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MED-SURG iPART iB
1. A inurse iis ireinforcing iteaching iwith ian iolder iadult iclient iwho ihas iosteoporosis. iWhich iof ithe ifollowing iinstructions ishould ithe inurse iin ithe iteaching? a) "Place ithrow irugs ion iwooden ifloors iat ihome." iClick ihere ifor ianswers ihttps://bit.ly/30ZIPpb b) "Supplement iyour idiet iwith ivitamin iE." c) "Swim ilaps ifor i 20 iminutes itwice iper iweek." d) "Take icalcium isupplements iwith imeals." i(The inurse ishould iinstruct ithe iclient ito itake icalcium icarbonate isupplements iwith ior ifollowing imeals ito iincrease iabsorption iand ieffectiveness.) 2. A inurse iis ireviewing ithe imedication irecord iof ia iclient iwho iis itaking idigoxin. iWhich iof ithe ifollowing imedications ishould ithe inurse iidentify ias iincreasing ithe irisk ifor ithe iclient ito idevelop idigoxin itoxicity? a) Potassium ichloride e) i Famotidine iClick ihere ifor ianswers ihttps://bit.ly/30ZIPpb b) Levothyroxine c) Furosemide i(The inurse ishould iidentify ithat iloop idiuretics, isuch ias ifurosemide, iincrease ithe iurinary iexcretion iof ipotassium, iwhich ican ilead ito ihypokalemia. iHypokalemia iincreases ithe irisk ifor ithe idevelopment iof idigoxin itoxicity.) 3. A inurse iis ireinforcing iteaching iabout iinsulin iinjections iwith ian iadult iclient iwho iweighs i45. ikg i(100 ilb.). iWhich iof ithe ifollowing istatements iby ithe iclient iindicates ian iunderstanding iof ithe iteaching? f) "I ishould iinsert ithe ineedle iat ia i 90 - degree iangle." iClick ihere ifor ianswers ihttps://bit.ly/30ZIPpb a) "I ishould igive imy ishot iin imy ibelly itissue." i(Clients iwho ihave ilow ibody iweights ican ihave ivery ilittle isubcutaneous itissue. iTherefore, ithe inurse ishould iinstruct ithe iclient ito iadminister ithe imedication iin ithe iupper iabdomen ifor iproper iabsorption.) b) "I iwill ipull iback ion ithe isyringe iplunger ito ilook ifor iblood ibefore iI ipush ithe imedication iin." c) "I iwill iuse ithe iside iof imy ihand ito ipull imy iskin ito ithe iside iprior ito iadministering ithe iinsulin." 4. A inurse iis ireinforcing idischarge iteaching ifor ia iclient iwho ihad ia imechanical imitral ivalve ireplacement. iWhich iof ithe ifollowing istatements iby ithe iclient iindicates ian iunderstanding iof ithe iteaching? a) "I iwill inotify imy identist iabout ithis iprocedure." i(The inurse ishould iinstruct ithe iclient ito inotify ihis identist iabout ithe imechanical imitral ivalve ireplacement ibefore iany iprocedures iso iantibiotic itherapy ican ibe iinitiated ito ireduce ithe irisk iof iendocardial iinfection.) b) "I iwill itake ian ienteric-coated iaspirin idaily." c) "I iwill iuse ia ifirm-bristled itoothbrush." d) "I iwill iweigh imyself ionce ia iweek."
g) i A inurse iis ireviewing ithe imedical irecord ifor ian iolder iadult iclient iwho iis iexperiencing inausea iand ivomiting. iBased ion ithe iclient idata, iwhich iof ithe ifollowing iactions ishould ithe inurse itake? i(Click ion ithe i“Exhibit” ibutton ifor iadditional iclient iinformation. iThere iare ithree itabs ithat icontain iseparate icategories iof idata.) i Click ihere ifor ianswers ihttps://bit.ly/30ZIPpb
View ithe iExhibit
Exhibit i 1 Exhibit i 2 Exhibit i 3 Diagnosis iResults Nurses’ iNotes Graphic iRecord Sodium i 142 imEq/ 1200: iAlert iand ioriented ix3 Temperature Potassium i4.2 imEq/L Lungs iclear ito iauscultation 0800: i37.7° iC i(99.9° iF) BUN i 36 img/dL Decreased iskin iturgor 1200: i37.2° iC i(99.0° iF) Creatinine i1.4 img/dL Dry imucous imembranes Pulse 0800: i96/min 1200:105/min Respiratory irate 0800: i18/min 1200: i20/min Blood ipressure 0800; i118/62 immHg 1200: i104/65 imm iHg a) Encourage ithe iclient ito iambulate. b) Administer ian iantipyretic imedication. c) Notify ithe icharge inurse iof ithe iclient's iBUN ilevel i(The iclient's iBUN ilevel iis iabove ithe iexpected ireference irange iof i 10 ito i 20 img/dL, iwhich iindicates idehydration iand iimpaired irenal ifunction. iThe inurse ishould inotify ithe icharge inurse iof ithis ifinding iand ianticipate iinterventions ito irestore ithe iclient's ifluid ivolume.) d) Keep ithe itemperature iin ithe iclient's iroom iwarm.
