Medical-Surgical Nursing 10th Edition by Ignatavicius All Chapters Covered 2024, Exams of Nursing

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Medical-Surgical Nursing 10th Edition by

Ignatavicius All Chapters Covered 2024

1. A new nurse is working with a preceptor on an inpatient medical-surgical unit. The preceptor advises the student that which is the priority when working as a professional nurse? - ANSWER>>>>b. Ensuring client safety
2. A nurse manager wishes to ensure that the nurses on the unit are practicing at their highest levels of competency. Which areas should the manager assess to determine if the nursing staff demonstrate competency according to the Institute of Medicine (IOM) report Health Professions Education: A Bridge to Quality? (Select all that apply.) - ANSWER>>>>a. Collaborating with an interdisciplinary team b. Implementing evidence-based care d. Routinely using informatics in practice e. Using quality improvement in client care

A nurse is interested in making interdisciplinary work a high priority. Which actions by the nurse best demonstrate this skill? (Select all that apply.) - ANSWER>>>>a. Consults with other disciplines on client care b. Coordinates discharge planning for home safety c. Participates in comprehensive client rounding d. Routinely asks other disciplines about client progress

3. A postoperative client has an epidural infusion of morphine and bupivacaine (Marcaine). What actions does the nurse delegate to the unlicensed assistive personnel (UAP)? (Select all that apply.) - ANSWER>>>>c. Perform a bladder scan if the client is unable to void after 4 hours. d. Remind the client to use the incentive spirometer every hour. e. Take and record the client's vital signs per agency protocol.

A home health care nurse assesses an older client for the intake of nutrients needed in larger amounts than in younger adults. Which foods found in an older adult's kitchen might indicate an adequate intake of these nutrients? (Select all that apply.) - ANSWER>>>>a. 1% milk b. Carrots d. Oranges e. Vitamin D supplements

4. A nurse manager institutes the Fulmer Spices Framework as part of the routine assessment

of older adults in the hospital. The nursing staff assesses for which factors? (Select all that - ANSWER>>>>confusion incontinence sleep disorder

A hospitalized older adult has been assessed at high risk for skin breakdown. Which actions does the registered nurse (RN) delegate to the unlicensed assistive personnel (UAP)? (Select all that apply.) - ANSWER>>>>keep pts skin dry obtain pressure relieving mattress turn pt every 2 hours

A nurse admits an older client to the hospital who lives at home with family. The nurse assesses that the client is malnourished. What actions by the nurse are best? (Select all that apply - ANSWER>>>>c. Perform and document results of a Braden Scale assessment. d. Request a dietary consultation from the health care provider. e. Suggest a high-protein oral supplement between meals

A visiting nurse is in the home of an older adult and notes a 7-pound weight loss since last month's visit. What actions should the nurse perform first? (Select all that apply.) - ANSWER>>>>a. Assess the client's ability to drive or transportation alternatives. b. Determine if the client has dentures that fit appropriately. d. d. Have the client complete a 3-day diet recall diary

A postoperative client is being discharged with a prescription for oxycodone hydrochloride with acetaminophen (Percocet). What instructions does the nurse give the client? (Select all - ANSWER>>>>a. "Check all over-the-counter medications for acetaminophen." b. "Do not take more pills each day than you are prescribed." c. "Eat a diet that is high in fiber and drink lots of water." d. "you shouldn't drive while on this medication

A client reports a great deal of pain following a fairly minor operation. The surgeon leaves a prescription for the nurse to administer a placebo instead of pain medication. What actions by the nurse are most appropriate? (Select all that apply.) - ANSWER>>>>a. Consult with the prescriber and voice objections. d. notify nurse manager of Drs request

know how to do drop factor question - ANSWER>>>>

1. A nurse cares for a client who recently completed genetic testing that revealed that she has a BRCA1 gene mutation. Which actions should the nurse take next? (Select all that apply.) - ANSWER>>>>a. Discuss potential risks for other members of her family. b. Assist the client to make a plan for prevention and risk reduction. e. Assess the client's response to the test results.

