T2

A nurse is caring for a client who has an active upper gastrointestinal bleed. The nurse is preparing to insert a NG tube. The client asks what the NG drainage will look like. What is the nurses best response ?

Drainage will likely be coffee ground

The middle aged client with diabetes mellitus is being treated for the third episodes of acute pylenonephritis in the past year and asks what can be done to help prevent these infections. which is the nurses bet response ?

Drink more water and try to empty your bladder at least every two to three hours while you are awake

The nurse is teaching a client about self management of gastroesophageal reflux which statement by the nurse is most appropriate

Eat four to six small meals each day

The nurse is teaching a group of young man about sexually transmitted diseases. What statement from one of the men indicates an understanding of the teaching about the primary stage of syphilis

A painless chancre is expected

The nurse is providing education to a client with benign prostatic hyperplasia (BPH) which statement by the client indicates teaching has been successful ?

A transurethral resection of the prostate (TURP) is the most common surgical intervention for BPH

The nurse conducts a physical assessment for a client with abdominal pain. Which finding leads the nurse to suspect appendicitis

Abdominal pain at McBurneys point

The nurse is carrying for a client with continuous bladder irrigation following surgery for BPH. Upon assessment the nurse observes the client has no output in the catheter drainage bag. What actions by the nurse are appropriate (select all that apply)

Assess the catheter tubing for any kinks or blockage Manually irrigate the catheter

A nurse is caring for a client with a suspect the Kittystone who reports for current flight pain nausea and vomiting for 24 hours which of the following actions the nurses priority

Administer an analgesic

A client with severe bacterial cystitis is prescribed cefadroxil (Duricef) and phenazopyridine (Pyridium). What statement by the client indicates an accurate understanding of these medications ?

An orange color in my urine won't alarm me

A client with renal calculi has just returned from and extracorporeal shockwave lithotripsy procedure and the nurse finds ecchymosis area on the clients right lower back. which is the nurses priority intervention

Apply ice to the site

A nurse is teaching a group of newly licensed nurses on effective techniques for counseling clients about sexually transmitted infections (STIs). Which of the following statements should the nurse include in the teaching ?

Ask about the clients exposure to any past or present STIs

A client to experience an episode of reflux with regurgitation. What assessment by the nurse is the priority

Auscultate the lungs for crackles

The nurse is caring for a client who has just undergone traditional cholecystectomy surgery and has a T-tube drain in place. The nurse notes serosanguineous drainage present in the drain. Which is the nurses priority action?

Document the finding in the clients chart

The nurse is caring for a client with cholecystitis which assessment finding indicates to the nurse that the condition is chronic rather than acute

Clay colored stools and dark amber urine

To obtain a sterile urine specimen from a client with a Foley catheter the nurse begins by applying a clamp to the drainage tubing distal to the injection port. Which of the following action is most appropriate for the nurse to do next

Clean the injection port cap of the drainage tubing with providone-iodine solution

A nurse is teaching a client who has urolithiasis. Which statement by the nurse best explains what can increase the risk for renal calculi

Dehydration increases the risk for developing urolithiasis

A nurse assesses a male patient with an abdominal hernia. Which abdominal hernias are correctly paired with their physiologic processes

Direct inguinal hernia- a peritoneum sac passes through a weak point in the abdominal wall Ventral hernia- results from inadequate healing of an incision incarcerated hernia- contents of the hernia sac cannot be reduced back into the abdominal cavity

Which client statement indicates a good understanding regarding antibiotic therapy for recurrent urinary tract infections

Even if I feel completely well, I should take the medication until it is gone

An Obese client asks the nurse about what lifestyle modifications she should make. What response by the nurse are appropriate? (Select all that apply)

Get atleast 7 hours of sleep every night participate in a regular exercise regimen set appropriate weight loss goals

A nurse is providing education to a client about pelvic inflammatory disease. What statement by the nurse are appropriate to include in the teaching (select all that apply)

Having a history of sexually transmitted diseases (STDs) is a risk factor it may cause abdominal tenderness if left untreated it may cause infertility

A client has had two episodes of bacterial cystitis in the last six months. Which question should the nurse ask (select all that apply)

How much water do you drink every day do you take estrogen replacement Do you have any condition that affects your immune system are you on steroids or other immune suppressant drugs

A client has a history of renal calculi. Which statement by the client indicates a good understanding of preventative measure?

