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,The emergency department nurse is assessing a client who has sustained a blunt injury to the chest wall.
Which finding indicates the presence of a pneumothorax in this client?
1.A low respiratory rate
2.Diminished breath sounds
3.The presence of a barrel chest
4.A sucking sound at the site of injury - correct ans:2
Rationale:
This client has sustained a blunt or closed-chest injury. Basic symptoms of a closed pneumothorax are
shortness of breath and chest pain. A larger pneumothorax may cause tachypnea, cyanosis, diminished
breath sounds, and subcutaneous emphysema. Hyperresonance also may occur on the affected side. A
sucking sound at the site of injury would be noted with an open chest injury.
Priority Concepts: Gas Exchange, Perfusion
Test-Taking Strategy:
Focus on the subject, a blunt chest injury. Noting the word blunt will assist in eliminating option 4, which
describes a sucking chest wound injury. Knowing that in a respiratory injury increased respirations will
occur will assist you in eliminating option 1. Option 3 can be eliminated because a barrel chest is a
characteristic finding in a client with chronic obstructive pulmonary disease.
A client with trigeminal neuralgia is being treated with carbamazepine, 400 mg orally daily. Which value
indicates that the client is experiencing an adverse effect to the medication?
1.Sodium level, 140 mEq/L (140 mmol/L)
2.Uric acid level, 4.0 mg/dL (0.24 mmol/L)
3.White blood cell count, 3000 mm3 (3.0 × 109/L)
4.Blood urea nitrogen level, 10 mg/dL (3.6 mmol/L) - correct ans:3
Rationale:
Adverse effects of carbamazepine appear as blood dyscrasias, including aplastic anemia,
agranulocytosis, thrombocytopenia, and leukopenia; cardiovascular disturbances, including
,thrombophlebitis and dysrhythmias; and dermatological effects. The low white blood cell count reflects
agranulocytosis. The laboratory values in options 1, 2, and 4 are normal values.
Priority Concepts: Clinical Judgment, Cellular Regulation
Test-Taking Strategy:
Focus on the subject, an adverse effect of carbamazepine. If you are familiar with normal laboratory
values, you will note that the only option that indicates an abnormal value is the correct option
Trimethoprim-sulfamethoxazole is prescribed to be administered by intravenous infusion to a client with
a recurrent urinary tract infection. How should the nurse administer this medication?
1. Over 30 minutes
2. Over 60 to 90 minutes
3. Piggybacked into the peripheral line containing parenteral nutrition
4. Piggybacked into the existing infusion of normal saline and potassium chloride - correct ans:2
Rationale:
Trimethoprim-sulfamethoxazole may be administered by intravenous infusion but should not be mixed
with any other medications or solutions. Trimethoprim-sulfamethoxazole is infused over 60 to 90
minutes, and bolus infusions or rapid infusions must be avoided.
Priority Concepts: Clinical Judgment, Safety
Test-Taking Strategy:
Focus on the subject, administering intravenous trimethoprim-sulfamethoxazole. Eliminate options 3
and 4, the piggybacking options, because they address mixing the trimethoprim-sulfamethoxazole with
other solutions. From the remaining choices, the correct option identifies the longer time frame and is
the safe and correct choice.
A child with sickle cell anemia who is in vaso-occlusive crisis is admitted to the hospital. Which health
care provider prescription would assist in reversing the vaso-occlusive crisis?
1.Monitor pulse oximetry.
, 2.Begin intravenous fluids.
3.Administer oxygen by face mask.
4.Monitor vital signs and respiratory status. - correct ans:2
Rationale:
Increased fluid volume reduces the viscosity of the blood, preventing further vascular occlusion and
further sickling caused by dehydration. Pulse oximetry and vital sign monitoring may be components of
care, but they are actions that relate to monitoring the client versus treating. The intravenous fluids,
however, will treat the condition. Vaso-occlusive crisis treatment includes analgesic and fluid
administration. Oxygen may help relieve symptoms of respiratory distress, but analgesics and fluids
treat the condition.
Priority Concepts: Clinical Judgment, Fluid and Electrolyte Balance
Test-Taking Strategy:
Focus on the subject, reversing the vaso-occlusive crisis. Options 1, 3, and 4 can be eliminated because
they all relate to the respiratory system and are monitoring actions rather than treatment options.
A client is being weaned from parenteral nutrition (PN) and is expected to begin taking solid food today.
The ongoing solution rate has been 100 mL/hour. The nurse anticipates that which prescription
regarding the PN solution will accompany the diet prescription?
1.Discontinue the PN.
2.Decrease PN rate to 50 mL/hour.
3.Start 0.9% normal saline at 25 mL/hour.