A nurse completes pedigree charts for clients at a community health center. Which diagnosis should the nurse refer for carrier genetic testing? (Select all that apply.) - ANSWER>>>>hemophilia sickle cell cystic fibrosis

A nurse teaches clients about patterns of inheritance for genetic disorders among adults. Which disorders have an autosomal dominant pattern of inheritance? (Select all that - ANSWER>>>>breast cancer Huntington disease marfan syndrome

A nurse manager educates staff nurses in the use of clinical practice guidelines. Which statement should the nurse include in this teaching? - ANSWER>>>>c. "Clinical practice guidelines are official recommendations based on evidence."

A nurse is developing a clinical question in a PICOT format. What components are included in the question? (Select all that apply.) - ANSWER>>>>b. Comparison c. Outcome e. time

A nurse plans care for a client who is bedridden. Which assessment should the nurse complete to ensure to prevent pressure ulcer formation? - ANSWER>>>>Nutritional intake and serum albumin levels

A rehabilitation nurse cares for a client who is wheelchair bound. Which intervention should the nurse implement to prevent skin breakdown? - ANSWER>>>>Have the client do wheelchair push-ups.

A nurse assists a client with left sided weakness to walk with a cane. What is the correct order or steps for gait training with a cane? - ANSWER>>>>B. 1,3,5,2,4,

A nurse collaborates with an occupational therapist when providing care for a rehabilitation client. With which activities should the occupational therapist assist the client? (Select all that apply.) - ANSWER>>>>b. Attaining independence with dressing e. performing ADLS (daily living)

A rehabilitation nurse is caring for an older adult client who states, "I tire easily." How should the nurse respond? (Select all that apply.) - ANSWER>>>>b. "Use a cart to push your belongings instead of carrying them." d. "Plan to gather all of the supplies needed for a chore prior to starting the activity." e. "Try to break large activities into smaller parts to allow rest periods between activities."

A nurse is caring for clients as a member of the rehabilitation team. Which activities should the nurse complete as part of the nurse's role? (Select all that apply.) - ANSWER>>>>b. Coordinate rehabilitation team activities to ensure implementation of the plan of care e.. Support the client's choices by acting as an advocate for the client and family.

A hospice nurse is caring for a dying client and her family members. Which interventions should the nurse implement? - ANSWER>>>>a. teach family members signs of impending death b. encourage management of adverse symptoms d. Encourage reminiscence by both client and family members.

A nurse admits an older adult client to the hospital. Which criterion should the nurse use to determine if the client can make his own medical decisions? (Select all that apply.) - ANSWER>>>>a. can communicate his treatment preferences c. Is oriented enough to understand information provided d. Can evaluate and deliberate information

A hospice nurse plans care for a client who is experiencing pain. Which complementary therapies should the nurse incorporate in this client's pain management plan? (Select all that apply.) - ANSWER>>>>a. play music client enjoys c. rub lavender lotion on clients feet

A nurse teaches a client's family members about signs and symptoms of approaching death. Which manifestations should the nurse include in this teaching? (Select all that apply.) - ANSWER>>>>d. Decreased appetite e. Congestion and gurgling

An emergency room nurse is caring for a trauma client. Which interventions should the nurse perform during the primary survey? (Select all that apply.) - ANSWER>>>>b. Needle decompression c. Initiating IV fluids e. endotracheal intubation f. remove wet clothing

The complex care provided during an emergency requires interdisciplinary collaboration. Which interdisciplinary team members are paired with the correct responsibilities? (Select - ANSWER>>>>a. Psychiatric crisis nurse - e. paramedic

A nurse prepares to discharge an older adult client home from the emergency department (ED). Which actions should the nurse take to prevent future ED visits? (Select all that - ANSWER>>>>d. Screen for depression and suicide. e. Complete a functional assessment.

