Final med surg
The nurse reads a patient's chart and sees that the health care provider assessed mucosal erythroplakia. What does the nurse understand that this means for the patient? Select one: a. Fungal mouth infection b. Candidiasis (thrush) c. Precancerous lesion d. Inflammation of the gums
C
A nurse assesses a patient who is admitted with an acid-base imbalance. The patient's arterial blood gas values are pH 7.32, PaCO2 34 mm Hg, and HCO, 16 mEq/L. The nurse identifies this imbalance as: Select one: a.Respiratory Alkalosis-uncompensated b. Respiratory Alkalosis - compensated c. Metabolic Acidosis - uncompensated d. Metabolic acidosis- compensated
No right answer 7,8,9
What is the nursing priority when caring for a patient with a peptic ulcer? Select one: a. Monitor the patient for signs and symptoms of shock b. Maintain the patient NPO status while the ulcer heals C. Administer NSAID medications for pain relief d. Provide emotional support while patient is hospitalized
Not b
7 A nurse assesses a patient who is admitted for treatment of fluid overload. Which manifestations does the nurse expect to find? (Select all that apply.) Select one or more: a. Increased pulse rate b. Warm and pink skin c. Distended neck veins d. Weight gain e. Decreased blood pressure
A,b,c,d
A new nurse reports to the nurse preceptor that a patient requested pain medication, and when the nurse brought it, the patient was sound asleep. The nurse states the patient cannot possibly sleep with the severe pain the patient described. Which response by the experienced nurse is best? Select one: a. "You're right; I would put the medication back." b. "Being able to sleep doesn't mean pain doesn't exist." c. "Have you ever experienced any type of pain?" d. "The patient should be assessed for drug addiction."
B
A nurse assesses a patient's peripheral IV site, and notices edema and tenderness above the site. What action will the nurse take next? Select one: a, Flush the catheter with normal saline b.Stop the infusion of intravenous fluids c. Elevate the extremity on a pillow d. Apply cold compresses to the IV site
B
Which findings are AIDS-defining characteristics? (Select all that apply.) Select one or more: a. Positive enzyme-linked immunosorbent assay (ELISA) test for human immune deficiency virus (HIV) b. Kaposi's sarcoma c. CD4+ cell count less than 200/mm or less than 14% d. Dementia e. Taking antiretroviral medications f. Infection with Pneumocystis carinii
B, C, D, F
The nurse assesses patients for the cardinal signs of inflammation. Which signs/symptoms does this include? (Select all that apply.) Select one or more: a. Pallor b. Edema c. Redness d. Pulselessness e. Warmth
B, c, e
3) A nurse assesses a patient who is dying. Which manifestation of a dying patient does the nurse assess to determine whether the patient is near death? Select one: a. Level of consciousness b. Pain level on a 0-to-10 scale c. Respiratory rate d. Bowel sounds
C
A nurse cares for a patient with hepatitis C. The patient's brother states, "I do not want to contract this infection, so I will not go into his hospital room." How would the nurse respond? Select one: a. "This virus is only transmitted through a fecal specimen." b. "If you wear a gown and gloves, you will not get this virus." c. "Viral hepatitis is not spread through casual contact." d. "I can give you an update on your brother's status from here.
