CASAL II High Stakes Study Guide with
Complete Solutions
A 50-year-old client tells the nurse, "I have labored breathing and chest pain while doing
vigorous physical activities, but feel comfortable at rest." Which stage does the client fall
under according to the New York Heart Association's classification of functional status?
- ANSWER-Stage III
A client diagnosed with myasthenia gravis is prescribed neostigmine. Which side effects
are likely to be observed? Select all that apply. - ANSWER-3.
Bradycardia
4.
Muscle twitches
5.
Stomach cramps
A client dies post-surgery due to cardiac failure. What step should the nurse adhere to
when providing post-mortem care? - ANSWER-Treat the body with respect, and
incorporate any applicable religious or cultural practices.
A client has developed a sudden high fever and has clear respiratory secretions. Which
infection does this likely indicate? - ANSWER-Viral influenza viral
A client has impairment of lower extremity function and poor trunk control. Which part of
the spinal cord is the client most likely to have injured? - ANSWER-Thoracic region
A client has undergone a thymectomy after detection of myasthenia gravis (MG). The
symptoms did not subside after the surgery. Which drug will be most beneficial for the
client? - ANSWER-Cyclosporine
A client has unilateral weakness and upper extremity tremors. Which stage of
Parkinson's disease does this indicate? - ANSWER-Initial stage
A client in the active dying phase has been admitted to the palliative care unit. What is
the nurse's most important course of action when dealing with the caregivers? -
ANSWER-The nurse should educate the client's family members about the signs and
symptoms of dying.
A client involved in an auto accident has severe spinal cord injuries. If the client is
having difficulty with diaphragmatic breathing, which level of the spinal cord is injured? -
ANSWER-C6 to C7
,A client is admitted to the palliative care unit after having an unsuccessful kidney
transplant surgery. The nurse in charge is educating the caregivers about appropriate
symptom management. Which statement made by the nurse is accurate? -
ANSWER-"Surround the client with familiar sights, sounds and smells, in case delirium
occurs."
A client is admitted to the palliative care unit after undergoing multiple bowel resection
surgeries. The client tells the nurse, "I wish to speak to a priest as my soul needs
cleansing." Which statement made by the nurse in answer to the client's request needs
correction? - ANSWER-"A priest does not provide scientific solutions to health
problems."
A client is diagnosed with a tumor in the left inferior frontal lobe (Broca's Area). Which
symptom is the client likely to exhibit? - ANSWER-Difficulty with speech
A client is diagnosed with myasthenia gravis (MG). The client also has paralytic ileus
and is unable to take oral medication. Which drug is most likely to benefit the client? -
ANSWER-Neostigmine
A client is known to have risk factors for heart failure. Diagnostic testing reveals the
absence of left ventricular involvement. In which stage of heart failure development,
according to the American Heart Association (AHA), is the client? - ANSWER-Stage A
A client reporting chest tightness and an inability to talk in full sentences arrives at the
hospital. On assessment, the nurse finds increased pulse rate and blood pressure.
Which is the most beneficial diagnostic test to further evaluate and diagnose the client's
condition? - ANSWER-Forced expiratory volume
A client reporting chest tightness arrives at the hospital. On assessment, the client is
confirmed as having acute exacerbations of asthma. Which drug class is most effective
for this client? - ANSWER-Short-acting beta-2 adrenergic agonists
A client reporting shortness of breath arrived at the hospital. On assessment the nurse
observes progressive shortness of breath with exertion. What is the grade of severity
based on the Global Initiative for Obstructive Lung Disease (GOLD)? - ANSWER-GOLD
II
A client reports a sharp, throbbing, and shock-like pain after brushing the teeth, smiling,
or talking. Which drug is the most appropriate as first-line therapy? - ANSWER-
Carbamazepine
A client reports inability to see objects placed at a distance. Which condition does the
client most likely have? - ANSWER-Myopia
A client reports numbness, pain, weakness in the lower extremities, and an inability to
control motor movement. The primary health-care provider prescribes gabapentin and
,tramadol. What should be the outcome of this intervention? - ANSWER-Decreased
lower-back pain
A client taking a daily dose of ibuprofen reports a severe headache every day. Which
intervention is most likely to help in relieving the client's condition? - ANSWER-
Encouraging the client to discontinue use of ibuprofen
A client who arrived at the health-care facility reports sticky discharge from the eyes and
the sensation of a foreign body in the eyes. Which condition does the client most likely
have? - ANSWER-Chlamydial conjunctivitis
A client who needs surgery is asked to sign an informed consent. What are the
requirements for an informed consent? Select All That Apply. - ANSWER-1.
The client must be mentally competent to give consent for medical procedures.
2.
The client must be aware of the risks associated with the procedure.
3.
The information is delivered to the client in a language that is understood by the client.
4.
The client must be provided with an opportunity to ask questions.
A client with a body temperature of 102°F reports headaches, sensitivity to light and
sound, and neck stiffness but denies vomiting and stomach upset. With which condition
do these symptoms most likely correspond? - ANSWER-Encephalitis
A client with a history of asthma arrives at the hospital with symptoms of chest
tightness, wheezing, dry cough, shortness of breath, and severe respiratory distress.
