ACCUMLATIVE NCLEX TEST BANK | NCLEX: Respiratory, Neuro, GI, Ortho Cardio GI, Endocrine, Integumentary

Which statement by the client indicates a need for further teaching? Collagenase (Santyl) is prescribed for a client with a severe burn to the hand. The nurse provides instructions to the client regarding the use of the medication. Which statement by the client indicates an accurate understanding of the use of this medication? Isotretinoin (Amnesteem, Clavaris) is prescribed for a client with severe acne. Before the administration of this medication, the nurse anticipates that which laboratory test will be prescribed? A client is newly admitted to the hospital with cellulitis of the lower leg. The nurse checks the health care provider’s prescription sheet to see if which therapy has been prescribed for site care A client with eczema has a prescription for a topical corticosteroid. The nurse cautions the client to use the product carefully in which area where the risk of systemic absorption is greater? The nurse is providing instructions to a client with a diagnosis of scabies regarding the administration of crotamiton (Eurax). Which statement by the client indicates an understanding regarding the application of this medication? The health care provider has prescribed silver sulfadiazine (Silvadene) for the client with a partial-thickness burn, which has cultured positive for gram-negative bacteria. The nurse is reinforcing information to the client about the medication. Which statement made by the client indicates a lack of understanding about the treatments? A client is seen in the clinic for complaints of skin itchiness that has been persistent over the past several weeks. Following data collection, it has been determined that the client has scabies. Lindane is prescribed, and the nurse is asked to provide instructions to the client regarding the use of the medication. How should the nurse teach the client to apply the cream? The nurse is applying a topical glucocorticoid on a client with eczema. The nurse monitors for systemic absorption of the medication if the medication is being applied to which body areas? Coal tar has been prescribed for a client with a diagnosis of psoriasis, and the nurse reinforces instructions to the client about the medication. Which statement by the client indicates a need for further teaching? Isotretinoin (Accutane) is prescribed for a client to treat severe cystic acne. The nurse tells the client that the length of the usual prescribed course of treatment is which? Mafenide acetate (Sulfamylon) is prescribed for the client with a burn injury. When applying the medication, the client complains of local discomfort and burning. Which is the most appropriate nursing action? The burn client is receiving treatments of topical mafenide acetate (Sulfamylon) to the site of injury. The nurse monitors the client knowing that which indicates a systemic effect has occurred? Collagenase (Santyl) is prescribed for a client with a severe burn to the hand. The nurse is preparing to reinforce instructions to the client and spouse regarding the wound treatment. Which directions should the nurse include in the instructions? The nurse is assigned to care for a client with a leg ulcer. Sutilains (Travase) treatments are prescribed. The nurse should avoid which action when performing the treatment? A client is undergoing radiation therapy to treat lung cancer. Following the treatment, the nurse notes that the chest and neck are red, and the client is complaining of pain at the radiation site. How should the nurse interpret this data? A client with severe acne is seen in the clinic, and the health care provider (HCP) prescribes isotretinoin (Amnesteem, Clavaris). The nurse reviews the client’s medication record and should contact the HCP if the client is taking which medication? The nurse is applying a topical corticosteroid to a client with eczema. The nurse should monitor for the potential for increased systemic absorption of the medication if the medication is being applied to which body area? A client with a burn injury is applying mafenide acetate (Sulfamylon) to the wound. The client calls the health care provider’s office and tells the nurse that the medication is uncomfortable and is causing a burning sensation. Which instructions should the nurse reinforce to the client? The nurse reinforces instructions to a client regarding the use of tretinoin (Retin-A). Which statement by the client indicates the need for further teaching? The nurse is caring for a client with a burn injury to the lower legs. Silver sulfadiazine (Silvadene) is prescribed to be applied to the sites of injury. Which indicates the appropriate method to apply this medication? The nurse is caring for a client diagnosed with scabies who has just been prescribed crotamiton (Eurax). The nurse provides which instruction for application of this medication? Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client, knowing that which finding indicates the presence of systemic toxicity from this medication? The nurse reviews the laboratory results for a client diagnosed with leukemia who is receiving chemotherapy. The nurse notes that the white blood cell (WBC) count is 2000 cells/mm3. The nurse identifies the finding as indicative of which? The nurse in a health care provider’s office has scheduled a client with dermatitis to be seen in 1 week for a patch test. The nurse should reinforce instructions to the client to do which action before the procedure? The clinic nurse is collecting data on a client being admitted. The nurse notes that the client is taking azelaic acid (Azelex). Because of the medication prescription the nurse should suspect that the client is being treated for which condition? 1. An adult client was burned as a result of an explosion. The burn initially affected the client’s entire face (the anterior half of the head) and the upper half of the anterior torso, and there were circumferential burns to the lower half of both of the arms. The client’s clothes caught on fire, and the client ran, which caused subsequent burn injuries of the posterior surface of the head and the upper half of the posterior torso. According to the rule of nines, what is the extent of this client’s burn injury? Fill in the blank. 2. A client returns to the clinic for follow-up treatment after a skin biopsy of a suspicious lesion that was performed 1 week ago. The biopsy report indicates that the lesion is a melanoma. The nurse understands that which describes a characteristic of this type of a lesion? 3. The nurse is reviewing the health care record of a client with a lesion that has been diagnosed as malignant melanoma. The nurse should expect which characteristic of this type of lesion to be documented in the client’s record? 4. The nurse reinforces instructions to a group of clients regarding measures that will assist with the prevention of skin cancer. Which statement by a client indicates the need for further teaching? 5. A client arrives at the emergency department and has experienced frostbite to the right hand. Which should the nurse expect to find when inspecting the client’s hand? 6. The evening nurse reviews the nursing documentation in the client’s chart and notes that the day nurse has documented that the client has a stage 2 pressure ulcer in the sacral area. Which should the nurse expect to find when checking the client’s sacral area? 7. The nurse inspects the skin of a client who is suspected of having psoriasis. Which finding should the nurse note if this disorder is present? 8. Which should be the anticipated therapeutic outcome of an escharotomy procedure performed for a circumferential arm burn? 9. The nurse is caring for a client with circumferential burns of both legs. Which leg position is appropriate for this type of a burn? 10. The nurse is assigned to care for a client with herpes zoster. Which characteristics should the nurse expect to note when checking the lesions of this infection? 11. The nurse is caring for a client with a diagnosis of pemphigus vulgaris. The nurse understands that which is a characteristic of this condition? 12. A client asks the nurse about the causes of acne. The nurse should respond by making which statement to the client? 13. The nurse inspects the oral cavity of a client with cancer and notes white patches on the mucous membranes. The nurse interprets this occurrence as which? 14. The nurse is caring for a client after an autograft of a burn wound on the right knee. Which position should the nurse anticipate being prescribed for the client? 15. The nurse reinforces discharge instructions regarding skin care to a client after the grafting of burn injuries of the left chest and left arm. Which statement by the client indicates the need for further teaching? 16. The nurse determines that which individual presenting to the clinic is at the greatest risk for development of an integumentary disorder? 17. The nurse is reinforcing discharge instructions to a client who had a skin biopsy. Which statement by the client indicates the need for further teaching? 18. The nurse prepares to assist a health care provider examine the client’s skin with a Wood’s light. Which action should be included in the plan for this procedure? 19. The nurse reinforces instructions to a client who has complained of chronic dry skin and episodes of pruritus. Which client statement indicates the need for further teaching? 20. A client calls the emergency department and tells the nurse that he has been cleaning a wooded area and that he came into direct contact with poison ivy shrubs. The client tells the nurse that he cannot see anything on the skin and asks the nurse what to do. The nurse makes which statement to the client? 21. A client is being admitted to the hospital for the treatment of acute cellulitis of the lower left leg. The client asks the nurse to explain what cellulitis means. Which response should the nurse give to the client’s question? 22. The nurse prepares to care for a client with acute cellulitis of the lower leg. Which treatment should the nurse anticipate being prescribed for the client? 