RN Adult Medical Surgical Online Practice NGN: Practice 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 is planning care for a client who is postoperative following a parathyroidectomy. Which of the following actions should the nurse identify as the priority? A) Use pillows to support the client's head and neck. B) Offer opioid medication. C) Place a tracheostomy tray at the bedside.

D) Place the client in semi-Fowler's position. - CORRECT ANSWER c;

The priority action the nurse should take when using the airway, breathing, and circulation approach to client care is to place a tracheostomy tray at the client's bedside in case of airway obstruction. A nurse is planning discharge teaching for a client with an external fixation device for a lower extremity fracture. Which of the following instructions should the nurse include in the plan of care? A) Secure the straps firmly around the boot. B) Remove the device before showering. C) Use crutches with rubber tips.

D) Adjust the screws to maintain alignment. - CORRECT ANSWER c;

Using crutches with rubber tips prevents the client from slipping and decreases the risk of falls. a - The surgeon directly applies the external fixation device to the client's bone to form a rigid structure around the affected extremity. Casts, boots, or splints are applied to the leg for internal fixation. b - The client should wear external fixation devices continuously for a period of 4 to 6 weeks. The nurse should teach the client to care for the wound and pin sites at home.

d - Only the provider should adjust the client's external fixation device to maintain bone alignment. 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? A) Potassium 3.5 mEq/L B) pH 7. C) Glucose 272 mg/dL

D) HCO3- 14 mEq/L - CORRECT ANSWER c; A glucose reading less

than 300 mg/dL indicates improvement in the client's status. 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? A) Sedimentation rate B) Hematocrit C) Calcium

D) Acid phosphatase - CORRECT ANSWER a; An increased

sedimentation rate occurs when a client has any type of inflammatory process, such as osteomyelitis. 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? A) Temperature 37.2° C (99° F) B) Blood pressure 100/70 mm Hg C) Weight loss

D) Restlessness - CORRECT ANSWER d; Using the urgent vs.

nonurgent approach to client care, the nurse should determine that the priority finding to report to the provider is restlessness, which can be an indication the client is experiencing disequilibrium syndrome. Disequilibrium syndrome is caused by the rapid removal of electrolytes

A nurse is assessing a client's hydration status. Which of the following findings indicates fluid volume overload? A) Warm, moist skin B) Distended neck veins C) Dark amber, odiferous urine

D) Orthostatic hypotension - CORRECT ANSWER b

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? A) Extremity cool upon palpation B) Serosanguineous drainage on the dressing C) Capillary refill of 2 seconds

D) Client report of discomfort when moving toes - CORRECT ANSWER

a; The nurse should report indicators of reduced circulation, such as pallor, cool temperature, or paresthesia of the client's ext. These findings can indicate that the client is at risk for developing acute compremitiesartment syndrome. A nurse is planning care for a client scheduled for a thoracentesis. Which of the following interventions should the nurse include in the plan? A) Encourage the client to take deep breaths after the procedure. B) Assist the client in holding their arms up during the procedure. C) Instruct the client to remain NPO after midnight before the procedure. D) Keep the client on bed rest for 8 hr following the procedure. -

CORRECT ANSWER a

b - The nurse should place the client upright with their arms resting on an overhead table to widen the intercostal space and spread the ribs for tube insertion. The nurse should assist a client who cannot sit up into a side-lying position with the affected side up.

c - The client should receive a local anesthetic for the procedure and will not require an NPO status after midnight prior to the procedure. d - The nurse should instruct the client that they can resume activity within 1 hr following the procedure. A nurse is administering packed RBCs to a client. Which of the following assessment findings indicates a hemolytic transfusion reaction? A) Anorexia and jaundice B) Bronchospasm and urticaria C)

