Nursing MedicalSurgical Revew Study Guide Rated A

Nursing: Medical-Surgical Revew Study Guide Rated A+ Which method elicits the most accurate information during a physical assessment of an older adult? A. use reliable assessment tools for older adults B. Review the past medical record for medications C. Ask the client to recount one's health history D. Obtain the client's information from a caregiver A client who has just tested positive for HIV does not appear to hear what the nurse is saying during post-test counseling. Which information should the nurse offer to facilitate the client's adjustment to HIV infection? A. teach the client about the medications that are available for treatment B. discuss retesting to verify the results, which will ensure continuing contact C. identify the need to test others who have had risky contact with the client D. inform the client how to protect sexual and needle-sharing partners The nurse is caring for a client with HIV infection who develops Mycobacterium avium complex (MAC). what is the most significant desired outcome for this client? A. free from injury of drug side effects B. maintenance of intact perineal skin c. adequate oxygenation D. return to pre-illness weight A client who had abdominal surgery two days ago has prescriptions for intravenous morphine sulfate 4 mg every 2 hours and a clear liquid diet. the client complains of feeling distended and has sharp, cramping gas pains. What nursing intervention should be implemented? A. assist the client to ambulate in the hall B. obtain a prescription for a laxative C. administer the prescribed morphine sulfate D. withhold all oral fluid and food A client with Meniere's disease is incapacitated by vertigo and is lying in bed grasping the side rails and staring at the television. Which nursing intervention should the nurse implement? A. keep the head of the bed elevated 30 degrees B. turn off the television and darken the room c. encourage fluids to 3000 mL per day D. change the client's position every two hours a client who has a chronic cough with blood-tinged sputum returns to the unit after a bronchoscopy. What nursing interventions should be implemented in the immediate post-procedural period? A. check vital signs every 15 minutes for 2 hours B. allow the client nothing by mouth until the gag reflex returns C. encourage fluid intake to promote elimination of the contrast media D. keep the client on bed rest for 8 hours The nurse is assessing a client with a cuffed tracheostomy tube in place who is breathing spontaneously. to evaluate if the client can tolerate cuff deflation to promote speaking and swallowing, what action should the nurse implement? A. observe the client for coughing colored sputum after drinking a small amount of colored water B. ask the client to try to speak C. auscultate for pulmonary crackles after the client drinks a small amount of clear water D. assess for respiratory distress What assessment finding should the nurse identify that indicates a client with an acute asthma exacerbation is beginning to improve after treatment? A. vesicular breath sounds decrease B. wheezing becomes louder C. bronchodilators stimulate coughing D. cough remains unproductive A client with sickle cell anemia is admitted with severe abdominal pain and the diagnosis is sickle cell crisis. What is the most important nursing action to implement? A. limit the client's intake of oral fluids B. teach the client about prevention of crises C. evaluate the effectiveness of narcotic analgesics D. encourage the client to ambulate as tolerated The nurse is caring for a client with non-Hodgkin's lymphoma who is receiving chemotherapy. Laboratory results reveal a platelet count of 10,000/mL. What action should the nurse implement? A. provide oral hygiene every 2 hours B. check for fever every 4 hours C. encourage fluids to 3000 mL/day D. check stools for occult blood A client is admitted for complaints of chest pain and aching for the past 4 days. the results for serum creatine kinase-MB (CK-MB) and troponin are obtained. What rationale should the nurse use to evaluate the laboratory findings? A. serum myoglobin levels are needed to confirm myocardial damage B. myocardial damage that occurred several days earlier is best validated by serum troponin levels C. the most reliable indicator of myocardial necrosis is serum CK-MB D. serum cardiac markers are inconclusive in determining myocardial injury after waiting several days Three weeks after discharge fro an acute myocardial infarction (MI), a client returns to the cardiac center for follow-up. When the nurse asks about sleep patterns, the client tells the nurse that he sleeps fine but that his wife moved into the spare bedroom to sleep when he returned home. He states "I guess we will never have sex again after this." Which response is best for the nurse to provide? A. sexual activity can be resumed whenever you and you wife feel like it because the sexual response is more emotional rather than physical B. you should discuss your questions about your sexual activity with your healthcare provider because sexual activity may be limited by your heart damage C. sexual activity is similar in cardiac workload and energy expenditure as climbing two flights of stairs and may be resumed like other activities D. sexual intercourse can be strenuous on your heart, but closeness and intimacy, such as holding and cuddling, can be maintained with your wife A male client with chronic atrial fibrillation and a slow ventricular response is scheduled for surgical placement of a permanent pacemaker. The client asks the nurse how this devise will help him. How should the nurse explain the action of a synchronous pacemaker? A. an impulse is fired every second to maintain a heart rate of 60 beats per minute B. ectopic stimulus in the atria is suppressed by the device of usurping depolarization C. ventricular irritability is prevented by the constant rate setting of a pacemaker D. an electrical stimulus is discharged when no ventricular response is sensed A man who smokes two packs of cigarettes a day wants to know if smoking is contributing to the difficulty that he and his wife are having getting pregnant. what information is best for the nurse to provide? A. smoking can decrease the quantity and quality of sperm B. the first semen analysis should be repeated to confirm sperm counts C. only marijuana cigarettes affect sperm count D. cessation of smoking improves general health and fertility E. sperm specimens should be collected in 2 subsequent