PN Adult Medical Surgical Online Practice 2023 B Graded A

A nurse in a telemetry unit is collecting data from a client who has a newly inserted permanent pacemaker. Which of the following findings should the nurse report to the provider? The client experiences hiccups when sitting. A nurse is reinforcing preoperative teaching with a client. Which of the following statements by the client indicates an understanding of the teaching? Select all that apply. " I will need to do the breathing exercises every 1 to 2 hrs after surgery." "I will use my PCA medication before my knee starts to hurt too bad." "I will probably be going home with a walker." Click to highlight the findings the nurse should report to the charge nurse immediately. To deselect a finding, click on the finding again. • Perineal pad is saturated with blood, and large clots are present is correct. The presence of vaginal bleeding and blood clots is a manifestation of vaginal hemorrhage. Therefore, the nurse should report this finding to the charge nurse. • Blood pressure 98/56 mm Hg is correct. Decreased blood pressure is a manifestation of vaginal hemorrhage. Therefore, the nurse should report this finding to the charge nurse. • Heart rate 102/min is correct, Tachycardia is a manifestation of vaginal hemorrhage. Therefore, the nurse should report this finding to the charge nurse. A nurse is assisting with the care for a client who reports shortness of breath and has an oxygen saturation 90%. Which of the following actions should the nurse take? Administer oxygen via nasal cannula R: The nurse should administer oxygen via nasal cannula to a client who reports shortness of breath and has an oxygen saturation below the expected reference range. The nurse should continue to monitor the client and adjust the oxygen flow rate as needed. A nurse is reinforcing teaching with the caregiver of a client who is terminally ill about manifestations of impending death. Which of the following manifestations should the nurse include? Incontinence of the bowel and bladder. Rationale:The nurse should inform the caregiver that incontinence of the bowel and bladder is a manifestation of impending death. Other manifestations include hypotension, bradycardia, restlessness, and coolness of the skin. A nurse in a clinic is collecting data from a client who has hyperthyroidism and has been taking methimazole for 4 weeks. Which of the following statements by the client indicates a therapeutic response to the medication? "I have gained 3 lbs since my last appointment" R: Hyperthyroidism can cause weight loss. Therefore, the nurse should identify weight gain as an indication that the methimazole therapy has been effective A nurse is contributing to the plan of care for a client who is postoperative following a total knee arthroplasty. The client is using a continuous passive motion (CPM) machine. Which of the following interventions should the nurse recommend for the plan of care? Keep a sheepskin pad between the client's extremity and the CPM machine. R: The nurse should plan to keep a sheepskin pad between the dient's extremity and the cOM madhune to protect the client's skin. The nurse should check the client's skin condition frequendy wile the cient is using the CPM machine. A nurse is reinforcing teaching with a client about testicular self-examination. Which of the following instructions should the nurse include in the teaching? "Perform testicular self-examination after taking a warm shower." Rationale: The nurse should instruct the client to perform testicular self-examination after taking a warm shower or bath. This causes relaxation of the scrotal skin, which allows for better palpation of the testes. A nurse is reinforcing discharge teaching for the caregivers of a client who has Parkinson's disease. Which of the following information should the nurse include in the teaching? Remind the client to avoid watching their feet when walking. R: The nurse should remind the client's caregivers to frequently remind the client to maintain correct posture and prevent falls by not watching their feet when walking. A home health nurse is assisting with the care for a client who has COPD. The client reports shortness of breath while eating, despite the use of home oxygen. Which of the following recommendations should the nurse make? "Use a bronchodilator 30 minutes before your meal."