MED-SURG PART B
1. A nurse is reinforcing teaching with an older adult client who has osteoporosis. Which of the
following instructions should the nurse in the teaching?
a) "Place throw rugs on wooden floors at home." Click here for answers
https://bit.ly/30ZIPpb
b) "Supplement your diet with vitamin E."
c) "Swim laps for 20 minutes twice per week."
d) "Take calcium supplements with meals." (The nurse should instruct the client to take
calcium carbonate supplements with or following meals to increase absorption and
effectiveness.)
2. A nurse is reviewing the medication record of a client who is taking digoxin. Which of the
following medications should the nurse identify as increasing the risk for the client to
develop digoxin toxicity?
a) Potassium chloride
e) Famotidine Click here for answers https://bit.ly/30ZIPpb
b) Levothyroxine
c) Furosemide (The nurse should identify that loop diuretics, such as furosemide, increase
the urinary excretion of potassium, which can lead to hypokalemia. Hypokalemia
increases the risk for the development of digoxin toxicity.)
3. A nurse is reinforcing teaching about insulin injections with an adult client who weighs 45.4
kg (100 lb.). Which of the following statements by the client indicates an understanding of
the teaching?
f) "I should insert the needle at a 90-degree angle." Click here for answers
https://bit.ly/30ZIPpb
a) "I should give my shot in my belly tissue." (Clients who have low body weights can
have very little subcutaneous tissue. Therefore, the nurse should instruct the client to
administer the medication in the upper abdomen for proper absorption.)
b) "I will pull back on the syringe plunger to look for blood before I push the medication
in."
c) "I will use the side of my hand to pull my skin to the side prior to administering the
insulin."
4. A nurse is reinforcing discharge teaching for a client who had a mechanical mitral valve
replacement. Which of the following statements by the client indicates an understanding of
the teaching?
a) "I will notify my dentist about this procedure." (The nurse should instruct the client to
notify his dentist about the mechanical mitral valve replacement before any procedures so
antibiotic therapy can be initiated to reduce the risk of endocardial infection.)
b) "I will take an enteric-coated aspirin daily."
c) "I will use a firm-bristled toothbrush."
d) "I will weigh myself once a week."
, g) A nurse is reviewing the medical record for an older adult client who is experiencing
nausea and vomiting. Based on the client data, which of the following actions should
the nurse take? (Click on the “Exhibit” button for additional client information.
There are three tabs that contain separate categories of data.) Click here for answers
https://bit.ly/30ZIPpb
View the Exhibit
Exhibit 1 Exhibit 2 Exhibit 3
Diagnosis Results Nurses’ Notes Graphic Record
Sodium 142 mEq/ 1200: Alert and oriented x3 Temperature
Potassium 4.2 mEq/L Lungs clear to auscultation 0800: 37.7° C (99.9° F)
BUN 36 mg/dL Decreased skin turgor 1200: 37.2° C (99.0° F)
Creatinine 1.4 mg/dL Dry mucous membranes Pulse
0800: 96/min
1200:105/min
Respiratory rate
0800: 18/min
1200: 20/min
Blood pressure
0800; 118/62 mmHg
1200: 104/65 mm Hg
a) Encourage the client to ambulate.
b) Administer an antipyretic medication.
c) Notify the charge nurse of the client's BUN level (The client's BUN level is above the
expected reference range of 10 to 20 mg/dL, which indicates dehydration and impaired
renal function. The nurse should notify the charge nurse of this finding and anticipate
interventions to restore the client's fluid volume.)
d) Keep the temperature in the client's room warm.
5. A nurse is providing information regarding transmission-based precautions for a client who
has Clostridium difficile to an assistive personnel (AP). Which of the following instructions
should the nurse include? (Select all that apply).
h) "Provide the client with disposable utensils and dishes for meals." (Clients who have C.
difficile require contact precautions, which include using disposable utensils and dishes
during meals to prevent exposure to contaminants by others.) Click here for answers
https://bit.ly/30ZIPpb
a) "Leave blood pressure equipment in the client's room." (When using contact precautions,
the health care staff should dedicate equipment to single-client use to prevent
transmission of the pathogen.)
b) "Clean contaminated surfaces with a bleach solution." (The health care staff should use a
bleach solution to clean equipment to prevent transmission of the pathogen.)
c) "Use an alcohol-based hand sanitizer after client care."
d) "Wear a face mask when in the client's room."
