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Medical-Surgical Exam - Version A The nurse is assessing a client with bacterial meningitis. Which assessment finding indicates the client may have developed septic emboli? A. Cyanosis of the fingertips. B. Bradycardia and bradypnea. C. Presence of S3 and S4 heart sounds. D. 3+ pitting edema of the lower extremities. Septic emboli secondary to meningitis commonly lodge in the small arterioles of the extremities, causing a decrease in circulation to the hands (A) which may lead to gangrene.
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(B, C, and D) are abnormal findings, but do not indicate the development of septic emboli. Points Earned: 0/ Correct Answer: A Your Response: C A client experiencing uncontrolled atrial fibrillation is admitted to the telemetry unit. What initial medication should the nurse anticipate administering to the client? A. Xylocaine (Lidocaine). B. Procaina mide (Pronest yl).
NURS 3356 Medical Surgical Exam A TEST EXAM
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and effecting cardiac output. (A, B, and C) are not indicated in the initial treatment of uncontrolled atrial fibrillation. Points Earned: 0/ Correct Answer: D Your Response: A Response: A A 20-year-old female client calls the nurse to report a lump she found in her breast. Which response is the best for the nurse to provide? A. Check it again in one month, and if it is still there schedule an appointment. B. Most lumps are benign, but it is always
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best to come in for an examination. C. Try not to worry too much about it, because usually, most lumps are benign. D. If you are in your menstrual period it is not a good time to check for lumps. (B) provides the best response because it addresses the client's anxiety most effectively and encourages prompt and immediate action for a potential problem. (A) postpones treatment if the lump is malignant, and does not relieve the client's anxiety. (C and D) provide false reassurance and do not help relieve anxiety. Points Earned: 0/ Correct Answer: B Your
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his speech. Which action should the nurse take? A. Determine the client is anxious and allow him to sleep. B. Evaluate his blood pressure, pulse, and respiratory status. C. Review the client's pre-operative history for alcohol abuse. D. Continue to monitor the client for reactivity to anesthesia. Slurred speech in the post-operative client who received a local anesthetic is an atypical finding and may indicate neurological deficits that require further assessment, so obtaining the client's vital signs (B) will provide information about possible cardiovascular complications, such as stroke. The client's anxiety (A), a history
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of alcohol abuse (D), or local anesthesia (D) are unrelated to the client's sudden onset of slurred speech. Points Earned: 1/ Correct Answer: B Your Response: B A client is admitted to the hospital with a diagnosis of severe acute diverticulitis. Which assessment finding should the nurse expect this client to exhibit? A. Lower left quadrant pain and a low-grade fever. B. Severe pain at McBurney's point and
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pneumonia. The nurse knows that the prognosis for gram-negative pneumonias (such as E. coli, Klebsiella, Pseudomonas, and Proteus) is very poor because
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A. they occur in the lower lobe alveoli which are more sensitive to infection. B. gram-negative organisms are more resistant to antibiotic therapy. C. they occur in healthy young adults who have recently been debilitated by an upper respiratory infection. D. gram-negative pneumonias usually affect infants and small children. The gram-negative organisms are resistant to drug therapy (B) which makes recovery very difficult. Gram-negative pneumonias affect all lobes of the lung (A). The mean age for contracting this type of pneumonia is 50 years (C and D), and it usually strikes debilitated persons such as alcoholics, diabetics, and those with chronic lung diseases. Points
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specialist. C. Schedule an appointment with an allergist to determine if the client is allergic to the cat. D. Encourage the client to slightly increase his use of oxygen at night and to always use humidified oxygen. The nurse should suggest creative methods to increase the intake of fluids (A), such as having disposable fruit juices readily available. Clients with COPD should have at least three liters of fluids a day. These clients often reduce fluid intake because of shortness of breath. (B) is not indicated. These symptoms are not indicative of an allergy (C). Many elderly depend on their pets for socialization and self- esteem. Humidified oxygen will not relieve these symptoms and increased oxygen levels will stifle
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the COPD client's trigger to breathe (D). Points Earned: 1/ Correct Answer: A Your Response: A Which symptoms should the nurse expect a client to exhibit who is known to have a pheochromocytoma? A. Numbness, tingling, and cramps in the extremities. B. Headache, diaphoresis, and palpitations. C. Cyanosis, fever, and classic signs of shock. D. Nausea, vomiting, and muscular
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by clients diagnosed with hypoparathyroidism. (C) lists the signs of an Addisonian (adrenal) crisis. (D) lists the signs of hyperparathyroidism. Points Earned: 0/ Correct Answer: B Your Response: A The nurse working in a postoperative surgical clinic is assessing a woman who had a left radical mastectomy for breast cancer. Which factor puts this client at greatest risk for developing lymphedema? A. She sustained an insect bite to her left arm yesterday. B. She has lost twenty pounds since the
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surgery. C. Her healthcare provider now prescribes a calcium channel blocker for hypertension. D. Her hobby is playing classical music on the piano. A radical mastectomy interrupts lymph flow, and the increased lymph flow that occurs in response to the insect bite increases the risk for the occurrence of lymphedema (A). (B) is not a factor. Lymphedema is not significantly related to vascular circulation (C). Only overuse of the arm, such as weight-lifting, would cause lymphedema--(D) would not. Points Earned: 1/ Correct Answer: A
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best time to draw a trough is the closest time to the next administration (C). (A, B, and D) are not as good a time to draw the trough as (C). (B and D) are not the best times to draw the peak of an aminoglycoside that has been administered IV. Points Earned: 0/ Correct Answer: C
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Your Response: A When preparing a client who has had a total laryngectomy for discharge, which instruction is most important for the nurse to include in the discharge teaching? A. Recommend that the client carry suction equipment at all times. B. Instruct the client to have writing materials with him at all times. C. Tell the client to carry a medic alert card stating that he is a total neck breather. D. Tell the client not to travel alone. It is imperative that total neck breathers carry a medic alert notice (C) so that if they have a cardiac arrest, mouth-to-neck breathing can be done. Mouth-to-mouth resuscitation will not
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