RN Adult Medical Surgical Online Practice 2023, Exams of Medicine

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RN Adult Medical Surgical Online

Practice 2023 A NGN

NGN

1000:

Client is alert and oriented and reports not feeling well for a few days. Client is on continuous ambulatory peritoneal dialysis (CAPD) and reports dialysate appeared cloudy this morning. Reports abdominal pain as 4 on a scale of 0 to 10. Bowel sounds active in all quadrants. Peritoneal dialysis access site red, warm to touch, with a small amount of purulent drainage noted on dressing.1300: Client is lying in bed with the knees flexed, guarding the abdomen. Abdomen is slightly distended, hypoactive bowel sounds. Client reports nausea. Reports pain as 6 on a scale of 0 to 10. Provider notified and updated with client condition and diagnostic results. - CORRECT ANS The client is experiencing manifestations of peritonitis due to x-ray results . NGN Client admitted to medical-surgical unit from PACU. Client reports incisional pain as 2 on a scale of 0 to

10. Client appears restless and frequently asks for water. Bilateral lower extremities cool with +1 pedal pulses. Urine output is 40 mL for the past 2 hr. Moderate amount of bright red drainage noted on surgical incision dressing. - CORRECT ANS Insert a large-gauge IV. Initiate a fluid challenge. Hypovolemia

Urine output Blood pressure A nurse is caring for a client who has a potassium level of 3 mEq/L. Which of the following assessment findings should the nurse expect? - CORRECT ANS Hypoactive Bowel Sounds NGN 0900: Client presents with abdominal pain in the upper left quadrant for the past 2 days. States pain became worse this morning and is radiating to the back. Rates pain as 8 on a scale of 0 to 10. Hypoactive bowel sounds; reports nausea, no vomiting; client is passing flatus. Febrile, oriented to person, place, and time. Tachypnea with diminished breath sounds. Sinus tachycardia. Client voids 300 mL of clear, amber urine. 0930: Client vomited 100 mL brown liquid. - CORRECT ANS The client is experiencing manifestations of pancreatitis as evidenced by the amylase and lipase . 0530: Client is awake and alert. Arteriovenous fistula (AVF) to right forearm with thrill palpated and auscultated for bruit. Lung sounds 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 confused. - CORRECT ANS Perform a 12-lead ECG is not indicated. Place the client in Trendelenburg position is indicated. Administer a 0.9% sodium chloride 200 mL IV bolus is indicated. Apply oxygen at 2 L/min via nasal cannula is indicated Notify the provider immediately is indicated Obtain the client's blood glucose level is not indicated. 1800: Emergency medical team removed client's shirt at the scene and initiated 18-gauge IV therapy in the right antecubital space. Client has full-thickness burns over the upper half of the chest and both forearms; partial-thickness burns are present on the client's face and neck. Sinus tachycardia, pulses to brachial extremities palpable. 1+ edema to upper extremities. Respirations even, labored with scattered rhonchi. Soot noted to the client's mouth and nose. Oxygen 40% via face tent applied. Hypoactive bowel sounds. 16 French indwelling urinary catheter inserted with return of 250 mL of yellow urine. Lactated Ringer's infusing to right antecubital. Provider preparing to insert right femoral central line catheter.

1830:

Client's voice is becoming hoarse and reports difficulty swallowing. Wheezes present to upper lobes bilaterally. Provider notified. Client positioned upright, oxygen via face tent. Blood collected - CORRECT ANS During the emergent phase of burn care, the client is at risk for developing hypovolemia and respiratory failure . A nurse is teaching a class about client rights. Which of the following instructions should the nurse include? - CORRECT ANS A client should sign an informed consent before receiving a placebo during a research trial. A nurse in an emergency department is caring for a client who reports vomiting and diarrhea for the past 3 days. Which of the following findings should indicate to the nurse that the client is experiencing fluid volume deficit? - CORRECT ANS Heart rate 110/min A nurse is creating a plan of care for a client who has neutropenia as a result of chemotherapy. Which of the following interventions should the nurse include in the plan? - CORRECT ANS Monitor the client's temperature every 4 hr. A nurse in an emergency department is caring for a client who has full-thickness burns over 20% of their total body surface area. After ensuring a patent airway and administering oxygen, which of the following items should the nurse prepare to administer first? - CORRECT ANS IV fluids A nurse is caring for a client who is 4 hr postoperative following an open reduction internal fixation of the right ankle. Which of the following assessment findings should the nurse report to the provider? - CORRECT ANS Extremity cool upon palpation A nurse is caring for a client who is 12 hr postoperative following a total hip arthroplasty. Which of the following actions should the nurse take? - CORRECT ANS Place a pillow between the client's legs.