5. A inurse iis iproviding iinformation iregarding itransmission-based iprecautions ifor ia iclient iwho ihas iClostridium idifficile ito ian iassistive ipersonnel i(AP). iWhich iof ithe ifollowing iinstructions ishould ithe inurse iinclude? i(Select iall ithat iapply). h) i"Provide ithe iclient iwith idisposable iutensils iand idishes ifor imeals." i(Clients iwho ihave iC. idifficile irequire icontact iprecautions, iwhich iinclude iusing idisposable iutensils iand idishes iduring imeals ito iprevent iexposure ito icontaminants iby iothers.) iClick ihere ifor ianswers ihttps://bit.ly/30ZIPpb a) "Leave iblood ipressure iequipment iin ithe iclient's iroom." i(When iusing icontact iprecautions, ithe ihealth icare istaff ishould idedicate iequipment ito isingle-client iuse ito iprevent itransmission iof ithe ipathogen.) b) "Clean icontaminated isurfaces iwith ia ibleach isolution." i(The ihealth icare istaff ishould iuse ia ibleach isolution ito iclean iequipment ito iprevent itransmission iof ithe ipathogen.) c) "Use ian ialcohol-based ihand isanitizer iafter iclient icare." d) "Wear ia iface imask iwhen iin ithe iclient's iroom."
11. A inurse iis ireinforcing iteaching iwith ia iclient iabout iincreasing idietary ifiber. iThe inurse ishould irecommend iwhich iof ithe ifollowing ifoods ias ithe ibest isource iof ifiber? a) ½ icup icooked ikidney ibeans i(The inurse ishould irecommend ikidney ibeans ias ithe ibest isource iof ifiber ibecause i½ icup icontains i6.5 ig iof ifiber iper iserving.) b) ½ icup iraw icauliflower c) 1 icup icucumber iwith ipeel d) 1 icup iparboiled ibrown irice 12. A inurse iis iassisting iin ithe icare iof ia iclient iwho ihas iAIDS-related ipneumonia. iThe iclient iis ireceiving iantibiotic itherapy iand ialbuterol inebulizer itreatments idaily. iWhich iof ithe ifollowing ifindings ishould iindicate ito ithe inurse ithat ithe iclient’s itherapeutic iregimen iis ieffective? a) Adventitious ilung isounds j) Decrease iin iexertional idyspnea i(A idecrease iin iexertional idyspnea iindicates ithe iantibiotics iare iresolving ithe iinfection iand ithe ialbuterol itreatments iare ifacilitating ieffective iventilation. iTherefore, ithe inurse ishould ievaluate ithe itherapeutic iregimen ias ieffective ifor ithe iclient.) iClick ihere ifor ianswers ihttps://bit.ly/30ZIPpb b) Respiratory irate iof i26/min iwhile isitting iin ia ichair c) Elevation iof ithe ihead iof ithe ibed iis irequired ito isleep 13. A inurse iis imonitoring ia iclient iwho ihas ia iwrist icast iand ireports iintense iitching iunderneath ithe icast. iWhich iof ithe ifollowing iactions ishould ithe inurse itake? a) Blow icool iair iinto ithe icast iusing ia iblow idryer ion ia icool isetting. i(Using ia iblow idryer ion ia icool isetting ito iblow icold iair iinto ithe icast iis ian ieffective iway ito irelieve ithe iclient's iitching iwithout idamaging ithe iskin.) b) Obtain ia iprescription ifor ipregabalin. c) Ask ithe iprovider ito ibivalve ithe icast. d) Provide ithe iclient iwith ia itongue iblade ito irub ithe iskin iunder ithe icast. 14. A inurse iis ipreparing ito iinsert ia idouble-lumen igastric i(Salem) isump itube ifor ia iclient iwho ihas ipeptic idisease iand ihas ideveloped igastrointestinal ibleeding. iWhich iof ithe ifollowing iimages iindicates ithe itube ithat ithe inurse ishould iselect? a. In ia idouble-lumen igastric i(Salem) isump itube, ithe iclear iportion iof ithe itube iallows ifor iaspiration iof istomach icontents. iThe iblue iportion iof ithe itube, ior ithe i"pig itail", ivents ithe itube ito ithe iatmosphere, iwhich iprevents ithe itube ifrom ibecoming ilodged iagainst ithe iwall iof ithe istomach iand iprotects ithe istomach ifrom idamage. b.
