Med Surg Exam

When providing discharge teaching for a client with multiple sclerosis (MS), the nurse should include which instruction? "Avoid taking daytime naps." "Avoid hot baths and showers." "Restrict fluid intake to 1,500 ml/day." "Limit your fruit and vegetable intake."

"Avoid hot baths and showers."

A nurse is working with a client with rheumatic disease who is being treated with salicylate therapy. What statement would indicate that the client is experiencing adverse effects of this drug? "I have this ringing in my ears that just won't go away." "I feel so foggy in the mornings and it takes me so long to wake up." "When I eat a meal that's high in fat, I get really nauseous." "I seem to have lost my appetite, which is unusual for me."

"I have this ringing in my ears that just won't go away."

The nurse is teaching the client newly diagnosed with systemic lupus erythematous about the condition. Which statement by the client indicates teaching was effective? "I do not need to make any changes in my diet." "My energy level will gradually increase over time." "My medications will ultimately correct my problem." "I should avoid prolonged sun exposure."

"I should avoid prolonged sun exposure."

A client with systemic lupus erythematosus (SLE) is preparing for discharge. The nurse knows that the client has understood health education when the client makes what statement? "I'll stop taking my steroids when I get relief from my symptoms." "I'll make sure to monitor my body temperature on a regular basis." "I'll make sure I get enough exposure to sunlight to keep up my vitamin D levels." "I'll try to be as physically active as possible between flare-ups."

"I'll make sure to monitor my body temperature on a regular basis."

A client with rheumatoid arthritis expresses not feeling the need to take medication any longer since being in remission without symptoms. What is the best response by the nurse? "It is important that you continue to take your medication to avoid an acute exacerbation." "Be sure to let the physician know after you stop your medications." "If you don't take your medication, you will become very ill." "As long as you are not having symptoms, you can take a medication vacation."

"It is important that you continue to take your medication to avoid an acute exacerbation."

A nurse is teaching a client about rheumatoid arthritis. Which statement by the client indicates understanding of the disease process? "When it clears up, it will never come back." "It will get better and worse again." "I'll definitely need surgery for this." "It will never get any better than it is right now."

"It will get better and worse again."

A nurse is preparing a client with systemic lupus erythematosus (SLE) for discharge. Which instruction should the nurse include in the teaching plan? "Exposure to sunlight will help control skin rashes." "Corticosteroids may be stopped when symptoms are relieved." "There are no activity limitations between flare-ups." "Monitor your body temperature."

"Monitor your body temperature."

A client asks the nurse what the difference is between osteoarthritis (OA) and rheumatoid arthritis (RA). Which response is correct? "OA affects joints on both sides of the body. RA is usually unilateral." "OA is more common in women. RA is more common in men." "OA is a noninflammatory joint disease. RA is characterized by inflamed, swollen joints." "OA and RA are very similar. OA affects the smaller joints and RA affects the larger, weight-bearing joints."

"OA is a noninflammatory joint disease. RA is characterized by inflamed, swollen joints."

A client who has experienced an initial transient ischemic attack (TIA) states: "I'm glad it wasn't anything serious." Which is the best nursing response to this statement? "TIA is a warning sign. Let's talk about lowering your risks." "TIA symptoms are short-lived and resolve within 24 hours". "I sense that you are happy it was not a stroke". "People who experience a TIA will develop a stroke".

"TIA is a warning sign. Let's talk about lowering your risks."

A client recently experienced a stroke with accompanying left-sided paralysis. His family voices concerns about how to best interact with him. They report the client doesn't seem aware of their presence when they approach him on his left side. What advice should the nurse give the family? "This condition is temporary." "The client is unaware of his left side. You need to encourage him to interact from this side." "The client is feeling an emotional loss. He'll eventually start acknowledging you on his left side." "The client is unaware of his left side. You should approach him on the right side."

"The client is unaware of his left side. You should approach him on the right side."

A client suspected of having systemic lupus erythematosus (SLE) is being scheduled for testing. The client asks which of the tests ordered will determine positivity for the disorder. Which statement by the nurse is most accurate? "SLE is a very serious systemic disorder." "The diagnosis won't be based on the findings of a single test but by combining all data found." "Tell me more about your concerns about this potential diagnosis." "You should discuss that matter with your health care provider."

"The diagnosis won't be based on the findings of a single test but by combining all data found."

A client with early stage rheumatoid arthritis asks the nurse what to do to help ease the symptoms of the disease. What would be the best response by the nurse? "The health care provider could prescribe antineoplastic drugs." "The health care provider could prescribe antipyretic drugs." "The health care provider could prescribe anti-inflammatory drugs." "The health care provider could prescribe antihypertensive drugs."

