EXAM #3 - Socrative ?s

A client is starting celecoxib to treat osteoarthritis. The nurse should instruct the client ot watch for and report which of the following adverse effects? 1. black, tarry stool 2. bone pain 3. dry mouth 4. polyuria

1

A nurse is caring for a client following a coronary artery bypass graft. Which assessment finding in the immediate postop period should be most concerning to the nurse? 1. No chest tube output for 1 hour when previously it was copious 2. Client temperature of 99.1 3. ABG result show pH 7.32; PCO2 48; HCO3 28: PO2 80 4. Urine output of 160 mL in the last 4 hours

1

A nurse is caring for a client who has had a MI. Upon his first visit to cardiac rehabilitation, he tells the nurse that he doesn't understand why he needs to be there because there is nothing more to do , as the

1

A nurse is caring who has rheumatoid arthritis about self care strategies for managing the disease. Which of the following activities should the nurse include in the teaching? 1. Press water form a sponge rather than wringing it 2. turn doorknobs using a clockwise motion 3. finish weekly household tasks within 1 to 2 days 4. Engage in repetitive tasks, even when joints are inflamed, to keep the joints mobile

1

A nurse is teaching the partners 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 enzymes studies 1. these tests help determine the degree of damage to the heart 2. cardiac enzymes will identify the location of the MI 3. These tests will enable the provier to determine the heat strucutre and mobility of the heart valves

1

A nurse's laboring client suddenly experiences a dramatic drop in the fetal heart rate from the 150s to the 110s. A vaginal exam reveals the presence of the fetal cord that has protruded through the cervix. What is the initial step the nurse should take? 1. Provide continuous pressure to hold the presenting part off the cord 2. Place the client in trendelenburg's position 3. insert and fill a foley 4. COntinue to monitor the FHR

1

A pt learns of having a 1 cm abdominal aortic aneurysm. What should the nurse emphasize when discussing the health problem with this patient? 1. stop smoking 2. increase physical activity 3. engage in stress management 4. reduce the intake of saturated fat

1

The nurse is assessing a client who complains of chest pain. Which laboratory parameter may differentiate between MI and angina pectoris? 1. Troponin 2. Myoglobin 3. Fibrinogen 4. C-reactive protein

1

The nurse is caring for a client with cardiogenic shock. Would the nurse expect the pulmonary capillary wedge pressure to be which of the following? 1. Increased 2. decreased 3. Normal 4. Unchanged

1

the husband of a postpartum client, who has been dx with postpartum depression, is concerned and asks a nurse what kind of treatment his wife will require. the nurse's response should be based on the knowledge that the collaborative place of care for PPD includes which of the following? 1. Antidepressant meds

1

A nurse is instructing a client dx with COD about care at home. The nurse determines that teaching is effective when the client states: SATA 1. If i have chest pain, i should contact my physician immediately 2. i should carry my nitroglycerin in my front pants pocket to it si handy 3. if i have chest pain, i stop activity and plane one nitro tab under my tongue 4. I should always take 3 nitro tablets, 5 minutes apart 5. I plan to avoid being around people when they are smoking 6. I plan on walking on most days of the week for at least 30 minutes

1, 3, 4, 5, 6

Which statement is not true about limited systemic scleroderma? SATA 1. the onset is rapid 2. it involves the trunk 3. internal organ involvement is unlikely 4. it involves the occurrence of Raynaud's phenomenon after the dx

1, 4

A nurse in the ED is preparing to administer alteplase accelerated therapy to a client who is having a MI. Which of the following actions should the nurse plan to take?SATA 1. Administer the med within 30 min of the client's arrival to the department 2. Reconstitute the med with sterile water 3. Administer a 15 mg IV bolus 4. Tell the client that the purpose of the med is to keep a new clot from forming 5. assess the client for back pain

