A+ WITH LEGIT QUESTION AND ANSWERS
AInurseIisIprovidingIteachingItoIaIclientIwhoIhasIstageIIIIcervicalIcancerIandIisIscheduledIforIbrachy
therapy.IWhichIofItheIfollowingIinstructionsIshouldItheInurseIinclude?
"YouIwillIhaveIanIimplantIplacedItwiceIeachImonthIforItheIdurationIofItheItreatment."I"YouIsh
ouldIremainIatIleastI6IfeetIawayIfromIothersIbetweenItreatments."
"YouIshouldIexpectItoIhaveIbloodIinIyourIurineIforIaIfewIdaysIafterItreatment."
"YouIwillIneedItoIstayIstillIinItheIbedIduringIeachItreatmentIsession."I-
I"YouIwillIneedItoIstayIstillIinItheIbedIduringIeachItreatmentIsession."
TheInurseIshouldIinstructItheIclientIthatItheyIwillIneedItoIremainIonIbedIrestIwithIveryIlimitedImov
ementIbecauseIexcessiveImovementIcanIcauseItheIradioactiveIsourceItoIbecomeIdislodged.
AInurseIinIanIemergencyIdepartmentIisIcaringIforIaIclientIwhoIreportsIvomitingIandIdiarrheaIforIt
heIpastI3Idays.IWhichIofItheIfollowingIfindingsIshouldIindicateItoItheInurseIthatItheIclientIisIexpe
riencingIfluidIvolumeIdeficit?
HeartIrateI110/min
BloodIpressureI138/90ImmIHgIUr
ineIspecificIgravityI1.020
BUNI15Img/dLI-IHeartIrateI110/min
AIclientIwhoIhasIaI3-
dayIhistoryIofIvomitingIandIdiarrheaIisIlikelyItoIhaveIfluidIvolumeIdeficitIandIanIelevatedIheart
Irate.
AInurseIisIcaringIforIaIclientIwhoIhasIterminalIcancer.ITheIclientItellsItheInurse,I"IIwishIIIcouldIsto
pItheseItreatments.IIIamIreadyItoIdie."IWhichIofItheIfollowingIstatementsIshouldItheInurseImake?
"DiscontinuingIwithItheItreatmentsIisIyourIchoiceIifIitIisIyourIwishItoIdoIso."
"YourIchildIisInamedIasIyourIhealthIcareIsurrogate.IIIwillIaskIthemIifIyouIcanIstopItheItreat
ments."
"IIwillIcallIyourIspiritualIadvisorItoIcomeIin,IsoIyouIcanIdiscussIthisIwithIthem."I"Ne
xtItimeIyouIhaveIanIoncologyIappointment,IyouIshouldIaskItheIoncologist."I-
I"DiscontinuingIwithItheItreatmentsIisIyourIchoiceIifIitIisIyourIwishItoIdoIso."
TheInurseIshouldIrecognizeItheIclient'sIrightItoIrefuseItheItreatmentsIandIinformItheIclientIofIthisIr
ight.ITheInurseIshouldIadvocateIforItheIclientIandIofferItoIcontactItheIproviderIforItheIclient.
AInurseIisIcaringIforIaIclientIwhoIisIreceivingIdialysisItreatment..
ForIeachIpotentialInursingIintervention,IclickItoIspecifyIifItheIinterventionIisIindicatedIorInotIindicat
ed.I-IINDICATED:
- ApplyIoxygenIatI2IL/minIviaInasalIcannula.
- AdministerIaI0.9%IsodiumIchlorideI200ImLIIVIbolus.
- NotifyItheIproviderIimmediately.
- PlaceItheIclientIinITrendelenburgIposition.
,NOTIINDICATED:
- PerformIaI12-leadIECG.
- ObtainItheIclient'sIbloodIglucoseIlevel.
AInurseIisIcaringIforIaIclientIwhoIisIpostoperative.IWhichIofItheIfollowingIactionsIshouldItheInurs
eItake?ISelectIallIthatIapply.I-I-IInstructItheIclientItoIsplintItheIabdomenIwithIaIpillowIforIcoughing
- PlanItoIambulateItheIclientIasIsoonIasIpossible
- ReportIurinaryIoutputItoItheIprovider
- AskItheIclientItoIrateItheirIpainIonIaI0ItoI10IpainIscale
Rationale:
- ItIisIimportantIforItheIclientItoIturn,Icough,IandIdeepIbreatheItoIreduceItheIriskIforIrespira
toryIcomplicationsIandIreduceItheIriskIofIcomplicationsItoItheIsurgicalIincision.
- TheInurseIshouldIplanItoIambulateItheIclientIasIsoonIasIpossibleItoIpromoteIventilationIandIdec
reaseItheIriskIofIthrombosis.
- TheIclientIshouldIproduceIatIleastI30ImLIofIurineIperIhour.ITherefore,ItheInurseIshouldIrep
ortIthisIfindingItoItheIprovider.
- TheInurseIshouldIhaveItheIclientIrateItheirIpainIpriorItoIandIfollowingItheIadministrationIofIpai
nImedicationItoIevaluateIitsIeffectiveness.
AInurseIisIcaringIforIaIclientIwhoIisIreceivingItotalIparenteralInutritionI(TPN).IAInewIbagIisInotIa
vailableIwhenItheIcurrentIinfusionIisInearlyIcompleted.IWhichIofItheIfollowingIactionsIshouldIt
heInurseItake?