A nurse is assessing a client who has Graves' disease. Which of the following images should indicate to the nurse that the client has exophthalmos? - CORRECT ANS D- the lady looking eyes A nurse is providing teaching for a female client who has recurrent urinary tract infections. Which of the following information should the nurse include in the teaching? - CORRECT ANS Void before and after intercourse. A nurse is providing postoperative teaching for a client who had a total knee arthroplasty. Which of the following instructions should the nurse include? - CORRECT ANS Flex the foot every hour when awake A nurse is assessing a client who has had a suspected stroke. The nurse should place the priority on which of the following findings? - CORRECT ANS Dysphagia A nurse is administering packed RBCs to a client. Which of the following assessment findings indicates a hemolytic transfusion reaction? - CORRECT ANS Low back pain and apprehension A nurse in an emergency department is assessing an older adult client who has a fractured wrist following a fall. During the assessment, the client states, "Last week I crashed my car because my vision suddenly became blurry." Which of the following actions is the nurse's priority? - CORRECT ANS Check the client's neurologic status. A nurse is evaluating the plan of care for four clients after 2 days of hospitalization. The nurse should identify the need to revise the plan for which of the following clients? - CORRECT ANS A client who is postoperative following abdominal surgery and reports feeling that something "popped" when they coughed. A nurse is assessing a client who had extracorporeal shock wave lithotripsy (ESWL) 6 hr ago. Which of the following findings should the nurse expect? - CORRECT ANS Stone fragments in the urine

A nurse is providing teaching to a client who has stage II cervical cancer and is scheduled for brachytherapy. Which of the following instructions should the nurse include? - CORRECT ANS "You will need to stay still in the bed during each treatment session." A nurse is caring for a client has who has chronic glomerulonephritis with oliguria. Which of the following findings should the nurse identify as a manifestation of chronic glomerulonephritis? - CORRECT ANS Hyperkalemia A nurse is admitting a client who has active tuberculosis. Which of the following types of transmission precautions should the nurse initiate? - CORRECT ANS Airborne A nurse is providing teaching to a client who is receiving chemotherapy and has a new prescription for epoetin alfa. Which of the following client statements indicates an understanding of the teaching? - CORRECT ANS "I will monitor my blood pressure while taking this medication." A nurse is caring for a client who has terminal cancer. The client tells the nurse, "I wish I could stop these treatments. I am ready to die." Which of the following statements should the nurse make? - CORRECT ANS Discontinuing with the treatments is your choice if it is your wish to do so. A nurse is caring for a client who has anorexia, low-grade fever, night sweats, and a productive cough. Which of the following actions should the nurse take first? - CORRECT ANS Initiate airborne precautions. A nurse is reviewing the laboratory results of a client who has aplastic anemia. Which of the following findings indicates a potential complication? - CORRECT ANS WBC count 2,000/mm NGN 2330: Report received from ambulance crew:

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. Client's shirt covered with bright red blood. Client reports pain as 6 on a scale of 0 to 10. Shortness of breath noted.2345: Client is alert and oriented with a GCS score of 15. Client has a penetrating wound to the anterior right upper chest measuring 2.5 cm (1 in). No other wounds or injuries found. Bilateral radial and pedal pulses are +1. Left lung sounds are clear, right upper lung sounds diminished. Client still reports pain as 6 on a scale of 0 to 10 over anterior chest. Bowel sounds are present in all 4 quadrants. - CORRECT ANS Client reports pain as 3 on a scale of 0 to 10 is correct. Client reports shortness of breath has decreased is correct. Client reports nausea, awaiting prescription for nausea is incorrect. Transfused 1 unit of packed RBCs, awaiting second unit is incorrect. Wound dressing is dry and intact is correct. Respiratory rate 24/min, blood pressure 108/74 mm Hg, and oxygen saturation 95% on 2 L/min via nasal cannula are correct. NGN 2330: Report received from ambulance crew: 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. Client's shirt covered with bright red blood. Client reports pain as 6 on a scale of 0 to 10. Shortness of breath noted.2345: Client is alert and oriented with a GCS score of 15. Client has a penetrating wound to the anterior right upper chest measuring 2.5 cm (1 in). No other wounds or injuries found.

Bilateral radial and pedal pulses are +1. Left lung sounds are clear, right upper lung sounds diminished. Client still reports pain as 6 on a scale of 0 to 10 over anterior chest. Bowel sounds are present in all 4 quadrants. - CORRECT ANS Place the client in high-Fowler's position is correct. Ensure there is continuous bubbling in the water seal chamber is incorrect. Monitor drainage every 30 min for the first hour is incorrect. Strip the drainage tubing to ensure it is patent is incorrect. Place two rubber-tipped hemostats in the client's room is correct. Palpate the chest tube insertion site for subcutaneous emphysema is correct. Ensure that all chest tube connections are securely attached is correct. NGN 2330: Report received from ambulance crew: 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. Client's shirt covered with bright red blood. Client reports pain as 6 on a scale of 0 to 10. Shortness of breath noted.2345: Client is alert and oriented with a GCS score of 15. Client has a penetrating wound to the anterior right upper chest measuring 2.5 cm (1 in). No other wounds or injuries found. Bilateral radial and pedal pulses are +1. Left lung sounds are clear, right upper lung sounds diminished. Client still reports pain as 6 on a scale of 0 to 10 over anterior chest.

Bowel sounds are present in all 4 quadrants. - CORRECT ANS Transfuse packed RBCs is anticipated. Place the client in Trendelenburg position is contraindicated. Prepare the client for chest tube insertion is anticipated. Cover the client with a cooling blanket is contraindicated. Initiate NPO status is anticipated. NGN 2330: Report received from ambulance crew: 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. Client's shirt covered with bright red blood. Client reports pain as 6 on a scale of 0 to 10. Shortness of breath noted.2345: Client is alert and oriented with a GCS score of 15. Client has a penetrating wound to the anterior right upper chest measuring 2.5 cm (1 in). No other wounds or injuries found. Bilateral radial and pedal pulses are +1. Left lung sounds are clear, right upper lung sounds diminished. Client still reports pain as 6 on a scale of 0 to 10 over anterior chest. Bowel sounds are present in all 4 quadrants. - CORRECT ANS The nurse should first address the client's oxygenation followed by the client's blood pressure . NGN

2330:

Report received from ambulance crew: 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. Client's shirt covered with bright red blood. Client reports pain as 6 on a scale of 0 to 10. Shortness of breath noted.2345: Client is alert and oriented with a GCS score of 15. Client has a penetrating wound to the anterior right upper chest measuring 2.5 cm (1 in). No other wounds or injuries found. Bilateral radial and pedal pulses are +1. Left lung sounds are clear, right upper lung sounds diminished. Client still reports pain as 6 on a scale of 0 to 10 over anterior chest. Bowel sounds are present in all 4 quadrants. - CORRECT ANS The client is most likely experiencing a hemothorax as evidenced by the client's respiratory findings NGN 2330: Report received from ambulance crew: 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. Client's shirt covered with bright red blood. Client reports pain as 6 on a scale of 0 to 10. Shortness of breath noted. - CORRECT ANS GCS score is incorrect. Temperature is incorrect. Oxygen saturation is correct. Pain level is correct.

