NUR 2755 CORRECT QUESTIONS AND ANSWERS
SET A+
✔✔What is the nurse's priority action during a mass casualty incident? - ✔✔Assess
personal safety and then use the START triage method to categorize victims.
✔✔What assessment finding indicates a potential sign of shock? - ✔✔Shallow, rapid
respirations.
✔✔What agent is likely causing symptoms of cholinergic crisis in a client exposed to a
chemical agent? - ✔✔Nerve agent.
✔✔What should the nurse include in the plan of care for a client with suspected anthrax
exposure? - ✔✔Begin treatment with ciprofloxacin or doxycycline immediately.
✔✔What assessment finding is consistent with the early stage of compensation in a
client experiencing a GI bleed? - ✔✔-Cool, clammy skin,
-expressions of anxiety,
- decreased urine output.
✔✔Which client should the nurse categorize as 'Immediate' for treatment during triage?
- ✔✔The client with the sucking chest wound.
✔✔What condition would lead the nurse to suspect a child is experiencing anaphylactic
shock? - ✔✔respiratory distress.
✔✔What precautions should a nurse implement for a client suspected of having COVID-
19? - ✔✔Use airborne precautions, including an N95 respirator, and isolate the client.
✔✔What priority action should a nurse take to reduce blood pressure in a client with an
intracerebral hemorrhage? - ✔✔Initiate a continuous IV infusion of an antihypertensive
agent.
, ✔✔What statement indicates a client understands discharge teaching after a
hemorrhagic stroke? - ✔✔"I will frequently monitor my blood pressure and report
changes."
✔✔What is the most important nursing action when managing a client with a traumatic
brain injury being medicated for seizures? - ✔✔Observe for side effects of
anticonvulsant medications, such as altered mental status.
✔✔What should the nurse monitor first in a client with a traumatic brain injury at risk for
diabetes insipidus? - ✔✔Monitor urine output and specific gravity.
✔✔What actions should the nurse take to maintain adequate cerebral perfusion
pressure in a client with a traumatic brain injury? - ✔✔Administer hypertonic saline to
reduce cerebral edema and maintain blood volume.
✔✔What is the priority action for a nurse caring for a client with severe headaches from
a metastatic brain tumor? - ✔✔Administer prescribed analgesics and assess the client's
pain level regularly.
✔✔What is the nurse's best initial action for a client showing signs of wound infection
post-surgery? - ✔✔Reinforce the dressing and notify the surgeon.
✔✔What priority nursing action can prevent perioperative positioning injury in a client in
the Trendelenburg position? - ✔✔Use padded shoulder braces to prevent sliding.
✔✔What interventions should the nurse implement to prevent further embolic events in
a client with atrial fibrillation? - ✔✔Administer enoxaparin subcutaneously, encourage
early ambulation, and apply sequential compression devices.
✔✔What action should the nurse take to reduce the risk of septic shock in an
immunocompromised client with a UTI? - ✔✔Remove invasive devices as soon as they
are no longer needed.
✔✔What actions should the nurse implement for a client experiencing a generalized
tonic-clonic seizure? - ✔✔Place the client in a side-lying position and stay with the client
until they are fully oriented.
✔✔What activities should a client avoid after a craniotomy to prevent cerebrospinal fluid
leak? - ✔✔Blowing the nose and strenuous exercise.
SET A+
✔✔What is the nurse's priority action during a mass casualty incident? - ✔✔Assess
personal safety and then use the START triage method to categorize victims.
✔✔What assessment finding indicates a potential sign of shock? - ✔✔Shallow, rapid
respirations.
✔✔What agent is likely causing symptoms of cholinergic crisis in a client exposed to a
chemical agent? - ✔✔Nerve agent.
✔✔What should the nurse include in the plan of care for a client with suspected anthrax
exposure? - ✔✔Begin treatment with ciprofloxacin or doxycycline immediately.
✔✔What assessment finding is consistent with the early stage of compensation in a
client experiencing a GI bleed? - ✔✔-Cool, clammy skin,
-expressions of anxiety,
- decreased urine output.
✔✔Which client should the nurse categorize as 'Immediate' for treatment during triage?
- ✔✔The client with the sucking chest wound.
✔✔What condition would lead the nurse to suspect a child is experiencing anaphylactic
shock? - ✔✔respiratory distress.
✔✔What precautions should a nurse implement for a client suspected of having COVID-
19? - ✔✔Use airborne precautions, including an N95 respirator, and isolate the client.
✔✔What priority action should a nurse take to reduce blood pressure in a client with an
intracerebral hemorrhage? - ✔✔Initiate a continuous IV infusion of an antihypertensive
agent.
, ✔✔What statement indicates a client understands discharge teaching after a
hemorrhagic stroke? - ✔✔"I will frequently monitor my blood pressure and report
changes."
✔✔What is the most important nursing action when managing a client with a traumatic
brain injury being medicated for seizures? - ✔✔Observe for side effects of
anticonvulsant medications, such as altered mental status.
✔✔What should the nurse monitor first in a client with a traumatic brain injury at risk for
diabetes insipidus? - ✔✔Monitor urine output and specific gravity.
✔✔What actions should the nurse take to maintain adequate cerebral perfusion
pressure in a client with a traumatic brain injury? - ✔✔Administer hypertonic saline to
reduce cerebral edema and maintain blood volume.
✔✔What is the priority action for a nurse caring for a client with severe headaches from
a metastatic brain tumor? - ✔✔Administer prescribed analgesics and assess the client's
pain level regularly.
✔✔What is the nurse's best initial action for a client showing signs of wound infection
post-surgery? - ✔✔Reinforce the dressing and notify the surgeon.
✔✔What priority nursing action can prevent perioperative positioning injury in a client in
the Trendelenburg position? - ✔✔Use padded shoulder braces to prevent sliding.
✔✔What interventions should the nurse implement to prevent further embolic events in
a client with atrial fibrillation? - ✔✔Administer enoxaparin subcutaneously, encourage
early ambulation, and apply sequential compression devices.
✔✔What action should the nurse take to reduce the risk of septic shock in an
immunocompromised client with a UTI? - ✔✔Remove invasive devices as soon as they
are no longer needed.
✔✔What actions should the nurse implement for a client experiencing a generalized
tonic-clonic seizure? - ✔✔Place the client in a side-lying position and stay with the client
until they are fully oriented.
✔✔What activities should a client avoid after a craniotomy to prevent cerebrospinal fluid
leak? - ✔✔Blowing the nose and strenuous exercise.
