NR511 Final Exam Differential Diagnosis and
Primary Care 1 – 450+ Practice Questions with
Verified Answers Latest / NR 511 Final Exam
Prep Test Bank
The client returns to the unit after abdominal surgery with a 5″ × 9″ absorbent dressing in
place to the mid abdomen. The nurse notes a spot of red staining centrally on the dressing.
What is the nurse's next action?
A.
Note the size of the stain in the chart.
B.
Circle the stain with an ink pen.
C.
Remove the dressing to assess the source of the bleeding.
A+ TEST BANK 1
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D.
Place a pressure dressing on the existing dressing. –
Correct Answer :B
Rationale:
By circling the existing stain upon admission to the unit, the nurse can then assess any
increase, though subtle, in the amount of drainage over time. The size of the stain will need to
be noted in the chart, but it is not the first action. The nurse removes the dressing under the
prescription of the health care provider or in an emergency. Neither of those conditions exist
in the question. The dressing in place is an absorbent dressing. There is no need for a further
dressing until the existing dressing becomes saturated.
For the client undergoing hemodialysis, the nurse suspects the client has an air embolism.
What symptoms lead the nurse to this conclusion? (Select all that apply.)
A.
Dyspnea
B.
B/P 168/92 mm Hg
C.
Chest pain
D.
Anxiety
E.
O2 saturation of 98%
F.
Blue nail beds –
Correct Answer :A, C, D, F
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Rationale:
For the client experiencing an air embolism, the nurse will see hypotension and not
hypertension. The O2 saturation will also fall with an air embolism. The remaining are signs of
an air embolism.
The nurse is preparing teaching for nursing students who are participating in a flu vaccine
clinic at a local school. Who should receive the vaccine? (Select all that apply.)
A.
Health care personnel
B.
Those who are allergic to eggs
C.
Individuals who are over 50 years old
D.
Individuals with chronic health conditions
E.
Those who live in nursing homes
F.
Infants under 6 months of age –
Correct Answer :A, C, D, E
Rationale:
The current recommendation is those who are allergic to eggs can receive the flu vaccine if it
is administered in a healthcare environment that can quickly deliver treatment for
anaphylaxis. Infants over 6 months van receive the flu shot, but not under 6 months. The
remaining options are recommended to receive the flu vaccine.
A+ TEST BANK 3
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A practical nurse (PN) tells the charge nurse in a long-term facility that she does not want to
be assigned to one particular resident. She reports that the male client keeps insisting that
she is his daughter and begs her to stay in his room. What is the best managerial decision?
A.
Notify the family that the resident will have to be discharged if his behavior does not improve.
B.
Notify administration of the PN's insubordination and need for counseling about her
statements.
C.
Ask the PN what she has done to encourage the resident to believe that she is his daughter.
D.
Reassign the PN until the resident can be assessed more completely for reality orientation. –
Correct Answer :D
Rationale:
Temporary reassignment is the best option until the resident can be examined and his
medications reviewed. He may have worsening cerebral dysfunction from an infection or
electrolyte imbalance. Option A is not the best option because the family cannot control the
resident's actions. The administration may need to know about the situation, but not as a
case of insubordination. Implying that the PN is somehow creating the situation is
inappropriate until a further evaluation has been conducted.
The nurse is assessing a 75-year-old client for symptoms of hyperglycemia. Which symptom of
hyperglycemia is an older adult most likely to exhibit?
A.
Polyuria
B.
Polydipsia
A+ TEST BANK 4