N3 - Exam 3 Questions And Answers( Complete Solution Rated A)

N3 - Exam 3 Questions And Answers 1. A client is learning about cholesterol. The nurse explains that the good cholesterol transports plasma cholesterol away from plaques and to the liver for met abolism. This type of cholesterol is called: 1. high-density lipoprotein. 2. low-density lipoprotein. 3. very-high-density lipoprotein. 4. very-low-density lipoprotein. 2. A client has a blood pressure of 132/82 mmHg and a triglyceride level of 160 mg/dL. Based on these results, the nurse knows that the client has: 1 an optimal blood pressure and triglyceride level. 2 .a prehypertensive blood pressure and an optimal triglyceride level. 3 .a prehypertensive blood pressure and a borderline high triglyceride level. I hypertension and a high triglyceride level. 3. A client is complaining of chest pain that occurs during exercise. This pain is relieved when the client rests. The nurse realizes that this client is experiencing which type of angina? 1. Prinzmetals variant angina 2. Silent angina 3. Stable angina 4. Unstable angina 4. A nurse is considering contraindications to fibrinolytic therapy. Which of the following patients is an appropriate candidate for fibrinolytic therapy? 1 .A patent with a peptic ulcer disease 2. A patient with a history of hemorrhagic stroke 3 .A patient with a history of a motor vehicle accident 1 year ago 4. A patient with inflammatory bowel disease 5. A client is at risk for coronary artery disease. Which of the following should the nurse instruct as modifiable risk factors for this health condition? (Select all that apply.) 1. Alcohol consumption 2. Diabetes mellitus 3. Family history 4. Gender 5. Low daily fruit intake 6. Psychosocial index 6. A client is experiencing a sudden onset of chest pain. Which of the following will the nurse do to manage this chest pain? 1. Administer intravenous morphine as prescribed. 2. Provide oxygen. 3. Insert an indwelling urinary catheter. 4. Position the client on the left side. 5. Administer nitroglycerin as prescribed. 6. Administer aspirin as prescribed. 7. A client, complaining of weight gain, has thin extremities, a buffalo hump, and a protruding abdomen. The nurse realizes that this client is most likely to be diagnosed with which disease process? 1. Addisons disease 2. Cretinism 3. Cushings syndrome 4. Obesity 8. A client tells the nurse that he is so thirsty that he has already consumed four pitchers of water. The clients urine output is 3500 mL in an 8-hour period. The client is recovering from surgery on the pituitary gland. What endocrine disorder is the client most likely experiencing? 1. Diabetes insipidus 2. Diabetes mellitus 3. Myxedema 4. Syndrome of inappropriate antidiuretic hormone secretion 9. Which of the following symptoms would suggest to the nurse that a client is experiencing symptoms of pheochromocytoma? (Select all that apply.) HYPERTENSION, AVOID TYRAMINE 1. Severe headache 2. Decreased urine output 3. Palpitations 4. Diarrhea 5. Profuse sweating 6. Weight gain 10. A client diagnosed with chronic renal failure is prescribed a diet low in protein. The rationale for this diet is that: Diet low in protein 1. protein sources are broken down and converted to urea, which is then filtered by the kidney. 2. protein sources are of low biological value. 3. protein increases calcium and sodium levels. 4. deficit protein metabolism breaks down muscle tissue. 13. The nurse is assessing circulation through a clients arteriovenous shunt. Which of the following are signs of a patent site? (Select all that apply.) Call MD due to not working if not hearing/feeling 1. Normal blood pressure 2. Positive bruit 3. Pulse present distal to the site 4. Dry dressing 5. Palpable thrill 6. Good skin turgor 14. A client is assessed by the nurse after a hemodialysis session. The nurse notes bleeding from the client’s nose and around the intravenous catheter. What action by the nurse is the priority? a. Hold pressure over the client’s nose for 10 minutes. b. Take the clients pulse, blood pressure, and temperature. c. Assess for a bruit or thrill over the arteriovenous fistula. d. Prepare protamine sulfate for administration. 15. The nurse is caring for a client experiencing hypovolemic shock. Which of the following interventions would be appropriate for this client? (Select all that apply.) 1. Monitor intravenous fluid replacement 2. Monitor vital signs 3. Assess for manifestations of fluid overload 4. Monitor white blood cell count and hemoglobin and hematocrit levels 5. Position for comfort 6. Assist to a sitting position 16. The nurse gets the hand-off report on four clients. Which client should the nurse assess first? Sickle cell anemia with chest pain a. Client with a blood pressure change of 128/74 to 110/88 mm Hg b. Client with oxygen saturation unchanged at 94% c. Client with a pulse change of 100 to 88 beats/min d. Client with urine output of 40 mL/hr for the last 2 hours 17. A nurse is caring for a client after surgery who is restless and apprehensive. The unlicensed assistive personnel (UAP) reports the vital signs and the nurse sees they are only slightly different from previous readings. What action does the nurse delegate next to the UAP? a. Assess the client for pain or discomfort. b. Measure urine output from the catheter. c. Reposition the client to the unaffected side. d. Stay with the client and reassure him or her. 18. A client has been brought to the emergency department after being shot multiple times. What action should the nurse perform first? a. Apply personal protective equipment. b. Notify local law enforcement officials. c. Obtain universal donor blood. d. Prepare the client for emergency surgery. 