Alzheimer’s disease has developed altered thought processes and is having difficulty performing self-care activities of daily living.
A client with Alzheimer’s disease has developed altered thought processes and is having difficulty performing self-care activities of daily living. Which action should the nurse include in the client’s plan of care?
Ask a family member to participate in the client’s ADL care
Provide client care by the nursing staff that includes ADL care
Delegate the client’s ADL care consistently to the same caregivers
Encourage the client to perform self-care as much as possible
A female client has a hemoglobin of 9grams/dL or 90 grams/L and iron supplements are prescribed. When teaching this client about the administration of iron supplements, how should the nurse instruct her to take the iron tablets?
With a full meal at breakfast, lunch, or dinner
Before breakfast, with a glass of orange juice
Two hours after breakfast, with a small snack
Prior to bedtime, with a glass of low fat milk
An adult client with newly diagnosed hypothyroidism begins a new prescription for levothyroxine. The client tells the nurse about wanting to lose weight. The client’s current BMI is 32 on the medical record. How should the nurse respond?
Encourage a well-balanced diet that is low in fat and promotes gradual weight loss
Advise the client the BMI is within normal limits and weight loss may be unhealthy
Explain that the client will begin to lose weight after she starts her new prescription
Explain the need to monitor the capillary glucose level when reducing the caloric intake
A client who is taking an sulfonylurea agent glyburide-metformin to control type 2 diabetes mellitus arrives to the clinic describing of frequent episodes of fatigue, weakness, and sweating. Which information should the nurse obtain?
Glucose readings for the last week
The client’s 24-hour diet intake including times and amount
Urinary ketone levels of the first void in the morning
Primary and secondary family history of diabetes mellitus
A client with type 1 diabetes mellitus reports that for the last 2 weeks blood glucose monitoring levels have required less insulin. The client asks the nurse if this is an indication of the diabetes improving. Which action should the nurse take?
Discuss with the client that these levels are likely temporary.
Graph the client’s blood glucose testing results for a week.
Explain that the client is experiencing glycemic control.
Advise the client to include more carbohydrates in the diet.
What is the pathophysiological basis for Parkinson’s disease?
Increased amount of serotonin
Diminished amount of dopamine
Decreased amount of acetylcholine
Disruption in the myelin sheath
During an assessment, the nurse determines that a client with hypothyroidism has a goiter. An increase in which laboratory test results supports this finding?
Iodine
Serum T3 and T4
Calcium
Thyroid stimulating hormone
A Client presents to the emergency room vomiting dark brown emesis and in severe abdominal pain. The client reports to the nurse of recently being diagnosed with adenocarcinoma of the small intestine. After auscultating bowel sounds and obtaining vital signs, which prescription should the nurse implement next?
Insert a NGT and attach to low intermittent suction
Place an indwelling urinary catheter and attach a bedside drainage unit
Give a prescribed analgesic for temperature above 101F
Send the client to x-ray for a flat plate of the abdomen
An older resident of a skilled nursing facility has not had a bowel movement in the last week. After assessing the client’s abdomen, which action should the nurse take next?
Increase assisted ambulation
Perform a digital examination for fecal impaction
Administer an oil retention enema
Increase dietary fiber and add prune juice daily
How should the nurse explain to a male client why those with BPH often experience urinary retention?
Inflammation causes spasms of the gland
Nerve compression decreases the sensation that the bladder is full
The enlarged gland compresses the urethra
Abnormal growth results in loss of bladder muscle tone
A client arrives to the medical-surgical unit 4 hours after a transurethral resection of the prostate. A triple-lumen catheter for continuous bladder irrigation with normal saline is infusing and the nurse observes dark, pink-tinged outflow with blood clots in the tubing and collection bag. Which action should the nurse take?
Monitoring catheter drainage
Discontinuing infusing solution
Decreasing the flow rate
Irrigating the catheter manually
A client is diagnosed with diverticulosis following a colonoscopy. The client denies any symptoms and asks the nurse what to expect. Which is the best response by the nurse?
As the sacs enlarge pain may be experienced in the lower abdomen
Episodes of burning pain are commonly experienced
Symptoms may not occur unless sacs become inflamed
Appetite loss, with resultant feelings of weakness, are common problems
A postoperative client reports incisional pain. The client has two prescriptions for PRN analgesia that accompanied the client from the PACU. Before selecting which medication to administer, which action should the nurse implement?
Determine which prescription will have the quickest onset of action
Document the client’s report of pain in the electronic medical record
Compare the client’s pain scale rating with the prescribed dosing
Ask the client to choose which medication is needed for the pain
A client with rheumatoid arthritis has an elevated serum rheymatoid factor. Which interpretation of this finding should the nurse make?
Representative of a decline in the client’s condition
Confirmation of the autoimmune disease process
Evidence of spread of the disease to the kidneys
Indication of the onset of join degeneration
The nurse assists a client with Parkinson’s disease to ambulate in the hallway. The client appears to freeze and then carefully lifts one leg and steps forward. The client tells the nurse of pretending to step over a crack on the floor. How should the nurse respond?
