RN Comprehensive Online Practice 2019 B with NGN Exam Questions And Answers

A nurse has just received change-of-shift report on four clients. Which of the following clients should the nurse assess first? A client who is postoperative with abdominal distention and no bowel sounds A client who has diabetes mellitus and a blood glucose level of 105 mg/dL A client who has heart failure and 2+ pitting edema A client who is receiving maintenance IV fluids and needs a new IV catheter - ANS A client who is postoperative with abdominal distention and no bowel sounds Using the acute vs. chronic approach to client care, the nurse should first assess the client who is postoperative with abdominal distention and no bowel sounds because these manifestations are indications of a paralytic ileus. For each assessment finding, click to specify if the finding is consistent with attention deficit hyperactivity disorder (ADHD) or intellectual disability (ID). Each finding may support more than 1 disease process. Assessment Findings Intellectual impairment Interrupting others Impaired language skills Hyperreactivity to sensory input Losing necessary things A nurse is caring for a school-age child. Nurses' Notes First visit: A child is brought to the clinic accompanied by guardians. The guardians have received feedback from the child's teacher that the child has become disinterested in schoolwork and has difficulty paying attention during class. The child often loses their school supplies. The guardians report that the child demonstrates these behaviors at home as well. The child refuses to participate in household chores, keeps their room untidy, does not clean up when told to, and is generally careless and disi - ANS ADHD Hyperreactivity to sensory input Losing necessary things Interrupting others Intellectual impairment ID Intellectual impairment Hyperreactivity to sensory input When analyzing cues, the nurse should identify that manifestations of ADHD include losing necessary things, interrupting others, intellectual impairment, and hyper reactivity to sensory input. In ADHD, the client often loses necessary things in daily life, such as pencils, erasers, and books. The client often interrupts others and has difficulty waiting for their turn in conversation. The client might have an intellectual impairment, which can lead to poor academic performance and difficulties with socialization. The client might exhibit hyperreactivity or hyporeactivity to stimuli. A charge nurse is providing an educational session about infection control for a group of staff nurses. Which of the following statements by one of the staff nurses indicates an understanding of isolation precautions? "Droplet precautions should be initiated for a client who tests positive for measles." "A client who requires airborne precautions should be placed in a negative-pressure airflow room." "Airborne precautions should be initiated for a client who has Clostridium difficile." "A client who is immunocompromised should be placed in a negative-pressure airflow room." - ANS A client who requires airborne precautions should be placed in a negative-pressure airflow room." Airborne precautions require a negative-pressure airflow room that has at least six to 12 air exchanges each hour using a HEPA filtration system. A nurse is admitting a client who has pneumonia. The nurse should initiate which of the following isolation precautions for the client? Droplet Airborne Contact Protective environment - ANS Droplet The nurse should initiate droplet precautions for this client by placing the client in a private room and wearing a surgical mask when caring for the client. Pneumonia is transmitted by droplet particles. A nurse in a community center is providing an educational session to a group of clients about ovarian cancer. Which of the following manifestations of ovarian cancer should the nurse include in the teaching? Diarrhea Urinary retention Purulent discharge Abdominal bloating - ANS Abdominal bloating The nurse should include the presence of abdominal bloating as an early manifestation of ovarian cancer. Other manifestations include an increase in abdominal girth, pelvic or abdominal pain, early satiety, and urinary frequency or urgency. A nurse is reviewing the ABG values of a client. The client has a pH of 7.2, PaCO2 of 60 mm Hg, and HCO3- of 25 mEq/L. The nurse should identify that the client has which of the following acid-base imbalances? Respiratory alkalosis Metabolic alkalosis Respiratory acidosis Metabolic acidosis - ANS Respiratory acidosis A client who has respiratory acidosis will have a decreased pH below the expected reference range of 7.35 to 7.45, an increased PaCO2 above the expected reference range of 35 to 45 mm Hg, and an HCO3- within the expected reference range of 22 to 26 mEq/L. A nurse is caring for a client who has type 1 diabetes mellitus and reports severe ankle pain after falling off a stepstool at home. Which of the following prescriptions should the nurse clarify with the provider? Obtain capillary blood glucose level every 2 hr. Check the neurovascular status of the client's lower extremities every hour. Apply a cold pack to the client's ankle for 30 min every hour. Maintain the affected ankle elevated and immobilized. - ANS Apply a cold pack to the client's ankle for 30 min every hour. The nurse should clarify a prescription for a cold pack to the client's ankle because type 1 diabetes mellitus is a contraindication for receiving cold therapy. A client who has type 1 diabetes mellitus can have impaired circulation due to arteriosclerosis and a loss of sensory perception due to neuropathy. Ice can further impair circulation. A nurse is caring for a client who has active tuberculosis (TB). Which of the following actions should the nurse plan to take to prevent the transmission of the disease? Initiate contact precautions for the client upon admission. Restrict visitors from entering the client's room during hospitalization. Wear a surgical mask while providing care for the client. Have the client wear a surgical mask while being transported outside the room. - ANS Have the client wear a surgical mask while being transported outside the room. A client who has active TB should wear a surgical mask while being transported to prevent transmission of the disease. A nurse manager is reviewing clients' rights with the nurses on the unit. The nurse manager should tell the nurses that informed consent promotes which of the following ethical principles? Autonomy Nonmaleficence Justice Fidelity - ANS Autonomy Autonomy refers to a client's ability to make their own decisions about treatment. Informed consent promotes autonomy by providing clients with complete information about treatment. A nurse is caring for a client who is taking valproic acid for seizure control. For which of the following adverse effects should the nurse monitor and report? Weight loss Jaundice Bradycardia Polyuria - ANS Jaundice The nurse should monitor the client for jaundice and report any indication to the provider. Clients who take valproic acid are at risk for liver damage, which can lead to jaundice. For each potential provider's prescription, click to specify if the potential prescription is anticipated or contraindicated for the client. Potential Order Keep the client supine. Oxygen therapy to keep oxygen saturation above 95%. Maintain the client's hips in flexion. Keep the lights in the client's room dim. Cluster nursing care. Monitor blood glucose every 4 hr. Nurses' Notes Day 1, 1000: Client presents to the emergency department (ED) with right-sided hemiparesis, lethargy, and aphasia. The client's symptoms started 1 hr prior to arrival at the ED. Client received fibrinolytic therapy and was transferred to the ICU. Day 2, 0800: Client is awake and alert to person, place, and time. Client has weak right-side hand grasp. However, this is improved from admission. Client to be evaluated by speech therapy due to aphasia. Day 2, 1930: Called to the client's room by a family member. Client is lethargic and restl - ANS Anticipated Oxygen therapy to keep oxygen saturation above 95% Monitor blood glucose every 4 hr Keep the lights in the client's room dim. Contraindicated Cluster nursing care. Maintain the client's hips in flexion. Keep the client supine. Oxygen therapy to keep oxygen saturation above 95% is anticipated. The nurse should titrate oxygen therapy to maintain the oxygen saturation level above 95% to avoid hypoxia. The client is exhibiting manifestations of increased intracranial pressure (ICP). Therefore, oxygenation and perfusion are the priority for this client.