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 :

0.2 g = 200 mg

200 ÷ 100 = 2 capsules ✅

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 2

Correct Answers:

Decrease speaking speed.

Rationale :

🔹 Older adults often experience presbycusis, an age-related hearing loss that makes it difficult to distinguish sounds, especially when spoken rapidly.

🔹 Shouting can distort words and make it harder for the client to understand.

🔹 Over-enunciating syllables also distorts normal speech patterns, making comprehension more difficult.

🔹 Slowing down speech while maintaining normal tone and clear articulation allows the client to process words more effectively.

🔹 Additional helpful strategies include maintaining eye contact, reducing background noise, and using written communication if necessary.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 3

Correct Answers:

Hematuria.

Rationale :

🌟 Hematuria is an urgent finding in systemic lupus erythematosus (SLE) because it suggests renal involvement (lupus nephritis), which can progress rapidly to kidney failure if untreated.

🌟 While fatigue is a common chronic manifestation of SLE, it does not pose an immediate threat to life or organ function.

🌟 Alopecia (hair loss) is also a frequent but non–life-threatening manifestation caused by autoimmune activity or corticosteroid therapy.

🌟 Joint pain is a hallmark symptom of SLE but is less urgent compared to renal impairment.

🌟 Early recognition and treatment of lupus nephritis is essential to preserve kidney function and prevent irreversible damage.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 4

Correct Answers:

Swallowing ability.

Rationale :

🌟 A mask-like facial expression in Parkinson’s disease indicates decreased facial muscle movement, which can also affect chewing and swallowing muscles.

🌟 Impaired swallowing ability (dysphagia) puts the client at risk for aspiration, malnutrition, and weight loss, making it the top priority.

🌟 While neck flexion and speech changes are common complications, they do not present the same immediate risk as aspiration.

🌟 Respiratory rate is always important, but the mask-like expression directly signals the need to evaluate swallowing first.

🌟 Early assessment allows the nurse to implement strategies such as modified diets, swallowing techniques, and speech therapy referral.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 5

Correct Answers:

Complete blood count.

Rationale :

🌟 Pernicious anemia is caused by a vitamin B12 deficiency due to lack of intrinsic factor, leading to impaired red blood cell production.

🌟 Even with folate supplementation, if vitamin B12 is not adequately absorbed or utilized, the client may develop megaloblastic anemia characterized by fatigue and pallor.

🌟 A complete blood count (CBC) will show low hemoglobin, hematocrit, and abnormal RBC indices, which directly explains the client’s fatigue.

🌟 Liver enzymes are not directly related to anemia monitoring.

🌟 Platelet count is part of a CBC but alone does not explain the fatigue.

🌟 Serum electrolytes reflect hydration and metabolic balance, not the status of anemia.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 6

Correct Answers:

0.5

Rationale :

Ordered dose = 10 mcg = 0.01 mg

Supply = 0.02 mg ÷ 1 mL

Calculation:

0.01 mg ÷ 0.02 mg/mL = 0.5 mL ✅

Final Answer: 0.5

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 7

Correct Answers:

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

Rationale :

♦ Dark brown emesis indicates possible bowel obstruction with retained gastric contents that may be decomposing. In the setting of adenocarcinoma of the small intestine, obstruction is a common complication, which can lead to abdominal pain, nausea, vomiting, and risk for perforation or aspiration.

♦ The priority intervention is gastric decompression using a nasogastric tube attached to low intermittent suction (LIS). This relieves pressure, pain, and vomiting, prevents aspiration, and reduces risk of further complications such as peritonitis.

♦ While a flat plate abdominal x-ray may be ordered, the client is already symptomatic with severe abdominal pain and vomiting; decompression takes priority before diagnostic imaging.

♦ A urinary catheter may be useful for fluid balance but does not address the acute gastrointestinal emergency.

♦ Giving analgesics for fever is inappropriate because fever is not the primary issue; the pain stems from obstruction, not infection.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 8

Correct Answers:

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

Rationale :

♦ Intermittent claudication is a classic symptom of peripheral arterial disease (PAD), which commonly occurs in clients with type 2 diabetes mellitus due to poor circulation and atherosclerosis. PAD increases the risk of skin breakdown, non-healing ulcers, and gangrene, especially in the lower extremities.

♦ The priority outcome in the plan of care is the prevention of complications—specifically, maintaining intact skin integrity to reduce the risk of infection, ulcer formation, and potential limb amputation.

♦ Teaching the family about diet and showing the client how to check glucose are important interventions, but they are not the most direct outcome related to intermittent claudication and PAD.

♦ Acceptance of health status is a psychosocial outcome, whereas skin integrity addresses the immediate physiologic risk.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 9

Correct Answers:

The client will adhere to the medication regimen after discharge.

Rationale :

♦ A client with type 2 diabetes mellitus who develops postoperative hyperglycemia and now requires self-injections of insulin must prioritize long-term management to prevent complications such as infection, poor wound healing, and cardiovascular problems.

♦ The most appropriate outcome statement focuses on adherence to the prescribed insulin regimen, since consistent use is critical for glucose control and overall recovery.

♦ While ostomy care is essential, the priority for this client’s new diagnosis and safety after discharge is ensuring that they will properly manage their insulin therapy.

♦ Statements about breath sounds or inability to inject insulin reflect interventions or problems, not measurable outcomes. Outcomes should be client-centered, specific, and measurable.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 10

Correct Answers:

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

Rationale :

🔷 Emphysema is a form of chronic obstructive pulmonary disease (COPD) characterized by the destruction of alveoli, which leads to air trapping and hyperinflation of the lungs.

🔷 Over time, the lungs remain in an overexpanded state, pushing the rib cage outward and producing the characteristic “barrel chest” appearance.

🔷 This occurs because clients use increased work of breathing and accessory muscles, but despite hyperventilation, gas exchange remains impaired, causing dyspnea and exercise intolerance.

🔷 Unlike in the incorrect statements, oxygen requirements actually increase, not decrease, and pursed-lip breathing is a compensatory strategy to prolong exhalation, not a cure.

🔷 Clients with emphysema have decreased tolerance for exertion, not increased, due to chronic hypoxemia and carbon dioxide retention.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

HU NSG 123/128 MedSurg 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?

Connect With Us

HU NSG 123/128 MedSurg 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?