Exam 2 - PrepUs
A client who has suffered a compound fracture is preparing for discharge to home. During the teaching session, the client asks why he needs antibiotics for a broken bone. Which response by the nurse is most appropriate?
"Antibiotic therapy has been prescribed as a precaution because your bone was exposed to the environment at the time of your injury."
A client with a forceful, pounding heartbeat is diagnosed with mitral valve prolapse. Which client statement indicates to the nurse a need for additional teaching?
"I can still drink coffee and tea"
The nurse teaches 17-year-old girl with has a severe gonorrheal infection about her disease. The nurse realizes that the girl understands the implications of her disease when the client makes which statement?
"I could have trouble getting pregnant"
the nurse is teaching a 17-year-old girl who has a severe gonorrheal infection. The nurse realizes that the girl understands the implications of her disease when she tells the nurse:
"I could have trouble getting pregnant."
The nurse is evaluating a female client's understanding of how to prevent sexually transmitted infections (STIs). Which statement indicates that the client understands how to protect herself?
"I'll be sure my partner uses a condom."
The nursing student learning on a cardiac unit asks the instructor why loss of the "atrial kick" causes a decrease in cardiac output, because the ventricles are still contracting. What is the nursing instructor's best response?
"The atrial contraction fills the ventricles and accounts for nearly one-third of the volume ejected during ventricular contraction."
An 56-year-old menopausal client comes to the clinic reporting painful intercourse. Her pelvic examination reveals vaginal dryness. Which suggestion would be most appropriate?
"Try using a water-soluble lubricant before intercourse."
A nurse is preparing a teaching plan for a female client diagnosed with genital ulcers. Which instructions would the nurse include in this teaching plan? Select all that apply.
"Use a condom when having sexual intercourse with any noninfected partner." "Avoid having sex when any ulcers are present." "Air dry any lesions with a hair dryer on the low setting."
A monitor technician on the telemetry unit asks a charge nurse why every client whose monitor shows atrial fibrillation is receiving warfarin. Which response by the charge nurse is best?
"Warfarin prevents clot formation in the atria of clients with atrial fibrillation."
A community health nurse is conducting a class on sexually transmitted infections (STIs). She states that "STIs are discriminatory." What would the nurse most likely use to support this statement?
"Women are diagnosed with two thirds of the new cases of STIs annually." "After only a single exposure, women are twice as likely as men to acquire STIs." "Certain infections can be transmitted to the newborn."
A home care nurse is visiting a left-handed client who has an implantable cardioverter-defibrillator (ICD) implanted in the left chest. The client is planning to go rifle hunting. How should the nurse respond?
"You can't shoot a rifle left-handed because the rifle's recoil will traumatize the ICD site."
A patient with a musculoskeletal injury is instructed to increase dietary calcium. Which of the following statements by the nurse is appropriate?
"You need to increase the amount of vitamin D in your diet."
The nurse is admitting a client to the medical-surgical unit after a diagnosis of cellulitis of the calf. What factors does the nurse know impact the processes of inflammation, repair, and replacement? Select all that apply.
-nature of the injury -condition of the host -severity of the injury
A nurse is teaching a local community group about STIs. When discussing syphilis, the nurse would identify which stages as being most infectious? Select all that apply.
2' 1' early latent
A client is admitted to the emergency department reporting chest pain and shortness of breath. The nurse notes an irregular rhythm on the bedside electrocardiograph monitor. The nurse counts 9 RR intervals on the client's 6-second rhythm tracing. The nurse correctly identifies the client's heart rate as
90 BPM
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
The nurse is caring for patient with a hip fracture. The physician orders the patient to start on a bisphosphonate. Which medication would the nurse document as given?
Alendronate (Fosamax)
A client was playing softball and was hit in the right ankle by the ball sustaining a contusion. What is the first action taken to help alleviate pain and swelling?
Apply a cold pack to the ankle.
A client is transported to the emergency department for a femur fracture following a motor vehicle crash. What action by the nurse is the highest priority?
Assess vital signs and level of consciousness. NOT assess pedal pulses
The clinic nurse has been assigned to a 43-year-old client who is obese and loves to eat. The client has been diagnosed with hyperlipidemia and has been prescribed lovastatin. Which dietary instruction would be a priority for the nurse to discuss with the client?
Avoid drinking grapefruit juice
Which of the following terms refers to difficult or painful sexual intercourse?
Dyspareunia
Assessment of a newly admitted patient reveals the characteristic signs and symptoms of cellulitis on the back of the hand. A swab of the patient's wound was ordered upon admission, but the results of culture and sensitivity (C&S) testing are not yet available. What strategy will most likely be adopted to treat this patient's infection?
