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MDC IV Exam 1
1. The nurse is preparing a care plan for a newly admitted postoperative client. Which nursing
intervention is the most important when planning to prevent alveolar collapse? a. Apply
supplemental oxygen at 2-liter nasal cannula
b. Administration of bronchodilators via nebulizer
c. Monitoring for signs of infection in the surgical wound
d. Encouraging hourly coughing and deep breathing
2. The nurse is caring for a client with Parkinson’s disease. Which intervention does the nurse
implement to prevent respiratory complications in the client? a. Maintain the head of the bed
at 30 degrees or greater
b. Keep an oral airway at the bedside
c. Teach the client pursed-lip breathing techniques
d. Ensure fluid intake of at least 3 L/day
3. A nurse is caring for a client with a closed head injury with intracranial pressure (ICP) readings
between 16- and 22-mm Hg. Which of the following actions should the nurse take to decrease the
potential for raising the client’s ICP? (Select all that apply) a. Suction the endotracheal tube
frequently
b. Decrease the noise in the client’s room
c. Keep the client well hydrated
d. Evaluate the client’s head on two pillows
e. Administer a stool softener
4. When planning care for a client with myasthenia gravis, the nurse understands that the client is at
highest risk for which of the following? a. Aspiration
b. Sensory loss
c. Bladder dysfunction
d. Hypertension
5. The nurse is assessing a client with Parkinson’s disease who is beginning to display bradykinesia.
Which of the following statements from the client indicates an understanding of the disease?
a. “I need to take larger, faster steps when ambulate”
b. “I should stop my routine exercises to avoid the potential for injury”
c. “I need to allow extra time to complete activities”
d. Bradykinesia will only affect my extremities as my disease progresses”
6. Emergency medical services arrive at the emergency department with a client who has a cervical
spinal cord injury. Which priority assessment does the emergency department nurse perform at
this time?
a. Heart rate and rhythm
b. Level of consciousness and orientation
c. Reparatory status and airway patency