lOMoAR cPSD| 24448587
RN VATI Adult Medical Surgical Predictor Exam 2019
With NGN
Question: 45 of 90
CORRECT
A nurse is preparing a teaching plan for a client who is starting to receive hemodialysis for
chronic kidney disease. Which of the following instructions should the nurse include in the
teaching?
"Use salt substitutes to reduce your sodium intake."
Salt substitutes can contain high amounts of potassium. The client should use herbs and spices
instead of salt or salt substitutes to decrease the risk for retention of sodium, potassium, and
fluids due to reduced kidney function.
"Increase your fluid intake to 1,000 mL a day."
Fluid restriction is common for clients who have chronic kidney disease. Most clients are
allowed 500 mL to 700 mL of fluid intake per day plus a volume equal to the amount of urine
excreted each day.
"Include phosphorus-rich foods in your diet."
A client who is starting hemodialysis needs an increased protein intake, which will also increase
phosphorus intake. Phosphorus restriction is necessary to prevent renal osteodystrophy.
"Increase your intake of protein to 1 to 1.5 grams per kilogram per day."
MY ANSWER
A client who receives hemodialysis for chronic kidney disease needs protein to prevent a
negative nitrogen balance and muscle wasting. A client who is receiving hemodialysis is
allowed 1 g to 1.5 g of protein/kg/day.
Question: 44 of 90
CORRECT
A nurse is caring for a client who has deep-vein thrombosis and is receiving heparin via
continuous IV infusion. The client's weight is 80 kg (176.4 lb). Using the client information
provided, which of the following actions should the nurse take? (Click on the "Exhibit" button
below for additional information about the client. There are three tabs that contain separate
categories of data.)
, EXHIBIT
Stop the heparin infusion for 1 hr.
MY ANSWER
According to the titration table, when the aPTT is greater than 95, the nurse should stop the
infusion for 1 hr, then restart the infusion with a decrease of 3 units/kg/hr, which is a decrease
of 240 units/hr for a client who weighs 80 kg (176.4 lb).
Increase the rate of the infusion by 160 units/hr.
An aPTT greater than 95 seconds is outside the expected reference range of 60 to 70 seconds.
Therefore, increasing the rate of the heparin infusion places the client at risk for hemorrhage.
The nurse should monitor for manifestations of bleeding.
Administer heparin 2,400 unit IV bolus.
An aPTT greater than 95 seconds is outside the expected reference range. Therefore,
administering heparin 2,400 unit IV bolus places the client at risk for hemorrhage. The nurse
should monitor for manifestations of bleeding.
Continue the infusion without change.
An aPTT greater than 95 seconds is outside the expected reference range. Therefore,
continuing the infusion at the current rate places the client at risk for hemorrhage. The nurse
should monitor for manifestations of bleeding.
Question: 43 of 90
CORRECT
A nurse is caring for a client who is intubated and receiving mechanical ventilation for heroin
toxicity. Which of the following assessments is the nurse's priority?
WBC count
The nurse should monitor the client's WBC count to check for infection. However, there is
another assessment that is the nurse's priority.
Intake and output
The nurse should monitor the client's intake and output to evaluate hydration status.
However, there is another assessment that is the nurse's priority.
ABGs
MY ANSWER
When using the airway, breathing, and circulation (ABC) approach to client care, the nurse's
priority assessment is to monitor the client's ABGs, including respiratory status.
Blood glucose level
, lOMoAR cPSD| 24448587
The nurse should monitor the client's blood glucose level to check for hypoglycemia or
hyperglycemia. However, there is another assessment that is the nurse's priority.
Question: 42 of 90
INCORRECT
A nurse is assessing a client who has a new diagnosis of pericarditis. Which of the following
findings should the nurse identify as a manifestation of cardiac tamponade?
Fever
Fever and an elevated WBC count are manifestations of bacterial pericarditis, not cardiac
tamponade.
Atrial fibrillation
MY ANSWER
Atrial fibrillation is a manifestation of acute pericarditis, not cardiac tamponade.
