MS  

11. Dialysis is used to manage patients with:

1. A client with very dry mouth, skin and 5. A patient experienced a full thickness burn 72   renal failure
mucous membrane is diagnosed of having hours ago. The patient’s vital signs are within  
dehydration. Which intervention should the normal limits and urinary output is 50 mL/hour. 12. Adam has just been diagnosed with
nurse perform when caring for a client This is known as what phase of burn diabetes insipidus and was rushed to the ER .
diagnosed with fluid volume deficit?ect! management?  The most common presenting sign is:rect!
  Assessing urinary intake and output.   Acute phase.   increase in urination.
     
2. Which electrolytes would the nurse identify 6. An inflammatory bowel disorder in which the 13. A decrease in renal function leading to
as the major electrolyte responsible for patient develops abdominal pain, bloody serious derangements of body fluid
determining the concentration of the diarrhea, tenesmus and weight loss is...  homeostasis is calledect!
extracellular fluid? ct!   ulcerative colitis   Acute Renal Failure
  Sodium.     
   7. Chronic hepatitis C may be treated with:  ! 14. Acute fulminant hepatic failure is a complex
3. A 58 year old female patient, weighing 63 kg   interferon and ribavirin neuropsychiatric syndrome precipitated by
has superficial partial thickness burns to the abnormal liver function
anterior head and neck, front and back of the 8. The patient with gastroesophageal reflux   False
left arm, front of the right arm, posterior trunk, disease should be taught:   
front and back of the right leg, and back of the
  All items are correct. 15. Depending on the solution, ICU patients
right leg. The accident occurred when gasoline
  receives parenteral nutrition boosts the
ignited while she was refilling gasoline in the
9. One of your patients is awaiting lab results patient’s calorie intake or surpasses his calorie
engine of her motorcycle.
for kidney function. The patient requirements. Thus nurses in ICU can start it on
According to the burned areas described above,
has recently recovered from a streptococcal any available vain of the client.
the nurse is using the “Rule of Nine”, would
throat infection. The patient has   False
determine that approximately what percentage
most likely developed symptoms of:    
of the patient’s body surface has been burned?
  glomerulonephritis. 16. The Hemodialysis nurse noted a possible
rect!
  signs of complications during the dialysis ; she
  63%
10. Acute renal failure due to a decrease in should except; 
 
circulating blood volume causing   continue the Hemodialysis
4. In a burned patient, in order to promote
diminished renal perfusion is treated with:   
adequate fluid within first 24 hours, which of
  intravenous fluids
the following intravenous fluid is appropriate to
 
administer?
  Plain Lactated Ringer's.
17. The nurse is assigned to a client with insulin- 22. The nurse has just finished inserting a
dependent diabetes who was brought to the nasogastric (NG) tube in a client who has 28. A nurse is caring for a client with severe
emergency department because of shortness of difficulty swallowing. The best measure to test burns. The client complains of abdominal pain
breath and confusion. On admission, the client’s for placement of the tube is and begins vomiting blood. The nurse
blood glucose level is 720 mg/ml, and ABG   aspirating gastric contents. anticipates diagnostic testing to determine if
values are pH of 7.28, PaCO2 of 35 mm Hg, and   the client has developed  
bicarbonate level of 15 mEq/L. The nurse 23. The nurse in ICU is planning to irrigte a   a Curling’s ulcer
interprets these readings as indicating   nasogastric (NG) tube and prepares to use    
  uncompensated metabolic acidosis.   normal saline. 29. A nurse is assessing a client with a history of
  a duodenal ulcer. Which finding is consistent
18. A client who has begun receiving TPN with 24. A client with acute gastritis is admitted to with the nurse’s knowledge about this
lipids develops shaking chills, shortness of the emergency department for GI bleeding. The condition?  
breath, and chest pain. The priority action by nurse would anticipate the client’s history will   Pain may awaken the client in the middle
the nurse is to immediately includeCorrect! of the night.
  stop the infusion.   alcohol abuse.   
     30.  The nurse administers alternating doses of
19. The nurse should anticipate that a client 25. The nurse is caring for a client with chronic two antacids into the NG tube of a client with a
with mechanical obstruction of the esophagus atrophic gastritis. When taking an admission duodenal ulcer. The finding that best indicates
would initially have difficulty swallowing ! history, the nurse would anticipate a history of ! that this drug regimen has been successful is
  bread.   pernicious anemia.   increased gastric pH.mild diarrhea.
      
20. During a health interview, the nurse informs 26. A client is taking cortisone. The nurse 31. Ranitidine (Zantac) is prescribed for a client
a client with GERD that of all the drugs the schedules the medication with food because with a gastric ulcer. The statement that best
client is presently taking, the drug that will cortisone can have which effect on gastric indicates to the nurse that the client
aggravate the clinical manifestations of GERD is mucosa when given on an empty stomach? understands the action of this drug is
  theophylline (Theo-Dur). Cortisone will cause     “This drug reduces the acid in my
    susceptibility of the mucosa to injury. stomach.” 
21.  An important health promotion activity for     
nurses to teach clients with chronic gastritis is 27.  A nurse is instructing a client with a peptic 32. The nurse is monitoring a client who has
to ulcer on recommended dietary changes. A goal had gastric surgery for manifestations of
  see the health care provider at regular of teaching has been met when the client states dumping syndrome. The nurse should be
intervals. that he/she will avoid which of the following particularly watchful for the early manifestation
beverages?  of Correct!
Milk   vertigo.
  37. Before tube insertion, the nurse performs 43. A client has a history of diarrhea. The nurse
33. A client asks the nurse about the prescribed the NEX measurement, which is the! is attempting to obtain information from the
diet after gastric surgery. The nurse clarifies   distance from the tip of the nose to the ear review of systems. When the nurse asks if
that a high-protein, high-fat, low-carbohydrate, lobe and to the xiphoid. several different foods cause diarrhea, the
dry diet is the best choice after gastric surgery    client responds, “Hmm, I don’t usually eat that.”
because this diet 38. The history finding in a client with elevated Which action by the nurse is most appropriate?
  is slow to leave the stomach. carcinoembryonic antigen (CEA) that suggests   Ask the client why he/she doesn’t eat
  to the nurse that this result might not be specific foods. 
34. A client asks the  SICU nurse about the related to colorectal cancer is a  
prescribed diet after gastric surgery. The nurse   history of heavy smoking.  44.  The nurse explains that the non-urinary
clarifies that a high-protein, high-fat, low-   manifestations that frequently accompany
carbohydrate, dry diet is the best choice after 39.  A large, frothy, foul-smelling stool that urinary diseases are
gastric surgery because this diet  floats in toilet water indicates to the nurse that   nausea, vomiting, and anorexia. 
  is slow to leave the stomach.  the client has an alteration in the metabolism of  
    fats.  45.  When a client tells the nurse that she
35. A nurse is caring for a patient who had   recently began experiencing urgency and
surgery and will be receiving chemotherapy and 40.  A nurse is assessing a client with right frequency, the appropriate question for the
radiation treatment for stage III gastric cancer. upper quadrant pain. The nurse asks questions nurse to ask as part of the psychosocial history
The client is planning several extensive trips directly related to the health of the client’s ! is
after the chemotherapy and radiation are   “Have you been experiencing any anxiety?”
  liver. 
finished. Which statement by the nurse is most  
 
appropriate at this time? 46. A client is admitted to the emergency
41.  A client is being admitted for
  “What has the physician told you about “hematochezia.” The nurse would plan to department with severe, colicky pain that
your disease and treatment?” assess for rect! radiates to his bladder and scrotum. The nurse
   assesses these manifestations to be indicative
  blood in the stool.
36.  A client in the emergency department is of
 
hemorrhaging from a peptic ulcer and is being   a kidney stone in the ureter. 
42.   A client is complaining of “arthritis” in the
prepared quickly for emergency surgery. The  
hands and wrists. The nurse questions the client
nurse notes that the client is crying and reaches 47. A client is admitted to the emergency
about bowel habits and the client asks why. The
for the nurse frequently. The best response by department with severe, colicky pain that
best response by the nurse is  
the nurse to this client is to  radiates to his bladder and scrotum. The nurse
  “Arthritis complaints often go along with
  make eye contact, touch the client, and assesses these manifestations to be indicative
inflammatory bowel conditions.”
say, “This must be very scary for you.” of 
 
