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MED-SURG AGENCY II GU NCLEX EXAM BRAND NEW ACTUAL EXAM UPDATED WITH VERIFIED AND APPROVED QUESTIONS WITH WELL ELABORATED ANSWERS AND RATIONALE (GRADED A+) $19.99
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MED-SURG AGENCY II GU NCLEX EXAM BRAND NEW ACTUAL EXAM UPDATED WITH VERIFIED AND APPROVED QUESTIONS WITH WELL ELABORATED ANSWERS AND RATIONALE (GRADED A+)
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Course
MED-SURG AGENCY II GU NCLEX
Institution
MED-SURG AGENCY II GU NCLEX
MED-SURG AGENCY II GU NCLEX EXAM BRAND NEW
ACTUAL EXAM UPDATED WITH VERIFIED AND
APPROVED QUESTIONS WITH WELL ELABORATED
ANSWERS AND RATIONALE (GRADED A+)
The nurse is caring for a client diagnosed with bulimia. The most
appropriate initial goal for a client diagnosed with bulimia is to:...
The nurse is caring for a client diagnosed with bulimia. The most
appropriate initial goal for a client diagnosed with bulimia is to:
1. avoid shopping for large amounts of food.
2. control eating impulses.
3. identify anxiety-causing situations.
4. eat only three meals per day. - ANSWER-3. identify anxiety-causing
situations.
RATIONALES: Bulimic behavior is generally a maladaptive coping
response to stress and underlying issues. The client must identify
anxiety-causing situations that stimulate the bulimic behavior and
then learn new ways of coping with the anxiety. Controlling shopping
for large amounts of food isn't a goal early in treatment. Managing
eating impulses and replacing them with adaptive coping
mechanisms can be integrated into the plan of care after initially
addressing stress and underlying issues. Eating three meals per day
isn't a realistic goal early in treatment.
,2|Page
A client with a serum glucose level of 618 mg/dl is admitted to the facility.
He's awake and oriented. He has hot, dry skin and the following vital signs:
a temperature of 100.6° F (38.1° C), a heart rate of 116 beats/minute, and
a blood pressure of 108/70 mm Hg. Based on these findings, which nursing
diagnosis takes highest priority?
1. Deficient fluid volume related to osmotic diuresis
2. Decreased cardiac output related to elevated heart rate
3. Imbalanced nutrition: Less than body requirements related to insulin
deficiency
4. Ineffective thermoregulation related to dehydration - ANSWER-1.
Deficient fluid volume related to osmotic diuresis
RATIONALES: A serum glucose level of 618 mg/dl indicates
hyperglycemia, which causes polyuria and deficient fluid volume. In
this client, tachycardia is more likely to result from deficient fluid
volume than from decreased cardiac output because his blood
pressure is normal. Although the client's serum glucose is elevated,
food isn't a priority because fluids and insulin should be administered
to lower the serum glucose level. Therefore, a diagnosis of
Imbalanced nutrition: Less than body requirements isn't appropriate.
A temperature of 100.6° F isn't life-threatening, which eliminates
ineffective thermoregulation as the top priority.
,3|Page
A pregnant client in her second trimester visits the health care practitioner
for a regular prenatal checkup. The nurse weighs the client. She then
compares the client's current and previous weights. During the second
trimester, how much weight should the client gain per week?
1. 0.5 lb (0.23 kg)
2. 1 lb (0.45 kg)
3. 1.5 lb (0.68 kg)
4. 2 lb (.91 kg) - ANSWER-2. 1 lb (0.45 kg)
RATIONALES: During the second and third trimesters, weight gain
should average about 1 lb per week in a client with a single fetus. A
woman with a multiple-fetus pregnancy should gain about 1.5 lb per
week, on average, during the second half of pregnancy.
The nurse is caring for a client with pneumonia. As part of prescribed
therapy, the client must use a bedside incentive spirometer to promote
maximal deep breathing. The nurse checks to make sure the client is using
the spirometer properly. During each waking hour, the client should perform
a minimum of how many sustained, voluntary inflation maneuvers?
1. 1 to 2
, 4|Page
2. 3 to 4
3. 5 to 7
4. 8 to 10 - ANSWER-4. 8 to 10
RATIONALES: The client should perform at least 8 to 10 sustained,
voluntary maximal inflation maneuvers with the incentive spirometer
during each waking hour. Performing fewer than 8 maneuvers would
reduce the respiratory benefits of this therapy.
A client admitted to the facility for treatment for tuberculosis receives
instructions about the disease. Which statement made by the client
indicates the need for further instruction?
1. "I will have to take the medication for up to a year."
2. "This disease may come back later if I am under stress."
3. "I will stay in isolation for at least 6 weeks."
4. "I will always have a positive test for tuberculosis." - ANSWER-3. "I will
stay in isolation for at least 6 weeks."
RATIONALES: The client needs to be in isolation for 2 weeks, not 6,
while receiving antitubercular drug therapy. After 2 weeks of
antitubercular therapy, the client is no longer considered contagious.
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