C
A nurse in the family clinic is teaching a patient newly diagnosed with osteoarthritis (OA) about drugs used to treat the disease, For which medication does the nurse plan primary teaching? Select one: a. Cyclobenzaprine hydrochloride (Flexeril) b. Hyaluronate (Hyalgan) C. Acetaminophen (Tylenol) d. Ibuprofen (Motrin)
C
A nurse on the postoperative inpatient unit receives a hand-off report on four patients using patient-controlled analgesia (PCA) pumps. Which patient would the nurse see first? Select one: a. Patient who appears to be sleeping soundly b. Patient who is pressing the button every 10 minutes c. Patient with a respiratory rate of 8 breaths/min d. Patient with no bolus request in 6 hours
C
A patient has been diagnosed with tuberculosis (TB). What action by the nurse takes highest priority? Select one: a. Teaching the patient ways to balance rest with activity b. Educating the patient on adherence to the treatment regimen c. Informing the patient about follow-up sputum cultures d. Encouraging the patient to eat a well-balanced diet
C or B
The nurse is assessing a patient with a possible small bowel obstruction. Which findings will be noted for this condition? (select all that apply) Select one or more: a. Rectal bleeding b. Excessive flatus and diarrhea c. Vomiting d. Wave-like abdominal pain e. High pitched tinkling sounds proximal to the obstruction
C, D, E
The PACU nurse is determining if a postoperative patient is ready for discharge from the PACU. What assessment findings would indicate the patient is meeting PACU discharge criteria? (Select all that apply.) Select one or more: a. Ability to move 2 extremities voluntarily b. Blood pressure within 30 points of preanesthetic level c. Return of gag, cough, and swallow reflexes d. Oxygen saturation of >95% on room air e. Dressing intact without any drainage
C, d, e
4) A nurse teaches a patient's family members about signs and symptoms of approaching death. Which manifestations does the nurse include in this teaching? (Select all that apply.) Select one or more: a. Long periods of insomnia b. Warm and flushed extremities c. Decreased appetite 2 d. Congestion and gurgling e. Increased respiratory rate
C,d
A nurse assesses a patient who is prescribed a medication that inhibits angiotensin I from converting into angiotensin II (angiotensin-converting enzyme (ACE] inhibitor). For which expected therapeutic effect does the nurse assess? Select one: a. Daily weight increase from 121 to 125 Ibs (55 kg to 57 kg) b. Respiratory rate increase from 12 to 15 breaths/min c. Heart rate decrease from 100 to 82 beats/mir d. Blood pressure decrease from 180/72 to 144/50 mm Hg
D
A nurse assesses patients on the medical-surgical unit. wihich patient is at greatest risk for the development of carcinoma of the liver? Select one: a. A 22-year-old with a history of blunt liver trauma b. A 48-year-old with a history of diabetes mellitus C. An 82-year-old who has chronic malnutrition d. A 66-year-old who has a history of cirrhosis
D
A nurse cares for a patient who had a chest tube placed B hours ago and refuses to take deep breaths because of the pain. What action would the nurse take? Select one: a. Encourage the patient to take shallow breaths to help with the pain b. Ambulate the patient in the hallway to promote deep breathing C. Auscultate the patient's anterior and posterior lung fields d. Administer pain medication and encourage the patient to take deep breaths
D
A pulmonary nurse cares for patients who have chronic obstructive pulmonary disease (COPD). Which patient would the nurse assess first? Select one: a. A 68-year-ald who has dependent edema and clubbed fingers b. A 46-year-old with a 30-pack-year history of smoking C. A 74-year-old with a chronic cough and thick, tenacious secretions d. A 52-year-old in a tripod position using accessory muscles to breathe
D
A student is practicing suctioning a tracheostomy in the skills laboratory. What action by the student demonstrates that more teaching is needed? Select one: a. Preoxygenating the patient prior to suctioning b. Suctioning for a total of three times if needed c. Suctioning for only 10 to 15 seconds each time d. Applying suction while inserting the catheter
D
A trauma nurse cares for several patients with fractures. Which patient would the nurse identify as at highest risk for developing deep vein thrombosis? Select one: a. A 36-year-old female with type 2 diabetes and fractured ribs b. An 18-year-old male athlete with a fractured clavicle C. A 55-year-old woman prescribed aspirin for rheumatoid arthritis d. A 74-year-old man who smokes and has a fractured pelvis
D
A client who experienced the sudden onset of respiratory distress has been intubated with an endotracheal tube. After the tube is placed in the trachea, the nurse should take which immediate action? Select one: a. Auscultate both lungs for the presence of breath sounds b. Send the patient fora chest x-ray c. Tape the tube in place d. Note how far the tube has been inserted
Find out
