Exam (elaborations)
KAPLAN MEDICAL SURGICAL COMP IEN_A
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KAPLAN MEDICAL SURGICAL COMP IEN_A
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KAPLAN MEDICAL SURGICAL COMP IEN_AA client is diagnosed with HTN. The client says, "I have trouble remembering to take my
medications, but I am now only smoking 5 cigarettes a day instead of 2 packs." Which
response by the nurse is best?
a. "Ask your spouse to help you remember the medications. The smoking needs to be
reduced even more."
b. "It is good that your smoking has decreased. Let's talk about ways to remember the
medication."
c. "You must take the medication, and the smoking habit needs to stop very soon."
d. "It sounds like you are trying to adhere to the plan. Tell me about your current diet." -
Answers- b. "It is good that your smoking has decreased. Let's talk about ways to
remember the medication."
A client is diagnosed with myasthenia gravis. The client says, "I am tired all the time and
I don't want to live any more. If I stop taking my medication, I can stop breathing." Which
is the nurse's best response?
a. Ask client about feelings of hopelessness
b. Give client information about a myasthenia gravis group
c. Place client on suicide watch
d. Teach client about the new medication - Answers- a. Ask client about feelings of
hopelessness
The nurse suctions a client's tracheostomy. Which technique does the nurse use?
(select all)
a. Routinely instills sterile normal saline before suctioning
b. Applies suction when inserting the catheter
c. Suctions the client every hour
d. Uses sterile technique when suctioning
e. Rotates the catheter when withdrawing
f. Uses intermittent suctioning - Answers- a. Routinely instills sterile normal saline
before suctioning
d. Uses sterile technique when suctioning
e. Rotates the catheter when withdrawing
f. Uses intermittent suctioning
A client is diagnosed with epilepsy following a series of seizures. The nurse identifies
which client goal as the priority?
a. Client will maintain optimal mental functioning
b. Client will have no injuries during a seizure
c. Client will meet with a counselor as needed
, d. Client will take all medications as directed - Answers- d. Client will take all
medications as directed
A client just had an upper GI X-ray procedure. Which information is most important for
the nurse to give the client?
a. Save stool specimen after 48 hours
b. Take a laxative after 72 hours if no stool
c. Clear liquid diet only for 24 hours then a regular diet
d. Drink large amounts of fluid for 72 hours - Answers- d. Drink large amounts of fluid
for 72 hours
A client experiences anaphylactic shock caused by a reaction to a medication. IV
diphenhydramine is administered, and the client appears to be recovering. Which VS is
the most important for the nurse to monitor for the next several hours?
a. Respirations
b. Blood pressure
c. Pulse
d. Temperature - Answers- a. Respirations
A client with heart failure is to be weighed daily. The client asks why this is necessary.
Which is the best information for the nurse to give the client?
a. Helps determine if the medication is working
b. Shows how activity affects activity intolerance
c. Is an indication of the fluid status in the body
d. Determines the number of calories for the diet - Answers- c. Is an indication of the
fluid status in the body
A client reports difficulty speaking and swallowing. The client is diagnosed with a stroke.
The nurse expects to find weakness in which extremities?
a. Lower extremities
b. Upper extremities
c. Left-side extremities
d. Right-side extremities - Answers- d. Right-side extremities
A client tells the nurse of a latex-food allergy. Which is the nurse's responsibility to the
client?
a. Request meals without potatoes and tomatoes
b. Inform surgery to use only lactated Ringer solution
c. Notify the health care provider
d. Request foods not wrapped in plastic wrap - Answers- a. Request meals without
potatoes and tomatoes
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