MED SURG FINAL STUDY SET 2

A nurse is teaching a client who has chronic kidney failure about planning a low-protein diet. The client states, "Why do I have to be concerned about protein?" Which of the following responses should the nurse make? "A low-protein diet reduces the risk for uremia." "A low-protein diet reduces the risk for edema." "A low -protein diet will reduce the risk for hyperkalemia." "A low-protein diet will increase the nitrogenous wastes in the blood."

"A low-protein diet reduces the risk for uremia."

A nurse is teaching a client who has septic shock about the development of disseminated intravascular coagulation (DIC). Which of the following statements should the nurse make? "DIC is controllable with lifelong heparin usage." "DIC is characterized by an elevated platelet count." "DIC is caused by abnormal coagulation involving fibrinogen." "DIC is a genetic disorder involving a vitamin K deficiency."

"DIC is caused by abnormal coagulation involving fibrinogen."

A nurse is assessing a client who has a suspected diagnosis of Guillain-Barré syndrome (GBS). Which of the following questions should the nurse ask the client?

"Have you had a recent influenza infection?" The nurse should ask the client about a recent Haemophilus influenzae infection. The cause of GBS is unknown, but it usually follows a viral infection.

A nurse is teaching the family of a client who has a new diagnosis of epilepsy about actions to take if the client experiences a seizure. Which of the following instructions should the nurse include in the teaching? "Insert a padded tongue blade into the client's mouth." ''Restrain the client." "Place the client on his back." "Move objects away from the client."

"Move objects away from the client."

A nurse is caring for a client who will have blood sampling for a serum creatinine level and asks what this test shows. Which of the following responses should the nurse make?

"This test will tell your doctor how your kidneys are functioning."

A nurse is calculating the output of a client at the end of the shift. The nurse notes the following: client voided 400 mL at 1100 and 350 mL at 1430. The closed chest drainage system was previously marked at 155 mL and is now at 175 mL. The NG tube has 575 ml in drainage container, and 25 mL is emptied out of the Jackson-Pratt drainage tube. How many mL should the nurse record in the medical record as the client's output?

1370

A nurse is caring for a client who has cervical cancer and is scheduled for brachytherapy. Which of the following actions should the nurse take? (SATA) A. Permit visitors to stay with the client 30 min at a time B. Place the client on bed rest C. Insert an indwelling urinary catheter D. Administer fiber laxatives E. Dispose soiled linens in hamper outside clients room

A. Permit visitors to stay with the client 30 min at a time B. Place the client on bed rest C. Insert an indwelling urinary catheter

A nurse is reviewing the health record of a client who has suspected ovarian cancer. Which of the following findings supports this diagnosis? (SATA) A. Previous treatment for endometriosis B. Family history of colon cancer C. First pregnancy at age 24 D. Report of scant menses E. Use of oral contraceptives for 10 years

A. Previous treatment for endometriosis B. Family history of colon cancer

A nurse notes increasing edema in the calf of a client who has multiple fractures of the leg. The nurse should recognize that increasing edema is a manifestation of which of the following complications? Fat embolism syndrome Acute compartment syndrome Pulmonary embolism Malignant hypothermia

Acute compartment syndrome

A nurse is caring for a client who has acute osteomyelitis. Which of the following interventions is the nurse's priority? Provide the client with antipyretic therapy. Administer antibiotics to the client. Increase the client's protein intake. Teach relaxation breathing to reduce the client's pain.

Administer antibiotics to the client.

A nurse is planning care for a client who has cirrhosis of the liver. Which of the following actions should the nurse include in the plan? (Select all that apply.) Administer furosemide. Administer warfarin. Implement a low-sodium diet. Measure the client's abdominal girth. Encourage weight lifting during physical therapy.

Administer furosemide Implement a low-sodium diet. Measure the client's abdominal girth.

