The nurse is planning discharge teaching for a client following a stapedectomy. What would be included in the discharge plan? Select all that apply. 1. The client can shower and wash hair when at home. 2. Avoid using a straw to drink beverages for 2 to 3 weeks. 3. Keep your mouth closed when blowing your nose. 4. Avoid air travel for 6 months. 5. If constipated, take a laxative.

What is a priority nursing concern with a client who has had recent onset of vertigo from Ménière’s disease? 1. Loss of hearing 2. Nausea and vomiting 3. Falls 4. Hydrops diet

Which medications would the nurse anticipate being ordered for the client who has Ménière’s disease and is having an acute attack? Select all that apply. 1. Antihistamine 2. Benzodiazepine 3. Antibiotic 4. Antiemetic 5. Cholinergic

A client comes to the clinic complaining of eye problems, especially difficulty reading signs. Which action should the nurse always assess on the client who presents with an eye problem? 1. Consensual and accommodation response. 2. Pupillary reaction. 3. Visual fields. 4. Visual acuity.

What are the causes of increased intraocular pressure? Select all that apply. That's Incorrect | Correct Answer(s): 4,5 1. Blockage of the nasolacrimal canal and duct. 2. Edema of the optic disk. 3. Vasodilation of the retinal arterioles. 4. Increased production of aqueous humor by the ciliary process. 5. Decreased outflow of aqueous humor in the trabecular meshwork. 6. Diminished visual acuity with refractive error.

After a tonic-clonic (formerly grand mal) seizure, what nursing action is the highest priority? 1. Loosen or remove constricting clothing and protect the client from injuring himself or herself. 2. Maintain a patent airway by turning the client on the side and suctioning, if necessary. 3. Remain with the client and administer anticonvulsant medications as ordered by the physician. 4. Describe and record events before the onset of the seizure, during the seizure, and after the seizure.

What will the nurse anticipate the neurologic assessment of an 88-year-old client with a left cranial hemisphere hemorrhage to reveal? 1. Spasticity and bilateral Babinski sign 2. Right-sided flaccidity and hemiparesis 3. Spasticity and left foot clonus 4. Flaccidity and bilateral foot clonus

The nurse would question the use of which drug for the client with cerebral hemorrhage: That's Incorrect | Correct Answer: 3 1. Gemfibrozil 2. Mannitol 3. Enoxaparin 4. Nitroprusside

A client is 1 day postoperative for a craniotomy. What would the nurse recognize as the earliest indication of increased intracranial pressure (ICP)? 1. Severe nausea 2. Projectile vomiting 3. Pupil sluggish and nonresponsive to accommodation 4. Change in level of consciousness

The nurse is caring for a client who had a stroke. The nurse assigned a nursing assistant to assist the client with meals. What observation of the certified nursing assistant's (CNA) activities by the nurse would cause the most concern? 1. The CNA places the client in a high-Fowler's position. 2. The CNA is placing the food on the affected side of the mouth. 3. The CNA is talking with the client during feeding. 4. The CNA provides liquids that have been thickened.

The nurse is providing care for a client who had a stroke affecting the left side of the body. Homonymous hemianopsia has developed. Considering this problem, what will be important for the nurse to include when providing care? 1. Stand on the right side of the client when speaking to him or her. 2. Speak slowly and pronounce words very clearly. 3. Encourage activity and increase fluid intake. 4. Assist with eating by placing the food on the right side of the mouth.

In planning daily care for a client with Parkinson disease, which consideration should be given priority? 1. Completing the client's care in as short a time as possible 2. Organizing the client's care so that the client will feel unhurried 3. Encouraging the client to assume full responsibility for his care 4. Providing long rest periods for the client after each of his care activities

While caring for a client who has recently been diagnosed with trigeminal neuralgia, what is important for the nurse to understand? Select all that apply. 1. Abrupt onset of paroxysmal intense pain in the lower and upper jaw, cheek, and lips 2. Tearing of the eyes and frequent blinking may occur 3. Visual problems caused by ptosis 4. Facial twitching and grimacing may occur 5. Pain is usually brief; ends as abruptly as it begins 6. May experience poor appetite because of a loss of taste

When assessing an adult client, the nurse notes that the client has right eyelid lag, drooping of the mouth, decreased taste sensation, and muscle weakness on the right side of the face. What condition will the nurse suspect? 1. Guillain-Barré syndrome 2. Bell palsy 3. Trigeminal neuralgia 4. Grave's disease

The nurse is assessing a client who had a fractured femur repaired with an external fixator device. Which assessment finding(s) would cause the nurse concern regarding the development of compartment syndrome? Select all that apply. 1. Increase in pulse rate in leg 2. Tingling and numbness distal to area of injury 3. Toes on affected leg cool to touch and edematous 4. Complaints that the pins are hurting 5. Complaints of leg pain unrelieved by analgesics or repositioning 6. Client angry and calling loudly to the nurse every 10 minutes

In taking the health history of a client with severe painful osteoarthritis, the nurse would expect the client to report which of the following? 1. A gradual onset of the disease, with involvement of weight-bearing joints 2. A sudden onset of the disease, with involvement of all joints 3. Complaints of joint stiffness after periods of activity 4. Pain that improves with use of the joint

The postoperative nursing care plan for a client who has had a right-above-the-knee amputation includes which intervention? 1. Applying ice packs to the residual limb for 72 hours 2. Having the client lie on his or her abdomen for 30 minutes three to four times per day 3. Wrapping the residual limb with elastic bandages from proximal to distal ends 4. Managing client's pain with antiinflammatory medications

The nurse educator is instructing a student nurse concerning the differences in the joints affected in osteoarthritis and rheumatoid arthritis. Which important fact should be included? 1. In rheumatoid arthritis, weight-bearing joints are affected first. 2. In osteoarthritis, only the small joints of the fingers are affected. 3. Rheumatoid arthritis usually has bilateral joint involvement. 4. In osteoarthritis, the joint destruction is caused by changes in the synovial fluid.

Which statement by the client who has recently had a total hip replacement indicates that the client does not understand the mobility limitations? That's Correct 1. "I should not bend down to put on shoes or socks." 2. "It is okay to cross my legs if I am sitting in a chair." 3. "I should put a pillow between my legs when lying on my side." 4. "I should not sit in low chairs or on toilet seats that are low."

A client has a fractured femur and is scheduled for surgery and stabilization with internal fixation. The nurse is assessing the client for the development of a fat embolism. What early assessment findings would suggest the development of this complication? That's Correct 1. Swelling and redness in the affected area 2. Blood and fat in the stool 3. Hypotension 4. Confusion and restlessness

The nurse is caring for a client with a fractured femur that has not been repaired. Fat emboli and pulmonary emboli are both potential complications of this condition. Which symptoms would be suggestive of fat emboli versus a pulmonary emboli? 1. Difficulty breathing 2. Blood-tinged sputum 3. Restless and confusion 4. Petechiae over the trunk and in axillary folds

The nurse is preparing health teaching for adult women regarding the prevention of osteoporosis. What would be important to include in the teaching plan? Select all that apply. 1. Daily walking for 15 to 30 minutes 2. Supplemental calcium intake 3. Reduction of caffeine intake 4. Increased intake of water 5. Avoidance of sunlight because of photosensitivity