Med surg final
A client is complaining of severe pain in the left great toe.What lab studies that the nurse reviews indicate that the client may have gout?
Elevated uric acid levels
The nurse is completing a health history with a client in a clinic.Which assessment finding best correlates with a diagnosis of osteoarthritis?
Joint stiffness that decrease with activity
An older adult encourages her husband to visit their primary provider with concerns that her husband may have Parkinson's disease which of the descriptions of her husband function suggest Parkinson's disease
Lately, he seems to move slower than he ever has in the past
The nurse is assessing a client with a history of ankylosing spondylitis.What will the nurse most commonly assess?
Lower back pain
Which topic is most important for the nurse to include in the teaching plan for a client newly diagnosed with Parkinson's disease?
Maintaining a safe enviorment
When preparing a client for insertion of a nasogastric tube it is essential for the nurse to instruct which of the following aspects of the procedure?
Measure the tube from the tip of the nose to the earlobe to the xyphoid process
The nurse is discussing the new medication that a client will be taking for treatment of rheumatoid arthritis.Which disease modifying antirheunatic drug(DMARD)will the nurse educate the client about?
Methotrexate(Rheumatrex)
A diet plan is developed for a patient with gouty arthritis What should the nurse advise the client to limit intake of
Organ meats
A client is undergoing diagnostic testing to determine the etiology of recent joint pain.The client asks th nurse about the different between Osteoarthritis and Rheumatoid arthritis.What is the best reponse?
Ostreoartheitis is considered noninflammatory joint disease Rheumatoid arthritis is symthemic and characterizws by imflammed and swollen joints
A client with diverticulitis is being assessed by the nurse on a medical surgical unit The nurse expect the client to have which of the following symptoms?
Pain in the left lower quadrant
A client has Crohn's disease plans for nursing interventions should include
Peri anal care and restoration of fluids and electrolytes
Which of the following might a patient undergoing a gastrectomy develop post operatively?
Pernicious Anemia
What nursing intervention should the nurse prioritize to facilitate healing in a client who has suffered a hip fracture?
Place a pillow between the clients legs when turning
The client has had a liver biopsy Which post procedure intervention should the nurse expect to implement?
Place the client on the right side
A client is receiving subcutaneous heparin after surgery to repair a hip fracture The nurse understands the rationale for this therapy is to reduce the risk for.
Pulmonary embolism
An enema is prescribed for a client with suspected appendicitis. Which of the following actions should the nurse take?
Question the physician about the order
Which information will the nurse include when teaching a patient with peptic ulcer disease and the effects of Ranitdine?
Ranitidine decreases gastric acid production
A patient is suspected to have appendicitis.What assessment finding confirms the suspension
Rebound tenderness at MC Burney's point
A patient has been prescribed morphine post op due to severe pain.What is the most common complication of this medication?
Respiratory depression
To reduce the occurance of dumping syndrome the nurse should instruct a client to do the following?
Rest 30 minutes after eating
A 53 year old client has a diagnosis of hepatic encephalopathy The measure that aids managemnet of this complication is to?
Restrict dietary protein intake
A nurse is assigned to care for a client post liver biopsy What is the best position following a liver biopsy?
Right Sims with a small pillow under the puncture site
The nurse practitioner is able to correlate the patient neurologic deficit with the location in the brain affected by ischemic hemorrhage for a patient with hemispheric stroke the nurse will expect to see
Right sided paralysis
A client is admitted with a diagnosis of rule out cholecystitis Which of the following clinical manifestations should alert a nurse to the possibility of this condition?
Right upper quadrant abdominal pain after eating a hamburger with fries
A nurse is writing a care plan for a client admitted to the emergency department (ED) with an open fracture.The nurse will assign priorty to what nursing diagnosis for a client with an open fracture of the radius?
Risk for Infection
A nurse is completing discharge teaching for the client who has left sided hemiparesis following a stroke.When investigating the clients home environment the nurse should focus on which nursing diagnosis?
Risk for Injury
A nurse is writing a care plan for a patient with an open fracture.The nurse will assign priority to which nursing diagnosis for a client with an open fracture to the radius?
Risk for infection
A patient with Parkinson's disease is undergoing a swallowing assessment, because she is experiencing difficulty when swallowing what consistency is appropriate to reduce the risk of aspiration
Semi solid food with thick liquids
A client has had surgical repair of a hip injury after joint manipulation was unsuccessful after surgery the nurse implements measures to prevent complications.Which complications is the nurse seeking to prevent?Select All That Apply
Skin breakdown,Wound Infection,Pneumonia
Which client would the nurse identify as having the greatest risk for osteoperososis?
Small framed thin 45 yr old white woman
A client with Crohn's disease experience 20 watery stools per day.When assessing the client the nurse would anticipate which finding?
Sticky Mucus membranes and low urine output
An adult is swinging a small child by the arms and the child screams and grabs his left arm It os determined in the emergency department that the radial head is partially dislocated.What is this partially dislocated radial head documented as?
Sublucation
The nurse is planning to administer the morning medications at 0730 to coat the ulcer for a patient with peptic ulcer disease`Which medication in the list would the nurse plan to use?
