Med/Surg Test 3 practice questions
A nurse is providing teaching about ileostomy care to a client. Which of the following statements by the client indicates a need for further teaching?
"I will be certain to take enteric-coated medications."
A nurse is providing information about pain control for a client who has acute pain following a subtotal gastric resection. Which of the following client statements indicates an understanding of pain control?
"I will call for pain medication before the previous dose wears off."
A nurse is providing discharge teaching for a client who has chronic pancreatitis. Which of the following statements should the nurse make?
"You should increase your daily intake of protein."
A nurse is caring for a client who has just been diagnosed with cancer of the colon. The nurse several questions about what the provider might be planning to do. Which of the following responses should the nurse make?
Encourage the client to write down any questions to ask the provider
A nurse is providing nutritional teaching to a client who has dumping syndrome following a hemi-colectomy. Which of the following foods should the nurse instruct the client to avoid?
Fresh apples (avoid fresh fruits, choose canned or well-cooked fruits instead)
Aa nurse is providing preoperative teaching to a client who is to undergo an open bowel resection at 1300 next week. Which of the following statements by the client indicates the need for further teaching?
I will be able to eat solid food when i wake up from anesthesia
A nurse is caring for a client who returns to the nursing unit from the recovery room after a sigmoid colon resection for adenocarcinoma. The client had an episode of intraoperative bleeding. Which finding indicates to the nurse that the client may be developing hypovolemic shock?
Increase in the heart rate from 88 to 110/min. Rationale: Hypovolemic shock is a condition in which the heart is unable to supply enough blood to the body because of blood loss or inadequate blood volume. In an effort to compensate for this, the heart rate increases steadily. In the first stage of shock (compensatory), the heart rate is > 100/min. As shock progresses, the heart rate continues to accelerate to more than 150/min. In the final (irreversible or refractory) stage, the heart rate becomes very erratic and may develop asystole.
A nurse is planning care for a client who has pernicious anemia. Which of the following interventions should the nurse include in the plan?
Initiate weekly injections of vitamin B12 Rationale: Pernicious anemia is caused by a lack of intrinsic factor needed to absorb vitamin B12 from the GI tract.
A nurse is providing preoperative teaching for a client who is scheduled for a gastrectomy. Which of the following information regarding prevention of postoperative complications should the nurse include in in the teaching?
Instruct the client about the use of a sequential compression device. Rationale: The nurse should instruct the client about the use of a sequential compression device to prevent deep-vein thrombosis, a postoperative complication.
A nurse in a PACU is assessing a client who has a newly created colostomy. Which of the following findings should the nurse report to the provider?
Purplish-colored stoma
A nurse is planning care for a client who has end-stage cirrhosis of the liver with encephalopathy. Which of the following interventions should the nurse plan to implement to decrease the client's ammonia level?
Reduce the client's intake of protein. Rationale: Ammonia is formed in the gastrointestinal tract by the action of bacteria on protein. Limiting dietary protein intake can assist with decreasing the client's ammonia level. Protein is necessary for healing, so strict limitation of dietary protein is not recommended.
