Nursing Care for Various Medical Conditions: Case Studies, Exams of Nursing

Download Nursing Care for Various Medical Conditions: Case Studies and more Exams Nursing in PDF only on Docsity! RN adult medical surgical online practice 2019 B with NGN. A nurse is assessing for compartment syndrome in a client who has a short leg cast. Which of the following findings should the nurse identify as a manifestation of this condition? A. Bounding pedal pulse B. Capillary refill less than 2 seconds C. Pain that increases with passive movement D. Areas of warmth on the cast C. Pain that increases with passive movement A nurse is providing teaching to a client who has a severe form of stage II Lyme disease. Which of the following statements made by the client reflects an understanding of the teaching? A. "I will need to take antibiotics for 1 year" B. "My partner will need to take an antiviral medication" C. "My joints ache because I have Lyme disease" D. "I will bruise easily because I have Lyme disease" C. "My joints ache because I have Lyme disease" Read More A nurse is preparing to administer phenytoin 600 mg PO daily to a client. The amount available is oral solution 125 mg/5 mL. How many mL should the nurse administer? 24 A nurse is caring for a client who has an arterial line. Which of the following actions should the nurse take? A. Flush the line before administering antibiotics B. Position the client in Trendelenburg to obtain measurements C. Have the client bear down when readings are obtained D. Place a pressure bag around the flush solution D. Place a pressure bag around the flush solution A nurse is updating the plan of care for a client who is receiving chemotherapy. Which of the following findings should the nurse identify as the priority? A. Report of sore throat B. Report of memory loss C. Alopecia D. Mucositis A. Report of sore throat A nurse is planning care for a client who is postoperative following a parathyroidectomy. Which of the following actions should the nurse identify as the priority? A. Use pillows to support the client's head and neck B. Offer opioid medication C. Place a tracheostomy tray at the bedside D. Place the client in semi-Fowler's position C. Place a tracheostomy tray at the bedside A nurse is assessing a client who has diabetes insipidus. Which of the following findings should the nurse expect? A. Low urine specific gravity B. Hypertension C. Bounding peripheral pulses D. Hyperglycemia A. Low urine specific gravity A nurse is providing teaching to a client who has stage II cervical cancer and is scheduled for brachytherapy. Which of the following instructions should the nurse include? A. "You will have an implant placed twice each month for the duration of the treatment" B. "You should remain at least 6 feet away from others between treatments" C. "You should expect to have blood in your urine for a few days after treatment" D. "You will need to stay still in the bed during each treatment session" D. "You will need to stay still in the bed during each treatment session" A nurse is planning care for a client who is scheduled for a thoracentesis. Which of the following interventions should the nurse include in the plan? A. Encourage the client to take deep breaths after the procedure B. Assist the client to hold their arms up during the procedure C. Instruct the client to remain NPO after midnight prior to the procedure D. Keep the client on bedrest for 8 hr following the procedure A. Encourage the client to take deep breaths after the procedure A nurse is caring for a client who is receiving a blood transfusion. The client becomes restless, dyspneic, and has crackles noted to the lung bases. Which of the following actions should the nurse anticipate taking? A. Administer an antihistamine B. Slow the infusion rate C. Give the client a corticosteriod D. Elevate the client's lower extremities B. Slow the infusion rate A nurse is providing preoperative teaching for a client who is scheduled for a mastectomy. Which of the following statements should the nurse make? A. "You should accept your body image change before discharge" B. "It is important for you to look at the incisional site when the dressings are removed" C. "I will refer you to community resources that can provide support" D. "The scar will remain red and raised for many years after surgery" C. "I will refer you to community resources that can provide support" A nurse is teaching a family about the care of a patient who has a new diagnosis of Alzheimer's disease. Which of the following information should the nurse include in the teaching? A. Position tabletop clocks with multi-colored backgrounds throughout the home B. Explain how to complete a task while having the client do the task C. Place a calendar on the wall with days and weeks included D. Create complete outfits and allow the client to select one each day D. Create complete outfits and allow the client to select one each day C. Glucose 272 mg/dL D. HCO3 14 mEq/L C. Glucose 272 mg/dL A nurse is evaluating the plan of care for four clients after 2 days of hospitalization. The nurse should identify the need to revise the plan for which of the following clients? A. A client who is taking potassium supplements, has a potassium level of 3.2 mEq/L and reports constipation B. A client who has Alzeimer's Disease (AD), has a room near the nurse's station, and is agitated C. A client who is postoperative following abdominal surgery and reports feeling that something "popped" when they coughed D. A client who has a