23. The health care provider suspects a client has herpes zoster. To confirm the diagnosis of herpes zoster, for which diagnostic test does the nurse gather equipment? 24. A client scheduled for a skin biopsy asks the nurse how painful the procedure is. The nurse should make which response to the client? 25. The nurse is checking for the presence of cyanosis in a dark-skinned client. Which body area should provide the best information? 26. The nurse reinforces discharge instructions to a client following patch testing. Which statement by the client indicates the need for further teaching? 27. The nurse prepares to assist in instructing a client about prevention of Lyme disease. Which should the nurse include in the instructions? 28. Following diagnostic evaluation, it has been determined that the client has Lyme disease, stage 2. The nurse understands that which is most indicative of this stage? 29. A client arrives at the health care clinic and tells the nurse that he was just bitten by a tick and would like to be tested for Lyme disease. Which nursing action is appropriate? 30. A client with acquired immunodeficiency syndrome (AIDS) is diagnosed with cutaneous Kaposi’s sarcoma. Based on this diagnosis, the nurse understands that this has been determined by which? 31. Which individual is least likely at risk for the development of Kaposi’s sarcoma? 32. The nurse reviews a client’s chart and notes that the health care provider has documented a diagnosis of paronychia. Based on this diagnosis, which should the nurse expect to note during data collection? 33. The nurse is assigned to assist in caring for a client with frostbite of the toes. Which should the nurse anticipate to be prescribed for this condition? 34. The nurse is checking her clients for skin breakdown. Which client should have the lowest priority for concern in the development of skin breakdown? 35. A client is undergoing radiation therapy to treat lung cancer. Following the treatment, the nurse notes that the chest and neck are red, and the client is complaining of pain at the radiation site. How should the nurse interpret this data? 36. Sodium hypochlorite (Dakin’s solution) is prescribed for a client with a leg wound containing purulent drainage. The nurse is assisting in developing a plan of care for the client and includes which in the plan? 37. Collagenase (Santyl) is prescribed for a client with a severe burn to the hand. The nurse provides instructions to the client regarding the use of the medication. Which statement by the client indicates an accurate understanding of the use of this medication? 38. The nurse inspects a pressure ulcer on a client’s sacrum and notes that the ulcer has partial-thickness skin loss and the formation of a blister. The nurse should document the ulcer as which category? 39. A client is receiving topical corticosteroid therapy in the treatment of psoriasis. The nurse expects the health care provider to prescribe which measure to maximize the effectiveness of this therapy? 40. Which individuals is least likely at risk for the development of psoriasis? 41. The nurse is assisting in caring for a client with a severe burn who has just received an autograft to the knee area of the right leg. The nurse plans to keep the right leg in which position? 42. A client with a burn injury is scheduled for a heterograft. The nurse is preparing the client for the skin grafting, and the client asks the nurse what “heterograft” means. Which is the most appropriate response to the client? 43. The nurse is caring for a client who sustained burns on the entire right leg and anterior thorax. Using the rule of nines, the extent of the burn injury would be which percentage? 44. A client enters the ambulatory clinic, stating she has just been stung by a bee. Her vital signs are stable, and she has no previously known allergy to bee stings. The “stinger” is still visible in her arm. What should be the nurse’s first action? 45. A client had a radical neck dissection with a musculocutaneous flap. Twenty-four hours following the procedure, the nurse observes that the flap has a slightly blue hue. The nurse draws which conclusion? 46. A client has a non-infected pressure ulcer on the left heel. The nurse should use which sterile solutions to cleanse the wound as part of a dressing change procedure? 47. A client sustains a burn injury to the entire right and left arms, right leg, and anterior thorax. According to the rule of nines, the nurse should determine that this injury constitutes which body percentage? 48. The nurse is assigned to care for a client with partial-thickness burns to 60% of her body surfaces. On the fourth day after injury, the client’s vital signs include an oral temperature of 102.8 F, pulse of 98 beats per minute, respirations of 24 breaths per minute, and blood pressure of 105/64 mm Hg. Parenteral nutrition is infusing at 82 mL/hr. Based on these data, the nurse plans to initially perform which action? 