Term
| Healthcare workers must protect themselves against becoming infected with HIV. The Center for Disease Control has issued guidlines for healthcare workers in relation to protection from HIV which include... |
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Definition
| Wear gloves when coming in contact with the blood or body fluids of any client |
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Term
| Two days postoperative, a male client reports aching pain in his left leg. The nurse assesses redness and warmth on the lower left calf. What intervention should be most helpful to this client? |
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Definition
| Advise the client to remain in bed with the legs elevated |
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Term
| A client is admitted to the medicl intensive care unit with a diagnosis of myocardial infarction. The client's history indicates the infarction occurred ten hours ago. What laboratory test result should the nurse expect the client to exhibit? |
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Definition
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Term
| The nurse is preparing a teaching plan for a client who is newly diagnosed with Type 1 diabetes mellitus. Which signs and symptoms should the nurse describe when teaching the client about hypoglycemia? |
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Definition
| Sweating, trembling, tachycardia |
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Term
| A middle-aged male client with diabetes continues to eat an abundance of foods that are high in sugar and fat. According to the Health Belief model, which event is most likely to increase the client's willingness to become compliant with the prescribed diet? |
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Definition
| He visits his diabetic brother who just had surgery to amputate an infected foot. |
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Term
| A client who is receiving chemotherapy ask the nurse, "Why is so much of my hair falling out each day?" Which response by the nurse best explains the reason for alopecia? |
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Definition
| Chemotherapy affects the cells of the body that grow rapidly, both normal and malignant. |
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Term
| The healthcare provider prescribes aluminum and magnesium hydroxide (Maaloc), 1 tab PO PRN, for a client with chronic renal failure who is complaining of indigestion. What intervention should the nurse implement? |
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Definition
| question the healthcare provider's prescription |
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Term
| A 46-year old female client is admitted for acute renal failure secondary to diabetes and hypertension. Which test is the best indicator of adequate glomerulare filtration? |
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Definition
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Term
| A client receiving cholestyramine (Questran) for hyperlipidemia should be evaluated for what vitamin deficiency? |
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Definition
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Term
| A client with heart disease is on a continuous telemetry monitor and has developed sinus bradycardia. In determining the possible cause of bradycardia, the nurse assesses the cliet's medication record. Which medication is most likely the cause of bradycardia? |
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Definition
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Term
| A client taking a thiazide diuretic for the past six months has a serum ****11****potassium level of 3. The nurse anticipates which change in prescription for the client? |
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Definition
| A potassium supplement will be prescribed |
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Term
| The nurse is assessing a client with bacterial meningitis. Which assessment finding indicates the client may have developed septic emboli? |
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Definition
| cyanosis of the fingertips |
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Term
| During CPR, when attempting to ventilate a client's lungs, the nurse notes that the chest is not moving. What action should the nurse take first? |
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Definition
| Reposition the head to validate that the head is in the proper position to open the airway. |
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Term
| The nurse is interviewing a male client with hypertension. Which additional medical diagnosis in the client's history presents the greatest risk for developing a cerebral vascular accident (CVA)? |
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Definition
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Term
| What types of medications should the nurse expect to administer to a client during an acute respiratory distress episode? |
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Definition
| Bronchodilators and steroids |
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Term
| A client who has heart failure is admitted with a serum potassium level of 2.9mEq?L. Which action is most important for the nurse to implement? |
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Definition
| Initiate continuous cardiac monitoring |
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Term
| A 51-year old truck driver who smokes two packs of cigarettes a day and is 30 pounds overweight is diagnosed with having a gastric ulcer. What content is most important for the nurse to include in the discharge teaching for this client? |
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Definition
| Information about smoking cessation |
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Term
| A client taking furosemide (Lasix), reports difficulty sleeping. What question is important for the nurse to ask the client? |
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Definition
| What time do you take you medication? |
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Term
| How should the nurse position the electrodes for modified chest lead one (MCL 1) telemetry monitoring? |
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Definition
| Negative polarity left shoulder, positive polarity right chest nipple line, ground left chest nipple line. |
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Term
| The nurse is assessing a client who smokes cigarettes and has been diagnosed with emphysema. Which finding should the nurse expect this client to exhibit? |
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Definition
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Term
| The nurse is planning care for a client with newly diagnosed diabetes mellitus that requires insulin. Which assessment should the nurse identify before beginning the reaching session? |
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Definition
| Willingness of the client to learn the injection sites. |
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Term
| Which client should the nurse recognize as most likely to experience sleep apnea? |
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Definition
| Obese older male client with a short thick neck. |
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Term
| In assessing cancer risk, the nurse identifies which woman as being at greatest risk of developing breast cancer? |
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Definition
| A 50-year-old whose mother had unilateral breast cancer. |
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Term
| A client has been taking oral corticosteroids for the past five days because of seasonal allergies. Which assessment finding is the most concern to the nurse? |
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Definition
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Term
| During lung assessment, the nurse places a stethoscope on a client's chest and instructs him/her to say "99" each time the chest is touched with the stethoscope. What should be the correct interpretation if the nurse hears the spoken words "99" very clearly through the stethoscope? |
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Definition
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Term