2. A nurse teaches a client who has severe allergies to prevent bug bites. Which statements should the nurse include in this client's teaching? (Select all that apply.) - ANSWER>>>>a. "Consult an exterminator to control bugs in and around your home." b. "Do not swat at insects or wasps." e. use screen in windows and doors

A nurse is providing health education at a community center. Which instructions should the nurse include in teaching about prevention of lightning injuries during a storm? (Select all - ANSWER>>>>a. seek shelter inside building or car c. do not take bath or shower d. turn off tv e. put down golf clubs

An emergency department nurse moves to a new city where heat-related illnesses are common. Which clients does the nurse anticipate being at higher risk for heat-related illnesses? (Select all that apply.) - ANSWER>>>>a. homeless b. illicit drug users e. older adults

An emergency department nurse plans care for a client who is admitted with heat stroke. Which interventions should the nurse include in this client's plan of care? (Select all that

apply.) - ANSWER>>>>a. Administer oxygen via mask or nasal cannula. d. Infuse 0.9% sodium chloride via a large-bore intravenous cannula. e. Obtain baseline serum electrolytes and cardiac enzymes.

Emergency medical services (EMS) brings a large number of clients to the emergency department following a mass casualty incident. The nurse identifies the clients with which injuries with yellow tags? (Select all that apply.) - ANSWER>>>>a Partial-thickness burns covering both legs c. Neck injury and numbness of both legs d. Small pieces of shrapnel embedded in both eyes f. Bruising and pain in the right lower abdomen

A nurse triages clients arriving at the hospital after a mass casualty. Which clients are correctly classified? (Select all that apply.) - ANSWER>>>>a. A 35-year-old female with severe chest pain: red tag d. A 60-year-old male with an open fracture with distal pulses: yellow tag

A hospital prepares to receive large numbers of casualties from a community disaster. Which clients should the nurse identify as appropriate for discharge or transfer to another facility? (Select all that apply.) - ANSWER>>>>b. Client who had open reduction and internal fixation of a femur fracture 3 days ago e. Client on the medical unit for wound care

A hospital prepares for a mass casualty event. Which functions are correctly paired with the personnel role? (Select all that apply.) - ANSWER>>>>b. Hospital incident commander - Assumes overall leadership for implementing the emergency plan d. Triage officer - Rapidly evaluates each client to determine priorities for treatment

A nurse is assessing a client who has an electrolyte imbalance related to renal failure. For which potential complications of this electrolyte imbalance should the nurse assess? (Select all that apply.) - ANSWER>>>>a. Electrocardiogram changes d. paralytic ileus e. skeletal muscle weakness

A nurse is caring for clients with electrolyte imbalances on a medical-surgical unit. Which clinical manifestations are correctly paired with the contributing electrolyte imbalance?

(Select all that apply.) - ANSWER>>>>a. Hypokalemia - Flaccid paralysis with respiratory depression c. Hyponatremia - Decreased level of consciousness

After administering 40 mEq of potassium chloride, a nurse evaluates the client's response. Which manifestations indicate that treatment is improving the client's hypokalemia? (Select all that apply.) - ANSWER>>>>c. Strong productive cough d. Active bowel sounds

A nurse assesses a client who is admitted for treatment of fluid overload. Which manifestations should the nurse expect to find? (Select all that apply.) - ANSWER>>>>a. Increased pulse rate b. Distended neck veins e. Skeletal muscle weakness

A nurse is assessing clients on a medical-surgical unit. Which clients are at increased risk for hypophosphatemia? (Select all that apply.) - ANSWER>>>>a. A 36-year-old who is malnourished b. A 42-year-old with uncontrolled diabetes e. A 76-year-old who is prescribed antacids

A nurse assesses a client who is prescribed a medication that inhibits aldosterone secretion and release. For which potential complications should the nurse assess? (Select all that apply.) - ANSWER>>>>b. Serum potassium level of 5.4 mEq/L e. Blood osmolality of 250 mOsm/L

