RN ADULT MEDICAL SURGICAL ONLINE PRACTICE 2023 A NGN QUESTIONS AND ANSWERS

NGN 1000: Client is alert and oriented and reports not feeling well for a few days. Client is on continuous ambulatory peritoneal dialysis (CAPD) and reports dialysate appeared cloudy this morning. Reports abdominal pain as 4 on a scale of 0 to 10. Bowel sounds active in all quadrants. Peritoneal dialysis access site red, warm to touch, with a small amount of purulent drainage noted on dressing.1300: Client is lying in bed with the knees flexed, guarding the abdomen. Abdomen is slightly distended, hypoactive bowel sounds. Client reports nausea. Reports pain as 6 on a scale of 0 to 10. Provider notified and updated with client condition and diagnostic results. The client is experiencing manifestations of peritonitis due to x-ray results . NGN Client admitted to medical-surgical unit from PACU. Client reports incisional pain as 2 on a scale of 0 to 10. Client appears restless and frequently asks for water. Bilateral lower extremities cool with +1 pedal pulses. Urine output is 40 mL for the past 2 hr. Moderate amount of bright red drainage noted on surgical incision dressing. Insert a large-gauge IV. Initiate a fluid challenge. Hypovolemia Urine output Blood pressure A nurse is caring for a client who has a potassium level of 3 mEq/L. Which of the following assessment findings should the nurse expect? Hypoactive Bowel Sounds NGN 0900: Client presents with abdominal pain in the upper left quadrant for the past 2 days. States pain became worse this morning and is radiating to the back. Rates pain as 8 on a scale of 0 to 10. Hypoactive bowel sounds; reports nausea, no vomiting; client is passing flatus. Febrile, oriented to person, place, and time. Tachypnea with diminished breath sounds. Sinus tachycardia. Client voids 300 mL of clear, amber urine. 0930: Client vomited 100 mL brown liquid. The client is experiencing manifestations of pancreatitis as evidenced by the amylase and lipase . 0530: Client is awake and alert. Arteriovenous fistula (AVF) to right forearm with thrill palpated and auscultated for bruit. Lung sounds clear upon auscultation; client denies shortness of breath. No peripheral edema noted; capillary refill is less than 3 seconds; +2 bilateral pedal and radial pulses. AVF access prepared and cannulated twice with no difficulty. Lines are taped and secured; treatment is initiated.0600: Client is reading a book. Access is visible, and lines are secure. Client reports no discomfort or pain.0630: Client reports feeling warm, nauseated, and lightheaded; appears restless and slightly confused. Perform a 12-lead ECG is not indicated. Place the client in Trendelenburg position is indicated. Administer a 0.9% sodium chloride 200 mL IV bolus is indicated. Apply oxygen at 2 L/min via nasal cannula is indicated Notify the provider immediately is indicated Obtain the client's blood glucose level is not indicated. 1800: Emergency medical team removed client's shirt at the scene and initiated 18-gauge IV therapy in the right antecubital space. Client has full-thickness burns over the upper half of the chest and both forearms; partial-thickness burns are present on the client's face and neck. Sinus tachycardia, pulses to brachial extremities palpable. 1+ edema to upper extremities. Respirations even, labored with scattered rhonchi. Soot noted to the client's mouth and nose. Oxygen 40% via face tent applied. Hypoactive bowel sounds. 16 French indwelling urinary catheter inserted with return of 250 mL of yellow urine. Lactated Ringer's infusing to right antecubital. Provider preparing to insert right femoral central line catheter. 1830: Client's voice is becoming hoarse and reports difficulty swallowing. Wheezes present to upper lobes bilaterally. Provider notified. Client positioned upright, oxygen via face tent. Blood collected During the emergent phase of burn care, the client is at risk for developing hypovolemia and respiratory failure . A nurse is teaching a class about client rights. Which of the following instructions should the nurse include? A client should sign an informed consent before receiving a placebo during a research trial. A nurse in an emergency department is caring for a client who reports vomiting and diarrhea for the past 3 days. Which of the following findings should indicate to the nurse that the client is experiencing fluid volume deficit? Heart rate 110/min A nurse is creating a plan of care for a client who has neutropenia as a result of chemotherapy. Which of the following interventions should the nurse include in the plan? Monitor the client's temperature every 4 hr. A nurse in an emergency department is caring for a client who has full-thickness burns over 20% of their total body surface area. After ensuring a patent airway and administering oxygen, which of the following items should the nurse prepare to administer first? IV fluids A nurse is caring for a client who is 4 hr postoperative following an open reduction internal fixation of the right ankle. Which of the following assessment findings should the nurse report to the provider? Extremity cool upon palpation A nurse is caring for a client who is 12 hr postoperative following a total hip arthroplasty. Which of the following actions should the nurse take? Place a pillow between the client's legs. A nurse is assessing a client who has Graves' disease. Which of the following images should indicate to the nurse that the client has exophthalmos? D- the lady looking eyes A nurse is providing teaching for a female client who has recurrent urinary tract infections. Which of the following information should the nurse include in the teaching? Void before and after intercourse. A nurse is providing postoperative teaching for a client who had a total knee arthroplasty. Which of the following instructions should the nurse include? Flex the foot every hour when awake A nurse is assessing a client who has had a suspected stroke. The nurse should place the priority on which of the following findings? Dysphagia