REx-PN® Bundled Exams With Actual
Exam Newest With Complete Questions And
Correct Detailed Answers| Brand New
Version!
The nurse has completed teaching a client with type 2 diabetes about taking gliclazide. Which of
the following client statements indicate a need for additional teaching?
a. "My diabetes is not as likely to cause complications as if I needed to take insulin."
b. "Other medications besides the gliclazide may affect my blood sugar."
c. "When I become ill, I may have to take insulin to control my blood sugar."
d. "If I overeat at a meal, I will still take just the usual dose of medication." Answer: A
The client should understand that type 2 diabetes places the client at risk for many complications
and that good glucose control is as important when taking oral agents as when using insulin. The
other statements are accurate and indicate good understanding of the use of gliclazide.
The nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who is
receiving oxygen. Which of the following actions is best for the nurse to implement to determine
the appropriate oxygen flow rate?
a. Maintain the pulse oximetry level at 90% or greater.
b. Minimize oxygen use to avoid oxygen dependency.
c. Administer oxygen according to the client's level of dyspnea.
d. Avoid administration of oxygen at a rate of more than 2 L/minute. Answer: A
The best way to determine the appropriate oxygen flow rate is by monitoring the client's
oxygenation either by arterial blood gases (ABGs) or pulse oximetry; an oxygen saturation of
90% indicates adequate blood oxygen level without the danger of suppressing the respiratory
drive. For clients with an exacerbation of COPD, an oxygen flow rate of 2 L/minute may not be
adequate. Because oxygen use improves survival rate in clients with COPD, there is not a
concern about oxygen dependency. The client's perceived dyspnea level may be affected by other
factors (such as anxiety) besides blood oxygen level.
Which of the following findings in a client who has received omalizumab is considered an
adverse effect?
a. Pain at injection site
b. Respiratory rate 22 breaths/minute
c. Flushing and dizziness
d. Peak flow reading 75% of normal Answer: A
Reaction at injection site is the only adverse effect of omalizumab. The other information is not
related to omalizumab therapy.
1
,Which of the following actions by the occupational health nurse at a manufacturing plant where
there is potential exposure to inhaled dust is most helpful in reducing incidence of lung disease?
a. Treat workers who inhale dust particles.
b. Require the use of protective equipment.
c. Monitor workers for shortness of breath.
d. Teach about symptoms of lung disease. Answer: B
Prevention of lung disease requires the use of appropriate protective equipment such as masks.
The other actions will help in recognition or early treatment of lung disease, but will not be
effective in prevention of lung damage.
The nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who has a
nursing diagnosis of imbalanced nutrition: less than body requirements. Which of the following
interventions is best to address this problem?
a. Offer high calorie snacks between meals and at bedtime.
b. Have the client exercise for 10 minutes before meals.
c. Assist the client in choosing foods with a lot of texture.
d. Increase the client's intake of fruits and fruit juices. Answer: A
Eating small amounts more frequently (as occurs with snacking) will increase caloric intake by
decreasing the fatigue and feelings of fullness associated with large meals. Clients with COPD
should rest before meals. Foods that have a lot of texture may take more energy to eat and lead to
decreased intake. Although fruits and juices are not contraindicated, foods high in protein are a
better choice.
The nurse has received a change-of-shift report about the following clients with chronic
obstructive pulmonary disease (COPD). Which client should the nurse assess first?
a. A client with jugular vein distension and peripheral edema
b. A client who has a cough productive of thick, green mucus
c. A client with a respiratory rate of 38
d. A client with loud expiratory wheezes Answer: c
A respiratory rate of 38 indicates severe respiratory distress, and the client needs immediate
assessment and intervention to prevent possible respiratory arrest. The other clients also need
assessment as soon as possible, but they do not need to be assessed as urgently as the client with
tachypnea.
A young adult client with cystic fibrosis (CF) tells the nurse that she is considering having a
child. Which of the following responses is best for the nurse to respond initially?
a. "Are you aware of the normal lifespan for clients with CF?"
b. "Do you need any information to help you with the decision?"
c. "You will need to have genetic counselling before making a decision."
d. "Many women with CF do not have difficulty in conceiving children." Answer: B
2
,The nurse's initial response should be to assess the client's knowledge level and need for
information. Although the lifespan for clients with CF is likely to be shorter than normal, it
would not be appropriate for the nurse to address this as the initial response to the client's
comments. The other responses are accurate, but the nurse should first assess the client's
understanding about the issues surrounding pregnancy.
