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PN Adult Medical Surgical Online Practice 2020
A Questions and Answers
A nurse is caring for a client who is 3 days postoperative following a total right hip arthroplasty. Which of the following actions should the nurse take? Use a traction boot to keep the client's right leg internally rotated. Have the client sit in a reclining chair when out of bed. Maintain abduction of the client's right leg while in bed. Encourage the client to perform passive range-of-motion exercises. - answers Maintain abduction of the client's right leg while in bed. A nurse is caring for a client who has terminal pancreatic cancer. The client states, "I don't think I can go on any longer." Which of the following responses should the nurse make? "Are you experiencing abdominal pain?" "You should talk about this with the people you're closest to." "Many people who have cancer feel this way." "You feel like you want to discontinue treatment?" - answers "You feel like you want to discontinue treatment?" A nurse is contributing to the plan of care for a client who is having difficulty eating following a stroke. Which of the following actions should the nurse take first? Collaborate with a dietitian. Ensure that the client is provided with a high-ber diet. Implement recommendations from the speech-language pathologist. Request a referral for an occupational therapist. - answers Implement recommendations from the speech-language pathologist. A nurse is contributing to the plan of care for a client who was admitted to the neurological unit following a stroke 3 hr ago. Which of the following interventions should the nurse identify as the priority? Encourage the client to participate in self-care. Assist the client with active range-of-motion exercises. Keep the client in a side-lying position.
Maintain the client's body alignment - answers Keep the client in a side- lying position. A nurse is participating in a health fair for older adult clients. Which of the following vaccines should the nurse recommend for this age group? Meningococcal Herpes zoster Human papillomavirus (HPV) Measles, mumps, and rubella (MMR) - answers Herpes zoster A nurse is contributing to the plan of care for a client who has a new prescription for nystatin suspension for oral candidiasis. Which of the following interventions should the nurse include in the plan? Use a commercial mouthwash before taking the medication. Instruct the client to swish the medication in their mouth. Discontinue the medication as soon as the lesions are healed. Combine the medication with applesauce - answers Instruct the client to swish the medication in their mouth. A nurse is preparing to perform intermittent urinary catheterization for a female client who has been unable to void following surgery 6 hr ago. Which of the following catheters should the nurse use to perform this procedure? - answers intermittent straight catheter (clear tube with blue top) A nurse is preparing to auscultate the bowel sounds of a client who has a mechanical bowel obstruction in the descending colon. When listening in the left upper quadrant, the nurse should identify this sound as which of the following? Hyperactive bowel sounds Friction rub Normal bowel sounds Abdominal bruit - answers Hyperactive bowel sounds A nurse is contributing to the plan of care for a client who has multiple sclerosis and is taking dantrolene to manage muscle spasms. Which of the following interventions should the nurse include?
A nurse is monitoring a client who is taking acarbose. Which of the following findings should the nurse identify as an adverse effect of the medication? Polyuria Abdominal cramps Renal insufficiency Insomnia - answers Abdominal cramps A nurse is caring for a client who has a new cast on their left forearm and reports severe pain in the affected arm with numbness in the ngers. The nurse nds the skin is pale and cold with sluggish capillary refill. Which of the following fracture complications should the nurse suspect? Compartment syndrome Fat embolism Deep-vein thrombosis Osteomyelitis - answers Compartment Syndrome A nurse is assisting with the discharge planning for a client who is postoperative following a total hip arthroplasty. Which of the following instructions should the nurse include in the discharge plan? Expect decreased sensation for the rst postoperative week. Avoid lying on the operative side. Obtain a raised toilet seat. Cross legs at the ankles - answers Obtain a raised toilet seat. A nurse is assisting in the care of a client who has manifestations of sepsis. Which of the following provider prescriptions should the nurse implement first? Collect a sputum culture Administer ceftriaxone by intermittent IV bolus. Initiate oxygen at 4 L/min via nasal cannula Obtain blood cultures. - answers Initiate oxygen at 4 L/min via nasal cannula
A nurse is reviewing the laboratory results of a client who has type 2 diabetes mellitus. The nurse should identify that which of the following laboratory values indicates the client is at risk for delayed wound healing? HbA1c 6% Prealbumin 12 mg/dL WBC count 8,000/mm Creatinine 0.8 mg/dL - answers Prealbumin 12 mg/dL A nurse is contributing to the plan of care for a client who has a methicillin- resistant Staphylococcus aureus (MRSA) infection and is on contact isolation precautions. Which of the following actions should the nurse take? Keep the door of the client's room closed at all times. Remove gloves after leaving the client's room. Wear a mask when working within 1 m (3 feet) of the client. Have a designated stethoscope in the client's room. - answers Have a designated stethoscope in the client's room. A nurse is caring for a client who has a compound fracture of the femur and was placed in balanced suspension skeletal traction 4 days ago. Which of the following actions should the nurse take? Perform pin site care daily. Remove the overbed trapeze. Remove the boot every 2 hr. Keep the weights on a stable, at surface. - answers Perform pin site care daily. A nurse is monitoring a client who has a history of an enlarged prostate and is experiencing suprapubic discomfort. Which of the following actions should the nurse take first? Administer doxazosin. Palpate the abdomen. Insert an indwelling urinary catheter. Notify the provider. - answers Palpate the abdomen.