Empiric antimicrobial therapy will be implemented until laboratory results are available.
Which is a modifiable risk factor for coronary artery disease (CAD)?
Hyperlipidemia
The nurse understands that asystole can be caused by several conditions. Select all that apply.
Hypoxia Hypovolemia Hypothermia Acidosis
Which of the following is accurate regarding sildenafil (Viagra)?
Its side effects include headache, flushing, and dizziness.
The nurse identifies which symptom as a characteristic of right-sided heart failure?
JVD
When caring for a client with a fracture, what assessment would take priority?
Neurovascular compromise
The nurse is reviewing the history of a client with erectile dysfunction. Which of the following would the nurse least likely identify as contributing to the client's condition?
New onset of anemia being treated with iron supplements
The nurse is providing teaching to a client who is at risk for hyperlipidemia. The nurse knows that which risk factors can be controlled or modified?
Obesity, inactivity, diet, and smoking
Nursing students are reviewing information about the male reproductive system and normal age-related changes. They demonstrate understanding of the topic when they identify which of the following as occurring?
Plasma testosterone levels decrease.
Which physiological conditions are common triggers for the development of cardiac arrhythmias? Select all that apply.
Respiratory distress Potassium imbalance Metabolic acidosis Faulty sinoventricular node
What do class IB anti-arrhythmics result in? (Select all that apply.)
Shortening of the action potential duration Depression of cardiac conduction
A 30-year-old female client received an insect bite that has progressed to cellulitis over the past several days. What client characteristic should the nurse prioritize when administering anti-infectives?
The client is in the second trimester of pregnancy.
Which of the following is not a definition of erectile dysfunction?
The inability to achieve an erection after sexual activity
Which vitamin supplements should the nurse recommend while a postmenopausal client is taking alendronate (Fosamax)?
Vitamin D and Calcium
During assessment, a patient with chronic liver dysfunction tells the nurse that he is experiencing spontaneous episodes of bleeding and has noticed increased areas of bruising on his chest and arms. The nurse suspects a deficiency in:
Vitamin K
Which of the following dinner selections demonstrates an understanding of nutritional therapy used by women to decrease the signs and symptoms of menopause?
Wheat toast, apple slices, broiled chicken breast, and steamed carrots
A client sustains an injury to the left ankle when he fell down three steps. There was immediate swelling and pain from the injury, and the client was taken to the local emergency department. What initial test does the nurse anticipate the physician will order to rule out a fracture?
X-ray
The nurse is educating a group of women on the prevention of osteoporosis. The nurse recognizes the education as being effective when the group members make which of the following statements?
adequate sunshine exposure
A client with stage IV heart failure has a living will indicating a ventilator may not be used. The client begins experiencing severe dyspnea. What should the nurse who is caring for this client do?
administer oxygen, morphine, and a bronchodilator for client comfort
The nurse is caring for a client who is displaying a third-degree AV block on the EKG monitor. What is the priority nursing intervention for the client?
alerting the HCP of the 3rd degree heart block
Lactulose (Cephulac) is administered to a patient diagnosed with hepatic encephalopathy to reduce which of the following?
ammonia
Which of the following terms describes the involuntary flapping movements of the hands associated with metabolic liver dysfunction?
asterixis
A nurse completes a shift assessment on a client admitted to the telemetry unit with a diagnosis of syncope. The client's heart rate is 55 bpm with a blood pressure of 90/66 mm Hg. The client is also experiencing dizziness and shortness of breath. Which medication will the nurse anticipate administering to the client based on these clinical findings?
atropine
A nurse is caring for a client who has premature ventricular contractions. What sign would the nurse assess in this client?
atropine
Which medication is the drug of choice for sinus bradycardia?
atropine
A client tells the nurse "my heart is skipping beats again; I'm having palpitations." After completing a physical assessment, the nurse concludes the client is experiencing occasional premature atrial complexes (PACs). The nurse should instruct the client to
avoid caffeinated beverages
A nurse is caring for a client who has had an automatic cardiac defibrillator implanted. What instructions should the nurse provide to the client?
avoid devices with magnetic field
The nurse is providing discharge instructions to a client after a permanent pacemaker insertion. Which safety precaution will the nurse communicate to the client?
avoid undergoing MRI
A nurse educator is teaching a client about sexually transmitted infections. The client would learn that which medications are appropriate to treat chlamydia? Select all that apply.
