Medical Surgical NCLEX test 2

Study online at quizlet.com/_c4ads

1.

A 30 y/o male patient comes into the emergency department with sever asthma-related signs and symptoms. What medication is recommended to prevent the signs and symptoms of asthma? A 37 y/o male patient presents at the emergency department complaining of nausea and vomiting and severe abdominal pain. While the nurse is assessing the patient, the patient;s wife informs the nurse that the patient had ingested 24 ounces of alcohol last evening. The patients abdomen is rigid, and there is bruising to the patients flank. What is the patient exhibiting signs of? A 40 y/o male newly diagnosed with HTN is discussing risk factors with the nurse. The nurse talks about lifestyle changes with the patient and advises that the patient should avoid tobacco use. What is the rationale behind that advise to the patient? A 42 y/o women comes to the clinic complaining of intermittent urinary incontinence when she sneezes. The clinic nurse is aware this is what type of incontinence? A 45 y/o adult male patient is admitted to emergency following a fall from a tree stand in which he sustained a large laceration to the occipital area of his head. The patient relates that prior to the fall, he had developed unrelieved chest pain that was present for approximately 20 minutes before he fell and is still present. The DR. diagnoses the patient with an MI and deep laceration to the head. To minimize cardiac damage, what physician's order will the nurse expect to see for this patient? A 47 y/o male patient calls the nurse and asks about risk factors of HTN. What should the nurse list as risk factors for primary HTN. A 48 y/o male presents to the ED c/o severe substernal chest pain radiating down his left arm. He's admitted to the CCU with a diagnosis of MI. What nursing assessment activity is priority on admission to CCU?

Zafirlukast (Accolate)

8.

A 55 y/o male with acute pancreatitis is being admitted. What is the critical care nurse aware of concerning the common description of acute pancreatitis? A 55 y/o patient comes to the clinic for a routine check-up. The patient's blood pressure is 160/100 and the physician diagnoses hypertension. The patient asks why it is important to treat hypertension. What would be the nurses best response? An 80 y/o male, newly diagnosed with primary HTN, has just been put on a beta-blocker. The nurse knows that in addition to teaching the patient about his medication, she should also focus her teaching on what?

Pancreatic enzymes digest the pancreas.

9.

2.

Severe pancreatitis with possible peritonitis.

"In people over the age of 50, hypertension increases the risk of death, stroke, and heart failure." Use of supportive devices such as handrails and walkers to prevent falls stemming from postural hypotension Wiping the teeth and gums with gauze pad

10.

3.

Increases the risk of heart disease.

11.

4.

Stress incontinence
12.

A comatose patient is receiving oral care. What oral regimen would be most effective in decreasing the client's risk of tooth decay and plaque accumulation? A community health nurse is providing an educational event at the local high school The topic nurse is speaking about is varicose veins. What would the nurse suggest as a proactive preventative measure for varicose veins. A critical car nurse s caring for a patient with pulmonary artery catheter in place. What does this catheter measure that is particularly important in critically ill patients? The diabetic educator is teaching a patient about type 2 diabetes. The educator recognizes the patient understands the primary treatment for type 2 diabetes when the patient states what? During a mumps outbreak at a local school, a patient, who is a school teacher, is exposed. She has previously been immunized form mumps. What type of immunity does she possess?

5.

Morphine sulphate, Oxygen administration, and bed rest

Walking for several minutes every hour to promote circulation

13.

Left Ventricular preload

14.

6.

Obesity, high intake of sodium and saturated fat Begin ECG monitoring

"I will follow the weight loss plan designed by the dietitian." Acquired immunity

15.

7.

16.

An elderly lady is diagnosed with pernicious anemia. The nurse caring for this patient knows that intrinsic factor, which combines with dietary B12, is secreted by what? A geriatric nurse is preforming an assessment of body systems on an 85 y/o patient. The nurse realizes that what particular change is age related affecting the renal or urinary system? In one primary immunodeficiency disease WBC cannot initiate an inflammatory response to infectious organisms. What disease is it? A local public health nurse is informed that a cook in a local restaurant has been diagnoses with hepatitis A. What should the nurse advise individuals who ate at his restaurant and have never received the hepatitis A vaccine? A new nurse on the cardiac unit is taking a class in the anatomy and physiology of the heart. What does the nurse learn is a cardiac action potential? The nurse has implemented a bladder retraining program in a 65 y/o woman after the removal of an indwelling urinary catheter from this patient. The nurse places the patient on a timed voiding schedule and performs an ultrasonic bladder scan after each void. The nurse notes that the patient has 50 mL of urine remaining in her bladder after voiding. What would be the nurse's best response to this finding?

Gastric mucosa

22.

The nurse is assessing a patient with Graves' disease. What physical characteristics of Graves' disease would the nurse expect to find? The nurse is assessing a patient's bladder by percussion. The nurse elicits dullness after voiding. What does this finding indicate? A nurse is caring for a 16 y/o who as sickle cell anemia. The nurse is concerned about substance abuse in this patient. What would the nurse encourage the patient to do to prevent substance abuse of analgesics in the patient? A nurse is caring for a 73 y/o male patient with a urethral obstruction related to prostatic enlargement. The nurse is aware this may result in what? The nurse is caring for a patient diagnosed with Hashimoto's thyroiditis. When assessing this patient, what symptom would the nurse expect in a patient with hypothyroidism? The nurse is caring for a patient scheduled for an infusion drip pyelography. What patient preparation is necessary for this test? The nurse is caring for a patient who is scheduled for a colonscopy. The nurse is preparing to instruct the patient on a colon preparation procedure that will include polyethylene glycol electrolyte lavage prior to the procedure. What is the nurse aware of about the use of lavage solutions and when they are contraindicated? The nurse is caring for a patient who underwent percutaneous lithrotripsy earlier in the day. In this procedure, an ultrasonic probe inserted into a nephrostomy tube into the renal pelvis generates ultra-high-frequency sound waves to shatter renal calculi. What instruction should the nurse give the patient?

Bulging eyes

23.

17.

Decreased GFR

Incomplete bladder emptying Seek care from a single provider for pain relief

24.

18.

Hyperimmunoglobulinemia E Syndrome

25.

A UTI

19.

An immune globulin injection

26.

Numbness and tingling in the fingers

27.

Fluids are not restricted. In a patient with inflammatory bowel disease

20.

The cycle of depolarization and repolarization

28.

21.

Avoid further interventions at this time, as this is an acceptable finding.

29.

Notify the physician about cloudy of foulsmelling urine

30.

The nurse is caring for a patient with a history of systemic lupus erythematosus who has been recently diagnosed with ESRD. The patient has an elevated phosphorus level and has been prescribed calcium acetate to bind the phosphorus. What is an important instruction that the nurse should give the patient about how to take the prescribed phosphorus-binding medication? A nurse is caring for a patient with Crohn's disease. The patient is scheduled for a barium enema. What is an appropriate nursing intervention the day before the test? The nurse is caring for a patient with hyperthyroidism. What would the nurse closely monitor for? The nurse is caring for a patient with liver failure. The nurse understands that patients in liver failure often require vitamin therapy. Which vitamin does the liver require for the synthesis of prothrombin? The nurse is caring for a patient with suspected renal dysfunction is assessing ankle and sacral edema and the presence of crackles in the bases of the lungs bilaterally. A daily weight indicates that the patient's weight has incrased by 5 pounds in the past 24 hours. The nurse notes that evaluation of the patient's intake and output records for the prior 24 hours indicate greater fluid intake than urine output. Based upon the assessment findings and the daily weight information, the nurse estimates that the patient has retained how much fluid? The nurse is caring for a teenage girl who as had an anaphylactic reaction after a bee sting. The nurse is providing patient teaching prior to the patient's discharge. In the event of an anaphylactic reaction, the nurse informs the patient that she should self-administer epinephrine in what site?

With each meal

36.

The nurse is doing triage at the community clinic when a middle-age patient presents with abdominal pains and heartburn. The patient states the symptoms have persisted for several days following a particularly spicy meal. When assessing the patient, the nurse notes the patient has a history of acute gastritis. What complication would the nurse be particularly likely to assess for? The nurse is planning patient teaching for a patient with end-stage renal disease who is scheduled for the creation of a fistula. The nurse would included which of the following in teaching the patient about the fistula? The nurse is preforming a shift assessment on a patient with aldosteronism. What would the nurse recognize that the kidney's response to this condition would lead to? A nurse is preforming blood pressure screenings at a local healthfair. While obtaining subjective assessment data from a patient with HTN, the patient tells the nurse that she has a family history of HTN and she herself has high cholesterol and lipids. The patient says she smokes 1 pack of cigarettes daily and drinks "about a pack of beer" everyday. The nurse notes that a modifiable risk factor of this patient is what? The nurse is providing patient education for a patient with peptic ulcer disease secondary to chronic nonsteroidal antiinflammatory drug (NSAID) use. The patient has been newly prescribed misoprostol (cytotec). What would the nurse be most accurate in informing the patient about the drug? The nurse is teaching a newly diagnosed diabetic about his insulin regimen. When administering Humalog insulin the nurse should teach the patient what? The nurse notes that a client who has undergone skin, tissue, and muscle grafting following a modified radical neck dissection requires suctioning. What is the most important consideration for the nurse when suctioning this client?

Esophageal or pyloric obstruction r/t scarring.

31.

Encourage plenty of fluids

37.

32.

Thyroid storm Vitamin K

A vein and an artery in your arm will be attached surgically? Polyuria

38.

33.

39.

Excessive alcohol intake

34.

2273 mL of fluid in 24 hours

40.

Protects the stomach's lining

35.

Thigh

41.

Have the patient's meal tray available. Avoid applying suction on or near the graft site

42.

43.

The nursing instructor is discussing diabetes mellitis with the junior nursing class. What would the instructor tell the class may develop in the patient when ketone bodies accumulate in excessive amounts? The nursing instructor is discussing ulcerative colitis with her clinical group. What would she tell her students about the characteristics of the stools of these patients? The nursing instructor is going over laboratory results for HIV/AIDS patients. The instructor tells the students that upon interpretation of the patient's labs the nurse should recognize that a patient with HIV is considered to have AIDs when the CD4+ T-lymphocyte cell count drops below what? A nursing instructor is talking with her clinical group about patients with acute glomerulonephritis. The instructor tells the students that the patient may exhibit which of the following clinical manifestations? A nursing student asks when you formula feeding can begin on a patient you are caring for. The patient has just returned to your floor after having a PEG tube placed. What would be your best response. A nursing student is writing a teaching plan for a patient with venous insufficiency. The student covers measures to prevent complications from venous insufficiency. What is one measure the student should include in the plan? A patient admitted with inflammatory bowel disease asks the nurse for help with menu selections. What menu selection is the best choice for this patient? The patient asks the nursing assistant for a bedpan. When the patient is finished, the nursing assistant notifies the nurse that the patient has bright red streaking blood in the stool. What is this most likely the result of? A patient comes to the clinic c/o pain in the epigastric region. The nurse suspects that the patient's pain is r/t a peptic ulcer when the patient states the pain is relieved by what?

DKA, diabetic ketoacidosis.

52.

A patient comes to the walk-in clinic complaining of a lump in her gum and severe pain. What would the nurse expect the diagnosis to be? A patient has a glomular filtration rate of 43 mL/min/1.73m2. Based upon this GFR, the nurse interprets that the patient's chronic kidney disease is at what stage? The patient has been newly diagnosed with HIV. The patient asks the nurse what is going on inside his body. The nurse explains that the body produces antibody molecules in an effort to contain the free HIV particles and assist in their removal. The nurse goes on to explain that after this first inital immune response the remaining amount of virus in the body is called what? A patient has undergone surgery for oral cancer and has just been extubated. When the anesthesia wears off, what nursing action would promote comfort and facilitate breathing for this patient? A patient is prescribed corticosteroid therapy. What would be important information for the nurse to give the patient who is prescribed corticosteroid therapy? A patient is scheduled to have a fecal occult blood test. Before the test, the nurse should instruct the patient to avoid: A patient newly admitted to your unit has an ileal conduit. You need to determine the appliance size to order for this patient. What does the nurse measure to determine the size of the appliance needed? A patient presents at the free clinic c/o urticaria and red rash. She is diagnosed with a delayed hypersensitive reaction. The nurse caring for this patient knows that an example of hypersensitivity reactions characterized by delayed reaction that occurs 24-72 hours after exposure to an antigen is what? A patient returns to the floor after a laparoscopic cholecystectomy. The nurse caring for the patient is aware that the most serious potential complication is what?

Acute pariapical abscess Stage 3

53.

44.

Watery with blood and mucus

54.

Viral Set point

45.

200 cells/mm^3 of blood

46.

Hematuria

55.

Placing the patient in Fowler's position. The patient is at in increased risk for developing infection. Nonsteroidal antiinflammatory drugs The widest part of the stoma

56.

47.

Second day after placement of tube

57.

48.

Avoiding tight-fitting socks

58.

49.

Tofu

59.

50.

Hemorrhoids

Contact dermatitis from tape adhesive

60.

51.

Eating

Bile duct injury

61.

A patient who has undergone liver transplantation is ready to be discharged home. The nurse is providing discharge teaching. What topic will the nurse emphasize the most related to discharge teaching? A patient with a liver mass is undergoing a percutaneous liver biopsy. After the procedure the nurse assists the physician in position the patient. What position should they position the patient in? A patient with AIDS is being prepared for discharge. The nurse caring for the patient with AIDS knows the patient receives Agenerase. What dietary counseling will the nurse provide based upon the patient's medication regimen? A patient with chronic pancreatitis had a pancreaticojejunostomy created 3mo ago for relief of pain and to restore drainage of pancreatic secretions. The patient has come to the office for a routine post surgical appointment. The patient is frustrated that the pain has not decreased. What is the most appropriate initial response by the nurse? A patient with primary HTN comes into the clinic c/o a change in vision- ie, blurring and decreased visual acuity. The nurse is aware that these symptoms could be indicative of what? A patient with primary HTN complains of dizziness with ambulation. The patient is currently on an alpha-adrenergic blocker. The nurse assesses postural hypotension. When teaching this patient about risks associated with postural hypotension, what should the emphasis be placed on? A patient with renal insufficiency has been hospitalized on your unit. The patient knows that renal function depends on the functional status of nephrons. The patient asks you when she will need to start dialysis based upon loss of nephron function. What would your respond?

The patient will take immunosuppressive agents as required.

68.

62.

On the right side with a pillow under the costal margin

The pharmacology instructor is talking with the pre-nursing class about drugs used to control HTN. Propranolol hydrochloride, like other antihypertensive drugs, has side effects. Patients are often anxious about the side effects of anti-hypertensives. A nursing diagnosis of Risk for noncompliance with therapeutic regimen r/t side effects of prescribed therapy would be evaluated how? The physician has explained to the patient that he has developed diabetic neuropathy in his right foot. Later that day the patient calls the nurse and asks what causes diabetic neuropathy. What would be the nurse's best response?

Patient takes medications as prescribed and reports any side effects.

69.

63.

Avoid high-fat meals while taking this medication

64.

"Pain relief occurs by 6 months in more that 85% of the patients who undergo this procedure, and it has been 2 months since your surgery."

"The cause is not known for sure but it is thought to involve elevated blood glucose levels over a period of years." Weigh the patient before administration to determine onset of edema. Gamma Globulin

70.

Prior to administration of IV immunoglobulin what interventions should the nurse implement?

71.

65.

Retinal blood vessel damage

A staff nurse is exposed to hepatitis B. Hospital protocol is the staff nurse report to the ED for the administration of what substance to provide passive acquired immunity? A student asks the pathophysiology instructor what causes ascites. What would the instructor tell the student is involved in the physiologic process that causes ascites? A. Sodium and water retention B. A damaged liver C. Insufficient renal flow D.Increased lymphatic flow E. Decreased synthesis of Immunoglobulin G What are the complications that can occur following gastric surgery?

72.

66.

Rising slowly from a lying or sitting position

Sodium and Water retention, A damaged liver, Increased lymphatic flow

73.

Stomal ulcers, pneumonia, metabolic imbalances Sudden onset with high risk of mortality

67.

"When about 80% of the nephrons are no longer functioning."

74.

What defines pancreatitis as acute?

75.

What physiologic abnormalities indicate the development of chronic renal disease? A.Hypophosphatemia B.Anemia C.Metabolic acidosis D.Respiratory Alkalosis E.Hypercalcemia Where are most uncomplicated UTIs acquired? A woman has been diagnosed with breast cancer and is being treated aggressively with a chemotherapeutic regimen. As a result of this regimen she has an inablilty to fight infection due to the fact her bone marrow is unable to produce a sufficient amount of what? You are admitting a patient to your unit with diverticular diesease. What questions should the nurse ask during her assessment?

Anemia, Metabolic acidosis, Hypercalcemia

83.

76.

Community
84.

A young woman is contacted by a public health nurse and informed that one of her sexual contacts has tested positive for HIV. The young woman comes into the clinic to be tested. She tells the nurse that she has heard that people who are infected with HIV have a period when they test negative even though they are infectious. What is this period called? Your patient is on tube feedings and is experiencing diarrhea. You suspect the patient is experiencing dumping syndrome. How might the nurse help to alleviate this problem?

Primary infection

77.

Lymphocytes

Dilute the feeding solution

78.

Review of dietary habits, about tenesmus, onset and duration of pain Spray or gargle the back of the throat with local anesthetic In the bone marrow

79.

You are caring for a patient who is scheduled for a gastroscopy. What preparation is needed for this test?

80.

You are caring for a patient with a hematologic disorder. The patient asks you where the body forms blood cells. Where would you tell the patient that blood cells are formed? You are caring for a patient with biliary colic and are aware that the patient may experience referred abdominal pain. When you assess for referred pain on this patient what is the common location you would assess for referred pain r/t the biliary colic? You are caring for four patients, all diagnosed with type 1 diabetes. Based upon components of managing diabetes, which patient will likely have the greatest success in maintaining tight glucose control of type 1 diabetes?

81.

Below the right nipple

82.

A patient who adheres to a meal plan and meal schedule.