A nurse is planning care for a client who is postoperative following a laparotomy and has a closed- suction drain. Which of the following actions should the nurse take to manage the drain? - CORRECT ANS Compress the drain reservoir after emptying. A nurse is planning care to decrease psychosocial health issues for a client who is starting dialysis treatments for chronic kidney disease. Which of the following interventions should the nurse include in the plan? - CORRECT ANS Tell the client that it is possible to return to similar previous levels of activity. A nurse is planning care for a client who is undergoing brachytherapy via a sealed vaginal implant to treat endometrial cancer. Which of the following actions should the nurse include in the client's plan of care? - CORRECT ANS Wear a lead apron while providing care to the client. A nurse is planning care for a client who is scheduled for a thoracentesis. Which of the following interventions should the nurse include in the plan? - CORRECT ANS Encourage the client to take deep breaths after the procedure. A nurse in an acute care facility is caring for a client who is at risk for seizures. Which of the following precautions should the nurse implement? - CORRECT ANS Ensure that the client has a patent IV. A nurse is providing preoperative teaching for a client who is scheduled for an open cholecystectomy. Which of the following actions should the nurse take? - CORRECT ANS Demonstrate ways to deep breathe and cough. A nurse is caring for a client who has homonymous hemianopsia as a result of a stroke. To reduce the risk of falls when ambulating, the nurse should provide which of the following instructions to the client?

• CORRECT ANS "Scan the environment by turning your head from side to side." A nurse is assessing a client who has advanced lung cancer and is receiving palliative care. The client has just undergone thoracentesis. The nurse should expect a reduction in which of the following common manifestations of advanced cancer? - CORRECT ANS dyspnea

A nurse is caring for a client who is receiving total parenteral nutrition (TPN). A new bag is not available when the current infusion is nearly completed. Which of the following actions should the nurse take? - CORRECT ANS Administer dextrose 10% in water until the new bag arrives. A nurse is providing teaching to a client who has a gastric ulcer and a new prescription for omeprazole. The nurse should instruct the client that the medication provides relief by which of the following actions? - CORRECT ANS Suppressing gastric acid production A nurse is planning to irrigate and dress a clean, granulating wound for a client who has a pressure injury. Which of the following actions should the nurse take? - CORRECT ANS Use a 30-mL syringe. A nurse is providing teaching to a client who has cancer and a new prescription for an opioid analgesic for pain management. Which of the following information should the nurse include in the teaching? - CORRECT ANS "You should void every 4 hours to decrease the risk of urinary retention." A nurse in a provider's office is assessing a client who has hypertension and takes propranolol. Which of the following findings should indicate to the nurse that the client is experiencing an adverse reaction to this medication? - CORRECT ANS Report of a night cough A nurse is teaching a group of newly licensed nurses about pain management for older adult clients. Which of the following statements by a newly licensed nurse indicates an understanding of the teaching? - CORRECT ANS "Ibuprofen can cause gastrointestinal bleeding in older adult clients." A nurse is assessing a client following the completion of hemodialysis. Which of the following findings is the nurse's priority to report to the provider? - CORRECT ANS Restlessness A nurse is assessing a client who is postoperative following a thyroidectomy. Which of the following findings is the nurse's priority? - CORRECT ANS Temperature 38.9° C (102° F)

