GCC 325 - 350

Which sign or symptom typically occurs early in the development of multiple sclerosis (MS)?

• Diplopia
• Grief
• Paralysis
• Dementia

When preparing the room for admission of a multigravid client at 36 weeks’ gestation diagnosed with severe preeclampsia, which of the following should the nurse obtain?

• Oxytocin infusion solution.
• Disposable tongue blades.
• Portable ultrasound machine.
• Padding for the side rails.

The nurse knows which burn involves the entire thickness of the skin?

• First degree.
• Second degree.
• Third degree.
• Fifth degree.

A client with a severe corneal ulcer has an order for Gentamycin gtt. q 4 hours and Neomycin 1 gtt q 4 hours. Which of the following schedules should be used when administering the drops?

• Allow 5 minutes between the two medications.
• The medications may be used together.
• The medications should be separated by a cycloplegic drug.
• The medications should not be used in the same client.

Diphenoxylate hydrochloride and atropine sulfate (Lomotil) is prescribed for the client with ulcerative colitis. The nurse realizes that the medication is having a therapeutic effect when which of the following is noted?

• There is an absence of peristalsis.
• The number of diarrhea stools decreases.
• Cramping in the abdomen has increased.
• Abdominal girth size increases.

A client presents to the emergency department (ED) via ambulance with SOB for the past 3 days. After spending 4 hours in the ED, the client is admitted to the intensive care unit (ICU) with pulmonary edema requiring intubation and ventilation. The ED nurse reports to the ICU nurse that a Foley catheter was placed and that the client has had a total of 25 mL of urine output. The labs from the ED reveal (1) BG of 300, (2) BUN of 100, and (3) creatinine of 5.0. The client has a medical history of CAD, CHF, diabetes, COPD, and asthma. What is the most likely cause of the client’s low urine output?

• Acute and chronic renal failure due to diabetes and a decreased blood flow to the kidneys due to heart failure.
• Renal failure due to decreased coronary output secondary to heart failure.
• Decreased blood flow to the kidneys due to congestive heart failure (CHF) secondary to noncompliance with home fluid restriction.
• Severe dehydration.

A nurse is performing the Trendelenburg test for the client with multiple sclerosis. The nurse is aware that this test is used to measure:

• Muscle weakness
• Fluid retention
• Ability to concentrate
• Dexterity

A newborn has been diagnosed with exstrophy of the bladder. The nurse should position the newborn:

• Prone
• Supine
• On either side
• With the head elevated

When performing Leopold’s maneuvers, which of the following would the nurse ask the client to do to ensure optimal comfort and accuracy?

• Breathe deeply for 1 minute.
• Empty her bladder.
• Drink a full glass of water.
• Lie on her left side.

The nurse is caring for a patient admitted to the emergency department after a motor vehicle accident. Under the law, the nurse must obtain informed consent before treatment unless the patient:

• is mentally ill.
• refuses to give informed consent.
• is in an emergency situation.
• asks the nurse to give substituted consent.