N432 Test 2; Priority Questions with
complete solutions
The nurse is caring for clients on a medical unit. Which client should the nurse assess first?
a. the client diagnosed with COPD who has a pulse oximeter reading of 93%
b. the client diagnosed with CHF who has bilateral 4+ peripheral edema
c. the client diagnosed with pneumonia who has a temperature of 100 degrees F
d. the client diagnosed the Guillian-Barre syndrome who is unable to feel the hips - correct
answer ✔✔ d
Which medication should the nurse administer first after receiving the morning shift report?
a. the IVPB antibiotic to the client admitted at 0530 this morning
b. the sliding scale short-acting insulin to the client with diabetes
c. the non-narcotic pain medication to a client with a headache
d. the proton-pump inhibitor to the client with a peptic ulcer - correct answer ✔✔ a
The nurse in a critical care unit is administering medications to a client. Which intervention
should the nurse implement first?
a. check the radial pulse before administering digoxin, a cardiac glycoside
b. monitor the oxygen saturation before administering the bronchodilator
c. obtain the latest PTT results on the client with a heparin drip
d. administer the mucosal barrier agent to the client who is NPO - correct answer ✔✔ c
, The surgical nurse is admitting a client to the operating room. Which information would require
the nurse to call a time-out?
a. the client is drowsy from the preoperative medication and drifts off to sleep
b. the consent form lists a left knee, but the client tells the nurse it is the right knee
c. the surgical technician cannot find the surgeon's preferred surgical tray
d. the client states his or her name and birth date as it appears in the client - correct answer
✔✔ b
The nurse is administering medications at 1800 to a client and uses the following medication
administration record (MAR). Which interventions should the nurse implement first?
a. assess the client's potassium and digoxin levels
b. monitor the client's partial thromboplastin level
c. check the client's international normalized ratio (INR)
d. verify the client's name and identification (ID) number with the MAR - correct answer ✔✔ c
The nurse is administering medications to clients on a medical unit. Which medications should
the nurse question administering?
a. the steroid, prednisone, to the client diagnosed with COPD
b. the anticoagulant, enoxaprin (Lovenox), to a client who had knee surgery
c. the antiplatelet, ticlopidine (Ticlid), to a client being prepared for surgery
d. the ACE inhibitor, captopril (Capoten), to a client who has a blood pressure (BP) of 100/68 -
correct answer ✔✔ c
complete solutions
The nurse is caring for clients on a medical unit. Which client should the nurse assess first?
a. the client diagnosed with COPD who has a pulse oximeter reading of 93%
b. the client diagnosed with CHF who has bilateral 4+ peripheral edema
c. the client diagnosed with pneumonia who has a temperature of 100 degrees F
d. the client diagnosed the Guillian-Barre syndrome who is unable to feel the hips - correct
answer ✔✔ d
Which medication should the nurse administer first after receiving the morning shift report?
a. the IVPB antibiotic to the client admitted at 0530 this morning
b. the sliding scale short-acting insulin to the client with diabetes
c. the non-narcotic pain medication to a client with a headache
d. the proton-pump inhibitor to the client with a peptic ulcer - correct answer ✔✔ a
The nurse in a critical care unit is administering medications to a client. Which intervention
should the nurse implement first?
a. check the radial pulse before administering digoxin, a cardiac glycoside
b. monitor the oxygen saturation before administering the bronchodilator
c. obtain the latest PTT results on the client with a heparin drip
d. administer the mucosal barrier agent to the client who is NPO - correct answer ✔✔ c
, The surgical nurse is admitting a client to the operating room. Which information would require
the nurse to call a time-out?
a. the client is drowsy from the preoperative medication and drifts off to sleep
b. the consent form lists a left knee, but the client tells the nurse it is the right knee
c. the surgical technician cannot find the surgeon's preferred surgical tray
d. the client states his or her name and birth date as it appears in the client - correct answer
✔✔ b
The nurse is administering medications at 1800 to a client and uses the following medication
administration record (MAR). Which interventions should the nurse implement first?
a. assess the client's potassium and digoxin levels
b. monitor the client's partial thromboplastin level
c. check the client's international normalized ratio (INR)
d. verify the client's name and identification (ID) number with the MAR - correct answer ✔✔ c
The nurse is administering medications to clients on a medical unit. Which medications should
the nurse question administering?
a. the steroid, prednisone, to the client diagnosed with COPD
b. the anticoagulant, enoxaprin (Lovenox), to a client who had knee surgery
c. the antiplatelet, ticlopidine (Ticlid), to a client being prepared for surgery
d. the ACE inhibitor, captopril (Capoten), to a client who has a blood pressure (BP) of 100/68 -
correct answer ✔✔ c
