Med Surg 1 Final Review Fall2019

Place the pathophysiological steps in correct order for the development of dumping syndrome. Hypertonic food bolus from the stomach to the small intestine Release of metabolic peptides Tachycardia, dizziness, sweating, nausea, vomiting, bloating, abdominal cramping, and diarrhea Rapid rise of glucose, release of insulin, reactive hypoglycemia

ABCD

Which is one of the most common causes of death in clients diagnosed with fat emboli syndrome? Myocardial infarction Stroke Acute respiratory distress syndrome Pulmonary embolism

Acute respiratory distress syndrome

The nurse is reviewing lab work on a newly admitted client. Which of the following diagnostic studies confirm the nursing diagnosis of Deficient Fluid Volume? Select all that apply. An elevated hematocrit levels A low urine specific gravity Electrolyte imbalance Low protein level in the urine Absence of ketones in urine

An elevated hematocrit levels Electrolyte imbalance

To prevent thromboembolism in the postoperative client, the nurse should include which of the following in the plan of care? Place a pillow under the knees. Assist the client with deep breathing. Splint the incision when ambulating. Assist with oral fluid intake.

Assist with oral fluid intake

Which is often the most disabling clinical manifestation of multiple sclerosis? Pain Fatigue Spasticity Ataxia

Fatigue

The nurse is caring for a client in acute kidney injury. Which of the following complications would most clearly warrant the administration of polystyrene sulfonate? Hypernatremia Hypomagnesemia Hyperkalemia Hypercalcemia

Hyperkalemia

A diagnostic test has determined that the appropriate diet for the client with a left cerebrovascular accident (CVA) should include honey thickened liquids. Which of the following is the priority nursing diagnosis for this client? Risk for Fluid Volume Deficit Risk forElectrolyte Imbalance Impaired Swallowing Altered Nutrition:Less Than Body Requirements

Impaired Swallowing

A nurse is providing care to a client with primary hyperparathyroidism. Which interventions would be included in the client's care plan? Select all that apply. Monitor gait, balance, and fatigue level with ambulation. Monitor for fluid overload. Monitor for signs and symptoms of diarrhea. Encourage intake of dairy products, seafood, nuts, broccoli, and spinach.

Monitor gait, balance, and fatigue level with ambulation. Monitor for fluid overload.

Which of the following would be appropriate nursing interventions for a client with hypokalemia? Select all that apply. Offer a diet with fruit juices and citrus fruits. Administer the ordered Kayexalate enema. Administer the ordered furosemide 60 mg po. Monitor intake and output every shift. Administer the ordered potassium 40 mg IV push.

Offer a diet with fruit juices and citrus fruits Monitor intake and output every shift.

The nurse is performing an assessment for a patient with congestive heart failure. The nurse asks if the patient has difficulty breathing in any position other than upright. What is the nurse referring to? Dyspnea Orthopnea Tachypnea Bradypnea

Orthopnea

When caring for a client with essential hypertension what instruction should the nurse provide to the client to normalise blood pressure? Increase iodine intake. Increase intake of fluids. Avoid intake of low-fat diet. Reduce sodium intake.

Reduce sodium intake

A client who has developed congestive heart failure must learn to make dietary adaptations. The client should avoid: canned peas. dried peas. angel food cake. ready-to-eat cereals.

canned peas

The nurse is caring for a client with coronary artery disease. What is the nurse's priority goal for the client? decrease anxiety enhance myocardial oxygenation administer sublingual nitroglycerin educate the client about his symptoms

enhance myocardial oxygenation

The nurse is administering a stool softener to a client who experienced a myocardial infarction. The client says, "I had a heart attack; I don't have a problem with constipation." What explanation will the nurse use to answer the client's question? "If you strain to have a bowel movement, you can cause a drop in your heart rate that can be dangerous." "The heart attack sets you up for limited activity, so constipation is often a problem for clients after a heart attack." "Please talk this over with your healthcare provider for further information." "The prescribed stool softener will decrease stress with a bowel movement and protect your heart from further injury."

"If you strain to have a bowel movement, you can cause a drop in your heart rate that can be dangerous."

The nurse is teaching the client about coronary artery damage after an abnormal fasting lipid profile. The client asks the nurse what type of lipid is most troublesome. What is the nurse's best response? "The total cholesterol level of 252 mg/dL warrants medication treatment alone." "The low-density lipoproteins (LDL) pose a threat to plague formation and can cause a heart attack or stroke." "The higher the high-density lipoproteins (HDL), the more at risk you are for heart damage or a stroke." "The triglycerides levels measure good fat, so the higher the level, the less risk you are for a heart attack or stroke."

"The low-density lipoproteins (LDL) pose a threat to plague formation and can cause a heart attack or stroke."