"The health care provider could prescribe anti-inflammatory drugs."

A client with exacerbation of systemic lupus erythematosus (SLE) has been hospitalized on the medical unit. The nurse observes that the client expresses anger and irritation when their call bell isn't answered immediately. What would be the most appropriate response? "I can see you're angry. I'll come back when you've calmed down." "Would you like to talk about the problem with the nursing supervisor?" "You seem like you're feeling angry. Is that something that we could talk about?" "Try to remember that stress can make your symptoms worse."

"You seem like you're feeling angry. Is that something that we could talk about?"

Which client is most likely to develop systemic lupus erythematosus (SLE)? A 25-year-old Jewish female A 25-year-old White male A 27-year-old Black female A 35-year-old Hispanic male

A 27-year-old Black female

A client has been hospitalized for diagnostic testing. The client has just been diagnosed with multiple sclerosis, which the physician explains is an autoimmune disorder. How would the nurse explain an autoimmune disease to the client? A disorder where the body has too many immunoglobulins. A disorder where histocompatible cells attack the immunoglobulins. A disorder where the body does not have enough immunoglobulins. A disorder where killer T cells and autoantibodies attack or destroy natural cells—those cells that are "self."

A disorder where killer T cells and autoantibodies attack or destroy natural cells—those cells that are "self."

A client is experiencing an acute exacerbation of rheumatoid arthritis. What should the nursing priority be? Administering ordered analgesics and monitoring their effects Providing comprehensive client teaching; including symptoms of the disorder, treatment options, and expected outcomes Supplying adaptive devices, such as a zipper-pull, easy-to-open beverage cartons, lightweight cups, and unpackaged silverware Performing meticulous skin care

Administering ordered analgesics and monitoring their effects

The nurse is advising a client with multiple sclerosis on methods to minimize spasticity and contractures. Which of the following techniques would the nurse instruct the client to perform? Apply warm packs to the affected area. Exercise following a circuit training regimen. Relax in a hot bath. Avoid swimming and any weight-bearing activity.

Apply warm packs to the affected area.

A nurse is providing education to a client with newly diagnosed multiple sclerosis (MS). Which of the following will the nurse include? Avoid hot temperatures. Take moderate amounts of alcohol. Avoid physical activity. Avoid analgesic medication.

Avoid hot temperatures.

A client is brought to the emergency department with symptoms of a cerebrovascular accident (CVA). The nurse would anticipate which diagnostic evaluation to be completed prior to initiation of treatment? Chest x-ray Brain CT scan or MRI Prothrombin level Lumbar puncture

Brain CT scan or MRI

A nurse is providing education about hypertension to a community group. What are possible consequences of untreated hypertension? Select all that apply. Coronary artery disease Tension pneumothorax Pancreatitis Stroke Myocardial infarction

CAD CVA MI

A client is newly diagnosed with relapsing-remitting multiple sclerosis (RRMS). Which instruction should the nurse provide? "Your type of MS is the least common, making it difficult to manage." "You should take your medications only during times of relapse." "You must avoid stress and extreme fatigue, because these can trigger a relapse." "You will have a steady and gradual decline in function."

Chronic fatigue, generalized muscle aching, and stiffness

The nurse intervenes to assist the client with fibromyalgia to cope with which symptoms? Pain, viral infection, and tremors Diminished vision, chronic fatigue, and reduced appetite Chronic fatigue, generalized muscle aching, and stiffness Generalized muscle aching, mood swings, and loss of balance

Chronic fatigue, generalized muscle aching, and stiffness

The nurse identifies a nursing diagnosis of self-care deficit, bathing related to motor impairment and decreased cognitive function for a client with cerebral metastasis. Which outcome would the nurse most likely identify on this client's plan of care? Client demonstrates positive coping strategies. Client consumes adequate calories to meet energy needs. Client participates in daily hygiene activities with assistive devices. Client expresses feelings related to self-care ability.

Client participates in daily hygiene activities with assistive devices.

A nurse is communicating with a client who has aphasia after having a stroke. Which action should the nurse take? Keep the television on while she speaks. Talk in a louder than normal voice. Face the client and establish eye contact. Use one long sentence to say everything that needs to be said.

Face the client and establish eye contact.

