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Med-Surg #1 FINAL (Davis Edge)

Total questions: 56

Worksheet time: 3hrs 48mins

Name
Class
Date
1.

A client started having chest pain 2 hours ago. After the health-care provider explains that her cardiac troponin level is normal," the client states, "I'm so happy that I didn't have a heart attack." Which response by the nurse is the priority?

a)

Lets discuss the heart benefits of stopping smoking

b)

You may need to follow up with a cardiologist after discharge

c)

A healthy balanced diet reduces your risk for coronary artery disease

d)

The troponin level may be normal right now even if you have had a heart attack

2.

The nurse is caring for a client who is at risk for orthostatic hypotension. Which action should the nurse take?

a)

Assist the client to quickly change positions

b)

Use a walking belt when ambulating the client

c)

Administer opioid analgesic prior to ambulation

d)

Restrict fluids between the hours of 14:00 and 08:00

3.

A client returns to the unit immediately after a cardiac catheterization in which the femoral artery was used. Which action should the nurse take first

a)

Palpate peripheral pulses

b)

encourage PO fluids

c)

assist the client with ambulation

d)

encourage the client to lie still and not bend knees

4.

A client scheduled for the next dose of atenolol has a BP of 94/60 mm Hg. Which action should the nurse take next?

a)

Administer the meds as prescribed

b)

notify the HCP

c)

obtain an ECG

d)

Administer O2 at 2L per minute

5.

The nurse is reviewing a client's laboratory results. Because the client is taking digoxin, which electrolyte imbalance most concerns the nurse?

a)

Hypermagnesemia

b)

Hypocalcemia

c)

Hypokalemia

d)

Hypernatremia

6.

The nurse is caring for a client with pulmonary edema. In which position should the nurse place the client?

a)

Fowler's

b)

Left side-lying

c)

Prone

d)

Supine

7.

Which of the following are the earliest symptoms of chronic heart failure? Select all that apply

a)

Fatigue

b)

clammy, cold skin

c)

weakness

d)

crackles

e)

pink, frothy sputum

8.

The nurse is caring for a client with heart failure. Which intervention should the nurse implement?

a)

encourage ambulation

b)

weight the client daily at the same time

c)

instruct the client to increase sodium in their diet

d)

teach the client to sleep without a pillow

9.

The nurse is teaching a client with heart failure about nutrition. Which statement made by the client indicates an understanding of the teaching?

a)

I should increase the amount of sodium in my diet

b)

I need to reduce the amount of fluids I drink like the HCP said

c)

I ate a bag of chips and a deli sandwich for lunch today

d)

I need to eat 3 large meals each day

10.

The nurse is administering furosemide (Lasix) to a client with heart failure. Which laboratory value would concern the nurse?

a)

Sodium 135 mEq/dL

b)

Potassium 2.8 mEq/dL

c)

Calcium 9.0 mg/dL

d)

Magnesium 2.0 mEq/L

11.

The nurse is teaching a client about monitoring fluid status at home. How often should the nurse encourage the client to weigh?

a)

daily

b)

weekly

c)

biweekly

d)

monthly

12.

How many liters of blood are contained in the human body?

a)

1-3

b)

4-6

c)

7-9

d)

10-12

13.

Which disease process causes an accelerated destruction of red blood cells?

a)

renal failure

b)

sickle cell anemia

c)

Lung cancer

d)

Crohn disease

14.

The nurse is caring for a client with a white blood cell count of 21,000/mm3. In which client will the nurse expect this finding?

a)

A client with anemia

b)

A client with thrombocytopenia

c)

A client with neutropenia

d)

A client with an infection

15.

The nurse is caring for a client who underwent a splenectomy. This procedure places the client at risk for which of these illnesses

a)

Cancer

b)

meningitis

c)

asthma

d)

anemia

16.

The nurse is caring for a client with a hematologic disorder. Which clinical manifestations can the nurse expect to find? Select all that apply

a)

petechiae

b)

increase in energy

c)

weakness

d)

dyspnea

e)

weight gain

17.

The nurse is caring for a client who underwent a bone marrow biopsy. Which intervention will the nurse implement following the procedure?

a)

Take the client's vital signs every 8 hours

b)

Monitor the site for bleeding and infections

c)

position the client in supine position

d)

prepare the client for a chest x-ray

18.

The nurse is caring for a client receiving a blood transfusion who suddenly develops a fever, chills headache, and back pain. The nurse recognizes this as which type of reaction?

a)

Febrile nonhemolytic

b)

Urticarial

c)

Hemolytic

d)

Anaphylactic

19.

The nurse is caring for a client with suspected lymphoma. For which diagnostic tool will the nurse prepare the client next?

a)

Computed tomography

b)

Magnetic resonance imaging

c)

Lymphangiography

d)

Electroencephalogram

20.

The nurse is assessing a client with cold. Which lymph nodes will the nurse expect to find enlarged?

a)

femoral

b)

mediastinal

c)

popliteal

d)

cervical

21.

