RN Adult Medical Surgical Online Practice: Exam Questions and Answers, Exams of Nursing

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RN Adult Medical Surgical Online Practice NGN\ RN Adult Medical Surgical Online Practice ACTUAL EXAM WITH REAL QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) LATEST |GUARANTEED A+ a nurse in an emergency department is caring for a client who reports visiting 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 ANSWER heart rate 110/min

a nurse is caring for a client who is on bed rest and has a new prescription for enoxaparin subcutaneous. which of the following

actions should the nurse take? - CORRECT ANSWER inject the

medication into the anterolateral abdominal wall a nurse in a provider's office is caring for a client who requests sildenafil to treat erectile dysfunction. which of the following

statements should the nurse take? - CORRECT ANSWER you will not

be able to use sildenafil if you are taking nitroglycerin 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 ANSWER it's like a curtain closed over

my eye a nurse is providing teaching to an older adult 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 ANSWER you should void every 4 hours to

decrease the risk of urinary retention a nurse is assessing a client following the administration of magnesium sulfate 1 g IV bolus. for which of the following adverse

effects should the nurse monitor? - CORRECT ANSWER respiratory

paralysis

a nurse is assessing a male client for an inguinal hernia. which of the following areas should the nurse palpate to verify that the client has

an inguinal hernia? - CORRECT ANSWER C

a nurse is caring for a client who has type 1 diabetes mellitus and has had acute bronchitis for the past 3 days. which of the following statements should the nurse include when instructing the client? -

CORRECT ANSWER take insulin even if you are unable to eat your

regular diet a nurse has received change-of-shift report for a group of clients. which of the following clients should the nurse assess first? -

CORRECT ANSWER a client who had a myocardial infarction (MI) 4

days ago and is asking for a PRN sublingual nitroglycerin tablet 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 in the nurse's priority? - CORRECT

ANSWER increased respiratory secretions

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 ANSWER monitor the

client's temperature every 4 hrs. a nurse is providing teaching to a client who has hypothyroidism and is receiving levothyroxine. The nurse should instruct the client that which of the following supplements can interfere with the

effectiveness of the medication? - CORRECT ANSWER calcium

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 ANSWER initiate airborne

precautions 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

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 ANSWER wear a lead apron while providing care to the

client 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 ANSWER hypoactive bowel sounds

a nurse in an ICU is assessing a client who has a traumatic brain injury. which of the following findings should the nurse identify as a

component of Cushings triad? - CORRECT ANSWER bradycardia

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 ANSWER demonstrate

ways to deep breathe and cough a nurse is caring for a client who has a leg cast and is returning demonstration on the proper use of crutches while climbing stairs. identify the sequence the client should follow when demonstrating

crutch use. - CORRECT ANSWER places body weight on the crutches.

advances the unaffected leg onto the stair. shifts weight from the crutches to the unaffected leg. brings the crutches and effected leg up to the stair. a nurse in an emergency department is caring for a client who is experiencing a thyroid storm. which of the following manifestations

should the nurse expect? - CORRECT ANSWER fever

hypertension tachycardia a nurse is caring for a client who has a prescription for enalapril. the nurse should identify which of the following findings as an adverse

effect of the medication? - CORRECT ANSWER orthostatic

hypotension

a nurse is providing teaching to a client who has irritable bowel syndrome (IBS). which of the following instructions should the nurse

include in teaching? - CORRECT ANSWER increase fiber intake to at

least 30 mg per day a nurse is caring for a client who has a stage 3 pressure injury. which of the following findings contributes to delayed wound healing? -

CORRECT ANSWER urine output 25 mL/hr

a nurse is caring for a client who is experiencing supraventricular tachycardia. upon assessing the client, the nurse observes the following findings: heart rate 200/min, blood pressure 78/40 mm Hg, and respiratory rate 30/min. which of the following actions should the

nurse take? - CORRECT ANSWER perform synchronized cardioversion

a nurse is caring for a client who presents to a clinic for a 1-week follow-up visit after hospitalization for heart failure. based on the information in the client's chart, which of the following findings should

the nurse report to the provider? - CORRECT ANSWER heart rate

55/min a nurse is planning to irrigate and dress a client, granulating wound for a client who has a pressure injury. which of the following actions

should the nurse take? - CORRECT ANSWER use a 30-mL syringe

a nurse is caring for a client who has a new prescription for total parenteral nutrition (TPN). the client is to receive 2,000 kcal per day. the TPN solution has 500 kcal/L. the IV pump should be set at how

