“Medical Surgical Nursing Review Questions Part 5” plus 2 more nursing article(s): NursingCrib.com Updates

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• Medical Surgical Nursing Review Questions Part 5
• Medical Surgical Nursing Review Questions Part 4
• General Nursing Interventions for the Mental Health Client

Medical Surgical Nursing Review Questions Part 5 Posted: 24 Nov 2010 10:58 PM PST December 2010 Nursing Board Exam Review Questions on Medical Surgical Nursing. Mark the letter of your choice then click on the next button. Your score will be posted as soon as the you are done with the quiz. We will be posting more of this soon. 1.    The nurse is caring for a child who has just returned from surgery following a tonsillectomy and adenoidectomy. Which action by the nurse is appropriate? a. Offer ice cream every 2 hours b. Place the child in a supine position c. Allow the child to drink through a straw d. Observe swallowing patterns 2.    The nurse is teaching administration of albuterol inhalation to an adult with asthma. Which of the following demonstrates proper teaching? a. " Use this medication at bedtime to promote rest " b. " Discontinue the inhalation if you are dizzy " c. " Inhale this medication after other asthma sprays" d. " Notify the health care provider if you need the drug more often " 3.    The nurse is teaching a client with asthma about the correct use of the Azmacort (triamcinolone) inhaler. Which of the following statements, if made by the client, would indicate that the teaching was effective? a. " The inhaler can be used whenever I feel short of breath" b. "I should rinse my mouth after using the inhaler" c. "If I forget a dose, I can double up on the next dose" d. I should not use the spacer with my Azmacort 4.    The nurse is administering albuterol (Proventil) to a child with asthma. Which of the following assessments by the nurse indicate the need for an adjustment of the medication? a. Lethargy and fatigue b. Edema is the lower extremities c. Apical Pulse of 112 d. Temperature of 101 degrees Farenheit 5.    An elderly client is on an anticholinergic metered dose inhaler (MDI) for chronic obstructive pulmonary disease. Why should the nurse suggest a spacer? a. Decrease administration time of the medication b. Increase client compliance c. Improve aerosol delivery in clients who are not able to coordinate the MDI d. Prevent exacerbation of COPD 6.    A client is 2 days post operative. The vital signs are: BP-120/70, HR-110, RR-26, and temperature- 100.4 degrees Fahrenheit (38degrees Celsius). The client suddenly becomes profoundly short of breath, skin color is gray. Which assessment would have alerted the nurse first to the client's change in condition? a. Heart rate b. Respiratory rate c. Blood pressure d. Temperature 7.    The nurse must know that the most accurate oxygen delivery system available is a. The venturi mask b. Nasal cannula c. Partial non-re breather mask d. Simple face mask 8.    The nurse has been assigned to these clients in the emergency room. Which client would the nurse go check first? a. Viral pneumonia with atelectasis b. Spontaneous pneumothorax with a respiratory rate of 38 c. Tension pneumothorax with slight tracheal deviation to the right d. Acute asthma with episodes of bronchospasm 9.    The nurse is performing an assessment on a client with pneumococcal pneumonia. Which finding would the nurse anticipate? a. Bronchial breath sounds in outer lung fields b. Decreased tactile fremitus c. Hacking, non productive cough d. Hyper resonance of areas of consolidation 10.    When teaching a client with chronic obstructive pulmonary disease about oxygen by cannula, the nurse should also instruct the client's family to a. Avoid smoking near the client b. Turn off oxygen during meals c. Adjust the liter flow to 10 as needed d. Remind the client to keep mouth closed 11.    The nurse walks into a client's room and found the client lying still and silent on the floor. The nurse should first a. Assess the client's airway b. Call for help c. Establish that the client is unresponsive d. See if anyone saw the client fall 12.    A client with emphysema visits the clinic. While teaching about proper nutrition, the nurse should emphasize that the client. a. Eat foods high in sodium increases sputum liquefaction b. Use oxygen during meals improves gas exchange c. Perform exercise after respiratory therapy enhances appetite d. Cleanse the mouth of dried secretions reduces the risk of infection 13.    The nurse is caring for a client with a tracheostomy. An appropriate nursing diagnosis for this client is a. Impaired verbal communication related to absence of speaking ability b. Ineffective airway clearance related to increased tracheobronchial secretions c. Risk for impaired skin integrity related to tracheostomy incision d. Alteration in comfort: pain related to tracheostomy 14.    When obtaining a specimen from a client for sputum culture and sensitivity (C and S), the nurse knows that which of the following instructions is BEST? a. After pursed-lip breathing, cough into a container b. Upon awakening, cough deeply and expectorate into a container c. Save all the sputum for three days in a covered container d. After respiratory treatment, expectorate into a container 15.    A four year old is admitted with drooling and an inflamed epiglottis. During the assessment, the nurse would identify which of the following symptoms as indicative of an increase in respiratory distress? a. Bradycardia b. Tachypnea c. General pallor d. Irritability 16.    A home care nurse is planning activities for the day. Which of the following clients should the nurse see first? a. A new mother is breastfeeding her two day old infant who was born five days early. b. A man discharged yesterday following treatment with IV heparin for a deep vein thrombosis. c. An elderly woman discharged from the hospital three days ago with pneumonia. d. An elderly man who used all his diuretic medication and is expectorating pink tinged mucus 17.    The nurse is caring for a client 2 hours after a right lower lobectomy. During the evaluation of the water seal chest drainage system, it is noted that the fluid level bubbles constantly in the water seal chamber. On inspection of the chest dressing and tubing, the nurse does not find any air leaks in the system. The next best action for the nurse is to a. Check for subcutaneous emphysema in the upper torso b. Reposition the client to a position of comfort c. Call the health care provider as soon as possible d. Check for any increase in the amount of thoracic drainage 18.    The nurse is caring for a child receiving chest physiotherapy (CPT). Which of the following actions by the nurse would be appropriate? a. Schedule the therapy thirty minutes after meals b. Teach the child not to cough during the treatment c. Confine the percussion to the rib cage area d. Place the child in a prone position for therapy 19.    A 48-year-old man with an endocrinal tube needs suctioning. Which of the following statements is an accurate description of how the nurse should perform the procedure? a. Insert the suction catheter four inches into the tube. Apply suction for 30 seconds, using a twirling motion as the catheter is withdrawn. b. Hyperoxygenate the client and then insert the suction catheter into the tube. Suction while you remove the catheter using a back and forth motion c. Explain the procedure to the patient. Insert the catheter while gently applying suction, and withdraw using a twisting motion d. Insert the suction catheter until resistance is met, then withdraw it slightly, apply suction intermittently as the catheter is withdrawn. 20.    After receiving report which of the following patients should the nurse see first? a. A patient in sickle-cell crisis with an infiltrated IV b. A patient with leukemia who has received one-half unit of packed cells c. A patient schedule for a bronchoscopy d. A patient complaining of a leaky colostomy bag 21.    A client is diagnosed with lung cancer and undergoes a pneumonectomy. In the immediate postoperative period, which of the following nursing assessments is MOST important? a. Presence of breath sounds bilaterally. b. Position of the trachea in the sternal notch c. Amount and consistency of sputum d. Increase in the pulse pressure 22.    The nurse is caring for an eight year old child after a tonsillectomy. The nurse would be most concerned if which of the following was observed? a. A heart rate of 88 beats per minute b. Expectorating bright red secretions c. 30 ml of dark brown secretions d. Infrequent swallowing 23.    A client is admitted to the emergency room following an acute asthma attack. Which of the following actions would the nurse do first? a. Check the carotid pulse b. Deliver 5 abdominal thrusts c. Give 2 rescue breaths d. Open the client's airway 24.    A client is admitted to the emergency room following an acute asthma attack. Which of the following assessments would be expected by the nurse? a. Diffuse expiratory wheezing b. Loose, productive cough c. No relief from inhalant d. Fever and chills 25.    A nurse admits a premature infant who has respiratory distress syndrome. In planning care, nursing actions are based on the fact that the most likely cause of this problem stems from the infant's inability to a. Stabilize thermoregulation b. Maintain alveolar surface tension c. Begin normal pulmonary blood flow d. Regulate intracardiac pressure Related posts: Medical Surgical Nursing Review Questions Part 4 Medical Surgical Nursing Review Questions Part 3 Medical Surgical Nursing Review Questions Part 2

