NUR 257 Exam 6 - indicates that the client has received proper n...

NUR 257 Exam 6

• A client with a confirmed DVT is being discharged from the ED. Which client statement

indicates that the client has received proper nursing instruction and understands how to manage this condition?"I should try not to drink too much during the daytime." "I should lie on my side with my knees bent when sleeping." "I need to ice my leg every 2 hours for about 20 minutes." "I need to do my leg exercises five times or more every hour."

Answer

"I need to do my leg exercises five times or more every hour."

• A nurse is caring for a client who had an aortic balloon valvuloplasty. The nurse should

inspect the surgical insertion site closely for which complication(s)?Bleeding and infection Bleeding and wound dehiscence Thrombosis and infection Evisceration

Answer

Bleeding and infection

• A client who recently had a myocardial infarction develops pericarditis and complains of

chest pain rated 6 (on a scale of 0-10) with deep breathing. Which ordered pro re nata medications is most appropriate for the nurse to administer?Morphine sulfate 6 mg IVP every 2-4 hours Fentanyl 2 mg intravenous pyelogram (IVP) every 2-4 hours Acetaminophen 650 mg PO every 4 hours Ibuprofen 800 mg PO every 8 hours

Answer

Ibuprofen 800 mg PO every 8 hours

• The nurse instructs a client recovering from mechanical valve replacement surgery. Which

client statement indicates that teaching has been effective?"I can play soccer in a week or two." "I will not drive until informed by my health care provider." 1 / 4

"I have a low risk of developing an infection in my heart." "I will not need to take anticoagulant medication every day."

Answer

"I will not drive until informed by my health care provider."

• A nurse is caring for a client receiving warfarin therapy following a mechanical valve

replacement. The client had a prothrombin time and International Normalized Ratio (INR) drawn before breakfast. The laboratory report shows the client's INR reading was 4. What is the nurse's first priority ?Assess the client for bleeding and notify the health care provider of the results.Notify the next nurse on afternoon shift to hold the evening dose of warfarin.Notify the health care provider to request an increase in the warfarin dose.Be prepared to administer an I.M. vitamin K injection and notify the healthcare provider of the results.

Answer

Assess the client for bleeding and notify the health care provider of the results.

• The nurse suspects a client has developed pericarditis after a week of cold-like symptoms.

Which of the client's signs and symptoms indicate peri- carditis?low urine output secondary to left ventricular dysfunction fever, chest discomfort, and elevated erythrocyte sedimentation rate (ESR) pitting edema, chest discomfort, and nonspecific ST-segment elevation lethargy, anorexia, and heart failure

Answer

fever, chest discomfort, and elevated erythrocyte sedimentation rate (ESR)

• A client is admitted to the hospital with aortic stenosis. What assessment findings would

indicate the development of left ventricular failure?Orthopnea, nausea, pedal edema Distended jugular veins, pedal edema, nausea Dyspnea, orthopnea, pulmonary edema Dyspnea, distended jugular veins, orthopnea

Answer

Dyspnea, orthopnea, pulmonary edema 2 / 4

• Which would the nurse stress as a periodic lifelong necessity for a client managing infective

endocarditis?Exercise regimen Antihypertensive medication Potassium replacement Antibiotic therapy Answer Antibiotic therapy

• The nurse is caring for a client who has been diagnosed with aortic stenosis. The client is

prescribed digoxin. What is the rationale for the medication?left ventricular dysfunction angina dyspnea edema

Answer

left ventricular dysfunction

• A client is admitted to the hospital with possible acute pericarditis and pericardial effusion.

The nurse knows to prepare the client for which diagnostic test to confirm the client's diagnosis?Computed tomography Echocardiography Chest x-ray Cardiac catheterization Answer

Echocardiography

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• A client comes to the clinic reporting fever, chills, and sore throat and is diagnosed with

streptococcal pharyngitis. A nurse knows that early diagnosis and effective treatment is essential to avoid which preventable disease?

Rheumatic fever Cardiomyopathy Pericarditis Mitral stenosis Answer Rheumatic fever

• The nurse is educating a client about the care related to a new diagnosis of mitral valve

prolapse. What statement made by the client demonstrates understanding of the teaching?"I will take antibiotics before getting my teeth cleaned." "I can get my tongue pierced at a store in the shopping mall." "I will avoid caffeine, alcohol, and smoking." "I can get a tattoo at a local parlor."

Answer

"I will avoid caffeine, alcohol, and smoking."

• A nurse is caring for a client with aortic stenosis whose compensatory mechanisms of the

heart have begun to fail. The nurse will monitor the client carefully for which initial symptoms?Dizziness, nausea, diarrhea Exertional dyspnea, orthopnea, pulmonary edema Syncope, fever, vomiting Nausea, vomiting, exertional fatigue

Answer

Exertional dyspnea, orthopnea, pulmonary edema

• The nurse is assessing a client admitted with infective endocarditis. Which

manifestation would the nurse expect to find?Bruising on the palms of the hands and soles of the feet Raised red rash on the trunk and face Involuntary muscle movements of the extremities

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