RN Adult Medical Surgical Online Practice - A.pdf file:///C:/Users/HP/Desktop/SSSSSSS/RN%20Adult%20Medical%20S
RN Adult Medical Surgical Online Practice A
1. NGN
*0900:Client presents with abdominal pain in the upper left quadrant for the past 2 days.
States pain became worse this morning and is radiating to the back. Rates pain as 8 on a
scale of 0 to 10.Hypoactive bowel sounds; reports nausea, no vomiting; client is passing
flatus.Febrile, oriented to person, place, and time.Tachypnea with diminished breath
sounds.Sinus tachycardia.Client voids 300 mL of clear, amber urine.
*0930:Client vomited 100 mL brown liquid
ANS The client is experiencing manifesta- tions of pancreatitis as evidenced by the amylase and
lipase.
Rational:
Drop Down 1:
Pancreatitis is correct. The client's laboratory results and physical assessment indicate the client
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is experiencing manifestations of pancreatitis. Clients who have pancreatitis experience an
increase in pancreatic enzymes, amylase, and lipase. Paralytic ileus, adult respiratory distress
syndrome (ARDS), cardiogenic shock, and a cerebral vascular accident (CVA) are incorrect.The
client is not experiencing man- ifestations of paralytic ileus because they have bowel sounds and
are passing flatus. The client is not experiencing manifestations of ARDS because there is no
indication the client is in respiratory distress. The client is not experiencing manifestations of
cardiogenic shock because there is no indication from the client's medical record that there is a risk
for cardiogenic shock.The client is not experiencing manifestations of a CVA because there is no
indication from the client's medical record that there is a risk for a CVA.
Drop Down 2:
Amylase and lipase is correct. The client's laboratory results and physical assess- ment indicate
the client is experiencing manifestations of pancreatitis. Clients who have pancreatitis experience
an increase in pancreatic enzymes, amylase, and lipase.
Oxygen saturation, urine output, platelet levels, and blood pressure are incorrect. These findings
do not indicate pancreatitis.
2. A nurse is caring for a client who is postoperative.
Client admitted to medical-surgical unit from PACU. Client reports incisional pain as 2 on
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a scale of 0 to 10. Client appears restless and frequently asks for water. Bilateral lower
extremities cool with +1 pedal pulses. Urine output is 40 mL for the past 2 hr. Moderate
amount of bright red drainage noted on
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surgical incision dressing
ANS Complete the diagram by dragging from the choices below to specify what condition the
client is most likely experiencing, two actions the nurse should take to address that condition, and
two parameters the nurse should monitor to assess the client's progress.
Answer:
*Insert a large-gauge
*IV.Initiate a fluid challenge.
*Hypovolemia
*Urine output
*Blood pressure
Rational:
The nurse should insert a large-gauge IV and initiate a fluid challenge because the client is most
likely experiencing hypovolemia as evidenced by the client's restlessness, tachycardia,
hypotension, decreased pulses, cool extremities, and decreased urine output.The nurse should
monitor the client's urine output and blood pressure to evaluate the effectiveness of treatment.
3. A nurse on a medical-surgical unit is reviewing the medical record of an older adult
client who is receiving IV fluid therapy.Which of the following client information should
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