Med Surg Final Class Review

A nurse is caring for a client who has a diagnosis of renal calculi and reports severe flank pain. Which of the following is the priority nursing action? A: relieve the client's pain B: encourage the client to increase fluid intake C: Monitor the clients I&O D: Strain the clients urine

A

During the postoperative assessment of a client with a history obstructive sleep apnea (OSA), which assessment finding should cause the nurse the most concern? A. Irregular and noisy respirations B. Disorientation and confusion C. A report of a dry mouth and sore throat D. A pain report of 8 on a 0 - 10 scale

A

Patient comes into the ED for constipation. Iron deficiency anemia from blood loss in the stool, weakness, weight loss, distended abdomen, and crampy lower abdomen pain, and loops of large bowel becoming visible through the abdominal wall. What are the manifestations of this? A.) Large Bowel Obstruction B.) GI Bleed C.) Bloating D.) Liver Disease

A

The nurse is providing discharge teaching for a client with newly diagnosed Crohn's disease about dietary measures to implement during exacerbation episodes. Which statement by the client indicates a need for further instruction? A. "I need to increase the fiber in my diet" B. "I will need to avoid caffeinated beverages C. "I'm going to learn some stress-reduction techniques" D. "I can have exacerbations and remissions with Crohn's disease"

A

When a client is diagnosed with aplastic anemia, the nurse monitors for changes in which of the following physiological functions? A. Bleeding tendencies B. Intake and output C. Peripheral sensation D. Bowel function

A

When planning the correction of fluid loss for the patient with FVD, the primary provider considers the patient's maintenance requirements and other factors (e.g., fever) that can influence fluid needs. If the deficit is not severe, the oral route is preferred, provided the patient can drink. However, if fluid losses are acute or severe, the IV route is required. Isotonic electrolyte crystalloid solutions are frequently the first-line choice to treat the hypotensive patient with FVD because they expand plasma volume. Which of the following are isotonic solutions? Select all that apply. A. Lactated Ringers B. 0.9 NaCl C. D5W D. 0.45% Sodium Chloride

A, B, C

Mr. Jone's is a 54 y.o. male coming in with urinary problems. He states he can't quite say when his symptoms started because this has been going on for awhile. It has gradually been getting worse. He has trouble urinating. He states that he cannot empty his bladder and that he has no stream anymore, just dribbles. He has also had a hard time initiating urination. He occasionally has low back pain as well. States he feels like his bladder in constantly full. Identify the clinical manifestations of prostate cancer that Mr. Jones is exhibiting. Select all that apply. A. Urinary dribbling B. Difficulty urinating C. Urinary retention D. Low back pain E. Bladder discomfort F. Blood in urine

A, B, C, D, E

Which statement by the client requires further education regarding hypothyroid disorders therapy? (Select all that apply) A. I can stop Levothyroxine as soon as I feel better. B. This medication will dry my skin, so I need to apply body lotion after taking it. C. I will take this medication as long as I live. D. I do not need to take any medication, my thyroid will go back to functioning effectively after I rest.

A, B, D

Diabetes can lead to which of the following long-term complications? Select all that apply. A. Blindness B. Cardiovascular disease C. Diabetic ketoacidosis D. Renal disease E. Peripheral neuropathy

A, B, D, E

A nurse is taking care of a client with hyperthyroid disorders, what are the cues that confirm the client's diagnosis? Select all that apply. A. Client is using a fan, with the AC on and a temperature of 40F. B. Client report having 3 bowel movements within 2hrs C. Client is experiencing weight gain despite not eating too much D. Client has a heart rate of 150 beats per minute. E. Client's skin is dry F. Client has lower extremities edema.

