Nurse Busy Medical Explained for Students (Easy Guide)

This question focuses on applying theory to practical scenarios.

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This topic involves nurse busy medical. A strong answer should include explanation, application, and examples.

Original Question

1. The nurse on a busy medical surgical unit has several tasks that need to be completed in order to prepare a pre-operative client for the operating room the nurse is supervising a a practical nurse and a nurse assistant which task would be appropriate to delegate to the nursing assistant 0 Adjust the delivery note on the client intravenous infusion pump is ordered O Informing the physician about the clients abnormal preoperative blood glucose O Placing the client Onto the stretcher for transport to the operating room O completing the clients preoperative checklist. 22. A newly admitted client touches other Clients on the head Speaks rapidly, wears several layers of clothing & laughs Continuously which of these manifestation should the nurse focus on first? O the Clients dress O Touching others patents on the head O Rapid speech O The client’s affect 23. The nurse inadvertently administers an incorrect medication to a client , which action would Nurse take first? O Asses the client O contact the nurse manager O Notify the health are manager O Complete an incorrect report 24) The Client urine out put is 500 ml in 24 hour , which action would the nurse take O Report the findings to the health care provider. O Encourage the client to the limit fluid intake O Obtain a prescription for a diuretic O Record the findings and continue to monitor the client 9.The nurse is planning to the interview a client that speaks limited English which strategy would the nurse include? O Maintain constant eye contact throughout the interview O Keep the interview short to decrease the Client fatt O observe the client for indication Confusion or not Understanding Question O Smile frequently during the interview to reduce the Client anxiety. 21.Which of these employe demonstrate the competence of compere to Work ethics as expected by employees O An employee who Arrive on time takes only the allowed break O An employee who applies theory into clinical practices O an employee who documents relevant data observations of client O An employee who like to work over time frequentl 1.When assessing the motor ability of a client who has a chronic muscle disorder a nurse should give priority to which of these measure O measuring the circumference and strings of the lines lift thigh O determining the clients ability to turn and perform activities of daily living O Taking the physiotherapistis report off of muscular weakness in all extremities O assessing the clients range of joint motion of the upper extremities 2. When turning inclined to the side lying position which actions should the nurse take O place a rolled pillow parallel to the plants back O Place a a small pillow under the client lumbar spine O Put a small pillow under the client ankles O Put a footboard against the bottom of the client’s feet 86.A client is scheduled for a total abdominal hysterectomy Which instruction should a nurse give to the client to prevent post operative thrombophlebitis? O Keep your legs as straight as possible while in bed O Dangle your legs over the side of bed for 20 minutes O tighten and relax your leg muscles every hour. O Gently rub the back of your legs before getting out or bed 88.Which preventative measure should a nurse manager in a long term care facility plan to institute to decrease clients risk for falls O Placing all client’s personal items in the bedside drawers. O Monitoring clients frequently for evidence of activity intolerance. O Raising the side rails for all clients who have memory impairment. O Maintaining all client beds in the highest position 89.Anelderly, forgetful client who is residing in a long term care facility urinate several times during the night which of this action if taken by a staff nurse will reduce the clients risk for injury O The nurse tells the client not to get up without assistance O The nurse keeps the bedin the highest position O The nurse toilets the client several times during the day. O the nurse keeps a light on in the client’s room Which of these clients is at increased risk for developing a nosocomial infection? 