A nurse assesses a male patient with an abdominal hernia. Which abdominal hernias are correctly paired with their physiologic processes? (Select all that apply) Select one or more a. Indirect inguinal hernia-an enlarged plug of fat eventually pulls the peritoneum and often the bladder into a sac b. Direct inguinal hernia-a peritoneum sac passes through a weak point in the abdominal wall c. Incarcerated hernia-contents of the hernia sac cannot be reduced back into the abdominal cavity d. Femoral hernia-a peritoneum sac pushes downward and may descend into the scrotum e. Ventral hernia-results from inadequate healing of an incision
Find out
A patient with tuberculosis is being started on isoniazid and the nurse stresses the importance of returning to the clinic for follow-up blood testing. Which blood test will be performed? Select one: a. Liver enzymes b. Blood urea nitrogen C. Red blood cell count d. Serum creatinine
A
A nurse assesses a patient who has developed epistaxis. Which conditions in the patient's history would the nurse identify as potential contributors to this problem? (Select all that apply.) Select one or more: a. Hypertension b. Leukemia c. Cocaine use d. Migraines e. Diabetes mellitus
A, B, C
A nurse is teaching a patient about possible complications and hazards of home oxygen therapy. About which complications does me nurse plan to teach the patient? (Select all that apply.) Select one or more: a. Toxicity b. Absorptive atelectasis c. Combustion (fire hazard) d. Oxygen-induced hyperventilation e. Dried mucous membranes
A, B, C, E
A nurse works with several patients who have gout. Which types of gout and their drug treatments are correctly matched? (Select all that apply.) Select one or more: a. Colchicine (Colcrys)-acute gout b. Febuxostat (Uloric)-chronic gout c. Probenecid (Benemid)-acute gout d. Indomethacin (Indocin)-acute gout e. Allopurinol (Zyloprim)-acute gout
A, B, D,
A nurse cares for a patient who has cirrhosis of the liver. What action would the nurse take to decrease the presence of ascites? Select one: a. Monitor intake and output b. Provide a low-sodium diet c. Weigh the patient daily d. Increase oral fluid intake
B
A nurse observes that a patient's anteroposterior (AP) chest diameter is the same as the lateral chest diameter (Barrel chest). Which question would the nurse ask the patient in response to this finding? Select one: a. "Are you taking any medications or herbal supplements?" b. "Do you have any chronic breathing problems?" c. "How often do you perform aerobic exercise?" d. "What is your occupation and what are your hobbies?"
B
A nurse assesses a patient who has appendicitis. Which clinical manifestation would the nurse expect to find? Select one: a. Marked peristalsis and hyperactive bowel sounds b. Abdominal pain associated with nausea and vomiting C. Rebound tenderness to right lower quadrant of the abdomen d. Abdominal pain that increases with knee flexion
C
A nurse assesses a patient with a mechanical bowel obstruction who reports intermittent abdominal pain. An hour later the patient reports constant abdominal pain. Which action would the nurse take next? Select one: a. Administer intravenous opioid medications b. Position the patient with knees to chest c. Assess the patient's bowel sounds d. Insert a nasogastric tube for decompression
C
A nurse cares for a patient who has packing inserted for posterior nasal bleeding. What action would the nurse take first? Select one: a. Keep the patient's head tilted back b. Teach the patient about the causes of nasal bleeding C. Make sure that the string is taped to the patient's cheek d. Assess the patient's pain level
C
A patient has gastroesophageal reflux disease (GERD). The provider prescribes a proton pump inhibitor. About what medication would the nurse anticipate teaching the patient? Select one: a. Ranitidine (Zantac) b. Magnesium hydroxide (Maalox) c. Famotidine (Pepcid) d. Omeprazole (Prilosec)
D
A patient is in the oncology clinic for a first visit since being diagnosed with cancer. The nurse reads in the patient's chart that the cancer classification is TisNoMo. What does the nurse conclude about this patient's cancer? Select one: a. Regional lymph nodes could not be assessed b. There are multiple lymph nodes involved already C. The primary site of the cancer cannot be determined d. There are no distant metastases noted in the report
D
A patient is two days postoperative after a total hip replacement. Which postoperative order would the nurse expect to find? Select one: a. Use a lowered toilet seat b. Keep knees bent at all times c. Keep legs adducted at all times d. Do not flex hips more than 90 degrees
D
The post-anesthesia care unit (PACU) charge nurse notes vital signs on four postoperative patients. Which patient would the nurse assess first? Select one: a. Patient with a pulse of 118 beats/min b. Patient with a temperature of 96° F (35.6° C) c. Patient with a blood pressure of 100/50 mm Hg d. Patient with a respiratory rate of 6 breaths/min vomited.
