Med Surg Hesi BSN 266 Practice Questions and Answers.
A female client who received a nephrotoxic drug is admitted with acute renal failure and asks the
... [Show More] nurse
if she will need dialysis for the rest of her life. Which pathophysiologic consequence should the nurse
explain that supports the need for temporary dialysis until acute tubular necrosis subsides?
Nephron obstruction
An emaciated homeless client presents to the emergency department complaining of a
productive cough, with blood-tinged sputum and night sweats. Which action is most
important for the emergency department triage nurse to implement for this client?
Initiate airborne infection precautions.
A client is being discharged following radioactive seed implantation for prostate cancer.
What is the most important information that the nurse should provide to this client's family?
Follow exposure precautions.
A 77-year-old female client is admitted to the hospital with confusion and anorexia of
several days' duration. She has symptoms of nausea and vomiting and is currently
complaining of a headache. The client's pulse rate is 43 beats/min. The nurse is most
concerned about the client's history related to which medication?
Digoxin
The nurse is planning care for a client with diabetes mellitus who has gangrene of the toes
to the midfoot. Which goal should be included in this client's plan of care? Prevent
infection.
The nurse is caring for a critically ill client with cirrhosis of the liver who has a nasogastric
tube draining bright red blood. The nurse notes that the client's serum hemoglobin and
hematocrit levels are decreased. Which additional change in laboratory data should the
nurse expect? Decreased serum ammonia level
A client who is receiving an angiotensin-converting enzyme (ACE) inhibitor for hypertension
calls the clinic and reports the recent onset of a cough to the nurse. Which action should the
nurse implement? Encourage the client to keep taking the drug until seen by the
health care provider.
The nurse is assessing a male client with acute pancreatitis. Which finding requires the most
immediate intervention by the nurse? While the nurse is taking the client's blood
pressure, he has a carpal spasm. |The client has a carpal spasm when taking a
blood pressure.
The nurse is administering a nystatin suspension for stomatitis. Which instruction will the
nurse provide to the client when administering this medication? "Hold the medication in
your mouth for a few minutes before swallowing it."
Which nursing action is necessary for the client with a flail chest? Encourage coughing
and deep breathing.
Which consideration is most important when the nurse is assigning a room for a client being
admitted with progressive systemic sclerosis (scleroderma)?
Provide a room that can be kept warm.
When a nurse assesses a client receiving total parenteral nutrition (TPN), which laboratory
value is most important for the nurse to monitor regularly? Glucose
The nurse on a medical-surgical unit is receiving a client from the postanesthesia care unit
(PACU) with a Penrose drain. Before choosing a room for this client, which information is
most important for the nurse to obtain? If the client's wound is infected
One day after a Billroth II surgery, a male client suddenly grabs his right chest and becomes
pale and diaphoretic. Vital signs are assessed as blood pressure 100/80 mm Hg, pulse 110
beats/min, and respirations 36 breaths/min. Which action is most important for the nurse to
take? Apply oxygen at 2 L via nasal cannula.
The nurse is reviewing routine medications taken by a client with chronic angle closure
glaucoma. Which medication prescription should the nurse question? Anticholinergic with a
side effect of pupillary dilation
When educating a client after a total laryngectomy, which instruction would be most
important for the nurse to include in the discharge teaching? Tell the client to carry a
medical alert card that explains his condition.
A home health nurse knows that a 70-year-old male client who is convalescing at home
following a hip replacement is at risk for developing pressure ulcers. Which physical
characteristic of aging puts the client at risk? Thinning of the skin, with loss of
elasticity
A client with alcohol-related liver disease is admitted to the unit. Which prescription should
the nurse call the health care provider about for reverification for this client? Nembutal
sodium at bedtime for rest
The nurse witnesses a baseball player receive a blunt trauma to the back of the head with a
softball. What assessment data should the nurse collect immediately? Ability to open the
eyes spontaneously before any tactile stimuli are given
During report, the nurse learns that a client with tumor lysis syndrome is receiving an IV
infusion containing insulin. Which assessment should the nurse complete first? Monitor the
client's serum potassium and blood glucose levels.
Which statement reflects the highest priority nursing diagnosis for an older client recently
admitted to the hospital for a new-onset cardiac dysrhythmia? Risk for injury related to
syncope and confusion
The home health nurse is assessing a male client being treated for Parkinson disease with
carbidopa-levodopa. The nurse observes that he does not demonstrate any apparent
emotion when speaking and rarely blinks. Which intervention should the nurse implement?
Document the presence of these assessment findings. [Show Less]