NSG 4800 [Comp exams] questions and
answers 2024\2025 A+ Grade
The nurse is monitoring a client in the immediate postpartum period for signs of hemorrhage. Which
sign, if noted, would be an early sign of excessive blood loss?
A .temperature of 100.4°F (38°C)
B. An increase in the pulse rate from 88 to 102 beats/minute
C. A blood pressure change from 130/88 to 124/80 mm Hg
D. An increase in the respiratory rate from 18 to 22 breaths/minute
- correct answer B, During the fourth stage of labor, the maternal blood pressure, pulse, and respiration
should be checked every 15 minutes during the first hour. An increasing pulse is an early sign of
excessive blood loss because the heart pumps faster to compensate for reduced blood volume. A slight
increase in temperature is normal. The blood pressure decreases as the blood volume diminishes, but a
decreased blood pressure would not be the earliest sign of hemorrhage. The respiratory rate is slightly
increased from normal.
The nurse in the ambulatory care unit is providing home care instructions to a client after cryotherapy
for the treatment of malignant skin lesions. Which statement would be most appropriate for the nurse
to include in the home care instructions for this client?
"Apply ice to the site to prevent swelling."
"Clean the site with alcohol 3 times daily."
"Apply a warm, damp washcloth if discomfort occurs."
"Avoid showering or taking baths until seen by the health care provider in 1 week."
- correct answer 3, Cryotherapy involves the local application of liquid nitrogen to the lesion; this causes
cell death and tissue destruction. Tissue freezing is followed in 1 to 2 days by hemorrhagic blister
formation; therefore, ice is not applied to the site. The application of a warm, damp washcloth
intermittently to the site will provide relief of any discomfort. The nurse instructs the client to clean the
site with the prescribed solution to prevent secondary infection. A topical antibiotic also may be
prescribed. Alcohol would cause irritation to the skin. There is no reason for the client to avoid
showering or bathing.
The registered nurse is caring for the following clients. It would be a priority for the nurse to initiate a
multidisciplinary conference for the client who is
,A.12 years old with Autism who is starting a new school and recently had a URI (upper respiratory tract
infection)
B.39 years old, has type 2 Diabetes Mellitus, is homeless and had a recent Hemoglobin A1c of 13%
C.52 years old, with Myasthenia Gravis, recently prescribed Mestinon (pyridostigmine) and is employed
as a mail carrier
D.79 years old, has bipolar and schizophrenia, lives alone and reports hearing non threatening voices.
- correct answer B
A client with uncontrolled Diabetes Mellitus would require the greatest number of disciplines
(multidisciplinary) to manage their care i.e. Medicine, Nursing, Social Work, Nutritionist; the other
choices do not require as many providers of care to meet their needs.
A client is scheduled to begin therapy with carbamazepine. The nurse should assess the results of which
test(s) before administering the first dose of this medication to the client?
Liver function tests
Renal function tests
Pancreatic enzyme studies
Complete blood cell count
- correct answer D. Carbamazepine may be used to treat a seizure disorder. It can cause leukopenia,
anemia, thrombocytopenia, and, very rarely, fatal aplastic anemia. To reduce the risk of serious
hematological effects, a complete blood cell count should be done before treatment and periodically
thereafter. This medication should be avoided in clients with preexisting hematological abnormalities.
The client also is told to report the occurrence of fever, sore throat, pallor, weakness, infection, easy
bruising, and petechiae. The results of the remaining tests listed in the options are not associated with
the use of this medication.
A client is admitted to a hospital with a diagnosis of diabetic ketoacidosis (DKA). The initial blood glucose
level is 950 mg/dL (54.2 mmol/L). A continuous intravenous (IV) infusion of short-acting insulin is
initiated, along with IV rehydration with normal saline. The serum glucose level is now decreased to 240
mg/dL (13.7 mmol/L). The nurse would next prepare to administer which medication?
