RN Adult Medical Surgical Online Practice 2019 B with NGN Exam Updated 2023, Exams of Nursing

Download RN Adult Medical Surgical Online Practice 2019 B with NGN Exam Updated 2023 and more Exams Nursing in PDF only on Docsity! RN Adult Medical Surgical Online Practice 2019 B with NGN Exam Updated 2023-2024 New Latest Version with All Questions from Actual Past Exam and 100% Correct Answers 1 / 26 1. A nurse is caring for a client who is 24 hr postoperative following a total hip arthroplasty. Which of the following actions should the nurse take? A. Place the affected leg in external rotation. B. Encourage the client to use the incentive spirometer every shift. C. Instruct the client to lean forward when rising from a chair. D. Maintain abduction of the affected extremity.: D. Maintain abduction of the affected extremity. The nurse should ensure that the affected extremity is in a position of abduction to prevent hip dislocation. The nurse should place an abductor pillow or several pillows between the client's legs to keep the affected extremity in abduction while the client is in bed 2. A nurse is assessing a client who takes salmeterol to treat moderate asthma. Which of the following findings should indicate to the nurse that the medica- tion has been effective? A. The client's daily peak expiratory flow (PEF) measures 85% above personal best. B. The client's ABGs shows a pH level of 7.32. RN Adult Medical Surgical Online Practice 2019 B with NGN Exam Updated 2023-2024 New Latest Version with All Questions from Actual Past Exam and 100% Correct Answers 2 / 26 C. The client's forced expiratory volume is decreased after treatment with medication. D. The client's wheezing is limited to expiratory.: A. The client's daily peak expiratory flow (PEF) measures 85% above personal best. A client who has asthma should use a peak flow meter twice daily to monitor asthma control. A PEF in the green zone, or 80% or above personal best, indicates the effectiveness of medication therapy 3. A nurse is caring for a client who has atopic dermatitis and a prescription for triamcinolone ointment. The nurse should assess the client to monitor for which of the following adverse effects? A. Increased pigmentation B. Localized hair loss C. Thinning of the hair D. Increased sensitivity to the sun: C. Thinning of the hair Thinning of the skin and delayed healing are adverse effects of topical glucocorticoid preparations. The client should only apply the ointment to dry patches of the skin because topical steroids can cause atrophy of the dermis and epidermis, which can result in thinning of the skin 4. A nurse is assessing a client who has left-sided heart failure. Which of the following findings should the nurse identify as a manifestation of left-sided RN Adult Medical Surgical Online Practice 2019 B with NGN Exam Updated 2023-2024 New Latest Version with All Questions from Actual Past Exam and 100% Correct Answers 5 / 26 improve with oxygen therapy. Extensive pulmonary edema evident on a chest x-ray is a manifestation of ARDS 12. An emergency room nurse is assessing a client who has asthma and difficulty breathing. Which of the following findings should indicate to the nurse that the client is experiencing status asthmaticus? A. Coughing B. Flat neck veins C. Use of accessory muscle D. Presence of coarse crackles: C. Use of accessory muscles A client who has status asthmaticus uses accessory muscles to help facilitate breathing, which is a manifestation of severe airflow obstruction. The situation is life-threatening and the nurse should intervene immediately with strong systemic bronchodilators, epinephrine, corticosteroids, and oxygen. 13. A nurse is teaching a client who has a new prescription for phenytoin to treat a seizure disorder. Which of the following adverse effects should the nurse instruct the client to report immediately to the provider? A. Tender bleeding gums B. Increased facial hair C. Constipation D. Skin Rash: D. Skin Rash When using the urgent vs. nonurgent approach to client care, the nurse should determine that the priority finding is a rash, which can have a measles-like appear- ance and progress to exfoliative dermatitis or Stevens-Johnson syndrome. The client should report this finding to the provider immediately. 14. A nurse is monitoring a client following a lumbar laminectomy. The client has a drain and indwelling urinary catheter. The nurse should identify which of the following findings as an indication of a complication of the surgery? A. Oral temperature of 37.2 C (99 F) B. Clear drainage on the dressings C. Drain output 75 mL in 4 hours D. Decreased bowel sounds in all quadrants of the abdomen: B. Clear drainage on the dressings The nurse should identify clear drainage on or around the dressing as an indication of a cerebral spinal leak and should report this finding to the provider immediately. 