Med Surg Test 2
The nurse identifies a client's rhythm to be a sustained supraventricular tachycardia. What medication does the nurse administer?
Diltiazem (Cardizem)
The nurse is providing discharge teaching for a client who has peptic ulcer disease caused by Helicobacter pylori (spiral shaped) infection. Which statement by the client indicates that additional teaching is needed?
"I will take my medication every day until my heartburn is gone."
The nurse is teaching a client recovering from a laparoscopic cholecystectomy. Which statement indicates the discharge teaching was effective? 1. "I will take my lipid-lowering medicine at the same time each night. "2. "I may experience some discomfort when I eat a high-fat meal. "3. "I need someone to stay with me for about a week after surgery. "4. "I should not splint my incision when I deep breathe and cough.
2. "I may experience some discomfort when I eat a high-fat meal."
A nurse working for a home health agency is teaching a client who has diabetes mellitus about disease management. Which of the following HBA1C values should the nurse include in the teaching as an indicator that the client is appropriately controlling his glycemic index?
6.3% is within the normal range. 10-12% is too high.
For clients on heparin, a PTT of 1.5 to 2.5 times the normal value is needed to demonstrate the heparin is working.
A normal PTT is 25 to 35 seconds
What do you assess for on day 1 following a BKA?
A. Hemorrhage
A nurse is conducting a preoperative interview with a client who is scheduled for surgery. The client states that he takes acetylsalicylic acid (Aspirin) 81 mg by mouth daily. Prior to the client's upcoming surgery, the nurse should instruct the client to do which of the following?
A. discontinue the dose 2 weeks before surgery
A nurse evaluates prescriptions for a client with chronic atrial fibrillation. Which medication should the nurse expect to find on this clients medication administration record to prevent a common complication of this condition?
Adenosine (adenocard)
A client with myocardial ischemia is having frequent early, wide ventricular complexes seen on the cardiac monitor. Which medication does the nurse administer?
Amiodarone (Cordarone)
What drug do you give for PE?
Anticoagulant/Blood thinner - heparin
A client is admitted with suspected cholecystitis and elevated amylase. Which is the best action?
Ask about alcohol use
A patient with chronic cholecystitis reports pruritus, clay-colored stools, and voiding dark, frothy urine. Which laboratory analysis is a priority in the nurse's assessment of this patient? A) Lipase level B) Total bilirubin C) Liver function tests D) White blood cell count
B) Total bilirubin
A nurse is teaching the partner of a client who had an acute MI about the reason blood was drawn from the client. Which of the following statements should the nurse make regarding cardiac enzyme studies? A. Cardiac enzymes will identify the location of the MI B. These lab tests help determine the degree of damage to the heart tissue (troponin and creatine pho. are most commonly measured) C. These tests will enable the provider to determine the heart structure and mobility of the valves D. Cardiac enzymes assist in dug paint the presence of pulmonary congestion
B. These lab tests help determine the degree of damage to the heart tissue (troponin and creatine
History of MI and prescribed aspirin the nurse understand that the aspirin is ordered due to what?
Blood thinner to help release blockage
Before the nurse brings the client to the operating room (OR) for knee surgery, the client reports to the nurse that he did not mark the operative knee with the surgeon. What is the priority action of the nurse? a. Proceed with transferring the client to the OR as planned .b. Call a "time out" so the site can be marked before surgery begins. c. Call the surgeon to mark the site with the client before transfer to the OR. d. Have the client mark the site before transfer to the OR.
C. Call the surgeon to mark the site with the client before transfer to the OR.
A patient with diabetes wants teaching on how to delay complications of macro and microvascular disease?
Control your hyperglycemia
A nurse is caring for a client who is postoperative following abdominal surgery. The surgeon initially prescribes a clear liquid diet. Which of the following items should the nurse include on the client's lunch tray? A. Plain Yogurt B. Carrot Juice C. Lemon Sherbet D. Cranberry Juice
D. Cranberry Juice
The nurse is alerted to a client's telemetry monitor. After assessing the following ECG, what is the nurse's priority intervention?*there is a picture of the strip that shows ventricular fibrillation* a. Start a large-bore IV. b. Administer atropine. c. Prepare for intubation. d. Perform defibrillation.
D. Perform defibrillation
Where does peptic ulcer disease form???
Duodenum ?
When a patient comes into emergency room with hard time breathing what do you do?
Give oxygen/assess airway
A client admitted with a gastrointestinal ulcer is NPO and has a nasogastric tube connected to low suction. The nurse monitors the client for which type of shock? a. Distributive shock b. Obstructive shock c. Cardiogenic shock d. Hypovolemic shock
Hypovolemic shock
A client with ventricular tachycardia (VT) is unresponsive and has no pulse. The nurse calls for assistance and a defibrillator. What is the nurse's priority intervention while waiting for the defibrillator to arrive?
Initiate CPR
EGD client teaching?