91.A nurse identifies all of these nursing diagnoses for a client. Which of these nursing diagnosis should the nurse assign the highest priority O impaired tissue perfusions O impaired urinary elimination. O Imbalanced nutrition: less than body requirement O Impaired skin integrity 92.A six-week-old client is transferred to the pediatric unit following pyloromctomy. The infant is receiving an intravenous fluids in gradually increasing amounts. Which of these positions would be appropriate for the client after each feeding O On the left side with the infant’s head slightly lowered O On the back with the infant’s head flat. O On the abdomen with the infants head turned to the side O On the right side with the infant’s head slightly elevated 93.After an appendectomy, a client returns to the assigned room with a nasogastric tube, a Perrose drain and an intravenous infusion Which is the best position for this client postoperatively? O Supine, with a pillow under the lower portion of the client’s trunk O in semi Fowler’s O On either side with the client’s head sightly lower than the trunk O On the left side. 95.Which nursing action demonstrates use of good body mechanics? O Bending the knees when helping a client transfer from the bed to the chair O Standing at arm’s length from a client who is to be lifted O Reaching across a streicher when helping a client to transfer. O Raising the bed above the nurses was before lifting the clent 78.Which rationale explains the purpose of a nasogastric tube with suction for a client who had abdominal surgery O Prevention of gastric decompression. O Promotion of abdominal distention O Provision of postoperative nutrition: O Removal of secretions from the stomach. 79.Which instruction should a nurse give to a client when collecting a sputum specimen? O Spit whatever sputum you have in your mouth into this container O ‘Gargle with antiseptic mouthwash before you spit into this container O Drink some fluids to loosen your secretions and then spit into this container. O Take a deep breath, then cough and spit into this container: 80.A client who is 24-hours post subtotal thyroidectomy reports a tingling around the mouth and some mid muscle twitching which of this erum laboratory test results should a nurse assess? O calcium O Potassium O Glucose O Sodium 82.An 18-month-old child is admitted to the hospital for repair of a cleft palate. After the surgery, the client is transferred to the pediatric unit he child is to be offered liquids by mouth. Which method would be most appropriate to use in feeding the child? O Aplastic cup. O A paper cup with a straw. O A bottle with a large hole nipple. O A training cup with a mouthpiece. 81.Nursing care for a child immediately after a cardiac catheterization should include which of these measures? O Checking the pulses above the catheterization site for smmetry. O Allowing the child to ambulate as tolerated. O Assessing the pulses and temperature of the affected extremity O Monitoring vital signs every four to eight hours. 83.One hour after a client’s induction begins, the nurse makes several observations. Which finding indicates that the reduction should be stopped O Decreased fetal movement between contractions. O Maternal urinary output of 45 ml per hour, O Four uterine contractions lasting one minute each O Six uterine contractions in ten minutes 84.A 38-year-old multigravida client, with a history of recurrent chlamydial infections, attends the antepartal clinic for a routine visit when she is 38 weeks pregnant. This client is most likely to have a predisposition for which complication? O Anemia. O Urinary tract infection. Oincompetent cervical os. OPreeclampsia. 85.A client admitted with abruptio placenta is taken for a cesarean section with epidural anesthesia. Which assessment findings would indicate that the client is developing disseminated intravascular coagulation (DIC) O The client has petechiae on her chest O The clients lochia contains dots. O The client has unilateral calf pain. O The client has postural hypotension. 74. Aclient in the clinic states “I told you i can’t come back on Friday” Which response by the nurse would be likely to repair the client-nurse relationship? O You don’t have to be rude about it. What day do you want? O Friday is really the best day. You wont have to wait as long às you would on other days O Nothing could be more important than your health Arrange to come on Friday O I don’t seem to have been listening. What day is good for you? 73.A client reports that the cal light is not being answered in a timely manner. Which response should a nurse make? O were short staffed today: O I’m here now how may I help you O You must remember that I have other clients to care for O What do you want now? 69.A nurse is taking care of a primigravida who has had a spontaneous abortion The aborted embryo reveal a gross defect that is incompatible to life Which of these measures is the most therapeutic for the nurse to take at this time ? O Reflecting on the client’s feelings by asking her what made her upset. O Suggest that the client speak with the physician about when she can get pregnant O.explaining to the client that embryonic defects are the common cause of spontaneous abortion O Recommending genetic counseling for the client and her husband 67.Which technique should a nurse plan to use with a client who is delusional? O Explain clearly why the dients belief is incorrect. O Focus on reality, based topics. O Explore the delusion so the client will know it is false O Avoid speaking with the client when he/she is delusional 65.When interacting with a client who is paranoid, a nurse should O maintain a caring facial expression. O maintain a professional attitude towards the client O stand close to the client. O use touch to place the client at ease. 63.Which statement made by a client with