CS medsurg ASSESSMENT #2
A nurse is assisting a client who is weak and has lost weight due to decreased appetite. Which
of the following actions should the nurse plan to take to encourage adequate nutrition? -
ANS-Ask the client to suggest favorite foods.
\A nurse is assisting with the care of a client who has endometrial cancer and a prescription for
oxycodone. The nurse should monitor the client for which of the following findings as an adverse
effect of this medication? - ANS-Respiratory depression
\A nurse is assisting with the care of a client who is 3 hr postoperative following an
above-the-knee amputation. Which of the following findings is the priority for the nurse to report
to the provider? - ANS-Fresh bleeding on dressing
\A nurse is assisting with the recording of triage information following a local natural disaster.
Which of the following triage tags should the nurse record for a client who has a closed fracture
of the tibia? - ANS-Green
\A nurse is caring for a client who had a transurethral resection of the prostate and is receiving
continuous bladder irrigation using a three-way urethral catheter. Which of the following actions
should the nurse take? - ANS-Use 0.9% sodium chloride for irrigation catheter irrigation.
\A nurse is caring for a client who has HIV. Which of the following findings should indicate to the
nurse that the client has developed AIDS? - ANS-The client's CD4-T-cell count is less than 200
cells/uL.
\A nurse is caring for a client who has severe pain from metastatic lung cancer and a
prescription for oxycodone. The client tells the nurse they are worried about becoming addicted
to the medication. Which of the following statements should the nurse make? - ANS-"I
understand your concern, but when taken as prescribed for pain control, very few clients
become addicted."
\A nurse is caring for a client who is postoperative and has an abdominal incision. Which of the
following actions should the nurse take to prevent complications? - ANS-Instruct the client to
splint the incision when coughing.
\A nurse is collecting data from a client who has a pneumothorax and a newly inserted chest
tube. Which of the following findings should the nurse report to the charge nurse? -
ANS-Persistent bubbling in the water seal chamber
\A nurse is collecting data from a client who has hypocalcemia. Which of the following findings
should the nurse expect? (Select all that apply.) - ANS-- Muscle spasms
- Wheezing
- Paresthesia
\A nurse is collecting data from a client who has hypothyroidism. Which of the following findings
should the nurse expect? (Select all that apply.) - ANS-- Brittle fingernails
- Hair loss
-Cold intolerance
\A nurse is completing a dressing change for a client who is postoperative following a
mastectomy. The client becomes tearful and states, "I don't think my partner will find me
A nurse is assisting a client who is weak and has lost weight due to decreased appetite. Which
of the following actions should the nurse plan to take to encourage adequate nutrition? -
ANS-Ask the client to suggest favorite foods.
\A nurse is assisting with the care of a client who has endometrial cancer and a prescription for
oxycodone. The nurse should monitor the client for which of the following findings as an adverse
effect of this medication? - ANS-Respiratory depression
\A nurse is assisting with the care of a client who is 3 hr postoperative following an
above-the-knee amputation. Which of the following findings is the priority for the nurse to report
to the provider? - ANS-Fresh bleeding on dressing
\A nurse is assisting with the recording of triage information following a local natural disaster.
Which of the following triage tags should the nurse record for a client who has a closed fracture
of the tibia? - ANS-Green
\A nurse is caring for a client who had a transurethral resection of the prostate and is receiving
continuous bladder irrigation using a three-way urethral catheter. Which of the following actions
should the nurse take? - ANS-Use 0.9% sodium chloride for irrigation catheter irrigation.
\A nurse is caring for a client who has HIV. Which of the following findings should indicate to the
nurse that the client has developed AIDS? - ANS-The client's CD4-T-cell count is less than 200
cells/uL.
\A nurse is caring for a client who has severe pain from metastatic lung cancer and a
prescription for oxycodone. The client tells the nurse they are worried about becoming addicted
to the medication. Which of the following statements should the nurse make? - ANS-"I
understand your concern, but when taken as prescribed for pain control, very few clients
become addicted."
\A nurse is caring for a client who is postoperative and has an abdominal incision. Which of the
following actions should the nurse take to prevent complications? - ANS-Instruct the client to
splint the incision when coughing.
\A nurse is collecting data from a client who has a pneumothorax and a newly inserted chest
tube. Which of the following findings should the nurse report to the charge nurse? -
ANS-Persistent bubbling in the water seal chamber
\A nurse is collecting data from a client who has hypocalcemia. Which of the following findings
should the nurse expect? (Select all that apply.) - ANS-- Muscle spasms
- Wheezing
- Paresthesia
\A nurse is collecting data from a client who has hypothyroidism. Which of the following findings
should the nurse expect? (Select all that apply.) - ANS-- Brittle fingernails
- Hair loss
-Cold intolerance
\A nurse is completing a dressing change for a client who is postoperative following a
mastectomy. The client becomes tearful and states, "I don't think my partner will find me