An ampule of 50% dextrose
NPH insulin subcutaneously
IV fluids containing dextrose
Phenytoin for the prevention of seizures
- correct answer C. Emergency management of DKA focuses on correcting fluid and electrolyte
imbalances and normalizing the serum glucose level. If the corrections occur too quickly, serious
, consequences, including hypoglycemia and cerebral edema, can occur. During management of DKA,
when the blood glucose level falls to 250 to 300 mg/dL (14.2 to 17.1 mmol/L), the IV infusion rate is
reduced and a dextrose solution is added to maintain a blood glucose level of about 250 mg/dL (14.2
mmol/L), or until the client recovers from ketosis. Fifty percent dextrose is used to treat hypoglycemia.
NPH insulin is not used to treat DKA. Phenytoin is not a usual treatment measure for DKA.
A client is being discharged from the emergency department after an evaluation for a concussion. The
nurse reinforces teaching regarding follow-up should the client develop complications. Which of the
following complications, if listed by the client, would require further instruction?
1.Vomiting
2.Minor headache
3.Difficulty speaking
4.Difficulty awakening
- correct answer 2; all others responses would indicate IICP and needs to go to the ER
The patient sustained an open fracture of the femur from an automobile accident. The nurse should
assess the client for which type of shock?
A. cardiogenic
B. hypovolemic
C. neurogenic
D. anaphylactic
- correct answer B. A fractured femur, especially an open fracture, can cause much soft tissue damage
and lead to significant blood loss. Hypovolemic shock can develop. Cardiogenic shock occurs when
cardiac output is decreased as a result of ineffective pumping. Neurogenic shock occurs as a result of an
impaired autonomic nervous system function. Anaphylactic shock is the result of an allergic reaction.
The registered nurse has received a report on four clients. The nurse should first assess the client who
has:
A.Chronic Obstructive Pulmonary Disease (COPD) with a pulse oximetry reading of 89%
B.Parkinson's Disease and is demanding to leave the hospital against medical advice (AMA)
C.been admitted with suspected Guillian Barre Syndrome and has begun plasmapheresis therapy
D.Congestive Heart Failure (CHF) whose pitting edema has increased to 2(+)
- correct answer C.
answers 2024\2025 A+ Grade
The nurse is monitoring a client in the immediate postpartum period for signs of hemorrhage. Which
sign, if noted, would be an early sign of excessive blood loss?
A .temperature of 100.4°F (38°C)
B. An increase in the pulse rate from 88 to 102 beats/minute
C. A blood pressure change from 130/88 to 124/80 mm Hg
D. An increase in the respiratory rate from 18 to 22 breaths/minute
- correct answer B, During the fourth stage of labor, the maternal blood pressure, pulse, and respiration
should be checked every 15 minutes during the first hour. An increasing pulse is an early sign of
excessive blood loss because the heart pumps faster to compensate for reduced blood volume. A slight
increase in temperature is normal. The blood pressure decreases as the blood volume diminishes, but a
decreased blood pressure would not be the earliest sign of hemorrhage. The respiratory rate is slightly
increased from normal.
The nurse in the ambulatory care unit is providing home care instructions to a client after cryotherapy
for the treatment of malignant skin lesions. Which statement would be most appropriate for the nurse
to include in the home care instructions for this client?
"Apply ice to the site to prevent swelling."
"Clean the site with alcohol 3 times daily."
"Apply a warm, damp washcloth if discomfort occurs."
"Avoid showering or taking baths until seen by the health care provider in 1 week."
- correct answer 3, Cryotherapy involves the local application of liquid nitrogen to the lesion; this causes
cell death and tissue destruction. Tissue freezing is followed in 1 to 2 days by hemorrhagic blister
formation; therefore, ice is not applied to the site. The application of a warm, damp washcloth
intermittently to the site will provide relief of any discomfort. The nurse instructs the client to clean the
site with the prescribed solution to prevent secondary infection. A topical antibiotic also may be
prescribed. Alcohol would cause irritation to the skin. There is no reason for the client to avoid
showering or bathing.