Sulcralfate
A client who has experienced an intial transient ischemic stroke(TIA)states "Im glad it was'nt anything serious"Whuch is the best nursing response to this statement?
TIA is a warning sign "Lets talk about lowering your risks"
The nurse is caring for a client with trigeminal neuralgia the care plan reflects the clients eating due to jaw pain to assist the client meeting adequate nutritional needs. What should the nurse suggest?
Take small meals of soft consistency
The nurse recieved the report from s previous shift. One of her clients was reported to have a history of basilar skull fracture with otorrhea.What assessment finding does the nurse anticipate?
The client cerebral spinal fluid leaking from the ear
A client with early stays warm up the word off writers extenders what to do to help ease the symptoms of the disease. What would be the best response of the nurse
The healthcare provider could prescribe anti-inflammatory drugs
A client who is being treated with laculose for hepatic encephalopathy reports experiencing 10 to 20 stools daily What is the nurse best reponse
This is a normal response to the medication
A patient diagnosed with ischemic stroke should be treated within the first three hours of symptoms on sat with which of the following
Tissue plasminogen activator(tpa)
A client falls to the floor in a generalized seizure with tonic clonic movements . which is the first action taken by taken by the nurse?
Turn client to side lying position
A patient with end stage liver failure has an elevated pt/Inr Which interventions should the nurse implement?select all that apply
Use soft toothbrush Administer stool softeners as ordered
A nurse is planning discharged teaching regarding excercise for a client at risk for osteoporosis.Which exercise would the nurse be most likely to suggest?
Walking
The nurse has just finished explaining the necessity of coughing and deep breathing following surgery to a peroperative client Which of the following response by the client show they have understanding and acceptance of what he has been taught?
When I do the coughing and deep breathing I reduce my chances of getting pneumonia
The nurse is caring for a client who has undergone supratentoial removal of a pituitary mass.What medication would the nurse expect to administer prophylactically to prevent seizures in this client?
phenytoin
A client with Crohn's disease is experiencing an exacerbation.Which instruction would the nurse include in planning his care?
promote bowel rest
The nurse is caring for a client who has been treated for a hip fracture instruct the client not to cross their legs and to have someone to assist with tying their shoes which additional instructions should the nurse provide to the client
Do not flex to hit more than 90°
The nurse is providing discharge instructions for a client who has undergone a gastric resection with pyloric sphincter involvement.The nurse is aware is that the client is at risk for?
Dumping Syndrome
The nurse is counseling a client on how to prevent cholecystitis exacerbation What is important guideline for the nurse to include?
Eat a low fat,low cholesterol diet
A client is undergoing testing to confirm diagnosis of myasthenia GRAVIS. The nurse explains that. A diagnosis is me if muscle function improves after the client receives an IV injection of a medication. What is the medication? The nurse tells the client he will receive during the test?
Edrophorium(tensilon)
The nurse is caring for a client diagnosed with gastroesophageal reflux disease which nursing interventions should be implemented
Elevate head of bed and discuss lifestyle modifications with the client
Which of the following clients is most at risk of developing hepatitis B?
26 year old female with multiple sexual partners
When planning care for a client with a head injury which position should the nurse include in the care plan to enhance client outcomes?
30 degree head elevation
The nurse is caring for a patient with a hip fracture.The physician has ordered the patient to start taking bisphosphate.Which medication would the nurse mark as given?
ALENDRONATE
A client with a history of duodenal ulcers wants to know what would be the best over the counter medication for headaches.What should the nurse counsel him is the best choice?
Acetaminophen
A nurse is caring for a client with a brain tumor and increase intracranial pressure(ICP).Which intervention should the nurse include in the plan of care to reduce (ICP)
Administer stool softners
The nurse is caring for a client with a hip fracture.The physician orders the client to start taking bisphosphonate.Which medication would the nurse document as given?
Alendronate
Which of the following clients should the nurse recognize as the most risk for osteomyelitis?
An elderly client with a pressure ulcer in the sacral area
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 cold pack to the ankle
The nurse is reviewing the medication administration record for a female client who possesses numerous risk factors for stroke.Which of the womans medication carries the greatest potential for reducing her risk of stroke?
Aspirin 81 PO
The nurse is caring for clients in an outpatient clinic Which information should the nurse teaching regarding the American Cancer Society recommendation for the early detection of colon cancer
At the age of 50 have a colonoscopy done and then once every 5 to 10 years
The nurse will encourage a client diagnosed with diverticulitis to make with lifestyle modification to prevent diverticulitis
Avoid seeds, nuts, and popcorn
Which laboratory result if elevated is most indicative that the client may develop hepatic encephalopathy
Blood Ammonia
A client diagnosed with carpal tunnel syndrome(CTS)asks the nurse about numbness in the fingers and pain in the wrist.What is the best response by the nurse?
CTS is a neuropathy that is characterized by compression by the median nerves at the wrist
And 85 year old male patient diagnosed with colon cancer asks the nurse why did I get this disease which is the nurse best response
Cancer of the colon is associated with low fiber in high fat diet
Which assessment should the nurse expect to find in a patient who had an barium enema
Chalky white stools
A client diagnosed with acute pancreatitis is prescribed TPN what intervention should the nurse implement?
