REx-PN® Bundled Exams With Actual
Exam Newest With Complete Questions And
Correct Detailed Answers| Brand New
Version!
A client with chronic obstructive pulmonary disease (COPD) and a history of coronary artery
disease receive an IV drip of aminophylline. Which finding would require immediate
intervention?
A. Flushing and headache
B. Changes in blood pressure and respirations
C. Increased heart rate and sweating
D. Restlessness and palpitations Answer: D. Restlessness and palpitations
Aminophylline is a bronchodilator. Dosing needs to be individualized (based on body weight) so
that the maximum benefit is obtained with minimal risk of adverse reactions. Side effects include
nervousness, restlessness, headaches, and palpitations. Muscle twitching or nausea are associated
with toxicity of this medication.
The health care provider orders an osmotic diuretic for a client diagnosed with a traumatic brain
injury (TBI). Why is this medication ordered?
A. Reduce pulmonary edema
B. Prevent electrolyte imbalance
C. Reduce intracranial pressure
D. Prevent seizures Answer: C. Reduce intracranial pressure
Osmotic diuretics, such as mannitol, are used to reduce intracranial or intraocular pressure.
Osmotic diuretics reduce the amount of water normally reabsorbed by the renal tubules and loop
of Henle, so urinary output is increased. Osmotic diuretics can cause excessive loss of water and
electrolytes, which can lead to serious electrolyte imbalances. In addition to water intoxication
and dehydration, adverse reactions of osmotic diuretics include pulmonary edema and circulatory
overload. Anticonvulsants prevent seizures.
The nurse is caring for an older client who had a large volume of intravenous solution infused
rapidly. What findings should the nurse now anticipate?
A. Lowered blood pressure, thready pulse, hypoventilation
B. Lethargy, tachycardia, diaphoresis
C. Edema, fluctuating blood pressure, glucosuria
D. Elevated blood pressure, bounding pulse, dyspnea Answer: D. Elevated blood pressure,
bounding pulse, dyspnea
Early findings of fluid volume excess include elevated blood pressure, bounding pulse, and
dyspnea. Severe fluid volume overload leads to heart failure and pulmonary edema. Sometimes,
1
,when you are dealing with options that contain a series on each line, it helps to compare each
item in the series by reading vertically. For example, you would read: "elevated blood pressure,
lowered blood pressure, edema, and lethargy." Because the client received too much fluid, you
would expect an increase in any findings, so you can eliminate the options with lowered blood
pressure and lethargy. Then read bounding pulse with fluctuating blood pressure. And lastly
compare dyspnea with glucosuria; you can eliminate the one option with "glucose" because this
is new information not given in the question.
A client is scheduled for an intravenous pyelogram (IVP). After the contrast material is injected,
which client reaction requires an immediate intervention?
A. Salty taste
B. Face flushing
C. Feeling warm
D. Hives Answer: D. Hives
Hives are one sign of anaphylaxis and require immediate action with an injection of epinephrine.
The other listed reactions are normal (expected), and the client should be reminded that they may
occur.
The nurse provides regular mouth care to the hospice client who is actively dying at home. The
family wants to know why the doctor doesn't order an IV since the client's mouth seems so dry.
What information can the nurse provide to the family that best answers their question?
A. The client will need to be hospitalized if an IV is started
B. The client will need to have an indwelling catheter inserted if an IV is started
C. Intravenous hydration will increase episodes of delirium
D. Intravenous hydration can delay death Answer: D. Intravenous hydration can delay death
Dehydrated clients may experience delirium and may benefit from IV therapy. However,
intravenous hydration does not improve dry mouth and can even delay death. The nurse should
explain that the client's comfort can be enhanced by providing frequent mouth care and that
decreased oral intake is a natural and non-painful part of the dying process.
The client, diagnosed with an acute myocardial infarction (MI), is admitted to the cardiac care
unit. There is an order for oxygen at 4L/min per nasal cannula. What is the best rationale for
administering oxygen?
A. Saturate the red blood cells
B. Relieve dyspnea on exertion
C. Increase oxygen to ischemic cardiac cells
D. Return skin color to normal tones Answer: C. Increase oxygen to ischemic cardiac cells
Anoxia of the myocardium occurs in MI. Oxygen administration may help relieve dyspnea on
exertion and cyanosis associated with the condition. However, the major purpose is to increase
the oxygen concentration in the ischemic, damaged myocardial cells.
A client with moderate persistent asthma is admitted for a minor surgical procedure. On
admission, the peak flow meter is measured at 480 litres/minute. Postoperatively the client
2
,reports having chest tightness. The peak flow is now 200 litres/minute. What should the nurse do
first?
