Question

A client is receiving phenytoin 0.2 gram orally twice daily. The medication is available in 100 mg capsules. How many capsules should the nurse administer? (Enter numeric value only.)

Answer 1

Correct Answers:

2

Rationale :

🧮Phenytoin 0.2 grams is equivalent to 200 mg, as 1 gram = 1,000 mg.

🧾The available capsule strength is 100 mg, so the nurse must administer 200 ÷ 100 = 2 capsules per dose.

📏Administering the correct dose conversion ensures therapeutic levels and avoids toxicity or underdosing.

💊Accurate calculation is critical for antiepileptic drugs like phenytoin, which have a narrow therapeutic index.

📌Core Message

Accurate medication dose calculation based on metric conversions and available strengths is essential for safe medication administration.

Answer 2

Correct Answers:

Decrease speaking speed.

Rationale :

🦻Older adults often experience presbycusis, which affects the ability to hear high-frequency sounds, not just volume.

🗣️Decreasing the speaking speed allows the client time to process spoken words, improving communication effectiveness.

🙅‍♀️Shouting or over-enunciating can distort sounds and make it more difficult for the client to understand speech.

👂Effective communication requires adjusting for hearing deficits using clear, slow, and low-pitched speech.

📌Core Message

Clear communication with older adults often requires slower speech patterns rather than increased volume or exaggerated expressions.

Answer 3

Correct Answers:

Hematuria.

Rationale :

🩸Hematuria is a sign of possible renal involvement, such as lupus nephritis, which is a life-threatening complication of systemic lupus erythematosus (SLE).

⚠️This finding requires immediate follow-up to prevent irreversible kidney damage or renal failure.

🦴Fatigue, alopecia, and joint pain are common manifestations of SLE but are not immediate threats to organ function.

🩺Prompt identification of organ-threatening complications is crucial in autoimmune disorders like SLE.

📌Core Message

Hematuria in SLE warrants urgent evaluation due to the risk of renal complications like lupus nephritis.

Answer 4

Correct Answers:

Swallowing ability.

Rationale :

😶A mask-like face in Parkinson’s disease can indicate decreased facial muscle movement, which can impair swallowing.

🚫This places the client at high risk for aspiration, which can lead to pneumonia and other respiratory complications.

💁‍♂️Assessing respiratory rate is important but less immediate than identifying dysphagia risks.

🍴Early evaluation of swallowing ability ensures timely interventions such as diet modifications or speech therapy.

📌Core Message

In Parkinson’s disease, a mask-like face suggests possible dysphagia, making swallowing assessment the highest priority.

Answer 5

Correct Answers:

Complete blood count.

Rationale :

🩸Fatigue in a client with pernicious anemia suggests possible worsening of anemia, best assessed by a complete blood count (CBC).

💉Although the client receives B12 injections, a CBC will show if they are effective or if there is another underlying issue.

🧪MCV and Hgb/Hct levels on the CBC will help confirm macrocytic anemia characteristic of B12 deficiency.

🔍Other labs like liver enzymes and electrolytes are less directly linked to oxygen-carrying capacity and fatigue symptoms.

📌Core Message

A CBC is essential to evaluate the effectiveness of B12 therapy and investigate ongoing fatigue in pernicious anemia.

Answer 6

Correct Answers:

0.5

Rationale :

📏The ordered dose is 10 mcg, and the concentration is 0.02 mg/mL.

🔄Convert 0.02 mg = 20 mcg, so 10 ÷ 20 = 0.5 mL.

💉Administering the correct volume ensures proper opioid reversal with naloxone without exceeding the dose.

⚖️Precise unit conversion from mg to mcg is critical to avoid medication errors.

📌Core Message

Administering naloxone safely requires precise unit conversions and volume calculations based on mcg dosage.

Answer 7

Correct Answers:

Insert a nasogastric tube (NGT) and attach to low intermittent suction (LIS).

Rationale :

🤢Dark brown emesis in the setting of bowel cancer suggests a possible bowel obstruction, requiring immediate gastric decompression.

🧯An NGT to LIS helps relieve pressure, reduce vomiting, and prevent aspiration.

🖼️Abdominal x-ray can follow but is not the immediate intervention for active symptoms.

💊Administering pain medication or inserting a Foley catheter is supportive but not problem-solving in this scenario.

📌Core Message

Vomiting dark emesis in suspected bowel obstruction warrants immediate NG tube insertion to prevent complications.

Answer 8

Correct Answers:

The client's skin on the shins will be intact at the next clinic visit.

Rationale :

🚶‍♂️Intermittent claudication reflects peripheral arterial disease (PAD), increasing the risk for skin breakdown due to poor perfusion.

💉A key nursing goal is maintaining intact skin to prevent ulcers and infections.

🧬While glucose control and family education are important, preserving tissue integrity directly addresses the circulatory deficit.

⚠️PAD-related wounds can progress quickly to necrosis or amputation if not prevented.

📌Core Message

For clients with intermittent claudication, maintaining intact skin reflects effective management of circulatory complications.

Answer 9

Correct Answers:

The client will adhere to the medication regimen after discharge.

Rationale :

💉Post-op clients with new insulin requirements must demonstrate understanding and compliance with self-administration for safety.