Paradoxical pulse
Cardiac tamponade results from an excess of fluid in the pericardial cavity and causes a sudden
drop in cardiac output. Paradoxical pulse is a systolic blood pressure of 10 mm Hg or more on
expiration and is a manifestation of cardiac tamponade. The nurse should report
manifestations of cardiac tamponade to the provider immediately. Pericardial friction rub
A pericardial friction rub is a scratchy, high-pitched sound resulting from inflamed pericardial
tissue and is a manifestation of acute pericarditis, not cardiac tamponade.
Question: 41 of 90
CORRECT • Time Remaining: 00:32:26
• Pause Remaining: 00:05:00
PAUSE
FLAG
A nurse is assessing a client who is undergoing radiation therapy for breast cancer. Which of
the following findings is an indication to the nurse that the client is experiencing an adverse
effect of the therapy?
, Stomatitis
Stomatitis is an adverse effect of chemotherapy. Stomatitis can occur with radiation of the
head and neck, but not radiation of the breast. A client who is receiving radiation therapy can
have an adverse effect of taste changes due to dead cell metabolism.
Vomiting
Vomiting is an adverse effect of chemotherapy and generally develops after radiation to the
abdomen and pelvis. Radiation therapy to the abdomen can also cause vomiting. Skin changes
MY ANSWER
A client who is receiving radiation therapy to the breast will have localized adverse effects of
the treatment, such as skin changes, esophagitis, and lymphedema.
Hematuria
Hematuria is an adverse effect of chemotherapy and generally develops after radiation to the
abdomen and pelvis, causing cystitis that can lead to bleeding.
Question: 40 of 90
CORRECT
A nurse is preparing to administer enoxaparin 0.75 mg/kg subcutaneously to a client who
weighs 154 lb. The amount available is enoxaparin 60 mg/0.6 mL. How many mL should the
nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do
not use a trailing zero.)
MY ANSWER mL
Follow these steps for the Ratio and Proportion method of calculation: Step 1:
What is the unit of measurement the nurse should calculate? kg Step 2: Set up
an equation and solve for X.
2.2 lb Client's weight in lb
=
1 kg X kg
2.2 lb 154 lb
= X kg = 70 kg
1 kg X kg Step 3: What is the unit of measurement the nurse should
RN VATI Adult Medical Surgical Predictor Exam 2019
With NGN
Question: 45 of 90
CORRECT
A nurse is preparing a teaching plan for a client who is starting to receive hemodialysis for
chronic kidney disease. Which of the following instructions should the nurse include in the
teaching?
"Use salt substitutes to reduce your sodium intake."
Salt substitutes can contain high amounts of potassium. The client should use herbs and spices
instead of salt or salt substitutes to decrease the risk for retention of sodium, potassium, and
fluids due to reduced kidney function.
"Increase your fluid intake to 1,000 mL a day."
Fluid restriction is common for clients who have chronic kidney disease. Most clients are
allowed 500 mL to 700 mL of fluid intake per day plus a volume equal to the amount of urine
excreted each day.
"Include phosphorus-rich foods in your diet."
A client who is starting hemodialysis needs an increased protein intake, which will also increase
phosphorus intake. Phosphorus restriction is necessary to prevent renal osteodystrophy.
"Increase your intake of protein to 1 to 1.5 grams per kilogram per day."
MY ANSWER
A client who receives hemodialysis for chronic kidney disease needs protein to prevent a
negative nitrogen balance and muscle wasting. A client who is receiving hemodialysis is
allowed 1 g to 1.5 g of protein/kg/day.
Question: 44 of 90
CORRECT
A nurse is caring for a client who has deep-vein thrombosis and is receiving heparin via
continuous IV infusion. The client's weight is 80 kg (176.4 lb). Using the client information
provided, which of the following actions should the nurse take? (Click on the "Exhibit" button
below for additional information about the client. There are three tabs that contain separate
categories of data.)
, EXHIBIT
Stop the heparin infusion for 1 hr.
MY ANSWER
According to the titration table, when the aPTT is greater than 95, the nurse should stop the
infusion for 1 hr, then restart the infusion with a decrease of 3 units/kg/hr, which is a decrease
of 240 units/hr for a client who weighs 80 kg (176.4 lb).
Increase the rate of the infusion by 160 units/hr.