many mL/hr? - CORRECT ANSWER 167 mL/hr

a nurse is caring for a client who is receiving morphine for daily dressing changes. the client tells the nurse, "I don't want any more morphine because I don't want to get addicted." which of the following

actions should the nurse take? - CORRECT ANSWER instruct the

client on alternative therapies for pain reduction

following items should the nurse prepare to administer first? -

CORRECT ANSWER IV fluids

a nurse is caring for a client who is having a seizure. which of the

following interventions is the nurse's priority? - CORRECT ANSWER

turn the client to the side a nurse is caring for a client 1 hr following a cardiac catheterization. the nurse notes the formation of a hematoma at the insertion side and a decreased pulse rate in the affected extremity. which of the

following interventions is the nurse's priority? - CORRECT ANSWER

apply firm pressure to the insertion site a nurse is providing teaching to a client who has esophageal cancer and is to undergo radiation therapy. which of the following statements should the nurse identify as an indication that the client understands

the teaching? - CORRECT ANSWER I will use my hands rather than a

washcloth to clean the radiation area a nurse is preparing to admit a client who has dysphagia. the nurse should plan to place which of the following items at the client's

bedside? - CORRECT ANSWER suction machine

a nurse is teaching a class about client rights. which of the following

instructions should the nurse include? - CORRECT ANSWER a client

should sign an informed consent before receiving a placebo during a research trial A nurse is providing teaching to a client who has esophageal cancer and is to undergo radiation therapy. which of the following statements should the nurse identify as an indication that the client understands the teaching? A) After each treatment, I will wash the ink markings off the radiation area." B) "I will use my hands rather than a washcloth to clean the radiation area." C) I can be out in the sun 1 month after my radiation treatments are over."

D) "I will use a heating pad on my neck if it becomes sore during the

radiation therapy." - CORRECT ANSWER b; The client should gently

wash the radiation area with their hands using warm water and mild soap to protect the skin from further irritation. a - The ink markings designate the exact radiation area. The client should not remove these markings until they complete the radiation treatment. c - Radiation therapy causes skin to become sensitive to the effects of sun exposure and increases the risk of developing skin cancer. The client should avoid direct sunlight during the radiation treatments and for at least 1 year following the conclusion of the therapy. d - The client should avoid exposing the treatment area to heat as this can cause further irritation to the skin. Clinic for a 1-week follow-up visit after hospitalization for heart failure. What should the nurse report Discharge:

• Weight 66.7 kg (147 lb)
• SaO2 94%
• 2+ pedal edema
• Heart rate 74/min Current:
• Weight 67.1 kg (148 lb)
• SaO2 92%
• 1+ pedal edema
• Heart rate 55/min A) Potassium 4.1 mEq/L B) Heart rate 55/min C) SaO2 92%

D) Weight 67.1 kg (148 lb) - CORRECT ANSWER b; The client's heart

rate of 55/min is a decrease from the client's baseline of 74/min, and it

A) Avoid foods that are high in ascorbic acid. B) Add oatmeal to the water when taking a tub bath. C) Urinate every 6 hr.

D) Take daily cranberry supplements. - CORRECT ANSWER d - The

client should take cranberry supplements or drink low-fructose cranberry juice because it contains compounds that adhere to the urinary tract wall, decreasing the risk of developing a UTI. a - A client at risk for developing UTIs should increase intake of ascorbic acid to acidify the urine. b - A client at risk for developing UTIs should take showers rather than tub baths because bacteria in the bath water can enter the urethra. c - A client who is at risk for developing UTIs should urinate every 2 to 4 hr. What pH urine favors preventing UTIs. Acidic urine or basic urine? -

CORRECT ANSWER Acidic urine

A client who is at risk for developing UTIs should urinate every ____-

_____ hrs - CORRECT ANSWER 2 - 4

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? A) "I will monitor my blood pressure while taking this medication." B) "I should take a vitamin D supplement to increase the effectiveness of the medication." C) "I should inform the provider if I experience an increased appetite while taking this medication." D) "I will decrease the amount of protein in my diet while taking this

medication." - CORRECT ANSWER a; The client should monitor their

blood pressure while taking this medication because hypertension is a common adverse effect and can lead to hypertensive encephalopathy.

b - The client requires an adequate intake of iron, folic acid, and vitamin B12 while taking this medication because they are essential to producing erythrocytes. c - Increased appetite is not an adverse effect of epoetin alfa. Adverse effects of epoetin alfa include seizures, heart failure, myocardial infarction, stroke, thrombolytic events, and hypertension. d - The client should increase the amount of protein in their diet while receiving chemotherapy to decrease the risk of infection While receiving chemotherapy, a pt should _______________ the amount

of protein in their diet to decrease the risk for infection - CORRECT

ANSWER protein

a nurse is caring for a client for 1 hour following 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? A) Initiate oxygen at 2 L/min via nasal cannula. B) Apply firm pressure to the insertion site. C) Take the client's vital signs.

