Chronic conditions exam 2

a client with a peptic ulcer is diagnosed with H. pylori infection. the nurse is teaching the client about the medications prescribed, including metronidazole, omeprazole, and clarithromycin. which statement by the client indicates the best understanding of the medication regimen?

the medications will kill the bacteria and stop the acid production

a client with diabetes mellitus develops sinusitis and otitis media accompanied by a temperature of 100.8 F (38.2 C). what effect do these findings have on his need for insulin?

they increase the need for insulin

the nurse is reviewing the clients urinalysis result. the finding that is most suggestive of dehydration of the client is:

specific gravity 1.035

a client with type 2 diabetes asks the nurse why he can't have a pancreatic transplant. which of the following would the nurse include as a possible reason?

underlying problem of insulin resistance

a 24-hour urine collection is scheduled to begin at 8:00 am when should the nurse initiate the procedure?

after discarding the 8:00am specimen

a patient has undergone a renal biopsy. after the test, while the patient is resting, the patient reports severe pain in the back, arms, and shoulders. which intervention should be offered by the nurse?

assess the patient's back and shoulder areas for signs of internal bleeding

a client has been diagnosed with peripheral arterial occlusive disease. which of the following instructions is appropriate for the nurse to gibe the client for promoting circulation to the extremities?

participate in a regular walking program

A client has been diagnosed with raynaud's disease. which self-care strategies minimize risks associated with this disease?

- wear gloves to protect hands from injury when performing tasks. -do not smoke, or stop smoking. -avoid over the counter decongestants and cold remedies.

a nursing student is caring for a client with gastritis. which of the following would the student recognize as a common cause of gastritis?

-ingestion of strong acids -overuse of aspirin -irritating foods

a patient is diagnosed with type 1 diabetes. what clinical characteristics does the nurse expect to see in this patient?

-ketosis prone -little to no endogenous insulin -younger than 30 years of age

a nurse is monitoring a client with peptic ulcer disease. which assessment findings would most likely indicate perforation of the ulcer?

-tachycardia -hypotension -a rigid, board-like abdomen

a nurse assesses a client diagnosed with megaloblastic anemia. which clinical findings will the nurse most likely find?

-ulcerated corners of the mouth -jaundice -concave nails

the nurse is conducting discharge teaching for a client with diverticulosis. which instruction should the nurse include in the teaching?

drink 8-10 glasses of fluid daily

a nurse is providing follow-up teaching at a clinic visit for a client recovering from gastric resection. the client reports sweating, diarrhea, nausea, palpitations, and the desire to lie down 15-30 minutes after meals. based on the client's assessment, what will the nurse suspect?

dumping syndrome

to check for arterial insufficiency when a client is in a supine position, the nurse should elevate the extremity at a 45-degree angle and then have the client sit up. the nurse suspects arterial insufficiency if the assessment reveals:

elevational pallor

the nurse recognized which condition as an integumentary manifestation of chronic renal failure?

gray-bronze skin color

a client with chronic renal failure complains of generalized bone pain and tenderness. which assessment finding would alert the nurse to an increased potential for the development of spontaneous bone fractures?

hyperphosphatemia

a nurse is teaching an older adult client about good bowel habits. which statement by the client indicates to the nurse that additional teaching is required?

i need to use laxatives regularly to prevent constipation.

the nurse is providing instructions to the client prior to an intravenous pyelogram. which statement by the client indicates teaching was effective?

i will feel a warm sensation as the dye is injected

a nurse provides nutritional information for a patient diagnosed with an iron deficiency anemia. what education should the nurse provide?

increase the intake of green, leafy vegetables.

it is important for the nurse to monitor serum electrolytes in a patient with acute diarrhea. select the electrolyte result that should be immediately reported.

potassium of 2.8 mEq/L

what is a hallmark of the diagnosis of nephrotic syndrome?

proteinuria

a nurse is reviewing the history of a client who is suspected of having glomerulonephritis. which of the following would the nurse consider significant?

recent history streptococcal infection

a client has just been diagnosed with iron deficiency anemia. what would you recommend the client consume to promote the absorption of iron?