D) - CORRECT ANSWER d; Hemolytic transfusion reactions result

from the infusion of incompatible blood products and create a systemic inflammatory response. Manifestations include low back pain, hypotension, tachycardia, and apprehension. a - The development of transfusion association graft versus host disease can occur within 14 days of transfusion and include thrombocytopenia, anorexia, nausea, chronic hepatitis, and weight loss. b - Allergic transfusion reactions can occur up to 24 hr following a transfusion and include manifestations such as bronchospasm, urticaria, and anaphylaxis. c - Circulatory overload occurs when the infusion rate is faster than the client can tolerate. Manifestations include hypertension, restlessness, and a bounding pulse. A nurse is reviewing the laboratory results of a client who has AIDS and is taking amphotericin B for a fungal infection. The nurse should identify which of the following values is an indication of an adverse effect of the medication. A) Potassium 4.8 mEq/L B) Magnesium 1.7 mEq/L

B) Oral secretions C) Hoarseness

D) Sore throat - CORRECT ANSWER a; Using the urgent vs. nonurgent

approach to client care, the nurse should determine that the priority finding is stridor. Stridor can indicate a narrowing airway or possible obstruction caused by edema or laryngeal spasms. The nurse should report the finding immediately and implement an intervention. A nurse is preparing to administer a blood transfusion to an anemic client. Which of the following actions should the nurse take first? A) Obtain the client's vital signs. B) Describe the blood transfusion procedure to the client. C) Check for the type and number of units of blood to administer.

D) Initiate a peripheral IV line. - CORRECT ANSWER c

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? A) Decreased heart rate B) Crackles heard on auscultation C) Increased urinary output

D) Decreased deep tendon reflexes - CORRECT ANSWER b; Mannitol

is an osmotic diuretic that prevents the reabsorption of water in the kidneys, thus increasing urinary output. With the exception of the brain, mannitol can leave the vascular system at the capillary site, which can result in edema. The nurse should identify crackles as a manifestations of pulmonary edema and notify the provider. Other manifestations include dyspnea and decreased oxygen saturation. A nurse is assessing for compartment syndrome in a client who has a short leg cast. Which of the following findings should the nurse identify as a manifestation of this condition? A) Bounding pedal pulse B) Capillary refill less than 2 seconds

C) Pain that increases with passive movement

D) Areas of warmth on the cast - CORRECT ANSWER c; The nurse

should identify that a client who has compartment syndrome experiences pain that increases with passive movement. Compartment syndrome results from a decrease in blood flow in the extremity caused by a decrease in the muscle compartment size due to a cast that is too tight. A nurse is assessing a client who has diabetes insipidus. Which of the following findings should the nurse expect? A) Low urine specific gravity B) Hypertension C) Bounding peripheral pulses

D) Hyperglycemia - CORRECT ANSWER a; An expected finding for a

client with diabetes insipidus is a urine-specific gravity between 1. and 1.005. Decreased water reabsorption by the renal tubules is caused by an alteration in antidiuretic hormone release or the kidneys' responsiveness to the hormone. b - the client would have hypotension due to dehydration c - the client would have weak peripheral pulses due to dehydration d - hyperglycemia is a manifestation of diabetes mellitus. Manifestations of diabetes insidious include polydipsia and polyuria. A nurse is teaching a client about transcutaneous electrical nerve stimulation (TENS) to manage bone cancer pain. The nurse should explain that applying a TENS unit to the painful area has which of the following effects? A) Electrically generated feelings of heat B) Cryotherapy for painful areas C) A tingling sensation replacing the pain

D) Realignment of energy flow through meridians - CORRECT ANSWER

c

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

implement? - CORRECT ANSWER ensure that the client has a patent

IV

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 ANSWER administer dextrose 10% in water until the new

bag arrives a nurse is providing dietary teaching to a client who is postoperative following a thyroidectomy with removal of the parathyroid glands. the nurse should instruct the client to include which of the following foods

that has the greatest amount of calcium in her diet? - CORRECT

ANSWER 12 almonds

a nurse is caring for a client who is experiencing a tonic-clonic seizure. which of the following actions should the nurse take? -

CORRECT ANSWER loosen restrictive clothing

a nurse is performing a cardiac assessment for a client who had a myocardial infraction 2 days ago. which of the following actions should the nurse take first after hearing the following sound? -