The nurse is assessing a client who has just arrived after an automobile accident and the nurse
notes that the breath sounds are absent on the right side. Which of the following actions should
the nurse anticipate?
a. Stabilization of the chest wall with tape
b. Insertion of a chest tube with a chest drainage system
c. Administration of an inhaled bronchodilator
d. Emergency pericardiocentesis Answer: B
The nurse is caring for a client with a pleural effusion who is scheduled for a thoracentesis.
Which of the following actions should the nurse implement prior to the procedure?
a. Start a peripheral intravenous line to administer the necessary sedative drugs.
b. Position the client sitting upright on the edge of the bed and leaning forward.
c. Instruct the client about the importance of incentive spirometer use after the procedure.
d. Remove the water pitcher and remind the client not to eat or drink anything for 6 hours.
Answer: B
When the client is sitting up, fluid accumulates in the pleural space at the lung bases and can
more easily be located and removed. The lung will expand after the effusion is removed;
incentive spirometry is not needed to assure alveolar expansion. The client does not usually
require sedation for the procedure, and there are no restrictions on oral intake because the client
is not sedated or unconscious.
The nurse is caring for a client who is hospitalized with active tuberculosis (TB) and the nurse
observes a family member who is visiting the client. Which of the following actions by the
visitor should cause the nurse to intervene?
a. Hands the client a tissue from the box at the bedside
b. Puts on a surgical face mask before visiting the client
c. Washes hands before entering the client's room
d. Brings food from a "fast-food" restaurant to the client Answer: B
A high-efficiency particulate air (HEPA) mask, rather than a standard surgical mask, should be
used when entering the client's room because the HEPA mask can filter out 100% of small
airborne particles. Handwashing before visiting the client is not necessary, but there is no reason
for the nurse to stop the family member from doing this. Because anorexia and weight loss are
frequent problems in clients with TB, bringing food from outside the hospital is appropriate. The
family member should wash the hands after handling a tissue that the client has used, but no
precautions are necessary when giving the client an unused tissue.
After 2 months of tuberculosis (TB) treatment with a standard four-drug regimen, a client
continues to have positive sputum smears for acid-fast bacilli (AFB). Which of the following
actions should the nurse take next?
3
, a. Discuss the need to use some different medications to treat the TB.
b. Schedule the client for directly observed therapy three times weekly.
c. Ask the client whether medications have been taken as directed.
d. Educate about using a 2-drug regimen for the last 4 months of treatment. Answer: C
The first action should be to determine whether the client has been compliant with drug therapy
because negative sputum smears would be expected if the TB bacillus is susceptible to the
medications and if the medications have been taken correctly. Depending on whether the client
has been compliant or not, different medications or directly observed therapy may be indicated.
A two-drug regimen will be used only if the sputum smears are negative for AFB.
The nurse is caring for a client who has an adrenocortical adenoma and hyperaldosteronism.
Which of the following actions should the nurse implement?
a. Provide a potassium-restricted diet
b. Maintain extremities in an elevated position
c. Evaluate blood glucose level every 4 hours
d. Monitor the blood pressure every 4 hours Answer: D
Hypertension caused by sodium retention is a common complication of hyperaldosteronism.
Hyperaldosteronism does not cause elevation in blood glucose. The client will be hypokalemic
and require potassium supplementation before surgery. Edema does not usually occur with
hyperaldosteronism.
Which of the following findings in a client with a hiatal hernia who returned from a laparoscopic
Nissen fundoplication 4 hours ago is most important for the nurse to address immediately?
a. The client is experiencing intermittent waves of nausea.
b. The client has absent breath sounds throughout the left lung.
c. The client complains of 6/10 (0-10 scale) abdominal pain.
d. The client has decreased bowel sounds in all four quadrants. Answer: B
Decreased breath sounds on one side may indicate a pneumothorax, which requires rapid
diagnosis and treatment. The abdominal pain and nausea also should be addressed but they are
not as high priority as the client's respiratory status. The client's decreased bowel sounds are
expected after surgery and require ongoing monitoring but no other action.
The nurse is caring for a client in the outpatient clinic who has a decreased serum magnesium
level. Which of the following assessment areas should the nurse include in the health history?
a. Use of over-the-counter (OTC) laxatives
b. Daily alcohol intake
c. Intake of dietary protein
d. Multivitamin/mineral use Answer: B
Hypomagnesemia is associated with alcoholism. Protein intake would not have a significant
effect on magnesium level. OTC laxatives (such as milk of magnesia) and use of multivitamin
or mineral supplements would tend to increase magnesium level.