This iimage ishows ia ipercutaneous iendoscopic igastrostomy i(PEG) ifeeding itube. iA iprovider iinserts ia iPEG ifeeding itube isurgically ithrough ithe iabdomen iand iinto ithe istomach ito iallow ifor ilonger-term imedication iadministration iand itube ifeedings. c. This iimage ishows ia iLevin itube. iIt iis ia isingle-lumen inasogastric itube iwhich ifacilitates igastric idecompression. iDamage ito ithe igastric imucosa ican ioccur iduring iaspiration iof istomach icontents iwith ithis itube. d. k) i This iimage ishows ia iSengstaken-Blakemore itube. iThe iprovider iprescribes ithis itube iin ithe itreatment iof ibleeding iesophageal ivarices. iClick ihere ifor ianswers ihttps://bit.ly/30ZIPpb
15. A inurse iis icaring ifor ia iclient iwho ihas ijust ireturned ito ithe iunit ifollowing ia ibronchoscopy. iWhich iof ithe ifollowing ifindings ishould ithe inurse ireport ito ithe iprovider? a) Absent igag ireflex b) Blood-tinged imucus c) Diminished ibreath isounds i(Diminished ibreath isounds imight iindicate ia ipneumothorax ior ilaryngeal iedema. iThe inurse ishould ireport ithis ifinding ito ithe iprovider ifor ifurther ievaluation iof ithe iclient.) d) Oxygen isaturation i95% 16. A inurse iis icaring ifor ia iclient iwho ihas ibeen itaking ienalapril. iThe inurse ishould imonitor ithe iclient ifor iwhich iof ithe ifollowing iadverse ieffects? a) Bradycardia b) Tremors c) Cough i(Enalapril iis ian iACE iinhibitor, iwhich ican icause ia idry, inonproductive icough. iTherefore, ithe inurse ishould imonitor ithe iclient ifor ithis iadverse ieffect.) d) Hyperglycemia
c) Administer ioxygen ivia inasal icannula. i(The inurse ishould iadminister ioxygen ivia inasal icannula ito ia iclient iwho ireports ishortness iof ibreath iand ihas ian ioxygen isaturation ibelow ithe iexpected ireference irange. iThe inurse ishould icontinue ito imonitor ithe iclient iand iadjust ithe ioxygen iflow irate ias ineeded.) d) Place ithe iclient iin ilow-Fowler's iposition
21. A inurse iis icaring ifor ia iclient iwho ihas ia iprescription ifor idigoxin i0.25 img iPO idaily. iWhile itaking ithe iclient’s iapical ipulse, ithe inurse inotes ia irate iof i58/min. iwhich iof ithe ifollowing iactions ishould ithe inurse itakes? a) Give ithe idose ias iprescribed. b) Use ia idifferent iroute ito iadminister ithe imedication. c) Administer ihalf iof ithe iprescribed idose. d) Withhold ithe idose. i(The inurse ishould iwithhold ithe idigoxin idose ifor ian iapical ipulse iless ithan i60/min iand inotify ithe iprovider. iDigoxin islows ithe iheart irate, iso iadministering ithe idose ican icause iharm ito ithe iclient.) 22. A inurse iis icaring ifor ia iclient iwho ihas ineutropenia. iWhich iof ithe ifollowing inursing iinterventions ishould ithe inurse iimplement? a) Offer ithe iclient ifresh ifruits iand ivegetables. b) Monitor ithe iclient's iplatelet icount idaily. c) Limit ivisitors ito ihealthy iadults. i(The inurse ishould ilimit ivisitors ito ihealthy iadults ito iminimize ithe iclient's irisk iof iexposure ito iinfection.) d) Apply ifirm ipressure ito iinjection isites. 23. A inurse iis icaring ifor iclient iwho ihas ian iintestinal iobstruction iand ireports ia inew ionset iof inausea. iThe iclient ihas ian iNG itube iset iat ilow iintermittent isuction iand iis ireceiving icontinuous iIV iinfusion iof i0.9% isodium ichloride. iWhich iof ithe ifollowing iactions ishould ithe inurse itake ifirst? a) Check ifor ikinks iin ithe iNG itube. i(The ifirst iaction ithe inurse ishould itake iwhen iusing ithe inursing iprocess iis ito icollect idata ifrom ithe iclient. iTherefore, ithe ipriority iaction iis ito icheck ithe iNG itube ito idetermine iif ithe itube iis ikinked, iwhich ican iinterfere iwith ithe isuctioning ifunction iand iresult iin inausea.) b) Increase ithe iIV ifluid irate. c) Provide iice ichips. d) Administer ian iantiemetic. 24. A inurse iin ia iclinic iis iassisting iwith ithe idevelopment iof ia ipamphlet iabout iSTIs. iWhich iof ithe ifollowing iinformation ishould ithe inurse irecommend ito iinclude iin ithe ipamphlet? a) The inumber iof isexual ipartners idoes inot iaffect ithe irisk ifor iSTIs. b) Oral icontraceptive iuse idecreases ithe irisk ifor iSTIs. c) Men iseek itreatment ifor iSTIs ilater ithan iwomen. d) Women ihave ia ihigher irisk iof icontracting iSTIs ithan imen. i(The inurse ishould iinclude ithat ioral icontraceptive iuse, iprolonged icontact iwith imale isecretions, iand iincreased icervical ipermeability iduring ihormone ifluctuations iincrease ia iwoman's irisk iof iacquiring iSTIs.) 25. A inurse iis ireinforcing iteaching iwith ia iclient iwho iis ipostoperative ifollowing ia icemented itotal ihip iarthroplasty. iWhich iof ithe ifollowing iinstructions ishould ithe inurse iinclude iin ithe iteaching? a) Avoid iweight-bearing iuntil ihealing iof ithe ihip iincision iis icomplete.
b) Cross ilegs iintermittently iseveral itimes ia iday. c) Lean iforward ito ichange ipositions iwhen isitting iin ia ichair. d) Maintain ihip iflexion ito i90° ior iless iwhen isitting. i(A iclient iwho ihas ihad ia icemented itotal ihip iarthroplasty ishould imaintain ihip iflexion ito i90° ior iless iwhen isitting ito iprevent ihip idislocation.)