A nurse is providing education to a client who has tuberculosis (TB) and their family. Which of the following information should the nurse include in the teaching? - CORRECT ANS Family members in the household should undergo TB testing. A nurse is providing discharge instructions to a client following an upper gastrointestinal series with barium contrast. Which of the following information should the nurse provide? - CORRECT ANS Increase fluid intake 1NGN 000:Client presents to the ED with visual disturbances, expressive aphasia, and numbness and tingling of the lips. Manifestations started about 30 min ago. Client reports flashing lights in their vision, especially on the right side. Client's partner states the client had some difficulty with finding words when speaking. Client is alert and oriented x 3 and appears anxious. No facial drooping noted. Right hand grasp is weaker than left. Client denies pain.1045:Client states the flashing lights, numbness, and tingling in the lips have gone away. Client states they now have throbbing pain behind the left eye, photophobia, and nausea. Client is requesting medication for pain that is 7 on a scale of 0 to 10. Hand grasps are equal and strong bilaterally.1300:Client reports pain as 2 on a scale of 0 to 10 and nausea has resolved. Provided client with discharge instructions regarding sumatriptan and migraine triggers. - CORRECT ANS "Foods that contain tyramine might trigger my headaches" is correct. "I will keep a food and headache diary" is correct. "I will place a cool cloth on my forehead when I experience a migraine" is correct. "I will take the sumatriptan once every day" is incorrect. "I should stay awake until my headache is gone" is incorrect.

NGN

1000:Client presents to the ED with visual disturbances, expressive aphasia, and numbness and tingling of the lips. Manifestations started about 30 min ago. Client reports flashing lights in their vision, especially on the right side. Client's partner states the client had some difficulty with finding words when speaking. Client is alert and oriented x 3 and appears anxious. No facial drooping noted. Right hand grasp is weaker than left. Client denies pain.1045:Client states the flashing lights, numbness, and tingling in the lips have gone away. Client states they now have throbbing pain behind the left eye, photophobia, and nausea. Client is requesting medication for pain that is 7 on a scale of 0 to 10. Hand grasps are equal and strong bilaterally. - CORRECT ANS Following the administration of sumatriptan, the nurse should monitor for chest pain due to the risk of myocardial ischemia NGN 1000:Client presents to the ED with visual disturbances, expressive aphasia, and numbness and tingling of the lips. Manifestations started about 30 min ago. Client reports flashing lights in their vision, especially on the right side. Client's partner states the client had some difficulty with finding words when speaking. Client is alert and oriented x 3 and appears anxious. No facial drooping noted. Right hand grasp is weaker than left. Client denies pain.1045:Client states the flashing lights, numbness, and tingling in the lips have gone away. Client states they now have throbbing pain behind the left eye, photophobia, and nausea. Client is requesting medication for pain that is 7 on a scale of 0 to 10. Hand grasps are equal and strong bilaterally. - CORRECT ANS Administer sumatriptan is correct. Dim the lights in the client's room is correct. Nurses' Notes

1000:Client presents to the ED with visual disturbances, expressive aphasia, and numbness and tingling of the lips. Manifestations started about 30 min ago. Client reports flashing lights in their vision, especially on the right side. Client's partner states the client had some difficulty with finding words when speaking. Client is alert and oriented x 3 and appears anxious. No facial drooping noted. Right hand grasp is weaker than left. Client denies pain.1045:Client states the flashing lights, numbness, and tingling in the lips have gone away. Client states they now have throbbing pain behind the left eye, photophobia, and nausea. Client is requesting medication for pain that is 7 on a scale of 0 to 10. Hand grasps are equal and strong bilaterally. - CORRECT ANS The nurse should identify that the client is most likely experiencing a migraine and the nurse should address the client's pain . 1000:Client presents to the ED with visual disturbances, expressive aphasia, and numbness and tingling of the lips. Manifestations started about 30 min ago. Client reports flashing lights in their vision, especially on the right side. Client's partner states the client had some difficulty with finding words when speaking. Client is alert and oriented x 3 and appears anxious. No facial drooping noted. Right hand grasp is weaker than left. Client denies pain. - CORRECT ANS Hand grasps is consistent with migraine, stroke, and meningitis. Numbness is consistent with migraine and stroke. Aphasia is consistent with migraine and stroke. Visual changes are consistent with migraine, stroke, and meningitis.