1. KeepItheIlineIopenIwithI0.9%IsodiumIchlorideIuntilItheInewIbagIarrives.
2. AdministerIdextroseI10%IinIwaterIuntilItheInewIbagIarrives.
3. FlushItheIlineIandIcapItheIportIuntilItheInewIbagIarrives.
4. DecreaseItheIinfusionIrateIuntilItheInewIbagIarrives.I-
I2.IAdministerIdextroseI10%IinIwaterIuntilItheInewIbagIarrives.
TPNIsolutionsIhaveIaIhighIconcentrationIofIdextrose.ITherefore,IifIaITPNIsolutionIisItemporaril
yIunavailable,ItheInurseIshouldIadministerIdextroseI10%IorI20%IinIwaterItoIavoidIaIprecipitousId
ropIinItheIclient'sIbloodIglucoseIlevel.
AInurseIisIcaringIforIaIclientIwhoIhadIaInephrostomyItubeIinsertedI12IhrIago.IWhichIofItheIfollowing
IfindingsIshouldItheInurseIreportItoItheIprovider?
1. TheIclient'sIurinaryIoutputIhasIincreased.
2. TheIclientIreportsIbackIpain.
3. TheIclient'sIurineIcolorIisIredItinged.
4. TheIclient'sIBUNIisI18Img/dL.I-I2.ITheIclientIreportsIbackIpain.
TheInurseIshouldInotifyItheIproviderIifItheIclientIreportsIbackIpain,IwhichIcanIindicateIthatItheI
nephrostomyItubeIisIdislodgedIorIclogged.
AInurseIisIcaringIforIaIclientIwhoIisIhavingIaIseizure.IWhichIofItheIfollowingIinterventionsIisItheIn
urse'sIpriority?
1. LoosenItheIclothingIaroundItheIclient'sIneck.
2. CheckItheIclient'sIpupillaryIresponse.
3. TurnItheIclientItoItheIside.
, 4. MoveIfurnitureIawayIfromItheIclient.I-I3.ITurnItheIclientItoItheIside.
TheIgreatestIriskItoIthisIclientIisIhypoxiaIfromIanIimpairedIairway.ITherefore,ItheIpriorityIinte
rventionItheInurseIshouldItakeIisItoIplaceItheIclientIinIaIside-
lyingIpositionItoIpreventIaspiration.
AInurseIinIaIprovider'sIofficeIisIassessingIaIclientIwhoIhasIhypertensionIandItakesIpropranolol.I
WhichIofItheIfollowingIfindingsIshouldIindicateItoItheInurseIthatItheIclientIisIexperiencingIanIa
dverseIreactionItoIthisImedication?
1. ReportIofIaInightIcough
2. ReportIofItinnitus
3. ReportIofIexcessiveItearing
4. ReportIofIincreasedIsalivationI-I1.IReportIofIaInightIcough
TheInurseIshouldIrecognizeIthatIaInightIcoughIisIanIearlyIindicationIofIheartIfailureIandIreportIthisIa
dverseIreactionItoItheIprovider.
AInurseIisIplanningItoIirrigateIandIdressIaIclean,IgranulatingIwoundIforIaIclientIwhoIhasIaIpressureIin
jury.IWhichIofItheIfollowingIactionsIshouldItheInurseItake?
ApplyIaIwet-to-
dryIgauzeIdressing.IIrrigateIwithIhydrogenI
peroxideIsolution.IUseIaI30-mLIsyringe.
AttachIaI24-gaugeIangiocatheterItoItheIsyringe.I-IUseIaI30-mLIsyringe.
TheInurseIshouldIuseIaI30-mLItoI60-mLIsyringeIwithIanI18-IorI19-
gaugeIcatheterItoIdeliverItheIidealIpressureIofI8IpoundsIperIsquareIinchI(psi)IwhenIirrigatingIaIwo
und.IToImaintainIhealthyIgranulationItissue,ItheIwoundIirrigationIshouldIbeIdeliveredIatIbetweenI
4IandI15Ipsi.
AInurseIisIassessingIaIclientIwhoIhasIGraves'Idisease.IWhichIofItheIfollowingIimagesIshouldIindic
ateItoItheInurseIthatItheIclientIhasIexophthalmos?I-IEyesIbulgingIandIwideIopen
TheInurseIshouldIidentifyIanIoutwardIprotrusionIofItheIeyesIasIexophthalmos,IaIcommonIfindingIofI
Graves'Idisease.IAnIoverproductionIofItheIthyroidIhormoneIcausesIedemaIofItheIextraocularImuscl
eIandIincreasesIfattyItissueIbehindItheIeye,IwhichIresultsIinItheIeyesIprotrudingIoutward.IExophthal
mosIcanIcauseItheIclientItoIexperienceIproblemsIwithIvision,IincludingIfocusingIonIobjects,IasIwellI
asIpressureIonItheIopticInerve.
AInurseIisIcaringIforIaIclientIwhoIhasIdiabeticIketoacidosisI(DKA).IWhichIofItheIfollowingIlaborato
ryIfindingsIshouldItheInurseIexpect?
PotassiumI3.5ImEq/L
pHI7.28
GlucoseI272Img/dL
HCO3-I14ImEq/LI-IGlucoseI272Img/dL
AIglucoseIreadingIlessIthanI300Img/dLIindicatesIimprovementIinItheIclient'sIstatus.
AInurseIisIcaringIforIaIclientIwhoIhasIhypothyroidism.IWhichIofItheIfollowingImanifestationsIshoul
dItheInurseIexpect?