PN ADULT MEDICAL SURGICAL ONLINE PRACTICE 2023 A/REVISION QUESTIONS WITH CORRECT ANSWERS, Exams of Nursing

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PN ADULT MEDICAL SURGICAL ONLINE

PRACTICE 2023 A/REVISION QUESTIONS WITH

CORRECT ANSWERS

1. A nurse is preparing to administer furosemide to a client who has heart failure. Which of the following findings should the nurse report before admin- istering the medication?: Decreased potassium
2. A nurse is reviewing the chart of a client who is experiencing an adrenal crisis, which was precipitated by the client not taking their medication for several days. The nurse should identify that withdrawal from which of the following medications potentiated the adrenal crisis?: Prednisone
   3. A nurse is assisting with the care for a client who has a prescription for digoxin 0.25 mg PO daily. While taking the client's apical pulse, the nurse notes a rate of 58/min. Which of the following actions should the nurse take?: With- hold the dose.
3. A nurse is reinforcing teaching about glycosylated hemoglobin (HbA1c) testing with a client who has diabetes mellitus. Which of the following state- ments indicates that

the client understands the teaching?: "I will have my HbA1c checked twice per year." 5.A nurse is providing information regarding transmission-based precautions for a client who has Clostridium difficile to an assistive personnel (AP). Which of the following instructions should the nurse include? (Select all that apply.): "Provide the client with disposable utensils and dishes for meals." "Leave blood pressure equipment in the client's room." "Clean contaminated surfaces with a bleach solution."

6. A nurse is reinforcing teaching with a client who has coronary artery disease. Which of the following instructions should the nurse include in the teaching?: "Add oily fish to your diet twice weekly."
7. A nurse in an oncology clinic is reinforcing teaching about Mohs surgery with a client who has skin cancer. Which of the following information should the nurse include in the teaching?: Mohs surgery is a horizontal shaving of thin layers of the tumor.

clear upon auscultation. Dressing to abdomen is intact with a small amount of serosanguinous drainage noted and marked. No bowel sounds in all four quadrants. Indwelling urinary catheter is in place and draining clear, yellow urine. Lactated Ringer's is infusing at 100 mL/hr via IV catheter in the right forearm.1200: Client reports nausea and pain as an 8 on a scale of 0 to 10. Abdominal dressing is intact with no further drainage noted. Urine output of 15 mL noted since arrival from PACU. Analgesic and antiemetic were administered as prescribed.1230: Client reports relief from nausea, and pain as a 4 on a scale of 0 to 10. Oxygen saturation is 96%. Client was repositioned for comfort and encouraged to turn, cough, and deep breathe.1300: No additional urine output noted since 1200.: Which of the following actions should the nurse take? Select all that apply. Instruct the client to splint their abdomen with a pillow when coughing. Report the client's urinary output to the charge nurse.

Monitor the client's pain level.

12. A nurse is assisting with monitoring a client who is receiving dialysis treatment. Exhibit 1 Nurses' Notes 0530:Client is awake and alert. Arteriovenous fistula (AVF) to right forearm with thrill palpated and auscultated for bruit. Breath sounds are clear upon auscultation; client denies shortness of breath. No peripheral edema noted; capillary refill is less than 3 seconds; +2 bilateral pedal and radial pulses.AVF access prepared and cannulated twice with no difficulty. Lines are taped and secured; treatment is initiated.0600:Client is reading a book. Access is visible, and lines are secure. Client reports no discomfort or pain.0630:Client reports feeling warm, nauseated, and lightheaded; appears restless and slightly con- fused. Exhibit 2 Vital Signs 0530:Current weight 88 kg (194 lb)Temperature 37° C (98.6° F)Blood pres- sure• Lying - 152/92 mm Hg• Sitting - 148/90 mm Hg• Standing - 144/88 mm

the nurse include in the plan?: Remind the client to swish the medication in their mouth. 14.A nurse is reinforcing teaching with the caregiver of a client who has a cervical injury and has a halo vest in place. Which of the following safety precautions should the nurse include in the teaching?: Change the sheepskin liner weekly. 15.A nurse is assisting in the care of a client who is receiving a continuous tube feeding of 60 mL/hr at 1.2 cal/mL. How many calories will the client receive in 12 hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.): 864 cal 16.A nurse is reinforcing teaching with a client who has diabetes mellitus and a new prescription for regular and NPH insulin. Which of the following instructions on preparing the insulins should the nurse include?: Withdraw the regular insulin before withdrawing the NPH insulin.

17. A nurse is preparing to assist a client out of bed 4 hr following a laparo- scopic cholecystectomy. Which of the following actions should the nurse take first?: Obtain the client's blood pressure.

18.A nurse is assisting with the care for a client who has age-related macular degeneration. Which of the following findings should the nurse expect?: Dis- torted central vision of the eyes

19. A nurse is reinforcing teaching with a client who is on a low-sodium diet and asks about how to improve the taste of bland food. Which of the following foods should the nurse recommend?: Lemon juice 20.A nurse is preparing to assist with the insertion of a double-lumen gastric sump tube for a client who has peptic ulcer disease and has developed gastrointestinal bleeding. Which of the following images depicts the tube that the nurse should select?: clear with blue tube 21.A nurse is contributing to the plan of care for a client who has tuberculosis (TB). Which of the following interventions should the nurse include?: Place the client in a negative-pressure airflow room. 22.A nurse is contributing to the plan of care for a client who had a stroke. For which of the following interprofessional team members should the nurse recommend a referral prior to initiating oral intake for the client?: Speech-lan- guage pathologist

