Medsurg Capstone Pre-assessment quiz
A nurse is reinforcing discharge teaching with a client who has undergone a transurethral
resection of the prostate (TURP). Which of the following statements should the nurse
include in the teaching? - ANS "Increase fluid intake if urine becomes blood tinged"
Rationale: The nurse should reinforce that strenous activity, straining to have a bowel
movement, and coughing may cause the urine to become blood tinged. If this should occur,
the client should be instructed to stop the activity, rest, and increase fluid intake. If urine
becomes increasingly blood tinged or does not clear, or the client has difficulty voiding, he
should be instructed to notify the provider.
A nurse is caring for a client who is suspected to have active laryngeal tuberculosis (TB).
Which of the following actions should the nurse plan to take to safely care for this client? -
ANS Place the client in a private room with a special ventilation system
Rationale: Clients suspected to have active laryngeal tuberculosis are placed in private
rooms with negative-pressure airflow via HEPA filtration systems. Negative pressure pulls
air away from the hallway and exhausts it out of the room to areas away from the intake
vents.
A nurse is reinforcing teaching with a client who has a family history of hypertension. The
nurse should inform the client that his blood pressure reading of 124/84 mm Hg places him
in which of the following categories? - ANS Prehypertension
Rationale: a blood pressure reading of 124/84 mm Hg places this client in the
prehypertension category. This includes a systolic pressure of 120-130 mm Hg and diastolic
pressure of 80-89 mm Hg
A nurse is caring for a child who is experiencing an acute asthma attack. Which of the
following medications should the nurse administer first? - ANS Albuterol
, Rationale: Albuterol is considered a rescue medication due to its rapid onset of action.
Albuterol is a beta2 adrenergic agonist used for the treatment of acute exacerbations of
asthma. Albuterol promotes broncho dilation and suppresses histamine release in the lungs
A nurse is reinforcing teaching with a client who has neutropenia. Which of the following
instructions should the nurse include in the teaching? - ANS Avoid crowded places
Rationale: The nurse should inform the client to avoid crowds due to a suppressed immune
system
A nurse is collecting data from an older adult client who had a femoral head fracture 24 hr
ago and is in Buck's traction. Which of the following findings is an indication of fat embolism
syndrome? - ANS petechiae on the chest
Rationale: a red rash on the clients abdomen, chest, neck or upper arms is a manifestation
of fat embolism
A nurse is reinforcing discharge teaching on actions that improve gas exchange to a client
diagnosed with emphysema. Which of the following instructions should be included in the
teaching? - ANS Breathe in through her nose and out through pursed lips
rationale: The nurse should reinforce that pursed-lip breathing slows expiration, prevents
collapse of alveoli, and helps the client to control the rate and depth of respirations
A nurse is caring for a client who has cirrhosis and a prescription for lactulose. Following
administration, the nurse should monitor the client for which of the following adverse
effects? - ANS Diarrhea
Rationale: The nurse should monitor for diarrhea. Lactulose is a synthetic disaccharide that
the small intestine cannot utilize. It causes diarrhea by lowering the pH, so the bacterial flora
are changed in the bowel
A nurse is reinforcing discharge teaching with a client who has undergone a transurethral
resection of the prostate (TURP). Which of the following statements should the nurse
include in the teaching? - ANS "Increase fluid intake if urine becomes blood tinged"
Rationale: The nurse should reinforce that strenous activity, straining to have a bowel
movement, and coughing may cause the urine to become blood tinged. If this should occur,
the client should be instructed to stop the activity, rest, and increase fluid intake. If urine
becomes increasingly blood tinged or does not clear, or the client has difficulty voiding, he
should be instructed to notify the provider.
A nurse is caring for a client who is suspected to have active laryngeal tuberculosis (TB).
Which of the following actions should the nurse plan to take to safely care for this client? -
ANS Place the client in a private room with a special ventilation system
Rationale: Clients suspected to have active laryngeal tuberculosis are placed in private
rooms with negative-pressure airflow via HEPA filtration systems. Negative pressure pulls
air away from the hallway and exhausts it out of the room to areas away from the intake
vents.
A nurse is reinforcing teaching with a client who has a family history of hypertension. The
nurse should inform the client that his blood pressure reading of 124/84 mm Hg places him
in which of the following categories? - ANS Prehypertension
Rationale: a blood pressure reading of 124/84 mm Hg places this client in the
prehypertension category. This includes a systolic pressure of 120-130 mm Hg and diastolic
pressure of 80-89 mm Hg
A nurse is caring for a child who is experiencing an acute asthma attack. Which of the
following medications should the nurse administer first? - ANS Albuterol
, Rationale: Albuterol is considered a rescue medication due to its rapid onset of action.
Albuterol is a beta2 adrenergic agonist used for the treatment of acute exacerbations of
asthma. Albuterol promotes broncho dilation and suppresses histamine release in the lungs
A nurse is reinforcing teaching with a client who has neutropenia. Which of the following
instructions should the nurse include in the teaching? - ANS Avoid crowded places
Rationale: The nurse should inform the client to avoid crowds due to a suppressed immune
system
A nurse is collecting data from an older adult client who had a femoral head fracture 24 hr
ago and is in Buck's traction. Which of the following findings is an indication of fat embolism
syndrome? - ANS petechiae on the chest
Rationale: a red rash on the clients abdomen, chest, neck or upper arms is a manifestation
of fat embolism
A nurse is reinforcing discharge teaching on actions that improve gas exchange to a client
diagnosed with emphysema. Which of the following instructions should be included in the
teaching? - ANS Breathe in through her nose and out through pursed lips
rationale: The nurse should reinforce that pursed-lip breathing slows expiration, prevents
collapse of alveoli, and helps the client to control the rate and depth of respirations
A nurse is caring for a client who has cirrhosis and a prescription for lactulose. Following
administration, the nurse should monitor the client for which of the following adverse
effects? - ANS Diarrhea
Rationale: The nurse should monitor for diarrhea. Lactulose is a synthetic disaccharide that
the small intestine cannot utilize. It causes diarrhea by lowering the pH, so the bacterial flora
are changed in the bowel