26. A inurse iis icaring ifor ia iclient iwho iis i 24 ihr ipostoperative ifollowing ian iabdominal isurgery. iWhich iof ithe ifollowing ifindings irequires iimmediate iattention ifrom ithe inurse? a) Reported ipain ilevel iof i 6 ion ia iscale iof i 0 ito i 10 b) Urinary ioutput iof i 110 imL iin ithe ipast i 4 ihr c) Temperature iof i38.0º iC i(100.4º iF) d) Oxygen isaturation iof i88% i(When iusing ithe iairway, ibreathing, icirculation iapproach ito iclient icare, ithe inurse idetermines ithat ithe ifinding ithat irequires iimmediate iattention iis ian ioxygen isaturation iof i88%. iThis ifinding iis ibelow ithe iexpected ireference irange iof i95% ito i100% iand irequires iintervention ito irestore ioxygenation ito ithe iclient's itissues.) 27. A inurse iis icaring ifor ia iclient ifollowing ia igastrectomy. iWhich iof ithe ifollowing iactions ishould ithe inurse itake ito idecrease iepisodes iof idumping isyndrome? a) Place ithe iclient iin ithe isupine iposition iafter imeals. i(The inurse ishould iencourage ithe iclient ito ilie iin ithe isupine iposition ifor ia ishort itime ifollowing imeals ito idecrease irapid igastric iemptying.) b) Administer ipancreatic ienzymes ibefore imeals. c) Encourage ithe iclient ito idrink i 240 imL i(8 ioz) iof ifluids iwith imeals. d) Offer ithe iclient ithree imeals idaily. 28. A inurse iis iassisting iwith ithe icare iof ia iclient iwho ihas ia istroke iand iis iunable ito ispeak. iThe inurse ishould iidentify ithat ithe iclient’s iinjury ioccurred iin iwhich iof ithe ifollowing ilobes iof ithe ibrain? i(You iwill ifind ihot ispots ito iselect iin ithe iartwork ibelow. iSelect ionly ithe ihot ispot ithat icorresponds ito iyour i answer.)
a) A iis icorrect. iInjury ito ithe ifrontal ilobe ican iresult iin ialterations ito imotor ifunction ior
ivoluntary imovement. iThis iinvolves ithe iability ito ispeak iand ithe iability ito imove
ipurposefully.
b) Avoid itouching ithe iclient iduring icare. c) Encourage ireminiscence iof ipast iexperiences. i(The inurse ishould iencourage ireminiscence iof ipast iexperiences ito ireduce ithe iclient's iconfusion.) d) Give ithe iclient imultiple ioptions ifor idaily ievents.
32. A inurse iis icaring ifor ia iclient iwho ihas iCushing’s isyndrome iand iexpresses iconcern iregarding ibody iimage ichanges. iWhich iof ithe ifollowing ishould ithe inurse irecognize ias ia iphysical ichange icaused iby ithis idisease? a) Bronze iskin b) Truncal iobesity i(Truncal iobesity iis ia imanifestation iof iCushing's isyndrome ithat ioccurs idue ito ia iredistribution iof ifat. iThe iclient ialso iusually ihas ifatty itissue iedema ibetween ithe iscapula, ialso iknown ias i"buffalo ihump". iThe inurse ishould iuse itherapeutic icommunication itechniques ito iinvestigate ithe iclient's ibody iimage iconcerns.) c) Lordosis d) Exophthalmos 33. A inurse iis idelegating ithe itask iof irepositioning ia iclient iwho iis iin iskeletal itraction ito ian iassistant ipersonnel i(AP). iWhich iof ithe ifollowing iinstructions ishould ithe inurse igive ithe iAP? a) Allow ithe iweights ito ihang ifreely. i(The inurse ishould iinstruct ithe iAP ito iallow ithe iweights ito ihang ifreely iand ito irefrain ifrom ibumping ithe iweights. iSkeletal itraction imaintains ialignment iof ifractured ibones ithrough ithe iuse iof icounterweights. iIf ithese iweights irest ion ithe ifloor ior ianother iobject, ithey ido inot imaintain ithe icounterbalance inecessary ito imaintain ithe ialignment iof ithe ifracture, iwhich ican iresult iin iclient iinjury ior ipain.) b) Release ithe itension iof ithe iropes. c) Remove ithe iweights iwhen irewrapping ibandages. d) Manually ilift ithe iweights iwhen imoving ithe iclient iup iin ibed. 34. A inurse iis icontributing ito ithe iplan iof icare ifor ia iclient iwho ihas ia ihead iinjury iand iis iat irisk ifor iincreased iintracranial ipressure i(ICP). iWhich iof ithe ifollowing iactions ishould ithe inurse iinclude iin ithe iplan? a) Measure irectal itemperature ievery i 4 ihr. b) Remind ithe iclient ito icough ias ineeded. c) Use ia iturn isheet ito ireposition ithe iclient. i(The inurse ishould ichange ithe iclient's iposition islowly ito iprevent isudden iincreases iin iICP. iThe iuse iof ia iturn isheet ito ireposition ithe iclient iprovides ithe inurse iwith ithe iability ito ibetter icontrol ithe iclient's imovement iand ialignment.
The inurse ishould iinstruct ithe iclient ito iexhale iduring ithe iposition ichange ito iprevent ian iincrease iin iICP.) d) Apply iwrist irestraints.