15. A nurse is assessing a client who has right-sided heart failure. Which of the following findings should the nurse identify as a manifestation of right-sided heart failure? A. S3 gallop B. Weak peripheral pulses RN Adult Medical Surgical Online Practice 2019 B with NGN Exam Updated 2023-2024 New Latest Version with All Questions from Actual Past Exam and 100% Correct Answers 6 / 26 C. Increased abdominal girth d. Wheezing: C. Increased abdominal girth Increased abdominal girth is an expected finding with right-sided heart failure due to systemic congestion and an enlarged liver and spleen. Systemic congestion can lead to fluid retention and increased pressure in the venous system, which can manifest with edema in the lower extremities. 16. A nurse is caring for a client who recently assumed the role of caregiver for their aging parents who have chronic illnesses. The nurse should identify that which of the following statements by the client indicates acceptance of the role change? A. " I changed the floor plan of our home to accommodate my father's wheel- chair." B. "I'm so stressed out that it makes it difficult for me to manage everything." C. "At times, I get so frustrated with how to care for my parents." D. "I am learning to take care of my parents as I go.": A. " I changed the floor plan of our home to accommodate my father's wheelchair." The nurse should identify that the client has accepted the role change of caring for their aging parents by changing the floor plan of the home to accommodate their father's wheelchair. 17. A nurse is caring for a client who is receiving vancomycin intermittent IV bolus therapy for methicillin-resistant Staphylococcus aureus (MRSA). Which of the following findings is an indication to the nurse that the client is experi- encing an adverse effect of the medication? A. The client's BP is elevated B. the client is becoming flushed C. the client reports blurred vision D. The client is experiencing polyuria: A. The client's BP is elevated The client can have an adverse effect called red man syndrome, which causes hypotension and tachycardia, due to infusing the vancomycin too rapidly. The nurse should infuse the medication over at least 60 min. 18. A nurse is caring for a male client who has a new prescription for cy- closporine following a kidney transplant. Which of the following findings should the nurse identify as an adverse effect of this therapy? A. WBC count of 8,000/mm3 B. RBC count of 6 million/mm3 C. BUN 24 mg/dL D. Potassium of 3.5 mEq/L: C. BUN 24 md/dL A BUN of 24 mg/dL is above the expected reference range of 10 to 20 mg/dL, indicating renal impairment. An adverse effect of cyclosporine is nephrotoxicity. The RN Adult Medical Surgical Online Practice 2019 B with NGN Exam Updated 2023-2024 New Latest Version with All Questions from Actual Past Exam and 100% Correct Answers 7 / 26 nurse should monitor the client for increases in BUN and creatinine and report any elevation to the provider. A rise in BUN could indicate transplant rejection. 19. A nurse is caring for a client who has dumping syndrome following a gas- tric resection. The nurse should monitor the client for which of the following complications of dumping syndrome? A. Weight Gain B. Iron-deficiency anemia C. Hypercalcemia D. Reduced heart rate: B. Iron-deficiency anemia The nurse should monitor the client for manifestations of anemia, such as pallor, tachycardia, and fatigue. Rapid emptying of the stomach contents into the intestine can lead to reduced absorption of iron in the duodenum, causing iron-deficiency anemia. 20. A nurse is providing teaching about health promotion activities for a client who has a new diagnosis of type 1 diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching? A. "If I can keep my hemoglobin A1C less than 6.5%, I will be cured of diabetes." B. "I will check my blood sugar level before exercising." C. "I should have my eyes checked every two years." D. "I should soak my feet daily in warm, soapy water.": B. "I will check my blood sugar level before exercising." Clients who have diabetes mellitus should not exercise if their blood glucose level is less than 80 mg/dL or greater than 250 mg/dL. A client who has type 1 diabetes mellitus and is hyperglycemic can experience even higher blood glucose levels. Hypoglycemia can also occur during exercise and up to 24 hr following exercise. The nurse should instruct the client to monitor blood glucose levels before, during, and following exercise. 