1
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Comprehensive exam 3 Questions and
Answers (100% Correct Answers) Already
Graded A+
A 38-year-old female client is admitted to the mental health unit
after a recent manic episode of spending large amounts of
money on new furniture, making excessive long-distance phone
calls, and not sleeping for three days. During the admission
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process, the client is wearing a green bathing suit. What
intervention should the nurse implement?—Ans: Assess the client's
needs for food, liquids, and rest.
During a group therapy session, a client with hypomania threatens
Guru01 - Stuvia
to strike another client. What intervention is best for the nurse to
implement?—Ans: Firmly inform the client that acting out anger is
not acceptable.
A client who is a laboratory technician and has a history of allergic
rhinitis, asthma, and multiple food allergies is scheduled for
surgery. Which action should the nurse implement?—Ans:
Document a possible Type I latex allergy.
In reviewing the medical record, the nurse notes that a client's last
eye examination revealed an IOP of 28 mmHg. What information
should the nurse ask the client?—Ans: Use of prescribed eye drops
since last exam by ophthalmologist.
Which action should the nurse implement to assess for JVD in a
client with HF?—Ans: Observe the vertical distention of the veins
as the client is gradually elevated to an upright position.
The nurse identifies a client's laboratory results and identifies an
elevated serum ammonia level. Which pathophysiological process
contributes to this finding?—Ans: Failure of the liver to convert
ammonia absorbed from the bowel to urea.
, 2
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A client with GERD is unconscious and unresponsive to stimuli. The
nurse places the client in a side-lying position. The nurse should
monitor for the risk of which complication?—Ans: Aspiration
pneumonia.
A client returns to the unit after abdominal Nissen fundoplication
for treatment of GERD. After 4 hours, the nurse determines the
client has no drainage from the NGT and has absent bowel
sounds. What action should the nurse implement?—Ans: Irrigate
the NGT with normal saline.
A male client who is admitted with a bleeding peptic ulcer
develops sudden, severe upper abdominal pain. The client
becomes diaphoretic and draws his knees over his abdomen.
© 2025 Assignment Expert
Which finding should the nurse report to the healthcare
provider?—Ans: A rigid, boardlike abdomen.
A client returns to the postoperative unit after a
Guru01 - Stuvia
gastroduodenostomy (Billroth I) for treatment of a perforated
ulcer. The healthcare provider's prescriptions include morphine
with a patient-controlled analgesia (PCA), nasogastric tube (NGT)
to low intermittent nasogastric suction, and IV fluids and
antibiotics. The client complains of increasing abdominal pain 12
hours after returning to the surgical unit. The nurse determines the
client has no bowel sounds, and 200 ml of bright red nasogastric
drainage is in the suction canister in the past hour. What is the
priority action the nurse should implement?—Ans: Notify HCP
A client returns from surgery after undergoing an abdominal-
perineal resection with a sigmoid colostomy. The colostomy is
dressed with petroleum jelly gauze and dry gauze dressings. The
perineal incision is partially closed with two drains attached to
Jackson-Pratt suction bulbs. During the early postoperative period,
the nurse should give the highest priority to which nursing
action?—Ans: Maintain dry perineal dressings
What information in a client's history indicates the highest risk
factor for hepatitis C?—Ans: Intravenous drug abuse
, 3
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A client with advanced cirrhosis and hepatic encephalopathy is
manifesting mounting ascites and 4+ pitting edema of the feet
and legs. The nurse identifies fluid leaking from his skin when he is
turned. Which intervention is most important for the nurse to
include in the client's plan of care?—Ans: Apply a pressure-
relieving mattress under the client.
A female client arrives at the clinic because her boyfriend
received the results of a Gram stain smear that revealed the
presence of Neisseria gonorrhoeae. The client tells the nurse that
she has not had any symptoms and almost did not come to the
clinic. What information should the nurse provide the client?—Ans:
Gonorrhea is often asymptomatic in women because the
© 2025 Assignment Expert
infection is not visible.
A client with an open reduction and application of an external
fixator for open, comminuted fractures of the tibia and fibula
Guru01 - Stuvia
begins to complain of severe pain in the affected leg, which is not
relieved by analgesics. The client says the toes are numb and
tingling, although they appear pink. What action should the nurse
implement?—Ans: Notify HCP
A client is comatose upon arrival to the emergency department
after falling from a roof. The client flexes with painful stimuli, and
the nurse determines the client's Glasgow Coma Scale (GCS) is 6.
Which intervention should the nurse prepare to implement to
maintain the client's airway?—Ans: A nasopharyngeal tube.
The nurse is evaluating the external fetal monitor and identifies
variable fetal heart rate (FHR) decelerations. The nurse recognizes
that this change in the FHR pattern is due to which
pathophysiological incident?—Ans: Umbilical cord compression
Which FHR finding should the nurse report to the HCP
immediately?—Ans: Late decelerations
A mother brings her 4-week-old infant for the first well-child visit
and tells the nurse that the baby is not smiling. Which information
should the nurse provide?—Ans: Social smiling begins at
approximately 2 months of age
For Expert help and assignment solutions, +254707240657
Comprehensive exam 3 Questions and
Answers (100% Correct Answers) Already
Graded A+
A 38-year-old female client is admitted to the mental health unit
after a recent manic episode of spending large amounts of
money on new furniture, making excessive long-distance phone
calls, and not sleeping for three days. During the admission
© 2025 Assignment Expert
process, the client is wearing a green bathing suit. What
intervention should the nurse implement?—Ans: Assess the client's
needs for food, liquids, and rest.
