Nur 215 Medical Surgical 1
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Which test should the nurse anticipate discussing with a patient who has a possible seizure disorder?
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Cerebral angiography
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Electromyography (EMG)
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Lumbar puncture
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Electroencephalography (EEG)
Explanation
Correct Answer:
Electroencephalography (EEG)
Explanation:
An EEG (electroencephalogram) is the most appropriate diagnostic test for evaluating seizure disorders. It measures electrical activity in the brain and can identify abnormal patterns suggestive of epilepsy or other seizure conditions. The EEG helps determine the type and origin of seizures, aiding in diagnosis and treatment planning. It is noninvasive, commonly used, and essential for neurologic assessment in suspected seizure disorders.
Why Other Options Are Wrong:
Cerebral angiography
This imaging technique visualizes blood vessels in the brain and is more appropriate for detecting aneurysms or vascular malformations. It is not typically used to diagnose seizures.
Electromyography (EMG)
EMG assesses muscle and nerve function and is useful for conditions like neuropathy or myopathy. It does not evaluate brain activity and is unrelated to seizure assessment.
Lumbar puncture
A lumbar puncture may be used if infection (like meningitis) is suspected, but it is not the primary test for seizure disorders. It helps rule out CNS infections rather than identify seizure activity.
The nurse is caring for a client who has been under constant stress for several weeks. The client is now exhibiting signs of irritability, difficulty concentrating, and muscle tension. The nurse recognizes these symptoms as an indication that the client is in which stage of the General Adaptation Syndrome (GAS)?
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Alarm
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Reflex
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Resistance
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Exhaustion
Explanation
During the resistance stage of GAS, the body continues to cope with prolonged stress by maintaining a heightened state of arousal, which manifests as irritability, difficulty concentrating, and muscle tension as the body attempts to adapt over an extended period.
Why the other options are incorrect:
A. The alarm stage is the initial, immediate "fight-or-flight" response to a stressor, not a prolonged reaction over several weeks.
B. Reflex is not a recognized stage of the General Adaptation Syndrome.
D. The exhaustion stage occurs when the body's resources are depleted after prolonged stress, typically resulting in more severe symptoms such as burnout, illness, or system failure, rather than moderate irritability and muscle tension.
The nurse is caring for a patient following a cystoscope. Which assessment finding would the nurse report to the provider as a complication after the procedure?
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Bright red blood in urine
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Urinary frequency
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Pink-tinged urine
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Burning on urination
Explanation
Correct Answer:
Bright red blood in urine
Explanation:
Bright red blood in the urine following a cystoscopy may indicate active bleeding and should be reported immediately. While some mild hematuria (pink-tinged urine) is expected, bright red bleeding suggests a complication such as trauma or vessel injury during the procedure. This finding requires prompt evaluation by the provider to rule out serious issues and initiate appropriate treatment. It goes beyond expected post-procedure symptoms.
Why Other Options Are Wrong:
Urinary frequency
This is a common and expected side effect after cystoscopy due to bladder irritation. It typically resolves without intervention and does not signal a serious complication.
Pink-tinged urine
Mild hematuria is normal post-procedure and results from minor mucosal irritation. It usually subsides within a day or two and doesn’t require reporting unless it worsens.
Burning on urination
Dysuria can occur after cystoscopy as the urethra may be irritated. This symptom should be monitored, but it is not necessarily a complication unless accompanied by signs of infection or worsening discomfort.
The nurse overhears the son of a client speaking to another nurse about the possibility of palliative care for his mother. What statement made by the nurse colleague to the son causes the nurse to intervene?
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"Her condition is slow and progressive, so palliative care is ideal for your mother."
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"Your mother is not yet at the dying stage of the disease, so palliative care is not an option."
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"Treatment for her illness is ongoing, but you can certainly consider palliative care for her."
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"I agree with starting her on palliative care as it will provide comfort throughout the illness."
Explanation
This statement is factually incorrect and requires the nurse to intervene because palliative care is not limited to end-of-life or dying patients—it can be provided alongside curative treatment at any stage of a serious illness to improve quality of life and manage symptoms.
Why the other options are incorrect:
A. This statement correctly reflects that palliative care is appropriate for clients with chronic, progressive conditions.
C. This statement accurately conveys that palliative care can be pursued concurrently with ongoing treatment.
D. This statement correctly supports palliative care as an appropriate option for providing comfort during illness
A home health nurse is visiting a client who uses an oxygen cylinder at home. During the visit, the nurse notices that the oxygen cylinder is not secured and is placed in a location where it could easily fall over. What is the most important safety recommendation the nurse should provide to the client?
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The oxygen cylinder should be placed in a closet with the door closed.
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The oxygen cylinder should be securely stored in a location where it cannot tip over or roll.
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The oxygen cylinder should be stored in the bathroom for easier access during bathing.
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The oxygen cylinder should be kept near a heater to ensure the client stays warm while using oxygen.
Explanation
Correct Answer: (B) The oxygen cylinder should be securely stored in a location where it cannot tip over or roll.
Securing the oxygen cylinder in a stable position prevents it from falling and potentially causing damage to the valve, which could result in the tank becoming a projectile or leaking oxygen, a serious safety hazard.
Why the other options are incorrect:
A. Storing the cylinder in a closed closet restricts airflow and access in an emergency and does not address the securing issue.
C. Bathrooms have high humidity and are not an appropriate storage location; this doesn't address the tipping hazard either.
