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Which dermatological problem is treated by using intralesional corticosteroids? Psoriasis Cellulitis Erysipelas Carbuncles
Psoriasis Psoriasis is a dermatological problem treated by using intralesional corticosteroids. Cellulitis, erysipelas, and carbuncles are treated by using systemic antibiotics such as synthetic sulfur.
Which surgery is used to treat excessive wrinkling or sagging of facial skin? Rhinoplasty Rhytidectomy Dermabrasion Blepharoplasty
Rhytidectomy Rhytidectomy is the removal of excess skin and tissue from the face; this is the surgery used to treat wrinkling or sagging of facial skin. Rhinoplasty is the removal of excessive tissue or cartilage from the nose. Dermabrasion is the process of removing the facial epidermis or a portion of the dermis to treat acne scars. Blepharoplasty is the removal of bulging fat in the periorbital area; this is used to treat bags under the eyes.
When assessing a client's abdomen, the nurse palpates directly above the umbilicus. This location is known as which area? Iliac area Epigastric area Hypogastric area Suprasternal area
Epigastric area The stomach is located within the sternal angle, known as the epigastric area. The iliac area is in the area of the iliac bones. The hypogastric area is the lowest middle abdominal area. The suprasternal area is the area above the sternum.
Which synovial joint movement is described as turning the sole away from the midline of the body? Pronation Eversion Adduction Supination
Eversion Eversion is a synovial joint movement that describes turning the sole outward away from the midline of the body. Pronation is a synovial joint movement that describes turning the palm downward. Adduction is a synovial joint movement that describes movement toward midline of the body. Supination is a synovial joint movement that describes turning the palm upward.
The nurse is caring for a client who is receiving azathioprine, cyclosporine, and prednisone before receiving a kidney transplant. Which medication action would the nurse identify as the purpose of these medications? Stimulate leukocytosis Provide passive immunity Prevent iatrogenic infection Reduce antibody production
Reduce antibody production
Which mechanism of action explains how glyburide decreases serum glucose levels? Stimulates the pancreas to produce insulin Accelerates the liver's release of stored glycogen Increases glucose transport across the cell membrane Decreases absorption of glucose from the gastrointestinal system
Stimulates the pancreas to produce insulin Glyburide, an antidiabetic sulfonylurea, stimulates insulin production by the beta cells of the pancreas. Accelerating the liver's release of stored glycogen occurs when serum glucose drops below normal levels. Increasing glucose transport across the cell membrane occurs in the presence of insulin and potassium. Antidiabetic medications of the biguanide chemical class improve sensitivity of peripheral tissue to insulin, which ultimately increases glucose transport into cells. Beta cells must have some function to enable this medication to be effective.
Which pain-related clinical manifestation would the nurse expect in a client who had received a diagnosis of a peptic ulcer? The pain intensifies after vomiting stomach contents. The pain occurs 1 to 2 hours after having a meal. The pain increases when ingesting an excess of fatty foods. The pain begins in the epigastrium and radiates to the abdomen.
The pain occurs 1 to 2 hours after having a meal. Pain occurs after the stomach empties; eating stimulates gastric secretions, which act on the gastric mucosa of an empty stomach, causing gnawing pain. Vomiting temporarily alleviates pain because acid secretions are removed. There is no intolerance of fats, and eating generally alleviates pain. Pain associated with the ingestion of fatty foods is associated with cholecystitis. Pain is localized in the epigastrium; however, it only radiates to the abdomen if the ulcer has perforated.
The health care provider prescribes a blood transfusion for a client with esophageal varices. Place the following nursing actions in the correct order. Check the client's vital signs. Verify the blood product with another nurse against the client's identification (ID) bracelet. Monitor the client's vital signs and status according to agency policy. Establish intravenous (IV) access with IV normal saline.
Check the clients vital signs. Establish intravenous (IV) Access with IV normal saline Verify the blood produc with another nurse against the clients identification (ID) bracelet. Monitor the clients vital signs and status according to agency policy.