Assist the client to a carpeted area where he can walk more easily
Plan to assess the client’s cognition after returning to his room
Confirm that this is an effective technique to help with ambulation
Re-orient the client to his present location and circumstances
A client with a seizure disorder tells the nurse of plans to stop taking divalproex, a prescribed anticonvulsant, because of not experiencing a seizure for over four years. How should the nurse respond?
Determine if the client’s serum drug level is currently within the therapeutic range
Explain to the client of the life-long need to take the medication
Advise the client to obtain a neurologic evaluation before discontinuing the medication.
Assess the client’s gait and balance before confirming readiness to stop the medication.
A client is receiving tamsulosin, an alpha adrenergic blocking agent, for the management of urinary retention due to benign prostatic hyperplasia (BPH). Which instruction is most important for the nurse to provide?
Reduce daily fluid intake.
Use a twice-a-week dosing schedule.
Take the medication early in the day.
Stand and sit up slowly.
A client is admitted for treatment of acute diverticulitis with associated nausea and vomiting. Which serum laboratory value is most important for the nurse to monitor during the client’s treatment?
White blood cell count.
Liver enzymes.
Platelet count.
Albumin and protein levels.
The nurse is caring for a client with elevated parathyroid hormone levels. Which safety precaution should the nurse include in the plan of care?
Aspiration.
Suicide.
Falls.
Hypothermia.
A home-bound client with severe, end-stage chronic obstructive pulmonary disease (COPD) is being visited by the home health nurse. Which instruction should the nurse include in the client’s teaching plan?
Use pursed-lip breathing techniques continually, around the clock.
Use the beta-agonist inhalers q2h, around the clock.
Cluster activities together, first thing in the morning.
Use oxygen continuously, at the lowest dose possible.
While planning care for a client experiencing pain, which outcome statement should the nurse include in the plan of care?
Report a 5 point decrease on a 1 to 10 pain scale one hour after analgesia.
Request no PR pain medication after experiencing a precipitating cause.
Be pain free and sleep through the night.
Learn four pain management techniques.
A client with diabetes mellitus is admitted with an upper respiratory infection. Which changes in blood glucose management should the nurse tell the client to expect?
Fewer fingerstick glucose checks.
Increased oral fluid intake.
Higher doses of insulin.
Restriction of caloric intake.
A male client who has erectile dysfunction (ED) recently received a new prescription for sildenafil citrate. During a clinic visit, the client reports the onset of nasal congestion, dizziness, nausea, and dyspepsia. Which nursing assessment takes priority?
Palpate abdomen for distention or tenderness.
Measure blood pressure while lying and standing.
Assess for the presence of muscle or back pain.
Auscultate and compare breath sounds bilaterally.
An adult client who was admitted yesterday with bilateral pneumonia has congested breath sounds, an oxygen saturation of 94%, and a temperature of 100° F (37.8° C). The client has a weak cough effort and is using their accessory muscles to breathe. Which intervention should the nurse implement first?
Suction to clear secretions from airway.
Offer a prescribed PRN analgesic.
Obtain arterial blood gases.
Administer a prescribed antipyretic.
A client with hypertension is complaining of dizziness and blurred vision. The client’s vital signs are temperature 99° F (37.2°C), heart rate 128 beats/minute, respirations 18 breaths/minute, and blood pressure 188/98. Which intervention should the nurse implement?
Dim lights in client’s room and limit number of visitors.
Prepare client for computed tomography (CAT) scan.
Administer PRN IV antihypertensive medication.
Obtain a 12 lead electrocardiogram (ECG).
An older male client is brought to the emergency department by his daughter. He is complaining of abdominal pain and the inability to urinate, except for small amounts of incontinence. What action should the nurse implement first?
Insert an indwelling catheter to drain bladder of retained urine.
Administer intravenous pain medication for ongoing abdominal pain.
Scan bladder to determine the amount of urine in the bladder.
Obtain a urine sample from incontinence for culture and sensitivity.
A client diagnosed with a seizure disorder is receiving phenytoin. Which instruction should the nurse provide this client?
“Decrease fluid intake when taking this medication.”
“Stop taking the medication if hirsutism occurs.*
“Take the medication on an empty stomach.*
“Contact your healthcare provider before trying to get pregnant.”
A middle-aged client is admitted to the hospital for the new onset of a non-productive cough, elevated temperature, and sweating. The healthcare provider makes a preliminary diagnosis of community-acquired pneumonia (CAP). Which prescription should the nurse address first?
Complete blood count (CBC).
Portable chest radiograph.
Comprehensive metabolic panel.
Arterial blood gases (ABGs).
After administering an antihypertensive medication to an older client, which actions should the nurse implement? (Select all that apply.)
Insert an indwelling Foley catheter to monitor urinary output.
Instruct the client to call the nurse before getting out of bed.
Assess the client’s blood pressure before getting out of bed.
Maintain the head of the client’s bed elevated at all times.’
Verify that the client understands how to use the call button.
Two hours before a client’s scheduled surgery, the nurse is completing the preoperative checklist. Which information requires the most immediate action by the nurse?
Preoperative serum potassium level is 2.8 mE/L (2.8 mol/L).
Preoperative chest x-ray report is not available.
Surgical consent form is not signed.
Client’s pulse oximeter reading is 96%.
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