A nurse is teaching a client about risk factors for osteoarthritis. Which of the following factors should the nurse include in the teaching? (Select all that apply.) Bacteria Diuretics Aging Obesity Smoking

Aging Obesity Smoking

A nurse is reviewing the laboratory data of a client who has acute pancreatitis. The nurse should expect to find an elevation of which of following values? Calcium RBC count Magnesium Amylase

Amylase

A nurse at a providers office is caring for an older adult client who is having an annual physical exam. Which of the following indicates additional follow ups is needed in regard to the prostate gland? (SATA) A. PSA is 7.1 ng/mL B. A digital rectal exam (DRE) reveals an enlarged and nodular prostate C. The client reports weak urine stream D. The client reports urinating once during the night E. Smegma is present below the glans of the penis

Answer: A, B, C A. PSA is 7.1 ng/mL B. A digital rectal exam (DRE) reveals an enlarged and nodular prostate C. The client reports weak urine stream

A nurse in a providers office is obtaining a history from a client who is undergoing evaluation for BPH. The nurse should identify that which of the following findings are indicative of this condition?(SATA) A. Backache B. Frequent UTI C. Weight loss D. Hematuria E. Urinary incontinence

Answer: B, D, E B. Frequent UTI D. Hematuria E. Urinary incontinence

A nurse is teaching a client who has gastrosophageal reflux disease about managing his illness. Which of the following recommendations should the nurse include in the teaching? Limit fluid intake not related to meals. Chew on mint leaves to relieve indigestion. Avoid eating within 3 hr of bedtime. season foods with black pepper.

Avoid eating within 3 hr of bedtime.

A nurse is caring for a client who has ulcerative colitis and is teaching the client about the common link with Crohn's disease. Which of the following information should the nurse include? Both are inflammatory Both begin in the rectum Both manifest fistula formation Both require frequent surgery

Both are inflammatory

A nurse is assessing a client who has Parkinson's disease. Which of the following manifestations should the nurse expect? Pruritus Hypertension Bradykinesia Xerostomia

Bradykinesia

A nurse is obtaining a health history from a client who has cancer of the cervix. Which of the following manifestations should the nurse expect? A. weight gain B. Oliguira C. vaginal bleeding D. back pain

C. vaginal bleeding

A nurse who is off duty finds a woman who has collapsed and has right-sided weakness and slurred speech. Which of the following actions should the nurse take? Obtain the telephone number of the client's provider. Find a location for the client to sit. Call emergency services. Drive the client to the nearest emergency department.

Call emergency services.

A nurse is teaching a client who has urolithiasis (renal calculi). The nurse should explain that which of the following conditions can increase the risk for renal calculi?

Dehydration

A nurse is caring for a client who has benign prostatic hyperplasia (BPH). The nurse should expect which of the following findings?

Difficulty starting the flow of urine Hesitancy or difficulty starting the flow of urine is an expected finding of BPH.

A nurse is providing dietary teaching to a client who has a history of recurring calcium oxalate kidney stones. Which of the following instructions should the nurse include in the teaching? Drink 3 L of fluid every day. Take 3,000 mg of vitamin C daily. Restrict calcium intake to one serving per day. Eat 12 oz of animal protein daily.

Drink 3 L of fluid every day.

A nurse in a clinic is interviewing a client who has a possible diagnosis of endometriosis. Which of the following findings in the client's history should the nurse recognize as consistent with a diagnosis of endometriosis? A history of pelvic inflammatory disease (PID). Abdominal bloating starting several days before menses. An atypical Papanicolaou smear at her last clinic visit. Dysmenorrhea that is unresponsive to NSAIDs.

Dysmenorrhea that is unresponsive to NSAIDs.

A nurse is caring for a client who has increased intracranial pressure. Which of the following interventions should the nurse take? Teach controlled coughing and deep breathing. Provide a brightly lit environment. Elevate the head of the bed. Encourage a minimum intake of 2000 mL (67.6 oz) of clear fluids per day.

Elevate the head of the bed.

A nurse at a community health clinic is caring for a client who reports a headache and stiff neck. Which of the following actions should the nurse take first?

Evaluate the client's neurological status Manifestations of a headache and stiff neck (nuchal rigidity) are indications that the client might have meningitis. The greatest risk to the client is injury from increased intracranial pressure, which can lead to brain herniation and death. Therefore, the nurse should complete a neurological assessment as a baseline. If the client does have meningitis, neurological checks should be completed every 2 to 4 hr.

A nurse is teaching a group of male adolescents about testicular self-examination. Which of the following information should the nurse include? Perform testicular self-examination twice per year. Pinch the testicles to feel for abnormalities. Examine the testicles after a bath or shower. Expect a moderate amount of swelling.

Examine the testicles after a bath or shower.