Family history is consistent with migraine and stroke. NGN 1000:Temperature 36.8° C (98.4° F)Heart rate 98/minRespiratory rate 18/minBlood pressure 134/75 mm HgOxygen saturation 98% on room air - CORRECT ANS Visual disturbances is correct. Tingling of the lips is correct. Hand grasps is correct. Expressive aphasia is correct. A nurse on a medical-surgical unit is reviewing the medical record of an older adult client who is receiving IV fluid therapy. Which of the following client information should indicate to the nurse that the client requires re-evaluation of the IV therapy prescription? (Click on the "Exhibit" button for additional information about the client. There are three tabs that contain separate categories of data.) - CORRECT ANS BUN A nurse is reviewing the ABG results of a client who has advanced COPD. Which of the following results should the nurse expect? - CORRECT ANS PaCO2 56 mm Hg A nurse is preparing to administer a blood transfusion to a client who has anemia. Which of the following actions should the nurse take first? - CORRECT ANS Check for the type and number of units of blood to administer. A nurse is caring for a client who had a nephrostomy tube inserted 12 hr ago. Which of the following findings should the nurse report to the provider? - CORRECT ANS The client reports back pain.

A nurse is caring for a client who has amyotrophic lateral sclerosis (ALS) and is being admitted to the hospital with pneumonia. Which of the following assessment findings is the nurse's priority? - CORRECT ANS Increased respiratory secretions A nurse is caring for a client 1 hr following a cardiac catheterization. The nurse notes the formation of a hematoma at the insertion site and a decreased pulse rate in the affected extremity. Which of the following interventions is the nurse's priority - CORRECT ANS Apply firm pressure to the insertion site. A nurse is assessing a group of clients for indications of role changes. The nurse should identify that which of the following clients is at risk for experiencing a role change? - CORRECT ANS A client who has multiple sclerosis and is experiencing progressive difficulty ambulating. MY ANSWER A nurse is providing discharge instructions to a client who has laryngeal cancer and is receiving radiation therapy. Which of the following statements by the client indicates an understanding of the teaching? - CORRECT ANS "I will avoid direct exposure to the sun." A nurse is caring for a client who is experiencing a tonic-clonic seizure. Which of the following actions should the nurse take? - CORRECT ANS Loosen restrictive clothing. A nurse is performing a dressing change for a client who is recovering from a hemicolectomy. When removing the dressing, the nurse notes that a large part of the bowel is protruding through the abdomen. Which of the following actions should the nurse take first? - CORRECT ANS Call for help. A nurse is providing instructions to a client who has type 2 diabetes mellitus and a new prescription for metformin. Which of the following statements by the client indicates an understanding of the teaching?

• CORRECT ANS "I should take this medication with a meal." A nurse is providing follow-up care for a client who sustained a compound fracture 3 weeks ago. The nurse should recognize that an unexpected finding for which of the following laboratory values is a manifestation of osteomyelitis and should be reported to the provider? - CORRECT ANS Sedimentation rate

A nurse is assessing a client while suctioning the client's tracheostomy tube. Which of the following findings should indicate to the nurse the client is experiencing hypoxia? - CORRECT ANS The client's heart rate increases. A nurse is providing preoperative teaching for a client who is scheduled for a mastectomy. Which of the following statements should the nurse make? - CORRECT ANS "I will refer you to community resources that can provide support." A nurse is preparing to present a program about prevention of atherosclerosis at a health fair. Which of the following recommendations should the nurse plan to include? (Select all that apply.) - CORRECT ANS Follow a smoking cessation program is correct. Maintain an appropriate weight is correct. Eat a low-fat diet is correct. A nurse is caring for a client who is receiving total parenteral nutrition (TPN) and is NPO. When reviewing the chart, the nurse notes the following prescription: capillary blood glucose AC and HS. Which of the following actions should the nurse take? - CORRECT ANS Contact the provider to clarify the prescription. A nurse is caring for a client who has an arterial line. Which of the following actions should the nurse take? - CORRECT ANS Place a pressure bag around the flush solution. A nurse is caring for a client who is having a seizure. Which of the following interventions is the nurse's priority? - CORRECT ANS Turn the client to the side. A nurse at an urgent care clinic is caring for a client who is experiencing an anaphylactic reaction. After ensuring a patent airway, which of the following nursing interventions is the priority? - CORRECT ANS Administering epinephrine

