NRS 326/Practice Qs for Final Exam

The nurse is caring for a patient with a positive Chvostek's sign. Which electrolyte imbalance is the patient likely experiencing?

Hypocalcemia

A patient newly diagnosed with emphysema is receiving discharge teaching. Which of the following statements by the patient indicates to the nurse that the patient correctly understands their diagnosis?

"Emphysema can cause my chest to appear abnormally pushed out"

A patient is receiving hydrochlorothiazide for their hypertension. What statement by the patient indicates that teaching was effective?

"I may experience hypotension and dehydration so I should drink lots of water and stand up slowly"

You are providing education to a patient with a new diagnosis of heart failure who is newly prescribed Furosemide. Which of the following patient statements demonstrates a need for further teaching about Furosemide?

"I should buy a scale and take my weight every other day"

A nurse is teaching a client about the importance of increasing fluids when experiencing the early stages of dehydration. Which statement by the client would express understanding?

"I should drink more water when I feel thirsty or becoming irritable"

Which of the following statements by a new nurse indicates further teaching regarding blood transfusions is required?

"Most reactions to blood transfusions will occur between 12-24 hours after the transfusion finishes."

A 6 year old boy was recently diagnosed with asthma and was prescribed albuterol to treat his acute exacerbations. What statement by the parent shows the need for further teaching?

"This medication can cause thrush if we don't rinse his mouth after use"

A nurse is assigned a new patient with cerebral edema and is reviewing the patient's orders. Which of the following orders would the nurse question?

0.45% NaCl solution

A nurse is preparing to administer 3% NS to one of their patients and is wondering if this IV fluid will be safe to administer to their patient. Which of the following patients would the nurse expect this IV fluid to be given to?

A patient that was just admitted for a traumatic head injury.

Which patient is most likely going into hypoxic drive?

A patient with COPD on supplemental oxygen experiencing decreased respirations

A patient with hypocalcemia is being admitted to your med-surg floor. Which finding would you likely observe while conducting an admission assessment?

A positive chvostek sign

Which patient would you prioritize seeing first?

A pt who looks extremely pale, and the CNA just reported they had a CBG of 50.

A nurse is administering a packed RBC transfusion to a 60 year old patient with type B+ blood. Which of the following blood types would the nurse question transfusing?

AB+

A patient develops a pulmonary embolism resulting from clots forming due to being immobile. They are seen with tachypnea (26 RR), chest retractions, and an SpO2 of 86% on 4L NC. Which of the following actions would the nurse expect to take to address these symptoms?

Administer an ordered anticoagulant medication after contacting the provider

A 20-year-old patient is admitted to the ER due to an acute asthma exacerbation. After receiving 2 puffs of albuterol, the patient continues to display anxiety, chest retractions, nasal flaring, and dyspnea. Which of the following actions would the nurse expect to do?

Anticipate an order for an IV corticosteroid.

Which of the following is not a sign of cirrhosis?

Blurred vision

A client with lower extremity edema and excess fluid in the lungs has been discharged home with the medication furosemide. For this client, which finding is the best indicator that the medication is working effectively:

Consistent daily weight

You are providing care for a client with COPD and have been notified that the patient's oxygen saturation is at 89%. You enter the patient's room, and see that the patient is resting comfortably in bed. The patient is on 2L of O2 via NC. Which of the following actions is your priority:

Continue to monitor the patient

A pt with extremely high cortisol levels most likely has which disease?

Cushing's

A new nurse is caring for a patient receiving a blood transfusion. Which assessment findings would not indicate to the nurse that the patient is experiencing a transfusion reaction?

Decrease in HR from 70 to 55 BPM

The health care provider orders lactulose for a patient with hepatic encephalopathy. The nurse will monitor for effectiveness of this medication for this patient by assessing what?

Decreased ammonia levels

Which of the following descriptions best describes the underlying pathophysiology of emphysema?

Decreased gas exchange related to a destruction of the elastin fibers in the alveoli

You are caring for a patient receiving an infusion of 0.45% NS. Which assessment finding is more concerning?

Decreased level of consciousness

Which sign/symptom is most likely to result in metabolic acidosis?

Diarrhea due to food poisoning

patient who was recently diagnosed with chronic bronchitis comes in due to an exacerbation. Which of the following symptoms would we not expect to see in the patient?

Diminished sounds upon auscultation

A patient's lab results came back: RBC (4.0); Sodium (143); Potassium (5.7); Calcium (8.2); Magnesium (2.2). Based on these lab results, which one of the following signs/symptoms should the nurse suspect to see in the patient?

Dysrhythmias and peaked T waves

A patient has been on spironolactone for five years and is getting an EKG at their primary care provider after feeling lightheaded recently. Which of the following findings would be unexpected based on the history?

Flat T waves

Decreased oncotic pressure and increased hydrostatic pressure is most likely to occur in which state?

Fluid volume excess

The nurse is reviewing laboratory values for a patient suspected of having a fluid imbalance. Which laboratory value should indicate a diagnosis of dehydration to the nurse?

Hematocrit 53%

Which of the following is NOT an intervention regarding impaired gas exchange?

High fat, high calorie diet

A patient's ABG results come back as: pH: 7.48, PaCO2: 47, and HCO3: 30. Which of the following signs may a patient exhibit as a compensatory mechanism?

Hypoventilation

Which of the following terms is synonymous with low oxygenation to the tissues?

Hypoxia

You are caring for a post surgical patient that needs to use an incentive spirometer. Which statement made by the client indicates that teaching was effective?

I will use this to decrease my likelihood of pneumonia

An older patient with chronic bronchitis who is reporting difficulty breathing and a productive cough is admitted to an acute care unit for further monitoring and diagnostic testing. When the nurse enters the patient room to check on them, the patient is confused about why they are in the hospital and appears irritable. Which of the following etiologies does the nurse suspect for the patient's behavior?

Ineffective ventilation

The nurse is reviewing the lab results for a pt with cirrhosis and notes that the ammonia level is elevated. Which diet does the nurse anticipate to be presribed for this patient?

Low protein

A client is taking furosemide and digoxin for heart failure. Why does the nurse advise the client to drink a glass of orange juice every day?

Maintaining serum potassium levels

Baby Angela is seen in the ER for profuse diarrhea during the past 3 days and difficulty breastfeeding. Her respiratory rate is elevated and she has sunken fontanels. An ABG was taken, and the results came back as: pH: 7.39, PaCO2: 27 mmHg, and HCO3: 19 mEq/L. These results indicate which of the following?

Metabolic Acidosis with full compensation.

A patient with heart failure is currently being given diuretics in the hospital to reduce their edema. Diuretics help rid the body of sodium and water through urination. They are most at risk of developing...

Metabolic alkalosis

Which of the following supplemental oxygen devices is most appropriate for a pediatric patient who temporarily requires roughly 4 L/min of oxygen and who has frequent emesis?

Nasal cannula

A nurse is assessing the patency of a client's left arm arteriovenous fistula prior to initiating hemodialysis. Which finding indicates that the fistula is patent?

Palpation of a thrill over the fistula.

Which breakfast diet would you recommend to a patient that has a magnesium level of 1.3?

Peanut butter whole grain toast and oatmeal with almonds

Which is not a symptom of hypoglycemia?

Polyuria

A patient with advanced cirrhosis asks why his abdomen is so swollen. The nurse's best response is based on the knowledge that

Portal hypertension and hypoalbuminemia cause fluid shift into the peritoneal space.

A patient is presenting with a thready and weak pulse of 58, and decreased bowel tones. In addition, the patient has been having frequent episodes of vomiting and nausea and is taking hydrochlorothiazide. Which of the following findings would explain the patient's condition?

Potassium level of 2.4

You are preparing to administer Spironolactone for a client with acute exacerbations of HF. Which of the following assessment findings would cause you to HOLD the dose?

Potassium level of 5.5

Which of the following is the best indicator that Kayexalate has achieved the desired effect?

Potassium of 3.8

What is the best position for a patient who has ARDs?

Prone

The patient with COPD is experiencing shortness of breath. Which one of the following interventions should the nurse implement to help the patient?

Pursed lip breathing

A patient recently had their ABG drawn and their results were: PaCO2: 29, PaO2: 80, HCO3: 24, pH: 7.56. What type of respiratory distress is this patient experiencing?

Respiratory alkalosis no compensation

A 17-year-old patient comes into the ED experiencing an increased heart rate, diaphoresis, pallor, and a respiratory rate of 32. Their ABG results come back as: pH: 7.47, PaCO2: 31, and HCO3: 22. These results indicate which of the following.

Respiratory alkalosis with no compensation

A patient with a potassium level of 3.1 has been taking Furosemide daily. Which medication will the nurse anticipate the patient being switched to?

Starting spironolactone

On assessment, the nurse notices a patient receiving an IV bolus is short of breath, has crackles in their lungs and a bounding HR, and is confused. Which of the following is the priority nursing intervention for this patient?

Stop the IV infusion

Which of the following nursing actions is the priority for a patient experiencing a potential transfusion reaction?

Stop the transfusion

A five-year-old is diagnosed with asthma following an acute exacerbation, and was prescribed both an inhaled beclomethasone and albuterol. Which of the following indicates the need for intervention by the nurse?

The child complains of an unpleasant taste when taking both inhalers.

When admitting a patient in possible respiratory failure with a high PaCO2, which assessment information will be of most concern to the nurse?

The patient is somnolent

The nurse is reviewing a patients complete blood count (CBC) following the administration of 2 units packed red blood cells. The nurse anticipates which values will not have changed as a a result of that administration:

WBC count, platelets

Which symptom would you not expect of a pt with Hashimoto's disease?

Weight loss

Which ABG would indicate that a patient is in respiratory acidosis with partial compensation?

pH: 7.33, PaCO2: 49 mmHg, HCO3: 28 mEq/L