rich sources of vitamin C

the nurse is preparing the patient for a test to determine the cause of vitamin B12 deficiency. the patient will receive a small oral dose of radioactive vitamin B12 followed by a large parenteral dose of nonradioactive vitamin B12. what test is the patient being prepared for?

schilling test

laboratory studies indicate a client's blood glucose level is 185 mg/dL. two hours have passed since the client ate breakfast. what test would yield the most conclusive diagnostic information about the client's glucose use?

serum glycosylated hemoglobin (Hb A1c)

a nursing assessment of a client with peritonitis reveals hypotension, tachycardia, and signs and symptoms of dehydration. what else would the nurse expect to find?

severe abdominal pain with direct palpation or rebound tenderness

a client is admitted with a gastrointestinal bleed. what client symptom may indicate a peptic ulcer perforation to the nurse?

sudden, severe, upper abdominal pain.

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 and symptoms of which disease/condition?

ulcerative colitis

a 60 year old client comes to the ED reporting weakness, vision problems, increased thirst, increased Urination, and frequent infections that do not seem to heal easily. the physician suspects the client has diabetes. what classic symptom should the nurse watch for to confirm the diagnosis of diabetes?

increased hunger

a client is receiving enoxaparin and warfarin therapy for venous thromboembolism (VTE). which laboratory value indicates that anticoagulation is adequate and enoxaparin can be discontinued?

international normalized ration (INR) is 2.5

after teaching a group of students about how to perform peritoneal dialysis, which statement would indicate to the instructor that the students need additional teaching?

it is appropriate to warm the dialysate in a microwave

a client with peripheral arterial disease asks the nurse about using a heating pad to warm the feet. the nurse's best response is which of the following?

it is better to put the heating pad on your abdomen, which causes vasodilation and warmth to your feet

during the review of morning lab values for a client reporting severe fatigue and a red, swollen tongue, the nurse suspects chronic, severe iron deficiency anemia based on which finding?

low ferritin level concentration

diet modifications for patients diagnosed with chronic inflammatory bowel disease include which of the following?

low residue

a client is diagnosed with peripheral arterial disease. review of the client's chart shows an ankle- brachial index (ABI) on the right of 0.45. this indicates that the right foot has which of the following?

moderate to severe arterial insufficiency

a client with a diagnosis of pernicious anemia comes to the clinic complaining of numbness and tingling in his arms and legs. what do these symptoms indicate?

neurologic involvement

a nurse is caring for a client who is undergoing a diagnostic workup for suspected gastrointestinal problem. the client reports gnawing epigastric pain following meals and heartburn. what would the nurse suspect this client has?

peptic ulcer disease

a client is receiving insulin lispro at 7:30 am. the nurse ensures that the client has breakfast by which time?

7:45am

a client with chronic renal failure (CRF) is admitted to the urology unit. which diagnostic test results are consistent with CRF

Blood urea nitrogen (BUN) 100 mg/dL and serum creatinine 6.5 mg/dL

during a colonoscopy with moderate sedation, the patient groans with obvious discomfort and beings bleeding from the rectum. the patient is diaphoretic and has an increase in abdominal girth from distention. what complication of this procedure is the nurse aware may be occurring?

bowel perforation

hyperkalemia is a serious side effect of acute renal failure. identify the electrocardiogram (ECG) tracing that is diagnostic for hyperkalemia.

Tall, peaked T waves

A home health nurse is seeing an elderly male client for the first time. During the physical assessment of the skin on the lower legs, the nurse notes edema, brown pigmentation in the gaiter area, pedal pulses, and a few irregularly shaped ulcers around the ankles. from these findings, the nurse knows that the client has a problem with peripheral circulation. which of the following does the nurse suspect?

venous insufficiency

the nurse is caring for a client with chronic gastritis. the nurse monitors the client knowing that the client is at risk for which vitamin deficiency?

vitamin B12

the nurse is assisting a patient with peripheral arterial disease to ambulate in the hallway. what should the nurse include in the education of the patient during ambulation?

walk to the point of pain, rest until the pain subsides, the resume ambulation.