RN Adult Medical Surgical Online Practice
2023 B
(NGN)
A nurse is caring for a client who presents to a clinic for a 1-week follow-up visit after
hospitalization for heart failure. Based on the information in the client's chart, which of
the following findings should the nurse report to the provider?
(Click on the "Exhibit" button for additional information about the client. There are three
tabs that contain separate categories of data.)
Heart rate 55/min
Rational:
The client's heart rate of 55/min is a decrease from the client's baseline of 74/min, and it
can indicate the development of digoxin toxicity. The nurse should report this finding to
the provider.
A nurse is teaching a client about the use of transcutaneous electrical nerve stimulation
(TENS) for the management of bone cancer pain. The nurse should explain that
applying a TENS unit to the painful area has which of the following effects?
A tingling sensation replacing the pain
Rational:
A TENS unit applies small electric currents to the painful area, with the client increasing
the current until the "pins and needles" sensation overrides the pain.
,A nurse in an ICU is assessing a client who has a traumatic brain injury. Which of the
following findings should the nurse identify as a component of Cushing's triad?
Bradycardia
Rational:
A client who has increased intracranial pressure from a traumatic brain injury can
develop bradycardia, which is one component of Cushing's triad. The other components
of Cushing's triad are severe hypertension and a widened pulse pressure.
A nurse is teaching a family about the care of a parent who has a new diagnosis of
Alzheimer's disease. Which of the following information should the nurse include in the
teaching?
Create complete outfits and allow the client to select one each day.
Rational:
The family should place completed outfits on hangers and allow the client to select
which one to wear each day.
A nurse is planning care for a client who has extensive burn injuries and is
immunocompromised. Which of the following precautions should the nurse include in
the plan of care to prevent a Pseudomonas aeruginosa infection?
Avoid placing plants or flowers in the client's room.
Rational:
Live plants can harbor P. aeruginosa, and this bacterium can infect burn wounds and
cause life-threatening complications. The nurse should ensure no one brings live plants
or flowers into the client's room.
,A nurse is providing teaching to a client who has irritable bowel syndrome (IBS). Which
of the following instructions should the nurse include in the teaching?
Increase fiber intake to at least 30 g per day.
Rational:
Dietary fiber helps produce bulky, soft stools and establish regular bowel patterns.
A nurse is assessing a client who has diabetes insipidus. Which of the following findings
should the nurse expect?
Low urine specific gravity
Rational:
An expected finding for a client who has diabetes insipidus is a urine specific gravity
between 1.001 and 1.005. Decreased water reabsorption by the renal tubules is caused
by an alteration in antidiuretic hormone release or the kidneys' responsiveness to the
hormone.
A nurse is caring for a client who has a new prescription for total parenteral nutrition
(TPN). The client is to receive 2,000 kcal per day. The TPN solution has 500 kcal/L. The
IV pump should be set at how many mL/hr? (Round the answer to the nearest whole
number. Use a leading zero if it applies. Do not use a trailing zero.)
167 mL/hr
Rational:
mL/hr =
4000/24 = 166.6 = 167
, (NGN)
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
Rational:
Perineal pad saturated with blood, large clots present, blood pressure trend, and heart
rate of 102/min are correct. The client has manifestations of vaginal hemorrhage,
including vaginal bleeding, blood clots, reduced blood pressure, and tachycardia. The
nurse should report these findings to the provider.
A nurse is preparing to admit a client who has dysphagia. The nurse should plan to
place which of the following items at the client's bedside?
Suction machine
Rational:
The nurse should ensure that a suction machine is at the bedside of a client who has
dysphagia to clear the client's airway as needed and reduce the risk for aspiration.
A nurse is providing discharge teaching about infection prevention to a client who is
receiving chemotherapy. Which of the following statements by the client indicates
understanding of the teaching?
"I can ask a friend to change my cats litter box."
Rational:
2023 B
(NGN)
A nurse is caring for a client who presents to a clinic for a 1-week follow-up visit after
hospitalization for heart failure. Based on the information in the client's chart, which of
the following findings should the nurse report to the provider?
(Click on the "Exhibit" button for additional information about the client. There are three
tabs that contain separate categories of data.)
Heart rate 55/min
Rational:
The client's heart rate of 55/min is a decrease from the client's baseline of 74/min, and it
can indicate the development of digoxin toxicity. The nurse should report this finding to
the provider.
A nurse is teaching a client about the use of transcutaneous electrical nerve stimulation
(TENS) for the management of bone cancer pain. The nurse should explain that
applying a TENS unit to the painful area has which of the following effects?
A tingling sensation replacing the pain
Rational:
A TENS unit applies small electric currents to the painful area, with the client increasing
the current until the "pins and needles" sensation overrides the pain.
,A nurse in an ICU is assessing a client who has a traumatic brain injury. Which of the
following findings should the nurse identify as a component of Cushing's triad?
Bradycardia
Rational:
A client who has increased intracranial pressure from a traumatic brain injury can
develop bradycardia, which is one component of Cushing's triad. The other components
of Cushing's triad are severe hypertension and a widened pulse pressure.
A nurse is teaching a family about the care of a parent who has a new diagnosis of
Alzheimer's disease. Which of the following information should the nurse include in the
teaching?
Create complete outfits and allow the client to select one each day.
Rational:
The family should place completed outfits on hangers and allow the client to select
which one to wear each day.
A nurse is planning care for a client who has extensive burn injuries and is
immunocompromised. Which of the following precautions should the nurse include in
the plan of care to prevent a Pseudomonas aeruginosa infection?
Avoid placing plants or flowers in the client's room.
Rational:
Live plants can harbor P. aeruginosa, and this bacterium can infect burn wounds and
cause life-threatening complications. The nurse should ensure no one brings live plants
or flowers into the client's room.
,A nurse is providing teaching to a client who has irritable bowel syndrome (IBS). Which
of the following instructions should the nurse include in the teaching?
Increase fiber intake to at least 30 g per day.
Rational:
Dietary fiber helps produce bulky, soft stools and establish regular bowel patterns.
A nurse is assessing a client who has diabetes insipidus. Which of the following findings
should the nurse expect?
Low urine specific gravity
Rational:
An expected finding for a client who has diabetes insipidus is a urine specific gravity
between 1.001 and 1.005. Decreased water reabsorption by the renal tubules is caused
by an alteration in antidiuretic hormone release or the kidneys' responsiveness to the
hormone.
A nurse is caring for a client who has a new prescription for total parenteral nutrition
(TPN). The client is to receive 2,000 kcal per day. The TPN solution has 500 kcal/L. The
IV pump should be set at how many mL/hr? (Round the answer to the nearest whole
number. Use a leading zero if it applies. Do not use a trailing zero.)
167 mL/hr
Rational:
mL/hr =
4000/24 = 166.6 = 167
, (NGN)
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
Rational:
Perineal pad saturated with blood, large clots present, blood pressure trend, and heart
rate of 102/min are correct. The client has manifestations of vaginal hemorrhage,
including vaginal bleeding, blood clots, reduced blood pressure, and tachycardia. The
nurse should report these findings to the provider.
A nurse is preparing to admit a client who has dysphagia. The nurse should plan to
place which of the following items at the client's bedside?
Suction machine
Rational:
The nurse should ensure that a suction machine is at the bedside of a client who has
dysphagia to clear the client's airway as needed and reduce the risk for aspiration.
A nurse is providing discharge teaching about infection prevention to a client who is
receiving chemotherapy. Which of the following statements by the client indicates
understanding of the teaching?
"I can ask a friend to change my cats litter box."
Rational:
