MEDSUREG FINAL EXAM Which of the following

MEDSUREG FINAL EXAM Which of the following places an individual for developing risk for Osteoporosis? Fractured arm at a young age Active smoking Vitamin D supplement Weight lifting Which statement by the client regarding lifestyle changes to prevent osteomalacia indicates that the client needs further teaching? I will be sure to stay out of the sun I will be sure to drink milk more often I will purchase juice that have added vitamin c I will eat more egg and chicken Which of the following clients has the highest risk for hypokalemia Client with heart failure using a salt substitute Client taking a thiazide diuretic for hypertension Client taking non-steroidal antiiinflammatory drugs daily Clients with type 2 diebetes who takes an oral anti-diabetes agent An emergency department (ED) nurse gives report on a client who is being transferred to the medical surgical unit. The ED nurse informs the nurse of the clients current elevated blood pressure and mental status. The information provided represents which part of the SBAR hand – off Situation Background assessment Recommendation 12. Mrs. W. has a nasogastric tube that was just inserted. What is the most important fact that should be considered before the installation of any type of fluid? Radiographic confirmation of non-respiratory placement. 13. Determine drop/ minutes of 45% NS 1L @ 120ml/hr using drip factor of 20gtt per/ml. 120ml/60 * 20gtt/x = 40gtt/min 14. The nurse knows that post-operative client is voiding very small amount of urine. Which of the following should the nurse perform first?. Palpate for bladder distention 15. The nurse is caring for a client who has had diarrhea for the past 4days, when assessing the client, the nurse would expect to find which of the following-select all that apply Hypotension Poor skin turgor 23. Ms. James is to receive Keflex (Cephalexin) 1g PO for her treatment of her infection. The medication is labeled Keflex 500mg per capsule. How many capsules will you administer to Ms James in 24 hours? a. 4 capsules b. 6 capsules c. 8 capsules d. 10 capsules 24. The nurse is providing preoperative teaching to a class of six clients who are awaiting surgery. The primary purpose of the nurse’s class is to: a. Explain legal responsibilities b. Promote less complicated postoperative complication c. Distribute information to most individuals in the shortest possible time d. Provide uniform inform 25. The nurse for a client who has a cast applied for a fractured tibia. Which of the following would prompt the nurse to call the physician? a. the client complaining of numbness and tingling b. the client reports of pain as rated on a 1-10 scale c. edema of the distils of the cast extremity d. the client refusal to use the ice pack 26. A patient with an eye infection is being sent home with antibiotics eye drop. The nurse instruct the patient to place the drop a. In the lower conjunctival sac b. Under the upper eye lid c. Directly on the cornea d. In the inner cannus 27. A client has genetic testing done his result came out positive but his family member came out negative. He said that he is feeling bad and guilty that he is the only positive in the family. What should the nurse do? a. Tell him that even though he is positive, that he can still be symptomatic b. Tell him to go redo the test c. Tell him to tell his family about the positive status and get it over with d. refer him to counselling and support 28. A patient is having GI bleeding. Which lab value will manifest this? a. K4 b. Na 146 c. INR 1.05 d. Hematocrit 25% 29. When auscultating the lung sound of a patient with left ventricular failure, what type of sound will you hear? Crackles and Wheezing 30. An old man is confused, how can nurse tell he is in pain-select all that apply a. Decreased blood pressure b. Increased blood pressure c. Grimacing d. Restlessness Approach to hospice/end of life care? An interdisciplinary team approach is used for the care of the client and family 46. The nurse wants to recommend medication as an alternative therapy to pain med. What should the nurse do? Consider patient preferences and type of disease 47. Nurse is assessing and discovered that a patient is taking garlic. What should the nurse do? ?? 48. A client has acute osteomyelitis. What are the clinical manifestation? a. Fever over 101 b. Edema c. Erythrema 49. A patient with tricuspid value disorder ….which blood flow disorder will the patient have? Right atrium and Right ventricle 54. Which intervention would be best to prevent the development of pressure ulcers in the bedridden clients? a. Slide the client instead of lifting b. Turn and reposition the client at least every 8 hours c. Apply lotion after bathing and vigorously massage the skin d. Implement a turning schedule directly position changes every two hours 55. A client is recovering from a bowel resection that resulted in the creation of colostomy. What is the most appropriate action of the nurse in response to the clients reluctance to participate in self care of the colostomy. a. Insist that the client becomes involved b. Provide a mirror for the client to observe the stoma c. Assess the client for readiness to learn how to care for the colostomy d. Allow care to be deferred to the clients family member 56. the nurse suspects a client is having an adverse transfusion reaction to a blood transfusion. The first action by the nurse should be which of the following? a. Notify the physician immediately b. Take the vital signs and blood pressure and compare them with the baseline c. Dilute infusing blood with equal amount of normal saline d. Stop the transfusion and start a new patent intravenous med lock site 57. A client has been admitted to the acute care unit for an exacerbation of heart failure. Which is the nurse’s priority intervention? a. Assess respiratory status b. Monitor electrolyte levels c. Administer intravenous d. Insert a Foley catheter 70. A female patient decided to have breast augmentation surgery. Which kind of surgery is this? a. Palliative