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MED SURG EXAM 3 GALEN COLLEGE OF NURSING
NEWEST 2024 ACTUAL EXAM TEST BANK 200 QUESTIONS
AND CORRECT DETAILED ANSWERS ( VERIFIED ANSWERS )
|ALREADY GRADED A+
The nurse is discussing preventative interventions to avoid musculoskeletal injuries. What should the nurse encourage the client to take with calcium to help metabolize the calcium?
- Vitamin B6
- Magnesium
- Vitamin D
d. Potassium - ANSWER- Answer: c
Cognitive Level: Apply
Rationale: Communicate to clients the importance of appropriate
exercise and a diet that includes adequate amounts of proteins and minerals. Calcium is especially important. Adequate vitamin D is also required for the body to metabolize calcium. Although important to the diet, vitamin B6, potassium, and magnesium do not assist with the metabolizing of calcium.
An older adult client is admitted to the acute care facility. What nursing action is a priority to help with the prevention of falls?
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- Perform a fall risk assessment.
- Have restraints in the room if the client tries to get out of bed.
- Obtain a walker for ambulation.
- Inform the client not to get out of bed without assistance. - ANSWER-
Answer: a
Cognitive Level: Apply
Rationale: A fall risk assessment should be performed on all clients
regardless of age to determine what interventions may be required.Although the client in this scenario is an older adult, the level of ambulation may be independent and would not necessarily require a walker or other assistive device. The client should be able to ambulate in the room but if it is determined after performing a fall risk assessment that the client requires assistance, the client should be instructed to use the call bell so someone can come and assist the client out of bed.
The nurse is caring for a client who states, "My knees are so stiff this morning." What nursing action may the healthcare provider order to alleviate the discomfort?
- Apply cool compresses to the knees.
- Encourage adequate nutrition.
- Apply moist heat to the knees.
d. Administer a narcotic analgesic. - ANSWER- Answer: c
Cognitive Level: Apply
Rationale: For joint stiffness and discomfort, hydrotherapy and
warm heat are helpful to alleviate the discomfort. Cool compresses 2 / 4
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will cause more stiffness in the joints. Adequate nutrition and maintaining weight can help with arthritic pain in the future but is not an immediate remedy.
A client suffered a stroke that affected the left side of the body. What nursing action will assist with the prevention of contractures of the lower extremities?
- Apply heat to the extremities.
- Position the client as if standing.
- Apply sequential compression devices to the lower extremities.
- Stand the client on both feet several times a day. - ANSWER-
Answer: b
Cognitive Level: Apply
Rationale: Positioning clients as if they are standing while in the bed
will help prevent contractures and foot drop. Applying heat will not prevent contractures. Applying sequential compression devices will assist with the prevention of thrombophlebitis. The client may not be ready for aggressive physical therapy and standing at this time could cause falls.
A client is having symptoms associated with an alteration in muscle function. What diagnostic tests should the nurse prepare the client for?Select all that apply.
- Creatine kinase
- Electromyelogram 3 / 4
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- Lumbar puncture
- Muscle biopsy
e. Electrocardiogram - ANSWER- Answer: a, b, d
Cognitive Level: Apply
Rationale: Tests of muscle function and/or disorders include the
blood level of creatine kinase, electromyogram (measurement of electrical activity of muscle tissue), and muscle biopsy. Neither a lumbar puncture nor an electrocardiogram are tests for muscle function.The nurse is gathering data from a client with a loss of melanin production from age-related changes. What observation made by the nurse correlates with this change?
- White hair
- Freckles on the nose and cheeks
- Ridges on the skin surface
d. Thickened areas on the palms and heels - ANSWER- Answer: a
Cognitive Level: Analyze
Rationale: Melanocytes are cells within the epidermis that, through
a complex process, create the pigment melanin. Melanin gives color to the hair, skin, and other structures in the body. With aging, there is a decrease in production of melanin and the color may be lost in the hair rendering it white. Freckles would relate to an increase in melanin, which can occur with sun exposure or genetics. Ripples or ridges on the skin surface that are particularly visible on the tips of the fingers are known as fingerprints. The ridges provide some friction, helping to grasp objects. Areas of greater friction, such as
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