PN Medical-Surgical Adult Medical Surgical Practice Exam Questions and Answers, Exams of Nursing

Download PN Medical-Surgical Adult Medical Surgical Practice Exam Questions and Answers and more Exams Nursing in PDF only on Docsity! 1470 ALL PRACTICE EXAM QUESTIONS AND ANSWERS FOR PN MEDICAL-SURGICAL ADULT MEDICAL SURGICAL 2023 100% CORRECTLY ANSWERED QUESTIONS WITH EXPLANATION A nurse is caring for a client who has a percutaneous endoscopic gastrostomy (PEG) tube and is receiving intermittent feedings. Prior to initiating the feeding, which of the following actions should the nurse take first? A. Flush the tube with water. B. Place the client in semi-Fowler's position. C. Cleanse the skin around the tube site. D. Aspirate the tube for residual contents. - CORRECT ANSWER B. Place the client in semi-Fowler's position. A nurse is caring for a client who is scheduled to undergo an esophagogastroduodenoscopy (EGD). The nurse should identify that this procedure is used to do which of the following? A. To visualize polyps in the colon B. To detect an ulceration in the stomach C. To identify an obstruction in the biliary tract D. To determine the presence of free air in the abdomen - CORRECT ANSWER A. A sigmoidoscopy or barium enema is used to visualize the lower gastrointestinal tract, where polyps are found. B. CORRECT: An EGD is used to visualize the esophagus, stomach, and duodenum with a lighted tube to detect a tumor, ulceration, or obstruction. C. Identifying an obstruction in the biliary tract is performed during endoscopic retrograde cholangiopancreatography (ERCP). D. The measurement of free air, which is a gas, is obtained using fluoroscopy or an x-ray, not an EGD. A nurse is teaching a client who has Barrett's esophagus and is scheduled to samii 1 undergo an esophagogastroduodenoscopy (EGD). Which of the following statements should the nurse include in the teaching? A. "This procedure is performed to measure the presence of acid in your esophagus." samii 2 A. Hypertension B. Excessive thirst C. Fever D. Diaphoresis - CORRECT ANSWER A. A client experiencing fluid volume overload will exhibit hypertension. B. A client experiencing hyperglycemia will exhibit excessive thirst. C. A client who has an infection will have an increased temperature. D. CORRECT: The nurse should recognize that the client has the potential for the development of hypoglycemia due to the sudden withdrawal of the TPN solution. In addition to diaphoresis. other potential manifestations of hypoglycemia can include weakness, anxiety, confusion. and hunger. A nurse is caring for a client who has celiac disease. which of the following foods should the nurse remove from the client's meal tray? A. Wheat toast B. Tapioca pudding C. Hard-boiled egg D. Mashed potatoes - CORRECT ANSWER A. CORRECT: Celiac disease is an autoimmune disorder characterized by a permanent intolerance to wheat, barley, and rye. Wheat toast contains gluten and should be removed from the clients tray. B. Tapioca pudding is rich in dairy and does not contain gluten. Therefore, it is an acceptable food to include in the clients diet. C. A hard-boiled egg does not contain gluten and is a good source of protein. Therefore, it is an acceptable food to include in the client's diet. D. Mashed potatoes do not contain gluten and are a good source of protein and potassium. Therefore mashed potatoes are an acceptable food to include in the clients diet. A nurse is caring for a client who is scheduled to undergo a liver biopsy for a suspected malignancy. which of the following laboratory findings should the nurse monitor prior to the procedure? samii 5 A. Prothrombin time samii 6 B. Serum lipase C. Bilirubin D. Calcium - CORRECT ANSWER A. CORRECT: A major complication following a liver biopsy is hemorrhage. Many clients who have liver disease have clotting defects and are at risk for bleeding. Along with the prothrombin time (PT), the activated partial thromboplastin time (aPTT) and the platelet count should be monitored. Liver dysfunction causes the production of blood clotting factors to be reduced, which leads to an increased incidence of bruising nosebleeds, bleeding from wounds, and gastrointestinal bleeding. This is due to a deficient absorption of vitamin K from the gastrointestinal tract caused by the inability of liver cells to use vitamin K to make prothrombin. B. Serum lipase is monitored to detect pancreatic disease and does not need to be monitored prior to this procedure. C. Bilirubin is monitored to detect biliary obstruction and does not need to be monitored prior to this procedure. D. Calcium is monitored to detect kidney failure or pancreatitis and does not need to be monitored prior to this procedure. A nurse is assessing a client who is experiencing perforation of a peptic ulcer. Which of the following manifestations should the nurse expect? A. Increased blood pressure B. Decreased heart rate C. Yellowing of the skin D. Boardlike abdomen - CORRECT ANSWER A. The nurse should expect the client who is experiencing perforation of a peptic ulcer to exhibit manifestations of shock, including hypotension. B. The nurse should expect the client who is experiencing perforation of a peptic ulcer to exhibit manifestations of shock, including tachycardia. C. The nurse should expect a client who has liver disease to exhibit jaundice, or yellowing of the skin. D. CORRECT: The nurse should expect the client who is experiencing perforation of a peptic ulcer to exhibit manifestations of a boardlike abdomen and severe pain in the abdomen or back that radiates to the right shoulder. Vomiting of blood and shock can occur if the perforation causes hemorrhaging. samii 7 A. Right shoulder pain B. Urine output 20 mL/hr C. Temperature 38.4 degrees C (101.1 degrees F) D. Oxygen saturation 92% - CORRECT ANSWER A. CORRECT: The client can experience pain in the right upper shoulder due to gas (carbon dioxide) injected into the abdominal cavity during the laparoscopic procedure, which can irritate the diaphragm and cause referred pain in the shoulder area. The pain disappears in 1- 2 days. Mild analgesics and a recumbent position can help with client comfort. B. Urine output following surgery should be at least 30 mL/hr. Less than this amount can indicate hypovolemia or renal complications and should be reported to the provider immediately. C. A temperature greater than 38.4. C (101.1 F) can indicate infection and should be reported to the provider immediately. D. An oxygen saturation of less than 95% can indicate an impaired gas exchange following surgery and should be reported to the provider immediately. A nurse in the emergency dependent is caring for a client who has bleeding esophageal varies. The nurse should anticipate a prescription for which of the following medications? A. Famotidine B. Esomeprazole C. Vasopressin D. Omeprazole - CORRECT ANSWER A. Famotidine is an H2 receptor antagonist used to treat stress ulcers. B. Esomeprazole is a proton pump inhibitor used to treat gastrointestinal reflux disease. C. CORRECT: Vasopressin constricts the splanchnic bed and decreases portal pressure. Vasopressin also constricts the distal esophageal and proximal gastric veins, which reduces inflow into the portal system and is used to treat bleeding varies. D. Omeprazole is a proton pump inhibitor used to treat duodenal and gastric ulcers. samii 10 A nurse is assessing a client who is in the early stages of hepatitis A. which of the following manifestations should the nurse expect? A. Jaundice samii 11 B. Anorexia