b. Emergent c. Elective 71. When the nurse is about to give blood, what should she do? Select all that apply Check the lab (Check K level) Check the blood type Check clients name (DOB) 72. A person with stroke only combs the right side of her hair, and wash only the right side of her hair, how will the nurse interpret this? Loss of motor function in the left 73. A person is having peritoneal dialysis at home, what is the most common complication Infection (Peritonitis) 74. ANA Standards of professional performance Provide standards, guidelines and principals for nurses 75. The nurse is caring for a client who is disoriented as the result of a smoke. Which action does the nurse implement to help orient the client? a. Ask the family to bring in pictures familiar to the client b. Turn on the television to a 24hour news station c. Maintain a calm and quiet environment by minimizing visitors d. Provide auditory and visual stimulation simultanously 76. A client with a history of diabetes, complains of feeding clammy, week and has a headache that will not go away. The nursing tech reports a blood sugar of 62. What is the most appropriate action of the nurse at this time? a. Administer Tylenol b. Give the client a snack of milk and crackers c. Call the physician d. Administer insulin. 77. The client is receiving DS ½ NS at 12ml/hr for the past 6 hours and has eaten the following fro breakfast, calculate the clients total intake in millimeters. 1cup of apple juice, 2 sausages, I boiled egg, ½ cup of coffee, ½ pint of milk.. a. 600ml b. 750ml c. 1300ml d. 1350ml 89. We use nursing process to convert data. Three (3) parts in nursing diagnosis? What Why How (I Don’t understand this . It might be the problem, symptom, and etiology) 90. Evidenced based practice according? Research according to studies 91. Patient centered care Get patient involved 92. Proper way to cough….. post-op a. Relax abdomen muscles b. Splits incision when coughing c. Breath in through the mouth and out the nose d. Deep breath after coughing Intervention for position ……………. Tell client to keep up…..that it is harmless (I Don’t understand this .) 93. Which statement by the female client indicates that instruction in ways to prevent urinary tract infection (UTI) was understood. Select all that apply a. I should limit tub baths and take showers instead b. I should drink 8 to 10 glasses of fluid a day c. I should only wear nylon panties d. I should use powder to aid in keeping the perinea skin dry 94.which of the following is a characteristics of Acute Kidney injury a. Decreased creatinine b. Increased BUN c. Decreased potassium level d. Decreased urine sodium 95. The nurse reviewed the domains of palliative care and teaches a colleague about the spiritual religious section. What statement by the colleague tells the nurse if the teaching was effective? a. I don’t think religion has a place in health care b. I know I would feel better if my religions and spiritual beliefs were aspects of care c. Religions/Spiritual needs are important aspects of clients care d. Why is this so important to some client? 96. The UAP is bathing an older adult client who is uncircumcised. What specifically should the UAP do while providing hygienic care? a. Defer, cleaning the penis because it may be embarrassing to the client b. Replace the foreskin over the penis after bathing c. Clean around the foreskin and be sure not to move it d. Avoid touching the foreskin because of hypersensitivity 101. Which of the following activities can be delegated to a nursing assistant? Correctly assessing the clients height and weight preoperatively 102. The nurse counseling a client in the prevention of goiter would suggest increased intake of? Iodine 103. A client with chelycystitis has pain in the right shoulder area and asked, “what is happening to me, what did I do to my shoulders” what is nurses best response? Sometimes pain from certain organ is referred elsewhere. 104. A client admitted for drug of possible myocardial infaction (MI). What laboratory result would the nurse ………… CPK-MB 105. The nurse is providing disease management education to a client with Raynaud’s diagnosis. What intervention does the nurse suggest to prevent constipation? Wear warm clothing when exposed to cold temperature 106. A client asked the nurse if it is important to be weight everyday if has right sided heart failure. Nurse best response Weight is the best indication that you are gaining or losing fluid. Medsurge Exam 1 Review-2015 1. did not get 2. Which of the following should the nurse include: gloves/gown (&answer not audible) 3. Define evidence based practice and define its role: _individual answer varies________________________ 4. A client was hospitalized with rheumatoid pneumonia. The client reports shortness of breath with activity and extreme fatigue. What intervention is the best to promote comfort? Pace activity allowing for adequate rest 5. A client with acquired immune deficiency syndrome had oral crust and difficulty eating. What action does the nurse delegate to the unlicensed assistive personnel or UAP? Assist client with oral care every two (2) hours 6. A client is just been diagnosed with Human immune deficiency virus (HIV). The client is disrupt and does not know what to do. what intervention by the nurse is the best? Assess the client for support systems 7. A client is in the hospital receiving IV antibiotics when the nurse the call light, the client presents an appearance as shown below. What action by the nurse takes priority? Ensure Patent airway—–(Picture is Anaphylactic reaction) 8. The nurse has educated a client on epinephrine auto-injector or Epipen. What statement by the client indicates additional instruction? I do not need to go to the hospital after using it….. 