D) Obtain a stat order for an aPTT. - CORRECT ANSWER b; The

greatest risk to the client is bleeding. Therefore, the priority intervention is for the nurse to apply firm pressure to the hematoma to stop the bleeding. a - The nurse can apply oxygen to promote adequate tissue oxygenation. However, another intervention is the priority. c - The nurse should take the client's vital signs to determine the client's status further. However, another intervention is the priority. d - The nurse can request laboratory data to provide information about the client's coagulation status. However, another intervention is the priority.

A nurse is assessing a client who has had a plaster cast applied to their left leg 2 hours ago. which of the following actions should the nurse take? A) Inspect the cast for drainage once every 24 hr. B) Check that one finger fits between the cast and the leg. C) Perform neurovascular checks every 2 to 3 hr. D) Make sure the client has a warm blanket covering the cast. -

CORRECT ANSWER b; To ensure the cast is not too tight, the nurse

should be able to slide one finger under the cast. It is not uncommon for casts to loosen as swelling subsides, but that should not be an issue 2 hr after application. a - The nurse should inspect the cast for drainage and alignment at least once every 8 to 12 hr. c - For the first 24 hr after cast application, the nurse should check the neurovascular status of the client's leg every hour. The nurse does this by assessing sensation, motion, and circulation. d - The nurse should make sure the cast is uncovered to allow for thorough air drying of the plaster. Also, the heat that is generated by the drying process has to escape. A nurse is conducting an admission history for a client who is to undergo a CT scan with an IV contrast agent. the nurse should identify that which of the following findings requires further assessment. A) History of asthma B) Appendectomy 1 year ago C) Penicillin allergy

D) Total knee arthroplasty 6 months ago - CORRECT ANSWER A; A

client who has a history of asthma has a greater risk of reacting to the contrast dye used during the procedure. Other conditions that can result in a reaction to contrast media include food allergies, such as shellfish, eggs, milk, and chocolate.

b - A history of an appendectomy does not have an effect on a CT scan. However, clients who have a history of diabetes mellitus, renal impairment, or heart failure have an increased risk for renal failure when contrast media is used and require further screening. c - A penicillin allergy does not have an effect on a CT scan. However, a client who is taking certain medications, such as aminoglycosides, NSAIDs, and the biguanide metformin, is at increased risk for renal damage and requires further screening. d - A total knee arthroplasty does not have an effect on a CT scan. A nurse is caring for a group of clients. the nurse should plan to make a referral to physical therapy for which of the following clients? A) A client who is receiving preoperative teaching for a right knee arthroplasty B) A client who states they will have difficulty obtaining a walker for home use C) client who reports an increase in pain following a left hip arthroplasty D) A client who is having emotional difficulty accepting that they have

a prosthetic leg - CORRECT ANSWER a; The nurse should make a

referral to physical therapy for a client who is receiving preoperative teaching for a knee arthroplasty so the client can begin understanding postoperative exercises and physical restrictions. b - The nurse should refer to a social worker for a client who reports difficulty obtaining a walker for home use. c - The nurse should contact the provider for a client who is experiencing increased pain following a left hip arthroplasty. d - The nurse should refer the client to a counselor to assist with coping with the adjustment to the need of a prosthetic leg.

a - The nurse should check the client's most recent laboratory results, including hemoglobin and hematocrit levels, as these provide information regarding the need for eventual blood product replacement. However, there is another action the nurse should take first. b - Although the nurse should initiate a peripheral IV line for saline or blood administration, there is another action the nurse should take first. c - Although drawing the client's blood to check for a low platelet count is important because a low platelet level indicates problems with blood clotting, there is another action the nurse should take first. d - The first action the nurse should take using the nursing process is to assess the client's vital signs. A client who has portal hypertension can develop esophageal varices, which are fragile and can rupture, resulting in large amounts of blood loss and shock. Obtaining vital signs provides information about the client's condition that can contribute to decision making. a nurse is preparing a client who has supraventricular tachycardia for elective cardioversion. which of the following prescribed medications should the nurse instruct the client to withhold for 48 hours prior to cardioversion? A) Enoxaparin B) Metformin C) Diazepam

