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1. Which method elicits the most accurate in- A. use reliable assessment tools for older
formation during a physical assessment of adults
an older adult?
A. use reliable assessment tools for older Specific assessment tools (D) for an old-
adults er adult, such as Older Adult Resource
B. Review the past medical record for med- Services Center Instrument, mini-mental
ications assessment, fall risk, depression, or skin
C. Ask the client to recount one's health breakdown risk, consider age-related phys-
history iologic and psychosocial changes related to
D. Obtain the client's information from a aging and provide the most accurate and
caregiver complete information. A and B are subjec-
tive and may vary in reliability based on
the client's memory and caregiver's current
involvement. Although C is a good resource
to identify polypharmacy, a written record
may not be available or currently accurate.
2. A client who has just tested positive for HIV B. discuss retesting to verify results, which
does not appear to hear what the nurse is will ensure continuing contact
saying during post-test counseling. Which
information should the nurse offer to facil- encouraging retesting supports hope and
itate the client's adjustment to HIV infec- gives the client time to cope with the
tion? diagnosis. Although post-test counseling
A. teach the client about the medications should include education about A, B, and C,
that are available for treatment retesting encourages the client to maintain
B. discuss retesting to verify the results, medical follow-up and management.
which will ensure continuing contact
C. identify the need to test others who have
had risky contact with the client
D. inform the client how to protect sexual
and needle-sharing partners
4/7/2026, 3:37:58 PM
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3. The nurse is caring for a client with HIV D. return to pre-illness weight
infection who develops Mycobacterium avi-
um complex (MAC). what is the most signif- MAC is an opportunistic infection that pre-
icant desired outcome for this client? sents as a TB like pulmonary process. MAC
A. free from injury of drug side effects is a major contributing factor to the devel-
B. maintenance of intact perineal skin opment of wasting syndrome, so the most
c. adequate oxygenation significant desired outcome is the client's
D. return to pre-illness weight return to a pre-illness weight. drug sched-
ules and side effects remain a life-long
management problem. Client outcomes for
adequate oxygenation are often dependent
on management of anemia, maintenance
of activities without fatigue, and supple-
mental oxygen to prevent hypoxia. Skin in-
tegrity is dependent upon resolution of di-
arrhea, which is not as significant as opti-
mal nutrition.
4. A client who had abdominal surgery two a. assist the client to ambulate in the hall
days ago has prescriptions for intravenous
morphine sulfate 4 mg every 2 hours and a Post-operative abdominal distention is
clear liquid diet. the client complains of feel- caused by decreased peristalsis as a result
ing distended and has sharp, cramping gas of handling the intestine during surgery,
pains. What nursing intervention should be limited dietary intake before and after
implemented? surgery, and anesthetic and analgesic
A. assist the client to ambulate in the hall agents. Peristalsis is stimulated and disten-
B. obtain a prescription for a laxative tion minimized by implementing early and
C. administer the prescribed morphine sul- frequent ambulation. Based on the client's
fate status, laxatives or withholding dietary pro-
D. withhold all oral fluid and food gression are not indicated at this time. al-
though pain management should be im-
plemented, another analgesic prescription
4/7/2026, 3:37:58 PM
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may be needed because morphine reduces
intestinal motility and contributes to the
client's gas pains.
5. A client with Meniere's disease is incapaci- B. turn off the television and darken the
tated by vertigo and is lying in bed grasp- room
ing the side rails and staring at the televi-
sion. Which nursing intervention should the to decrease the client's vertigo during an
nurse implement? acute attack of Meniere's disease, any vi-
A. keep the head of the bed elevated 30 sual stimuli or rotational movement, such
degrees as sudden head movements or position
B. turn off the television and darken the changes, should be minimized. Turning off
room the television and darkening the room min-
c. encourage fluids to 3000 mL per day imize fluorescent lights, flickering television
D. change the client's position every two lights, and distracting sound. The other are
hours ineffective in managing the client's symp-
toms.
6. a client who has a chronic cough with B. allow the client nothing by mouth until
blood-tinged sputum returns to the unit af- the gag reflex returns
ter a bronchoscopy. What nursing interven-
tions should be implemented in the imme- the nasal pharynx and oral pharynx are
diate post-procedural period? anesthetized with local anesthetic spray pri-
A. check vital signs every 15 minutes for 2 or to bronchoscopy, and the bronchoscope
hours is coated with lidocaine gel to inhibit the
B. allow the client nothing by mouth until gag reflex and prevent laryngeal spasm
the gag reflex returns during insertion. The client should be NPO
C. encourage fluid intake to promote elimi- until the client's gag reflex returns to pre-
nation of the contrast media vent aspiration from any oral intake or se-
D. keep the client on bed rest for 8 hours cretions. The others are not indicated after
bronchoscopy
7.
4/7/2026, 3:37:58 PM
4/7/2026 2026/04/07
of 29 Medical-Surgical
Nursing:Revew
Medical-Surgical Revew
Study online at https://quizlet.com/_6u61u0
1. Which method elicits the most accurate in- A. use reliable assessment tools for older
formation during a physical assessment of adults
an older adult?
