Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Med Surg 1 > Midterm > Flashcards

Midterm Flashcards

1
Q

A nurse is providing teaching to a client who has hypertension and a new prescription for hydrochlorothiazide. Which of the following instructions should the nurse provide?

A. Weigh weekly to monitor therapeutic effect.
B. Take the medication on an empty stomach.
C. Take the medication early in the day.
D. Muscle pain is an expected adverse effect.

A

C. Take the medication early in the day.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

A nurse is caring for a client who has hypertension and has a potassium level of 6.8 mEq/L. Which of the following actions should the nurse take?

A. Suggest that the client use a salt substitute.
B. Obtain a 12-lead ECG.
C. Advise the client to add citrus juices and bananas to her diet.
D. Obtain a blood sample for a serum sodium level.

A

B. Obtain a 12-lead ECG.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

A nurse is assessing a client who is taking lisinopril to treat hypertension. Which of the following findings is a priority to report?

A. Dry cough
B. Swelling of the tongue
C. Nausea
D. Nasal congestion

A

B. Swelling of the tongue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

A nurse is teaching a client who has hypertension and a new prescription for atenolol. Which of the following findings should the nurse include as adverse effects of this medication?

A. Bradycardia
B. Tremor
C. Cough
D. Constipation

A

A. Bradycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

A nurse is caring for a client who has congestive heart failure and is taking digoxin daily. The client refused breakfast and is complaining of nausea and weakness. Which of the following actions should the nurse take first?

A. Check the client’s vital signs.
B. Request a dietitian consult.
C. Suggest that the client rests before eating the meal.
D. Request an order for an antiemetic.

A

A. Check the client’s vital signs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

A nurse is providing instruction to a new nurse about caring for clients who are receiving diuretic therapy to treat heart failure. The nurse should explain that which of the following medications puts clients at risk for both hyperkalemia and hyponatremia?

A. Furosemide
B. Hydrochlorothiazide
C. Metolazone
D. Spironolactone

A

D. Spironolactone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

The nurse is caring for a client who has heart failure and a history of asthma. The nurse reviews the provider’s orders and recognizes that clarification is needed for which of the following medications?

A. Carvedilol
B. Fluticasone
C. Captopril
D. Isosorbide dinitrate

A

A. Carvedilol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

A nurse is caring for an older adult client who has left-sided heart failure. Which of the following assessment findings should the nurse expect?

A. Frothy sputum
B. Dependent edema
C. Nocturnal polyuria
D. Jugular distention

A

A. Frothy sputum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

A home health nurse is making a home visit to a client who takes a daily diuretic for heart failure. Which of the following manifestations should the nurse identify as indicating the client is hypokalemic?

A. Pitting edema
B. Fatigue
C. Dyspnea
D. Oliguria

A

B. Fatigue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

A nurse is providing instructions to a client who has a new prescription for sublingual nitroglycerin (Nitrostat) to treat angina pectoris. Which of the following instructions should the nurse include?

A. “Place the tablet under your tongue, and then take a small sip of water.”
B. “The medication can take up to 15 minutes to take effect.”
C. “Avoid taking the medication prior to exercising.”
D. “Stop taking the medication and notify your provider if you develop a headache.”

A

A. “Place the tablet under your tongue, and then take a small sip of water.”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

A nurse is teaching a client about snacks that are appropriate on a low-fat, low-sodium, and low-cholesterol diet. Which of the following food choices by the client indicates the need for further teaching?

A. A slice of cheese
B. jam sandwich
C. A cup of plain popcorn
D. A small container of applesauce

A

A. A slice of cheese

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

A nurse is caring for a client who is scheduled for surgery. The nurse’s role in regard to informed consent is which of the following?

A. Ensuring the charge nurse is available to witness the client’s signature on the consent form
B. Explaining the risks involved with the procedure
C. Discussing alternate treatment options
D. Determining the client’s level of understanding about the procedure

A

D. Determining the client’s level of understanding about the procedure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

A client who is 2 days postoperative following abdominal surgery is about to progress from a clear liquid diet to full liquids. Which of the following items should the nurse tell the client he may now request to have on his meal tray?

