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A nurse is assessing a client who has appendicitis. Which of the following findings should
the nurse report to the provider immediately? - CORRECT ANSWER- -Board-like abdomen
A nurse is teaching a client who has gastroesophageal reflux disease about ways to prevent
reflux. Which of the following information should the nurse include in the teaching? -
CORRECT ANSWER- -Plan to finish eating at least 3 hr before bedtime.
A nurse is teaching a client who has a deep-vein thrombosis about a new prescription for
warfarin. Which of the following client statements indicates an understanding of the
teaching? - CORRECT ANSWER- -"I should contact my provider if I notice a pink-tinged
color to my urine."
A nurse is planning care for a client who has renal calculi. Which of the following
interventions should the nurse include to promote elimination of the calculi? - CORRECT
ANSWER- -Encourage intake of at least 3 L of fluid each day.
A nurse is providing postoperative education for a client following a laparoscopic
cholecystectomy for cholelithiasis. Which of the following client statements indicates an
understanding of the teaching? - CORRECT ANSWER- -"The adhesive bandages on my
incision will fall off as the incision heals."
A nurse is planning care to prevent hospital-acquired methicillin-resistant Staphylococcus
aureus (MRSA) infection for a client who is immunocompromised. Which of the following
interventions should the nurse include to prevent this antibiotic-resistant infection? -
CORRECT ANSWER- -Bathe the client with chlorhexidine wipes.
,A nurse is assessing a client who has developed type 1 herpes simplex virus. Which of the
following images should the nurse identify as this type of viral infection? - CORRECT
ANSWER- -Picture of lips.
A nurse is assessing a client who has Graves' disease. Which of the following findings
should the nurse expect? - CORRECT ANSWER- -Exophthalmos
A nurse is teaching an older adult client who has peripheral neuropathy about a new
prescription for duloxetine. Which of the following client statements indicates an
understanding of the teaching? - CORRECT ANSWER- -It might take several weeks to notice
an improvement in my symptoms."
A nurse is teaching a client who has scabies about a new prescription for lindane lotion.
Which of the following client statements indicates an understanding of the treatment for
this parasitic infection? - CORRECT ANSWER- -"I will wash the lotion off 12 hours after I
apply it."
A nurse is reviewing the urinalysis results of a client who has completed a 14-day course of
ciprofloxacin to treat pyelonephritis. Which of the following values should indicate to the
nurse that the client has a continuing infection? - CORRECT ANSWER- -Positive leukocyte
esterase
A nurse is assessing a client for manifestations of grief after having a colostomy for removal
of colon cancer. Which of the following findings indicates to the nurse that the client has
accepted the loss? - CORRECT ANSWER- -Touches the colostomy stoma when the bag is
changed
A nurse is assessing a school-age child who has appendicitis with possible perforation.
Which of the following findings should the nurse identify as a manifestation of peritonitis? -
CORRECT ANSWER- -Abdominal distention
, A nurse is reviewing the medical record of a client who has a peptic ulcer. Which of the
following findings is a priority to report to the provider? - CORRECT ANSWER- -Hemoglobin
7.6 mg/dL
A nurse in an emergency department is assessing a client who has hyperthermia. Which of
the following findings should the nurse identify as an indication that the client has heat
exhaustion? - CORRECT ANSWER- -Vomiting
A nurse is providing teaching to a client who is experiencing malabsorption related to
lactose intolerance. Which of the following foods should the nurse recommend to the
client as the best nondairy source of calcium? - CORRECT ANSWER- -Collard greens
A nurse is planning care for a client who is postoperative and has developed left lower leg
deep-vein thrombosis. Which of the following interventions should the nurse include in the
plan of care? - CORRECT ANSWER- -Make sure the client's legs are elevated while in bed.
A nurse is assessing a client who is 1 day postoperative following open ileostomy
placement to treat an inflammatory bowel disorder. Which of the following findings is the
priority for the nurse to report to the provider? - CORRECT ANSWER- -The stoma is purple in
color.
A nurse is developing a plan of care for a preschooler who has heart failure. Which of the
following interventions should the nurse include in the plan? - CORRECT ANSWER- -Offer
small, frequent meals based on the child's endurance level.
A nurse in an emergency department is caring for a client who has heat stroke. Which of the
following actions should the nurse take to treat this form of hyperthermia? - CORRECT
ANSWER- -Apply ice packs to the client's axillae, neck, groin, and chest.