The nurse is caring for a client with severe anemia and a hemoglobin level of 4 g/dL. Which clinical manifestation will the nurse expect the client to exhibit?

a)

Glossitis

b)

Palpitations

c)

Exertional dyspnea

d)

Petechiae

22.

The nurse is caring for a client with pernicious anemia. Which classic clinical manifestation can the nurse expect to find?

a)

bradycardia

b)

sore, beefy red tongue

c)

bradypnea

d)

fissure at the corners of the mouth

23.

A client asks the nurse to explain sickle cell anemia. Which response by the nurse is accurate?

a)

This is a type of anemia in which the bone marrow becomes fatty and cannot produce blood cells

b)

Sickle cell anemia is a result of not including foods high in iron in your diet

c)

This is an inherited anemia in which hemoglobin is not synthesized normally

d)

It is an inherited anemia that causes blood cells to take on a crescent shape and clump

24.

The nurse is caring for a client with polycythemia vera (PV). Which clinical

a)

sore, beefy red tongue

b)

hypotension

c)

tinnitus

d)

abdominal pain

25.

The nurse is caring for a group of clients. Which client is at highest risk for developing leukemia?

a)

An individual with Down syndrome

b)

A client with iron deficiency anemia

c)

An individual who drinks alcohol

d)

A client with hemophilia

26.

The nurse is caring for a client with multiple myeloma who reports loss of bladder function. Which action will the nurse take?

a)

Insert an indwelling catheter

b)

position the client on the left side while in bed

c)

instruct the client to perform Kegel exercises

d)

Notify the HCP

27.

The nurse is reinforcing teaching for a client who underwent a splenectomy. Which statement made by the client indicates a need for further teaching?

a)

I am at a higher risk for bleeding

b)

I will be able to live a normal life

c)

I should have yearly vaccinations

d)

I am at high risk for bleeding now

28.

The nurse Is caring for a group of clients. Which client will the nurse see first?

a)

A client with non-Hodgkin lymphoma (NHL) reporting malaise

b)

A client with hemophilia having a nosebleed

c)

A client with anemia on the third hour of a blood transfusion

d)

A client with leukemia waiting for discharge

29.

The nurse is caring for a client with pancytopenia who reports dyspnea upon exertion. Which condition will the nurse assess further?

a)

pain

b)

anemia

c)

neutropenia

d)

thrombocytopenia

30.

The nurse is caring for a client with leukemia who is undergoing chemotherapy and is neutropenic. Which intervention will the nurse implement?

a)

Encourage the family to bring flowers for the client

b)

Instruct the client to eat fresh fruits and vegetables

c)

Administer aspirin when the client complains of fever

d)

Ensure all staff and visitors wash hands before visiting

31.

The nurse is caring for a client with thrombocytopenia. Which bleeding precautions will the nurse implement? Select all that apply

a)

Avoid intramuscular injections

b)

Encourage use of slippers when out of the bed

c)

keep the area free of clutter

d)

instruct the client to blow nose only when necessary

e)

Encourage the client to floss teeth frequently

32.

Which internal factor may contribute to hypertension?

a)

Decreased blood viscosity

b)

decreased fluid volume

c)

decreased peripheral vascular resistance

d)

decreased elasticity of blood vessels

33.

The nurse is providing teaching regarding the DASH diet for a client diagnosed with hypertension. Which statement made by the client indicates a need for further education?

a)

I should eat five servings of fresh fruit each day

b)

Four times per week I can eat 1/3 cup of nuts or 1/2 cup of cooked beans

c)

I should eat 1/2 cup of oatmeal in the morning

d)

I can eat foods high in sodium as long as I drink plenty of water

34.

The nurse is caring for a client receiving furosemide. The nurse should provide the following education to the client:

a)

Avoid all sources of potassium

b)

Take the medication in the morning

c)

If edema occurs, double the dose

d)

This medication must be taken on an empty stomach

35.

The nurse is preparing a client for a cardiac cauterization. Which of the following is the most important piece of data to know prior to procedure?

a)

Current height and weight

b)

Allergies to iodine, shellfish, or contrast dye

c)

Baseline pulse assessment

d)

The client's last oral intake

36.

The nurse is assessing a client who reports chest pain along with pain in the shoulder. Which term describes this pain?

a)

radiate

b)

severity

c)

type

d)

onset

37.

The nurse is discussing immunity with a client. The client asks what type of immunity her child will receive if she breastfeeds. The nurse will reply with which type of following?

a)

Naturally acquired passive immunity

b)

Artificially acquired active immunity

c)

Naturally acquired active immunity

d)

Artificially acquire passive immunity

38.

After an infection, a client develops antibodies and memory cells specific to the pathogen that caused the infections. What type of immunity will the client receive?

a)

Artificially acquired passive immunity

b)

naturally acquired active immunity

c)

naturally acquired passive immunity

d)

artificially acquired active immunity

39.

The nurse is caring for a client with systemic lupus erythematous (SLE). What clinical manifestations will the nurse expect to find during assessment?

a)

Expiratory wheezing

b)

Pericardial friction rub

c)

Enlarged lymph nodes

d)

Watery diarrhea

40.