D
A nurse evaluates a patient's arterial blood gas values (ABGS): pH 7.30, PaCO2 55 mm Hg, and HCO, 22 mEg/L. Which acid-baye imbalance is indicated by these values? Select one: a. Respiratory acidosis compensated b. Metabolic alkalosis compensated c. Metabolic acidosis - uncompensated d. Respiratory alkalosis - compensated
A
A nurse is caring for a patient who has just had a central venous access line inserted. What action will the nurse take next? Select one: a. Ensure that an x-ray is completed to confirm placement b. Check medication calculations with a second RN C. Make sure that the solution is appropriate for a central line d. Begin the prescribed infusion via the new access
A
A patient comes to the family medicine clinic and reports joint pain and stiffness. The nurse is asked to assess the patient for Heberden's nodules. What assessment technique is correct? Select one: a. Inspect the patient's distal finger joints b. Palpate the patient's abdomen for tenderness c. Perform range of motion on the patient's wrists d. Palpate the patient's upper body lymph nodes
A
A nurse is providing community education on the seven warning signs of cancer. Which signs are included? (Select all that apply.) Select one or more: a. Indigestion or trouble swallowing b. A sore that does not heal c. Near-daily abdominal pain d. Obvious change in a mole e. Unusual bleeding or discharge
A, B, D, E
The student nurse studying stomach disorders learns tha the risk factors for acute gastritis include which of the following? (Select all that apply.) Select one or more: a, smoking b. protein-rich foods c. alcohol d. Helicobacter pylori infection e. Nonsteroidal anti-inflammatory drugs (NSAIDS)
A,C, D, E
A patient recently diagnosed with systemic lupus erythematosus (SLE) is in the clinic for a follow-up visit. The nurse evaluates that the patient practices good self-care when the patient makes which statement? Select one: a. "Since I can't be exposed to the sun, I have been using a tanning bed. b. "I always wear long sleeves, pants, and a hat when outdoors. c. "I try not to use cosmetics that contain any type of sunblock. d. "Since I tend to sweat a lot, I use a lot of baby powder.
B
An inpatient nurse brings an informed consent form to a patient for an operation scheduled for tomorrow. The patient asks about possible complications from the operation. What response by the nurse is best? Select one: a. Remind the patient of what teaching the surgeon has done b. Do not have the patient sign the consent and call the surgeon c. Have the patient sign the consent, and then call the surgeon d. Answer the questions and document that teaching was done
B
Oxygen by way of nasal cannula has been prescribed for a patient with emphysema. The nurse checks the health care provider's prescriptions to ensure that the prescribed flow is not greater than which liter (L) per minute (min)? Select one: a. 3 L/min b. 4 L/min c. 1 L/min d. 6 L/min
A
A nurse is caring for a patient who has just undergone esophagogastroduodenoscopy (EGD). The patient says to the nurse, "I'm really thirsty - may I have something to drink?" Before giving the patient a drink, the nurse should: Select one: a. Ask the client to gargle with a warm saline solution b. Check the patient's vital signs C. Assess the patient for the presence of bowel sounds d. Check for the presence of a gag reflex
D
A postoperative patient vomited. After cleaning and comforting the patient, which action by the nurse is most important? Select one: a. Auscultate lung sounds b. Document the episode c. Encourage the patient to eat dry toast d. Allow the patient to rest
A
What information does the nurse teach a women's group about osteoporosis? Select one: a. "Women and men have an equal chance of getting osteoporosis." b. "There is no way to prevent or slow osteoporosis after menopause C "Primary osteoporosis occurs in postmenopausal women due to lack of estrogen d. "Men actually have higher rates of the disease but are underdiagnosed."
C
A patient is scheduled to have fundoplication surgery for gastroesophageal reflux disease (GERD).. What statement by the patient indicates a need for more preoperative teaching? Select one: a. "After the operation I can eat anything I want." b. "I will have to eat smaller, more frequent meals." c. "This surgery may not totally control my symptoms." d. "I will take stool softeners for several weeks."
