NUR2474 / MDC 3 FINAL EXAM
WITH ALL CORRECT ANSWERS.
What action by the nurse is the priority when a neutropenic client is
confused?
Assess the client for a urinary tract infection
What is the priority nursing intervention for a client experiencing a
transfusion reaction?
Stop the transfusion immediately
What statement by the client indicates understanding of safe nitroglycerin
topical administration?
I will apply the patch to a clean, dry, and hairless area on the skin.
What signs and symptoms are consistent with a diagnosis of leukemia?
Bleeding gums; bone pain; bruising
What is the priority nursing intervention for a post-operative heart transplant
client?
Monitor for cardiac dysrhythmias
,A client with an abdominal aortic aneurysm arrives at the emergency
department. Which finding is consistent with rupture into the abdominal
cavity?
Abdominal distension
A nurse is caring for four clients with leukemia. After receiving report, which
client should the nurse see first?
Client who had two bloody diarrhea stools this morning
A nurse is caring for a client recently diagnosed with hypertension. Which
statement by the client indicates the need for further teaching?
I will reduce my smoking to half a pack a day.
The nurse assesses a client with edema 2+ of the bilateral ankles, brown
pigmentation of the lower extremity skin, aching pain of the lower
extremities when standing that resolves with elevation, and 2+ pedal pulses.
What condition does the client likely have?
Venous insufficiency.
The nurse is caring for four clients in a post-surgical unit. Which client should
the nurse assess first?
A client who needs to use the bathroom 1 hour after receiving their first dose
of captopril
, The nurse is caring for a client with pericarditis. If left untreated, the client is
at risk for cardiac tamponade. Which clinical manifestation is associated with
cardiac tamponade?
Muffled heart sounds
The nurse is working in the emergency department and has four clients at
the same time. Which client should the nurse see first?
A client with a history of chronic obstructive pulmonary disease reporting
increased dyspnea.
A female client is being treated for a deep-vein thrombus postoperatively
and was treated with unfractionated heparin. One week later she presents
with petechiae on the hands and feet and a platelet count of 42,000/mm³.
The nurse suspects which condition?
Heparin-induced thrombocytopenia (HIT)
The American Association recommends which lifestyle changes to manage
modifiable risk factors associated with atherosclerosis? (SATA)
Limit red meat; exercise 3-4 times per week for at least 40 minutes each
session; adhere to prescribed medication therapy; consume 5 or more
servings per day of fresh fruits and vegetables
Which assessment finding is associated with acute pericarditis?
New ST-segment elevation on the electrocardiogram (ECG)
WITH ALL CORRECT ANSWERS.
What action by the nurse is the priority when a neutropenic client is
confused?
Assess the client for a urinary tract infection
What is the priority nursing intervention for a client experiencing a
transfusion reaction?
Stop the transfusion immediately
What statement by the client indicates understanding of safe nitroglycerin
topical administration?
I will apply the patch to a clean, dry, and hairless area on the skin.
What signs and symptoms are consistent with a diagnosis of leukemia?
Bleeding gums; bone pain; bruising
What is the priority nursing intervention for a post-operative heart transplant
client?
Monitor for cardiac dysrhythmias
,A client with an abdominal aortic aneurysm arrives at the emergency
department. Which finding is consistent with rupture into the abdominal
cavity?
Abdominal distension
A nurse is caring for four clients with leukemia. After receiving report, which
client should the nurse see first?
Client who had two bloody diarrhea stools this morning
A nurse is caring for a client recently diagnosed with hypertension. Which
statement by the client indicates the need for further teaching?
I will reduce my smoking to half a pack a day.
The nurse assesses a client with edema 2+ of the bilateral ankles, brown
pigmentation of the lower extremity skin, aching pain of the lower
extremities when standing that resolves with elevation, and 2+ pedal pulses.
What condition does the client likely have?
Venous insufficiency.
The nurse is caring for four clients in a post-surgical unit. Which client should
the nurse assess first?
A client who needs to use the bathroom 1 hour after receiving their first dose
of captopril
, The nurse is caring for a client with pericarditis. If left untreated, the client is
at risk for cardiac tamponade. Which clinical manifestation is associated with
cardiac tamponade?
Muffled heart sounds
The nurse is working in the emergency department and has four clients at
the same time. Which client should the nurse see first?
A client with a history of chronic obstructive pulmonary disease reporting
increased dyspnea.
A female client is being treated for a deep-vein thrombus postoperatively
and was treated with unfractionated heparin. One week later she presents
with petechiae on the hands and feet and a platelet count of 42,000/mm³.
The nurse suspects which condition?
Heparin-induced thrombocytopenia (HIT)
The American Association recommends which lifestyle changes to manage
modifiable risk factors associated with atherosclerosis? (SATA)
Limit red meat; exercise 3-4 times per week for at least 40 minutes each
session; adhere to prescribed medication therapy; consume 5 or more
servings per day of fresh fruits and vegetables
Which assessment finding is associated with acute pericarditis?
New ST-segment elevation on the electrocardiogram (ECG)
