Nursing Practice IV care Of Clients Physiologic And Psychosocial Alterations
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- 1.Randy has undergone kidney transplant, what assessment would prompt Nurse Katrina to suspect organ rejection?
- A.
Sudden weight loss
- B.
Polyuria
- C.
Hypertension
- D.
Shock
- 2.The immediate objective of nursing care for an overweight, mildly hypertensive male client with ureteral colic and hematuria is to decrease:
- A.
Pain
- B.
Weight
- C.
Hematuria
- D.
Hypertension
- 3.Matilda, with hyperthyroidism is to receive Lugol’s iodine solution before a subtotal thyroidectomy is performed. The nurse is aware that this medication is given to:
- A.
Decrease the total basal metabolic rate.
- B.
Maintain the function of the parathyroid glands.
- C.
Block the formation of thyroxine by the thyroid gland.
- D.
Decrease the size and vascularity of the thyroid gland.
- 4.Ricardo, was diagnosed with type I diabetes. The nurse is aware that acute hypoglycemia also can develop in the client who is diagnosed with:
- A.
Liver disease
- B.
Hypertension
- C.
Type 2 diabetes
- D.
Hyperthyroidism
- 5.Tracy is receiving combination chemotherapy for treatment of metastatic carcinoma. Nurse Ruby should monitor the client for the systemic side effect of:
- A.
Ascites
- B.
Nystagmus
- C.
Leukopenia
- D.
Polycythemia
- 6.Norma, with recent colostomy expresses concern about the inability to control the passage of gas. Nurse Oliver should suggest that the client plan to:
- A.
Eliminate foods high in cellulose.
- B.
Decrease fluid intake at meal times.
- C.
Avoid foods that in the past caused flatus.
- D.
Adhere to a bland diet prior to social events.
- 7.Nurse Ron begins to teach a male client how to perform colostomy irrigations. The nurse would evaluate that the instructions were understood when the client states, “I should:
- A.
Lie on my left side while instilling the irrigating solution.”
- B.
Keep the irrigating container less than 18 inches above the stoma.”
- C.
Instill a minimum of 1200 ml of irrigating solution to stimulate evacuation of the bowel.”
- D.
Insert the irrigating catheter deeper into the stoma if cramping occurs during the procedure.”
- 8.Patrick is in the oliguric phase of acute tubular necrosis and is experiencing fluid and electrolyte imbalances. The client is somewhat confused and complains of nausea and muscle weakness. As part of the prescribed therapy to correct this electrolyte imbalance, the nurse would expect to:
- A.
Administer Kayexalate
- B.
Restrict foods high in protein
- C.
Increase oral intake of cheese and milk.
- D.
Administer large amounts of normal saline via I.V.
- 9.Mario has burn injury. After Forty48 hours, the physician orders for Mario 2 liters of IV fluid to be administered q12 h. The drop factor of the tubing is 10 gtt/ml. The nurse should set the flow to provide:
- A.
18 gtt/min
- B.
28 gtt/min
- C.
32 gtt/min
- D.
36 gtt/min
- 10.Terence suffered form burn injury. Using the rule of nines, which has the largest percent of burns?
- A.
Face and neck
- B.
Right upper arm and penis
- C.
Right thigh and penis
- D.
Upper trunk
- 11.Herbert, a 45 year old construction engineer is brought to the hospital unconscious after falling from a 2-story building. When assessing the client, the nurse would be most concerned if the assessment revealed:
- A.
Reactive pupils
- B.
A depressed fontanel
- C.
Bleeding from ears
- D.
An elevated temperature
- 12.Nurse Sherry is teaching male client regarding his permanent artificial pacemaker. Which information given by the nurse shows her knowledge deficit about the artificial cardiac pacemaker?
- A.
Take the pulse rate once a day, in the morning upon awakening
- B.
May be allowed to use electrical appliances
- C.
Have regular follow up care
- D.
May engage in contact sports
- 13.The nurse is ware that the most relevant knowledge about oxygen administration to a male client with COPD is
- A.
Oxygen at 1-2L/min is given to maintain the hypoxic stimulus for breathing.
- B.
Hypoxia stimulates the central chemoreceptors in the medulla that makes the client breath.
- C.
Oxygen is administered best using a non-rebreathing mask
- D.
Blood gases are monitored using a pulse oximeter.
- 14.Tonny has undergoes a left thoracotomy and a partial pneumonectomy. Chest tubes are inserted, and one-bottle water-seal drainage is instituted in the operating room. In the postanesthesia care unit Tonny is placed in Fowler's position on either his right side or on his back. The nurse is aware that this position:
- A.