9. The client is been admitted for a possible infection, which action should the nurse perform first? Obtain blood culture — 10. A hospitalized client is placed on airborne precaution, the client need to have a CT Scan. What action by the nurse is most appropriate? Provide mask for patient to be used during transport 11. A nurse is caring for a client who has MRSA cultured from the urine, what action by the nurse is most appropriate. Hand hygiene before and after providing care 12. The nurse is concerned about the number of infection in the hospital. What action by the manager will best help prevent this infection? Audit staff member routine hygiene and practice 13. Under what type of precaution does the charge nurse implement for the client who is diagnosed with influenza? Droplet precaution 14. Which action by the nurse is most helpful in preventing the client from acquiring infections while hospitalized? Consistently using appropriate hand hygiene 15. a client with systemic Lupus Erythematosus for many years is in the clinic report with hip pain and ambulation, which action by the nurse should be done first. Perform a pain assessment 16. A client with systemic Lupus Erythematosus was recently discharged from the hospital after an acute exacerbation. The client is been evaluated and is disrupt about the possibility of another hospitalization disruptive of pain. What action by the nurse is best. Help client create backup plans to minimize disruption 17. Identify which of the following are the reasons why older adult are more prone to infection than younger adult. Select all that apply. Age related Thinning skin 18. A home health nurse has conducted a home safety assessment for an older adult. They have scattered rugs throughout the home. Which intervention will be most helpful in keeping the older adult safe in the home Educate the patient about home hazards related to scattered rugs 19. A nurse is caring for an older client on a medical surgical unit, notices the client only wants to eat soft food such as rice, bread and pudding. What assessment should the nurse perform first. Oral Assessment 20. An older adult client is in the hospital, the client is ambulatory and independent. What intervention by the nurse would be helpful in preventing fall in this client? Keep the light on in the bathroom at night 21. An older adult client takes medication three times a day and becomes confused of which medication should be taken at which time. What is the best intervention by the nurse? Suggest the use of a pill sorter 22. An older adult who recently retired was feeling depressed and lonely. Which of the following should the nurse assess as the priority for this patient The role that work played in the patient’s life 23. The nurse acknowledges the subset of the older population of which group The old old 24. What is the best nursing intervention to prevent falls? Providing assistance with ambulation 25. A client with Gout the nurse about food, which of the following would the nurse is sure to tell the client Avoid Sardines—/Beef 26. When assessing for complication of the client with hose right hip replacement, which of the following would require an immediate intervention? Pellar of the right lower extremity 27. A nurse is caring for a hinge hector joint replacement surgery, what action by the nurse is most important to prevent wound infection Use Aseptic technique for dressing change 28. The nurse is working with the client who has RA. The nurse has identified the priority problem of poor value ending by the client. What findings by the nurse indicative of the goal for this client problem are being met? Attend meeting of community book club 29. Which of the following are clinical manifestations of RA? Swelling 30. The nursing student is studying RA learns which step about the disease? Antibiotics lead to inflammation 31. The client comes into the family medical clinic reports joint pain and stiffness, the nurse asked to assess the client for nudges….. What assessment technique is correct? Assess the client’s distal finger joint. 32. Which of the following are not a modified risk factor for the development of Osteoarthritis Age 33. Which of the following manifestation is the nurse expected to find in a client with osteoarthritis Morning Joint stiffness 34. When providing care to a client with oseteoarthritis, which intervention by the nurse is inappropriate? Allowing the client to stay in the bed the entire day and not get up 35. The nurse caring for the client diagnosed with RA, which outcome will be priority for the client? Report pain as two or less, only one out of ten pain score 36. Which of the following manifestation will the nurse expect to find in a client who is in stage I Lyme disease. Flulike symptoms 37. Which of the following can be a cause of primary depression in the older adult Lack of neurotransmitter to the brain 38. Which of the following statement is true concerning dementia? Dementia is chronic and progressive 39. missed 40. Which of the following is the sign and symptoms of elder neglect Mismanaged resources 41. Airborne allergy can be reduced by: Removing carpet 41. Which of the following is the most effective trend in preventing infection? Hand hygiene and wearing gloves 42. It is important for nurses to be in compliance to which of the following vaccination of immunization Agree to all three doses of HEB B 43. Which of the following will be least effective in the prevention of infection in an 88 yrs old hospitalized client? Inserting a Foley catheter 44. Which of the following is a sign of an infected wound? A foul odour 45. Which assessment finding should alert the nurse that a client have an increased risk for fall Confusion 46. Which of the following nursing intervention would be most appropriate to meet the safety need of an older client with sensory changes? Assist the client in preparing water to bath 47. A client with vancomycin resistant staphylococcus is admitted, what type of precaution should the nurse implement? Contact precaution 48. A nurse is preparing to administer an injection to a client diagnosed with HEB B, which precaution should the nurse use to protect against exposure? Gloves 49. Calculation 50. Calculation SCIENCE HEALTH SCIENCE NURSING NURS 323

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