Med/Surg Exam 6
When admitting a client to the hospital, what should the nurse do initially to prevent pressure injuries? 1-Identify if the client is at risk for the development of pressure sores. 2-Inform the other healthcare team members to be sure the client is turned every 2 hours. 3-Make sure the client is kept clean and dry. 4-Pad the body areas that are prone to breakdown.
1
Which of the following conditions is the cause of thickening of the nail? 1-Fungal infection 2-Long-standing pulmonary disease 3-Myocardial infarction 4-Iron-deficiency anemia
1
A client asks the nurse what psoriasis is. What is the best answer? 1-It is a chronic, infectious inflammatory disease. 2-It is characterized by patches of redness covered with silvery scales. 3-A cure is possible with prompt treatment. 4-The onset typically occurs in young children.
2
A client has been diagnosed with melanoma. What treatment option can the nurse expect will be used? 1-Cryosurgery 2-Radical excision 3-Radiation therapy 4-Laser surgery
2
A client has just been diagnosed with rosacea. The nurse knows that initial treatment of rosacea includes what? 1-Corticosteroids 2-Antibiotics 3-Antifungals 4-Retinoids
2
A client is coming to the office to have a growth removed by the doctor. The client asks "What does cryosurgery do to the growth?" What is the correct response by the nurse? 1-Removes the entire growth 2-Through the application of extreme cold, the tissue is destroyed. 3-Freezes the growth, so the physician can remove it at the next appointment 4-Lasers the growth off
2
An older adult client is being seen in the dermatology clinic for lesions on the hands and forearm. The client is concerned about the possibility of having melanoma and wants to be evaluated. The nurse documents the lesions as small, brown lesions of the hands and forearms. What type of benign lesions are these characteristic of? 1-Senile keratoses 2-Senile lentigines 3-Melanoma 4-Freckles
2
The nurse is assisting the eye surgeon in completing an examination of a client's eye. Which piece of equipment would the nurse provide to the surgeon to examine the optic disc under magnification? 1-Retinoscope 2-Ophthalmoscope 3-Tonometer 4-Amsler grid
2
The nurse is caring for a client with a furuncle. What advice should the nurse give the client to prevent the spread of the infection? 1-Keep hair short, clean, and away from the face and forehead. 2-Never pick or squeeze a furuncle. 3-Avoid the use of cosmetics. 4-Use tepid bath water.
2
The nurse is caring for a client with a new tattoo. Which nursing diagnosis is of highest priority? 1-Altered Skin Integrity 2-Infection Risk 3-Acute Pain 4-Altered Tissue Perfusion
2
The nurse is caring for a client with recurrent ear infections. The nurse assesses the client for further infectious processes traveling deeper into the tissue and becoming more lethal. Which infection, originated in the ear, is of most concern? 1-Mastoiditis 2-Meningitis 3-Sinusitis 4-Labyrinthitis
2
The nurse is collecting the history of a client diagnosed with a cataract and is performing a focused assessment. Which finding should the nurse anticipate? 1-A burning sensation and the sensation of an object in the eye 2-Blurred or cloudy vision 3-Inability to produce sufficient tears 4-A swollen lacrimal caruncle
2
The nurse is establishing a visual test using the Snellen chart for a client experiencing visual changes. At which distance should the nurse instruct the client to stand? 1-A 10-feet distance 2-A 20-feet distance 3-A 30-feet distance 4-A 40-feet distance
2
The nurse is obtaining a history from a client who indicates hearing loss due to drug toxicity. Which type of hearing loss is noted? 1-Conductive 2-Sensorineural 3-Mixed 4-Central
2
The nurse is teaching a parent how to instill drops in a 12-year-old child's eyes. Which action would the nurse instruct the parent to perform first? 1-Close the eye gently. 2-Tilt the head slightly backward. 3-Instill the prescribed number of drops into the conjunctival pocket. 4-Do not allow the tip of the container to touch the eye.