21. A nurse is providing teaching to a client who has a new prescription for warfarin. Which of the following medications should the nurse instruct the client to avoid? (Select all that apply.) A. Ferrous sulfate B. Echinacea C. Aspirin D. Dextromethorphan E. Naproxen: C. Aspirin E. Naproxen 22. A nurse is assisting with the care of a client who is scheduled for a thoracentesis. Which of the following interventions should the nurse plan to RN Adult Medical Surgical Online Practice 2019 B with NGN Exam Updated 2023-2024 New Latest Version with All Questions from Actual Past Exam and 100% Correct Answers 10 / 26 the plan? A. Maintain the head of the bed greater than 45. B. Place a donut-shaped cushion under the client's sacrum C. Massage bony prominences three times daily D. Apply moisturizer to damp skin after bathing: D. Apply moisturizer to damp skin after bathing Applying a moisturizer to damp skin after bathing helps prevent dry skin. The drier the skin is, the greater the risk is for skin breakdown. 30. A nurse is caring for a client who has a new diagnosis of type 1 diabetes mellitus. Which of the following findings should the nurse identify as a mani- festation of type 1 diabetes? A. Hypernatremia B. Decreased serum osmolality C. Ketones in the urine D. Hypoglycemia: C. Ketones in the urine Clients who have type 1 diabetes mellitus can have ketones in the urine, which are a byproduct of the breakdown of fats for energy. Ketones in the urine are an indicator of inadequate amounts of insulin and high blood glucose levels. 31. A nurse is caring for a client who had a surgical repair of an abdominal aortic aneurysm 3 days ago. The client's vital signs are: temperature 38.3° C (100.9° F), heart rate 80/min, respirations 16/min, and blood pressure 128/76 mm Hg. Which of the following actions is the nurse's priority? A. Notify the surgeon of the temperature elevation. B. Encourage the client to drink more fluids. C. Assess the surgical incision for signs of infection. D. Monitor vital signs every 4 hr.: C. Assess the surgical incision for signs of infection. A surgical wound infection typically appears 3 to 6 days following the surgery. Fever from the third postoperative day onward indicates that this client's greatest risk is either a wound infection or a pulmonary infection; therefore, this is the priority action the nurse should take. 32. A nurse is providing discharge teaching to a client following a loop electro- surgical excision procedure (LEEP) for the treatment of cervical cancer. Which of the following statements by the client indicates an understanding of the teaching? A. "I can resume sexual intercourse in 48 hours." B. "I can expect some heavy vaginal bleeding for 24 hours." C. "I can use tampons when my period comes in a week." D. "I may have mild cramping for several hours.": D. "I may have mild cramping RN Adult Medical Surgical Online Practice 2019 B with NGN Exam Updated 2023-2024 New Latest Version with All Questions from Actual Past Exam and 100% Correct Answers 11 / 26 for several hours." The client should expect very little discomfort from the LEEP procedure, which is performed in ambulatory care using a painless electrical current. 33. A nurse is assessing a group of clients. For which of the following clients should the nurse make a referral to palliative care? A. A client who is newly diagnosed with type 1 diabetes mellitus and cannot afford insulin B. A client who has Meniere's disease and cannot safely ambulate due to vertigo C. A client who had a stroke and cannot eat or drink without choking D. A client whose medications to manage Parkinson's disease are no longer effective: D. A client whose medications to manage Parkinson's disease are no longer effective Parkinson's disease is a neurodegenerative disease marked by alterations in mo- bility, cognition, mood, and functioning of the sympathetic nervous system. The effectiveness of medications used to manage the symptoms can decrease over time. When this occurs, the nurse should make a referral to palliative care. Palliative care is designed to maintain the client's current quality of life through symptom management, assist with decision making regarding care needs, and work with families to identify care outcomes. 34. A nurse is providing teaching to a client who has a new prescription for cephalexin oral suspension. Which of the following statements by the client indicates an understanding of the teaching? A. "I will increase my consumption of foods high in potassium." B. "I will apply lotion to my skin if I feel any itching." C. "I will avoid sun exposure while taking this medication." D. "I will keep the medication refrigerated.": D. "I will keep the medication refrig- erated." The nurse should instruct the client to refrigerate the oral cephalosporin suspension to maintain its full strength until the completion of the medication regimen. 