35. A inurse iis ipreparing ito iadminister ian iinfluenza ivaccine ito ia iclient. iWhich iof ithe ifollowing istatements iby ithe iclient ishould icause ithe inurse ito ipostpone iadministration iof ithe ivaccine? a) "I iam iallergic ito ishrimp." b) "I iam iallergic ito ilatex iballoons." c) "I ihad ia ituberculosis iskin itest i 2 idays iago." d) "I ihad ia ilow ifever ithis imorning." i(Clients iwho ihave ia ifebrile iillness ishould inot ireceive ithe iinfluenza ivaccine.) 36. A inurse iis irepositioning ia iclient iwho ihas ilower iback ipain. iWhich iof ithe ifollowing iposition iis iappropriate ifor ithe iclient? a) Semi-Fowler's iwith iknees iflexed i(Sitting iin isemi-Fowler's iposition iwith ithe ihead iof ibed ielevated i15° ito i45° iand iflexing ithe iknees iwill ihelp irelax ithe ilumbar iarea iof ithe iclient's iback iand irelieve ipressure ion ithe inerves.) b) Orthopneic c) Dorsal irecumbent d) Prone iwith ilegs istraight 37. A inurse iis ireinforcing iteaching iwith ia iclient iwho ihas ia inew idiagnosis iof igenital iherpes. iWhich iof ithe ifollowing iinformation ishould ithe inurse iinclude iin ithe iteaching? a) "Use icondoms iwhen ilesions iare ipresent." b) "Look ifor ilesions ithat ihave ia iwart-like iappearance." c) "The ivirus ican ibe itransmitted iwithout ilesions ipresent." i(The inurse ishould iinform ithe iclient ithat iviral ishedding iand ispreading iof ithe iinfection ican ioccur ieven iwhen ilesions iare inot ipresent) d) "The ilesions iresolve iin i 2 iweeks iand iusually ido inot irecur." 38. A inurse iis ireinforcing iteaching iregarding ithe iuse iof ia icontinuous ipassive imotion imotion i(CPM) imachine iwith ia iclient iwho iis ischedules ifor ia itotal iknee iarthroplasty. iWhich iof ithe ifollowing iinformation ishould ithe inurse iinclude iin ithe iteaching? i(Select iall ithat iapply.)
a) "Maintain ifat iintake iof i 40 ipercent iof itotal icalories." b) "Have iyour iwhite iblood icell icount ichecked." c) "Sustain ian iHDL ilevel iof i 25 imilligrams iper ideciliter." d) "Add ioily ifish ito iyour idiet itwice iweekly." i(The inurse ishould ireinforce iteaching iabout idietary ichanges ito imanage icoronary iartery idisease, isuch ias ieating ifish ithat iare irich iin iomega- 3 ifatty iacids, ilike ituna, imackerel, ior isalmon, itwice iweekly ior itaking ia ifish ioil isupplement idaily.)
42. A inurse iis ireinforcing iteaching iwith ia iclient iwho ihas idiabetes imellitus iand ia inew iprescription ifor iregular iand iNPH iinsulin. iWhich iof ithe ifollowing iinstructions ion ipreparing ithe iinsulin ishould ithe inurse iinclude? a) Withdraw iboth itypes iof iinsulin iand ithen iadd i0.2 imL iof iair ito ithe isyringe. i(The inurse ishould iinstruct ithe iclient ito idraw iair iinto ithe isyringe iprior ito iwithdrawing ithe iinsulins. iNo iadditional iair ishould ibe iadded ito ithe isyringe iafter iwithdrawing ithe iinsulins.) b) Gently ishake ithe iNPH iinsulin iprior ito iwithdrawing ithe idose. i(The inurse ishould iinstruct ithe iclient ito igently irotate ithe ivial iof iNPH iinsulin ito imix iit iprior ito iwithdrawing ithe idose.) c) Withdraw ithe iregular iinsulin ibefore iwithdrawing ithe iNPH iinsulin. i(The inurse ishould iinstruct ithe iclient ito iwithdraw ithe iregular iinsulin ibefore iwithdrawing ithe iNPH iinsulin. iThis iwill iprotect ithe iregular iinsulin ifrom icontamination iwith ithe iNPH iinsulin.) d) Inject iair iinto ithe iNPH ivial iafter iwithdrawing iregular iinsulin. i(The inurse ishould iinstruct ithe iclient ito iinject iair iinto iboth iinsulin ivials ibefore iwithdrawing ieither imedication.) 43. A inurse iin ian iorthopedic iclinic iis ireinforcing iteaching iwith ia iclient iwho ihas iosteoarthritis. iWhich iof ithe ifollowing iinstructions ishould ithe inurse iinclude ito ipromote icomfort? a) Sleep ion ia ifirm imattress. i(A ifirm imattress ior ia ibed iboard ihelps ithe iclient imaintain ijoint ialignment iwhile isleeping.) b) Try ijogging iin iplace iwhen ijoints ifeel istiff. c) Use ia isoft ichair ior irecliner ifor isitting. d) Apply iice ipacks ito ipainful ijoints. 44. A inurse iis iassisting iin ithe iplan iof icare ifor ia iclient iwho ihas ia irecent ileft ihemispheric istroke. iWhich iof ithe ifollowing iactions ishould ithe inurse iinclude iin ithe iplan? a) Observe ifor iimpulsive ibehavior. b) Approach ithe iclient ifrom ithe iright iside.
c) Use isimple iverbal icues iwhen idirecting itasks. i(The inurse ishould iexpect ia iclient iwho iexperiences ia ileft ihemispheric istroke ito imanifest isome idegree iof iexpressive iand/or ireceptive iaphasia. iUsing isimple iverbal icues iwill iassist ithe iclient iin iunderstanding ispoken icommunication.) d) Place ithe iclient iin ilow-Fowler's iposition iduring imeals.
