(6) A client on the cardiac telemetry

(6) A client on the cardiac telemetry unit unexpectedly begins manifesting ventricular fibrillation and advanced cardiac life support (ACLS) team defibrillates the client, restoring a normal sinus rhythm. Later in the day, a family member questions why the code was called, telling the nurse the client has a living well. How should the nurse respond? (a) Explain that living wills can not be followed by emergency personnel (b) Check the client’s arm for a “DO NOT RESUSCITATE” (DNR) bracelet (c) Schedule a client and family conference to review the plan of care (d) Seek clarification of the type of advance directive the client has (7) A client tells the nurse about beginning an exercise program a month ago to lose weight and improve sleep. The client states that it still takes hours to fall asleep at night. Which action should the nurse implement? (a) Encourage the client to exercise everyday to eliminate bedtime wakefulness (b) Ask the client for a description of the exercise schedule that is being followed (c) Advise the client that lifestyle changes often take several weeks to be effective (d) Determine the amount of weight the client has lost since increasing activity (9) A client with metastatic bone cancer is requesting pain medication. What should the nurse use to assess the quality of the pain (a) Ask the client to describe the pain (b) Observe body language and movement (c) Provide a numeric pain scale (d) Identify effective pain relief measures. (16) The nurse observes a practical nurse (PN) pouring warm water over the perineal area of a female client who his frequent urinary incontinence while the client is positioned on a bed pan. What action should the nurse take (a) Recommend a complete bath to cleanse the perineal area more fully (b) Instruct the PN that this technique promotes infection in the elderly females (c) Evaluate the effectiveness of this measure to stimulate client voiding (d) Suggest contacting the health care provider for a prescription of catheter insertion (18) 2 years old is brought to the emergency department with a history of several days of rhinitis and difficulty breathing. Which additional finding should alert the nurse the child is experiencing respiratory distress? (a) Flaring of the nares (b) A resting respiratory rate of 35 breaths/minutes (c) Bilateral bronchial breath sounds (d) Diaphragmatic respirations (19) A client who weighs 154 pounds receives a prescription of epoetin alfa 50 unit/kg subcutaneous 3 times a day. How may ML should the nurse administer (Enter numerical value only ) **** (20) A client catheter bag was left on the clients bed for a long period of time, and the client develops of the infection, what should the nurse identify as the infection reservoir ***** (a) Urinary meatus (b) Clients’ bladder (c) the clients bed (d) Catheter tubing (21) When caring for an older male client with urinary frequency, which measure is most important for the nurse to implement to help the client prepare to go to bed for the night? (a) Offer the client an evening snack before providing oral care (b) Reassure the client that someone will check on him hourly (c) Ensure that the call bell is easily accessible to the client (d) Place fresh water and a glass within reach on the bedside table (25) A 4 year old child is brough to the emergency department by a parent after being bitten by a non-venomous snake. The child has a heart rate of 120 beats/minute and respiration of 42 breaths/minute. The nurse anticipates the child developing which acid ********* (a) Respiratory alkalosis (b) Respiratory acidosis (c) metabolic acidosis (d) metabolic alkalosis (27) While changing a clients post operative dressing, the nurse observes a red and swollen wound with moderate amount of yellow and green drainage and foul odor. Given there is a positive MRSA, which is the most important action for the nurse to take? (a) Reapply a sterile non adhesive dressing (b) administer prescribed antibiotics (c) limit visitors to immediate family only (d) force oral fluids (29) An older adult client is diagnosed with severe shingles and starts a new prescription for acyclovir, an antiviral medication. Which action should be a client teaching prior to discharge? (a) Schedule an appointment for medication peak and trough levels (b) Demonstrate how to apply sterile gauze dressing over the infected site (c) Explain the increased risk of postherpetic neuralgia during treatment (d) Encourage increased oral fluid intake while taking the medication (30) A male client who arrives in the emergency department after a motor vehicle collision (MVC) tells the nurse, “The car started to slide, and I . Everyone would be better off if I was no longer around”. How should the nurse respond? ****** (a) Assess the client for other symptoms of depression (b) Ask the client if the MVC was a suicide attempt (c) Determine what is going on in the client’s life to make him feel depressed (d) Report to the healthcare provider that the client may need an antidepressant (35) A school age child with chronic renal failure receives a prescription from the health care provider for losartan. Which action should the nurse implement prior to administering the medication? (a) Determine the time of the last meal (b) Evaluate the ability of swallow medication (c) Assess strength and range of motion (d) examine the color of the sclera 36) An adolescent client on a drug treatment unit becomes angry and pulls the refrigerator from the wall and then throws the microwave, after staff redirection, the healthcare provider prescribes restraints. Which assessment should the nurse include in the clients record while the client is in restraint (a) Speech patterns and processes (b) Range of motion and circulation (c) Responsiveness to painful stimuli (d) Pupils equal, round and reactive (40) A client who received and open reduction and internal fixation (ORIF) of the right femur after experiencing a fall at home experiences a sudden onset of increasing confusion and agitation. When reporting to the healthcare provider using SBAR (situation, background, assessment, recommendation) communication, which information should the nurse provide first ? (a) currently prescribed medication (b) Increasing confusion of the client (c) client’s healthcare power of attorney (d) Fall at the home as reason for admission (41) A post term infant is delivered with meconium-stained skin and cord. The newborn is having substernal retractions, grunting and is administered. Which statement should the nurse provide to the family about the purpose of surfactant? ******* (a) It increases cerebral blood flow (b) It increases lung compliance and decreases surface tension (c) It increases pulmonary circulation and decreases blood viscosity (d) it increases pulmonary vascular resistance (44) A client informs the nurse that acupuncture treatment have provided some relief with lower back pain. Which explanation should the nurse give for control theory of pain******* (a) The spinal cord fails to send the pain impulse to the brain (b) Cutaneous stimulation can alter spinal cord transmission of pain (c) the neuroanatomy of pain is underdeveloped (d) Nociceptor pathways are interrupted (45) An older client with the history of diabetes mellitus for 20 years is taking furosemide 40mg by mouth daily. Which action should the nurse take (a) Encourage the client to eat more bananas (b) Determine if potassium supplement is prescribed (c) Assess for muscle weakness, fatigue, or leg cramps (d) Review the daily serum electrolyte results

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