The client is unresponsive to bronchodilators. Which is beneficial in determining the
severity of respiratory distress in this client? Select all that apply. - ANSWER-2.
Pulse oximetry
3.
Arterial blood gases
5.
Peak expiratory flow readings
A client with a severe cough and decreased appetite arrived at the hospital. On
assessment, the nurse finds the anterior-posterior diameter as 2:2. What is the most
likely condition of the client? - ANSWER-Chronic obstructive pulmonary disease
(COPD)
, A client with acute rhinosinusitis has developed rhinitis medicamentosa after receiving a
medication for 7 days. Which is the most appropriate nursing action in this situation? -
ANSWER-Administering a nasal corticosteroid
A client with allergic rhinitis reports sneezing, running nose, and severe itching of the
skin. Which class of medication can be used to effectively treat these symptoms in the
client? - ANSWER-Antihistamines
A client with Parkinson's disease is on medication. During the follow-up visit, the client
reports blurred vision, confusion, and urinary retention. Which medication is most likely
to be responsible for the client's condition? - ANSWER-Benztropine
A client's larynx is removed surgically. Which clinical condition is most likely to be
observed in the client? - ANSWER-Impaired verbal communication
A medical-surgical nurse is a member of the interprofessional care team (ICT) caring for
a client. What is the purpose of this team? - ANSWER-To provide efficient and cost-
effective client care
A nurse is assessing a client who has had a kidney transplant. Which would be the
minimum induration after a purified protein derivative (PPD) test to be considered a
positive reaction? - ANSWER-7 mm
A nurse is attending to the caregivers of a client in the palliative care unit who has just
died. The nurse notes that the client belongs to a different culture than he or she. Which
statements made by the nurse conform to the appropriate method of communicating
with the client's caregivers? Select all that apply. - ANSWER-1.
"Please tell me about your funeral practices."
2.
"Would you like to share anything about the process of grieving in your community?"
3.
"Tell me about the way in which suffering is dealt with in your community."
A nurse is caring for a client receiving palliative care. What course of action should the
nurse take in case the client is incapable of making decisions? - ANSWER-Determine
the client's surrogate decision-maker.
A nurse is caring for a client who has severe influenza. Which action is most appropriate
for the nurse to take? - ANSWER-The nurse should administer antipyretics to the client.
A nurse is checking the preoperative laboratory assessment of a female client who is
scheduled for a surgery that day. The results are: The perioperative laboratory
assessment of a 30-year-old female client is hemoglobin: 10.6 g/dL; hematocrit: 39%;
Complete Solutions
A 50-year-old client tells the nurse, "I have labored breathing and chest pain while doing
vigorous physical activities, but feel comfortable at rest." Which stage does the client fall
under according to the New York Heart Association's classification of functional status?
- ANSWER-Stage III
A client diagnosed with myasthenia gravis is prescribed neostigmine. Which side effects
are likely to be observed? Select all that apply. - ANSWER-3.
Bradycardia
4.
Muscle twitches
5.
Stomach cramps
A client dies post-surgery due to cardiac failure. What step should the nurse adhere to
when providing post-mortem care? - ANSWER-Treat the body with respect, and
incorporate any applicable religious or cultural practices.
A client has developed a sudden high fever and has clear respiratory secretions. Which
infection does this likely indicate? - ANSWER-Viral influenza viral
A client has impairment of lower extremity function and poor trunk control. Which part of
the spinal cord is the client most likely to have injured? - ANSWER-Thoracic region
A client has undergone a thymectomy after detection of myasthenia gravis (MG). The
symptoms did not subside after the surgery. Which drug will be most beneficial for the
client? - ANSWER-Cyclosporine
A client has unilateral weakness and upper extremity tremors. Which stage of
Parkinson's disease does this indicate? - ANSWER-Initial stage
A client in the active dying phase has been admitted to the palliative care unit. What is
the nurse's most important course of action when dealing with the caregivers? -
ANSWER-The nurse should educate the client's family members about the signs and
symptoms of dying.
A client involved in an auto accident has severe spinal cord injuries. If the client is
having difficulty with diaphragmatic breathing, which level of the spinal cord is injured? -
ANSWER-C6 to C7
,A client is admitted to the palliative care unit after having an unsuccessful kidney
transplant surgery. The nurse in charge is educating the caregivers about appropriate
symptom management. Which statement made by the nurse is accurate? -
ANSWER-"Surround the client with familiar sights, sounds and smells, in case delirium
occurs."
A client is admitted to the palliative care unit after undergoing multiple bowel resection
surgeries. The client tells the nurse, "I wish to speak to a priest as my soul needs
cleansing." Which statement made by the nurse in answer to the client's request needs
correction? - ANSWER-"A priest does not provide scientific solutions to health
problems."
