34 A client recovering from pneumonia who

34 A client recovering from pneumonia who has a history of severe chronic obstructive pulmonary disease (COPD) and peripheral vascular disease (PVD) is be… discharged from a skilled nursing facility. Which action is most important for the nurse to implement? Reinforce need for adequate hydration. Demonstrate specific strengthening exercises. Prove typed instructions for healthy die selections. Explain exercise daily regimen. 35 A client diagnosed with pancreatitis is complaining of severe epigastric pain and intense nausea. After the nurse administers a narcotic analgesic and an antiemetic, the client sitting up and leaning forward. Which action should the nurse implement? Raise head of the bed until at a 90-degree angle. Position bedside table for client to lean across. Reinforce bed rest until analgesic is effective. Place bed in reverse Trendelenburg position. 36 The nurse caring for a 3-month-old infant who is one day after a pylorotomy notices that the infant is restless, is exhibiting facial grimaces, and knees to the chest. Which action should the nurse take? Provide additional blankets to increase body temperature Increase IV infusion rate for rehydration Feed one ounce of formula to correct hypoglycemia Administer a prescribed analgesic for pain 37 A young adult who is hit with a baseball bat on the temporal area of the left skull is conscious when admitted to the Emergency Department, the neurological unit to be monitored for symptoms of closed head injury, which assessment finding is indicative of a developing epidural hematoma? Headache and pupillary changes 48 hours after head injury. Fever, nuchal rigidity and opisthotonos within hours. Altered consciousness within the first 24 hours after injury. Cushing reflex and cerebral edema after 24 hours. 38 The nurse is planning care for a client who has had a suprapubic resection of the prostate gland. Which nursing problem has the highest priority for this client’s care? Impaired physical mobility related to multiple drainage devices. Risk for deficient fluid volume related to NPO status. Risk for decreased cardiac output related to bleeding. Pain related to inability to use patient-controlled analgesia. 39 The nurse notes that a client’s legs become dusky red whenever the client is sitting with both feet dangling. Which follow-up assessment should the nurse complete? Ankle brachial index (ABI). Skin elasticity. Calf diameter. Joint range of motion. 40 The nurse is assessing an adolescent female diagnosed with anorexia nervosa who is admitted to the unit with severe malnutrition and electorally imbalance. Which pathological process results from the adolescent’s consistent maladaptive behavior? Sinus tachycardia. Amenorrhea. Hypertension. Menstrual cramps. 41 The nurse is preparing a client with an acoustic neuroma for a magnetic resonance image (MRI). Which client complaint is the threatening and should be reported to the healthcare provide immediately Difficult with balance Right ear hearing loss Facial numbness Intensifying headache 42 The nurse is conducting intake interviews of children at a city clinic. Which child is most susceptible t contracting lead poisoning? An 8-year-old lives in a housing project. A 2-year-old who plays on aging outdoor playground equipment. An adolescent who works part time in a paint factory. A 10-year-old who has Type 1 diabetes mellitus. A, C, E (Monitoring for increasing abdominal firth and generalized tissue edema and swelling are focused assessments that provide data about the progression of disease related complication. In advanced cirrhosis, liver function failure results in low serum albumin and serum protein levels. Which cause third spacing that results in generalized.) 43 Which needle should the nurse use to administer intravenous fluids (IV) via a client’s implanted port? 44 The nurse implements a primary prevention program for sexually transmitted diseases in a nurse managed health center. Which outcome indicates that the program was effective? Average client scores improved on specific risk factor knowledge test. More than half of at-risk clients were diagnosed early in their disease process. New screening protocols were developed, validated, and implemented. Clients who incurred disease complications……….. 45 A nurse working on the psychiatric intensive care unit (PICU) observes a male client pacing and hitting the wall with his fist which intervention should the nurse implement first? Restrain the client to prevent self-injury. Isolate the client until he is calm. Medicate the client with a prescribed PRN sedative. Encourage the client to verbalize his frustrations. 46 A client with bladder cancer had surgical placement of a ureteroileostomy (ileal condult) yesterday. Which postoperative assessment finding should the nurse report to the healthcare provider immediately? Stomal output of 40 mL in last hour. Liquid brown drainage from stoma. Mucous strings floating in the drainage. Red edematous stomal appearance. 47 A female adult who is undergoing chemotherapy tells the nurse that she plans to volunteer at the elementary school this winter When is best for the nurse to ask this client? Are you aware that you do not have a fully functioning immune system? Is it possible that you will be in direct contact with the children at school? Do you realize that you will be exposed to many different kinds of germs? Have you considered that you are putting yourself at risk for developing infections? 48 While caring for a client with a full thickness burn covering 40% of the body surface area (BSA). The nurse observes purulent drainage at the wound before reporting this finding to the healthcare provider, the nurse should note which of the client’s laboratory values? Serum blood glucose (BG) level. Serum albumin. Neutrophil count. Hematocrit. 49 The nurse is caring for a client with pneumonia who now develops initial signs of septic shock and multi-organ failure. The healthcare provider prescribes a sepsis protocol. Which intervention is most important for the nurse to include in the plan of care? 50 The healthcare provider prescribed finasteride 5 mg by mouth daily for a client with benign prostatic hyperplasia (BPH). In evaluating the effectiveness of this drug, the nurse should assess for which outcome? Increased sperm count. Relief from urinary tract infection. Enhanced libido. Decreased post-voiding dribbling. 