A. Repeat the peak flow reading in 30 minutes
B. Notify the doctor
C. Administer the PRN dose of albuterol
D. Apply oxygen at 2 litres per nasal cannula Answer: C. Administer the PRN dose of
albuterol
Peak flow monitoring during exacerbations of asthma is recommended for clients with moderate-
to-severe persistent asthma. This will help determine the severity of the exacerbation and guide
the treatment. A peak flow reading of less than 50% of the client's baseline reading is a medical
alert condition and a short-acting beta-agonist (such as albuterol) should be taken immediately.
The nurse checks a client diagnosed with chronic obstructive pulmonary disease (COPD). The
client is using oxygen per nasal cannula. Which action would be a priority for the nurse?
A. Monitor activity tolerance
B. Check for digital clubbing
C. Evaluate SaO2 levels
D. Observe skin color for changes Answer: C. Evaluate SaO2 levels
The best method for the nurse to use in evaluating a client's oxygenation is to evaluate the SaO2
using a pulse oximeter. This is an effective alternative to arterial blood gases to evaluate
oxygenation; it is also less traumatic and less expensive. The skin color and activity tolerance
options are evaluation parameters for oxygenation, but they are not considered initial changes.
Digital clubbing is a later finding associated with a chronic lack of oxygen (as seen in COPD or
anemia.)
A client is receiving heparin therapy for a deep vein thrombosis (venous thromboembolism) of
the left leg. Which side effect should the nurse address first?
A. Fever and chills
B. Black, tarry stools
C. Slightly raised red rash on left leg
D. Pain in the left leg Answer: B. Black, tarry stools
Black, tarry stools indicate blood in the gastrointestinal (GI) tract and must be reported to the
health care provider immediately. It is a priority over the other options. When reading the
options, decide which findings would require your attention first - a rash, bleeding, fever, or pain
and then select the one that is the most potentially life-threatening.
A hospitalized client who has been receiving enteral nutrition has had four loose or watery stools
in the past 24 hours. What action should a nurse take first?
A. Increase the amount of water used to flush the tube
B. Notify the prescriber of the complaints
C. Maintain the enteral formula infusion rate
3
, D. Review the medications the client has received Answer: D. Review the medications the
client has received
Antibiotics or substances containing sorbitol (often contained in liquid drug preparations) may
contribute to frequent, loose stools. Further information is needed. After this step, the prescriber
should be notified of the problem. When asked about what should be done "first," think data
collection (ASSESSMENT); only the response that states to review the medications is about data
collection.
A client who has been diagnosed with Raynaud's disease and hypertension is prescribed
nifedipine. For which side effect should the nurse monitor the client?
A. Decreased urine output
B. Cyanosis of the lips
C. Increased pain in fingers
D. Facial flushing Answer: D. Facial flushing
Nifedipine is a calcium channel blocker (CCB) used to treat Raynaud's disease and hypertension
by producing vasodilation. As a result of this vasodilating effect, facial flushing can occur.
Cyanosis of the lips and decreased urinary output are not expected findings with nifedipine.
Raynaud's disease causes vasoconstriction, resulting in pain in the fingers that should decrease
when nifedipine is taken.
The hospice nurse is visiting a client diagnosed with end-stage lung cancer and metastases to the
bone. What should the nurse keep in mind when planning for effective pain management?
A. Relief of pain will be achieved quickly.
B. The client will most likely become addicted.
C. Pain therapy is based on the client's report of pain.
D. High doses of opioid analgesics will be required. Answer: C. Pain therapy is based on the
client's report of pain.
Every person's pain experience is unique and should be treated based on the individual's goals for
pain management. Therefore, the amount of medication needed is dependent on the client's needs
and reports of pain relief. The nurse should not assume that high doses of analgesics will be
needed to alleviate the client's pain. Immediate or quick pain relief might be difficult to achieve,
especially considering the client's type of cancer and bone metastases. Addiction is a
psychological condition and not a concern for this client. However, the client may develop a
physical dependence and tolerance to pain medications that may require an increase in dosage to
manage pain effectively.
The nurse is evaluating the effectiveness of therapy for a client who received albuterol via
nebulizer during an acute episode of shortness of breath due to asthma. Which finding is the best
indicator that the therapy was effective?
A. No wheezes are audible.
B. The respiratory rate is 16 breaths/minute.
C. Oxygen saturation is greater than 90%.
D. Accessory muscle use has decreased. Answer: C. Oxygen saturation is greater than 90%.
4
Exam Newest With Complete Questions And
Correct Detailed Answers| Brand New
Version!