C. Dark urine D. Pale feces - CORRECT ANSWER A. Jaundice is a late manifestation of hepatitis A. B. CORRECT: Anorexia is an early manifestation of hepatitis A and is often severe. It is thought to result from the release of a toxin by the damaged liver or by the failure of the damaged liver cells to detoxify an abnormal product. C. Dark urine is a late manifestation of hepatitis A. D. Pale feces is a late manifestation of hepatitis A. A nurse is caring for a client who has acute pancreatitis. Which of the following serum laboratory values should the nurse anticipate returning to the expected reference range within 72 hr after treatment begins? A. Aldolase B. Lipase C. Amylase D. Lactic dehydrogenase - CORRECT ANSWER A. Elevated aldolase levels are caused by inflammation of the muscles, also known as myositis. The levels of aldolase are not affected by pancreatic disorders. B. Lipase levels in clients who have pancreatitis increase after a rise in serum amylase and stay elevated for up to 14 days longer than amylase. C. CORRECT: Pancreatitis is the most common diagnosis for marked elevations in serum amylase. Serum amylase begins to increase about 3 to 6 hr following the onset of acute pancreatitis. The amylase level peaks in 20 to 30 hr and returns to the expected reference range within 2 to 3 days. D. Lactic dehydrogenase (LDH) increases are typically seen in clients who have anemia, leukemia, or liver damage. A nurse is caring for a client who is 2 days postoperative following a gastric bypass. The nurse notes that bowel sounds are present. Which of the following foods should the nurse provide at the initial feeding? A. Vanilla pudding B. Apple juice samii 12 A. Children B. Older adults samii 15 C. Women who are pregnant D. Middle-aged men - CORRECT ANSWER A. CORRECT: The hepatitis A virus can be contracted from the feces. bile, and blood of infected clients. The usual mode of transmission is the fecal-oral route. Children and young adults are the two groups most often affected by the hepatitis A virus. Typically, a child or young adult acquires the infection at school, through poor hygiene, hand-to-mouth contact, or another form of close contact. B. Older adults are not often affected by or at risk for developing hepatitis A. C. Women who are pregnant are not often affected by or at risk for developing hepatitis A. D. Middle-aged men are not often affected by or at risk for developing hepatitis A. A nurse is assessing a client who was admitted with a bowel obstruction. The client reports severe abdominal pain. Which of the following findings should indicate to the nurse that a possible bowel perforation has occurred? A. Elevated blood pressure B. Bowel sounds increased in frequency and pitch C. Rigid abdomen D. Emesis of undigested food - CORRECT ANSWER A. A client who has experienced a bowel perforation will not display an elevated blood pressure. However, hypotension or shock can be present. B. Intestinal peristalsis increases in frequency and intensity as the bowel attempts to move intestinal contents past the obstructed area. Bowel sounds are silent with a bowel perforation C. CORRECT: Abdominal tenderness and rigidity occur with a bowel perforation. As fluid escapes into the peritoneal cavity, there is a reduction in circulating blood volume and a lowered blood pressure. or hypotension, results. D. Vomiting is frequent and copious with a small bowel obstruction. This does not indicate a bowel perforation. A nurse is caring for a client who has fulminant hepatic failure. Which of the following procedures should the nurse anticipate for this client? A. Endoscopic sclerotherapy samii 16 B. Liver lobectomy C. Liver transplant samii 17 A. Severe, radiating abdominal pain B. Black, tarry stools and dark urine C. Increased and painful urination D. Increased appetite and weight gain - CORRECT ANSWER A. Severe, radiating abdominal pain A nurse is providing dietary instructions to a client with a history of pancreatitis. Which instruction is correct? A. Maintain a high-fat diet and drink at least 3 L of fluid a day. B. Maintain a high sodium, high-calorie diet C. Maintain a high carbohydrate, low-fat diet D. Maintain a high-fat, high-carbohydrate diet - CORRECT ANSWER C. Maintain a high carbohydrate, low-fat diet A nurse is assisting with serving dinner trays on the unit. Upon receiving the dinner tray for a patient admitted with acute gallbladder inflammation, the nurse will question which of the following foods on the tray? A. Fried chicken B. Mashed potatoes C. Dinner roll D. Tapioca pudding - CORRECT ANSWER A. Fried chicken A nurse is caring for a patient with liver failure and is performing an assessment in the knowledge of the patients increased risk of bleeding. The nurse recognizes that this risk is related to the patients inability to synthesize prothrombin in the liver. What factor most likely contributes to this loss of function? A. Alterations in glucose metabolism B. Retention of bile salts samii 20 C. Inadequate production of albumin by hepatocytes samii 21 D. Inability of the liver to use vitamin K - CORRECT ANSWER D. Inability of the liver to use vitamin K Which of the following is a true statement regarding regional enteritis (Crohn's disease)? A. It has a progressive disease pattern B. It is characterized by lower left quadrant abdominal pain. C. The clusters of ulcers take on a cobble stone appearance. D. The lesions are in continuous contact with one another. - CORRECT ANSWER C. The clusters of ulcers take on a cobble stone appearance. A nurse is preparing to provide care for a patient whose exacerbation of ulcerative colitis has required hospital admission. During an exacerbation of this health problem, the nurse would anticipate that the patients stools will have what characteristics? A. Watery with blood and mucus B. Hard and black or tarry C. Dry and streaked with blood D. Loose with visible fatty streaks - CORRECT ANSWER A. Watery with blood and mucus What is the cause of a 'non-mechanical' bowel obstruction? A. A tumor or twisting of the bowel B. Constipation. C. General anesthesia, narcotics, and handling of the bowel during surgery. D. Adhesions - CORRECT ANSWER C. General anesthesia, narcotics, and handling of the bowel during surgery. What should the nurse advise a pt. who has diverticulosis to eat? samii 22 B. Monitor for shock. samii 25 C. Position the pt. on his back with a pillow under his right ribs and his right hand under his head. D. Guiac his stool - CORRECT ANSWER B. Monitor for shock. Which of the following is an appropriate nursing intervention for a pt. who has gastritis? A. Lavage the NG tube with iced saline. B. Give sucralfate with meals and follow it with antacids. C. Advise the pt. to avoid irritating foods such as spicy foods. D. Advise the pt. to drink milk every two hours. - CORRECT ANSWER C. Advise the pt. to avoid irritating foods such as spicy foods. Which of the following is an appropriate nursing intervention for a pt. who has an inguinal hernia? A. Turn, cough, & deep breath every hour while awake to prevent pneumonia. B. Avoid prolonged standing. C. Decrease fiber intake to control diarrhea. D. Monitor your stools for occult blood. - CORRECT ANSWER B. Avoid prolonged standing. Which of the following should the nurse advise a pt who has ulcerative colitis to call the doctor for? A. Occasional abdominal cramping B. Nine mucous bloody stools per day. C. Signs of colon perforation and peritonitis. D. Diarrhea. - CORRECT ANSWER C. Signs of colon perforation and peritonitis. Which