35. A nurse is caring for a client who has acute kidney injury and a potassium level of 6.5 mEq/L. Which of the following ECG changes should the nurse expect? A. Prominent P waves B. Narrowed QRS complexes C. Shortened PR intervals D. Peaked T waves: C. Shortened PR intervals The PR interval reflects conduction from the sinoatrial node through the atrioven- RN Adult Medical Surgical Online Practice 2019 B with NGN Exam Updated 2023-2024 New Latest Version with All Questions from Actual Past Exam and 100% Correct Answers 12 / 26 tricular node. A potassium level between 6.0 and 6.5 mEq/L slows the impulse conduction between the atria and the ventricles, resulting in a prolonged PR interval. 36. A nurse is caring for a client who had abdominal surgery. The client tells the nurse that "something gave way." The nurse removes the dressing and sees the wound has eviscerated. Identify the correct sequence of steps the nurse should follow. (Move the steps into the box on the right, placing them in the selected order of performance. Use all the steps - Place the client in a low Fowler's position with the knees bent - Cover the client's wound with a sterile saline-soaked dressing - Notify the surgeon about the finding - Prepare the client for transfer to surgery: CORRECT STEPS - Notify the surgeon about the finding - Cover the client's wound with a sterile saline-soaked dressing - Place the cline in a low Fowler's position with the knees bent - Prepare the client for transfer to surgery 37. A nurse is caring for a client who is hemorrhaging and hypotensive from esophageal variceal bleeding. Which of the following actions should the nurse take first? A. Administer vasopressin to the client B. Request blood from the blood bank C. Verify that the client has adequate IV access. D. Insert an indwelling urinary catheter: C. Verify that the client has adequate IV access When using the airway, breathing, and circulation approach to client care, the nurse should first verify that the client has at least a 20-gauge IV for the administration of blood. 38. A nurse is assessing a client who has a new diagnosis of diabetes mellitus. The nurse should identify that which of the following findings is a manifesta- tion of hyperglycemia? A. Increased thirst B. Decreased urine output C. Dry Skin D. Tremors: A. Increased thirst The nurse should teach the client that increased thirst, or polydipsia, is a mani- festation of hyperglycemia, which can lead to dehydration. Other manifestations of hyperglycemia include an increase in appetite, or polyphagia, an increase in urine production, or polyuria, and fatigue. 39. A nurse is reviewing the health histories of a group of clients. Which of the following findings should the nurse identify as an indication that a client is at RN Adult Medical Surgical Online Practice 2019 B with NGN Exam Updated 2023-2024 New Latest Version with All Questions from Actual Past Exam and 100% Correct Answers 15 / 26 thyroidism. Elevated thyroid hormone levels (T3 and T4) and a decreased thyroid stimulating hormone level reflect primary hyperthyroidism. 47. A nurse is preparing a teaching plan for a client who is starting to receive hemodialysis for chronic kidney disease. Which of the following instructions should the nurse include in the teaching? A. "Use salt substitutes to reduce your sodium intake." B. "Increase your fluid intake to 1,000 mL a day." C. "Include phosphorus-rich foods in your diet." D. "Increase your intake of protein to 1 to 1.5 grams per kilogram per day.": D. "Increase your intake of protein to 1 to 1.5 grams per kilogram per day." A client who receives hemodialysis for chronic kidney disease needs protein to prevent a negative nitrogen balance and muscle wasting. A client who is receiving hemodialysis is allowed 1 g to 1.5 g of protein/kg/day 48. A nurse is caring for a client who has deep-vein thrombosis and is receiv- ing heparin via continuous IV infusion. The client's weight is 80 kg (176.4 lb). Using the client information provided, which of the following actions should the nurse take? (Click on the "Exhibit" button below for additional information about the client. There are three tabs that contain separate categories of data.) A. Stop the heparin infusion for 1 hr B. Increase the rate of the infusion by 160 units/hr. C. Administer heparin 2,400 unit IV bolus. D. Continue the infusion without change.: A. Stop the heparin infusion for 1 hr According to the titration table, when the aPTT is greater than 95, the nurse should stop the infusion for 1 hr, then restart the infusion with a decrease of 3 units/kg/hr, which is a decrease of 240 units/hr for a client who weighs 80 kg (176.4 lb). 