VATI Medsurg Reduction of Risk practice exam questions and answers 2024

A client who has been experiencing prolonged vomiting has the following ABG results: pH 7.48; pCO2 40 mm Hg; HCO3 34 mEq/L; pO2 85 mm Hg. The nurse determines that the client is experiencing which of the following imbalance? Select one: a. Respiratory Alkalosis b. Metabolic Alkalosis c. Respiratory Acidosis d. Metabolic Acidosis b. Metabolic Alkalosis Alkalosis is reflected by an arterial pH greater than 7.45. Because this client has an increase in the base component, HCO3, this is a metabolic alkalosis. Metabolic alkalosis results from: • Base excess - Oral ingestion of bases (antacids) - Venous administration of bases (blood transfusions, TPN, or sodium bicarbonate) - Acid deficit - Loss of gastric secretions (through prolonged vomiting, NG suction) - Potassium depletion (due to thiazide diuretics, laxative abuse, Cushing's syndrome) - Metabolic alkalosis results in: - Increased HCO3 A client experiencing intermittent chest pain has been admitted to the hospital. Which of the following laboratory values should the nurse report to the health care provider immediately? Select one: a. Creatine kinase (CK) 90 units/L b. C-reactive protein (CRP) 0.2 mg/dL c. Total myoglobin 60 mcg/L d. Cardiac troponin T 1.2 ng/mL d. Cardiac troponin T 1.2 ng/mL A client is having an exercise electrocardiography (stress test) performed. The nurse recognizes the need to stop the test if which of the following occurs? Select one: a. The client begins to breathe harder b. The client experiences an increase in heart rate. c. QRS complexes begin to occur more frequently. d. An ST segment depression or T wave inversion on the EKG. d. An ST segment depression or T wave inversion on the EKG. A client is discharged following a cardiac catheterization procedure. Which of the following should the nurse include in the discharge teaching? Select one: a. Limit activity for several days after the procedure. b. Remove dressing the evening of the procedure. c. Notify provider if bruising is noted at the site. d. Tub baths the night following the procedure are acceptable. a. Limit activity for several days after the procedure. A nurse is caring for a client post aortofemoral bypass surgery. Which of the following interventions would be contraindicated? Select one: a. Encouraging client to sit in high Fowler's position. b. Monitoring client for changes in blood pressure. c. Maintaining NPO status until first postoperative day. d. Coughing and deep breathing every 1 to 2 hours. a. Encouraging client to sit in high Fowler's position. A nurse is caring for a client at risk for atelectasis. Which of the following should the nurse monitor for manifestations of atelectasis? Select one: a. Pulse oximetry b. Daily weight c. Intake and output d. Lung sounds a. Pulse oximetry A client is admitted to the hospital with a diagnosis of Grave's disease. Which of the following findings should be reported to the provider immediately? Select one: a. Hyperactive deep tendon reflexes b. Increase in temperature from 99.5 F to 100.5 F c. Increased number of stools d. Increase in white blood cell count from 6,000 mm3 to 8,000 mm3 b. Increase in temperature from 99.5 F to 100.5 F A nurse is caring for a client with a new onset bowel obstruction. What assessment finding would be anticipated when completing an abdominal assessment? Select one: a. Absent bowel sounds. b. Hyperactive bowel sounds. c. Normal bowel sounds. d. Hypoactive bowel sounds. b. Hyperactive bowel sounds. Reduction of Risk: ARDS A client is recovering from acute respiratory distress syndrome (ARDS). Which clinical manifestation requires immediate attention by the nurse? Select one: a. Increased oxygen saturation b. Increase in pulse rate c. A decrease in blood pressure d. A decrease in temperature c. A decrease in blood pressure A client is receiving chemotherapy for the treatment of breast cancer. Which of the following findings should be reported to the provider immediately? Select one: a. Mucositis b. Alopecia c. Absolute neutrophil count 8,000/mm3 d. Temperature 38.1°C d. Temperature 38.1°C A client is prescribed TPN (total parenteral nutrition) to be infused through a single lumen PICC (peripherally inserted central catheter). Which of the following actions should the nurse take if the client is prescribed intravenous antibiotic therapy? Select one: a. Stop the TPN to administer the antibiotic as ordered. b. Administer the antibiotic through the TPN line. c. Identify alternative methods of administration. d. Request the provider insert a second PICC line. c. Identify alternative methods of administration. A nurse is providing education to a client with coronary artery disease. Which of the following cholesterol values should the nurse identify as a goal for this client? Select one: a. HDL-C level 20 mg/dL b. LDL-C level 120 mg/dL c. HDL-C level 60 mg/dL d. LDL-C level 98 mg/dL c. HDL-C level 60 mg/dL A client is admitted to the inpatient care unit with a diagnosis of diabetic ketoacidosis (DKA). Which of the following laboratory findings should the nurse expect? Select one: a. Serum pH 7.40 b. Serum glucose 200 mg/dL c. Low serum osmolality d. Urine ketones positive d. Urine ketones positive Physiological Integrity: COPD, Oxygen Therapy A client diagnosed with chronic obstructive pulmonary disease (COPD) is reporting shortness of breath upon exertion. The client is prescribed oxygen at 3 L/min and his oxygen saturation level is measuring 86%. The nurse understands which of the following is the priority intervention? Select one: a. Teach the client to eat several small meals a day. b. Encourage the client to stop smoking. c. Increase oxygen from 3L/min to 6 L/min. d. Position the client in the high-Fowlers. d. Position the client in the high-Fowlers. A nurse is caring for a client who underwent a right below the knee amputation yesterday. Which of the following findings should the nurse report to the provider immediately? Select one: a. Quarter size spot of blood on dressing b. White blood cell count of 10,000 mm3 c. Redness of the incision site d. Blood glucose 200 mg/dL d. Blood glucose 200 mg/dL A client diagnosed with cervical cancer is prescribed a loop electrosurgical excision procedure (LEEP). Following the procedure, which of the following findings should the nurse instruct the client to report to the provider? Select one: a. Elevated temperature. b. Clear vaginal drainage. c. Mild pelvic pain. d. Spotting of blood. a. Elevated temperature. A nurse is caring for a client who is scheduled for an electroencephalogram (EEG). Which statement by the client indicates a need for further education? Select one: a. "I will not eat or drink anything after midnight." b. "I will expect the procedure to be painless." c. "A tracing will be obtained to evaluate my brain activity." d. "I should wash my hair on the morning of the test." a. "I will not eat or drink anything after midnight." A nurse is caring for a client with heart failure. Which of the following interventions should the nurse take if the client is experiencing dyspnea? Select one: a. Obtain serial ABGs every 8 hours. b. Perform coughing and deep breathing exercises every 8 hours. c. Place client in high Fowler's position. d. Place client in the reverse trendelenberg position. c. Place client in high Fowler's position.