ATI Med Surg Practice Exam

A nurse is caring for a male client who has peripheral vascular disease and is taking dietary supplements and has a new prescription for warfarin (coumadin). The nurse should instruct the client to stop which of the following supplements prior to starting the warfarin? (select all that apply) A. Saw palmetto B. Echinacea C. Glucosamine D. Black cohosh E. Gingko biloba - A. Saw Palmetto C. Glucosamine E. Gingko bilboa A nurse is providing discharge instructions to a client who developed deep-vein thrombosis (DVT) postoperatively and is prescribed anticoagulant therapy. Which of the following instructions should the nurse include? Applying cool compresses to her legs Wearing loose, non-constricting stockings Flexing her knees and feet frequently Taking an NSAID tablet daily - Flexing her knees and feet frequently (warm compresses would be used not cold, and compression stockings would be beneficial to move blood back to the heart) What reverses warfarin toxicity? - Vitamin K (produced in intestines) When giving a unit of blood the nurse should verify the information on the blood label with the client's information by checking what? - identification wristband A nurse is caring for a client who recently had surgery for insertion of a permanent pacemaker. Which of the following prescriptions should the nurse clarify? Serum cardiac enzyme levels MRI of the chest Physical therapy low-sodium diet - MRI of the chest (magnets would cause the pacemaker to malfunction) A nurse is caring for a client in the critical care unit following a knife wound to the chest. The nurse suspects the client is developing cardiac tamponade. Which of the following findings supports this suspicion? Sudden lethargy Muffled heart sounds Flattened neck veins Bradycardia - Muffled heart sounds (caused by excess fluid around the heart) (Cardiac Tamponade would manifest as restlessness, JVD, and tachycardia) A nurse receives a unit of packed RBC's from a blood bank and notes that the time is 1130. The nurse should begin the infusion at which of the following times? - As soon as the nurse can prepare the client and the administration set A nurse is teaching a Group of postmenopausal women about activities to reduce the risk of developing CAD. Which of the following statements by a client requires further teaching? A. "A weight loss program can increase the LDL cholesterol levels." B."Exercising regularly will lower HDL cholesterol levels." C. "Adding foods containing omega-3 fatty acids to my diet can lower my risk." D. "Increasing the intake of foods containing trans-fatty acids in my diet can lower my risk." - D. "Increasing the intake of foods containing trans-fatty acids in my diet can lower my risk." A nurse in a clinic is caring for a client who has recently begun taking warfarin. The nurse should instruct the client to avoid which of the following? Cabbage Cantaloupe Green beans White beans - Cabbage (high in Vitamin K) A nurse is assessing a client before administering a unit of packed RBCs. The nurse should identify which of the following data as most important to obtain prior to the infusion? Skin color Fluid intake Temperature Hemoglobin level - Temperature (a baseline temp is needed to be able to identify an infusion reaction) A nurse in a cardiac unit is caring for a client with acute right-sided heart failure. which of the following findings should the nurse expect? decreased brain natriuretic peptide (BNP) elevated central venous pressure (CVP) increased pulmonary artery wedge pressure (PAWP) decreased specific gravity - elevated CVP (BNP would be elevated, increased PAWP is w/ L-HF, urine specific gravity is increased) A nurse is preparing to administer blood to a client. Which of the following actions should the nurse take to identify the client? (Select all that apply) Verify the provider's prescription with another RN Confirm that the room number matches the medical record Scan the barcode on the client's identification band Ask the client to verbalize if blood type is Rh-negative or positive Compare client identification number to the blood component tag number - Verify the provider's prescription with another RN Scan the barcode on the client's identification band Compare client identification number to the blood component tag number A nurse is caring for a client 1 hr following a subtotal thyroidectomy. In which of the following positions should the nurse place the client? Semi-Fowler's Dorsal recumbent Supine Sims' - Semi Fowler's A nurse is caring for a client 8 hr postoperative following a total knee replacement. Which of the following actions should the nurse take? Place a pillow under the affected limb Apply cool compresses to the affected limb every 6 hr Promote bed rest for 5-7 days Encourage increased fluid intake - Encourage