A client is diagnosed with a tumor in the left inferior frontal lobe (Broca's Area). Which
symptom is the client likely to exhibit? - ANSWER-Difficulty with speech
A client is diagnosed with myasthenia gravis (MG). The client also has paralytic ileus
and is unable to take oral medication. Which drug is most likely to benefit the client? -
ANSWER-Neostigmine
A client is known to have risk factors for heart failure. Diagnostic testing reveals the
absence of left ventricular involvement. In which stage of heart failure development,
according to the American Heart Association (AHA), is the client? - ANSWER-Stage A
A client reporting chest tightness and an inability to talk in full sentences arrives at the
hospital. On assessment, the nurse finds increased pulse rate and blood pressure.
Which is the most beneficial diagnostic test to further evaluate and diagnose the client's
condition? - ANSWER-Forced expiratory volume
A client reporting chest tightness arrives at the hospital. On assessment, the client is
confirmed as having acute exacerbations of asthma. Which drug class is most effective
for this client? - ANSWER-Short-acting beta-2 adrenergic agonists
A client reporting shortness of breath arrived at the hospital. On assessment the nurse
observes progressive shortness of breath with exertion. What is the grade of severity
based on the Global Initiative for Obstructive Lung Disease (GOLD)? - ANSWER-GOLD
II
A client reports a sharp, throbbing, and shock-like pain after brushing the teeth, smiling,
or talking. Which drug is the most appropriate as first-line therapy? - ANSWER-
Carbamazepine
A client reports inability to see objects placed at a distance. Which condition does the
client most likely have? - ANSWER-Myopia
A client reports numbness, pain, weakness in the lower extremities, and an inability to
control motor movement. The primary health-care provider prescribes gabapentin and
,tramadol. What should be the outcome of this intervention? - ANSWER-Decreased
lower-back pain
A client taking a daily dose of ibuprofen reports a severe headache every day. Which
intervention is most likely to help in relieving the client's condition? - ANSWER-
Encouraging the client to discontinue use of ibuprofen
A client who arrived at the health-care facility reports sticky discharge from the eyes and
the sensation of a foreign body in the eyes. Which condition does the client most likely
have? - ANSWER-Chlamydial conjunctivitis
A client who needs surgery is asked to sign an informed consent. What are the
requirements for an informed consent? Select All That Apply. - ANSWER-1.
The client must be mentally competent to give consent for medical procedures.
2.
The client must be aware of the risks associated with the procedure.
3.
The information is delivered to the client in a language that is understood by the client.
4.
The client must be provided with an opportunity to ask questions.
A client with a body temperature of 102°F reports headaches, sensitivity to light and
sound, and neck stiffness but denies vomiting and stomach upset. With which condition
do these symptoms most likely correspond? - ANSWER-Encephalitis
A client with a history of asthma arrives at the hospital with symptoms of chest
tightness, wheezing, dry cough, shortness of breath, and severe respiratory distress.
The client is unresponsive to bronchodilators. Which is beneficial in determining the
severity of respiratory distress in this client? Select all that apply. - ANSWER-2.
Pulse oximetry
3.
Arterial blood gases
5.
Peak expiratory flow readings
A client with a severe cough and decreased appetite arrived at the hospital. On
assessment, the nurse finds the anterior-posterior diameter as 2:2. What is the most
likely condition of the client? - ANSWER-Chronic obstructive pulmonary disease
(COPD)
, A client with acute rhinosinusitis has developed rhinitis medicamentosa after receiving a
medication for 7 days. Which is the most appropriate nursing action in this situation? -
ANSWER-Administering a nasal corticosteroid
A client with allergic rhinitis reports sneezing, running nose, and severe itching of the
skin. Which class of medication can be used to effectively treat these symptoms in the
client? - ANSWER-Antihistamines
A client with Parkinson's disease is on medication. During the follow-up visit, the client
reports blurred vision, confusion, and urinary retention. Which medication is most likely
to be responsible for the client's condition? - ANSWER-Benztropine
A client's larynx is removed surgically. Which clinical condition is most likely to be
observed in the client? - ANSWER-Impaired verbal communication
A medical-surgical nurse is a member of the interprofessional care team (ICT) caring for
a client. What is the purpose of this team? - ANSWER-To provide efficient and cost-
effective client care
A nurse is assessing a client who has had a kidney transplant. Which would be the
minimum induration after a purified protein derivative (PPD) test to be considered a
positive reaction? - ANSWER-7 mm
A nurse is attending to the caregivers of a client in the palliative care unit who has just
died. The nurse notes that the client belongs to a different culture than he or she. Which
statements made by the nurse conform to the appropriate method of communicating
with the client's caregivers? Select all that apply. - ANSWER-1.
"Please tell me about your funeral practices."
2.
"Would you like to share anything about the process of grieving in your community?"
3.
"Tell me about the way in which suffering is dealt with in your community."
A nurse is caring for a client receiving palliative care. What course of action should the
nurse take in case the client is incapable of making decisions? - ANSWER-Determine
the client's surrogate decision-maker.
A nurse is caring for a client who has severe influenza. Which action is most appropriate
for the nurse to take? - ANSWER-The nurse should administer antipyretics to the client.
A nurse is checking the preoperative laboratory assessment of a female client who is
scheduled for a surgery that day. The results are: The perioperative laboratory
assessment of a 30-year-old female client is hemoglobin: 10.6 g/dL; hematocrit: 39%;