49. A nurse is caring for a client who is intubated and receiving mechanical ventilation for heroin toxicity. Which of the following assessments is the nurse's priority? A. WBC count B. Intake and output C. ABGs D. Blood glucose level: C. ABGs When using the airway, breathing, and circulation (ABC) approach to client care, the nurse's priority assessment is to monitor the client's ABGs, including respiratory status. 50. A nurse is assessing a client who has a new diagnosis of pericarditis. Which of the following findings should the nurse identify as a manifestation of cardiac tamponade? A. Fever RN Adult Medical Surgical Online Practice 2019 B with NGN Exam Updated 2023-2024 New Latest Version with All Questions from Actual Past Exam and 100% Correct Answers 16 / 26 B. Atrial fibrillation C. Paradoxical pulse D. Pericardial friction rub: C. Paradoxical pulse Cardiac tamponade results from an excess of fluid in the pericardial cavity and causes a sudden drop in cardiac output. Paradoxical pulse is a systolic blood pressure of 10 mm Hg or more on expiration and is a manifestation of cardiac tamponade. The nurse should report manifestations of cardiac tamponade to the provider immediately. 51. A nurse is assessing a client who is undergoing radiation therapy for breast cancer. Which of the following findings is an indication to the nurse that the client is experiencing an adverse effect of the therapy? A. Stomatitis B. Vomiting C. Skin changes D. Hematuria: C. Skin changes A client who is receiving radiation therapy to the breast will have localized adverse effects of the treatment, such as skin changes, esophagitis, and lymphedema. 52. A nurse is preparing to administer enoxaparin 0.75 mg/kg subcutaneously to a client who weighs 154 lb. The amount available is enoxaparin 60 mg/0.6 mL. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.): 0.5 mL 53. A nurse is caring for a group of clients. In which of the following scenarios is the nurse acting as a client advocate? A. The nurse refers a client who has chronic obstructive pulmonary disease for palliative care services. B. The nurse provides wound care to a client at the time promised to the client. C. The nurse declines to inform a client's neighbor about the client's progno- sis. D. The nurse files an incident report regarding a medication error.: A. The nurse refers a client who has chronic obstructive pulmonary disease for palliative care services. Palliative care is an interdisciplinary approach to client care that works toward optimizing the quality of life for a client who has a chronic illness. Nurses advocate for their clients when they promote the health, safety, and rights of the client, such as providing a referral for needed services to relieve suffering and promote a client's quality of life RN Adult Medical Surgical Online Practice 2019 B with NGN Exam Updated 2023-2024 New Latest Version with All Questions from Actual Past Exam and 100% Correct Answers 17 / 26 54. A nurse is assessing a client who recently had a myocardial infarction. Which of the following findings indicates that the client might be developing pulmonary edema? (Select all that apply.) A. Excessive somnolence B. Epistaxis C. Pink, frothy sputum D. Tachypnea E. Urinary frequency: A, C, D 55. A nurse is teaching a client about preventing the transmission of HIV. Which of the following information should the nurse include? A. Use a natural material condom during oral, genital, and anal intercourse. B. Medication is available that will reduce the risk for HIV transmission. C. Use skin lotion as a lubricant when using a condom. D. A diaphragm will provide protection against HIV transmission.: B. Medication is available that will reduce the risk for HIV transmission. enofovir/emtricitabine is an oral medication that can be used prophylactically by a client who does not have an HIV infection to reduce the risk for HIV transmission. Pre-exposure prophylaxis is recommended for men who have sexual relationships with men, clients who are heterosexual and sexually active, noninfected partners who have a sexual relationship with a partner who has HIV, and clients who use intravenous drugs. 