The nurse is caring for a client in the intensive care unit (ICU) following a near-drowning event in saltwater. The client is restless, lethargic, and demonstrating tremors. Additional assessment findings include swollen and dry tongue, flushed skin, and peripheral edema. The nurse anticipates that the client's serum sodium value would be 155 mEq/L (155 mmol/L) 145 mEq/L (145 mmol/L) 135 mEq/L (135 mmol/L) 125 mEq/L (125 mmol/L)

155 mEq/L (155 mmol/L)

A patient is admitted with severe vomiting for 24 hours as well as weakness and "feeling exhausted." The nurse observes flat T waves and ST-segment depression on the electrocardiogram. Which potassium level does the nurse observe when the laboratory studies are complete? 4.0 mEq/L 8.0 mEq/L 2.0 mEq/L 2.6 mEq/L

2.0 mEq/L

A nurse is caring for a client who has been admitted to the hospital with diverticulitis. What would be appropriate nursing diagnoses for this client? Select all that apply. Acute Pain Related to Increased Peristalsis and GI Inflammation Activity Intolerance Related to Generalized Weakness Bowel Incontinence Related to Increased Intestinal Peristalsis Deficient Fluid Volume Related to Anorexia, Nausea, and Diarrhea Impaired Urinary Elimination Related to GI Pressure on the Bladder

Acute Pain Related to Increased Peristalsis and GI Inflammation Activity Intolerance Related to Generalized Weakness Deficient Fluid Volume Related to Anorexia, Nausea, and Diarrhea

Which nursing action would help prevent deep vein thrombosis in a client who has had an orthopedic surgery? Instruct about using client-controlled analgesia, if prescribed Instruct about exercise, as prescribed Apply antiembolism stockings Apply cold packs

Apply antiembolism stockings

A client who was diagnosed with Parkinson's disease several months ago recently began treatment with levodopa-carbidopa. The client and his family are excited that he has experienced significant symptom relief. The nurse should be aware of what implication of the client's medication regimen? The client is in a "honeymoon period" when adverse effects of levodopa-carbidopa are not yet evident. Benefits of levodopa-carbidopa do not peak until 6 to 9 months after the initiation of treatment. The client's temporary improvement in status is likely unrelated to levodopa-carbidopa. Benefits of levodopa-carbidopa often diminish after 1 or 2 years of treatment.

Benefits of levodopa-carbidopa often diminish after 1 or 2 years of treatment.

The nurse is completing an assessment on a client with myasthenia gravis. Which of the following historical recounting provides the most significant evidence regarding when the disorder began? Shortness of breath Sensitivity to bright light Muscle spasms Drooping eyelids

Drooping eyelids

When teaching a client about hypertension and lifestyle changes what does the nurse emphasizes should be included in the diet? Fresh fruits and vegetables Chloride-containing foods Whole milk and cheeses A glass of red wine

Fresh fruits and vegetables

A nurse is caring for a client with metastatic breast cancer who is extremely lethargic and very slow to respond to stimuli. The laboratory report indicates a serum calcium level of 12.0 mg/dl, a serum potassium level of 3.9 mEq/L, a serum chloride level of 101 mEq/L, and a serum sodium level of 140 mEq/L. Based on this information, the nurse determines that the client's symptoms are most likely associated with which electrolyte imbalance? Hyperkalemia Hypocalcemia Hypokalemia Hypercalcemia

Hypercalcemia

Immediately after a burn injury, electrolytes need to be evaluated for a major indicator of massive cell destruction, which is: Hyperkalemia. Hypernatremia. Hypocalcemia. Hypoglycemia.

Hyperkalemia

The nurse is caring for a client who has been admitted with a possible clotting disorder. The client is complaining of excessive bleeding and bruising without cause. The nurse knows to take extra care to check for signs of bruising or bleeding in what condition? Dehydration Hypokalemia Hypocalcemia Hypomagnesemia

Hypocalcemia

Crohn's disease is a condition of malabsorption caused by which pathophysiological process? Inflammation of all layers of intestinal mucosa Infectious disease Disaccharidase deficiency Gastric resection

Inflammation of all layers of intestinal mucosa

The nurse is working in a long-term care facility with a group of older adults with cardiac disorders. Why would it be important for the nurse to closely monitor an older adult receiving digitalis preparations for cardiac disorders? Older adults are at increased risk for toxicity. Older adults are at increased risk for cardiac arrests. Older adults are at increased risk for hyperthyroidism. Older adults are at increased risk for asthma.

Older adults are at increased risk for toxicity.

To help prevent infections in clients with COPD, the nurse should recommend vaccinations against two bacterial organisms. Which of the following are the two vaccinations? Streptococcus pneumonia and Haemophilus influenzae Streptococcus pneumonia and varicella Haemophilus influenzae and varicella Haemophilus influenzae and Gardasil

Streptococcus pneumonia and Haemophilus influenzae

A nurse is caring for a client receiving skeletal traction. Due to the client's severe limits on mobility, the nurse has identified a risk for atelectasis or pneumonia. What intervention should the nurse provide in order to prevent these complications? Perform chest physiotherapy once per shift and as needed. Teach the client to perform deep breathing and coughing exercises. Administer prophylactic antibiotics as prescribed. Administer nebulized bronchodilators and corticosteroids as prescribed.