1,2,3,5

A nurse should anticipate instructing a client schedule for a coronary artery bypass graft 1. discontinue taking aspirin prior to surgery 2. perform post op cardiac rehab exercises and stress management strategies 3. wash with an antimicrobial soap the evening prior to surgery 4. shave the chest and legs and then shower to remove the hair 5. resume normal activities when discharged from the hx 6. expect close monitoring after surgery, several IB lins, a urinary catheter, endotracheal tube, and chest tube

1,2,3,6

A nurse is preparing a presentation at a community center about osteoarthritis. The nurse should plan to include which of the following information? SATA 1. affects weight -bearing joints 2. crepitus can occur in affected joints 3. affects bilateral, symmetrical joints 4. causes joint stiffness 5. causes joint pain

1,2,4,5

while dx a client with oral trauma, the nurse finds ineffective airway clearance. Which characteristic findings are likely observed. SATA? 1. Respiratory stridor 2. impaired ability to eat or drink 3. Swelling in and around the mouth 4. increase vascularity of the face and mouth 5. Difficulty in managing oral secretions

1,3

Which is true regarding diffuse systemic sceroderma? SATA 1. it is a chronic systemic autoimmune disease 2. it shows an insidious onset 3. it involves the skin of the extremities and the trunk 4. it is most likely to affect internal organ, generally w/in 2 years of onset 5. Raynaud's phenomenon may precede disease dx by years

1,3,4

A nurse is preparing a client for a thoracic aneurysm repair. Which assessment findings lead the nurse to suspect that a rupture has occurred?SATA 1. severe chest pain radiating to the back 2. abdominal distention 3. hypotension 4. dyspnea 5. oliguria

1,3,4,5

As part of discharge education for a postpartum client, a nurse suggests prevention strategies for postpartum depression. WHich prevention strategies should the nurse include when educating the client on postpartum depression? 1. attending a postpartum support group\ 2. using the baby's nap time ton complete household chores 3. keeping a journal of feelings during the postpartum period 4. notifying the health care provider if feeling of being overwhelmed do not subside quickly 5. setting a daily schedule and following it 6. completing major life changes within the first year after the birth

1,3,4,5

A client is in the ED w an esophageal trauma. The nurse palpates subcutaneous emphysema in the mediastinal area and up into the lower part of teh clients neck. What action by the nurse takes priority? 1. assess the client's oxygenation 2. facilitated a STAT chest x-ray 3. Prepare for immediate surgery 4. Start 2 large bore IVs

1`

A client admitted with a dx of acute coronary syndrome calls for a nurse after experiencing sharp chest pains that radiate to the left should. THe nurse notes, prior to entering the client's room, that the client's rhythm is sinus tachycardia with a 10-beat run of premature ventricular contractions. Admitting orders included all of the following interventions for treating chest pain. Which should the nurse implement first? 1. Obtain 12 - lead ECG 2. Administer oxygen by nasal cannula 3. Administer sublingual nitroglycerin 4. Administer morphine sulfate intravenously

2

A nurse in a prover's office is caring for a client who is at 34 weeks of gestation and at risk for placental abruption. The nurse should recognize that which of the following is the most common risk factor for abruption? 1. cocaine use 2. hypertension 3. blunt force trauma 4. cigarette smoking

2

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 hep C. 1. A client who eats raw shellfish 2. A client who has multiple tattoos 3. A client who works in child care center 4. A client who has recently traveled to a underlying country

2

A nurse is providing teaching to a client who is ostop following coronary artery bypass graft surgery and is receiving opioid meds to manage discomfort. Aside from managing pain, which of the followed desired effects of meds should the nurse identify as most important for the client's recovery 1.

