Med-Surg II Quiz #1

A registered nurse is teaching a student nurse about the reason for the development of natriuresis. Which statement made by the student nurse indicates effective teaching?

"Natriuresis develops as a result of the excretion of large amounts of sodium."

A patient who has a positive test for human immunodeficiency virus (HIV) antibodies is admitted to the hospital with Pneumocystis jiroveci pneumonia (PCP) and a CD4+ count of less than 200 cells/mL. Based on diagnostic criteria established by the Centers for Disease Control and Prevention (CDC), which statement by the nurse is correct?

"The patient has developed acquired immunodeficiency syndrome (AIDS)."

A male patient with hemophilia asks the nurse if his future children will have hemophilia. Which response by the nurse is accurate?

"Your female children will be carriers for hemophilia."

What nutritional advice should the nurse give to a hypokalemic client? Select all that apply.

"Consume more orange juice." (Foods such as orange juice are good sources of potassium, so they should be included in the hypokalemic client's diet.) "Consume more bananas and meat." Bananas and meat are abundant sources of potassium. Having a banana, meat, and big glass of orange juice every day is sufficient to replace the potassium lost after 1 hour of hard exercise. "Add dried fruits to your diet." Dried fruits are a good source of potassium, and they can help reverse hypokalemia

When counseling a couple in which the man has an autosomal recessive disorder and the woman has no gene for the disorder, the nurse uses Punnett squares to show the couple the probability of their having a child with the disorder. Which statement by the nurse is accurate?

"Each child would be a carrier of the disorder."

Which clinical sign signifies leukocytosis?

A white blood count of 52,000/microliter (An increase in white blood cell count in excess of 50,000/microliter is leukocytosis.)

A physician orders IV potassium infusion for a hypokalemic client. Which intervention should be avoided by the nurse while administering IV potassium?

Administration of hypertonic potassium chloride IV bolus (Hypertonic IV potassium chloride should not be administered as an IV bolus. Though IV potassium is never administered IV push, it is often administered in a diluted, controlled rate bolus referred to as a K-run.)

A client's lab results show overproduction of aldosterone. What is the best nursing intervention to maintain serum electrolytes levels in the client?

Administration of spironolactone

A patient who has ovarian cancer is crying and tells the nurse, "My husband rarely visits. He just doesn't care." The husband tells the nurse that he does not know what to say to his wife. Which problem is appropriate for the nurse to address in the plan of care?

Difficulty coping

Which finding should the nurse expect when assessing a patient who has osteoarthritis (OA) of the knee?

Discomfort with joint movement

delusional hyponatremia in the presence of hypervolemia.

Headache, confusion, vomiting, muscle cramps, and lethargy are some of the symptoms

An adult client who has hypervolemia reports a headache, muscle cramps, and vomiting. The nurse notices confusion. Which condition has the client developed?

Hyponatremia

Natriuresis is a natural dieresis initiated by the body...

It is the excretion of large amounts of sodium and water by the kidneys.

An alert older patient who takes multiple medications for chronic cardiac and pulmonary diseases lives with a daughter who works during the day. During a clinic visit, the patient tells the nurse that she has a strained relationship with her daughter and does not enjoy being alone all day. In planning care for this patient, which problem should the nurse consider as the priority?

Risk for injury

After assessing a client, a nurse finds that the client has a growth of cancer cells in the bladder, rectum, and other parts of the body. Which stage of cervical cancer should the nurse expect in the client?

Stage IV During stage IV of cervical cancer, the cancerous cells spread to different parts of the body, including the bladder and rectum.

What suggestion should the nurse make to a group of women with rheumatoid arthritis (RA) about managing activities of daily living?

Stand rather than sit when performing daily household and yard chores. Patients are advised to avoid repetitious movements. Sitting during household chores is recommended to decrease stress on joints. Wringing water out of sponges would increase joint stress. Patients are encouraged to position joints in the extended (neutral) position. Sleeping with a pillow behind the knees would decrease the ability of the knee to extend and also decrease knee range of motion.

The registered nurse (RN) is caring for a patient who is living with HIV and admitted with tuberculosis. Which task can the RN delegate to unlicensed assistive personnel (UAP)?

Stock the patient's room with the necessary personal protective equipment. A patient diagnosed with tuberculosis would be placed on airborne precautions. Because all health care workers are taught about the various types of infection precautions used in the hospital, the UAP can safely stock the room with personal protective equipment. Obtaining contact information and patient teaching are higher-level skills that require RN education and scope of practice.

A hospitalized patient who has received chemotherapy for leukemia develops neutropenia. Which observation by the nurse indicates a need for further teaching?

The patient's visitors bring in fresh peaches.

A client with leukemia received chemotherapy 2 days ago and has subsequently developed acute renal failure. Which laboratory result should the nurse assess?

The release of high amounts of uric acid (After initiation of cancer treatment for 48 hours to 72 hours, a complication called tumor lysis syndrome may occur. This releases high amounts of uric acid into the circulation, which damages glomeruli and nephron tubules. This leads to renal failure in the client.)

The home health nurse cares for an older adult patient who lives alone and takes several different prescribed medications for chronic health problems. Which intervention, if implemented by the nurse, would support both the patient's self-management and the goal of medication adherence?

Use a marked pillbox to set up the patient's medications.

The patient's age and multiple medications indicate _____

a risk for injury caused by interactions between the multiple drugs being taken and a decreased drug metabolism rate.

Hemophilia is caused by

a single genetic mutation and is not a multifactorial inherited condition.

Because hemophilia is caused by a mutation of the X chromosome,

all female children of a man with hemophilia are carriers of the disorder and can transmit the mutated gene to their offspring. Sons of a man with hemophilia will not have the disorder.

Problems with social isolation, caregiver strain, or difficulty coping ___

are not physiologic priorities.

Which substance is transported to the cells by facilitated transport?

glucose

What are the initial symptoms of OA?

include: pain with joint movement. Heberden's nodules occur on the fingers. Redness of the joint is associated with inflammatory arthritis such as rheumatoid arthritis. Stiffness in OA is worse right after the patient rests and decreases with joint movement

Spironolactone is an aldosterone antagonist that causes potassium retention in the bloodstream.

it interferes with sodium reabsorption in the distal tubules and stimulates the excretion of sodium.

Fresh, thinned-skin fruits are not permitted in a neutropenic diet because ____

of the risk of bacteria being present. The patient should ambulate in the room rather than the hospital hallway to avoid exposure to other patients or visitors. Because overuse of soap can dry the skin and increase infection risk, showering every other day is acceptable. Careful cleaning after having a bowel movement will help prevent skin breakdown and infection.

When one parent has an autosomal recessive disorder and the other parent has no genes for the autosomal recessive disorder,

the children will be carriers of the autosomal recessive disorder. The children will not have the disorder or display characteristics of the disorder, regardless of gender.

Drug-drug interactions could cause _____

the most harm to the patient and are therefore the priority.