A. Cranberry juice
B. Flavored gelatin
C. Skim milk
D. Chicken broth

A

C. Skim milk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

A nurse is monitoring a client who is receiving a blood transfusion. Which of the following findings indicates an allergic transfusion reaction?

A. Generalized urticaria
B. Distended jugular veins
C. Blood pressure 184/92 mmHg
D. Bilateral flank pain

A

A. Generalized urticaria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

A nurse is teaching a client who has asthma about how to use an albuterol inhaler. Which of the following actions by the client indicates an understanding of the teaching?

A. The client holds his breath for 10 seconds after inhaling the medication.
B. The client exhales as the medication is released from the inhaler.
C. The client takes a quick inhalation while releasing the medication from the inhaler.
D. The client waits 10 min between inhalations.

A

A. The client holds his breath for 10 seconds after inhaling the medication.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

The nurse is assessing a client for hypoxemia during an asthma attack. Which of the following manifestations should the nurse expect?

A. Nausea
B. Dysphagia
C. Agitation
D. Hypotension

A

C. Agitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

A nurse is collaborating on care for a client who has COPD. Which of the following tasks should the nurse recommend be referred to an occupational therapist for assistance?

A. Instructing how to measure oxygen saturation
B. Instructing how to use kitchen tools to prepare a meal
C. Instruction how to plan a diet based on individual caloric needs
D. Instructing how to perform pursed-lip breathing

A

B. Instructing how to use kitchen tools to prepare a meal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

A nurse is assessing a client who has pulmonary tuberculosis. Which of the following findings should the nurse expect?

A. lethargy
B. high-grade fever
C. weight gain
D. dry cough

A

A. lethargy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

A nurse is caring for a client who has active pulmonary tuberculosis(TB). The client requires airborne precautions and is receiving multidrug therapy. Which of the following precautions should the nurse take to transport and client safely to the radiology department for a chest x-ray?

A. Ask the x-ray technician to come to the client’s room to obtain a portable x-ray.
B. Have the client wear a fitted N95 mask.
C. Notify the x-ray department that the client requires airborne precautions.
D. Wear a filtration mask and gloves during transport.

A

B. Have the client wear a fitted N95 mask.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

A nurse is preparing an adolescent client who has pneumonia for percussion, vibration, and postural drainage. Prior to the procedure, which of the following nursing actions should the nurse complete first?

A. Auscultate lung fields.
B. Assess pulse and respirations.
C. Assess characteristics of her sputum.
not the first action the nurse should take.
D. Instruct to slowly exhale with pursed lips.

A

A. Auscultate lung fields.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

A nurse on a medical unit is caring for a client who has angina pectoris and reports chest pain with a severity of 6 on a 0 to 10 scale. The nurse administers sublingual nitroglycerin (Nitrostat). After 5 min, the client states that his chest pain is now a 2. Which of the following actions should the nurse take?

A. Administer another nitroglycerin tablet.
B. Measure the client’s blood pressure.
C. Check the client’s apical heart rate.
D. Obtain an ECG.

A

A. Administer another nitroglycerin tablet.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

In preparation for the discharge of a client with peripheral arterial disease (PAD), the nurse should include which of the following instructions?

A. Apply a heating pad on a low setting to help relieve leg pain.
B. Adjust the thermostat so that the environment is warm.
C. Wear antiembolic stockings during the day.
D. Rest with the legs above heart level.

A

B. Adjust the thermostat so that the environment is warm.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

A nurse is caring for a client who has Peripheral Arterial Disease (PAD), which of the following symptoms should the nurse expect to find in the early stage of the disease

A. Pain at Rest
B. Intermittent Claudication
C. Dependent Rubor
D. Foot Pain

A

B. Intermittent Claudication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

A nurse is caring for a client who has peripheral vascular disease and reports difficulty sleeping because of cold feet. Which of the following nursing actions should the nurse take to promote the client’s comfort?

A. Obtain a pair of slipper socks for the client
B. Rub the clients feet briskly for several minutes
C. Increase the client’s oral fluid intake
D. Place a moist heating pad under the client’s feet

A

A. Obtain a pair of slipper socks for the client

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

A nurse is planning care for a client who has deep vein thrombosis of the lower leg. Which of the following interventions should the nurse include in the plan of care?

