MEDSURG

121問 • 1年前

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Mrs. Clean is admitted to the hospital for a thyroidectomy. She first sought help because of a goiter of the thyroid. Mrs. Clean's preoperative nursing care includes monitoring for clinical manifestations of thyroid storm such as:

Fever and tachycardia

Mrs. Clean is admitted to the hospital for a thyroidectomy. She first sought help because of a goiter of the thyroid. After thyroidectomy surgery, a priority nursing implementation for Mrs. Clean's care is to:

Monitor every hour for signs of respiratory distress

Mr. Stephen Kare takes oral corticosteroid medication for Addison's disease. He is going for abdominal surgery this morning. A priority nursing implementation is to:

Ascertain if he has received his corticosteroids by IV this morning

Mrs. Mia Chalifa is a 60-year-old, newly diagnosed diabetic. She is 70lbs overweight. As a new diabetic, the first topic Mrs. Mia should be taught about is:

The nature of the disease process of DM

Mrs. Mia Chalifa is a 60-year-old, newly diagnosed diabetic. She is 70lbs overweight. Oral hypoglycemic medication was prescribed for Mrs. Mia because she:

Has a pancreas that secretes sufficient insulin when stimulated by medication.

Mrs. Mia Chalifa is a 60-year-old, newly diagnosed diabetic. She is 70lbs overweight. Mrs. Mia demonstrates comprehension of your teaching by accurately selecting which of the following as clinical manifestation of hypoglycemia?

Sweating, nervousness, dizziness

Mrs. Mia Chalifa is a 60-year-old, newly diagnosed diabetic. She is 70lbs overweight. Mrs. Mia is put on a 1600-calorie diet. A goal of her diet teaching is that she will choose a diet that:

Consists of three regular scheduled meals plus snacks, to maintain a stable pattern as to time of eating and amounts consumed

After hypophysectomy, a client complains of being thirsty and having to urinate frequently. The initial nursing action is to

Assess urine specific gravity

A nurse develops a plan of care for a client with hyperthyroidism and includes which of the following in the plan?

Provide a restful environment

A nurse is performing an assessment on a client following a thyroidectomy. The nurse notes that the client has developed hoarseness and a weak voice. Which nursing action is most appropriate?

Continue monitoring the symptoms

A client is brought to the emergency room in an unresponsive state, and a diagnosis of hyperglycemic hyperosmolar nonketotic syndrome is made. The nurse would prepare immediately to initiate which of the following anticipated physician's orders?

intravenous infusion of normal saline

A client newly diagnosed with diabetes mellitus has been stabilized with insulin injections daily. A nurse prepares a discharge teaching plan regarding the insulin. The teaching plan should reinforce which of the following concepts?

Systematically rotate insulin injection sites

A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in an emergency room. Which finding would a nurse expect to note as confirming this diagnosis?

Elevated blood glucose level and a low plasma bicarbonate

A nurse teaches a client with diabetes mellitus about differentiating between hypoglycemia and ketoacidosis. The client demonstrates an understanding of the teaching by stating that glucose will be taken if which of the following symptoms develops?

Shakiness

A client with diabetes mellitus demonstrates acute anxiety when first admitted for the treatment of hyperglycemia. The most appropriate intervention to decrease the client's anxiety would be to

Convey empathy, trust, and respect toward the client

A nurse provides instructions to a client newly diagnosed with the type 1 diabetes mellitus. The nurse recognizes accurate understanding of measures to prevent diabetic ketoacidosis when the client states,

"I will notify my physician if my blood glucose level is greater than 250 mg/dL."

A physician has prescribed propylthiouracil (PTU) for client with hyperthyroidism. A nurse develops a plan of care for the client. A priority nursing assessment to be included in the plan regarding this medication is to assess for

Signs and symptoms of hypothyroidism

A nurse develops a plan of care for a client with hyperparathyroidism who is receiving calcitonin salmon (Calcimar). Which of the following outcome criteria has the highest priority regarding this medication?

Achievement of normal serum calcium levels

A physician prescribes levothyroxine sodium (Synthroid), 0.15 mg PO daily, for a client with hypothyroidism. A nurse will prepare to administer this medication

In the morning to prevent sleeplessness

A nurse is monitoring a client receiving chlorpropamide (Diabinese). The nurse knows that which of the following is not a therapeutic outcome for this client?

