RN Adult Medical Surgical Online 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 caring for a client who has hepatic encephalopathy that is being treated with lactulose. the client is experiencing excessive stools. which of the following findings is an adverse effect of the

medication? - CORRECT ANSWER hypokalemia

a nurse is caring for a client who has emphysema and is receiving mechanical ventilation. the client appears anxious and restless, and the high-pressure alarm is sounding. which of the following actions

should the nurse take first? - CORRECT ANSWER instruct the client

to allow the machine to breathe for them 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 ANSWER add

cabbage to the diet a home health nurse is assigned to a client who was recently discharged from a rehabilitation center after experiencing a right- hemispheric stroke. which of the following neurological deficits should

the nurse expect to find when assessing the client? - CORRECT

ANSWER visual spatial deficits

left hemianopsia one-sided neglect a nurse is caring for a client who has viral pneumonia. the client's pulse oximeter readings have fluctuated between 79% and 88% for the last 30 min. which of the following oxygen delivery systems should the nurse initiate to provide the highest concentration of oxygen? -

CORRECT ANSWER nonrebreather mask

a nurse is caring for a client who has bilateral pneumonia and an SaO of 85%. the client has dyspnea with a productive cough and is using

accessory muscles to breathe. which of the following actions should

the nurse take first? - CORRECT ANSWER place the client in high-

fowler's position a nurse is planning care for a client who has extensive burn injuries and is immunocompromised. which of the following precautions should the nurse include in the plan of care to prevent a Pseudomonas

aeruginosa infection. - CORRECT ANSWER avoid placing plants or

flowers in the client's room an older adult client is brought to an emergency department by a family member. which of the following assessment findings should cause the nurse to suspect that the client has hypertonic dehydration?

- CORRECT ANSWER Urine specific gravity of 1.

a nurse in an emergency department is reviewing the providers prescriptions for a client who sustained a rattlesnake bite to the lower leg. which of the following prescriptions should the nurse expect? -

CORRECT ANSWER administer an opioid analgesic to the client

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 ANSWER dysphagia

a nurse is teaching a young adult client how to perform testicular self- examination. which of the following instructions should the nurse

include? - CORRECT ANSWER roll each testicle between the thumb

and fingers 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 ANSWER I should take this medication with a meal

a nurse is teaching a client who has venous insufficiency about self- care. which of the following statements should the nurse identify as an

indication that the client understands the teaching? - CORRECT

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 ANSWER place a pillow between the client's legs

a nurse in a provider's office is assessing a client who has migraine headaches and is taking feverfew to prevent headaches. the nurse should identify that which of the following client medications interact

with feverfew - CORRECT ANSWER naproxen

a nurse is caring for a client who has pancreatitis. the nurse should expect which of the following laboratory results to be below the

expected reference range? - CORRECT ANSWER calcium

a nurse is providing discharge instructions to a client following an upper gastrointestinal series with barium contract. which of the

following information should the nurse provide? - CORRECT ANSWER

increase fluid intake a nurse is assessing a client who had extracorporeal shock wake lithotripsy (ESWL) 6 hr ago. which of the following findings should the

nurse expect? - CORRECT ANSWER stone fragments in the urine

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 ANSWER a client who

has multiple sclerosis and is experiencing progressive difficulty ambulating a nurse is caring for a client who has a new diagnosis of hyperthyroidism. which of the following is the priority assessment

finding that the nurse should report to the provider? - CORRECT

ANSWER blood pressure 170/80 mm Hg

a nurse is providing discharge instructions to a client who has a partial-thickness burn on the hand. which of the following instructions

should the nurse include? - CORRECT ANSWER wrap fingers with

individual dressings

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 ANSWER I will monitor my blood pressure

while taking this medication a nurse is providing discharge teaching to a client who has heart failure and a new prescription for a potassium-sparing diuretic. which of the following information should the nurse include in the teaching? -

CORRECT ANSWER try to walk at least three times per week for

exercise a nurse is caring for a client who has HIV. which of the following findings indicates a positive response to the prescribed HIV

treatment? - CORRECT ANSWER decreased viral load

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 ANSWER Hgb 8 g/dL

a nurse is assessing a client who has had a plaster cast applied to their left leg 2 hr ago. which of the following actions should the nurse

take? - CORRECT ANSWER check that one finger fits between the

cast and the leg a nurse is providing teaching to a client who has chronic kidney disease and a new prescription for erythropoietin. which of the following statements by the client indicates and understanding of the

teaching? - CORRECT ANSWER I am taking this medication to

increase my energy level a nurse is caring for a client who is undergoing hemodialysis to treat end-stage kidney disease (ESKD). the client reports muscle cramps and a tingling sensation in their hands. which of the following

medications should the nurse plan to administer? - CORRECT ANSWER

calcium carbonate

ANSWER remind the client to scan their complete range of vision

during ambulation 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

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

- 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 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

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 can indicate the development of digoxin toxicity. The nurse should report this finding to the provider.

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.