med surg I final
A client diagnosed with bladder cancer wants to avoid surgery. For which intravesical treatment will the nurse prepare teaching for this client?
Bacillus Calmette Guerin (BCG) Live
The nurse is caring for a client with an endotracheal tube who is on a ventilator. When assessing the client, the nurse knows to maintain what cuff pressure to maintain appropriate pressure on the tracheal wall?
Between 20 and 25 mm Hg
A client has a gaping wound on his forearm that is bleeding profusely. Applying pressure to which pressure point would be most helpful?
Brachial
A patient admitted with electrolyte imbalance has carpopedal spasm, ECG changes, and a positive Chvostek sign. What deficit does the nurse suspect the patient has?
Calcium Calcium deficit is associated with abdominal and muscle cramps, stridor, carpopedal spasm, hyperactive reflexes, tetany, positive Chvostek's or Trousseau's sign, tingling of fingers and around mouth, and ECG changes.
Accidental removal of one or both parathyroid glands can occur during a thyroidectomy. Which of the following is used to treat tetany?
Calcium gluconate
The nurse is educating a client about the risks of stroke related to the new prescription for a COX-2 inhibitor and what symptoms to report. Which COX-2 inhibitor is the nurse educating the client about?
Celecoxib
In which group is it most important for the client to understand the importance of an annual Papanicolaou test?
Clients infected with the human papillomavirus (HPV)
The nurse is visiting the home of a client who is receiving at-home peritoneal dialysis therapy. Which finding indicates to the nurse that the client is developing peritonitis?
Cloudy dialysate effluent
The nurse is reviewing the medication administration record of the client. Which medication would lead the nurse to suspect that the client is suffering from an acute attack of gout?
Colchicine
The nurse is explaining the DASH diet to a client diagnosed with hypertension. The client inquires about how many servings of fruit per day can be consumed on the diet. What is the nurse's best response?
4-5 servings per day
What is the duration of regular insulin?
4-6 hours The duration of regular insulin is 4 to 6 hours; 3 to 5 hours is the duration for rapid-acting insulin such as Novolog. The duration of NPH insulin is 12 to 16 hours. The duration of Lantus insulin is 24 hours.
The nurse is changing the dressing of a chronic wound. There is no sign of infection or heavy drainage. How long will the nurse leave the wound covered for?
48-72 hours
Approximately what percentage of the arterial lumen must be obstructed before intermittent claudication is experienced?
50
A patient is on highly active antiretroviral therapy (HAART) for the treatment of HIV. What does the nurse know would be an adequate CD4 count to determine the effectiveness of treatment for a patient per year?
50 mm3 to 150 mm3
The goal for oxygen therapy in COPD is to support tissue oxygenation, decrease the work of the cardiopulmonary system, and maintain the resting partial arterial pressure of oxygen (PaO2) of at least ______ mm Hg and an arterial oxygen saturation (SaO2) of at least ___%.
60 mm Hg; 90%
CD4 count that indicates progression to AIDS
<200
What diet can the nurse recommend to a patient with hypoproteinemia that spares protein?
A diet high in carbohydrates
A client has been admitted with primary syphilis. Which signs or symptoms should the nurse expect to see with this diagnosis?
A painless genital ulcer that appeared about 3 weeks after unprotected sex
Which long-term care facility resident most likely faces the greatest risk for aspiration?
A resident who suffered a severe stroke several weeks ago
The nurse is assessing a client with severe hypertension. Which symptom indicates to the nurse that the client is experiencing dissection of the aorta?
A ripping sensation in the chest
To prevent pneumonia and promote the integrity of the pulmonary system, an essential postoperative nursing intervention includes:
Ambulating the client as soon as possible
Which drug should be available to counteract the effect of edrophonium chloride?
Atropine
For a client who has had a stroke, which nursing intervention can help prevent contractures in the lower legs?
Attaching braces or splints to each foot and leg
The nurse is caring for the client in the intensive care unit immediately after removal of the endotracheal tube. Which of the following nursing actions is most important to complete every hour to ensure that the respiratory system is not compromised?
Auscultate lung sounds.
During a routine medical evaluation, a client is found to have a random blood glucose level of 210 mg/dL. Which client statement(s) made by the client are concerning to the nurse? Select all that apply.
"At times my vision is blurry." "I have to void nearly every hour." "I cannot seem to quench my thirst." "I have lost 10 pounds without even trying."