2

A nurse is teaching a client how to follow a low-purine diet for the management of gout. which of the following statements indicates the client UNDERSTANDS the teaching? 1. i will need to limit the # of fruit servings each day 2. i should avoid eating liver and onions 3. I can drink only white wine 4. i should choose red meat instead of poultry

2

A nurse is teaching a client who has a new prescription of allopurinol for the treatment of gout. WHich of the following instructions should the nurse include? 1. take the medication on an empty stomach 2. drink 2 liter of fluid each day while taking the medication 3. take a 650 mg dose of aspirin for joint pain 4. do not crush the med before taking it

2

A nurse on the obstetric unit is caring for a client who experienced abruptio placentae. The nurse observes petechiae and bleeding around the IV access site. The nurse should recognize that this client is at risk for which of the following complications? 1. anaphylactoid syndrome of pregnancy 2. disseminated intravascular coagulation 3. preeclampsia 4. puerperal infection

2

A patient is dx with an abdominal aneurysm measuring 5 cm. Which teaching materials should the nurse prepare for this patient? 1. Dietary changes 2. Preoperative and postoperative care 3. Actions to reduce high BP 4. Activities to prevent aneurysm rupture

2

The nurse if reviewing the ECG of the pt admitted for acute pericarditis. Which ECG change does the nurse anticipate? 1. Normal ECG 2. ST segment Elevation 3. Peaked t wave 4. Wide QRS complexes

2

The nurse is caring for a client with a PA catheter. The nurse understands that the SVO2 will most likely be which of the following if the client is in cardiogenic shock? 1. increased 2. decreased 3. normal 4. not significant

2

The nurse is managing the care of a pt w an arterial line. Which assessment finding warrants immediate intervention by the nurse? 1. a damped or flat waveform on the monitor 2. Tubing disconnected from the arterial line 3. IV medications being infused into an arterial line 4. Redness at the arterial line insertion site

2

The nurse is providing care to a pt who presents to the ED with an abdominal stab injury. WHich the the nurse assess for based on the current data? 1. spleen injury 2. liver laceration 3. intestinal obstruction 4. TBI

2

Which nursing intervention should a nurse take when caring for a client before heart catheterization? 1. Obtain an ECG test 2. delay administering diabetic medications 3. Restrict the client from performing activity 4. Monitor peripheral pulses of the affected extremity

2

Which statement about complication of PPD is accurate? 1. Children of mothers treated with PPD will develop language delay 2. newborns of mother untreated for PPD may fail to thrive 3. Mothers treated for PPD will develop chronic depression

2

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? 1. a grey colored, non-purpuri papular rash 2. a dry, red rash across the bridge of the nose and on the cheeks 3. pitting edema of the hands and fingers 4. subcutaneous nodules on the ulnar side of the arm

2

a nurse is teaching a client who has a new prescription for colchicine to tx gout. Which of the following instructions should the nurse include? 1. Take the med with food if nausea develops 2. monitor for muscle pain 3. expects to have increased bruising 4. increase grapefruit juice intake

2

an older adult, hospitalized with chest trauma following a MVA, has a r. femoral arterial line. Because the client has been thrashing about in bed, a physician writes an order for wrist restraints to be applied. Based on this information, which action by a nurse is correct? 1. Apply the wrist restraints as ordered 2. Request an order for a right ankle restraint also 3. Request an order for sedation instead of restraints 4. Question the order because restraints will increase the client's agitation

2

cliet dx with cirrhosis, has become increasingly irritable and restless. Is put on protein-restricted diet, why? 1. help to restore their father's liver function 2. Help reduce the amount of ammonia in the clients' blood 3. prevent fluid from leaking intor abdomen 4. give's the liver a change to rest, since protein in the diet make th eliver work harder.