Teach the client to perform deep breathing and coughing exercises

Which is a true statement regarding regional enteritis (Crohn's disease)? It has a progressive disease pattern. It is characterized by pain in the lower left abdominal quadrant. The clusters of ulcers take on a cobblestone appearance. The lesions are in continuous contact with one another.

The clusters of ulcers take on a cobblestone appearance.

The nurse is providing care for a client whose peptic ulcer disease will be treated with a Billroth I procedure (gastroduodenostomy). The nurse should address which of the following topics when providing health education? Select all that apply. The procedure carries a risk for dumping syndrome The client is likely to require long-term total parenteral nutrition (TPN) The client's vagus nerve may be altered The client can resume a usual diet in 3 to 5 weeks Part of the client's stomach and colon will be removed

The procedure carries a risk for dumping syndrome The client's vagus nerve may be altered

A client has a serum calcium level of 7.2 mg/dl (1.8 mmol/L). During the physical examination, the nurse expects to assess: Trousseau's sign. Homans' sign. Hegar's sign. Goodell's sign.

Trousseau's sign

A nurse is assessing a client diagnosed with multiple sclerosis (MS). Which symptom does the nurse expect to find? Vision changes Absent deep tendon reflexes Tremors at rest Flaccid muscles

Vision changes

A client returns for a follow-up visit to the cardiologist 4 days after a trip to the ED for sudden shortness of breath and abdominal pain. The nurse realizes the client had a myocardial infarction because the results from the blood work drawn in the hospital shows: elevated troponin levels. decreased LDH levels. decreased myoglobin levels. increased C-reactive protein levels.

elevated troponin levels

The nurse is caring for a client who is having chest pain associated with a myocardial infarction (MI). What medication will the nurse administer intravenously to reduce pain and anxiety? fentanyl hydromorphone hydrochloride morphine sulfate codeine sulfate

morphine sulfate

The nurse is assessing a client with severe angina pectoris and electrocardiogram changes in the emergency room. What is the most important cardiac marker for the client? creatine kinase lactate dehydrogenase myoglobin troponin

troponin

During auscultation of the lungs, what would a nurse note when assessing a client with left-sided heart failure? wheezes with wet lung sounds stridor high-pitched sounds laborious breathing

wheezes with wet lung sounds

A client sustained second- and third-degree burns to the chest and neck 4 days ago and is now refusing analgesics stating, "I don't want to become addicted to pain medication." What is the best response by the nurse? "I don't blame you for feeling that way; we have people who do become addicted." "Don't worry about this now; take the pain medications, and we will worry about addiction later." "Although misusing the medication may cause addiction, there is little evidence that those who require narcotics for legitimate pain become addicted." "The physician has ordered the medication every 4 hours, and you must take it so that you will heal quicker."

"Although misusing the medication may cause addiction, there is little evidence that those who require narcotics for legitimate pain become addicted."

The nurse is assisting the client to manage the cardiovascular risk factors of hyperlipidemia and hypertension. The client asks the nurse what type of a diet would be best to follow. What is the best response by the nurse? A diet low in sodium, fat, cholesterol A diet high in transfats and potassium A diet with restricted fruits and fluids A diet with high sodium, fruits, vegetables

A diet low in sodium, fat, cholesterol

A client with asthma is being treated with albuterol. Which of the findings from the client's history would indicate to the nurse the need to administer this drug with caution? Raynaud's disease Peptic ulcer disease Bronchospasm Angina

Angina

The nurse is interviewing a patient who says he has a dry, irritating cough that is not "bringing anything up." What medication should the nurse question the patient about taking? Angiotensin converting enzyme (ACE) inhibitors Aspirin Bronchodilators Cardiac glycosides

Angiotensin converting enzyme (ACE) inhibitors

The nurse should be alert for a complication of bronchiectasis that results from a combination of retained secretions and obstruction that leads to the collapse of alveoli. This complication is known as Atelectasis Emphysema Pleurisy Pneumonia

Atelectasis

A nurse is caring for a critically ill client with autonomic dysreflexia. What clinical manifestations would the nurse expect in this client? Respiratory distress and projectile vomiting Bradycardia and hypertension Tachycardia and agitation Third-spacing and hyperthermia

Bradycardia and hypertension

The nurse is reviewing the laboratory results for a patient having a suspected myocardial infarction (MI). What cardiac-specific isoenzyme does the nurse observe for myocardial cell damage? Alkaline phosphatase Creatine kinase MB Myoglobin Troponin

Creatine kinase MB

A patient has been diagnosed with congestive heart failure (CHF). The health care provider has ordered a medication to enhance contractility. The nurse would expect which medication to be prescribed for the patient? Digoxin Clopidogrel Enoxaparin Heparin

Digoxin

A patient has been diagnosed with myasthenia gravis. The nurse documents the initial and most common manifestation of: Dysphoria. Facial muscle weakness. Diplopia. Generalized fatigue.

Diplopia

The clinic nurse caring for a client with Parkinson disease notes that the client has been taking levodopa and carbidopa (Sinemet) for 7 years. For what common side effect should the nurse assess this client? Pruritus Dyskinesia Lactose intolerance Diarrhea

Dyskinesia

A client has just been diagnosed with Parkinson's disease. The nurse is teaching the client and family about dietary issues related to this diagnosis. Which of the following are risks for this client? Select all that apply. Fluid overload Dysphagia Choking Constipation Anorexia

Dysphagia Choking Constipation

The diagnosis of pulmonary hypertension associated with chronic obstructive pulmonary disease (COPD) is suspected when which of the following is noted? Select all that apply. Dyspnea and fatigue disproportionate to pulmonary function abnormalities Right ventricular enlargement Elevated plasma brain natriuretic peptide (BNP) Enlargement of central pulmonary arteries Left ventricular hypertrophy

Dyspnea and fatigue disproportionate to pulmonary function abnormalities Right ventricular enlargement Elevated plasma brain natriuretic peptide (BNP) Enlargement of central pulmonary arteries

The nurse is preparing the client for an acetylcholinesterase inhibitor test to rule out myasthenia gravis. Which is the priority nursing action? Assess facial weakness 5 minutes after injection. Ensure atropine is readily available. Administer edrophonium chloride per orders. Document the results.

Ensure atropine is readily available.

The nurse is developing a plan of care for a patient with peptic ulcer disease. What nursing interventions should be included in the care plan? Select all that apply. Making neurovascular checks every 4 hours Frequently monitoring hemoglobin and hematocrit levels Observing stools and vomitus for color, consistency, and volume Checking the blood pressure and pulse rate every 15 to 20 minutes Inserting an indwelling catheter for incontinence

Frequently monitoring hemoglobin and hematocrit levels Observing stools and vomitus for color, consistency, and volume Checking the blood pressure and pulse rate every 15 to 20 minutes

A nurse teaches a client with angina pectoris that he or she needs to take up to three sublingual nitroglycerin tablets at 5-minute intervals and immediately notify the health care provider if chest pain doesn't subside within 15 minutes. What symptoms may the client experience after taking the nitroglycerin? Nausea, vomiting, depression, fatigue, and impotence. Sedation, nausea, vomiting, constipation, and respiratory depression. Headache, hypotension, dizziness, and flushing. Flushing, dizziness, headache, and pedal edema.

Headache, hypotension, dizziness, and flushing.

The nurse is caring for a patient with bone metastasis from a primary breast cancer. The patient complains of muscle weakness and nausea and is voiding large amounts frequently. Cardiac dysrhythmias are observed on the telemetry monitor. What should the nurse suspect based on these clinical manifestations? Hypercalcemia Hypocalcemia Hypokalemia Hyperkalemia

Hypercalcemia

Which is a modifiable risk factor for coronary artery disease (CAD)? Increasing age Hyperlipidemia Male gender Family history

Hyperlipidemia

A client who is post op from bariatric surgery experiences dumping syndrome. What is the nurse's understanding of the cause of this condition? Hypertonic food draws extracellular fluid from the blood into the small intestines. Hypertonic food releases metabolic peptides. Hypotonic food pulls fluid from the blood and small intestines. Hypotonic food releases toxic substances.

Hypertonic food releases metabolic peptides

Which combination of adverse effects should a nurse monitor for when administering IV insulin to a client with diabetic ketoacidosis? Hypokalemia and hypoglycemia Hypocalcemia and hyperkalemia Hyperkalemia and hyperglycemia Hypernatremia and hypercalcemia

Hypokalemia and hypoglycemia

Which are the most commonly reported clinical manifestations of multiple sclerosis? Select all that apply. Pain Fatigue Spasticity Aphasia Depression Numbness

Pain Fatigue Spasticity Depression Numbness

The nurse is performing an initial assessment on a client who is admitted to rule out myasthenia gravis. Which of the following findings would the nurse expect to observe? Ptosis and diplopia Muscle weakness and hyporeflexia of the lower extremities Difficulty with urination Facial distortion and pain

Ptosis and diplopia

A client has been diagnosed with congestive heart failure. Which is a cause of crackles heard in the bases of the lungs? Pulmonary hypertension Aortic valve stenosis Pulmonary congestion Mitral valve stenosis

