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    Exam Review

    1. Which instruction should the nurse include in the discharge teaching plan for an adult client with hypernatremia?
      A)Use salt tablets after strenuous exercise.
      B)Drink plenty of water whenever thirsty.
      C)Monitor daily urine output volume.
      D)Review food labels for sodium content.
    2. A client who is experiencing respiratory distress is admitted with respiratory acidosis. Which pathophysiological process supports the client's respiratory acidosis?
      A)Hyperventilation is eliminating carbon dioxide rapidly.
      B)High levels of carbon dioxide have accumulated in the blood.
      C)Carbon dioxide is converted in the kidneys for elimination.
      D)Blood oxygen levels are stimulating the respiratory rate.
    3. A client with multiple sclerosis (MS) fell while walking to the bathroom. Upon transfer to the intensive care unit, the client is confused and has had projectile vomiting twice. Which intervention should the nurse implement first?
      A)Determine the client's last dose of corticosteroids.
      B)Determine neurological baseline prior to the fall.
      C)Administer a PRN IV antiemetic as prescribed.
      D)Complete head-to-toe neurological assessment.
    4. A client has been administered lactulose for several days. Which therapeutic response should the nurse expect for a client with hepatic encephalopathy?
      A)Reduction in number of liquid stools.
      B)Improved mental status.
      C)Increase in urine output.
      D)Ability to ambulate independently.
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    Exam Review

    1. Which approach is best for the nurse to use when directing a client with Huntington's disease to the hospital cafeteria?
      A)Provide step-by-step verbal directions.
      B)Escort the client to the cafeteria.
      C)Use the hospital map to show the client where the cafeteria is located.
      D)Orient the client to the color-coding system used for locating hospital services.
    2. A client who is newly diagnosed with erosive esophagitis secondary to gastroesophageal reflux disease (GERD) reports to the home health nurse that there has been only a minimal reduction in symptoms after taking lansoprazole PO for one full week. Which action should the nurse take?
      A)Advise the client that healing typically takes several weeks to occur.
      B)Confirm that the client is taking the medication one hour after meals.
      C)Notify the healthcare provider that the client may need a change in dosage.
      D)Auscultate the client's bowel sounds and measure the abdominal girth.
    3. A client with psoriasis returns to the clinic reporting the persistence of several silvery, scaly areas on the elbows and palms that frequently burn and sometimes bleed. Which prescription should the nurse teach the client to use for the skin condition?
      A)Topical corticosteroids.
      B)Topical analgesics.
      C)Topical antifungal.
      D)Colloidal oatmeal-based lotion.
    4. A client with open-angle glaucoma asks the nurse how long the prescribed eye drops will need to be used. Which response made by the nurse is accurate?
      A)For long-term control of pain and swelling.
      B)Until a smaller angle can be restored.
      C)For long-term control of normal eye pressure.
      D)Until the excess pressure is reduced.
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    Exam Review

    1. A client with a history of asthma and bronchitis arrives at the clinic with shortness of breath, productive cough with thickened, tenacious mucus, and the inability to walk up a flight of stairs without experiencing breathlessness. Which action is most important for the nurse to instruct the client about self-care?
      A)Increase the daily intake of oral fluids to liquefy secretions.
      B)Teach anxiety reduction methods for feelings of suffocation.
      C)Call the clinic if undesirable side effects of medications occur.
      D)Avoid crowded enclosed areas to reduce pathogen exposure.
    2. A client is being cared for in the emergency department with acute abdominal pain and a provisional diagnosis of pancreatitis. The nurse assesses the client and obtains the results from laboratory studies. Which information is most valuable in reporting the client's status to the healthcare provider?
      A)Serum Helicobacter pylori (H. pylori) antibody results and urine output amounts.
      B)Presence of bowel sounds and degree of abdominal pain.
      C)Reports of chronic constipation and serum gastrin levels.
      D)Severity of nausea and vomiting and serum amylase results.
    3. The nurse is caring for a client with chronic obstructive pulmonary disease who develops an onset of dyspnea and tachypnea with coughing. After positioning the client upright, which action should the nurse take next?
      A)Attach humidification to oxygen delivery.
      B)Obtain a pulse oximetry reading.
      C)Coach through using huff coughing.
      D)Provide nebulizer breathing treatment.
    4. Which technique should the nurse use when assessing for early signs of rheumatoid arthritis?
      A)Observe the client's fingers.
      B)Palpate the lymph nodes.
      C)Observe the skin for lesions.
      D)Palpate large joints for nodules.
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    Exam Review