56. A nurse is caring for a client who has multiple leg fractures and is 24 hr postoperative following placement of skeletal traction. Which of the following actions should the nurse take? A. Apply petroleum jelly to the pin sites. B. Apply a sterile hydrocolloid dressing every 24 hr. C. Cleanse the pin sites with isopropyl alcohol. D. Inspect the pin sites at least every 8 hr.: D. Inspect the pin sites at least every 8 hr. The nurse should inspect the pin sites at least every 8 hr, noting any inflammation or evidence of infection. Expected findings after the insertion of pins include redness, warmth, and serosanguineous drainage, which should subside after 72 hr. 57. A nurse in a long-term care facility is caring for a client who has dementia. Which of the following actions should the nurse take? A. Give detailed directions when addressing the client. B. Provide finger food at mealtime. C. Use written signs to redirect the client. D. Seat the client at a large table for meals.: B. Provide finger food at mealtime. The nurse should provide the client who has dementia with fingers foods. Clients RN Adult Medical Surgical Online Practice 2019 B with NGN Exam Updated 2023-2024 New Latest Version with All Questions from Actual Past Exam and 100% Correct Answers 20 / 26 rotoxicosis with manifestations of tachycardia, insomnia, tremors and nervousness, hyperthermia, heat intolerance, and sweating. The provider should retest the client's thyroid hormone levels and adjust the dosage accordingly. 64. A nurse is assessing a client who has an exacerbation of diverticular disease. In which of the following quadrants should the nurse anticipate the client to be experiencing abdominal pain? A. Left lower quadrant B. Left upper quadrant C. Right lower quadrant D. Right upper quadrant: A. Left lower quadrant Diverticula commonly develop in the sigmoid colon because of the high pressure it takes to move stool into the rectum. Therefore, the pain with this disorder is often in the left lower quadrant 65. A nurse is planning care for a client who has a lump in their right breast. Which of the following findings increases the client's risk of developing breast cancer? A. Menarche started at age 15 B. First born child was at 20 years of age C. History of fibrocystic breasts D. Oral contraceptives were taken for the last 6 years: D. Oral contraceptives were taken for the last 6 years Clients who take hormones, such as estrogen therapy, fertility drugs, and oral contraceptives, have an increased risk of developing breast cancer. 66. A nurse is providing teaching for a client who has constipation-predom- inant irritable bowel syndrome (IBS-C). Which of the following statements should the nurse include in the teaching? A. "Take a dose of loperamide each morning." B. "Increase your fluid intake to 1,000 milliliters per day." C. "Take psyllium in the evening." D. "Consume a diet that is low in protein.": C. "Take psyllium in the evening." A client who has IBS-C should take a bulk-forming laxative, such as psyllium, to increase the bulk of the stool, reduce constipation, and promote regular bowel movements. 67. A nurse is caring for a client who is receiving mechanical ventilation. Which of the following actions should the nurse implement to decrease the client's risk for ventilator-associated pneumonia (VAP)? (Select all that apply.) Wear a protective gown when suctioning the client's airway. B. Monitor for oral secretions every 2 hr. RN Adult Medical Surgical Online Practice 2019 B with NGN Exam Updated 2023-2024 New Latest Version with All Questions from Actual Past Exam and 100% Correct Answers 21 / 26 C. Provide oral care every 2 hr. D. Maintain the client in a supine position. E. Maintain the client in a supine position.: B, C, E 68. A nurse is planning care for a client who is receiving intermittent IV fluids via a peripherally inserted central catheter (PICC). Which of the following information should the nurse include in the client's plan of care? A. Assess the PICC infusion system systematically. B. Use a 3-mL syringe to flush the PICC following infusions. C. Change the needleless connector device on the IV tubing after each infu- sion. D. Provide daily dressing changes to the PICC insertion site.: A. Assess the PICC infusion system systematically. The nurse should assess the infusion system in a systematic fashion beginning with the insertion site, observing for signs of infection, and working upward and following the tubing to ensure that all connections are secure 69. A nurse is performing a risk assessment for a client. Which of the following factors should the nurse identify as increasing the client's risk for falls? A. The client has gastroesophageal reflux disease B. The client is 62 years old. C. The client had cataract surgery 1 day ago. D. The client takes colesevelam.: C. The client had cataract surgery 1 day ago. A client who had recent eye surgery is at increased risk for falls. The nurse should ensure the client is wearing prescription glasses when ambulating and that environ- mental hazards, such as loose rugs, are removed because the client's vision might be blurred. 