A nurse is assessing a client who has disseminated intravascular coagulation (DIC). Which of the following findings should the nurse expect? Excessive thrombosis and bleeding Progressive increase in platelet production Immediate sodium and fluid retention Increased clotting factors

Excessive thrombosis and bleeding The nurse should expect excessive thrombosis and bleeding of mucous membranes because both DIC impairs both coagulation and anticoagulation pathways.

A nurse is caring for a client who has benign prostatic hyperplasia (BPH). What medications should the nurse plan to administer?

Finasteride

A nurse is assessing a client who has fluid volume deficit. The nurse should expect which of the following findings? Decreased urine specific gravity Decreased Hgb Increased BUN Increased urine ketones

Increased BUN

A nurse admits a client to the emergency department who reports nausea and vomiting that worsens when he lies down. Antacids do not help. The provider suspects acute pancreatitis. Which of the following laboratory test results should the nurse expect to see? Decreased WBC Increased serum amylase Decreased serum lipase Increased serum calcium

Increased serum amylase

A nurse is completing a physical examination of a client and notes that laboratory values indicate leukocytosis. The nurse should recognize that which of the following manifestations is associated with leukocytosis? Anemia Coagulation disorders Inflammation Renal disorder

Inflammation

A nurse is assessing an older adult client who has osteoporosis. Which of the following spinal deformities should the nurse expect to find in this client? Lordosis Ankylosis Kyphosis Scoliosis

Kyphosis

A nurse is caring for a client who has diverticular disease. When palpating the client's abdomen, in which of the following locations should the nurse expect the client to report abdominal pain? Lower left quadrant Upper left quadrant Lower right quadrant Upper right quadrant

Lower left quadrant

A nurse is caring for a client who has a suspected diagnosis of myasthenia gravis. The provider prescribes a Tensilon test. Which of the following findings indicates a positive test? A pill-rolling tremor appears. Muscle contractions become progressively stronger. Electrical charge in a muscle increases in intensity. Muscle strength shows no change.

Muscle contractions become progressively stronger.

A nurse is assessing a client who is 3 days postoperative following abdominal surgery and notes the absence of bowel sounds, abdominal distention, and the client passing no flatus. Which of the following conditions should the nurse suspect? Ulcerative colitis Cholecystitis Paralytic ileus Wound dehiscence

Paralytic ileus

A nurse is assessing a client who has advanced cirrhosis. Which of the following manifestations should the nurse expect? Petechiae Hypertension Osteoarthritis Peripheral ulcers

Petechiae

A nurse enters a client's room and finds him on the floor in the clonic phase of a tonic-clonic seizure. Which of the following actions should the nurse take? Insert a padded tongue blade into the client's mouth. Place a pillow under the client's head. Gently restrain the client's extremities. Apply a face mask for oxygen administration.

Place a pillow under the client's head.

A nurse enters a client's room and finds the client on the floor having a seizure. Which of the following actions should the nurse take?

Place the client on his side

A nurse is reviewing the laboratory data of a client following a hemodialysis treatment. The nurse should expect to find a decrease in which of the following laboratory values? RBC count Protein Calcium Potassium

Potassium

A health care professional is caring for a patient who is about to begin taking finasteride (Proscar) to treat benign prostatic hyperthropy. The health care professional should explain to the patient the need to monitor which of the following laboratory tests?

Prostate-specific antigen(PSA).

A nurse is providing dietary teaching to a client who has chronic kidney disease (CKD). The nurse should instruct the client to limit which of the following nutrients? (Select all that apply.) Protein Calcium Calories Phosphorous Sodium

Protein Phosphorous Sodium

A nurse is talking to a client who is taking a calcium supplement for osteoporosis. The client tells the nurse she is experiencing flank pain. Which of the following adverse effects should the nurse suspect? Hepatitis Peptic ulcer fracture Renal stones Pancreatitis

Renal stones

A nurse is assessing a client who is experiencing prostatic hypertrophy. Which of the following findings associated with urinary retention should the nurse expect? (Select all that apply.) Report of feeling pressure Tenderness over the symphysis pubis Distended bladder Voiding 30 mL frequently Dysuria

Report of feeling pressure Tenderness over the symphysis pubis Distended bladder Voiding 30 mL frequently

A nurse suspects that a client admitted for treatment of bacterial meningitis is experiencing increased intracranial pressure (ICP). Which of the following assessment findings by the nurse supports this suspicion? Photophobia Nuchal rigidity Positive Kernig's sign Restlessness

Restlessness

A nurse is caring for a client who has a traumatic brain injury. Which of the following findings should the nurse identify as an indication of increased intracranial pressure (ICP)?

