8/29/23, 3:27 PM AH 2022 Final Notes
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A client with Chronic obstructive pulmonary disease (COPD) has developed
secondary polycythemia Vera. When assessing for this condition the nurse
should observe for which of the following?
a. Pallor and cyanosis
b. Dyspnea on elxertion
c. A decrease
on hematocrit
d. An elevated
hemoglobin
During a code (a cardiac arrest) the physician orders epinephrine 1mg IV, the nurse
administers the medication quickly. The nurse is preparing to give the second
dose of epinephrine but does not remember how many minutes to wait between
doses. The student nurse just reviewed the ACLS algorithms and remain the nurse
to wait:
a. 5-6
minutes b. 3-
5 minutes
c. Only 3 minutes
d. 1-2 minutes
The nurse witnesses a client begin to experience a tonic-clonic seizure and loss
of consciousness. What action would the nurse take first?
a. Tum the client's head to the side to prevent aspiration.
b. Prepare to intubate the client immediately.
c. Start fluids via large-bore catheter.
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d. Insert a padded tongue blade into the mouth.
A patient is admitted to the emergency department with possible diabetic keto
acidosis, which of the following laboratory values would be the most supportive
of this diagnosis?
a. Urine negative
for glucose b. Low
Bicarbonate level
c. Low creatinine
d. pH 7.45
The nurse is aware that one of the earliest signs of hypoxia/respiratory distress is:
a. Patient has low blood pressure
b. Patient has a change in level of consciousness
c. Patient has an 02 sat of 98%
d. Patient appears calm and cooperative
The ambulance is bringing a patient that was trapped in a house fire. Upon arrival
to the emergency room, the trauma team assesses the patient, and visualize partial
thickness burns to the anterior chest and abdomen, posterior upper and lower
back, and circumferential burns to the entire of the upper extremities. What is the
percent total body surface area burned for this patient? 54%
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,8/29/23, 3:27 PM AH 2022 Final Notes
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A 24 year old female patient arrives to the emergency room after being exposed to
a chemical at her work. Upon assessment, the nurse observes partial thickness
burns to the anterior surface of
bilateral upper and lower legs, genital area, and abdomen. The Patient weights
275lbs. What is the hourly rate (mL/Hr) of fluid the patient will need within
the first 3 hours? 875 mL/hr
When assessing a client with pernicious anemia which of the following
questions should the nurse ask?
a. “Do you have a sores on your lips and tongue?”
b. “Do you have tingling or numbness to your hands or feet?”
c. “Have you ever had a blood transfusion in the past”
d. “Are you having black stools”
A client is receiving the Amino-glycoside antibiotic Garamycin (Gentamycin)
for gram negative sepsis. In addition to a peak and through levels what other lab
values should be monitored when giving this medication?
a. BUN and creatinine
b. Sodium and potassium
c. Amylase and lipase
d. Hemoglobin and hematocrit
The patient with acute renal failure tells the nurse “My fingers and toes
are twitching and tingling, what is causing this?” What response by the
nurse would be correct?
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a. It is caused by a low calcium level
b. It is caused by metabolic acidosis
c. It is caused by a high BUN and Creatinine
d. It is caused by a high level of potassium
While assessing a patient involved in a major trauma, the nurse observes the
patient is not able to open his eyes, is not able to verbalize, and not able to
move extremities. The nurse understands the patients Glasgow coma scale
based on assessment at this time is:
a. 15
b. 0
c. 1
2
d. 3
The nurse is administering fluids intravenously as prescribed to a patient who
sustained superficial partial thickness burn injuries of the back and legs. In
evaluating the adequacy of fluid resuscitation, the nurse understands that
which of the following would provide the most reliable indicator for
determining the adequacy of fluid replacement?
a. Urine output
b. Parkland status
c. Mental status
d. Vital signs
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2023
A client with Chronic obstructive pulmonary disease (COPD) has developed
secondary polycythemia Vera. When assessing for this condition the nurse
should observe for which of the following?
a. Pallor and cyanosis
b. Dyspnea on elxertion
c. A decrease
on hematocrit
d. An elevated
hemoglobin
During a code (a cardiac arrest) the physician orders epinephrine 1mg IV, the nurse
administers the medication quickly. The nurse is preparing to give the second
dose of epinephrine but does not remember how many minutes to wait between
doses. The student nurse just reviewed the ACLS algorithms and remain the nurse
to wait:
a. 5-6
minutes b. 3-
5 minutes
c. Only 3 minutes
d. 1-2 minutes
The nurse witnesses a client begin to experience a tonic-clonic seizure and loss
of consciousness. What action would the nurse take first?
a. Tum the client's head to the side to prevent aspiration.
b. Prepare to intubate the client immediately.
c. Start fluids via large-bore catheter.
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,8/29/23, 3:27 PM AH 2022 Final Notes
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d. Insert a padded tongue blade into the mouth.
A patient is admitted to the emergency department with possible diabetic keto
acidosis, which of the following laboratory values would be the most supportive
of this diagnosis?
a. Urine negative
for glucose b. Low
Bicarbonate level
c. Low creatinine
d. pH 7.45
The nurse is aware that one of the earliest signs of hypoxia/respiratory distress is:
a. Patient has low blood pressure
b. Patient has a change in level of consciousness
c. Patient has an 02 sat of 98%
d. Patient appears calm and cooperative
The ambulance is bringing a patient that was trapped in a house fire. Upon arrival
to the emergency room, the trauma team assesses the patient, and visualize partial
thickness burns to the anterior chest and abdomen, posterior upper and lower
back, and circumferential burns to the entire of the upper extremities. What is the
percent total body surface area burned for this patient? 54%
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2023
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,8/29/23, 3:27 PM AH 2022 Final Notes
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2023
A 24 year old female patient arrives to the emergency room after being exposed to
a chemical at her work. Upon assessment, the nurse observes partial thickness
burns to the anterior surface of
bilateral upper and lower legs, genital area, and abdomen. The Patient weights
275lbs. What is the hourly rate (mL/Hr) of fluid the patient will need within
the first 3 hours? 875 mL/hr
When assessing a client with pernicious anemia which of the following
questions should the nurse ask?
a. “Do you have a sores on your lips and tongue?”
b. “Do you have tingling or numbness to your hands or feet?”
c. “Have you ever had a blood transfusion in the past”
d. “Are you having black stools”
A client is receiving the Amino-glycoside antibiotic Garamycin (Gentamycin)
for gram negative sepsis. In addition to a peak and through levels what other lab
values should be monitored when giving this medication?
a. BUN and creatinine
b. Sodium and potassium
c. Amylase and lipase
d. Hemoglobin and hematocrit
The patient with acute renal failure tells the nurse “My fingers and toes
are twitching and tingling, what is causing this?” What response by the
nurse would be correct?
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, 8/29/23, 3:27 PM AH 2022 Final Notes
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a. It is caused by a low calcium level
b. It is caused by metabolic acidosis
c. It is caused by a high BUN and Creatinine
d. It is caused by a high level of potassium
While assessing a patient involved in a major trauma, the nurse observes the
patient is not able to open his eyes, is not able to verbalize, and not able to
move extremities. The nurse understands the patients Glasgow coma scale
based on assessment at this time is:
a. 15
b. 0
c. 1
2
d. 3
The nurse is administering fluids intravenously as prescribed to a patient who
sustained superficial partial thickness burn injuries of the back and legs. In
evaluating the adequacy of fluid resuscitation, the nurse understands that
which of the following would provide the most reliable indicator for
determining the adequacy of fluid replacement?
a. Urine output
b. Parkland status
c. Mental status
d. Vital signs
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