An aPTT greater than 95 seconds is outside the expected reference range of 60 to 70 seconds.
Therefore, increasing the rate of the heparin infusion places the client at risk for hemorrhage.
The nurse should monitor for manifestations of bleeding.
Administer heparin 2,400 unit IV bolus.
An aPTT greater than 95 seconds is outside the expected reference range. Therefore,
administering heparin 2,400 unit IV bolus places the client at risk for hemorrhage. The nurse
should monitor for manifestations of bleeding.
Continue the infusion without change.
An aPTT greater than 95 seconds is outside the expected reference range. Therefore,
continuing the infusion at the current rate places the client at risk for hemorrhage. The nurse
should monitor for manifestations of bleeding.
Question: 43 of 90
CORRECT
A nurse is caring for a client who is intubated and receiving mechanical ventilation for heroin
toxicity. Which of the following assessments is the nurse's priority?
WBC count
The nurse should monitor the client's WBC count to check for infection. However, there is
another assessment that is the nurse's priority.
Intake and output
The nurse should monitor the client's intake and output to evaluate hydration status.
However, there is another assessment that is the nurse's priority.
ABGs
MY ANSWER
When using the airway, breathing, and circulation (ABC) approach to client care, the nurse's
priority assessment is to monitor the client's ABGs, including respiratory status.
Blood glucose level
, lOMoAR cPSD| 24448587
The nurse should monitor the client's blood glucose level to check for hypoglycemia or
hyperglycemia. However, there is another assessment that is the nurse's priority.
Question: 42 of 90
INCORRECT
A nurse is assessing a client who has a new diagnosis of pericarditis. Which of the following
findings should the nurse identify as a manifestation of cardiac tamponade?
Fever
Fever and an elevated WBC count are manifestations of bacterial pericarditis, not cardiac
tamponade.
Atrial fibrillation
MY ANSWER
Atrial fibrillation is a manifestation of acute pericarditis, not cardiac tamponade.
Paradoxical pulse
Cardiac tamponade results from an excess of fluid in the pericardial cavity and causes a sudden
drop in cardiac output. Paradoxical pulse is a systolic blood pressure of 10 mm Hg or more on
expiration and is a manifestation of cardiac tamponade. The nurse should report
manifestations of cardiac tamponade to the provider immediately. Pericardial friction rub
A pericardial friction rub is a scratchy, high-pitched sound resulting from inflamed pericardial
tissue and is a manifestation of acute pericarditis, not cardiac tamponade.
Question: 41 of 90
CORRECT • Time Remaining: 00:32:26
• Pause Remaining: 00:05:00
PAUSE
FLAG
A nurse is assessing a client who is undergoing radiation therapy for breast cancer. Which of
the following findings is an indication to the nurse that the client is experiencing an adverse
effect of the therapy?
, Stomatitis
Stomatitis is an adverse effect of chemotherapy. Stomatitis can occur with radiation of the
head and neck, but not radiation of the breast. A client who is receiving radiation therapy can
have an adverse effect of taste changes due to dead cell metabolism.
Vomiting
Vomiting is an adverse effect of chemotherapy and generally develops after radiation to the
abdomen and pelvis. Radiation therapy to the abdomen can also cause vomiting. Skin changes
MY ANSWER
A client who is receiving radiation therapy to the breast will have localized adverse effects of
the treatment, such as skin changes, esophagitis, and lymphedema.
Hematuria
Hematuria is an adverse effect of chemotherapy and generally develops after radiation to the
abdomen and pelvis, causing cystitis that can lead to bleeding.
Question: 40 of 90
CORRECT
A nurse is preparing to administer enoxaparin 0.75 mg/kg subcutaneously to a client who
weighs 154 lb. The amount available is enoxaparin 60 mg/0.6 mL. How many mL should the
nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do
not use a trailing zero.)
MY ANSWER mL
Follow these steps for the Ratio and Proportion method of calculation: Step 1:
What is the unit of measurement the nurse should calculate? kg Step 2: Set up
an equation and solve for X.
2.2 lb Client's weight in lb
=
1 kg X kg
2.2 lb 154 lb
= X kg = 70 kg
1 kg X kg Step 3: What is the unit of measurement the nurse should
