NSG 4800 Comp Exams – Questions With Verified
Solutions
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Terms in this set (61)
The nurse is monitoring a client in the B, During the fourth stage of labor, the maternal blood
immediate postpartum period for signs pressure, pulse, and respiration should be checked
of hemorrhage. Which sign, if noted, every 15 minutes during the first hour. An increasing
would be an early sign of excessive pulse is an early sign of excessive blood loss because
blood loss? the heart pumps faster to compensate for reduced
A .temperature of 100.4°F (38°C) blood volume. A slight increase in temperature is
B. An increase in the pulse rate from 88 normal. The blood pressure decreases as the blood
to 102 beats/minute volume diminishes, but a decreased blood pressure
C. A blood pressure change from 130/88 would not be the earliest sign of hemorrhage. The
to 124/80 mm Hg respiratory rate is slightly increased from normal.
D. An increase in the respiratory rate
from 18 to 22 breaths/minute
,The nurse in the ambulatory care unit is 3, Cryotherapy involves the local application of liquid
providing home care instructions to a nitrogen to the lesion; this causes cell death and tissue
client after cryotherapy for the treatment destruction. Tissue freezing is followed in 1 to 2 days by
of malignant skin lesions. Which hemorrhagic blister formation; therefore, ice is not
statement would be most appropriate applied to the site. The application of a warm, damp
for the nurse to include in the home care washcloth intermittently to the site will provide relief of
instructions for this client? any discomfort. The nurse instructs the client to clean
"Apply ice to the site to prevent the site with the prescribed solution to prevent
swelling." secondary infection. A topical antibiotic also may be
"Clean the site with alcohol 3 times prescribed. Alcohol would cause irritation to the skin.
daily." There is no reason for the client to avoid showering or
"Apply a warm, damp washcloth if bathing.
discomfort occurs."
"Avoid showering or taking baths until
seen by the health care provider in 1
week."
The registered nurse is caring for the B
following clients. It would be a priority A client with uncontrolled Diabetes Mellitus would
for the nurse to initiate a require the greatest number of disciplines
multidisciplinary conference for the (multidisciplinary) to manage their care i.e. Medicine,
client who is Nursing, Social Work, Nutritionist; the other choices do
A.12 years old with Autism who is starting not require as many providers of care to meet their
a new school and recently had a URI needs.
(upper respiratory tract infection)
B.39 years old, has type 2 Diabetes
Mellitus, is homeless and had a recent
Hemoglobin A1c of 13%
C.52 years old, with Myasthenia Gravis,
recently prescribed Mestinon
(pyridostigmine) and is employed as a
mail carrier
D.79 years old, has bipolar and
schizophrenia, lives alone and reports
hearing non threatening voices.
, A client is scheduled to begin therapy D. Carbamazepine may be used to treat a seizure
with carbamazepine. The nurse should disorder. It can cause leukopenia, anemia,
assess the results of which test(s) before thrombocytopenia, and, very rarely, fatal aplastic
administering the first dose of this anemia. To reduce the risk of serious hematological
medication to the client? effects, a complete blood cell count should be done
Liver function tests before treatment and periodically thereafter. This
Renal function tests medication should be avoided in clients with preexisting
Pancreatic enzyme studies hematological abnormalities. The client also is told to
Complete blood cell count report the occurrence of fever, sore throat, pallor,
weakness, infection, easy bruising, and petechiae. The
results of the remaining tests listed in the options are not
associated with the use of this medication.
A client is admitted to a hospital with a C. Emergency management of DKA focuses on
diagnosis of diabetic ketoacidosis correcting fluid and electrolyte imbalances and
(DKA). The initial blood glucose level is normalizing the serum glucose level. If the corrections
950 mg/dL (54.2 mmol/L). A continuous occur too quickly, serious consequences, including
intravenous (IV) infusion of short-acting hypoglycemia and cerebral edema, can occur. During
insulin is initiated, along with IV management of DKA, when the blood glucose level
rehydration with normal saline. The falls to 250 to 300 mg/dL (14.2 to 17.1 mmol/L), the IV
serum glucose level is now decreased infusion rate is reduced and a dextrose solution is added
to 240 mg/dL (13.7 mmol/L). The nurse to maintain a blood glucose level of about 250 mg/dL
would next prepare to administer which (14.2 mmol/L), or until the client recovers from ketosis.
medication? Fifty percent dextrose is used to treat hypoglycemia.
An ampule of 50% dextrose NPH insulin is not used to treat DKA. Phenytoin is not a
NPH insulin subcutaneously usual treatment measure for DKA.
IV fluids containing dextrose
Phenytoin for the prevention of seizures
A client is being discharged from the 2; all others responses would indicate IICP and needs to
emergency department after an go to the ER
evaluation for a concussion. The nurse
reinforces teaching regarding follow-up
should the client develop
complications. Which of the following
complications, if listed by the client,
would require further instruction?