🏷️The outcome focuses on long-term self-care and adherence, which is key after transitioning from oral to injectable therapy.

🧼Ostomy care and auscultating breath sounds are important but not the primary behavioral outcome in this context.

📦A well-written outcome should reflect client-centered behavioral changes and self-management skills.

📌Core Message

For post-op clients with new insulin regimens, focus on promoting adherence to ensure safe self-management after discharge.

Answer 10

Correct Answers:

A barrel chest results because of using a hyperventilating breathing pattern.

Rationale :

📦A barrel chest is a hallmark of emphysema, resulting from chronic air trapping in the overdistended alveoli.

💨The client uses increased respiratory effort, including hyperventilation, to compensate for impaired gas exchange.

📉The lungs lose their elasticity, leading to chest wall remodeling that results in the barrel-shaped appearance.

🧍This physical change is a result of prolonged use of accessory muscles, not necessarily increased tolerance or decreased oxygen demand.

📌Core Message

Chronic hyperinflation of alveoli in emphysema causes a barrel chest due to chest wall expansion.

NSG 123128 Med-Surg Final Exam

No.

1 :
A client is receiving phenytoin 0.2 gram orally twice daily. The medication is available in 100 mg capsules. How many capsules should the nurse administer? (Enter numeric value only.)

2 :
An older adult female client is hospitalized with a fractured femur. During a routine nursing assessment, she repeatedly asks the nurse to "speak up" so that she can hear the questions. Which action is best for the nurse to take?

3 :
The nurse completes the admission assessment of a client with systemic lupus erythematosus. Which finding requires immediate follow up by the nurse?

4 :
The nurse observes that a newly admitted client with Parkinson's disease exhibits a mask like facial appearance. Which additional nursing assessment takes priority in response to this finding?

5 :
A client with pernicious anemia takes supplemental folate and self-administers monthly vitamin B12 injections. The client reports feeling increasingly fatigued. Which laboratory value should the nurse review?

6 :
The healthcare provider (HCP) prescribes naloxone HCl 10 mcg IV bolus stat. Naloxone HCL is supplied as "0.02 mg/ml." How many mL should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.)

8 :
The nurse is developing a plan of care (POC) for a client with type 2 diabetes mellitus (DM) who reports intermittent claudication in the legs. Which outcome should the nurse include in the POC for this client?

10 :
An adult client who has been diagnosed with emphysema asks the nurse to talk about the symptoms of the disease. Which statement should be included in the nurse's description of emphysema?

NSG 123128 Med-Surg Final Exam

No.

1 : A client is receiving phenytoin 0.2 gram orally twice daily. The medication is available in 100 mg capsules. How many capsules should the nurse administer? (Enter numeric value only.)

2 : An older adult female client is hospitalized with a fractured femur. During a routine nursing assessment, she repeatedly asks the nurse to "speak up" so that she can hear the questions. Which action is best for the nurse to take?

3 : The nurse completes the admission assessment of a client with systemic lupus erythematosus. Which finding requires immediate follow up by the nurse?

4 : The nurse observes that a newly admitted client with Parkinson's disease exhibits a mask like facial appearance. Which additional nursing assessment takes priority in response to this finding?

5 : A client with pernicious anemia takes supplemental folate and self-administers monthly vitamin B12 injections. The client reports feeling increasingly fatigued. Which laboratory value should the nurse review?

6 : The healthcare provider (HCP) prescribes naloxone HCl 10 mcg IV bolus stat. Naloxone HCL is supplied as "0.02 mg/ml." How many mL should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.)

8 : The nurse is developing a plan of care (POC) for a client with type 2 diabetes mellitus (DM) who reports intermittent claudication in the legs. Which outcome should the nurse include in the POC for this client?

10 : An adult client who has been diagnosed with emphysema asks the nurse to talk about the symptoms of the disease. Which statement should be included in the nurse's description of emphysema?

1 :
A client is receiving phenytoin 0.2 gram orally twice daily. The medication is available in 100 mg capsules. How many capsules should the nurse administer? (Enter numeric value only.)

2 :
An older adult female client is hospitalized with a fractured femur. During a routine nursing assessment, she repeatedly asks the nurse to "speak up" so that she can hear the questions. Which action is best for the nurse to take?

3 :
The nurse completes the admission assessment of a client with systemic lupus erythematosus. Which finding requires immediate follow up by the nurse?

4 :
The nurse observes that a newly admitted client with Parkinson's disease exhibits a mask like facial appearance. Which additional nursing assessment takes priority in response to this finding?

5 :
A client with pernicious anemia takes supplemental folate and self-administers monthly vitamin B12 injections. The client reports feeling increasingly fatigued. Which laboratory value should the nurse review?

6 :
The healthcare provider (HCP) prescribes naloxone HCl 10 mcg IV bolus stat. Naloxone HCL is supplied as "0.02 mg/ml." How many mL should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.)

8 :
The nurse is developing a plan of care (POC) for a client with type 2 diabetes mellitus (DM) who reports intermittent claudication in the legs. Which outcome should the nurse include in the POC for this client?

10 :
An adult client who has been diagnosed with emphysema asks the nurse to talk about the symptoms of the disease. Which statement should be included in the nurse's description of emphysema?