RN Adult Medical Surgical Online
Practice B Comprehensive Study
Guide + Exam Questions &
Solutions Graded A+
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A nurse is caring for a client in the emergency department (ED).
Physical Examination
Client presents to the ED with upper abdominal pain that radiates to the
right shoulder. Client rates pain as 7 on a scale of 0 to 10. Client also reports
nausea, vomiting, and dyspepsia.
Client is awake, alert, and oriented x3. Lung sounds clear bilaterally, S1 and
S2 heart tones noted. All pulses palpable. Bowel sounds active in all 4
quadrants.
Complete the diagram by dragging from the choices below to specify what
condition the client is most likely experiencing, 2 actions the nurse should
take to address that condition, and 2 parameters the nurse should monitor
to assess the client's progress. - Answer: The nurse should plan to
administer an opioid analgesic, such as morphine, for acute pain. Since the
client is experiencing nausea and vomiting, the nurse should also ensure
they are NPO. The client is likely experiencing cholecystitis, which typically
presents with nausea, vomiting, upper abdominal pain that radiates to the
right shoulder, fever, and dyspepsia. The client also has elevated liver
enzymes and a WBC count, which is consistent with cholecystitis. Surgical
management for cholecystitis might be indicated. The nurse should monitor
the client's stool and urine color because a biliary obstruction from
gallstones may cause clay-colored stools and dark urine.
,A nurse is caring for a client who was just admitted from the emergency
department (ED).
Nurses' Notes
0945:
Client is experiencing a sickle cell crisis. Client states that they began
experiencing pain in the lower extremities 3 days ago and is now
experiencing pain in the chest, rating it as 4 on scale of 0 to 10.
Oxygen at 3 L/min via nasal cannula in place.
Oral mucosa pink, no cyanosis.
Pulses palpable in all four extremities, no peripheral edema noted.
Respirations even and slightly labored; lung sounds with slight wheezing in
left upper lobe.
Abdomen soft and nontender, bowel sounds active in all four quadrants.
0.45% sodium chloride IV at 200 mL/hr infusing to left hand with no reports
of pain or swelling at the site.
Drag words from the choices below to fill in each blank in the following
sentence. - Answer: Fluid volume overload is incorrect. While the client is
experiencing an increased respiratory rate and shortness of breath, fluid
volume overload typically includes moist crackles on auscultation, pitting
edema in dependent areas, neck vein distension, and hypertension.
Right-sided heart failure is incorrect. While clients who have sickle-cell
disease are at risk for developing heart failure, the client does not have
manifestations of right-sided heart failure. Right-sided heart failure typically
presents with signs of fluid volume overload, which includes jugular vein
distention, dependent edema, and blood pressure alterations.
, Acute chest syndrome is correct. The client is most likely experiencing acute
chest syndrome, which can be caused by respiratory infections and debris
from sickled cells. The client is displaying manifestations of acute chest
syndrome, which include cough, shortness of breath, wheezing, tachypnea,
fever, and chest pain.
Pneumonia is correct. The client is most likely experiencing pneumonia as
evidenced by the manifestations of cough, shortness of breath, fever,
tachypnea, blood-tinged sputum, and chest pain.
Pneumothorax is incorrect. While the client is experiencing increased
respiratory distress, a pneumothorax typically presents with reduced or
absent breath sounds and unequal chest expansion.
A nurse is caring for a client.
Nurses' Notes
1200:
Client was admitted to the unit with shortness of breath, a nonproductive
cough, chest discomfort, and myalgia. Prefers orthopneic position. Client
reports that manifestations began about 2 days ago.
For each assessment finding, click to specify if the finding is consistent with
emphysema, asthma, or pneumonia. Each finding may support more than 1
disease process. - Answer: Temperature is consistent with pneumonia.
Fever is a manifestation of pneumonia and is related to inflammation or
infection.
Breath sounds are consistent with emphysema, asthma, and pneumonia.
The client's wheezing is a manifestation of emphysema, asthma, and
pneumonia. It is the result of narrowed airways and alveoli.
