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A client goes to the Emergency Department with acute respiratory distress and the following arterial blood gases (ABGs): pH 7.35, PCO2 40 mmHg, PO2 63mmHg, HCO3 23, and oxygenation saturation ( SaO2) 93%. Which of the following represents the best analysis of the etiology of these ABGs?
Several passengers aboard an airliner suddenly become weak and suffer breathing difficulty. The diagnosis is likely to be:
A primigravida begins labor when her family is unavailable and she is alone. She is very upset that her family is not with her. Which approach can the nurse take to meet the client’s needs at this time?
When planning care of a client who has a been diagnosed with Amphetamine Abuse, the nurse should use the knowledge that:
The nurse working with elderly clients should keep in mind that falls are most likely to happen to elderly who are:
During the work phase of the nurse-client relationship, the client says to her primary nurse, “You think that I could walk if I wanted to, don’t you?” What is the best response by the nurse?
In teaching bleeding precautions to a client with leukemia, the PN should include which of the following instructions?
Which of the following NSAIDS is most commonly used for a brief time for acute pain?
A client is admitted with a diagnosis of Multiple Drug Use. The nurse should plan care based on knowledge that:
When a client who is having trouble conceiving says to the nurse, “I have started taking ginseng,” the best response by the nurse is:
Which of the following conditions has a severe complication of respiratory failure?
The nurse has completed client teaching about introducing solid foods to an infant. To evaluate teaching, the nurse asks the mother to identify an appropriate first solid food. Which of the following is an appropriate response?
A client is given an opiate drug for pain relief following general anesthesia. The client becomes extremely somnolent with respiratory depression. The physician is likely to order the administration of:
The physician orders the antibiotics ampicillin (Omnipen) and gentamicin (Garamycin) for a newly admitted client with an infection. The nurse should:
A child comes to the clinic with a skin rash. The maculopapular lesions are distributed around the mouth and have honey-colored drainage. The caregiver states that the rash is getting worse and seems to spread with the child’s scratching. Which of the following advisory comments should be given?
At what point in the nurse-client relationship should termination first be addressed?
The client’s lab culture report is negative for a suspected infection. A test that can correctly identify those who do not have a given disease is:
Which is the best way to position a client’s neck for palpation of the thyroid?
Fat emulsions are frequently administered as a part of total parenteral nutrition. Which statement is true regarding fat emulsions?
The death of a beloved spouse places the surviving partner in which type of crisis?
Following the change of shift report, the nurse should analyze the information and set priorities accordingly. When the plan has been formulated, at what point during the shift can or should the nurse’s plan be altered or modified?
A 17-year-old female was raped by a young man in her neighborhood. She is in the Emergency Department for evaluation and tests. After the procedure is completed, a rape crisis counselor (nurse specialist) talks to the client in a conference room regarding the rape. Implementing counseling by the nurse specialist for the raped victim represents:
A nurse discharge planner is preparing a client for discharge from an acute care setting. The nurse assesses that skilled home care services are clinically indicated. This assessment is based on all of the following indicators except:
The nurse and a colleague are on the elevator after their shift, and they hear a group of health caregivers discussing a recent client scenario. Which client right might be breached?
The nurse is caring for a dying client who has persistently requested that the nurse “help her to die and be in peace.” According to the Code of Ethics for Nurses, the nurse should:
A client with a pleural drainage system to suction has gentle bubbling of the water seal. What should the nurse do?
The nurse is working with families who have been displaced by a fire in an apartment complex. What is the priority intervention during the initial assessment?
A client has just returned from surgery where a femoral-popliteal bypass was performed. The nurse has assessed the client and is unable to feel a pulse at either the dorsalis pedis or the posterior tibial sites of the left foot. The foot feels warm and the color is pink. What action should the nurse perform next to prevent ischemia?
Which of the following symptoms is most characteristic of a client with cancer of the lungs?
The nurse teaching a client about hepatitis and its transmission should explain that one type of hepatitis does not produce a carrier state after its acute phase. Which type is it?
During surgery, it is found that a client with adenocarcinoma of the rectum has positive peritoneal lymph nodes. What is the next most likely site of metastasis?
One day postoperative, the client complains of dyspnea, and his respiratory rate (RR) is 35, slightly labored, and there are no breath sounds in the lower-right base. The nurse should suspect:
A nurse is teaching a group of clients with a diagnosis of Schizophrenia who are nearing discharge from a residential care facility. An essential topic to include is:
A day care center has asked the nurse to provide education for parents regarding safety in the home. What type of preventive care does this represent?
Which of the following needs immediate medical attention and emergency intervention? The client who:
A client who is immobilized secondary to traction is complaining of constipation. Which of the following medications should the nurse expect to be ordered?
