Medsurg Practice Questions

The nurse is describing palliative care and hospice services to a client with end-stage congestive heart failure. The client and family have many questions about the differences between palliative care and hospice. Which statement should the nurse provide the family? "Curative care can continue in hospice." "Hospice occurs in a facility with specially trained staff." "Hospice is the application of palliative care at the end of life." "Palliative care requires hospitalization."

"Hospice is the application of palliative care at the end of life."

The nurse is caring for a client with laboratory values indicating dehydration. Which clinical symptom is consistent with the dehydration? Crackles in the lung fields Distended jugular veins Cool and pale skin Dark, concentrated urine

Dark, concentrated urine

The health care provider orders a nasogastric (NG) tube for a young adult diagnosed with end-stage ovarian cancer and suspected of having a bowel obstruction. After the nurse explains the procedure and the rationale for the NG tube placement, the client refuses to consent to NG tube placement, stating "I would rather keep vomiting than have the tube in my nose." What is the nurse's most appropriate action? Delegate the NG tube placement to a more experienced nurse. Call the client's spouse for consent to the procedure. Document the client's wishes and notify the provider. Make a referral to Social Services related to body-image disturbance.

Document the client's wishes and notify the provider.

A patient with chronic obstructive pulmonary disease has asked an adult child to make medical decisions in the event the patient will not be able to make them. What type of advance directive should the patient sign? Financial power of attorney Ethical committee form Durable power of attorney for health care Do not resuscitate order

Durable power of attorney for health care

Nurses and members of other health disciplines at a state's public health division are planning programs for the next 5 years. The group has made the decision to focus on diseases that are experiencing the sharpest increases in their contributions to the overall death rate in the state. This team should plan health promotion and disease prevention activities to address what health problem? Adult failure to thrive related to chronic disease and circulatory disturbance Disturbed thought processes related to adverse drug effects and hypotension Risk for falls related to polypharmacy and impaired balance Risk for infection related to polypharmacy and hypotension

Risk for falls related to polypharmacy and impaired balance

Your client has a diagnosis of hypervolemia. What would be an important intervention that you would initiate? Give medications that promote fluid retention. Teach client behaviors that decrease urination. Limit sodium and water intake. Assess for dehydration.

Limit sodium and water intake

A nurse is providing care to a client who has just been diagnosed with a terminal illness. Which of the following would be most appropriate for the nurse to do? Listen nonjudgmentally while allowing time for client reflection. Attempt to help the client make decisions about care. Explain to the client that the nurse understands how he or she must feel. Engage the client in conversation to provide distraction.

Listen nonjudgmentally while allowing time for client reflection.

The nurse is to administer a potassium supplement to the client. The nurse does not check the potassium level prior to administering the medication and later finds that the potassium level was at a critical high. What principle has this nurse violated? Autonomy Fidelity Beneficence Nonmaleficence

Nonmaleficence

The nurse is providing care for a client who just discussed palliative care with the primary health care provider. The client's family member was also part of the discussion and asks the nurse, "I feel like this kind of treatment means we've given up on trying." How should the nurse respond? Choose the best option. "You are not giving up. Unfortunately the tumor has won the fight." "This is your best option considering the end is near for the client. " "The goal of this type of care is to promote the best quality of life that is now possible." "The prognosis for the client is poor, so it would be wasteful to provide any more aggressive treatment."

"The goal of this type of care is to promote the best quality of life that is now possible."

The nurse is discharging a 4-year-old client from the emergency department. The client was seen for an insect bite that became swollen, reddened, warm, and painful to touch. The client's vital signs are all within normal range for age. While the nurse is giving discharge instructions to the client's parent, the parent asks why the child is not going to get antibiotics for the infected insect bite. What would be the nurse's best response? "In children who are previously healthy, inflammation and infections usually resolve without the need for drugs." "Infection is not the same as inflammation. What your son has is inflammation." "This is a local inflammatory response to the insect bite; it is not an infection, so antibiotics will not help." "I'll make sure the doctor is made aware that you'd like your child to have a course of antibiotics."

"This is a local inflammatory response to the insect bite; it is not an infection, so antibiotics will not help."

The nurse knows which is the normal serum value for potassium? 96-106 mEq/L (96-106 mmol/L). 3.5-5.0 mEq/L (3.5-5.0 mmol/L). 135-145 mEq/L (135-145 mmol/L). 8.5-10.5 mg/dL (2.13-2.63 mmol/L).

3.5-5.0 mEq/L (3.5-5.0 mmol/L).

