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Med Surg 3 Exam 3

front 1

When administering alendronate (Fosamax) to a patient with osteoporosis, the nurse will

back 1

assist the patient to sit up at the bedside

front 2

A client had an arthroscopy 1 hour ago on the left knee. The nurse finds the left lower leg to be pale and cool, with a 1+ pedal pulse. What action would the nurse perform first?

back 2

Assess the neurovascular status of the right leg

front 3

A client with rheumatoid arthritis (RA) has an acutely swollen, red, and painful joint. What nonpharmacologic intervention does the nurse recommend?

back 3

Ice packs

front 4

The nurse is assessing a client who has hepatitis C. What extrahepatic complications would the nurse anticipate?

back 4

Polyarthritis

Heart Disease

Myalgia

front 5

A client has a bone density score of -2.8. What intervention would the nurse anticipate based on this assessment?

back 5

Planning to teach about bisphosphonates

front 6

A client who had a partial gastrectomy 3 days ago begins experience vertigo sweating and tachycardia about 30 minutes after eating breakfast what postoperative complications would the nurse suspect

back 6

Dumping syndrome

front 7

After a patient has had a hemorrhoidectomy at an outpatient surgical center, which instructions will the nurse include in discharge teaching?

back 7

Take prescribed pain medications before you expect a bowel movement

front 8

Which assessment finding would the nurse need to report most quickly to the health care provider regarding a patient who has acute pancreatitis?

back 8

Muscle twitching and finger numbness

front 9

Which assessment finding is of most concern for a 46-year-old woman with acute pancreatitis?

back 9

Palpable abdominal mass

front 10

A woman receiving chemotherapy for breast cancer develops a Candida albicans oral infection. Which intervention should the nurse anticipate?

back 10

Nystatin tablets

front 11

A patient with knee pain who is diagnosed with bursitis asks the nurse to explain just what bursitis is. The nurse will respond that bursitis is an inflammation of

back 11

a small, fluid-filled sac found at many joints

front 12

The nurse is caring for a client who has pain during circumduction of the shoulder when the nurse moves the arm behind the client. Which of the following questions should the nurse ask?

back 12

"Do you have difficulty putting on a jacket?

front 13

The nurse admitting a patient with acute diverticulitis explains that the initial plan of care is to

back 13

Administer IV fluid

front 14

A client had an open traditional Whipple procedure this morning. For what priority complication would the nurse assess?

back 14

Fluid and electrolyte imbalances

front 15

The nurse is performing an initial assessment and notes that the client weighs 186.4 Ib (84.7 kg). Six months ago, the client weighed 211.8 lb (96.2 kg). What action by the nurse is appropriate?

back 15

Ask the client if the weight loss was intentional

front 16

The nurse will be teaching self-management to patients after gastric bypass surgery. Which information will the nurse plan to include?

back 16

Drink fluids between meal but not with meals

front 17

Which assessment finding is of most concern for a patient with acute pancreatitis?

back 17

Palpable abdominal mass

front 18

The nurse is caring for a client who has cirrhosis of the liver. Which risk factor is the leading cause of cirrhosis?

back 18

Hepatitis C

front 19

The nurse notes that the primary health care provider documented the presence of mucosal erythroplasia in a client. What does the nurse understand that this most likely means for this client ?

back 19

Early sign of oral cancer

front 20

Which daily behavior of a client with GI problems requires further nursing assessment? Select all that apply.

back 20

Smokes a pack of cigarettes

Uses Fleet enemas frequently to assist with bowel movements

Takes 325 mg of aspirin at night for arthritic pain

Travels extensively across the world

front 21

A 26-yr-old patient with a family history of stomach cancer asks the nurse about ways to decrease the risk for developing stomach cancer. The nurse will teach the patient to avoid

back 21

Smoked foods such as ham and bacon

front 22

Which information will the nurse include when teaching a patient with peptic ulcer disease about the effect of ranitidine (Zantac)?

back 22

Ranitidine decreases gastric acid secretion

front 23

The nurse is caring for a client who has been diagnosed with peptic ulcer disease. For which complication would the nurse monitor?