1.Vomiting
2.Minor headache
3.Difficulty speaking
4.Difficulty awakening
Solutions
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Terms in this set (61)
The nurse is monitoring a client in the B, During the fourth stage of labor, the maternal blood
immediate postpartum period for signs pressure, pulse, and respiration should be checked
of hemorrhage. Which sign, if noted, every 15 minutes during the first hour. An increasing
would be an early sign of excessive pulse is an early sign of excessive blood loss because
blood loss? the heart pumps faster to compensate for reduced
A .temperature of 100.4°F (38°C) blood volume. A slight increase in temperature is
B. An increase in the pulse rate from 88 normal. The blood pressure decreases as the blood
to 102 beats/minute volume diminishes, but a decreased blood pressure
C. A blood pressure change from 130/88 would not be the earliest sign of hemorrhage. The
to 124/80 mm Hg respiratory rate is slightly increased from normal.
D. An increase in the respiratory rate
from 18 to 22 breaths/minute
,The nurse in the ambulatory care unit is 3, Cryotherapy involves the local application of liquid
providing home care instructions to a nitrogen to the lesion; this causes cell death and tissue
client after cryotherapy for the treatment destruction. Tissue freezing is followed in 1 to 2 days by
of malignant skin lesions. Which hemorrhagic blister formation; therefore, ice is not
statement would be most appropriate applied to the site. The application of a warm, damp
for the nurse to include in the home care washcloth intermittently to the site will provide relief of
instructions for this client? any discomfort. The nurse instructs the client to clean
"Apply ice to the site to prevent the site with the prescribed solution to prevent
swelling." secondary infection. A topical antibiotic also may be
"Clean the site with alcohol 3 times prescribed. Alcohol would cause irritation to the skin.
daily." There is no reason for the client to avoid showering or
"Apply a warm, damp washcloth if bathing.
discomfort occurs."
"Avoid showering or taking baths until
seen by the health care provider in 1
week."
The registered nurse is caring for the B
following clients. It would be a priority A client with uncontrolled Diabetes Mellitus would
for the nurse to initiate a require the greatest number of disciplines
multidisciplinary conference for the (multidisciplinary) to manage their care i.e. Medicine,
client who is Nursing, Social Work, Nutritionist; the other choices do
A.12 years old with Autism who is starting not require as many providers of care to meet their
a new school and recently had a URI needs.
(upper respiratory tract infection)
B.39 years old, has type 2 Diabetes
Mellitus, is homeless and had a recent
Hemoglobin A1c of 13%
C.52 years old, with Myasthenia Gravis,
recently prescribed Mestinon
(pyridostigmine) and is employed as a
mail carrier
D.79 years old, has bipolar and
schizophrenia, lives alone and reports
hearing non threatening voices.
, A client is scheduled to begin therapy D. Carbamazepine may be used to treat a seizure
with carbamazepine. The nurse should disorder. It can cause leukopenia, anemia,
assess the results of which test(s) before thrombocytopenia, and, very rarely, fatal aplastic
administering the first dose of this anemia. To reduce the risk of serious hematological
medication to the client? effects, a complete blood cell count should be done
Liver function tests before treatment and periodically thereafter. This
Renal function tests medication should be avoided in clients with preexisting
Pancreatic enzyme studies hematological abnormalities. The client also is told to
Complete blood cell count report the occurrence of fever, sore throat, pallor,
weakness, infection, easy bruising, and petechiae. The
results of the remaining tests listed in the options are not
associated with the use of this medication.
A client is admitted to a hospital with a C. Emergency management of DKA focuses on
diagnosis of diabetic ketoacidosis correcting fluid and electrolyte imbalances and
(DKA). The initial blood glucose level is normalizing the serum glucose level. If the corrections
950 mg/dL (54.2 mmol/L). A continuous occur too quickly, serious consequences, including
intravenous (IV) infusion of short-acting hypoglycemia and cerebral edema, can occur. During
insulin is initiated, along with IV management of DKA, when the blood glucose level
rehydration with normal saline. The falls to 250 to 300 mg/dL (14.2 to 17.1 mmol/L), the IV
serum glucose level is now decreased infusion rate is reduced and a dextrose solution is added
to 240 mg/dL (13.7 mmol/L). The nurse to maintain a blood glucose level of about 250 mg/dL
would next prepare to administer which (14.2 mmol/L), or until the client recovers from ketosis.
medication? Fifty percent dextrose is used to treat hypoglycemia.
An ampule of 50% dextrose NPH insulin is not used to treat DKA. Phenytoin is not a
NPH insulin subcutaneously usual treatment measure for DKA.
IV fluids containing dextrose
Phenytoin for the prevention of seizures
A client is being discharged from the 2; all others responses would indicate IICP and needs to
emergency department after an go to the ER
evaluation for a concussion. The nurse
reinforces teaching regarding follow-up
should the client develop
complications. Which of the following
complications, if listed by the client,
would require further instruction?
1.Vomiting
2.Minor headache
3.Difficulty speaking
4.Difficulty awakening