D) Digoxin - CORRECT ANSWER d; Cardiac glycosides like digoxin

are withheld prior to cardioversion. These medications can increase ventricular irritability and put the client at risk for ventricular fibrillation after the synchronized countershock of cardioversion. a - Anticoagulants can be beneficial during cardioversion due to their ability to prevent blood clots that can be released into the client's circulatory system after cardioversion. This medication should not be withheld.

b - Metformin might be withheld for a client scheduled for cardiac catheterization or other procedures involving contrast dye in order to prevent damage to the kidneys. However, metformin should not be withheld prior to cardioversion. c - Sedatives are generally administered to clients prior to cardioversion to reduce anxiety and minimize the discomfort associated with the procedure. This medication should not be withheld. A nurse is caring for a client who has a closed head injury and has an intraventricular catheter placed. Which of the following findings indicates that the client is experiencing increased intracranial pressure (ICP)? (Select all that apply.) A) Flat jugular veins B) A Glasgow Coma Scale score of 15 C) Sleepiness exhibited by the client D) Widening pulse pressure

E) Decerebrate posturing - CORRECT ANSWER c, d, e: Sleepiness or

difficulty arousing the client from sleep indicates increased ICP. A widening pulse pressure (increase in systolic with concurrent decrease in diastolic blood pressure) indicates increased ICP. Both decerebrate and decorticate posturing indicate increased ICP. a - With increased ICP, the jugular veins are typically distended. b - A Glasgow Coma Scale score of 15 indicates neurological functioning within the expected reference range for eye-opening, motor, and verbal response. A nurse is preparing to admit a client with dysphagia. which item should be at the patient's bedside? A) Suction machine B) Wire cutters C) Padded clamp

Hemianopsia: - CORRECT ANSWER absence of vision in half of the

visual field A nurse is planning to provide discharge teaching for the family of an older adult client who has hemianopsia and is at risk for falls. which of the following instructions should the nurse include? A) Keep the client's personal care items in the bathroom. B) Keep the overhead lights on in the client's bedroom while sleeping. C) Remind the client to scan their complete range of vision during ambulation.

D) Secure the client's extension cords under carpeting. - CORRECT

ANSWER c; The nurse should instruct the family to remind a client

who has hemianopsia, or blindness in half of the visual field, to use visual scanning to look over their complete range of vision during ambulation. This practice can accommodate for the loss of vision and help to reduce the risk for falls. a - The nurse should instruct the client's family to keep the client's personal care items within the client's reach to reduce the risk for falls. b - The nurse should instruct the family to use nightlights in the client's bedroom and bathroom to reduce the risk for falls. Keeping the overhead lights on while the client is sleeping can disrupt the client's circadian rhythm. c - The nurse should instruct the family to remind a client who has hemianopsia, or blindness in half of the visual field, to use visual scanning to look over their complete range of vision during ambulation. This practice can accommodate for the loss of vision and help to reduce the risk for falls. d - The nurse should instruct the client's family that they should secure extension cords to the client's baseboards using electrical tape, rather than placing them under carpeting. This practice can help to reduce the risk for falls.

A family member brings An older adult client to an emergency department. Which of the following assessment findings should cause the nurse to suspect that the client has hypertonic dehydration? A) Serum sodium level 145 mEq/L B) Forearm skin tents, when pinched C) Respiratory rate decreased

D) Urine specific gravity 1.045 - CORRECT ANSWER d; A urine-

specific gravity greater than 1.030 indicates a decrease in urine volume and an increase in osmolarity, a manifestation of hypertonic dehydration. a - A serum sodium level of 145 mEq/dL is within the expected reference range. A sodium level higher than the expected reference range, or greater than 145 mEq/L, can indicate excessive free water loss resulting in hypertonic dehydration. b - Skin turgor can be an unreliable indication of dehydration in older adult clients because of age-related changes to skin elasticity. The nurse should check an older adult client's skin turgor on the sternum rather than on the limbs for a more reliable indicator. c - The nurse should expect the client's respiratory rate to increase if dehydration occurs because the decreased vascular fluid volume seen with dehydration decreases oxygenation and organ perfusion, requiring a compensatory increase in the respiratory rate. a nurse is teaching a client who has a family history of colorectal cancer. to help mitigate this risk, which dietary alterations should the nurse recommend? A) Add full-fat yogurt to the diet. B) Add cabbage to the diet. C) Replace butter with coconut oil.

D) Replace shellfish with red meat - CORRECT ANSWER b; To help

reduce the risk for colorectal cancer, the client should consume a diet that is high in fiber, low in fat, and low in refined carbohydrates.