A client with chronic obstructive pulmonary disease (COPD) and a history of coronary artery
disease receive an IV drip of aminophylline. Which finding would require immediate
intervention?
A. Flushing and headache
B. Changes in blood pressure and respirations
C. Increased heart rate and sweating
D. Restlessness and palpitations Answer: D. Restlessness and palpitations
Aminophylline is a bronchodilator. Dosing needs to be individualized (based on body weight) so
that the maximum benefit is obtained with minimal risk of adverse reactions. Side effects include
nervousness, restlessness, headaches, and palpitations. Muscle twitching or nausea are associated
with toxicity of this medication.
The health care provider orders an osmotic diuretic for a client diagnosed with a traumatic brain
injury (TBI). Why is this medication ordered?
A. Reduce pulmonary edema
B. Prevent electrolyte imbalance
C. Reduce intracranial pressure
D. Prevent seizures Answer: C. Reduce intracranial pressure
Osmotic diuretics, such as mannitol, are used to reduce intracranial or intraocular pressure.
Osmotic diuretics reduce the amount of water normally reabsorbed by the renal tubules and loop
of Henle, so urinary output is increased. Osmotic diuretics can cause excessive loss of water and
electrolytes, which can lead to serious electrolyte imbalances. In addition to water intoxication
and dehydration, adverse reactions of osmotic diuretics include pulmonary edema and circulatory
overload. Anticonvulsants prevent seizures.
The nurse is caring for an older client who had a large volume of intravenous solution infused
rapidly. What findings should the nurse now anticipate?
A. Lowered blood pressure, thready pulse, hypoventilation
B. Lethargy, tachycardia, diaphoresis
C. Edema, fluctuating blood pressure, glucosuria
D. Elevated blood pressure, bounding pulse, dyspnea Answer: D. Elevated blood pressure,
bounding pulse, dyspnea
Early findings of fluid volume excess include elevated blood pressure, bounding pulse, and
dyspnea. Severe fluid volume overload leads to heart failure and pulmonary edema. Sometimes,
1
,when you are dealing with options that contain a series on each line, it helps to compare each
item in the series by reading vertically. For example, you would read: "elevated blood pressure,
lowered blood pressure, edema, and lethargy." Because the client received too much fluid, you
would expect an increase in any findings, so you can eliminate the options with lowered blood
pressure and lethargy. Then read bounding pulse with fluctuating blood pressure. And lastly
compare dyspnea with glucosuria; you can eliminate the one option with "glucose" because this
is new information not given in the question.
A client is scheduled for an intravenous pyelogram (IVP). After the contrast material is injected,
which client reaction requires an immediate intervention?
A. Salty taste
B. Face flushing
C. Feeling warm
D. Hives Answer: D. Hives
Hives are one sign of anaphylaxis and require immediate action with an injection of epinephrine.
The other listed reactions are normal (expected), and the client should be reminded that they may
occur.
The nurse provides regular mouth care to the hospice client who is actively dying at home. The
family wants to know why the doctor doesn't order an IV since the client's mouth seems so dry.
What information can the nurse provide to the family that best answers their question?
A. The client will need to be hospitalized if an IV is started
B. The client will need to have an indwelling catheter inserted if an IV is started
C. Intravenous hydration will increase episodes of delirium
D. Intravenous hydration can delay death Answer: D. Intravenous hydration can delay death
Dehydrated clients may experience delirium and may benefit from IV therapy. However,
intravenous hydration does not improve dry mouth and can even delay death. The nurse should
explain that the client's comfort can be enhanced by providing frequent mouth care and that
decreased oral intake is a natural and non-painful part of the dying process.
The client, diagnosed with an acute myocardial infarction (MI), is admitted to the cardiac care
unit. There is an order for oxygen at 4L/min per nasal cannula. What is the best rationale for
administering oxygen?
A. Saturate the red blood cells
B. Relieve dyspnea on exertion
C. Increase oxygen to ischemic cardiac cells
D. Return skin color to normal tones Answer: C. Increase oxygen to ischemic cardiac cells
Anoxia of the myocardium occurs in MI. Oxygen administration may help relieve dyspnea on
exertion and cyanosis associated with the condition. However, the major purpose is to increase
the oxygen concentration in the ischemic, damaged myocardial cells.
A client with moderate persistent asthma is admitted for a minor surgical procedure. On
admission, the peak flow meter is measured at 480 litres/minute. Postoperatively the client
2
,reports having chest tightness. The peak flow is now 200 litres/minute. What should the nurse do
first?