azithromycin doxycycline ceftriaxone
The nurse in the intensive care unit (ICU) hears an alarm sound in the patient's room. Arriving in the room, the patient is unresponsive, without a pulse, and a flat line on the monitor. What is the first action by the nurse?
begin CPR
A client who has developed congestive heart failure must learn to make dietary adaptations. The client should avoid:
canned peas
When planning the care of a client with an implanted pacemaker, what assessment should the nurse prioritize?
heart rate and rhythm
What is a modifiable risk factor for the development of atherosclerosis?
high-fat diet
The nurse is preparing to administer hydralazine and isosorbide dinitrate. When obtaining vital signs, the nurse notes that the blood pressure is 90/60. What is the priority action by the nurse?
hold the med and call the HCP
Hormone therapy decreases the risk of which of the following?
hot flashes
An 80-year-old client is being seen by the urologist because of erectile dysfunction. This client has a history of hypertension and heart disease. Which of the following would be the most likely cause of his erectile dysfunction?
hypertension depression atherosclerosis
A nurse is caring for a client with heart failure. The nurse knows that the client has left-sided heart failure when the client makes which statement?
i sleep on 3 pillows at night
A woman seen in the emergency walk-in clinic is diagnosed with chlamydia trachomatis. She asks the nurse how this disease is different from other sexually transmitted infectious diseases. What is the nurse's best response?
infection of your cervix
A woman seen in the emergency walk-in clinic is diagnosed with chlamydia trachomatis. She asks the nurse how this disease is different from other sexually transmitted infectious diseases. What is the nurse's best response?
it is in the cervix
A community health nurse is presenting to group of adolescents on how to reduce their risks of contracting sexually transmitted infections (STIs). The nurse feels confident learning has taken place when the participants identify which as the best preventative measure?
latex condom during sexual activity
A nurse is performing patient education for a woman who has just been prescribed a bisphosphonate. Which diagnostic and history findings would have prompted the woman's care provider to prescribe a bisphosphonate?
low bone density and family hx of osteoporosis
The nurse is writing a plan of care for a client with a cardiac dysrhythmia. What would be the priority goal for the client?
maintain adequate cardiac output
Which of the following describes failure of the ends of a fractured bone to unite in normal alignment?
nonunion
What organ provides the control over the amount of calcium in the blood?
parathyroid glands
The nurse is evaluating a female client's understanding of how to prevent sexually transmitted infections (STIs). Which statement indicates that the client understands how to protect herself?
partner will use a condom
The nurse is administering an antibiotic to a client with a diagnosis of cellulitis of the left leg. Which client condition would have the greatest effect on the drug's distribution?
peripheral vascular disease
The nurse completes an assessment of a client admitted with a diagnosis of right-sided heart failure. What will be a significant clinical finding related to right-sided heart failure?
pitting edema
A nurse is caring for a client with acute pulmonary edema. To immediately promote oxygenation and relieve dyspnea, what action should the nurse perform?
place pt in high fowlers
A nurse is caring for a client undergoing treatment for bacterial vaginosis. Which instruction should the nurse give the client to prevent recurrence of bacterial vaginosis?
practice monogamy
Ac client with a lengthy history of alcohol addiction is diagnosed with cirrhosis. The nurse emphasizes that the principal goal of cirrhosis therapy is:
preserving liver function
A client is receiving adenosine for treatment of supraventricular tachycardia. The nurse understands that this drug results in:
prolonged refractory period
Which is a risk-lowering strategy for osteoporosis?
smoking cessation
A patient with suspected esophageal varices is scheduled for an upper endoscopy with moderate sedation. After the procedure is performed, how long should the nurse withhold food and fluids?
until the gag reflex returns
A nurse is planning discharge teaching regarding exercise for a client at risk for osteoporosis. Which of the following exercises would be appropriate?
walking
A client is using high-dose estrogen oral contraceptives. The nurse would assess the client for which finding?
yeast infection
A client who has been treated for recurring gonorrhea visits the sexual health clinic reporting dysuria, urinary frequency, and whitish-yellow vaginal discharge. A pelvic examination reveals cervicitis. How would the nurse interpret these findings?
the possibility of a chlamydia infection
A client arrives in the emergency room complaining of severe pain in her left hip after falling out of the bed. What indication upon assessment does the nurse recognize as a dislocated left hip? Select all that apply. The skin of the lower left leg is pale. Limited range of motion of the left hip. The client is able to bend the knee but not move toes. The skin over the left hip is warm. The left leg is shorter than the right.
the skin of the lower left leg is pale. Limited range of motion of the left hip. The left leg is shorter than the right.
