PN Comprehensive Online Practice 2023 A
(150 Questions and Verified Answers).
A nurse is assisting in the care of a client who is 1 hr postpartum.
Exhibit 1
Nurses' Notes
1200:
Large amount of lochia rubra noted on perineal pad. Fundus boggy at two
fingerbreadths above the umbilicus.Oxytocin 20 units being administered
via continuous IV infusion
1215:
Large amount of lochia rubra with several large clots noted. Client reports
feeling anxious. Skin cool and clammy. Provider notified.
Exhibit 2
Vital Signs
1200:
Temperature 37.5° C (99.5° F)Heart rate 92/minRespiratory - Verified
Answer Select the 6 actions the nurse should take.
Weigh the perineal pads.
Insert an indwelling urinary catheter.
Administer methylergonovine.
Provide emotional support.
Administer oxygen at 12 L/min via nonrebreather face mask.
Firmly massage the uterine fundus.
When taking action for the client, the nurse should firmly massage the
uterine fundus, administer methylergonovine, weigh the perineal pads,
provide emotional support, insert an indwelling urinary catheter, and
administer oxygen at 12 L/min via nonrebreather face mask. The nurse
should identify that the client is experiencing a postpartum hemorrhage,
which requires immediate intervention to prevent hemorrhagic shock.
A nurse is collecting data from a client who is scheduled for surgery.
Exhibit 1
Vital Signs
,0630:
Temperature 36.9° C (98.5° F)Heart rate 74/minRespiratory rate
20/minBlood pressure 122/76 mmHgOxygen saturation 96% on room air
0730:
Temperature 36.9° C (98.5° F)Heart rate 76/minRespiratory rate
20/minBlood pressure 128/78 mmHgOxygen saturation 95% on room air
Exhibit 2
Nurses' Notes
0630:
Client reports restlessness and inability to sleep more than 3 to 4 hr per
night for the last week. Cli - Verified Answer Click to highlight the data
collection findings that the nurse should report to the provider prior to the
procedure. To deselect a finding, click on the finding again.
Hemoglobin level
Allergy
Family history
When collecting data from the client and analyzing cues, the nurse should
determine the client's hemoglobin level, latex allergy, and family history of
malignant hyperthermia should be reported to the provider. When the
client's hemoglobin level is below the expected range, the client might
require blood products during the intraoperative phase. The client's allergy
to avocados and bananas can indicate an allergy to latex products and
should be reported to the provider. The surgical team will need to remove
all latex products from the operating room. During the intraoperative phase,
the nurses must be diligent in monitoring the client's vital signs and
laboratory values, especially in a client who has a family history of
malignant hyperthermia.
A nurse is caring for a client who is recovering from a stroke and is
experiencing difficulty using eating utensils. The nurse should identify the
need for a referral to which of the following interprofessional team
members? - Verified Answer Occupational therapist
The nurse should identify the need for a referral to an occupational
therapist to teach the client how to use special eating utensils.
,A nurse is reviewing the electronic health records of four clients. Which of
the following client conditions should the nurse recognize as reportable to a
regulatory agency? - Verified Answer A client who is newly diagnosed with
tuberculosis
The nurse should identify that certain communicable diseases, such as
tuberculosis, require notification of the local and state health departments.
A nurse is caring for a client who is being discharged home following a
cerebrovascular accident. Which of the following documents should the
nurse plan to include with the discharge report? - Verified Answer List of
potential complications to report
Discharge instructions are defined as any form of documentation provided
to the client, upon discharge to home, which facilitates safe and appropriate
continuity of care. The nurse should plan to include a list of potential
complications that should be reported to the provider in the client's
discharge instructions.
A nurse is reinforcing teaching with the parent of a preschooler who has
lactose intolerance. Which of the following statements by the parent
indicates an understanding of the teaching? - Verified Answer "I should
offer my child yogurt that has a probiotic as a snack."
Children who have lactose intolerance should be offered dairy products that
have a probiotic, such as lactobacillus. The probiotic promotes tolerance of
lactose in the colon.