4
Exam Newest With Complete Questions And
Correct Detailed Answers| Brand New
Version!
The nurse has completed teaching a client with type 2 diabetes about taking gliclazide. Which of
the following client statements indicate a need for additional teaching?
a. "My diabetes is not as likely to cause complications as if I needed to take insulin."
b. "Other medications besides the gliclazide may affect my blood sugar."
c. "When I become ill, I may have to take insulin to control my blood sugar."
d. "If I overeat at a meal, I will still take just the usual dose of medication." Answer: A
The client should understand that type 2 diabetes places the client at risk for many complications
and that good glucose control is as important when taking oral agents as when using insulin. The
other statements are accurate and indicate good understanding of the use of gliclazide.
The nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who is
receiving oxygen. Which of the following actions is best for the nurse to implement to determine
the appropriate oxygen flow rate?
a. Maintain the pulse oximetry level at 90% or greater.
b. Minimize oxygen use to avoid oxygen dependency.
c. Administer oxygen according to the client's level of dyspnea.
d. Avoid administration of oxygen at a rate of more than 2 L/minute. Answer: A
The best way to determine the appropriate oxygen flow rate is by monitoring the client's
oxygenation either by arterial blood gases (ABGs) or pulse oximetry; an oxygen saturation of
90% indicates adequate blood oxygen level without the danger of suppressing the respiratory
drive. For clients with an exacerbation of COPD, an oxygen flow rate of 2 L/minute may not be
adequate. Because oxygen use improves survival rate in clients with COPD, there is not a
concern about oxygen dependency. The client's perceived dyspnea level may be affected by other
factors (such as anxiety) besides blood oxygen level.
Which of the following findings in a client who has received omalizumab is considered an
adverse effect?
a. Pain at injection site
b. Respiratory rate 22 breaths/minute
c. Flushing and dizziness
d. Peak flow reading 75% of normal Answer: A
Reaction at injection site is the only adverse effect of omalizumab. The other information is not
related to omalizumab therapy.
1
,Which of the following actions by the occupational health nurse at a manufacturing plant where
there is potential exposure to inhaled dust is most helpful in reducing incidence of lung disease?
a. Treat workers who inhale dust particles.
b. Require the use of protective equipment.
c. Monitor workers for shortness of breath.
d. Teach about symptoms of lung disease. Answer: B
Prevention of lung disease requires the use of appropriate protective equipment such as masks.
The other actions will help in recognition or early treatment of lung disease, but will not be
effective in prevention of lung damage.
The nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who has a
nursing diagnosis of imbalanced nutrition: less than body requirements. Which of the following
interventions is best to address this problem?
a. Offer high calorie snacks between meals and at bedtime.
b. Have the client exercise for 10 minutes before meals.
c. Assist the client in choosing foods with a lot of texture.
d. Increase the client's intake of fruits and fruit juices. Answer: A
Eating small amounts more frequently (as occurs with snacking) will increase caloric intake by
decreasing the fatigue and feelings of fullness associated with large meals. Clients with COPD
should rest before meals. Foods that have a lot of texture may take more energy to eat and lead to
decreased intake. Although fruits and juices are not contraindicated, foods high in protein are a
better choice.
The nurse has received a change-of-shift report about the following clients with chronic
obstructive pulmonary disease (COPD). Which client should the nurse assess first?
a. A client with jugular vein distension and peripheral edema
b. A client who has a cough productive of thick, green mucus
c. A client with a respiratory rate of 38
d. A client with loud expiratory wheezes Answer: c
A respiratory rate of 38 indicates severe respiratory distress, and the client needs immediate
assessment and intervention to prevent possible respiratory arrest. The other clients also need
assessment as soon as possible, but they do not need to be assessed as urgently as the client with
tachypnea.
A young adult client with cystic fibrosis (CF) tells the nurse that she is considering having a
child. Which of the following responses is best for the nurse to respond initially?
a. "Are you aware of the normal lifespan for clients with CF?"
b. "Do you need any information to help you with the decision?"
c. "You will need to have genetic counselling before making a decision."
d. "Many women with CF do not have difficulty in conceiving children." Answer: B
2
,The nurse's initial response should be to assess the client's knowledge level and need for
information. Although the lifespan for clients with CF is likely to be shorter than normal, it
would not be appropriate for the nurse to address this as the initial response to the client's
comments. The other responses are accurate, but the nurse should first assess the client's
understanding about the issues surrounding pregnancy.
