NURSE 315/PN Adult Medical Surgical Online Practice 2020 B,100% CORRECT

NURSE 315/PN Adult Medical Surgical Online Practice 2020 B A nurse is assisting with the development of a plan of care to manage pain for a client who has herpes zoster with lesions on the lower extremities. Which of the following interventions should the nurse include in the plan of care? Keep bed linens o of the affected areas. A nurse in an orthopedic clinic is reinforcing teaching with a client who has osteoarthritis. Which of the following instructions should the nurse include to promote comfort? Sleep on a firm mattress. A nurse is caring for a client who has an intestinal obstruction and reports a new onset of nausea. The client has an NG tube set at low intermittent suction and is receiving continuous IV infusion of 0.9% sodium chloride. Which of the following actions should the nurse take first? Check for kinks in the NG tube. A nurse is assisting in the care of a client who has AIDS-related pneumonia. The client is receiving antibiotic therapy and albuterol nebulizer treatments daily. Which of the following findings should indicate to the nurse that the client's therapeutic regimen is effective? Decrease in exertional dyspnea A nurse is caring for a client who is in Buck's traction for a fractured hip. The client reports increased pain at the site of the fracture. Which of the following actions should the nurse take? Reposition the client A nurse is caring for a client who begins to have a seizure while ambulating in the hall. Identify the sequence of actions the nurse should follow. (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.) Lower the client to the floor. Place a pad beneath the client's head. Loosen the clothing around the client's neck. Time the length of the client's seizure. Reorient and reassure the client. A nurse is reinforcing teaching with a client who has diabetes mellitus and a new prescription for regular and NPH insulin. Which of the following instructions on preparing the insulins should the nurse include? Withdraw the regular insulin before withdrawing the NPH insulin. A nurse is reinforcing teaching with a client who has type 1 diabetes mellitus about glycosylated hemoglobin (HbA1c) testing. Which of the following information should the nurse include in the teaching? HbA1c results measure glucose control for the prior 3 months. A nurse is collecting data from a client who has 30% body surface area deep partial-thickness and full-thickness burns. Which of the following findings indicates that fluid resuscitation is adequate? Urine output is 50 mL/hr. A nurse is planning care for a group of clients after receiving change-of-shift report. Which of the following clients should the nurse plan to see first? A client who is dehydrated, has mental confusion, and has tried to get out of bed several times during the night A nurse is reinforcing teaching with a client who has a new diagnosis of genital herpes. Which of the following information should the nurse include? "The virus can be transmitted without lesions being present." A nurse is collecting data from a client who has an obstructive pulmonary disorder. The nurse should document the sound as which of the following? (Click on the audio button to listen to the clip.) Wheezes A nurse is reviewing the medication record of a client who is taking digoxin. Which of the following medications should the nurse identify as increasing the risk for the client to develop digoxin toxicity? Furosemide A nurse is changing the dressing for a client who has an abdominal incision and a closed-suction drain. Which of the following actions should the nurse take? Cleanse the drainage plug with alcohol swabs. A nurse is caring for a client who has end-stage liver disease and just underwent an abdominal paracentesis. For which of the following manifestations should the nurse monitor as an adverse effect of the procedure? Decreased blood pressure A nurse is reinforcing teaching with a client who has chronic kidney disease about disease management. Which of the following statements by the client indicates an understanding of the teaching? "I will limit my daily intake of protein." A nurse is reinforcing instructions with a client who has a new hearing aid. Which of the following instructions should the nurse include? "Adjust the volume to a level where you can hear others speak at a distance of 3 feet." A nurse is caring for a client who is postoperative following an above-the- knee amputation of the right leg and reports pain in the absent portion of the limb. The client received an opioid analgesic 1 hr prior. Which of the following actions should the nurse take? Collaborate with the physical therapist to initiate alternative pain therapies A nurse is caring for a client who has restricted movement of the chest due to a burn injury. The nurse should anticipate preparing the client for which of the following procedures? Escharotomy A nurse is caring for a client who is 2 hr postoperative following the amputation of a foot. Which of the following actions should the nurse take first? Check the incisional dressing A nurse is assisting with the care of a client who had a stroke and is unable to speak. The nurse should identify that the client's injury occurred in which of the following lobes of the brain? (You will nd hot spots to select in the artwork