Exam Review
- The nurse is providing education to a client who experiences recurrent levels of moderate anxiety to situations and perceived stress. In addition to information about prescribed medication and administration, which instruction should the nurse include in the teaching?A)Find outlets for more social interaction.B)Center attention on positive upbeat music.C)Practice using muscle relaxation techniques.D)Think about reasons the episodes occur.
- Patient Data The nurse starts discharge teaching. Which findings indicate the client understands the discharge teaching? Select all that apply.(SATA)A)Monitor for temperatures greater than 100.4° F (38° C).B)Schedule a glucose tolerate test in 6 weeks.C)Eat 500 additional calories daily.D)Insulin requirements increase with lactation.E)Check blood sugar before breastfeeding.F)Wear a medical-alert bracelet.G)Eat 15 grams of carbohydrates if glucose is less than 150 mg/dL (8.3 mmol/L).H)Avoid low-dose contraceptives postpartum.
- A client with a diagnosis of schizophrenia sits in the day room and fails to interact with the staff or peers. Which intervention is best for the nurse to implement with this client?A)Encourage the client to have lunch off the unit.B)Complete an assessment of social support.C)Give the client a schedule of planned daily activities.D)Engage the client in a game of cards.
- The nurse reviews the history and physical and assessment. Select the 3 findings that require immediate follow up by the nurse.(SATA)A)Dry skinB)Testicular rugaeC)Decreased toneD)Mild tachypneaE)Thin lanugo presentF)Nasal flaring
Exam Review
- A client with peripheral artery disease receives a meal tray from the dietary department. Which statement indicates to the nurse that the client is following a meal plan to support healthy blood flow?A)"I'm going to eat the cookies last with my coffee."B)"I need an additional serving of butter for my roll."C)"The meat patty with gravy needs more salt."D)"I would like skim milk instead of whole milk,
- The nurse is caring for a client who is four days postpartum. Which color should the nurse expect the lochial discharge to be?A)Dark red.B)Yellow.C)Brown.D)White.
- At the end of a preoperative teaching session on pain management techniques, a client starts to cry and states, "I just know I can't handle all the pain." Which is the priority nursing problem for this client?A)Pain (acute).B)Knowledge deficit.C)Anticipatory grieving.D)Anxiety.
- A female client is taking a bisphosphonate for postmenopausal osteoporosis. The client tells the nurse that she is experiencing jaw pain. How should the nurse respond?A)Report the client's jaw pain to the healthcare provider (HCP).B)Confirm that this is a common symptom of osteoporosis.C)Determine how the client is administering the medication.D)Advise the client to gargle with warm salt water twice daily.
Exam Review
- The home health nurse makes a home visit to a client with amyotrophic lateral sclerosis (ALS). The client is sitting upright while feeding themself and coughs frequently during the meal. Which action should the nurse implement?A)Recommend the use of supplemental liquid feedings.B)Assist the client to lie down and turn to the side.C)Demonstrate use of a tucked-chin position while eating.D)Encourage the use of assistive feeding devices.
- While auscultating the abdomen of a thin older adult client, the nurse detects a pulsatile mass. Which action should the nurse implement?A)Notify the healthcare provider.B)Document the findings.C)Roll the patient onto his right side.D)Call an emergency code.
- Patient Data (Highlight — findings requiring follow-up are marked)
Patient Data
Click to highlight the assessment findings that require immediate follow up by the nurse.Client is admitted to the medical floor. She has mild subcostal retractions and is sitting in an upright position. Wheezes are noted throughout the lung fields. The client is pale. She has strong peripheral pulses that are equal bilaterally. Her heart rate is 122 beats/minute, blood pressure 134/85 mm Hg, oxygen saturation 91% on room air.
- Patient Data Choose the most likely options for the information missing from the statement by selecting from the lists of options provided. Considering the client's history and assessment findings, it is likely the client has ▾ Acute asthma exacerbation related to ▾ Physical exertion during hikingDropdown 1:Option 1: Acute asthma exacerbationOption 2: Pulmonary embolismOption 3: PneumothoraxDropdown 2:Option 1: Alcohol useOption 2: Physical exertion during hikingOption 3: Marijuana use
Exam Review
- Patient Data After the nurse assesses the client, the healthcare provider (HCP) writes prescriptions. The nurse reviews the prescriptions. Which 2 prescriptions should the nurse complete first?(SATA)A)Give albuterol as prescribedB)Provide a regular diet trayC)Perform pulmonary function testD)Apply oxygen 1 L/minuteE)Measure vital signs
- Patient Data The nurse starts the albuterol nebulizer as prescribed. Which should the nurse assess after the albuterol nebulizer treatment is complete? Select all that apply.(SATA)A)Oxygen saturationB)Serum sodiumC)Peak inspiratory flowD)Complete blood countE)Peak expiratory flow (PEF)F)Heart rateG)Breath soundsH)Temperature
- Patient Data The nurse assesses the client after the dose of albuterol and documents the findings in the chart. Which action(s) should the nurse plan for the rest of the shift? Select all that apply.(SATA)A)Discuss with the client potential asthma triggersB)Discuss aggressive respiratory treatment optionsC)Allow the client to take a position of comfortD)Consider positive pressure ventilationE)Obtain a sputum cultureF)Monitor the oxygen saturationG)Wean the supplemental oxygenH)Prepare for deep tracheal suctioning
- The nurse considers the client's condition and reviews the imaging results. Choose the most likely options for the information missing from the statements by selecting from the lists of options provided. The nurse considers that the client is experiencing an ▾ acyanoticdefect known as ▾ Patent ductus arteriosusthat causes▾ Increased pulmonary flowDropdown 1:Option 1: cyanoticOption 2: acyanoticOption 3: obstructiveDropdown 2:Option 1: Patent ductus arteriosusOption 2: Tetralogy of FallotOption 3: Pulmonary stenosisDropdown 3:Option 1: Decreased pulmonary flowOption 2: Decreased systemic perfusionOption 3: Increased pulmonary flow
Exam Review
- The nurse is considering priorities for the client's care. Drag from Word Choices to complete the sentence. The nurse knows that the priority concepts for nursing care management of the newborn with a patent ductus arteriosus are to ▾ manage altered hemodynamicsand▾ manage pulmonary congestionDropdown 1:Option 1: manage altered hemodynamicsOption 2: manage pulmonary congestionOption 3: minimize systemic fluid overloadOption 4: maintain nutritional statusOption 5: reduce afterloadOption 6: decrease cardiac demandsDropdown 2:Option 1: manage altered hemodynamicsOption 2: manage pulmonary congestionOption 3: minimize systemic fluid overloadOption 4: maintain nutritional statusOption 5: reduce afterloadOption 6: decrease cardiac demands
- Patient data The nurse begins client education and asks the client what potential asthma triggers may have been involved in her recent exacerbation. For each statement click to specify if the client has an understanding or no understanding of asthma triggers. Each row must have one option selected.
Understanding No Understanding "My friend smoked cigarettes during the hike." ✓ "I should have taken an extra dose of fluticasone- salmeterol." ✓ "I should have eaten a snack halfway through the hike." ✓ "I should have taken some allergy medications before going on the hike." ✓ "I have been very stressed out lately and should work on stress management." ✓ - A client with metastatic bone cancer is requesting pain medication. Which approach should the nurse use to assess the quality of the client's 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.
- A client with advanced cirrhosis is being treated for hepatic encephalopathy. In reviewing the client's serum laboratory results, which finding requires the most immediate intervention by the nurse?A)Decreased ammonia.B)Prolonged prothrombin time (PT).C)Elevated direct bilirubin.D)Lowered total protein and albumin.