Which of the following best reflects the rationale for evidence-based practice? A way to establish accountability A means to ensure quality care A process for accreditation A method for determining reimbursement

A means to ensure quality care

The RN is obtaining a health history and performing a physical assessment for a client who is admitted to the hospital with complaints of chest pain. What part of the nursing process is the RN performing? Planning Assessment Implementation Evaluation

Assessment

The health care provider has recommended an amniocentesis for an 18-year-old primiparous client. The client is at 34 weeks' gestation and does not want this procedure but the health care provider arranges for the amniocentesis to be performed. The nurse should recognize that the provider is in violation of which ethical principle? Autonomy Veracity Nonmaleficence Beneficence

Autonomy

A nurse working in the intensive care unit refers to the Institute for Healthcare Improvement (IHI) Ventilator Bundle before planning patient care. The nurse realizes nursing interventions outlined in the bundle will improve clients' outcomes. Which statement best describes how nursing interventions established by the IHI should be included in each bundle? Hospitals, physicians, and nurses worked collaboratively to design patient care activities included in IHI bundles Nurse case managers serving as patient advocates recommended nursing interventions to be included in the IHI bundles based on patient preference Nursing interventions found within the IHI bundles were selected based on the ability to provide optimal time management for the nurse Best practices derived from valid and reliable research studies guided nursing interventions being added to the IHI bundles

Best practices derived from valid and reliable research studies guided nursing interventions being added to the IHI bundles

The nurse is caring for a terminally ill client in the intensive care unit that is on life support measures. The family members are opposed in their decision to take the client off of life support. What option does the nurse discuss with the nurse manager? Ask the family to go out of the unit and make a decision that is final. Take the client off of life support when the family is not present. Contact the ethics committee for their input. Have the health care provider inform the family that they are not responsible for the decision.

Contact the ethics committee for their input.

A client comes to the emergency department with swelling in the left knee. The nurse is aware of the cardinal signs of inflammation occurring in the knee. Identify the correct cardinal signs of inflammation. Select all that apply. Paralysis Erythema Subluxation Warmth Rash

Erythema Warmth

A nurse working in an acute care setting volunteers to participate in a research study. The nurse understands that research findings add to the scientific base of nursing practice. Evidence-based practice (EBP) accomplishes which results? Select all that apply. Validate nursing diagnoses Improve patient outcomes Decrease health care costs Establish best nursing practices Provides answers to ethical questions Delineate the health-illness continuum

Improve patient outcomes Decrease health care costs Establish best nursing practices

For individuals known to be dying by virtue of age and/or diagnosis, which sign indicates approaching death? Increased urinary output Increased wakefulness Increased restlessness Increased eating

Increased restlessness

The nurse is describing hospice services to the family of a patient with end-stage heart failure. Which of the following would the nurse be least likely to include as a major focus of care? Symptom management Emotional support Pain control Invasive therapy

Invasive therapy

The nurse is reviewing client lab work for a critical lab value. Which value is called to the physician for additional orders? Potassium: 5.8 mEq/L Calcium: 10 mg/dL Sodium: 138 mEq/L Magnesium:2 mEq/L

Potassium: 5.8 mEq/L

Which of the following is true regarding the use of narcotic analgesics in older adults? A short duration of pain relief is achieved. An increased dosage is necessary for desired effect. There is an increased potential for falls related to sedation. There is a decreased susceptibility to drug reactions.

There is an increased potential for falls related to sedation.

A client has a serum calcium level of 7.2 mg/dl (1.8 mmol/L). During the physical examination, the nurse expects to assess: Goodell's sign. Hegar's sign. Trousseau's sign. Homans' sign.

Trousseau's sign.

A client was admitted to the hospital unit after 2 days of vomiting and diarrhea. The client's spouse became alarmed when the client demonstrated confusion and elevated temperature, and reported "dry mouth." The nurse suspects the client is experiencing which condition? hyperkalemia hypercalcemia hypervolemia dehydration

dehydration

A client diagnosed with acute kidney injury (AKI) has a serum potassium level of 6.5 mEq/L. The nurse anticipates administering: Calcium supplements sodium polystyrene sulfonate (Kayexalate) Sorbitol IV dextrose 50%

sodium polystyrene sulfonate (Kayexalate)

A nurse saw a coworker steal drugs from a locked cabinet. The supervisor notices the missing drugs and has a good idea who is responsible for the theft. The supervisor asks if the nurse saw anything out of the ordinary. Which professional value reflects a nurse's duty to tell the truth? nonmaleficence autonomy veracity beneficence

veracity