4.Continue current infusion rate prescriptions for PN. - correct ans:2
Rationale:
AND LATEST EXAM VERSION With
Expected real and comprehensive
Questions and Revised Correct
Answers Guarantee Pass A+
Professional Academic Assistance Services
Services Offered
Proctored Exam Assistance
Online Class Management (Full Course Support)
Exam Preparation & Study Materials
Assignments and Coursework Support
Essays and Research Papers
Discussion Posts and Replies
,The emergency department nurse is assessing a client who has sustained a blunt injury to the chest wall.
Which finding indicates the presence of a pneumothorax in this client?
1.A low respiratory rate
2.Diminished breath sounds
3.The presence of a barrel chest
4.A sucking sound at the site of injury - correct ans:2
Rationale:
This client has sustained a blunt or closed-chest injury. Basic symptoms of a closed pneumothorax are
shortness of breath and chest pain. A larger pneumothorax may cause tachypnea, cyanosis, diminished
breath sounds, and subcutaneous emphysema. Hyperresonance also may occur on the affected side. A
sucking sound at the site of injury would be noted with an open chest injury.
Priority Concepts: Gas Exchange, Perfusion
Test-Taking Strategy:
Focus on the subject, a blunt chest injury. Noting the word blunt will assist in eliminating option 4, which
describes a sucking chest wound injury. Knowing that in a respiratory injury increased respirations will
occur will assist you in eliminating option 1. Option 3 can be eliminated because a barrel chest is a
characteristic finding in a client with chronic obstructive pulmonary disease.
A client with trigeminal neuralgia is being treated with carbamazepine, 400 mg orally daily. Which value
indicates that the client is experiencing an adverse effect to the medication?
1.Sodium level, 140 mEq/L (140 mmol/L)
2.Uric acid level, 4.0 mg/dL (0.24 mmol/L)
3.White blood cell count, 3000 mm3 (3.0 × 109/L)
4.Blood urea nitrogen level, 10 mg/dL (3.6 mmol/L) - correct ans:3
Rationale:
Adverse effects of carbamazepine appear as blood dyscrasias, including aplastic anemia,
agranulocytosis, thrombocytopenia, and leukopenia; cardiovascular disturbances, including
,thrombophlebitis and dysrhythmias; and dermatological effects. The low white blood cell count reflects
agranulocytosis. The laboratory values in options 1, 2, and 4 are normal values.
Priority Concepts: Clinical Judgment, Cellular Regulation
Test-Taking Strategy:
Focus on the subject, an adverse effect of carbamazepine. If you are familiar with normal laboratory
values, you will note that the only option that indicates an abnormal value is the correct option
Trimethoprim-sulfamethoxazole is prescribed to be administered by intravenous infusion to a client with
a recurrent urinary tract infection. How should the nurse administer this medication?
1. Over 30 minutes
2. Over 60 to 90 minutes
3. Piggybacked into the peripheral line containing parenteral nutrition
4. Piggybacked into the existing infusion of normal saline and potassium chloride - correct ans:2
Rationale:
Trimethoprim-sulfamethoxazole may be administered by intravenous infusion but should not be mixed
with any other medications or solutions. Trimethoprim-sulfamethoxazole is infused over 60 to 90
minutes, and bolus infusions or rapid infusions must be avoided.
Priority Concepts: Clinical Judgment, Safety
Test-Taking Strategy:
Focus on the subject, administering intravenous trimethoprim-sulfamethoxazole. Eliminate options 3
and 4, the piggybacking options, because they address mixing the trimethoprim-sulfamethoxazole with
other solutions. From the remaining choices, the correct option identifies the longer time frame and is
the safe and correct choice.
A child with sickle cell anemia who is in vaso-occlusive crisis is admitted to the hospital. Which health
care provider prescription would assist in reversing the vaso-occlusive crisis?
1.Monitor pulse oximetry.
, 2.Begin intravenous fluids.
3.Administer oxygen by face mask.
4.Monitor vital signs and respiratory status. - correct ans:2
Rationale:
Increased fluid volume reduces the viscosity of the blood, preventing further vascular occlusion and
further sickling caused by dehydration. Pulse oximetry and vital sign monitoring may be components of
care, but they are actions that relate to monitoring the client versus treating. The intravenous fluids,
however, will treat the condition. Vaso-occlusive crisis treatment includes analgesic and fluid
administration. Oxygen may help relieve symptoms of respiratory distress, but analgesics and fluids
treat the condition.
Priority Concepts: Clinical Judgment, Fluid and Electrolyte Balance
Test-Taking Strategy:
Focus on the subject, reversing the vaso-occlusive crisis. Options 1, 3, and 4 can be eliminated because
they all relate to the respiratory system and are monitoring actions rather than treatment options.
A client is being weaned from parenteral nutrition (PN) and is expected to begin taking solid food today.
The ongoing solution rate has been 100 mL/hour. The nurse anticipates that which prescription
regarding the PN solution will accompany the diet prescription?
1.Discontinue the PN.
2.Decrease PN rate to 50 mL/hour.
3.Start 0.9% normal saline at 25 mL/hour.
4.Continue current infusion rate prescriptions for PN. - correct ans:2
Rationale:
