Medical-Surgical Nursing Practice Questions and Answers, Exams of Medicine

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Medical-Surgical: Final Practice (

questions and Answers)

A nurse is monitoring a client following a thyroidectomy. Which of the following findings should the nurse identify as an indication of hypoparathyroidism? - Correct answer Involuntary muscle spasms (occurs if the parathyroid glands are damaged or removed during a thyroidectomy. Muscle twitching and paresthesias can result due to decreased parathyroid hormone levels and calcium deficiency.) A nurse is reinforcing discharge teaching with a client who has a new permanent pacemaker. Which of the following statements by the client indicates an understanding of the teaching? - Correct answer "I should check my heart rate each day."• A nurse is reinforcing discharge teaching about improving gas exchange with a client who has emphysema. Which of the following information should the nurse include in the teaching? - Correct answer Use pursed-lip breathing during periods of dyspnea. A nurse is reinforcing teaching with a client who has a new diagnosis of multiple sclerosis (MS). The client asks the nurse about the usual course of MS. Which of the following responses should the nurse make? - Correct answer "Acute episodes are usually followed by remissions, which can last varying lengths of time." a nurse in an emergency department is caring for a client who reports developing severe right eye pain with a gritty sensation while sawing wood. Whats priority? - Correct answer Ask the client about first aid performed at the scene A nurse is preparing to administer timolol eye drops for a client who has glaucoma. When instilling the medication, which of the following actions should the nurse take? - Correct answer Apply pressure to puncta after instillation of the medication.

A nurse is caring for a client who has a stage III pressure ulcer on his heel. When preparing to irrigate the wound, which of the following actions should the nurse take rst? - Correct answer Check the client's pain level A nurse is caring for a client who begins having a tonic-clonic seizure while sitting in a chair at the bedside. Which of the following actions should the nurse take first? - Correct answer Lower the client to the floor. A nurse is caring for a client who has type 1 diabetes mellitus and a capillary blood glucose reading of 48 mg/dL. Which of the following findings should the nurse expect? - Correct answer Diaphoresis A client who has a blood glucose level below 70 mg/dL to exhibit indications of hypoglycemia. Including weakness, hunger, diaphoresis, nausea, shakiness, and confusion. A nurse is reinforcing teaching with a client who is scheduled for a sigmoid colon resection with colostomy. Which of the following statements by the client indicates a need for further teaching? - Correct answer "My diet will have to change to a soft diet after surgery."• ( After surgery, the client's diet quickly returns to a regular diet and there are not any food restrictions.) A nurse is reviewing a client's laboratory report. The client's ABG levels are pH 7.5, PaCO 32 mm HG, and HCO 24 mEq/L. The nurse should determine that the client has which of the following acid-base imbalances?

• Correct answer Respiratory alkalosis (The nurse should identify that the client's pH is elevated above the expected reference range of 7.35 to 7.45, indicating alkalosis. The nurse should then identify that the client's PaCO is low, below the expected reference range of 35 to 45 mm Hg, which indicates a respiratory origin. The nurse should conclude that the client's elevated pH and decreased PaCO indicate respiratory alkalosis.) A nurse in an urgent care clinic is collecting data from a client who sustained a fall. Which of the following findings should the nurse identify as an indication of a skull fracture? - Correct answer Clear fluid coming from the nares. (cerebrospinal fluid)

A nurse is reinforcing teaching with a client about preventing the transmission of hepatitis A. The nurse should identify that hepatitis A is transmitted by which of the following routes? - Correct answer Fecal-oral contamination A nurse is reinforcing teaching with a client who has tuberculosis (TB) and a prescription for isoniazid. Which of the following instructions should the nurse include? - Correct answer "Your provider will monitor your liver function while you are taking this medication." A nurse is collecting data from a client who develops a fruity breath odor, dry mouth, and extreme thirst. Which of the following additional data should the nurse collect? - Correct answer Blood glucose using a glucometer A nurse is contributing to the plan of care for a client who is 72 hr postoperative following an above-the-knee amputation. Which of the following actions should the nurse recommend? - Correct answer Assist the client to a prone position every 4 hours. (for 20 to 30 min every 3 to 4 hr following an amputation to reduce the risk of flexion contractures.) A nurse is assisting with the care of a client who has a chest tube in place following a thoracotomy. Which of the following actions should the nurse take? - Correct answer Place the drainage unit below the client's chest level. A nurse is contributing to the plan of care for a client who has thrombocytopenia due to chemotherapy. Which of the following interventions should the nurse include? - Correct answer Avoid IM injections (because of risk of bleeding) A nurse is reinforcing teaching about a low-cholesterol diet with a client who had a myocardial infarction. Which of the following meal selections by the client indicates an understanding of the teaching? - Correct answer Chicken breast and corn on the cob. A nurse is caring for a client who is to have his chest tube removed. Which of the following actions should the nurse take? - Correct answer Auscultate the lungs after removal.

A nurse is reinforcing teaching with a client about how to perform a breast self exam (BSE). The nurse should identify which of the following findings as an indication of breast cancer? - Correct answer A non-tender, hard lump that is palpated in one breast A nurse in an urgent care clinic is collecting data from a client who has extensive burns, including on her face. Which of the following data should the nurse collect first? - Correct answer Characteristics o cough and sputum A nurse is contributing to the plan of care for a client during a sickle cell crisis. Which of the following interventions should the nurse recommend? - Correct answer Administer oxygen via nasal cannula. (Hypoxia increases sickling and client discomfort.) A nurse is working with an assistive personnel (AP) who is assigned to bathe a client who has herpes zoster. The AP asks the nurse if herpes zoster is contagious. Which of the following responses should the nurse make? - Correct answer "Herpes zoster is contagious to people who have never had chickenpox."• A nurse is caring for a client who is scheduled to receive intermittent peritoneal dialysis. Which of the following actions should the nurse take? - Correct answer Weigh the client before and after each dialysis treatment. (monitor I & O closely) A nurse in a provider's office is caring for a client who has blepharitis. Which of the following actions should the nurse take first? - Correct answer Inspect the eyes for drainage or redness. ( blepharitis-inflammation of the eyelid) A nurse is obtaining a weekly weight for a client who has obesity and osteoarthritis and is on a weight management program. The nurse determines that the client gained 1.36 kg (3 lb) in the past week. Which of the following statements should the nurse make? - Correct answer "Were there any issues last week that kept you from focusing on your diet?" A home health nurse enters a client's home and finds a used insulin syringe, without a cap, on the table. Which of the following actions should

the nurse take? - Correct answer Place the syringe in a puncture-proof disposal container. A nurse is collecting data from a client who has asthma and reports several food allergies. Which of the following actions should the nurse take first? - Correct answer Ask the client to identify the specific food allergies. A community health nurse is reinforcing teaching about melanoma with a group of clients. Which of the following characteristics of lesions associated with melanoma should the nurse include in the teaching? - Correct answer An irregular border. A nurse is preparing to care for a group of clients after receiving change-of- shift report. From which of the following clients should the nurse collect data first? - Correct answer A client who has emphysema and reports dyspnea. A nurse is caring for a male client who is undergoing screening tests for atherosclerosis. Which of the following laboratory findings should the nurse identify as an increased risk for this disorder? - Correct answer Elevated LDL levels• (The client's desirable LDL level is below 130 mg/dL.) A nurse is caring for a client who has continuous bladder irrigation following a transurethral resection of the prostate (TURP). Which of the following actions should the nurse take? - Correct answer Report viscous drainage with clots to the provider. A nurse is caring for a client who has thrombocytopenia and develops epistaxis. Which of the following actions should the nurse take? - Correct answer Pinch the soft portion of the client's nose for 10 min. (epistaxis- nose bleed) A nurse is contributing to the plan of care for a client who has cancer and is scheduled to receive internal radiation therapy. Which of the following actions should the nurse recommend? - Correct answer Place the client in a private room.• (To prevent exposing other clients and visitors to radiation.)

A nurse is reinforcing teaching with a client who has gout and urolithiasis. The client asks how to prevent future uric acid stones. Which of the following suggestions should the nurse make? (Select all that apply.) - Correct answer 1) Take allopurinol as prescribed.

2. Exercise several times a week.
3. Limit intake of foods high in purine. A nurse is collecting data from a client who has encephalitis due to West Nile virus. Which of the following findings should the nurse expect? (Select all that apply.) - Correct answer 1) Stiff neck is correct.
4. Photophobia is correct.
5. Lethargy is correct. A nurse is collecting data from a client who has encephalitis due to West Nile virus. which of the following actions should the nurse take? - Correct answer Monitor vitals every 2 hours Assess neuro status every 4hrs Keep room dark A nurse is caring for a client who is receiving continuous enteral feedings. Which of the following actions should the nurse take? - Correct answer Monitor the client's blood glucose level. A nurse is assisting with the care of a client who is to receive a transfusion of packed red blood cells (RBCs). Which of the following actions should the nurse take? (Select all that apply.) - Correct answer 1) Check and document the client's vital signs is correct.
6. Verify that the blood type and Rh of the packed RBCs are checked by two nurses is correct.
7. Provide the RN with IV tubing that has a filter is correct. A nurse is preparing to change the bed linens of a client who has AIDS and is incontinent of stool. Which of the following personal protective equipment (PPE) should the nurse don prior to providing client care? (Select all that apply.) - Correct answer 1) Gown
8. Gloves A nurse is contributing to the plan of care for a client who had a stroke. The client has hemiplegia and occasional urinary incontinence. Which of the

following interventions should the nurse recommend? - Correct answer Offer the client a bedpan every 2 hr. A nurse is reinforcing teaching with a client who has stomatitis due to chemotherapy. Which of the following statements by the client indicates a need for further instructions? - Correct answer Client should avoid the use of alcohol-based mouthwash because it can irritate and burn the mucous membranes. A nurse is reinforcing teaching with a client who has tuberculosis and a prescription for rifampin. The nurse should identify which of the following findings as a harmless and expected adverse effect of rifampin? - Correct answer Red-orange discoloration of urine A nurse is collecting data from a client who has a fractured left femur and is in skeletal traction. Which of the following findings should the nurse identify as an indication of fat emboli to report to the provider? - Correct answer Identify chest petechiae as an indication of a fat embolism A nurse is reinforcing dietary teaching with a client who has diabetes mellitus. Which of the following actions should the nurse take first? - Correct answer Ask the client to identify the types of foods she prefers. A nurse is reinforcing discharge teaching with a client who has AIDS. Which of the following statements should the nurse include? - Correct answer "You should clean bathroom surfaces with a bleach and water solution." A nurse is contributing to the plan of care for a client who has thrombophlebitis. Which of the following actions should the nurse recommend for the plan of care? - Correct answer Place compression stockings on the lower extremities. A nurse is caring for a client following a hip arthroplasty. The nurse should place an abduction pillow on the client for which of the following purposes?

• Correct answer Preventing dislocation of the hip during position changes or movement. A nurse is reinforcing teaching with a client who has a history of tonic-clonic seizures and is scheduled for a standard electroencephalogram (EEG).

Which of the following instructions should the nurse include in the teaching? - Correct answer Thoroughly shampoo hair prior to the EEG A nurse is reinforcing discharge teaching with a client who has infective endocarditis about how to prevent recurrence. Which of the following statements by the client indicates an understanding of the teaching? - Correct answer "I will notify my doctor before I have dental procedures."