PN Adult Medical Surgical Online Practice 2023 A Questions & Answers

A nurse is preparing to administer furosemide to a client who has heart failure. Which of the following findings should the nurse report before administering the medication? - ANSWERSDecreased potassium A nurse is reviewing the chart of a client who is experiencing an adrenal crisis, which was precipitated by the client not taking their medication for several days. The nurse should identify that withdrawal from which of the following medications potentiated the adrenal crisis? - ANSWERSPrednisone A nurse is assisting with the care for a client who has a prescription for digoxin 0.25 mg PO daily. While taking the client's apical pulse, the nurse notes a rate of 58/min. Which of the following actions should the nurse take? - ANSWERSWithhold the dose. A nurse is reinforcing teaching about glycosylated hemoglobin (HbA1c) testing with a client who has diabetes mellitus. Which of the following statements indicates that the client understands the teaching? - ANSWERS"I will have my HbA1c checked twice per year." A nurse is providing information regarding transmission-based precautions for a client who has Clostridium difficile to an assistive personnel (AP). Which of the following instructions should the nurse include? (Select all that apply.) - ANSWERS"Provide the client with disposable utensils and dishes for meals." "Leave blood pressure equipment in the client's room." "Clean contaminated surfaces with a bleach solution." A nurse is reinforcing teaching with a client who has coronary artery disease. Which of the following instructions should the nurse include in the teaching? - ANSWERS"Add oily fish to your diet twice weekly." A nurse in an oncology clinic is reinforcing teaching about Mohs surgery with a client who has skin cancer. Which of the following information should the nurse include in the teaching? - ANSWERSMohs surgery is a horizontal shaving of thin layers of the tumor. A nurse is collecting data from an older adult client who has several concerns. Which of the following concerns should the nurse recognize as an expected change associated with aging? - ANSWERS"My food tastes bland even after I add seasoning." A nurse is reinforcing dietary teaching with a client about increasing the intake of foods containing vitamin C to enhance absorption of oral iron supplements. Which of the following food choices should the nurse include in the teaching? - ANSWERS1 cup of boiled broccoli A nurse is assisting with the care for a client who is 2 hr postoperative following the amputation of a foot. Which of the following actions should the nurse take first? - ANSWERSCheck the incisional dressing. A nurse is assisting with the care of a client who is postoperative following abdominal surgery. Exhibit 1 Nurses' Notes 1100: Client received from PACU; initial vital signs recorded. Client is drowsy but arouses to verbal stimuli. Oriented to person, place, and time. Client is able to move all extremities. Normal sinus rhythm noted. Breath sounds are clear upon auscultation. Dressing to abdomen is intact with a small amount of serosanguinous drainage noted and marked. No bowel sounds in all four quadrants. Indwelling urinary catheter is in place and draining clear, yellow urine. Lactated Ringer's is infusing at 100 mL/hr via IV catheter in the right forearm.1200: Client reports nausea and pain as an 8 on a scale of 0 to 10. Abdominal dressing is intact with no further drainage noted. Urine output of 15 mL noted since arrival from PACU. Analgesic and antiemetic were administered as prescribed.1230: Client reports rel - ANSWERSWhich of the following actions should the nurse take? Select all that apply. Instruct the client to splint their abdomen with a pillow when coughing. Report the client's urinary output to the charge nurse. Monitor the client's pain level. A nurse is assisting with monitoring a client who is receiving dialysis treatment. Exhibit 1 Nurses' Notes 0530:Client is awake and alert. Arteriovenous fistula (AVF) to right forearm with thrill palpated and auscultated for bruit. Breath sounds are 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. Exhibit 2 Vital Signs 0530:Current weight 88 kg (194 lb)Temperature 37° C (98.6° F)Blood pressure• Lying - 152/92 mm Hg• Sitting - 148/90 mm Hg• Standing - 144/88 mm HgHeart rate 90/minRespir - ANSWERSFor each potential nursing intervention, click to specify if the intervention is indicated or not indicated. Nursing Intervention Request a chest x-ray - not indicated Place the client in reverse Trendelenburg position - indicated Assist with administering a 0.9% sodium chloride 200 mL IV bolus - indicated Apply oxygen at 2 L/min via nasal cannula - indicated Notify the charge nurse immediately - indicated Obtain the client's blood glucose level - not indicated A nurse is contributing to the plan of care for a client who has a new prescription for nystatin suspension for oral candidiasis. Which of the following interventions should the nurse include in the plan? - ANSWERSRemind the client to swish the medication in their mouth. A nurse is reinforcing teaching with the caregiver of a client who has a cervical injury and has a halo vest in place. Which of the following safety precautions should the nurse include in the teaching? - ANSWERSChange the sheepskin liner weekly. A nurse is assisting in the care of a client who is receiving a continuous tube feeding of 60 mL/hr at 1.2 cal/mL. How many calories will the client receive in 12 hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) - ANSWERS864 cal A nurse is reinforcing teaching with a client who has diabetes mellitus and a new prescription for regular and NPH insulin. Which of the following instructions on preparing the insulins should the nurse include? - ANSWERSWithdraw the regular insulin before withdrawing the NPH insulin. A nurse is preparing to assist a client out of bed 4 hr following a laparoscopic cholecystectomy. Which of the following actions should the nurse take first? - ANSWERSObtain the client's blood pressure. A nurse is assisting with the care for a client who has age-related macular degeneration. Which of the following findings should the nurse expect? - ANSWERSDistorted central vision of the eyes A nurse is reinforcing teaching with a client who is on a low-sodium diet and asks about how to improve the taste of bland food. Which of the following foods should the nurse recommend? - ANSWERSLemon juice A nurse is preparing to assist with the insertion of a double-lumen gastric sump tube for a client who has peptic ulcer disease and has developed gastrointestinal bleeding. Which of the following images depicts the tube that the nurse should select? - ANSWERSclear with blue tube A nurse is contributing to the plan of care for a client who has tuberculosis (TB). Which of the following interventions should the nurse include? - ANSWERSPlace the client in a negative-pressure airflow room. A nurse is contributing to the plan of care for a client who had a stroke. For which of the following interprofessional team members should the nurse recommend a referral prior to initiating oral intake for the client? - ANSWERSSpeech-language pathologist A nurse is reviewing the medical record of a client who is postoperative. Which of the following findings should the nurse identify as a complication of surgery? - ANSWERSWBC count of 15,000/mm3 A nurse is reinforcing teaching about pursed-lip breathing with a client who has a new diagnosis of COPD. The nurse should identify that which of the following client statements indicates an understanding of the teaching? - ANSWERS"Pursed-lip breathing works best for activities like walking up stairs." A nurse is reinforcing teaching about joint protection with a client who has an acute exacerbation of rheumatoid arthritis. Which of the following information should the nurse include in the teaching? - ANSWERSApply cold packs to the inflamed joints. A nurse is reinforcing teaching with a client who has mitral valve disease. Which of the following statements by the client indicates an understanding of the disease process? - ANSWERS"I should call my doctor if my ankles swell." A nurse is reinforcing teaching with a client who has asthma and a new prescription for a corticosteroid. Which of the following findings should the nurse include as an adverse effect of the medication? - ANSWERSOrthostatic hypotension A nurse is collecting data from a 55-year-old female client who reports vaginal dryness and hot flashes. The client is interested in trying hormone replacement therapy (HRT). Which of the following should the nurse recognize as a contraindication to HRT? - ANSWERSHistory of treatment for blood clots A nurse is contributing to the plan of care for a client who has COPD and is dyspneic. Which of the following interventions should the nurse include in the plan? - ANSWERSEncourage abdominal breathing. A nurse is assisting with the care for a client who has a history of breast cancer. The client asks the nurse about birth control. Which of the following methods of birth control is contraindicated for this client? - ANSWERSCombination oral contraceptives A home health nurse is reinforcing teaching with a client about preventing complications of peripheral vascular disease. Which of the following statements indicates that the client is adhering to the nurse's instructions? - ANSWERS"I don't cross my legs anymore." A nurse is collecting data from a client who has heart failure and is taking digoxin. Which of the following outcomes from the medication should the nurse expect? - ANSWERSDecreased shortness of breath A nurse is assisting with the care for a client who is receiving chemotherapy. The client mentions that they have a loss of appetite because of sores in their mouth and that food no longer tastes good. Which of the following suggestions to the client should the nurse make? - ANSWERSEat several small-portioned meals daily. A nurse on a medical-surgical unit is assisting with the care of a newly admitted client. Exhibit 1 Progress ReportDay 1 2330:Report received from emergency department:Client has a penetrating wound to the anterior upper right chest. Client is alert and oriented with a Glasgow Coma Scale (GCS) score of 15. Wound dressing has moderate serosanguineous drainage. Client reports pain as a 6 on a scale of 0 to 10. Shortness of breath noted.