The nurse is evaluating the results of treatment with erythropoietin. Which assessment finding indicates an improvement in the underlying condition being treated? 2+ pedal pulses Decreased pallor Decreased jaundice 2+ deep tendon reflexes
Decreased pallor
Which relationship reflects the relationship of naloxone to morphine sulfate? Aspirin to warfarin Amoxicillin to infection Enoxaparin to dalteparin Protamine sulfate to heparin
Protamine sulfate to herparin Protamine sulfate is the antidote for heparin overdose, and naloxone will reverse the effects of opioids such as morphine. Aspirin and warfarin both interfere with coagulation. Although amoxicillin is used to treat some infections, an infection is not a medication, so amoxicillin cannot be considered an antidote. Both enoxaparin and dalteparin are low-molecular-weight heparins.
A client expresses a complete lack of interest in food. How would the nurse document this finding in the client's medical record? Apathy Aphasia Adactyly Anorexia
Anorexia Anorexia refers to loss of appetite. Apathy refers to lack of concern or emotion. Aphasia is the absence of or inability to produce communication through speech. Adactyly refers to the absence of digits on the hands or feet.
Which type of laser is used in the treatment of vascular and other pigmented lesions? Argon Gold vapors Neodymium Carbon dioxide
Argon An argon laser is used in the treatment of vascular and other pigmented lesions. Gold vapors and neodymium are type of lasers used in the treatment of skin disorders. A carbon dioxide laser is also a type of laser used in the treatment of skin disorders; it has numerous applications as a vaporizing and cutting tool for most tissues.
When a client is diagnosed with Hodgkin disease, which lymph nodes would the nurse expect to be affected first? Cervical Axillary Inguinal Mediastinal
Cervical Painless enlargement of the cervical lymph nodes often is the first sign of Hodgkin disease, a malignant lymphoma of unknown etiology. Axillary node enlargement occurs after cervical lymph node enlargement. Inguinal node enlargement occurs later. Mediastinal node involvement follows the disease progresses.
Which finding in older adult clients is associated with aging? Decrease in height Decreased neck rigidity Increased fine-motor dexterity Increased range of motion (ROM)
Decrease in height Loss of height and deformity and shortening of the trunk are common in older adults because of vertebral compression and degeneration. Rigidity in the neck, shoulders, back, hips, and knees increases with age because of loss of elasticity in ligaments, tendons, and cartilage. A decline in fine-motor dexterity occurs in the older adult because of slow impulse conduction along motor units. Range of motion (ROM) is limited in the older adult because of cartilage erosion, increased friction between the bones, and overgrowth of bone around joint margins.
During a health symposium the nurse teaches the group how to prevent food poisoning. Which statement by one of the participants indicates the teaching is understood? "Meats and cream-based foods need to be refrigerated." "Once most food is cooked, it does not need to be refrigerated." "Poultry should be stuffed and then refrigerated before cooking." "Cooked food should be cooled before being put into the refrigerator."
"Meats and cream-based foods need to be refrigerated." A cold environment limits growth of microorganisms. All food should be refrigerated before and after it is cooked to limit the growth of microorganisms. Stuffing and then refrigerating poultry promotes the growth of microorganisms because the stuffing will still be warm for a period before the refrigerator's cold environment cools the center of the bird. It is advocated that poultry not be stuffed. If it is stuffed, it should be done immediately before cooking. Letting cooked foods cool before refrigeration promotes the growth of microorganisms because microorganisms thrive in warm, moist environments.
A client has been receiving digoxin. The client calls the clinic and complains of "yellow vision." Which response would the nurse provide? "This is related to your illness rather than to your medication." "This is an expected side effect; you will become accustomed to it over time." "This side effect is only temporary. You should continue the medication." "The medication may need to be discontinued. Come to the clinic this afternoon."
"The medication may need to be discontinued. Come to the clinic this afternoon."
A client with cancer experiences severe nausea and vomiting from chemotherapy. The client wants to know if it is true that smoking marijuana will help. How will the nurse respond? "Nurses are not allowed to discuss illegal substances with clients." "Marijuana is effective for nausea and vomiting if it is injected." "Marijuana is not proven to be effective in preventing chemotherapy-induced nausea and vomiting." "There are some tetrahydrocannabinol (THC)-based medications that contain marijuana control chemotherapy-induced nausea and vomiting in some people."