days A couple trying to cope with an infertility problem wants to know what can be done to preserve emotional equilibrium. What is the best response for the nurse to provide? A. "talk only to other friends who are infertile since only they can help" B. "tell your friends and family so that they can help you" C. "get involved in a support group. I will give you some names" D. "start adoption proceedings immediately since obtaining an infant is very difficult" The nurse is providing post-operative instructions for a female client after a mastectomy. Which information should the nurse include in the teaching plan? A. avoid lifting more than 4.5 kg (10 lb) or reaching above her head B. empty surgical drains once a week using procedural gloves C. report inflammation of the incision site or the affected arm D. wearing clothing with snug sleeves over the arm on the operative side the nurse directs an unlicensed assisstive personnel (UAP) to obtain vital signs for a client who returns to the unit after having a mastectomy for cancer. What information should the nurse provide the UAP? A. elevate the arm with an IV infusing on the operative side with a pillow B. apply the blood pressure cuff to the arm on the non-operative side C. position the arm on the operative side close to the body D. collect a fingerstick blood specimen from the arm on the operative side Which client is at the highest risk for compromised psychological adjustment after a hysterectomy? A. a 62-year-old widow who has three friends who had uncomplicated hysterectomies B. A 29-year-old woman whose uterus ruptured after giving birth to her first child C. A 46-year-old woman with three children and a recent promotion at work D. A 55-year-old woman with abnormal bleeding and pain for 3 years A 48-year-old client with endometrial cancer is being discharged after a total hysterectomy and bilateral salpingo-oophorectomy. Which client statement indicates that further teaching is needed? A. "I have asked my daughter to stay with me next week after I am discharged" B. "Well, I don't have to worry about getting pregnant anymore" C. "I know I will miss having sexual intercourse with my husband" D. "I can't wait to go on the cruise that I have planned for this summer" A client in the pre-operative holding area receives a prescription for midazolam (Versed) IV. The nurse determines that the surgical consent form needs to be signed by the client. Which action should the nurse implement? A. give the drug and allow the client to read and sign the consent form B. withhold the drug until the client validates understanding of the surgical procedure and signs the consent form C. counter-sign the client's initials on the consent form after giving the drug D. call the healthcare provider to explain the surgical procedure before the client signs the consent A client with acute osteomyelitis has undergone surgical debridement of the diseased boen and asks the nurse how long will antibiotics have to be administered. Which information should the nurse communicate? A. parenteral antibiotics for 2 to 3 weeks, then oral antibiotics for 4 weeks B. parenteral antibiotics for 4 to 6 weeks, then oral antibiotics for up to 1 year C. oral antibiotics for 2 to 4 months, then for dental procedure prophylaxis D. parenteral antibiotics for 4 to 8 weeks, then oral antibiotics for 4 to 8 weeks A client with osteoarthritis request information from the nurse about what type of exercise regimen would be most beneficial for him. The nurse should communicate which information? A. repetitive strength-building exercises with weights or resistance bands B. high-impact aerobic exercise C. circuit training alternating with frequent rest periods D. low impact exercise, walking, swimming and water aerobics The nurse is preparing an adult client for an upper gastrointestinal (UGI) series. Which information should the nurse include in the teaching plan? A. enemas are given to empty the bowel after the procedure B. the xray procedure may last for several hours C. a nasogastric tube (NGT) is inserted to instill the barium D. nothing by mouth is allowed for 6 to 8 hours before the study The nurse is caring for a client scheduled to undergo insertion of a percutaneous endoscopic gastrostomy (PEG) tube. The client asks the nurse to explain how a PEG tube differs from a gastrostomy tube (GT). Which explanation best describes how they are different? A. diameter of the tubes B. procedure for feedings C. method of insertion D. location of the tubes The healthcare provider prescribes high-protein, high-fat, low-carbohydrate diet with limited fluids during meals for a client recovering from gastric surgery. The client asks the nurse what the purpose is for this type of diet. Which rationale should be included in the nurse's explanation to the client? A. it does not dilate the stomach B. it does not cause diarrhea C. it is slow to leave the stomach D. it is quickly digested The nurse is caring for a client with a small bowel obstruction. The client is vomiting foul smelling fecal-like material. What action should the nurse implement? A. position on the left side with knees drawn up B. Encourage ice chips sparingly C. administer anti-emetics every 2 to 3 hours D. give IV fluids with electrolytes What instruction should the nurse include in the discharge teaching for a client who needs to perform self-catheterization technique at home? A. maintain sterile technique B. drink 500 mL of fluid within 2 hours of catheterization C. use the Cred maneuver before catheterization D. catheterize every 3 to 4 hours A client's prostate-specific antigen (PSA) exam result showed a PSA density o 0.13 ng/ml. Which conclusion regarding this lab data is accurate? A. biopsy of the prostate is indicated B. probably prostatitis C. low risk for prostate cancer D. the presence of cancer cells The nurse is caring for a client after a transurethral resection of the prostate and determines the client's urinary catheter is not draining. What should the nurse implement? A. encourage the client to drink oral fluids B. change drainage unit tubing C. irrigate the catheter D. reposition the catheter drainage tubing A male client with a prostatic stent is preparing for discharge. What should the nurse ensure the client understands? A. increased frequency of assessment for prostatic cancer is needed B. ongoing antibiotic therapy is needed for one year C. the client should not undergo magnetic resonance imaging D. the client should not be catheterized though the stent for at least three months