Reduce incisional pain.
- B.
Facilitate ventilation of the left lung.
- C.
Equalize pressure in the pleural space.
- D.
Increase venous return
- 15.Kristine is scheduled for a bronchoscopy. When teaching Kristine what to expect afterward, the nurse's highest priority of information would be:
- A.
Food and fluids will be withheld for at least 2 hours.
- B.
Warm saline gargles will be done q 2h.
- C.
Coughing and deep-breathing exercises will be done q2h.
- D.
Only ice chips and cold liquids will be allowed initially.
- 16.Nurse Tristan is caring for a male client in acute renal failure. The nurse should expect hypertonic glucose, insulin infusions, and sodium bicarbonate to be used to treat:
- A.
Hypernatremia.
- B.
Hypokalemia.
- C.
Hyperkalemia.
- D.
Hypercalcemia.
- 17.Ms. X has just been diagnosed with condylomata acuminata (genital warts). What information is appropriate to tell this client?
- A.
This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) smear annually.
- B.
The most common treatment is metronidazole (Flagyl), which should eradicate the problem within 7 to 10 days.
- C.
The potential for transmission to her sexual partner will be eliminated if condoms are used every time they have sexual intercourse.
- D.
The human papillomavirus (HPV), which causes condylomata acuminata, can't be transmitted during oral sex.
- 18.Maritess was recently diagnosed with a genitourinary problem and is being examined in the emergency department. When palpating the her kidneys, the nurse should keep which anatomical fact in mind?
- A.
The left kidney usually is slightly higher than the right one.
- B.
The kidneys are situated just above the adrenal glands.
- C.
The average kidney is approximately 5 cm (2") long and 2 to 3 cm (¾" to 1-1/8") wide.
- D.
The kidneys lie between the 10th and 12th thoracic vertebrae.
- 19.Jestoni with chronic renal failure (CRF) is admitted to the urology unit. The nurse is aware that the diagnostic test are consistent with CRF if the result is:
- A.
Increased pH with decreased hydrogen ions.
- B.
Increased serum levels of potassium, magnesium, and calcium.
- C.
Blood urea nitrogen (BUN) 100 mg/dl and serum creatinine 6.5 mg/ dl.
- D.
Uric acid analysis 3.5 mg/dl and phenolsulfonphthalein (PSP) excretion 75%.
- 20.Katrina has an abnormal result on a Papanicolaou test. After admitting that she read her chart while the nurse was out of the room, Katrina asks what dysplasia means. Which definition should the nurse provide?
- A.
Presence of completely undifferentiated tumor cells that don't resemble cells of the tissues of their origin.
- B.
Increase in the number of normal cells in a normal arrangement in a tissue or an organ.
- C.
Replacement of one type of fully differentiated cell by another in tissues where the second type normally isn't found.
- D.
Alteration in the size, shape, and organization of differentiated cells.
- 21.During a routine checkup, Nurse Mariane assesses a male client with acquired immunodeficiency syndrome (AIDS) for signs and symptoms of cancer. What is the most common AIDS-related cancer?
- A.
Squamous cell carcinoma
- B.
Multiple myeloma
- C.
Leukemia
- D.
Kaposi's sarcoma
- 22.Ricardo is scheduled for a prostatectomy, and the anesthesiologist plans to use a spinal (subarachnoid) block during surgery. In the operating room, the nurse positions the client according to the anesthesiologist's instructions. Why does the client require special positioning for this type of anesthesia?
- A.
To prevent confusion
- B.
To prevent seizures
- C.
To prevent cerebrospinal fluid (CSF) leakage
- D.
To prevent cardiac arrhythmias
- 23.A male client had a nephrectomy 2 days ago and is now complaining of abdominal pressure and nausea. The first nursing action should be to:
- A.
Auscultate bowel sounds.
- B.
Palpate the abdomen.
- C.
Change the client's position.
- D.
Insert a rectal tube.
- 24.Wilfredo with a recent history of rectal bleeding is being prepared for a colonoscopy. How should the nurse Patricia position the client for this test initially?
- A.
Lying on the right side with legs straight
- B.
Lying on the left side with knees bent
- C.
Prone with the torso elevated
- D.
Bent over with hands touching the floor
- 25.A male client with inflammatory bowel disease undergoes an ileostomy. On the first day after surgery, Nurse Oliver notes that the client's stoma appears dusky. How should the nurse interpret this finding?
- A.
Blood supply to the stoma has been interrupted.
- B.
This is a normal finding 1 day after surgery.
- C.
The ostomy bag should be adjusted.
- D.
An intestinal obstruction has occurred.
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