A, B, D, F

A nurse working in an outpatient clinic is assessing a client who has rheumatoid arthritis (RA). The client reports increased joint tenderness and swelling. Which of the following findings should the nurse expect? (Select all that apply) A. Recent influenza B. Decreased range of motion C. Hypersalivation D. Increased blood pressure E. Pain at rest

A, B, E

Which risk factors for atherosclerosis are considered modifiable risks? Select all that apply. A. Diet B. Race C. Genetics D. Smoking E. Age F. Religion

A, D

You're providing an in-service on viral hepatitis to a group of healthcare workers. You are teaching them about the types of viral hepatitis that can turn into chronic infections. Which types are known to cause ACUTE infections ONLY? Select all that apply: A. Hepatitis A B. Hepatitis B C. Hepatitis C D. Hepatitis D E. Hepatitis E

A, E

A nurse is educating a client on the use of calcipotriene topical medication for the treatment of psoriasis. Which of the following laboratory values should the nurse monitor? A. Potassium B. Calcium C. Sodium D. Chloride

B

A patient is admitted with rupture of the Achilles tendon. The patient was recently treated with antibiotics for pneumonia. Which of the following medications below can cause this adverse effect? A. Penicillin B. Fluroquinolones C. Tetracylclines D. Macrolides

B

An 85 year old patient has an accidental fall while going to the bathroom without assistance. It appears the patient has sustained a bone fracture to the left leg. The leg's shape is deformed and the patient is unable to move it. The patient is alert and oriented but in pain. What will you do FIRST after confirming the patient is safe and stable? A. Apply an ice pack covered with a towel to the site. B. Immobilize the fracture with a splint. C. Administer pain medication. D. Elevate the extremity above heart level.

B

HgbA1C represents an average blood glucose over what period of time? A. 1 month B. 2-3 months C. 6 months D. This number doesn't matter

B

Which goal of the clients care should take priority during the first days of hospitalization for an exacerbation of ulcerative colitis? A. Promoting self-care and independence B. Managing diarrhea C. Maintain adequate nutrition D. Promoting rest and comfort

B

Which of the following patients does not have a risk factor for hypertension? A. A 40-year-old female with a family history of hypertension and diabetes. B. A 35-year-old female with a total cholesterol level of 100. C. A 25-year-old male with a BMI of 35. D. A 68-year-old male who reports smoking 2 packs of cigarettes a day.

B

You're providing education to a group of nursing students about the care of a patient with appendicitis. Which statement by a nursing student requires re-education about your teaching?* A. "After an appendectomy the patient may have a nasogastric tube to remove stomach fluids and swallowed air." B. "Non-pharmacological techniques for a patient with appendicitis include application of heat to the abdomen and the side-lying position." C. "The nurse should monitor the patient for signs and symptoms of peritonitis which includes increased heart rate, respirations, temperature, abdominal distention, and intense abdominal pain." D. "It is normal for some patients to have shoulder pain after a laparoscopic appendectomy."

B

A nurse is admitting an adult client who has suspected osteoporosis. Which of the following findings are risk factors for osteoporosis? (Select all that apply) A. History of consuming one glass of wine daily B. Loss in height of 2 in. (5.1cm) C. Body Mass Index (BMI) of 18 D. Kyphotic curve at upper thoracic spine E. History of Lactose intolerance

B, C, D

Mr. West is a 58 year old man that comes to the clinic complaining of fatigue and says that he is "just not feeling well". He works over 50 hours a week as a computer analyst and says that he doesn't have time to exercise. On his days off he likes to drink a few beers and eats a high fat diet. The physician reviews his lab results and notices his HDL level is 30 mg/dl, triglycerides 228 mg/dL, and his LDL 142 mg/dL. Mr. West is at a high risk for CAD due to which of the following primary causes? Select all that apply. A. Gender B. Diet C. Lack of exercise D. Recent lab results

B, C, D

A client is admitted following a thrombotic stroke. What priority assessment is most important for the nurse to perform in the first 24 hours? A. A 12-lead electrocardiogram B. If bowel sounds are hypo or hyperactive C. Pupil size and pupillary response D. Coagulation laboratory tests

C

A client was rushed into the Emergency Department due to an acute upper GI hemorrhage. Which action by the nurse is correct? A. Manage the client's hypervolemia. B. Control the source of bleeding. C. Perform interventions for hypovolemia. D. Diagnose the source of bleeding.

