Final exam 1 Med Surge
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| What is the nurses first action when beginning client education | Determine clients interest and learning prior to initiation of teaching session
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| Which action shows an understanding of the principle of self determination | The nurse allows a post operative client to decide to take medication with fruit juice rather than water
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| The nurse is initiating a series of teaching sessions with an older client, what is the nurses highest priority action prior to to beginning the session | Make sure the client is wearing his glasses
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| which action demonstrates the nurse is using critical thinking for planning a menu for a vietnamese client who is newly diagnosed with diabetes | researching the vietnamese culture prior to discussing diabetes and planning
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| what assessment data should be collected first from a client admitted to an emergency dept with a lacerated artery | history of what medications the client is currently taking
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| the clients primary health care provider is an advanced practice nurse in an ambulatory care setting which intervention can the client expect to receive from the nurse in an ambulatory care center | teaching the client how to change a dressing
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| how does a community nurse run client clinic differ from a physicians office practice setting | the primary health care provider are advanced practice nurses
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| which client is most likely to require transitional subacute care before being discharged to the home setting | client requiring deep wound management
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| a client arrives in a health clinic is concern by being assessed by a np instead of a dr the rn develops a teaching plan on the differences between np and a dr other than educational preparation what is the main difference health care provided by a np and | nurse practitioners provided care from a wellness model and physicians more often focus on illness care
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| which statement best describes the process of nursing case management | a collective process to promote quality and cost effective care
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| which client is best served by a case manager | an older woman with chronic congestive heart failure and diabetes
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| which statement indicates that the health professional requires teaching about clinical pathways | without implementation of clinical pathways our agency could not be accredited by the TJC
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| the nurse is caring for a client who is medicated for pain one hour ago, client is stating that the medication is not working and she still has pain, what is the first action the nurse's will take | believe the clients report of pain
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| when is the nurse correct in decreasing the dose of pain medication in a client with end stage cancer | the client wants remain alert during the visit of a long time friend
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| a client with chronic pain is being discharged from the hospital when planning the clients pain of relief for the regiment for home it is most important for the nurse to communicate with which member of the healthcare team | the home health care nurse
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| a client with arthritic pain is considering taking a herbal supplement to relive arthritic pain what teaching is most important for the nurse to carry out with the client | informing any healthcare providers about the use of this supplement
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| which instruction should the nurse include in the discharge teaching plan of a client who has had a transcutaneous electronic nerve stimulation unit implanted | you can perceive a pins and needle stimulation
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| why does the nurse always ask the client his or her pain level after taking routine vital signs | to ensure that pain assessment occurs on regular basis
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| a client with cholecystitis has pain in the right shoulder area and asks what is happening to me what did I do to my shoulder, what is the nurses best response | sometimes pain from a certain organ is referred elsewhere in the body
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| a nurse is assigned to care for the following four clients who have to the potential for having pain. which client is most likely not be treated adequately for their problem | older adult client with arthritis
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| the physician orders a dose medication that does not resolve the clients chronic pain, when the nurse questions the order the physician explains that he fears the client will develop an addiction with higher drug dosages, what is the nurses best response | consult with a pain controlled specialist
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| a client who is taking oxycodone for an extended period of time comes to the clinic complaining the drug no longer relieving his pain, which category would be given to the clients complaint | tolerance
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| a home care client who is taking morphine for pain management abruptly stops taking his medication which symptoms would indicate a physical dependence | abdominal cramping
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| a home care client who is currently on hydromorphone for pain management presents to the hospital complaining of abdominal cramping, nausea, and sweating. when taking the clients history the nurse should ask which question | when did you take your last dose of hydromorphone
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| the nurse is assessing a client with a history of arthritic pain, assessment findings reveal a heart rate of 120 bpm, bp 170/80 which intervention will the nurse carry out first | assess if the client has developed another type of pain
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| the nurse is caring for four clients who are complaining of pain based on the following assessment and history which clients pain is most likely chronic in nature | history of rheumatoid arthritis bp 110/70
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| when assessing the client which behavior most indicates that he or she is experiencing changes associated with acute pain | inability to concentrate
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| a nurse anticipates a client who rates his pain level at a 10 on a scale of 1-10 has undergone which of the following surgical procedures | upper abdominal
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| which assessment finding is caused for concern in a client who has taken four grams of tylenol to relieve his back pain | increase liver function test
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| during the perioperative assessment the client tells the nurse that he has been taking NSAID for years, what questions is most important for the nurse to ask | when was the last time you took it
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| a client has been receiving 10 mg of morphine Q4H for acute pain his discharge medication includes an oral combination of opioid and NSAIDs preparation oxycodone what dosage would be considered to be equianalgesic | 30 mg
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| a client is taking oxycodone tylenol preparation tylox at home daily for chronic pain management what instructions will the nurse give the client | drink plenty of water and eat foods high in fiber
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| a client was given 15 mg of morphine IM for post surgical pain, when the nurse checks the client for pain relief an hour later, the client is sleeping and has a respiratory rate of 8 breaths/minute, what is the nurses first action | arouse the client by calling his or her name and lightly shaking the clients arm
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| the nurse accidentally administers 15 mg of morphine to a patient who has been given another dose of morphine 15 mg IM about 30 minutes early, what initial action should the nurse be prepared to take | administer Narcan
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| a client is admitted to the hospital with a history of oxycodone for percodan abuse which clinical manifestation would the nurse observe the client | muscle twitching and perfuse perspiration
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| which client would the nurse suggest to try subcutaneous opioid anagelsic for pain management | client with cancer patient who is nauseous
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| a client with colon cancer is discharged home with morphine for pain management is having episodes of nausea and vomiting which route of morphine administration would be most advantageous to use | rectal
