PN Adult Medical Surgical 2023

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A nurse is contributing to the plan of care for a client who has HIV. Which of the following interventions should the nurse plan to include?

  • A. Provide a diet of pureed foods.
  • B. Encourage fluids with meals.
  • C. Offer small, frequent meals.
  • D. Suggest fresh fruits and vegetables.
Correct Answer: C

Rationale: Clients with HIV often experience nutritional challenges due to symptoms like nausea, fatigue, or opportunistic infections, necessitating a tailored dietary plan. Option A, pureed foods, is suited for swallowing difficulties, not a general HIV need, so it's inappropriate. Option B, encouraging fluids with meals, may dilute gastric juices and worsen digestion or appetite, countering nutritional goals. Option C is correct small, frequent meals help maintain energy, combat weight loss, and accommodate reduced appetite or early satiety common in HIV, supporting immune function and medication tolerance. Option D, fresh fruits and vegetables, sounds healthy but risks infection (e.g., from unwashed produce) in immunocompromised clients, requiring caution or cooking instead. Small, frequent meals align with evidence-based HIV care, optimizing calorie intake and nutrient absorption without overwhelming the digestive system, making it the most effective and safe intervention for this population.

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A nurse is reinforcing discharge teaching for a client who had a cerebrovascular accident (CVA) and requires assistance to perform their ADLs. Which of the following statements should the nurse provide?

  • A. You will not become fatigued when you use assistive devices.
  • B. Plan to hire a home care aid to perform all of your ADLs.
  • C. Install grab bars in your shower to assist with your balance.
  • D. Place a towel in the shower to prevent slipping
Correct Answer: C

Rationale: Grab bars enhance safety and independence in the shower post-CVA. Fatigue is possible, full assistance isn't always needed, and a towel could be a slip hazard.

A nurse is caring for a client who has a prescription for propranolol for the treatment of atrial fibrillation. Which of the following actions should the nurse take?

  • A. Request a dosage increase if the apical heart rate is less than 60/min.
  • B. Withhold the medication if the systolic blood pressure is less than 90 mm Hg.
  • C. Administer the medication with an antacid.
  • D. Instruct the client to expect increased hair growth.
Correct Answer: B

Rationale: Propranolol is a beta-blocker, and it should be withheld if the systolic blood pressure is below 90 mm Hg to prevent hypotension. A heart rate below 60/min might also warrant withholding, not increasing, the dose, and the other options are unrelated to its administration.

A nurse is reinforcing teaching with a client who will be wearing a Holter monitor for the next 24 hr. Which of the following information should the nurse include?

  • A. You will need to record daily activities in a diary.
  • B. You should remove the electrodes when you go to bed.
  • C. You can bathe while wearing the electrodes.
  • D. You should not have sexual intercourse while the monitor is in place.
  • E. Avoid exercise entirely.
  • F. Keep the monitor in water.
  • G. Remove it if it beeps.
Correct Answer: A

Rationale: Recording activities helps correlate symptoms with heart activity; electrodes stay on, and bathing is avoided.

A nurse is assisting with the care of a client who has a closed-chest tube drainage system. Which of the following actions should the nurse take?

  • A. Replace the unit when the drainage chamber is full.
  • B. Clamp the tube for 30 min every 8 hr.
  • C. Pin the tubing to the client's bed sheets.
  • D. Monitor for at least 150 mL of drainage every hour.
Correct Answer: A

Rationale: Replacing the unit when full maintains system function. Clamping risks tension pneumothorax, pinning can dislodge tubing, and 150 mL/hr is excessive and not a standard expectation.

A nurse is reinforcing teaching about environmental modifications in the home with a family member of a client who has Alzheimer's disease. Which of the following information should the nurse include in the teaching?

  • A. Leave the television on.
  • B. Install locks at the top of doors.
  • C. Place throw rugs on the floor.
  • D. Schedule alternate caregivers.
Correct Answer: B

Rationale: Locks at the top of doors prevent wandering, a safety concern in Alzheimer's. TV can agitate, rugs are a fall risk, and caregiver scheduling isn't an environmental modification.

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