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COMPREHENSIVE EXAM 2021 QUESTIONS AND ANSWERS FINAL EXAMINATION TEST PAPER 2026 FULL ANSWERS GRADED A+

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COMPREHENSIVE EXAM 2021 QUESTIONS AND ANSWERS FINAL EXAMINATION TEST PAPER 2026 FULL ANSWERS GRADED A+

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COMPREHENSIVE EXAM 2021 QUESTIONS
AND ANSWERS FINAL EXAMINATION TEST
PAPER 2026 FULL ANSWERS GRADED A+

⩥ A client is scheduled to undergo an upper gastrointestinal (GI) series,
and the nurse provides instructions to the client about the test. Which
statement by the client indicates a need for further instruction?


"The test will take about 30 minutes."
"I need to fast for 8 hours before the test."
"I need to drink citrate of magnesia the night before the test and give
myself a Fleet enema on the morning of the test."
"I need to take a laxative after the test is completed, because the liquid
that I'll have to drink for the test can be constipating.". Answer: "I need
to drink citrate of magnesia the night before the test and give myself a
Fleet enema on the morning of the test."


Rationale: No special preparation is necessary before a GI series, except
that NPO (nothing by mouth) status must be maintained for 8 hours
before the test. An upper GI series involves visualization of the
esophagus, duodenum, and upper jejunum by means of the use of a
contrast medium. It involves swallowing a contrast medium (usually
barium), which is administered in a flavored milkshake. Films are taken
at intervals during the test, which takes about 30 minutes. After an upper
GI series, the client is prescribed a laxative to hasten elimination of the

,barium. Barium that remains in the colon may become hard and difficult
to expel, leading to fecal impaction.


⩥ A nurse on the evening shift checks a primary health care provider's
prescriptions and notes that the dose of a prescribed medication is higher
than the normal dose. The nurse calls the primary health care provider's
answering service and is told that the primary health care provider is off
for the night and will be available in the morning. What should the nurse
do next?


Call the nursing supervisor
Ask the answering service to contact the on-call primary health care
provider
Withhold the medication until the primary health care provider can be
reached in the morning
Administer the medication but consult the primary health care provider
when he becomes available. Answer: Ask the answering service to
contact the on-call primary health care provider


Rationale: The nurse has a duty to protect the client from harm. A nurse
who believes that a primary health care provider's prescription may be in
error is responsible for clarifying the prescription before carrying it out.
Therefore the nurse would not administer the medication; instead, the
nurse would withhold the medication until the dose can be clarified. The
nurse would not wait until the next morning to obtain clarification. It is
premature to call the nursing supervisor.

,⩥ An emergency department (ED) nurse is monitoring a client with
suspected acute myocardial infarction (MI) who is awaiting transfer to
the coronary intensive care unit. The nurse notes the sudden onset of
premature ventricular contractions (PVCs) on the monitor, checks the
client's carotid pulse, and determines that the PVCs are not perfusing.
What is the nurse's most appropriate action?


Document the findings
Ask the ED primary health care provider to check the client
Continue to monitor the client's cardiac status
Inform the client that PVCs are expected after an MI. Answer: Ask the
ED primary health care provider to check the client


Rationale: The most appropriate action by the nurse would be to ask the
ED health care provider to check the client. PVCs are a result of
increased irritability of ventricular cells. Peripheral pulses may be absent
or diminished with the PVCs themselves because the decreased stroke
volume of the premature beats may in turn decrease peripheral
perfusion. Because other rhythms also cause widened QRS complexes, it
is essential that the nurse determine whether the premature beats are
resulting in perfusion of the extremities. This is done by palpating the
carotid, brachial, or femoral artery while observing the monitor for
widened complexes or by auscultating for apical heart sounds. In the
situation of acute MI, PVCs may be considered warning dysrhythmias,
possibly heralding the onset of ventricular tachycardia or ventricular
fibrillation. Therefore, the nurse would not tell the client that the PVCs

, are expected. Although the nurse will continue to monitor the client and
document the findings, these are not the most appropriate actions of
those provided.


⩥ NPO status is imposed 8 hours before the procedure on a client
scheduled to undergo electroconvulsive therapy (ECT) at 1 p.m. On the
morning of the procedure, the nurse checks the client's record and notes
that the client routinely takes an oral antihypertensive medication each
morning. What action should the nurse take?


Administer the antihypertensive with a small sip of water
Withhold the antihypertensive and administer it at bedtime
Administer the medication by way of the intravenous (IV) route
Hold the antihypertensive and resume its administration on the day after
the ECT. Answer: Administer the antihypertensive with a small sip of
water


Rationale: The nurse should administer the antihypertensive with a small
sip of water. General anesthesia is required for ECT, so NPO status is
imposed for 6 to 8 hours before treatment to help prevent aspiration.
Exceptions include clients who routinely receive cardiac medications,
antihypertensive agents, or histamine (H2) blockers, which should be
administered several hours before treatment with a small sip of water.
Withholding the antihypertensive and administering it at bedtime and
withholding the antihypertensive and resuming administration on the
day after the ECT are incorrect actions, because antihypertensives must
be administered on time; otherwise, the risk for rebound hypertension
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