A client presents to the urgent care and tells the health care provider he came home from vacation 4 days ago and does not feel well. Upon assessment, the provider notes the client's right upper thigh area is red, warm, and painful, and the lymph nodes are palpable. The client states he had been swimming in a lake all week. The health care provider recognizes these manifestations as:
cellulitis
Which type of fracture produces several bone fragments?
comminuted
Which of the following type of fracture is associated with osteoporosis?
compression
A client has a fractured femur and is being seen in the emergency department. The nurse assessing the area notices there is a grating sound that is suspected to be bone ends moving over one another. This would be called: or The nurse is assessing a client's knee. The area has a grating sensation. What would this be documented as?
crepitus
The nurse is assessing a client's knee. The area has a grating sensation. What would this be documented as?
crepitus
A patient has been prescribed a tetracycline drug for Rocky Mountain spotted fever. The patient also takes antacids. Which of the following effects is likely to occur due to an interaction between the two drugs?
decreased absorption of tetracycline
The health care provider has prescribed a class IV calcium channel blocker for a client diagnosed with acute supraventricular tachycardia. Which drug does this nurse expect to be prescribed?
diltiazem
A client with primary syphilis is allergic to penicillin. The nurse would expect the primary care provider to prescribe which agent?
doxycycline
What is the most common early symptom of a sexually transmitted infection?
dysuria
Which finding would the nurse most likely find in a male diagnosed with a chlamydia trachomatis infection?
dysuria
A client's Holter monitor strip reveals a heart rate with normal conduction but with a rate consistently above 105 beats/minute. What other conditions can cause this response in a healthy heart?
elevated temp shock strenuous exercise
The home care nurse is caring for an elderly female patient who has been diagnosed with osteoporosis. When explaining the disease and its treatment to the patient, what should the nurse identify as a potentially serious complication?
fracture
Which term refers to a break in the continuity of a bone?
fracture
A primary care provider tells a client to return 2 to 3 months after treatment to have a repeat culture done to verify the cure. This prescription would be appropriate for a woman with which condition?
gonorrhea
A 66-year-old man has made an appointment with his primary care provider to discuss his recent erectile dysfunction (ED) and has requested a prescription for tadalafil (Cialis) based on television commercials he has seen. What characteristic of this client would contraindicate the use of tadalafil for his ED?
has unstable angina and uses a nitroglycerin patch
A nurse is providing care to a client diagnosed with genital/vulvovaginal candidiasis. As part of the client's plan of care, the nurse would teach the client about which medication?
miconazole
A client has been admitted to the cardiac step-down unit with acute pulmonary edema. Which symptoms would the nurse expect to find during assessment?
moist, gurgling respirations
The nurse is administering intravenous amiodarone to a patient in the emergency department. Which task would the nurse need to prioritize?
monitor BP
The nursing student asks the nurse to describe the difference between sinus rhythm and sinus bradycardia on the electrocardiogram strip. What is the nurse's best reply?
only difference is HR
Which of the following is an age-related functional change of the female reproductive system?
ovulation decreases
A female client with an anal gonorrheal infection experiences painful bowel elimination and a purulent rectal discharge. The nurse would expect which finding once the microorganism disseminates throughout the body?
painful joints
A patient, admitted to a health care facility with cardiac arrhythmia, is prescribed propranolol. Which factor should the nurse closely monitor as a part of the ongoing assessment during the therapy?
pulse rate
A client sprains an ankle while playing tennis and is brought to the emergency department. What is the priority action by the nurse?
rest, ice, compression, elevation
The staff educator is presenting a class on cardiac dysrhythmias. How would the educator describe the characteristic pattern of the atrial waves in atrial flutter?
sawtooth
The nurse is preparing to defibrillate a client with no breathing or pulse. Which nursing action precedes the nurse pressing the discharge button?
shouts, "all clear!"
A client is unconscious on arrival to the emergency department. The nurse in the emergency department identifies that the client has a permanent pacemaker due to which characteristic?
spike on EKG strip
An instructor is teaching a group of students about the incidence of sexually transmitted infections (STIs) and those that must be reported by law. The instructor determines that the students have understood the information when they state that which STI must be reported?
syphilis
A nurse is performing discharge teaching for an elderly client with osteoporosis. Which instruction about taking a calcium supplement should the nurse include?
take supplement with a meal or orange juice
The nurse is caring for a client with dysrhythmia. What would be an important procedure to teach a client with dysrhythmia to perform to evaluate his or her response to treatment?
technique for palpating and measuring radial pulse
Tetracyclines should not be used in children younger than 8 years of age because of their effects on:
teeth and bones
