Exam (elaborations)
RN Adult Medical Surgical Online Practice 2023 B
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RN Adult Medical Surgical Online Practice 2023 B
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RN Adult Medical Surgical Online Practice 2023 Bx x x x x x x
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1. A nurse is caring for a client who presents to a clinic for a 1-week follow-
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up visit after hospitalization for heart failure. Based on the information in the c
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lient's chart, which of the following findings should the nurse report to the pro
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vider? (Click on the "Exhibit" button for additional information about the clien
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t. There are three tabs that contain separate categories of data.): Heart rate 55/
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min
Rational:
The client's heart rate of 55/min is a decrease from the client's baseline of 74/min, an
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d it can indicate the development of digoxin toxicity. The nurse should report this findi
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ng to the provider.
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2. A nurse is teaching a client about the use of transcutaneous electrical nerve s
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timulation (TENS) for the management of bone cancer pain. Thenurse should ex
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plain that applying a TENS unit to the painful area has which of the following effe
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cts?: A tingling sensation replacing the pain
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Rational:
A TENS unit applies small electric currents to the painful area, with the client increasin
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g the current until the "pins and needles" sensation overrides the pain.
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3. A nurse in an ICU is assessing a client who has a traumatic brain injury. W
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hich of the following findings should the nurse identify as a componentof Cu
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shing's triad?: Bradycardia x x
Rational:
A client who has increased intracranial pressure from a traumatic brain injury can dev
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elop bradycardia, which is one component of Cushing's triad. The other compo-
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nents of Cushing's triad are severe hypertension and a widened pulse pressure.
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4. A nurse is teaching a family about the care of a parent who has a new di-
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agnosis of Alzheimer's disease. Which of the following information shouldthe
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nurse include in the teaching?: Create complete outfits and allow the client to sele
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ct one each day.
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Rational:
The family should place completed outfits on hangers and allow the client to select wh
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ch one to wear each day.
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5. A nurse is planning care for a client who has extensive burn injuries and is i
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mmunocompromised. Which of the following precautions should thenurse incl x x x x x x x x
ude in the plan of care to prevent a Pseudomonas aeruginosa infection?-
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: Avoid placing plants or flowers in the client's room.
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1x/x27
, RN Adult Medical Surgical Online Practice 2023 B
x x x x x x x
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Rational:
Live plants can harbor P. aeruginosa, and this bacterium can infect burn wounds and
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cause life- x
threatening complications. The nurse should ensure no one brings live plants or flowe
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s into the client's room.
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6. A nurse is providing teaching to a client who has irritable bowel syndrome (I
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BS). Which of the following instructions should the nurse include in the teachi
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ng?: Increase fiber intake to at least 30 g per day.
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Rational:
Dietary fiber helps produce bulky, soft stools and establish regular bowel patterns.
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7. A nurse is assessing a client who has diabetes insipidus. Which of the f
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ollowing findings should the nurse expect?: Low urine specific gravity
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Rational:
An expected finding for a client who has diabetes insipidus is a urine specific gravity be
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ween 1.001 and 1.005. Decreased water reabsorption by the renal tubules is caused
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by an alteration in antidiuretic hormone release or the kidneys' responsive-
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xness to the hormone. x x x
8. A nurse is caring for a client who has a new prescription for total parenteral n
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utrition (TPN). The client is to receive 2,000 kcal per day. The TPN solution has
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500 kcal/L. The IV pump should be set at how many mL/hr? (Round the answer
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xto the nearest whole number. Use a leading zero if it applies. Do not use a trail
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ing zero.): 167 mL/hr
x x x
Rational:
mL/hr = x
4000/24 = 166.6 = 167 x x x x
9. A nurse is caring for a client who is 4 hr postoperative following a totalvagi-
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nal hysterectomy.Click to highlight the findings the nurse should report to the
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provider immediately.: Perineal pad saturated with blood, large clots present
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Change of blood pressure, heart rate of 102/min Ration
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al:
Perineal pad saturated with blood, large clots present, blood pressure trend, and hear
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rate of 102/min are correct. The client has manifestations of vaginal he-
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morrhage, including vaginal bleeding, blood clots, reduced blood pressure, and tach
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cardia. The nurse should report these findings to the provider.
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2x/x27
, RN Adult Medical Surgical Online Practice 2023 B
x x x x x x x
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10. A nurse is preparing to admit a client who has dysphagia.The nurse should p
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lan to place which of the following items at the client's bedside?: Suction machi
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ne
Rational:
The nurse should ensure that a suction machine is at the bedside of a client who has dys
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phagia to clear the client's airway as needed and reduce the risk for aspiration.
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11. A nurse is providing discharge teaching about infection prevention to a cli
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ent who is receiving chemotherapy. Which of the following statements by the
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client indicates understanding of the teaching?: "I can ask a friend to change my ca
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ts litter box."x x
Rational:
Changing a pet's litter box increases the client's risk of being exposed to toxoplas-
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xmosis.Therefore, the client should wear gloves or avoid changing the pet's litter box.
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12. A nurse is assessing a client who has had a plaster cast applied to their lef
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t leg 2 hr ago. Which of the following actions should the nurse take?: Check that
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one finger fits between the cast and the leg.
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Rational:
To make sure the cast is not too tight, the nurse should be able to slide one finger und
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er the cast. It is not uncommon for casts to loosen as swelling subsides, but that should
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not be an issue 2 hr after application.
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13. A nurse is performing a preoperative assessment for a client. The nurse s
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hould identify that an allergy to which of the following foods can indicate a lat
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ex allergy?: Avocados
x x
Rational:
Clients who have an avocado allergy might have an allergic reaction or a sensitivity to lat
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ex. Allergies to certain fruits, such as strawberries and bananas, can also indicate late
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x allergy or sensitivity.
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14. A nurse is caring for a client who has diabetic ketoacidosis (DKA). Which o
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f the following should the nurse plan to administer?: Regular insulin 20 units IV
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bolus
Rational:
DKA is a complication of diabetes mellitus that results in dehydration, ketosis, metabo
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lic acidosis, and elevated blood glucose levels. Management of DKA involves providing
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hydration, correcting acid-base imbalances, and decreasing blood glucose
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3x/x27
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