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Exam (elaborations)

Rn Comprehensive Online Practice A 2023 With Ngn Exam ( Questions With Answers ) Highly Rated A+

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RN COMPREHENSIVE ONLINE PRACTICE A 2023 WITH NGN EXAM ( QUESTIONS WITH ANSWERS ) HIGHLY RATED A+

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RN COMPREHENSIVE ONLINE PRACTICE A 2023
WITH NGN EXAM ( QUESTIONS WITH
ANSWERS ) HIGHLY RATED A+


A nurse is caring for a 5-year-old child



Physical Examination:

1510:

Upon visual inspection, throat is inflamed, tonsils appear pink, reddened and epiglottis is edematous and
cherry red in appearance. Skin appears pale. Stridor noted upon inspiration with diminished bilateral
lung sounds.



Nurse's Notes:

1500

Child accompanied to emergency department by caregiver. Caregiver states child has a sore throat and
reports the child has "pain on swallowing" and denies cough. Child is agitated and lean - ANSWER
Condition: Epiglottis

Actions: Initiate droplet precautions and request a prescription for IV antibiotics

Monitors: Breath sounds and temperature



The nurse should anticipate initiating droplet precautions and requesting a prescription for IV antibiotics.
The child is most likely experiencing epiglottis because of the clinical manifestations of a high fever,
inflammation and redness of the throat, pale skin, stridor with inspiration, painful swallowing, no cough,
is sitting in tripod position, and drooling. The nurse should monitor the child's temperature and breath
sounds.



A nurse is caring for a client who is on the spinal cord injury (SCI) unit



Nurses' Notes

,Day 3, 1700

Client admitted to SCI unit 3 days ago following C7 injury. Skin is cool, pale, and dry to touch.
Respirations easy and unlabored. Lung sounds diminished in lower lobes. Abdomen soft and
nondistended with active bowel sounds. Client passed a small amount of hard formed stool this AM.
Indwelling urinary catheter draining clear yellow urine. Deep tendon reflexes (DTR) are biceps 1+, triceps
1+, pa - ANSWER The client is most likely experiencing manifestations of pneumonia and autonomic
dysreflexia.



The nurse should analyze cues from the client's manifestations and determine that the client is most
likely experiencing manifestations of pneumonia and autonomic dysreflexia. A client who has a cervical
SCI is at risk for respiratory complications because spinal innervation to the respiratory muscles is
disrupted. Adventitious breath sounds in the lower lobes bilaterally and a decrease in oxygen saturation
to less than 92% can indicate pneumonia. The client's sudden increase in blood pressure, bradycardia,
flushing of the skin above the area of the injury, headache, and blurred vision are manifestations of
autonomic dysreflexia, which can be a life-threatening condition.



A nurse is caring for a client who has abdominal pain



Nurses' Notes

0900

Client reports loss of appetite, weight loss, and fatigue for 1 week. Reports abdominal pain, 6 on a scale
from 0 to 10, for 2 days. Client is a perioperative nurse, returned 1 week ago from a 2-week mission trip
to an underdeveloped country



1200

Results of antibody studies obtained. Provider prescription for antiviral medication pending.



Physical Examination

0930

Lung sounds clear bilaterally. Skin warm to touch and jau - ANSWER Hepatitis A: Client's risk from fecal-
oral transmission, laboratory results, and physical examination findings



Hepatitis B: Antiviral treatment, laboratory results, client's risk from bloodborne transmission, physical
examination findings

,Hepatitis C: Antiviral treatment, laboratory results, client's risk from bloodborne transmission, and
physical examination findings



When analyzing cues, the nurse should recognize that manifestations of hepatitis A, hepatitis B, and
hepatitis C include jaundice, yellow sclerae, right upper quandrant pain upon palpation, dark yellow
urine, and elevated AST and ALT levels. When analyzing cues, the nurse should also recognize the client's
risk for contracting hepatitis A through the fecal-oral route during recent travel to an underdeveloped
country and the client's occupational risk as a perioperative nurse for contracting hepatitis B and
hepatitis C through bloodborne transmission. The nurse should recognize that the current standard of
practice for



A nurse is caring for a client on a medical-surgical unit



Vital Signs

0700

Temperature 37.6 C (99.7 F)

Heart rate 100/min

Respiratory rate 22/min

Blood pressure 115/70 mmHg

Oxygen saturation 98% on room air



Nurses' Notes

1100

Client alert and oriented to person, place, and time. Client had episode of diarrhea, provided perineal
care. Noted 2 cm x 2 cm (0.8 in x 0.8 in) painful edematous area on sacrum. Client repositioned every 4
hr. - ANSWER Click to highlight the findings that require follow up. To deselect a finding, click on the
finding again.

- Noted 2 cm x 2 cm (0.8 in x 0.8 in) painful edematous area on sacrum

- Client repositioned every 4 hr



When recognizing cues, the nurse should determine that the client's painful edematous area on their
sacrum and that the client has only been repositioned every 4 hr requires follow up. The client has

, manifestations of a pressure injury that need to be addressed. The client should be repositioned at least
every 2 hr to prevent worsening of the pressure injury and to relieve pressure from the sacral area.



A nurse in an outpatient mental health clinic is caring for a client



Vital Signs

3 months ago

Blood pressure 116/68 mmHg

Heart rate 82/min

Respiratory rate 16/min

Temperature 36.7 C (98.1 F)

SaO2 97% on room air



Today:

Blood pressure 128/76 mmHg

Heart rate 104/min

Respiratory rate 22/min

Temperature 37.4 (99.4 F)

SaO2 97% on room air



Nurses' Notes

3 months ago

Client recently admitted with new diagnosis of schizophrenia. Received inpatient treatment for 10 days
and was discharged 1 week ago. - ANSWER Select the 3 findings that require immediate follow up:

- Auditory hallucinations

- Speech

- Restlessness

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