49. The nurse reinforces home care instructions with a client diagnosed with impetigo. Which statement indicates the need for further teaching about the measures that will prevent the spread of infection? 50. A client, admitted to the emergency department, is suspected of having frostbite of the hands. Which finding should the nurse note in this condition? a. White skin that is insensitive to touch – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – 86. A client is diagnosed with hyperparathyroidism. The nurse teaching the client about dietary alterations to manage the disorder tells the client to limit which food in the diet? 87. The nurse participating in a free health screening at the local mall obtains a random blood glucose level of 200 mg/dL on an otherwise healthy client. The nurse tells the client to do which as a next step? 88. The nurse is instructing a client with Addison’s disease about a newly prescribed medication, fludrocortisone acetate (Florinef). Which statement by the client indicates a need for further teaching? 89. The nurse reviews the nursing care plan of an older client with diabetic neuropathy of the lower extremities as a result of type 2 diabetes mellitus. The nurse plans care, knowing that which problem has the highest priority for this client? 90. An older client with a history of hyperparathyroidism and severe osteoporosis is hospitalized. The nurse caring for the client plans to address which problem first? 91. A client has been diagnosed with hypoparathyroidism. Which food groups should be included in the diet? 92. A hospitalized client is newly diagnosed with diabetes mellitus. The client must take both NPH and Regular insulin for glucose control. The nurse develops a teaching plan to help the client meet which outcome as a first step in managing the disease? 93. A client newly diagnosed with diabetes mellitus takes NPH insulin every day at 7:00 AM. The nurse has taught the client how to recognize the signs of hypoglycemia. The nurse determines that the client understands the information presented if the client watches for which signs and symptoms in the late afternoon? 94. A client newly diagnosed with diabetes mellitus is having difficulty learning the technique of blood glucose measurement. The nurse should teach the client to do which action to perform the procedure properly? . 95. The nurse is planning to instruct a client with diabetes mellitus who has hypertension about “sick day management.” Which beverage does the nurse avoid putting on a list of easily consumed carbohydrate-containing beverages for use when the client cannot tolerate food orally? 96. The nurse is monitoring the results of periodic serum laboratory studies drawn on a client with diabetic ketoacidosis (DKA) receiving an insulin infusion. The nurse determines that which value needs to be reported? 97. The wife of a client with diabetes mellitus who takes insulin calls the nurse in a health care provider’s office about her husband. She states that her husband is sleepy and that his skin is warm and flushed. She adds that his breathing is faster than normal and his pulse rate seems fast. Which action should the nurse tell the wife to do first? 98. A client recently diagnosed with diabetes mellitus requiring insulin tells the clinic nurse that he is traveling by air throughout the next week. The client asks the nurse for any suggestions about managing the disorder while traveling. Which action should the nurse tell the client to do? 99. A client scheduled for a thyroidectomy says to the nurse, “I am so scared to get cut in my neck.” Based on the client’s statement, the nurse determines that the client is experiencing which problem? 100. The nurse is caring for a client with Addison’s disease. The nurse checks the client’s vital signs and determines that the client has orthostatic hypotension. The nurse determines that this finding relates to which factor? 101. Which nursing measure would be effective in preventing complications in a client with Addison’s disease? 102. The nurse is collecting data on a client with a diagnosis of hypothyroidism. Which of these behaviors, if present in the client’s history, should the nurse determine as being likely related to the symptoms of this disorder? 103. While collecting data on a client being prepared for an adrenalectomy, the nurse obtains a temperature reading of 100.8 F. The nurse analyzes this temperature reading as which? 104. The anticipated intended effect of fludrocortisone acetate (Florinef) for the treatment of Addison’s disease is which? 105. The nurse is caring for a client with hypothyroidism who is overweight. Which food items should the nurse suggest to include in the plan? 106. A client has a blood glucose level drawn for suspected hyperglycemia. After interviewing the client, the nurse determines that the client ate lunch approximately 2 hours before the blood specimen was drawn. The laboratory reports the blood glucose to be 180 mg/dL, and the nurse analyzes this result as indicative of which interpretation? 107. In planning nutrition for the client with hypoparathyroidism, which diet would be appropriate? 