The nurse is assessing the deep tendon reflexes of a client with preeclampsia. Which method is used to elicit the biceps reflex? A. The nurse places her thumb on the muscle inset in the antecubital space and taps the thumb briskly with the reflex hammer. B. The nurse loosely suspends the client’s arm… Read More »
A client has undergone a penile implant. After 24 hrs of surgery, the client’s scrotum was edematous and painful. The nurse should: A. Assist the client with sitz bath B. Apply warm soaks in the scrotum C. Elevate the scrotum using a soft support D. Prepare for a possible incision and… Read More »
A diabetic multigravida is scheduled for an amniocentesis at 32 weeks gestation to determine the L/S ratio and phosphatidylglycerol level. The L/S ratio is 1:1 and the presence of phosphatidylglycerol is noted. The nurse’s assessment of this data is: A. The infant is at low risk for congenital anomalies. B. The infant is… Read More »
A patient arrives in the emergency department with symptoms of myocardial infarction, progressing to cardiogenic shock. Which of the following symptoms should the nurse expect the patient to exhibit with cardiogenic shock? A. Hypertension B. Bradycardia C. Bounding pulse D. Confusion Correct Answer: D. Confusion Cardiogenic shock… Read More »
A client has been diagnosed with hypertension. The nurse priority nursing diagnosis would be: A. Ineffective health maintenance B. Impaired skin integrity C. Deficient fluid volume D. Pain Correct Answer: A. Ineffective health maintenance Managing hypertension is the priority for the client with hypertension. Clients with hypertension… Read More »
A client is scheduled for a percutaneous transluminal coronary angioplasty (PTCA). The nurse knows that a PTCA is the A. Surgical repair of a diseased coronary artery. B. Placement of an automatic internal cardiac defibrillator. C. Procedure that compresses plaque against the wall of the diseased coronary artery to improve blood flow.… Read More »
After insertion of a chest tube for a pneumothorax, a client becomes hypotensive with neck vein distention, tracheal shift, absent breath sounds, and diaphoresis. Nurse Amanda suspects a tension pneumothorax has occurred. What cause of tension pneumothorax should the nurse check for? A. Infection of the lung B. Kinked or obstructed chest tube… Read More »
Which of the following laboratory test results would suggest to the nurse Len that a client has a corticotropin-secreting pituitary adenoma? A. High corticotropin and low cortisol levels B. Low corticotropin and high cortisol levels C. High corticotropin and high cortisol levels D. Low corticotropin and low cortisol levels … Read More »
The client has elected to have epidural anesthesia to relieve labor pain. If the client experiences hypotension, the nurse would: A. Place her in Trendelenburg position B. Decrease the rate of IV infusion C. Administer oxygen per nasal cannula D. Increase the rate of the IV infusion … Read More »
A male client is scheduled for a transsphenoidal hypophysectomy to remove a pituitary tumor. Preoperatively, the nurse should assess for potential complications by doing which of the following? A. Testing for ketones in the urine. B. Testing urine specific gravity. C. Checking temperature every 4 hours. D. Performing capillary glucose testing… Read More »