RN Adult Medical Surgical Practice A.pdf file:///C:/Users/HP/Desktop/SSSSSSS/RN%20Adult%20Medical%20S
RN Adult Medical Surgical Practice A
1. A nurse is reviewing the medical record of a client who has systemic lupus
erythematosus. Which of the following findings should the nurse expect
ANS Fa- cial butterfly rash.
R: A butterfly rash is a manifestation of SLE. It appears as a dry red rash on the clients cheeks and
nose and can disappear during times of remission.
2. A nurse is caring for a client who is receiving plasmapheresis through a venous access
site. Which of the following actions should the nurse take
ANS - Check electrolyte levels before and after therapy.
R: Plasmapheresis can cause citrate induced hypocalcemia. Therefore the nurse should monitor
the clients electrolyte levels before and after therapy.
3. A nurse is assessing a client who has Graves disease. Which of the fol- lowing images
should indicate to the nurse that the client has exophthal- mos
ANS The nurse should identify an outward protrusion of the eyes is exophthalmos a common
finding of graves disease. An overproduction of the thyroid hormone causes edema of the
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extraocular muscle and increases fatty tissue behind the eye which results in the eyes
protruding outward. Exophthalmos can cause the client to experience problems with vision
including focusing on objects as well as pressure on the optic nerve.
4. A nurse is performing a cardiac assessment for a client who had a myocar- dial
infarction 2 days ago. Which of the following actions should the nurse take first after
hearing the following sound
ANS Listen with the client on his left side. When providing nursing care the nurse should first
use the least invasive intervention. Therefore after auscultating a murmur the first action the
nurse should take is to place the client on his left side and listen to his heart again.
5. A nurse is providing teaching to an older adult female client who has stress incontinence
and a BMI of 32. Which of the following statements by the client indicates an
understanding of the teaching question mark: I am dieting to lose weight. Excess weight cut
creates increased abdominal pressure that can result in stress incontinence.
6. A nurse is reviewing the ABG results of a client who has advanced COPD. Which of the
following results should the nurse expect
ANS Paco2 of 56. A client who has COPD retains paco2 due to the weakening and the collapse of
the alveolar sacs which decreases the area and lungs for gas exchange and causes the paco2 to
increase above the expected reference range.
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7. A nurse is providing teaching to a client who is perimenopausal and has a
prescription for hormone replacement therapy. For which of the following adverse
effects should the nurse instruct the client to notify the provider?
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Select all that apply.: Calf pain, numbness in the arms and intense headache. Calf pain is an
indication of DVT and the client should report this finding to the provider immediately.
Numbness in the arms can indicate cerebrovascular accident which is an adverse effect of
hormone replacement therapy and an intense headache can indicate a cerebrovascular accident.
8. A nurse is providing teaching to a client who has chronic kidney disease and a new
prescription for erythropoietin.Which of the following statements by the client indicates an
understanding of the teaching
ANS I am taking this medication to increase my energy level. The goal of erythropoietin therapy is
to increase the level of hematocrit and clients who have anemia. When the medication is
effective the client should have a decreasing fatigue and an improvement and activity tolerance.
9. A nurse is teaching a client who has venous insufficiency about self-care. Which of the
following statements should the nurse identify as an indication that the client
understands teaching
ANS I will wear clean graduated compression stockings everyday. The client should apply a
clean pair of graduated compression stockings each day and clean soiled stockings with mild
detergent and warm water by hand.
10. A nurse is preparing to present a program about atherosclerosis at a health fair.
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