108. The nurse is caring for a client with type 1 diabetes mellitus who is hyperglycemic. Which problem should the nurse consider first, when planning care for this client 109. A preoperative client is scheduled for adrenalectomy to remove a pheochromocytoma. The nurse should most closely monitor which assessment in the preoperative period? 110. The nurse working on an endocrine nursing unit understands that which correct concept is used in planning care? 111. Glucagon hydrochloride injection would most likely be prescribed for which disorder? 112. The nurse is caring for a child with a diagnosis of diabetes insipidus. The nurse anticipates that the health care provider will prescribe which medications? 113. When caring for a client diagnosed with pheochromocytoma, which information should the nurse know when assisting with planning care? 114. A client with pheochromocytoma is scheduled for surgery and says to the nurse, “I’m not sure that surgery is the best thing to do.” Which response by the nurse is appropriate? 115. A client with Cushing’s syndrome verbalizes concern to the nurse regarding the appearance of the buffalo hump that has developed. Which response by the nurse is appropriate? 116. A client with diabetes mellitus demonstrates acute anxiety when admitted to the hospital for the treatment of hyperglycemia. Which intervention would be appropriate to decrease the client’s anxiety 117. The nurse is collecting data from a client with type 2 diabetes mellitus. Which statement by the client indicates an understanding of the medication regimen? 118. The nurse is collecting data from a client who is being admitted to the hospital for a diagnostic workup for primary hyperparathyroidism. The nurse understands that which client complaint would be characteristic of this disorder? 119. The nurse is preparing to discharge a client who has had a parathyroidectomy. When reinforcing instructions to the client about the prescribed oral calcium supplement, which information should the nurse include? 120. A client is brought to the emergency department with suspected diabetic ketoacidosis (DKA). Which finding should the nurse note as being consistent with this diagnosis? 121. A client is admitted with a diagnosis of pheochromocytoma. The nurse should monitor which parameter to detect the most common sign of pheochromocytoma? 122. During data collection on a postoperative client who has undergone hypophysectomy, the client complains of thirst and frequent urination. Knowing the expected complication of this surgery, the nurse should check which parameter next? 123. A client with diabetes mellitus is scheduled to have a fasting blood glucose level determined in the morning. The nurse tells the client not to eat or drink after midnight. When the client asks for further information, the nurse clarifies by stating that which should be acceptable to take before the test? 124. A client with a pituitary tumor will undergo transsphenoidal hypophysectomy. The nurse reinforces which information in the preoperative teaching plan for the client? 125. A client who returned to the nursing unit 8 hours ago after hypophysectomy has clear drainage saturating the nasal dressing. The nurse should take which action? 126. A client with newly diagnosed Cushing’s syndrome expresses concern about personal appearance, specifically about the “buffalo hump” that has developed at the base of the neck. When counseling the client about this symptom, the nurse should incorporate which knowledge? 127. A client has just been admitted with a diagnosis of myxedema coma. If all of the following interventions were prescribed, the nurse should place highest priority on completing which action first? 128. The nurse has just supervised a newly diagnosed diabetes mellitus client self-inject NPH insulin at 7:30 __. The nurse reviews the time frames for peak insulin action with the client, telling the client to be especially watchful for a hypoglycemic reaction between which time frame? 129. The nurse is discussing foot care with a diabetic client and the spouse. The nurse includes which instruction during this informational session? 130. The nurse has provided diabetic teaching with the family of a client newly diagnosed with diabetes. The nurse determines that the family understands the reason for having glucagon on hand for emergency home use if the family indicates that the purpose of the medication is to treat which condition? 131. After receiving furosemide (Lasix) 40 mg slow intravenous push for chest pain related to shortness of breath and generalized edema, the client responds poorly. The client has no relief of the chest pain, shortness of breath, or edema and only minimal urine output (less than 40 mL of urine). The health care provider is notified, and after reviewing the chart, suspects the client has syndrome of inappropriate antidiuretic hormone (SIADH). Which findings would lead to this specific diagnosis? Refer to chart. [Show less]

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