A nurse assesses a client with diabetes mellitus who is admitted with an acid-base imbalance. The client's arterial blood gas values are pH 7.36, PaO2 98 mm Hg, PaCO2 33 mm Hg, and HCO

• 18 mEq/L. Which manifestation should the nurse identify as an

example of the client's compensation mechanism? - ANSWER>>>>a. Increased rate and depth of respirations

A nurse is caring for a client who has chronic emphysema and is receiving oxygen therapy at 6 L/min via nasal cannula. The following clinical data are available: Arterial Blood Gases Vital Signs

pH = 7.28 Pulse rate = 96 beats/min PaO2 = 85 mm Hg Blood pressure = 135/ PaCO2 = 55 mm Hg Respiratory rate = 6 breaths/min HCO

• = 26 mEq/L O2 saturation = 88%

Which action should the nurse take first? - ANSWER>>>>a. Notify the Rapid Response Team and provide ventilation support.

1. A nurse is planning interventions that regulate acid-base balance to ensure the pH of a client's blood remains within the normal range. Which abnormal physiologic functions may occur if the client experiences an acid-base imbalance? (Select all that apply.) - ANSWER>>>>a. Reduction in the function of hormones b. Fluid and electrolyte imbalances e. Increase in the effectiveness of many drugs

A nurse is assessing clients who are at risk for acid-base imbalance. Which clients are correctly paired with the acid-base imbalance? (Select all that apply.) - ANSWER>>>>b. Metabolic acidosis - Older adult who is following a carbohydrate-free diet c. Respiratory alkalosis - Client on mechanical ventilation at a rate of 28 breaths/min e. Metabolic alkalosis - Older client prescribed antacids for gastroesophageal reflux disease

A nurse assesses a client who is experiencing an acid-base imbalance. The client's arterial blood gas values are pH 7.32, PaO2 94 mm Hg, PaCO2 34 mm Hg, and HCO

• 18 mEq/L. For which clinical manifestations should the nurse assess? (Select all that apply.) - ANSWER>>>>a. Reduced deep tendon reflexes b. Drowsiness c. Increased respiratory rate

A nurse assesses a client who is receiving total parenteral nutrition. For which adverse effects related to an acid-base imbalance should the nurse assess? (Select all that apply.) - ANSWER>>>>a Positive Chvostek's sign e. anxiety and irritability

A nurse is planning care for a client who is anxious and irritable. The client's arterial blood

gas values are pH 7.30, PaO2 96 mm Hg, PaCO2 43 mm Hg, and HCO

• 19 mEq/L. Which questions should the nurse ask the client and spouse when developing the plan of care? (Select all that apply.) - ANSWER>>>>b. "Is your spouse's current behavior typical?" c. "Do you drink any alcoholic beverages?"

A nurse evaluates the following arterial blood gas values in a client: pH 7.48, PaO2 98 mm Hg, PaCO2 28 mm Hg, and HCO

• 22 mEq/L. Which client condition should the nurse

correlate with these results? - ANSWER>>>>b. Anxiety-induced hyperventilation

After providing discharge teaching, a nurse assesses the client's understanding regarding increased risk for metabolic alkalosis. Which statement indicates the client needs additional teaching? - ANSWER>>>>c. "I take sodium bicarbonate after every meal to prevent heartburn."

A registered nurse (RN) delegates client care to an experienced licensed practical nurse (LPN). Which standards should guide the RN when delegating aspects of IV therapy to the LPN? (Select all that apply.) - ANSWER>>>>a. State Nurse Practice Act b. The facility's Policies and Procedures manual

A nurse prepares to administer a blood transfusion to a client, and checks the blood label with a second registered nurse using the International Society of Blood Transfusion (ISBT) universal bar-coding system to ensure the right blood for the right client. Which components must be present on the blood label in bar code and in eye-readable format? (Select all that - ANSWER>>>>a. Unique facility identifier b. Lot number related to the donor d. ABO group and Rh type of the donor

A nurse assists with the insertion of a central vascular access device. Which actions should the nurse ensure are completed to prevent a catheter-related bloodstream infection? (Select all that apply.) - ANSWER>>>>a. Include a review for the need of the device each day in the client's plan of care. b. Remind the provider to perform hand hygiene prior to starting the procedure. d. Ask everyone in the room to wear a surgical mask during the procedure.