    1. A client presents to the emergency department with muscle aches, headache, fever, and describes a recent loss of taste and smell. The nurse obtains a nasal swab for COVID-19 testing. Which action is most important for the nurse to take?
      A)Isolate the client from other clients, family, and healthcare workers not wearing proper personal protective equipment (PPE).
      B)Counsel family members to monitor for illness symptoms for 2 weeks after last contact with the patient.
      C)Report the COVID-19 result to the local health department according to Centers for Disease Control and Prevention (CDC) guidelines.
      D)Teach the client to wear a mask, hand wash, and social distance to prevent spreading the virus.
    2. A client with emphysema is reporting difficulty in breathing and exhibiting audible wheezing. The nurse administers albuterol as prescribed for the third time within the last 12 hours. Which assessment finding warrants immediate intervention by the nurse?
      A)Uncontrollable shaking.
      B)Increased anxiety.
      C)Throat irritation.
      D)Irregular rapid heart rate.
    3. The nurse is caring for a client with emphysema who is mildly dyspneic after ambulation. Which instruction should the nurse provide to the client to improve gas exchange?
      A)Raise hands above the head to expand the diaphragm.
      B)Lay down on each side with knees bent and breathe from the abdomen.
      C)Increase breathing rate for a full 30 seconds.
      D)Draw air in through the nose and exhale slowly through pursed lips.
    4. A client with chronic cirrhosis has esophageal varices. It is most important for the nurse to monitor the client for the onset of which problem?
      A)Clay-colored stool.
      B)Brown, foamy urine.
      C)Hematemesis.
      D)Anorexia.
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    Exam Review

    1. The client with Clostridium difficile in the stool receives a prescription for vancomycin PO. Which action should the nurse take before administering the first dose?
      A)Assess body temperature.
      B)Auscultate bowel sounds.
      C)Measure oxygen saturation.
      D)Check serum creatinine.
    2. A client who was admitted yesterday with bilateral pneumonia has congested breath sounds, an oxygen saturation of 94% on room air, and an oral temperature of 100° F (37.8° C). The client has a weak cough effort and is using accessory muscles to breathe. Which intervention should the nurse implement first?
      A)Obtain arterial blood gases.
      B)Administer a prescribed antipyretic.
      C)Offer a prescribed PRN analgesic.
      D)Suction to clear secretions from airway.
    3. A client has a nasogastric (NG) tube placed during abdominal surgery. During postoperative convalescence, the nurse identifies that the client is manifesting a hand tremor, muscle twitching, and confusion. Which arterial blood gas values are consistent with metabolic alkalosis that the nurse should report to the healthcare provider?
      A)pH 7.30, PCO2 20 mm Hg, HCO3 22 mEq/L (22 mmol/L), PO2 85 mm Hg.
      B)pH 7.49, PCO2 45 mm Hg, HCO3 32 mEq/L (32 mmol/L), PO2 90 mm Hg.
      C)pH 7.46, PCO2 55 mm Hg, HCO3 36 mEq/L (36 mmol/L), PO2 95 mm Hg.
      D)pH 7.29, PCO2 35 mm Hg, HCO3 25 mEq/L (25 mmol/L), PO2 99 mm Hg.
    4. A client with symptoms of influenza that started the previous day asks the clinic nurse about taking oseltamivir to treat the infection. Which response should the nurse provide?
      A)Advise the client that once symptoms occur it is too late to receive an influenza vaccination.
      B)Refer the client to the healthcare provider at the clinic to obtain a medication prescription.
      C)Instruct the client that over-the-counter medications are sufficient to manage influenza symptoms.
      D)Explain to the client that antibiotics are not useful in treating viral infections such as influenza.
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