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Med/ Surg Proctored Retake Study
Guide
A nurse at a providers office is caring for an older adult client who is having an annual physical exam. Which of the following findings indicates additional follow-up is needed in regard to the prostate gland? (Select all that apply.)
A. Prostate specific antigen (PSA) is 7.1 ng/mL.
B. A digital rectal exam (DRE) reveals an enlarged and nodular prostate.
C. The client reports a weak urine stream.
D. The client reports urinating once during the night.
E. Smegma is present below the glans of the penis.
A. Prostate specific antigen (PSA) is 7.1 ng/mL.
B. A digital rectal exam (DRE) reveals an enlarged and nodular prostate.
C. The client reports a weak urine stream.
A nurse is providing information to a client who is scheduled for a transrectal ultrasound (TRUS). Which of the following information should the nurse include?
A. "This procedure will determine if you have prostate cancer."
B. "The procedure is contraindicated if you have an allergy to eggs."
C. "Sound waves will be used to create a picture of your prostate."
D. "You should avoid having a bowel movement 1 hr prior to the procedure."
C. "Sound waves will be used to create a picture of your prostate."
A nurse on a medical-surgical unit is admitting a client who has hepatitis B with ascites. Which of the following actions should the nurse include in the plan of care?
A. Initiate contact precautions.
B. Weigh the client weekly.
C. Measure abdominal girth 7.5 cm (3 in) above the umbilicus.
D. Provide a high-calorie and high-carbohydrate diet.
D. Provide a high-calorie and high-carbohydrate diet.
A nurse is caring for a client who has a new diagnosis of hepatitis C. Which of the following laboratory findings should the nurse expect?
A. Presence of immunoglobulin G antibodies (IgG)
B. Positive EIA test
C. Aspartate aminotransferase (AST) 35 units/L
D. Alanine aminotransferase (ALT) 15 IU/L
B. Positive EIA test
A nurse is assessing a client who has advanced cirrhosis. The nurse should identify which of the following findings as indicators of hepatic encephalopathy? (Select all that apply.)
A. Anorexia
B. Change in orientation
C. Asterixis
D. Ascites
E. Fetor hepaticus
B. Change in orientation
C. Asterixis
A nurse is reviewing the health record of a client who is to undergo total joint arthroplasty. The nurse should recognize which of the following findings as a contraindication to this procedure?
A. Age 78 years
B. History of cancer
C. Previous joint replacement
D. Bronchitis 2 weeks ago
D. Bronchitis 2 weeks ago
A nurse is admitting a client to the orthopedic unit following a total knee arthroplasty. Which of the following actions by the nurse is appropriate?
A. Check continuous passive motion device settings.
B. Palpate dorsal pedal pulses.
C. Place a pillow behind the knee
D. Elevate heels off bed.
E. Apply heat therapy incision.
A. Check continuous passive motion device settings.
B. Palpate dorsal pedal pulses.
D. Elevate heels off bed.
A nurse is planning a discharge teaching for a client who had a total hip arthroplasty. Which of the following should the nurse include in the teaching? (Select all that apply.)
A. Clean the incision daily with soap and water.
B. Turn the toes inward when sitting or lying.
C. Sit in a straight-backed armchair.
D. Bend at the waist when putting on socks.
E. Use a raised toilet seat.
A. Clean the incision daily with soap and water.
C. Sit in a straight-backed armchair.
E. Use a raised toilet seat.
A nurse is assessing a client who is scheduled to undergo a right knee arthroplasty. The nurse should expect which of the following findings? (Select all that apply.)
A. Skin reddened over the joint
B. Pain when bearing weight
C. Joint crepitus
D. Swelling of affected joint
E. Limited joint motion
B. Pain when bearing weight
C. Joint crepitus
D. Swelling of affected joint
E. Limited joint motion
A nurse is completing a preoperative teaching plan for a client who is scheduled to have a total hip arthroplasty. Which of the following should the nurse include in the teaching plan? (Select all that apply.)
A. Encourage complete autologous blood donation.
B. Sit in a low reclining chair.
C. Instruct the client to role onto the operative hip.
D. Use an abductor pillow when turning the client.
A nurse is reviewing strategies to promote comfort with a client who received an immunization. Which of the following information should the nurse include?