A glycosylated heroglobin of 10%

The client with hyperparathyroidism should have extremities handled gently because:

Decreased calcium bone deposits can lead to pathologic fractures

A 28-year-old female client with hyperthyroidism complains of her "ugly" appearance and asks, "Will I always look so terrible?" What is the nurse's best response?

"With treatment, the fluid buildup behind your eyes will decrease."

Which of the following laboratory result should the nurse expect for a patient with Diabetic Insipidus?

Decreased Urine Specific Gravity, Increased Serum osmolality

Saturated solution of potassium iodide (SSKI) is prescribed preoperatively to a client with a large goiter who is scheduled for a subtotal thyroidectomy to treat thyrotoxicosis, the nurse knows that SSKI is given to help:

Reduce the vascularity of the thyroid gland

The nurse is teaching a diabetic client, DM type 1, about taking isophane insulin suspension NPH (Humulin N) at 5pm each day. Which of the following instructions should be taught to a client that the greatest risk of having hypoglycemia is at?

1am, while sleeping

A patient is suffering from an increased levels of growth hormone. The attending nurse is a aware that this will lead to what type of Disorder?

Acromegaly

To control Elevation of Growth Hormone The nurse will expect to give which medication?

Octreotide (Sandostatin)

Temari, a retired Barangay captain, came to the OPD for her check-up for her diabetes mellitus. She had been diabetic since she was 45-years-old. She has been taking her maintenance dose exercise, sometimes does not comply with. While the Nurse was completing her assessment, she has discovered the following findings. Which of the following should she refer immediately to the physician?

Fruity odor breath

Ms. Temari was admitted to the hospital for further check-up. Which of the following diagnostic tests do you expect to be ordered by the diabetologist as an indicator that the patient is compliant to her prescribed diet?

Glycosylated hemoglobin level (hgb, Alc)

Tlere are metabolic abnormalities in the development of type 2 Diabetes. Which of the following is NOT included in these abnormalities?

Increase ability of the pancreas to produce insulin

The nurse in charge for patient Temari, informed her physician that her serum qlucose level is 38mmol/L and quite unresponsive to verbal questioning. The nurse suspects that she is starting to develop Diabetes Ketoacidosis (DKA). Which of the following manifestations is UNIQUE to this condition?

Rapid deep respirations

SELENA, 72 years old, has been diagnose to have type 2 Diabetes Mellitus and has been admitted due to headache and blurring of vision. She had been on insulin therapy for almost 10 years now. Which of the following is NOT TRUE of Type 2 Diabetes Mellitus?

Destruction of beta cells from autoimmune mechanisms which result in lack of insulin and hyperglycemia

SELENA, 72 years old, has been diagnose to have type 2 Diabetes Mellitus and has been admitted due to headache and blurring of vision. She had been on insulin therapy for almost 10 years now. The granddaughter of SELENA asked you. How does regular exercise help my grandmother overcome her diabetes?" Your BEST response is exercise

"Increases, metabolic rate and consumption of glucose by the muscle."

W/hich of the following is the cause of Somogyi effect, which occurs during sleep in patient with diabetes mellitus?

Increased insulin in the body

A common chronic complication of diabetes due to the thickening of the capillaries and arterioles of the eye is?

Diabetic retinopathy

Alpha, who has had emphysema for 25 years, is admitted to the hospital with a diagnosis of emphysema. During assessment, the nurse notes the presence of a barrel chest, which the nurse knows is caused by:

A compensatory expansion of the bronchial airway

Alpha, who has had emphysema for 25 years, is admitted to the hospital with a diagnosis of emphysema. The spouse of the client with emphysema asks the nurse about the disease process. The nurse explains that the disorder results from a decreased oxygen supply because of:

Loss of surface area for gas exchange

A client is being prepared for thoracentesis. A nurse assists the client to which of the following positions for the procedure?

Lying in bed on the unaffected side.

An emergency room nurse is assessing a client who sustained a blunt injury to the chest wall. Which of these signs would indicate the presence of pneumothorax in this client?

Diminished breath sounds

An oxygen delivery system is prescribed for a client with chronic obstructive pulmonary disease to deliver a precise oxygen concentration. Which of the following types of oxygen delivery systems would the nurse anticipated to be prescribed?