| The nurse notes that the only ECG for a 55-year-old male client scheduled for surgery in two hours is dated two years ago. The client reports he has a history of "heart trouble," but has no problems at present. Hospital protocol requires that those over 50years of age have a recent ECG prior to surgery. What nursing g action is best for the nurse to implement? |
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Definition
| Call for an ECG to be performed immediately. |
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Term
| While working in the emergency room, the nurse is exposed to a client with active tuberculosis. When should the nurse plan to obtain a tuberculin skin test? |
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Definition
| 4-6 weeks after the exposure |
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Term
| A client who is HIV positive ask the nurse, "How will I know when I have AIDS?" which response is best for the nurse to provide? |
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Definition
| It is diagnosed when a specific opportunistic infection is found in an otherwise healthy individual. |
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Term
| The nurse is taking a history of a newly diagnosed Type 2 diabetic who is beginning treatment. Which subjective information is most important for the nurse to note? |
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Definition
| An allergy to sulfa drugs |
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Term
| The nurse should be correct in withholding a dose of digoxin in a client with congestive heart failure without specific instruction from the healthcare provider if the client'... |
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Definition
| Serum potassium level is 3 |
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Term
| In preparing a discharge plan for a 22-year-old male client diagnosed with Buerger's disease (thromboangiitis obliterans), which referral is most important? |
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Definition
| Smoking cessation program |
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Term
| A 57-year-old male client is scheduled to have a stress-thallium test the following morning and is NPO after midnight. At , he is agitated because he cannot eat and is demanding food. Which response is best for the nurse to provide to this client? |
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Definition
| The test you are having tomorrow requires that you have nothing by mouth. |
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Term
| Which finding should the nurse identify as most significant for a client diagnosed with polycystic kidney disease (PKD)? |
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Definition
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Term
| The nurse is planning care to prevent complication for a client with multiple myeloma. Which intervention is most important for the nur4se to include? |
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Definition
| Maintain a fluid intake of 3 -4 L/day |
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Term
| When preparing a client who has had a total laryngectomy for discharge, which instruction is most important for the nurse to include in the discharge teaching? |
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Definition
| Tell the client to carry a medic alert card stating that he is a total neck breather. |
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Term
| Which symptoms should the nurse expect a client to exhibit who is known to have pheocromocytoma? |
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Definition
| Headache, diaphoresis, and palpitations |
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Term
| A client with diabetes mellitus is experiencing polyphagia. Which outcome statement is the priority for this client? |
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Definition
| Adequate cellular nourishment |
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Term
| The nurse is assessing a client with chronic renal failure (CRF). Which finding is most important for the nurse to respond to first? |
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Definition
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Term
| After the fourth dose of gentamicin sulfate (Garamycin)IV, the nurse plans to draw blood samples to determine peak and trough levels. When are the best times to draw these samples? |
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Definition
| 5 min before and 30 min after the next dose. |
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Term
| During a health fair, a 72-year-old male client tells the nurse that he is experiencing shortness of breath. Auscultation reveals crackles and wheezing in both lungs. Suspecting that the client might have chronic bronchitis, which classic symptom should the nurse expect this client to have? |
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Definition
| productive cough with grayish-white sputum |
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Term
| In assessing a client diagnosed with primary hyperaldosteroinism, the nurse expects the laboratory test results to indicate a decreased serum level of which substance? |
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Definition
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Term
| A client reports unprotected sexual intercourse one week ago and is worried about HIV exposure. An initial HIV antibody screen (ELISA)is obtained. The nurse teaches the client that seroconversion to HIV positive relies on antibody production by B lymphocytes after exposure to the virus. When should the nurse recommend the client return for repeat blood testing? |
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Definition
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Term
| A male client who has ne3ver smoked but has COPD for the past 5 years is not being assessed for cancer of the lung. The nurse knows that he is most likely to develop which type of lung cancer? |
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Definition
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Term
| A client had taken steroids for 12years to help manage chronic obstructive pulmonary disease (COPD). When making a home visit, which nursing function is of greatest importance to this client? Assess the client's... |
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Definition
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Term
| A client with cirrhosis develops increasing pedal edema and ascites. What dietary modification is most important for the nurse to teach this client? |
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Definition
| Restrict salt and fluid intake |
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Term
| A client with a 16-year history of diabetes mellitus is having renal function test because of recent fatigue, weakness, elevated blood urea nitrogen, and serum creatinine levels. Which finding should the nurse conclude as a early symptom of renal insufficiency? |
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Definition
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Term
| An 81-year-old male client has emphysema. He lives at home with his cat and manages self-care with no difficulty. When making a home visit, the nurse notices that his tongue is somewhat cracked and his eyeballs are sunken into his head. What nursing intervention is indicated? |
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Definition
| Help the client to determine ways to increase his fluid intake. |
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Term
| when teaching diaphragmatic breathing to a client with chronic obstructive pulmonary disease (COPD), which information should the nurse provide? |
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Definition
| Place a small book or magazine on the abdomen and make it rise while inhaling deeply. |
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Term
| The nurse is providing dietary instructions to a 68-year-old client who's at high risk for development of coronary heart disease (CHD). Which information should the nurse include? |
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Definition
| Increase intake of soluble fiber to 10 to 25 grams per day |
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