I know I should drink 2-3L of fluid every day

The nurse is providing discharge teaching for a client who has just undergone laparoscopic cholecystectomy surgery which statement by the client in the case understanding of the instructions

I need a diet without a lot of fatty foods

A nurse is planning care for a client who has cystitis. Which of the following statements from the client indicates an understanding of the treatment plan?

I will avoid drinking carbonated beverages

A nurse is caring for a male client preparing to have an inguinal hernia repair. What statement made by the client indicates need for additional teaching

I will be wearing a truss after surgery is completed

The nurse is educating a client about preventing toxic shock syndrome. Which take me by the client indicates a need for further teaching

I will wear tampons only at night

The nurse is caring for a client with peptic ulcer disease. The client vomits a large amount of undigested food after breakfast and a pyloric obstruction is expected. Which intervention does the nurse prepare to provide for the client

Insert a nasogastric (NG) tube to low intermittent suction

The nursing instructor recognizes that the student nurse knows how to perform a patients abdominal assessment when he does the assessment in what order

Inspection, auscultation, palpitation, and percussion

At a team conference a nurse asks why extracorporeal shock wave lithotripsy is used. Which gives the most correct answer

It breaks up kidney stones into smaller ones that can pass through the system

A nurse is teaching a client who has herpes simplex virus type two about disease transmission. Which of the following statements by the client indicates understanding of the teaching

Itching or tingling occurs at the site were a blister forms blisters will rupture leaving painful ulcers

Hey postmenopausal female client has had two episodes of bacteria urethritis in the last six months. She asked her nurse why this is happening to her now. Which is the nurses best response

Low estrogen levels can make the tissue more susceptible to infection

The nurse is providing health education to a patient scheduled for a colonoscopy. The nurse explained that she will be placing what position during the diagnostic test

Lying on the left side with legs drawn toward the chest

A client has been admitted from a nursing home for a work up to determine the cause of several recent falls. What intervention by the nurse takes priority?

Obtain a clean catch or Catherized urine specimen

A nurse in a community clinic is counseling a client who received a positive test result for chlamydia. Which of the following statements should the nurse provide

This infection is treated with one dose of azithromycin

The nurse is caring for a client with peptic also disease who reports increased abdominal pain nausea and vomiting. The nurse notes a tinder rigid abdomen. Which conclusion does a nurse draw from these assessment findings

Perforation of the ulcer client needs emergency surgery

A client is hospitalized with urinary retention has an indwelling catheter and he's getting IV fluids. Which intervention does a nurse add to the care plan to prevent complications for this client

Perform catheter care per policy every shift

A client is admitted with a. 3 day history of vomiting and diarrhea with a diagnosis or gastroenteritis. The clients vital signs are blood pressure 80/50 mm Hg, and heart rate 105 beats/min. Which intervention by the nurse takes priority

Start an IV of normal saline as ordered

A nurse is caring for a client who has peptic ulcer disease . The nurse should monitor the client for which of the following findings as an indication of gastrointestinal perforation? (Select all that apply)

Sudden abdominal pain hypoactive bowel sounds

A patient ass the nursing assistant for a bed pan. When the patient is finished the nursing assistant notifies the nurse that the patient has bright red streaking of blood in the stool. What statement from the nurse explains the likely cause of this

The bleeding from hemorrhoids

An older patient diagnosed with bacterial gastroenteritis reports abdominal cramping diarrhea nausea and vomiting and fatigue for the past 24 hours. Which statement by the nurse indicates understanding of the priority nursing assessment

The priority in care is monitoring for dehydration

An obese client has reflux and asks how being overweight could cause this condition. Which response by the nurse is Best

The weight increases intra-abdominal pressure

The nurse is teaching a 19 year old female with genital warts about her condition. Which client statement requires further education from the nurse?

Wart remover treatment from the drugstore will help me get rid of them

The nurse conducts A physical assessment for a client with severe right lower quadrant abdominal pain. The nurse notes that the abdomen is rigid and the clients temperature is 101.1°F. Which laboratory value does the nurse bring to the attention of the healthcare provider as a priority

White blood cell count is 22,000/mm3

An EGD confirms that the patient has PUD. Three hours later the patient is admitted to the medical unit for work up and further testing. On admission the patient reports midline epigastric tenderness and indigestion. The patient is prescribed triple therapy which statement by the nurse gives the best explanation for the triple

You will be starting on a proton pump inhibitor(PPI) and two antibiotics

A female patient with a purulent vaginal discharge is seen at an outpatient clinic and is given a diagnosis or gonorrhea. Which statement from the nurse is most appropriate

You will be treated with a single dose of IM rocephin