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Exam (elaborations)

RN Comprehensive Online Practice 2019 B

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1. A nurse is assessing a client who received 2 units of packed RBCs 48 hr ago. Which of the following findings should indicate to the nurse that the therapy has been effective? a. Hemoglobin 14.9 g/dl b. WBC count 12000/mm3 c. Potassium 4.8 mEq/L d. BUN 18 mg/dl 2. A nurse working in an emergency department is triaging four clients. Which of the following clients should the nurse recommend for treatment first? a. An older adult client who reports constipation of 4 days. b. A preschooler who has a skin rash. c. An adolescent who has a closed fracture d. A middle adult client who has unstable vital signs. 3. A nurse is caring for a client who has fluid volume overload. Which of the following tasks should the nurse delegate to an assistive personnel (AP) a. Palpate the degree of edema b. Regulate IV pump fluid rate. c. Measure the client’s daily weight. d. Assess the client’s vital sign. 4. A nurse is preparing to administer mannitol 0.2 g/kg IV bolus over 5 min as a test dose to a client who has severe oliguria. The client weights 198 lb. What is the amount in grams the nurse should administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) a. 18 G 5. A nurse is conducting a physical examination for an adolescent and is assessing the range of motion of the legs. Which of the following images indicates the adolescent is abducting the hip joint? e. La foto que está parado de frente y pies separados uno del otro hacia afuera. The image, on the adolescent is abducting the hip joint by moving the leg away from the midline of the body. 6. A nurse is caring for a client who has hyperthyroidism. Which of the following findings should the nurse expect? a. Dry, coarse hair b. Bradycardia c. Tremors d. Periorbital edema 7. A nurse is assessing a school-age child who has bacterial meningitis. Which of the following findings should the nurse expect? a. Nuchal rigidity b. Weight gain c. Tinnitus d. Positive Trendelenburg sign. 8. A nurse is assessing a newborn’s heart rate. Which of the following actions should the nurse take? a. Assess the apical pulse is most accurate when the newborn is in a quiet state. The sound of crying obscures the heart sounds. b. Palpate the radial pulse for 30 seconds. c. Listen to the apical pulse while palpating the radial pulse. d. Auscultate the apical pulse at least 1 min. 9. A nurse is preparing to assist with a thoracentesis for a client who has pleurisy. The nurse should plan to perform which of the following actions? a. Administer a bowel preparation the night before the procedure. b. Place the client on bed rest for 24 hr after the procedure. c. Perform pulmonary function tests following the procedure. d. Instruct the client to avoid coughing during the procedure. 10. A nurse in the emergency department is assessing a preschooler who has a facial laceration. The nurse should identify which of the following findings as a potential indication of child sexual abuse? a. A child exhibits discomfort while walking. b. The child has thin extremities. c. The child has bruises on the upper back. d. The child is wearing a stained shirt. 11. A nurse is preparing to teach about dietary management to a client who has Crohn’s disease and an enteroenteric fistula. Which of the following nutrients should the nurse instruct the client to decrease in their diet? a. Calories b. Protein c. Potassium d. Fiber. 12. A nurse is caring for a client who has a prescription for a continuous passive motion (CPM) machine following a total knee arthroplasty. Which of the following actions should the nurse take? a. Turn off the CPM machine during mealtime. b. Maintain the client’s affected hip in an externally rotated position. c. Instruct the client how to adjust the CPM setting for comfort. d. Store the CPM machine under the client’s bed when not in use. 13. A nurse is preparing to initiate IV access for an older adult client. Which of the following sites should the nurse select when initiating the IV for this client? a. Radial vein of the inner arm. b. Great saphenous vein of the leg. c. Dorsal plexus vein of the foot. d. Basilic vein of the hand. 14. A nurse is developing a client education program about osteoporosis for older adult clients. The nurse should include which of the following variables as a risk factor for osteoporosis? a. Obesity b. Acromegaly c. Estrogen replacement therapy. d. Sedentary lifestyle. 15. A nurse in an emergency department is caring for a child who has a fever and fluid-filled vesicles on the trunk and extremities. Which of the following interventions should the nurse identify as the priority? a. Encourage oral fluids. b. Apply topical calamine lotion c. Administer acetaminophen as an antipyretic. d. Initiate transmission-based precautions.

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