2
There are several types of hearing loss. Which type of hearing loss benefits from the use of a hearing aid? 1-Sensorineural 2-Conductive 3-Genetic 4-Acquired
2
Which nursing suggestion would be most helpful to the client with recurrent otitis externa? 1-Use a cotton applicator to ensure that the ear canal is dry. 2-Place ear plugs into the ears before swimming 3-Flush the ear with hydrogen peroxide 4-Avoid lying on the side of the affected ear
2
Which of the following causes odor in perspiration? 1-Sunlight 2-Bacteria on the skin 3-Air pollutants 4-Cloudy environment
2
A client comes to the occupational health nurse complaining of eye irritation. The client works in a dusty, outdoor environment. Why should the nurse advise periodic blinking to this client? 1-To control the amount of sunlight that enters the eye 2-To minimize the impact of the wind on the eye and to trap foreign debris 3-To clear the dust and particles from the surface of the eyes 4-To prevent the collection of tears over the surface of the eye
3
A client has been referred to an ophthalmologist for suspected macular degeneration. The nurse knows to prepare what test for the physician to give the client? 1-Ishihara polychromatic plates 2-Visual field 3-Amsler grid 4-Slit lamp
3
A client receives treatment for a dermatophyte infection of the toenail. How would the nurse document this condition in the chart? 1-Pediculosis 2-Tinea pedis 3-Onychomycosis 4-Onychocryptosis
3
A middle-aged client reports increasing difficulty reading newspaper print. Which of the following nursing explanations best describes this type of refractive error? 1-Client is nearsighted. 2-Lens has become cloudy and thick. 3-Loss of elasticity of the lens. 4-Floaters in the eye increase with age.
3
A nurse is caring for a client immediately following cataract removal. Which symptom would be most alarming to the nurse? 1-Irritation in the operative eye 2-Dilation of the pupil 3-Dry, tickling cough 4-Fever
3
A nurse is caring for a client who has undergone enucleation. What complication of enucleation should be addressed by the nurse? 1-Hypotension 2-Nausea and vomiting 3-Hemorrhage 4-Pneumonia
3
Audiometry is testing that measures hearing acuity precisely. Who does the nurse know can perform audiometric testing? 1-School nurse 2-Hearing aide salesperson 3-Audiologist 4-Office nurse
3
The nurse has assessed a client's superficial fungal infection that began in the skin between the toes and has spread to the soles of the feet. How would the nurse document this finding? 1-Tinea corporis 2-Tinea capitis 3-Tinea pedis 4-Tinea cruris
3
The nurse is applying a cool compress to the forehead of a client with an elevated temperature. This is an example of what type of heat loss? 1-Radiation 2-Evaporation 3-Conduction 4-Convection
3
The nurse is assessing a client for objective symptoms of hearing difficulties. Which sign leads the nurse to take alternate measures to ensure client understanding of teaching? 1-The client interrupts by asking the nurse to repeat instruction. 2-The client is quiet and responds appropriately. 3-The client leans forward and turns the head. 4-The client quietly reads the instructional literature.
3
The nurse is caring for a client with increased fluid accumulation in the eye. When assessing the client, which structure within the eye is noted to drain fluid from the anterior chamber? 1-Fovea centralis 2-Canthus 3-Canal of Schlemm 4-Choroid
3
The nurse is instructing the client with dried cerumen blocking the ear canal on potential methods to reduce symptoms. Which at-home methods of cerumen removal are discouraged? 1-Instilling 1 to 2 drops of half-strength peroxide in the ear 2-Using warm glycerin or mineral oil to soften the cerumen 3-Removing the cerumen by means of a cotton tip applicator 4-Irrigating the ear with warm water and a rubber-bulb syringe
3
What aspect should the nurse closely monitor for in clients who have been administered salicylates, loop diuretics, quinidine, quinine, or aminoglycosides? 1-Signs of hypotension 2-Reduced urinary output 3-Tinnitus and sensorineural hearing loss 4-Impaired facial movement
3
What is the cause of shingles? 1-Parasitic fungi 2-Itch mite 3-Reactivated virus 4-Hormonal change
3
A nurse is caring for an older adult client with macular degeneration who has received injections of angiogenesis inhibitors. Which assessment finding would indicate the condition is worsening? 1-Blurred vision 2-Burning sensation of the eyes 3-Loss of peripheral field vision 4-Central vision impairment
4
Following cataract removal, the client receives discharge instructions from the nurse. Which of the following instructions is most important? 1-Apply a protective patch to the affected eye at bedtime. 2-For the first 48 hours, avoid any activity that could cause particles to lodge in the eye. 3-Avoid washing face and eyes for the first 24 hours. 4-Avoid heavy lifting for 1 week.
