MED SURG FINAL STUDY EXAMS AND
ANSWERS
A nurse is caring for a client who is postprocedure following
lumbar puncture and reports a throbbing headache when sitting
upright. Which of the following actions should the nurse take?
(Select all that apply)
a.) Use the Glasgow Coma Scale when ass...
A nurse is caring for a client who is postprocedure following
lumbar puncture and reports a throbbing headache when sitting
upright. Which of the following actions should the nurse take?
(Select all that apply)
a.) Use the Glasgow Coma Scale when assessing the client
b.) Assist the client to a supine position
c.) Administer an opioid medications
d.) Encourgae the client to increase fluid intake
e.) Instruct the client to perform deep breathing and coughing
exercises - CORRECT ANSWER-b,c,d
A nurse is caring for a client who experienced a traumatic head
injury and has an intraventricular catheter (ventriculostomy) for
ICP monitoring. The nurse should monitor the client for which of
the following complications related to the ventriculostomy?
a.) Headache
b.) Infection
,c.) Aphasia
d.) Hypertension - CORRECT ANSWER-b
A nurse is assessing a client for changes in the level of
consciousness using the Glasgow Coma Scale (GCS). The
client opens his eyes when spoken to, speaks incoherently, and
moves his extremities when pain is applied. Which of the
following GCS scores should the nurse document?
a.) E2+V3+M5 = 10
b.) E3+V4+M4= 11
c.) E4+V5+M6= 15
d.) E2+V2+M4= 8 - CORRECT ANSWER-b
A nurse is developing a plan of care for a client who is
scheduled for a cerebral angiography with contrast media.
Which of the following statements by the client should the nurse
report to the provider? (Slect all that apply)
a.) "I think I might be pregnant."
b.) "I take warfarin."
c.) "I take antihypertensive medication."
d.) "I am allergic to shrimp."
e.) "I ate a light breakfast this morning." - CORRECT
ANSWER-a,b,d,e
,A nurse is providing a education to a client who is to undergo
an electroencephalogram (EEG) the next day. Which of the
following information should the nurse include in the teaching?
a.) "Do not wash your hair the morning of the procedure."
b.) "Try to stay awake most of the night prior to the procedure."
c.) "The procedure will take approximately 15 minutes."
d.) "You will need to lie flat for 4 hours after the procedure." -
CORRECT ANSWER-b
A nurse is assessing a client who has a seizure disorder. The
client tells the nurse, "I am about to have a seizure." Which of
the following actions should the nurse implement?
a.) provide privacy
b.) Ease the client to the floor if standing
c.) Move furniture away from the client
d.) Loosen the client's clothing
e.) Protect the client's head with padding
f.) Restrain the client - CORRECT ANSWER-a,b,c,d,e
A nurse is caring for a client who just experienced a
generalized seizure. Which of the following actions should the
nurse perform first?
a.) Keep the client in a side-lying position
b.) Document the duration of the seizure
, c.) Reorient the client to the environment
d.) Provide client hygeine - CORRECT ANSWER-a
A nurse is providing discharge instructions to a client who has a
prescription for phenytoin. Which of the following information
should the nurse include?
a.) Consider taking an antacid on this medication
b.) Watch the receding gums when taking the medication
c.) Take the medication at the same time everyday
d.) Provide a urine sample to determine therapeutic levels of
the medication - CORRECT ANSWER-c
A nurse is reviewing trigger factors that can cause seizure with
a client who has a new diagnosis of generalized seizures.
Which of the following information should the nurse include in
this review? (Select all that apply)
a.) Avoid overwhelming fatigue
b.) Remove caffeinated products from diet
c.) Limit looking at flashing lights
d.) Perform aerobic exercise
e.) Limit episodic of hypoventilation
f.) Use of aerosol hairspray is reccomended - CORRECT
ANSWER-a,b,c
A nurse is completing discharge teaching to a client who has
seizures and recieved a vagal nerve simulator to decrease
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