2

the nurse is providing discharge teaching to a client who has SLE. Which of the following institutions should the nurse include? 1. avoid using moisturizing lotions on the skin 2. wash the hair with a mild protein shampoo 3. apply power liberally to sensitive skin areas 4. use a sun blocking agent with a sun protection factor of at least 15

2

the nurse receives change of shift report on 4 clients. WHich client should the nurse assess first? 1. The 29 yo pt with HR who is experiencing anxiety r/t scheduling of a valvuloplasty later today 2. The 40 yo client

2

A nurse is providing teaching a client who has rheumatoid arthritis and a new prescription for methotrexate. Which of the following instructions should the nurse include: SATA 1. Expect to feel the medication's effects immediately 2. Do not drink alcoholic beverages while taking this medication 3. Report unexplained bruising to the provider 4. avoid people who have infections 5. Take NSAIDs to help minimize the adverse effects of the medication

2,3,4

During the postop period after an aneurysmectomy, the nurse will implement which actions? SATA 1. keep the HOB elevated at 60 degrees 2. Keep firm pressure on the ab incision during coughing 3. Change dressing as ordered with aseptic technique 4. monitor peripheral pulses of both lower extremities 5. use the bed's knee gatch to allow for knee flexion during bed rest

2,3,4

A 77 yo pt is dx w an ab AAA measuring 3.5cm, which was discovered on a routine health physical. The pt has a 30 pack year hx of cigarette smoking. Which learning need should a nurse identify as most important for the client? 1. understand the importance and begin the process of smoking cessation 2. understand and follow a reduced sodium and low sat fat diet 3. follow through with medical supervision so the size of the aneurysm can be monitored at regular intervals 4. verbalize understanding of preoperative and postoperative care following surgical repair of the aneurysm

3

A client has a hx of MI is prescribed asprin 325 mg. the nuse recognizes that the aspirin is given due to which of the following actions of the medications? 1. analgesic 2. anti-inflammatory 3. Antiplatelet aggregate 4. Antipyretic

3

A nurse is caring for a client who received a dx of systemic scleroderma 5 years ago. The nurse plans to assess the client to document the disease's progression. In addition to skin changes, which of the following findings should the nurse expect? 1. Periorbital edema 2. Excessive salivation 3. Finger contractures 4. Thinning of the skin

3

A nurse is caring for a client who reports a new onset of severe chest pain. Which of the following actions should the nurse take to determine if the client is experiencing a MI? 1. Check BP 2. Auscultate heart tones 3. Perform 12-lead ECG 4. Determine if pain radiates to the left arm

3

A nurse is examining a client in the ED who has just sustained blunt force trauma to the abdomen. The nurse notes ecchymosis located on the flank region of the client. THe nurse notes this is which of the following 1. BLue's sign 2. Cullen's sign 3. Turner's sign 4. Melon's sign

3

A nurse is teaching a client who has Hep A about preventing transmission of the virus. Which of the following strategies should the nurse include in the teaching? 1. avoid eating at fast food restaurants 2. avoid serving raw foods 3. practice effective hand hygiene 4. Wear barrier protection during vaginal intercourse

3

A nurse is teaching a group of clients about osteoarthritis. Which of the following recommendations should the nurse include in the teaching? 1. Use echinacea to manage joint pain 2. apply ice to the joint before exercising 3. maintain a recommended body weight 4. reduce the amount of purine in the diet

3

The pt is admitted for pericarditis. In order to assess and help the patient to feel more comfortable, what does the nurse instruct the pt to do? 1. sit in semi-fowlers 2. lie on their side in the recovery position 3. sit up and lean forward 4. lie down in the supine and ned the legs at the knees

3

Which statement about postpartum psychosis is accurate? 1. the clinical features appear few weeks after childbirth 2. a family history of schizophrenia is a significant risk factor 3. a woman with a history of bipolar disorder is at risk for postpartum psychosis

3

a nurse is admitting a client who has acute heart failure following MI. The nurse recognizes that which of the following prescription by the provider requires clarification 1. morphine sulfate 2 mg IV bolus 2. LAb testing of serum potassium upon admission 3. 0.9% NS IV at 50 mL/hr continuous 4. Bumetanide 1 mg IV bolus every 12 hour

3

a nurse is assessing a client who has systemic lupus erythematosus. WHich of the following findings is the highest priority for the nurse to report to the provider? 1. client report of feelings of depression 2. dry, raised rash on the face 3. presence of peripheral edema 4. joint pain in hands and knees