below. Select only the hot spot that corresponds to your answer.) A is correct. Injury to the frontal lobe can result in alterations to motor function or voluntary movement. This involves the ability to speak and the ability to move purposefully. A nurse is repositioning a client who has low back pain. Which of the following positions is should the nurse place the client in? Semi-Fowler's with knees flexed A nurse is reinforcing teaching about pursed lip breathing with a client who has a new diagnosis of COPD. The nurse should identify that which of the following client statements indicates an understanding of the teaching? "Pursed-lip breathing works best for activities like walking up stairs." A nurse is reinforcing discharge teaching with a client who has leukemia and is receiving chemotherapy. Which of the following statements should the nurse include in the teaching? "You should place your toothbrush in hydrogen peroxide." A nurse is reviewing the medication administration record of a client who has osteoarthritis. Which of the following analgesic prescriptions should the nurse expect to administer when the client reports pain? Acetaminophen A nurse is reinforcing teaching regarding the use of a continuous passive motion (CPM) machine with a client who is scheduled for a total knee arthroplasty. Which of the following information should the nurse include in the teaching? (Select all that apply.) "Your knee is flexed and extended as prescribed by your provider." "The machine is padded with sheep skin." A nurse is contributing to the plan of care for a client who had a stroke. For which of the following interprofessional team members should the nurse recommend a referral prior to initiating oral intake for the client? Speech-language pathologist A nurse in a clinic is assisting with the development of a pamphlet about STIs. Which of the following information should the nurse recommend including in the pamphlet? Females have a higher risk for contracting STIs than males. A nurse is reinforcing teaching with a client who has coronary artery disease. Which of the following instructions should the nurse include in the teaching? "Add oily fish to your diet twice weekly." A nurse is caring for a client who is receiving a continuous tube feeding of 60 mL/hr at 1.2 cal/mL. How many calories will the client receive in 12 hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) 864 A nurse is preparing a client for a cardiac catheterization. Which of the following actions should the nurse take rst? Verify the client has given informed consent. A nurse is reinforcing discharge teaching with a client who has hearing loss. Which of the following actions should the nurse take when communicating with the client? Rephrase client instructions when not understood. A nurse is caring for a client who is 24 hr postoperative following an abdominal surgery. Which of the following findings requires immediate attention from the nurse? Oxygen saturation of 88% A nurse in a clinic is collecting data from a client who has hyperthyroidism and has been taking methimazole for 4 weeks. Which of the following statements by the client indicates a therapeutic response to the medication? "I have gained 3 pounds since my last appointment." A nurse is reviewing the medical record of a client who is postoperative. Which of the following findings should the nurse identify as a complication of surgery? WBC count of 15,000/mm3 A nurse is reinforcing discharge teaching with a client who has Crohn's disease. Which of the following statements should the nurse include in the teaching? "Maintain a low-residue diet." A nurse is caring for a client who has age-related macular degeneration. Which of the following findings should the nurse expect? Distorted central vision of the eyes A nurse is collecting data from a client who is receiving sumatriptan. Which of the following is an expected outcome? Diminished headache A nurse is reinforcing teaching with a client who is taking levothyroxine. Which of the following statements by the client indicates an understanding of the teaching? "The medication should be taken before I eat breakfast every morning." A nurse is reinforcing teaching with a client about testicular self-examination. Which of the following instructions should the nurse include in the teaching? "Perform testicular self-examination after taking a warm shower." A nurse is preparing to assist a client out of bed 4 hr following a laparoscopic cholecystectomy. Which of the following actions should the nurse take first? Obtain the client's blood pressure. A nurse is contributing to the plan of care to promote a restful night's sleep for a client who has Alzheimer's disease. Which of the following interventions should the nurse include in the plan? Offer a small snack at bedtime. A nurse is preparing to assist with the insertion of a double-lumen gastric sump tube for a client who has peptic ulcer disease and has developed gastrointestinal bleeding. Which of the following images depicts the tube that the nurse should select? (first picture, clear tube ending with blue tube) When using a double-lumen gastric sump tube, the clear portion of the tube allows for aspiration of stomach contents. The blue portion of the tube, or the "pigtail", vents the tube to the atmosphere, which prevents the tube from becoming lodged against