"There are some tetrahydrocannabinol (THC)-based medications that contain marijuana control chemotherapy-induced nausea and vomiting in some people." THC, an ingredient in marijuana, acts as an antiemetic in some people and can be absorbed through the gastrointestinal tract or inhaled. THC-based medications, dronabinol and nabilone, are available by prescription to control nausea and vomiting resulting from cancer chemotherapy. Nurses are not forbidden to talk about illegal issues and marijuana is prescribed legally in some states. Marijuana is not injected. THC is an effective antiemetic for some clients.
A client is scheduled for an adrenalectomy. Which action would the nurse expect in the plan of care? Provide a low-protein diet. Administer parenteral corticosteroids. Collect a preoperative 24-hour urine specimen. Withhold all medications 48 hours before surgery.
Administer parenteral corticosteroids. Steroid therapy usually is given intravenously or intramuscularly preoperatively and continued intraoperatively to prepare for the acute adrenal insufficiency that follows surgery. The diet must supply ample protein and potassium. A 24-hour urine specimen is unnecessary. Corticosteroids must be administered preoperatively to prevent adrenal insufficiency during surgery, so withholding all medications for 48 hours before surgery is contraindicated.
Which reaction is an example of a type I hypersensitivity reaction? Anaphylaxis Serum sickness Contact dermatitis Blood transfusion reaction
Anaphylaxis An example of a type I hypersensitivity reaction is anaphylaxis. Serum sickness is a type III immune complex reaction. Contact dermatitis is a type IV delayed hypersensitivity reaction. A blood transfusion reaction is a type II cytotoxic reaction.
Which type of allergic skin condition is associated with immunological irregularity, asthma, and allergic rhinitis? Urticaria Psoriasis Acne vulgaris Atopic dermatitis
Atopic dermatitis Atopic dermatitis is an allergic skin condition that is a genetically influenced, chronic, relapsing disease. It is associated with immunological irregularity involving inflammatory mediators associated with allergic rhinitis and asthma. Urticaria is an allergic skin condition that results in a local increase in permeability of capillaries, causing erythema and edema in the upper dermis. Psoriasis is an autoimmune chronic dermatitis but not an allergic skin condition. Acne vulgaris is an inflammatory disorder of sebaceous glands.
The nurse assesses a client's intravenous (IV) site. Which clinical finding leads the nurse to conclude that the IV has infiltrated, rather than caused inflammation? Pain Coolness Localized swelling Cessation in flow of solution
Coolness Rationale When an IV infiltrates, the IV solution entering the interstitial space is at room temperature (approximately 75°F [23.9°C]), whereas body temperature is approximately 98.6°F (37°C); therefore the client's skin will feel cool to the touch at the site of an IV infiltration. The site of an inflammation will feel warm to the touch because of vasodilation and hyperemia. Pain may occur with both an inflammation and an infiltration. The pain of an inflammation is related to the pressure of edema on nerve endings. The pain of an infiltration is related to the IV solution in the interstitial compartment pressing on nerve endings. An increase in interstitial fluid occurs with both an inflammation and an infiltration. With an inflammation there is increased vascular permeability at the site; fluid, proteins, and leukocytes then move from the intravascular compartment into the interstitial compartment. With an infiltration the IV solution enters the interstitial compartment rather than the intravascular compartment. A cessation in flow of solution occurs with both an inflammation and an infiltration. An inflammation in the vein at the insertion site may narrow the lumen of the vessel, interfering with the flow of solution. An infiltration will cause excess fluid in the interstitial compartment to the extent that it will not accommodate more solution, interfering with the flow of the solution.
A beta blocker is prescribed for the client with persistent ventricular tachycardia. Which response indicates that the beta blocker is working effectively? Decreased anxiety Reduced chest pain Decreased heart rate Increased blood pressure
Decreased heart rate A decreased heart rate is the expected response to a beta blocker. Beta blockers inhibit the activity of the sympathetic nervous system and of adrenergic hormones, decreasing the heart rate, conduction velocity, and workload of the heart. A beta blocker is not an anxiolytic and does not reduce anxiety. A beta blocker is not an analgesic and does not reduce chest pain. Beta blockers reduce blood pressure.
