Medsurg Last PDF

**MEDSURG LAST** 1. Before discharge, the nurse educates her client who has had a lithotripsy that he should? **Watch for stone debris in the urine for 1 to 4 weeks** 2. When a client comes into a medical clinic with complaints of urgency, frequency, pain in the area of the symphysis...

**MEDSURG LAST** 1. Before discharge, the nurse educates her client who has had a lithotripsy that he should? **Watch for stone debris in the urine for 1 to 4 weeks** 2. When a client comes into a medical clinic with complaints of urgency, frequency, pain in the area of the symphysis pubis, and dark cloudy urine, the nurse suspects that this client is experience? **Cystitis, probably from bacterial infection** 3. The home health client has a diagnosis of cystitis and placed on the medication Phenazopyridine (Pyridium). The nurse should instruct the client. **urine changes color** 4. The nurse is caring for a client with acute glomerulonephritis is aware that inflammation of the capillary loops in the glomeruli can lead to. **Moderate to high blood pressure** 5. A client with chronic kidney disease is complaining of being very weak and short of breath due to a low hemoglobin. What should the nurse know as being the best explanation for the anemia? **Secretion of erythropoietin by the diseased kidney is decreased** 6. A client recovering from a thyroidectomy is being assessed for tetany. What is the most likely cause of tetany after this surgery? **Accidental removal of the parathyroid gland** 7. The nurse is planning care for a client with diabetes insipidus. What data should the nurse monitor for this client? **Intake and output, daily weights** 8. A client enters the emergency room in adrenal crisis. The client is lethargic, and his vital signs include a blood pressure of 82/52 mmHg and a pulse of 88 BPM. Which event in the client's week most likely caused this crisis? **Being laid off from a job** 9. A client is diagnosed with hyperthyroidism. The nurse realizes the most common cause of this disorder is. **Graves' disease** 10. A client asks what can be done to prevent the long-term complications of diabetes. How should the nurse best respond to the client's question? **Keep your blood sugars under 120"** 11. A diabetic client has been given 10 units of regular insulin at 0730. When should the nurse watch for signs of hypoglycemia as a result of receiving the insulin? **0930-1030** 12. Antidiuretic hormone is a hormone that acts on the kidneys to? **Reduce urine volume and prevent dehydration** 13. The nurse is caring for a client with diabetes. For which symptom that the client may exhibit should the nurse be most concerned? **Diaphoresis** 14. The nurse is assisting in the education of diabetic clients about complications with this disease. What information should the nurse include as factors that may contribute to hyperglycemia? **Stress or illness** 15. A medication record for a client reads to administer Lispro (Humalog) insulin 15 units subcutaneously at 0800. Which of the following actions should the nurse take in giving this medication? **Administer the medication when the breakfast tray is in front of the client** 16. A client is being diagnosed with diabetic keto acidosis. Which symptoms should the nurse expect to see in the client? **Kussmaul respiration** 17. A nurse is caring for a client with a diagnosis of gastroesophageal reflux. Which of the following instructions should the nurse reinforce in her teaching? **Remain in an upright position for 2 hours after eating"** 18. The nurse is caring for a client with an inflamed appendix. What complication is most likely to occur if the appendix ruptures? **Peritonitis** 19. A client who is morbidly obese tells her HCP she is very unhappy about her weight. The nurse knows the treatment plan will initially include. **Diet management** 20. A client is scheduled for a paracentesis. What does the nurse teach the client about the procedure? **A needle is inserted into the abdomen to remove ascitic fluid** 21. A client presents with a strangulated hernia. What does the nurse tell the client about this condition? **"It occurs when intestinal flow and blood flow is obstructed from the organ"** 22. The nurse is supposed to check Chvostek's sign to see if the client is experiencing tetany after the removal of the thyroid gland. How does she perform this? **Tap the face over the facial nerve** 23. The nurse is caring for a client with a sliding hiatal hernia. Which position should the nurse expect the client to report that the symptoms are more severe? **Lying down** 24. The nurse is checking the patency of a new right arm AV fistula to be used for hemodialysis. How does the nurse monitor that the fistula is patent? **Palpate for a thrill and listen for a bruit over the fistula** 25. The nurse is caring for a client with acute kidney injury. Which of the following actions should the nurse take