COMPLETE STUDY GUIDE 2026 | CASE
STUDIES, PRACTICE QUESTIONS,
RATIONALES & CHEAT SHEET
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Updated 2026 Questions and Answers
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Rationales Included
,A nurse of the telemetry unit is caring for a client who has A
had a MI and is now attached to a cardiac monitor. The The pattern of ventricular fibrillation is identified and can be a result after a
nurse is monitoring the client's cardiac rhythm and nots patient with an MI. VF makes the patient feel faint, then loses consciousness and
ventricular fibrillation. Which nursing intervention should becomes pulseless and apneic (BP and heart sounds absent). Treatment is to
the nurse take first? terminate VF and covert it into a rhythm via defibrillation-> call a rapid and initiate
a. Calling the rapid response team CPR. Cardioversion is used for ventricular or supraventricular tachydysrhythmias.
b. Preparing the client for cardioversion
c. Asking the client to bear down and cough
d. Preparing to administer diltiazem
A nurse developing a plan of care for a client with a B
spinal cord injury includes measures to prevent The most frequent cause of autonomic dysreflexias are a distended bladder and
autonomic dysreflexia (hyperreflexia). Which intervention impacted feces. Other causes include stimulation of the skin by tactile, thermal, or
does the nurse incorporate into the plan to prevent this painful stimuli. The nurse renders care in such a way as to minimize these risks.
complication?
a. Keeping the fan running in the client's room
b. Keeping the linens wrinkle free under the client
c. Limiting bladder catheterization to once every 12 hours
d. Avoiding the administration of enemas and rectal
suppositories
A nurse provides home care instructions to a client who C
has been fitted with a halo device to treat a cervical Cleanse the skin under the wool liner each day to prevent rashes and soars.
fracture. Which statement by the client indicates the need
for further teaching?
a. I need to get more fluids and fiber into my diet
b. I should cut my food into small pieces before I eat
c. I need to put powder under the vest twice a day to
prevent sweating
d. I have to check the pin sites everyday and watch for
signs of infection
A nurse is caring for a client with increased intracranial D
pressure. In which position should the nurse maintain the Proper positioning promotes venous drainage from the cranium to minimize ICP.
client?
a. Supine with the head extended
b. Side lying with the neck flexed
c. Supine with the head turned to the side
d. Head midline and elevated 30-45 degrees
, A client with a basilar skull fracture has clear fluid leaking B
from the ears. The nurse should take which action first? CSF contains glucose not protein.
a. Asses the clear fluid for protein
b. Check the clear fluid for glucose
c. Place cotton calls or dry gauze loosely in the ears
d. Use an otoscope to assess the tympanic membrane for
rupture
A nurse is caring for a client who has just undergone A
cardioversion. Which intervention is the nurse's priority ABC's of nursing. All other choices are correct, but not priority.
after this procedure.
a. Administer oxygen
b. Monitoring the BP
c. Administering antidysrhythmic medications
d. Monitoring the client's LOC
A client with diabetes mellitus who is scheduled to have B
blood drawn for determination of the glycosylated
hemoglobin (HbA1c) level asks the nurse why the test is
necessary if he is performing blood glucose monitoring
at home. Which is the best response for the nurse to
provide?
a. Detect diabetic complications
b. Assess long-term glycemic control
c. Determine whether the client is at risk for
hypoglycemia
d Determine whether the prescribed insulin dosage is
correct
A nurse caring for a client with acquired B, D, E
immunodeficiency syndrome is monitoring the client for A opportunistic respiratory infection associated with AIDs that causes dyspnea,
signs of complications. Which of the following would nonproductive cough, intermittent fever, fatigue, anorexia, tachypnea, wt. loss.
cause the nurse to suspect infection with Pneumocystis
jirovec? SATA
a. Diarrhea
b. Tachypnea
c. Pedal edema
d. Intermittent fever
e. Dyspnea with ambulating
f. Expectoration of frothy mucus
Zidovudine is prescribed for a client with AIDS. The nurse C
tells the client that it is important to report back to the Zidovudine is an antiviral medication that cause cause agranulocytosis and
clinic as scheduled for which follow-up diagnostic? anemia.
a. Blood glucose checks
b. Blood pressure checks
c. Complete blood counts (CBC)
d. Electrocradiographic studies