of the following promotes rest and healing of the bowel in a pt. who has ulcerative colitis? samii 26 A. High fiber diet samii 27 The drug that used to be the prototype for H2 receptor Antagonists: - CORRECT ANSWER cimetidine (Tagamet) Serious Side effects of ranitidine (Zantac): - CORRECT ANSWER neutropenia, Agranulocytosis, Thrombocytopenia Aplastic anemia The potential electrolyte imbalances w/use of aluminum hydroxide w/magnesium hydroxide: - CORRECT ANSWER Hypophosphatemia & hypermagnesiemia The diet restrictions that should be taught for treatment of peptic ulcers: - CORRECT ANSWER avoiding Highly acidic, Spicey foods, alcohol, & caffeine The reason omeprazole dose may need to be adjusted in Asians: - CORRECT ANSWER the duration Of action is lengthened The common adverse effects of magnesium hydroxide: - CORRECT ANSWER cramps, Diarrhea, and nausea Caused by overactive GI activity Barium swallow: - CORRECT ANSWER Fluoroscopic observation of a client swallowing a flavored barium solution and its progress down the esophagus to detect structural abnormalities of the esophagus as well as swallowing discoordination and oral aspiration. Barium enema: - CORRECT ANSWER Radiographic study used to identify polyps, tumors, inflammation, strictures, and other abnormalities of the colon after instilling barium solution rectally. Endoscopic retrograde cholangio-pancreatography: - CORRECT ANSWER Procedure in which an endoscope is used to visualize the common bile duct and the pancreatic and hepatic ducts through the ampulla of Vater in the duodenum. Esophagogastro-duodenoscopy: - CORRECT ANSWER Examination of the esophagus, stomach, and duodenum through an endoscope to inspect, treat, or obtain specimens from any of the upper GI structures. samii 30 Melena: - CORRECT ANSWER Black, tarry stools. samii 31 PY test: - CORRECT ANSWER Test in which a client's breath is analyzed after consuming 14 C-urea capsules to detect Helicobacter pylori, the bacteria associated with peptic ulcer disease. Percutaneous liver biopsy: - CORRECT ANSWER Procedure in which a small core of liver tissue is obtained by placing a needle directly into the liver through the lateral abdominal wall. Radionuclide imaging: - CORRECT ANSWER Technique used to detect lesions in organs using a radioactive natural or synthetic element that is injected intravenously or ingested orally. Ultrasonography: - CORRECT ANSWER Technique that uses high-frequency sound waves to show the size and location of organs and to outline structures and abnormalities. A nurse is completing an admission assessment of a client who has pancreatitis. which of the following is an expected finding? A. Pain in right upper quadrant radiating to right shoulder B. Report of pain being worse when sitting upright C. Pain relieved with defecation D. Epigastric pain radiating to left shoulder - CORRECT ANSWER D. Epigastric pain radiating to left shoulder A nurse is reviewing the health record of a client who has pancreatitis. The physical exam report by the provider indicates the presence of cullens sign. Which of the following is an appropriate action by the nurse to identify this finding? A. Tap lightly at the costovertebral margin on the clients back. B. Palpate the clients Right lower quadrant C. Inspect the skin around the umbilicus D. Auscultate the area below the clients scapula - CORRECT ANSWER C. Inspect samii 32 C. Record the results as normal D. Test the clients urine for blood. - CORRECT ANSWER C. Record the results as normal samii 35 You are working in the paracentesis clinic. Which of the following clients is most likely to have an adverse reaction to the lidocaine local anesthetic? A. Asian (Chinese) B. African american C. Caucasian D. Hispanic (Puerto rican) E. Native american (Navajo) - CORRECT ANSWER E. Native american (Navajo) A nurse is caring for a client who had a Paracentesis. Which of the following findings indicate the bowel was perforated during the procedure? A. Client report of upper chest pain B. Decreased urine output C. Pallor D. Temperature elevation - CORRECT ANSWER D. Temperature elevation The physician orders cholestyramine (questran) for the client with cirrhosis. The nurse determines that the drug is effective when the client exhibits which of the following? A. Reduced serum ammonia levels B. Improved clotting ability C. Decreased complaints of pruritus D. Improved serum protein levels - CORRECT ANSWER C. Decreased complaints of pruritus A college student is diagnosed with Hepatitis A (HAV). Which of the following actions by the nurse best accomplishes the goal of reducing potential transmission of HAV? samii 36 A. The nurse dons a mask and gown when providing direct care B. The nurse maintains the client in private room at all times samii 37 The nurse is providing care for a patient who has acute Hepatitis B. Which of the following findings should the nurse expect? A. Joint pain B. Obstipation C. Periumbilical discoloration D. Right upper quadrant tenderness - CORRECT ANSWER D. Right upper quadrant tenderness The nurse is providing discharge teaching for a patient who has chronic hepatitis C. Which of the following statements by the patient indicates an understanding of the teaching? A. "I will decrease my intake of calories." B. "I will need treatment for 3 months" C. "I will avoid alcohol until i am no longer contagious" D. "I will avoid medications that contain acetaminophen" - CORRECT ANSWER D. "I will avoid medications that contain acetaminophen" The nurse is providing care for a patient who has peritonitis. The patient expresses anxiety about the impending surgery. Which of the following actions should the nurse take? A. "Why are you feeling so anxious?" B. "Tell me more about your concerns." C. "You should distract yourself by reading a magazine" D. "You have nothing to worry about. Your surgeon is excellent." E. "Others who have had this procedure have had great results." - CORRECT ANSWER B. "Tell me more about your concerns." A client is diagnosed with Hepatitis A (HAV). Which of the following should the nurse include in client education? samii 40 A. "This type of hepatitis can now be cured by using a new medication every day for 12 weeks." samii 41 B. "You cannot transmit this type of Hepatitis to others unless you have unprotected sex." C. "It's just fine to continue working as a food handler as long as you wear gloves." D. "You and everyone in your household should preform good handwashing." - CORRECT ANSWER D. "You and everyone in your household should preform good handwashing." Which layer of the uterus is responsible for labor and delivery? - CORRECT ANSWER Myometrium The smooth muscle of the prostate gland contributes to what function? - CORRECT ANSWER Ejaculation What hormone stimulates the release of milk from the breast of a nursing mother ? - CORRECT ANSWER Oxytocin Women secrete less estrogen as they age. What is one effect of this decrease? - CORRECT ANSWER Osteoporosis What change in the reproductive system do men experience as a normal part of aging? - CORRECT ANSWER Prostatic hypertrophy A woman has had two pregnancies. The first pregnancy produced a healthy baby girl. The second pregnancy produced a set of twins, a boy and a girl. How would the nurse document this history? - CORRECT ANSWER GII, PII What does the term abortus mean in an obstetrical history? - CORRECT ANSWER Loss of a fetus before it was mature enough to live outside of the mother The nurse is assisting with teaching a woman about early detection of cancer. According to the