the wall of the stomach and protects the stomach from damage. A nurse is caring for a client who has Cushing's syndrome and expresses concern regarding physical changes associated with the syndrome. Which of the following should the nurse recognize as a physical change caused by this disorder? Truncal obesity A nurse is reviewing the chart of a client who is experiencing an adrenal crisis, which was precipitated by the client not taking their medication for several days. The nurse should identify that withdrawal from which of the following medications potentiated the adrenal crisis? Prednisone A nurse is caring for a client who has neutropenia. Which of the following nursing interventions should the nurse implement? Limit visitors to healthy adults. A nurse in a dermatology clinic is reviewing the medical records of a group of clients. Which of the following prescriptions for a client who has psoriasis should the nurse clarify with the provider? Dermabrasion A nurse is caring for four clients. Which of the following conditions should the nurse identify as a risk for developing vascular disease? Diabetes mellitus A nurse is caring for a client who has just returned to the unit following a bronchoscopy. Which of the following findings should the nurse report to the provider? Diminished breath sounds A nurse is reviewing the laboratory reports of a client who reports chest pain. Which of the following laboratory results indicates the client is experiencing a myocardial infarction? Elevated troponin A nurse is delegating the task of repositioning a client who is in skeletal traction to an assistive personnel (AP). Which of the following instructions should the nurse give the AP? Allow the weights to hang freely. A nurse is reinforcing discharge teaching with a client who had a mechanical mitral valve replacement. Which of the following statements by the client indicates an understanding of the teaching? "I will notify my dentist about this procedure." A nurse is caring for a client who reports shortness of breath and has an oxygen saturation of 90%. Which of the following actions should the nurse take? Administer oxygen via nasal cannula. A nurse is caring for a client following a gastrectomy. Which of the following actions should the nurse take to decrease episodes of dumping syndrome? Place the client in the supine position after meals. A home health nurse is caring for a client who has COPD. The client reports shortness of breath while eating, despite the use of home oxygen. Which of the following recommendations should the nurse make? "Use a bronchodilator 30 minutes before your meal." A nurse is reinforcing teaching with a client who has a new diagnosis of tuberculosis (TB) and a prescription for isoniazid and rifampin. Which of the following information should the nurse include in the teaching? Household family members should be tested for TB. A nurse is reviewing the medical record for a client who is experiencing nausea and vomiting. Based on the client data, which of the following actions should the nurse take? Notify the charge nurse of the client's BUN level. A nurse is preparing to administer an influenza vaccine to a client. Which of the following statements by the client should cause the nurse to postpone administration of the vaccine? "I had a low fever this morning." A nurse is reinforcing teaching about nutrition choices with a client who has leukemia and is receiving chemotherapy. The nurse should identify that which of the following statements by the client indicates an understanding of the teaching? "I drink bottled water." A nurse is reviewing the medical record of a client who has acute pancreatitis. Which of the following findings should the nurse anticipate? Elevated serum amylase level A nurse is providing information regarding transmission-based precautions for a client who has Clostridium dicile to an assistive personnel (AP). Which of the following instructions should the nurse include? (Select all that apply.) "Provide the client with disposable utensils and dishes for meals." "Leave blood pressure equipment in the client's room." "Clean contaminated surfaces with a bleach solution." A nurse is reinforcing teaching with a client who has asthma and a new prescription for a corticosteroid. Which of the following findings should the nurse include as an adverse effect of the medication? Frequent colds A nurse is reinforcing teaching with a client about increasing dietary fiber. The nurse should recommend which of the following foods as the best source of fiber? 1/2 cup cooked kidney beans A nurse in a telemetry unit is collecting data from a client who has a newly- inserted permanent pacemaker. Which of the following findings should the nurse report to the provider? The client experiences hiccups when sitting. A nurse is reinforcing teaching with a client who is postoperative following a cemented total hip arthroplasty. Which of the following instructions should the nurse include in the teaching? Maintain hip exion at 90° or less when sitting. A nurse is reinforcing teaching with a client prior to the removal of a leg cast. Which of the following statements should indicate to the nurse that the client understands the teaching? "I will feel vibrations on my leg from the cast cutter." A nurse is caring for a client who is postoperative following a transurethral resection