Which disorder is caused by the deficiency of antidiuretic hormone? Acromegaly Diabetes insipidus Cushing syndrome Syndrome of inappropriate antidiuretic hormone
Diabetes insipidus Diabetes insipidus is caused by the deficiency of antidiuretic hormone. Acromegaly and Cushing syndrome are not associated with antidiuretic hormone; excessive production of growth hormone results in acromegaly and excessive production of adrenocorticotropic hormone causes Cushing syndrome. Syndrome of inappropriate antidiuretic hormone occurs as a result of increased production of antidiuretic hormone.
A client with supraventricular tachycardia (SVT) has a heart rate of 170 beats/minute. After treatment with diltiazem, which assessment indicates to the nurse that the diltiazem is effective? Increased urine output Blood pressure of 90/60 mm Hg Heart rate of 98 beats/minute No longer complaining of heart palpations
Heart rate of 98 beats/minute Diltiazem hydrochloride's purpose is to slow down the heart rate. SVT has a heart rate of 150 to 250 beats/minute. A heart rate of 110 beats/minute indicates that the diltiazem hydrochloride is having the desired effect. Hypotension is a side effect of diltiazem hydrochloride, not a desired effect. Heart palpations are experienced by some with various dysrhythmias. A decreased sensation of heart palpations is a positive finding but is not present in all clients. Increased urine output may occur over a period of time because of the increased ventricular filling time but would not occur until after the heart rate had stabilized.
A client, transferred to the postanesthesia care unit after a transurethral resection of the prostate (TURP), has an intravenous (IV) line and a urinary retention catheter. During the immediate postoperative period, for which potentially critical complication would the nurse monitor? Sepsis Phlebitis Hemorrhage Leakage around urinary catheter
Hemorrhage After transurethral surgery, hemorrhage is common because of venous oozing and bleeding from many small arteries in the area. Sepsis is unusual, and if it occurs, it will manifest later in the postoperative course. The nurse assesses for phlebitis, but phlebitis is not the most important complication. Hemorrhage is more important than phlebitis. Leaking around the IV catheter is not a major complication.
A client is admitted to the hospital for an adrenalectomy. Before the client's replacement steroid therapy is regulated fully, the nurse will monitor the client for which complication? Hypotension Hypokalemia Hypernatremia Hyperglycemia
Hypotension Because of instability of the vascular system and the lability of circulating adrenal hormones after an adrenalectomy, hypotension frequently occurs until the hormonal level is controlled by replacement therapy. Hyperglycemia is a sign of excessive adrenal hormones; after an adrenalectomy, adrenal hormones are not secreted. Sodium retention is a sign of hyperadrenalism; it does not occur after the adrenals are removed. Potassium excretion is a response to excessive adrenal hormones; after an adrenalectomy, adrenal hormones are decreased until replacement therapy is regulated.
A client who has experienced a subarachnoid hemorrhage would be maintained in which position? Supine On the unaffected side In bed with the head of the bed elevated With sandbags on either side of the head
In bed with the head of the bed elevated With the head of the bed elevated, the force of gravity helps prevent additional intracranial pressure (ICP), which will intensify the ischemic manifestations of hemorrhage. The supine position will not facilitate drainage of cerebral fluid; this position promotes accumulation of fluid, which increases ICP. Lying on the unaffected side will not facilitate drainage of cerebral fluid; this position promotes accumulation of fluid, which increases ICP. Vomiting can occur with increased ICP, and placing sandbags to immobilize the head can result in aspiration.
A client with hyperthyroidism is to receive methimazole. Which information would the nurse provide? Initial improvement will take several weeks. Few side effects are associated with this medication. This medication may be taken at any time during the day. Large loading doses are used initially to normalize thyroid function.
Initial improvement will take several weeks. Methimazole blocks thyroid hormone synthesis; it takes several weeks of medication therapy before the hormones stored in the thyroid gland are released and the excessive level of thyroid hormone in the circulation is metabolized. There are many common side effects that include nausea, vomiting, diarrhea, rash, urticaria, pruritus, alopecia, hyperpigmentation, drowsiness, headache, vertigo, and fever. Methimazole should be spaced at regular intervals because blood levels are reduced in approximately 8 hours. Large doses cause toxic side effects that can be life threatening, including nephritis, hepatitis, agranulocytosis, leukopenia, thrombocytopenia, hypothrombinemia, and lymphadenopathy.