70. A nurse is providing teaching to a group of clients about the prevention of coronary artery disease. Which of the following information should the nurse include in the teaching? A. Walk 30 min daily at a comfortable pace. B. Limit saturated fat intake to 10% of total daily calories. C. Maintain a BMI of 30. D. Consume at least 2,000 mg of sodium per day.: A. Walk 30 min daily at a comfortable pace. The clients should walk 30 min daily at a comfortable pace to prevent weight gain and decrease the risk of coronary artery disease. 71. A home health nurse is inspecting a client's residence for electrical haz- ards as part of the agency's quality improvement plan. Which of the following findings should the nurse identify as a safety hazard? A. The client's bed has a three-prong plug attached to the electrical cord. RN Adult Medical Surgical Online Practice 2019 B with NGN Exam Updated 2023-2024 New Latest Version with All Questions from Actual Past Exam and 100% Correct Answers 22 / 26 y the hot ould assess iciency for the venous ulcer. nd edema as the medial or B. A protective cover is inserted into an unused outlet. C. An IV pump is plugged into an outlet near a sink. D. An electrical cord is coiled and secured to the floor.: C. An IV pump is plugged into an outlet near a sink. The nurse should plug all electrical appliances into outlets away from wet areas. Water conducts electricity and places the client at risk for electrocution 72. A nurse is teaching a client about self-management of their halo fixator device. Which of the following information should the nurse include in the teaching? A. Give each screw a quarter turn daily using the wrench provided. B. Apply powder liberally under the chest portion of the halo fixator device. C. Avoid the use of straws when drinking liquids. D. Place a small pillow under the head while lying supine.: D. Place a small pillow under the head while lying supine. The halo fixator device is worn for a period of 8 to 12 weeks and immobilizes the cervical spine, preventing flexion and hyperextension of the neck. The use of a small pillow under the head provides support to the head and neck, preventing additional discomfort and pressure from the device. 73. A nurse is providing teaching to a client about strategies to manage menopausal symptoms. Which of the following instructions should the nurse include in the teaching? A. "Drink green tea to relieve menopausal hot flashes." B. "Take vitamin D supplements to relieve menopausal hot flashes." C. "Use water-based lubricant during intercourse to reduce discomfort." D. "Apply estrogen cream during intercourse to reduce discomfort.": C. "Use water-based lubricant during intercourse to reduce discomfort." The nurse should instruct the client to use water-based lubricants to help relieve vaginal dryness and irritation during sexual intercourse. Atrophic vaginitis is a common manifestation of menopause 74. A nurse is caring for a client who has chronic venous insufficiency. Which of following areas should the nurse assess for the presence of a venous ulcer? (You will find hot spots to select in the artwork below. Select onl spot that corresponds to your answer.): A is correct. The nurse sh the medial malleolus (ankle) of a client who has chronic venous insuff presence of a venous ulcer. The ankle is the most common area for a A client who has venous insufficiency can exhibit skin discoloration a well as a large or superficial ulcer with irregular borders at the site of lateral malleolus that weeps exudate. A pulse is palpable in this area and the client typically experiences a moderate level of pain at the site. RN Adult Medical Surgical Online Practice 2019 B with NGN Exam Updated 2023-2024 New Latest Version with All Questions from Actual Past Exam and 100% Correct Answers 25 / 26 the water seal chamber Constant bubbling in the water seal chamber can be an indication of an air leak, which is caused by a disruption in the system such as a loose connection. Pulmonary air leaks create intermittent bubbling that is synchronous with respiration. This finding should be reported to the provider immediately 83. A nurse is caring for a client who has a small bowel obstruction and an NG tube in place. Which of the following actions should the nurse take? A. Maintain low intermittent suction. B. Assess patency and irrigate the NG tube every 12 hr. C. Record gastric output every 8 hr. D. Fasten the end of the tube to the client's pillow case.: A. Maintain low intermittent suction. The nurse should maintain low intermittent suction to prevent gastric irritation and ulceration. With a small bowel obstruction, the NG tube removes gastric secretions and