of the prostate (TURP) and is receiving continuous bladder irrigation. The nurse notes decreased output from the urethral catheter. Which of the following provider prescriptions should the nurse expect? Irrigate the urethral catheter with 0.9% sodium chloride. A nurse is reinforcing teaching with a client who has osteoporosis and a new prescription for calcitonin. Which of the following statements should the nurse make to describe the effect of calcitonin in treating osteoporosis? "Calcitonin will slow the breakdown of bone in your body." A nurse is caring for a client who is postoperative and has a portable wound bulb suction device. Which of the following actions should the nurse take? Compress the bulb reservoir and then close the drainage valve A nurse is caring for a client who is undergoing testing for multiple sclerosis. Which of the following findings should the nurse expect? Muscle spasticity A nurse is reinforcing teaching about hospice care with a client who has terminal cancer. Which of the following statements should the nurse make? "Hospice care will provide support for you and your loved ones during the dying process." A nurse is assisting with an educational program for clients who have been newly diagnosed with diabetes mellitus. Which of the following instructions should the nurse include in the program regarding insulin? Opened insulin can be stored on a cool countertop away from light A nurse is caring for a client who is suspected of having a myocardial infarction. Which of the following actions should the nurse take to prepare the client for an ECG? Cleanse the client's skin prior to electrode placement. A nurse is monitoring a client who has a cast and reports intense itching underneath the cast. Which of the following actions should the nurse take? Blow cool air into the cast using a blow dryer on a cool setting. A nurse is caring for a client who has dementia due to Alzheimer's disease. Which of the following actions should the nurse take to reduce the client's confusion? Encourage reminiscence of past experiences. A nurse is reinforcing teaching with a client who has osteoporosis. Which of the following instructions should the nurse include in the teaching? "Take calcium supplements with meals." A nurse is reinforcing teaching with a client about preventing osteoporosis. Which of the following client statements indicates an understanding of the teaching? "I will limit my coffee intake." A nurse is caring for a client following a thyroidectomy. Which of the following findings should alert the nurse to the possibility of parathyroid gland injury? Muscle twitching A nurse is collecting data from an older adult client who has several concerns. Which of the following concerns should the nurse recognize as an expected change associated with aging? "My food tastes bland even after I add seasoning." A nurse is caring for a client who has been taking enalapril. The nurse should monitor the client for which of the following adverse effects? Cough A nurse is caring for a client who has prostate cancer. The client asks the nurse why they are having difficulty with urination. Which of the following responses should the nurse make? "The tumor causes obstruction of urine from the urethra." A nurse is contributing to the plan of care for a client who has just transferred to the medical-surgical unit from the PACU following a right total knee arthroplasty. Which of the following interventions should the nurse include in the plan? Assist the client to change positions at least every 2 hr. A nurse in a health clinic is reinforcing teaching with a client about tuberculosis (TB). Which of the following client statements indicates an understanding of the teaching? "I can develop TB by breathing in the infection." A nurse is contributing to the plan of care for a client who has a head injury and is at risk for increased intracranial pressure (ICP). Which of the following actions should the nurse include in the plan? Use a turn sheet to reposition the client. A nurse is contributing to the plan of care for a client who has pericarditis. In which of the following positions should the nurse plan to place the client to decrease pain? Upright, leaning forward A nurse is caring for a client who has a prescription for digoxin 0.25 mg PO daily. While taking the client's apical pulse, the nurse notes a rate of 58/min. Which of the following actions should the nurse take? Withhold the dose. A nurse is collecting data from a client who is being treated for hypovolemia due to nausea and vomiting. Which of the following findings should the nurse report to the provider? Heart rate 120/min A nurse is reinforcing dietary teaching with a client about increasing the intake of foods containing vitamin C to enhance absorption of oral iron supplements. Which of the following food choices should the nurse include in the teaching? 1 cup of boiled broccoli A nurse is reviewing the plan of care for a client who is 1 day postoperative following a total hip arthroplasty. Which of the following interventions should the nurse contribute to the plan of care? Keep an abduction pillow between the client's legs. A nurse is contributing to the plan of care for a client who has tuberculosis (TB). Which of the following interventions should the nurse include? Place the client in a negative-pressure airflow room.