Restlessness Increased intracranial pressure is a condition in which the pressure of the cerebrospinal fluid or brain matter within the skull exceeds the upper limits for normal. Signs of increasing ICP include restlessness, irritability and confusion along with a change in level of consciousness, or a change in speech pattern.

A nurse is caring for a client who the provider suspects might have pernicious anemia. The nurse should expect the provider to prescribe which of the following diagnostic tests? Sweat test Haptoglobin Antinuclear antibodies Schilling test

Schilling test

A nurse in a provider's office is collecting a health history from a client who is at risk for primary osteoporosis. Which of the following findings is a risk factor for the development of osteoporosis? Obesity Sedentary lifestyle Long-term use of diuretics Prolonged stress

Sedentary lifestyle

A nurse is teaching a client about risk factors for osteoporosis. Which of the following factors should the nurse include in the teaching? (Select all that apply.) Sedentary lifestyle Obesity Aging Caffeine intake Secondhand smoke

Sedentary lifestyle Aging Caffeine intake Secondhand smoke

A nurse in an urgent care center is caring for a client who has a greenstick fracture of the forearm. The nurse should explain that which of the following injuries has occurred with a greenstick fracture? The bone is cracked lengthwise but did not break all the way through. Fragments of bone have splintered into the surrounding tissue. The bone ends have been forced toward each other. Sharp edge of the bone has broken through the skin.

The bone is cracked lengthwise but did not break all the way through.

A nurse is assessing a client who has end-stage kidney disease and is receiving hemodialysis. Which of the following findings should the nurse identify as an indication the client is experiencing fluid overload? The client has a 5 lb weight gain since yesterday. Flattened neck veins Oxygen saturation 93% Return of skin to previous position when the client's shin is palpated

The client has a 5 lb weight gain since yesterday.

NGN - Hematology A nurse is reviewing the medical record of a client who has acute leukemia

The client is at risk for developing BLEEDING and INFECTION

A nurse is caring for a client who has chronic renal disease and is receiving therapy with epoetin alfa. Which of the following laboratory results should the nurse review for an indication of a therapeutic effect of the medication?

The hematocrit (Hct) Epoetin alfa is an antianemic medication that is indicated in the treatment of clients who have anemia due to reduced production of endogenous erythropoietin, which may occur in clients who have end-stage renal disease or myelosuppression from chemotherapy. The therapeutic effect of epoetin alfa is enhanced red blood cell production, which is reflected in an increased RBC, Hgb, and Hct.

A nurse is caring for a client who has chemotherapy- induced peripheral neuropathy. The nurse should expect the client to report having experienced which of the following symptoms? Extremities that turned blue when exposed to cold Tingling feeling in the extremities Jerking movements of the extremities Spasms of the extremities

Tingling feeling in the extremities

A nurse is admitting a young adult client who has suspected bacterial meningitis. The nurse should closely monitor the client for increased intracranial pressure (IC) as indicated by which of the following findings? Nuchal rigidity Pupils reactive to light Widened pulse pressure Elevated temperature

Widened pulse pressure

A nurse is caring for a client who has acute pancreatitis. After treating the client's pain, which of the following should the nurse address as the priority intervention? Auscultate the client's lungs. Assist the client to a side-lying position. Provide oral hygiene. Withhold oral fluids and food.

Withhold oral fluids and food.

A nurse is assessing a client who had a craniotomy and has developed syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following manifestations should the nurse anticipate? Hypernatremia Oliguria Weight loss Increased thirst

Oliguria

NGN Parkinson's/Stroke/MS

Orientation status - all 3 Ambulation pattern - Parkinson's Muscle movements - Parkinson's Speech - all 3 Facial rigidity - Parkinson's

A nurse is caring for a client who has an epidural hematoma. Which of the following manifestations should the nurse expect? A lucid period followed by an immediate loss of consciousness A change in the level of consciousness that develops over 48 hr Neurologic deficits that increase up to 2 weeks post-injury Cognitive perception that decreases over several months post-injury

A lucid period followed by an immediate loss of consciousness

A nurse is caring for a client who has a new diagnosis of BPH. The nurse should anticipate a prescription for which of the following medications? A. Oxybutynin B. Diphenhydramine C. Ipratoprium D. Tamsulosin

D. Tamsulosin

A nurse is assessing a client who has chronic kidney disease for fluid volume increase. Which of the following provides a reliable measure of fluid retention?

Daily weight

A nurse is assessing a client in the oliguric phase of acute kidney injury. Which of the following findings should the nurse expect?

Hyperkalemia

A nurse is caring for a child who is admitted with suspected acute appendicitis. Which of the following manifestations should indicate to the nurse that the child's appendix is perforated? Sudden decrease in abdominal pain Absent Rovsing's sign Flaccid abdomen Low-grade fever

Sudden decrease in abdominal pain

A nurse is preparing a teaching plan for a client who has chronic constipation secondary to irregular bowel habits. Which of the following should the nurse plan to include in the teaching? The client should drink two to three 8 oz glasses of water each day. The client should follow a high-fiber diet to establish bowel regularity. The client should try to take in all of the required dietary fiber with the morning meal. The client should be taught that the goal of therapy is to have a bowel movement daily.

The client should follow a high-fiber diet to establish bowel regularity.

A nurse is instructing a client who is scheduled for a TURP about his postoperative care. Which of the following information should the nurse include in the teaching? A. "You may have a continuous sensation of needing to void even though you have a catheter." B."You will be on bed rest for the first 2 days after the procedure." C. "You will be instructed to limit your fluid intake after the procedure." D. "Your urine should be clear yellow the evening after the surgery."

A. "You may have a continuous sensation of needing to void even though you have a catheter."

A nurse in a clinic is caring for a client who is suspected uterine cancer. Which of the following assessment techniques should the nurse anticipate the provider will perform? A. Bi-manual pelvic exam B. PAP test with cultures C. Digital rectal exam D. Percussion of the upper abdominal quadrant for tympany

A. Bi-manual pelvic exam

A nurse is providing teaching for a client who is to undergo a cervical biopsy. Which of the following information should the nurse include? (SATA) A. " The procedure is painless" B. " Avoid heavy lifting for approx. 2 weeks after the procedure" C. " Heavy bleeding is common during the first 12 hours after the procedure" D. " Plan to rest for 72 hours after the procedure" E. " Avoid the use of tampons for 2 weeks after the procedure"

Answer: B, E B. " Avoid heavy lifting for approx. 2 weeks after the procedure" E. " Avoid the use of tampons for 2 weeks after the procedure"

A nurse is caring for a client who has continuous bladder irrigation following a transurethral resection of the prostate. Upon detecting an output obstruction, which of the following actions should the nurse take first? A. Irrigate the catheter with normal saline. B. Notify the provider. C. Check the irrigation tubing for kinks. D. Provide PRN pain medication.

C. Check the irrigation tubing for kinks.

A nurse is providing discharge instructions to a client who is postoperative following a TURP. Which of the following instructions should the nurse include? (SATA) A. Avoid sexual intercourse for 3 months after surgery B. If urine appears bloody, stop activity and rest C. Avoid drinking caffeinated beverages D. Take a stool softener once a day E. Treat pain with ibuprofen

B. If urine appears bloody, stop activity and rest C. Avoid drinking caffeinated beverages D. Take a stool softener once a day

A health care professional is caring for a patient who has benign prostatic hypertrophy and is taking tamsulosin (Flomax). The health care professional should question the use of the drug if the patient also has which of the following? A.) A seizure disorder for which he takes carbamazepine (Tegretol) B.) Erectile dysfunction for which he takes sildenafil (Viagra) C.) Diabetes mellitus for which he takes glyburide (DiaBeta) D.) Angle-closure glaucoma for which he takes pilocarpine

B.) Erectile dysfunction for which he takes sildenafil (Viagra)

A nurse is reviewing the laboratory values of a client who has chronic glomerulonephritis. Which of the following is an expected finding for this client? Serum creatinine 0.8 mg/dL RBC 4.9 mm3 BUN 100 mg/dL Serum potassium 4.0 mEg/L

BUN 100 mg/dL

A nurse is reviewing the BUN and creatinine levels of an older adult client who has chronic kidney disease. The nurse should expect which of the following findings? BUN 10 mg/dL and creatinine 0.3 mg/dL BUN 23 mg/dL and creatinine 1.0 mg/dL BUN 8 mg/dL and creatinine 0.7 mg/dL BUN 45 mg/dL and creatinine 8 mg/dL

BUN 45 mg/dL and creatinine 8 mg/dL

A nurse is caring for a client who has an intracranial pressure (IC) reading of 40 mm Hg. Which of the following findings should the nurse identify as a late sign of ICP? (Select all that apply.) Confusion Bradycardia Hypotension Nonreactive dilated pupils Slurred speech

Bradycardia Nonreactive dilated pupils

A nurse is assessing a client who has meningitis and notes when passively flexing the client's neck there is an involuntary flexion of both legs. Which of the following conditions is the client displaying?