Air entrainment mask

Which of the following arterial blood gas results indicates metabolic alkalosis?

pH of 7.47, Pcoz of 40 mm Hg, HCO, of 36 mEq/L, Poz of 78 mm Hg

patient with Asthma?

Use bronchodilator before corticosteroids

What needs to be reported for a patient with pneumothorax?

absent breath sound

A ward nurse has been assigned to a client, diagnosed of having pneumothorax, with a chest tube drainage system. What will suggest the nurse that the system is malfunctioning?

Intermittent bubbling in the suction control chamber

The other term for ARDS is?

STIFF LUNG

Roger, age 52, is admitted to the medical-surgical floor with a 2-weekhistory of hemoptysis.*The doctor suspects lung cancer and has ordered the appropriate diagnostic tests. While preparing Roger for a diagnostic test, the nurse explains. "The doctor will insert a tube down your throat to visualize your trachea and lung passages. "The nurse has explained which of the following diagnostic tests?

Bronchoscopy

Roger, age 52, is admitted to the medical-surgical floor with a 2-weekhistory of hemoptysis.*The doctor suspects lung cancer and has ordered the appropriate diagnostic tests. The nurse is caring for roger immediately after bronchoscopy. Which of the following nursing diagnoses should receive priority?

Risk for aspiration related to gag reflex suppression

Roger undergoes a right pneumonectomy for lung cancer. Which of the following positions shouldn't be used when repositioning her immediately following procedure?

Left side-lying position

The client is initially diagnosed of having pancreatitis if there is an elevation of which of the following serum values?

Amylase

Burning pain occurs in the mid-epigastric area 2-3 hours after meal; often awakened between 1-2 am While giving discharge teaching to a client with a peptic ulcer disease, which of the following diet would a nurse most likely to explain to the client?

Bland foods

You have to prevent dumping syndrome. The following are the nursing measures of preventing it EXCEPT:

Allow him to walk after eating meal

Mr. Hayabusa, an alcoholic is admitted in the hospital due to cirrhosis of the liver. What is the rationale of giving him low-protein diet?

decrease formation of ammonia

A 26-year-old patient with GI bleeding requires fluid resuscitation and 4 units of packed RBC's. Which electrolyte imbalance should the nurse monitor following the transfusion of packed RBC's?

Calcium

The patient is being transfused with PRBC and the attending nurse monitors the time of infusion strictly to prevent what problem?

Hyperkalemia

What is the treatment for pernicious anemia?

Monthly IM injections of B12 for life

Aurora is an 18-year-old patient admitted to the medical-surgical floor with onset of abdominal pain in the right lower quadrant. The doctor suspects that aurora has appendicitis. Which of the following is a classic sign of appendicitis that leads to his suspicion?

Rebound abdominal tenderness

Aurora is an 18-year-old patient admitted to the medical-surgical floor with onset of abdominal pain in the right lower quadrant. Aurora requests a heating pad for his abdominal pain. Which would be the nurse's best verbal response?

"Heat stimulates bowel activity, which can cause your appendix to rupture."

Aurora is an 18-year-old patient admitted to the medical-surgical floor with onset of abdominal pain in the right lower quadrant. The most appropriate nursing diagnosis for Aurora before surgery would be:

Knowledge deficit related to the disease process and anticipated surgery

Granger, a 45-year-old editor, has a bleeding gastric ulcer. Despite multiple blood transfusions, his hemoglobin is 7.6 g/di and hematocrit is 28%. His doctor determines that intervention is necessary. Mr. Granger's doctor performed a partial gastrectomy with a vagotomy. What was the purpose of performing the vagotomy?

To reduce acid and production

Granger, a 45-year-old editor, has a bleeding gastric ulcer. Despite multiple blood transfusions, his hemoglobin is 7.6 g/di and hematocrit is 28%. His doctor determines that intervention is necessary. Postoperatively, Mr. Granger should be assessed for dumping syndrome, a complication of partial gastrectomy. Which of the following are early signs and symptoms of dumping syndrome?

Diaphoresis and tachycardia

Granger, a 45-year-old editor, has a bleeding gastric ulcer. Despite multiple blood transfusions, his hemoglobin is 7.6 g/di and hematocrit is 28%. His doctor determines that intervention is necessary. How should the nurse instruct Mr. Granger to decrease the effects of dumping syndrome?

