MED SURG 2021

MED SURG 2021 HESI V1 44 of 55 A client who is taking and oral dose of tetracycline complains of gastrointestinal upset. What snack should the nurse instruct the client to take with the tetracycline? a. toasted wheat bread and jelly b. cheese and crakers c. cold cereal with skim milk d. fruit flavored yogurt ANS: A 45 of 55 The therapeutic effect of insulin in treating type 1 diabetes mellitus is based on which physiologic action? a. Facilitates transport of glucose into the cell b. Increases intracellular receptor site sensitivity c. Stimulates function of beta cells in the pancreas d. Delays carbohydrates digestion and absorption ANS: A 46 of 55 The health care provider prescribe a medication for an older adult client who is complaining of insomnia. And instructs the client to return in 2 weeks. The nurse should question which prescription? a. Eszoplicone (Lunesta)10 mg orally at bed time b. Zolpidem 10 mg orally at bed time c. Temazepan orally at bed time d. Ramelteon orally at bedtime ANS: A 47 of 55 A male client reports to the nurse that he is experiencing GI distress from high dose of a corticosteroid and is planning to stop taking the medication. In response to the clients statement what nursing action is most important for the nurse to take? a. Encourage the client to take medication with food to decrease GI distress b. Advice the client that the medication should be stopped gradually rather than abruptly. c. Review the clients dosing schedule to ensure he is taking the prescribed amount d. Assess the client for other indication of adverse effects of corticosteroid ANS: B 48 of 55 Fifteen minutes after receiving sulfa athenozole . A male client report a burning sensation over his abdomen chest and groin. Which intervention is most important for the nurse to implement? a. Auscultate lung sounds for wheezing b. Review the clients list if drugs allergies c. Add sulfamethinozole to clients allergies d. Check neurological vital signs ANS: B 49 of 55 Antibiotic resistant organism are a major infection control problems. To help minimize the emergence of resistant bacteria what instruction should the nurse provide to the clients? a. stop taking prescribed antibiotics when symptoms decrease b. avoid using antibiotics when suffering from colds or the flu c. ask the healthcare provider to prescribe the newest antibiotic when needed d. request a prescription for first time vancomysin for a sore throat ANS: B 50 of 55 A client with symptoms of influenza that started the previous day ask the clinic nurse about taking oseltamivir (Tamiflu) to treat the infection. Which response should the nurse provide? a. Advise the client once symptoms occur is too late to receive an influenza vaccination b. Refer the client to the healthcare provider at the clinic to obtain a medication prescription c. Explain to the client that antibiotics are not useful in treating viral infections such as influenza d. Instruct the client that over the counter medications are sufficient to manage influenza symptoms ANS: B 51 of 55 Twenty minutes after the nurse starts a secondary IV infusion of cafepime (maxipime) 2 grams using an infusion pump to deliver the dose in one hour, the client reports feeling nauseated. What action should the nurse implement? a. stop medication infusion and notify the healthcare provider of the adverse effect b. increase the rate of the infusion to complete the dose of the medication more rapidly c. continue the infusion and administer a prn antiemetic prescription d. reasurre the client that the nausea is not related to the iv infusion ANS: C 52 of 55 The nurse administer donepezil hydrochloride (Aricept) to a client with Alzheimers disease as an intervention for which client problem? a. fluid volume excess b. disturbed though processes c. chronic pain d. tered breathing patterns ANS: B 53 of 55 To prevent deep vein thrombosis following knee replacement surgery, an adult male client is receiving enoxaparin (Lovenox) subcutaneously daily. Which laboratory finding requires immediate action by the nurse? a. blood urea nitrogen (BUN) 20mg/dl or 7.1 mmol/L (SI) b. Hematocrit 45% c. Serum creatinine 1.0 mg/dl or 88.4 mol/L (SI) d. Platelet count of 100,000/mm3 or 100x10??/ L (SI) ANS: D 54 of 55 A client with type 2 diabetes mellitus is managed with metformin (Glucophage), an oral hypoglycemic agent. The primary health care provider prescribes ad additional medication injected exenatide (byetta). Which information is most important for the nurse to teach this client? a. Administer subcutaneously after meals b. Consume additional sources of potassium c. Notify the healthcare provider if anorexia occurs d. Watch for signs of jitteriness or diaphoresis ANS: B 55 of 55 A client is who is diagnose with schizophrenia receives a prescription for a atypical antipsychotic drug aripipazole (Abilify). Which assessment should the nurse perform to monitor for an adrenergic receptor antagonist side effect that commonly occurs atypical antipsychotic agents? a. observe the client hallucinatory behaviors b obtain the client fingerstick glucose levels c. measure the clients lying and standing blood pressure d. determine the clients abnormal involuntary movements scale (AIMS) PART BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB 1. A client with eczema is using an OTC topical product with urea 10% OTC (Aqua Care Cream) to the affected skin areas. Which finding reflects the expected therapeutic response. Hydration of affected dry skin areas Healing with a return to normal skin appearance Reduced pain in eczematous areas Decreased weeping of ulcerations in affected area 2. A male client with a primary lung cancer was told by his healthcare provider that he now has a secondary tumor. After the healthcare provider leaves, the client asks the nurse what "secondary tumor" means. What response would be best for the nurse to provide. Tell me why you are concerned about this term? Your original cancer has spread to another location You need to remain hopeful, treatment can still be effective Let me call your health care provider back to explain the meaning of secondary tumors. 3. The UAP reports to the nurse that a client who was admitted with abdominal pain has just had a large black tarry stool. What intervention should the nurse implement first. Test the stool for occult blood Obtain consent for a blood transfusion Review history for gastrointestinal bleeding Notify the rapid response team 4. Which action is most important for the nurse to implement to reduce the risk for DVT in a post op client. Change the client’s IV access site in the next 72 h Assist the client in turning from side to side q 2h Advise the client to perform leg exercises regularly Encourage frequent cough and deep breathing exercises 5. A male tells the clinic nurse that he is experiencing burning on urination, and assessment reveals that he had sexual intercourse four days ago with a woman he casually met. Which action should the nurse implement. Assess for perineal itching, erythema, and excoriation Obtain a specimen of urethral drainage for culture Observe the perineal area for a chancroid-like lesion Identify all sexual partners in the last four days 6. The nurse is planning care for a pt with CKD who is a resident at a long term care facility. The pt is anuric and has hemodialysis 3x per week. Which intervention should the nurse include in the pt's plan of care? plan meals that include dark leafy veg use adult briefs to prevent skin breakdown monitor for signs of bleeding record strict urinary output 7. A male client who reports feeling chronically fatigued has a hemoglobin of 11.0 grams/dl (110 mmol/L or SI), hematocrit of 34% and microcytic and hypochromic red blood cells. Based on the findings, which dinner selection should the nurse suggest for the patient? Beef steak with steam broccoli and orange slices Cheese pasta and a lettuce and tomato salad Broil white fish with a baked sweet potato Grill shrimp and seasoned rice with asparagus salad. 8. Tthe nurse is preparing a client for a bronchoscopy. While obtaining consent, the client complaints of thirst and admits to drinking a small amount of orange juice two hours ago. What action should the nurse take? Offer the client ice chip. Admi