A. use reliable assessment tools for older Specific assessment tools (D) for an old-
adults er adult, such as Older Adult Resource
B. Review the past medical record for med- Services Center Instrument, mini-mental
ications assessment, fall risk, depression, or skin
C. Ask the client to recount one's health breakdown risk, consider age-related phys-
history iologic and psychosocial changes related to
D. Obtain the client's information from a aging and provide the most accurate and
caregiver complete information. A and B are subjec-
tive and may vary in reliability based on
the client's memory and caregiver's current
involvement. Although C is a good resource
to identify polypharmacy, a written record
may not be available or currently accurate.
2. A client who has just tested positive for HIV B. discuss retesting to verify results, which
does not appear to hear what the nurse is will ensure continuing contact
saying during post-test counseling. Which
information should the nurse offer to facil- encouraging retesting supports hope and
itate the client's adjustment to HIV infec- gives the client time to cope with the
tion? diagnosis. Although post-test counseling
A. teach the client about the medications should include education about A, B, and C,
that are available for treatment retesting encourages the client to maintain
B. discuss retesting to verify the results, medical follow-up and management.
which will ensure continuing contact
C. identify the need to test others who have
had risky contact with the client
D. inform the client how to protect sexual
and needle-sharing partners
4/7/2026, 3:37:58 PM
4/7/2026 2026/04/07
, Page 2 Nursing:
of 29 Medical-Surgical
Nursing:Revew
Medical-Surgical Revew
Study online at https://quizlet.com/_6u61u0
3. The nurse is caring for a client with HIV D. return to pre-illness weight
infection who develops Mycobacterium avi-
um complex (MAC). what is the most signif- MAC is an opportunistic infection that pre-
icant desired outcome for this client? sents as a TB like pulmonary process. MAC
A. free from injury of drug side effects is a major contributing factor to the devel-
B. maintenance of intact perineal skin opment of wasting syndrome, so the most
c. adequate oxygenation significant desired outcome is the client's
D. return to pre-illness weight return to a pre-illness weight. drug sched-
ules and side effects remain a life-long
management problem. Client outcomes for
adequate oxygenation are often dependent
on management of anemia, maintenance
of activities without fatigue, and supple-
mental oxygen to prevent hypoxia. Skin in-
tegrity is dependent upon resolution of di-
arrhea, which is not as significant as opti-
mal nutrition.
4. A client who had abdominal surgery two a. assist the client to ambulate in the hall
days ago has prescriptions for intravenous
morphine sulfate 4 mg every 2 hours and a Post-operative abdominal distention is
clear liquid diet. the client complains of feel- caused by decreased peristalsis as a result
ing distended and has sharp, cramping gas of handling the intestine during surgery,
pains. What nursing intervention should be limited dietary intake before and after
implemented? surgery, and anesthetic and analgesic
A. assist the client to ambulate in the hall agents. Peristalsis is stimulated and disten-
B. obtain a prescription for a laxative tion minimized by implementing early and
C. administer the prescribed morphine sul- frequent ambulation. Based on the client's
fate status, laxatives or withholding dietary pro-
D. withhold all oral fluid and food gression are not indicated at this time. al-
though pain management should be im-
plemented, another analgesic prescription
4/7/2026, 3:37:58 PM
4/7/2026 2026/04/07
, Page 3 Nursing:
of 29 Medical-Surgical
Nursing:Revew
Medical-Surgical Revew
Study online at https://quizlet.com/_6u61u0
may be needed because morphine reduces
intestinal motility and contributes to the
client's gas pains.
5. A client with Meniere's disease is incapaci- B. turn off the television and darken the
tated by vertigo and is lying in bed grasp- room
ing the side rails and staring at the televi-
sion. Which nursing intervention should the to decrease the client's vertigo during an
nurse implement? acute attack of Meniere's disease, any vi-
A. keep the head of the bed elevated 30 sual stimuli or rotational movement, such
degrees as sudden head movements or position
B. turn off the television and darken the changes, should be minimized. Turning off
room the television and darkening the room min-
c. encourage fluids to 3000 mL per day imize fluorescent lights, flickering television
D. change the client's position every two lights, and distracting sound. The other are
hours ineffective in managing the client's symp-
toms.
6. a client who has a chronic cough with B. allow the client nothing by mouth until
blood-tinged sputum returns to the unit af- the gag reflex returns
ter a bronchoscopy. What nursing interven-
tions should be implemented in the imme- the nasal pharynx and oral pharynx are
diate post-procedural period? anesthetized with local anesthetic spray pri-
A. check vital signs every 15 minutes for 2 or to bronchoscopy, and the bronchoscope
hours is coated with lidocaine gel to inhibit the
B. allow the client nothing by mouth until gag reflex and prevent laryngeal spasm
the gag reflex returns during insertion. The client should be NPO
C. encourage fluid intake to promote elimi- until the client's gag reflex returns to pre-
nation of the contrast media vent aspiration from any oral intake or se-
D. keep the client on bed rest for 8 hours cretions. The others are not indicated after
bronchoscopy
7.
4/7/2026, 3:37:58 PM
4/7/2026 2026/04/07
