RN exams medical-surgical practice questions set 27

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The correct answer is C because the patient being 5 ft, 2 in tall and weighing 180 lb indicates potential obesity, which can increase the risk for musculoskeletal problems. Excess weight puts strain on the bones and joints, leading to conditions like osteoarthritis. A: Taking a multivitamin daily is generally positive for overall health but does not directly indicate an increased risk for musculoskeletal problems. B: Disliking fruits and vegetables may point to potential nutritional deficiencies but does not directly indicate musculoskeletal issues. D: Preferring whole milk over nonfat milk may impact overall nutritional intake but is not directly linked to musculoskeletal problems. In summary, choice C is correct because obesity is a significant risk factor for musculoskeletal problems, while choices A, B, and D do not directly indicate an increased risk in this context.

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The clinical presentation of fatigue, pallor, exertional dyspnea along with the laboratory findings of severe anemia, low serum iron, low transferrin saturation, and elevated TIBC are consistent with iron deficiency anemia. In iron deficiency anemia, there is inadequate iron available for erythropoiesis leading to microcytic hypochromic anemia. The low serum iron and transferrin saturation, along with the elevated TIBC, indicate decreased iron stores and increased iron-binding capacity as the body tries to compensate for the deficiency by increasing absorption and recycling of iron. Anemia of chronic disease typically presents with mild to moderate anemia, normal to low TIBC, and low transferrin saturation due to iron sequestration in macrophages. Sideroblastic anemia usually has elevated serum iron, high saturation, and normal to low TIBC. Thalassemia presents with microcytic hyp

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When a woman in active labor is experiencing intense pain and requests non-pharmacological pain relief measures, the nurse should prioritize providing continuous labor support. Continuous labor support, also known as a doula or labor companion, has been shown to be effective in reducing the perception of pain and improving labor outcomes. The presence of a supportive person can provide physical, emotional, and informational support, helping the woman cope with the pain and navigate through the labor process. This intervention can enhance the woman's overall experience of labor and improve maternal and neonatal outcomes without the need for pharmacological interventions. Administering opioids, performing epidural analgesia, or initiating nitrous oxide inhalation are pharmacological pain relief measures and may not align with the woman's preference for non-pharmacological options.

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The correct answer is B: Administer opioid analgesics to alleviate abdominal pain and discomfort. Opioid analgesics are effective in managing severe pain associated with malignant bowel obstruction. By providing adequate pain relief, the patient's comfort and quality of life can be significantly improved. Choice A is incorrect because initiating bowel rest and maintaining the patient in a semi-Fowler's position may not effectively address the severe pain and discomfort experienced by the patient. Choice C is incorrect as surgical intervention in this scenario may not be appropriate or feasible due to the advanced stage of cancer and the presence of malignant bowel obstruction. Choice D is incorrect as antiemetic medications primarily target nausea and vomiting, which may not be the primary symptoms of concern in this case. Focusing on pain management should be the priority.

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The correct answer is B: Increase the heparin rate. A PTT of 25 seconds indicates that the client's blood is not adequately anticoagulated, as the therapeutic range for PTT is typically around 60-80 seconds for heparin therapy. Therefore, the nurse should anticipate increasing the heparin rate to achieve the desired anticoagulant effect and prevent further clot formation. Incorrect choices: A: Decreasing the heparin rate would further decrease the anticoagulant effect, potentially putting the client at risk for thrombus progression. C: No change to the heparin rate would not address the subtherapeutic PTT level and could lead to inadequate anticoagulation. D: Stopping heparin and starting warfarin is not appropriate at this time as warfarin takes time to reach therapeutic levels, whereas heparin provides immediate anticoagulation for acute situations like a pulmonary embolism.

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The correct answer is C: Wash hands and properly dispose of soiled dressings. This is the best method to prevent the spread of infection when changing the dressing over a wound infected with Staphylococcus aureus. Washing hands helps to remove any potential pathogens, reducing the risk of cross-contamination. Proper disposal of soiled dressings ensures that any infectious material is contained and not spread to others. Incorrect options: A: Changing the dressing using sterile gloves is important, but it is not sufficient on its own to prevent the spread of infection. B: Applying antibiotic ointment over the wound may help treat the infection locally but does not address the risk of spreading the infection. D: Soaking the dressing in sterile normal saline before removal may help with the removal process, but it does not address preventing the spread of infection to others.

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The correct answer is C: Request a patient-controlled analgesia (PCA) pump for the client. This option is appropriate because the client is experiencing severe pain (level 10) due to full-thickness burns, which require consistent pain management. PCA allows the client to self-administer pain medication within safe limits, ensuring adequate pain control. It provides better pain relief compared to intermittent dosing like IM injections every 2 hours. Option A is incorrect because administering 5 mg of morphine immediately may not provide sustained pain relief and could lead to overmedication. Option B is not the best choice as it delays immediate pain relief and does not address the need for continuous pain management. Option D is also not ideal as assessing for complications should not delay pain relief and is not as effective as providing continuous pain control with a PCA pump.

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The correct answer is D because a history of recent loss of balance and fall in an elderly patient may indicate potential underlying issues such as vestibular dysfunction, neurological problems, medication side effects, or musculoskeletal issues. Further assessment and intervention are crucial to prevent future falls and ensure patient safety. A: Symmetric joint swelling of fingers is common in older adults and may be related to arthritis or other degenerative conditions, but it does not necessarily require immediate intervention. B: Decreased right knee range of motion could be due to age-related changes or arthritis, which may warrant assessment but does not pose an immediate safety risk. C: Report of left hip aching when jogging may indicate musculoskeletal issues or overuse injury, but it does not pose an immediate safety concern that requires urgent intervention.

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Yellowish-green drainage is the correct finding to report to the wound care specialist, as it strongly suggests infection or necrosis in the pressure ulcer. This purulent exudate, often tied to bacterial presence like Pseudomonas or Staphylococcus, requires urgent evaluation, possibly a culture, and treatment to prevent worsening or systemic spread. Foul odor may hint at infection or anaerobic bacteria but isn't definitive alone, as some wounds smell without being infected, making it less specific. Granulation tissue is a positive healing sign, not a concern, indicating new tissue formation. Partial-thickness skin loss aligns with pressure ulcer staging (e.g., Stage 2) and isn't an acute issue to report unless deteriorating. The yellowish-green drainage stands out as a critical, actionable finding, necessitating specialist input to address potential infection and optimize care.

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The correct answer is A because during clonal selection, lymphocytes specific to the pathogen are activated, leading to their proliferation and differentiation into effector cells. This results in an increase in the number of lymphocytes specific for the pathogen, enhancing the immune response. Choice B is incorrect because clonal selection does not involve the elimination of non-specific lymphocytes but rather the expansion of specific lymphocytes. Choice C is also incorrect because clonal selection does not change the antigen receptor specificities expressed by lymphocytes but instead focuses on expanding the population of lymphocytes with receptors specific to the pathogen. Therefore, the correct outcome of clonal selection is the increase in the number of lymphocytes specific for the pathogen that activated the response, making choice A the most accurate option.