NURS 2310 Unit 4 Questions With Complete Solutions
3L per day Correct Answers necessary amount of fluids for
febrile pt?
A) Check the client's temperature history.
Although early morning temperatures are routinely low, the best
practice is for the nurse to check the client's previous
temperatures. Clients may routinely have a low temperature.
Depending on the client's temperature history, the nurse may
retake the temperature with another thermometer to check for a
malfunction. If everything seems satisfactory, the nurse should
chart the temperature and check the client for signs of
hypothermia. Correct Answers Using an oral electronic
thermometer, the nurse checks the early morning temperature of
a client. The client's temperature is 36.1° C (97° F). The client's
remaining vital signs are in the normally acceptable range. What
should the nurse do next?
A) Check the client's temperature history.
B) Document the results; temperature is normal.
C) Recheck the temperature every 15 minutes until it is normal.
D) Get another thermometer; the temperature is obviously an
error.
afebrile Correct Answers when the fever breaks, the client
becomes _______
antipyretics; nonsteroidal drugs such as acetaminophen,
salicylates, indomethacin, and ketorolac Correct Answers
drugs that reduce fever
,apnea Correct Answers respirations cease for several seconds;
persistent cessation results in respiratory arrest
assess fever Correct Answers before giving acetaminophen or
ibuprofen
B) Headache, flushing of the face, and nosebleed Correct
Answers Besides high blood pressure values, what other signs
and symptoms may the nurse observe if hypertension is present?
A) Unexplained pain and hyperactivity
B) Headache, flushing of the face, and nosebleed
C) Dizziness, mental confusion, and mottled extremities
D) Restlessness and dusky or cyanotic skin that is cool to the
touch
B) The client has an arrhythmia.
The apical pulse gives the nurse the most information and
accuracy when assessing irregular cardiac rhythm. The carotid
or femoral pulses are usually used to assess a client in shock.
The radial pulse is adequate for determining routine
postoperative vital signs and for checking changes in orthostatic
heart rate. Correct Answers The nurse decides to take an apical
pulse instead of a radial pulse. Which of the following client
conditions influenced the nurse's decision?
A) The client is in shock.
B) The client has an arrhythmia.
C) The client underwent surgery 18 hours earlier.
D) The client showed a response to orthostatic changes.
, biot's respiration Correct Answers respirations are abnormally
shallow for 2-3 breaths followed by irregular period of apnea
bmr - basal metabolic rate Correct Answers depends on body
surface area; accounts for heat produced by body at absolute rest
body temperature Correct Answers heat produced - heat loss =
bradypnea Correct Answers rate of breathing is regular but
abnormally slow (less than 12 bpm)
C) Assessing the apical pulse and the radial pulse for the same
minute and subtracting the difference
To measure pulse deficit the nurse and a colleague assess the
radial and apical pulse rates simultaneously and subtract the
radial from the apical pulse rate. The result is the pulse deficit.
Tachycardia and bradycardia are assessed by measuring the
pulse rate for 1 minute. A rate of more than 100 beats per minute
is categorized as tachycardia, whereas a rate of less than 60
beats per minute constitutes bradycardia. Correct Answers The
nurse's documentation indicates that a client has a pulse deficit
of 14 beats. The pulse deficit is measured by:
A) Subtracting 60 (bradycardia) from the client's pulse rate and
reporting the difference
B) Subtracting the client's pulse rate from 100 (tachycardia) and
reporting the difference
C) Assessing the apical pulse and the radial pulse for the same
minute and subtracting the difference
D) Assessing the apical pulse and 30 minutes later assessing the
carotid pulse and subtracting the difference
3L per day Correct Answers necessary amount of fluids for
febrile pt?
A) Check the client's temperature history.
Although early morning temperatures are routinely low, the best
practice is for the nurse to check the client's previous
temperatures. Clients may routinely have a low temperature.
Depending on the client's temperature history, the nurse may
retake the temperature with another thermometer to check for a
malfunction. If everything seems satisfactory, the nurse should
chart the temperature and check the client for signs of
hypothermia. Correct Answers Using an oral electronic
thermometer, the nurse checks the early morning temperature of
a client. The client's temperature is 36.1° C (97° F). The client's
remaining vital signs are in the normally acceptable range. What
should the nurse do next?
A) Check the client's temperature history.
B) Document the results; temperature is normal.
C) Recheck the temperature every 15 minutes until it is normal.
D) Get another thermometer; the temperature is obviously an
error.
afebrile Correct Answers when the fever breaks, the client
becomes _______
antipyretics; nonsteroidal drugs such as acetaminophen,
salicylates, indomethacin, and ketorolac Correct Answers
drugs that reduce fever
,apnea Correct Answers respirations cease for several seconds;
persistent cessation results in respiratory arrest
assess fever Correct Answers before giving acetaminophen or
ibuprofen
B) Headache, flushing of the face, and nosebleed Correct
Answers Besides high blood pressure values, what other signs
and symptoms may the nurse observe if hypertension is present?
A) Unexplained pain and hyperactivity
B) Headache, flushing of the face, and nosebleed
C) Dizziness, mental confusion, and mottled extremities
D) Restlessness and dusky or cyanotic skin that is cool to the
touch
B) The client has an arrhythmia.
The apical pulse gives the nurse the most information and
accuracy when assessing irregular cardiac rhythm. The carotid
or femoral pulses are usually used to assess a client in shock.
The radial pulse is adequate for determining routine
postoperative vital signs and for checking changes in orthostatic
heart rate. Correct Answers The nurse decides to take an apical
pulse instead of a radial pulse. Which of the following client
conditions influenced the nurse's decision?
A) The client is in shock.
B) The client has an arrhythmia.
C) The client underwent surgery 18 hours earlier.
D) The client showed a response to orthostatic changes.
, biot's respiration Correct Answers respirations are abnormally
shallow for 2-3 breaths followed by irregular period of apnea
bmr - basal metabolic rate Correct Answers depends on body
surface area; accounts for heat produced by body at absolute rest
body temperature Correct Answers heat produced - heat loss =
bradypnea Correct Answers rate of breathing is regular but
abnormally slow (less than 12 bpm)
C) Assessing the apical pulse and the radial pulse for the same
minute and subtracting the difference
To measure pulse deficit the nurse and a colleague assess the
radial and apical pulse rates simultaneously and subtract the
radial from the apical pulse rate. The result is the pulse deficit.
Tachycardia and bradycardia are assessed by measuring the
pulse rate for 1 minute. A rate of more than 100 beats per minute
is categorized as tachycardia, whereas a rate of less than 60
beats per minute constitutes bradycardia. Correct Answers The
nurse's documentation indicates that a client has a pulse deficit
of 14 beats. The pulse deficit is measured by:
A) Subtracting 60 (bradycardia) from the client's pulse rate and
reporting the difference
B) Subtracting the client's pulse rate from 100 (tachycardia) and
reporting the difference
C) Assessing the apical pulse and the radial pulse for the same
minute and subtracting the difference
D) Assessing the apical pulse and 30 minutes later assessing the
carotid pulse and subtracting the difference