A. Maintain the client on bed rest
B. Restrict the client to 1 L of fluid per day
C. Place cool compresses on the edematous area
D. Keep the client’s affected leg elevated while in bed

A

D. Keep the client’s affected leg elevated while in bed

26
Q

A nurse is caring for an antepartum client who has iron-deficiency anemia. When teaching the client about nutrition, the nurse should emphasize the need for an increased intake of which of the following foods?

A

Red meat and organ meat

27
Q

A nurse is providing teaching about dietary recommendations to a client who has iron-deficiency anemia. Which of the following dietary recommendations should the nurse include as a food that enhances iron absorption when consumed with nonheme iron?

A. Tomato juice
B. Tea
C. Milk
C. Dried beans

A

A. Tomato juice

28
Q

A nurse is planning care for a client who has pernicious anemia. Which of the following interventions should the nurse plan to implement?

A. Administer ferrous sulfate supplement.
B. Increase dietary intake of folic acid.
C. Initiate weekly injections of vitamin B 12
D. Initiate a blood transfusion.

A

C. Initiate weekly injections of vitamin B 12

29
Q

A nurse is caring for a client who has a central venous catheter and develops acute shortness of breath. Which of the following actions should the nurse take first?

A. Clamp the catheter
B. Initiate oxygen therapy
C. Auscultate breath sounds
D. Position the patient in left lateral trendelenburg

A

A. Clamp the catheter

30
Q

A nurse is teaching a client who has a new diagnosis of venous insufficiency. Which of the following instructions should the nurse include?

A. Apply Ice packs to your legs
B. Use elastic stockings
C. Remain on bed rest
D. Place your legs in a dependent position while in bed

A

B. Use elastic stockings

31
Q

A nurse is caring for a client who is receiving a continuous IV through a peripheral intravenous device. The nurse notes the catheter site is warm and painful to touch. Which of the following actions should the nurse take?

A. Slow the infusion
B. Place the affected extremity below the level of the patient’s heart
C. Apply a warm compress to the IV site
D. Place a pressure dressing over the IV site

A

C. Apply a warm compress to the IV site

32
Q

While performing an admission assessment for a client, the nurse notes that the client has varicose veins with ulcerations and lower extremity edema with a report of a feeling of heaviness. Which of the following nursing diagnosis should the nurse identify as being the priority in the client’s care?

A) Impaired tissue perfusion
B) Alteration in body image
C) Alteration in activity intolerance
D) Impaired skin integrity

A

A) Impaired tissue perfusion

33
Q

A nurse is caring for a client who has hypernatremia and requires IV fluid therapy d/t NPO status. Which solution should the nurse prepare to infuse?

A. Lactated Ringer’s
B. Dextrose 5% in 0.9% NaCl
C. 0.45% NaCl
D. Dextrose 10% in water

A

C. 0.45% NaCl

34
Q

A nurse is assessing an IV infusion site on an infant’s left hand. Which of the following findings should the nurse identify as an indication of an indication of an infiltration?

A. Blood in the IV tubing
B. Absence of blanching at the insertion site
C. Edema in the palm of the hand
D. Warmth around the insertion site

A

C. Edema in the palm of the hand

35
Q

A nurse is teaching a client who is postpartum and has been diagnosed with iron deficiency anemia. Which of the following dietary recommendations should the nurse include in the teaching plan?

A

Eat spinach and beef since they are foods that are high in iron.

36
Q

A nurse is reviewing the laboratory findings for a client who has idiopathic thrombocytopenia purpura (ITP). Which of the following findings should the nurse expect to be decreased?

A. WBC
B. RBC
C. Granulocytes
D. Platelets

A

D. Platelets

37
Q

A nurse is preparing an educational material for a client who has thrombocytopenic disorder. Which of the following information should the nurse include?

A. “Use rectal suppository if constipated”
B. “Swish with the commercial mouthwash after brushing the teeth”
C. “Notify the dentist of your condition prior to invasive procedures”
D. “Take aspirin for headaches

A

C. “Notify the dentist of your condition prior to invasive procedures”

38
Q

A home health nurse visits a client who has COPD and receives oxygen at 2L/min via nasal cannula. The client reports difficulty breathing. Which of the following actions is the nurse’s priority?

