PNR 408 Review Questions With Certified Solutions

PNR 408 Review Questions With Certified Solutions the nurse who is caring for a client with kidney failure notes that the client is to dyspneic and crackles are heard when listening to the breath sounds in the lungs. Which additional signs and symptoms should the nurse expect to note in this client? an increase in blood pressure a nurse is reviewing the health records of an assigned client. The nurse should plan care knowing that which client is a risk for potassium deficiency? the client receiving nasogastric suction the nurse reviews a client's electrolyte results and those of potassium level of 5.5 mEq/L. the nurse understands that potassium values at this level would be noted with which condition? traumatic burn the nurse reviews a client's electrolyte results and knows that the potassium level is 5.4 mEq/L. what should the nurse look for on the cardiac monitor as a result of this laboratory value? narrow, peaked t-waves the nurse is reading the primary health care providers progress notes in the clients records and sees that the primary health care provider has documented insensible fluid loss approximately 800 ml daily. Which client is at risk for this loss? the client with a fast respiratory rate the nurse is reviewing the health records of assigned clients. The nurse should plan care knowing that which client is at risk for fluid volume deficit? the client with an ileostomy the nurse is caring for a client who has been taking diuretics on a long-term basis. Which finding should the nurse expect to note as a result of this long-term use? increase Pacific gravity of urine the nurse reviews electrolyte values and knows the sodium level of 130 mEq/L. the nurse expects that the sodium level would be noted in a client with which condition? a client with the syndrome of inappropriate secretion of antidiuretic hormones the nurse is caring for a client with leukaemia and notes that the client has poor skin turgor and a flat neck and hand veins. The nurse expects hyponatremia. Which additional signs and symptoms should the nurse expect to know in this client is hyponatremia is present? posterior blood pressure changes The nurse is admitting a client who has abdominal pain, nausea, and vomiting. A bowel obstruction is suspected. The nurse assesses this client for which of the following anticipated primary acid-base imbalances if the obstruction is high in the intestine? Metabolic alkalosis The nurse is caring for a client admitted with an exacerbation of asthma. After several treatments, the ABG results are pH 7.40, PaCO2 40 mm Hg, HCO3 24 mmol/L, PaO2 92 mm Hg, and O2 saturation 99%. Which of the following interpretations would the nurse document? Within normal limits The nurse is caring for a client admitted with a diagnosis of COPD who has the following arterial blood gas results: pH 7.33, PaO2 47 mm Hg, PaCO2 60 mm Hg, HCO3 32 mmol/L, and O2 saturation of 92%. Which of the following is the correct interpretation of these results? Partially compensated respiratory acidosis The nurse is caring for a client admitted with heart failure. The morning laboratory results reveal a serum potassium level of 2.9 mmol/L. Which of the following classifications of medications should the nurse withhold until consulting with the health care provider? Loop diuretics The nurse is caring for an older-adult client who is receiving IV fluids postoperatively. During the 0800 hour assessment of this client, the nurse notes that the IV solution, which was ordered to infuse at 125 mL/hour, has infused 950 mL since it was hung at 0400. Which of the following actions is the priority nursing intervention? Listen to the client's lung sounds and assess respiratory status. The nurse is assessing a client admitted with nausea and vomiting. Which of the following findings supports the nursing diagnosis of deficient fluid volume? General restlessness The nurse is caring for a client with dehydration. Which of the following actions should the nurse implement? Monitor daily weight, intake and output The nurse is planning care for a client with dehydration related to nausea and vomiting. Which of the following fluid shifts would the nurse anticipate in this client? Fluid movement from the interstitial spaces into the blood vessels The nurse is planning care for an adult client and concludes that which of the following oral intakes is adequate to meet daily fluid needs of a stable client? ml The nurse is caring for a client with metastatic bone cancer. Which of the following clinical manifestations would alert the nurse to the possibility of hypercalcemia in this client? Weakness The nurse is caring for a client admitted with diabetes mellitus, malnutrition, and a massive GI bleed. In analyzing the morning laboratory results, the nurse understands that a potassium level of 5.5 mEq/L could be caused by which of the following factors in this client? Hyperglycemia related to diabetes and stress of hospitalization. A nurse is caring for a client who has second- and third-degree burns to 50% of the body. The nurse prepares fluid resuscitation based on knowledge of the Parkland (Baxter) formula that includes which of the following recommendations? One half of the total 24-hour fluid requirement should be administered in the first 8 hours. Correct The nurse is caring for a client with superficial partial-thickness burns of the face sustained within the last 12 hours. Which of the following symptoms should the nurse expect to find? Reddening of the skin The nurse is caring for a client with partial- and full-thickness burns to 65% of the body and is planning nutritional interventions for this client. Which of the following dietary choices should the nurse implement? High calorie and high protein diet The nurse is caring for a client with an electrical burn injury. Which of the following health care provider orders should the nurse question? Lactate Ringer's at 25ml/hr The nurse is caring for a client with metastatic cancer and notes a hemoglobin level of 87 mmol/L and hematocrit of 26%. The nurse should place highest priority on initiating interventions that will reduce which of the following symptoms? Fatigue The nurse is caring for a client who is to receive a transfusion of two units of packed red blood cells. After obtaining the first unit from the blood bank, the nurse should ask which of the following health team members to assist in checking the unit before administration? Another Register Nurse Before starting a transfusion of packed red blood cells for an anemic client, the nurse should arrange for a peer to monitor his or her other assigned clients for how many minutes when the nurse begins the transfusion? 