, Neutrophil count- The patient is experiencing infection, so a nurse should review the
neutrophil count before contacting the HCP. - CORRECT ANSWERS -While caring for a
client with full thickness burns covering 40% of the body, the nurse observes purulent
drainage from the wounds. Before reporting the finding, what is the best lab value to
evaluate?
Demonstrate the use of visual scanning during meals to the client and family. -
CORRECT ANSWERS -An older woman who experienced a cerebrovascular accident
(CVA) has difficulty with visual perception and she only eats half of the food on her meal
tray. Her family expresses concern about her nutritional status. How should the nurse
respond to the family's concern?
High Fowler's Position- High fowlers helps to decrease venous return, which decreases
fluid volume in the heart that results in decreased cardiac workload. - CORRECT
ANSWERS -Best position for respiratory distress?
High risk for injury - CORRECT ANSWERS -A patient with peripheral artery disease has
marked peripheral neuropath. An appropriate nursing diagnosis for the patient is
Check feet every day for cuts or injuries. - CORRECT ANSWERS -Type 2 diabetes
patient discharge teaching patient and family
Institute Contact precautions for staff and visitors
Send wound drainage for culture and sensitivity
Monitor the clients WBC count - CORRECT ANSWERS -Plan of care for patient with
skin lesions of lower extremities with possible MRSA. SATA
Hematemesis- - Contact HCP if blood is visible in body fluids such as hematemesis. -
CORRECT ANSWERS -A patient with acute anterior wall MI 1 week ago is given low-
dose aspirin. The medication is related to which problem and HCP should be notified?
Elevated blood urea nitrogen (BUN) - CORRECT ANSWERS -For a patient with SLE
exacerbation what is the most important to report which assessment finding?
Rate of pain on a scale from 0-10. - CORRECT ANSWERS -Before selecting a
medication to administer, which action should the nurse implement in the post-op
patient who reports incisional pain and has 2 PRN analgesia available in MAR?
Keep patient NPO- Patient should be kept NPO until procedure is successfully
completed. The patient should not take anything by mouth. - CORRECT ANSWERS -
Patient had bariatric surgery 2 months ago who developed post-op strictures who is
experiencing nausea and vomiting and anorexia who is admitted for fluid resuscitation.
Which intervention should the nurse implement?
Vital sign changes and ECGs- Priority parameters are vital sign changes related to
hypovolemia and ECG changes due to serum electrolyte loss, which can be life
neutrophil count before contacting the HCP. - CORRECT ANSWERS -While caring for a
client with full thickness burns covering 40% of the body, the nurse observes purulent
drainage from the wounds. Before reporting the finding, what is the best lab value to
evaluate?
Demonstrate the use of visual scanning during meals to the client and family. -
CORRECT ANSWERS -An older woman who experienced a cerebrovascular accident
(CVA) has difficulty with visual perception and she only eats half of the food on her meal
tray. Her family expresses concern about her nutritional status. How should the nurse
respond to the family's concern?
High Fowler's Position- High fowlers helps to decrease venous return, which decreases
fluid volume in the heart that results in decreased cardiac workload. - CORRECT
ANSWERS -Best position for respiratory distress?
High risk for injury - CORRECT ANSWERS -A patient with peripheral artery disease has
marked peripheral neuropath. An appropriate nursing diagnosis for the patient is
Check feet every day for cuts or injuries. - CORRECT ANSWERS -Type 2 diabetes
patient discharge teaching patient and family
Institute Contact precautions for staff and visitors
Send wound drainage for culture and sensitivity
Monitor the clients WBC count - CORRECT ANSWERS -Plan of care for patient with
skin lesions of lower extremities with possible MRSA. SATA
Hematemesis- - Contact HCP if blood is visible in body fluids such as hematemesis. -
CORRECT ANSWERS -A patient with acute anterior wall MI 1 week ago is given low-
dose aspirin. The medication is related to which problem and HCP should be notified?
Elevated blood urea nitrogen (BUN) - CORRECT ANSWERS -For a patient with SLE
exacerbation what is the most important to report which assessment finding?
Rate of pain on a scale from 0-10. - CORRECT ANSWERS -Before selecting a
medication to administer, which action should the nurse implement in the post-op
patient who reports incisional pain and has 2 PRN analgesia available in MAR?
Keep patient NPO- Patient should be kept NPO until procedure is successfully
completed. The patient should not take anything by mouth. - CORRECT ANSWERS -
Patient had bariatric surgery 2 months ago who developed post-op strictures who is
experiencing nausea and vomiting and anorexia who is admitted for fluid resuscitation.
Which intervention should the nurse implement?
Vital sign changes and ECGs- Priority parameters are vital sign changes related to
hypovolemia and ECG changes due to serum electrolyte loss, which can be life