American Cancer Society, how should a 52-year-old woman be instructed to monitor for breast cancer? - CORRECT ANSWER Monthly BSE and a mammogram and clinical examination yearly samii 42 denies discomfort. Which of the following statements, recorded in the chart, is most appropriate? - CORRECT ANSWER "Gynecomastia noted bilaterally, no complaints of tenderness." samii 45 While performing a physical examination on a male patient, the nurse notes that the urethral opening is located on the underside of the penis. Which of the following terms best describes this condition? - CORRECT ANSWER Hypospadias The nurse is helping a patient who is scheduled to have a cystourethroscopy. Which of the following questions is most important for the nurse to ask? - CORRECT ANSWER "Do you have any allergies?" The nurse is caring for a patient who recently underwent cystourethroscopy. Which of the following instructions should the nurse provide before the patient is discharged? - CORRECT ANSWER "You should report any changes in your usual urination pattern." A patient learns he has an elevated prostate-specific antigen (PSA) and asks the nurse what this means. What is the best response? - CORRECT ANSWER "An elevated PSA can indicate prostatic hypertrophy or cancer. You should follow up as your physician advises." According to the American Cancer Society, how often should a breast self- examination (BSE) be performed? - CORRECT ANSWER Monthly The vulva includes which of the following structures? (Select all that apply.) - CORRECT ANSWER Mons pubis Bartholin's glands Clitoris Which glands produce secretions that become part of semen? (Select all that apply.) - CORRECT ANSWER Bulbourethral glands Prostate gland Seminal vesicles What assessment findings on breast palpation should the nurse report to the physician for follow-up? (Select all that apply.) - CORRECT ANSWER Puckering or dimpling of skin samii 46 Asymmetrical movement of the breasts Areas of different consistency Different pointing position of nipples samii 47 Rationale: "The client chooses a treatment plan presented by the provider based on the client's preferences" is correct. Shared decision making is an important component of patient-centered healthcare in which the client and the provider work together to make a decision for a treatment plan. Shared decision making in this case would involve the client discussing his options for surgery with his provider and then making a decision based on the client's preferences and on clinical outcomes. A client is suffering from osteoarthritis in the knees and the nurse is providing care. The nurse is assessing the client's pain level and pain tolerance. Based on the nurse's understanding of pain, the nurse knows that a client's pain tolerance is most likely increased by which of the following? a. Sleep b. Boredom c. Introversion d. Anger - CORRECT ANSWER a. People have varying levels of pain tolerance, which is described as the amount of pain a person can endure. Some activities and conditions may positively affect a client's pain tolerance and may improve how pain is handled. Regular and restorative sleep can help a person to manage pain better than being sleep deprived. Other conditions that can raise pain tolerance include relaxation therapy, diversion, and social inclusion. A nurse is educating a client about his osteoarthritis and how best to manage his condition at home. Which of the following statements made by the client indicate that more teaching is necessary? a. I am going to quit smoking because it will help with my disease b. I can sit at my computer and perform my data entry job like I usually do c. I play football, but I am going to switch to walking instead d. I'm going to work on losing weight - CORRECT ANSWER b. Rationale: "I can sit at my computer and perform my data entry job like I usually do" is correct. Osteoarthritis is a type of joint disease in which the cartilage between the bones and joints breaks down, causing pain and deformity in the affected areas. A client who has osteoarthritis can make some lifestyle changes that will improve quality of life and help to control pain and disability. The client should be taught to quit smoking if he does smoke and to limit activities that cause significant pressure or damage to the joints, such as with certain contact sports. The client should also avoid or modify activities that involve repetitive actions, like samii 50 data entry, which can cause further damage from repeated stress to the joints. samii 51 The nurse received report on 4 clients and has decided that the client who needs methotrexate should be seen first. Which of the following clients needs methotrexate? a. A client with osteoarthritis b. A client with a bowel obstruction c. A client with rheumatoid arthritis d. A client with seizures - CORRECT ANSWER c. rationale: Methotrexate is an anti-rheumatic used to treat psoriasis or rheumatoid arthritis. Etanercept is a subcutaneous DMARD injection. The nurse understands that this drug does which of the following? a. Increases endogenous endorphins b. Reduces substance P in the tissues c. Blocks tumor necrosis factor receptors d. Decreases perception of pain - CORRECT ANSWER c. rationale: Etanercept binds with tumor necrosis factor (TNF) and blocks the TNF receptors on the cells, decreasing the symptoms of the disease. This reduces swelling and inflammation, therefore improving symptoms for the client with RA. A client takes medication for rheumatoid arthritis. The nurse reviews the client's list of medications and knows that which of the following medications is used to treat and manage rheumatoid arthritis? a. Immodium b. Indomethacin c. Imdur d. Inderal - CORRECT ANSWER b. rationale: "Indomethacin" is correct. This is an anti-rheumatic medication used most often for clients with rheumatoid arthritis. samii 52 b. Get plenty of calcium. c. Lose weight if needed. d. Engage in weight-bearing exercise. - CORRECT ANSWER c. rationale: Obesity can lead to OA, and if the client is overweight, losing weight can help prevent OA or reduce symptoms once it occurs. Arthritis can be caused by contact sports, but this is less common than obesity. Calcium and weight-bearing exercise are both important for osteoporosis. A nurse is caring for a 78-year-old client with severe, debilitating rheumatoid arthritis who lives at home with the spouse. The nurse assesses the client's level of safety in the home. Which aspects should be included as part of this home safety assessment? Select all that apply. a. Whether there is sufficient lighting b. Whether the home has ceiling fans c. Whether there is space available for a caregiver to help with the client d. Whether there are changes in floor levels e. Whether there are stairs in the home - CORRECT ANSWER a., c., d., e. rationale: When caring for a client in the home, the nurse may notice safety hazards that could protect the client if changed. The client should be able to move about in the home and have assistive devices, such as grab bars in the bathroom, levers instead of round handles, and railings on stairs. The nurse should point out any obvious hazards so they can be changed as soon as possible. When caring for a client in the home, the nurse may notice safety hazards that could protect the client if changed. The client should be able to move about in the home and have assistive devices, such as grab bars in the bathroom, levers instead of round handles, and railings on stairs. The nurse should point out any obvious hazards so they can be changed as soon as possible.When caring for a client in the home, the nurse may notice safety hazards that could protect the client if changed. The client should be able to move about in the home and have assistive devices, such as grab bars in the bathroom, levers instead of round handles, and railings on stairs. The nurse should point out any obvious hazards so they can be changed as soon as possible. When caring for a client in the home, the nurse may notice safety hazards that could protect the client if changed. The client should be able to move about in the home and have assistive devices, such as grab bars in the bathroom, levers instead of round handles, and railings on stairs. The nurse should point out any obvious hazards so they can be changed as soon as possible. samii 55 A client with potential rheumatoid arthritis is having laboratory testing and requires an ESR blood test. Which of the following best describes the ESR? samii 56 a. The rate at which blood cells settle to the bottom of a tube containing blood b. The amount of by-product produced with muscle breakdown c. The presence of a gene that increases rheumatoid factor d. The level of antibodies present in response to an inflammatory antigen - CORRECT ANSWER a. ratoinale: A client with rheumatoid arthritis may have a laboratory test of an ESR (erythrocyte sedimentation rate), or 'sed rate' to determine the amount of inflammation present. Inflammation causes red blood cells to clump. When the cells clump, they become denser and sink to the bottom of the tube more quickly. The ESR is the rate at which blood cells settle to the bottom of a tube containing blood. The nurse is educating a client on managing gout. Which of the following statements by the client indicates more education is necessary? Select all that apply. a. "I can't wait to get home. My wife and I have our weekly wine and cheese night with friends" b. "When I have a flare-up, I try to increase my activity to get the blood flowing better and hopefully have it resolve faster" c. "I try to limit my intake of water. I feel like that helps my symptoms" d. I need to make sure I get a refill of my allopurinol for my gout" e. "Man, these tophi are incredibly painful" - CORRECT ANSWER a. , b., , c. rationale: "I can't wait to get home. My wife and I have our weekly wine and cheese night with friends" This statement indicates that more education is necessary. Wine and cheese are high in purines, which worsen symptoms of gout. Foods high in purines should be avoided. "When I have a flare-up, I try to increase my activity to get the blood flowing better and hopefully have it resolve faster" This statement indicates that more education is necessary. While activity and blood flow can help decrease pain and prevent flare ups, rest is always recommended during an actual flare up. "I try to limit my intake of water. I feel like that helps my symptoms" This statement indicates that more education is necessary. Adequate hydration is samii 57 b. The patient must not have suffered a fracture in the past c. The patient must have had osteoporosis for at least five years prior samii 60 d. The patient cannot have a history of cancer - CORRECT ANSWER a. rationale: "The patient should not have a vitamin D deficiency" is correct. Ibandronate is a type of medication known as a biphosphonate, which works for the treatment of osteoporosis. Ibandronate works by changing how bone is formed and broken down in the body, slowing the progression of osteoporosis. The patient who takes this drug must be able to sit up for at least 60 minutes after administration. It is also not intended for those who have vitamin D deficiency, because this affects calcium levels in the body. Additionally, the patient with kidney disease should not take biphosphonates because of the risk of renal toxicity. A client with osteoporosis asks the nurse why it is important to take vitamin D. Which response by the nurse is correct? a. Vitamin D reduces excretion of calcium in the kidneys b. Vitamin D minimizes the risk of kidney stones c. Vitamin D helps prevent constipation from increased calcium intake d. Vitamin D improves the absorption of calcium - CORRECT ANSWER d. rationale: "Vitamin D improves the absorption of calcium" is correct. Taken with calcium, vitamin D aids with calcium absorption which is essential for bone building and slowing the progression of osteoporosis. A 70-year-old client has been diagnosed with osteoporosis after undergoing a bone mineral density test. When reviewing the results of the test, the nurse explains to the client that the T score is which of the following? a. The amount of bone density compared to that of a healthy 30-year-old b. The test results of the DEXA scan, expressed in mg/mL c. The level of calcium found in a particular bone in the body d. The amount of radiation used with the test - CORRECT ANSWER a. rationale: "The amount of bone density compared to that of a healthy 30-year-old" is correct. A T-score of a bone mineral density test checks the amount of bone density the client has and compares it to the bone density of a healthy 30-year- old. The T-score is given so that the client understands if their bone density is samii 61 above or below average levels. samii 62 The nurse is caring for a client with suspected osteomyelitis. Which of the following are key features of this condition? Select all that apply. a. Temperature of 101.5 degrees Fahrenheit b. Increased drainage from the affected area c. Skin ulceration around the affected area d. Constant bone pain that increases with movement e. Increased swelling around the affected area - CORRECT ANSWER a., d. , e. rationale: A fever is usually seen with acute osteomyelitis. Constant bone pain is typically how a client with osteomyelitis describes their pain. The client may also say the pain is localized and pulsating. Increased edema is associated with the infection and inflammatory response. As for increased drainage, it is often seen with CHRONIC osteomyelitis. When osteomyelitis is suspected, it is likely in the ACUTE phase. The home care nurse is caring for a client who was recently discharged from the hospital with a diagnosis of osteomyelitis. The nurse learns that the client stopped taking the prescribed oral antibiotics once symptoms improved. What is an appropriate response from the nurse? a. "I'm glad you are feeling better! You are correct that antibiotic therapy should be discontinued once you start to feel better" b. "I'm not sure why you were discharged on oral antibiotics in the first place. They are less effective than other forms of treatment" c. "The whole course of antibiotics should be completed. Even though you are feeling better, you should continue to take the medication" d. "Since you are diabetic it is important that you stop the antibiotics as soon as possible. I'm glad you were able to stop them" - CORRECT ANSWER c. rationale: The full course of antibiotics should always be taken to ensure that the infection is resolved, and resistant strains of bacteria do not develop. The nurse is working with a client who is hospitalized for osteomyelitis. The nurse notes that this is the client's third hospitalization for osteomyelitis in three months. Which of the following conditions in this client's health history does NOT put the samii 65 client at higher risk for developing osteomyelitis? a. Type 2 diabetes samii 66 b. Kidney stones c. Malnutrition d. Alcoholism - CORRECT ANSWER b. rationale: A history of kidney stones does not increase a client's risk of developing osteomyelitis. However, kidney disease would increase a person's risk for developing osteomyelitis because diseased kidneys increase the risk for infection, and one way infection can reach the bone is by traveling through the bloodstream. Remember, Type II DM, malnutrition, and ETOH increase a person's risk for developing osteomyelitis because they all decrease the body's defense against infection. The nurse is caring for a client who is admitted for acute osteomyelitis. The client's vital signs are as follows: Temperature: 102.1 degrees fahrenheit Blood pressure: 88/50 Heart rate: 107 Respiratory rate: 20 Pulse oximetry: 97% on room air Which orders does the nurse expect the provider to order for this client based on this set of vital signs? Select all that apply. a. Morphine 4 mg Q4H PRN b. 1,000 ml fluid bolus c. Two sets of blood cultures d. Tylenol 650 mg Q4H PRN e. STAT Lactic Acid level - CORRECT ANSWER b. , c., d., e. rationale: This client is showing classic signs of sepsis and needs the fluid bolus to support blood pressure. 