Tell the patient to sit in a semirecumbent position during and immediately following meals.

The stools of a child with Hirschsprung's disease are best described as:

Ribbon - or pellet-like

A client has been admitted to the hospital with fever, diarrhea, cramping, abdominal pain, and weight loss. Upon assessing the client it has been found out that he has a history of Crohn's disease. The nurse would anticipate which of the following laboratory findings?

Hypokalemia

A client with ulcerative colitis has been placed on steroid therapy. The client asks the nurse why is he on this kind of therapy if steroid can be potentially dangerous to him. Which of the following statements by the nurse is correct regarding the use of steroid therapy to a client with ulcerative colitis?

"Long-term use of steroids will prolong periods of remission"

Aling Marlet, 49 years old, was admitted to the hospital due to complain of frequent nausea and vomiting hours after heavy meal. Cholelithiasis was ruled out after series of laboratory exams was performed. Nurse Sassy has just received Aling Marlet's lab results from the laboratory department. Upon evaluation, she notes that which of the following is an expected laboratory finding in a client with cholelithiasis?

Elevated serum bilirubin

Aling Marlet, 49 years old, was admitted to the hospital due to complain of frequent nausea and vomiting hours after heavy meal. Cholelithiasis was ruled out after series of laboratory exams was performed. In assessing Aling Marlet who has cholelithiasis, nurse Sassy would expect the client to report pain in what site?

Right upper abdomen radiating to the back or right shoulder

Which of the following statements accurately describes the cause of pain in cholelithiasis?

When the gallstone obstruct the cystic duct the gallbladder becomes distended, inflamed, and eventually infected

Nicandro, a 67 year old Retired General, was admitted at St. Luke's Medical Center due to liver cirrhosis. Nurse Mark was assigned to care for this client. Nurse Mark is providing health teaching to Nicandro. Which of the following statements if made by the client indicates a need for further instructions?

"I will take Tylenol if I get headache."

Nicandro, a 67 year old Retired General, was admitted at St. Luke's Medical Center due to liver cirrhosis. Nurse Mark was assigned to care for this client. The physician arrives on the nursing unit and deflates the Sengstaken-Blakemore tube. Afterward, the nurse should inform the client closely for which of the following?

Hematemesis

Nicandro, a 67 year old Retired General, was admitted at St. Luke's Medical Center due to liver cirrhosis. Nurse Mark was assigned to care for this client. Nurse Mark is reviewing the chart of Nicandro and expecting to find which of the following laboratory values?

Increased serum ammonia

Nicandro, a 67 year old Retired General, was admitted at St. Luke's Medical Center due to liver cirrhosis. Nurse Mark was assigned to care for this client. Nurse Mark is reviewing the record of Mang Nicandro and note that there is a documentation of the presence of asterixis. How should he assess for its presence?

Ask the client to extend the arms

Nicandro, a 67 year old Retired General, was admitted at St. Luke's Medical Center due to liver cirrhosis. Nurse Mark was assigned to care for this client. Which diet does Nurse Mark anticipate to be prescribed for this client?

Low-protein diet

Nurse Brenty admits Mrs. Ruby, a 30-year-old, was brought to the Emergency room by his husband because of severe abdominal pain. He was observed to be very anxious; holding his abdomen with his right hand while bending towards his right side. The Emergency Room doctor referred the patient to the Surgical doctor on duty for further assessment. made his initial assessment and Nurse Brenty assesses pain intensity of Mrs. Ruby. The pain assessment tool APPROPRIATE to be used for Mrs, Ruby is?

Numeric Rating Scale

Nurse Brenty admits Mrs. Ruby, a 30-year-old, was brought to the Emergency room by his husband because of severe abdominal pain. He was observed to be very anxious; holding his abdomen with his right hand while bending towards his right side. The Emergency Room doctor referred the patient to the Surgical doctor on duty for further assessment. made his initial assessment and Mrs. Ruby was diagnosed with ruptured appendicitis. When appendix is suspected ruptured, a generalized abdominal pain is felt and become:

Merely a discomfort and steady rather that intermittent

Nurse Brenty admits Mrs. Ruby, a 30-year-old, was brought to the Emergency room by his husband because of severe abdominal pain. He was observed to be very anxious; holding his abdomen with his right hand while bending towards his right side. The Emergency Room doctor referred the patient to the Surgical doctor on duty for further assessment. made his initial assessment and To describe a sensation of severe pain felt for ruptured appendicitis, Nurse Brenty applies moderate pressure of her finger into the abdomen at a point away from the pain and then releases. This maneuver is termed as:

Rovsing's sign

A client has just returned to a nursing unit after an above-the-knee amputation of the right leg. A nurse places the client in which of the following most appropriate positions?