Pulmonary congestion

Which action should a nurse perform to prevent deep vein thrombosis when caring for a postsurgical client? Reinforce the need to perform leg exercises every hour when awake Massage the calves or thighs Instruct the client to cross the legs or prop a pillow under the knees Maintain bed rest

Reinforce the need to perform leg exercises every hour when awake

Which nursing assessment finding indicates the client with traction has not met expected outcomes? Capillary refill < 3 seconds Repositions self with trapeze Peripheral pulses +2 bilaterally Right calf warm and swollen

Right calf warm and swollen

A client has been scheduled for a urea breath test in 1 months' time. What nursing diagnosis most likely prompted this diagnostic test? Impaired Dentition Related to Gingivitis Risk for Impaired Skin Integrity Related to Peptic Ulcers Imbalanced Nutrition: Less Than Body Requirements Related to Enzyme Deficiency Diarrhea Related to Clostridium Difficile Infection

Risk for Impaired Skin Integrity Related to Peptic Ulcers

A client with peptic ulcer disease wants to know nonpharmacologic ways to prevent recurrence. Which of the following measures would the nurse recommend? Select all that apply. Smoking cessation Substitution of coffee with decaffeinated products Avoidance of alcohol Eating whenever hungry Following a regular schedule for rest, relaxation, and meals

Smoking cessation Avoidance of alcohol Following a regular schedule for rest, relaxation, and meals

A nurse is developing a teaching plan for an adult client with asthma. Which teaching point should have the highest priority in the plan of care that the nurse is developing? Gradually increase levels of physical exertion. Change filters on heaters and air conditioners frequently. Take prescribed medications as scheduled. Avoid goose-down pillows.

Take prescribed medications as scheduled

Following abdominal surgery, which factor predisposes a client to deep vein thrombosis? The client is 5' 9" tall and weighs 128 lb (58 kg). The client has been pregnant four times. The client usually walks 3 miles a day. The client will be immobile during and shortly after surgery.

The client will be immobile during and shortly after surgery

Nursing students are reviewing information about Parkinson's disease in preparation for class the next day. The students demonstrate understanding of the material when they identify which of the following as a cardinal sign of this disorder? Select all that apply. Tremor Rigidity Bradykinesia Postural instability Intellectual decline

Tremor Rigidity Bradykinesia Postural instability

A client presents to the emergency department with complaints of acute GI distress, bloody diarrhea, weight loss, and fever. Which condition in the family history is most pertinent to the client's current health problem? Ulcerative colitis Hypertension Gastroesophageal reflux disease Appendicitis

Ulcerative colitis

A nurse is preparing to provide care for a client whose exacerbation of ulcerative colitis has required hospital admission. During an exacerbation of this health problem, the nurse would anticipate that the client's stools will have what characteristics? Watery with blood and mucus Hard and black or tarry Dry and streaked with blood Loose with visible fatty streaks

Watery with blood and mucus

A client is receiving captopril for heart failure. During the nurse's assessment, what sign indicates that the medication therapy is ineffective? skin rash peripheral edema dry cough postural hypotension

peripheral edema

A nurse is evaluating a client who had a myocardial infarction (MI) 7 days earlier. Which outcome indicates that the client is responding favorably to therapy? The client demonstrates ability to tolerate more activity without chest pain. The client exhibits a heart rate above 100 beats/minute. The client verbalizes the intention of making all necessary lifestyle changes except for stopping smoking. The client states that sublingual nitroglycerin usually relieves his chest pain.

The client demonstrates ability to tolerate more activity without chest pain.

A client with a strong family history of coronary artery disease asks the nurse how to reduce the risk of developing the disorder. Which is the best response by the nurse? "Moderation is the key to everything." "Ask your physician to prescribe the new reverse lipid drug." "Increase the soy in your diet." "Exercise, keep your blood sugar in check, and manage your stress."

"Exercise, keep your blood sugar in check, and manage your stress."

When assessing a client who reports recent chest pain, the nurse obtains a thorough history. Which client statement most strongly suggests angina pectoris? "The pain lasted about 45 minutes." "The pain resolved after I ate a sandwich." "The pain got worse when I took a deep breath." "The pain occurred while I was mowing the lawn."

"The pain occurred while I was mowing the lawn."

When planning care for a client in the postoperative period, prioritize nursing diagnoses in the sequence from highest to lowest priority? Impaired Gas Exchange Fluid Volume Deficit Altered Comfort Anxiety Risk for Infection

ABCDE

The nurse is evaluating the types of medications prescribed for a client's hypertension. Which of the following medication classifications establishes an action on vasoconstrictive hormones in the blood stream? Beta-blocker ACE inhibitor Loop diuretic Calcium channel blocker

ACE inhibitor

During a health history, a client explains that he was just diagnosed with Parkinson's disease and wants to know what to expect. What should the nurse include during client teaching? Abnormal body movements such as tremors may occur at rest along with asymmetry of movement. Eventually there will be paralysis of the extremities on one side of the body. Whole-body convulsive movements will occur as the disease progresses. Over time, the client's eyesight will diminish, especially at night.