Medical Surgical Nursing Review Questions Part 4 Posted: 24 Nov 2010 05:44 PM PST December 2010 Nursing Board Exam Review Questions on Medical Surgical Nursing. Mark the letter of your choice then click on the next button. Your score will be posted as soon as the you are done with the quiz. We will be posting more of this soon. Please go to Medical Surgical Nursing Review Questions Part 4 to view the quiz Related posts: Medical Surgical Nursing Review Questions Part 5 Medical Surgical Nursing Review Questions Part 3 Medical Surgical Nursing Review Questions Part 2

General Nursing Interventions for the Mental Health Client Posted: 24 Nov 2010 05:39 PM PST Forming a one-to-one relationship with the client It will help the client to enhance communication, problem solving, and social skills. Coping skills and trust in relationships may be learned or enhanced. The nurse who establishes this relationship needs to be clear about its purpose and provide positive interaction with the client. Establishment of a specific meeting time, expectations for interaction, and the duration of therapy are important boundaries to establish. Constructive Feedback Given to the client so that the client's self-esteem will not be compromised. When the confrontation technique is used, the nurse needs to discuss the discrepancies between the client's verbalized intensions and non-verbal behavior carefully, without appearing to be attacking the client. Trust Essential to establish a therapeutic relationship. Consistency is the key. If the nurse cannot meet with client at an appointed time, the client must be informed at the earliest possible time. A new meeting time is scheduled. Direct communication is essential for the building of a therapeutic relationship. Other factors that facilitate trust within the nurse/client relationship include: Recognizing the client's feelings. Honesty Respect for the client Non-judgmental attitude Emphasize Positive Results Do not argue with the client. Recognize that the client is experiencing pain but do not dwell on that pain. Assessment Critical of their behavior at the time of admission or initial treatment. Reassessment is indicated at appropriate intervals. The client must also learn how to self-monitor his or her symptoms. This communicates to the client that he or she is respected and can control his or her symptoms. Safety The primary concern. The client may require protection interventions; these must be provided in a safe manner with respect for the client. The milieu may need to be evaluated for safety Environment Provide privacy and time with decreased stimuli. It should be a calm environment in which the client feels safe from psychological and physical threats. Physical needs Intricately related to psychological function. Ensure that the client's nutritional, fluid, sleep, hygiene, activities of daily leaving, and exercise needs are met. Treatment planning The client should encourage to participate in every planning. Medications Approach the confused or combative client in a calm, firm manner when administering client. Restrains or the assistance of another care provider may be necessary for injections. Ensure that the client takes medications and is not hoarding pills. Client will need to learn about his or her medications and hot to maintain this treatment without direct staff supervision. Education Very important throughout treatment. Discharge planning Begins with the client is admitted, whether it is in the hospital, home care, or any other treatment program. The family must be involved in the process to become successful. Related posts: Psychiatric Mental Health Assessment Three Phases of Nurse-Client Relationship Therapeutic Community or Milieu Therapy

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