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

Fatigue

The nursing instructor gives their students an assignment of making a plan of care for a client with Huntington's disease. What would be important for the students to include in the teaching portion of the care plan? How to exercise How to perform household tasks How to facilitate tasks such as using both hands to hold a drinking glass How to take a bath

How to facilitate tasks such as using both hands to hold a drinking glass

A nurse is planning discharge for a client who experienced right-sided weakness caused by a stroke. During his hospitalization, the client has been receiving physical therapy, occupational therapy, and speech therapy daily. The family voices concern about rehabilitation after discharge. How should the nurse intervene? The nurse should do nothing because she is responsible only for inpatient care. Contact the appropriate agencies so that they can provide care after discharge. Suggest that the family members speak with the physician about their concerns. Inform the case manager of the family's concern and provide information about the client's current clinical status so appropriate resources can be provided after discharge.

Inform the case manager of the family's concern and provide information about the client's current clinical status so appropriate resources can be provided after discharge.

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, especially in the morning Cool joints with decreased range of motion Visible atrophy of the knee and shoulder joints Signs of systemic infection

Joint stiffness, especially in the morning

The nurse is caring for a client who had a hemorrhagic stroke. What assessment finding constitutes an early sign of deterioration? Tonic-clonic seizures Generalized pain Alteration in level of consciousness (LOC) Shortness of breath

LOC

The nurse is discussing the new medication that a client will be taking for treatment of rheumatoid arthritis. Which disease-modifying antirheumatic drug (DMARD) will the nurse educate the client about? Celecoxib Methotrexate Methylprednisolone Mercaptopurine azathioprine

Methotrexate

A client with systemic lupus erythematosus (SLE) asks the nurse why the client has to come to the office so often for "check-ups." Which rationale for frequent office visits would be best for the nurse to mention? Seeing the client face to face Monitoring the disease process and how well the prescribed treatment is working Drawing blood work every month Ensuring that the client is taking medications as prescribed

Monitoring the disease process and how well the prescribed treatment is working

Which of the following is considered a central nervous system (CNS) disorder? Myasthenia gravis Bell's palsy Multiple sclerosis Guillain-Barré

Multiple sclerosis

A client is receiving baclofen for management of symptoms associated with multiple sclerosis. To evaluate the effectiveness of this medication, what does the nurse assess? Mood and affect Muscle spasms Sleep pattern Appetite

Muscle spasms

Which is the leading cause of disability and pain in the elderly? Scleroderma Osteoarthritis (OA) Rheumatoid arthritis (RA) Systemic lupus erythematosus (SLE)

Osteoarthritis is the leading cause of disability and pain in the elderly. RA, SLE, and scleroderma are not leading causes of disability and pain in the elderly.

A client has had several diagnostic tests to determine if he has systemic lupus erythematosus (SLE). What result is very specific indicator of this diagnosis? Positive ANA titer Elevated ESR Positive Anti-dsDNA antibody test Positive Anti-Sm antibodies

Positive Anti-dsDNA antibody test

A nurse's plan of care for a client with rheumatoid arthritis includes several exercise-based interventions. What goal should the nurse prioritize? Maximize range of motion while minimizing exertion. Increase joint size and strength. Preserve or increase range of motion while limiting joint stress. Limit energy output in order to preserve strength for healing.

Preserve or increase range of motion while limiting joint stress.

The client has been diagnosed with aphasia after suffering a stroke. What can the nurse do to best make the client's atmosphere more conducive to communication? Provide a board of commonly used needs and phrases. Have the client speak to loved ones on the phone daily. Speak in a loud and deliberate voice to the client. Help the client complete his or her sentences as needed.

Provide a board of commonly used needs and phrases.

The nurse notes that a client is being treated for fibromyalgia. For which additional rheumatic conditions will the nurse analyze the client's health history? Select all that apply. Ankylosing spondylitis Rheumatoid arthritis Psoriatic arthritis Systemic lupus erythematosus Ostearthritis

RA SLE Ankylosing spondylitis

A client with systemic lupus erythematosus is prescribed belimumab. For which reason will the nurse question giving the client this medication? Discoid rash present over the face Received a live vaccination a week ago Report of constipation Bilateral knee joint swelling is present

Received a live vaccination a week ago

A client has an exacerbation of multiple sclerosis. The physician orders dantrolene (Dantrium), 25 mg P.O. daily. Which assessment finding indicates the medication is effective? Reduced muscle spasticity Relief from constipation Relief from pain Increased ability to sleep

Reduced muscle spasticity

A client is diagnosed with systemic lupus erythematosus (SLE). What is the most appropriate action for the nurse to take in order to evaluate the client's stage of disease? Review the client's medical record. Inspect the client's mouth. Observe the client's gait. Auscultate the client's lung sounds.

Review the client's medical record.

