Care Management 4 Post Test Exam Graded A

1. A patient/client has been brought to the emergency department with multiple trauma after a motor vehicle accident. After the nurse stabilizes the patient, which of the following would the nurse perform? (Select all that apply) a. Assist the physician with insertion of a chest tube b. Draw blood for a type and cross c. Perform a rapid physical assessment d. Splint fractures e. Checks IV for patency Answer: B, C, D, E 2. An older adult patient/client has been admitted to your unit with a gastrointestinal ulcer. The patient/client is NPO and has a nasogastric tube in place connected to low suction. What form of shock should you monitor this patient/client for? a. Cardiogenic shock b. Hypovolemic shock c. Distributive shock d. Obstructive shock Answer: B 3. The community health nurse is designing programs to reduce kidney problems and kidney injury among the general public. In order to do so, the nurse targets health promotion and compliance with therapy for which conditions? a. Diabetes mellitus and hypertension b. Frequent episodes of sexually transmitted diseases c. Osteoporosis and other bone diseases d. Gastroenteritis and poor eating habits Answer: A 4. A patient is admitted for a poisonous snake bite. The nurse observes that the patient has hematuria, hemoptysis, petechiae, and extensive bruising. These clinical observations indicate to the nurse that the patient may be experiencing which hemorrhagic complication associated with snakebites? a. Disseminated intravascular coagulation b. Agranulocytosis c. Thrombocytopenia d. Aplastic anemia Answer: A 5. During the early emergent phase of burns, the nurse understands that analgesics should be given intravenously because a. Absorption or oral or IM drugs is diminished because of impaired circulation b. Analgesics do not need to be administered as frequently when they are given IV c. Larger doses of narcotics can be given when administered IV than when given IM d. Respiratory depression is easier to diagnose and treat when narcotics are administered intravenously Answer: A 6. The nursing student is assisting in the care of a patient on a mechanical ventilator. Which action by the student contributes to the prevention of ventilator assisted pneumonia? A. Suctions the patient frequently B. Performs oral care every 2 hours C. Encourages visitors to wear a mask D. Obtains a sputum specimen for culture Answer: B 7. A patient/client who underwent a lobectomy and has a water seal chest drainage system is breathing with a little more effort and at a faster rate that 1 hour ago. The clients pulse rate is also increased. The nurse should a. Increase the suction b. Lower the drainage bottles 2 to 3 feet below the level of the clients chest c. Ensure that the chest tube has two clamps on it to prevent air leaks d. Check the tubing to ensure that the client is not lying on it or kinking it Answer: D 8. A nurse in the telemetry unit observes the following rhythm. Based on the interpretation of the above rhythm, what is the priority action of the nurse? a. Initiate CPR b. Defibrillate the patient with 360 joules c. Assess the patients carotid pulse and level of consciousness d. Administer amiodarone 150 mg IV Answer: C 9. The new registered nurse is giving a blood transfusion to a patient. Which statement by the new nurse indicates the need for action by the supervising nurse? (Select all that apply). a. I will be sure to complete the red blood cell transfusions within 6 hours of removal from refrigeration b. I will check the patient verification with another registered nurse c. I will use Lactated Ringers solution to dilute the blood d. I will remain with the patient for the first 15 to 30 minutes of the infusion