conductive hearing loss, speaks softly, and is scheduled for a cerumen removal C. A client who is postoperative following abdominal surgery and reports feeling that something "popped" when they coughed We have an expert-written solution to this problem! A nurse is providing teaching to a client who has a new prescription for psyllium. Which of the following information should the nurse include in the teaching? A. Drink 240 mL (8 oz) of water after administration B. Expect results in 4 to 6 hr C. Take this medication before meals to increase appetite D. Reduce dietary fiber intake to improve medication absorption A. Drink 240 mL (8 oz) of water after administration A nurse is admitting a client who has active tuberculosis. Which of the following types of transmission precautions should the nurse initiate? A. Airborne B. Droplet C. Contact D. Protective environment A. Airborne A nurse is reviewing the medical record of a client who has osteomyelitis and a prescription for gentamicin. Which of the following findings from the client's medical record should indicate to the nurse the need to withhold the medication and notify the provider? A. WBC count B. Temperature C. Blood pressure D. Serum creatinine D. Serum creatinine A nurse is providing teaching to a client who is perimenopausal and has a prescription for hormone replacement therapy. For which of the following adverse effects should the nurse instruct the client to notify the provider? (Select all that apply.) A. Night sweats B. Calf pain C. Vaginal dryness D. Numbness in the arms E. Intense headache B, D, E A nurse is planning discharge teaching for a client who has an external fixation device for a fracture of the lower extremity. Which of the following instructions should the nurse include in the plan of care? A. Secure the straps firmly around the boot B. Remove the device before showering C. Use crutches with rubber tips D. Adjust the screws to maintain alignment C. Use crutches with rubber tips A nurse is teaching a group of newly licensed nurses about pain management for older adult clients. Which of the following statements by a newly licensed nurse indicates an understanding of the teaching? A. "Older adult clients might require up to 6 grams of acetaminophen over 24 hours for effective pain control" B. "Ibuprofen can cause gastrointestinal bleeding in older adult clients" C. "Meperidine is the medication of choice for older adult clients experiencing severe pain" D. "Older adult clients taking oxycodone are at risk for diarrhea" B. "Ibuprofen can cause gastrointestinal bleeding in older adult clients" A nurse is assessing a client who has advanced lung cancer and is receiving palliative care. The client has just undergone thoracentesis. The nurse should expect a reduction in which of the following common manifestations of advanced cancer? A. Dyspnea B. Hemoptysis C. Mucus production D. Dysphagia A. Dyspnea A nurse is providing teaching to a client who takes ginkgo biloba as an herbal supplement. which of the following statements should the nurse make? A. "Ginkgo biloba relieves nausea for people who have vertigo" B. "Taking ginkgo biloba will help relieve your joint pain" C. "Ginko biloba can cause an increased risk for bleeding" D. "Taking ginkgo biloba decreases the risk of migraine headache" C. "Ginko biloba can cause an increased risk for bleeding" A nurse is obtaining a medication history from a client who is scheduled to undergo cataract surgery. The nurse should recognize that which of the following client medications is a contradiction for the surgery and notify the provider? A. Hydrocondone B. Bupropion C. Lactulose D. Warfarin D. Warfarin A nurse is assessing a client who has peripheral arterial disease. Which of the following findings should the nurse expect? A. Painless ulcerations on the ankles B. Hair loss on the lower legs C. No extremity pain when resting D. Rubor with elevation of the extremity B. Hair loss on the lower legs A home health nurse is providing teaching to a client who has a stage 1 pressure injury on the greater trochanter of his left hip. Which of the following instructions should the nurse include in the teaching? A. Clean the wound daily with an antiseptic B. Use a donut-shaped pillow when sitting in a chair C. Change positions every hour D. Massage the area two times daily C. Change positions every hour A nurse is assessing a client who has a diagnosis of rheumatoid arthritis. Which of the following nonpharmacological interventions should the nurse suggest to the client to reduce pain? A. Increase intake of foods containing calcium B. Alternate application of heat and cold to the affected joints C. Keep the affected extremities elevated D. Limit movement of the affected joints B. Alternate application of heat and cold to the affected joints A nurse is assessing a client following the completion of hemodialysis. Which of the following findings is the nurse's priority to report to the provider? A. Temperature 37.2 C (99 F) B. Blood pressure 100/70 mmHg C. Weight loss D. Restlessness D. Restlessness A nurse is caring for a client who is 4 hr postoperative following an open reduction internal fixation of the right ankle. Which of the following assessment findings should the nurse report to the provider? A. Extremity cool upon palpation B. Serosanguineous drainage on the dressing C. Capillary refill of 2 seconds D. Client report of discomfort when moving toes A. Extremity cool upon palpation A nurse is assessing a client who is postoperative following a