C

Patient comes into the ED for crampy pain in this abdomen. They are passing blood and mucus but no fecal matter and no flatus. They are vomiting, distended abdomen, intense thirst, aching, parched tongue, and dehydration. What are these manifestations of this? A.) GI Bleed B.) Diverticulitis C.) Small Bowel Obstruction D.) Crohn's

C

The nurse would instruct the client to eat which of the following foods to obtain the best supply of vitamin B12? A. Whole grains B. Green leafy vegetables C. Meat and dairy products D. Broccoli and brussel sprouts

C

Which is a risk factor for gallbladder​ disease? A. Male gender B. Hypocalcemia C. Rapid weight loss D. Hypolipidemia

C

A nurse is assessing a client's laboratory values before surgery. Which of the following results should the nurse report to the provider? (Select all that apply) A. Potassium 3.9 mEq/L B. Sodium 145 mEq/L C. Creatinine 2.8 mg/dL D. Blood glucose 235 mg/dL E. WBC 17,850/mm^3

C, D, E

A nurse is caring for a client who has regular occupational exposure to sunlight and presents for evaluation for several skin lesions. Which of the following findings should alert the nurse to the possibility of malignant melanoma? A: A pearly papule that is 0.5 cm wide with raised, indistinct borders on the upper right shoulder B: Several flat, pigmented, circumscribed areas of various sizes over the bridge of the nose C: A raised, circumscribed lesion on the face that contains yellow - white purulent material D: An irregularly shaped brown lesion with light blue areas on the neck

D

For an unconscious patient who is experiencing hypoglycemia in a healthcare facility, the nurse would make what emergency management intervention? A. Glucagon 10mg IM B. IV bolus of 500mL D5W over 30 minutes C. 2-3 tablespoons of honey D. 25-50 mL of dextrose 50% in water

D

The client diagnosed with osteosarcoma is scheduled for a surgical amputation. Which nursing diagnosis would be a priority for this client compared with other surgical clients? A. Inadequate nutrition B. Impaired physical mobility C. Risk for infection D. Disturbed body image

D

The nurse and rehabilitation disciplines are collaborating on the care for a client with Parkinson's disease. Which collaborative goal is the most appropriate for the client with Parkinson's disease? A. To stop progression of the disease B. To cure the disease C. To establish palliative care D. To maintain optimal body function

D

The nurse explains to the patient with gastroesophageal reflux disease that this disorder: A. Results in acid erosion and ulceration of the esophagus caused by frequent vomiting. B. Will require surgical wrapping or repair of the pyloric sphincter to control the symptoms. C. Is the protrusion of a portion of the stomach into esophagus through an opening in the diaphragm. D. Often involves relaxation of the lower esophageal sphincter, allowing stomach contents to back up into the esophagus.

D

The nurse has administered an antibiotic, a proton pump inhibitor, and Pepto-Bismol for peptic ulcer disease secondary to H. Pylori. Which data would indicate to the nurse the medications are effective? A. A decrease in alcohol intake B. Maintaining a bland diet C. A return to previous activities D. A decrease in gastric distress

D

The nurse is performing an assessment on a client with peripheral vascular disease​ (PVD). Which finding should the nurse​ expect? A. Wheezing upon auscultation of the lungs B. Decreased sensation of the upper extremities C. Dilated blood vessels in the eye D. Delayed capillary refill in the lower extremities

D

The nurse understands that the pathophysiology of type 1 diabetes is characterized by which of the following? A. Insulin resistance B. Necrosis of pancreatic alpha cells C. Impaired insulin production D. Destruction of pancreatic beta cells

D

What is Paralytic Ileus motion in the intestine? A.) Cramping B.) Liver Disease C.) Pain D.) Wave-like

D