A nurse is assessing clients who have intravenous therapy prescribed. Which assessment finding for a client with a peripherally inserted central catheter (PICC) requires immediate attention? - ANSWER>>>>d. upper extremity swelling is noted

The postanesthesia care unit (PACU) charge nurse notes vital signs on four postoperative clients. Which client should the nurse assess first? - ANSWER>>>>c- client with respiratory rate of 6breaths/min

A preoperative nurse is assessing a client prior to surgery. Which information would be most important for the nurse to relay to the surgical team? - ANSWER>>>>d. use of multiple herbs and supplements

A nurse prepares to discharge an older adult client home from the emergency department (ED). Which actions should the nurse take to prevent future ED visits? (Select all that - ANSWER>>>>d. Screen for depression and suicide. e. Complete a functional assessment.

A clinic nurse is teaching a client prior to surgery. The client does not seem to comprehend the teaching, forgets a lot of what is said, and asks the same questions again and again. What action by the nurse is best? - ANSWER>>>>a. assess the client for anxiety

An older adult has been transferred to the postoperative inpatient unit after surgery. The family is concerned that the client is not waking up quickly and states "She needs to get back to her old self!" What response by the nurse is best? - ANSWER>>>>d. sometimes older people take a longer time to wake up

A client waiting for surgery is very anxious. What intervention can the nurse delegate to the unlicensed assistive personnel (UAP)? - ANSWER>>>>b. Give the client a back rub.

A client is clearly uncomfortable and anxious in the preoperative holding room waiting for emergent abdominal surgery. What actions can the nurse perform to increase comfort? (Select all that apply.) - ANSWER>>>>a. Allow the client to assume a position of comfort. b. Allow the client's family to remain at the bedside. d. Provide warm blankets or cool washcloths as desired. e. Pull the curtains around the bed to provide privacy.

A nurse orienting to the postoperative area learns which principles about the postoperative

period? (Select all that apply.) - ANSWER>>>>b. Phase I care may last for several days in some clients. d. Phase II ends when the client is stable and awake. e. Vital signs may be taken only once a day in phase III.

A postanesthesia care unit (PACU) nurse is assessing a postoperative client with a nasogastric (NG) tube. What laboratory values would warrant intervention by the nurse? (Select all that apply.) - ANSWER>>>>b. Hemoglobin: 7.8 mg/dL c. pH: 7. d. Potassium: 2.9 mEq/L

A postoperative client is being discharged with a prescription for oxycodone hydrochloride with acetaminophen (Percocet). What instructions does the nurse give the client? (Select all that apply.) - ANSWER>>>>a. "Check all over-the-counter medications for acetaminophen." b. "Do not take more pills each day than you are prescribed." c. "Eat a diet that is high in fiber and drink lots of water." e. Wheelchair-bound client

A nurse ANSWER>>s a call light on the postoperative nursing unit. The client states there was a sudden gush of blood from the incision, and the nurse sees a blood spot on the sheet. What action should the nurse take first? - ANSWER>>>>Perform hand hygiene and apply gloves.

a client is taking prednisone to prevent a transplant rejection. what instruction by the nurse is MOST impt? - ANSWER>>>>a. avoid large crowds and people who are ill

A clinic nurse is working with an older client. What assessment is most impt for preventing infections in this client? - ANSWER>>>>a. assessing vaccine records for booster shots needed

A client has a leg wound that is in the second stage of the inflammatory response. For what manifestation does the nurse assess? - ANSWER>>>>Purulent draining