A nurse is reinforcing teaching for a client who has type 1 diabetes mellitus.
Which of the following client statements indicates an understanding of the
teaching? - Verified Answer "I should check my blood sugar if my appetite
is decreased."
The nurse should instruct the client to monitor blood glucose levels closely.
Change in appetite can be an early sign of hyperglycemia and inadequate
intake may cause blood glucose to drop.
A nurse is collecting data from a client who has iron deficiency anemia.
Which of the following findings should the nurse expect? - Verified Answer
Difficulty concentrating
, In clients who have iron deficiency anemia, body cells do not receive the
required oxygen because there is less hemoglobin for binding. The nurse
should recognize that impaired oxygenation of brain tissue can lead to
dizziness and difficulty concentrating.
A nurse is caring for a client who is immunocompromised. Which of the
following immunizations is contraindicated? - Verified Answer Measles,
mumps, and rubella (MMR)
The MMR vaccine consists of a live virus and is contraindicated for a client
who is immunocompromised.
A nurse is caring for a client who has expressive aphasia following a
stroke. Which of the following methods should the nurse use when
communicating with the client? - Verified Answer Provide a picture board.
A client who has expressive aphasia has difficulty expressing needs or
wants through verbalization or writing. The use of a picture board provides
an alternative means of communication that might be less frustrating for the
client.
A nurse is preparing to administer insulin to a client who has type 1
diabetes mellitus. After drawing up the medication, the nurse accidentally
brushes the needle on the counter's surface. Which of the following actions
should the nurse take? - Verified Answer Prepare a new dose of insulin
for injection.
Insulin is administered using an insulin syringe with a preattached needle.
Therefore, to ensure the sterility of the needle, the nurse should prepare a
new dose of insulin for injection using a new syringe and new dose of
insulin.
A nurse is checking the reflexes of a newborn. Which of the following
techniques should the nurse use to elicit the Babinski reflex? - Verified
Answer Stroke the sole of the newborn's foot upward and toward the great
toe.
(150 Questions and Verified Answers).
A nurse is assisting in the care of a client who is 1 hr postpartum.
Exhibit 1
Nurses' Notes
1200:
Large amount of lochia rubra noted on perineal pad. Fundus boggy at two
fingerbreadths above the umbilicus.Oxytocin 20 units being administered
via continuous IV infusion
1215:
Large amount of lochia rubra with several large clots noted. Client reports
feeling anxious. Skin cool and clammy. Provider notified.
Exhibit 2
Vital Signs
1200:
Temperature 37.5° C (99.5° F)Heart rate 92/minRespiratory - Verified
Answer Select the 6 actions the nurse should take.
Weigh the perineal pads.
Insert an indwelling urinary catheter.
Administer methylergonovine.
Provide emotional support.
Administer oxygen at 12 L/min via nonrebreather face mask.
Firmly massage the uterine fundus.
When taking action for the client, the nurse should firmly massage the
uterine fundus, administer methylergonovine, weigh the perineal pads,
provide emotional support, insert an indwelling urinary catheter, and
administer oxygen at 12 L/min via nonrebreather face mask. The nurse
should identify that the client is experiencing a postpartum hemorrhage,
which requires immediate intervention to prevent hemorrhagic shock.
A nurse is collecting data from a client who is scheduled for surgery.
Exhibit 1
Vital Signs
,0630:
Temperature 36.9° C (98.5° F)Heart rate 74/minRespiratory rate
20/minBlood pressure 122/76 mmHgOxygen saturation 96% on room air
0730:
Temperature 36.9° C (98.5° F)Heart rate 76/minRespiratory rate
20/minBlood pressure 128/78 mmHgOxygen saturation 95% on room air
Exhibit 2
Nurses' Notes
0630:
Client reports restlessness and inability to sleep more than 3 to 4 hr per
night for the last week. Cli - Verified Answer Click to highlight the data
collection findings that the nurse should report to the provider prior to the
procedure. To deselect a finding, click on the finding again.