19. A client in shock is apprehensive and slightly confused. What action by the nurse is best? a. Offer to remain with the client for awhile. b. Prepare to administer antianxiety medication. c. Raise all four siderails on the clients bed. d. Tell the client everything possible is being done. 20. A client is in the early stages of shock and is restless. What comfort measures does the nurse delegate to the nursing student? (Select all that apply.) a. Bringing the client warm blankets b. Giving the client hot tea to drink c. Massaging the clients painful legs d. Reorienting the client as needed e. Sitting with the client for reassurance 21. The nurse is caring for a client with suspected severe sepsis. What does the nurse prepare to do within 3 hours of the client being identified as being at risk? (Select all that apply.) a. Administer antibiotics. b. Draw serum lactate levels. c. Infuse vasopressors. d. Measure central venous pressure. e. Obtain blood cultures. 22. A client with severe sepsis has a serum lactate level of 6.2 mmol/L. The client weighs 250 pounds. To infuse the amount of fluid this client requires in 24 hours, at what rate does the nurse set the IV pump? (Record your answer using a whole number.) mL/hr 142 mL/hr 23. What can you do for someone with 80% blockage of coronary artery? balloon, stent, CABG 24. A nurse is caring for four clients. Which client should the nurse assess first? Potassium 3.1mEq/L a. Client with an acute myocardial infarction, pulse 102 beats/min b. Client who is 1 hour post angioplasty, has tongue swelling and anxiety c. Client who is post coronary artery bypass, chest tube drained 100 mL/hr d. Client who is post coronary artery bypass, potassium 4.2 mEq/L 25. A nursing student learns about modifiable risk factors for coronary artery disease. Which factors does this include? (Select all that apply.) a. Age b. Hypertension c. Obesity d. Smoking e. Stress 26. A nurse is caring for a client who had coronary artery bypass grafting yesterday. What actions does the nurse delegate to the unlicensed assistive personnel (UAP)? (Select all that apply.) a. Assist the client to the chair for meals and to the bathroom. b. Encourage the client to use the spirometer every 4 hours. c. Ensure the client wears TED hose or sequential compression devices. d. Have the client rate pain on a 0-to-10 scale and report to the nurse. e. Take and record a full set of vital signs per hospital protocol. 27. A nursing student planning to teach clients about risk factors for coronary artery disease (CAD) would include which topics? (Select all that apply.) a. Advanced age b. Diabetes c. Ethnic background d. Medication use e. Smoking 28. A client is assessed by the nurse after a hemodialysis session. The nurse notes bleeding from the client’s nose and around the intravenous catheter. What action by the nurse is the priority? a. Hold pressure over the client’s nose for 10 minutes. b. Take the clients pulse, blood pressure, and temperature. c. Assess for a bruit or thrill over the arteriovenous fistula. d. Prepare protamine sulfate for administration. 29. Addisons Low Cortisol, Low Aldosterone 30. Hypophysectomy Removal of pituitary gland 31. AKI susceptibility is higher Lupus 32. Glomerulonephritis LUPUS 33. Chest pain MONA, PIC? Thrombolytics? 34. CKD crackles/rales Furosemide 35. Nephrotic syndrome –No oliguria, hematuria 36. DIC –interventions to avoid Venipunctures/IM injections 37. Cushings—4S high sugar, sodium, steroids, skin is fragile 38. Diabetes Insipidus—Treatment DDAVP 39. White out in CXR—ARDS 40. Medication for Addison’s crisis—SoluCortef 41. Medication for Cushings disease 42. GFR at 12 = End stage renal disease 43. 400mg in 250ml, 6mcg/kg/min, 80kg; how many ml/hr = 18ml/hr 44. Autosomal Polycystic Kidney Disease- hematuria, pain 45. Who would be more at risk for DIC—Abrupto Placenta 46. Who would you not give tPA to (contraindication)?—stroke pt from 2 months ago 47. Rhabdomylitis–check BUN/Creatinine 48. EKG strip—STEMI 49. Pt just came back from abdominal surgery and incision is red/warm, what does pt have? -- 50. Select all that apply: Pt has SOB but receiving 100% Oxygen 51. Systemic inflammatory multi organ away from the site—SIADH, MODS 52. Initial stages of shock—decrease MAP 5-10 53. Lactic acid—Hypoxia 54. Ejection Fraction Normal = 55-70% 55. DDAVP should be given for? If I am thirsty Show Less