A. Increase the oxygen flow to 3L/min
B. Assess the client’s respiratory status
C. Call emergency services for the client
D. Have the client cough and expectorate secretions.

A

B. Assess the client’s respiratory status

39
Q

A provider prescribes a transfusion of one unit packed RBC for a client who has a low hemoglobin level. The provider also prescribes diphenhydramine (Benadryl) for administration before the transfusion to prevent:

A. hemolysis
B. fluid overload
C. fever
D. urticaria

A

D. urticaria

40
Q

A nurse is assessing a client before administering a unit of packed RBCs. The nurse should identify which of the following data as most important to obtain prior to the infusion?

A

Temperature

41
Q

A nurse is preparing to administer blood to a client. The unit of blood on hand is type O negative and the client has type A positive blood. Which of the following actions should the nurse take?

A

Administer the blood as ordered.

42
Q

A nurse is preparing to administer 2 units of packed RBCs to an older adult client. Which of the ff. actions should the nurse take?

A. Administer each unit over 3 hr.
B. Use an 18-gauge needle to obtain venous access.
C. Use blood that is less than a month old.
D. Obtain the client’s vital signs every 30 min throughout the transfusion.

A

A. Administer each unit over 3 hr.

43
Q

A nurse is caring for a client who decides not to have surgery despite significant blockages of the coronary arteries. The nurse understands that this client’s choice is an example of which of the following ethical principles?

A

Autonomy

44
Q

A patient is receiving a 3% NaCl solution for correction of hyponatremia. During administration of the solution, the most important assessment for the nurse to monitor is

a. lung sounds.
b. urinary output.
c. peripheral pulses.
d. peripheral edema.

A

a. lung sounds

45
Q

After teaching a client with a history of renal calculi, the nurse assesses the client’s understanding. Which statement made by the client indicates a correct understanding of the teaching?

A

I should drink at least 3 liters of fluid everyday.

46
Q

On admission, a patient’s blood alcohol limit is greater than 400mg/dL. The patient reports drinking a 12 pack of beer on a daily basis. Which of the following conditions is this patient most at risk for?

A

Hypomagnesemia

47
Q

A client who is 16 hours postoperative rates pain as 7 out of 10, has a respiratory rate of 28 breaths/min, and an arterial blood gas (ABG) result of pH 7.47, CO2 33 mm Hg (4.39 kPa), and HCO3 26 mEq/L (26 mmol/L). Which action should the nurse take?

A

Administer I.V. morphine sulfate 4 mg as prescribed

48
Q

The outpatient surgery nurse reviews the complete blood cell (CBC) count results for a patient who is scheduled for surgery in a few days. The results are white blood cell (WBC) count 10.2 ´ 103/µL; hemoglobin 15 g/dL; hematocrit 45%; platelets 150 ´ 103/µL. Which action should the nurse take?

a. Call the surgeon and anesthesiologist immediately.
b. Ask the patient about any symptoms of a recent infection.
c. Discuss the possibility of blood transfusion with the patient.
d. Send the patient to the holding area when the operating room calls.

A

d. Send the patient to the holding area when the operating room calls.

49
Q

The nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who is receiving oxygen. Which of the following actions is best for the nurse to implement to determine the appropriate oxygen flow rate?

a. Minimize oxygen use to avoid oxygen dependency.
b. Maintain the pulse oximetry level at 90% or greater.
c. Administer oxygen according to the client’s level of dyspnea.
d. Avoid administration of oxygen at a rate of more than 2 L/minute.

A

b. Maintain the pulse oximetry level at 90% or greater.

50
Q

The nurse is admitting a client with chronic obstructive pulmonary disease (COPD) to the hospital. Which of the following positions should the nurse place the client in to improve gas exchange?

a. Resting in bed with the head elevated to 45–60 degrees
b. Sitting up at the bedside in a chair and leaning slightly forward
c. Resting in bed in a high Fowler’s position with the knees flexed
d. In the Trendelenburg position with several pillows behind the head

A

b. Sitting up at the bedside in a chair and leaning slightly forward

51
Q

A patient is scheduled for spirometry. Which action should the nurse take to prepare the patient for this procedure?

a. Give the rescue medication immediately before testing.
b. Administer oral corticosteroids 2 hours before the procedure.
c. Withhold bronchodilators for 6 to 12 hours before the examination.
d. Ensure that the patient has been NPO for several hours before the test.