A
A patient is taking immunosuppressant medication to prevent transplant rejection. What instruction by the nurse is most important? Select one: a. "Take this medicine exactly as prescribed." b. "You have a higher risk of developing cancer. c. "Avoid large crowds and people who are ill." d. "Check over-the-counter meds for acetaminophen.
A
A patient who had knee replacement surgery 2 days ago has a sudden onset of dyspnea and cough and reports a sharp, stabbing pain in the chest. The nurse notes a heart rate of 110 beats/min, bilateral crackles in lung fields, and an oxygen saturation of 97% on room air. Which postoperative complication does the nurse suspect the patient has developed? Select one: a. Pulmonary embolism b. Pneumonia c. Deep vein thrombosis d. Atelectasis
A
6) A nurse is caring for an older adult patient who is admitted with moderate dehydration. Which intervention will the nurse implement to prevent injury while in the hospital? Select one: a. Dangle the patient on the bedside before ambulating b. Ask family members to speak quietly to keep the patient calm c. Encourage the patient to drink at least 1 liter of fluids each shift d. Assess urine color, amount, and specific gravity each day
A
A nurse assesses a patient who is experiencing an acid-base imbalance. The patient's arterial blood gas values are pH 7.34, PaCo, 38mm Hg, and HCO, 19 mEg/L. Which acid-base imbalance do these values indicate? Select one: a. Metabolic Acidosis - compensated b. Metabolic Alkalosis - uncompensated c. Respiratory Alkalosis compensated d. Respiratory Acidosis-uncompensated
A
A nurse assesses patients on the medical-surgical unit. Which patient is at greatest risk for development of obstructive sleep apnea? Select one: a. A 55-year-old woman who is 50 Ibs (23 kg) overweight b. A 73-year-old man with type 2 diabetes mellitus C. A 42-year-old man with gastroesophageal reflux disease d. A 26-year-ald woman who is 8 months pregnant
A
A patient has a great deal of pain when coughing and deep breathing after abdominal surgery despite having pain medication. What action by the nurse is best? Select one: a. Demonstrate how to splint the incision b. Call the provider to request more analgesia c. Tell the patient that a little pain is expected d.Have the patient take shallower breaths
A
A patient is 1 day postoperative after having Zenker's diverticula removed. The patient has a nasogastric (NG) tube to suction, and for the last 4 hours there has been no drainage. There are no specific care orders for the NG tube in place. What action by the nurse is most appropriate? Select one: a. Notify the surgeon about this finding b. Remove and reinsert the NG tube c. Irrigate the NG tube with sterile saline d. Document the findings as normal
A
A patient had a bunionectomy with osteotomy. The patient asks why healing may take up to 3 months. What explanation by the nurse is best? Select one: a. "The bones in your feet are hard to operate on. b. "The surrounding bones and tissue are damaged. c. "Your feet have less blood flow, so healing is slower d. "Your feet bear weight so they never really heal."
C
A patient with rheumatoid arthritis (RA) has an acutely swollen, red, and painful joint. What nonpharmacologic treatment does the nurse apply? Select one: : a. Weight loss b. Wax dips c. Splints d. Heat/Cold application
D
A nurse is preparing for the admission of a patient with pulmonary tuberculosis. Which of the following actions reflects the use of evidence- based practice in the care of the patient? Select one: a. Using a surgical mask when entering the patient's room b. Placing the patient in a semiprivate room with a similar patient C. Keeping the door to the patient's room closed d. Fitting the patient for an N95 or HEPA (high-efficiency particulate air) mask to be worn at all times
Find out
The nurse is caring for a patient who develops compartment syndrome from a severe tibial fracture. The patient asks how this could have happened. The nurse responds with the understanding that: Select one: a. An injured artery causes impaired arterial perfusion through the compartment b. A bone fragment has injured the nerve supply in the area c. hemorrhage and edema causes increased pressure in an area that cannot expand d. The fascia expands with injury, causing pressure on underlying nerves and muscles
Not D