The nurse is reviewing orders for a group of clients. Which client might the nurse see a prescription for CD4 count?

a)

a client with renal failure

b)

a client with HIV

c)

a client with anemia

d)

a client with arthritis

41.

The nurse is caring for a client with allergic rhinitis. Which interventions will the nurse anticipate implementing? Select all that apply

a)

administration of a prescribed antihistamine

b)

teach client to avoid environmental stimuli

c)

administration of corticosteroids as ordered

d)

administration of antibiotics as ordered

e)

routinely check vital signs every 2 hours

42.

A client presents to the emergency department with stridor, wheezing dyspnea, and facial edema. The nurse concludes this client is experiencing an anaphylactic reaction. Which interventions will the nurse implement? Select all that apply

a)

Administer oxygen as prescribed

b)

Place an endotracheal (ET) intubation kit at the bedside

c)

administer the prescribed antibiotic

d)

place the client on a cardiac monitor

e)

obtain the prescribed intravenous (IV) access

43.

The nurse is caring for a client admitted with urticaria. Which clinical manifestations will the nurse expect to see during assessment?

a)

raised, pruritic, contender, erythematous wheals on the skin

b)

Pruritus, edema, and extremely dry skin

c)

sneezing, itching, rhinorrhea, and itchy eyes

d)

fever, malaise, muscle soreness, arthralgia, and splenomegaly

44.

The nurse is providing teaching to a client receiving methylprednisolone (Solu-Medrol). Which statement indicates a need for further teaching?

a)

I need to take this medication w/ food

b)

I should monitor my weight while taking this medicine

c)

I can stop taking this medication as soon as I feel better

d)

This medicine might make my blood sugar high

45.

The nurse is caring for a client with pernicious anemia. The nurse can expect to implement which intervention?

a)

Administer vitamin B12 as prescribed

b)

Strict 1500 mL/day fluid restriction

c)

Place the client in protective isolation

d)

Teach the client to use brown soap

46.

The nurse is caring for a client hypothyroidism. Which clinical manifestations can the nurse expect the client to exhibit? Select all that apply

a)

hypertension

b)

dyspnea

c)

diarrhea

d)

slow mental process

e)

sensitivity to heat

47.

Which of the following antibodies is produced first during an infection?

a)

IgG

b)

IgA

c)

IgM

d)

IgD

48.

The nurse is discussing vaccinations with an older adult. Which of the following statements made by the client indicates an understanding regarding the teaching?

a)

I should get the flu shot every other year so I don't get the flu

b)

I should get a shingles vaccine because I am over 60

c)

I had a tetanus shot 15 years ago, so I don't need another one

d)

I should get a shot for pneumonia every 5 years

49.

The nurse is caring for a client who presents with sever shortness of breath, wheezing and hives. Which of the following medications would the nurse expect to administer as ordered?

a)

Proton-pump inhibitor (PPI)

b)

Antibiotic

c)

Epinephrine

d)

Opioid Analgesic

50.

The nurse is caring for a client with a localized infection caused by an insect bite to the hand. Which of the following are clinical manifestations the nurse can expect to see?

a)

redness at the site

b)

elevated temperature

c)

warmth at the site

d)

pain

e)

swelling at the site

51.

The nurse is teaching an elementary school class about preventing the spread of infection. Which is most important for the nurse to include in the teaching?

a)

avoiding other people

b)

wearing a mask

c)

hand washing

d)

taking antibiotics

52.

The nurse is reinforcing teaching for a client who is being discharged home on antibiotics. Which of the following statements indicates an understanding of the teaching?

a)

my wife has the same antibiotics left over from when she was sick. I can take those

b)

I will take the antibiotics until they are gone, even if I feel better

c)

I can take these every other day so they will last me longer

d)

I can save some of these to take when I get the flu

53.

The nurse has a cough. What should the nurse do to prevent the spread of infection among his or her assigned group of clients?

a)

wear a mask when entering rooms

b)

cover mouth with hand when coughing

c)

wash hands for 10 seconds

d)

only care for clients who have a cough

54.

The nurse is reviewing infection rates on a medical unit. Which of the following indicates a need for staff education?

a)

The nurse wears a mask, glove, and gown when entering a room of a client with chickenpox

b)

The nurse does not wear gloves when feeding a client who has a recent stroke

c)

The nurse sends a client with active tuberculosis for a computed tomography (CT) scan with no mask

d)

The nurse obtains a new urinary catheritization kit when the tubing of the first one touches the bed before insertion

55.

The nurse is inserting an indwelling catheter on a client with difficulty voiding. Which of the following warrants correction by the charge nurse?

a)

The nurse positions the drainage bag below the level of the bladder

b)

The nurse inserts the catheter using clean technique

c)

The nurse does not open the closed urinary drainage system seal

d)

The nurse anchors the catheter tubing to the client's leg

56.

Which type of immunity is acquired through breastfeeding?

a)

Natural

b)

Innate

c)

Active

d)

Passive