A

c. Withhold bronchodilators for 6 to 12 hours before the examination.

52
Q

Which group of drugs will the nurse plan to include when teaching a patient who has a new diagnosis of peripheral artery disease (PAD)?

a. Statins
b. Antibiotics
c. Thrombolytics
d. Anticoagulants

A

a. Statins

53
Q

A 67-year-old patient is admitted to the hospital with a diagnosis of venous insufficiency. Which patient statement is most supportive of the diagnosis?

a. I can’t get my shoes on at the end of the day.
b. I can’t seem to ever get my feet warm enough.
c. I have burning leg pains after I walk two blocks.
d. I wake up during the night because my legs hurt.

A

a. I can’t get my shoes on at the end of the day.

54
Q

The nurse is developing a discharge teaching plan for a patient diagnosed with thromboangiitis obliterans (Buerger‘s disease). Which expected outcome has the highest priority for this patient?

a. Cessation of all tobacco use
b. Control of serum lipid levels
c. Maintenance of appropriate weight
d. Demonstration of meticulous foot care

A

a. Cessation of all tobacco use

55
Q

Which assessment finding for a patient who has been admitted with a right calf venous thromboembolism (VTE) requires immediate action by the nurse?

a. Report of right calf pain
b. Redness of right lower leg
c. New onset shortness of breath
d. Temperature of 100.4F (38C)

A

c. New onset shortness of breath

56
Q

Which action by the patient with newly diagnosed Raynaud‘s phenomenon demonstrates that the nurse‘s teaching about managing the condition has been effective?

a. The patient exercises indoors during the winter months.
b. The patient immerses hands in hot water when they turn pale.
c. The patient takes pseudoephedrine (Sudafed) for cold symptoms.
d. The patient avoids taking nonsteroidal antiinflammatory drugs (NSAIDs).

A

a. The patient exercises indoors during the winter months.

57
Q

Which statement by a patient indicates good understanding of the nurse‘s teaching about preventing sickle cell crisis?

A. “Home oxygen therapy is frequently used to decrease sickling.”
B. “There are no effective medications that can help prevent sickling.”
C. “Routine continuous dosage opioids are prescribed to prevent a crisis.”
D. “Risk for a crisis is decreased by having an annual influenza vaccination.”

A

D. “Risk for a crisis is decreased by having an annual influenza vaccination.”

58
Q

Which assessment finding would the nurse caring for the patient with thrombocytopenia communicate immediately to the health care provider?

A. Bruises on the patient’s back.
B. Difficulty awakening the patient.
C. Purpura on the patients’ oral mucosa
D. The patient‘s platelet count is 52,000/L.

A

B. Difficulty awakening the patient.

59
Q

Which patient would the nurse assign as the roommate for a patient who has aplastic anemia?

A. A patient with chronic heart failure.
B. A patient who has viral pneumonia.
C. A patient who has right leg cellulitis.
D. A patient with multiple abdominal drains.

A

A. A patient with chronic heart failure.

60
Q

A patient has chronic peripheral artery disease (PAD) of the legs and an ulcer on the right second toe. Which assessment finding would the nurse expect?

a. Dilated superficial veins
b. Swollen, dry, scaly ankles
c. Prolonged capillary refill in all the toes
d. Serosanguineous drainage from the ulcer

A

c. Prolonged capillary refill in all the toes

61
Q

Which nursing intervention is important when providing care for a patient in sickle cell crisis?

A. Limiting the patient‘s intake of oral and IV fluids
B. Evaluating the effectiveness of opioid analgesics
C. Encouraging the patient to ambulate as much as tolerated
D. Teaching the patient about high-protein, high-calorie foods

A

B. Evaluating the effectiveness of opioid analgesics

62
Q

Which intervention will the nurse include in the plan of care for a patient with immune thrombocytopenic purpura?

a. Assign the patient to a private room.
b. Avoid intramuscular (IM) injections.
c. Use rinses rather than a soft toothbrush for oral care.
d. Restrict activity to passive and active range of motion.

A

b. Avoid intramuscular (IM) injections.

Med Surg 1 (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions