University of South Alabama:NU 301 NCLEX Challenge 6 Questions and Answers,100% CORRECT

University of South Alabama:NU 301NCLEX Challenge 6 Questions and Answers NCLEX Challenge 6 A nurse is planning care for a client who has diverticulitis. Which of the following menu selections should the nurse include in the plan? Grilled chicken breast with white rice A nurse is caring for a child who has acute gastroenteritis but is able to tolerate oral fluids. The nurse should anticipate providing which of the following type of fluid? Oral rehydration solution A nurse is teaching a client who has a new prescription for esomeprazole to manage his GERD. Which of the following statements by the client indicates an understanding of the teaching? “I have an increased risk of getting pneumonia while taking this medication.” A nurse is teaching a client who has a hiatal hernia about dietary recommendations. Which of the following client statements indicates an understanding of the teaching? (Select all that apply.) “I will consume less caffeine and fewer spicy foods.” “I will sleep with the head of my bed elevated.” “I will try not to gain weight.” A nurse is working with an assistive personnel (AP) while caring for a surgical client who is 1 day postoperative. Which task should the nurse take responsibility for completing? Removing the abdominal dressing A nurse is calculating the output of a client at the end of the shift. The nurse notes the following: client voided 400 mL at 1100 and 350 mL at 1430. The closed chest drainage system was previously marked at 155 mL and is now at 175 mL. The NG tube has 575 mL in drainage container, and 25 mL is emptied out of the Jackson-Pratt drainage tube. How many mL should the nurse record in the medical record as the client’s output? 1,370 mL A nurse is caring for a client who is postoperative following abdominal surgery. The surgeon initially prescribes a clear liquid diet. Which of the following items should the nurse include on the client’s lunch tray? Cranberry juice A nurse is caring for a client who is postoperative following vascular surgery. Which of the following signs should indicate to the nurse that the client has developed a thrombus? Dull, aching calf pain A nurse is providing discharge teaching to a client who has gastroesophageal reflux disease. Which of the following statements by the client indicates an understanding of the teaching? “I will sleep with the head of my bed elevated.” A nurse is caring for a client who has a postoperative ileus and an NG tube that has drained 2,500 mL in the past 6 hr. Which of the following electrolyte imbalances should the nurse monitor the client for? Decreased potassium level A nurse is teaching a group of middle adult clients about early detection of colorectal cancer. The nurse should include the American Cancer Society recommendation that men and women beginning at age 50 who are at average risk should have a fecal occult blood test (FOBT) and a colonoscopy at which of the following intervals? Ten years A nurse is caring for a client who is postoperative following a cholecystectomy and reports pain. Which of the following actions should the nurse take? (Select all that apply.) Offer the client a back rub. Remind the client to use incisional splinting. Identify the client’s pain level. Change the client’s position. A nurse is teaching a client about strategies to manage gastroesophageal reflux disease (GERD). Which of the following statements should the nurse include? “Lie on your right side when sleeping.” A nurse is assessing a client who is 48 hr. postoperative following abdominal surgery. Which of the following findings should the nurse report to the provider? Yellow-green drainage on the surgical incision A nurse is providing preoperative teaching for a client who will undergo surgery. The nurse explains that the client will wear antiembolism stockings during and after the procedure. When the client asks what the stockings do, which of the following responses should the nurse make? “They improve your circulation to keep blood from pooling in your legs.” A nurse is planning care for a client who is postoperative and at risk for paralytic ileus. Which of the following interventions should the nurse plan to take to promote peristalsis? Increase ambulation A nurse is caring for a client who receives intermittent enteral feedings through an NG tube. Before administering a feeding, the nurse should measure the gastric residual for which of the following purposes? To identify delayed gastric emptying A nurse is teaching a client who has stomatitis. Which of the following instructions should the nurse include? Brush teeth with a soft toothbrush A nurse is caring for client who just returned from the PACU with an IV fluid infusion and an NG tube in place following abdominal surgery. Which of the following data is the priority for the nurse to assess? The surgical dressing A nurse is assessing a client who has peritonitis. Which of the following findings should the nurse expect? Rigid abdomen A nurse is caring for a client who returns to the nursing unit from the recovery room after a sigmoid colon resection for adenocarcinoma. The client had an episode of intraoperative bleeding. Which finding indicates to the nurse that the client may be developing hypovolemic shock? Increase in the heart rate from 88 to 110/min. A nurse is providing information about pain control for a client who has acute pain following a subtotal gastric resection. Which of the following client statements indicates an understanding of pain control? “I will call for pain medication before the previous dose wears off.” A nurse is providing preoperative teaching for a client who is scheduled for a gastrectomy. Which of the following information regarding prevention of postoperative complications should the nurse include in the teaching? Instruct the client about the use of a sequential compression device A nurse is teaching a client who is preoperative for a colectomy. The client asks the nurse why he needs a large-bore NG tube. Which of the following statements should the nurse make? “The tube will remove gas and fluid from your stomach.” A nurse is administering an enteral feeding through a client’s NG tube. Which of the following actions should the nurse take? Cleanse the top of the can of formula with an alcohol wipe A nurse is caring for a client who has diverticular disease. When palpating the client’s abdomen, in which of the following locations should the nurse expect the client to report abdominal pain? Lower left quadrant A nurse is talking with a client who has cholelithiasis and is about to undergo an oral cholangiogram. Which of the following client statements indicates to the nurse understanding of the procedure? “They are going to examine my gallbladder and ducts.” A nurse is preparing dietary instructions for a