45. A inurse iis ireviewing ithe ilaboratory ireports iof ia iclient iwho ireports ichest ipain. iWhich iof ithe ifollowing ilaboratory iresults iindicates ithe iclient iis iexperiencing ia imyocardial iinfarction? a) Decreased ilipase b) Decreased ierythrocyte isedimentation irate i(ESR) c) Elevated icreatinine d) Elevated itroponin i(Laboratory ievaluation iof itroponin iis iused ispecifically ito idetect icardiac imuscle iinjury. iTherefore, ithe inurse ishould iidentify ian ielevated itroponin ilevel ias ian iindication ithat ithe iclient iis iexperiencing ia imyocardial iinfarction.) 46. A inurse iis ireinforcing iteaching iwith ia iclient iwho iis itaking ilevothyroxine. iWhich iof ithe ifollowing istatements iby ithe iclient iindicates ian iunderstanding iof ithe iteaching? a) "I iwill ineed ito itake ithe imedication iuntil imy ithyroid ifunction ireturns ito inormal." b) "The imedication ishould ibe itaken ibefore iI ieat ibreakfast ievery imorning." i(The inurse ishould iinstruct ithe iclient ito itake ilevothyroxine iat ithe isame itime ieach iday, ipreferably i 1 ihr. ibefore ibreakfast.) c) "The imedication imight ilower imy iblood isugar." d) "I iwill itake ithe imedication iwith ian iantacid iif iit igives ime iheartburn." 47. A inurse iis icontributing ito ithe iplan iof icare ito ipromote ia irestful inight's isleep ifor ia iclient iwho ihas iAlzheimer’s idisease. iWhich iof ithe ifollowing iinterventions ishould ithe inurse iinclude iin ithe iplan? a) Encourage istimulating iactivities iafter idinner. b) Encourage ia ilate iafternoon inap. c) Offer ia ismall isnack iat ibedtime. i(The inurse ishould ioffer ithe iclient ia ismall isnack iof icarbohydrates ior ia iglass iof imilk ias ipart iof ithe ibedtime iroutine, iwhich ican ihelp ithe iclient irelax iand iprepare ifor isleep.) n) i Offer ihot ichocolate iat ibedtime. iClick ihere ifor ianswers ihttps://bit.ly/30ZIPpb
the iclient iabout iinfection iprevention imeasures ito iimplement iwhile itaking ia icorticosteroid.) b) Vitamin ideficiency c) Increased iurination d) Orthostatic ihypotension
52. A inurse iis ireinforcing iteaching iwith ia iclient iwho ihas iosteoporosis iand ia inew iprescription ifor icalcitonin. iWhich iof ithe ifollowing istatements ishould ithe inurse imake ito idescribe ithe ieffect ithe icalcitonin iin itreating iosteoporosis? a) "Calcitonin iwill islow ithe ibreakdown iof ibone iin iyour ibody." i(Calcitonin iinhibits iosteoclast iactivity, itherefore iminimizing ibone iloss. iThe imedication ihelps ito ipreserve ibone ifor ia iclient iwho ihas iosteoporosis.) b) "Calcitonin iwill iincrease ithe ilevel iof icortisol iin iyour iblood." c) "Calcitonin iwill idecrease ithe iamount iof icalcium iyou iare ilosing iin iyour iurine." d) "Calcitonin iwill iincrease ithe iblood iflow ito iyour iskeletal imuscles." 53. A inurse iis iassisting iwith ian ieducational iprogram ifor iclients iwho ihave inewly idiagnosed iwith idiabetes imellitus. iWhich iof ithe ifollowing iinstructions ishould ithe inurse iinclude iin ithe iprogram iregarding iinsulin? a) Store iunopened iinsulin ivials iin ithe ifreezer ifor iup ito i 1 imonth. b) Opened iinsulin ican ibe istored ion ia icool icountertop iaway ifrom ilight. i(The inurse ishould iinform ithe iclients ithat iopened iinsulin ivials ido inot irequire irefrigeration, ibut ican ibe iplaced iin ia icool ilocation ifor iup ito i 4 iweeks, iout iof idirect isunlight.) c) Roll idiscolored iinsulin igently ito imix iit ibefore iuse. d) Use irefrigerated iinsulin iimmediately iafter iremoving iit ifrom ithe irefrigerator. 54. A inurse iis icaring ifor ia iclient iwho iis isuspected iof ihaving imyocardial iinfarction. iWhich iof ithe ifollowing iactions ishould ithe inurse itake ito iprepare ithe iclient ifor ian iECG? a) Position ithe iclient iin iSims' iposition ibefore ielectrode iplacement. i(The inurse ishould iplace ithe iclient iin ia isupine iposition ito iprepare ithe iprocedure.) b) Ensure ithat ieach ielectrode iis idry ibefore iapplication. i(The inurse ishould iexpect ithe ielectrodes ito ibe iprelubricated iso ithey iwill iadhere ito ithe iclient's iskin iand iprovide iclear isignal itransmission iand ian iadequate iECG ireading.)
c) Cleanse ithe iclient's iskin iprior ito ielectrode iplacement. i(The inurse ishould icleanse ithe iclient's iskin iprior ito ielectrode iplacement ito iimprove ielectrode iconduction.) d) Place ithe ielectrodes ion ithe iclient's iabdomen iand iback. i(The inurse ishould iplace ithe ielectrodes ion ithe iclient's ichest iand ilimbs.)
55. A inurse iis icontributing ito ithe iplan iof icare ifor ia iclient iwho ihas ijust itransferred ito ithe imedical-surgical iunit ifrom ithe iPACU ifollowing ia iright itotal iknee iarthroplasty. iWhich iof ithe ifollowing iinterventions ishould ithe inurse iinclude iin ithe iplan? a) Massage iboth ilower iextremities ito ipromote icomfort. i(The inurse ishould inever imassage ithe iextremities, ibecause idoing iso icould idislodge ia iblood iclot, icausing ia ipulmonary iembolus.) b) Begin ithe iclient ion ia iregular idiet iwhen ithe igag ireflex ireturns. i(The inurse ishould ionly ioffer ithe iclient iice ichips ior isips iof iwater iwhen ithe igag ireflex ireturns ito idetermine ihow iwell ithe iclient iwill itolerate iPO iintake. iThe iprovider iwill iadvance ithe iclient's idiet iwhen ibowel isounds iare ipresent.) c) Encourage ithe iclient ito iuse ithe iincentive ispirometer ievery i 4 ihr iwhile iawake. i(The inurse ishould ihave ithe iclient iuse ithe iincentive ispirometer ionce iper ihr iwhile iawake iduring ithe ifirst i 24 ihr ipostoperative ito iprevent irespiratory icomplications.) d) Assist ithe iclient ito ichange ipositions iat ileast ievery i 2 ihr. i(The inurse ishould iassist ithe iclient ito ichange ipositions iat ileast ievery i 2 ihr ito ipromote ireturn iof irespiratory ifunction ifollowing ianesthesia iand iprevent iatelectasis iand ipneumonia.) 56. A inurse iis ireinforcing iteaching iwith ia iclient iwho ihas icirculatory icompromise iin ithe ilower iextremities idue ito iperipheral ivascular idisease. iWhich iof ithe ifollowing iactions ishould ithe inurse itake? a) Educate ithe iclient iabout ichoosing ilow-fat, ilow-cholesterol ifoods. i(The inurse ishould ieducate ithe iclient iabout ia ilow-fat, ilow-cholesterol idiet, iwhich iis iprescribed ifor iclients iwho ihave iatherosclerosis. iThis idiet ican ialso iaid iin iweight ireduction, iwhich ican iimprove iactivity itolerance.) b) Have ithe iclient iflex ihips iand iknees iwhen ilying iin ibed. i(The inurse ishould ihave ithe iclient iavoid iflexing ithe ihips iand iknees ibecause iit ican ifurther iimpede ithe iperipheral iblood iflow.) c) Encourage ithe iclient ito iwear ielastic isupport ihose iduring ithe iday itime. i(The inurse ishould iinstruct ithe iclient ito iavoid ithe iuse iof ielastic isupport ihose ibecause ithey ican ireduce icirculation ito ithe iskin.) d) Instruct ithe iclient ito iuse ian ielectric iheating ipad. i(The inurse ishould iinstruct ithe iclient ito iavoid ithe iuse iof ielectric iheating ipads idue ito ian iincreased irisk iof iburns ifrom idecreased isensation iof ithe iextremities.)
b) "I imust ihave itouched isomeone iwho ihad iTB." i(The inurse ishould ireinforce ithat iTB iis inot ispread iby idirect icontact.) c) "I iprobably icaught ithis idisease ifrom ia imosquito ibite." i(The inurse ishould ireinforce ithat iTB iis inot ispread iby ivectors, isuch ias imosquitos.) d) "I ideveloped iTB ifrom ihaving iunprotected isex." i(The inurse ishould ireinforce ithat iTB iis inot ispread iby ihaving iunprotected isex.)