During a group therapy session, a client with hypomania threatens
Guru01 - Stuvia
to strike another client. What intervention is best for the nurse to
implement?—Ans: Firmly inform the client that acting out anger is
not acceptable.
A client who is a laboratory technician and has a history of allergic
rhinitis, asthma, and multiple food allergies is scheduled for
surgery. Which action should the nurse implement?—Ans:
Document a possible Type I latex allergy.
In reviewing the medical record, the nurse notes that a client's last
eye examination revealed an IOP of 28 mmHg. What information
should the nurse ask the client?—Ans: Use of prescribed eye drops
since last exam by ophthalmologist.
Which action should the nurse implement to assess for JVD in a
client with HF?—Ans: Observe the vertical distention of the veins
as the client is gradually elevated to an upright position.
The nurse identifies a client's laboratory results and identifies an
elevated serum ammonia level. Which pathophysiological process
contributes to this finding?—Ans: Failure of the liver to convert
ammonia absorbed from the bowel to urea.
, 2
For Expert help and assignment solutions, +254707240657
A client with GERD is unconscious and unresponsive to stimuli. The
nurse places the client in a side-lying position. The nurse should
monitor for the risk of which complication?—Ans: Aspiration
pneumonia.
A client returns to the unit after abdominal Nissen fundoplication
for treatment of GERD. After 4 hours, the nurse determines the
client has no drainage from the NGT and has absent bowel
sounds. What action should the nurse implement?—Ans: Irrigate
the NGT with normal saline.
A male client who is admitted with a bleeding peptic ulcer
develops sudden, severe upper abdominal pain. The client
becomes diaphoretic and draws his knees over his abdomen.
© 2025 Assignment Expert
Which finding should the nurse report to the healthcare
provider?—Ans: A rigid, boardlike abdomen.
A client returns to the postoperative unit after a
Guru01 - Stuvia
gastroduodenostomy (Billroth I) for treatment of a perforated
ulcer. The healthcare provider's prescriptions include morphine
with a patient-controlled analgesia (PCA), nasogastric tube (NGT)
to low intermittent nasogastric suction, and IV fluids and
antibiotics. The client complains of increasing abdominal pain 12
hours after returning to the surgical unit. The nurse determines the
client has no bowel sounds, and 200 ml of bright red nasogastric
drainage is in the suction canister in the past hour. What is the
priority action the nurse should implement?—Ans: Notify HCP
A client returns from surgery after undergoing an abdominal-
perineal resection with a sigmoid colostomy. The colostomy is
dressed with petroleum jelly gauze and dry gauze dressings. The
perineal incision is partially closed with two drains attached to
Jackson-Pratt suction bulbs. During the early postoperative period,
the nurse should give the highest priority to which nursing
action?—Ans: Maintain dry perineal dressings
What information in a client's history indicates the highest risk
factor for hepatitis C?—Ans: Intravenous drug abuse
, 3
For Expert help and assignment solutions, +254707240657
A client with advanced cirrhosis and hepatic encephalopathy is
manifesting mounting ascites and 4+ pitting edema of the feet
and legs. The nurse identifies fluid leaking from his skin when he is
turned. Which intervention is most important for the nurse to
include in the client's plan of care?—Ans: Apply a pressure-
relieving mattress under the client.
A female client arrives at the clinic because her boyfriend
received the results of a Gram stain smear that revealed the
presence of Neisseria gonorrhoeae. The client tells the nurse that
she has not had any symptoms and almost did not come to the
clinic. What information should the nurse provide the client?—Ans:
Gonorrhea is often asymptomatic in women because the
© 2025 Assignment Expert
infection is not visible.
A client with an open reduction and application of an external
fixator for open, comminuted fractures of the tibia and fibula
Guru01 - Stuvia
begins to complain of severe pain in the affected leg, which is not
relieved by analgesics. The client says the toes are numb and
tingling, although they appear pink. What action should the nurse
implement?—Ans: Notify HCP
A client is comatose upon arrival to the emergency department
after falling from a roof. The client flexes with painful stimuli, and
the nurse determines the client's Glasgow Coma Scale (GCS) is 6.
Which intervention should the nurse prepare to implement to
maintain the client's airway?—Ans: A nasopharyngeal tube.
The nurse is evaluating the external fetal monitor and identifies
variable fetal heart rate (FHR) decelerations. The nurse recognizes
that this change in the FHR pattern is due to which
pathophysiological incident?—Ans: Umbilical cord compression
Which FHR finding should the nurse report to the HCP
immediately?—Ans: Late decelerations
A mother brings her 4-week-old infant for the first well-child visit
and tells the nurse that the baby is not smiling. Which information
should the nurse provide?—Ans: Social smiling begins at
approximately 2 months of age
