Rasmussen College MDC 2 Exam 2

A nurse is caring for a patient who presents to the emergency department with acute asthma exacerbation. The RR is 36 breaths/min, O2 stats is 85% on room air with use of accessory muscles. The nurse places the client on a 4L O2 nasal cannula. ABGs are: pH: 7.28, PaCO2: 50 mmHg, PaO2: 75 mmHg, HCO3: 26 mEq/L. Which of the following treatments are the nurse's priority? - Administer bronchodilators The nurse is caring for an 80yr old diagnosed with gastric cancer three months ago. The client has undergone chemo and radiation and has recently undergone surgery to remove the cancer. During the procedure, the surgeon notices that the cancer has metastasized. The client's family is having difficulty deciding treatment options. Which of the following interventions are appropriate for the RN in providing client's care? - Request a consult for palliative care services What is the nurse's priority to include when educating a client with esophageal cancer about their plan of care? - One of the most important things we need to monitor is weight loss. Please weigh yourself daily A client has the following ABGs. How does the nurse interpret them? pH: 7.50 PaCO2 30 mmHg HCO3: 20 mEq/L - Respiratory alkalosis with partial metabolic compensation Which of the following clients is an example of developing secondary stomatitis? - 64 yo client with a history of metastatic breast cancer receiving chemotherapy presenting with stomatitis The nurse provides discharge instructions to a client recently diagnosed with a hiatal hernia. The client also has a history of GERD. Which should be included in the education? - Remain in an upright position for 1-2 hours after eating Which of the following clients are at risk for developing stomatitis? - 55 yo with colon cancer A nurse is caring for a client diagnosed with severe GERD. Which of the following medications would the nurse expect the provider to order? - A client has the following ABGs. How does the nurse interpret them? pH: 7.36 PaCO2 58 mmHg HCO3: 30 mEq/L - Respiratory acidosis with full metabolic compensation A nurse is caring for a type 1 diabetic client with metabolic acidosis. Which of the following symptoms would the nurse expect the client to exhibit? - Kussmaul respirations A nurse is caring for a client with metabolic acidosis related to GI loss of bicarbonate from diarrhea. The nurse anticipates implementing which of the following? - Administer an antidiarrheal A nurse is caring for a client with metabolic acidosis from pancreatitis. The nurse anticipates implementing which of the following? - Administer sodium bicarbonate A nurse is caring for a client diagnosed with oral cancer who recently underwent surgery. Which of the following is a post-op nursing priority? - Airway management A nurse is caring for a client who is status post endoscopic procedure. Which of the following should be included as a priority in the post-op assessment? - Gag Reflex Which of the following interventions would the nurse NOT include in the care of a client with stomatitis? - Encourage the continued use of dentures to assist with chewing A client has the following ABGs. How does the nurse interpret them? pH: 7.42 PaCO2 55 mmHg HCO3: 32 mEq/L - Metabolic alkalosis with full respiratory compensation Which of the following electrolyte imbalances would be the priority to address in a client with end-stage renal failure? - Hyperkalemia Which of the following lab tests does the nurse need to assess to determine if the client's acid-base imbalance is respiratory or metabolic? - Arterial Blood Gas A nurse is caring for a client who identifies as Native American and is being treated for metabolic alkalosis. Before discharge, which of the following will address the multidimensional needs of the client? (SATA) - Provide emotional support Provide education Conduct a cultural assessment Consult the dietician When caring for a client suffering from metabolic acidosis, which of the following does the nurse anticipate as a treatment option? - Sodium bicarbonate The nurse is caring for a 50 yo client admitted to the ER for suspected upper GI bleed. Which of the following clinical findings would support the diagnosis? (SATA) - Bright red or coffee-ground vomitus Vertigo or dizziness Weak peripheral pulses Decreased hemoglobin and hematocrit levels A client has the following ABGs. How does the nurse interpret them? pH: 7.38 PaCO2 40 mmHg HCO3: 26 mEq/L - Normal arterial blood gas The nurse is caring for a client who is concerned about developing oral tumors. Which client statement requires immediate nursing intervention? - I don't have dental insurance so I can't get dental check ups A client is at risk for acid-base imbalance. Which lab value indicates the client is acidotic? - pH - 7.30 A nurse is providing discharge instructions to a client recently diagnosed with peptic ulcer disease. Which of the following should NOT be part of the instructions? - Resume alcohol in moderation The nurse is caring for a client with respiratory alkalosis. Which of the following assessments are consistent with the diagnosis? - Increased pH levels and decreased CO2 levels A 42 yo was recently diagnosed with gastric cancer. The client has a wife and 3 small children. The client and wife are having a difficult time dealing with the recent diagnosis. Which of the following interventions is appropriate for this client? - Consult social services to provide support for client and family