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| the nurse is caring for four clients which client assessment would be the most indicative for having pain | heart rate of 100 bpm and restless
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| the client has a history of alcohol abuse which pain relief regimen should the nurse anticipate in morphine ms contin is given for pain | a higher dose of opioids will be needed to provide a effective pain relief
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| which instructions is the most accurate for the nurse to give a client who has client controlled has a pca after abdominal surgery | push the button when you feel pain beginning rather than waiting till the pain is at its worse
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| the nurse assess several post operative patients receiving PCA epidural, which client will the nurse prioritize to assess first | client receiving marcaine complaining of the inability to move the legs
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| because the client has an epidural analgesia with marcaine for pain relief which condition should the nurse anticipate as a potential problem | inability to raise legs off the bed
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| when assessing the client who is taking long term motrin for pain the nurse finds numerous areas of bruising what is the nurses first action | assess for gastric discomfort
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| which statement made by a nurse represents the need for further education regarding pain medication in an older adult clients | older clients have a different pain mechanism and do not feel it as much
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| prior to surgery the nurse observes the client listening to music on the radio based on this observation the nurse may try which non pharmacological intervention for pain relief in the post operative setting | imagery
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| morphine for pain management, the family expresses concern that morphine may cause the client to stop breathing and die what is the nurses best response | his respirations are not affected by this morphine dosing
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| primary prevention interventions for older adult should include prevention of which condition | accidents
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| how is a handicap different from an impaired as defined by the WHO | impairment of physical abnormalities and handicaps are societal values placed on individuals with impairments
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| the nurses is planning discharge teaching for rehabilitation for a client who is a paraplegic the client verbalizes he doesn't know why he should go, what is the nurses best response | rehabilitation will teach you how to maintain the functional ability you have
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| the client who has longstanding COPD is recovering from a stroke which intervention is a priority when caring for a client to assess activity tolerance during rehabilitation | assessing vital signs before during and after activity
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| a client with a past history of angina has had a total knee replacement what wil the nurse teach the client prior to rehabilitation activities | take nitroglycerin prior to activity
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| the nurse is assessing a client who has recently had a brain attack for the ability to toilet independently what should the nurse assess in establishing a level of independence for toileting | the ability to sit on a toilet unassisted
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| what test will best assist the nurse in determining the severity of a clients disability | functional independence measure
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| what is the priority nursing diagnosis for a client in a rehabilitation program after a stroke that has caused excessive right sided weakness | risk for impaired skin integrity
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| the nurse is assessing the clients ability to transfer from the bed to the wheelchair what might impair a clients ability to perform this task | weight gain
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| the nurse is performing passive range of joint motion exercise on a semiconscious client and meets resistance while attempting to extend the right elbow more than 45 degrees, what will the nurse do | move the joint only to the point at which resistance is met
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| what intervention will best help the client with decrease mobility decrease the risk for fractures | performing weight bearing activities
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| the nurse assess a client admitted to rehabilitation, the client has full range of motion but presents with a weak grasp, what exercise does the nurse perform | resistant range of motion
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| which assessment finding will prevent a client from being a candidate for self catheterization | confusion
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| which action will the nurse implement to prevent pressure ulcers in a bed ridden client | adjusting nutritional intake based on serum albumin and transferrin levels
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| the client has left sided weakness which gait training technique will the nurse and physical therapist use to assist a client with cain | placing a cane in a clients stronger side hand and moving the cain forward followed by moving the weaker leg moving one step forward
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| which nursing intervention will the nurse implement to prevent venous stasis and thrombus formation in a client undergoing rehabilitation | range of motion exercises
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| which activity plan will best conserves a clients energy without compromising the clients physical or mental health | scheduling energy intense activities in the morning when energy levels are high
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| which dietary modification will the nurse reinforce to reduce the risk of skin impairment in a client of impaired physical mobility | high protein hig carbohydrate and low fat
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| a nurse catheterizes a client immediately after voiding the residual volume of 50 ml, what will the nurse do | document the findings as the only action
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| the client is performing intermittent self catheterization at home is concerned about the cost of the catheter, what is the nurses best response | you can reuse the catheter at home clean technique rather than sterile technique is acceptable
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| the nurse teaches a client at risk for urinary tract infections to increase which juices in their diet | tomato juice
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| an older adult client is getting out of bed for the first time the nurse is alert for the development of which potential problem | orthostatic hypotension
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| a paraplegic client is being evaluated for transfer to rehabilitation unit, the nurse refers to an interdisciplinary team member for evaluation for activities of daily living | occupational therapist
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| the nurse performs an admission history on a client who has been transferred to a rehabilitation floor of a hospital the client asks why are you doing this again they took my history on the floor how will the nurse respond | i need to formulate and individualized plan of care
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| prior to ambulating a client, what information is essential for the nurse to know | when the client has a nitroglycerin patch
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| during the admission history intake the client with hip problems as why are you asking my bowels and bladder | it is best schedule an activity around your elimination pattern
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| a client starting on a structured cardiac rehabilitation program before starting the activity what will the nurse do | determine the level of activity before shortness of breath occurs
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| the nurse is caring for a client with a spinal cord injury at level T3 how will the nurse assist the client with bladder disfunction | use the crede manuever for the bladder every 3 hours
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| a client with a flaccid bladder is undergoing bladder training the nurse begins the clients bladder training by teaching which technique | Valsava manuever and crede manuever
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| the client is receiving the following medication synthroid 0700 and digoxin at 0900 what will be the best time to administer metamucil | after the lanoxin at 0900, 1300
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