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What relevant assessment data would the nurse observe when a patient in acute
respiratory failure has the complication of cerebral hypercapnia?
a. decreased intracranial pressure
b. delerium
c. progressive somnolence and coma
d. restlessness and combative behavior ---------CORRECT ANSWER-----------------c.
A new nurse appears to be unsure of nursing assessments. The nurse asks co-
workers to rehearse what needs to be reported to the physician. This seems to be
annoying to some of the nurse co-workers.What is the nurse managers best
response?
a. Tell the staff that all new nurses go through this phase and ignored the
behaviors
b. agree with the staff and have someone follow and work more closely with a
preceptor
c. Explain to coworkers that this is a characteristics of critical thinking that is
important.
d. Have a talk with the nurse and suggest asking fewer questions ---------CORRECT
ANSWER-----------------c.
,The nurse is to obtain a sample of exudate for culture from a patient. What
information will this test provide?
a. which specific pathogen is causing the infection
b.what cells are being utilized by the body to attack an infection
c.where an infection is located
d. whether a patient has an infection ---------CORRECT ANSWER-----------------a.
the patient has been diagnosed with aphasia after suffering a stroke. What can
the nurse do to best make the patients atmosphere more conductive for
communication?
a. have the patient speak to loved ones on the phone daily
b. provide a board of commonly used needs and phrases
c. help the patient complete his/her sentences
d. speak in a loud and deliberate voice to the patient ---------CORRECT ANSWER----
-------------b.
A patient diagnosed with a TIA is scheduled for a carotid endarterectomy. The
nurse explains that this procedure will be done for what purpose?
a. to decrease cerebral edema
b. to determine the cause of the TIA
,c. To prevent seizure activity this is common following a TIA
d. To remove atherosclerotic plaques blocking cerebral blood flow ---------
CORRECT ANSWER-----------------d.
The patient with ARDS is placed on a ventilator to achieve adequate lung
ventilation. The goal includes maintain normal PaCo2, Achieve PaO2 within
normal limits for age and SaO2 greater than 90%. Which diagnostic test will be
best to determine if the goals have been met?
a. Arterial blood gases
b.CXR
c. Oxygen saturation
d. Tidal volumes ---------CORRECT ANSWER-----------------a.
The nurse is caring for a male patient diagnosed with cirrhosis. The patient status
has improved and is now ordered a general diet. When his meal is served , the
patient asks the nurse for salt. What teaching will the nurse provide?
a. tell him that since he just started eating again salt may cause nausea
b. give him the salt and weigh him to see if salt increases his weight
c. explain that his salt intake is limited so his fluid retention does not increase.
d. inform the patient that it is necessary to follow physicians order for no salt ------
---CORRECT ANSWER-----------------c.
, A patient has a history of TIA and has an order for aspirin 160mg daily. When the
nurse is administrating medications the patient says "I dont need that aspirin
today, I don't have any aches or pains" what action should the nurse take?
a. call the healthcare provider to clarify the medication
b. explain that aspirin is used to decrease risk
c. tell the patient the aspirin is used to relieve the pain
d. document the aspirin is ordered to decrease stroke risk ---------CORRECT
ANSWER-----------------b.
A patient diagnosed with acute respiratory distress syndrome (ARDS) is restless
and has low oxygen saturation level. If the patient;s condition does not improve
and the oxygen saturation level continues to decrease, what procedure will the
nurse expect to assist with in order to assist the patient to breath easier?
a. administer a large dose of lasix
b. increase oxygen administration
c. intubate the patient for controlled breathing with mechanical ventilation
d. schedule the patient for pulmonary surgery ---------CORRECT ANSWER-------------
----c.
A patient suspected of developing ARDS is experiencing anxiety and agitation due
to increased hypoxia and dyspnea. The nurse would implement which of the
following interventions to improve oxygenation and provide comfort for the
patient?