D. Oxygen is highly combustible and should never be stored near heat sources or open flames due to fire risk.
The nurse is caring for a client receiving oxygen via nasal cannula at 4 L/min. During the morning assessment, the nurse notes that the client is increasingly restless and has an oxygen saturation of 88%. Which action should the nurse take first?
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Assess the client's respiratory rate and effort
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Increase the oxygen flow rate to 6 L/min
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Notify the health care provider of the saturation level
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Switch the client to a nonrebreather mask
Explanation
Correct Answer: (A) Assess the client's respiratory rate and effort
Following the nursing process, the nurse must first assess the client to gather complete data on the underlying cause of the restlessness and low saturation before implementing interventions, since restlessness can be an early sign of hypoxia.
Why the other options are incorrect:
B. Increasing oxygen flow without first assessing the client skips necessary assessment data and may not address the underlying cause.
C. The provider should be notified after the nurse has completed a thorough assessment and, if needed, initiated appropriate interventions.
D. Switching to a nonrebreather mask is an intervention that should follow a proper assessment of the client's respiratory status first.
A patient is suspected to have pyelonephritis. How will the nurse assess for flank tenderness?
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Palpate along both sides of the lumbar vertebral column
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Strike a flat hand covering the costovertebral angle (CVA)
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Push fingers upward into the two lowest intercostal spaces
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Percuss between the iliac crest and ribs at the midaxillary line
Explanation
Correct Answer:
Strike a flat hand covering the costovertebral angle (CVA)
Explanation:
Assessment for costovertebral angle (CVA) tenderness is a standard method for evaluating flank pain, often associated with kidney infection such as pyelonephritis. The nurse places one hand flat over the CVA region and strikes it with the fist of the other hand. A positive response is pain or discomfort, indicating possible inflammation or infection in the kidney. This is a quick, non-invasive method to support diagnostic decisions.
Why Other Options Are Wrong:
Palpate along both sides of the lumbar vertebral column
Palpation can assess muscle or skeletal tenderness but is not specific or reliable for evaluating kidney inflammation or infection.
Push fingers upward into the two lowest intercostal spaces
This technique is not relevant to kidney assessment. It may be used in abdominal exams but does not target the CVA where the kidneys are located.
Percuss between the iliac crest and ribs at the midaxillary line
Although this area may be near the CVA, this technique does not accurately localize kidney tenderness and is not the standard method for assessing flank pain related to pyelonephritis.
When caring for a patient on bed rest who has an indwelling urinary catheter, which action would be a priority for the nurse?
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Follow good health habits to change the course of the disease
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Keep active, use stress-reduction strategies and avoid fatigue
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Practice using the mechanical aids that you will need with future disabilities arise
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You will need to accept the necessity of a quiet and inactive lifestyle
Explanation
Correct Answer:
Keep active, use stress-reduction strategies and avoid fatigue
Explanation:
Even for patients on bed rest, encouraging as much activity as tolerated helps reduce complications like muscle atrophy, pressure injuries, and respiratory issues. For patients with an indwelling catheter, stress and fatigue can also impair immune function and recovery. Stress-reduction and energy conservation strategies are essential to preserve physical and mental well-being during limited mobility. Maintaining a positive, proactive approach to care supports recovery.
Why Other Options Are Wrong:
Follow good health habits to change the course of the disease
This does not directly address the immediate nursing concern for a patient with a catheter and on bed rest. It is vague and not a priority intervention.
Practice using the mechanical aids that you will need with future disabilities arise
This statement assumes future decline and is not patient-centered or timely. The focus should be on current needs and abilities.
You will need to accept the necessity of a quiet and inactive lifestyle
This promotes passivity and can worsen physical deconditioning. Bed rest should be managed with interventions that promote safe mobility and prevent complications.
A client is scheduled for a routine colonoscopy and expresses anxiety about the procedure. The client mentions that they have never had a medical procedure before and are particularly nervous about being sedated. The nurse notes that the client is also worried about not being in control during the procedure. What should the nurse include in the client's pre-procedure plan of care to address their concerns?
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Suggesting the client not to worry, as everything will be fine and the procedure will be quick.
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Instructing the client to avoid asking questions and to remain calm during the procedure.
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Offering a sedative to calm the client before the procedure to help reduce anxiety.
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Reinforce education already provided by the provider and anesthesia team.
Explanation
Correct Answer:
D
Why the other options are incorrect:
A. Dismissing the client's concerns by telling them not to worry invalidates their feelings and does not provide meaningful support or information.
B. Discouraging questions removes the client's ability to gain understanding and control, worsening rather than addressing their anxiety.
C. Administering a sedative is a medical intervention that must be ordered by the provider; offering it independently is not within appropriate nursing scope for the described situation, and education addresses the root anxiety more effectively.
A client with advanced heart failure is transitioning to hospice care after exhausting curative treatment options. The client and their family are concerned about what to expect from hospice care. What interventions are appropriate when this client is admitted to hospice care? (Select all that apply)
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Making all healthcare decisions for the client and their family
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Helping the family prepare for the client's death emotionally and spiritually
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Prioritizing curative treatment over symptom management
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Providing comfort measures such as pain and symptom management
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Ensuring the client's wishes for end-of-life care are respected
Explanation
Hospice care focuses on holistic support, including emotional and spiritual preparation for the family, aggressive symptom and comfort management, and honoring the client's autonomy and end-of-life wishes, all of which align with the core philosophy of hospice.
Why the other options are incorrect:
A. Hospice care emphasizes client and family autonomy in decision-making, not the healthcare team making decisions for them.
C. Hospice care shifts the focus away from curative treatment entirely toward comfort and symptom management.
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