    a kidney stone in the ureter.
    ask the client about iodine allergies.
53.  The nurse explains to the client that the  
48. Before palpating the bladder of a client with glucosuria in the urinalysis indicates that 59. In counseling a pregnant woman scheduled
chronic urinary retention, the nurse should    the serum glucose level is above the renal for an ultrasound of the kidneys, the nurse
  get the bladder scanner to determine if the threshold.  would advise that
bladder is full.      the procedure is safe for the fetus.
  54. A client experiencing hematuria tells the
49. A client has an oral intake of 1500 ml and a nurse that the bleeding occurs at the end of 60.  A client is admitted with appendicitis and is
urine output of 350 ml in a 24-hour period. The urination, which could indicate a lesion in the awaiting surgery. The client states, “Now
nurse can correctly chart that the client is   prostate.  instead of pain in just one spot, the pain is kind
Correct!   of all over my abdomen.” Which action by the
  oliguric. 55. A client with inflammatory bowel disease nurse takes priority?
   (IBD) takes sulfasalazine (Azulfadine) for   Assess the client’s abdomen.
50. A client was released from the hospital management of manifestations. To counteract a  
following a lengthy course of IV antibiotics. The side effect of this drug, the nurse would 61. In caring for a client with peritonitis from
home health care nurse assesses that the client encourage the client to increase intake of  inflamed diverticuli, the nurse should assign
has been having new-onset diarrhea. What   peas and beans. priority to assessing
would the nurse suspect to be the cause of this      bowel sounds.
problem?  56. The nurse explains that a large increase of  
  difficile infection urobilinogen in the client’s urine is consistent 62. A 13-year-old client with ulcerative colitis
  with the diagnosis ofCorrect! says, “I am so glad I will grow out of this
51. In ER, an 83-year-old client is seen for   hepatitis or other liver disease. disease. It’s so embarrassing at school.” Which
urinary frequency and burning. A dipstick urine   action by the nurse would best address this
test reveals positive nitrates. Which action by 57.  The nurse explains that the serum statement?
the nurse is most appropriate? creatinine level is a better indicator for renal   Ask the client to explain what he/she
  Send the urine for a culture.  disorders because serum creatinine  means. 
    does not change in other systemic  
52. A nurse is taking a history from a middle-age disorders. 63. In caring for a client with Crohn’s disease
male client. He states that he takes no    and the nursing diagnosis of Imbalanced
prescribed medications, but he does take saw 58. A client is in the emergency department Nutrition: Less Than Body Requirements related
palmetto and pumpkin daily. The nurse with a suspected kidney stone and is scheduled to diarrhea, the nurse would plan to observe for
recognizes these herbs as being used to  for an intravenous pyelogram (IVP). Pre-   manifestations of anemia.
  maintain prostate health. procedure, which action is most important for   
   the nurse to do? The nurse should 
 68.  The nurse is preparing to assess a patient’s  
64.  In counseling a client with ulcerative colitis gastrointestinal system. What should the nurse 73. An 85-year-old patient is concerned about
for 25 years about health maintenance plans, say to gain the most information about this the loss of sensation of the need to defecate.
the nurse would include the advice that the patient’s elimination pattern?  How should the nurse respond? 
client shouldCorrect!   “Tell me about your usual bowel habits.”    “As you age, the rectum loses tone, and
  schedule regular proctoscopic   there is a reduced sensation of the need to
examinations.  69. A patient with a 2-month history of diarrhea defecate.” 
  is prescribed a diagnostic test that uses a  
65. The nurse is caring for a patient with narrow x-ray beam to provide a 360-degree 74. The nurse is teaching a patient scheduled
multiple skin lesions who reports following a view of abdominal structures. For which for a colonoscopy. Which patient statement
very-low-calorie diet to maintain weight loss. diagnostic test should the nurse prepare the indicates a need for further teaching?
What should the nurse identify as the patient’s patient?    “It might be quite painful.”
priority problem?    computed tomography   
Correct!    
  inadequate nutritional intake   75. During the admission assessment, the nurse
  70. While conducting an abdominal assessment, learns that a patient is having her menstrual
66. The healthcare provider determines that a the nurse notes dullness on percussion when period. Which ordered tests could be impacted
pregnant patient is at risk for having a baby the patient turns from the supine position to by this finding?
with a weak neurological system. Which foods the right side. How should the nurse interpret   stool culture
should the nurse counsel the patient to this finding?    
consume to address this potential problem?    The patient is exhibiting signs consistent 76. A 60-year-old patient who is pale and weak
  Food's high in folic acid help in growth and with ascites. has a hemoglobin level of 9 gm/dL. The patient
development and nervous system health. These   states, “I eat a healthful diet. Why am I not
foods include dark green vegetables, lean beef, 71. The nurse is planning the diet for a patient well?” How should the nurse respond? 
and eggs. scheduled to have a barium enema in 2 days.   “As we age, the amount of iron absorbed
  What kind of diet should the nurse plan for the by our body decreases.”
67. A patient is scheduled for a liver biopsy. next 48 hours?  
What should the nurse include in this patient’s   full diet today, clear liquids tomorrow 77. When assessing a patient’s abdomen, the
pre procedure teaching?    nurse notes frequent pulsations in the
  Complete blood tests prior to the 72. A patient is recovering from a epigastric region. What action should the nurse
procedure.  sigmoidoscopy with removal of a benign polyp. take? 
  What should the nurse include in this patient’s   notify the physician about the findings
discharge instructions?    
  Report abdominal pain, fever, or chills.
 83. The nurse reviews the functions of the 88. A patient with diabetes mellitus and poor
78. The nurse is conducting an abdominal gastrointestinal system for a patient with celiac circulation has thick and ingrown toenails. What
assessment. Which finding should the nurse disease. Which statement by the patient should the nurse instruct the patient to do? 
realize is most likely related to a diagnosis of indicates that teaching has been effective?    Make an appointment with a podiatrist.
acute diverticulitis?   “The stomach turns food into liquid so it  
  lower-left-quadrant pain can be digested.” 89.  A patient with diabetes asks what can be
    done to prevent the development of corns on
79. A patient reports epigastric abdominal pain, 84. The nurse is assessing a patient who uses the feet. How should the nurse respond to this
nausea, and vomiting. The serum amylase level chewing tobacco. Which data would be most patient? 
is 450 units/dL. For which health problem important for the nurse to obtain?   “Make sure that you select shoes that are
should the nurse plan care?    The patient has no leukoplakia. appropriately fitted.”
  pancreatitis    
  85. The nurse is preparing to percuss the 90. A patient at risk for the development of
80. The nurse determines that a patient has a abdomen of a patient. Which information type 2 diabetes mellitus asks why weight loss
scaphoid abdomen. Which health problem indicates that the nurse might need assistance will reduce risk of the condition. Which
should the nurse suspect the patient is with this assessment?  response by the nurse is most accurate?
experiencing? orrect!   The nurse anticipates hearing tympany   “Excess body weight impairs the body’s
  malnutrition over stool-filled intestines. release of insulin.”
     