Check the clients glucose level every four hours
Nurse is teaching a client the characteristics about osteoarthritis how will the nurse determine the client teaching was successful
Clients may develop Herben Nodes
A client diagnosis with a liver disorder is scheduled to have an invasive procedure The nurse would monitor which test result to ensure the safety the safety of the client?
Coagulation studies
The nurse is reviewing the medication administration record of a client which medication will lead the nurse to suspect the client is suffering from an acute attack of gout
Colchicine's
A client sustained a fractured right humerus in an automobile accident.The arm is edematous the client states that he cannot feel or move his fingers and the nurse does not feel a pulse.What condition should the nurse be concerned about that requires emergency measures?
Compartment syndrome
A patient with acute pancreatitis is admitted to the medical surgical unit and is NPO When caring for him the nurse is aware that an important goal of nursing care for this patient is?
Complete bowel rest and pain control
A client is admitted to an acute care facility after an episode of status epilepticus.After the client is stabilized which factor is most benefecial in determinung the potential cause of the episode?
Compliance with the prescribed medication regimen
A client is admitted to the emergency room after to the emergency room after being hit by a car while riding a bicycle.The client sustained a fractured of the left femur and the bone is protruding through the skin.What type of fracture does the nurse recognize requires emergency interveention?
Compound
The patient with peptic ulcer disease has been placed on regular doses of bismuth salicy combat H Pylori.What color will the drug tuen stool?
Dark Black stool
The nurse is asked to explain to the client the age related processes that contibute to the bone loss and osteoporosis.What is the nurses best response?
Decrease Estogen
A client with cirrhosis of the liver develops ascites. Which measure is used to decrease the accumulation of serous fluid in the peritoneal cavity? .
Decrease sodium intake
Laboratory test results that the nurse would expect to find in a patient with cirrhosis include
Decreased albumin
The nurse is assessing a client newly diagnosed with Myasthenia GRAVIS which of the following signs with the nurse, most likely observed
Diplopia and ptosis
The has created a care plan for a client at risk for Increased ICP.The client's care plan should specify monitoring for what early sign of Increased ICP?
Disorientation and Restlessness
A nurse is communicating with a client who has aphasia after having a stroke.Which action should the nurse take?
Face the client and establish eye contact
The nurse is assessing a client with a suspected stroke.What assessment finding is most suggestive of a stroke?
Facial droop
A client is admitted with a diagnosis of hepatic encephalopathy.The nurses documentation will include which of the following?
Flapping tremor of the hands
When the nurse is conducting the initial interview specific data should the nurse ask the client who is suspected of having peptic ulcer disease?
Frequency of use of non steroidal anti inflammatory drugs
A client is diagnosed with ulcerative colitis when assessing a client which sign and symptom, would the nurse expect to find
Frequent bloody stools throughout the day
A client diagnosed with Hepatitis A and asks the nurse how to avoid infecting other family members The nurses response would be based on the understanding that the spread of Hepatitis A primarily
From person to person through fecial contaminated food/water
The client is diagnosed with Crohns disease When assessing this client which sign and symptoms has greatest concern
Hard,Rigid,board like abdomen
A client has been prescribed alendronate for the prevention of osteoporosis.Which is the highest priority intervention associated with the administration of the medication?
Have the client sit upright for at least 30 minutes following administration
The nurse is assessing a client who has meningitis which of the findings with the nurse expect to observe
Headache and nuchal rigidly
A client is experiencing dysphagia following a stroke.Which measure may be taken by the nurse to ensure that the client's diet allows for easy swallowing?
Help the client sit upright when eating and feed slowly
Which assessment finding would strongly indicate the possible of cirrhosis?
Hepatomegaly
A nurse is providing education to a client with newly diagnosed multiple sclerosis(MS).Which of the following will the nurse include?
Hot temperature
A nurse is providing education to a community group ischemic strokes.One group member asks if there are ways to reduce the risk for stroke.Which of the following is a risk factor that can be modified?
Hypertension
A patient presents to the emergency department reporting that he has been vomitting every 30 minutes for the past 8 hours The nurse is aware that the client is at risk for which?
Hypokalemia
The nurse is caring for a patient with peptic ulcer disease Which of the following observation would the nurse report immediately ?Select all that apply
Hypotension,Tachycardia,Restlessness
After providing discharge instructions to a patient following a laparoscopocic cholectomy The nurse recognize that the teaching has been effective when the patient states?
I will always need to maintain a low fat diet since i no longer have a gallbladder
A patient complains of abdominal discomfort. I have an elevated WBC. Has rebound tenderness in the right lower quadrant. Appendicitis is suspected. Which nursing intervention ship would be appropriate
Ice pack for Comfort
The nurse is caring for a client recently diagnosed with Myasrhenia Gravis.The client has begun treatment with pyridostigmine bromide.What changes in status would mosr clearly suggest a therapeutic benefit of this medication?
Increased muscle strength