A nurse is caring for a client who has increased intracranial pressure (ICP) and is receiving mannitol via continuous IV infusion. Which of the following findings should the nurse report to the provider as an adverse effect of this medication? - CORRECT ANS Crackles heard on auscultation A nurse is providing discharge teaching to a client who is postoperative following a modified radical mastectomy. Which of the following instructions should the nurse include? - CORRECT ANS Numbness can occur along the inside of the affected arm. A nurse is caring for a client who has DKA. Which of the following findings should indicate to the nurse that the client's condition is improving? - CORRECT ANS Glucose 272 mg/dL A nurse is providing teaching to a client who takes ginkgo biloba as an herbal supplement. Which of the following statements should the nurse make? - CORRECT ANS "Ginkgo biloba can cause an increased risk for bleeding." A nurse is providing teaching to a female client who has stress incontinence and a BMI of 32. Which of the following statements by the client indicates an understanding of the teaching? - CORRECT ANS "A risk factor for my condition is obesity." A nurse is caring for a client who has portal hypertension. The client is vomiting blood mixed with food after a meal. Which of the following actions should the nurse take first? - CORRECT ANS Obtain vital signs. A nurse is caring for a client who is postoperative following a total hip arthroplasty. Which of the following laboratory values should the nurse report to the provider? - CORRECT ANS Hgb 8 g/dL NGN 1100: Client received from PACU; initial vital signs recorded. Client is drowsy, but arouses to verbal stimuli. Oriented x3, moves all extremities. Normal sinus rhythm. Chest clear. Dressing to abdomen intact, small

amount of serosanguinous drainage noted and marked. No bowel sounds x 4 quadrants. Indwelling urinary catheter in place, draining clear yellow urine. Lactated Ringer's infusing at 100 mL/hr via IV catheter to right forearm.1200: Client reports nausea and pain as 8 on a scale of 0 to 10. Abdominal dressing intact, no further drainage noted. Urine output 15 mL since arrival from PACU. Analgesic and antiemetic administered as prescribed.1230: Client reports relief from nausea and pain as 4 on a scale of 0 to 10. SaO2 96%. Repositioned for comfort. Encouraged to turn, cough, and deep breathe.1300: No additional urine output since 1200. - CORRECT ANS Report urinary output to the provider is correct. Plan to ambulate the client as soon as possible is correct Instruct the client to splint the abdomen with a pillow for coughing is correct. A nurse is teaching a client who has a family history of colorectal cancer. To help mitigate this risk, which of the following dietary alterations should the nurse recommend? - CORRECT ANS Add cabbage to the diet. A nurse in an emergency department is assessing a client who has a detached retina. Which of the following should the nurse expect the client to report? - CORRECT ANS "It's like a curtain closed over my eye." A nurse is caring for a client who is receiving a blood transfusion. The client becomes restless, dyspneic, and has crackles noted to the lung bases. Which of the following actions should the nurse anticipate taking? - CORRECT ANS Slow the infusion rate. A nurse is assessing a client who has a diagnosis of rheumatoid arthritis. Which of the following nonpharmacological interventions should the nurse suggest to the client to reduce pain? - CORRECT ANS Alternate application of heat and cold to the affected joints.

A nurse is caring for a client who has hypothyroidism. Which of the following manifestations should the nurse expect? - CORRECT ANS Constipation A nurse is caring for a client who has a leg cast and is returning to demonstrate on the proper use of crutches while climbing stairs. Identify the sequence the client should follow when demonstrating crutch use. (Move the steps into the box on the right, placing them in the selected order of performance. Use all the steps.) - CORRECT ANS Places body weight on the crutches advances the unaffected leg onto the stairs shifts weight from the crutches to the unaffected leg brings the crutches and the affected leg up the stairs