A. Massage the injection site.
B. Apply a cool compress to the injection site.
C. Take acetaminophen or ibuprofen.
D. Use the affected extremity.
E. Apply an antimicrobial ointment to the injection site.
B. Apply a cool compress to the injection site.
C. Take acetaminophen or ibuprofen.
D. Use the affected extremity.
A nurse is preparing to document administration of a meningococcal vaccine to a client. Which of the following information should the nurse include in the documentation? (Select all that apply.)
A. Age of the client receiving the vaccine
B. Name of the vaccine manufacturer
C. Vaccine expiration date
D. Date of administration
E. Serial number of the vaccine
B. Name of the vaccine manufacturer
C. Vaccine expiration date
D. Date of administration
A nurse in a clinic is caring for a client who is to receive an immunization. The client asks about contraindications to immunizations. Which of the following is an appropriate response by the nurse?
A. "The use of insulin is a contraindication."
B. "An anaphylactic reaction is a contraindication for any type of immunization."
C. "The common cold is a contraindication for receiving a immunization."
D. "Your provider will weigh the risks if you have experienced any adverse reactions."
D. "Your provider will weigh the risks if you have experienced any adverse reactions."
A nurse is caring for a client who has a serum sodium level 133 mEq/L and serum potassium level 3. mEq/L. The nurse should recognize that which of the following treatments can result in these laboratory findings?
A. Three tap water enemas
B. 0.9% sodium chloride solution IV at 50 mL/hr
C. 5% dextrose with 0.45% sodium chloride solution with 20 mEq of K+ IV at 80 mL/hr
D. Antibiotic therapy
A. Three tap water enemas
A nurse is caring for a client who has a serum potassium 5.4 mEq/L. The nurse should assess for which of the following manifestations?
A. ECG changes
B. Constipation
C. Polyuria
D. Paresthesia
A. ECG changes
A nurse is caring for a client who has a nasogastric tube attached to a low intermittent suctioning. The nurse should monitor for which of the following electrolyte imbalances?
A. Obtain consent from the client for the transfusion.
B. Assess for an acute hemolytic reaction.
C. Explain the transfusion procedure to the client.
D. Obtain blood culture specimens to send to the lab.
B. Assess for an acute hemolytic reaction.
A nurse is caring for a client who is receiving a blood transfusion. Which of the following actions should the nurse expect if an allergic transfusion reaction is suspected? (Select all that apply.)
A. Stop the transfusion.
B. Monitor for hypertension.
C. Maintain an IV infusion with 0.9% sodium chloride.
D. Position the client in an upright position with the feet lower than the heart.
E. Administer diphenhydramine.
A. Stop the transfusion.
C. Maintain an IV infusion with 0.9% sodium chloride.
E. Administer diphenhydramine.
A nurse is monitoring a client who began receiving a unit of packed RBCs 10 min ago. Which of the following findings should the nurse identify as an indication of a febrile transfusion reaction? (Select all that apply.)
A. Temperature change from 37 (98.6) pretransfusion to 37.2 (99.0)
B. Current blood pressure 178/90 mm Hg
C. Heart rate change from 88/min pretransfusion to 120/min
D. Client report of itching
E. Client appears flushed
C. Heart rate change from 88/min pretransfusion to 120/min
E. Client appears flushed
A nurse is providing a preoperative teaching for a client who requests autologous donation in preparation for a scheduled orthopedic surgical procedure. Which of the following statements should the nurse include in the teaching?
A. "You should make an appointment to donate blood 8 weeks prior to the surgery."
B. "If you need an autologous transfusion, the blood your brother donates can be used."
C. "You can donate blood each week if your hemoglobin is stable."
D. "Any unused blood that is donated can be used for other clients."
C. "You can donate blood each week if your hemoglobin is stable."
A nurse preceptor is observing a newly licensed nurse on the unit who is preparing to administer a blood transfusion to an older adult client. Which of the following actions by the newly licensed nurse indicates an understanding of the procedure?
A. Inserts an 18-gauge IV catheter in the client
B. Verifies blood compatibility and expiration date of the blood with an assistive personnel (AP)
C. Administers dextrose 5% in 0.9% sodium chloride IV with the transfusion
D. Obtains vital signs every 15 min throughout the procedure.
D. Obtains vital signs every 15 min throughout the procedure.
