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MSN 277 EXAM 2
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Exam study book Medical-Surgical Nursing of Sharon Mantik Lewis, Margaret McLean Heitkemper, Jean Foret Giddens, Shannon Ruff Dirksen - ISBN: 9780323026963 (MSN 277 EXAM 2)
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MSN 277 EXAM 2 LATEST ACTUAL EXAM QUESTIONSAND CORRECT ANSWERS |ALREADY GRADED A+
Which action will the nurse in the hypertension clinic take in order to obtain an
accurate baseline blood pressure (BP) for a new patient?
a. Obtain a BP reading in each arm and average the results.
b.Deflate the BP cuff at a rate of 5 to 10 mm Hg per second.
c.Have the patient sit in a chair with the feet flat on the floor.
d. Assist the patient to the supine position for BP measurements. - ANSWER: Have
the patient sit in a chair with the feet flat on the floor.
A nurse is providing teaching to a male client who has a continent internal ileal
reservoir following surgery to treat bladder cancer. Which of the following
statements should the nurse make?
a. "this should not affect your ability to function sexually"
b. "You should expect to gain some weight during the next few weeks."
c. "You will need to avoid foods that produce intestinal gas."
d. "you must insert a catheter through your stoma to drain the urine" - ANSWER:
"you must insert a catheter through your stoma to drain the urine"
a nurse in a women's health clinic is caring for a client who reports urinary urgency
and dysuria. which of the following additional finding should the nurse identify as an
indication of a urinary tract infection (UTI)?
a. vaginal discharge
b. pyuria
c. glycosuria
d. elevated creatine kinase-MB - ANSWER: pyuria
The nurse determines that instruction regarding prevention of future urinary tract
infections (UTIs) has been effective for a 22-year-old female patient with cystitis
when the patient states which of the following?
a.I can use vaginal antiseptic sprays to reduce bacteria.
b. I will drink a quart of water or other fluids every day.
c. I will wash with soap and water before sexual intercourse.
d. I will empty my bladder every 3 to 4 hours during the day. - ANSWER: I will empty
my bladder every 3 to 4 hours during the day.
,Which finding by the nurse will be most helpful in determining whether a 67-year-
old patient with benign prostatic hyperplasia has an upper urinary tract infection
(UTI)?
a. Bladder distention
b. Foul-smelling urine
c. Suprapubic discomfort
d. Costovertebral tenderness - ANSWER: Costovertebral tenderness
The nurse determines that further instruction is needed for a patient with interstitial
cystitis when the patient says which of the following?
a. I should stop having coffee and orange juice for breakfast.
b. I will buy calcium glycerophosphate (Prelief) at the pharmacy.
c. I will start taking high potency multiple vitamins every morning.
d. I should call the doctor about increased bladder pain or odorous urine. - ANSWER:
I will start taking high potency multiple vitamins every morning.
It is most important that the nurse ask a patient admitted with acute
glomerulonephritis about
a.history of kidney stones.
b. recent sore throat and fever.
c. history of high blood pressure.
d. frequency of bladder infections. - ANSWER: recent sore throat and fever.
Which finding for a patient admitted with glomerulonephritis indicates to the nurse
that treatment has been effective?
a. The patient denies pain with voiding.
b. The urine dipstick is negative for nitrites.
c. The antistreptolysin-O (ASO) titer is decreased.
d.nThe periorbital and peripheral edema is resolved. - ANSWER: The periorbital and
peripheral edema is resolved
,A nurse is caring for a client following extracorporeal shock wave lithotripsy (ESWL)
for the treatment of calcium phosphate kidney stones. Which of the following
actions should the nurse take?
a. monitor the client's urine for ketones
b. provide the client with an increased animal protein diet.
c. Limit the client's fluid intake to 1.5L per day
d. Strain all of the client's urine - ANSWER: Strain all of the client's urine
The nurse will anticipate teaching a patient with nephrotic syndrome who develops
flank pain about treatment with
a. antibiotics.
b. antifungals.
c. anticoagulants.
d. antihypertensives. - ANSWER: anticoagulants.
Flank pain in a patient with nephrotic syndrome suggests a renal vein thrombosis,
and anticoagulation is needed. Antibiotics are used to treat a patient with flank pain
caused by pyelonephritis. Fungal pyelonephritis is uncommon and is treated with
antifungals. Antihypertensives are used if the patient has high blood pressure
Calculating fluid recommendations - ANSWER: Weight (lbs)/2= # of ounces of
fluid/day recommended
- Example: 150lbs/2=75 ounces/day
- (-20%) will be obtained from food (15 oz): 60 oz fluid intake by drinking
To prevent recurrence of uric acid renal calculi, the nurse teaches the patient to
avoid eating
a.milk and cheese.
b. sardines and liver.
c. legumes and dried fruit.
d. spinach, chocolate, and tea. - ANSWER: sardines and liver.
The nurse teaches a 64-year-old woman to prevent the recurrence of renal calculi by
a. using a filter to strain all urine.
b. avoiding dietary sources of calcium.
, c. choosing diuretic fluids such as coffee.
d. drinking 2000 to 3000 mL of fluid a day. - ANSWER: drinking 2000 to 3000 mL of
fluid a day.
A 56-year-old female patient is admitted to the hospital with new onset nephrotic
syndrome. Which assessment data will the nurse expect?
a. Poor skin turgor
b. Recent weight gain
c. Elevated urine ketones
d. Decreased blood pressure - ANSWER: Recent weight gain
When planning teaching for a 59-year-old male patient with benign nephrosclerosis
the nurse should include instructions regarding
a. preventing bleeding with anticoagulants.
b. monitoring and recording blood pressure.
c. obtaining and documenting daily weights.
d. measuring daily intake and output volumes. - ANSWER: monitoring and recording
blood pressure.
A nurse is teaching a client who has a new diagnosis of acute pyelonephritis. Which
of the following instructions should the nurse include in the teaching?
a. Drink up to 1,500ml of fluid per day
b. avoid the use of NSAIDs for pain
c. Check peripheral blood glucose levels twice per day
d. Increase dietary protein intake. - ANSWER: avoid the use of NSAIDs for pain
A 68-year-old female patient admitted to the hospital with dehydration is confused
and incontinent of urine. Which nursing action will be best to include in the plan of
care?
a. Restrict fluids between meals and after the evening meal.
b. Apply absorbent incontinent pads liberally over the bed linens.
c. Insert an indwelling catheter until the symptoms have resolved.
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