Abnormal body movements such as tremors may occur at rest along with asymmetry of movement.

The nurse is caring for a client hospitalized with a severe exacerbation of myasthenia gravis. When administering medications to this client, what is a priority nursing action? Assess client's reaction to new medication schedule. Administer medications at exact intervals ordered. Document medication given and dose. Give client plenty of fluids with medications.

Administer medications at exact intervals ordered

. A client with end-stage liver disease has developed hypervolemia. What nursing interventions would be most appropriate when addressing the client's fluid volume excess? Select all that apply. Administering diuretics Administering calcium channel blockers Implementing fluid restrictions Implementing a 1500 kcal/day restriction Enhancing client positioning

Administering diuretics Implementing fluid restrictions Enhancing client positioning

The nurse is caring for a patient with hyperparathyroidism and observes a calcium level of 16.2 mg/dL. What interventions does the nurse prepare to provide to reduce the calcium level? Select all that apply. Administration of calcitonin Administration of calcium carbonate Intravenous isotonic saline solution in large quantities Monitoring the patient for fluid overload Administration of a bronchodilator

Administration of calcitonin Intravenous isotonic saline solution in large quantities Monitoring the patient for fluid overload

A patient with Parkinson's disease asks the nurse what can be done to prevent problems with bowel elimination. What would be an intervention that would assist this patient with a regular stool pattern? Take psyllium (Metamucil) daily. Take a laxative whenever bloating is experienced. Adopt a diet with moderate fiber intake. Adopt a high-fiber diet.

Adopt a diet with moderate fiber intake.

A client has been reporting regularly to the health care unit for blood pressure monitoring. The health care provider diagnoses the client with essential hypertension after analyzing the readings over two or more sessions. What options will the nurse use to inform the client about next steps for blood pressure care? Select all that apply. Advise the client to begin an exercise regimen based on the approval of the health care provider. Remind the client to return back to the health care provider once a year for follow-up. Ask the client to follow a diet that is low in saturated fats and sodium and high in fiber. Advise the client to purchase a self-monitoring cuff or use an automatic cuff at a local pharmacy. Educate the client about the correct position to measure blood pressure, as the position may affect readings.

Advise the client to begin an exercise regimen based on the approval of the health care provider. Ask the client to follow a diet that is low in saturated fats and sodium and high in fiber. Advise the client to purchase a self-monitoring cuff or use an automatic cuff at a local pharmacy. Educate the client about the correct position to measure blood pressure, as the position may affect readings.

The nurse is educating a patient with glaucoma about medications. What medications will the nurse educate the patient about that decrease aqueous production? Select all that apply. Alpha-adrenergic agonists Carbonic anhydrase inhibitors Beta-blockers Miotics Calcium channel blockers

Alpha-adrenergic agonists Carbonic anhydrase inhibitors Beta-blockers

A client's health history is suggestive of inflammatory bowel disease. Which of the following would suggest Crohn's disease, rather than ulcerative colitis, as the cause of the client's signs and symptoms? A pattern of distinct exacerbations and remissions Severe diarrhea An absence of blood in stool Involvement of the rectal mucosa

An absence of blood in stool

A client presents to the ED reporting severe substernal chest pain radiating down his left arm. He is admitted to the coronary care unit (CCU) with a diagnosis of myocardial infarction (MI). What nursing assessment activity is a priority on admission to the CCU? Begin ECG monitoring. Obtain information about family history of heart disease. Auscultate lung fields. Determine if the client smokes.

Begin ECG monitoring

The nurse is caring for a client who was admitted with fluid volume excess (FVE). Which nursing assessments should the nurse include in the ongoing monitoring of the client? Select all that apply. Nutritional status and diet Blood pressure, heart rate, and rhythm Intake and output, urine volume, and color Strength testing for muscle wasting Skin assessment for edema and turgor

Blood pressure, heart rate, and rhythm Intake and output, urine volume, and color Skin assessment for edema and turgor

A 54-year-old male patient is admitted to the hospital with a case of severe dehydration. The nurse reviews the patient's laboratory results. Which of the following results are consistent with the diagnosis? Select all that apply. Blood urea nitrogen (BUN) of 23 mg/dL Serum osmolality of 310 mOsm/kg Serum sodium of 148 mEq/L Serum glucose of 90 mg/dL Urine specific gravity of 1.03 Hematocrit level of 48%

Blood urea nitrogen (BUN) of 23 mg/dL Serum osmolality of 310 mOsm/kg Serum sodium of 148 mEq/L Urine specific gravity of 1.03