Moderate sedation, consent, gag reflex,
A nurse in a clinic is caring for a client who has a prescription for digoxin. Which of the following statements indicates the client is experiencing digoxin toxicity?
My vision seems yellow/blurred???
The nurse notes frank red blood in the drainage container from the nasogastric (NG) tube of a client who is 2 days post esophagogastrostomy. Which is the nurse's priority intervention?
Notifying the physician that the suture line is bleeding;assess vitals and abdomen
When caring for a patient with an MI, what do you administer first?
Oxygen
A client comes to the outpatient clinic and tells the nurse that he has had leg pains that begin when he walks but cease when he stops walking. Which of the following conditions would the nurse assess for?
Peripheral vascular problem in both legs
A nurse is assessing the elastic bandage on the stump of a client who had right below the knee amputation. Which of the following findings should the nurse identify as a complication?
Pitting edema around stumps
A client with untreated DM has a BG of 500mg/dl with polyuria. What lab value is associated with this?
Serum osmolality 375mOsm/L
RVF signs and symptoms:
Systemic congestion, JVD, enlarged liver and spleen, anorexia, nausea, dependent edema, distended abdomen, swollen hands and fingers, polyuria, weight gain, increased or decreased BP
The nurse is monitoring the electrocardiogram (ECG) of a client who has a myocardial infarction. Which changes does the nurse expect to see in the ECG tracing? (Select all that apply.)
T WAVE INVERSION ST SEGMENT ELEVATIONABNORMAL Q WAVE
A client has been taught to inject insulin. Which statement made by the client indicates a need for further teaching? a. "The abdominal site is best because it is closest to the pancreas. "b. "I can reach my thigh the best, so I will use different areas of the same thigh." c. "By rotating the sites in one area, my chance of having a reaction is decreased. "d. "Changing injection sites from the thigh to the arm will change absorption rates."
a. "The abdominal site is best because it is closest to the pancreas."
The nurse is caring for a client who has heart failure and a history of asthma. The nurse reviews the providers orders and recognizes that clarification is needed for which of the following medications?
a. Carvedilol (coreg)
How do you know that a patient with newly diagnosed hypertension understands their diet restrictions ?
Two or fewer servings of lean meat fish. The diet also recommends 2 or 3 servings of low fat or fat free dairy foods, four or five servings of fruits. And veggies and 7 or 8 of grains and products. AVOID SODIUM
The nurse is caring for several postoperative clients on the unit. Which client does the nurse assess first? a. Client with 200 mL dark drainage from the nasogastric tube in an hour b. Client who received oral pain medication 20 minutes ago c. Client who has not yet ambulated after surgery 4 hours ago d. Client requiring discharge teaching and whose family is present
a. Client with 200 mL dark drainage from the nasogastric tube in an hour
A client in the emergency department has been diagnosed with DKA. Which manifestation does the nurse correlate with this condition? a. Increased rate and depth of respiration b. Extremity tremors followed by seizure activity c. Oral temperature of 102° F (38.9°C) d. Severe orthostatic hypotension
a. Increased rate and depth of respiration
A client who has just been transferred to the post-anesthesia care unit (PACU) from surgery is very restless and confused. What is the nurse's first action? a. Orient the client and remain with him or her. b. Call the surgeon for an intraoperative report. c. Notify the physician on call. d. Assess the client's level of pain.
a. Orient the client and remain with him or her.
A patient asks why do I have to maintain a blood sugar no less than 60 mg/dl?
Your brain needs a constant supply of glucose
The nurse notes the following rhythm on a client's telemetry monitor. How does the nurse interpret these findings?*another strip that shows tachycardia* Care of patients with dysrhythmias chapter. a. Ventricular tachycardia b. Second-degree heart block c. Supraventricular tachycardia d. Premature ventricular contractions
a. Ventricular tachycardia
A nurse is completing the preoperative teaching for a client who is to undergo a gastrectomy. Which of the following information should the nurse include in the prevention of postoperative complications?
a. apply a sequential compression device
The nurse is caring for a client 3 days after a below-knee amputation. Which is a priority intervention? a.Muscle-strengthening exercises b. Use of a very soft bed mattress c. Placing a pillow between the client's knees d. Placing the client in high Fowler's position
a.Muscle-strengthening exercises
The nurse has just completed preoperative teaching with a client who will be having surgery the following day. Which statement by the client indicates that additional teaching is needed? a. "When I brush my teeth before surgery, I will be sure to spit out the water." b. "I will go to the bathroom as soon as I receive all my preoperative medications." c. "I will remember to wear my glasses tomorrow instead of my contact lenses." d. "I won't have to worry about putting my makeup on tomorrow morning."
b. "I will go to the bathroom as soon as I receive all my preoperative medications."
An obese client has reflux and asks how being overweight could cause this condition. Which response by the nurse is best? a. "You eat more food, more often than nonobese people do. "b. "The weight adds extra pressure, which helps push stomach contents up." c. "Obese people tend to eat more high-fat food, which presents a risk. "d. "Obesity is not related to reflux, but losing weight would be healthy."
b. "The weight adds extra pressure, which helps push stomach contents up."