increased fluid intake A nurse is teaching a middle-age client about hypertension. Which of the following information should the nurse include in the teaching? A "Reaching your goal blood pressure will occur within 2 months." B "Diuretics are the first type of medication to control hypertension." C "Limit your alcohol consumption to three drinks a day. D "Plan to lower saturated fats to 10 percent of your daily calorie intake." - B "Diuretics are the first type of medication to control hypertension." A nurse is admitting a client who has acute heart failure following myocardial infarction (MI). The nurse recognizes that which of the following prescriptions by the provider required clarification? Morphine sulfate 2mg IV bolus every 2hr PRN pain Laboratory testing of serum potassium upon admission 0.9% Normal saline IV at 50ml/hr continuous Bumetanide 1mg IV bolus every 12 hr (loop diuretic) - 0.9% Normal saline IV at 50ml/hr continuous (NS is isotonic so wont cause the fluid shift needed to reduce circulatory overload) A nurse is teaching a client who has acute kidney injury about dietary sources of potassium. Which of the following statements by the client indicates a need for clarification? "I will enjoy eating cantaloupe for my morning snack." "I can easily add baked potatoes to my diet." "Eating yogurt will be a new experience." "Adding pecans will be a change I can readily make." - "Adding pecans will be a change I can readily make." (pecans are low in potassium) A nurse is teaching a client who is postoperative following the insertion of a permanent pacemaker. Which of the following instructions should the nurse include? Count your pulse for 1 min each morning. Resume activities that can cause jolting, such as horseback riding, after 4 weeks. Do not wear tight clothing over the insertion area. Request to be scanned with a handheld metal detector when in the airport. Do not have a microwave oven in the home. - Count your pulse for 1 min each morning. Do not wear tight clothing over the insertion area. A nurse is caring for an adolescent client in the emergency department who sustained a head injury. Thenurse notes the client's IV fluids are infusing at 125 mL/hour. Which of the following is an appropriate action bythe nurse? Slow the rate to 20 mL/hr. Continue the rate at 125 mL/hr. Slow the rate to 50 mL/hr. Increase the rate to 250 mL/hr. - Slow the rate to 50 mL/hr. (to prevent increased intracranial pressure) A nurse is caring for a client who has pericarditis and reports feeling a new onset of palpitations and shortness of breath. Which of the following assessments should indicate to the nurse that the client may have developed atrial fibrillation? Different blood pressures in the upper limbs. Different apical and radial pulses. Differences between oral and axillary temperatures. Differences in upper and lower lung sounds. - Different apical and radial pulses. A nurse is creating a dietary plan for an adult female who has a hemoglobin level of 9.8 g/dL. Which of the following foods will help to improve this result? Carrots Raisins Maple Syrup Orange Juice - Raisins (high in iron) A nurse is caring for a client with a ventricular pacemaker who is on ECG monitoring. The nurse understands that the pacemaker is functioning properly when which of the following appears on the monitoring strip? Pacemaker spikes after each QRS complex Pacemaker spikes before each P wave Pacemaker spikes before each QRS complex Pacemaker spikes with each T wave - Pacemaker spikes before each QRS complex A nurse is administering platelets to a client who reports feeling chilled and is itching. Which of the following is a priority nursing action? Notify the provider Stop the infusion Collect a urine sample from the client Return the platelet bag and tubing to the blood bank - Stop the infusion (transfusion reaction) A nurse is providing discharge teaching to a client who has an implantable cardioverter/defibrillator (ICD). Which of the following info should the nurse include? The client cannot travel by air due to security screenings. The client should hold their cell phone on the side opposite the ICD. The client should avoid the use of small electric devices The client can carry their ICD in a small pocket - The client should hold their cell phone on the side opposite the ICD. a nurse is performing tracheostomy care for a client and suctioning to remove copious secretions. what following action should the nurse perform? - Suction two to three times with a 60-second pause between passes. A nurse is providing discharge instructions to a client who has asthma and a new prescription for montelukast. The nurse should instruct the client to report which of the following adverse effects to the provider? Blurred vision Palpitations Constipation Depression - Depression