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Exam (elaborations)

VATI Med Surg New – Questions & Answers

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VATI Med Surg New – Questions & Answers

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  • November 24, 2023
  • 20
  • 2023/2024
  • Exam (elaborations)
  • Questions & answers
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VATI Med Surg New – Questions & Answers
A nurse is collecting data from a client who has right-sided heart failure.
Which of the following findings should the nurse expect? (Select all that
apply.) ✔️Ans - Poripheral edema
Hepatomegaly
Abdominal distention

A nurse is caring for a client who has heart failure and a new prescription for
furosemide. The nurse should monitor the client for which of the following
adverse effects of the medication? ✔️Ans - Tinnitus

The nurse should monitor clients who take furosemide for tinnitus and
hearing loss. Audiometry is recommended for clients recelving prolonged IV
furosemide.

A nurse is reinforcing teaching with a client who is recovering from severe
diarrhea and is ready to resume eating solid foods. Which of the following
food items should the nurse recommend? ✔️Ans - Yogurt

The nurse should recommend adding yogurt to the diet to provide probiotics
and add substance to the stool, making it more formed. A client who is
recovering from diarrhea should consume a diet that is low in fiber. Taking
probiotics can also help restore the natural gastrointestinal flora.

A nurse is monitoring a client who has a new prescription for furosemide for
peripheral edema. For which of the following adverse effects should the nurse
monitor? ✔️Ans - Muscle weakness

Furosemide is a loop diuretic, which is used to treat hypertension and edema.
Furosemide can cause excess excretion of potassium. The nurse should
monitor the client for manifestations of hypokalemia such as nausea, muscle
weakness, and spasms.

A nurse is contacting the provider of a client who has heart failure and a
potassium level of 3.4 mEq/L. Which of the following client medications
should the nurse expect the provider to withhold? ✔️Ans - Digoxin

,The nurse should expect the provider to withhold digoxin when the client's
potassium level is low to decrease the client's risk of dysrhythrmias due to
digoxin toxicity. Potassium assists in displacing digoxin, because digoxin binds
to potassiurm, and reduces the risk for digoxin toxicity.

A nurse is assisting with the care of a client who has cellulitis and is receiving
IV ceftriaxone. During data collection, the nurse notes the client is flushed and
the client reports urticaria. After stopping the IV infusion, which of the
following actions should the nurse take first? ✔️Ans - Check the client's
respirations.

After stopping the IV infusion, the first action the nurse should take when
using the airway, breathing, circulation approach to client care is to count the
client's respirations and monitor for dyspnea because a client experiencing an
allergic reaction can progress to anaphylactic shock and death.

A registered nurse (RN) in an acute care facility is caring for a group of clients
with the assistance of a licensed practical nurse (LPN). Which of the following
tasks should the RN delegate to the LPN? (Select all that apply.) ✔️Ans -
Inserting an NG tube
Monitoring an IV infusion
Administering IM medications

A nurse is reinforcing teaching with a young adult client about testicular self-
examination. Which of the following instructions should the nurse include?
✔️Ans - "Examine your testicles after a warm shower."

After exposure to warm water in a shower or bath, the scrotum relaxes and
becomes easy to palpate. The testicle should feel smooth and round, and the
client should report any lumps to his provider.

A nurse is assisting in the planning of a health education class for a group of
older adult clients. Which of the following recommendations should the nurse
include? ✔️Ans - Obtain a pneumococcal immunization

The pneumococcal immunization should be obtained to prevent pneumonia
and is generally given at or near the age of 65, One dose provides lifelong
immunity

, A nurse is preparing to administer eardrops to an adult client who has otitis
media. Which of the following actions should the nurse plan to take? ✔️Ans -
Warm the bottle by holding it in the palm for 5 min before administration.

The nurse should plan to warm the bottle of drops slightly by holding it in the
palm of the hand or putting the bottle in a pocket for about 5 min.
Administering cold ear drops can cause the client to experience discomfort or
dizziness.

A nurse is reinforcing teaching about the use of an oxygen concentrator in the
home for a client who has end-stage emphysema. Which of the following
instructions should the nurse include to promote client safety? ✔️Ans -
Maintain an electrical backup system.

medical services and the electric company of the The nurse should remind the
client to maintain an electrical backup system to ensure continuity of oxygen
therapy. This includes notifying local emergency use of home oxygen
equipment. In the event of power loss, the client should notify 911, the
provider, and the home health care agency.

A nurse is caring for a client who is receiving continuous bladder irrigation
following a transurethral resection of the prostate. The client has reduced
urinary output, red urine, and reports bladder pain. Which of the following
actions should the nurse take first? ✔️Ans - Increase the flow rate of the
irrigation

When providing client care, the nurse should use the least restrictive
intervention first; therefore, the nurse should first increase the flow rate of
continuous bladder irrigation to keep the urinary output light pink or yellow.

A nurse is reinforcing teaching with a newly licensed nurse about enoxaparin.
The nurse should include in the teaching that which of the following
medications can interact with enoxaparin? (Select all that apply.) ✔️Ans -
Clopidogrel
Aspirin
Ginkgo biloba

A nurse is collecting data from a client who has hypokalemia. Which of the
following findings should the nurse expect? ✔️Ans - Cardiac dysrhythmias

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