FREE CMSRN Medical-Surgical Nursing General Questions and Answers
Shana was diagnosed with gastroesophageal reflux disease following an EGD (GERD). Edna is taught by the nurse how to reduce symptoms. Which of the following Edna statements suggests that more instruction is required?
Explanation:
The client with GERD is encouraged to eat smaller, low-fat frequent meals and to avoid lying down after eating. Clients are instructed not to eat for at least 2 hours before bedtime and avoid foods that decrease lower esophageal pressure, such as anything containing caffeine (coffee, tea, cola, chocolate).
Twelve-year-old Shane loves skateboarding a lot. On her first attempt at learning the movements, she unintentionally fell. She was subsequently taken to the Emergency Department, where she was in excruciating pain. The left tibia's incomplete fracture was seen on the X-ray film. Her left leg was cast after the doctor prescribed a closed reduction. Which of the following is not the right way to help Shane?
The wrong kind of intervention is to design a turning timetable for position adjustments every three hours. It is recommended to arrange position changes every two hours in order to prevent deep vein thrombosis, pneumonia, and skin disintegration that can occur from immobility. For a client with closed reduction, the remaining options represent appropriate nursing interventions.
An autoimmune condition known as Hashimoto's disease has been identified in Ms. JMM. Which of the following descriptions of the client's indications and symptoms most likely contributed to the diagnosis?
Constipation, weight gain, and decreased appetite are signs of Hashimoto's disease, the most prevalent cause of hypothyroidism among clients. Additionally, fatigue, brittle nails, coarse hair, cramping in the muscles, weakness, and apnea are symptoms to be aware of. Choice A exhibits hyperthyroidism symptoms. Choice B's symptoms are indicative of uncontrolled diabetic mellitus. The symptoms listed in option D are indicative of hypercortisolism.
The nurse's most accurate explanation of a thyroid scan to a colleague is that it:
Explanation:
A thyroid scan utilizes the uptake of radioactive iodine by the thyroid gland to determine the size, shape, and function of the gland.
Mrs. Jones, a known diabetic, is being taught by the nurse how to use a glucometer to check her blood sugar. The nurse will be able to determine that Mrs. Jones is capable of doing her fingerstick blood collection when she:
Verifying that the customer has understood the health instruction on using a glucometer to monitor blood glucose is done by puncturing the side of the fingertip. Because the sides of the fingertips contain fewer nerve endings than the balls of the finger, choosing the sides as the puncture sites will cause less agony. Thumbs and both hands can be utilized as puncture sites.
A customer who had suffered an amputation is being urged by the nurse to put on a prosthetic right away. The benefit of taking this quick action is
Explanation:
When the prosthesis is in place immediately following surgery, the client can stand up several hours postoperatively and walk the next day. The operative site is closed to outside contamination and benefits from improved circulation due to ambulation.
The nurse should arrange for the following after a thyroid scan using radioactive iodine to check for a thyroid nodule:
After injecting radioactive iodine for the thyroid scan, no radiation protection measures are required. Option B relates to implants made of radium. When radioactive iodine therapy is used to reduce and regulate thyroid hypersecretion (hyperthyroidism), option C may be used. Option 4 does not represent standard radiation therapy practice.
Mr. Scott, a 55-year-old mechanic, was diagnosed with adult-onset diabetes. The nurse will know that Mr. Daniels understands the symptoms of a hyperglycemic reaction if he verbalized,
Explanation:
“I may feel flushed cheeks, will have acetone breath, and increased thirst”, is the statement that the client understands the manifestations of a hyperglycemic reaction.
Before being released, a patient with a fractured left leg must learn the three-point gait. Which directive ought the nurse to deliver to this patient?
Explanation:
In the three-point gait, both crutches and the affected “bad” leg and foot moved together, with the unaffected “good” leg and foot following.
Millet, age 32, visited a day clinic to report a sudden weight gain. She also reported to the nurse on duty that her abdomen is now bigger than before and her face looks “swollen” and rounded. Which additional assessment finding would lead the nurse to suspect that Millet has Cushing’s syndrome rather than obesity?
Explanation:
Posterior neck fat pad and thin extremities are also noted in a client with Cushing’s syndrome. “Buffalo hump” is the accumulation of fat pads over the upper back and neck. Fat may also accumulate on the face, which suggest a “swollen” and rounded face. There is truncal obesity but the extremities are thin.
On the day of operation, a patient with type 2 diabetes mellitus is admitted, and their glucose level is 610 mg/dl. The patient may be at risk for the following, according to the perianesthesia nurse:
The patient is at risk for "Diabetic ketoacidosis (DKA)," a dangerous consequence of diabetes marked by hyperglycemia, ketosis, and metabolic acidosis, if they have a history of type 2 diabetes mellitus and a glucose level of 610 mg/dl upon admission. Patients with type 1 diabetes are most affected, however people with type 2 diabetes may also experience it, particularly after stressful procedures like surgery. As a result, the perianesthesia nurse needs to watch out for any indications that the patient is experiencing DKA. In the setting of type 2 diabetes mellitus, uncontrolled hyperglycemia is generally not associated with hypercalcemia, diabetes insipidus, or hyperkalemia.