CORRECT ANSWER listen with the client on their left side

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 ANSWER suppressing gastric acid production

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 requires further assessment? - CORRECT

ANSWER history of asthma

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 a nurse is planning care to decreased 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 ANSWER tell the client that it is possible to return

to similar previous levels of activity a nurse in a provider's office assessing a client who has hypertension and takes propranolol. which of the following findings should indicate to the nurse that a client is experiencing an adverse reaction to this

medication? - CORRECT ANSWER report of a night cough

a nurse is reviewing the laboratory results of a client who has cirrhosis. which of the following laboratory values should the nurse

expect? - CORRECT ANSWER elevated bilirubin level

a nurse is preparing a client who has supra ventricular tachycardia for elective cardioversion. which of the following prescribed medications should the nurse instruct the client to withhold for 48hr prior to

cardioversion? - CORRECT ANSWER Digoxin

A nurse is providing teaching to an older adult female client who has stress incontinence and a BMI of 32. which of the following statements by the client indicates and understanding of the teaching?

- CORRECT ANSWER I am dieting to lose weight

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 ANSWER wide eyes

a nurse is caring for a client who has chronic glomerulonephritis with oliguria. which of the following findings should the nurse identify as a

manifestation of chronic glomerulonephritis? - CORRECT ANSWER

hyperkalemia

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 can indicate the development of digoxin toxicity. The nurse should report this finding to the provider. A nurse is planning to irrigate and dress a clean, granulating wound for a pressure injury client. Which of the following actions should the nurse take? A) Apply a wet-to-dry gauze dressing. B) Irrigate with hydrogen peroxide solution. C) Use a 30-mL syringe.

D) Attach a 24-gauge angiocatheter to the syringe. - CORRECT

ANSWER c; the nurse should use a 30-mL to 60-mL syringe with an

18 - or 19-gauge catheter to deliver the ideal pressure of 8 pounds per square inch (psi) when irrigating a wound. To maintain healthy granulation tissue, the wound irrigation should be delivered at between 4 and 15 psi. a - The nurse should not apply wet-to-dry dressings to clean, granulating wounds as they interrupt viable, healing tissues when removed. Appropriate dressings for a wound that is developing granulation tissue include a hydrocolloid dressing and a transparent film dressing. b - The nurse should use hydrogen peroxide to clean contaminated surfaces. Hydrogen peroxide should not be used on a pressure injury wound because it destroys newly granulated tissue. Instead, the nurse should use solutions specifically designed as wound cleansers or 0.9% sodium chloride irrigation to irrigate the wound. d - The nurse should use an 18- or 19-gauge catheter that will apply the appropriate irrigation pressure. A 24-gauge angiocatheter delivers solutions at a higher pressure than necessary for irrigation and a can potentially damage the developing granulation tissues

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 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 protrudes through the abdomen. which of the following actions should the nurse take first? A) Place the client in a supine position. B) Measure vital signs. C) Cover the wound with a sterile, saline-moistened dressing.

D) Call for help. - CORRECT ANSWER d; Evidence-based practice

indicates that the nurse should stay with the client and call for assistance. The client will require emergency surgery and is at risk for shock; therefore, the nurse should obtain immediate assistance. Then c, a, b A nurse is caring for a client who is receiving morphine for daily dressing changes. The client tells the nurse, "I do not want any more morphine because I do not want to get addicted." Which of the following actions should the nurse take? A) Administer a placebo to the client without their knowledge. B) Instruct the client on alternative therapies for pain reduction. C) Tell the client not to worry about addiction to prescribed narcotics. D) Suggest the client receive a different opioid for pain reduction. -

CORRECT ANSWER b; The nurse should respect the client's concerns

and offer nonpharmacologic alternatives to pain management, such as relaxing activities and distraction. a - The nurse should not administer a placebo to a client who thinks it is an active medication because this action violates the client's rights. c - This response by the nurse is nontherapeutic because it dismisses the client's concerns.