4
The nurse is assessing a client with onychocryptosis. Which of the following is evident if the tissue is infected? 1-Pressure 2-Redness and swelling 3-Pain 4-Purulent drainage and an odor
4
The nurse is teaching a family member how to instill ear drops to the client to remove impacted cerumen. What is important to teach this family member? 1-Insert the irrigating syringe deeply. 2-Direct the flow of the ear drops toward the eardrum. 3-Refrigerate before instillation. 4-Place the container in warm water before instillation.
4
Which of the following pigments influences hair color? 1-Pheromones 2-Keratin 3-Sebum 4-Melanin
4
Which stage of a pressure injury is exhibited by deeply ulcerated tissue, exposing muscle and bone? 1-I 2-II 3-III 4-IV
4
The nurse is performing a skin assessment on a client that is admitted to the hospital and observes an area over the left heel that is reddened but intact. How would the nurse stage this pressure sore? 1-Stage I 2-Stage II 3-Stage III 4-Stage IV
1
The nursing student is taking an anatomy and physiology class. What anatomical structure equalizes air pressure in the middle ear? 1-Eustachian tube 2-The malleus 3-The pinna 4-The meatus
1
A client comes to the walk-in clinic reporting feeling a "bug in my ear." What action should be taken when there is an insect in the ear? 1-Instillation of mineral oil 2-Instillation of carbamide peroxide 3-Instillation of hot water 4-Use of a small forceps
1
A client has joined a rowing team and has been enjoying the activity for approximately 1 month. The client comes to the clinic for a routine physical examination and shows the nurse the hands, which are observed to have thickened areas in several areas. What does the nurse recognize these are in response to the repeated friction of the oars? 1-Calluses 2-Senile keratosis 3-Senile lentigines 4-Rheumatoid nodules
1
A client is diagnosed with blepharitis. What symptoms should a nurse monitor in this client? 1-Patchy flakes clinging to the eyelashes 2-A red pustule in the internal tissue of the eyelid 3-Redness surrounding the conjunctival sac 4-A halo around the pupil
1
A client is having problems with dizziness and complains of the "room spinning." The physician performs the caloric stimulation test. The nurse knows that a diminished response in one eye during the caloric stimulation test is indicative of what? 1-Inner ear disorder 2-Middle ear disorder 3-Outer ear disorder 4-Age-related macular degeneration
1
A nurse is caring for a client newly diagnosed with glaucoma. Which would be a priority in the nurse's teaching about maintaining normal pressure range in the eye? 1-Increase fiber in the diet. 2-Avoid reading. 3-Eat small meals. 4-Treat allergy symptoms promptly.
1
A nursing instructor is teaching pre-nursing students in a pathophysiology class. What would the instructor teach the students about Ménière disease? 1-It is referred to as endolymphatic hydrops. 2-It originates in the middle ear. 3-It is referred to as lymphatic hydrops. 4-It originates in the outer ear.
1
An older adult client is scheduled for cataract surgery and asks the nurse, "Will I need to wear thick lenses after surgery?" Which is an appropriate response from the nurse? 1-"An implanted lens has replaced the need for corrective glasses." 2-"Contact lenses are preferred by most clients after this surgery." 3-"They can make corrective lenses much thinner now." 4-"No lens is necessary with cataract surgery."
1
The client with chronic open-angle glaucoma is receiving timolol eye drops. Which evaluation finding would indicate to the nurse the treatment is working? 1-Intraocular pressure 15 mm Hg 2-Reduced peripheral vision 3-Halos around lights 4-Decrease in nausea and vomiting
1
The nurse is caring for a client experiencing rosacea. Which is the earliest symptom of the disease process? 1-Flushed facial appearance 2-Bluish pallor of the skin 3-Large facial pores 4-Orange peel skin texture
1
The nurse is obtaining a history from a client complaining of ear pain and dizziness. Which assessment finding is the best evidence that the client has a perforated eardrum? 1-Fluid draining in the external canal 2-Pain has resolved 3-Elevated white blood cell count 4-Inflammation and a reddened eardrum
1