back 23

Upper gastrointestinal (GI) bleeding

front 24

A client has an open traditional hiatal hernia repair this morning. What is the nurse’s priority for client care at this time?

back 24

Preventing respiratory complications

front 25

The nurse working with older clients understands age-related changes in the gastrointestinal system. Which changes does this include? (SATA)

back 25

Decreased hydrochloric acid production

Diminished sensation that can lead to constipation

Fat not digested as well in older adults

Pancreatic vessels become calcified

front 26

The nurse will plan to monitor a patient with an obstructed common bile duct for

back 26

Steatorrhea

front 27

A nurse is learning about different surgical procedures and their classifications. Which examples below does this include? (Select all that apply.)

back 27

Liver biopsy: diagnostic

Arthroscopy: preventative. Ileostomy: palliative. Total shoulder replacement: reconstructive

Body contouring: cosmetic

front 28

A client is scheduled to have a total hip arthroplasty. What preoperative teaching by the nurse is most important?

back 28

Remind the client to have all dental procedures completed at least 2 weeks prior to surgery.

front 29

A client who had a fractured ankle open reduction internal fixation (ORIF) 4 weeks ago, reports burning pain and tingling in the affected foot. For which potential complication would the nurse anticipate?

back 29

Complex regional pain syndrome

front 30

A nurse plans care for a client who is recovering from open reduction and internal fixation(ORIF) surgery for a right hip fracture. Which interventions would the nurse include in this plan of care? (Select all that apply.)

back 30

Elevate heels off the bed with a pillow.

Ambulate the client on the first postoperative day.

Reposition the client every 2 hours.

front 31

A nurse teaches a client with a fractured tibia about external fixation. Which advantages of external fixation for the immobilization of fractures would the nurse share with the client? (Select all that apply.)

back 31

It leads to minimal blood loss.

It allows for early ambulation.

It promotes healing.

front 32

A nurse cares for a client with a recently fractured tibia. Which assessment would alert the nurse to take immediate action?

back 32

Numbness and tingling in the extremity

front 33

A nurse cares for a client who had a bronchoscopy/post endoscopy 2 hours ago. The client asks for a drink of water. What action would the nurse take next?

back 33

Assess the gag reflex before giving any food or water.

front 34

A client is recovering from an esophagogastroduodenoscopy (EGD) and requests something to drink. What action by the nurse is appropriate?

back 34

Assess the gag reflex.

front 35

A nurse cares for an older adult who is admitted to the hospital with complications of diverticulitis. Which actions should the nurse include in the plan of care?(Select all that apply.)

back 35

Administer pain medications as prescribed.

Palpate the abdomen for distention.

Assess for sudden changes in mental status.

Evaluate stools for occult blood.

front 36

Which finding in the mouth of a patient who uses smokeless tobacco is suggestive of oral cancer?

back 36

Red, velvety, patches on the buccal mucosa

front 37

Which statement to the nurse from a patient with jaundice indicates a need for teaching?

back 37

“I use acetaminophen (Tylenol) every 4 hours for back pain.”

front 38

What action(s) by the nurse is (are) appropriate to promote nutrition in a client who had a partial gastrectomy? (SATA)

back 38

Administer vitamin B12 injections

Ask the primary health care provider about folic acid replacement

Provide iron supplements for the client

front 39

When caring for a patient with a history of a total gastrectomy, the nurse will monitor for

back 39

cobalamin (vitamin B12) deficiency

front 40

A nurse teaches a client who is at risk for carpal tunnel syndrome. Which health promotion activities would the nurse include in the health teaching? (SATA)

back 40

“Frequently assesses the ergonomics of the equipment being used.”

“Take breaks to stretch fingers and wrists during working hours.”