A health care provider prescribes furosemide for a client with hypervolemia. The nurse recalls that furosemide exerts its effects in which part of the renal system? Distal tubule Collecting duct Glomerulus of the nephron Loop of Henle
Loop of Henle Furosemide acts in the ascending limb of the loop of Henle in the kidney. Thiazides act in the distal tubule in the kidney. Potassium-sparing diuretics act in the collecting duct in the kidney. Plasma expanders, not diuretics, act in the glomerulus of the nephron in the kidney.
Which finding would the nurse document as normal for a second, postabdominoperineal resection stoma? Dry, pale pink, and even with the skin Moist, skin-colored, and flush with the skin Moist, red, and raised above the skin surface Dry, purple, and depressed below the skin surface
Moist, red, and raised above the skin surface The surface of a stoma is mucous membrane and should be dark pink to red, moist, and shiny; elevation of the stoma beyond the skin surface usually occurs to allow drainage to go into the appliance rather than onto the skin. The stoma should be moist, not dry. Pale pink may indicate limited circulation to the stoma. Although some stomas can be flush with the skin, a raised stoma is more common. Although the stoma should be moist, a skin-colored stoma indicates limited circulation to the stoma. A purple color indicates compromised circulation.
Which benign condition of the client's skin is associated with the grouping of normal cells derived from melanocytelike precursor cells? Nevi Psoriasis Acne vulgaris Plantar warts
Nevi Nevi (moles) are hyperpigmented areas that vary in form and size. Nevi are a common benign condition of the skin that is associated with the grouping of normal cells derived from melanocytelike precursor cells. Psoriasis is an autoimmune chronic dermatitis that involves excessively rapid turnover of epidermal cells. Acne vulgaris is an inflammatory disorder of sebaceous glands. Plantar warts are formed due to a viral infection. Plantar warts appear on the bottom surface of the feet and grow inward because of pressure.
A client hospitalized for uncontrolled hypertension and chest pain was started on a daily diuretic 2 days ago upon admission, with prescriptions for a daily basic metabolic panel. The client's potassium level this morning is 2.7 mEq/L (2.7 mmol/L). Which action will the nurse take next? Send another blood sample to the laboratory to retest the serum potassium level. Notify the health care provider that the potassium level is above normal. Notify the health care provider that the potassium level is below normal. No action is required because the potassium level is within normal limits.
Notify the health care provider that the potassium level is below normal. The health care provider should be notified immediately because the client's potassium is below normal. The normal potassium level range is 3.5 mEq/L to 5.0 mEq/L (3.5-5.0 mmol/L). Clients on diuretic therapy require close monitoring of their electrolytes because some can cause hypokalemia, whereas others spare potassium, which can cause hyperkalemia. Retesting the serum potassium level is unnecessary and will delay the treatment required by the client.
After teaching a family member how to administer subcutaneous enoxaparin sodium, how will the nurse evaluate the effectiveness of the training? Return demonstration on a manikin. Verbalization of the side effects of the medication. Observing the family member administering enoxaparin sodium to the client. Correctly verbalizing all necessary steps in enoxaparin sodium administration.
Observing the family member administering enoxaparin sodium to he client. The best way to evaluate the effectiveness of the teaching is to observe the family member administering the medication to the client. The family member may be able to perform a subcutaneous injection on a manikin but fear hurting the family member. Knowing the side effects of enoxaparin sodium is important, but it does not provide any information as to the family member's ability to administer the medication. The family member may be able to verbalize all the steps but fear puncturing the skin with the needle.
Which clinical indicator would the nurse expect to find when assessing a client with hemiplegia? Paresis of both lower extremities Paralysis of one side of the body Paralysis of both lower extremities Paresis of upper and lower extremities
Paralysis of one side of the body Hemiplegia is paralysis of one side of the body. Paresis is a weakness or partial paralysis. Paraplegia is the paralysis of both lower extremities and the lower trunk. Paresis of upper and lower extremities is quadriparesis.
Which joint is an example of a condyloid joint? Wrist joint Elbow joint Shoulder joint Sacroiliac joint
Wrist joint The wrist joint is an example of a condyloid joint. It is a joint between the radial and carpals. The elbow joint is an example of a hinge joint. The shoulder joint is an example of a ball and socket joint. The sacroiliac joint is an example of a gliding joint.