51 A client who is seen in the clinic with possible neuropathic pain of the right leg rates the pain as a 7 on a 10-point scale. Which action should the nurse take? (a) Encourage the client to describe the pain (b) Measure the client’s capillary glucose (c) Ask the client to dorsiflex the right foot. (d) Elevate the client’s foot and leg on two pillows 52 of 160 The healthcare provider prescribes dalteparin 200 units/kg subcutaneously once day for a client who weighs 154 pounds. The medication is available in 25,000 units/mL vial. How many mL should the nurse administer? (Enter numerical value only. If rounding is required, round to the nearest tenth) 53 The nurse is assessing a middle-aged adult who is diagnosed with osteopathist. Which factor in this client’s history is a contributor to the osteopathist. Recently treated for deep vein thrombosis. Photosensitive to a drug currently taking. Lactose intolerant since childhood. Long distance runner since high school. 54 The nurse identifies several nursing problems for a client with tetraplegia who is experiencing fecal incontinence and diarrhea. The client’s spouse is the primary caregiver. In planning care, which identified nursing problem has the highest priority? Impaired bed mobility. Bowel incontinence. Caregiver role strain. Fluid volume deficit. 55 The nurse is assessing a client with pulmonary edema who is reporting two pillow orthopnea and paroxysmal nocturnal dyspnea. The nurse identifies crackles in all lung fields and use of accessory muscles. Which action should the nurse include in the client’s plan of care? Administer the prescribed amiodarone immediately. Arrange a prescribed electrophysiology study (EPS) for the client. Institute a daily fluid restriction while the client is in the hospital. Assess the client’s commitment to their daily exercise regimen. 56 The nurse is planning care for a child who is complaining of persistent itching due to scabies. Which measure should the nurse implement to minimize this child’s risk for complications? Shave the body hair before applying the scabicide lotion. Monitor for desquamation and normal flora overgrowth. Wash skin between application of topical antiparasitic doses. Keep the child’s nails short and encourage use of hand mittens. 57 An older client presents to the emergency department with abdominal pain due to constipation. The nurse is providing a list of high-fiber foods to the client that the healthcare provider has recommended. Which action should the nurse implement when reviewing the list of foods? Stand behind the client to avoid intimidation. Turn on overhead lights while giving instructions. Use background music to promote relaxation. Provide handouts written at a 12th grade reading level. 58 An adult male was diagnosed with stage IV lung cancer three weeks ago. His wife approaches the nurse and asks how she will know that her husband’s death in imminent because their two adult children want to be there when he dies. Which is the best response by the nurse? Gather information regarding how long it takes for the children to arrive. Offer to discuss the client’s health status with each of the adult children. Reassure the spouse that the healthcare provider will notify when to call the children. Explain that the client will start to lose consciousness and the body systems wi The charge nurse observes a new nurse preparing to insert an intravenous (IV) catheter. The new nurse has gathered supplies, including intravenous … an intravenous insertion kit, and 4×4 sterile gauze dressing to cover and secure the insertion site. What action should the charge nurse take? Remind the nurse to tape the gauze dressing securely in place. Plan to observe the secured IV site after the insertion procedure. Instruct the nurse to use a transparent dressing over the site. Confirm that the nurse has gathered the necessary supplies. 60 A female adolescent client is admitted to the hospital because she wrote a suicide note to her teacher at school. On the second day of hospitalization, the nurse asks the client to meet with the treatment team. After the team meeting, the client leaves in tears and goes to her room. Which nursing intervention is best? Let the client rest quietly in her room for a while. Go to the client’s room and ask what happened. Explore the client’s goals and desire for treatment. Ask the treatment team about the client’s behavior. 61 While caring for a client who is being mechanically ventilated, the nurse responds to a high-pressure alarm on the ventilator. Which assessment finding warrant immediate intervention by the nurse? 62 A client with renal lithiasis is receiving morphine sulfate every four hours for pain and renal comic, which assessment finding should prompt the nurse to administer a PRN dose of naloxone? Unresponsive to verbal or tactile stimuli. Respiratory rate of 12 breaths/minute. Statement about visual hallucinations. Complaints of increasing flank pain. 63 A 5-year-old child with a history of a wadding gait and frequent falls is brought into the hospital for diagnostic testing. When explaining the diagnostic test the parents, the nurse should provide information based on which understanding of the underlying disease pathology? Impaired neuron function. Systemic autoimmune vasculopathy. Muscle fiber degeneration. Autonomic neuropathy. 64 A male client admitted with chronic pulmonary obstruction disease (COPD) exacerbation is receiving assisted ventilation with continuous positive airway pressure (CPAP). His vital signs are: temperature 98.8 oF (37.1oC). heart rate 118 beats/minute, respirations 46 breaths/minute, blood pressure 176/92 mmHg. While completing the pulmonary assessment, his oxygen saturation reading is 78% and he is difficult to arouse. Which action should the nurse implement? Increase the oxygen delivery by 10%. Prepare for rapid sequence intubation. Administer PRN nebulizer treatment. Complete neurological assessment. 65 The nurse as assessing a cert who received a hematopoietic stem cell transplant 4 weeks ago. Which assessment finding dating gravers du should the nurse report to the healthcare provider? Widespread maculopapular rash. Decreased urinary output. High blood pressure. Change in level of consciousness. 66 When the nurse attempts to each self-administration of insulin injections to a client who is newly diagnosed with type 1 diabetes mellites (DM). the client the nurse in a loud voice to leave the room. Which action should the nurse take? Explain that insulin is a life saving drug for the client. Refer client to the social worker for support therapy. Encourage client to implement relaxation techniques. Leave the client’s room and return later in the day SCIENCE HEALTH SCIENCE NURSING NUR 230 230

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