NUR 2311 Medical –Surgical (Adult Health) Exit HESI.

NUR 2311 Medical –Surgical (Adult Health) Exit HESI. Client developed syndrome of inappropriate antidiuretic hormone (SIADH) assoc with small cell CA of lung and preparing for DC. When teaching about self-management with demeclocycline (declomycin), instruct to report what? Muscle cramping Determining the client position for insertion of indwelling catheter, Most important? Orthopnea Nurse teaching male with multiple sclerosis (MS) how to empty bladder using creude method. When performing return demonstration pt applies pressure to the umbilical area of his abdomen. What instruction? Apply downward manual pressure at the suprapubic region 35 yr old female client admitted to post anesthesia recovery unit following a partial thyroidectomy. What statement reflects accurate understanding of expected outcome for client? Supplemental hormone therapy will probably be necessary Following insertion of a LeVeen shunt in client with cirrhosis, which assessment finding indicates the shunt is effective? Decreased abdominal girth Finding a client sitting on the floor, nurse calls for help from UAP. Which task can ask to do? Get a BP cuff Client diagnosed with frontal lobe Glioma, benign tumor. Teaching about tumor what information? Personality changes or expressive aphasia are likely Greatest benefit for the client with which problem related to DM to change from the use of insulin syringes to using an insulin pen for med administration? Diminished dexterity due to dinger paresthesias Nurse evaluating asthmatic client’s response to an inhaled corticosteroid med. What assess finding indicates the med has been effective in controlling asthma symptoms. Increased peak flow meter rates Planning care for client with diagnosis of “impaired mobility” nurse instructs the UAP to assist client with ambulation. HCP has prescription for bed rest. Action Change the planned interventions to include range of motion exercises rather than ambulation Nurse is preparing DC client from hosp who has aphasia secondary to CVA. What instruction to family to help communicate? Be consistent in using the same words each time a Q is asked When assessing a restless, intubated client on mechanical ventilation, nurse auscultates breath sounds on right side only. Action Reposition the depth of the ET tube FrmRN2u Nurse is assessing a client following a thoracotomy and left lung pneumonectomy. What assess finding anticipate? Absent breath sounds on the left side of the chest Male client with type 1 DM takes a combination of short-acting and intermediate-acting insulin. Client complains of headache when awakening, blood glucose average for the past week has been 210ng/dl. Nurse recognizes client is experiencing a daily or rebound effect. Which dosing method Move the PM intermediate-acting dose to bedtime Which condition would likely cause secondary polycythemia High altitude exposure Nurse caring for 42 year old male excreting less sodium than consuming. If continues, what complication? Edema What instruction is most important for the nurse to provide a client with neutropenia Avoid sources of potential infection Client with acute laryngitis reports feeling “SOB”. Nurse assesses RR and it has increased from 16 to 28. What intervention? Assess for stridor and increased respiratory effort When caring for client who had craniotomy yesterday for removal of pituitary tumor, which finding indicates further info is needed? UO for 8 hrs is 2000 ml with specific gravity of 1.001 Nursing action has highest priority in preventing post-op bleeding following a sub-mucosal resection for deviated septum? Maintain intact nasal packing Female client chooses prophylactic mastectomy for positive BRCA1, mother died of breast CA at age 30, cousin diagnosed at age 28. Intervention Ensure adequate pain control using postoperative analgesics Client with pneumonia admitted with severe SOB, ABGs pH 7.30, PaO2 60, PaCO2 62, HCO3 35. Which needs immediate communication to HCP? Drowsiness and diff in arousing Nurse is caring for client with acute renal failure who complains of SOB, weakness, headache, and swelling of lower legs and feet. Intervention Elevate the HOB at least 45 degrees Client with acute low back pain reports pain radiating down buttocks to below knee. Initial nursing actions? This pain is along the path of the sciatic nerve FrmRN2u Nurse attempting to teach male client newly diagnosed with diabetes to administer insulin. Nurse attempts to answer Qs but he gets angry and tells the entire process is too much to learn. Action Acknowledge the client feelings and tell him that he will eventually be able to do the self administration Male Muslim client with pneumonia scheduled to receive dose of IV antibiotics but refuses to let nurse begin it, stating he cannot allow fluids to enter his body once he is cleansed for prayer. Action Reschedule administration of the antibiotic until after he completes his prayers Assess a 78 year old with L sided HF. Symptoms? Dyspnea, cough, fatigue Patient scheduled for liver biopsy. Most important PT results Patient with glaucoma who had trabaeculotomy Discharge teaching effective if “I should take my eye drops continuously” Caring for a burn patient with serum potassium of 4. Question which medication? Potassium Client after AKA in wheelchair for past 3 hours. Nurse assists to bed in prone position. Why is this position important Extend the affected hip joint Patient had liver biopsy. Most important for nurse to do Monitor VS Patient bedridden for 2 wks with following lab values: pH 7.37, PO2 90, PCO2 40, HCO3 25, hypoalbuminemia and hypocalcemia. Priority action Turn patient side to side q2h Patient has active tuberculosis. Action to prevent spread of infection? Wear mask when going to patient’s room Client with spinal cord injury has autonomic dysreflexia. What action should nurse take first? Check for fecal impaction or full bladder Which profession is at greatest risk of developing Hepatitis A Cook in a restaurant.