client who has episodes of biliary colic from chronic cholecystitis. Which of the following instructions should the nurse include in the teaching plan? Avoid foods high in fat A nurse is providing postmortem care for a client. Identify the sequence of steps the nurse should follow. Make sure the provider has certified the client’s death. Verify the client’s organ and tissue donation status. Remove medical equipment from the client. Cleanse the body while adhering to body fluid precautions. Attach identification tags to the body. A nurse is teaching a client who is receiving treatment for metastatic colorectal cancer about the adverse effects of bevacizumab. The nurse should instruct the client to report which of the following findings as an adverse effect of the medication? Nosebleeds A nurse is assessing a client who has peptic ulcer disease. Which of the following findings should the nurse identify as the priority? Hematemesis A nurse is caring for a client who is preoperative. The nurse signs as a witness on the client’s consent form. The nurse’s signature on the consent form indicates which of the following? Confirms the client appears competent to provide consent A nurse is reviewing the provider’s prescriptions for a client experiencing a paralytic ileus following an appendectomy. Which of the following actions should the nurse expect to take? Insert nasogastric tube A nurse is providing teaching for a client who has a new diagnosis of GERD. The client asks about foods he should avoid eating. Which of the following foods should the nurse tell him to avoid? Chocolate A nurse is caring for a client 8 hr. postoperative following a total knee replacement. Which of the following actions should the nurse take? Encourage increased fluid intake A nurse is caring for a client who is 2 days postoperative following abdominal surgery and observes that the client’s wound has eviscerated. After calling for help, which of the following actions should the nurse take first? Cover the area with a sterile dressing, moistened with 0.9% sodium chloride irrigation A nurse is preparing to administer liquid famotidine 20 mg PO every 6 hr. for a client who has GERD. Available is famotidine 40 mg/5 mL. How many mL should the nurse administer? 2.5 mL A nurse is caring for a school-age child who has a systemic disorder and is receiving antibiotics, immunosuppressants, and corticosteroids. Both of the child’s parents have a smoking history. The child reports soreness in his mouth and refuses to eat. Inspection of his mouth reveals a white, milky plaque that does not come off with rubbing. The nurse should suspect which of the following conditions? Candidiasis A nurse is caring for an older adult client who has had surgery for an intestinal obstruction and has an NG tube to wall suction. Which of the following interventions should the nurse include in the client’s postoperative plan of care? (Select all that apply.) Discontinue suction when assessing for peristalsis. Irrigate the NG tube with 0.9% sodium chloride irrigation solution. Place sequential compression devices on the bilateral lower extremities. Reposition the client from side to side every 2 hr. A nurse is providing care to a client who is on strict bed rest following surgery. The nurse assists the patient to the bedside commode and the client sustains an injury to the operative area. Which of the following types of torts has the nurse committed? Negligence A nurse is preparing to remove an NG tube from a client. Which of the following actions should the nurse take first? Verify the provider’s prescription to discontinue the tube A nurse is developing a plan of care for a client who is postoperative. Which of the following interventions should the nurse include in the plan to prevent pulmonary complications? Encourage the use of an incentive spirometer A nurse is preparing to administer three liquid medications to a client who has an NG tube with intermittent suction. Which of the following actions should the nurse take? Pinch the tube prior to attaching the medication syringe A nurse is caring for a client who has an NG tube. The nurse tests the pH of the secretions to determine if the tube is correctly place. Which of the following readings should the nurse expect? 4.0 A nurse is teaching a client who has a new prescription for sucralfate to treat a gastric ulcer. Which of the following statements by the client indicates an understanding of the teaching? “I will take this medication 1 hour before meals and at bedtime.” A nurse is caring for a client who is 1 day postoperative following a transsphenoidal hypophysectomy. While assessing the client, the nurse notes a large area of clear drainage seeping from the nasal packing. Which of the following should be the nurse’s initial action? Check the drainage for glucose A nurse is providing preoperative teaching by demonstrating diaphragmatic breathing to a client who is scheduled for surgery in the morning. Which of the following actions should the nurse include in the demonstration? Inhale slowly and evenly through her nose A nurse is preparing to perform an abdominal assessment on a child. Identify the sequence the nurse should follow. Inspection Auscultation Superficial palpitation Deep palpitation A nurse is teaching a client who is preoperative how to do deep-breathing exercises and cough effectively after surgery. Which of the following statements by the client indicates an understanding of the teaching? “I’ll splint my incision with a pillow to cough.” A nurse is instructing a client who has GERD about positions that can help minimize the effects of reflux during sleep. Which of the following statements indicates to the nurse that the client understands the instructions? “I will lie on my right side to sleep at night.” A nurse is preparing a teaching plan for a client who has chronic constipation secondary to irregular bowel habits. Which of the following should the nurse plan to include in the teaching? The client should follow a high-fiber diet to establish bowel regularity A nurse is caring for a client who has peptic ulcer disease. The nurse should monitor the client for which of the following findings as an indication of gastrointestinal perforation? Sudden abdominal pain A nurse is caring for four postoperative clients. The nurse can delegate obtaining vital signs to an assistive personnel (AP) for which of the following clients? A client who is 3 days postoperative following gastric bypass surgery A nurse is preparing to perform an abdominal assessment on a client. Identify the sequence of steps the nurse should take to conduct the assessment. Ask the client about having a history of abdominal pain. Inspect the abdomen for skin integrity. Auscultate the abdomen for bowel sounds. Percuss the abdomen in each of the four quadrants. Palpate the abdomen lightly for tenderness.