Medical surgical practice exam latest Updates

Medical surgical practice exam An adult client who is hospitalized after surgery reports sudden onset of chest pain and dyspnea. the client appears anxious, restless, and mildly cyanotic. the nurse should further assess the client for which condition? - Pulmonary embolism which information should the nurse obtain when performing an initial assessment of a client who presents to the emergency department with a painful ankle injury? (select all that apply) - Quality of the pain Signs of inflammation Ankle range of motion Visible deformities of the joint Which description of pain is consistent with a diagnosis of rheumatoid arthritis? - Joint pain is worse in the morning and involves symmetric joints Which physical assessment finding should the nurse anticipate in a client with long-term gastroesophagealreflux disease (GERD)? - Hoarseness A client presents with chronic venous insufficiency. Which assessment finding should the nurse anticipate? - Bilateral lower leg stasis dermatitis A client has been hospitalized with a femur fracture and is being treated with traction. which action by the nurse is the priority when caring for this client? - Assess neurovascular status Which statement made by a client with chronic pancreatitis indicates that further education is needed? - I will cut back on smoking cigarettes daily The nurse is teaching a female client who uses a contraceptive diaphragm about reducing the risk for toxic shock syndrome (TSS). Which information should the nurse include? (Select all that apply) - Do not leave the diaphragm in place longer than 8 hours after intercourse Replace the old diaphragm every 3 months A male client who smokes two packs of cigarettes a day states he understands that smoking cigarettes is contributing to the difficulty that he and his wife are having in getting pregnant and wants to know if other factors could be contributing to their difficulty. Which information is best for the nurse to provide? (Select all that apply). - Alcohol consumption can cause erectile dysfunction Low testosterone levels affect sperm production Cessation of smoking improves general health and fertility Twenty four hours after a client returns from surgical gastric bypass, the registered nurse (RN) observes large amounts of blood in the nasogastric tube (NGT) cannister. Which assessment finding should the RN report as early signs of hypovolemic shock? - lethargy the registered nurse (RN) is assessing a male client who arrives at the clinic with severe abdominal cramping, pain, tenesmus, and dehydration. the RN discovers that the client has had 14 to 20 loose stools with rectal bleeding. When taking the client's medical history, which information is most for the nurse to obtain? - Ulcerative colitis A client is newly diagnosed with diverticulosis. The registered nurse (RN) is assessing the client's basic knowledge about the disease process. Which statement by the client conveys an understanding of the etiology of diverticula? - Chronic constipation causes weakening of colon wall which results in out pouching sacs The registered nurse (RN) is assessing a client who was discharged home after management of chronic hypertension. Which equipment should the RN instruct the client to use at home? - Sphygmomanometer A young adult mail is diagnosed with stage 4 Hodgkin's lymphoma in the abdominopelvic region and is scheduled for radiation therapy (RT). The client expresses concern about becoming infertile. How should the nurse respond? - Propose sperm banking before RT then artificial insemination is an option A client's susceptibility to ulcerative colitis is most likely due to which aspect in the client's history? - Jewish European ancestry Small bowl obstruction is a condition characterized by which finding? - Severe fluid and electrolyte imbalances Which client should the nurse recognize as most likely to experience sleep apnea? - Obese older male client with a short, thick neck Which milestone indicates to the nurse successful achievement of young adulthood? - Completes education and becomes self-supporting A client who has heart failure is admitted with a serum potassium level of 2.9 mEq/L (2.9 mmol/L). Which action is most important for the nurse to implement? - Initiate continuous cardiac monitoring Which postmenopausal client's complaint should the nurse refer to the HCP? - episodes of vaginal bleeding The nurse is teaching a female client about the best time to plan sexual intercourse in order to conceive. Which information should the nurse provide? - Two weeks before menstruation A postmenopausal client asks the nurse why she is experiencing discomfort during intercourse. Which response is best for the nurse to provide? - Estrogen deficiency causes the vaginal tissue to become dry and thinner Which discharge instruction is most important for a client after a kidney transplant? - Use daily reminders to take immunosuppressants The nurse is assessing a client with chronic kidney disease (CKD). Which finding is most important for the nurse to respond to first? - Potassium 6.0 mEq Which finding should the nurse identify as most significant for a client diagnosed with polycystic kidney disease (PKD)? - 3+ bacteria in urine The nurse is planning care for a client with newly diagnosed diabetes mellitus that requires insulin. Which assessment should the nurse identify before beginning the teaching session? - Willingness of the client to learn the injections sites When providing discharge teaching for a client with osteoporosis, the nurse should reinforce which home care activity? - Elimination of hazards to home safety A client with gastroesophageal reflux disease (GERD) has been experiencing severe reflux during sleep. Which recommendation by the nurse is most effective to assist the client? - Raising the head of the bed on blocks An older adult female client is brought to the clinic by her daughter for a flu shot. She has lost significant weight since the last visit. She has poor personal hygiene and inadequate clothing for the weather. the client states that she lives alone and denies problems or concerns. Which action should the nurse implement? - Collect further data to determine whether self-neglect is occuring The nurse is assisting a client out of bed for the first time after surgery. Which action should the nurse do first? - Allow the client to sit with the bed in a high Fowler's position After checking the urinary drainage system for kinks in the tubing, the nurse determines that a client who has returned from the post-anesthesia care has a dark, concentrated urinary output of 54 ml for the last 2 hours. What priority nursing action should be implemented? - Report the findings to the surgeon A client who is fully awake after a gastroscopy asks the nurse for something to drink. After confirming that liquids are allowed, which assessment action should the nurse consider a priority? - Check the client's gag and swallow reflexes During an interview with a client planning elective surgery, the client asks the nurse, "What is the advantage of having a preferred provider organization insurance plan?" Which response is best for the nurse to provide? - An individual may select healthcare providers from outside of the PPO network The nurse is providing dietary instructions to a 69 year old client who is at high risk for development of coronary heart disease (CHD). Which information should the nurse include? - Increase intake of soluble fiber to 10 to 25 grams per day A male client receives a local anesthetic during surgery. During the post-operative assessment, the nurse notices the client is slurring his speech. Which action should the nurse take? - Evaluate his blood pressure, pulse, and respiratory status A client who is sexually active with several partners requests an intrauterine device (IUD) as a contraceptive method. Which information should the nurse provide? - Using an IUD offers no protection against sexually transmitted disease (STD), which increase the risk for pelvic inflammatory disease (PID). A female client requests information about using the calendar method of contraception. Which assessment is most important for the nurse to obtain? - An accurate menstrual cycle diary for the past 6 to 12 months A 32 year old female client complains of severe abdominal pain each month before her menstrual period, painful intercourse, and painful defecation. Which additional history should the nurse obtain that is consistent with the client's complaints? - Inability to get pregnant A 20 year old female client calls the nurse to report a lump she found in her breast. Which response is the best for the nurse to provide? - Most lumps are benign, but it is always best to come in form an examination. The nurse is working with a 71-year-old obese client with bilateral osteoarthritis (OA) of the hips. What recommendation should the nurse make that is most beneficial in protecting the client's joints? - Initiate a weight-reduction diet to achieve a health body weight A 58 year old client who has been post menopausal for five years is concerned about the risk of osteoporosis because her mother has the condition. Which information should the nurse offer? - Calcium loss from bones can be slowed by increasing calcium intake and exercise During assessment of a client with amyotrophic lateral sclerosis (ALS),