“Adjust chair height to allow for good posture.”

front 41

When assessing for Tinel’s sign in a patient with possible right carpal tunnel syndrome, the nurse will ask the patient about

back 41

Tingling in the right thumb and index finger

front 42

The nurse who notes that a 59-yr-old female patient has lost 1 inch in height over the past 2 years will plan to teach the patient about

back 42

dual-energy x-ray absorptiometry (DXA)

front 43

Which information in a 67-yr-old woman’s health history will alert the nurse to the need for a more focused assessment of the musculoskeletal system?

back 43

The patient’s mother became shorter with aging

front 44

The nurse reviews a list of drugs that can cause secondary osteoporosis. Which drugs are most commonly associated with this health problem? (SATA)

back 44

Barbiturates

Corticosteroids

Loop Diuretics

front 45

Which medication information will the nurse identify as a potential risk to a patient’s musculoskeletal system?

back 45

The patient has severe asthma requiring frequent therapy with oral corticosteroids.

front 46

A nurse assesses a client who has cirrhosis of the liver. Which laboratory findings would the nurse expect in clients with this disorder?

back 46

Elevated international normalized ratio (INR)

Elevated serum ammonia

Elevated prothrombin time (PT)

front 47

The nurse is reviewing the laboratory profile for a client who has muscular dystrophy. Which laboratory value(s) would the nurse expect to be elevated? (SATA)

back 47

Creatine Kinase (CK)

Lactic dehydrogenase (LDH)

Aspartate aminotransferase (AST)

Aldolase (ALD)

front 48

The nurse is caring for several clients with osteoporosis. For which client would bisphosphonates not be a good option?

back 48

Client with a spinal cord injury who cannot tolerate sitting up.

front 49

What abnormality on the skin of an older patient is the priority to discuss immediately with the health care provider?

back 49

Petechiae on the chest and abdomen

front 50

An older client's serum calcium level is 8.7 mg/dL (2.18 mmol/L). What possible etiology(ies) does the nurse consider for this result? (SATA)

back 50

Normal age-related decrease in serum calcium

Possible occurrence of osteoporosis or osteopenia

front 51

A nurse assesses a client who has cirrhosis of the liver. Which laboratory findings would the nurse expect in clients with this disorder? (SATA)

back 51

Elevated international normalized ratio (INR)

Elevated serum ammonia

Elevated prothrombin time (PT)

front 52

A patient with acute pancreatitis is NPO and has a nasogastric (NG) tube to suction. Which information obtained by the nurse indicates that these therapies have been effective?

back 52

Abdominal pain is decreased

front 53

An assessment finding for a 55-yr-old patient that alerts the nurse to the presence of osteoporosis is

back 53

A loss of height

front 54

Which action will the nurse take when caring for a patient with osteomalacia?

back 54

Teach about the use of vitamin D supplements

front 55

After teaching a client who has alcohol-induced cirrhosis, a nurse assesses the client's understanding. Which statement made by the client indicates a need for further teaching?

back 55

"I need to avoid protein in my diet."

front 56

Which action should the nurse take to evaluate treatment effectiveness for a patient who has hepatic encephalopathy?

back 56

Ask the patient to extend both arms forward

front 57

The nurse is caring for a patient who has cirrhosis. Which data obtained by the nurse during the assessment will be of most concern?

back 57

The patient’s hands flap back and forth when the arms are extended

front 58

Which topic is most important for the nurse to discuss preoperatively with a patient who is scheduled for an open cholecystectomy?

back 58

Deep breathing and coughing

front 59

The nurse is teaching a client about taking elbasvir for hepatitis C. What information in the client's history would the nurse need prior to drug administration?

back 59

History of hepatitis B

front 60

To prepare a patient with ascites for paracentesis, the nurse

back 60

asks the patient to empty the bladder

front 61

The nurse assesses a newly admitted client and documents a body mass index (BMI) of 31.2. What does this value indicate to the nurse?

back 61

The client is obese.

front 62

A patient being admitted with an acute exacerbation of ulcerative colitis reports crampy abdominal pain and passing 15 or more bloody stool a day. The nurse will plan to

back 62

Discontinue the patient's oral food intake

front 63

A patient in the outpatient clinic is diagnosed with acute hepatitis C (HCV) infection. Which action by the nurse is appropriate?

back 63

Schedule the patient for HCV genotype testing