Supine with the stump supported with pillows

After medical intervention for a long bone fracture the nurse is instructed to watch for signs and symptoms of developing fat embolism. Which of the following observation should the nurse report?

Petechial rashes on the upper chest and neck

A client is being admitted to the acute care facility with an initial diagnosis of osteomyelitis, what type of organism usually causes this disorder?

S. aureus

Which of the following are true with crutches?

The client's body should be erected, weight supported by the hands and the axilla is off the crutches

A 19-year-old patient is about to be delivered in the operating room for repair of a midshaft femur fracture after a vehicular accident. The nurse is aware that a possible lethal complication of femur fracture after is fat embolism syndrome (FES) that usually occurs

24-48 hours after surgery

Health teaching the nurse will provide to a patient diagnosed with osteoarthritis.

Weight reduction

Mr. XANDER CYRUS has had a total right hip replacement. The nurse understands that this operative hip is kept in extension and abduction because this position:

Helps prevent dislocation of the hip prosthesis

The nurse observes that a female client has asymmetry of the shoulder, hips and the tailhem of her dress. The nurse suspects that the client may be presenting with which of the following disorders?

Scoliosis

A patient is asking the nurse about Rheumatoid Arthritis. The nurse best response would be:

A chronic inflammatory disease that has an autoimmune component

A patient with Rheumatoid Arthritis will most often have pain and limited movement of joints especially:

When room is cool

A patient camè in due to joint pains. The doctor says that she has Osteoarthritis. The nurse explains that an important risk factor in development of Osteoarthritis is:

Obesity

Which of the following conditions or actions can cause primary osteoarthritis?

Overuse of joints, aging and obesity

In advanced gout, urate crystal deposits develop on the hands, knees, feet, forearms, ear and Achilles tendon. Which of the following terms refers to these deposits?

Tophi

A client has been prescribed a diet that limits purine-rich foods. Which of the following foods would the nurse teach her to avoid eating?

Anchovies, sardines, kidneys

A fracture is suspected when the nurse observes the ff, except:

Increase in the length of the limb

Carpal tunnel syndrome occurs due to the injury of which of the ff nerves:

Median nerve

Which blood analysis test would be consistent with a diagnosis of rheumatoid arthritis?

Elevated ESR, positive C-reactive CHON, positive RH factor

Which of the following drugs are used by a client with gouty arthritis for acute attacks?

Colchicine

Pharsa Abelgas, a 40-year-old woman, has a history of Rheumatold Arthritis for the last ten years. The following questions refer to this situation. Which of the following is a common sign/ symptom off rheumatoid arthritis?

Deformity and displacement of PIP/DIP

Pharsa Abelgas, a 40-year-old woman, has a history of Rheumatold Arthritis for the last ten years. The following questions refer to this situation. Which of the following would NOT be a common laboratory finding in rheumatoid arthritis?

Negative Lupus Erythematosus (LE) prep

Pharsa has been taking steroids for the last five years to control her arthritis. Which of the following is a common side effects of steroid therapy?

Increased blood glucose

Which of the following diets is best suited to decrease the side effects of Pharsa's steroid therapy?

Low carbohydrate, high protein, high potassium

You are a staff nurse in the Musculo-skeletal Unit of the hospital. You are taking care of patients with varied musculoskeletal conditions. Which of the following inflammatory conditions commonly occurs in the shoulder? 1. Bursitis 2. Carpal Tunnel Syndrome 3. Tendonitis 4. Dupuytrens

1 and 3

Which of the following is NOT considered a conservative treatment for inflammatory conditions of the shoulder?

Laser photo-therapy

100

Impaired movement of the rotator cuff of the shoulder is generally termed as Impingement Syndrome. Edema, which is an early manifestation of this syndrome, is due to

Acute trauma of the shoulder

Astignars random QS

Kyla Angelique Son · 19問 · 1年前

Astignars random QS