Brudzinski's sign This client is manifesting a positive Brudzinski's sign, which is indicated when the hips and knees flex when neck is flexed. A positive Brudzinski's sign is a common sign of meningitis.

A nurse is teaching a client who has a history of ulcerative colitis and a new diagnosis of anemia. Which of the following manifestations of colitis should the nurse identify as a contributing factor to the development of the anemia? Dietary iron restrictions Intestinal malabsorption syndrome Chronic blood loss Intestinal parasites

Chronic blood loss

A nurse is caring for a client who has a history of alcohol use disorder and reports bruising and frequent nosebleeds. The nurse should recognize that this client in manifesting which of the following conditions? Malnutrition Hepatitis A Diabetes Cirrhosis

Cirrhosis

A nurse is caring for an older adult client who has a urinary tract infection (UTI). Which of the following manifestations should the nurse identify as a finding specifically associated with this client? Urinary retention Low back pain Incontinence Confusion

Confusion

A nurse is providing teaching to a client who is preoperative prior to a transurethral resection of the prostate (TURP). Which of the following statements indicates an understanding of the information? A. "I will not need to have a urinary catheter following this procedure." B. "I will expect my urine to be cloudy after having this procedure." C. "At least I won't have leakage of urine after having this procedure." D. "I will feel the urge to urinate following this procedure."

D. "I will feel the urge to urinate following this procedure."

A nurse is assessing a client who is postoperative following a transurethral resection of the prostate (TURP). After the nurse discontinues the client's urinary catheter, which of the following findings should the nurse report to the provider? A. Pink-tinged urine B. Report of burning upon urination C. Stress incontinence D. Decreased urine output

D. Decreased urine output

A nurse is caring for a client who has a new diagnosis of urolithiasis. Which of the following should the nurse identify as an associated risk factor?

Family history

NGN - Hematology A nurse is caring for a toddler in the primary care office

GREEN: ACTIONS Educate guardians about the need for iron supplements Provide information about foods rich in ascorbic acid YELLOW: CONDITION Iron deficiency anemia GRAY: MONITOR Iron ferritin level Hgb level

A nurse is interviewing a client who has acute pancreatitis. Which of the following factors should the nurse anticipate finding in the client's history? Gallstones Hypolipidemia COPD Diabetes mellitus

Gallstones

A nurse is assessing a client who has peptic ulcer disease. Which of the following findings should the nurse identify as the priority? Epigastric discomfort Dyspepsia Constipation Hematemesis

Hematemesis

A nurse is reviewing the medical record of a client who has a peptic ulcer. Which of the following findings should the nurse recognize as a risk factor for this condition? History of bulimia History of NSAID use Drinks green tea Has a glass of wine with dinner each day

History of NSAID use

A nurse is reviewing the laboratory test results from a client who has prerenal acute kidney injury (AKI). Which of the following electrolyte imbalances should the nurse expect?

Hyperkalemia

A nurse is reviewing the laboratory test results from a client who has prerenal acute kidney injury (AKI). Which of the following electrolyte imbalances should the nurse expect? Hyperkalemia Hypernatremia Hypercalcemia Hypophosphatemia

Hyperkalemia

A nurse is shopping and finds a woman who has collapsed with right-sided weakness and slurred speech. Which of the following action should the nurse take? Provide the client with water to test the gag reflex. Perform carotid massage. Notify emergency management services. Drive the client to the nearest medical facility.

Notify emergency management services.

A nurse is reviewing laboratory findings for four clients. Which of the following clients has manifestations of acute kidney injury? BUN 15 mg/dL Serum creatinine 6 mg/dL Hemoglobin 16 g/dL Serum potassium 4.5 mEg/L

Serum creatinine 6 mg/dL

A nurse is caring for a male client who has chronic glomerulonephritis. Which of the following findings should the nurse expect? Urine specific gravity 1.035 Creatinine clearance 120 mL/min Serum creatinine 7 mg/dL BUN 15 mg/dL

Serum creatinine 7 mg/dL

A nurse is assessing a client who has meningitis. Which of the following findings should the nurse expect?