Practice B Comprehensive Study
Guide + Exam Questions &
Solutions Graded A+
Professional Academic Assistance Services
Services Offered
• Proctored Exam Assistance
• Online Class Management (Full Course Support)
• Exam Preparation & Study Materials
• Assignments and Coursework Support
• Essay and Research Paper Writing
• Discussion Posts & Responses
• Editing and Proofreading
• Confidential Academic Consultation
, Contact Information
Email:
WhatsApp link: https://wa.me/254704846336
Fast Response | Confidential | Reliable Academic
Support
Helping Students Achieve Academic Excellence
A nurse is caring for a client in the emergency department (ED).
Physical Examination
Client presents to the ED with upper abdominal pain that radiates to the
right shoulder. Client rates pain as 7 on a scale of 0 to 10. Client also reports
nausea, vomiting, and dyspepsia.
Client is awake, alert, and oriented x3. Lung sounds clear bilaterally, S1 and
S2 heart tones noted. All pulses palpable. Bowel sounds active in all 4
quadrants.
Complete the diagram by dragging from the choices below to specify what
condition the client is most likely experiencing, 2 actions the nurse should
take to address that condition, and 2 parameters the nurse should monitor
to assess the client's progress. - Answer: The nurse should plan to
administer an opioid analgesic, such as morphine, for acute pain. Since the
client is experiencing nausea and vomiting, the nurse should also ensure
they are NPO. The client is likely experiencing cholecystitis, which typically
presents with nausea, vomiting, upper abdominal pain that radiates to the
right shoulder, fever, and dyspepsia. The client also has elevated liver
enzymes and a WBC count, which is consistent with cholecystitis. Surgical
management for cholecystitis might be indicated. The nurse should monitor
the client's stool and urine color because a biliary obstruction from
gallstones may cause clay-colored stools and dark urine.
,A nurse is caring for a client who was just admitted from the emergency
department (ED).
Nurses' Notes
0945:
Client is experiencing a sickle cell crisis. Client states that they began
experiencing pain in the lower extremities 3 days ago and is now
experiencing pain in the chest, rating it as 4 on scale of 0 to 10.
Oxygen at 3 L/min via nasal cannula in place.
Oral mucosa pink, no cyanosis.
Pulses palpable in all four extremities, no peripheral edema noted.
Respirations even and slightly labored; lung sounds with slight wheezing in
left upper lobe.
Abdomen soft and nontender, bowel sounds active in all four quadrants.
0.45% sodium chloride IV at 200 mL/hr infusing to left hand with no reports
of pain or swelling at the site.
Drag words from the choices below to fill in each blank in the following
sentence. - Answer: Fluid volume overload is incorrect. While the client is
experiencing an increased respiratory rate and shortness of breath, fluid
volume overload typically includes moist crackles on auscultation, pitting
edema in dependent areas, neck vein distension, and hypertension.
Right-sided heart failure is incorrect. While clients who have sickle-cell
disease are at risk for developing heart failure, the client does not have
manifestations of right-sided heart failure. Right-sided heart failure typically
presents with signs of fluid volume overload, which includes jugular vein
distention, dependent edema, and blood pressure alterations.
, Acute chest syndrome is correct. The client is most likely experiencing acute
chest syndrome, which can be caused by respiratory infections and debris
from sickled cells. The client is displaying manifestations of acute chest
syndrome, which include cough, shortness of breath, wheezing, tachypnea,
fever, and chest pain.
Pneumonia is correct. The client is most likely experiencing pneumonia as
evidenced by the manifestations of cough, shortness of breath, fever,
tachypnea, blood-tinged sputum, and chest pain.
Pneumothorax is incorrect. While the client is experiencing increased
respiratory distress, a pneumothorax typically presents with reduced or
absent breath sounds and unequal chest expansion.
A nurse is caring for a client.
Nurses' Notes
1200:
Client was admitted to the unit with shortness of breath, a nonproductive
cough, chest discomfort, and myalgia. Prefers orthopneic position. Client
reports that manifestations began about 2 days ago.
For each assessment finding, click to specify if the finding is consistent with
emphysema, asthma, or pneumonia. Each finding may support more than 1
disease process. - Answer: Temperature is consistent with pneumonia.
Fever is a manifestation of pneumonia and is related to inflammation or
infection.
Breath sounds are consistent with emphysema, asthma, and pneumonia.
The client's wheezing is a manifestation of emphysema, asthma, and
pneumonia. It is the result of narrowed airways and alveoli.