, 6. A nurse is admitting a client who is suspected having active tuberculosis (TB). Which of the
following actions should the nurse take first? (chap. 20)
a) Administer antituberculosis medication.
b) Institute airborne precautions. (The greatest risk from this client is transmitting TB to
staff and other clients. Therefore, the first action the nurse should take is to implement
airborne precautions.)
c) Obtain sputum cultures.
d) Auscultate breath sounds.
7. A nurse is caring for a client who is postoperative and has a Jackson-Pratt drain. Which of
the following actions should the nurse take?
a) Fill the bulb reservoir with 0.9% sodium chloride.
b) Allow the Jackson-Pratt drain to hang freely.
c) Cut a slit in a gauze sponge and apply it around the tubing insertion site.
d) Compress the bulb reservoir and then close the drainage valve. (The nurse should fully
compress the bulb reservoir and then replace the valve plug using aseptic technique to
establish suction after emptying or activating a Jackson-Pratt drain.)
8. A nurse is reinforcing teaching with the parent of a toddler who has type I diabetes mellitus
and whose prescription has been changed from regular insulin to lispro insulin. Which of
the following information should the nurse include in the teaching?
a) Lispro is given once a day.
b) Lispro should be given before eating. (Lispro insulin should be given around mealtime,
within 15 min before or after eating.)
c) Lispro cannot be given with other insulin.
i) Lispro does not cause hypoglycemia. Click here for answers https://bit.ly/30ZIPpb
9. A nurse is reinforcing teaching with a client who has microcytic anemia and is prescribed a
daily iron supplement. The nurse tells the client to consume foods containing vitamin C
when taking the supplement to enhance iron absorption. Which of the following client food
choices indicates an understanding of the teaching?
a) 1 cup cooked brown rice
b) 1 cup boiled broccoli (The nurse should determine that choosing boiled broccoli indicates
an understanding of the teaching because 1 cup contains 101 mg of vitamin C per
serving.)
c) 1 cup cottage cheese
d) 1 cup cooked kidney beans
10. A nurse is assisting with the development of a plan of care to manage pain for a client who
has herpes zoster with lesions on the lower extremities. Which of the following interventions
should the nurse include in the plan of care?
a) Keep bed linens off of the affected areas. (The nurse should keep bed linens off of the
affected areas using a bed cradle, which will relieve pain caused by the linens rubbing
against the lesions.)
b) Position a heat lamp over the lower extremities.
c) Apply warm, moist compresses to the affected areas.
d) Initiate droplet isolation precautions.
1. A nurse is reinforcing teaching with an older adult client who has osteoporosis. Which of the
following instructions should the nurse in the teaching?
a) "Place throw rugs on wooden floors at home." Click here for answers
https://bit.ly/30ZIPpb
b) "Supplement your diet with vitamin E."
c) "Swim laps for 20 minutes twice per week."
d) "Take calcium supplements with meals." (The nurse should instruct the client to take
calcium carbonate supplements with or following meals to increase absorption and
effectiveness.)
2. A nurse is reviewing the medication record of a client who is taking digoxin. Which of the
following medications should the nurse identify as increasing the risk for the client to
develop digoxin toxicity?
a) Potassium chloride
e) Famotidine Click here for answers https://bit.ly/30ZIPpb
b) Levothyroxine
c) Furosemide (The nurse should identify that loop diuretics, such as furosemide, increase
the urinary excretion of potassium, which can lead to hypokalemia. Hypokalemia
increases the risk for the development of digoxin toxicity.)
3. A nurse is reinforcing teaching about insulin injections with an adult client who weighs 45.4
kg (100 lb.). Which of the following statements by the client indicates an understanding of
the teaching?
f) "I should insert the needle at a 90-degree angle." Click here for answers
https://bit.ly/30ZIPpb
a) "I should give my shot in my belly tissue." (Clients who have low body weights can
have very little subcutaneous tissue. Therefore, the nurse should instruct the client to
administer the medication in the upper abdomen for proper absorption.)
b) "I will pull back on the syringe plunger to look for blood before I push the medication
in."
c) "I will use the side of my hand to pull my skin to the side prior to administering the
insulin."
4. A nurse is reinforcing discharge teaching for a client who had a mechanical mitral valve
replacement. Which of the following statements by the client indicates an understanding of
the teaching?
a) "I will notify my dentist about this procedure." (The nurse should instruct the client to
notify his dentist about the mechanical mitral valve replacement before any procedures so
antibiotic therapy can be initiated to reduce the risk of endocardial infection.)
b) "I will take an enteric-coated aspirin daily."
c) "I will use a firm-bristled toothbrush."
d) "I will weigh myself once a week."
, g) A nurse is reviewing the medical record for an older adult client who is experiencing
nausea and vomiting. Based on the client data, which of the following actions should
the nurse take? (Click on the “Exhibit” button for additional client information.