15 The nurse is preparing to administer an ordered blood transfusion to a client. Which of the following intravenous solutions should the nurse use when priming the blood tubing? 0.9% sodium chloride The nurse notes a health care provider's prescription written at 1000 hours for two units of packed red blood cells to be administered to a client who is anemic as a result of chronic blood loss. The nurse obtains the transfusion at 11:30 hours. Which of the following times is the latest time that the nurse should plan to begin the administration? 1200 The nurse receives a health care provider's prescription to transfuse fresh-frozen plasma to a client suffering from an acute blood loss. Which of the following procedures is best for infusing this blood product? Infuse the fresh frozen plasma as rapidly as the client will tolerate. Before beginning a transfusion of red blood cells (RBCs), which of the following actions by the nurse should be of highest priority to avoid an error during this procedure? Check the identifying information on the unit of blood against the client's ID bracelet. The blood bank notifies the nurse that the two units of blood ordered for a client who is anemic are ready for pickup. The nurse should take which of the following actions to prevent an adverse effect during this procedure? Infuse the blood slowly for the first 15 minutes of the transfusion. Which of the following clients is most likely to experience anemia with an etiology of increased destruction of red blood cells? A 32-year-old African man who has a diagnosis of sickle cell disease The nurse is caring for a client in acute septic shock. Which of the following actions should the nurse anticipate? Infusing large amounts of intravenous fluids The nurse is caring for a critically ill client who is being mechanically ventilated. Which of the following findings indicate that the client is experiencing multiple organ dysfunction syndrome (MODS)? Decreased respiratory compliance The nurse is caring for an older-adult client who has a massive gastrointestinal bleed that has resulted in hypovolemic shock. Which of the following nursing diagnoses is priority? Ineffective tissue perfusion Which of the following laboratory findings fits with a diagnosis of cardiogenic shock? Increased blood urea nitrogen (BUN) and creatinine levels The nurse is caring for a client who has a localized infection that has progressed to the point where septic shock is now suspected. Which of the following actions is appropriate for this client? Aggressive fluid resuscitation The nurse would recognize which of the following clinical manifestations as suggestive of sepsis? Hyperglycemia in the absence of diabetes The nurse is admitting a client with asthma who is in acute respiratory distress. The nurse auscultates the client's lungs and notes cessation of inspiratory wheezing. The client has not yet received any medication. What of the following explanations is most likely related to this clinical presentation? Airway constriction requiring intensive interventions The nurse is caring for a client who is admitted with a barbiturate overdose. The client is comatose with BP 90/60, apical pulse 110, and respiratory rate 8/minute. Based upon the initial assessment findings, the nurse recognizes that the client is at risk for which of the following types of respiratory failure? Hypercapnic respiratory failure related to alveolar hypoventilation The nurse is providing care for an older-adult client who is experiencing low partial pressure of oxygen in arterial blood (PaO2) as a result of worsening left-sided pneumonia. Which of the following interventions should the nurse use to help the client mobilize secretions? Augmented coughing or huff coughing The nurse is caring for a client who is experiencing acute respiratory distress syndrome (ARDS) as a result of sepsis. Which of the following measures would most likely be implemented to maintain cardiac output? Administer crystalloid fluids or colloid solutions For which of the following clients would noninvasive positive pressure ventilation (NIPPV) be an appropriate intervention to promote oxygenation? A client who is experiencing respiratory failure as a result of the progression of myasthenia gravis The nurse is aware of the value of using a mini-tracheostomy to facilitate suctioning when clients are unable to independently mobilize their secretions. For which of the following clients is the use of a mini-trach indicated? A client whose increased secretions are the result of community-acquired pneumonia The nurse is caring for a client admitted to the hospital with pneumonia. Upon assessment, the nurse notes a temperature of 38.6°C (101.5°F), a productive cough with yellow sputum, and a respiratory rate of 20 breaths/minute. Which of the following nursing diagnoses is most appropriate based upon this assessment? Hyperthermia r/t to infectious disease Which of the following physical assessment findings in a client with a lower respiratory problem best supports the nursing diagnosis of ineffective airway clearance? Basilar crackles The nurse is providing discharge teaching to an older-adult client with COPD and pneumonia. Which of the following vaccines should the nurse recommend that this client receive? Pneumococcal The nurse is admitting a client to the medical unit with a diagnosis of pneumonia. Which of the following prescriptions should the nurse verify has been completed before administering a dose of trimethoprim-sulfamethoxazole to the client? Sputum culture and sensitivity Which of the following nursing interventions is most appropriate to enhance oxygenation in a client with unilateral malignant lung disease? Positioning client with "good lung down" The nurse is admitting a client with acute respiratory distress related to cor pulmonale. Which of the following nursing interventions is most appropriate during admission of this client? Perform a physical assessment of the respiratory system and ask specific questions related to this episode of respiratory distress. The nurse is planning care for a client with metastatic lung cancer who has a 60-pack-per-year history of cigarette smoking. Which of the following respiratory defences is impaired related to tobacco use? Mucociliary clearance