PN Adult Medical Surgical 2023

PN Adult Medical Surgical 2023 Related

Review PN Adult Medical Surgical 2023 related questions and content

A nurse is contributing to the plan of care for a client who reports difficulty eating due to chronic arthritis. Which of the following interventions should the nurse include in the plan?

  • A. Ask the provider for a prescription for a pureed diet.
  • B. Have an assistive personnel feed the client.
  • C. Obtain a referral for physical therapy.
  • D. Apply foam handles to the client's eating utensils.
Correct Answer: D

Rationale: Chronic arthritis often impairs hand dexterity and grip strength, making self-feeding challenging. Option A, a pureed diet, addresses swallowing issues, not arthritis-related difficulties with utensils, so it's irrelevant here. Option B, having assistive personnel feed the client, undermines independence and dignity without addressing the root issue of utensil handling. Option C, physical therapy, may improve joint function long-term but doesn't provide immediate help for eating. Option D is correct applying foam handles increases utensil girth, improving grip for arthritic hands, promoting self-feeding and autonomy. This intervention directly tackles the physical limitation caused by arthritis, aligning with nursing goals of enhancing quality of life and independence. It's practical, cost-effective, and can be implemented quickly, offering immediate relief while other therapies (like PT) work in the background. Evidence supports adaptive equipment as a first-line strategy for arthritis patients struggling with daily activities, making this the most appropriate and empowering choice.

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A nurse is reinforcing teaching with a client who has iron-deficiency anemia. The nurse should instruct the client that which of the following foods has the highest iron content?

  • A. 3 oz chicken breast
  • B. 3 oz canned tuna
  • C. 3 oz pork roast
  • D. 3 oz ground beef
Correct Answer: D

Rationale: Ground beef has the highest iron content (about 2.7 mg/3 oz) among these options, making it best for iron-deficiency anemia.

Nurses' Notes Day 1: Client brought to the emergency department (ED) following a fall that occurred while downhill skiing. Client states they fell when turning to avoid hitting another skier. Client reports feeling a severe, sudden pain of right leg upon falling. Right leg was immobilized at the scene and client transported to the ED.
Client states they were wearing a helmet while skiing. Client reports no headache or loss of consciousness.
Client reports pain as 10 on a scale of 0 to 10 to the right lower leg just below the knee and is unable to bear weight.
Right proximal tibia ecchymotic and swollen below the knee. Area is painful to touch. Open area noted on skin with bone visible. Right knee appears displaced. Left pedal pulses 3+, foot warm with intact movement and sensation. Right pedal pulses 1+, foot cool to palpation with minimal movement and reduced sensation.

The nurse is collecting data on the client. Which of the following findings require follow up? (Ski accident client)

  • A. Findings of right lower extremity assessment
  • B. Oxygen saturation
  • C. Right pedal pulses
  • D. Level of consciousness
  • E. Temperature
  • F. Pain level
  • G. X-ray results
Correct Answer: A,C,F,G

Rationale: Right leg swelling, weak pulses, pain, and X-ray (fracture) indicate urgent issues like compartment syndrome.

A nurse is reinforcing teaching with a client who wants to lose 0.9 kg (2 lb) of body fat per week. The nurse knows that 0.45 kg (1 lb) of body fat is equal to 3500 calories. The nurse should instruct the client to reduce his daily caloric intake by how many calories?

Correct Answer: 1000

Rationale: Calculation: 2 lb × 3,500 cal/lb = 7,000 cal/week; 7,000 ÷ 7 = 1,000 cal/day reduction achieves the weight loss goal.

A nurse is collecting data from a client who has hyperthyroidism and is taking propylthiouracil. Which of the following statements by the client indicates the medication is effective?

  • A. I continue to lose weight.
  • B. I have less oily skin.
  • C. I no longer feel nervous.
  • D. I no longer take a stool softener.
  • E. I feel more tired.
  • F. My appetite has decreased.
  • G. My heart rate is faster.
Correct Answer: C

Rationale: Reduced nervousness indicates propylthiouracil is controlling hyperthyroid symptoms like anxiety.

A nurse is collecting data from a client who has peritonitis. Which of the following findings should the nurse expect?

  • A. Polyuria
  • B. Peripheral edema
  • C. Decreased respirations
  • D. Absent bowel sounds
Correct Answer: D

Rationale: Absent bowel sounds indicate paralytic ileus, a common finding in peritonitis due to inflammation. Polyuria, edema, and decreased respirations are not typical.

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