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? Polymyositis Rheumatoid arthritis (RA) Osteoporosis Systemic lupus erythematosus (SLE)

Rheumatoid arthritis (RA)

A nurse provides care for a client who has a rheumatic disorder. The nurse's comprehensive assessment includes the client's mood, behavior, LOC, and neurologic status. What is this client's most likely diagnosis? Systemic lupus erythematosus (SLE) Osteoarthritis (OA) Rheumatoid arthritis (RA) Gout

SLE

Which of the following disorders is characterized by an increased autoantibody production? Scleroderma Rheumatoid arthritis (RA) Systemic lupus erythematosus (SLE) Polymyalgia rheumatic

SLE

A client with systemic lupus erythematosus (SLE) is prescribed hydroxychloroquine. Which teaching will the nurse include for this client? Smoking cessation High-protein diet Exercise Vitamin D supplements

Smoking cessation

The nurse is completing a health history with a client diagnosed with systemic lupus erythematosus (SLE). Which information will the nurse identify as environmental triggers for the condition? Select all that apply. Stress Sunlight Cigarette smoking Recent surgery Vegetarian diet

Stress Sunlight Cigarette smoking Recent surgery

Which client should the nurse assess for degenerative neurologic symptoms? The client with glioma. The client with Paget disease. The client with Huntington disease. The client with osteomyelitis.

The client with Huntington disease.

A nurse is caring for a client with multiple sclerosis. Client education about the disease process includes which explanation about the cause of the disorder? Excess cytokines cause tissue damage. Regulatory mechanisms fail to halt the immune response. The immune system recognizes one's own tissues as "self." The immune system recognizes one's own tissues as "foreign."

The immune system recognizes one's own tissues as "foreign."

When developing a care plan for a client who has recently suffered a stroke, a nurse includes the nursing diagnosis Risk for imbalanced body temperature. What is the rationale for this diagnosis? An elevated body temperature indicates infection. The stroke may have impacted the body's thermoregulation centers. An elevated temperature indicates cerebellum malfunction. A decreased body temperature will signal the need to cover the client.

The stroke may have impacted the body's thermoregulation centers. The body's thermoregulation centers are located in the hypothalamus. A stroke may impair their functioning. A decreased body temperature isn't necessarily an indication to cover the client. Although an elevated temperature may indicate cerebellum malfunction or infection, these factors aren't the focus of the risk described in the nursing diagnosis.

Which of the following would the nurse expect to assess as the most common finding associated with fibromyalgia? Widespread chronic pain Jaw locking Butterfly facial rash Heberden's nodes

Widespread chronic pain

A nurse is teaching a client who has facial muscle weakness and has recently been diagnosed with myasthenia gravis. The nurse should teach the client that myasthenia gravis is caused by: genetic dysfunction. a lower motor neuron lesion. upper and lower motor neuron lesions. decreased conduction of impulses in an upper motor neuron lesion.

a lower motor neuron lesion.

A client is suspected of having amyotrophic lateral sclerosis (ALS). To help confirm this disorder, the nurse prepares the client for various diagnostic tests. The nurse expects the physician to order: quantitative spectral phonoangiography. Doppler scanning. electromyography (EMG). Doppler ultrasonography.

electromyography (EMG).

The nurse is caring for a client with systemic lupus erythematosus (SLE). Which interventions will the nurse incorporate into this client's plan of care? Select all that apply. Providing high fiber diet for diarrhea Monitoring for rash to the skin Monitoring for jaundice Providing analgesics for joint pain Antipyretic medications for fever

fever pain rash

The nurse is assessing a client with a history of ankylosing spondylitis. What will the nurse most commonly assess? low back pain patchy hair loss on the scalp red, butterfly-shaped facial rash increased urine output

low back pain

The nurse is performing a health history with a new client in the clinic. What is the most common reason for a client to seek medical attention for arthritis? stiffness joint swelling weakness pain

pain

A nurse is teaching a client with multiple sclerosis (MS). When teaching the client how to reduce fatigue, the nurse should tell the client to: avoid naps during the day. increase the dose of muscle relaxants. take a hot bath. rest in an air-conditioned room

rest in an air-conditioned room

The nurse is caring for a client newly diagnosed with multiple sclerosis who is overwhelmed by learning about the disease. The client indicates understanding that there is a disruption in the covering of axons but does not remember what the covering is called. The nurse should tell the client: that because there is so much to learn, there will be another meeting to discuss it again. that the covering is called myelin and that it can be discussed further at the next meeting. that the disease process requires more research. not to worry about the finer details of the disease.

that the covering is called myelin and that it can be discussed further at the next meeting.