Hemoglobin level
Allergy
Family history
When collecting data from the client and analyzing cues, the nurse should
determine the client's hemoglobin level, latex allergy, and family history of
malignant hyperthermia should be reported to the provider. When the
client's hemoglobin level is below the expected range, the client might
require blood products during the intraoperative phase. The client's allergy
to avocados and bananas can indicate an allergy to latex products and
should be reported to the provider. The surgical team will need to remove
all latex products from the operating room. During the intraoperative phase,
the nurses must be diligent in monitoring the client's vital signs and
laboratory values, especially in a client who has a family history of
malignant hyperthermia.
A nurse is caring for a client who is recovering from a stroke and is
experiencing difficulty using eating utensils. The nurse should identify the
need for a referral to which of the following interprofessional team
members? - Verified Answer Occupational therapist
The nurse should identify the need for a referral to an occupational
therapist to teach the client how to use special eating utensils.
,A nurse is reviewing the electronic health records of four clients. Which of
the following client conditions should the nurse recognize as reportable to a
regulatory agency? - Verified Answer A client who is newly diagnosed with
tuberculosis
The nurse should identify that certain communicable diseases, such as
tuberculosis, require notification of the local and state health departments.
A nurse is caring for a client who is being discharged home following a
cerebrovascular accident. Which of the following documents should the
nurse plan to include with the discharge report? - Verified Answer List of
potential complications to report
Discharge instructions are defined as any form of documentation provided
to the client, upon discharge to home, which facilitates safe and appropriate
continuity of care. The nurse should plan to include a list of potential
complications that should be reported to the provider in the client's
discharge instructions.
A nurse is reinforcing teaching with the parent of a preschooler who has
lactose intolerance. Which of the following statements by the parent
indicates an understanding of the teaching? - Verified Answer "I should
offer my child yogurt that has a probiotic as a snack."
Children who have lactose intolerance should be offered dairy products that
have a probiotic, such as lactobacillus. The probiotic promotes tolerance of
lactose in the colon.
A nurse is reinforcing teaching for a client who has type 1 diabetes mellitus.
Which of the following client statements indicates an understanding of the
teaching? - Verified Answer "I should check my blood sugar if my appetite
is decreased."
The nurse should instruct the client to monitor blood glucose levels closely.
Change in appetite can be an early sign of hyperglycemia and inadequate
intake may cause blood glucose to drop.
A nurse is collecting data from a client who has iron deficiency anemia.
Which of the following findings should the nurse expect? - Verified Answer
Difficulty concentrating
, In clients who have iron deficiency anemia, body cells do not receive the
required oxygen because there is less hemoglobin for binding. The nurse
should recognize that impaired oxygenation of brain tissue can lead to
dizziness and difficulty concentrating.
A nurse is caring for a client who is immunocompromised. Which of the
following immunizations is contraindicated? - Verified Answer Measles,
mumps, and rubella (MMR)
The MMR vaccine consists of a live virus and is contraindicated for a client
who is immunocompromised.
A nurse is caring for a client who has expressive aphasia following a
stroke. Which of the following methods should the nurse use when
communicating with the client? - Verified Answer Provide a picture board.
A client who has expressive aphasia has difficulty expressing needs or
wants through verbalization or writing. The use of a picture board provides
an alternative means of communication that might be less frustrating for the
client.
A nurse is preparing to administer insulin to a client who has type 1
diabetes mellitus. After drawing up the medication, the nurse accidentally
brushes the needle on the counter's surface. Which of the following actions
should the nurse take? - Verified Answer Prepare a new dose of insulin
for injection.
Insulin is administered using an insulin syringe with a preattached needle.
Therefore, to ensure the sterility of the needle, the nurse should prepare a
new dose of insulin for injection using a new syringe and new dose of
insulin.
A nurse is checking the reflexes of a newborn. Which of the following
techniques should the nurse use to elicit the Babinski reflex? - Verified
Answer Stroke the sole of the newborn's foot upward and toward the great
toe.