decompresses the bowel 84. A nurse is teaching a client who has a new diagnosis of type 1 diabetes mellitus. Which of the following statements by the client indicates an under- standing of the teaching? A. "I am aware that my diabetes is caused by an autoimmune disorder." B. "I know that my diabetes developed slowly over several years." C. "If I lose weight, I may be able to stop taking insulin." D. "I have developed a resistance to insulin.": A. "I am aware that my diabetes is caused by an autoimmune disorder." Type 1 diabetes mellitus is an autoimmune disorder that destroys pancreatic beta cells. This autoimmune reaction is often triggered by a viral infection 85. A nurse is monitoring a client who has a traumatic brain injury. Which of the following findings should the nurse identify as a manifestation of Cushing's triad? A. Increase in temperature from 37.5º C (99.5º F) to 38.3º C (101º F) B. Increase in blood pressure from 130/80 mm Hg to 180/100 mm Hg C. Increase in urine output from 30 mL/hr to 100 mL/hr D. Increase in heart rate from 70/min to 90/min: B. Increase in blood pressure from 130/80 mm Hg to 180/100 mm Hg A change in blood pressure from 130/80 mm Hg to 180/100 mm Hg indicates a widened pulse pressure and hypertension, which are components of Cushing's triad, a sign of increased intracranial pressure. 86. A nurse is preparing to administer potassium chloride 10 mEq IV over 1 hr to a client. Available is potassium chloride 10 mEq in 100 mL of 0.9% sodium chloride. The nurse should set the infusion pump to deliver how many RN Adult Medical Surgical Online Practice 2019 B with NGN Exam Updated 2023-2024 New Latest Version with All Questions from Actual Past Exam and 100% Correct Answers 26 / 26 mL/hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.): 100 mL/hr 87. A nurse is providing teaching about dietary options for a client who has cholelithiasis. Which of the following statements should the nurse include in the teaching? A. "Cauliflower is a good dietary choice." B"Increase the amount of egg yolks in your diet." C. "Select desserts such as angel-food cake." D. "Eat choice or prime cuts of meat.": C. "Select desserts such as angel-food cake." Clients who have acute cholelithiasis will be prescribed a low-fat diet. Desserts such as sherbet, gelatin, and angel food cake are dessert choices that are low in fat. 88. A nurse is providing discharge teaching to a client who has COPD. Which of the following instructions should the nurse include in the teaching? A. "Schedule controlled coughing exercises after meals." B. "Consume a diet that is high in calories." C. "Practice breath-holding." D. "Perform arm-reaching exercises.": B. "Consume a diet that is high in calories." Dyspnea decreases energy available for eating. Therefore, the nurse should encour- age the client to eat soft, high-calorie and high-protein foods to prevent weight loss 89. A nurse is assessing a client's understanding of a surgical procedure prior to witnessing their signature on the informed consent form. The nurse deter- mines that the client does not understand what the procedure will involve. Which of the following actions should the nurse take? A. Provide teaching about the surgical procedure for the client. B. Instruct the client's spouse to sign the consent form. C. Read the consent form to the client using words the client will understand. D. Contact the provider who will be performing the procedure.: D. Contact the provider who will be performing the procedure. The nurse should advocate for the client by informing the provider if the client does not understand the procedure. It is the responsibility of the provider to discuss the procedure more fully with the client. 90. A nurse is providing teaching to a client who is scheduled for a bron- choscopy. Which of the following statements should the nurse include in the teaching? A. "You will not be able to eat or drink after the procedure until you are able to cough." B. "You will drink a contrast solution 30 minutes prior to the procedure." C. "The purpose of this procedure is to remove excess fluid from your lungs." RN Adult Medical Surgical Online Practice 2019 B with NGN Exam Updated 2023-2024 New Latest Version with All Questions from Actual Past Exam and 100% Correct Answers 27 / 26 D. "You will need to lie on your back for 4 to 6 hours following the procedure."- : A. "You will not be able to eat or drink after the procedure until you are able to cough." A client who had a bronchoscopy received a local anesthetic that can suppress the cough reflex. The cough reflex protects the client from aspirating fluids or food. Therefore, the client should not eat or drink until the cough reflex returns.