2 sets of blood culture is a standard of care prior to initiating antibiotics to determine what kind of infection is present when there is one in the blood. Tylenol is appropriate because managing this client's fever is a priority. Since this client is showing classic signs of sepsis, the lactic acid level should be drawn to verify whether it is elevated. The nurse took over the care of a client with a left foot amputation done two days ago. Which of the following tasks does the nurse NOT have to complete during client care? a. Check vital signs routinely b. Position every two hours samii 67 totally avoided. Women should not have more than one drink per day. samii 70 A nurse is helping a client to walk down the hall in the unit of the hospital. The client has recently had a prosthetic lower limb placed on his left lower leg. Which of the following should the nurse suggest to help the client to properly walk with this prosthesis? Select all that apply. a. Hike up the hip and swing the artificial leg forward with a step b. Keep the feet shoulder width apart c. Use a cane in the hand opposite the prosthetic limb d. Instruct the client to stand erect while ambulating e. Have the client look at their feet while walking - CORRECT ANSWER b., c. , d. , rationale: Keeping the feet shoulder width apart will promote balance and proper ergonomics. A cane may be used at first to assist with balance. A client who uses a prosthetic limb will take time and training from a physical therapist to learn to walk and move correctly with the limb. Correct technique will prevent stump damage and support muscle strength. The nurse can assist with proper technique as well, and should teach the client to stand erect and look ahead while walking and avoid hitching up the leg or dragging the leg when taking a step. A diabetic client arrives on the floor after a below the knee amputation and the stump is dressed and clean. Which of the following orders should the nurse implement first? a. Discuss nutrition with client b. Obtain vital signs c. Call physical therapy to see client d. Change the wound dressing - CORRECT ANSWER b. rationale: A client who uses a prosthetic limb will take time and training from a physical therapist to learn to walk and move correctly with the limb. Correct technique will prevent stump damage and support muscle strength. The nurse can assist with proper technique as well, and should teach the client to stand erect and look ahead while walking and avoid hitching up the leg or dragging the leg when taking a step. A client admitted with diabetic ketoacidosis (DKA) is very upset and concerned because a family member recently had to have an amputation due to diabetes samii 71 complications. The client asks what can be done to prevent amputation. Which of the following is the best response by the nurse? Select all that apply. a. Take your diabetic medications as prescribed b. Wear slippers or shoes around the house samii 72 rationale: The nurse will need to assess lab values to ensure the client is healthy enough to undergo the procedure. Preparation for a limb amputation requires specific care and teaching to best prepare the client for the procedure. High levels of anxiety are associated with this procedure, so it is important for the nurse to educate the client and family thoroughly. The nurse can instruct the client about maintaining appropriate nutrition and hydration adequately for surgery. A client who has undergone a below-the-knee amputation is getting ready for a fitting for prosthesis. The nurse performs interventions to shrink the leg stump. Which activity is part of stump shrinkage? Select all that apply. a. The nurse uses an elastic roller bandage b. The bandage is wrapped around the stump and kept smooth c. The stump is shrunk to a point that it is half its original size d. The client needs pain medication before the procedure e. The nurse should inspect the stump before applying the bandage - CORRECT ANSWER a., b., e. rationale: After an amputation, the nurse may need to wrap the stump to shrink it in order to prepare it to fit into a prosthesis. The nurse wraps the stump using an elastic roller bandage after first inspecting the site for signs of redness or drainage. After wrapping the stump tightly, the nurse ensures that the bandage is smooth and free of wrinkles.The nurse will always inspect the area of the body being wrapped to check for any lesions, redness, openings, or bruises that may need addressed. A nurse arrives and is assigned four clients to care for. The nurse knows that which of the following clients are the least at risk for developing the need for an amputation? a. 67-year-old client with Type 2 Diabetes and diabetic neuropathy b. 32-year-old client with Type 1 Diabetes that is noncompliant with medications and diet c. 58-year-old client with peripheral vascular disease (PVD) d. 76-year-old client with COPD and CHF with edematous bilateral lower extremities - CORRECT ANSWER d. rationale: The 76-year-old client with COPD and CHF with edematous bilateral lower extremities is at the lowest risk for developing the need for an amputation. samii 75 The nurse is caring for a client with a broken femur. The client is at higher risk for which of the following due to this specific bone fracture? Select all that apply. a. Deep vein thrombosis b. Pulmonary embolism c. Heart attack d. Pneumonia e. Stroke - CORRECT ANSWER b., c., e rationale: The femur is a long bone. Fractures to long bones increase the risk of a fat embolism, which can travel to the lungs and cause a pulmonary embolism.A fat embolism is possible following a long bone fracture. If this particle of fat becomes lodged in the vessels of the heart, it can cause the client a heart attack.Long bone fractures such as the femur, tibia, and pelvis, put the client at risk for a fat embolism. This embolism can travel to the heart, lungs, or brain and cause obstructed blood flow to these areas. A nurse is caring for a client who has suffered a fracture to the humerus after falling on their outstretched arm. The ends of the bone were driven into each other during the fall. This type of fracture is best described as which of the following? a. Comminuted fracture b. Oblique fracture c. Impacted fracture d. Greenstick fracture - CORRECT ANSWER c. rationale: "Impacted fracture" is correct. An impacted fracture is one in which the ends of the bone in a fracture are driven into each other. This type of fracture is