therapy (HRT). Which of the following should the nurse recognize as a contraindication to HRT?: History of treatment for blood clots 29.A nurse is contributing to the plan of care for a client who has COPD and is dyspneic. Which of the following interventions should the nurse include in the plan?: Encourage abdominal breathing. 30.A nurse is assisting with the care for a client who has a history of breast cancer. The client asks the nurse about birth control. Which of the following methods of birth control is contraindicated for this client?: Combination oral contraceptives 31.A home health nurse is reinforcing teaching with a client about preventing complications of peripheral vascular disease. Which of the following state- ments indicates that the client is adhering to the nurse's instructions?: "I don't cross my legs anymore." 32.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?: Decreased shortness of breath 33.A nurse is assisting with the care for a client who is receiving chemother- apy. The client mentions that they have a loss of appetite because of sores in their mouth and

that food no longer tastes good. Which of the following suggestions to the client should the nurse make?: Eat several small-portioned meals daily.

34. A nurse on a medical-surgical unit is assisting with the care of a newly admitted client. Exhibit 1 Progress ReportDay 1 2330:Report received from emergency depart- ment:Client has a penetrating wound to the anterior upper right chest. Client is alert and oriented with a Glasgow Coma Scale (GCS) score of 15. Wound dressing has moderate serosanguineous drainage. Client reports pain as a 6 on a scale of 0 to 10. Shortness of breath noted. Exhibit 2 Graphic RecordDay 1 2330:Vital signs from the emergency department:Heart rate 125/minRespiratory rate 28/minTemperature 36° C (96.8° F)Blood pres- sure 145/ mm HgOxygen saturation 90% on oxygen 2 L/min via nasal cannula: Select the 3 findings that require follow-up by the nurse.

C (96.6° F)Blood pressure 96/45 mm HgOxygen saturation 92% on oxygen 40% via face mask Exhibit 3 Nurses' NotesDay 1 2345:Client is alert and oriented with a CGS score of

15. Reinforced dressing over the chest wound with sanguineous drainage. No other wounds or injuries found.Bilateral radial and pedal pulses are +1. Left lung sounds are clear; right upper lung sounds are diminished.Client still reports pain as a 6 on a scale of 0 to 10 over anterior chest.Bowel sounds are present in all four quadrants: The client is most likely experiencing a hemothorax as evidenced by the client's respiratory findings 36. The nurse should first address the client's oxygenation , followed by the client's blood pressure: oxygenation

blood pressure 37.For each potential provider prescription, click to specify if the potential prescription is anticipated or contraindicated for the client.: Transfuse packed RBCs - anticipated Place the client in Trendelenburg position - contraindicated Prepare the client for chest tube insertion - anticipated Cover the client with a cooling blanket - contraindicated Initiate NPO status - anticipated

38. The nurse is assisting with the care of the client following the placement of a chest tube for a hemothorax. Which of the following actions should the nurse take? Select all that apply.: Ensure that all chest tube connections are securely attached. Palpate the chest tube insertion site for subcutaneous emphysema. Place two rubber-tipped hemostats in the client's room. Place the client in high-Fowler's position.

the steps into the box on the right, placing them in the order of performance. Use all the steps.): Lower client to the floor. Place a pad beneath the client's head. Loosen the clothing around the client's neck. Time the length of the client's seizure. Reorient and reassure the client. 43.A nurse is examining a client's IV site and notes a hardened vein above their IV site. 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?: Thrombophlebitis

44. A nurse is planning care for a group of clients after receiving change-of-shift report. Which of the following clients should the nurse plan to see first?: A client who is dehydrated, has mental confusion, and has tried to get out of bed several times during the night 45.A nurse is reinforcing teaching regarding the use of a continuous passive motion (CPM) machine with a client who is scheduled for a total knee arthro- plasty. Which of

the following information should the nurse include in the teaching? (Select all that apply.): "Your knee is flexed and extended as prescribed by your provider." "The machine is padded with sheep skin." 46.A nurse is assisting with the care for a client who has difficulty swallowing. Which of the following actions should the nurse implement to prevent aspira- tion?: Give the client liquids with increased viscosity. 47.A nurse is contributing to the plan of care for a client who has Ménière's disease. Which of the following interventions should the nurse include in the plan of care?: Administer an antiemetic to the client. 48.A nurse is reinforcing teaching with a client who has chronic kidney disease about disease management. Which of the following statements by the client indicates an understanding of the teaching?: "I will limit my daily intake of protein." 49.A nurse is assisting with the discharge planning for a client who is postop- erative following a total hip arthroplasty. Which of the following instructions should the nurse include in the discharge plan?: Obtain a raised toilet seat.

Capillary blood glucose 102 m: Agn/duLrse is preparing to administer scheduled medications to a client. Which of the following prescriptions should the nurse verify with the provider? Ceftriaxone 52.A nurse is reviewing the medical record of a client who has acute pancre- atitis. Which of the following findings should the nurse anticipate?: Elevated serum amylase level

53. Exhibit 1 Nurses' Notes1000:Client reports visual disturbances, including flashing lights in their vision, especially on the right side.Client is alert and oriented to person, place, and time; client appears anxious. No facial drooping noted. Hand grasps are equal and strong bilaterally.Client reports throbbing pain behind the left eye, photophobia, and nausea. The client rates the pain as a 7 on a scale of 0 to 10. Exhibit 2 Graphic Record1000:Temperature 36.9° C (98.4° F)Heart rate 112/minRespira- tory rate 22/minBlood pressure 138/80 mm HgOxygen saturation 98% on room air Exhibit 3 History and PhysicalHistory of high cholesterol, diet controlledFamily history of coronary artery disease, epilepsy, and migraines: Select the 3 findings that require follow-up by the nurse.