A nurse cares for a client who is post op bariatric surgery. Which position will the nurse place the client in order to best promote comfort?
"Low Fowler's"
A client is diagnosed with a corneal abrasion and the nurse has administered proparacaine hydrochloride per orders to assess visual acuity. The client requests a prescription for this medication because it completely took away the pain. What is the best response by the nurse?
"Prescriptions of this medication are generally not given because it can cause corneal problems."
A client with obesity is prescribed orlistat for weight loss. The client asks the nurse, "I understand the medication prevents digestion of fat, but what happens if I eat fat?" What is the nurse's best response?
"The fat is passed in your stools"
erectile dysfunction medications
-"afil" - example: sildenafil
The nurse is caring for a 72-year-old client who has been admitted to the unit for a fluid volume imbalance. The nurse knows which of the following is the most common fluid imbalance in older adults?
Dehydration
As the clinic nurse caring for a client with varicose veins, what is an appropriate nursing action for this client?
Demonstrate how to apply and remove elastic support stockings.
The nurse is assessing a client newly diagnosed with myasthenia gravis. Which of the following signs would the nurse most likely observe?
Diplopia and ptsosis
There are many ethical issues in the care of clients with HIV or HIV/AIDS. What is an ethical issue healthcare providers deal with when caring for clients with HIV/AIDS?
Disclosure of the client's condition
A client is suspected of having amyotrophic lateral sclerosis (ALS). To help confirm this disorder, the nurse prepares the client for various diagnostic tests. The nurse expects the physician to order:
Electromyography
What intervention should the nurse provide to reduce the incidence of renal damage when a patient is taking a chemotherapy regimen?
Encourage fluid intake to dilute the urine.
You are caring for a client who has been diagnosed with viral pneumonia. You are making a plan of care for this client. What nursing interventions would you put into the plan of care for a client with pneumonia?
Encourage increased fluid intake
A client is brought to the ED by friends. The friends tell the nurse that the client was using cocaine at a party. On arrival to the ED the client is in visible distress with an axillary temperature of 40.1ºC (104.2°F). What would be the priority nursing action for this client?
Ensure airway and ventilation
Which is a clinical manifestation of diabetes insipidus?
Excessive thirst
BPH medications
Finasteride (Proscar) and Dutasteride (Avodart)- S- Alpha reductase inhibitor; both lower levels of dihydrotestosterone, leading to shrinkage of prostate S/E- ED, libido Flomax- Alpha blocking agent; decreases contractions in smooth muscle of prostatic capsule Hormones, not usually effective IF BPH and HTN; alpha blockers doxazosin (Cadura) and terazosin (hytrin)
The nurse is reviewing a client's history which reveals that the client has had an oversecretion of growth hormone (GH) that occurred before puberty. The nurse interprets this as resulting in which condition?
Gigantism
The nurse is assessing a client in the emergency department who grimaces and reports swelling of the testicles, burning on urination and a green discharge from the penis. The nurse suspects the client will be diagnosed with which infection?
Gonorrhea
A school-age child is brought to the pediatric clinic for the assessment of redness and discharge from the eye and is diagnosed with viral conjunctivitis. Which education would the nurse share with the parents? Select all that apply.
Handwashing can prevent the spread of the disease to others. The child should not return to school until all symptoms have resolved.
Which body substance causes increased gastric secretion, dilation of capillaries, and constriction of the bronchial smooth muscle?
Histamine
A nurse is caring for a client in acute renal failure. The nurse should expect hypertonic glucose, insulin infusions, and sodium bicarbonate to be used to treat:
Hyperkalemia
Which term means a lack of one or more of the five immunoglobulins?
Hypogammaglobulinemia
What complication in the immediate postoperative period should the nurse understand requires early intervention to prevent?
Hypoxemia and hypercapnia
Management of hypertension includes three of the following four goals, depending on the primary and secondary causes. Select all that apply.
Impairing the synthesis of norepinephrine. Modifying the rate of myocardial contraction. Decreasing renal absorption of sodium.
What is a characteristic of the intrarenal category of acute kidney injury (AKI)?
Increased BUN
A client who underwent surgery 12 hours ago has difficulty breathing. He has petechiae over his chest and complains of acute chest pain. What action should the nurse take first?