There are three tabs that contain separate categories of data.) Click here for answers
https://bit.ly/30ZIPpb
View the Exhibit
Exhibit 1 Exhibit 2 Exhibit 3
Diagnosis Results Nurses’ Notes Graphic Record
Sodium 142 mEq/ 1200: Alert and oriented x3 Temperature
Potassium 4.2 mEq/L Lungs clear to auscultation 0800: 37.7° C (99.9° F)
BUN 36 mg/dL Decreased skin turgor 1200: 37.2° C (99.0° F)
Creatinine 1.4 mg/dL Dry mucous membranes Pulse
0800: 96/min
1200:105/min
Respiratory rate
0800: 18/min
1200: 20/min
Blood pressure
0800; 118/62 mmHg
1200: 104/65 mm Hg
a) Encourage the client to ambulate.
b) Administer an antipyretic medication.
c) Notify the charge nurse of the client's BUN level (The client's BUN level is above the
expected reference range of 10 to 20 mg/dL, which indicates dehydration and impaired
renal function. The nurse should notify the charge nurse of this finding and anticipate
interventions to restore the client's fluid volume.)
d) Keep the temperature in the client's room warm.
5. A nurse is providing information regarding transmission-based precautions for a client who
has Clostridium difficile to an assistive personnel (AP). Which of the following instructions
should the nurse include? (Select all that apply).
h) "Provide the client with disposable utensils and dishes for meals." (Clients who have C.
difficile require contact precautions, which include using disposable utensils and dishes
during meals to prevent exposure to contaminants by others.) Click here for answers
https://bit.ly/30ZIPpb
a) "Leave blood pressure equipment in the client's room." (When using contact precautions,
the health care staff should dedicate equipment to single-client use to prevent
transmission of the pathogen.)
b) "Clean contaminated surfaces with a bleach solution." (The health care staff should use a
bleach solution to clean equipment to prevent transmission of the pathogen.)
c) "Use an alcohol-based hand sanitizer after client care."
d) "Wear a face mask when in the client's room."
, 6. A nurse is admitting a client who is suspected having active tuberculosis (TB). Which of the
following actions should the nurse take first? (chap. 20)
a) Administer antituberculosis medication.
b) Institute airborne precautions. (The greatest risk from this client is transmitting TB to
staff and other clients. Therefore, the first action the nurse should take is to implement
airborne precautions.)
c) Obtain sputum cultures.
d) Auscultate breath sounds.
7. A nurse is caring for a client who is postoperative and has a Jackson-Pratt drain. Which of
the following actions should the nurse take?
a) Fill the bulb reservoir with 0.9% sodium chloride.
b) Allow the Jackson-Pratt drain to hang freely.
c) Cut a slit in a gauze sponge and apply it around the tubing insertion site.
d) Compress the bulb reservoir and then close the drainage valve. (The nurse should fully
compress the bulb reservoir and then replace the valve plug using aseptic technique to
establish suction after emptying or activating a Jackson-Pratt drain.)
8. A nurse is reinforcing teaching with the parent of a toddler who has type I diabetes mellitus
and whose prescription has been changed from regular insulin to lispro insulin. Which of
the following information should the nurse include in the teaching?
a) Lispro is given once a day.
b) Lispro should be given before eating. (Lispro insulin should be given around mealtime,
within 15 min before or after eating.)
c) Lispro cannot be given with other insulin.
i) Lispro does not cause hypoglycemia. Click here for answers https://bit.ly/30ZIPpb
9. A nurse is reinforcing teaching with a client who has microcytic anemia and is prescribed a
daily iron supplement. The nurse tells the client to consume foods containing vitamin C
when taking the supplement to enhance iron absorption. Which of the following client food
choices indicates an understanding of the teaching?
a) 1 cup cooked brown rice
b) 1 cup boiled broccoli (The nurse should determine that choosing boiled broccoli indicates
an understanding of the teaching because 1 cup contains 101 mg of vitamin C per
serving.)
c) 1 cup cottage cheese
d) 1 cup cooked kidney beans
10. A nurse is assisting with the development of a plan of care to manage pain for a client who
has herpes zoster with lesions on the lower extremities. Which of the following interventions
should the nurse include in the plan of care?
a) Keep bed linens off of the affected areas. (The nurse should keep bed linens off of the
affected areas using a bed cradle, which will relieve pain caused by the linens rubbing
against the lesions.)
b) Position a heat lamp over the lower extremities.
c) Apply warm, moist compresses to the affected areas.
d) Initiate droplet isolation precautions.