The nurse is assessing a client who has just arrived after an automobile accident and the nurse
notes that the breath sounds are absent on the right side. Which of the following actions should
the nurse anticipate?
a. Stabilization of the chest wall with tape
b. Insertion of a chest tube with a chest drainage system
c. Administration of an inhaled bronchodilator
d. Emergency pericardiocentesis Answer: B
The nurse is caring for a client with a pleural effusion who is scheduled for a thoracentesis.
Which of the following actions should the nurse implement prior to the procedure?
a. Start a peripheral intravenous line to administer the necessary sedative drugs.
b. Position the client sitting upright on the edge of the bed and leaning forward.
c. Instruct the client about the importance of incentive spirometer use after the procedure.
d. Remove the water pitcher and remind the client not to eat or drink anything for 6 hours.
Answer: B
When the client is sitting up, fluid accumulates in the pleural space at the lung bases and can
more easily be located and removed. The lung will expand after the effusion is removed;
incentive spirometry is not needed to assure alveolar expansion. The client does not usually
require sedation for the procedure, and there are no restrictions on oral intake because the client
is not sedated or unconscious.
The nurse is caring for a client who is hospitalized with active tuberculosis (TB) and the nurse
observes a family member who is visiting the client. Which of the following actions by the
visitor should cause the nurse to intervene?
a. Hands the client a tissue from the box at the bedside
b. Puts on a surgical face mask before visiting the client
c. Washes hands before entering the client's room
d. Brings food from a "fast-food" restaurant to the client Answer: B
A high-efficiency particulate air (HEPA) mask, rather than a standard surgical mask, should be
used when entering the client's room because the HEPA mask can filter out 100% of small
airborne particles. Handwashing before visiting the client is not necessary, but there is no reason
for the nurse to stop the family member from doing this. Because anorexia and weight loss are
frequent problems in clients with TB, bringing food from outside the hospital is appropriate. The
family member should wash the hands after handling a tissue that the client has used, but no
precautions are necessary when giving the client an unused tissue.
After 2 months of tuberculosis (TB) treatment with a standard four-drug regimen, a client
continues to have positive sputum smears for acid-fast bacilli (AFB). Which of the following
actions should the nurse take next?
3
, a. Discuss the need to use some different medications to treat the TB.
b. Schedule the client for directly observed therapy three times weekly.
c. Ask the client whether medications have been taken as directed.
d. Educate about using a 2-drug regimen for the last 4 months of treatment. Answer: C
The first action should be to determine whether the client has been compliant with drug therapy
because negative sputum smears would be expected if the TB bacillus is susceptible to the
medications and if the medications have been taken correctly. Depending on whether the client
has been compliant or not, different medications or directly observed therapy may be indicated.
A two-drug regimen will be used only if the sputum smears are negative for AFB.
The nurse is caring for a client who has an adrenocortical adenoma and hyperaldosteronism.
Which of the following actions should the nurse implement?
a. Provide a potassium-restricted diet
b. Maintain extremities in an elevated position
c. Evaluate blood glucose level every 4 hours
d. Monitor the blood pressure every 4 hours Answer: D
Hypertension caused by sodium retention is a common complication of hyperaldosteronism.
Hyperaldosteronism does not cause elevation in blood glucose. The client will be hypokalemic
and require potassium supplementation before surgery. Edema does not usually occur with
hyperaldosteronism.
Which of the following findings in a client with a hiatal hernia who returned from a laparoscopic
Nissen fundoplication 4 hours ago is most important for the nurse to address immediately?
a. The client is experiencing intermittent waves of nausea.
b. The client has absent breath sounds throughout the left lung.
c. The client complains of 6/10 (0-10 scale) abdominal pain.
d. The client has decreased bowel sounds in all four quadrants. Answer: B
Decreased breath sounds on one side may indicate a pneumothorax, which requires rapid
diagnosis and treatment. The abdominal pain and nausea also should be addressed but they are
not as high priority as the client's respiratory status. The client's decreased bowel sounds are
expected after surgery and require ongoing monitoring but no other action.
The nurse is caring for a client in the outpatient clinic who has a decreased serum magnesium
level. Which of the following assessment areas should the nurse include in the health history?
a. Use of over-the-counter (OTC) laxatives
b. Daily alcohol intake
c. Intake of dietary protein
d. Multivitamin/mineral use Answer: B
Hypomagnesemia is associated with alcoholism. Protein intake would not have a significant
effect on magnesium level. OTC laxatives (such as milk of magnesia) and use of multivitamin
or mineral supplements would tend to increase magnesium level.
4