Initiate oxygen therapy
The nurse is describing the action of insulin in the body to a client newly diagnosed with type 1 diabetes. Which of the following would the nurse explain as being the primary action?
It carries glucose into body cells.
Which points should be included in the medication teaching plan for a client taking adalimumab?
It is important to monitor for injection site reactions.
A nurse is caring for a client with atopic dermatitis. Which suggestions for the client by the nurse would be appropriate? Select all that apply.
Keep the room temperature at approximately 70 degrees Fahrenheit (21 degrees Celsius). Apply topical moisturizers to the skin. Humidify the home when the heat is on during the winter.
With which condition should the nurse expect that a decrease in serum osmolality will occur?
Kidney failure
What is histamine, a mediator that supports the inflammatory process in asthma, secreted by?
Mast cells
After 2-hour onset of acute chest pain, the client is brought to the emergency department for evaluation. Elevation of which diagnostic findings would the nurse identify as suggestive of an acute myocardial infarction at this time?
Myoglobin
A client is being discharged home from the ambulatory surgical center after cataract extraction with an Intraocular Lens Implant (IOL). The client should be instructed to report which of the following findings? Select all that apply.
New floaters in vision Flashing lights
The nurse is caring for a client diagnosed with enlarged adenoids. What condition is produced by enlarged adenoids?
Noisy breathing
During a home visit the nurse notes that a client recovering from peptic ulcer disease is experiencing cool clammy skin and has a heart rate of 96 beats a minute. Which action will the nurse take?
Notify the primary health care provider.
Which medication classification represents a proton (gastric acid) pump inhibitor?
Omeprazole
The nurse is caring for a client who has a type of urinary diversion that requires an external ostomy bag to collect the urine. This client has:
an incontinent urinary diversion
A nurse researcher is reviewing data obtained from a developing nation on nutrition and metabolism issues facing that country. What is the nurse's understanding of the "double-burden" many developing nations now face?
both undernutrition and obesity
Medical management of arthropod-borne virus (arboviral) encephalitis is aimed at
controlling seizures and increased intracranial pressure.
Which of the following is the main refracting surface of the eye?
cornea
Which microorganism is known to cause retinitis in people with HIV/AIDS?
cytomegalovirus
sickle cell triggers
dehydration, cold temp, resp distress
The nurse is caring for a client in the triage section of a walk-in clinic. Which triad of common symptoms suggests a diagnosis of Ménière disease?
hearing loss, vertigo, tinnitus
Bladder retraining following removal of an indwelling catheter begins with
instructing the client to follow a 2- to 3-hour timed voiding schedule.
A patient is being treated for chronic venous stasis ulcers of the lower extremities. What medication does the nurse understand will increase peripheral blood flow by decreasing the viscosity of blood and assist with the healing of the ulcers?
phentoxifylline
A client presents to the ED with a myocardial infarction. Prior to administering a prescribed thrombolytic agent, the nurse must determine whether the client has which absolute contraindication to thrombolytic therapy?
prior intracranial hemorrhage
The nurse encourages the client diagnosed with hypertension to rise slowly from a sitting or lying position because gradual changes in position
provide time for the heart to increase the rate of contraction to resupply oxygen to the brain.
A client is undergoing photochemotherapy involving a combination of a photosensitizing chemical and ultraviolet light. What health problem does this client most likely have?
psoriasis
An 82-year-old client is admitted to the hospital with a diagnosis of pneumonia. The nurse learns that the client lives alone and hasn't been eating or drinking properly. When assessing the client for dehydration, the nurse would expect to find:
tachycardia
The nurse is assisting in the transport of a client with an indwelling catheter to the diagnostic studies unit. Which action made by the nursing assistant would require instruction?
The nursing assistant places the drainage bag on the client's abdomen for transport.
Which statement accurately reflects current stem cell research?
The stem cell is known as a precursor cell that continually replenishes the body's entire supply of both red and white cells.
The nurse is caring for a client who will be having artificial implants for breast reconstruction. The client is arriving at the physician's office for which procedure to be completed before the surgery can be done?
Tissue expansion
A client in a clinic setting has just been diagnosed with hypertension. When the client asks what the end goal is for treatment, what is the nurse's best response?
To prevent complications/death by achieving and maintaining a blood pressure of 140/90 or less
A client with benign prostatic hyperplasia doesn't respond to medical treatment and is admitted to the facility for prostate gland removal. Before providing preoperative and postoperative instructions to the client, the nurse asks the surgeon which prostatectomy procedure will be done. What is the most widely used procedure for prostate gland removal?