to obtain the most accurate assessment of fluid balance for the client? **Obtain a daily weight** 26. A nurse is caring for a client with a small bowel obstruction from adhesions. Which assessment finding is consistent with this diagnosis? **Large amount vomitus with a fecal odor** 27. A client enters a clinic with possible Cushing\'s syndrome. Which of the following physical assessment findings support this diagnosis? **Stria, easy bruising** 28. The nurse is collecting data from a client who has developed jaundice and dark amber urine. The nurse recognizes that which of the following is the probable cause for these symptoms? **Bile duct** 29. A client with cirrhosis of the liver can have portal hypertension. The most serious result of portal hypertension is? **Bleeding esophageal varices** 30. A nurse is reinforcing teaching with a client who has had a gastrectomy. Which client statement indicates an understanding of why the client will need to receive Vitamin B12 for life? **As a result of your surgery, you can develop pernicious anemia** 31. A nurse is collecting a health history from a client. Which of the following client data should the nurse identify as a risk factor for contracting Hepatitis C? **Having many tattoos** 32. While collecting data, the nurse suspects that the client may have renal calculi. What did the nurse assess in the client to come to this conclusion? (Select all that apply) **\*Flank pain** **\*Nausea** **\*Pain radiating to the pubic area** 33. A client is prescribed a dose of epinephrine due to a deficiency in the adrenal medulla. What effects should the nurse expect to see her client show after receiving this medication? (Select all that apply) **\*Stimulates vasoconstriction of the skin** **\*Stimulates the liver to convert glycogen to glucose** **\*Decreased peristalsis** **\*Increases heart rate and force of contraction** 34. A nurse is collecting data from a client who has a gastric ulcer. Which of the following are expected findings? (Select all that apply) **\*Pain while palpating stomach area** **\*Pain while eating a meal** **\*Complaints of bloating** 35. A client has a diagnosis of diverticulitis. What nursing interventions should the nurse perform for this client? (Select all that apply) **\*Tell the client to drink more fluids** **\*Exercise regularly** **\*Tell the client to take antibiotics as ordered** 36. A client with Type 1 diabetes is having a hypoglycemic reaction. Which of the following does the nurse recognize as signs of hypoglycemia? (Select all that apply) **Profound perspiration** **Tremors** **Nervousness** 37. A client is scheduled for a renal biopsy in 1 hour. The HCP has ordered Ativan 1.5 mg IM to be given 30 minutes prior to the test. The vial reads Ativan 2 mg/ml. How many milliliters will the nurse administer? (Round to the nearest tenth) **0.80** 38. A client with Addison's disease has an order to receive Methylprednisolone 60 mg every 6 hours intravenously. The label on the vial reads 40 mg of Methylprednisolone in every 1 ml. How many milliliters will the nurse draw in the syringe to give the client? **1.50** 39. A client is in diabetic ketoacidosis. The HCP has ordered the client to start on an Insulin drip. The order reads Regular insulin 100 units in 100 milliliters of Normal Saline. How many units per milliliter is in the bag? **1.00** 40. The HCP writes an order for the diabetic client to receive 1 liter of Dextrose over 10 hours. The drip factor is 20. How many milliliters per hour will the client receive? **33** 41. The HCP orders Ampicillin 2 grams IV to be given every 8 hours. The medication is diluted in 50 milliliters of Normal Saline to infuse over 30 minutes. With a tubing with a drop factor of 60 what will the nurse infuse the medication at? **100** 42. A client is admitted with hypoparathyroidism.  When collecting data on the client, the nurse should expect to see which sign or symptom? **Hand twitching** 43. A client is admitted for acute pyelonephritis and is about to start antibiotic therapy.  Which symptoms would the nurse expect to find in this client? **Flank pain on the affected side** A client with hypothyroidism who experiences trauma, emergency surgery, or even an infection is at risk for developing which condition? **Myxedema coma** Murphys sign -- liver Pancrelipase for pancreatitis Hepaticencepalothy -- too much pneumonia -- lactulose Hepaticencepalothy- Diagnosis for it, altered level of mental status Ulcerative colitis -- s&s -- pain, frequent stools, anemia Barium swallow -- chalky dye, outlines esophagus Pt teaching for after procedure- move around, drink fluid, white stools white to grey. Complication of cirrhosis - , portal hypertension CHEAP, PG 658. ? Pacreatits -- labs? Cause- stone, Lq, Gallbladder disease, smoking, lipids Ha1c 3-4 months of how well glucose has been normal **[Pt for surgery hold which meds -- nsaids, metformin, warfarin ]**