A middle-aged woman tells the nurse that she has been experiencing irregular menses for the past six months. The nurse should assess the woman for other symptoms of:
James returns home from school angry and upset because his teacher gave him a low grade on an assignment. After returning home from school, he kicks the dog. This coping mechanism is known as:
Which of the following is likely to increase the risk of sexually transmitted disease?
When a client informs the nurse that he is experiencing hypoglycemia, the nurse provides immediate intervention by providing:
Which of the following methods of contraception is able to reduce the transmission of HIV and other STDs?
Which of the following medications is a serotonin antagonist that might be used to relieve nausea and vomiting?
In teaching clients with Buck’s Traction, the major areas of importance should be:
Which of the following terms refers to soft-tissue injury caused by blunt force?
Which of the following nursing actions is most effective when evaluating a kinetic family drawing?
Following a classic cholecystectomy resection for multiple stones, the PACU nurse observes a serosanguious drainage on the dressing. The most appropriate intervention is to:
Which of the following foods might a client with a hypercholesterolemia need to decrease his or her intake of?
Which of the following physical findings indicates that an 11–12-month-old child is at risk for developmental dysplasia of the hip?
A client with an ileus is placed on intestinal tube suction. Which of the following electrolytes is lost with intestinal suction?
A client with cirrhosis of the liver presents with ascites. The physician is to perform a parancentesis. For safety, the nurse should ask the client to:
The teaching plan for a postpartum client who is about to be discharged should include which of the following instructions?
When teaching a woman about possible side effects of hormone replacement therapy, the nurse should include information about all of the following except:
A client is to have an enema to reduce flatus. The enema tube should be inserted:
Mrs. Owens is the 81-year-old mother of Jonathan, who is 54 years old. Jonathan has had schizophrenia since he was 16 years old. Which of Mrs. Owens’s concerns is likely to predominate?
A client expresses anxiety about having magnetic resonance imaging performed. Which of the following is an appropriate response by the nurse?
Which of the following diseases places a client at risk for developing cirrhosis?
Support systems during the grieving process include all of the following except:
For which condition might a client’s antidiuretic hormone (ADH) level be increased?
Which is an appropriate outcome for the nursing diagnosis of Body Image Disturbance for a client with anorexia nervosa?
Incidences of child abuse apperar to be higher in the African-American community and might be explained by:
Accurate documentation of assessment findings regarding pressure ulcers is very important because:
When working with multicultural populations, the nurse should consider all of the following when planning care for a client with an altered sexuality pattern except:
A client with major head trauma is receiving bolus enteral feeding. The most important nursing order for this client is:
Which of the following statements by an adult child of a client with late-stage Alzheimer’s disease indicates a need for further teaching by the nurse?
A client who is newly diagnosed with Parkinson’s disease and beginning medication therapy asks the nurse, “How soon will I see improvement ?” The nurse’s best response is:
A pregnant client has congenital heart disease. The nurse should expect to see which alterations in this client’s diet during pregnancy?
A nurse has been ordered to set-up Buck’s traction on a patient’s lower extremity due to a femur fracture. Which of the following applies to Buck’s traction?
Why is it often necessary to draw a complete blood count and differential (CBC/differential) when a client is being treated with an antiepileptic drug (AED)?
A nurse suspects a patient is developing Bell’s Palsy. The nurse wants to test the function of cranial nerve VII. Which of the following would be the most appropriate testing procedures?
A nurse runs into the significant other of a patient with end stage AIDS crying during her smoke break. Which of the following is most appropriate action for the nurse to take?
When an elder client asks the nurse whether he will be capable of sexual activity in old age, the best response by the nurse is:
A nurse reviewed the arterial blood gas reading of a 25 year-old male. The nurse should be able to conclude the patient is experiencing which of the following conditions?
Bicarbonate ion-25 mEq/l
PH-7.41
PaCO2-29 mmHg
PaO2-54 mmHg
(FiO2)-.22
A client who has a known history of cardiac problems and is still smoking enters the clinic complaining of sudden onset of sharp, stabbing pain that intensifies with a deep breath. The pain is occurring on only one side and can be isolated upon general assessment. The nurse concludes that this description is most likely caused by:
Metformin (Glucophage) is administered to clients with type II diabetes mellitus. Metformin is an example of:
A 22 year-old patient in a mental health lock-down unit under suicide watch appears happy about being discharged. Which of the following is probably happening?
An infection in a central venous access device is not eliminated by giving antibiotics through the catheter. How might bacterial glycocalyx contribute to this?
A nurse is assessing a patient in the rehab unit at shift change. The patient has suffered a TBI 3 weeks ago. Which of the following is the most distinguishing characteristic of a neurological disturbance?
A nurse has been ordered to administer Morphine to a patient. Which of the following effects is unrelated to Morphine’s effects on the patient?
TESTED 19 May 2024