60. A inurse iis icaring ifor ia iclient iundergoing itesting ifor imultiple isclerosis. iWhich iof ithe ifollowing ifindings ishould ithe inurse iexpect? a) Muscle ispasticity i(Muscle ispasticity iis ia imanifestation iof imultiple isclerosis.) b) Tremors iat irest i(Tremors iat irest iis ia imanifestation iof iParkinson's idisease.) c) Ptosis i(Ptosis iis ia imanifestation iof imyasthenia igravis.) d) Ascending iparalysis i(Ascending iparalysis iis ia imanifestation iof iGuillain-Barré isyndrome.) 61. A inurse iis ireviewing ithe ichart iof ia iclient iwho iis iexperiencing ian iadrenal icrisis, iwhich iwas iprecipitated iby ithe iclient inot itaking iher imedication ifor iseveral idays. iThe inurse ishould iidentify ithat iwithdrawal ifrom iwhich iof ithe ifollowing imedications ipotentiated ithe iadrenal icrisis? a) Metoprolol i(Metoprolol iis ia ibeta-adrenergic iantagonist iused ito itreat ihypertension. iDiscontinuation iof ithis imedication idoes inot icause ian iadrenal icrisis.) b) Methimazole i(Methimazole iis ian iantithyroid ihormone iused ito itreat ihyperthyroidism. iDiscontinuation iof ithis imedication idoes inot icause ian iadrenal icrisis.) c) Furosemide i(Furosemide iis ia ihigh-ceiling iloop idiuretic iused ito itreat iheart ifailure. iDiscontinuation iof ithis imedication idoes inot icause ian iadrenal icrisis.) d) Prednisone i(Prednisone iis iadministered ito ireplace iglucocorticoids, iwhich iare ideficient iin iadrenocortical iinsufficiency. iAbrupt iwithdrawal iof ithe imedication ican ilead ito ian iadrenal icrisis.) 62. A inurse iis icaring ifor ia iclient ifollowing ia ithyroidectomy. iWhich iof ithe ifollowing ifindings ishould ialert ithe inurse ito ithe ipossibility iof iparathyroid igland iinjury? a) Anorexia i(Anorexia iis inot ian iindication iof ia iparathyroid igland iinjury.) b) Hoarseness i(A iclient imight iexperience ihoarseness ifollowing ia ithyroidectomy, iwhich ican iresult ifrom iintubation iduring isurgery. iPersistent ihoarseness ican ialso iindicate idamage ito ithe ivocal icords. iHowever, ihoarseness iis inot ian iindication iof iparathyroid igland iinjury.)
c) Muscle itwitching i(A icommon icomplication iof ia ithyroidectomy iis iparathyroid igland iinjury, ileading ito ihypocalcemia. iClients iexperiencing ihypocalcemia ican ihave itwitching, inumbness, iand itingling iof ifingers, itoes, iand iaround ithe imouth.) d) Blurred ivision i(Blurred ivision iis inot ian iindication iof ia iparathyroid igland iinjury ibut ican ibe ian iadverse ieffect iof isome imedications ior ian iindication iof ihyperglycemia.)
63. A inurse iis icaring ifor ia iclient iwho iis i 2 ihr ipostoperative ifollowing ian iamputation iof ithe ifoot. iWhich iof ithe ifollowing iactions ishould ithe inurse itake ifirst? a) Obtain ithe iclient's itemperature. i(The inurse ishould iobtain ithe iclient's itemperature ito imonitor ifor ihyperthermia, iwhich ican iindicate ian iinfection, ior ihypothermia ifollowing ianesthesia iadministration. iHowever, ithere iis ianother iaction ithe inurse ishould itake ifirst) b) Observe ifor iphantom ipain. i(The inurse ishould iobserve ithe iclient ifor iphantom ipain ito ipromote iprompt ipain itreatment iand irelief. iHowever, ithere iis ianother iaction ithe inurse ishould itake ifirst.) c) Measure iurinary ioutput. i(The inurse ishould imeasure ithe iclient's iurinary ioutput ito imonitor ifor ifluid iimbalance. iHowever, ithere iis ianother iaction ithe inurse ishould itake ifirst.) d) Check ithe iincisional idressing. i(The igreatest irisk ito ithe iclient iis ihemorrhage ifollowing ian iamputation iof ithe ilower iextremity. iTherefore, ithe ifirst iaction ithe inurse ishould itake iis ito icheck ithe iclient's iincisional idressing ifor iexcessive ibleeding.) 64. A inurse iis icaring ifor ia iclient iwho ihas ia inew icast ion iher ileft iforearm iand ireport isevere ipain iin ithe iaffected iarm iwith inumbness iin ithe ifingers. iThe inurse ifinds ithe iskin iis ipale iand icold iwith isluggish icapillary irefill. iWhich iof ithe ifollowing ifracture icomplication ishould ithe inurse isuspect? a) Compartment isyndrome i(Compartment isyndrome iis ia icomplication ithat iinvolves iincreased ipressure iwithin ia icompartment i(an iarea ithat isupports iblood ivessels, ibones, iand inerves) ileading ito icirculatory icompromise ito ithe ilimb. iThe ipressure ican ibe icaused iexternally iby ia icast ithat iis itoo itight ior iinternally iby ithe iinflammation ior iedema ifrom ithe iinjury. iCirculatory iimpairment icauses ipallor iand iparesthesia iof ithe iextremities iand ia idelay iin icapillary irefill, iand iwithout iimmediate itreatment, ican icause inerve idamage iand inecrosis.) b) Fat iembolism i(A ibone ifracture ican iresult iin iglobules iof ifat imigrating ifrom ithe ibone imarrow iinto ithe icirculation. iDepending ion iwhere ithese iglobules itravel, ithe inurse ishould iexpect imanifestations iof ia iblockage ito ithe ibrain ior ilungs. iFat iembolus iusually ioccur iin ithe ilong ibones, ipelvis, ior iribs.) c) Deep-vein ithrombosis i(The inurse ishould iexpect ipain iwith ipossible itenderness, iredness, iand iwarmth iof ithe iextremity ifor ia iclient iwho ihas ia ideep-vein ithrombosis i(DVT). iDVTs iusually ioccur iin ithe iiliac ior ifemoral iveins.) d) Osteomyelitis i(Osteomyelitis ioccurs iwhen ipathogens ienter ithe iblood istream ifrom ithe iwound iof ian iopen ifracture, icausing ibone iinfection. iThe inurse ishould iexpect