A. Repeat the peak flow reading in 30 minutes
B. Notify the doctor
C. Administer the PRN dose of albuterol
D. Apply oxygen at 2 litres per nasal cannula Answer: C. Administer the PRN dose of
albuterol
Peak flow monitoring during exacerbations of asthma is recommended for clients with moderate-
to-severe persistent asthma. This will help determine the severity of the exacerbation and guide
the treatment. A peak flow reading of less than 50% of the client's baseline reading is a medical
alert condition and a short-acting beta-agonist (such as albuterol) should be taken immediately.
The nurse checks a client diagnosed with chronic obstructive pulmonary disease (COPD). The
client is using oxygen per nasal cannula. Which action would be a priority for the nurse?
A. Monitor activity tolerance
B. Check for digital clubbing
C. Evaluate SaO2 levels
D. Observe skin color for changes Answer: C. Evaluate SaO2 levels
The best method for the nurse to use in evaluating a client's oxygenation is to evaluate the SaO2
using a pulse oximeter. This is an effective alternative to arterial blood gases to evaluate
oxygenation; it is also less traumatic and less expensive. The skin color and activity tolerance
options are evaluation parameters for oxygenation, but they are not considered initial changes.
Digital clubbing is a later finding associated with a chronic lack of oxygen (as seen in COPD or
anemia.)
A client is receiving heparin therapy for a deep vein thrombosis (venous thromboembolism) of
the left leg. Which side effect should the nurse address first?
A. Fever and chills
B. Black, tarry stools
C. Slightly raised red rash on left leg
D. Pain in the left leg Answer: B. Black, tarry stools
Black, tarry stools indicate blood in the gastrointestinal (GI) tract and must be reported to the
health care provider immediately. It is a priority over the other options. When reading the
options, decide which findings would require your attention first - a rash, bleeding, fever, or pain
and then select the one that is the most potentially life-threatening.
A hospitalized client who has been receiving enteral nutrition has had four loose or watery stools
in the past 24 hours. What action should a nurse take first?
A. Increase the amount of water used to flush the tube
B. Notify the prescriber of the complaints
C. Maintain the enteral formula infusion rate
3
, D. Review the medications the client has received Answer: D. Review the medications the
client has received
Antibiotics or substances containing sorbitol (often contained in liquid drug preparations) may
contribute to frequent, loose stools. Further information is needed. After this step, the prescriber
should be notified of the problem. When asked about what should be done "first," think data
collection (ASSESSMENT); only the response that states to review the medications is about data
collection.
A client who has been diagnosed with Raynaud's disease and hypertension is prescribed
nifedipine. For which side effect should the nurse monitor the client?
A. Decreased urine output
B. Cyanosis of the lips
C. Increased pain in fingers
D. Facial flushing Answer: D. Facial flushing
Nifedipine is a calcium channel blocker (CCB) used to treat Raynaud's disease and hypertension
by producing vasodilation. As a result of this vasodilating effect, facial flushing can occur.
Cyanosis of the lips and decreased urinary output are not expected findings with nifedipine.
Raynaud's disease causes vasoconstriction, resulting in pain in the fingers that should decrease
when nifedipine is taken.
The hospice nurse is visiting a client diagnosed with end-stage lung cancer and metastases to the
bone. What should the nurse keep in mind when planning for effective pain management?
A. Relief of pain will be achieved quickly.
B. The client will most likely become addicted.
C. Pain therapy is based on the client's report of pain.
D. High doses of opioid analgesics will be required. Answer: C. Pain therapy is based on the
client's report of pain.
Every person's pain experience is unique and should be treated based on the individual's goals for
pain management. Therefore, the amount of medication needed is dependent on the client's needs
and reports of pain relief. The nurse should not assume that high doses of analgesics will be
needed to alleviate the client's pain. Immediate or quick pain relief might be difficult to achieve,
especially considering the client's type of cancer and bone metastases. Addiction is a
psychological condition and not a concern for this client. However, the client may develop a
physical dependence and tolerance to pain medications that may require an increase in dosage to
manage pain effectively.
The nurse is evaluating the effectiveness of therapy for a client who received albuterol via
nebulizer during an acute episode of shortness of breath due to asthma. Which finding is the best
indicator that the therapy was effective?
A. No wheezes are audible.
B. The respiratory rate is 16 breaths/minute.
C. Oxygen saturation is greater than 90%.
D. Accessory muscle use has decreased. Answer: C. Oxygen saturation is greater than 90%.
4