The nursing instructor is teaching their clinical group how to assess a client for congestive heart failure. How would the instructor teach the students to assess a client with congestive heart failure for nocturnal dyspnea? By collecting the client's urine output By observing the client's diet during the day By measuring the client's abdominal girth By questioning how many pillows the client normally uses for sleep

By questioning how many pillows the client normally uses for sleep

A client presents to the clinic complaining of intermittent chest pain on exertion, which is eventually attributed to angina. The nurse should inform the client that angina is most often attributable to what cause? Decreased cardiac output Decreased cardiac contractility Infarction of the myocardium Coronary arteriosclerosis

Coronary arteriosclerosis

A nurse is caring for a client who experienced an MI. The client is ordered to received metoprolol. The nurse understands that this medication has which therapeutic effect? Decreases resting heart rate Decreases cholesterol level Increases cardiac output Decreases platelet aggregation

Decreases resting heart rate

Nursing assessment of hearing loss in an older adult client includes evaluation of age-related changes, as well as a history of current illnesses and medications. Which of the following factors are associated with ototoxic effects? Select all that apply. Coronary artery disease Diabetes mellitus Loop diuretics (e.g., Lasix) Asthma Bacterial meningitis Gentamicin

Diabetes mellitus Loop diuretics (e.g., Lasix) Asthma Bacterial meningitis Gentamicin

A nurse records a client's history and discovers several risk factors for coronary artery disease (CAD). Which cardiac risk factors can the client control? Diabetes, hypercholesterolemia, and heredity Diabetes, age, and gender Age, gender, and heredity Diabetes, hypercholesterolemia, and hypertension

Diabetes, hypercholesterolemia, and hypertension

A nurse is assessing a client who comes to the clinic for care. Which findings in this client suggest bacterial pneumonia? Nonproductive cough and normal temperature Sore throat and abdominal pain Hemoptysis and dysuria Dyspnea and wheezing

Dyspnea and wheezing

The perioperative nurse is writing a care plan for a client who has returned from surgery 2 hours ago. Which measure should the nurse implement to most decrease the client's risk of developing pulmonary emboli (PE)? Early ambulation Increased dietary intake of protein Maintaining the client in a supine position Administering aspirin with warfarin

Early ambulation

A client has a significant history of congestive heart failure. What should the nurse specifically assess during the client's semiannual cardiology examination? Select all that apply. Examine the client's neck for distended veins. Monitor the client for signs of lethargy or confusion. Examine the client's joints for crepitus. Examine the client's eyes for excess tears.

Examine the client's neck for distended veins. Monitor the client for signs of lethargy or confusion.

A client is experiencing muscle weakness and an ataxic gait. The client has a diagnosis of multiple sclerosis (MS). Based on these symptoms, the nurse formulates "Impaired physical mobility" as one of the nursing diagnoses applicable to the client. What nursing intervention should be most appropriate to address the nursing diagnosis? Use pressure-relieving devices when the client is in bed or in a wheelchair. Change body position every 2 hours. Help the client perform range-of-motion (ROM) exercises every 8 hours. Use a footboard and trochanter rolls.

Help the client perform range-of-motion (ROM) exercises every 8 hours.

A client in the emergent/resuscitative phase of a burn injury has had blood work and arterial blood gases drawn. Upon analysis of the client's laboratory studies, the nurse will expect the results to indicate what? Hyperkalemia, hyponatremia, elevated hematocrit Hypokalemia, hypernatremia, decreased hematocrit Hyperkalemia, hypernatremia, decreased hematocrit Hypokalemia, hyponatremia, elevated hematocrit

Hyperkalemia, hyponatremia, elevated hematocrit

When the postcardiac surgical patient demonstrates vasodilation, hypotension, hyporeflexia, slow gastrointestinal motility (hypoactive bowel sounds), lethargy, and respiratory depression, the nurse suspects which electrolyte imbalance? Hypokalemia Hyperkalemia Hypermagnesemia Hypomagnesemia

Hypermagnesemia

The nurse is assigned to care for clients with SCI on a rehabilitation unit. Which signs does the nurse recognize as clinical manifestations of autonomic dysreflexia? Select all that apply. Hypertension Tachycardia Fever Diaphoresis Nasal congestion

Hypertension Diaphoresis Nasal congestion

The nurse is educating a patient diagnosed with angina pectoris about the difference between the pain of angina and a myocardial infarction (MI). How should the nurse describe the pain experienced during an MI? (Select all that apply.) It is relieved by rest and inactivity. It is substernal in location. It is sudden in onset and prolonged in duration. It is viselike and radiates to the shoulders and arms. It subsides after taking nitroglycerin.

It is substernal in location. It is sudden in onset and prolonged in duration. It is viselike and radiates to the shoulders and arms.

