ATI MED SURGE PROCTORED EXAM

ATI MED SURGE PROCTORED EXAM1. A nurse is caring for a client following a bone marrow biopsy. What information should the nurse include in the discharge education? -Keep dressing clean and dry to prevent infection -Watch for bleeding and if notice excessive bleeding report to provider -Remind pt avoid aspirin or medications that would prevent clotting 2. A nurse is providing client education regarding modes of hepatitis transmission. What are the routes of transmission and risk factors for Hepatitis A, B, C, D and E? -Hep A transmission by fecal-oral. Risk=consumption of contaminated food/water (esp. shellfish) and close contact with an infected person -Hep B transmission by blood. Risk=unprotected sex, babies born from infected mothers, contact with infected blood, substance abuse (injected) -Hep C transmission by blood. Risk=substance abuse (injected), blood/blood products, transplants, needle sticks. -Hep D transmission by coinfection with HBV. Risk=substance abuse (injected), unprotected sex -Hep E transmission by fecal-oral. Risk=Consumption of contaminated food/water that has fecal waste in it. 3. What are three (3) risk factors for testicular cancer? List three (3) subjective and objective findings in the client with testicular cancer? -Risk Factors-Male gender age 20-35 years old, HIV, undescended testis. -Subjective findings-swelling/lump in testis, indication of metastases such as gynecomastia and back pain. -Objective findings-swollen lymph nodes in groin area, palpable lump by LIP, enlarged testis without presence of pain. 4. What dietary education should the nurse provide to a client diagnosed with a hiatal hernia? -Avoid fatty, fried foods, coffee and caffeinated beverages, spicy foods, citrus fruits, acidic vegetables such as tomatoes, and ETOH. 5. A nurse is caring for a client with chronic gastritis. Provide three (3) dietary recommendations the nurse should include in client education? -Eat small frequent meals, eat slowly, avoid food and beverages that cause gastric irritation, decrease consumption or eliminate caffeine and ETOH. 6. A nurse is caring for a client who has been admitted with renal calculi. List three (3) interventions the nurse will take in the management of renal calculi. -Strain urine to monitor for passing of calculi -Monitor intake/output of urine -Administer pain meds/NSAIDS/antibiotics/spasmolytics as ordered 7. A nurse has provided education to a client regarding the correct way to take prescribed nitroglycerin for the treatment of angina. Which of the following client statements indicates a need for further education -"If I still have pain after 5 minutes I will take two more tablets." 8. A nurse is caring for a client with Rheumatoid arthritis who is prescribed a nonsteroidal anti-inflammatory drug (NSAID) for the treatment of joint pain. Provide three (3) teaching points in client education the nurse should provide regarding this medication therapy. -Take with food or a full glass of water/milk -Teach pt to monitor for GI bleeding ad report dark emesis and tarry stools -Avoid ETOH 9. A nurse is caring for a client experiencing metabolic acidosis. What are three (3) causes of metabolic acidosis? -Excess production of hydrogen ions/increased H3 concentration -Excess elimination of bicarbonate/diarrhea -Inadequate production of bicarbonate/decreased Hco3 10. A nurse is caring for a client with pneumonia. What are three (3) physical assessment findings that are noted with the development of pneumonia? -SOB -Fever -Chills 11. A client diagnosed with asthma recently had pulmonary function testing. The client asks the nurse ‘What is peak expiratory flow?’ What information should the nurse provide? -The peak expiratory flow measures the ability to breath out air and the maximum amount and rate of the air that is forced out of the lungs. 12. A nurse is caring for a client scheduled for a liver biopsy. What nursing actions should be taken before, during and after this procedure? -Before-Signed informed consent, make sure pt has been NPO since midnight the day of biopsy, explain procedure. -During-Place pt supine, instruct patient to exhale and hold breath while needle is being inserted and to resume breathing when needle is withdrawn. -After-Position client on right side for at least 2 hours to reduce the risk for bleeding/hemorrhage. Monitor labs. Monitor site for bleeding. Monitor vitals, pain, assess abdomen for redness, swelling, bleeding. 13. A nurse is caring for a client with Cushing’s disease. Would the nurse expect this client’s plasma cortisol levels to be increased or decreased? -Plasma cortisol levels will be increased because the adrenal cortex is over functioning. 14. A nurse is providing pre-procedural instructions to the client having a barium swallow. What instructions should be included in this teaching? Select all that apply. 1. NPO after midnight 2. No smoking after midnight 3. Stools will be white for 24 to 72 hours post procedure 4. The feeling of abdominal fullness is normal post procedure 14. A nurse is caring for a client with multiple risk factors for peripheral vascular disease. List four (4) risk factors associated with peripheral vascular disease. -Age -Male -Type 1 diabetes -Hx of heart disease 15. A client with peripheral vascular disease had