provider? Hemoglobin of 12 grams/dl. Serum potassium of 4 mEq/L. Elevated serum ammonia. Urobilinogen.

Elevated serum ammonia.

A client with Parkinson's disease asks the practical nurse (PN) to explain how this disease causes his muscles to malfunction. Which underlying pathophysiology should the PN use as a basis for the explanation? Synaptic levels of norepinephrine decrease in the neuromuscular junction. Cerebellar levels of acetylcholine rise and inhibit voluntary movement. Degeneration of the basal ganglia leads to a decrease in dopamine levels. Neuronal signals from the cerebral cortex increase acetylcholine.

Degeneration of the basal ganglia leads to a decrease in dopamine levels.

The practical nurse (PN) is assisting the occupational health nurse with employee health screening. Which technique should the PN use to determine a client's visual acuity? Check the pupil response to light. Have the client read the Snellen eye chart. Observe both eyes for nystagmus. Tell the client to watch the PN's finger move.

Have the client read the Snellen eye chart.

What complication is most important for the practical nurse to monitor for in a client who has a total hip replacement? Depression. Infection. Immobility. Contractures.

Infection.

Which finding should the practical nurse (PN) identify as typical for a client who is hypoxic? Temperature of 103 F. Hemoglobin of 10 grams/dl. PO2 of 80 mmHg. PCO2 of 30 mmHg.

Hemoglobin of 10 grams/dl.

Which finding for a client who is 1-day postoperative for a partial thyroidectomy requires immediate follow-up by the practical nurse (PN)? High pitched expiratory sound. Throat pain rated "9." Voice is hoarse. Capillary refill is 4 seconds.

High pitched expiratory sound.

A male client is one day postoperative for surgical repair of a fractured femur when he suddenly experiences dyspnea, coughing, chest pain, and hemoptysis. Based on this data, what nursing diagnosis should the practical nurse address for this client? Knowledge deficit related to smoking cessation noncompliance. Anxiety related to internal cues that symbolize an aspect of trauma. Decreased cardiac output related to dysrhythmia. Impaired gas exchange related to altered blood flow to alveoli.

Impaired gas exchange related to altered blood flow to alveoli.

A client's results for this morning's platelet count is 30,000/mm 3 . What action should the practical nurse (PN) implement first? Notify the healthcare provider. Institute bleeding precautions. Observe intravenous access sites. Take vital signs as soon as possible.

Institute bleeding precautions.

A male client is admitted with lower right abdominal pain for the past two days. During the focused assessment, the practical nurse (PN) observes that the client's abdomen is rigid with tense positioning. Which action should the PN implement? Withhold opioid use that contributes to constipation. Ask the client if he recently ate any gluten products. Determine if the client has biliary colic pain. Keep the client NPO for possible surgery.

Keep the client NPO for possible surgery.

Which assessment is most important for the practical nurse (PN) to implement for a client who returns from surgery for an arthroscopic repair of the right knee? Evaluation of pain symptoms. Auscultation of bowel sounds. Palpation of both pedal pulses. Observation of body temperature.

Palpation of both pedal pulses.

Which client medical diagnosis is a contraindication for peritoneal dialysis in a client with chronic renal failure? Anemia. Peritonitis. Diabetes mellitus. Hypercholesterolemia.

Peritonitis.

Which finding is most important for the practical nurse (PN) to explore further for a client who had a total abdominal hysterectomy and bilateral oophorectomy yesterday? Right calf is 24 cm and the left calf is 21 cm. No bowel sounds or gurgles auscultated in the abdomen. No urine output 3 hours after the catheter is removed. Dried blood 3 cm in size noted on the abdominal dressing.

Right calf is 24 cm and the left calf is 21 cm.

A client with newly diagnosed essential hypertension is learning to cope with stressful situations in his life. Which activity should the practical nurse (PN) implement to help the client learn constructive coping? Role play a situation the client identifies as stressful. Have the client list feelings indicating response to stress. Discuss with the client the behaviors used to respond to stress. Review maladaptive coping strategies that the client uses.

Role play a situation the client identifies as stressful.

The practical nurse (PN) should place a client in which position for a thoracentesis? In a modified Sims' position with arms extended above the head. Sitting upright in a tripod position leaning on an overbed table. In a supine position with the head of the bed elevated 45 degrees. Lying prone in a Trendelenburg position with both arms extended.

Sitting upright in a tripod position leaning on an overbed table.

Which findings should the practical nurse identify in a client with anemia due to a vitamin B 12 deficiency? Select all that apply Gradual weight gain. Smooth, beefy-red oral cavity. Macrocytic red blood cells (RBC). Paresthesia of hands and feet. Leukopenia.

Smooth, beefy-red oral cavity. Paresthesia of hands and feet.

What equipment should the practical nurse (PN) ensure is the room for a client after a thyroidectomy? Tracheostomy tray. Padded tongue blades. Closed chest drainage system. Sterile gauze.

Tracheostomy tray.

After a stroke, a male client with left hemiplegia ignores his left leg and arm. He is unable to use his right arm to assist with moving his left arm or leg. Which descriptor should the practical nurse (PN) document to describe this behavior? Mood changes. Sensory deficits. Unilateral neglect. Behavioral changes.

Unilateral neglect.

A male client who is unconscious after blunt trauma to the head during a baseball game is admitted for observation for possible epidural hematoma. The client is awake and oriented at each hourly check and becomes more difficult to arouse. Which additional finding should the practical nurse report? Hyperactive gag reflex. Nuchal rigidity. Vomiting. Bounding peripheral pulses.

Vomiting.

A male client is having an intraocular pressure (IOP) measurement using a tonometer for the first time. The client is fearful that the test hurts and may damage his vision. Which explanation should the practical nurse provide? Eyedrops will be prescribed for abnormal IOP readings. A topical anesthetic will be used on the eye surface. The test is quick and does not cause injury or blindness. Reassure the client that the procedure does not hurt.

A topical anesthetic will be used on the eye surface.

A client is scheduled for a transurethral resection of the prostate (TURP). What statement by the client reveals to the practical nurse that the client needs additional information? "I need to drink a lot after surgery." "My urine should be red after surgery." "My incision will probably be painful." "I should have a catheter after surgery."

"My incision will probably be painful."

A male client receives the negative results for his recent fecal occult blood test and calls the clinic to cancel his colonoscopy scheduled for the next day. Which information should the practical nurse provide? The colonoscopy should be canceled if he is asymptomatic. A negative result for occult blood does not rule out lesions in the colon. A followup colonoscopy should be scheduled after one month. Two negative fecal occult results are needed to verify no bleeding is occurring.

A negative result for occult blood does not rule out lesions in the colon.