Complete Questions and Guide Answers
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A nurse is assessing a client who is 12hr postoperative following a colon resection. Whi of the
following findings should the nurse report to the surgeon?
a. Heart rate 90/min
b. Absent bowel sounds
c. Hgb 8.2 g/dl
d. Gastric pH of 3.0 (normal 0-4)
A nurse is caring for a client who has diabetes insipidus. Which of the following medications
should the nurse plan to administer?
a. Desmopressin
b. Regular insulin
c. Furosemide
d. Lithium carbonate
A nurse is admitting a client who has arthritic pain and reports taking ibuprofen several times
daily for 3 years. Which of the following test should the nurse monitor?
a. Fasting blood glucose
b. Stool for occult blood
c. Urine for white blood cells
d. Serum calcium -
A nurse in the emergency department is assessing a client. Which of the following actions
should the nurse take first (Click on the "Exhibit" button for additional information about the
,client. There are three tabs that contain separate categories of data.)
a. Obtain a sputum sample for culture
b. Prepare the client for a chest x-ray
c. Initiate airborne precautions
d. Administer ondansertron.
A nurse is contacting the provider for a client who has cancer and is experiencing breakthrough
pain. Which of the following prescriptions should the nurse anticipate?
a. Transmucosal fentanyl
b. Intramuscular meperidine
c. Oral acetaminophen
d. Intravenous dexamethasone
A nurse is admitting a client who reports chest pain and has been placed on a telemetry
monitor. Which of the following should the nurse analyze to determine whether the client is
experiencing a myocardial infarction?
a. PR interval
b. QRS duration
c. T wave
d. ST segment
A nurse is teaching a client who has ovarian cancer about skin care following radiation
treatment. Which of the following instructions should the nurse include?
a. Pat the skin on the radiation site to dry it
b. Apply OTC moisturizer to the radiation site
c. Cover the radiation site loosely with a gauze wrap before dressing
d. Use a soft washcloth to clean the area around the radiation site
A nurse is caring for a client who is receiving a blood transfusion. The nurse observes that the
client has bounding peripheral pulses, hypertension, and distended jugular veins. The nurse
should anticipate administering which of the following prescribed medications?
a. Diphenhydramine
b. Acetaminophen
,c. Pantoprazole
d. Furosemide
A nurse is assessing a client who is receiving magnesium sulfate IV for the treatment of
hypomagnesemia. Which of the following findings indicates effectiveness of the medication?
a. Lungs clear
b. Apical pulse 82/min
c. Hyperactive bowel sounds
d. Blood pressure 90/50 mm Hg
A nurse is reviewing a client's ABG results pH 7.42, PaC02 30 mm Hg, and HCO3 21 mEq/L. The
nurse should recognize these findings as indication of which of the following conditions?
a. Metabolic acidosis
b. Metabolic alkalosis
c. Compensated respiratory alkalosis
d. Uncompensated respiratory acidosis
A nurse is caring for a client who has a deep partial thickness burns over 15% of her body
which of the following labs should the nurse expect during the first 24 hours
a. Decreased BUN
b. Hypoglycemia
c. Hypoalbuminemia
d. Decreased Hematocrit
A nurse is caring for a client who has dumping syndrome following a gastrectomy, which of the
following actions should the nurse take ?
a. Offer the client high carbohydrate meal options
b. Provide the client with four full meals a day
c. Encourage the client to to drink at least 360 ml of fluids with meals
d. Have the client lie down for 30 minutes after meals
A nurse is teaching a group of young adult clients about risk factors for hearing loss. Which of
the following factors should the nurse include in the teaching? Select all that apply:
a. Born with a high weight
, b. Chronic infections of the middle ear
c. Use a loop diuretic
d. Perforation of the ear drum
e. Frequent exposure to low volume noise
A nurse is preparing to administer fresh frozen plasma to a client . Which of the following
actions should the nurse take?
a. Administer the plasma immediately after thawing
b. Transfuse the plasma over 4 hour
c. Hold the transfusion if the client is actively bleeding
d. Administer the transfusion through a 24 gauge saline lock
A nurse is assessing a clients who reports numbness and tingling of his toes and exhibits a
positive TROUSSEAU. Which of the following electrolyte imbalance should the nurse suspect?
a. Hypoatremia
b. Hyperchloremia
c. Hypermagnesemia
d. Hypocalcemia
A home health nurse is teaching a client how to care for a peripherally central catheter in his
right arm. Which of the following statements should the nurse include in the teaching?
a. Change the transparent dressing over the insertion site every 48 hours
b. Clean the insertion site with mild soap and water
c. Measure your right arm circumference once weekly
d. Use a 10 milliliter syringe when flushing the catheter
A nurse is caring for a client who has a central venous access device. Which of the following
assessment findings should the nurse report to the provider?
a. RBC count of 4.7 million/mm 3