thyroidectomy. Which of the following findings is the nurse's priority? A. Moderate serosanguinous drainage on the dressing B. Calcium 9.5 mg/dL C. Temperature 38.9 C (102 F) D. Decreased bowel sounds C. Temperature 38.9 C (102 F) A nurse is planning care for a client who is having a modified radical mastectomy of the right breast. Which of the following interventions should the nurse include in the plan of care? A. Applying oxygen via face mask B. Placing the client in Fowler's position C. Administering epinephrine D. Initiating an IV infusion of 0.9% sodium chloride A. Applying oxygen via face mask A nurse in an emergency department is assessing an older adult client who has a fractured wrist following a fall. During the assessment, the client states, "Last week I crashed my car because my vision suddenly became blurry." Which of the following actions is the nurse's priority? A. Check the client's neurologic status B. Document the client's statements C. Prepare the client for a CT scan D. Teach the client about using safety precautions for falls A. Check the client's neurologic status A nurse is caring for an older adult client who has dementia and requires acute care for a respiratory infection. The client is agitated and is attempting to remove their IV catheter. Which of the following actions should nurse take to avoid restraining the client? A. Check on the client every 2 hr B. Provide a quiet environment with no distractions C. Turn on the television in the client's room D. Keep the client occupied with a manual activity D. Keep the client occupied with a manual activity A nurse is caring for a client who has terminal cancer. The client tells the nurse, "I wish I could stop these treatments. I am ready to die." Which of the following statements should the nurse make? A. "Discontinuing the treatments is your choice if it is your wish to do so." B. "Your daughter is named as your health care surrogate. I will ask her if you can stop them" C. "I will call your spiritual advisor to come in, so you can discuss this with them" D. "Next time you have an oncology appointment, you should as the oncologist" A. "Discontinuing the treatments is your choice if it is your wish to do so." A nurse is planning care for an older adult client who has dementia. Which of the following interventions should the nurse include in the plan of care? A. Explain procedures as they occur to the client B. Place personal items, such as pictures, at the client's bedside C. Orient the client to their location once a shift D. Encourage the family members to remain home until the client has adjusted B. Place personal items, such as pictures, at the client's bedside A nurse is providing teaching to a client who has asthma about the use of a metered- dose inhaler. The nurse should identify that which of the following client actions indicates an understanding of the teaching? A. Breathing in rapidly while administering the medication B. Washing the plastic case and cap of the inhaler in the dishwasher C. Holding breath for 10 seconds after inhaling D. Waiting 15 seconds between puffs, if two puffs are required C. Holding breath for 10 seconds after inhaling A nurse is administering packed RBCs to a client. Which of the following assessment findings indicates a hemolytic transfusion reaction? A. Anorexia and jaundice B. Bronchospasm and urticaria C. Hypertension and bounding pulse D. Low back pain and apprehension D. Low back pain and apprehension A nurse is caring for a client who has increased intracranial pressure (ICP) and is receiving mannitol via continuous IV infusion. Which of the following findings should the nurse report to the provider as an adverse effect of this medication? A. Decreased heart rate B. Crackles heard on auscultation C. Increased urinary output D. Decreased deep tendon reflexes B. Crackles heard on auscultation A nurse is providing teaching to a client who has anemia and a new prescription for an oral iron supplement. Which of the following statements by the client indicates an understanding of the teaching? A. "I will take my iron with a glass of milk" B. "I will take an antacid with my iron" C. "I will limit my intake of red meat" D. "I will eat more high-fiber foods" D. "I will eat more high-fiber foods" A nurse is providing discharge teaching about infection prevention to a client who has AIDS. Which of the following statements by the client indicates understanding of the teaching? A. "I will eat a salad at least once each day to increase my intake of vitamin K" B. "I can work in my flower garden as long as I wear gardening gloves to cover my skin" C. "I will no longer floss my teeth after brushing my teeth" D. "I can sip on a glass of juice for at least 2 hours before I should discard it" C. "I will no longer floss my teeth after brushing my teeth" A nurse is providing teaching to a client who has hypertension and a new prescription for verapamil. Which of the following information should the nurse include in the teaching? A. "Take this medication on an empty stomach" B. "Eczema is an immediate expected adverse effect of this medication" C. "Increase fiber intake to avoid constipation" D. "Monitor your blood pressure monthly" C. "Increase fiber intake to avoid constipation" A nurse is checking the ECG rhythm strip for a client who has a temporary pacemaker. The nurse notes a pacemaker artifact followed by a QRS complex. Which of the following actions should the nurse take? A. Document that depolarization has occurred B. Increase the pacemaker's voltage