Transurethral resection of the prostate (TURP)
When a female client reports a frothy, yellow-green vaginal discharge, the nurse suspects the client has a vaginal infection caused by which organism?
Trichomonas vaginalis
What is the most common location for breast cancer?
Upper outer quadrant of the breast
Which clinical finding should a nurse look for in a client with chronic renal failure?
Uremia Uremia is the buildup of nitrogenous wastes in the blood, evidenced by an elevated blood urea nitrogen and creatine levels. Uremia, anemia, and acidosis are consistent clinical manifestations of chronic renal failure.
Which of the following would be most important to include in a teaching plan for a client who has had a vasectomy?
Using a reliable method of contraception for several weeks.
Which statement correctly identifies a difference between duodenal and gastric ulcers?
Vomiting is uncommon in clients with duodenal ulcers.
A client with cystic fibrosis is admitted to the hospital with pneumonia. When should the nurse administer the pancreatic enzymes that the client has been prescribed?
With meals
The nurse educator is providing orientation to a new group of staff nurses on an oncology unit. Part of the orientation is to help nurses understand the differences between various types of brain tumors. The nurse educator correctly identifies that glioma tumors are classified based on the fact that they originate where in the brain?
Within the brain tissue
Which term refers to the surgical removal of one or both testes?
Orchiectomy
A nurse is reviewing the history and physical examination of a client with a suspected malignant tumor of the bladder. Which finding would the nurse identify as the most common initial symptom?
Painless hematuria
Which term is used to describe edema of the optic nerve?
Papilledema
The nurse is providing education for a client with Raynaud disease. Which education will the nurse provide to minimize the triggers that cause exacerbation of the disease? Select all that apply.
Perform a regular exercise regimen Avoid smoking Dress warmly in cold weather
A postoperative client is experiencing a flash pulmonary edema. What finding in the client's sputum is consistent with this problem?
Pink color
The nurse is caring for a patient with Huntington's disease in the long-term care facility. What does the nurse recognize as the most prominent symptom of the disease that the patient exhibits?
Rapid, jerky, involuntary movements
A client who was diagnosed with type 1 diabetes 14 years ago is admitted to the medical-surgical unit with abdominal pain. On admission, the client's blood glucose level is 470 mg/dl. Which finding is most likely to accompany this blood glucose level?
Rapid, thready pulse This client's abnormally high blood glucose level indicates hyperglycemia, which typically causes polyuria, polyphagia, and polydipsia. Because polyuria leads to fluid loss, the nurse should expect to assess signs of deficient fluid volume, such as a rapid, thready pulse; decreased blood pressure; and rapid respirations. Cool, moist skin and arm and leg trembling are associated with hypoglycemia. Rapid respirations — not slow, shallow ones — are associated with hyperglycemia.
Most cervical cancers, if not detected and treated, spread to which area?
Regional pelvic lymph nodes
An older adult client who is postmenopausal informs the nurse that she believes she has developed another urinary tract infection (UTI). What risk factors do female clients in this age group have? Select all that apply.
Residual urine Urinary incontinence Estrogen deficiency
The nurse is caring for a client presenting to the emergency department (ED) reporting chest pain. Which electrocardiographic (ECG) finding would be most concerning to the nurse?
ST elevation
What is used to decrease potassium level seen in acute renal failure?
Sodium polystyrene sulfonate
Which of the following occurs when there is deviation from perfect ocular alignment?
Strabismus Strabismus is a condition in which there is deviation from perfect ocular alignment. Ptosis is a drooping eyelids. Chemosis is edema of the conjunctiva. Nystagmus is an involuntary oscillation of the eyeball.
A nurse is providing in-service education for staff members about evidence collection after sexual assault. The educational session is successful when staff members focus their initial care on which step?
Supporting the client's emotional status
A client with peptic ulcer disease has been prescribed sucralfate. What health education should the nurse provide to this client?
Take the medication 2 hours before or after other medications
Which instruction should a nurse give to a client with diabetes mellitus when teaching about "sick day rules"?
Test your blood glucose every 4 hours
Why would a client with COPD report feeling fatigued? Select all that apply.
The client is using all expendable energy just to breathe. Lung function gradually decreases over time in clients with COPD.