An adult client is admitted to the ED with chest pain. The client states that he had unrelieved chest pain for approximately 20 minutes before coming to the hospital. To minimize cardiac damage, the nurse should expect to administer which of the following interventions? Thrombolytics (fibrinolytics), oxygen administration, and nonsteroidal anti-inflammatories Morphine sulphate, oxygen, and bed rest Oxygen and beta-adrenergic blockers Bed rest, albuterol nebulizer treatments, and oxygen

Morphine sulphate, oxygen, and bed rest

The nurse is caring for a client with known myocardial ischemia. The client will be getting up to ambulate for the first time in three days after being on bedrest since admission to the intensive care unit. Which medication should the nurse administer before the client ambulates? Nitroglycerin Vasopressin Norepinephrine Dobutamine

Nitroglycerin

A 64-year-old client is brought in to the clinic with thirsty, dry, sticky mucous membranes, decreased urine output, fever, a rough tongue, and lethargy. Serum sodium level is above 145 mEq/L. Should the nurse start salt tablets when caring for this client? Yes, this will correct the sodium deficit. Yes, along with the hypotonic IV. No, start with the sodium chloride IV. No, sodium intake should be restricted.

No, sodium intake should be restricted.

A nurse in the emergency department is caring for a client with acute heart failure. Which laboratory value is most important for the nurse to check before administering medications to treat heart failure? Platelet count Potassium Calcium White blood cell (WBC) count

Potassium

Which of the following is the first-line therapy for myasthenia gravis (MG)? Pyridostigmine bromide (Mestinon) Deltasone (Prednisone) Azathioprine (Imuran) Lioresal (Baclofen)

Pyridostigmine bromide (Mestinon)

A client with cardiovascular disease is being treated with amlodipine, which is intended to cause what therapeutic effect? Reducing the heart's workload by decreasing heart rate and myocardial contraction Preventing platelet aggregation and subsequent thrombosis Reducing myocardial oxygen consumption by blocking adrenergic stimulation to the heart Increasing the efficiency of myocardial oxygen consumption, thus decreasing ischemia and relieving pain

Reducing the heart's workload by decreasing heart rate and myocardial contraction

A patient with Parkinson's disease is experiencing an on-off syndrome. What does the nurse recognize that the patient's clinical symptoms will be? The patient will have unilateral resting tremors and then will have a period of no tremors present. The patient will have a slow, shuffling gait and then will be able to move at a faster pace. The patient will have a period when medication with levodopa will be unnecessary. The patient will have periods of near immobility, followed by a sudden return of effectiveness of the medication.

The patient will have periods of near immobility, followed by a sudden return of effectiveness of the medication.

A client with asthma has developed obstruction of the airway. Which of the following does the nurse understand as having potentially contributed to this problem? Choose all that apply. Thick mucus Swelling of bronchial membranes Destruction of the alveolar wall Airway remodeling

Thick mucus Swelling of bronchial membranes Airway remodeling

The nurse is conducting a gastrointestinal assessment. When the client reports the presence of mucus and pus in the stool, the nurse assesses for additional signs/symptoms of which disease/condition? Small-bowel disease Ulcerative colitis Disorders of the colon Intestinal malabsorption

Ulcerative colitis

A client being treated for pancreatitis faces the risk of atelectasis. Which of the following interventions would be important to implement to minimize this risk? Monitor pulse oximetry every hour. Withhold analgesics unless necessary. Instruct the client to cough only when necessary. Use incentive spirometry every hour.

Use incentive spirometry every hour

The nurse caring for an older adult client diagnosed with diarrhea is administering and monitoring the client's medications. Because one of the client's medications is digitalis (digoxin), the nurse monitors the client closely for: hyperkalemia. hypokalemia. hyponatremia. hypernatremia.

hypokalemia

A client presents with muscle weakness, tremors, slow muscle movements, and vertigo. The following are the client's laboratory values:Sodium 134 mEq/L (134 mmol/L)Potassium 3.2 mEq/L (3.2 mmol/L)Chloride 111 mEq/L (111 mmol/L)Magnesium 1.1 mg/dL (0.45 mmol/L)Calcium 8.4 mg/dL (2.1 mmol/L)What fluid and electrolyte imbalance would the nurse relate to the client's findings? hyponatremia hypokalemia hypocalcemia hypomagnesemia

hypomagnesemia

A client with adrenal insufficiency is gravely ill and presents with nausea, vomiting, diarrhea, abdominal pain, profound weakness, and headache. The client's family reports that the client has been doing strenuous yard work all day and was sweating profusely. Nursing management of this client would include observation for signs of: hyponatremia and hyperkalemia. hyponatremia and hypokalemia. hypernatremia and hyperkalemia. hypernatremia and hypokalemia.

hyponatremia and hyperkalemia.

The nurse is administering digoxin to a client with heart failure. What laboratory value may predispose the client to digoxin toxicity? magnesium level of 2.5 mg/dL calcium level of 7.5 mg/dL sodium level of 152 mEq/L potassium level of 2.8 mEq/L

potassium level of 2.8 mEq/L