C. Decrease the pacemaker's sensitivity D. Check the placement of the ECG leads A. Document that depolarization has occurred A nurse is caring for a client who is receiving total paretneral nutrition (TPN) and is NPO. When reviewing the chart, the nurse notes the following prescription: capillary blood glucose AC and HS. Which of the following actions should the nurse take? A. Check the client's blood glucose according to facility mealtimes B. Contact the provider to clarify the prescription C. Request for meals to be provided for the client D. Hold the prescription until the client is no longer NPO B. Contact the provider to clarify the prescription A nurse is caring for a client who is receiving mechanical ventilation via a tracheostomy tube. The nurse should recognize that which of the following complications is associated with long-term mechanical ventilation? A. Elevated blood pressure B. Dehydration C. Stress ulcers D. Hypernatremia C. Stress ulcers A nurse is reviewing the ABG results of a client who has advanced COPD. Which of the following results should the nurse expect? A. PaCO2 56 mm Hg B. pH 7.38 C. HCO3 24 mEq/L D. PaO2 90 mm Hg A. PaCO2 56 mm Hg A nurse is providing education to a client who has tuberculosis (TB) and their family. Which of the following information should the nurse include in the teaching? A. After 1 week of medication, TB is no longer communicable B. Dispose of contaminated tissues in a paper bag C. Airborne precautions are necessary in the home D. Family members in the household should undergo TB testing D. Family members in the household should undergo TB testing A nurse is planning for a client who is postoperative following a laparotomy and has a closed-suction drain. Which of the following actions should the nurse take to manage the drain? A. Set the wall suction to 80 to 100 mm Hg B. Compress the drain reservoir after emptying C. Allow the drainage to collect on a sterile gauze dressing D. Position the drain below the bed to promote drainage B. Compress the drain reservoir after emptying A nurse is planning care for a client who has a sealed radiation implant for cervical cancer. Which of the following interventions should the nurse include in the plan of care? A. Keep a lead-lined container in the client's room B. Limit each visitor to 1 hr per day A nurse is caring for a client who is brought to the emergency department following an oil fire. Drag words from the choices below to fill in each blank in the following sentence.  During the emergent phase of burn care, the client is at risk for developing _______ and _______.  - hypovolemia - respiratory failure A nurse is caring for a client. For each assessment finding, click to specify if the finding is consistent with emphysema, asthma, or pneumonia. Each finding may support more than 1 disease process. Emphysema  - Breath Sounds  - ABG  - RR  - HR  - Cough  Asthma  - Breath Sounds  - RR  - Cough  Pneumonia  - Temperature  - Breath Sounds  - ABG  - RR  - HR  - Cough  A nurse has received report on a client who is being admitted to the emergency department. Select the 3 findings that require follow-up by the nurse. - GCS score - Oxygen saturation - Pain level The nurse is caring for the client. Complete the following sentence by using the lists of options.  The client is most likely experiencing a ________ as evidenced by the ________.  - hemothorax - respiratory findings The nurse is caring for the client. Drag words from the choices below to fill in each blank in the following sentence.  The nurse should first address the client's ________ followed by the client's ________.  - Oxygenation - blood pressure The nurse is caring for the client. For each potential provider's prescription, click to specify if the potential prescription is anticipated or contraindicated for the client. Anticipated  - Transfuse packed RBCs  - Prepare the client for chest tube insertion  - Initiate NPO status  Contraindicated  - Place the client in Trendelenburg position  - Cover the client with a cooling blanket  The nurse is caring for the client. The nurse is caring for the client following the placement of a chest tube for a hemothorax. Which of the following actions should the nurse take? Select all that apply.  - place the client in high fowler's position - place two rubber tipped hemostats in client's room - palpate the chest tube insertion site for subcutaneous emphysema - Ensure that all chest tube connections are securely attached The nurse is caring for the client. The nurse is caring for the client 1 hr following chest tube insertion. Click to highlight the findings in the nurses' note that indicate the client's condition is improving. To deselect a finding, click on the finding again. - client reports pain as 3 on a scale of 0 to 10 - client reports shortness of breath has decreased - wound dressing is dry and intact - respiratory rate 24/min, - blood pressure 108/74 - oxygen saturation 95% on 2 L/min via nasal cannula A nurse in the emergency department is caring for a client. Drag 1 condition and 1 client finding to fill in each blank in the following sentence.  The client is experiencing manifestations of __________ as evidenced by the _____________.  - Pancreatitis - amylase / lipase A nurse is caring for a client who is 4 hr postoperative following a total vaginal hysterectomy. Click to highlight the findings the nurse should report to the provider immediately. - perineal pad saturated with blood, large clots present - change of blood pressure, heart rate of 102/min