The registered nurse is caring for the following clients. It would be a priority for the nurse to initiate a
multidisciplinary conference for the client who is
,A.12 years old with Autism who is starting a new school and recently had a URI (upper respiratory tract
infection)
B.39 years old, has type 2 Diabetes Mellitus, is homeless and had a recent Hemoglobin A1c of 13%
C.52 years old, with Myasthenia Gravis, recently prescribed Mestinon (pyridostigmine) and is employed
as a mail carrier
D.79 years old, has bipolar and schizophrenia, lives alone and reports hearing non threatening voices.
- correct answer B
A client with uncontrolled Diabetes Mellitus would require the greatest number of disciplines
(multidisciplinary) to manage their care i.e. Medicine, Nursing, Social Work, Nutritionist; the other
choices do not require as many providers of care to meet their needs.
A client is scheduled to begin therapy with carbamazepine. The nurse should assess the results of which
test(s) before administering the first dose of this medication to the client?
Liver function tests
Renal function tests
Pancreatic enzyme studies
Complete blood cell count
- correct answer D. Carbamazepine may be used to treat a seizure disorder. It can cause leukopenia,
anemia, thrombocytopenia, and, very rarely, fatal aplastic anemia. To reduce the risk of serious
hematological effects, a complete blood cell count should be done before treatment and periodically
thereafter. This medication should be avoided in clients with preexisting hematological abnormalities.
The client also is told to report the occurrence of fever, sore throat, pallor, weakness, infection, easy
bruising, and petechiae. The results of the remaining tests listed in the options are not associated with
the use of this medication.
A client is admitted to a hospital with a diagnosis of diabetic ketoacidosis (DKA). The initial blood glucose
level is 950 mg/dL (54.2 mmol/L). A continuous intravenous (IV) infusion of short-acting insulin is
initiated, along with IV rehydration with normal saline. The serum glucose level is now decreased to 240
mg/dL (13.7 mmol/L). The nurse would next prepare to administer which medication?
An ampule of 50% dextrose
NPH insulin subcutaneously
IV fluids containing dextrose
Phenytoin for the prevention of seizures
- correct answer C. Emergency management of DKA focuses on correcting fluid and electrolyte
imbalances and normalizing the serum glucose level. If the corrections occur too quickly, serious
, consequences, including hypoglycemia and cerebral edema, can occur. During management of DKA,
when the blood glucose level falls to 250 to 300 mg/dL (14.2 to 17.1 mmol/L), the IV infusion rate is
reduced and a dextrose solution is added to maintain a blood glucose level of about 250 mg/dL (14.2
mmol/L), or until the client recovers from ketosis. Fifty percent dextrose is used to treat hypoglycemia.
NPH insulin is not used to treat DKA. Phenytoin is not a usual treatment measure for DKA.
A client is being discharged from the emergency department after an evaluation for a concussion. The
nurse reinforces teaching regarding follow-up should the client develop complications. Which of the
following complications, if listed by the client, would require further instruction?
1.Vomiting
2.Minor headache
3.Difficulty speaking
4.Difficulty awakening
- correct answer 2; all others responses would indicate IICP and needs to go to the ER
The patient sustained an open fracture of the femur from an automobile accident. The nurse should
assess the client for which type of shock?
A. cardiogenic
B. hypovolemic
C. neurogenic
D. anaphylactic
- correct answer B. A fractured femur, especially an open fracture, can cause much soft tissue damage
and lead to significant blood loss. Hypovolemic shock can develop. Cardiogenic shock occurs when
cardiac output is decreased as a result of ineffective pumping. Neurogenic shock occurs as a result of an
impaired autonomic nervous system function. Anaphylactic shock is the result of an allergic reaction.
The registered nurse has received a report on four clients. The nurse should first assess the client who
has:
A.Chronic Obstructive Pulmonary Disease (COPD) with a pulse oximetry reading of 89%
B.Parkinson's Disease and is demanding to leave the hospital against medical advice (AMA)
C.been admitted with suspected Guillian Barre Syndrome and has begun plasmapheresis therapy
D.Congestive Heart Failure (CHF) whose pitting edema has increased to 2(+)
- correct answer C.