81. A patient complains of constipation. Which    
question should the nurse ask to learn more  86. The nurse is reviewing data within a 91. A patient recently diagnosed with type 1
about the problem?  patient’s health history. Which factor in the diabetes mellitus does not understand why the
  “Are you taking any narcotic medication?” history should the nurse recognize as related to disease developed because the patient is thin
  the development of familial adenomatous and eats all of the time. What is the most
82. The home health nurse is teaching a patient polyposis? appropriate response by the nurse?ect!
about vitamin requirements. Which statement   The patient’s grandfather died of colon   “Diabetes makes it difficult for your body
indicates that the patient requires additional cancer.  to obtain energy from the foods you eat.”
teaching?     
  “Vitamins obtained through food are 87. The nurse is instructing a patient newly 92. A 78-year-old patient without polyuria,
superior to those obtained through tablets and diagnosed with celiac disease. The nurse knows polydipsia, or polyphagia has a serum glucose
pills.” follow-up is needed when the patient identifies level of 130 mg/dL. What should the nurse
  which foods as appropriate choices?  conclude about this patient? !
  whole-wheat toast and baked chicken   The patient will need to be assessed for
  other manifestations of diabetes.
    Obtain a capillary serum glucose level
93. The nurse notes that a 41-year-old patient’s reading with a glucose meter.
fasting blood glucose level is 125 mg/dL. What   
should the nurse suspect is occurring with the 98. The manager observes a graduate nurse
patient?  teaching a 5-year-old patient with diabetes
  consistent with prediabetes mellitus. The manager determines that content
  being instructed is appropriate when the nurse
94. A patient recently diagnosed with diabetes states, “Insulin acts like:
wants to check the urine for glucose instead of   a wagon that carries sugar into the cells of
using capillary blood because of the cost. Which the body.”
response should the nurse make to the  
patient?  99. A patient with type 1 diabetes mellitus
  “Urine testing is best when combined with voided 4,000 mL of urine in the past 24 hours.
serum testing.” The patient’s skin turgor is poor, and the
  patient is reporting polyphagia and polydipsia.
95. A patient with type 1 diabetes mellitus who Which blood glucose level should the nurse
had one episode of vomiting in the past 2 hours expect when assessing this patient? 
asks if the routine insulin injection should be   180 mg/dL
taken. What action by the nurse is best at this  
time?  
  Explain the need to take the insulin. 100. The nurse is concerned that a patient with
  type 1 diabetes mellitus is at risk for developing
96. A patient beginning insulin for type 2 diabetic ketoacidosis. What did the nurse assess
diabetes is experiencing blurred vision and is to come to this conclusion? 
concerned about becoming blind. What   serum glucose level of 325 mg/dL
response by the nurse is most appropriate?  
  “This is a normal response when insulin 101. The nurse is assessing a patient who has a
therapy is initiated.” family history of type 2 diabetes mellitus. Which
  finding would require follow-up by the nurse? 
97. A patient with diabetes is diaphoretic, has a   a new prescription for levothyroxine
heart rate of 112 beats per minute, and is (Synthroid) for hypothyroidism
feeling nervous and shaky. What action should
the nurse take first?