A client receiving cd3 asks the nurse how the drug works, what response is best? - ANSWER>>>>It increases the elimination of T lymphocytes from circulation

for a person to be immunocompetent, which processess need to be functional and interact appropriately with each other? Select all - ANSWER>>>>a antibody-mediated immunity b cell-mediated immunity c inflammation

A student nurse is learning about the types if different cells involved in the inflammatory response. Which principals does the student learn? Select all - ANSWER>>>>b. Eosinophils increase during allergic reactions and parasitic invasion c. Macrophages can participate in many episodes of phagocytosis d.monocytes turn into macrophages after they enter body tissues e. neutrophils can only take part in 1 episode of phagocytosis

the nurse working with clients who have autoimmune diseases understands that what component of cell-mediated immunity is the problem? - ANSWER>>>>d. suppressor t cells

A nurse is assessing an older client for the presence of infection. the clients temp is 97.6 what response by nurse is best? - ANSWER>>>>a. assess the client for the more specific signs

a nurse working with a community group promoting healthy aging. what reccomendation is best to help prevent osteoarthritis (OA) - ANSWER>>>>c. lose wight if needed

A nurse in the family clinic is teaching newly D/X pt with (OA) about drugs used to treat the disease. For which medication does the nurse plan primary teaching? - ANSWER>>>>a. Acetominophen (tylenol)

The clinis nurse assesses a client with diabetes during a check up. the client also has (OA). The nurse notes that the clients blood glucose readings have been elevated. What question by the nurse is most appropriate? - ANSWER>>>>b. "have you been taking glucosamine supplements?"

what are contraindications for surgery? Infection? - ANSWER>>>>Weak bones cant have surgery

antibiotics for surgery prophylatically? - ANSWER>>>>Verify patient

a client has a continuous passive motion (CPM) device after total knee replacement. What action does nurse delegate to the UAP after affected leg is placed in the machine while the client is in bed? - ANSWER>>>>c raise the lower siderail on the affected side

After total knee replacement, a client is on the postop nursing unit with a continuous femoral nerve blockade. On assessment, the nurse notes the clients pulses are 2+/4+ bilaterally; the skin is pale pink, warm, and dry; and the client is unable to dorsiflex or plantarflex the affected foot.

What action does the nurse perform next? - ANSWER>>>>c notify the surgeon or anesthesia provider immediatly

a nurse discharging a client to a short term rehab center after a joint replacement. Which action by the nurse is most impt? - ANSWER>>>>d. providing a verbal hand-off report to the facility

a client is started on Ectracept (Enbrel) what teaching by the nurse is most appropriate? - ANSWER>>>>a giving subQ injections

the nurse on an inpatient rheumatology unit receives hand-off report on a client with an acute exacerbation of systemic lupus (sle). Which reported lab value requries nurse to assess client further? - ANSWER>>>>a creatinine 3.

nurse discharging pt after total hip replacement which statement by client indicates they understood? - ANSWER>>>>i will not sit with my legs crossed

the nurse is caring for client using a CPM machine and has delegated some tasks to the UAP, what action by the UAP warrants intervention by the nurse? - ANSWER>>>>d storing the maching under the bed after removal

activities to help poor body image? - ANSWER>>>>book club

#96 ctd lab values, the last 2 are correct - ANSWER>>>>possible kidney disease b

a client has a newly D/X systemic lupus (sle) what instruction by the nurse is most impt? - ANSWER>>>>c notify your provider at once if you get a fever

a client has been D/X with fibromyalgia syndrome but does not want to take the perscribed meds. What non pharm measures can the nurse suggest to help manage this condition? - ANSWER>>>>a acupuncture b stretching d tai chi

a nurse is working with several clients who have gout. Which types of gout and their drug treatments are correctly matched? - ANSWER>>>>b colchicine-acute gout c febuxostat- chronic gout d indomethacin-acute gout

e probenecid- chronic gout