insulin-dependent diabetes mellitus indicates a need for further teaching O “i know that I should check my blood sugar before I eat and at bed time O I aways carry a package of hard candy with me in case start to feel shaky O “I avoid constriction of my feet from tight- fitting shoes by going bare foot in the house: O ” I have started an exercise program to help me lose some weight 62.The parents of a child with a ventricular septal defect are taught to reduce the risk of developing endocardts.by O giving the child antibiotics when a viral infection develop O maintaining an environment as clean as possible. O notifying the dentist of the need for prophylactic antibiotics O wearing masks when in public 59. A client tells a nurse that his/her mother has a history of diabetes mellitus Based on this information, which of these intervention hould the nurse make regarding the client’s health history? O The client may be at risk for developing diabetes O The client may need to have diabetic instructions O The information is irrelevant to the history, O This may affect the client’s diet during hospitalization 60.When a client who is in active labor is having moderate variable decelerations which of these actions the nurse take first O Change the position of the client. O increase the rate of intravenous fluid O Call The physician immediately. O Prepare the client for a double setup delivery 59.A client tells a nurse that his/her mother has a history of diabetes melitus, Based on this information which of these inferences should the nurse make regarding the client’s health history? O The client may be at risk for developing diabetes. O The client may need to have diabetic instructions . O The information is irrelevant to the history. O This may affect the client’s diet during hospitalization. 58.Before being discharged, a male client who has a new colostomy asks a nurse if his colostomy will affect his sexual relationship with his wife which of these responses should the nurse make? O You can resume normal sexual activity as soon as you feel ready O You should discuss this with your wife O ‘Sexual intercourse may cause an infection in the colostomy* O The surgery may decrease your serxual drive 57.A nurse should recognize which sign as a probable sign of pregnancy O Frequency of urination. O Abdominal distention. O Nausea in the morning O Positive pregnancy test. 52.A nurse is conducting an admission history of a client in labor Which substance, if indicated in the history would place the client at risk for abruptio placenta? O Amphetamines. O Marijuana. O Phencyclidine (PCP). O Cocaine. 53.Aclient who is breastfeeding her newborn asks the nurse, How do I know if my baby is gettng enough breast milk my baby has lost a pound and he is only a day old.” Which response by the nurse is most appropriate? O You can supplement your breast milk with formula once the baby is a week old* O That amount of weight loss Is normal As long as your baby is wetting At least six diaper A day He is getting enough Milk O if your aby is waking up every one and half to two hours, your baby may not be receiving adequate nutrition O if the weight loss concerns you you may want to consider switching to bottle feeding since bottle-feed baby’s loss less weight 51.A breastfeeding mother and baby are breastfeeding successfully when discharged from the hospital Two weeks after the client discharge the mother calls the hospital and reports several pieces of information to the nurse. Which statement when made by the mother, may indicate that she is developing mastitis O My breasts are firm to the touch three hours after breastfeeding* O My nipples are cracked and bleeding* O “lam experiencing pain when my baby latches on* O ‘My right breast is tender, reddened, and warm! 47.Which assessment finding present in a 4-month-old infant who has severe diarrhea should a nurse recognize as suggestive that the client is dehydrated? O Cyanosis of the mucous membrane, O Bulging anterior fontanel. O-decreased urine output. O Pulse rate of 120/minute 48.A newborn infant. whose mother has type 1 diabetes mellitus, is irritable and has tremors. A nurse should suspect that the infant has O hyperkalemia. O hypokalemia. O hyperglycemia. O hypoglycemia. 49.The sister of a client carries one gene for sickle cell anemia. She expresses concern about becoming ill like her sister The nurse resource should include which information? O it is unlikely that she will have a sickle cell crisis as she is a carner of the trat O The occurrence of a sickle cell crisis is more common in boys than in girls O Maintaining good healthy habit will usually prevent a sickle cell crisis O The severity of a sickle cell ons decreases with age 50. A 7-year-old child has been brought to the clinic for audiometric testing due to hearing loss noted during his well child examination test days ago Which client history finding is most likely to be in the report? O The client has had many episodes of otitis media O The client has been exposed to environmental noise O The client was born with a high arched palate O The cent has received the pneumococcal polysaccharide vaccine. 