Severe headache The nurse should expect a client who has meningitis to manifest a severe headache due to meningeal inflammation.

A nurse is assessing a client who has cirrhosis. Which of the following is an expected finding for this client? Moist skin Spider angiomas Tarry stools Blood in the urine

Spider angiomas

NGN Leukemia/Sickle Cell/Hemophilia

Temperature - leukemia and sickle cell bruising - leukemia and hemophilia bleeding - leukemia and hemophilia WBC - leukemia and sickle cell Pain - all 3

A nurse is reviewing the PT, aPTT, and IN laboratory values for a client who is experiencing an acute episode of disseminated intravascular coagulation (DIC). Which of the following laboratory results should the nurse expect? The laboratory values are within the expected reference range. The laboratory values are prolonged. The laboratory values are decreased. The laboratory values are the same as the previous test values.

The laboratory values are prolonged. These laboratory values measure clotting time. Because DIC results in the formation of multiple, small clots that consume key clotting factors, the nurse should expect the laboratory values to be prolonged.

A nurse is in a client's room when the client begins having a tonic-clonic seizure. Which of the following actions should the nurse take first? Turn the client's head to the side. Check the client's motor strength. Loosen the clothing around the client's waist. Document the time the seizure began.

Turn the client's head to the side.

A nurse is teaching a client who has acute kidney injury about the oliguric phase. Which of the following information should the nurse include in the teaching? Renal function is reestablished. BUN and creatinine levels decrease. Urine output is less than 400 mL per 24 hr. The glomerular filtration rate (GFR) recovers.

Urine output is less than 400 mL per 24 hr

A nurse is caring for a client who has impaired renal function. For which of the following findings should the nurse notify the provider? Urine output of 175 mL in the past 8 hr Urine output of 2,200 mL in the past 24 hr First-voided urine in the morning has a strong odor Urine is cloudy after sitting in the urinal for 6 hr

Urine output of 175 mL in the past 8 hr <30 mL/hr

A nurse is caring for a client who is receiving IV fluids to correct dehydration. Which of the following laboratory values should indicate to the nurse that the client is effectively responding to treatment? Sodium 165 mEg/L Potassium 5.2 mEg/L Urine specific gravity 1.020 Hct 62%

Urine specific gravity 1.020

A nurse is caring for a client who is 1 day postoperative following a transurethral resection of the prostate (TURP) and has a continuous bladder irrigation in place. What actions should the nurse take? (SATA)

Use sterile technique when preparing the irrigation solution. Ensure the drainage tubing is patent and without obstruction. Notify the surgeon if the urine is bright red in appearance or has large clots.

A nurse is planning care for a client who has pernicious anemia. Which of the following interventions should the nurse plan to implement? Vitamin B12 injections Iron supplements Blood transfusions Vitamin B6 supplements

Vitamin B12 injections

A nurse is reviewing the arterial blood gas values of a client who has chronic kidney disease. Which of the following sets of values should the nurse expect?

pH 7.25, HCO3- 19 mEq/L, PaCO2 30 mm Hg The nurse should expect a client who has renal failure to have metabolic acidosis, which is characterized by a low HCO3-, a low pH, and a low or normal PaCO2. Expected reference ranges for these laboratory values are as follows: pH 7.35 to 7.45, HCO3- 21 to 28 mEq/L, and PaCO2 35 to 45 mm Hg.

A nurse is caring for a client who has acute kidney injury (AKI). Which of the following arterial blood gas values would the nurse expect this client to have?

pH 7.26, HCO3 14, PaCO2 30 AKI causes metabolic acidosis because the kidneys cannot adequately process and excrete the acidic substances the usual bodily functions produce every day. With metabolic acidosis, the pH is low, the bicarbonate is low, and the PaCO2 is low or in the expected range, as in these results

A nurse is caring for a client who has acute kidney injury (AKI). Which of the following arterial blood gas values would the nurse expect this client to have?

pH 7.26, HCO3 14, PaCO2 30 metabolic acidosis ph is low bicarb is low co2 is at or below reference range (35-45)