most likely the result of a fall, such as onto an outstretched arm. It may also occur when the bone breaks from collapse of the structure, which is known as a buckle fracture. A client with osteoporosis is going home, where the client lives alone. What action by the nurse is best? a. Arrange a home safety evaluation. b. Ensure the client has a walker at home. samii 76 c. Help the client look into assisted living. d. Refer the client to Meals on Wheels. - CORRECT ANSWER a. samii 77 A pediatric nurse is caring for a 2-year-old child who suffered a femur fracture. The child has a cast on the leg and has been placed in Bryant's traction. Which of the following considerations must the nurse implement when working with a child who uses this traction? a. Perform range-of-motion of the affected hip every 4 hours b. The knee must be maintained at a 90-degree angle c. Provide the child with a liquid or mechanical soft diet d. Maintain the buttocks at a level just above the mattress of the bed - CORRECT ANSWER d. rationale: Bryant's traction is used for a fracture of the femur in some children. A child who uses Bryant's traction is typically less than 2 years old and weighs less than 30 pounds. While caring for this child, the nurse should ensure that the buttocks are at a level just above the mattress of the bed, as this form of traction pulls the legs and hips straight up off the bed. A nurse must give an intramuscular injection of pain medication to a patient who has suffered a left arm fracture. Which of the following situations would be a contraindication to administering medication in this manner? Select all that apply. a. The drug follows thrombolytic therapy b. A known reaction to the medication c. The patient is uncooperative d. A birthmark is at the site of injection e. The dose of the drug is over 2 mL - CORRECT ANSWER a. , b., d. rationale: If the patient has received thrombolytic therapy, an IM injection is contraindicated because of the increased bleeding potential.Any time the patient has a known reaction to a medication, the medication should be avoided. Other situations in which the nurse should not give an IM injection include if there is redness, inflammation, bleeding, or a birthmark over the injection site. A nurse is working with a client who has been wearing a fiberglass cast for an arm fracture for the past six weeks. Which intervention should the nurse perform after the cast has been removed? samii 80 a. Assess capillary refill and skin color in the distal extremity b. Ask the client to push against a solid object c. Obtain an x-ray of the arm samii 81 d. Perform the Weber-Rinne test with a tuning fork on the wrist - CORRECT ANSWER a. rationale: "Assess capillary refill and skin color in the distal extremity" is correct. When preparing to remove a client's cast, the provider may first order an x-ray to assess the fracture site. After the cast has been removed, the nurse should assess capillary refill in the area distal to the cast site and check the client's skin color to assess for good circulation. The newly exposed skin may itch, and the client should be instructed not to scratch it because this can cause damage to the skin. A nurse is caring for a client who has fallen out of a tree stand and has an obvious deformity to the right upper leg. What is the priority nursing action for this client? a. Stabilize the right leg b. Give the client oxygen c. Place the leg in traction d. Administer morphine - CORRECT ANSWER a. rationale: The leg should be stabilized to prevent further trauma, severe pain, and fat emboli. Basic stabilization is always the first step. If the client doesn't require surgery, traction would occur after this, otherwise the client will go to surgery for fixation. A 34-year-old client has suffered a femur fracture and is using skeletal traction while in bed. Which nursing diagnoses would be most applicable in this situation? Select all that apply. a. Fluid Volume Excess b. Acute Pain c. Risk for Peripheral Vascular Dysfunction d. Risk for Bowel Incontinence e. Risk for Impaired Gas Exchange - CORRECT ANSWER b., c., e. rationale: "Acute Pain", "Risk for Peripheral Vascular Dysfunction", and "Risk for Impaired Gas Exchange" are correct. Because the femur is such a large bone, a femur fracture has the potential to cause several complications for the affected client. The client may have activity intolerance and would be at risk of several samii 82 his lower leg. The nurse knows that the client is at risk for a fat embolism. What are signs and symptoms for the nurse to look for that indicate fat embolism syndrome (FES)? Select all that apply. a. Low body temperature b. Upper body petechiae samii 85 c. Respiratory distress d. Renal dysfunction e. Tachycardia - CORRECT ANSWER b., c., d., e. rationale: "Respiratory distress", "Tachycardia", "Renal dysfunction" and "Upper body petechiae" are correct. A fat embolism occurs when a small piece of fat enters the bloodstream and lodges into a vein, potentially obstructing blood flow. A client who has had a traumatic fracture is at high risk of FES. Signs and symptoms of FES include respiratory distress, tachycardia, petechiae on the upper body, fever, renal dysfunction and jaundice. Nursing care for the client in FES includes IV fluid therapy, oxygen administration, DVT prophylaxis and supportive care. The nurse on the postoperative inpatient unit assesses a client after a total hip replacement. The clients surgical leg is visibly shorter than the other one and the client reports extreme pain. While a co-worker calls the surgeon, what action by the nurse is best? a. Assess neurovascular status in both legs. b. Elevate the affected leg and apply ice. c. Prepare to administer pain medication. d. Try to place the affected leg in abduction. - CORRECT ANSWER a. rationale: This client has manifestations of hip dislocation, a critical complication of this surgery. Hip dislocation can cause neurovascular compromise. The nurse should assess neurovascular status, comparing both legs. The nurse should not try to move the extremity to elevate or abduct it. Pain medication may be administered if possible, but first the nurse should thoroughly assess the client. A client comes to the family medicine clinic and reports joint pain and stiffness. The nurse is asked to assess the client for Heberdens nodules. What assessment technique is correct? a. Inspect the clients distal finger joints. b. Palpate the clients abdomen for tenderness. c. Palpate the clients upper body lymph nodes. d. Perform range of motion on the clients wrists. - CORRECT ANSWER a. samii 86 rationale: Herberdens nodules are seen in osteoarthritis and are bony nodules at the distal interphalangeal joints. To assess for this finding, the nurse inspects the clients distal fingertips. These nodules are not found in the abdomen, lymph nodes, or wrists. A nurse is caring for four clients. After the hand-off report, which client does the nurse see first? a. Client with osteoporosis and a white blood cell count of 27,000/mm3 b. Client with osteoporosis and a bone fracture who requests pain medication c. Post-microvascular bone transfer client whose distal leg is cool and pale d. Client with suspected bone tumor who just returned from having a spinal CT - CORRECT ANSWER c. rationale: This client is the priority because the assessment findings indicate a critical lack of perfusion. A high white blood cell count is an expected finding for the client with osteoporosis. The client requesting pain medication should be seen