41.Which of these statements if made by a client taking prednisone indicate that the client is developing an adverse side effects O ‘l find that I sweat during the night and prefer to sleep with the window open O My ankles are swollen and I have gained ten pounds* O My nose itches and gets stuffy each evening* O”l feel so drowsy when I first wake up each day 45.Which assessment should the nurse make of the cient that had knee replacement surgery this morning? O Range of motion. O Signs of infection O Bowel movement frequency O Pain. 44.when a client receives chemotherapy for cancer, the nurse would administer the prescribed andemneos premedication at which time O When the client requests the medication after the chemotherapy. O Thirty minutes before the chemotherapy. O immediately before starting the chemotherapy O thirty minutes after starting the chemotherapy, 46.Which action would the nurse take initially if the client that is diagnosed with diabetes mellitus develops tremors and seana! O Administer a concentrated form of glucose to the clinf . O Administer a prn dose of insulin. O Measure the client’s urine for ketones O Measure the client’s blood sugar level. 43.When the client that has acute postoperative pain receives morphine, the nurse would monitor the cent for which of these conditions O increased urinary output O Respiratory depression O Hypertension. O Constipation. 42.When administering eye drops, the nurse would include which of these steps in the procedure O Hold the client’s lower lid down while installing the drops into the center of the lower conjunctival sac O Massage the client’s eyelids after administering the eye drops O Apply warm compresses to the client’s eyes before administering the drops O Have the client look to one side as the drops are placed in the client’s eye 40.Which of these statements, if made by a client receiving heparin sodium, would the nurse recognize as indicating a need for further assessment before giving the medication? O My stool is dark-brown colored! O My gums are red colored. O My urine looks pinkish:* O My toenails are pale.” 38.The client has a prn order for an opioid analgesic and requests the medication. The client last received the medication eight hours ago inch eltex actions would the nurse take prior to administering the medication? O Encourage the client to try other pain relief measures first O Determine the amount of mediation the client has received in the bs 24 hours O Have the client use the bathroom O Ask the dient to rate the pain on a scale of one to ten 33.Which statement made by the client taking furosemide, supports a nursing diagnosis of knowledge defor? O “I will need to add more salt to my diets because this medication will decrease is excretion* O I should change my position slowly to avoid dizziness related to this medication ” O This medication must be taken, even on days when I feel well° O This medication will increase the amount and frequency of my urination 28.The nurse gives instructions to a client that needs to continue wound irrigation at home Which of these actions if observed by the nurse would require further instructions? O The client irrigate the wound until the solution draining in to the basin is clear O The client dons sterile gloves, and then opens a sterile syringe and solution container O The client places a waterproof pad beside the wound before removing the dressing O The client irrigate the wound slowly and steadily flushing away drainage and debris 29.When teaching a client that has been discharged with orders to continue with dressing changes the nurse would include which of these measures O Discussing surgical asepsis. O Describing the process of sterilization. O Demonstrating proper gloving technique. O Demonstrating good hygiene technique. 26.Which of the following actons would the nurse recognize às a potential risk for causing a medcon err O Removing the unit dose wrapper from the medication at the medication room O Checking with the pharmacist when multiple tablets are needed for a single dose O Administering the medication, and looking up information about the medication afterwards O Questioning the doctor about a dosage that is greater than usual 20.All of the following tasks need to be accomplished. Considering client safety, which task should be delegated to the nurse rather than delegating to unlicensed personnel? O ‘Using an electric razor to shave a client that is on anticoagulant therapy* O ‘Feeding a client who has dysphagia O ‘Emptying all of the unit urinary collection bags and tabulating shift ourpurs* O Re: positioning a client that had a stroke one week ago 1.When assessing the motor abilities of a client who has a chronic muscle disorder A nurse should give priority To which of The choice O Measuring the circumference and strength of the client left thigh O Determining the cents ability to turn and pertormatites ADL O checking the physiotherapist report of muscular weakness in all extremity O Assessing the clients range of joint moton o the upper errenies

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