A nurse assesses the following electrocardiography (ECG) strip from a client's telemetry monitor. What does the nurse chart as the client's ventricular heart? *Look at the block method to calculate HR* a. 40 beats/min b. 80 beats/min c. 120 beats/min d. 160 beats/min
b. 80 beats/min
The nurse is assessing a client admitted to the post-anesthesia care unit (PACU) after abdominal surgery. The client's respiratory rate is 8 breaths/min and breath sounds are decreased in the bases. What is the nurse's priority action? a. Prepare to administer naloxone (Narcan). b. Assess oxygen saturation and level of consciousness. c. Call a code or the Rapid Response Team. d. Turn the client and perform chest physiotherapy.
b. Assess oxygen saturation and level of consciousness.
A client has Barrett's esophagus. Which client assessment by the nurse requires consultation with the health care provider? a. Sleeping with the head of the bed elevated b. Coughing when eating or drinking c. Wanting to eat several small meals during the day d. Chewing antacid tablets frequently during the day
b. Coughing when eating or drinking
The nurse assesses a client who has just been brought to the postanesthesia care unit (PACU). In the operating room, the client's blood pressure was 136/80 mm Hg; it is now 110/80 mmHg. Urine output was 40 mL/hr and is now 10 mL/hr. Which action by the nurse is best? a. Awaken the client and encourage oral fluids. b. Increase the IV of 0.9 NS as ordered to 100 mL/hr. c. Put the client in Trendelenburg position. d. Assess the client's levels of consciousness and pain.
b. Increase the IV of 0.9 NS as ordered to 100 mL/hr.
The nurse assesses a client with a below-knee amputation. Which assessment of the skin flap requires immediate action? a. Pink and warm to the touch b. Pale and cool to the touch c. Dark pink and dry to the touch d. Pink and slightly moist to the touch
b. Pale and cool to the touch
How do you Prevent reflux?
by teaching patient to use a pillow and elevate
Which instruction does the nurse provide to a client to prevent postoperative venous thromboembolism? a. "Cough and deep-breathe six times every hour after surgery." b. "Use your incentive spirometer hourly." c. "Get up and walk as much as possible." d. "Keep the sterile dressing on your incision."
c. "Get up and walk as much as possible."
A client has been newly diagnosed with diabetes mellitus. Which statement made by the client indicates a need for further teaching regarding nutrition therapy? a. "I should be sure to eat moderate to high amounts of fiber. "b. "Saturated fats should make up no more than 7% of my total calorie intake." c. "I should try to keep my diet free from carbohydrates. "d. "My intake of plain water each day is not restricted."
c. "I should try to keep my diet free from carbohydrates."
A client is undergoing diagnostic testing for gastroesophageal reflux disease (GERD). Which test does the nurse tell the client is best for diagnosing this condition? a. Endoscopy b. Schilling test c. 24-Hour ambulatory pH monitoring d. Stool testing for occult blood
c. 24-Hour ambulatory pH monitoring
A client who has had an above-knee amputation of the right leg reports pain in the right foot. Which priority medication does the nurse administer? a. IV morphine b. 650 mg of acetaminophen c. IV calcitonin d. 600 mg of ibuprofen
c. IV calcitonin
A client who has undergone Nissen fundoplication for gastroesophageal reflux disease (GERD) is ready for discharge home. Which statement made by the client indicates an understanding of the disease? a. "I will no longer need any medication for my GERD. "b. "I will avoid spicy foods because they can irritate the suture line. "c. "I should take anti-reflux medications when I eat a large meal. "d. "I will need to continue to watch my diet and may still need medication."
d. "I will need to continue to watch my diet and may still need medication."
The nurse is completing preoperative teaching for a client, and it becomes apparent that the client does not understand the surgery that will be performed. What is the priority action for the nurse? a. Obtain informed consent from the client. b. Continue teaching the client about the surgery. c. Revise the teaching plan for the client. d. Notify the surgeon and document the findings.
d. Notify the surgeon and document the finding.
The health care provider is prescribing medication to treat a client's severe gastroesophageal reflux disease (GERD). Which medication does the nurse anticipate teaching the client about? a. Magnesium hydroxide (Gaviscon) b. Ranitidine (Zantac) c. Nizatidine (Axid) d. Omeprazole (Prilosec)
d. Omeprazole (Prilosec)
The nurse administers a beta blocker to a client after a myocardial infarction. What assessment findings does the nurse expect? a. Blood pressure increase of 10% b. Increasing respiratory rate c. Increased cardiac output d. Pulse decrease from 100 to 80 beats/min
d. Pulse decrease from 100 to 80 beats/min
Risk factors for DVT:
immobility , diabetes, obesity, clotting, oral contraceptives, recent surgery,