second. The client who just returned from a CT scan is stable and needs no specific postprocedure care. A nurse assesses a client with a fracture who is being treated with skeletal traction. Which assessment should alert the nurse to urgently contact the health provider? a. Blood pressure increases to 130/86 mm Hg b. Traction weights are resting on the floor c. Oozing of clear fluid is noted at the pin site d. Capillary refill is less than 3 seconds - CORRECT ANSWER b. rationale: The immediate action of the nurse should be to reapply the weights to give traction to the fracture. The health care provider must be notified that the weights were lying on the floor, and the client should be realigned in bed. The clients blood pressure is slightly elevated; this could be related to pain and muscle spasms resulting from lack of pressure to reduce the fracture. Oozing of clear fluid is normal, as is the capillary refill time. A nurse assesses an older adult client who was admitted 2 days ago with a samii 87 rationale: Elevating the limb during the first 24 hrs facilitates venous return, decreases swelling, and promotes comfort. The dressing is usually a compression type to mold the residual limb and to decrease the edema associated with inflammation, so loosening the dressing is an inappropriate intervention. Placing the residual limb below the heart level increases risk of samii 90 edema at the surgical site. The dressing would be changed as ordered but is not usually done for the 1st 24 hrs to reduce edema, which could disrupt the surgical incision. A client with a femoral fracture is in Buck's traction. While making rounds, the nurse notices that the client's foot is touching the footboard of the bed. What is the appropriate action by the nurse? a. Wedge a pillow between the footboard and the client's foot b. Praise the client for maintaining countertraction c. Center the client on the bed d. Ask the client to pull up in bed while holding the weights - CORRECT ANSWER c. rationale: the aim in traction is to maintain a constant force to align the distal and proximal ends of a fractured bone. To be effective, the traction must have an opposing force (counter-traction). Centering the client in bed maintains the line of pull and ensures that countertraction is maintained. Placing a pillow between the foot and the footboard attempts to relieve pressure on the the foot but ignores that this position interrupts the proper pull of the traction. The client's current position interrupts traction rather than maintains proper countertraction. Holding the weight interrupts the line of pull of the traction and is contraindicated. A client taking colchicine for gout reports weakness, abdominal pain, and nausea and vomiting for the past 2 days. How should the nurse interpret these symptoms? a. therapeutic effects of the meds b. signs of toxicity c. expected side effects d. an allergic response - CORRECT ANSWER b. rationale: the symptoms described are signs of toxicity. The client should be instructed to stop the medication and be seen for follow-up treatment. The expected therapeutic effect of colchicine is to diminish the joint pain associated with the acute attack. The combo of symptoms is too severe to be expected as side effects of the medication. The symptoms are not consistent with an allergic response. samii 91 A client in skeletal traction for a right femur fracture reports pain in the affected limb. After assessing that the right foot is pale without a pulse, what should the nurse do next? Select all apply. a. Ensure that the leg is not raised above heart level samii 92 A nurse is reviewing the laboratory results of a client who is scheduled for a CT scan with an IV contrast agent. Which of the following laboratory findings should the nurse report to the provider prior to the procedure? - CORRECT ANSWER Creatinine 1.9 mg/dL A nurse is monitoring a client who is taking acarbose. Which of the following findings should the nurse identify as an adverse effect of the medication? - CORRECT ANSWER Abdominal cramps A nurse is contributing to the plan of care for a client who has chronic obstructive pulmonary disease (COPD) and is dyspneic. Which of the following interventions should the nurse include in the plan? - CORRECT ANSWER Encourage abdominal breathing. A nurse is preparing to administer phytonadione 7 mg subcutaneously to a client who has an INR of 4. Available is phytonadione 10 mg/mL. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.) - CORRECT ANSWER 0.7 A nurse is examining a client's IV site and notes a red line up his arm. The client reports a throbbing, burning pain at the IV site. The nurse should identify that the client's manifestations indicate which of the following complications of IV therapy? - CORRECT ANSWER Thrombophlebitis A nurse is reinforcing teaching about management of constipation with a client who has hypothyroidism. Which of the following should the nurse include in the teaching? - CORRECT ANSWER Increase intake of fiber-rich foods. A nurse is caring for a client who has a compound fracture of the femur and was placed in balanced suspension skeletal traction 4 days ago. Which of the following actions should the nurse take? - CORRECT ANSWER Perform pin site care daily. A nurse observes a client who is lying in bed experiencing a tonic-clonic seizure. Which of the following actions should the nurse take? - CORRECT ANSWER Loosen clothing around the client's neck. samii 95 A nurse is contributing to the plan of care for a client who has multiple sclerosis and is taking dantrolene to manage muscle spasms. Which of the following interventions should the nurse include? - CORRECT ANSWER Encourage the client to complete ADLs. A nurse is reinforcing discharge teaching to prevent dumping syndrome for a client following a partial gastrectomy for ulcers. Which of the following information should the nurse include in the teaching? - CORRECT ANSWER Avoid liquids at mealtimes. A nurse is collecting data from a client who has heart failure and is taking digoxin. Which of the following outcomes from the medication should the nurse expect? - CORRECT ANSWER Decreased shortness of breath 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? - CORRECT ANSWER Rephrase client instructions when not understood. A nurse is preparing to remove a client's NG tube. Which of the following interventions should the nurse take to decrease the risk of aspiration? - CORRECT ANSWER Pinch the NG tube. A nurse is contributing to the plan of care for an older adult client who is at risk for osteoporosis. Which of the following interventions should the nurse include to prevent bone loss? - CORRECT ANSWER Encourage weight-bearing exercises. A home health nurse is reinforcing teaching with a client about preventing complications of peripheral vascular disease. Which of the following statements indicates that the client is adhering to the nurse's instructions? - CORRECT ANSWER "I don't cross my legs anymore." A nurse is reinforcing teaching about glycosylated hemoglobin (HbA1c) testing with a client who has diabetes mellitus. Which of the following statements indicates that the client understands the teaching? - CORRECT ANSWER "I will have my HbA1c checked twice per year." A nurse is assisting the charge nurse with developing an in-service about caring for samii 96 clients who have internal sealed radiation implants. Which of the following information should the nurse include? - CORRECT ANSWER Dispose of radiation implants in a lead container. samii 97