Minimize the time the head of the bed is elevated. Apply a sterile gauze dressing to the site. Massage the site with moisturizing lotion. Place a donut-shaped cushion under the client's sacral area. - answers Minimize the time the head of the bed is elevated. A nurse is reinforcing teaching about the management of constipation with a client who has hypothyroidism. Which of the following instructions should the nurse include in the teaching? Increase intake of fiber-rich foods. Take a laxative every morning Maintain a fluid intake of 1,200 mL/day. Limit activity to preserve energy. • - answers Increase intake of fiber-rich foods. A nurse is reinforcing teaching with a client who is scheduled for a guaiac fecal occult blood test. Which of the following instructions should the nurse include in the teaching? Do not eat or drink for 6 hr prior to the test Ensure that the stool specimen is obtained in the morning. Take ibuprofen for mild pain until the test is complete. Avoid eating red meat for 3 days prior to the test. - answers Avoid eating red meat for 3 days prior to the test. A nurse is collecting data from a client who has hypokalemia. Which of the following findings should the nurse identify as the priority? Muscle weakness Dysrhythmia Abdominal pain Lethargy - answers Dysrhythmia A nurse is collecting data from a 55-year-old female client who reports vaginal dryness and hot ashes. The client is interested in trying hormone replacement therapy (HRT). Which of the following should the nurse recognize as a contraindication to HRT?
Five-year history of menopause manifestations History of treatment for blood clots Topiramate use for migraine headaches Increased serum cholesterol levels - answers History of treatment for blood clots A nurse is caring for a client who is receiving chemotherapy. The client mentions that they have a loss of appetite because of sores in their mouth and that food no longer tastes good. Which of the following suggestions to the client should the nurse make? Drink water before and after each bite. Consume foods that are served hot rather than cold. Rinse with a glycerin-based mouthwash before meals. Eat several, small-portioned meals daily. - answers Eat several, small- portioned meals daily. A nurse is reinforcing discharge instructions with a client who is postoperative following a right hip arthroplasty. Which of the following statements should the nurse make? "You may cross your legs in 60 days." "Avoid lying on your operative side." "Avoid bending your hips more than 90 degrees." "You may sleep on a soft mattress." - answers "Avoid bending your hips more than 90 degrees." A nurse is caring for a client who is 1 day postoperative following a hip arthroplasty. The client is exhibiting hypotension, tachycardia, and tachypnea. The nurse should recognize that these findings indicate which of the following complications? Wound infection Pulmonary embolism Thrombophlebitis Paralytic ileus - answers Pulmonary embolism A nurse is reinforcing teaching with a client who has mitral valve disease. Which of the following statements by the client indicates an understanding of the disease process?
"You should have a physical examination every other year." "You should have your hearing checked every 2 years." "You should have a pneumococcal immunization every 10 years." - answers "You should have a pneumococcal immunization every 10 years." A nurse is preparing to remove a client's NG tube. Which of the following interventions should the nurse take to decrease the risk for aspiration? Instill 10 mL of air through the NG tube. Place the client in the supine position. Irrigate the NG tube. Pinch the NG tube. - answers Pinch the NG tube. A nurse is preparing to administer phytonadione 7 mg subcutaneously to a client who has an INR of 4. Available is phytonadione 10 mg/mL. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.) - answers
A nurse is planning to implement droplet precautions for a client who has manifestations of pertussis. Which of the following interventions should the nurse include when contributing to the plan of care? Apply a mask on the client if the transport is needed. Wear a mask when working within 1.2 m (4 feet) of the client Don a gown when visiting with the client Wear an N95 mask when entering the client's room. - answers Apply a mask on the client if transport is needed. • A nurse is caring for a client who is in Buck's traction. Which of the following interventions should the nurse perform to reduce skin breakdown? Keep the skin dry and free of perspiration. Use hot water and antibacterial soap to bathe the client. Massage the skin over bony prominences to promote circulation. Limit the use of moisturizers on the skin over bony prominences. - answers Keep the skin dry and free of perspiration.
A nurse is assisting a client who reports difficulty falling asleep. Which of the following activities should the nurse recommend to promote sleep? Get out of bed if unable to fall asleep within 60 min. Take a brisk walk before sleeping. Listen to soft music before sleeping. Drink adequate amounts of uids before sleeping. - answers Listen to soft music before sleeping. A nurse is caring for a client who has meningococcal pneumonia. Which of the following personal protective equipment should the nurse use? Gown Mask Sterile gloves Protective eyewear - answers Mask A nurse is performing an ECG on a client who is scheduled for surgery the following morning. In which of the following locations should the nurse place the V1 electrode? (You will nd hot spots to select in the artwork below. Select only the hot spot that corresponds to your answer.) - answers C is correct. The nurse should identify that the V1 electrode should be placed in the fourth intercostal space just to the right of the sternum. Correct placement of the electrodes is vital in obtaining accurate information about the electrical activity of the heart. A nurse enters the room of a client whose transfusion of packed RBCs was initiated 15 min ago by the RN. The client reports dyspnea and urticaria. After stopping the infusion, which of the following actions should the nurse take next? Collect a urine sample. Take the client's vital signs. Return the blood to the laboratory. Administer an antihistamine. - answers Take the client's vital signs. A nurse is preparing to suction a client who has a tracheostomy. Which of the following actions should the nurse take first? Insert the suction catheter into the tracheostomy
Notify the charge nurse. Administer a PRN dose of diphenhydramine. Follow facility policy for appropriate reporting of the adverse reaction. - answers Stop the medication infusion. A home health nurse is reinforcing teaching with a client about preventing complications of peripheral vascular disease. Which of the following statements indicates that the client is adhering to the nurse's instructions? "I apply rubbing alcohol to my feet every day to prevent infection." "I will wear clean, knee-high wool socks every day to help improve my circulation." "I use hot water bottles to keep my feet warm at night." "I don't cross my legs anymore." - answers "I don't cross my legs anymore." A nurse is preparing to administer scheduled medications to a client. Which of the following prescriptions should the nurse verify with the provider? (Click on the exhibit tabs for additional information about the client. There are three tabs that contain separate categories of data.) Ceftriaxone Diltiazem Pioglitazone Hydrocodone 5 mg/acetaminophen 500 mg - answers Ceftriaxone A nurse is assisting with the care of a client who is receiving 0.9% sodium chloride by continuous IV infusion. The client reports pain and swelling at the IV site. In which order should the nurse perform the following steps? (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.) Notify the charge nurse. Stop the infusion. Elevate the affected arm. Withdraw the IV catheter. Check the IV site. - answers Check the IV site. Stop the infusion. Withdraw the IV catheter. Elevate the affected arm.
Notify the charge nurse. A nurse is assisting in the plan of care regarding bowel retraining for a client who has a cervical spinal cord injury. Which of the following interventions should the nurse plan to implement first? Determine the client's daily elimination habits. Administer a suppository to the client 30 min prior to defecation time. Offer the client 4 oz of warm prune juice to promote elimination. Provide dietary bulk to the client to ease the passage of stool. - answers Determine the client's daily elimination habits. A nurse is caring for a client who had an acute ischemic stroke 1 day ago. Which of the following actions should the nurse take to reduce the risk for aspiration? Allow for 30 min of rest before meals. Provide a straw for drinking liquids. Serve foods at room temperature. Place 2 tsp of food in the client's mouth at a time. - answers Allow for 30 min of rest before meals. A nurse is caring for a client who is at risk for developing pressure injuries. Which of the following actions should the nurse take? Position pillows between the bony prominences. Check for incontinence every 3 hr. Massage areas indicating potential breakdown of the skin. Elevate the head of the bed to 45°. - answers Position pillows between the bony prominences. A nurse in a long-term care facility is collecting data from a client who reports fullness in the rectum and abdominal cramping. Which of the following findings should indicate to the nurse that the client might have a fecal impaction? Halitosis Hemorrhoids Rebound tenderness Small liquid stools - answers Small liquid stools
"Follow a low-protein diet." - answers "Limit contact with large groups of people." A nurse is examining a client's IV site and notes a red line up their arm. The client reports a throbbing, burning pain at the IV site. The nurse should identify that the client's manifestations indicate which of the following complications of IV therapy? Thrombophlebitis Infiltration Hematoma Venous spasms - answers Thrombophlebitis A nurse is caring for a client who has acute pancreatitis. While providing care, the nurse observes ecchymosis around the umbilicus. The nurse should identify that this is a manifestation of which of the following? Cirrhosis of the liver Hypermotility of the bowel Intra-abdominal bleeding Acute cholecystitis - answers Intra-abdominal bleeding A nurse is collecting data from a client who has hypothyroidism. Which of the following manifestations should the nurse anticipate? Blurred vision Insomnia Bradycardia Weight loss - answers Bradycardia A nurse is caring for a client who is postoperative and has an epidural infusion. Which of the following findings should the nurse recognize as the priority? Pruritus Nausea Urinary retention Dyspnea - answers Dyspnea
A nurse is preparing to administer furosemide to a client who has heart failure. Which of the following findings should the nurse report before administering the medication? Elevated sodium Elevated blood pressure Decreased potassium Decreased urine output - answers Decreased potassium A nurse is reviewing the laboratory results of a client who has chronic kidney failure and is receiving epoetin alfa. The nurse should identify that which of the following laboratory values indicates the treatment is effective? BUN 40 mg/dL Hgb 11 g/dL Urine specific gravity 1. Blood glucose 105 mg/dL - answers Hgb 11 g/dL A nurse is caring for a client who has a methicillin-resistant Staphylococcus aureus (MRSA) infection in a surgical wound. Which of the following information should the nurse plan to share with visitors? Visitors should call prior to visiting the client. Visitors must don a gown and gloves prior to entering the client's room. Visitors need to wear a mask when in close proximity to the client. Visitors may not bring fresh flowers into the client's room. - answers Visitors must don a gown and gloves prior to entering the client's room. A nurse is contributing to the plan of care for a client who has partial hearing loss. Which of the following interventions should the nurse include in the plan of care? Face the client while speaking. Use a high-pitched tone when talking to the client. Avoid using gestures when communicating. Repeat misunderstood phrases. - answers Face the client while speaking.
A nurse in an oncology clinic is reinforcing teaching about Mohs surgery with a client who has skin cancer. Which of the following information should the nurse include in the teaching? Mohs surgery is a horizontal shaving of thin layers of the tumor. Mohs surgery uses liquid nitrogen to destroy the cancerous tissue. Mohs surgery is the preferred treatment for melanoma skin cancer. Mohs surgery is a palliative treatment for metastatic skin cancer. - answers Mohs surgery is a horizontal shaving of thin layers of the tumor. A nurse observes a client who is lying in bed and experiencing a tonic- clonic seizure. Which of the following actions should the nurse take? Lower the side rails of the client's bed. Apply wrist restraints to the client. Position the client in the semi-Fowler's position. Loosen clothing around the client's neck. - answers Loosen clothing around the client's neck. A nurse is reinforcing teaching about joint protection with a client who has an acute exacerbation of rheumatoid arthritis. Which of the following information should the nurse include in the teaching? Apply cold packs to the inamed joints. Participate in high-impact exercise. Carry a hand purse rather than a shoulder bag. Sleep on a soft foam mattress. - answers Apply cold packs to the inamed joints. A nurse is reinforcing teaching with a client who is to begin using an insulin pump. Which of the following instructions should the nurse include? "Insert the infusion needle into intramuscular tissue." "Change the needle every 5 days." "Calculate the insulin for each meal by using an insulin-to-protein ratio." "Use rapid-acting insulin in the infusion device." - answers "Use rapid- acting insulin in the infusion device."
A nurse is contributing to the plan of care for a client who has peripheral arterial disease of the lower extremities. Which of the following interventions should the nurse include? Place moist heat pads on the extremities. Perform manual massage of the affected extremities. Dangle the extremities o the side of the bed. Apply support stockings before getting out of bed. - answers Dangle the extremities o the side of the bed. A nurse is contributing to the plan of care for a client who is at risk for osteoporosis. Which of the following interventions should the nurse include to prevent bone loss? Increase fluid intake. Encourage range-of-motion exercises. Massage bony prominences. Encourage weight-bearing exercises. - answers Encourage weight-bearing exercises. A nurse is caring for a client who has difficulty swallowing. Which of the following actions should the nurse implement to prevent aspiration? Provide small, frequent meals. Tell the client to extend their neck when swallowing. Provide mouth care before meals. Give the client liquids with increased viscosity. - answers Give the client liquids with increased viscosity. A nurse is assisting with the care of a client who has a newly-inserted water-seal closed chest tube. Which of the following findings should the nurse report to the provider? Chest drainage is greater than 70 mL/hr. Water fluctuates in the water-seal chamber. Chest drainage is clear in color. Connections of the tubing are secured with tape. - answers Chest drainage is greater than 70 mL/hr.
