Exam Review
- A nurse is caring for a client following a total knee replacement. Which of the following medications should the nurse anticipate the provider will prescribe to prevent the formulation of a deep vein thrombosis (DVT)?A)AspirinB)WarfarinC)EnoxaparinD)Alteplase
- A nurse is assessing the chest drainage system of a client who is 24 hr post-thoracotomy. The nurse notes slow, steady bubbling in the suction control chamber. Which of the following actions should the nurse take?A)Check the system for an air leakB)Notify the provider immediatelyC)Continue to monitor the drainage systemD)Increase the suction pressure
- A nurse is planning care for a client who has an absolute neutrophil count (ANC) less than 1,000/mm³. Which of the following interventions should the nurse include in the plan?(SATA)A)Increase raw produce consumptionB)Initiate protective isolationC)Limit visitors to healthy adultsD)Permit fresh flowers in the room
- A nurse is caring for a client who is 1-day postoperative following a left lower lobectomy and has a chest tube in place. When assessing the client’s three-chamber drainage system, the nurse notes that there is no bubbling in the suction control chamber. Which of the following actions should the nurse take?A)Document the findingsB)Add more water to the suction control chamberC)Check the suction source and connectionsD)Milk the tubing to restore patencyE)Milk the tubing to restore patency
Exam Review
- A nurse is planning care for a client who has methicillin-resistant Staphylococcus aureus (MRSA). Which of the following precautions should the nurse implement? (Select all that apply)(SATA)A)Wear a gown when in the client’s roomB)Use disposable dishes for mealsC)Wear gloves when providing direct careD)Place the client in a private room
- A nurse is planning care for a client who has chronic obstructive pulmonary disease (COPD). The client tells the nurse, “I can feel the congestion in my lungs.” Which of the following is an appropriate nursing action?A)Encouraging the client to drink 2 to 3 L of water dailyB)Helping the client select a low-salt dietC)Delivering oxygen via nasal cannula at 2 L/minD)Changing the client’s position as often as possible
- A nurse is caring for a client on the medical-surgical unit. The client has been taking warfarin at home and her INR is 3.5. The client states she is checking herself out of the hospital and refuses to wait until her provider can discuss the situation with her. Which of the following actions should the nurse take?A)Notify the provider of the client’s decisionB)Ask the client to sign an against medical advice (AMA) formC)Explain the risks of leaving with an elevated INRD)Request security to prevent the client from leaving
- A nurse is obtaining a health history from a client. Which of the following findings should the nurse identify as possible risk factors for iron deficiency anemia? (Select all that apply)(SATA)A)The client eats red meat weeklyB)The client has had gastric bypass surgeryC)The client has had treatment for gonorrheaD)The client eats raw vegetablesE)The client has ulcerative colitis
Exam Review
- A nurse is admitting a child who has leukemia and a critically low platelet count. Which of the following precautions should the nurse initiate?A)BleedingB)DropletC)NeutropenicD)Contact
- A client who has had a myocardial infarction (MI) is prescribed aspirin 325 mg. The nurse recognizes that the aspirin is given due to which of the following actions of the medication?A)Anti-inflammatoryB)AntiplateletC)AntipyreticD)AnalgesicE)Permit fresh flowers in the room
- A nurse is caring for a client with acute respiratory distress syndrome (ARDS). Which of the following is a common cause of ARDS?A)Motor vehicle accident traumaB)SepsisC)AspirationD)All of the above
- A nurse is providing teaching to a client who has neutropenia. Which of the following information should the nurse include in the teaching?A)Perform mild exercise, such as gardeningB)Eat plenty of fresh fruits and vegetablesC)Avoid crowdsD)Use a high-efficiency particulate air (HEPA) filter mask at all times
Exam Review
- A nurse is admitting a client who has active tuberculosis to a medical-surgical unit. Which of the following precautions should the nurse make for the client?A)Contact precautionsB)Droplet precautionsC)Airborne precautionsD)Protective isolation
- A nurse is admitting a toddler who has respiratory syncytial virus (RSV). Which of the following actions should the nurse take?A)Keep the thermometer in the toddler’s roomB)Allow the toddler to play in the common roomC)Place the toddler in a negative-pressure roomD)Initiate contact and droplet precautions
- A nurse is reviewing the CBC findings for a female client who is receiving combination chemotherapy for breast cancer. Which of the following findings should the nurse report to the provider?A)RBC 4.2x10⁶/µLB)WBC 2,000/mm³C)Hgb 12.0 g/dLD)Platelets 150,000/mm³
- A nurse is planning nutritional teaching for a client who is experiencing fatigue due to iron deficiency anemia. Which of the following foods should the nurse recommend to the client?A)White breadB)SpinachC)Whole milkD)Black tea
Exam Review
- A nurse is providing teaching to a client who has atrial fibrillation and reports dizziness and palpitations. Which of the following should the nurse understand?A)The AV node is unusually slowB)This is an expected sinus arrhythmiaC)Rapid atrial rate may reduce ventricular fillingD)The client requires a pacemaker immediately
- A nurse is caring for a client who has pneumonia. Which of the following actions should the nurse take to promote thinning of respiratory secretions?A)Encourage the client to ambulate frequentlyB)Teach coughing and deep breathingC)Encourage increased fluid intakeD)Administer incentive spirometer
- A nurse is caring for a client who is receiving radiation therapy to treat lung cancer. Which of the following actions should the nurse take?A)Observe for signs of infectionB)Review laboratory results for low hemoglobinC)Examine the skin for generalized urticariaD)Monitor the mouth for signs of xerostomia
- A nurse is teaching a client who has septic shock about the development of disseminated intravascular coagulation (DIC). Which of the following statements should the nurse make?A)“DIC is characterized by an elevated platelet count.”B)“DIC is caused by abnormal coagulation involving fibrinogen.”C)“DIC is a bleeding disorder involving a vitamin K deficiency.”D)“DIC is controllable with life-long heparin usage.”