3

A nurse is caring for a client w a central venous catheter located in the subclavian vein. The provider has ordered the catheter to be discontinued. The nurse will place the client in which position for removal of the catheter? 1. Semi-fowler's 2. Prone 3. Trendelenburg 4. HOB at least 15-30 degrees

3 - to prevent air embolism

A nurse is teaching a client about risk factors for osteoarthritis. WHich of the following factors should the nurse include in the teaching? SATA 1. bacteria 2. diuretics 3. aging 4. obesity 5. smoking

3,4,5

a nurse is the ER is assessing a client who is having a suspected acute MI. WHich of the following manifestations should the nurse expect to find or a client experiencing an acute MI? SATA 1. Orthopnea 2. Headache 3. Nausea 4. Tachycardia 5 diaphoresis

3,4,5

A nurse is caring for a client with facial trauma. Which actions of the nurse are most beneficial in promoting wound healing? SATA 1. Keep wire cutters near the client at all times 2. provide oral humidification 3. encourage the client to consume adequate nutrition 4. providing frequent mouth care by rinsing the mouth after meals 5. administering antibiotics

3,4,5 all should be done - not all for wound healing

A nurse assesses a client who has just returned to a telemetry unit after having a coronary angiogram using the left femoral artery approach. The client's baseline BP during the procedure was 130/72 mmHg and the cardiac rhythm was a normal sinus throughout. WHich assessment finding should indicate to the nurse that the client may be experiencing a complication? 1. BP 144/78 mmHg 2. Pedial pulses palpable at 1+ 3. left groin soft with 1 cm 4. Atypical pulse 132 bpm w/an irregular-irregular rhythm

4

A nurse assessing a client hospitalized following a MI obtains the follwing vtial signs: BP 78/38 mmHG, HR 128, RR 32. For which life threatening

4

A nurse is admitting a client who is at 33 weeks of gestation and has a dx of placenta previa. Which of the following is the priority nursing action? 1. monitor vaginal bleeding 2. administer glucocorticoids 3. insert foley catheter 4. apply an external fetal monitor

4

A nurse is caring for a client who is in labor at 40 weeks of gestation and reports that she has saturated two perineal pads in the past 30 min. The nurse caring for her suspects placenta previa. WHich of the following is an appropriate nursing action? 1. Examination to determine cervical status 2. a magnesium sulfate infusion 3. initiation of pushing 4. Preparation for cesarean birth

4

A nurse is planning care for a client who has Hep B. Which of the following interventions should the nurse include in the plan? 1. administer antibiotics 2. provide a diet high in fat 3. Restrict fluids 4. Encourage short periods of ambulation

4

A nuse is caring for a client who has developed gout. which of the following medications should the nurse prepare to administer? 1. Zolpidem 2. Alprazolam 3. Spironolactone 4. Allopurinol

4

An ED nurse is assessing a pediatric client suspected of having acute pericarditis. Which assessment finding should the nurse conclude supports the dx of acute pericarditis? 1. bilateral lower extremity pain 2. pain on expiration 3. pleural friction rub 4. pericardial friction rub

4

The nurse is caring for 4 clients. Which client may be at risk of developing sclerodoma? 1. 29 yo caucasioan male 2. 50 yo caucasian female. 3. 40 yo african american male 4. 25 yo african american female

4

a nurse admits a client to a hx and obtains a nursing hx. The client tells the nurse that he had an endovascular repair of an AAA found 1 year earlier during routine screening. THe nurse understands that his procedure consists of: 1. Excision of the aneurysm and placement of a graft percutaneously 2. an angioplasty w placement of a stent around the outside of the aorta 3. placement of a filter within the aneurysm to block clots from becoming emboli 4. placement of a stent graft inside the aorta

4

a nurse is admitting a client with Hep C. Which of the following precautions should the nurse implement? 1. droplet 2. contact 3. airborne 4. standard

4